Veteran L.A. County sheriff's deputy charged with murder









After spending much of his life putting people behind bars, a veteran L.A. County sheriff's deputy stood in handcuffs Thursday, charged with gunning down a former neighbor who apparently got into a fight with his son.


Francisco Gamez, 41, is accused of shooting Armando "Cookie" Casillas, a well-known figure in his blue-collar neighborhood in Sylmar.


Gamez was off duty, sitting in his car, when he allegedly fired two shots on the night of June 17, killing Casillas and narrowly missing a second man, prosecutors said.





Gamez, a 17-year veteran who worked as a detective in West Hollywood, was allegedly furious over a fight between his 20-year-old son and Casillas, 38, prosecutors said. The younger Gamez had called his father to the scene, authorities said.


Casillas was later found by relatives lying near his home, and died later at Providence Holy Cross Medical Center.


Gamez was removed from duty in July after witnesses and evidence tied the detective to the slaying, authorities said. He was arrested Wednesday and led handcuffed from his San Fernando home by his former co-workers.


On Thursday he was formally charged with murder, attempted murder and discharging a firearm from an occupied vehicle. Gamez could face 75 years to life in prison if convicted of all charges.


In court, where he stood handcuffed in a plexiglass cage, sheriff's deputies peeked into the room to gawk at their former colleague. Sheriff Lee Baca described the whole thing as "deeply disturbing."


Gamez is being held on $4-million bail.


On Beaver Street in Sylmar, where the shooting occurred, Casillas' photo sat in a frame in the midst of a makeshift memorial, along with a cross and a potted plant with U.S. and Mexican flags and candles.


"He was a sweetheart, and very generous," said Patsy Telles-Cabrera, who lived across the street from Casillas for years. "He would check in on my parents." She left a box of chocolates at the growing shrine.


"It never should have happened," said one neighbor. "This is a family neighborhood."


sam.quinones@latimes.com


richard.winton@latimes.com


Times staff writer Wesley Lowery contributed to this report.





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Jesse & Joy take 4 Latin Grammys, Juanes wins too

LAS VEGAS (AP) — As Colombian rockero Juanes took home the best album award, Mexican brother-sister duo Jesse & Joy and their pop hit "Corre!" ran away with four awards at the 13th Annual Latin Grammys.

Hosted by actors Cristian De La Fuente and Lucero, Thursday night's event attracted stars from across the world and from dozens of Latin musical genres to the Mandalay Bay Events Center. Just like at a big family party, new faces shared the spotlight with older generations, and traditional styles mixed with electronica and Vegas dancers on stage.

Traditional Mexico met Las Vegas in a colorful number featuring Oaxaca native Lila Downs, Afro-Colombian singer Toto la Momposina and dancers in regional costumes, Carnival masques and skeleton makeup.

"What a great joy. Thank God, and all the fans," Juanes said as he dragged Dominican mereguero Juan Luis Guerra, who produced "MTV Unplugged," to the stage to accept the mini-gramaphone for best album at the close of the ceremony.

The winner for best new artist, the Mexican DJ trio 3ball MTY, threw down beats with America Sierra and Sky Blu of LMFAO. Pitbull performed "Don't Stop the Party" with dancers in gold spangled bikinis and hot pants. Juanes jammed with legendary guitarist Carlos Santana.

Michel Telo, the Brazilian sertanejo or country music singer, performed his hit, "Ai si eu te pego,"with Blue Man Group. Bachata heartthrob Prince Royce sang with veteran Mexican singer-songwriter Joan Sebastian. But the applause was also strong for the 1980s hit, "Yo No Te Pido la Luna," a duet between Spaniard Sergio Dalma and Mexican singer Daniela Romo, sporting a short silver hairdo following her bout with breast cancer.

Jesse & Joy also won for best contemporary pop vocal album for "Con Quien se Queda el Perro" and best short video for "Me voy."

"Thanks to people like Juanes and Juan Luis Guerro who have inspired us. Love and peace," Jesse said.

Guerra, who came into the ceremony as the leading nominee with six bids, won producer of the year for Juanes' album "MTV Unplugged."

Guerra performed "En el Cielo No Hay Hospital," which brought the audience to its feet to dance, and for a standing ovation.

Puerto Rican reggaeton singer Don Omar and Uruguayan alt rockers Cuarteto de Nos won two Latin Grammys each.

Downs won best folkloric album for "Pecados y Milagros." Colombian singer Fonseca won for best tropical fusion album, and Los Tucanes de Tijuana won best norteno album for "365 Dias," the narco-corrido band's 32nd album.

