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Category: Daily News

California “Test to Treat” Facilities May be COVID Game Changers

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The president launched a nationwide “Test to Treat” Initiative on March 8 that seeks to make treating COVID-19 simple: You get tested at a pharmacy-based clinic. If you’re positive and at high risk, you can get antiviral pills on the spot, which can cut the chance of developing severe disease by some 85%.

“It’s a very exciting time,” said Dr. Annie Luetkemeyer, professor of medicine at UC San Francisco, in a recent USC webinar.

According to the story in DailyNews, all told, more than 2,300 pharmacies, hospitals and medical providers are distributing the drugs in California. CVS, Walgreens and Rite Aid stores represent more than half of the stocked sites, with Kaiser Permanente, medical groups, hospitals, grocery chains and smaller pharmacies comprising much of the rest.

“The therapeutics are very different now than they were a year ago,” said Dr. George Rutherford, professor of epidemiology and biostatistics at UC San Francisco. They can be game-changers for people who can’t get vaccinated or who haven’t had a robust immune response after vaccination.

Test and treat can be helpful if it can be implemented well, said Dr. Elizabeth Hudson, regional chief of infectious diseases at Kaiser Permanente Southern California, which has 4.8 million members in Southern California.

What are these drugs?

Antivirals prevent viruses from making copies of themselves, while monoclonal antibodies bind to virus and help the body get rid of it. Here’s a few of the treatment options:

  • Pfizer’s Paxlovid is the new star in the antiviral treatment arsenal. It’s a series of pills, taken orally. They contain nirmatrelvir, which stops the virus from replicating, and ritonavir, which helps the main drug stay in the body longer, at higher concentrations. It’s three tablets taken together, twice daily, for five days, for a total of 30 tablets. Paxlovid significantly reduced the proportion of people with COVID-19-related hospitalization or death from any cause by 88% compared to placebo, the U.S. Food and Drug Administration said when it issued an emergency use authorization in December.
  • Also new is Merck’s molnupiravir, an antiviral that received emergency use authorization in December as well. It works by introducing errors into the virus’ genetic code, which prevents the virus from replicating. It’s only for patients 18 and older, as molnupiravir can affect bone and cartilage growth, the FDA said. It’s a course of four capsules taken orally every 12 hours for five days, for a total of 40 capsules.
  • Veklury, the antiviral remdesivir, has been available since 2020 and isn’t part of the federal/state effort; clinics can order it directly. The drug must be delivered intravenously.
  • Monoclonal antibodies must be given intravenously or through injection as well, within about 10 days after symptoms. Sotrovimab is effective against omicron and part of the federal effort; Evusheld is for those who can’t get COVID-19 vaccines for medical reasons, or who didn’t have robust immune responses to vaccination.

Candidates for these treatments are those at high risk for developing serious disease, including folks who are older, overweight, pregnant, diabetic or have heart issues and other underlying health problems.

People should act as quickly as possible, contacting their doctors or finding a Test to Treat site at a local CVS or Walgreens, officials said.

“Although supplies remain limited, more residents are receiving these treatments through pharmacies, partners, and providers,” L.A. County’s COVID-19 update said. “To date, Public Health has distributed 20,960 doses of Paxlovid, 39,764 doses of Molnupiravir, and 13,584 doses of Evusheld, with 73% of Paxlovid doses, 82% of Molnupiravir doses and 66% of Evusheld allocated to residents in the most under-resourced communities.”

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Calif. Supreme Court Clarifies L.C. Whistleblower Protections

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Wallen Lawson worked as a territory manager for defendant PPG Architectural Finishes, Inc. (PPG), a paint and coatings manufacturer.

He claimed he was ordered to intentionally mistint slow-selling PPG paint products – that is, to tint the paint to a shade the customer had not ordered. Lowe’s would then be forced to sell the paint at a deep discount, enabling PPG to avoid buying back what would otherwise be excess unsold product. Lawson did not agree with this mistinting scheme and filed two anonymous complaints with PPG’s central ethics hotline. He also told his supervisor directly that he refused to participate.

