Menu Close

Category: Daily News

City & County of S.F. Prevails in Disabled Retiree FEHA Claim

A group of retired City of San Francisco employees challenged the City’s disability retirement benefit calculations under the San Francisco Employees’ Retirement System (SFERS). The lawsuit originated as a class action filed by Joyce Carroll in 2017. The parties agreed to a stipulated class certification order which included the requirement that members of the class retired because they were “incapacitated for performance of duty because of disability determined by the retirement board to be of extended and uncertain duration.”

The plaintiffs, all of whom met the disability requirement, and were at least 40 years old when hired and had between 10 and 22.222 years of credited service at retirement. The operative complaint asserted FEHA claims based on disparate treatment (intentional discrimination) and disparate impact (facially neutral policy with unequal effects), along with related claims for declaratory relief, breach of contract, and equal protection violations under the California Constitution.

They focused on “Formula 2,” a provision in the City’s Charter that imputes additional years of service up to age 60 for employees whose actual service yields less than 40% of their average final compensation under Formula 1 (which multiplies average final compensation by 1.8% times years of service). Plaintiffs claimed this formula disproportionately disadvantaged older hires by capping their benefits below the 40% maximum that younger entrants could more easily achieve.

At a four-day bench trial, plaintiffs’ expert, Jeffrey Petersen, Ph.D., presented hypothetical arithmetic calculations showing that employees entering SFERS at age 40 or older could never reach the 40% benefit cap under Formula 2, assuming continuous service, while those entering at 37 or younger could. He did not use actual employee data or perform statistical analysis.

The City’s expert, Dubravka Tosic, Ph.D., criticized this approach, emphasizing the need for real-world data on the entire SFERS population, including factors like service breaks, reciprocity, and purchased credits, which could alter outcomes. Tosic also noted that considering average final compensation (which rises with age) and extending analysis to Formula 1 scenarios showed no overall age-based disadvantage.

The trial court ruled for the City. On disparate treatment, it found no adverse employment action (as benefits were calculated per a fixed formula) and no discriminatory animus, concluding Formula 2 was motivated by pension eligibility (credited service years), not age, akin to the U.S. Supreme Court’s reasoning in Kentucky Retirement Systems v. EEOC, 554 U.S. 135 (2008). For disparate impact, the court deemed plaintiffs’ hypothetical evidence insufficient, as it lacked actual statistical disparities across the protected group. Other claims failed derivatively, with no breach of contract (benefits matched Charter promises) and no equal protection violation (rational basis satisfied).

The Court of Appeal affirmed the trial court in the published case of Carroll v. City & County of S.F. -A169408 (November 2025).

Reviewing factual findings for substantial evidence and legal conclusions de novo, it upheld the disparate treatment ruling, agreeing pension status – not age – drove Formula 2, supported by parallels to Kentucky Retirement Systems (e.g., tracking normal retirement rules like the 60/10 provision, uniform ex ante terms, non-stereotypical assumptions, and scenarios benefiting older workers).

Plaintiffs’ “inexorable zero” argument failed, as hypotheticals ignored real variables like service breaks. For disparate impact, the court confirmed the need for actual statistical proof of disproportionate effects, which plaintiffs lacked. The amendment denial was not reversible error, as the trial court’s decision was not solely based on the pleading variance but on broader evidentiary shortcomings.

The judgment was affirmed, with no costs awarded, reinforcing that retirement formulas tied to pension eligibility, even if correlated with age, do not inherently violate FEHA absent proof of discriminatory motive or actual adverse impact.

High Level California Political Figures Indicted for Fraud

Dana Williamson, a 53-year-old political consultant from Carmichael, California, has long been a fixture in Sacramento’s high-stakes world of state governance, known for her no-nonsense style and role as a trusted enforcer in California’s political machine.

Born and raised in the region, Williamson built a career spanning over two decades, starting with stints in public affairs and lobbying before ascending to top advisory positions under multiple Democratic governors. Her early work included serving on the staff of former Gov. Gray Davis in the early 2000s, where she honed her skills amid the chaos of his recall election. She later joined former Gov. Jerry Brown’s administration, rising to the role of Cabinet secretary, overseeing key policy implementations during his tenure from 2011 to 2019.

By late 2022, amid California’s shift from budget surplus to deficit and intensifying legislative battles, Williamson was tapped as chief of staff to Gov. Gavin Newsom – a position she held through December 2024, navigating crises like budget shortfalls and policy gridlock while earning a reputation as a blunt, behind-the-scenes operator who could rally committed teams. She departed the governor’s office quietly last year, transitioning back to consulting., but her influence lingered as a veteran of three gubernatorial eras.

