Combating Privatization: Modifying the Veterans Administration Fiduciary Program To Protect Incompetent Veterans

Created to supervise the distribution of Veterans Administration benefits, the Veterans Benefit Administration Fiduciary Program was designed to help thousands of incompetent veterans handle their finances. Rather than directly managing each veteran\u27s funds, the Fiduciary Program employs a privatization model whereby a private individual or institution is appointed to manage a veteran\u27s assets. The Fiduciary Program then monitors these fiduciaries to ensure the veteran\u27s funds are properly expended. This Note argues that in practice this privatization model is seriously flawed and that it exposes some of the most vulnerable portions of the veteran population\u27s funds to misuse. In support of this conclusion, this Note compares the federal statutes, regulations, and internal directives that govern the Fiduciary Program—paying special attention to the Fiduciary Program Manual—with audits performed by the Veterans Affairs Office of Audits and Evaluations and the U.S. Government Accountability Office. Relying on these audits, this inquiry rejects total reliance on substantive statutory reform in light of legislative and judicial barriers. Instead, this Note advocates for critical internal reforms designed to improve the Program\u27s efficiency and functionality, the adoption of a state enforcement mechanism, and reliance on principles of cooperative federalism and interagency cooperation

The Impact of Native Language Status on the Frequency of Heart Failure Readmissions

Introduction. Heart failure readmissions are costly and lead to poor health outcomes. The efficacy of discharge instructions or other outpatient interventions may be affected by patient’s primary language status. The aim of this study is to look at the impact of primary language status on the frequency of heart failure admissions. Methods. This study was a retrospective chart review of EMRs, on Epic software, at Jefferson academic medical center and community affiliate in Philadelphia, PA between March 2017 and October 2018. Patients were included if they had a principal diagnosis of HF or a diagnosis associated with “acute” heart failure within the first five problems on their discharge problem list. More detailed chart review was performed on ambiguous cases. A patient encounter was classified as ‘readmission’ for any in-hospital stay within 30-days, whether the patient was placed into ‘observation’ or ‘inpatient’ status. Results. There were 2350 acute HF encounters; consisting of 1524 unique patients. Of those 1524, 1425 listed English as their primary language while 99 listed a different primary language. Of the 2350 encounters, 2209 of those were from English-speakers; 469 were thirty-day readmissions (0.212 readmission rate). The non-primary English speakers made up 141 of the total 2350 encounters; 29 were thirty-day readmissions (0.206 readmission rate). Conclusions. Our data, in contrast to other studies, suggests language barriers may not significantly influence HF readmission rates. Results may be regionally specific. Future studies are needed to further delineate the impact of primary language status on frequency of health care admissions

A Natural Framework for Bi-large Neutrino Mixing

In this letter we present a "natural" framework for obtaining bi-large neutrino mixing incorporating the FGY neutrino mass matrix ansatz. We show that an $SU(2) \times U(1)$ family symmetry can provide the desired FGY neutrino mass ansatz in the MSSM. We also show how to obtain an approximate FGY ansatz in an SO(10) SUSY GUT. In this context, the same $SU(2) \times U(1)$ family symmetry also generates the hierarchy of fermion masses as well as ameliorating SUSY flavor problems.Comment: 10 pages, no figures, extended discussion of standard model version including charged lepton analysi