He filed suit in the United States District Court for the Central District of California, and claimed that PPG had fired him because he blew the whistle on his supervisor’s fraudulent mistinting practices, in violation of the protections codified in Labor Code section 1102.5.  Because Lawson could not satisfy this third step of the United States Supreme Court’s decision in McDonnell Douglas Corp. v. Green (1973) 411 U.S. 792, the district court granted summary judgment in favor of PPG on the whistleblower retaliation claim. The three steps require that (1) the plaintiff establish a prima facie case of retaliation, (2) the defendant provide a legitimate, nonretaliatory explanation for its acts, and (3) the plaintiff show this explanation is merely a pretext for the retaliation

The California Supreme Court in the case of Lawson v PPG Architectural Finishes, Inc. (Jan, 2022) decided that the District Court applied the wrong standard.

The question in this case concerns the proper method for presenting and evaluating a claim of whistleblower retaliation under Labor Code section 1102.5. Since 2003, the Labor Code has prescribed a framework: Once an employee-whistleblower establishes by a preponderance of the evidence that retaliation was a contributing factor in the employee’s termination, demotion, or other adverse action, the employer then bears the burden of demonstrating by clear and convincing evidence that it would have taken the same action “for legitimate, independent reasons.”

But in the years since section 1102.6 became law, some courts have persisted in instead applying a well-worn, but meaningfully different, burden- shifting framework borrowed from the United States Supreme Court’s decision in McDonnell Douglas.

Noting the lack of uniformity, the United States Court of Appeals for the Ninth Circuit has asked the California Supreme Court to decide which of these frameworks governs section 1102.5 retaliation claims.

Unsurprisingly, the California Court concluded that courts should apply the framework prescribed by statute in Labor Code section 1102.6. Under the statute, employees need not satisfy the McDonnell Douglas test to make out a case of unlawful retaliation.

L.C. 1102.5 provides whistleblower protections to employees who disclose wrongdoing to authorities, and it prohibits an employer from retaliating against an employee.

In 2003, the Legislature amended the Labor Code’s whistleblower protections in response to a series of high-profile corporate scandals and reports of illicit coverups, specifically citing “the recent spate of false business reports and other illegal activity by Enron, WorldCom and others”

The 2003 amendments added a procedural provision, section 1102.6, which statesl: “In a civil action or administrative proceeding brought pursuant to Section 1102.5, once it has been demonstrated by a preponderance of the evidence that an activity proscribed by Section 1102.5 was a contributing factor in the alleged prohibited action against the employee, the employer shall have the burden of proof to demonstrate by clear and convincing evidence that the alleged action would have occurred for legitimate, independent reasons even if the employee had not engaged in activities protected by Section 1102.5.

To resolve the confusion, the Court clarified that section 1102.6, and not McDonnell Douglas three step process, supplies the applicable framework for litigating and adjudicating section 1102.5 whistleblower claims.

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WCAB Panel Clarifies Requirements for Reopening an Award

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Officer Jeffrey Wall injured his right knee during a foot pursuit of a felony suspect while employed as a Deputy Sheriff by the County of Sacramento as a deputy sheriff on April 11, 2015.

By Stipulations in December 2016, the parties agreed that he sustained injury AOE/COE to his right knee. The Stipulations did not include any reference to a right shoulder injury claim.

After the stipulation, Wall filed a timely Petition to Reopen his injury claim and amended the claim to include injury his right shoulder.

The parties proceeded to trial on September 25, 2020. Wall submitted an offer of proof stating: “Applicant would testify that at the time of the stipulations entered into in December 2016, he had no problems to his right shoulder.”

The WCJ found that Officer Wall showed good cause to reopen the injury claim and applicant sustained new and further disability as a result of the April 11, 2015 injury. Reconsideration of this finding was denied in the panel decision of Wall v County of Sacramento – ADJ 10046347 (March 2022).

On reconsideration the County contends that applicant was aware that he injured his right shoulder at the time that the parties submitted the Stipulations with Request for Award, so there is no good cause to reopen the injury claim.