On November 12, 2025, when federal authorities arrested Williamson at her home as part of a sprawling three-year investigation into political corruption, and unsealing a 23-count indictment that painted a picture of greed-fueled schemes exploiting dormant campaign funds and tax loopholes. The charges – ranging from conspiracy to commit bank and wire fraud, straight bank and wire fraud, conspiracy to defraud the U.S. and obstruct justice, filing false tax returns, to making false statements – stem from alleged activities between 2022 and 2024, during and after her time in Newsom’s inner circle.

Prosecutors accuse her of masterminding the diversion of over $225,000 from a long-dormant 2026 gubernatorial campaign account belonging to Xavier Becerra, then serving as U.S. Health and Human Services Secretary under President Biden. Working with co-conspirators including Becerra’s former chief deputy Sean McCluskie – a onetime close ally who has since agreed to plead guilty to a single fraud count and is cooperating with authorities – and lobbyist Greg Campbell, Williamson allegedly used shell companies to bill the account for fictitious “consulting services.”

When a January 2024 civil subpoena threatened to expose ties to Williamson’s own Paycheck Protection Program loan for her consulting firm, she and her allies allegedly scrambled to fabricate backdated contracts to cover their tracks, even pressuring reluctant participants to sign off.

Compounding the campaign fund heist were Williamson’s separate alleged tax crimes, where she wrote off more than $1 million in lavish personal indulgences as business expenses on her returns from 2021 and 2022. These included a $15,353 Chanel handbag and matching ring, a $5,818 Fendi wallet, $12,000 in additional Chanel jewelry and bags, a $20,000 home HVAC system upgrade, over $10,000 at a California theme park, and extravagant birthday getaways – like a $156,000 Mexico resort splurge featuring an $11,000 yacht rental and a $21,000 private jet charter.

Williamson pleaded not guilty to all counts. Her attorney decried the arrest as unnecessary, noting she was no flight risk and had recently been added to a liver transplant waiting list due to illness. She was released on a $500,000 bond, with conditions including surrendering her passport, submitting to drug tests, providing a DNA sample, and forfeiting any firearms – conditions she must fully comply with by November 26.

Newsom’s office, emphasizing that Williamson had left over a year prior and that the governor faced no accusations, reiterated a commitment to integrity among public servants while underscoring the presumption of innocence amid what they framed as politically charged scrutiny. However, according to a report by the Sacramento Bee, a spokesperson said the office put her on leave “as soon as” Williamson informed them that she was under federal investigation, and that she left the administration in November 2024, not the following month, as the office previously stated.

If convicted, Williamson faces a maximum statutory penalty of 20 years in prison and a $250,000 fine for each count of bank fraud, wire fraud, and conspiracy to commit bank fraud and wire fraud; up to five years in prison and a $250,000 fine for each count of conspiracy to obstruct and making a false statements; and up to three years in prison and a $100,000 fine for each count of subscribing to a false tax return.

The United States concurrently unsealed charging documents related to this case for two other individuals, Sean McCluskie and Greg Campbell, both of whom entered plea agreements prior to the November 12, 2025, unsealing and are cooperating with prosecutors as key witnesses against Dana Williamson.

McCluskie had ascended to chief deputy in the office of then California Attorney General Xavier Becerra by the mid-2010s. When Becerra was tapped by President Joe Biden in 2021 to lead the U.S. Department of Health and Human Services (HHS), McCluskie followed as chief of staff, serving through much of the Biden administration until early 2025.

While Becerra’s former chief of staff, McCluskie allegedly initiated the scheme in early 2022 by proposing to Williamson that they exploit Becerra’s dormant 2026 gubernatorial campaign account for supplemental income, given his dissatisfaction with his HHS salary; he then approved and received roughly $225,000 in monthly $10,000 transfers funneled through intermediaries. He reportedly pleaded guilty to one count of conspiracy to commit bank and wire fraud and agreed to full restitution.

Campbell, a Sacramento lobbyist, allegedly facilitated the laundering by routing the diverted funds through his consulting firm as bogus fees for his wife’s nonexistent work, then backdating contracts in early 2024 to conceal the scheme when a civil subpoena into Williamson’s PPP loan arose; he also aided in pressuring others to sign falsified documents. He reportedly pleaded guilty to one count of conspiracy to commit bank and wire fraud, plus one count of conspiracy to defraud the United States.