Milly Quezada brought home two statuettes, including best contemporary tropical album for "Aqui estoy yo."

"Long live merengue! Long live the Dominican Republic!" she said as she accepted the award. She also thanked Guerra, who helped produce the album.

Cuban-American jazz trumpeter Arturo Sandoval won three Latin Grammys, two for "Dear Diz (Every Day I Think of You)," but said these awards was just exciting as his first.

"The emotion is the same because one puts the same effort into each recording and the fact that the work is received well and respected by the public is very satisfying," he said.

The Latin Grammy celebration kicked off Wednesday with a tribute to Person of the Year winner, Caetano Veloso, one of the founders of the Tropicalismo movement.

The Brazilian singer, composer and activist sang in Spanish and Portuguese before Pitbull and Sensato closed with "Crazy People."

The event was broadcast live on Univision.

Interactive: http://hosted.ap.org/interactives/2012/latin-grammys/

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For Alzheimer’s, Detection Advances Outpace Treatment Options


Joshua Lott for The New York Times


Awilda Jimenez got a scan for Alzheimer’s after she started forgetting things. It was positive.







When Awilda Jimenez started forgetting things last year, her husband, Edwin, felt a shiver of dread. Her mother had developed Alzheimer’s in her 50s. Could his wife, 61, have it, too?




He learned there was a new brain scan to diagnose the disease and nervously agreed to get her one, secretly hoping it would lay his fears to rest. In June, his wife became what her doctor says is the first private patient in Arizona to have the test.


“The scan was floridly positive,” said her doctor, Adam S. Fleisher, director of brain imaging at the Banner Alzheimer’s Institute in Phoenix.


The Jimenezes have struggled ever since to deal with this devastating news. They are confronting a problem of the new era of Alzheimer’s research: The ability to detect the disease has leapt far ahead of treatments. There are none that can stop or even significantly slow the inexorable progression to dementia and death.


Families like the Jimenezes, with no good options, can only ask: Should they live their lives differently, get their affairs in order, join a clinical trial of an experimental drug?


“I was hoping the scan would be negative,” Mr. Jimenez said. “When I found out it was positive, my heart sank.”


The new brain scan technology, which went on the market in June, is spreading fast. There are already more than 300 hospitals and imaging centers, located in most major metropolitan areas, that are ready to perform the scans, according to Eli Lilly, which sells the tracer used to mark plaque for the scan.


The scans show plaques in the brain — barnaclelike clumps of protein, beta amyloid — that, together with dementia, are the defining feature of Alzheimer’s disease. Those who have dementia but do not have excessive plaques do not have Alzheimer’s. It is no longer necessary to wait until the person dies and has an autopsy to learn if the brain was studded with plaques.


Many insurers, including Medicare, will not yet pay for the new scans, which cost several thousand dollars. And getting one comes with serious risks. While federal law prevents insurers and employers from discriminating based on genetic tests, it does not apply to scans. People with brain plaques can be denied long-term care insurance.


The Food and Drug Administration, worried about interpretations of the scans, has required something new: Doctors must take a test showing they can read them accurately before they begin doing them. So far, 700 doctors have qualified, according to Eli Lilly. Other kinds of diagnostic scans have no such requirement.


In another unusual feature, the F.D.A. requires that radiologists not be told anything about the patient. They are generally trained to incorporate clinical information into their interpretation of other types of scans, said Dr. R. Dwaine Rieves, director of the drug agency’s Division of Medical Imaging Products.


But in this case, clinical information may lead radiologists to inadvertently shade their reports to coincide with what doctors suspect is the underlying disease. With Alzheimer’s, Dr. Rieves said, “clinical impressions have been misleading.”


“This is a big change in the world of image interpretation,” he said.


Like some other Alzheimer’s experts, Dr. Fleisher used the amyloid scan for several years as part of a research study that led to its F.D.A. approval. Subjects were not told what the scans showed. Now, with the scan on the market, the rules have changed.


Dr. Fleisher’s first patient was Mrs. Jimenez. Her husband, the family breadwinner, had lost his job as a computer consultant when the couple moved from New York to Arizona to take care of Mrs. Jimenez’s mother. Paying several thousand dollars for a scan was out of the question. But Dr. Fleisher found a radiologist, Dr. Mantej Singh Sra of Sun Radiology, who was so eager to get into the business that he agreed to do Mrs. Jimenez’s scan free. His plan was to be the first in Arizona to do a scan, and advertise it.


After Dr. Sra did the scan, the Jimenezes returned to Dr. Fleisher to learn the result.