In rejecting this contention, the panel reviewed the current law on the requirements of granting a Petition to Reopen.The employer argued that the case of Nicky Blair’s Restaurant v. Workers’ Comp. Appeals Bd., (1980) 109 Cal. App. 3d 941, 45 Cal.Comp.Cases 876, established the principle that reopening for “good cause” does not permit an attempt to simply re-litigate the original award.

There was no dispute that on February 11, 2015, while chasing a suspect, Officer Wall slipped and fell, landing on his right knee and shoulder, and that he sustained an abrasion and/or contusion to his right shoulder.

However, at no time prior to the December 15, 2016 Stipulations did he receive medical treatment for his right shoulder. Nor is there any evidence that he had any right shoulder disability before the parties settled the right knee injury claim.

The first treatment report indicating that applicant sustained an injury to his right shoulder was dated February 13, 2018. “Defendant provides no explanation as to how the February 13, 2018 report and the various treatment notes thereafter, could have been discovered and produced prior to the December 15, 2016 award. Nor does defendant refer to any evidence indicating that the February 13, 2018 report, and the subsequent right shoulder treatment reports, were merely cumulative or a restatement of the original evidence.”

The WCAB panel concluded that “defendant’s reliance on the Nicky Blair’s decision is inconsistent with the evidence submitted in this matter.“

Based on the record, there is no evidence that applicant sustained a compensable “injury” to his right shoulder prior to the 2015 stipulation. A compensable injury by definition requires either medical treatment, or compensable disability. Officer Ward had neither of these before the 2015 stipulation, and thus the shoulder is “new and further” not re-litigating something that existed before the award.

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9th Circuit to Rule on Federal Preemption of California Sick Pay Law

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A Ninth Circuit panel heard arguments Thursday in an appeal with major implications for labor law in the United States and the sick pay of railroad workers in California.

Courthouse News reports that a consortium of railroad operators, including Amtrack and Union Pacific, sued the state of California claiming its 2014 law requiring employers to offer sick leave to workers should not apply to railroads for a variety of reasons.

Mainly, the railroads say federal preemption – the legal concept holding that when federal laws are in conflict with state laws, one must defer to the federal statutes – applies here. They say the Railroad Unemployment Insurance Act regulates railroad worker issues like sick leave, as well as unemployment insurance and disability claims.

But California’s attorneys say the federal statute does not actually cover issues like short-term paid sick leave since it was passed in 1938, before the concept of paid sick leave for personal or family illnesses was fully integrated into employment law in the United States.

A federal judge in 2017 partly sided with the state, finding the rail operators must allow their California employees to use accrued sick time for family matters and issues related to domestic violence, sexual assault and stalking. She said Congress’ intent when it passed the 1938 Railroad Unemployment Insurance Act was to provide national short-term railroad worker disability insurance, not a “stand-alone sickness benefit statute.”

“[The railroad act] does not so much as mention these other, substantively different benefits, demonstrating that Congress did not regulate those matters and pre-empt state laws that do,” U.S. District Judge Kimberly Mueller wrote.

In 2021, however, Mueller granted judgment in favor of the rail operators, eventually finding that forcing the railroads to apply the California law would create an undue burden to interstate commerce under Dormant Commerce Clause of the U.S. Constitution.

California appealed. Arguing for the state before the Ninth Circuit panel on Thursday, attorney Kristin Liska doubled down on Mueller’s earlier ruling. “Congress understood and intended the phrase ‘sickness benefits’ to refer to situations that the RUIA’s language covers, namely when an employee is unable to work due to injury, illness or pregnancy,” she told the three-judge panel.

The state argues the railroad act does not cover “alternative forms of sickness” recognized under California’s law – caring for sick family members or attending to matters related to domestic violence – so the statutes are not in conflict and preemption doesn’t apply.

But U.S. Circuit Judge Morgan Christen did not seem persuaded during oral argument.  “The federal statute seems very broad so you are going to have to help me out in order to gain traction,” she said.

Arguing for the railroads, attorney Donald Monroe, agreed and said that if any provisions, including time off to vote or other activities, are provided to employees under laws that apply to sickness, they are automatically preempted. “No matter what it is, if California puts it under a sickness law, they can’t apply it to railroads,” Monroe said.

This dispute should be resolved at the Court of Appeals level over the next few months.