Monterey Grower to Pay $126K For Workers Pesticide Exposure

The Monterey County District Attorney announced that her Environmental Protection Unit resolved a case against The Growers Company, Inc. (“Growers”) for violations of pesticide-related laws, which exposed its employees to pesticides.

Specifically, on October 9, 2023, a supervisor for Growers ignored pesticide warning signs on a lettuce field and ordered his crew of 93 fieldworkers into a field that had been treated with various pesticides not 24 hours prior. One such pesticide, Sivanto Prime, had a 24-hour restricted entry interval during which no one was allowed to enter the field.

Sivanto Prime (also labeled as Sivanto 200 SL in some formulations) is a systemic insecticide manufactured by Bayer Crop Science, with the active ingredient flupyradifurone. While effective for integrated pest management (IPM), its risks stem from potential human exposure during application, handling, or re-entry into treated areas. Risks are primarily acute (short-term) from dermal, inhalation, or ocular contact, with low chronic (long-term) concerns at labeled use rates.

Sixty-six of the fieldworkers developed symptoms consistent with exposure to pesticides, including nausea, dizziness, headache, and irritation to the throat, nose, eyes, and skin. Moreover, despite legal requirements to take all exposed employees to a physician for medical care, Growers only took 34 of the exposed employees to a physician for evaluation.

The judgment requires Growers to pay a $125,194 in civil penalties and costs and includes injunctive terms prohibiting them from violating these requirements in the future.

A felony criminal charge was also filed against the Growers’ supervisor who ordered the employees into the field, but he has since passed away.

The Monterey County Agricultural Commissioner’s Office investigated this incident and referred the case to the District Attorney’s Office as a “priority investigation,” pursuant to 3 CCR section 6128, subdivision (e), because the incident caused over five persons to become ill.

This is not the first such enforcement under Pacioni’s tenure (elected in 2018 as the county’s first female DA). In 2021, three companies – Norcal Harvesting, Bay View Farms, and R&T Farms – paid $110,000 combined for failing to notify workers of a fumigant buffer zone (using Tri-Form 80 EC), leading to eye irritation in eight employees.

More recently, in an undated but recent case, Azcona Harvesting, LLC was fined $55,000 for not immediately seeking medical care after 27 workers suffered nausea and vomiting from pesticide drift at Reiter Berry Farms; the applicator paid $195,200 separately.

These cases, investigated similarly by the Ag Commissioner’s Office, show a pattern: drift/entry violations often stem from rushed operations, with penalties focusing on deterrence via fines and training mandates.

Nationally, the EPA tracks over 10,000 pesticide illness cases yearly, with California leading due to its ag scale -Monterey accounts for ~20% of the state’s incidents.

District Attorney Investigator George Costa assisted in the District Attorney’s investigation. The Growers Company cooperated with the Agricultural Commissioner’s Office and the District Attorney’s Office during its investigation.

New App Makes ER an Unnecessary Step for Orthopedic Injury

MedVanta, the nation’s largest physician-owned, fully integrated musculoskeletal (MSK) platform, announced the launch of VantaStat, an urgent care line and mobile app that redefines how patients access orthopaedic care.

The VantaStat app, launched on November 3, 2025, includes a symptom checker as a core feature to empower users with quick, preliminary assessments of musculoskeletal (MSK) issues. While detailed technical specs aren’t extensively documented in the initial launch materials (as the product is very new), it’s designed to streamline the path to care by allowing users to self-evaluate symptoms before connecting to specialists.

Key Features include

– – Interactive Symptom Input: Users start by describing their symptoms via text, voice, or selections from guided prompts (e.g., “sprained ankle,” “knee pain,” or “back strain”). The checker likely uses a step-by-step questionnaire tailored to common orthopaedic conditions, asking about pain location, severity, onset, and aggravating factors.
– – Multimedia Uploads: A standout element is the ability to upload photos or short videos of the affected area (e.g., a swollen wrist or limping gait). This visual input helps the tool provide more accurate initial insights, bridging the gap to a specialist review.
– – AI-Powered Preliminary Assessment: Powered by MedVanta’s integrated tech (including elements from their AI-focused VantaMotion platform), it generates an instant overview – such as potential causes (e.g., strain vs. fracture), severity level (low/medium/high), and self-care tips (e.g., RICE method: rest, ice, compression, elevation). It’s not a full diagnosis but flags when urgent specialist input is needed.
– – Seamless Triage and Next Steps: Based on the assessment, the app recommends actions like at-home remedies, virtual consult scheduling, or same-day in-person appointments. It integrates directly with VantaStat’s 365-day urgent care line, routing high-priority cases to board-certified orthopaedic experts within minutes.
– – Personalization and Tracking: Users can save assessments to a profile for ongoing tracking, including symptom progression over time, which informs future consultations and helps prevent recurring issues.

