Harold Winston is "an African-American male" with "over 30 years of service" with the County of Los Angeles. Winston worked in the Department of Treasurer and Tax Collector as the supervising deputy public conservator administrator in the public administration branch. Winston sued his employer L.A. County alleging race-based discrimination, retaliation, and failure to maintain a discrimination free environment under the California Fair Employment and Housing Act (FEHA) (Gov. Code, § 12900 et seq.) and whistleblower retaliation in violation of Labor Code section 1102.5. While Winston’s case was pending, Labor Code section 1102.5 was amended, effective January 1, 2021, to add a provision - subdivision (j) - authorizing courts to award reasonable attorney fees to whistleblower plaintiffs who prevail against their employer under section 1102.5. Trial began on November 17, 2021. On November 24, 2021, the jury returned a verdict on the three causes of action submitted to them. It found in favor of L.A. County and against Winston on the causes of action for retaliation under FEHA and failure to prevent discrimination/ harassment under FEHA. The jury found in Winston’s favor on his cause of action for whistleblower retaliation under section 1102.5. It awarded him damages totaling $257,000. After the jury found in Winston’s favor on his retaliation claim under section 1102.5, Winston filed a motion for attorney fees and requested $1,854,465 as the prevailing party based on section 1102.5’s recently enacted subdivision (j). The trial court denied the motion, ruling that the fee provision does not apply to Winston’s case because it was not in effect in 2019 when the complaint was filed and because it found no legislative intent supporting retroactive application. The Court of Appeal reversed in the published case of Winston v. County of Los Angeles - B323392 (December 2024). On appeal, Winston argued section 1102.5, subdivision (j) applies to his case "because [his] case was still in action at the time the provision became effective." He contends the trial court erroneously denied his motion based on "no legislative intent demonstrating retroactive application of [the statute]." The Court of Appeal agreed with Winston and reversed. The law invoked here, section 1102.5, is "California’s general whistleblower statute." When Winston filed this case, section 1102.5 did not include a one-way fee-shifting provision "authoriz[ing] an award of attorney fees to a worker who prevails on a claim of retaliation for blowing the whistle on workplace legal violations." The California Legislature amended the law by passing Assembly Bill No. 1947, which allows discretionary recovery of reasonable attorney fees to a prevailing whistleblower plaintiff. Effective January 1, 2021, section 1102.5, subdivision (j) provides: "The court is authorized to award reasonable attorney’s fees to a plaintiff who brings a successful action for a violation of these provisions." (§ 1102.5, subd. (j).) Under California law, the general rule is that absent a clear, contrary indication of legislative intent, courts interpret statutes to apply prospectively. However, "the California Supreme Court and many, many Courts of Appeal have treated legislation affecting the recovery of costs, including attorney fees, as addressing a ‘procedural’ matter that is ‘prospective’ in character and thus not at odds with the general presumption against retroactivity." (USS-Posco Industries v. Case (2016) 244 Cal.App.4th 197, 217-218) "Neither party points to a California decision directly addressing the issue of whether section 1102.5, subdivision (j) applies to cases pending at the amendment’s effective date and we have found none." "We conclude the statute authorizes an award of attorney fees to Winston because his action was pending when section 1102.5, subdivision (j), became effective. For that reason, we reverse." ...

The California Division of Occupational Safety and Health (Cal/OSHA) has issued $563,250 in penalties to Harbor Animal Services Center (A department of the City of Los Angeles that provides animal services and volunteer opportunities for people who live in the city of Los Angeles) based in San Pedro, California, for failing to evaluate and correct overcrowding at their animal shelter, which resulted in animal attacks and bites on employees. An employee was mauled on May 31, 2024, and according to Cal/OSHA it was due to the employer’s (the City of Los Angeles) willful violations of safety regulations. Kennel supervisor Leslie Corea was attacked by a pitbull mix that day after opening the dog's cage for a rescue group. According to a report by Fox 11, he dog isn't new to the the Harbor shelter and neither is Corea. She's spent 24 years at the city shelter. Her right leg was severely damaged and she needed extensive physical therapy and unfortunately, the dog was euthanized. Workers said the attack spotlights the growing crisis of overcrowding at local shelters because of illegal breeding, COVID returns, housing restrictions and situations like this. L.A. Animal Services acknowledged the severity of the attack and issued the following statement, "LA Animal Services has already launched an investigation into this incident. Due to the open investigation status of this incident and to protect the privacy of the staff involved, no further details are available at this time." Cal/OSHA, found that the employer had significant safety and training lapses, which put employees of Harbor Animal Services Center in harm’s way and resulted in a serious injury to the worker, whose leg was badly mauled, requiring hospitalization. What Cal/OSHA Chief Debra Lee said: "This incident underscores the severe consequences that arise when employers fail to take proper measures to protect their staff from preventable risks. While we cannot undo the harm caused, we can hold employers accountable. Every employee deserves a workplace that prioritizes their health and safety." Cal/OSHA has cited Los Angeles City Animal Services operating as Harbor Animal Services Center for six violations, including one general, two willful serious, and three willful serious accident-related in nature. Cal/OSHA’s key findings of the employer’s failure to protect its employees included: - - Overcrowding of Animals: The employer failed to evaluate and mitigate risks caused by overcrowding, which led to employee injuries from animal attacks. - - Inadequate Training: Employees and supervisors received insufficient training in handling animals or using personal protective devices. - - Personal Protective Equipment: Proper assessment and provision of personal protective equipment were not conducted. - - Emergency Communication: The lack of an effective communication system delayed critical emergency response and treatment for injuries. Representatives for the Los Angeles Animal Services Department, Mayor Karen Bass and City Councilman Tim McOsker, who represents the area where the shelter is located, did not immediately respond to a request by Fox 11 for comment ...