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Scientists Report on the Pandemic Related Research Sliver Lining

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The billions of dollars invested in covid vaccines and covid-19 research so far are expected to yield medical and scientific dividends for decades, helping doctors battle influenza, cancer, cystic fibrosis, and far more diseases.

“This is just the start,” said Dr. Judith James, vice president of clinical affairs for the Oklahoma Medical Research Foundation. “We won’t see these dividends in their full glory for years.”

James hopes that computer technology used to detect covid will improve the treatment of other diseases. For example, researchers have shown that cellphone apps can help detect potential covid cases by monitoring patients’ self-reported symptoms. James said she wonders if the same technology could predict flare-ups of autoimmune diseases.

“We never dreamed we could have a PCR test that could be done anywhere but a lab,” James said. “Now we can do them at a patient’s bedside in rural Oklahoma. That could help us with rapid testing for other diseases.”

According to the story published by California Healthline, building on the success of mRNA vaccines for covid, scientists hope to create mRNA-based vaccines against a host of pathogens, including influenza, Zika, rabies, HIV, and respiratory syncytial virus, or RSV, which hospitalizes 3 million children under age 5 each year worldwide.

Researchers see promise in mRNA to treat cancer, cystic fibrosis, and rare, inherited metabolic disorders, although potential therapies are still many years away.

Pfizer and Moderna worked on mRNA vaccines for cancer long before they developed covid shots. Researchers are now running dozens of clinical trials of therapeutic mRNA vaccines for pancreatic cancer, colorectal cancer, and melanoma, which frequently responds well to immunotherapy.

Ambitious scientific endeavors have provided technological windfalls for consumers in the past; the race to land on the moon in the 1960s led to the development of CT scanners and MRI machines, freeze-dried food, wireless headphones, water purification systems, and the computer mouse.

Likewise, funding for AIDS research has benefited patients with a variety of diseases, said Dr. Carlos del Rio, a professor of infectious diseases at Emory University School of Medicine. Studies of HIV led to the development of better drugs for hepatitis C and cytomegalovirus, or CMV; paved the way for successful immunotherapies in cancer; and speeded the development of covid vaccines.

Over the past two years, medical researchers have generated more than 230,000 medical journal articles, documenting studies of vaccines, antivirals, and other drugs, as well as basic research into the structure of the virus and how it evades the immune system.

Dr. Michelle Monje, a professor of neurology at Stanford University, has found similarities in the cognitive side effects caused by covid and a side effect of cancer therapy often called “chemo brain.” Learning more about the root causes of these memory problems, Monje said, could help scientists eventually find ways to prevent or treat them.

One of the most important pandemic breakthroughs was the discovery that 15% to 20% of patients over 70 who die of covid have rogue antibodies that disable a key part of the immune system. Although antibodies normally protect us from infection, these “autoantibodies” attack a protein called interferon that acts as a first line of defense against viruses.

The discovery of interferon-targeting antibodies “certainly changed my way of thinking at a broad level,” said E. John Wherry, director of the University of Pennsylvania’s Institute for Immunology, who was not involved in the studies. “This is a paradigm shift in immunology and in covid.”

For decades, public health officials created policies based on the assumption that viruses spread in one of two ways: either through the air, like measles and tuberculosis, or through heavy, wet droplets that spray from our mouths and noses, then quickly fall to the ground, like influenza.

Today it’s clear that the coronavirus – and all respiratory viruses – spread through a combination of droplets and aerosols, said Dr. Michael Klompas, a professor at Harvard Medical School and infectious disease doctor.

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Researchers Study Use of Plastic Barriers On COVID-19 Transmission

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Controlling the spread of COVID-19 has become a priority worldwide. After case reports in December 2019, social distancing has been widely adopted as a containment strategy. Therefore, it is essential to control the risks and ensure safety in educational, public, and workplaces.

To reduce the risk of COVID-19 transmission, measures against all three routes of infection (contact, droplet, and aerosol) and to reduce the probability of infection through multiple defenses, social distance, mask, vaccine, etc., are required.