How It Works for Users

– – Launch the Checker: Open the app (available on iOS/Android) and select “Symptom Checker” from the home screen.
– – Input Details: Answer questions and upload media – takes 2-5 minutes.
– – https://medvanta.com/platform/products/VantaStat: Receive an on-screen report with visuals (e.g., body maps highlighting issues) and clear recommendations.
– – Act Immediately: Tap to book care or call the dedicated line (available 24/7).

Why It’s an Advantage for Users

– – Speed and Empowerment: Get actionable advice in seconds, reducing anxiety and guesswork – ideal for athletes, active adults, or parents dealing with sudden injuries.
– – Cost and Time Efficiency: Avoids unnecessary visits (saving $500+ on ER co-pays) by triaging effectively, with 80% of cases potentially resolved via virtual guidance per MedVanta’s goals.
– – Accuracy Boost: Visual uploads and AI make it more reliable than generic web checkers, leading to better outcomes like faster recovery and fewer complications.
– – Accessibility: Free to start (app download via www.VantaStat.com), works offline for inputs, and supports underserved areas with limited specialist access.

As VantaStat is in early rollout (initially in select U.S. markets like Maryland and Virginia), features may evolve – check the app for the latest.

IMR Required Despite No Substantive Change in Med Condition

In November 2016, Orlando Rodriguez suffered severe head and brain injuries while working as a mechanic for Managed Mobile, Inc. His employer’s insurer, Illinois Midwest Insurance Agency LLC, acknowledged the injuries as work-related and began providing compensation benefits.

Starting in September 2018, Rodriguez’s primary treating physician, Dr. Yong Lee, repeatedly requested authorization for home health care services in six-week increments to support Rodriguez’s recovery. Illinois Midwest approved at least eight such requests between September 2018 and August 2019, sometimes directly by a claims adjuster and other times after subjecting them to utilization review.

However, when Dr. Lee submitted a new request for authorization on September 12, 2019, Illinois Midwest forwarded it to utilization review. On September 19, 2019, the reviewing physician denied the request, deeming the ongoing home health care no longer medically necessary. Rodriguez challenged this denial not through the statutorily required independent medical review (IMR) process, but by seeking an expedited hearing before a workers’ compensation administrative law judge (WCJ) at the Workers’ Compensation Appeals Board (WCAB).

In March 2020, the WCJ ruled in Rodriguez’s favor, awarding him ongoing home health care. The judge reasoned that since the treatment had been previously authorized and Rodriguez’s need was “ongoing and constant,” Illinois Midwest could not terminate it without demonstrating a substantive change in his medical condition – a showing the insurer had failed to make.

This decision relied heavily on a non-binding WCAB significant panel decision in Patterson v. The Oaks Farm (2014) 79 Cal.Comp.Cases 910 [2014 Cal. Wrk. Comp. P.D. LEXIS 98] (Patterson), that suggested employers must continue providing authorized ongoing treatments unless circumstances change, without restarting the review process.

A significant panel decision is a decision of the Appeals Board that has been designated by all members of the Appeals Board as of significant interest and importance to the workers’ compensation community. Although not binding precedent, significant panel decisions are intended to augment the body of binding appellate and en banc decisions by providing further guidance to the workers’ compensation community. (Cal. Code Regs., tit. 8, § 10305(r).)

The WCJ also noted that the facts presented were similar to those considered in Warner Brothers v. Workers’ Comp. Appeals Bd. (Ferrona) (2015) 80 Cal. Comp. Cases 831, 832-834 (writ denied), wherein the Appeals Board panel affirmed the trial judge’s finding that the reasoning in Patterson applies to assistive home care

Illinois Midwest petitioned the WCAB for reconsideration, arguing that the WCJ lacked jurisdiction because medical necessity disputes must be resolved exclusively through utilization review and IMR under reforms enacted in 2004 and 2013. These reforms aimed to shift such decisions from judges and courts to medical professionals, using evidence-based guidelines like the Medical Treatment Utilization Schedule (MTUS) to control costs and ensure quality care.

