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Employer Groups Obtain Preliminary Injunction Against SB 399

In 2024, the California Legislature enacted Senate Bill 399, codified as California Labor Code § 1137, which became effective January 1, 2025. It was enacted in response to the Legislature’s concern about “captive audience meetings” held by employers during which employers share their opinions on political or religious matters unrelated to the employees’ job duties.

California Chamber of Commerce, California Restaurant Association and the Western Growers Association filed a legal action last December over the enactment of  Senate Bill 399, arguing that it violates the rights of employers under the First Amendment and that the state law is preempted by the National Labor Relations Act.

Plaintiffs contend that SB 399 unlawfully regulates non-coercive speech of employers through implementing a “sweeping” limitation on speaking to employees about religious and political matters. In particular, Plaintiffs are concerned about the inclusion of “the decision to join or support any . . .labor organization” within the list of topics included within the definition of “political matters.” Plaintiffs argue that in enacting such a statute, the Legislature has placed its thumb on the scale in favor of labor.

Defendants and the Amici argue that Plaintiffs are distorting the description of SB 399 in defining it as a law that regulates non-coercive speech of employer. Rather, SB 399 is an anti-retaliation law that does not prohibit employers from speaking on matters of religious or political issues but prevents employers from punishing employees with adverse employment action who do not wish to attend such meetings.

The Amici argue that Plaintiffs lack standing to seek injunctive relief. Particularly, they contend that Plaintiffs cannot bring a pre-enforcement challenge because they have not adequately alleged a “concrete plan” to violate SB 399.

After hearing oral argument, a federal judge has issued a preliminary injunction on September 30, 2025 as requested by the plaintiffs, to block enforcement of the 2024 state law placing limits on employer communications with workers on a variety of issues, including possible union representation.

The Court found that Plaintiffs have adequately stated an injury in fact for purposes of a pre-enforcement injury. The Court also concluded that it is likely that Plaintiffs have established a likelihood of success on their arguments that SB 399 is preempted by the NLRA, and also found that the Plaintiffs have shown a likelihood of success on the merits on their First Amendment argument.

“We are pleased the court agreed with the key issues in this case,” said CalChamber President & CEO Jennifer Barrera. “SB 399 sought to wrongly limit the speech of employers across California while also exposing companies of all sizes to new legal liabilities if their leaders communicate important political and legal updates that impact the workplace.”

CalChamber’s co-plaintiffs also issued statements on the ruling. “The Eastern District Court ruling is encouraging, because it recognizes the overstep of SB 399,” said Jot Condie, President & CEO of the California Restaurant Association. “This law would put employers in the impossible position of deciding what is ‘political’ and what is not and goes beyond regulating the so called ‘captive audience’ meetings already regulated at the Federal level.”

“This decision affirms what we have said from the beginning: SB 399 tramples on federal labor law and the First Amendment,” said Dave Puglia, President & CEO of the Western Growers Association. “By enjoining this unconstitutional law, the court has preserved the right of agricultural and all California employers to communicate openly with their employees without the State tipping the scales in union organizing campaigns. We are proud to stand with our coalition partners in defending these fundamental rights.”

Senate Bill 399 was identified by CalChamber as a ‘Job Killer’ during the 2024 legislative session, the only proposal on the organization’s list of problematic bills that was signed into law.

CA Heat Standard Reduced Work Injuries by Over 15% on Hot Days

As more states adopt heat safety standards, a new study from the Workers Compensation Research Institute (WCRI) found that California’s 2005 heat standard led to fewer work-related injuries on hot days.

“Policymakers at the local, state, and federal levels are debating heat safety standards. These findings offer measurable evidence of how California’s policy reduced injury rates during extreme heat and offer relevant data to inform the national conversation about worker protection,” said Ramona Tanabe, president and CEO of WCRI.

The study, Impact of California’s Heat Standard on Workers’ Compensation Outcomes, measured how California’s heat standard impacted the frequency of injuries in occupations with substantial exposure to outdoor heat, like construction, agriculture, and transportation. The heat standard requires employers to provide water, shade, rest breaks, acclimatization plans, and emergency response protocols during excessive heat.

The study also answers the following questions:

– – How large is the impact of the heat standard on injury frequency in industries with outdoor heat exposure?
– – Does the impact of the heat standard increase with higher temperatures?
– – Does the impact of the heat standard vary for younger versus older workers?