Dr. Fleisher, sad to see so much plaque in Mrs. Jimenez’s brain, referred her to a psychiatrist to help with anxiety and suggested she enter clinical trials of experimental drugs.


But Mr. Jimenez did not like that idea. He worried about unexpected side effects.


“Tempting as it is, where do you draw the line?” he asks. “At what point do you take a risk with a loved one?”


At Mount Sinai Medical Center in New York, Dr. Samuel E. Gandy found that his patients — mostly affluent — were unfazed by the medical center’s $3,750 price for the scan. He has been ordering at least one a week for people with symptoms ambiguous enough to suggest the possibility of brain plaques.


Most of his patients want their names kept confidential, fearing an inability to get long-term care insurance, or just wanting privacy.


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JPMorgan's California energy dealings draw more fire









State and federal energy regulators moved on two fronts against the giant investment bank JPMorgan Chase & Co. over its dealings in the California electricity market.


On Wednesday, the Federal Energy Regulatory Commission hit Morgan's electricity-trading unit with one of the most stringent penalties in its arsenal, barring it from selling electricity in California's auction-based market for six months starting in April.


The ruling, which may deprive Morgan of millions of dollars in profits in California, stemmed from FERC's conclusion that JPMorgan Ventures Energy Corp. had misled the agency in its investigation of alleged overcharges to the California Independent System Operator, which runs much of the state's wholesale power grid.








Meanwhile, the ISO moved Thursday to stop Morgan from blocking the upgrade of two Huntington Beach power plants considered key to keeping air conditioners humming next summer in Southern California. Morgan could not be reached for comment.


The operator of California's far-flung power grid filed a petition with federal regulators, accusing Morgan of raising legal obstacles to getting the plants working in time to avoid possible brownouts and rolling blackouts when the temperatures climb.


The shoreline facilities, currently not in use, are needed to help make up for the loss of more than 2,000 megawatts of power caused by the shutdown for safety reasons of both reactors at Southern California Edison's San Onofre Nuclear Generating Station.


Several power plants in Huntington Beach are owned by AES Corp. Two of them currently supply power to Morgan. But it is two other plants there, currently not operating, that the state wants to upgrade.


But the ISO says AES is balking, saying Morgan doesn't want to go along with the upgrade. The state is trying to force Morgan and AES to go ahead.


Grid operators want FERC to rule that JPMorgan's consent is not needed to retrofit the Huntington Beach power plants. The retrofit is essential to maintain sufficiently high voltage in transmission lines to meet peak summertime demand.


"The inability to resolve the consent issue in time to allow construction to commence in early 2013 could leave Southern California exposed to reliance on a widespread load-shedding scheme in the summer of 2013," state officials warned the commission.


The state agency's petition was submitted one day after federal energy regulators suspended JPMorgan Ventures after finding that the energy firm had provided false data and omitted important information during the federal investigation. It is reviewing state allegations that the firm hit utilities with excessive charges of as much as $73 million in 2011 and the beginning of this year.


Of that, the state has recovered about $20 million in overcharges, said Stephanie McCorkle, a spokeswoman for the state power grid operator.


The suspension was ordered to begin April 13 of next year. The delay was aimed at giving the grid managers sufficient time to contract for new power deliveries to ensure the lights stay on across the state.


JPMorgan Ventures is one of several energy-trading firms that buy and sell power nationally and play a key role in delivering electricity to states when demand is high and supplies are short.


The firm fought the suspension and told the commission in October that the company's actions were "inadvertent mistakes" and said that suspending its trading authority would be an "unjustified reaction to unintentional, good-faith mistakes, misunderstandings and miscommunications."


marc.lifsher@latimes.com





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L.A. County sheriff's deputy held in fatal off-duty shooting









A veteran Los Angeles County sheriff's deputy was arrested Wednesday for allegedly shooting and killing a man in Sylmar while off-duty in June, authorities said.

The deputy, Francisco Gamez, 41, has been with the department for 17 years and was last working as a station detective in West Hollywood.

Law enforcement sources told The Times that the deputy's son got into a dispute with another person. The son, they said, called his father to the scene. The deputy allegedly drove up soon after and exchanged words before opening fire from inside his car, striking one man, the sources said.





He then allegedly drove a short distance before shooting at a second person, added the sources, who asked for anonymity because the investigation is ongoing.

That person was not injured, according to authorities.

The other victim, Armando Casillas, 38, was taken to a hospital, where he was pronounced dead from a gunshot wound to the chest just before midnight on June 17.


FOR THE RECORD:
An earlier version of this article misspelled the victim's first name as Armondo.

Neighbors said Gamez and Casillas lived a block apart.