However, compared to contact and droplet transmission, which can be prevented by social distancing and the use of masks, aerosol transmission is difficult to visually recognize, and the effectiveness of respective countermeasures has not been confirmed. Accordingly, mass transmissions of COVID-19 have been reported in poorly ventilated areas.

The inappropriate use of plastic sheeting for preventing droplet infection has caused clusters of infectious diseases and threatened workplace safety.

The use of carbon dioxide (CO 2) sensors to control indoor air quality has attracted significant attention. The measurement of indoor CO 2 concentration (referring to exhaled air) is considered an effective method for indirect risk management to ensure that exhaled aerosol particles containing SARS-CoV-2 do not remain indoors.

Therefore, these devices have been widely installed as a safety measure in places where people gather, such as restaurants, stores, classrooms, and offices. The guideline for its operation considers a provisional control value of 800-1000 ppm set by government agencies of each countries as the maximum CO 2 concentration. Under pandemic conditions, the Centers for Disease Control and Prevention has indicated that the CO 2 concentration should be maintained below 800 ppm, which has been considered a good safety indicator.

However, as CO 2 concentration is not a direct risk indicator and there is no direct epidemiological relationship between CO 2 concentration and COVID-19 transmission.

In a new study, researchers used a CO 2 sensor network and conducted a tracer gas experiment to evaluate the complex ventilation conditions in a business site in Japan, where a cluster of COVID-19 infections occurred. In 2021, 14 infections occurred among 30 workers who spent a short time in a large work preparation room. The room was divided by four partitions, and only a small number of entrances and exits served as ventilation routes.

The objectives of this research were to 1) demonstrate a method for evaluating and determining the state of air quality management in an office with a complex geometry using a CO2 sensor network, and 2) verify the effectiveness of ventilation improvement measures.

The Researchers concluded that for aerosol infection control, which should be conducted in parallel with measures against contact and droplet transmission, the maximum height of partitions should be strictly controlled, and they should be installed at a height and orientation that do not interfere with ventilation. Measurement using sensor networks is effective in detecting such a ventilation bias.

Ventilation bias caused by ventilation pathways and inappropriate use of plastic sheeting can be detected by a CO 2 sensor network and time series data analysis. Estimated ventilation rate will be a good index to suppress the formation of the COVID-19 cluster.

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Google Announces New Technology For Electronic Health Records

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Just a week after pulling back the curtain on new natural language processing features for Care Studio, its clinician-facing patient record interface, at the ViVE conference in Miami, Google Health took to HIMSS 2022 to announce the technology’s first-ever integration with an electronic health record vendor.

News site Fierce Healthcare cited a “to-be-published blog post” from Google saying “Using Google Health’s tools, Meditech will form a longitudinal health data layer, bringing together data from different sources into a standard format and offering clinicians a full view of patient records.“

Google wrote that it has entered into a collaboration with Meditech to develop “a deeply integrated solution” that marries the search, contextualization and data harmonization capabilities of Google Health’s Care Studio with Meditech Expanse, the vendor’s web-based EHR platform.

“Using Google Health’s tools, Meditech will form a longitudinal health data layer, bringing together data from different sources into a standard format and offering clinicians a full view of patient records,” Google Health wrote in the to-be-published blog post. “And with Google Health’s search functionality embedded into their EHR, clinicians can find salient information faster for a more frictionless experience and the intelligent summarization can highlight critical information directly in the Expanse workflow.”

Care Studio leans on Google’s expertise in organizing information to help clinicians find health record information faster. The tool’s Clinical Search feature enables clinicians to simply type what they’re looking for and quickly find the specific information requested, and even related concepts.

Today’s medical data is often siloed, health records live within and across multiple systems. Care Studio simplifies complex information by creating a real-time, normalized longitudinal representation of a person’s clinical data.

The Google tools give clinicians a single, centralized view that automatically brings forward a patient’s important information – including hospital visits, outpatient events, laboratory tests, medications, and treatment and progress notes. And the intuitive interface offers unique ways to visualize health data and trends in tables, graphs and other helpful formats.

The Care Studio mobile app makes it easy to find important information before seeing a new patient, or quickly check in on a patient’s progress. It helps clinicians easily search a patient’s record, review the most recent physician notes, view a patient’s lab trends and more right from their phone.