In January 2025 – after a nearly five-year delay – the WCAB affirmed the WCJ’s ruling, again invoking Patterson and concluding that Illinois Midwest bore the burden of proving changed circumstances to justify ending the treatment. It cited Patterson (supra)

Illinois Midwest then sought review in the California Court of Appeal. The Court of Appeal annulled the WCAB’s decision in the published case of Illinois Midwest Ins. Agency, LLC v. WCAB -B344044 (November 2025).

The Court of Appeal held that the WCAB exceeded its jurisdiction by bypassing the mandatory utilization review and IMR processes. It emphasized that the 2013 reforms (via Senate Bill No. 863) made IMR the sole avenue for appealing adverse utilization review decisions for injuries occurring after January 1, 2013, or denials communicated after July 1, 2013 – criteria met in Rodriguez’s case.

The Court of Appeal rejected any exception for “ongoing” or “continual” treatments, distinguishing and limiting Patterson to pre-2013 contexts where IMR was not yet exclusive. “We reject Patterson v. The Oaks Farm (2014) 79 Cal.Comp.Cases 910 (Patterson) to the extent it set forth a contrary rule for injuries or medical necessity determinations arising after the 2013 reforms.”

It clarified that even for extended treatments like home health care, each new request for authorization triggers the statutory review process, and the burden remains on the worker to prove ongoing medical necessity through medical evidence, not on the employer to prove changed circumstances.

The court underscored the legislative intent: to ensure medical professionals, not judges or courts, make medical necessity determinations, promoting efficiency and evidence-based care. By allowing the WCAB to intervene, the lower rulings had undermined this framework.

The case was remanded for proceedings consistent with the opinion, effectively requiring Rodriguez to pursue any further challenge through IMR if he sought to overturn the denial.

Top 10 OSHA Violations Topic at NSC Safety Congress & Expo

The Occupational Safety and Health Administration on Tuesday announced its most frequently cited workplace safety standards for fiscal year 2024.

Scott Ketcham, director of the directorate of enforcement programs for OSHA, together with Safety+Health magazine presented the preliminary data for OSHA’s Top 10 during the 2024 NSC Safety Congress & Expo, the world’s largest annual gathering of safety professionals.

Fall Protection – General Requirements remains at the top of the list for the 14th year in a row, followed by Hazard Communication and Ladders.

“While incredible advancements are made in safety each year, we continue to see many of the same types of violations appear on OSHA’s Top 10 list,” said Lorraine Martin, NSC president and CEO. “As a safety community, it’s critical we come together to acknowledge these persistent trends and identify solutions to better protect our workforces.”

The Top 10 most frequently cited workplace safety standards for FY 2024 are:

1. Fall Protection – General Requirements (1926.501): 6,307 violations
2. Hazard Communication (1910.1200): 2,888
3. Ladders (1926.1053): 2,573
4. Respiratory Protection (1910.134): 2,470
5. Lockout/Tagout (1910.147): 2,443
6. Powered Industrial Trucks (1910.178): 2,248
7. Fall Protection – Training Requirements (1926.503): 2,050
8. Scaffolding (1926.451): 1,873
9. Personal Protective and Lifesaving Equipment – Eye and Face Protection (1926.102): 1,814
10. Machine Guarding (1910.212): 1,541

A more in-depth analysis of the Top 10 violations for 2024 will be published in the December edition of Safety+Health magazine, a National Safety Council publication.

The National Safety Council is America’s leading nonprofit safety advocate – and has been for 110 years. As a mission-based organization, we work to eliminate the leading causes of preventable death and injury, focusing our efforts on the workplace and roadways. We create a culture of safety to not only keep people safer at work, but also beyond the workplace so they can live their fullest lives.

L.A. Fire Survivors Call for Insurance Commissioner Resignation

Survivors of the Eaton and Palisades fires on Thursday urged Gov. Gavin Newsom to call for the resignation of California Insurance Commissioner Ricardo Lara, following a front-page New York Times report revealing that Lara privately struck a deal with insurers allowing them to drop tens of thousands of policyholders ahead of the Los Angeles fires.

The New York Times investigation, based on internal state documents and communications, found that in 2023 Lara struck a secret deal with insurance companies that incentivized them to dump tens of thousands of policyholders in exchange for future rate hikes. The deal was sold to the public as a way to keep people out of the state’s high-cost, low-benefit FAIR Plan, but just the opposite happened. FAIR Plan nearly doubled, and many families lost coverage just months before the Los Angeles fires.

At a press conference in Altadena, survivors point to this and their own experience to say that California now faces two crises: families who can no longer buy or renew insurance, and those who still have coverage but cannot access the benefits they’ve already paid for. Both failures, survivors said, fall under Lara’s leadership – and now sit on the governor’s desk.