In August, a person who identified himself as the victim's brother commented on the website of the Los Angeles Times, saying he suspected a deputy was responsible.

"We think he is a L.A. COUNTY SHERIFF," the comment stated. "The reason we think he is a Sheriff is that he shouted to my Brother "L.A. COUNTY SHERIFF WHERE YOU FROM" as if the sheriff was in a gang."

The person who wrote the comment could not be reached Wednesday evening.

At the time of the killing, authorities said the victim got into an argument with an unknown person. At some point, the other person left the area only to return and shoot Casillas in a drive-by, authorities said then. Now they are saying that the shooter was not the same person who initially got into the argument.

LAPD officers arrested Gamez on suspicion of murder, attempted murder and use of a firearm in the commission of a felony. He was booked into the LAPD's 77th Street station Wednesday in lieu of $4-million bail, officials said. He has not been charged.

Casillas' sister said that the family was thankful for the arrest, but that they were not prepared to discuss the events that led to the fatal shooting.

In a statement, Sheriff Lee Baca called the incident "deeply disturbing."

His spokesman Steve Whitmore said the department placed Gamez on leave July 3 after learning from the LAPD about the investigation.

"He's been stripped of all law enforcement power," Whitmore said. "It casts a pall over the scores and scores of deputy sheriffs that every day do their job."

robert.faturechi@latimes.com

richard.winton@latimes.com

Times staff writer Andrew Blankstein contributed to this report.





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In Britain, spate of prosecutions for Twitter and Facebook tirades spark free-speech debate
















LONDON – One teenager made offensive comments about a murdered child on Twitter. Another young man wrote on Facebook that British soldiers should “go to hell.” A third posted a picture of a burning paper poppy, symbol of remembrance of war dead.


All were arrested, two convicted, and one jailed — and they’re not the only ones. In Britain, hundreds of people are prosecuted each year for posts, tweets, texts and emails deemed menacing, indecent, offensive or obscene, and the number is growing as our online lives expand.













Lawyers say the mounting tally shows the problems of a legal system trying to regulate 21st century communications with 20th century laws. Civil libertarians say it is a threat to free speech in an age when the Internet gives everyone the power to be heard around the world.


“Fifty years ago someone would have made a really offensive comment in a public space and it would have been heard by relatively few people,” said Mike Harris of free-speech group Index on Censorship. “Now someone posts a picture of a burning poppy on Facebook and potentially hundreds of thousands of people can see it.


“People take it upon themselves to report this offensive material to police, and suddenly you’ve got the criminalization of offensive speech.”


Figures obtained by The Associated Press through a freedom of information request show a steadily rising tally of prosecutions in Britain for electronic communications — phone calls, emails and social media posts — that are “grossly offensive or of an indecent, obscene or menacing character — from 1,263 in 2009 to 1,843 in 2011. The number of convictions grew from 873 in 2009 to 1,286 last year.


Behind the figures are people — mostly young, many teenagers — who find that a glib online remark can have life-altering consequences.


No one knows this better than Paul Chambers, who in January 2010, worried that snow would stop him catching a flight to visit his girlfriend, tweeted: “Crap! Robin Hood airport is closed. You’ve got a week and a bit to get your (expletive) together otherwise I’m blowing the airport sky high.”


A week later, anti-terrorist police showed up at the office where he worked as a financial supervisor.


Chambers was arrested, questioned for eight hours, charged, tried, convicted and fined. He lost his job, amassed thousands of pounds (dollars) in legal costs and was, he says, “essentially unemployable” because of his criminal record.


But Chambers, now 28, was lucky. His case garnered attention online, generating its own hashtag — (hash)twitterjoketrial — and bringing high-profile Twitter users, including actor and comedian Stephen Fry, to his defence.


In July, two and half years after Chambers’ arrest, the High Court overturned his conviction. Justice Igor Judge said in his judgment that the law should not prevent “satirical or iconoclastic or rude comment, the expression of unpopular or unfashionable opinion about serious or trivial matters, banter or humour, even if distasteful to some or painful to those subjected to it.”


But the cases are coming thick and fast. Last month, 19-year-old Matthew Woods was sentenced to 12 weeks in jail for making offensive tweets about a missing 5-year-old girl, April Jones.


The same month Azhar Ahmed, 20, was sentenced to 240 hours of community service for writing on Facebook that soldiers “should die and go to hell” after six British troops were killed in Afghanistan. Ahmed had quickly deleted the post, which he said was written in anger, but was convicted anyway.


On Sunday — Remembrance Day — a 19-year-old man was arrested in southern England after police received a complaint about a photo on Facebook showing the burning of a paper poppy. He was held for 24 hours before being released on bail and could face charges.