Previous WCRI research found that excessive heat not only causes heat-related illnesses such as heat exhaustion but also impairs judgment and perception, increasing the risk of accidents such as being struck by machinery. Heat-related illnesses are 11 to 18 times more frequent on days above 95°F compared with days between 75 and 80°F, yet they represent 20 to 25 percent of all injuries attributable to heat.

The report is free for WCRI members and available for purchase by nonmembers at www.wcrinet.org. It was authored by Olesya Fomenko, Melissa McInerney, and Sebastian Negrusa.

Chiropractic Care Limited to 24 Visits Despite Multiple Injuries

Jaime Ortiz filed two applications for adjudication of his claims. In Case No. ADJ9313543, applicant sustained injury to his bilateral knees and right shoulder while employed as an auto body worker by defendant City Auto Body from February 8, 2005 to May 12, 2005. In Case No. ADJ3093632, applicant sustained injury to his left knee while similarly employed by defendant City Auto Body on May 5, 2005. Both cases were resolved by Compromise and Release approved on February 18, 2014.

The parties proceeded to lien trial and placed in issue the liens of Reinherz Chiropractic, Tariq Mirza, M.D. and Mario Corzo Interpreting. The parties also framed related issues of, in relevant part, the reasonableness and necessity of treatment, liability for services, value of services, the “24-visit cap,” and defendant’s assertions that the interpreters were not certified.

The WCJ allowed the lien of Reinherz Chiropractic in an amount corresponding to 24 chiropractic visits prior to applicant’s June 1, 2006 surgery, and an additional 24 visits thereafter. The WCJ further determined that Dr. Mirza had not met the evidentiary burden of establishing that the provided services were medically reasonable and necessary, and disallowed the lien. The WCJ also found no evidence tat interpreter Mr. Corzo was certified or provisionally certified to act as an interpreter and thus disallowed the interpreting lien.

All three lien claimants Petitioned for Reconsideration. The WCAB panel affirmed the F&O except that the issue of whether Mr. Mario Corzo was certified or provisionally certified to provide interpreting services was deferred and returned to the WCAB for further proceedings in the panel decision of Ortiz v City Auto Body -ADJ3093632 -ADJ9313543 (September 2024).

Lien claimants’ joint Petition avers that notwithstanding the 24-visits maximum allowed under LC §  4604.5(c)(3), applicant in this instance “complained of injury to both knees,” and that “[a]t the very least, each knee should have been entitled to further treatment, in excess of the 24-visit cap.”

Petitioner avers that applicant’s June 1, 2006 surgery provided an exception to the 24-visit cap, and that applicant continued to experience ongoing knee pain after the surgery.

In response to this argument the WCAB panel wrote “Petitioners offer no persuasive legal argument as to why the WCJ’s application of section 4604.5 was in error. While Petitioners contend that the therapeutic allowances otherwise afforded under section 4604.5 are insufficient in light of the factual circumstances of this case, Petitioners offer no legal challenge to the validity or applicability of section 4604.5 in the first instance. Moreover, the WCJ has observed that the record lacks substantive evidence pertaining to a second knee surgery as alleged by petitioners. Accordingly, and in the absence of a colorable legal challenge to the application of section 4604.5 to the facts of this case, we decline to disturb the WCJ’s decision with respect to the lien of Reinherz Chiropractic.

“Because the Petition offers no new legal or factual basis for a finding of medical necessity pursuant to section 4604.5, we decline to disturb the WCJ’s regarding the lien of Dr. Mirza.”

Finally, Petitioners challenge the WCJ’s application of the “Interpreter Services Regulations” to determine that Mr. Corzo was not regularly or provisionally certified at the time the interpreting services were rendered, and that Mr. Corzo’s lien is “not enforceable” as a result.

The WCAB previously addressed the issue of interpreter services in connection with medical treatment in Guitron v. Santa Fe Extruders (2011) 76 Cal.Comp.Cases 228, 243 (Appeals Bd. en banc),3 wherein we held that in order “to recover its charges for interpreter services, the interpreter lien claimant has the burden of proving, among other things, that the services it provided were reasonably required, that the services were actually provided, that the interpreter was qualified to provide the services, and that the fees charged were reasonable.”