In an Axios interview in January, Google Chief Health Officer Karen DeSalvo said, “When we think about how we’re going to support the health ecosystem, we’ve got three big buckets. Is it going to support consumers in their health journey? Is it going to support caregivers who are providing the services on the front lines – or is it going to support community context? Those are our three C’s: consumer, caregiver and community context.”

Google also used last week’s ViVE healthcare conference in Miami Beach to preview its new Conditions capability.

A March 8 Google blog, said “Healthcare data is structured in numerous ways, making it difficult to organize. Clinical notes may be written differently and stored across different systems. Clinician notes also differ based on if content is meant for clinical decision making, billing or regulatory uses.”

“Further, when it comes to writing notes, clinicians use different abbreviations or acronyms depending on their personal preference, what health system they’re a part of, their region and other factors. All of this has made it difficult to synthesize clinical data – until now.”

Adding Conditions to Google Health enables algorithms to pull meaningful detail from physician and clinician notes often written in partial sentences or using non-standardized terms to describe diagnostic findings, even ferreting out misspellings that can cause problems.

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Judicial Council Votes to Rescind Covid-19 Superior Court Rules

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Emergency Covid-19 rules put in place two years ago to help California courts deal with the operational pitfalls of the pandemic will expire on June 30, as the Judicial Council voted Friday for their repeal at its first in-person business meeting in two years.

According to the report by Courthouse News the eight remaining Covid-19 rules lengthened time limits or filing civil lawsuits and bringing civil cases to trial, prioritized juvenile delinquency and dependency hearings, extended temporary restraining order or gun violence emergency protective orders and allowed defendants to appear remotely at hearings and waive their right to appear in-person at trial.

“The rules were always intended to be temporary,” said Justice Marsha Slough, chair of the council’s Executive and Planning Committee. “We believe it’s time to move past these rules.”

Last Friday, Chief Justice Tani Cantil-Sakauye decided to rollback four other Covid-19 rules extending deadlines for preliminary criminal hearings from 10 to 30 days, letting courts extend time to bring civil cases to trial by up to 60 days, and giving courts authority to conduct hearings by remote technology and adopt their own local Covid-19 measures. Those rules will now expire on April 30.

The sunset of these court rules does not spell the end of all remote hearings. The legislature passed a law last year to preserve remote access to civil proceedings either by videoconference or phone.

The Judicial Council will also sponsor legislation this year to continue allowing criminal defendants to appear remotely in court.

“We do recognize that the use of remote technology became much more widely used during the pandemic and it actually provided a way for people to access the courts they way they never had before,” Slough said. “It served to be a very important response, and we appreciate the fact that remote technology made courts accessible to users. We recognize the importance of continued remote access in all case types. And we want to continue to work towards additional measures to assure there are remote proceedings in all case types.”

The move comes a few weeks after Governor Gavin Newsom lifted some of his emergency executive orders.

Judicial Council administrative director Martin Hoshino said council members should encourage judicial officers and court staff to remember that the rules were temporary and the authority on which they were predicated will expire on June 30.

It remains to be seen if the same trend toward remote technology is embraced by district offices of the Workers’ Compensation Appeals Board.

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WCAB Panel Reviews Case Law Allowing Minor Pleading Errors

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Patrick Jamerson filed three applications for inter vivos benefits, two for a continuous trauma with ending dates in 2011 and 2016, and one for a specific injury on May 4, 2016. One of the CT cases was resolved via Stipulations with Request for Award, with the Award issuing September 8, 2014.

He died on September 25, 2018 of suicide. His spouse and children filed an application for death benefits on September 6, 2019. The death benefit application lists all three case numbers. and does not specify the dates of injury for either of the other two case numbers listed. The did not petition to reopen the one case with a Stipulated Award.

The parties proceeded to trial on September 14, 2020. The parties placed in issue whether sections 5406(b) (Proceedings shall not be commenced more than one year after the date of death, nor more than 240 weeks from the date of injury) or 5410 (the five year time limit to petition to reopen a case) barred compensation in all three cases.