Joy Chen, executive director of the Eaton Fire Survivors Network and a former deputy mayor of Los Angeles, said:

“Families can no longer buy or renew coverage, and those who still have it can’t access the benefits they’ve already paid for. Californians can’t afford another year of failed oversight. This crisis now sits on the governor’s desk. Governor Newsom should call for Commissioner Lara to resign and install leadership that enforces the law and restores public trust.”

A Department of Angels report found that 70 percent of insured Eaton and Palisades survivors face systemic underinsurance and delays and denials blocking their recovery. A second Department of Angels report, released in October 2025, found that more than eight in ten Los Angeles fire survivors remain displaced, with most expected to lose their temporary housing coverage within months. With coverage expiring in real time, families are being forced out of rentals now – a slow-motion disaster unfolding as state leaders fail to act. Survivors described widespread, needless suffering among tens of thousands of Los Angeles fire survivors – families still displaced, underinsured, or denied the benefits they’ve paid for.

Branislav Kecman, an Eaton Fire survivor, said his family paid premiums to State Farm for 12 years before being dropped just months before the fire. The cancellation forced them onto the state’s FAIR Plan, which costs more and covers less.

“That was painful enough,” he said. “But what’s truly devastating is learning that our own Insurance Commissioner secretly cut a deal that encouraged insurers to drop families like ours. We thought we could trust the system. We never imagined we’d be betrayed by the very person elected to protect us.”

Jill Spivack, a longtime Pacific Palisades resident and State Farm policyholder whose home burned in the Palisades Fire, said what began as heartbreak has turned into outrage.

“After the fire, I thought we were protected – we’d paid State Farm for 25 years. But the real disaster was the endless maze of delays and denials. I had to put my business on hold just to fight for what we’d already paid for. Governor Newsom, your words gave us hope. Now we need your actions to make that hope real. Californians deserve an Insurance Commissioner who protects families, not the insurers doing the most harm.”

Consumer Watchdog Executive Director Carmen Balber said Lara’s secret deal exposed a crisis of leadership that can only be resolved by the Governor.

Survivors warned that Los Angeles stands on the edge of a second catastrophe – one of permanent displacement. Lara has approved billion-dollar rate hikes for the state’s largest insurer, State Farm, while 82 percent of its policyholders report negative claims experiences.

A Los Angeles Times analysis found that five major California wildfires between 2017 and 2020 destroyed 22,500 homes – and by 2025, only 38 percent had been rebuilt. The Times identified insurance as the single biggest factor determining recovery: when insurance paid promptly, families rebuilt; when it didn’t, most never recovered.

The Eaton Fire Survivors Network, representing more than 8,500 Californians, has documented nearly 500 firsthand accounts of insurer misconduct and delivered a five-step enforcement plan to Commissioner Lara.. Every elected official representing the Eaton and Palisades fire zones – including Senators Sasha Renée Pérez and Ben Allen, Assembly members John Harabedian and Jacqui Irwin, Supervisor Kathryn Barger, Mayor Karen Bass, and Altadena Town Council President Victoria Knapp – has joined survivors’ call for accountability.

In closing, Chen added: “Let our Los Angeles experience be a warning to every Californian. Our entire housing market will collapse if families can’t buy or renew insurance, and if those who have it can’t get the benefits they’ve paid for. California cannot afford another year of Ricardo Lara. We call on Governor Newsom to act now: urge Commissioner Lara to resign, and install new leadership that enforces the law and rebuilds a functioning insurance market.”

Novartis Opens New Manufacturing Facility in Carlsbad

Novartis announced the opening of a new 10,000-square-foot radioligand therapy (RLT) manufacturing facility in Carlsbad, California. This state-of-the-art site represents a key milestone in the company’s previously announced $23 billion investment in US infrastructure over the next five years.

The opening of the Carlsbad manufacturing facility allows Novartis to seamlessly meet future demand for RLT, adding additional capacity and augmenting the company’s world-class supply chain capabilities. The Carlsbad facility has been filed with the FDA as an additional US point of supply, and commercial manufacturing may begin once approval is granted.

RLTs are a form of precision medicine that combines a tumor-targeting molecule (ligand) with a therapeutic radioisotope, enabling the delivery of radiation to the tumor with the goal of limiting damage to the surrounding cells. Because each RLT dose is custom-made and time-sensitive, with a radioactive half-life measured in hours, proximity to treatment centers and transit hubs helps ensure patients receive their treatment when and where they need it.