An interpreter lien claimant must also prove that the interpreter was qualified to provide the billed services. (Lab. Code, § 5705; Zenith Ins. Co. v. WCAB (Capi), 138 Cal.App.4th 373 [71 Cal. Comp. Cases 374];  Stokes v. Patton State Hospital(2007) 72 Cal. Comp. Cases 996 (Significant Panel Decision). A “qualified interpreter” means a “certified” or “provisionally certified” interpreter pursuant to AD Rule 9795.1(f) (Cal. Code Regs., tit. 8, § 9795.1(f)), or, for purposes of section 4600, a “qualified interpreter” means an interpreter certified or deemed certified pursuant to the Government Code.

Here, the WCJ has determined that “there is no evidence that Mr. Corzo was certified or provisionally certified … [p]rovisionally certified means an interpreter otherwise qualified to perform interpreter services does so when a certified interpreter cannot be present or by agreement of the parties.”

However, it was not clear from this record whether the WCJ fully applied the analysis described in Guitron, supra, including a determination of whether Mr. Corzo was provisionally certified, i.e., “certified for interpreting at medical examinations or deemed certified for medical examinations by virtue of being certified for court or administrative hearing interpreting, or, if a certified interpreter is unavailable, the interpreter is provisionally certified by agreement of the parties or selected for provisional use by the treating physician.” For that reason the matter was referred back to the WCJ for further proceedings to clarify this issue.

Time to File Applicant’s Attorney Malpractice Claim Tolled by Disability

Karynn S. Kelly worked at the Lawrence Berkeley National Laboratory. While there, she sustained injuries to her spine, and she retained Boxer & Gerson, LLP represent her in her workers’ compensation cases.

Kelly sued Boxer in October 2023, alleging various causes of action related to its representation. In an amended complaint, she alleged (1) breach of contract (failing to exercise the legal skill and expertise of competent attorneys); (2) professional negligence (failing to develop and implement case management strategies – including failing to negotiate a settlement with Lawrence Lab – or file a complaint against the medical examiner, and allowing the statute of limitations to expire on her claims); (3) unfair business practices (failing to take reasonable steps to prevent abuse from the examiner from occurring and concealing the abuse to maintain its public image); (4) breach of fiduciary duty; and (5) fraud.

The underlying facts she alleged supporting her case were categorized as follows:

– – Pressuring an Unfavorable Settlement: Boxer allegedly pressured Kelly to accept a settlement offer that required her to resign from her position at Lawrence Berkeley National Laboratory and forgo expected retirement benefits, rather than vigorously representing her interests.
– – Failure to Address Inappropriate Conduct by a Medical Examiner: Boxer referred Kelly to a medical examiner who, during a December 2014 exam, allegedly engaged in inappropriate behavior (kissing her and fondling her breasts). Despite Kelly informing Boxer of this conduct in January 2015 and requesting a different examiner, Boxer allegedly disregarded her objections and required her to return to the same examiner in October 2015, where further inappropriate behavior allegedly occurred (kissing her hand and disclosing personal information). Boxer allegedly continued to rely on this examiner’s report, which concluded her January 2014 injury was not work-related, despite knowing about the misconduct.
– – Failure to Communicate and Attend Hearings: Between September 2017 and November 2019, Boxer allegedly failed to maintain communication with Kelly, did not attend her hearings or trials, and forced her to represent herself despite their attorney-client relationship.
– – Allowing Statute of Limitations to Expire: Boxer allegedly neglected to pursue Kelly’s workers’ compensation claims, allowing the statute of limitations on those claims to expire, which barred her from recovering compensation for her work-related injuries.

The trial court sustained Boxer’s demurrer to Kelly’s first amended complaint, dismissing her legal malpractice claims on the grounds that they were barred by the one-year statute of limitations under Code of Civil Procedure § 340.6(a). She filed her lawsuit in October 2023, well after the alleged wrongful acts occurred (primarily between 2014 and 2019) and after the termination of Boxer’s representation in November 2019. The trial court rejected Kelly’s argument for tolling the statute of limitations under section 340.6(a)(4), finding that her psychiatric medications and post-traumatic stress disorder did not excuse her delay in filing the complaint. The trial court also sustained the demurrer as to the fraud claim because Kelly failed to allege sufficient facts to support each element. Kelly does not challenge that decision on appeal.

Representing herself, Kelly appealed and contends the limitations period must be tolled because mental and physical disabilities restricted her ability to commence the action. (CCP § 340.6, subd. (a)(4)) The Court of Appeal agreed and reversed the trial court in the unpublished case of Kelly v Boxer & Gerson LLP -A171946 (September 2025).