For civil libertarians, this was the most painfully ironic arrest of all. Poppies are traditionally worn to commemorate the sacrifice of those who died for Britain and its freedoms.


“What was the point of winning either World War if, in 2012, someone can be casually arrested by Kent Police for burning a poppy?” tweeted David Allen Green, a lawyer with London firm Preiskel who worked on the Paul Chambers case.


Critics of the existing laws say they are both inadequate and inconsistent.


Many of the charges come under a section of the 2003 Electronic Communications Act, an update of a 1930s statute intended to protect telephone operators from harassment. The law was drafted before Facebook and Twitter were born, and some lawyers say is not suited to policing social media, where users often have little control over who reads their words.


It and related laws were intended to deal with hate mail or menacing phone calls to individuals, but they are being used to prosecute in cases where there seems to be no individual victim — and often no direct threat.


And the Internet is so vast that policing it — even if desirable — is a hit-and-miss affair. For every offensive remark that draws attention, hundreds are ignored. Conversely, comments that people thought were made only to their Facebook friends or Twitter followers can flash around the world.


While the U.S. Supreme Court has ruled that First Amendment protections of freedom of speech apply to the Internet, restrictions on online expression in other Western democracies vary widely.


In Germany, where it is an offence to deny the Holocaust, a neo-Nazi group has had its Twitter account blocked. Twitter has said it also could agree to block content in other countries at the request of their authorities.


There’s no doubt many people in Britain have genuinely felt offended or even threatened by online messages. The Sun tabloid has launched a campaign calling for tougher penalties for online “trolls” who bully people on the Web. But others in a country with a cherished image as a bastion of free speech are sensitive to signs of a clampdown.


In September Britain’s chief prosecutor, Keir Starmer, announced plans to draw up new guidelines for social media prosecutions. Starmer said he recognized that too many prosecutions “will have a chilling effect on free speech.”


“I think the threshold for prosecution has to be high,” he told the BBC.


Starmer is due to publish the new guidelines in the next few weeks. But Chambers — reluctant poster boy of online free speech — is worried nothing will change.


“For a couple of weeks after the appeal, we got word of judges actually quoting the case in similar instances and the charges being dropped,” said Chambers, who today works for his brother’s warehouse company. “We thought, ‘Fantastic! That’s exactly what we fought for.’ But since then we’ve had cases in the opposite direction. So I don’t know if lessons have been learned, really.”


___


Jill Lawless can be reached at http://Twitter.com/JillLawless


Social Media News Headlines – Yahoo! News



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Alzheimer’s Tied to Mutation Harming Immune Response





Alzheimer’s researchers and drug companies have for years concentrated on one hallmark of Alzheimer’s disease: the production of toxic shards of a protein that accumulate in plaques on the brain.




But now, in a surprising coincidence, two groups of researchers working from entirely different starting points have converged on a mutated gene involved in another aspect of Alzheimer’s disease: the immune system’s role in protecting against the disease. The mutation is suspected of interfering with the brain’s ability to prevent the buildup of plaque.


The discovery, researchers say, provides clues to how and why the disease progresses. The gene, known as TREM2, is only the second found to increase Alzheimer’s risk substantially in older people.


“It points very specifically to a potential metabolic pathway that you could intervene in to change the course of Alzheimer’s disease,” said William Thies, chief medical and scientific officer of the Alzheimer’s Association.


Much work remains to be done before scientists understand precisely how the newly discovered gene mutation leads to Alzheimer’s, but already there are some indications from studies in mice. When the gene is not mutated, white blood cells in the brain spring into action, gobbling up and eliminating the plaque-forming toxic protein, beta amyloid. As a result, Alzheimer’s can be staved off or averted.


But when the gene is mutated, the brain’s white blood cells are hobbled, making them less effective in their attack on beta amyloid.


People with the mutated gene have a threefold to fivefold increase in the likelihood of developing Alzheimer’s disease in old age.


The intact gene, says John Hardy of University College London, “is a safety net.” And those with the mutation, he adds, “are living life without a safety net.” Dr. Hardy is lead author of one of the papers.


The discovery also suggests that a new type of drug could be developed to enhance the gene’s activity, perhaps allowing the brain’s white blood cells to do their work.


“The field is in desperate need of new therapeutic agents,” said Alison Goate, an Alzheimer’s researcher at Washington University in St. Louis who contributed data to Dr. Hardy’s study. “This will give us an alternative approach.”


