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.

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.

Northern California’s largest hospital chain prevailed in a landmark federal antitrust lawsuit claiming its contracting practices with insurers drove up the cost of premiums for millions of Californians.

Court House News reports that a nine-member jury unanimously found Sutter Health did not abuse its market power by forcing five major California health insurers to agree to all-or-nothing contracts that tied seven largely rural areas of the state where Sutter had the only hospital around to hospitals in areas with more competition.

The jury answered “no” to two critical questions. The first was whether Sutter sold inpatient hospital services in one or more tying hospitals located in Berkeley-Oakland, Antioch, Auburn, Crescent City, Davis, Jackson, Lakeport and Tracy, on the condition that health plans also include San Francisco, Sacramento, Santa Rosa and Modesto-based hospitals in their networks.

The second was whether Sutter’s contract terms preventing insurers from steering consumers toward cheaper care providers, or using tiered plans as an incentive for patients to go elsewhere.

The verdict is the culmination of 10 years of legal wrangling. Originally filed in 2012, the case has survived multiple motions to dismiss and a trip to the Ninth Circuit Court. In 2016, the appellate court reversed a federal judge’s order dismissing the case, finding the plaintiffs had alleged sufficiently detailed geographic markets for inpatient hospital services.

The lead plaintiffs – a handful of individuals and two small businesses – claimed Sutter’s practices caused 3 million California families and businesses to collectively pay nearly $411 million in insurance premium overcharges between 2011 and 2017.

The case was the first antitrust class action against the giant hospital network to go before a jury. Two similar state actions brought by a group of employers and unions in 2014 and California’s attorney general in 2018 settled just hours before the start of trial. Sutter agreed to pay $575 million and change some of its business practices “to restore competition in Northern California’s health care market.”

The four-week trial took place in a sealed courtroom in San Francisco. Though the press and the public were allowed access to the proceedings through a phone line and separate video feed in another courtroom, the trial was marked by frequent periods of confidential testimony, mostly at the request of the insurance companies.

Through testimony offered by its executives, Sutter argued that its contracting practices allowed them to better predict patient volume, which translates to revenue. For a nonprofit system like Sutter Health, more revenue means more resources that can be put back into improving hospital quality and patient care, and more funds to invest in innovative treatments and technology.

Sutter also asserted that Kaiser Permanente, one of the nation’s largest non-profit hospital systems with a growing presence in California, neutralized its market power by taking a large portion of Sutter’s market share. During the trial, LeVee presented the jury with a pie chart indicating that Sutter only has 25% market share in Northern California. Factoring in Kaiser, Sutter’s share went down to 17%.

It was an argument that persuaded at least one juror, who said Kaiser’s presence factored into her decision. “We don’t live in a vacuum with Kaiser,” said the juror, who asked not to be named.

“This case was difficult and we certainly saw both sides of the case,” she said. But ultimately, she did not believe the plaintiffs had done a sufficient job of proving their claims. Another juror, who also asked that his name be withheld, agreed, saying “This was a very complicated case for a jury to decide and both sides did a good job.” While he believed Kaiser does compete with Sutter for market share, his decision boiled down to whether the plaintiffs could prove that they had suffered $411 million in damages.

A federal workplace safety investigation found that a 34-year-old worker’s fatal fall might have been prevented had the operator of a Pauma Valley zip-line attraction implemented required safety measures.

ABC 10 News of San Diego reported that Joaquin Romero, 34, of Banning, Calif., died of multiple blunt force trauma injuries after he fell from a receiving platform of a zip line while trying to help a rider. The incident occurred at the Zip Zoom Zipline located on the La Jolla Indian Reservation, according to the La Jolla Band Of Luiseno Indians.

According to Fox 5, a witness said Romero was helping a woman get hooked on the platform when she started sliding out on the line. He couldn’t stop her and grabbed onto her harness, which caused them both to slide out about a hundred feet above the ground, according to the witness.

The friend said Romero feared the woman could fall because of the weight, so he made a heroic decision to let go. According to the witness, the woman was not injured.