“It is undisputed that CCP § 340.6(a) year statute of limitation governs Kelly’s claims for breach of contract, professional negligence, breach of fiduciary duty, and unfair business practices. The claims necessarily arise from Boxer allegedly violating its professional obligations while providing services to Kelly.”

“On the other hand, the trial court erred by finding section 340.6 (a)(4) – tolling due to a disability restricting the ability to commence a legal action – inapplicable.”

“Such a disability may exist where a person is incapable of caring for their property, transacting business, or understanding the nature or effects of their actions (Alcott Rehabilitation Hospital v. Superior Court (2001) 93 Cal.App.4th 94, 101), and it must concretely affect the plaintiff’s ability to sue.”

Kelly sufficiently alleged her mental and physical disabilities and that they restricted her ability to file her complaint. Her permanent physical disabilities – after multiple spinal injuries requiring five surgeries — require two different daily medications affecting her ability to remain focused on critical matters. Specifically, they render her unable to personally provide for her care or finances, as well as to understand the need to file a complaint.”

These episodes have lasted on a weekly and monthly basis for years, spanning 2013 through 2024. Kelly’s medical care giver reiterated these limitations, noting her physical and mental illnesses require opioid and psychotropic medications, resulting in her inability to remain alert, process information, or attend to her personal hygiene.”

“Kelly’s adult son has been caring for her since 2013, including managing all aspects of her personal care and finances; he notes she suffers from auditory and visual hallucinations. During those periods, she is afraid to leave her bedroom, groom herself, or take any medications to minimize her mental crises.”

We find nothing in the case law – and Boxer does not cite anything – mandating such further explanation. In sum, we conclude the trial court erred by failing to toll the statute of limitations.”

US Commercial Auto Insurance Has $10B Underwriting Loss

The U.S. commercial auto insurance line continues to burden the overall property and casualty (P/C) industry, accounting for more than $10 billion in net underwriting losses over the past two years, according to a new AM Best report.

The Best’s Market Segment Report, “Stuck in Reverse: Commercial Auto Losses Keep Mounting,” states that the segment’s rising loss severity, increasing claims costs and adverse prior-year loss reserve development continue to produce net calendar year underwriting losses for commercial auto insurers. The commercial auto insurance sector has now generated an underwriting loss for the 14th consecutive year. In fact, the losses are getting worse: total underwriting losses in 2024 were $4.9 billion dollars. Over the past 11 years, the average underwriting loss has been a little over $2.9 billion annually.

“One bright spot to note is that during the past decade, insurers have trimmed about six percentage points off their underwriting expense ratio for commercial auto insurance,” said Christopher Graham, senior industry analyst, AM Best. “While commercial auto insurers are not recognized as often as personal auto insurers for adopting and leveraging technology through their operations, commercial auto insurers have nevertheless made some strides in improving their efficiency.”

According to the report, the difference between auto liability and physical damage results has been stark and diverging. The underwriting expense ratio is relatively similar for the two coverages, with both improving by approximately three percentage points of improvements compared with the expense ratios six to seven years ago. The difference in the net loss and loss adjustment expense (LAE) ratio for the coverage parts, however, has typically been significant and far higher for liability coverage. The distinction between compulsory liability coverage and optional physical damage coverage may lead to insureds finding physical damage coverage not worth the cost. “Even if insureds find benefits in physical damage coverage, they may opt for higher deductibles to pay less for coverage,” Graham said.

The report also notes that despite significant rate increases, commercial auto insurers have not been able to offset rising loss severity driven by inflation, rising replacement costs due to technological advancements and rising labor costs related to repairs. “Adverse loss development has been a constant drain on commercial auto results and is getting worse,” said David Blades, associate director, AM Best.

To access the full copy of this market segment report, please visit http://www3.ambest.com/bestweek/purchase.asp?record_code=358186.

Cal/OSHA to Investigate UPS Worker Killed by Boxes in Truck

UPS driver Shelma Reyna Guerrero was crushed to death while loading packages inside a cargo trailer at the UPS driver facility on Atlas Road in Richmond, California. Guerrero was working alone on September 21 inside the trailer around 4:15 p.m. when an avalanche of packages fell onto her.

She was discovered later by a co-worker who immediately called emergency services. At approximately 4:16 p.m., Richmond Police Department officers responded to reports of an industrial accident in the 1600 block of Atlas Road in Richmond.