McKinsey & Company Inc., a global management consulting firm based in New York, has agreed to pay $650 million to resolve a criminal and civil investigation into the firm’s consulting work with opioids manufacturer Purdue Pharma L.P. The resolution pertains to McKinsey’s advice to Purdue concerning the sales and marketing of Purdue’s extended-release opioid drug, OxyContin, including a 2013 engagement in which McKinsey advised on steps to "turbocharge" sales of OxyContin. This resolution marks the first time a management consulting firm has been held criminally responsible for advice resulting in the commission of a crime by a client and reflects the Justice Department’s ongoing efforts to hold actors accountable for their roles in the opioid crisis. The resolution is also the largest civil recovery for such conduct. Additionally, a former McKinsey senior partner who worked on Purdue matters has been charged with obstruction of justice in federal court in Abingdon, Virginia. Martin E. Elling, 60, a U.S. citizen currently residing in Bangkok, Thailand, has been charged with one count of knowingly destroying records, documents and tangible objects with the intent to impede, obstruct and influence the investigation and proper administration of a matter within the jurisdiction of the Justice Department. Elling has agreed to plead guilty and is expected to appear in federal court in Abingdon to enter his plea and for sentencing at later dates. As part of the government’s resolution with McKinsey, the company has entered into a five-year deferred prosecution agreement (DPA) in connection with a criminal Information filed in U.S. District Court for the Western District of Virginia against McKinsey’s U.S. subsidiary (McKinsey & Company Inc. United States. The information charges McKinsey U.S. with one felony count of knowingly destroying records, documents and tangible objects with the intent to impede, obstruct, and influence the investigation and proper administration of a matter within the jurisdiction of the Justice Department; and one misdemeanor count of knowingly and intentionally conspiring with Purdue and others to aid and abet the misbranding of prescription drugs, held for sale after shipment in interstate commerce, without valid prescriptions. McKinsey has agreed to pay a penalty of over $231 million, a forfeiture amount of over $93 million (reflecting all money it was paid by Purdue from 2004 to 2019) and a payment of $2 million to the Virginia Medicaid Fraud Control Unit to resolve the criminal allegations. McKinsey also has entered into a civil settlement agreement in which it will pay over $323 million to resolve its liability under the False Claims Act for allegedly providing advice to Purdue Pharma L.P. that caused the submission of false and fraudulent claims to federal healthcare programs for medically unnecessary prescriptions of OxyContin, as well as allegedly failing to disclose to the U.S. Food and Drug Administration (FDA) conflicts of interest arising from McKinsey US’s concurrent work for Purdue and the FDA. This brings the total payments under the global resolution to $650 million. Today’s filing includes a 71-page Agreed Statement of Facts, which provides a detailed account of McKinsey’s work with Purdue relating to OxyContin. As part of the resolution, McKinsey has agreed to implement a significant compliance program, including a system of policies and procedures designed to identify and assess high-risk client engagements. As part of this compliance program, McKinsey will implement new document retention procedures and training for all partners, officers and employees who provide or implement advice to clients. This compliance program is in addition to the provisions negotiated between McKinsey and the Department in a concurrent resolution with McKinsey & Company Africa that was announced on Thursday, Dec. 5. McKinsey has also agreed that it will not do any work related to the marketing, sale, promotion or distribution of controlled substances during the five-year term of the DPA. The resolution requires McKinsey’s Managing Partner to certify, on an annual basis, the firm’s compliance with its obligations under the DPA and federal law. "For the first time in history, the Justice Department is holding a management consulting firm and one of its senior executives criminally responsible for the sales and marketing advice it gave resulting in the commission of crime by a client," said U.S. Attorney Christopher R. Kavanaugh for the Western District of Virginia. "This ground-breaking resolution demonstrates the Justice Department’s ongoing commitment to hold accountable those companies and individuals who profited from our Nation’s opioid crisis." ...

A Ventura County physician who worked for two Pasadena hospices was sentenced to 24 months in federal prison for defrauding Medicare out of more than $3 million through claims for medically unnecessary hospice services. Dr. Victor Contreras, 69, of Santa Paula, was sentenced by United States District Judge André Birotte Jr., who also ordered him to pay $3,289,889 in restitution. Contreras pleaded guilty on July 24 to one count of health care fraud. From July 2016 to February 2019, Contreras and co-defendant Juanita Antenor, 62, formerly of Pasadena, schemed to defraud Medicare by submitting nearly $4 million in false and fraudulent claims for hospice services submitted by two hospice companies: Arcadia Hospice Provider Inc., and Saint Mariam Hospice Inc. Antenor controlled both companies. Medicare only covers hospice services for patients who are terminally ill, meaning that they have a life expectancy of six months or less if their illness ran its normal course. Contreras falsely stated on claims forms that patients had terminal illnesses to make them eligible for hospice services covered by Medicare, typically adopting diagnoses provided to him by hospice employees whether or not they were true. Contreras did so even though he was not the patients’ primary care physician and had not spoken to those primary care physicians about the patients’ conditions. Medicare paid on the claims supported by Contreras’ false evaluations and certifications and recertifications of patients. In total, approximately $3,917,946 in fraudulently claims were submitted to Medicare, of which a total of approximately $3,289,889 was paid. According to Medical Board of California records, Contreras is a licensed physician in California, but has been on a 10 year probation with the Board since 2015 and is subject to limitations on his practice. On August 6, 2024 the Medical Board filed a Petition to Revoke his Probation. The expiration of his ten year probation is extended until there is a resolution of this Petition. Antenor remains at large. Co-defendant Callie Black, 66, of Lancaster, who allegedly recruited patients for the hospice companies in exchange for illegal kickbacks, has pleaded not guilty and is scheduled to go to trial on March 4, 2025. The United States Department of Health and Human Services Office of Inspector General, the FBI, and the California Department of Justice investigated this matter. Assistant United States Attorneys Kristen A. Williams of the Major Frauds Section and Aylin Kuzucan of the General Crimes Section are prosecuting this case ...