The WCJ issued Joint Findings of Fact on October 18, 2020, determining that applicants’ claim for death benefits in Case No. ADJ8129185 (injury through December 1, 2011) was barred under Section 5406(b). But the WCJ further found that defendant failed in its burden of proof to establish that benefits were barred under Section 5406(b) in ADJ11011618 (May 4, 2016 specific injury) and in ADJ11011740 (injury through June 10, 2016). The WCJ further determined section 5410 would not preclude applicant from seeking death benefits.

The employer’s petition for reconsideration was denied in the panel decision of Jamerson v Commercial Metals Co. ADJ11011618; ADJ11011740; ADJ8129185 (March 2022).

Defendant’s contended that the September 6, 2019 application for death benefits was procedurally defective because it listed more than one case number. And applicant’s failure to file three separate applications for death benefits invalidates the filings.

In rejecting this contention, the WCAB Panel noted “that the principles of ‘liberal pleading’ have infused California’s statutory landscape for more than 150 years.”

The Panel went on to discuss statutory provisions enacted in 1872, and proceeded to carefully summarize case law interpreting and implementing the rule that the workers’ compensation system “was intended to afford a simple and nontechnical path to relief.” And that “Informality of pleading in proceedings before the Board is recognized and courts have repeatedly rejected pleading technicalities as grounds for depriving the Board of jurisdiction.”

Moreover the Panel noted that, section 5709 states that “[n]o informality in any proceeding or in the manner of taking testimony shall invalidate any order, decision, award, or rule made and filed as specified in this division.” And “it is the policy of the law to favor, whenever possible, a hearing on the merits.”

This Panel decision is an excellent narration of statutory and case law citations supporting forgiveness of technical errors in pleadings by parties who might seek judicial relief from minor technical errors.

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Newsom Proposes New Office of Health Care Affordability

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Governor Gavin Newsom’s California Budget for 2021-22 includes a proposal for a new Office of Health Care Affordability to be housed within the Office of Statewide Health Planning and Development (OSHPD).

The Office of Health Care Affordability will be charged with analyzing the health care market for cost trends and drivers of spending, creating a state strategy for controlling the cost of health care and ensuring affordability for consumers and purchasers, and enforcing cost targets.

The work of the Office will be guided by an Advisory Board comprised of experts that will advise on the key activities of the Office:

The Office will require reporting of total health care expenditure data, broken down by service category (e.g., hospital care, physician services, prescription drugs, etc.). This data will be supplemented with financial reports from providers and granular claims data from the emerging Health Care Payments Data System. The Office will publish an annual report in conjunction with a public meeting on health care spending trends and underlying factors, along with policy recommendations to control costs and improve the quality and equity of the health care system.

The Office will establish an overall health care cost target for changes in per capita spending in California, and have the ability to set specific targets by health care sector, including payers, providers, insurance market and line of business, as well as by geographic region. The targets will be based on established economic indicators.

The Office will progressively enforce compliance with cost targets, beginning with technical assistance and progressively increase to include testimony at public meetings, corrective action plans, and assessment of escalating financial penalties.

Because focusing on cost alone can have unanticipated consequences, performance on quality and equity measures will be reported for health plans, hospitals, and physician organizations, with special consideration of disparities in health care. Alignment with other payers and programs will be prioritized to reduce administrative burden and avoid duplication.

The Office will set a statewide goal for adoption of alternative payment models that promote shifting payments from fee-for-service to payments that reward high quality and cost-efficient care. The Office will measure progress towards the goal and adopt standards for alternative payment models that may be used by providers and payers during contracting. The standards will consider the current best evidence for strategies such as risk sharing arrangements and population-based contracts.

The Office will examine and analyze the role of the health care workforce and assist health care entities with strategies to implement cost-reduction strategies that do not exacerbate existing workforce shortages and promote the stability of the health care workforce.

Research has linked higher prices paid for health care services to increased market consolidation among health plans, hospitals, medical groups or physician organizations, pharmacy benefit managers, and other health care entities. The Office will increase public transparency, through cost and market impact reviews on transactions that may impact market competition and affordability for consumers and purchasers and work with other regulators to address them.

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