The preliminary investigation indicates that an employee of the package delivery company was loading packages into a cargo trailer when several packages fell onto her. The Guerrero was alone inside the trailer at the time. A co-worker later discovered her and immediately called for emergency responders.

Despite life-saving efforts by first responders, the victim succumbed to their injuries at the scene. This incident is being investigated as an industrial accident.

On September 23, 2025, Cal/OSHA announced an investigation into the workplace fatality, with up to six months to review evidence and issue citations related to safety violations (e.g., package restraint and solo work protocols).

“We are deeply saddened by the passing of one of our team members,” the company said. “Our thoughts are with their family, friends and colleagues during this difficult time” UPS said in a statement to media sources. It also said it is fully cooperating with the authorities to get to the bottom of what happened.

Family members have launched a GoFundMe page to help cover funeral expenses. Esmeralda Ocampo, cousin of Guerrero, stated in the fundraiser that a machine malfunction caused the accident. “She was healthy, had no prior health issues,” Ocampo reportedly said to the Richmond Herald. Guerrero reportedly leaves behind five children.

September 22, 2025 – News Podcast


Rene Thomas Folse, JD, Ph.D. is the host for this edition which reports on the following news stories: California to Pay $3.3M in FEHA Damages + $4.9M Attorney Fees. Uber Sued For $125M by DOJ for Riders’ Disability Discrimination. Published Opinion Sanctions LA Attorney for “AI Fabricated Authorities”. Feds Sue Inland Empire Health Plan (IEHP) for False Medi-Cal Claims. Oxnard Man Faces Felony Charges For Fraudulent Injury. CWCI Reports Functional Restoration Programs 59% More Costly. Stanford Study Shows Shift From AI as Tool to Physician Teammate. California Counties Face Skyrocketing Insurance Cost.

Partial Summary Judgement Granted in Grimway Farms ADA Case

A U.S. District Court for the Eastern District of California decision ruling that Grimmway Farms – purportedly the largest grower, producer, and shipper of carrots in the world – engaged in a pattern or practice of disability discrimination against farmworkers. The ruling comes after the State of California Civil Rights Department (CRD) filed a lawsuit against the farm in 2021. As a result of the decision, the case can now move forward to trial on potential monetary damages and other forms of relief for affected workers.

The plaintiff, California’s Civil Rights Department (CRD), sued defendant Grimmway Enterprises, Inc.(Case No. 2:21-cv-01552-DAD-AC) under the Americans with Disabilities Act (ADA) and California’s Fair Employment and Housing Act (FEHA). CRD alleges patterns or practices of disability discrimination against a group of over 600 employees referred to Grimmway’s “Interactive Process Section” (for handling disability accommodations). Claims include disability discrimination, failure to accommodate, failure to engage in the interactive process, retaliation, unlawful interference, and failure to prevent discrimination/retaliation.

According to CRD, while some employees were able to use workers’ compensation benefits, as soon as those benefits expired, they faced a choice: take unpaid leave or get back to work without accommodations. As a result, hundreds of workers were allegedly deprived of their rights and many were effectively terminated.

“This decision is a major victory for disability rights and the rights of farmworkers across California,” said CRD Director Kevin Kish. “The court has ruled loud and clear that forcing injured workers into unpaid leave is disability discrimination. Here in California, farmworkers have rights, they are protected, and we will not shy away from fighting on their behalf.”

In a more than 50-page decision on cross motions for summary judgment, the federal court found that Grimmway Farms engaged in systemic disability discrimination by automatically placing disabled workers on unpaid leave when other reasonable accommodations were available. The court also ruled that CRD may pursue relief on a group-wide basis.

The case proceeds to trial on the issues unresolved by the cross summary judgment motions as follows:

– – ADA-based claim 1 (discrimination) re: unpaid leave.
– – ADA/FEHA claims 2-3 (accommodation/interactive process) re: unpaid leave, assistive technology, and reassignment.
– – ADA/FEHA claims 1-3 re: assistive technology and reassignment.
– – Claims 4-5 (retaliation/interference).
– – Claims 6-7 (failure to prevent discrimination/retaliation), except sexual harassment prevention.
– – Defendant’s remaining affirmative defenses (e.g., good faith, no discrimination).
– – Punitive damages (disputed).

According to a report by kvpr (NPR Network) Grimmway Farms representatives disagreed with the Civil Rights Division’s complaint and said the matter is not yet fully resolved.