The fact that two research groups converged on the same gene gives experts confidence in the findings. Both studies were published online Wednesday in The New England Journal of Medicine. “Together they make a good case that this really is an Alzheimer’s gene,” said Gerard Schellenberg, an Alzheimer’s researcher at the University of Pennsylvania who was not involved with the work.


The other gene found to raise the odds that a person will get Alzheimer’s, ApoE4, is much more common and confers about the same risk as the mutated version of TREM2. But it is still not clear why ApoE4, discovered in 1993, makes Alzheimer’s more likely.


Because the mutations in the newly discovered gene are rare, occurring in no more than 2 percent of Alzheimer’s patients, it makes no sense to start screening people for them, Dr. Thies said. Instead, the discovery provides new clues to the workings of Alzheimer’s disease.


To find the gene, a research group led by Dr. Kari Stefansson of deCODE Genetics of Iceland started with a simple question.


“We asked, ‘Can we find anything in the genome that separates those who are admitted to nursing homes before the age of 75 and those who are still living at home at 85?’ ” he said.


Scientists searched the genomes of 2,261 Icelanders and zeroed in on TREM2. Mutations in that gene were more common among people with Alzheimer’s, as well as those who did not have an Alzheimer’s diagnosis but who had memory problems and might be on their way to developing Alzheimer’s.


The researchers confirmed their results by looking for the gene in people with and without Alzheimer’s in populations studied at Emory University, as well as in Norway, the Netherlands and Germany.


The TREM2 connection surprised Dr. Stefansson. Although researchers have long noticed that the brain is inflamed in Alzheimer’s patients, he had dismissed inflammation as a major factor in the disease.


“I was of the opinion that the immune system would play a fairly small role, if any, in Alzheimer’s disease,” Dr. Stefansson said. “This discovery cured me of that bias.”


Meanwhile, Dr. Hardy and Rita Guerreiro at University College London, along with Andrew Singleton at the National Institute on Aging, were intrigued by a strange, rare disease. Only a few patients had been identified, but their symptoms were striking. They had crumbling bones and an unusual dementia, sclerosing leukoencephalopathy.


“It’s a weird disease,” Dr. Hardy said.


He saw one patient in her 30s whose brain disease manifested in sexually inappropriate behavior. Also, her bones kept breaking. The disease was caused by mutations that disabled both the copy of TREM2 that she had inherited from her mother and the one from her father.


Eventually the researchers searched for people who had a mutation in just one copy of TREM2. To their surprise, it turned out that these people were likely to have Alzheimer’s disease.


They then asked researchers around the world who had genetic data from people with and without Alzheimer’s to look for TREM2 mutations.


“Sure enough, they had good evidence,” Dr. Hardy said. The mutations occurred in one-half of 1 percent of the general population but in 1 to 2 percent of patients with Alzheimer’s disease.


“That is a big effect,” Dr. Hardy said.


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Staying smart about end-of-year healthcare









November is one of the most important months for health benefits. And it's half over.

This month is a time of open enrollment, when many workers sign up for next year's health insurance. Deadlines are a big deal, and you don't want to miss one.

But once you're set for 2013, experts say, shift your attention back to 2012 and those use-'em-or-lose-'em benefits awaiting you.





"Anything employees can do to accelerate elective care at year end allows them to get the full benefit" of their health plans, says Mike Thompson of consulting firm PricewaterhouseCoopers.

Here is a look at ways experts recommend to avoid leaving money on the table.

Make the most of your deductibles. Deductibles — the money you're required to pay out of pocket before insurance covers all or part of your healthcare services — are becoming more prevalent and more expensive.

If you've met your annual deductible for 2012, now may be a good time to schedule any medical treatment you've been delaying.

"At the beginning of the calendar year, everything resets with new out-of-pocket limits and deductibles. It's better to get any discretionary services done by the end of the year so you're in benefit and can get expenses reimbursed," Thompson says.

Today, a person with single coverage pays $1,097 on average in medical bills before insurance kicks in. According to Menlo Park, Calif.-based Kaiser Family Foundation, 72% of workers enrolled in an employer plan are on the hook for a deductible, up from about half in 2006. The amount of deductibles has also risen 88% during the same period.

And don't forget the possible savings of ordering prescription drugs before year end. You may be able to order a 90-day supply now to get you through the first few months of the year.

"It may make sense to accelerate your purchases of prescription drugs toward the end of the year because you know you're going to need them and they won't be subject to the deductible," Thompson says.

Be careful with your calculations. It should be easy to determine whether you've met your deductible for the year. But it can get tricky when you consider a lag, sometimes months long, between the time your doctor submits a claim and your insurance company processes it. You and your insurer may not have the same tally with regard to how much you've spent during this benefit year.