According to the California Medical Board records, Kevin Tien Do M.D.was born in Saigon, Vietnam and came to the United States in 1982, when he was 16 years old. He graduated from USC Medical School in 1991 and completed his residency in Physical Medicine and Rehabilitation at UCLA on June 30, 1995. After about eight years following completion of his UCLA Residency, Dr. Do was convicted, on on August 15, 2003, following his plea of guilty, of violating Title 18, United States Code, sections 2 and 1347 (aiding and abetting health care fraud) in the United States District Court for the Eastern District of California, Case Number 2:02CR00338-01, entitled The United States of America v. Kevin Tien Do, He was sentenced to 12 months in federal prison, commencing October 15, 2003, and ordered to pay an assessment of $100 and restitution of $366,031.24 From April of 1997 through December 31, 1998, he aided and abetted a billing company named "Medi-Syn" in a scheme to defraud Medi-Cal. He permitted Medi-Syn to use hisr Medi-Cal provider number to submit claims requesting payment for services purportedly rendered by him which he did not provide and which were never provided by anyone else. Do Medi-Syn opened a joint account under the name "Premier Health Providers Network" into which the Medi-Cal checks were deposited. Do provided 80 percent of these funds to Medi-Syn and kept 20 percent for himself. As a result of the scheme, Medi-Cal was defrauded out of $366,031.24. In order to obtain leniency in the 2003 case against him, Do agreed to act as an undercover operative and to cooperate with the FBI in its investigation of Edgemont Hospital a psychiatric hospital in Los Angeles, and in a third investigation regarding podiatrist Gary Feldman and the West Pico Medical Clinic where Do worked. He participated in 43 undercover operations from December of 1998 through May of 1999. He also provided additional assistance in 2000. Respondent's cooperation led to the conviction of Dr. Feldman. Do began serving his federal prison sentence in the 2003 case on October 15, 2003, and was officially released from custody on October 13, 2004. He remained on federal probation until October of 2007.By 2004, Do had paid in full the $366,03 1.24 restitution ordered by the criminal court. The Physician's and Surgeon' s Certificate No. G 76640 issued to Kevin Tien Do was revoked in late 2005 after an Accusation was filed against him by the California Medical Board. However, the revocation was stayed and he was placed on probation for ten years under several terms and conditions. On October 26, 2016 the Medical Board concluded that Dr. Do had "completed probation in Case No. 06-2002-136106, is entitled to full restoration of the Physician's and Surgeon's Certificate." It was therefore ordered that his medical license "be fully restored to renewed/current status and free of probation requirements, effective September 22, 2016." Now, more than two decades after his 2003 conviction,,Kevin Tien Do, M.D., who is now 59 years old and lives in Pasadena, worked for an Inland Empire medical company, and has now agreed to plead guilty - in new case - to conspiring to defraud California’s workers’ compensation fund of millions of dollars by continuing to work on workers’ compensation matters after being suspended due to a prior health care fraud conviction. He agreed to plead guilty to one count of conspiracy to commit mail fraud and one count of subscribing to a false tax return. . Beginning in 2016, Do began to work for Liberty Medical Group Inc., a Rancho Cucamonga-based medical company, for which he would draft SIBTF-related medical reports that Liberty would then bill to the California SIBTF program. In October 2018, California suspended Do from participating in California’s workers’ compensation program, which included the SIBTF, because he had previously been convicted of federal health care fraud in 2003. Despite his suspension, Do continued to work for Liberty on SIBTF-related workers’ compensation matters. To conceal that Do was unlawfully continuing to participate in the workers’ compensation SIBTF program after his suspension, Liberty’s owner came up with a plan. That plan was that Do would continue to author the SIBTF-related reports, which Liberty would then continue to mail to the California SIBTF for payment. rather than listing Do’s name on the billing forms and the attached medical reports mailed to the California SIBTF, like they had had done before Do’s suspension, Liberty instead fraudulently listed other doctors’ names on the billing forms and attached medical reports, even though Do had drafted and compiled the reports. Do admitted that Liberty was paid more than $3 million by California SIBTF for such reports that Liberty mailed to the California SIBTF for payment after Do’s October 2018 suspension. Do’s plea agreement also details that Liberty’s owner edited Do’s medical reports, even though that co-conspirator was not a doctor or other licensed medical professional. Under California law, shareholders/owners of a medical corporation must be licensed in the practice of medicine or other related medical fields, such as a psychologist, registered nurse, or licensed physician assistant. In his plea agreement, Do admitted that real owner of Liberty and Do’s co-conspirator was another person who was not a doctor or other medical professional, but rather, was a California attorney then employed as a prosecutor for the Orange County District Attorney’s Office, and who later became an Orange County Superior Court judge during the conspiracy. According to the Orange County Register, the Orange County Superior Court Judge named in the plea agreement is Israel Claustro, Claustro has served as a Senior Deputy District Attorney and an Assistant Head of Court at the Orange County District Attorney’s Office since 2020, where he has served in several roles since 2002. He served as a Law Clerk at the Orange County District Attorney’s Office from 2001 to 2002. Claustro earned a Juris Doctor degree from the Western State College of Law. And MSN reports that the plea agreement with Do refers to the judge only as "co-conspirator #1," but an investigation by the Southern California News Group has identified the jurist as Israel Claustro, who was appointed to the bench in 2022.. A reporter’s request for comment from Claustro was relayed to him through Orange County Superior Court officials. In response, court spokesperson Kostas Kalaitzidis said, "The court cannot discuss any case pending before any court, as ethical rules prohibit any such discussion." Officials with the U.S. Attorney’s Office declined to comment. Additionally, the state Commission on Judicial Performance would not disclose whether it is investigating Claustro, That true owner who was Do’s co-conspirator not only was a signatory on Liberty’s bank account, but also issued and signed Liberty’s checks to Do and others. The plea agreement specifies that much of the more than $3 million that the SIBTF paid Liberty during the years following Do’s suspension then flowed to another company controlled by Liberty’s owner and his wife, which totaled to more than $1.5 million. Do also admitted that he failed to accurately report to the IRS all the money he had been paid by Liberty. Do admitted that on his 2021 tax return, he failed to report approximately $66,227 of the income that Liberty paid him. Once Do enters his guilty plea, he will face a statutory maximum sentence of 20 years in federal prison for the mail fraud count and up to three years in federal prison for the tax fraud count. The FBI, IRS Criminal Investigation, and the California Department of Insurance are investigating this matter. Assistant United States Attorneys Charles E. Pell of the Orange County Office and Ryan J. Waters of the Asset Forfeiture and Recovery Section are prosecuting the case ...

The California Division of Occupational Safety and Health (Cal/OSHA) has issued $276,425 in penalties to Parkwood Landscape Maintenance, based in Van Nuys, California, for willfully violating state heat illness prevention regulations. Cal/OSHA, a division of the Department of Industrial Relations (DIR), determined that the employer deliberately and knowingly failed to follow heat protection requirements, marking its first willful heat violation citation. This investigation began on June 6, 2024, when the Cal/OSHA Van Nuys District Office received a complaint about employees working outdoors without access to water or heat illness training provided by their employer. The company failed to provide employees with required protections, such as access to water, shaded areas, and proper training on preventing heat-related illnesses. Additionally, they lacked written procedures for addressing work conditions in high temperatures, which often exceeded 95 degrees Fahrenheit. Employees also had to purchase their own drinking water, a breach of California's heat illness prevention standard. This citation follows a previous violation in 2022, in which the company was cited under Title 8 Section 3395(i) for failing to meet heat safety requirements. Despite being provided with model heat illness prevention procedures, Parkwood Landscape Maintenance did not implement the necessary preventive measures to ensure worker safety. Cal/OSHA investigates heat-related incidents and complaints of hazards at both indoor and outdoor worksites in industries such as agriculture, landscaping, and construction among others. These investigations ensure compliance with the heat illness prevention standard, the injury and illness prevention standard, and indoor heat illness protections. Cal/OSHA’s Heat Illness Prevention special emphasis program includes enforcement of the heat regulation as well as multilingual outreach and training programs for California’s employers and workers. Details on heat illness prevention requirements and training materials are posted on Cal/OSHA’s Heat Illness Prevention web page and the 99calor.org informational website. A Heat Illness Prevention online tool is also available on Cal/OSHA’s website. Cal/OSHA helps protect workers from safety and health hazards on the job in almost every workplace in California. Employers who have questions or need assistance with workplace health and safety programs can call Cal/OSHA’s Consultation Services Branch at 800-963-9424. Employers with Questions on Requirements May Contact: InfoCons@dir.ca.gov, or call your local Cal/OSHA Consultation Office ...