Novartis is the only pharmaceutical company with a dedicated commercial RLT portfolio, and the Carlsbad facility is its third US RLT manufacturing site, reinforcing its global leadership in radioligand therapies with unmatched expertise in development, production, and delivery to patients worldwide. The Carlsbad facility is purpose-built to manufacture the company’s FDA-approved RLTs with capacity for future expansion.

“We commend Novartis for supporting our broader mission of bringing manufacturing capacity in the United States,” said FDA Commissioner Marty Makary, M.D., M.P.H.. “Our unique partnership approach is working.”

“Novartis is transforming the future of cancer care – and it’s happening right here in Carlsbad,” said Carlsbad City Council Member Melanie Burkholder. “This new advanced RLT production facility is a major milestone for our region, strengthening California’s position as a hub for life sciences innovation. It will bring exciting new opportunities for our community, including more engineering and manufacturing jobs. I’m proud our local community will be part of the future of cancer care.”

In addition to the Carlsbad opening, Novartis has announced multiple construction initiatives and future plans in the US, including:

– – Two additional RLT manufacturing facilities in Florida and Texas.
– – Expansion of existing sites in Durham, North Carolina, Indianapolis, Indiana, and Millburn, New Jersey.
– – Establishing its second global R&D hub in the US with a new state-of-the-art biomedical research innovation facility in San Diego, California.

These investments, enabled by a pro-innovation policy and regulatory environment in the US, reflect Novartis’ broad commitment to the market and building its infrastructure. Novartis expects to invest nearly $50 billion in its US operations over the next five years, including the $23 billion announced earlier this year, underscoring its long-term commitment to strengthening the US healthcare ecosystem.

Cal Supreme Court Says Criminal Misgendering Law is Constitutional

In 2017, the Legislature enacted the Lesbian, Gay, Bisexual, and Transgender Long-Term Care Facility Residents’ Bill of Rights. The legislation comprehensively addresses issues concerning lesbian, gay, bisexual, and transgender (LGBT) seniors’ access to, and treatment by, “[l]ong-term care facilit[ies] – an umbrella term covering entities that provide services ranging from skilled nursing to residential personal care for the elderly.

In December, just before the 2017 law went into effect, plaintiff Taking Offense (which describes itself as an entity dedicated to opposing efforts “to coerce society to accept [the] transgender fiction that a person can be whatever sex/gender s/he thinks s/he is, or chooses to be”) filed a petition for a writ of mandate in the superior court seeking to block enforcement of the pronouns provision as facially unconstitutional under the First Amendment to the United States Constitution. The lawsuit worked its way up to the California Supreme Court.

On November 6, 2025, the Supreme Court delivered a significant ruling in Taking Offense v. State of California (S270535), a case challenging a key provision of the 2017 Lesbian, Gay, Bisexual, and Transgender (LGBT) Long-Term Care Facility Residents’ Bill of Rights. This legislation aimed to fulfill existing anti-discrimination laws by explicitly prohibiting various forms of bias based on sexual orientation, gender identity, gender expression, or HIV status. The Legislature cited studies highlighting pervasive mistreatment of LGBT elders, including denial of admission, abrupt discharges, harassment, restrictions on visitation, and refusal to use preferred names or pronouns, often stemming from lifelong marginalization that left many without family support networks.

At the heart of the dispute was Health and Safety Code § 1439.51, subdivision (a)(5) – the “pronouns provision” – which makes it unlawful for facility staff to “[w]illfully and repeatedly fail to use a resident’s preferred name or pronouns after being clearly informed,” when motivated wholly or partially by the resident’s protected characteristics. Enforcement draws from pre-existing administrative, civil, and, in extreme cases, criminal penalties applicable to other violations in long-term care settings. Taking Offense, an unincorporated association of California taxpayers opposed to what it termed the “transgender fiction,” filed a pre-enforcement petition for writ of mandate in Sacramento County Superior Court in December 2017, seeking to block the provision as a facial violation of the First Amendment’s free speech protections.

The trial court denied the petition, upholding the provision against First Amendment challenges. On appeal, the Third District Court of Appeal partially reversed in 2021, deeming the pronouns provision overinclusive and insufficiently tailored to the state’s anti-discrimination interest, thus facially unconstitutional under heightened First Amendment scrutiny – whether viewed as content-based speech regulation or compelled speech. The appellate court emphasized that the law criminalized a viewpoint on gender identity without adequately advancing its goals.