"My recommendation is to work with your broker's office to get an accurate assessment as to where you are in your benefit," says Dave Morgan, senior employee benefits advisor with Morris and Garritano Insurance Services in San Luis Obispo.

If you get health insurance at work, talk with your benefits or human resources department for assistance.

Coordinate your care. There's a caveat to the recommendation that you squeeze in care before New Year's Day. Consider first, Morgan says, the "choreography" of your care and how that may affect costs.

For example, knee surgery is likely to require months of follow-up physical therapy. Would it be less expensive to have your surgery fully covered in 2012 and pay cash for your physical therapy starting in 2013 before your deductible is met? Or, might holding off on the surgery until early 2013 result in less cash out of your pocket given the overall course of treatment?

To reap the greatest benefit from your health plan, do the math on both scenarios.

Splitting care between one year and the next can make sense, especially for dentistry. Dental plans typically come with an annual maximum benefit of $1,000 to $1,500. If you're in need of an expensive procedure, it may make financial sense to get started in December and finish in January.

"There's no perfect way to navigate all of this," says Martin Rosen, executive vice president of Health Advocate, a patient advocacy organization based in Pennsylvania. The key, Rosen says, is to "understand how your particular plan works and the leverage points throughout the year for which timing does make a difference."

Use your annual benefits. Be sure to take advantage of benefits with calendar limits, such as semi-annual dental cleanings, free eyeglasses or contact lenses. The same goes for preventive health services.

"When you get that preventive care, you're going to have a sense of what issues you'll face with your health in the coming year," Morgan says. That may better inform your 2013 health benefit choices as well as how much money to set aside in a Flexible Spending Account, or FSA, for next year.

Use all your FSA money. Unlike Health Savings Accounts, or HSAs, which allow you to roll over pretax dollar savings from one year to the next, FSAs have a shelf life. Typically you need to fully spend the account by year's end or you'll lose the money left over.

On average, people forfeit about $120 each year, says Jody Dietel, chief compliance officer at San Mateo, Calif.-based WageWorks, which administers employer-based tax advantaged accounts.

The IRS allows a grace period of 2 1/2 months, or by mid-March of the following year, to spend FSA money. And, according to Dietel, 75% of her company's 22,000 employer clients offer employees a grace period. But the length of time varies widely among employers, so check with your plan administrator to learn what's allowed.

Also, keep in mind that some rules have recently changed because of health reform. "For example, with an FSA you can't get over-the-counter drugs without a prescription from the doctor," Rosen says. To see a list of eligible expenses, go to the FSA Store at http://www.fsastore.com and click on the eligibility list at the bottom of the home page.

Many people lose money simply by failing to claim the expenses they already have, Dietel says. "Go and see if there is unfound money someplace," she says.

For example, if you fill all your prescriptions at the same pharmacy, ask the pharmacist to print a list of the co-pays for this year, and submit any outstanding charges to your Flexible Spending Account.

One final piece of advice before you pick up the phone to schedule your end-of-year doctor visit: Follow your health plan's rules, Morgan says. Stay in your health plan's network of doctors and hospital, and "make sure you have the proper pre-authorization in place."

business@latimes.com





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If soldier killed Afghan civilians in rampage, did he act alone?









JOINT BASE LEWIS MCCHORD, Wash. — The case against U.S. Army Staff Sgt. Robert Bales appeared at first to be horribly simple: Days after a bomb blew off the leg of a friend in southern Afghanistan, the 39-year-old combat veteran picked up his rifle, a pistol and a grenade launcher, walked to two villages and allegedly conducted a one-man campaign of vengeance, killing 16 civilians and wounding six more.

But by the time a weeklong hearing wound up Tuesday in a military courtroom, one of the Army's highest-profile war crimes from Afghanistan raised almost as many questions as it answered.

If Bales acted alone, why were shots heard coming from one of the villages 20 minutes after he was spotted returning to the base for the first time?





Why was a witness who claimed to have seen two U.S. soldiers killing her husband while helicopters flew overhead not brought in to testify?

Why were the crime scenes so very different — at one house, a surgical execution of the head of the family, while at the next house, 11 men, women and children were shot and possibly stabbed, their bodies piled in a heap and burned?

The Article 32 hearing, held to determine whether there was evidence to hold the serviceman for a court-martial, drew a portrait not just of a rogue soldier, defense lawyers said. It revealed a U.S. combat outpost at which soldiers spent their evenings drinking alcohol, snorting Valium and taking steroids, all three of which Bales apparently had done before asking a friend to "take care of my kids" and setting out into the darkness outside the base perimeter, laughing.