CEO of one of California’s largest vocational return to work counseling centers, Hazel Ortega, 53, of La Habra, appeared in court after being charged with 23 felony counts including insurance fraud, theft, and forgery. A Department of Insurance investigation found Ortega allegedly defrauded at least four insurance companies by forging documents on behalf of unknowing injured workers. The Department’s investigation began after receiving multiple referrals from insurance companies alleging Ortega, owner of Ortega Counseling Center, a motivational speaker, and author of "From Bounced Checks to Private Jets," was referring injured workers to schools which were not approved and not eligible to receive the voucher funds through the Supplemental Job Displacement Benefit (SJDB) program, which provides an allowance of $6,000 to $10,000 for educational retraining or skill enhancement for qualifying injured workers to provide them a marketable skill to re-enter the workforce after a workplace injury. This benefit is provided as a voucher that can be used at state-approved or accredited schools. The Department of Insurance is urging any injured workers who believe they may have been victimized by Ortega or the Ortega Counseling Center to contact Detective Kuhlman or Sergeant Jimenez at the Department of Insurance by phone at (909) 919-2200. Through the course of the investigation, detectives located and interviewed injured workers who had SJDB and Vocational Return to Work counseling invoices submitted to insurance companies by Ortega and discovered Ortega was pressuring and coercing injured workers to attend these unapproved schools and not providing them with any other additional choices. Ortega also submitted forms to insurance companies on the injured workers' behalf which they had not seen or reviewed. Multiple injured workers were shown documents submitted on their behalf which they had never seen and stated their signature had been forged. In one instance, detectives interviewed an injured worker for whom Ortega submitted an invoice to an insurance company alleging she provided nearly five hours of counseling services. When the injured worker was contacted, they confirmed they had never heard of Ortega nor met with her for counseling services. Ortega was arraigned and charged previously in Los Angeles County for her participation in another nearly $1 million-dollar insurance fraud scheme. It is alleged Ortega and other vocational counselors received nearly $500,000 in illegal kick back payments for referring students to a fraudulent school in the Los Angeles area. This case is being prosecuted by the Los Angeles County District Attorney’s Office ...

Oroville Hospital was founded in 1962 and is a 153-bed acute care facility that offers a variety of services, including inpatient and outpatient care, a radiology department, and multiple physician practices. It's a Level 3 Trauma Center, which means its Emergency Service Department treats all but the most severe neurological, pediatric, and burn patients. It is owned by OroHealth Corporation, a private, non-profit organization. OroHealth Corporation has two subsidiaries: Oroville Hospital, an acute care inpatient and outpatient facility, and OroLake Corporation, a regional sales and service organization. . Oroville Hospital has agreed to pay $10.25 million to the United States and the State of California to resolve allegations that it violated the False Claims Act and the Anti-Kickback Statute, U.S. Attorney Phillip A. Talbert announced today. The settlement resolves allegations that Oroville Hospital engaged in an illegal kickback and physician self-referral scheme by paying kickbacks to physicians for patients they admitted to the hospital, and that it knowingly submitted false claims to Medicare and Medi-Cal for medically unnecessary hospital admissions and claims that included false diagnosis codes. Oroville Hospital will pay $9,518,954 to the federal government and $731,046 to the State of California. The settlement resolves allegations that, to increase hospital admissions, Oroville Hospital illegally paid kickbacks to its physicians who were responsible for deciding whether individuals should be admitted as inpatients. These physicians allegedly received a bonus based on how many patients they admitted, according to the settlement agreement. The settlement also resolves allegations that Oroville Hospital admitted patients as inpatients when it knew inpatient care was not medically necessary. Oroville Hospital then submitted claims to Medicare and Medicaid for inpatient care, which is more expensive. Oroville Hospital further allegedly submitted claims to Medicare and Medicaid that included false diagnosis codes for systemic inflammatory response syndrome (SIRS), resulting in excessive reimbursement to the Hospital. In connection with the settlement, Oroville Hospital entered into a five-year Corporate Integrity Agreement with the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) that requires, among other requirements, the implementation of a risk assessment and internal review process designed to identify and address evolving compliance risks. The Corporate Integrity Agreement also requires an independent review organization to, among other requirements, annually assess both the medical necessity and appropriateness of select claims billed to Medicare and policies and systems to track arrangements with some referral sources. The civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by Cecilia Guardiola. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. The qui tam case is captioned United States ex rel. Cecilia Guardiola v. Oroville Hosp., Case No. 2:20-CV-1558 (E.D. Cal.). As part of the settlement announced today, Ms. Guardiola will receive approximately $1.8 million. "Physicians should make decisions based the best interests of their patients, not their own personal financial interests," said U.S. Attorney Talbert. "Hospitals engaging in kickback schemes betray the trust placed in them by their communities and distort care decisions that should be untainted by illegal kickbacks. This settlement demonstrates my office’s commitment to preserving the integrity of public healthcare programs and ensuring that the well-being of patients remains paramount." "Improperly billing federal health care programs depletes valuable government resources used to provide medical care to millions of Americans," said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. "We will continue to advocate for the appropriate use of Medicare and Medicaid funds, and we will pursue health care providers who defraud taxpayers by knowingly submitting false claims." Assistant U.S. Attorney Steve Tennyson handled the case for the U.S. Attorney’s Office. The resolution obtained in this matter was the result of a coordinated effort between the U.S. Attorney’s Office for the Eastern District of California, the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section, the Department of Health and Human Services, Office of the Inspector General, and the California Department of Justice, Division of Medi-Cal Fraud and Elder Abuse. The claims resolved by this settlement are allegations only, and there has been no determination of liability ...

Kaiser Permanente's hospital-at-home program (HaH) has grown significantly in the past year, nearly quadrupling its capacity. The program's average daily census has increased from 22.5 to 80.6 across all regions. Some of the areas where Kaiser Permanente offers Care at Home services include: Northern California, Southern California, Georgia, Mid-Atlantic states, Northwest, and Washington state. Kaiser Permanente has been developing infrastructure to support the program's growth, and building confidence in the program among patients and staff. The program is also encouraging more admissions from the emergency department and inpatients. Research from Kaiser Permanente published last year reveals that its hospital-at-home program was scaled successfully, creating hospital capacity; however, the program’s care quality as it was being scaled could not be determined. Published in The American Journal of Managed Care, the study aimed to assess the feasibility of scaling a hospital-at-home program within an integrated healthcare delivery system. Such programs are well established in England, Canada, Israel, and other countries where payment policies encourage - or at least do not discourage - the provision of health care services in less costly venues. In Victoria, Australia, for example, every metropolitan and regional hospital has a hospital at home program, and roughly 6 percent of all hospital bed-days are provided that way. For specific conditions, the use of at-home care is significantly greater: nearly 60 percent of all patients with deep venous thrombosis (DVT) were treated at home in 2008, as were 25 percent of all hospital patients admitted for acute cellulitis. A 2018 study by the Cincinnati Veterans Affairs Medical Center examined hospital readmissions, costs, mortality, and nursing home admissions of veterans who received Hospital-in-Home (HIH) services. Average per person costs were $7,792 for HIH services and $10,960 for traditional inpatient care (P<0.001). HIH veterans were less likely to use a nursing home within 30 days of discharge (3.1%) than non-HIH veterans (12.6%) (P<0.001). Thirty-day readmission rates and mortality were not statistically different between HIH and non-HIH veterans. And a recent article in Forbes said that Since 2020, hospital-at-home programs have gained substantial traction as a patient-centered alternative to hospital care. Although available in the U.S. since the 1990s, these programs - delivering acute medical care in a home setting through care coordination, telehealth and remote patient monitoring (RPM) - are on the rise. Forbes reports that with the Centers for Medicare & Medicaid Services' waiver, over 350 hospitals across the U.S. have implemented or are planning to launch HaH programs. While high initial costs and implementation challenges remain, research shows that HaH care is 32% less expensive than inpatient care. As hospitals increasingly adopt these programs, evidence continues to support HaH as an affordable, viable model for acute care delivery. Traditional hospital care requires substantial resources to maintain inpatient beds, utilities and facility management. Operating a hospital involves constant operational costs - from electricity and water to the cleaning and upkeep of facilities. HaH programs alleviate much of this financial burden by shifting care to the home setting and minimizing the need for expensive infrastructure ...