The Supreme Court granted review. In a unanimous opinion the court first addressed standing, raised by the state for the first time on review. The justices agreed that the 2018 amendment to Code of Civil Procedure § 526a, which governs taxpayer standing, now limits such suits to local governments and excludes wholly state entities or officers. Tracing the evolution from common law taxpayer standing to the statute’s history, the court clarified that prior decisions blending the two doctrines no longer apply post-amendment. However, under the case’s unusual circumstances – including the state’s delayed objection, the parties’ full litigation of the merits, and the court’s own past expansive interpretations – the justices exercised discretion to reach the merits, avoiding an advisory opinion while deferring broader questions about common law or public interest standing.

On the substance, the court reversed the Court of Appeal, upholding the pronouns provision. Emphasizing the narrow context – vulnerable residents in a “captive audience” environment akin to their home, where staff provide intimate medical and personal care – the justices characterized the law as a regulation of discriminatory conduct that only incidentally burdens speech. Drawing on U.S. Supreme Court precedents like R.A.V. v. City of St. Paul (1992) and this court’s plurality in Aguilar v. Avis Rent A Car System, Inc. (1999), the opinion reasoned that anti-discrimination measures targeting hostile environments, such as workplace harassment, do not trigger First Amendment scrutiny merely because they involve words. The provision is carefully limited: it requires willful, repeated, knowing acts motivated by bias, exempts professionally reasonable clinical judgments, and does not bar staff from expressing gender views in other ways or contexts. Distinguishing cases like Reed v. Town of Gilbert (2015) and 303 Creative LLC v. Elenis (2023), which involved content-based restrictions in public forums or compelled expressive services, the court found no abridgment of free speech rights.

Even assuming intermediate scrutiny applied (as a content-neutral regulation), the provision was appropriate as it advances compelling state interests in protecting LGBT seniors’ dignity, access to care, and freedom from discrimination in a setting where avoidance is impractical, and it is narrowly tailored without restricting more speech than necessary. The court also rejected claims that potential criminal penalties – available only for egregious, unremedied violations after administrative processes – render the law facially invalid, noting their rarity and the Legislature’s intent to use them as a last resort.

Inland Empire Hospice Operators Sentenced in Fraud Case

Inland Empire Hospice operators, Ralph and Rochell Canales, were sentenced for submitting false claims to the Medicare and Medi-Cal programs. Ralph was sentenced by the San Bernardino County Court to seven years and four months in state prison and was jointly ordered to pay $1,455,233.

Rochelle was sentenced to one year in jail, and ordered to abstain from working with Medicare and Medi-Cal beneficiaries in a caregiver or fiduciary capacity and from working for any healthcare provider that receives funds from Medicare or Medi-Cal. The prosecution of these individuals was carried out by the California Department of Justice’s Division of Medi-Cal Fraud and Elder Abuse.

From 2013 through 2022, Ralph Canales and his wife Rochell Canales, along with brother Sherwin Canales and business partners Giovanni and wife Maureen Ibale, operated Sterling Hospice, New Hope Hospice, River of Light Hospice, and Mt Olive Hospice in the Inland Empire. Ralph Canales played a primary role as owner and operator of these companies while his wife played a supporting role at the direction of her husband. While running these companies, these individuals paid illegal kickbacks, in the form of cash and personal checks, to illicit marketers and two Inland Empire-area doctors, who certified patients for hospice services though the patients were not suffering from conditions likely to be terminal.

Between the four companies, at least 52 patients were identified as being ineligible to receive hospice care substantially defrauding the Medicare and Medi-Cal programs. In addition to committing fraud against the Medicare and Medi-Cal programs, Ralph and Rochell failed to pay corporate taxes to the Franchise Tax Board and California Employment Development Department.

Since taking office, the current Attorney General said that he has filed criminal charges against 109 individuals with hospice fraud-related offenses and conducted 24 civil investigations, which resulted in multiple civil filings. Building on his efforts to combat hospice fraud, this August, the Attorney General launched a new initiative aimed at educating the public and providing vital reporting resources to individuals and families who may have been impacted by hospice fraud.

DMFEA works to protect Californians by investigating and prosecuting those responsible for abuse, neglect, and fraud committed against elderly and dependent adults in the state, and those who perpetrate fraud on the Medi-Cal program.

The Division of Medi-Cal Fraud and Elder Abuse receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $77,652,892 for Federal Fiscal Year (FFY) 2026.  The remaining 25 percent, totaling $25,884,297 for FFY 2026, is funded by the California Attorney General’s Office.  FFY 2026 is from October 1, 2025 through September 30, 2026.