Cal Fire crews hoisted Romero up in a rescue basket, and he was airlifted to Sharp Memorial Hospital. The county medical examiner said Romero arrived without a pulse. After admission to the hospital, a poor prognosis was given by medical staff and Romero’s family decided to place him on comfort care measures until he was pronounced dead, the ME added.

The zip line course had billed itself as the longest of its kind in Southern California, with lines running across canyons, valleys, treetops and the San Luis Rey River. The three zipline courses at the attraction range from 300 to 2,700 feet in length and reach speeds up to 55 miles per hour. It opened in 2015.

A U.S. Department of Labor Occupational Safety and Health Administration investigation inspectors found La Jolla Zip Zoom Ziplines failed to install a guardrail, safety net or personal fall arrest system. The company also did not train employees on fall hazards and how to recognize them, as required. Additionally, OSHA determined that the company failed to assess the workplace to determine the presence of hazards and did not report a work-related hospitalization within 24 hours.

OSHA cited the company for four serious safety violations and proposed $24,861 in penalties. La Jolla Zip Zoom Ziplines is also accused of failing to train employees about fall hazards and failing to assess the workplace for hazards.

OSHA Area Director Derek Engard said,”La Jolla Zip Zoom Ziplines failed to meet their obligation to protect their employees,” OSHA Area Director Derek Engard in San Diego. “If they had simply provided the proper protective equipment, this senseless tragedy could have been prevented.”

The company has 15 business days from receipt of its citations and penalties to comply, request an informal conference with OSHA’s area director, or contest the findings before the independent Occupational Safety and Health Review Commission.

CorVel Corporation presented its Critical Incident Stress Debriefing program, highlighting positive outcomes with the City of Beverly Hills, at the annual Public Agency Risk Management Association (PARMA) meeting on March 1, 2022, in Anaheim, California.

Critical incident stress debriefing has been around for many years. However, it has recently re-emerged as a tool for employers facing several challenges in our current climate.

Originally designed for responders to traumatic events, critical incident stress debriefing (CISD) is a structured, brief intervention provided in a small group setting immediately following a crisis. It’s designed to help people process the event to minimize symptoms of traumatic stress, depression, and anxiety. Critical incident debriefing typically consists of seven stages, and altogether, it lasts approximately three hours or less.

“Critical incident” is another term for a traumatic event. It includes any occurrence faced by public safety responders, emergency workers, and related personnel that causes distress and disruption to typical psychological or physiological functioning. Critical incidents often involve death or extreme threats to safety, life, and well-being.

It was developed in 1974 by Dr. Jeffrey Mitchell, a former firefighter and paramedic, as one component of a broader critical incident stress management (CISM) program.

During the presentation, Tyla A. DiMaria, RN, Case Management Manager for CorVel, discussed the company’s patient-centered approach that helps employees who have witnessed a catastrophic or traumatic event process the situation, work through the hurdles and develop coping mechanisms to return to work as quickly as possible.

“These past two years have put a spotlight on mental health, as people have been dealing with the stresses of illness, death, civil unrest, isolation and so many other difficult situations,” DiMaria said. “We’ve seen a significant increase in depression, anxiety, crippling fear and other mental health issues, especially for essential workers, and these challenges must be addressed and not ignored.”

Last year, CorVel’s program was expanded to address COVID-19 traumatic stress – a syndrome developing due to the significant mental health challenges associated with the pandemic.

During the presentation, DiMaria outlined how the City of Beverly Hills partnered with CorVel to implement a critical incident and COVID-19 traumatic stress debriefing program for city employees, improving return to work and positively impacting overall costs and outcomes.

“We are very proud of our expanded Critical Incident Stress Debriefing program, which places emphasis on the injured worker and their overall wellbeing,” said Karen Thomas, Vice President, Clinical Solutions at CorVel.

“At CorVel, we take a patient-centered approach to claims management to ensure that the injured worker feels supported throughout the process, regardless of the type of illness or injury. By taking a proactive approach to mental health, we can improve outcomes and reduce costs for customers while increasing satisfaction and care for injured workers.”