54 year old Jingjin "Kathy" Bian, who lives in Cupertino, was arraigned on felony charges of insurance fraud after a California Department of Insurance investigation revealed she allegedly received over $900,000 in undeserved long-term care insurance benefits for her and her father. Bian, a former insurance agent, was in a car accident in August 2018, resulting in a back injury and her filing claims to enact her long-term care benefits on her life insurance policy. The benefits were approved by her insurance company in January 2019 and she ended up receiving over $300,000 in benefits including for caregiver reimbursement. The Department of Insurance began its investigation after her insurance company suspected fraud. Through surveillance she was observed performing activities independently, with no caregiver present, directly contradicting her claimed disabilities and reasons needing for caregiver reimbursement. Bian was also the legal representative for her 81-year-old father, who lived with her and also had a life insurance policy with the same insurance company. In February 2018 Bian’s father was diagnosed with Parkinson’s disease and he filed a claim to enact the long-term care benefits on his insurance policy. The claim stated he required hands on assistance and required a walker when going outside. Bian’s father’s claim application for benefits was approved by the insurance company in February 2019 and he received over $600,000 in benefits. Surveillance observed Bian’s father performing activities independently, with no caregiver present, directly contradicting his claimed disabilities. The investigation found that Bian was listed as her father’s legal representative in all correspondence and that all of her father’s policy correspondence, care provider scheduling, and billing were handled by Bian. Bian’s alleged actions resulting in a loss of $900,000 to the insurance company. Bian is out on bail and is scheduled to return to court on April 16, 2025. The Santa Clara County District Attorney’s Office is prosecuting this case ...

The Leapfrog Hospital Safety Grade is the only hospital ratings program focused exclusively on preventing medical errors and patient harm. It is fully transparent, free to the public and updated biannually in the fall and spring. The Group released its fall 2024 Hospital Safety Grade, evaluating nearly 3,000 hospitals on their ability to prevent medical errors, accidents and infections. The Hospital Safety Grade uses up to 30 performance measures to assign an "A," "B," "C," "D" or "F" to individual hospitals and uses a public, peer-reviewed methodology, calculated by top patient safety experts under the guidance of a National Expert Panel. It is transparent and free to the public. Leapfrog analysts use the data to observe national performance trends and state rankings. For fall 2024, Utah ranks number one with the highest percentage of "A" hospitals for the third cycle in a row, followed by Virginia and Connecticut in second and third. The latest Grades also show hospitals are making progress in patient safety across several performance measures including notable improvements in healthcare-associated infections, hand hygiene and medication safety. "Preventable deaths and harm in hospitals have been a major policy concern for decades. So, it is good news that Leapfrog’s latest Safety Grades reveal that hospitals across the country are making notable gains in patient safety, saving countless lives," stated Leah Binder, President and CEO of The Leapfrog Group. "Next, we need hospitals to accelerate this progress - because no one should have to die from a preventable error in a hospital." Key findings on state performance on the fall 2024 Leapfrog Hospital Safety Grade include: - - The states with the highest percentages of "A" hospitals are Utah, Virginia, Connecticut, North Carolina, New Jersey, California, Rhode Island, Idaho, Pennsylvania, Colorado and South Carolina. - - Utah ranks #1 in percentage of "A" hospitals for the third Safety Grade cycle in a row. - - California ranks in the top 10 for the first time since fall 2014. - - There were no "A" hospitals in Iowa, North Dakota, South Dakota or Vermont. Regrettably, Pacifica Hospital of the Valley in Sun Valley California received a grade of "F" and seventeen California hospitals received a grade of "D." Pacifica Hosptial was rated "D" in fall of 2021, and fell to "F" in sprint 2022 and has remained at "F" ever since. Detailed hospital performance information, including patient experience and safety measures, as well as grades for individual hospitals searchable by states and localities is available at HospitalSafetyGrade.org ...

Veronica Katz was sentenced to two years in federal prison and ordered to pay $543,634.34 in restitution for committing health care fraud.The sentence was handed down by U.S. District Court Judge James Donato. Katz, 36, of San Francisco, was indicted by a federal grand jury on Oct. 17, 2023, along with two co-defendants. Katz pleaded guilty on Apr. 18, 2024, to one count of health care fraud. Katz was the owner and operator of HealthNow Home Healthcare and Hospice (HealthNow), a home health agency that provided in-home medical care to patients in the Bay Area. HealthNow billed Medicare and private insurance companies for in-home medical care. In the course of operating HealthNow, Katz submitted false documentation to Medicare in order to obtain reimbursements in violation of Medicare’s rules and regulations. According to Katz’s plea agreement, she participated in a scheme to defraud Medicare that took a number of forms, including using the identities of licensed medical practitioners on electronic medical records and billing information without the practitioners’ knowledge or consent; directing certain individuals to prepare "Start of Care" (SOC) forms even though the individuals were not Registered Nurses (RNs), as required by Medicare; manipulating electronic patient medical records in order to make it appear as if RNs had completed the patient SOCs; and billing Medicare for physical therapy services that Katz knew had not been provided. In addition, Katz admitted that she took steps to thwart law enforcement’s investigation into HealthNow. In October 2019, Katz met with one of her HealthNow employees, who informed Katz that Federal Bureau of Investigation (FBI) agents had questioned the employee regarding the company’s billing practices and SOC assessments. Katz instructed the employee to lie to the FBI and falsely state that the employee had been trained and supervised by an RN in the course of conducting SOC assessments. In addition to the term of imprisonment and restitution, Judge Donato also sentenced Katz to a three-year period of supervised release and ordered her to pay a $50,000 fine Katz will begin serving her sentence on Jan. 6, 2025. Co-defendant Vennesa Herrera pleaded guilty on Aug. 30, 2021, to conspiracy to commit health care fraud and health care fraud, and will be sentenced on Mar. 17, 2025. Co-defendant Simon Katz’s trial is scheduled for May 12, 2025. Assistant United States Attorney Christiaan Highsmith is prosecuting the case with the assistance of Helen Yee and Mark DiCenzo. The prosecution is the result of a lengthy investigation by the FBI, HHS-OIG, and the California Department of Public Health ...