"We have a dysfunctional, drinking and drugging … team," civilian defense lawyer Emma Scanlan said in her closing argument.

"We can't isolate Sgt. Bales within a bubble," Scanlan said, noting that he was under the supervision of Special Forces officers. "They are the command. They are in charge. And they are terrible at it."

Army prosecutors claim Bales acted alone and with chilling rationality: walking to the village of Alkozai, where he is accused of killing four people and wounding six, coming back to the base and telling a friend what he had done, then venturing out again to the village of Najiban, where he is accused of killing 12.

When Bales returned to Camp Belambay the second time, he admitted to friends he had done some "sick" things, and told them they would thank him when fighting season got underway again during warmer weather later in the spring, said prosecutor Maj. Robert Stelle.

"Terrible, terrible things happened. That is clear. The second thing that is clear is that Staff Sgt. Bales did it," Stelle said.

He urged investigating officer Col. Lee Deneke to recommend a full court-martial and that it be tried as a capital case, with the possibility of the death penalty. Bales committed "the worst, most despicable crime a human being can commit: murdering children in their own homes," Stelle said.

If Deneke recommends a court-martial, a lengthy process of mental health evaluations and further forensic reports will follow. Defense lawyers have pledged there will be a full exploration of the medical care Bales received at the Madigan Army Medical Center for an earlier traumatic brain injury.

The hospital south of Seattle was the subject of an investigation this year for tossing aside diagnoses of post-traumatic stress disorder, making it harder for those soldiers to receive follow-up medical care.

In the year before the shootings, Scanlan said, Bales had received an exemplary evaluation, in which he was praised for "a strong moral compass, never wavering from what was right."

What went wrong?

Scanlan suggested part of the answer might lie in the steroids and sleep aids Bales was taking, along with the Jack Daniels he drank with two friends on the evening before the killings as they watched "Man on Fire," a movie about a former CIA operative who executes a violent campaign of revenge.

"They drank a ton, and they were all drunk," Scanlan said, noting that testimony showed that one of the soldiers who'd been drinking with Bales that night, Cpl. David Godwin, was stumbling, slurring his words and smelled like alcohol four hours later.

The prosecution said Bales had plenty of time to reach both villages and return at the end of the night with his clothing and weapons covered in blood. Before he left, prosecutors said, he had discussed his frustration with the Army's lack of response to the bomb that blew off his friend's leg; after his arrest, he reminded one soldier of an Afghan machine gunner the unit had faced earlier.

"That's not going to happen again," Bales said, according to Staff Sgt. Ross O'Rourke.

Prosecutors also established that DNA from at least one of the women killed at the home of Haji Mohammed Wazir in Najiban was found on Bales' clothing.

Yet defense lawyers continue to raise questions about whether Bales was the only one responsible — whether one person could have killed so many people in so many locations in one night.

A lot of the evidence suggests otherwise, Scanlan said, pointing to an agent from the Army's Criminal Investigations Command who said that Masuma Dawood, whose husband was shot, told her that two soldiers had killed her husband.

Army officials said Dawood did not testify because of "cultural differences," and the reluctance of Afghan families to allow a woman to testify in an American courtroom, even by remote video from Afghanistan. But sources in Afghanistan have told the Los Angeles Times that Dawood was, in fact, willing to testify.

Scanlan said the timeline laid out by prosecutors also raises questions, beginning with the Afghan guard who testified that he checked his watch, and was certain that the U.S. soldier he saw — returning from the initial killings in Alkozai, prosecutors allege — had returned to Camp Belambay at 1:30 a.m.

The shots heard from the direction of Alkozai didn't stop till 1:50 a.m., the defense attorney said.

"I don't know what that means," Scanlan said. "But one thing it means is, if you believe what the government is telling you, that Sgt. Bales is the one who came back through that wire at 1:30, then somebody else was firing for another 20 minutes."

kim.murphy@latimes.com





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'Gangnam Style' star joins Madonna onstage at MSG

NEW YORK (AP) — Madonna has gone "Gangnam Style."

Korean pop star PSY joined the pop icon Tuesday night during her second show this week at Madison Square Garden. They danced to his pop culture anthem "Gangnam Style" and to her jam "Music" in front of nearly 20,000.

Madonna said PSY flew "all the way from Frankfurt, Germany this morning." She also said she was a big fan of the rapper and loved his suit, which was bright red.

He added that he's had a lot of experiences in the last few months, and that performing at MSG with Madonna topped his list.

Madonna also collected money for those affected by Superstorm Sandy. Fans threw money onstage while she sang "Like a Virgin." She said she collected $3,000 at Monday's show.

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