“We firmly disagree with CRD’s characterizations of the court’s pre-trial decisions, noting that many of the motions were resolved in Grimmway’s favor,” Officials wrote to KVPR. “The allegations do not reflect the principles or values that guide our company, and we will respectfully see the matter through trial and the proper legal process.”

UCSD Virtual Transfer of Care Clinic Cuts Readmissions by 26%

In a recent study, researchers at the University of California San Diego School of Medicine found that a UC San Diego Health telemedicine clinic for high-risk patients to be seen immediately after leaving the hospital resulted in less readmissions.

The study results, published in the Sept. 23, 2025 online edition of JMIR Medical Informatics, found the overall 30-day readmission rate for patients seen in the virtual transition of care clinic (VToC) was 14.9%, compared to 20.1% for the benchmark group.

“With our virtual transition of care clinic, we are providing patients with the right care, at the right place, at the right time. With the convenience of meeting virtually, we’re able to reach patients much more efficiently,” said Sarah Horman, MD, lead author of the study and professor of medicine at UC San Diego School of Medicine.

Across the nation, hospital readmissions pose a significant burden on patients, health care providers and medical systems, with an estimated annual cost of $17 billion. To address this challenge, a team of physicians and executive leadership at UC San Diego Health implemented the virtual clinic to support clinical management and specialty care navigation for patients being discharged in the health system.

Launched in 2021, the virtual transition of care clinic is supported by 12 hospitalists, two medical assistants, one pharmacist and an on-demand interpreter service. Visits were occasionally converted to telephone encounters when patients faced technical challenges.

During the study, a standardized hand-off was routed to the patient’s primary care provider and relevant specialists that summarized the reason for hospitalization, follow-up care and timing recommendations. For patients that experienced issues post-discharge, expedited calls were made from the virtual care team to the patient’s primary care provider to ensure the patient was seen in-person quicker.

“When telemedicine first began, there was concern it would further increase health disparities, especially in vulnerable patient groups. However, through our research, we have found the opposite as the virtual clinic reaches patients more effectively,” said Horman, hospitalist and affiliate faculty at the Joan and Irwin Jacobs Center for Health Innovation at UC San Diego Health.

According to Horman, the clinic addresses three main themes that are paramount in a critical care setting: access to and availability of medications, patient and caregiver understanding in the care plan, and proper navigation with primary care and/or specialty care programs.

Our goal is to hardwire this linkage in the care chain between the hospital team and primary care in order to help expedite support during that very sensitive, post-hospital period of time,” said Horman. “As a result, patient outcomes are improving while they recover at home and hospitals have capacity to take care of the next patient in need of critical care.”

The virtual transition of care clinic and corresponding study involved more than 25,000 participants cared for at UC San Diego Health from Sept. 1, 2021 to Sept. 17, 2024. Of the participants, 2,314 were seen in the virtual clinic and 23,129 had standard follow-up care as the study’s benchmark group.

The typical time a patient is seen by their primary care physician after a hospital stay is two to four weeks. Through this clinic, patients who are considered moderate or high risk in terms of health outcomes are seen within a week after discharge.

“Our clinic is a one-time, virtual visit with a patient immediately after their hospital stay to ensure we’re doing all we can to mitigate risk,” added Horman.

The study relied on the LACE+ index to identify patients at high risk for hospital readmission or complications after discharge. LACE stands for length of stay, acuity of admission, comorbidity and emergency department visits, and considers certain factors such underlying health conditions, a patient’s age or sex and previous admissions.

“The use of LACE+ underscores the importance of data-driven and patient-centric strategies in enhancing patient outcomes,” said Horman. “By using this tool, we were able to target follow-up care to those most likely to benefit. This approach helped improve care transitions and reduce avoidable hospital visits.”

Horman adds that the results from this initiative are promising as health systems work toward improving population health, enhancing the care experience, reducing cost and advancing care equity.

The virtual transition of care clinic at UC San Diego Health is ongoing and currently seeing patients cared for at Hillcrest and Jacobs Medical Centers, with plans to launch at East Campus Medical Center soon.

Co-authors of the study include Milla Kviatkovsky, Edward Castillo, Patricia S. Maysent, Chad VanDenBerg, John Bell, and Christopher A. Longhurst, all at UC San Diego Health.