In 1938, President Roosevelt signed the Fair Labor Standards Act (FLSA) into law. It was a landmark piece of civil rights legislation designed to protect the rights of workers. At the time, there was a fear that people with disabilities would be disadvantaged by the law and experience high rates of unemployment if employers had to pay comparable wages to people with and without disabilities. Therefore Section 14(c) of the FLSA (14(c)) was written into the law to allow employers to pay workers with disabilities lower wages. Accordingly, California also included similar exemptions in its state Labor Code, in Sections 1191 and 1191.5. The Fair Labor Standards Act authorizes the Secretary of Labor to issue certificates allowing employers to pay productivity-based subminimum wages to workers with disabilities, but only where such certificates are necessary to prevent the curtailment of opportunities for employment. Employment opportunities for individuals with disabilities have vastly expanded in recent decades, in part due to significant legal and policy developments. Section 14(c) was little known and rarely used until the 1950s when sheltered workshops began to flourish. Sheltered workshops were started with good intentions as parents were seeking a way to keep their children out of institutions. The law currently has about 40,000 American workers laboring for half the minimum wage or less, according to the Labor Department. However a proposed new rule, announced on December 4 with a Notice of Proposed Rulemaking (NPRM), would end the issuing of 14(c) certificates, which permit businesses to pay people with disabilities below the federal minimum wage of $7.25 an hour. If implemented, the proposal would phase out 14(c) certificates altogether over a 3-year period, ending subminimum wage nationwide. The Labor Department's proposal follows a review of the program, and the new rule would not take effect until a public comment period ends on Jan. 17, 2025, days before President-elect Donald Trump takes office. The new administration could review and respond to the comments and issue a final rule, or withdraw it entirely. If finalized, the proposed federal rule would not require workers with disabilities to leave their current places of employment and would not require current section 14(c) certificate holders to amend the employment setting or type of services they provide. Subminimum wage for disabled workers in California will however end this January. In 2021, Disability Rights California sponsored legislation to phase out subminimum wage in California. With the passage of SB 639 (Durazo), subminimum wage for Californians with disabilities will be fully phased out at the start of 2025. California joins more than a dozen states and the District of Columbia that have already banned the program. Today, unemployment rates among people with disabilities remain disproportionally high, despite the continued use of 14(c) and California exemptions. In 2019, California ranked 22nd in the nation for its employment of people with disabilities. People with disabilities experienced employment rates at 36.9 percent compared to 75.6 percent for their peers. Additionally, people with disabilities also represent a larger portion of the population not included in the labor force. Nationally, about 8 in 10 were not in the labor force in 2019, compared with about 3 in 10 of those with no disability ...

The Workers’ Compensation Insurance Rating Bureau of California (WCIRB) released the WCIRB Geo Study 2024, which underscores regional differences in claim characteristics across California. A web-based interactive map allows you to quickly view key measures across regions. The study’s key findings include the following: - - Even after controlling for regional differences in wages and industry mix, indemnity claim frequency continues to be significantly higher than the statewide average in the LA Basin and significantly lower than the statewide average in Northern California. This relationship has been fairly consistent over time, although the magnitude of the difference has fluctuated. - - The LA/Long Beach region has the highest claim frequency, more than 35% above the statewide average. - - The Yuba City/Redding/Far North and Peninsula/Silicon Valley regions have the lowest claim frequency, more than20% below the statewide average. - - Regional differences in indemnity claim severity are more muted than for claim frequency. The magnitude of the differences has been consistent over time, but the relative severities by region have fluctuated. The severity relativities shown are adjusted for classification mix. - - The highest severity cost is in SLO/Santa Barbara, which is more than 10% above the statewide average. - - The lowest severity costs are in the San Bernardino/West Riverside and Sacramento regions, around 6% below the statewide average. - - After adjustment for industry mix, regions with lower indemnity frequency tend to have a higher share of large claims, and there is a significant amount of variation among regions. - - Yuba City/Redding/Far North, Sonoma/Napa and Bay Area have shares of large claims that are above the statewide average. - - San Bernardino/West Riverside, LA/Long Beach and San Gabriel Valley/Pasadena have shares of large claims that are below the statewide average. - - There has been a slight increase in the statewide share of indemnity claims that include permanent disability from PY 2021 to PY 2022 at 18 months (RL 1), reversing the decreases since PY 2015 - - Southern California regions have higher shares of indemnity claims with permanent disability than Northern California regions. SLO/Santa Barbara, Tulare/Inyo and LA/Long Beach have the highest shares, with more than 28% of their indemnity claims having permanent disability. - - Sacramento, Stockton/Modesto/Merced, Bay Area and Peninsula/Silicon Valley have the lowest shares, with less than 22% of their indemnity claims having permanent disability. - - The share of indemnity claims that include permanent disability is more than 17% above the statewide average in LA/Long Beach and 15% below the statewide average in Ventura at 90 months. - - Southern California regions were more likely to have an increase in the share of CT claims. San Bernardino/West Riverside and LA/Long Beach (16) have had the largest increases at more than 2%. - - The statewide share of paid medical for medical-legal reports continued to increase and is at an all-time high for this regional study. The share increased in nearly all regions, but the magnitude varied by region. - - Medical-legal reports account for a significantly greater share of paid medical in the LA Basin than in the rest of the state. - - Santa Monica/San Fernando Valley, LA/Long Beach and San Gabriel Valley/Pasadena have the highest shares, more than 12%. - - Yuba City/Redding/Far North has the lowest share, less than 6%. - - The LA/Long Beach and Orange County regions had the highest share of litigated indemnity claims, at more than 12% above the statewide average. - - The Yuba City/Redding/Far North and Sonoma/Napa regions had the lowest shares of litigated indemnity claims, at more than 17% below the statewide average ...

Safety National® is a specialty insurance and reinsurance provider with its corporate headquarters in St. Louis Missouri . It is a wholly-owned subsidiary of Tokio Marine Holdings, Inc., a Tokyo-based global insurer with a presence in over 40 countries. Safety National just announced the winners of its annual Safety First Grant Program. Three policyholders will be awarded matching grants in order to develop the creative risk control ideas they submitted into formal safety programs. "As a market leader and safety advocate, we are committed to identifying industry innovation that reduces the risk of employee injury and illness," said Mark Wilhelm, Executive Chairman of Safety National. "Over the last 10 years, the Safety First Grant Program has funded 32 risk control projects, responding to the emerging needs of our clients while building a blueprint for safer workplaces." Winners of the 2024 program included: - - First Place: Berry Global was awarded the $10,000 matching grant for the addition of radar technology capable of detecting human motion inside of an industrial robot cell. This innovation will prevent dangerous machine restarts, which can result in significant injury. - - Second Place: Bigge Group was awarded the $5,000 matching grant toward the implementation of an enterprise-wide system used to monitor workplace temperature. These sensors can detect rising heat levels, mitigating heat-related illnesses. - - Third Place: Lam Research was awarded the $2,500 matching grant to install ergonomic improvement equipment, including over 30 pneumatic and electric adjustable tables. This technology will eliminate problematic manual material handling tasks that lead to musculoskeletal disorders. Nominees for the annual Safety First Grant Program must be an active Safety National policyholder with a risk-reducing solution that applies to the workers’ compensation line of coverage. The applied solutions must relate to an identifiable and quantifiable loss source and include an anticipated estimate of injury cost savings for the policyholder. "Each year, our applicants submit increasingly impressive innovative and creative risk management ideas for this program, finding new ways to build a safer workplace for their employees," said Matt McDonough, Assistant Vice President Risk Control of Safety National. "In celebrating these winning submissions, we hope other organizations are inspired to discover their next great risk-reducing solutions." Full details on the 2024 Safety First Grant Program winning solutions can be found on its website. The 2025 grant application period will open in June 2025 ...

Stephnie Trujillo filed a complaint against her former employer J-M Manufacturing Company (JMM) and four former coworkers David Merritt, David Moore, David Christian, and Chuck Clark.alleging five causes of action: 1) unlawful sexual/gender discrimination; 2) unlawful sexual/gender harassment; 3) failure to prevent sexual/gender discrimination, harassment, and retaliation; 4) retaliation for opposing forbidden practices; and 5) injunctive relief. On February 22, 2021, JMM reminded Trujillo that in 2012, she executed JMM’s arbitration agreement that required her to resolve any employment disputes by private arbitration. Based thereon, JMM asked Trujillo to submit to arbitration. A dispute arose regarding the applicability and validity of some of the terms of the pre-dispute arbitration agreement. After weeks of negotiating, the parties entered into a stipulation for arbitration, later signed as an order by the trial court. Court proceedings were stayed and the parties initiated arbitration in May 2021. JMM timely paid the arbitrator’s invoices for over a year. On October 18, 2022, the arbitrator contacted JMM and requested payment for the invoice with a due date of September 12, 2022. JMM immediately paid the invoice. Later that evening, Trujillo gave notice of her intent to withdraw from arbitration due to JMM’s late payment. She filed a motion to withdraw from arbitration pursuant to Code of Civil Procedure2 section 1281.98, which the trial court granted. The Court of Appeal reversed in the published case of Trujillo v. J-M Manufacturing Co., Inc. B331083 (December 2024). On appeal, JMM and the four coworkers argue the trial court erred in ruling that section 1281.98 applied. Appellants contend the statute does not apply to them because: 1) they entered into a post-dispute stipulation to arbitrate with mutually agreed upon terms, whereas the statute governs mandatory pre-dispute arbitration agreements; and 2) they were not the "drafting party" as defined in section 1280, subdivision (e). The Court of Appeal agreed. "We decide, in the first instance, whether the parties’ entry into a post-, not pre-, dispute arbitration agreement affects the applicability of section 1281.98. We note that every single appellate opinion we reviewed above involved arbitration arising from a pre-dispute arbitration agreement. Not a single case considered or addressed a section 1281.98 issue arising from a post-dispute arbitration agreement." "We conclude the Legislature intended to limit section 1281.98’s applicability to arbitration arising from a pre-dispute agreement. We so conclude because the Legislature provided us with a clear answer by reading section 1281.98 alongside section 1280. Section 1281.98, subdivision (a)(1) refers to the failure to timely pay arbitration fees by 'the drafting party,' a term defined by section 1280, subdivision (e) as 'the company or business that included a predispute arbitration provision in a contract with a consumer or employee.' " ...

Nowhere Santa Monica and eight other Nowhere LLCs operate nine organic grocery stores and cafes known as Erewhon in the Los Angeles area. A tenth LLC, Nowhere Holdco, is their managing member. Edgar Gonzalez worked for Nowhere Santa Monica at its Erewhon market for approximately five months. As a condition of employment, Gonzalez entered into an individual (i.e., non-class) arbitration agreement with Nowhere Santa Monica which provided that any dispute "between Nowhere Santa Monica, LLC DBA Erewhon-Santa Monica" and Gonzalez relating to his employment would be submitted to arbitration. On May 25, 2022, Gonzalez filed suit against the ten Nowhere entities,defining them as "Defendants" those ten entities plus "any of their parent, subsidiary, or affiliated companies." He alleged that he and the putative class members "were employees or former employees of Defendants covered by" the Labor Code and applicable Industrial Welfare Commission Wage Orders. In ten causes of action Gonzalez alleged defendants violated the Labor Code by failing to pay minimum and overtime wages; provide meal or rest periods; provide timely wages and accurate wage statements; indemnify employees for expenses; or pay for vested vacation time on termination of employment. These violations, Gonzalez alleged, constituted unfair business practices. The complaint, a 20-page block of unbroken, nondescript boilerplate, mentioned no employment agreement, described no work performed or control exerted over such work, and made no distinction between any of the ten defendants. The ten Nowhere entities filed a joint motion to compel Gonzalez to arbitrate his claims on an individual, non-class basis and to dismiss his class allegations. In support of the motion, Tom Wong, Nowhere Holdco’s Chief Financial Officer, declared that each Erewhon market had its own management team that supervised its own employees. Wong declared that Gonzalez worked for Nowhere Santa Monica at the Erewhon market in Santa Monica from May 27, 2021 to October 15, 2021, and never worked at any other Erewhon market or was employed by any defendant other than Nowhere Santa Monica. Gonzalez opposed the motion on the ground the non-Santa Monica Nowhere entities were not parties to the arbitration agreement. The trial court found no evidence that Gonzalez was "attempting to enforce any benefit as to the [non-Santa Monica] Defendants while refusing to arbitrate with them," and thus no evidence demonstrating that his "claims against the nonsignatory Defendants were 'intimately founded in and intertwined with' Plaintiff’s arbitrable claims against Nowhere Santa Monica." The court therefore granted the motion to compel individual arbitration as to Nowhere Santa Monica but denied it as to the other Nowhere entities. Gonzalez thereafter dismissed his complaint against Nowhere Santa Monica. The other Nowhere entities appeal. The Court of Appeal reversed in the published case of Gonzalez v. Nowhere Beverly Hills LLC -B328959 (December 2024). It is undisputed that an arbitration agreement exists between Gonzalez and Nowhere Santa Monica. The non-Santa Monica entities admit they are nonsignatories to this agreement, but contend they may enforce it under principles of equitable estoppel because Gonzalez’s (and the class’s) claims against all Nowhere entities depend on and are intertwined with Nowhere Santa Monica’s obligations under the employment agreement with Gonzalez. The Court of Appeal agreed. "Because arbitration is a matter of contract, the basic rule is that one must be a party to an arbitration agreement to be bound by it or invoke it - with limited exceptions." One exception is the doctrine of equitable estoppel, which as a general matter precludes a party from asserting rights it otherwise would have had against another when its own conduct renders assertion of those rights inequitable. In the arbitration context, "If a plaintiff relies on the terms of an agreement to assert his or her claims against a nonsignatory defendant, the plaintiff may be equitably estopped from repudiating the arbitration clause of that very agreement. In other words, a signatory to an agreement with an arbitration clause cannot . . . ‘on the one hand, seek to hold the non-signatory liable pursuant to duties imposed by the agreement, which contains an arbitration provision, but, on the other hand, deny arbitration’s applicability because the defendant is a non-signatory." Applying these principles, the Court of Appeal concluded that the trial court incorrectly denied the non-Santa Monica entities’ motion to compel arbitration because all of Gonzalez’s claims against them are intimately founded in and intertwined with the employment agreement with Nowhere Santa Monica, an agreement which contains an arbitration provision ...