New H-1B Restrictions Cause California Tech Industry Chaos

On September 19, 2025, President Donald J. Trump issued a presidential proclamation titled “Restriction on Entry of Certain Nonimmigrant Workers,” targeting perceived abuses of the H-1B visa program, which allows temporary entry for specialty occupation workers, particularly in STEM fields. The proclamation argues that the program has been exploited by employers – especially IT outsourcing firms – to displace American workers with lower-paid foreign labor, suppressing wages, exacerbating unemployment among U.S. graduates (e.g., 6.1% for computer science majors aged 22-27), and posing national security risks by discouraging Americans from pursuing tech careers. It cites examples of major tech layoffs coinciding with H-1B approvals, such as one company laying off 15,000 while securing 5,000 visas.

Key provisions include:

– – Entry Restriction: Effective 12:01 a.m. EDT on September 21, 2025, H-1B petitions for workers outside the U.S. require a $100,000 payment (per the proclamation) to be approved or supplemented; without it, entries are restricted for 12 months (expiring September 21, 2026, unless extended). This applies only to new entries post-effective date and does not retroactively affect existing visa holders or approved petitions.
– – Exceptions: The Secretary of Homeland Security can waive the restriction for individuals, companies, or industries in the “national interest” without security threats (e.g., critical sectors).
– – Implementation: Employers must document the fee before filing; USCIS and State Department will verify and deny non-compliant petitions. Guidance prevents B-1/B-2 visa misuse for early H-1B starts before October 1, 2026.
– – Further Actions: Directs the Secretary of Labor to revise prevailing wage levels upward via rulemaking; Secretary of Homeland Security to prioritize high-wage, high-skilled H-1B admissions. A joint agency report on extension is due 30 days after the next H-1B lottery.

The policy invokes INA sections 212(f) and 215(a) to protect U.S. economic and security interests, with no impact on current H-1B workers’ status or travel, per subsequent clarifications.

Effects on California Employers

California, home to Silicon Valley and the Bay Area’s tech ecosystem, relies heavily on H-1B visas – accounting for about 40% of all issuances annually, with firms like Google, Meta, and Apple sponsoring thousands. The $100,000 fee (a 20-50x increase from prior $2,000-$5,000 costs) is expected to impose steep financial and operational burdens, particularly on startups and mid-sized firms, while sparking panic, legal scrutiny, and talent pipeline disruptions. Here’s a breakdown based on recent media analyses:

– – Cost Escalation and Hiring Disruptions: The fee applies per new petition, potentially adding millions in costs for high-volume sponsors (e.g., a firm filing 1,000 H-1Bs faces $100 million). This could force California tech employers to slash foreign hires, pivot to domestic talent amid a reported 3.02% unemployment spike in computer occupations, or pass costs to workers via lower salaries – exacerbating wage suppression the policy aims to fix. Bay Area experts predict “major disruptions” to innovation, as startups – already cash-strapped – may abandon H-1B recruitment altogether.
– – Panic and Immediate Chaos: The announcement triggered a “fast and furious” rush of H-1B workers abroad to reenter the U.S. before September 21, with flights booked en masse and aborted international trips. Tech giants like Microsoft and Amazon (with major California footprints) urged employees to stay put, fearing reentry denials despite clarifications. Immigration attorneys reported “aborted takeoffs” and confusion, delaying projects and straining HR teams.
– – Disproportionate Hit to Startups and SMEs: Silicon Valley startups, which sponsor ~20% of H-1Bs but lack big-firm resources, fear being “put in a bind” and “shut out” of global talent, hindering growth in AI, software, and biotech. One venture-backed firm estimated a 30% drop in engineering hires, potentially stalling funding rounds.
– – Broader Economic and Legal Repercussions: California’s Attorney General criticized the policy as having an “adverse impact” on the state’s $500B+ tech economy, vowing to assess legal violations (e.g., under INA or equal protection). Business groups like the Chamber of Commerce predict lawsuits, while supporters argue it could boost U.S. worker employment by 6-11% in tech. Long-term, it risks eroding U.S. competitiveness, as foreign talent eyes alternatives like Canada.

Overall, while large employers may absorb costs via the national interest waiver, smaller California firms face the brunt, with effects unfolding in the FY2026 lottery (March 2026). According to Politico the demand for H-1B visas far surpasses the number available, which Congress has capped at 65,000 annually plus an additional 20,000 for people with advanced degrees.

In the 2024 fiscal year, the U.S. Citizenship and Immigration Services approved nearly 400,000 employment petitions, with more than 70 percent coming from India and 12 percent from China. H-1B visas are awarded via lottery.