The Division of Workers’ Compensation (DWC) has posted proposed changes to its Supplemental Job Displacement Benefits (SJDB) Rules and Forms on its online forum where members of the public may review and comment on the proposals. The SJDB Rules have not been updated since 2013. The proposed updates will: - - require additional itemization on vocational & return to work counselor (VRTWC) billings, - - require that education programs offered to injured workers be provided by California public schools or by schools included on the EDD list of approved training providers and schools, - - update the application process for the VRTWC list maintained by the Administrative Director, - - limit payments from the Supplemental Job Displacement Benefits for vocational counseling to persons on the VRTWC list, - - prohibit VRTCWs from holding financial interests in entities that receive proceeds from the SJDB voucher, - - create a process for removal of VRTCWs from the VRTCW list, and - - update the SJDB voucher form and instructions. The proposed changes will update the California Code of Regulations, Title 8, Chapter 4.5, Division of Workers’ Compensation, Article 7.5, Supplemental Job Displacement Benefits, Sections, 10133.31, 10133.32, 10133.58, 10133.59, 10133.59.1, 10133.59.2. These proposed changes will increase efficiencies in the SJDB voucher program, improve management of the VRTCW list, and provide safeguards against fraud within the system. The forum can be found online on the DWC forums web page under "current forums." Comments will be accepted on the forum until 5 p.m. on December 16, 2022 ...

The California Legislative Analyst’s Office released a report Monday detailing the urgent need to fix the state’s "broken" unemployment insurance system, which currently faces significant financial challenges incurred during the pandemic, including an outstanding $20 billion loan from the federal government. According to the Executive Summary the "State’s Unemployment Insurance (UI) Financing System Is Broken. The state’s UI program is supposed to be self-sufficient-that is, the system should collect enough funds to pay for benefits over time. This means, in some years, the system will collect more than necessary so that, during most economic downturns, there is enough money to pay for rising benefit costs. That system is broken: tax collections routinely fall short of covering benefit costs. (The state’s fiscal problems are unrelated to the widespread fraud that affected temporary federal UI programs during the pandemic.) Both our office and the administration expect these annual shortfalls to continue for the foreseeable future. Under our projections, deficits would average around $2 billion per year for the next five years. This outlook is unprecedented: although the state has, in the past, failed to build robust reserves during periods of economic growth, it has never before run persistent deficits during one of these periods." The state’s UI tax system requires a full redesign so that contributions: (1) cover benefit costs in most years and (2) build up a reserve that can be drawn down during recessions. The Report recommend four main areas of change: - - We recommend the Legislature increase the taxable wage base from $7,000 to $46,800, tying the taxable wage base to the amount of UI benefits a worker can actually receive ($450 per week). Taxing this level of earnings means no taxes would be paid on wages that are not covered by UI. This taxable wage base level would place California among the ten states with taxable wages bases above $40,000 and all other Western states. While necessary, this step alone would not be sufficient to address the state’s solvency problems. - - Following federal guidelines, we recommend the state adopt a simple, robust UI tax structure comprised of a standard tax rate and a reserve-building tax rate. The standard tax rate would cover typical UI benefit costs. The reserve-building rate would help the state build up a robust reserve that can be drawn down during recessions. Under current conditions, the standard tax rate would be 1.4 percent and the reserve-building rate would be 0.5 percent, for a total of 1.9 percent UI tax rate applied to our proposed $46,800 taxable wage base. - - We recommend the Legislature transition to a new experience rating system that bases employers’ tax rates on increases or decreases in their employment, rather than an exact accounting of their former workers’ UI costs (as the current system operates). This approach would continue to reflect, indirectly, employers’ costs to the UI system because business that reduce employment tend to have higher UI usage. Thus, this alternative approach maintains the policy goals of experience rating but does not suffer from the main downsides of the current system. - - The outstanding federal loan complicates the state’s efforts to fix its broken UI financing system: as long as the federal loan remains outstanding, even an improved tax system would probably not be able to build reserves ahead of the next recession. To address this, and in acknowledgment of the unique nature of the pandemic that caused the significant UI loan, we outline a shared approach to refinancing the federal loan. This would involve two equal parts: (1) a revenue bond paid back by employers and (2) new borrowing from the Pooled Money Investment Account paid back by the General Fund. The Executive Summary concludes by saying "The scope and magnitude of our recommendations reflect the deep problems in the existing UI system. These include: (1) the staggeringly large and growing loan from the federal government and (2) the fact that the system is currently running a deficit even during an economic expansion. These are significant problems in isolation, let alone in combination. The significant changes proposed in this report are an honest reflection of these problems. However, whether or not the Legislature takes action, employers will soon pay more in UI taxes than they do today due to escalating charges under federal law. Making changes now will allow the Legislature to make strategic choices about how to repay the federal loan, while also replacing the UI financing system with one that is simpler, balanced, and flexible." ...

The Division of Workers’ Compensation (DWC) announced it will be moving from the telephone conference lines used for status conferences, mandatory settlement conferences (MSCs), priority conferences, and lien conferences to the CourtCall video platform. All hearings currently heard via the conference lines will transition to the CourtCall video platform on March 1, 2025. CourtCall developed the Remote Appearance Platform, creating an organized and voluntary way for attorneys to appear for routine matters in Civil, Family, Criminal, Probate, Bankruptcy, Workers' Compensation and other cases from their offices, homes or other convenient locations. Designed with reliable and user-friendly technologies, Courts and remote participants experience seamless communication during cases, while benefiting from significant time and cost savings. According to its website, CourtCall says it benefits judges and court staff in the following ways" - - Reduces the cost of litigation - - Less crowded courtrooms and increased security - - More efficient case flow - - Increases public access - - Connects all relevant parties, regardless of their locations - - "Privacy" and "Open Court" services available - - More efficient courtroom logistics; eliminates work for busy Court Staff Today, CourtCall says it remains the industry leader in providing supported Remote Legal Collaboration services throughout the United States, Canada and Worldwide. They maintain an updated list of the Courts they serve across the Nation. Each judge will have a link to their virtual courtroom on the CourtCall video platform. In the coming months, these links will be posted on DWC’s website and included on hearing notices. Every courtroom will also have a call-in number if needed by the parties. Training videos will be available on the DWC website. DWC believes that this technological upgrade will provide greater functionality for hearings and allow parties more flexibility during the conference process. There will be no charge to the parties for this service. All trials, lien trials, and expedited hearings will continue to be set in person. DWC will provide regular updates regarding the conversion timeline via its Newslines ...