Amazon Web Services (AWS) announced the inaugural AWS IMAGINE Grant: Children’s Health Innovation Award, which recognizes visionary institutions in the nonprofit healthcare sector who are using generative artificial intelligence (AI) and advanced cloud services to drive progress across critical children’s health domains.

This group represents AWS’s first cohort of recipients of the investment in children’s health announced earlier this summer. The goal is to empower nonprofit organizations to leverage cloud technology in order to accelerate their mission. The IMAGINE Grant program offers support both financially and strategically to the grant winners. As part of the program, it asked for proposals for pilot projects, proofs of concept, or existing programs that utilize technology in a new or expanded way.

The event gathered leaders and innovators to discuss how technology can positively impact healthcare and health research globally.

“We are thrilled to support these organizations as they pursue groundbreaking advancements in children’s health, pediatric care, and research enabled by the AWS Cloud,” said Dave Levy, head of worldwide public sector at AWS. “From applications of generative AI to enable precision care in pediatric genomics, to AI-powered tools for physicians that will provide access to more data insights than ever before, these organizations have bold plans to improve children’s health outcomes on a global scale. We’re excited to work closely with them to realize these goals with cloud technology.”

The tech giant selected nine winners from across the globe on Oct. 30. The 2024 Children’s Health Innovation Award recipients are: Texas Children’s Hospital, Rady Children’s Hospital and Institute for Genomic Medicine, Children’s Mercy Hospital,Memorial Sloan Kettering Cancer Center, Association of Public Health Laboratories, Elizabeth Glaser Pediatric Aids Foundation, Brightpoint, Great Ormond Street Hospital, and Centre Hospitalier Universitaire Sainte-Justine.

San Diego based Rady Children’s Hospital and Institute for Genomic Medicine is building pediatric genomics large language models (LLMs) to improve treatment of rare pediatric diseases, the Elizabeth Glaser Pediatric Aids Foundation is applying generative AI techniques to provide clinicians with real-time insights into HIV patient risks in children, and Memorial Sloan Kettering (MSK) Cancer Center is developing advanced machine learning (ML) and generative AI models that will drive improvements in translational research and broad-scale changes in precision cancer care for children worldwide. These are just a few of the high-impact projects planned by grant recipients.

Rady Children’s Institute for Genomic Medicine is a non-profit research organization embedded within Rady Children’s Hospital-San Diego. It pioneered a medical revolution to end the diagnostic odyssey for neonatal and pediatric rare disease. It is now moving to end the therapeutic odyssey.

The Genetics Division of UCSD Medical School is actively involved in clinical care, research, teaching and service. The Division sees more than 4,000 patients per year in a variety of clinics, primarily as outpatients at Rady Children’s Hospital-San Diego (RCHSD), but also throughout Southern California, and in Mexico. The Division has an active inpatient consult service, and also sees more than 500 inpatients per year. Faculty members in the Division presently hold more than $6 million in grants and contracts, and have published over 60 original articles and chapters within the last two years.

“Leveraging AI and cloud computing is a critical step for Rady Children’s Institute for Genomic Medicine as we work towards making genetic testing more equitable, inexpensive and widely available,” said Matthew Bainbridge, Ph.D, Supervising Research Scientist at Rady Genomics, a nonprofit research institute at Rady Children’s Hospital San Diego. “Working with AWS allows us to utilize their expertise in AI and cloud computing to improve the speed and access to pediatric genetic testing, ultimately shortening a child’s diagnostic odyssey.”

These organizations are poised to drive transformation across a variety of children’s health disciplines, with this cycle focusing on projects that accelerate pediatric research,o advance maternal child total health, and empower the pediatric workforce and caregivers.

As hospitals reconsider how and where they deliver care to patients, many are seeing the hospital-at-home model as a promising approach to improve value. Hospital-at-home enable some patients who need acute-level care to receive care in their homes, rather than in a hospital. This care delivery model has been shown to reduce costs, improve outcomes and enhance the patient experience.

In November 2020, the Centers for Medicare & Medicaid Services launched the Acute Hospital Care At Home program to provide hospitals expanded flexibility to care for patients in their homes.

On September 30, 2024, the Centers for Medicare & Medicaid Services (CMS) released a report on the agency’s study of the Acute Hospital Care at Home (AHCAH) initiative, which allows certain Medicare-certified hospitals to treat patients with inpatient-level care at home. While the initiative was launched during the COVID-19 public health emergency (PHE), the Consolidated Appropriations Act, 2023 (CAA, 2023) extended the waivers and flexibilities associated with the AHCAH initiative until December 31, 2024. The CAA, 2023 also required CMS to conduct a study and analysis on the AHCAH initiative and post such a report on a CMS website by September 30, 2024.

The new study fulfills the requirement in the CAA, 2023, and evaluates several aspects of the AHCAH initiative, including:

– – Criteria participating hospitals used to determine which individuals would qualify to receive services under AHCAH.
– – Demographic information on beneficiaries treated under the initiative.
– – Clinical conditions treated and diagnosis-related groups associated with discharges from the inpatient setting versus those under AHCAH.
– – Quality of patient care for those patients treated in the brick-and-mortar inpatient setting relative to patients with similar conditions and characteristics treated under AHCAH.
– – Beneficiary and caregiver experience with AHCAH.
– – Medicare spending and utilization for patients who received care in the inpatient setting and through AHCAH.
– – Quantity, mix, and intensity of services furnished through brick-and-mortar inpatient care relative to those served under the AHCAH initiative.

The study found that AHCAH-approved hospitals used a variety of sources and methods to establish patient selection criteria to determine which individuals would qualify for AHCAH services. These criteria were largely rooted in published hospital at home (HaH) literature, in addition to the individual hospital’s experience and resource capabilities to provide inpatient-level care in the home environment.

Participating hospitals indicated that these criteria were developed and utilized with the intent to ensure that eligible patients were willing and able to participate in a HaH program, that such patients were clinically and psychosocially appropriate to safely receive care in the home, and that patients’ home and community environments were conducive to the safe and effective provision of acute inpatient care at home.

CMS hosted a series of four virtual listening sessions with various groups of stakeholders, including patients and caregivers who had participated in the AHCAH initiative, to learn about their experiences with care and gather feedback on ways to improve the program. Additionally, CMS collected anecdotal information on shared lessons learned through site visits, direct correspondence with patients and hospital program operators, and other means, contributing to the qualitative analysis of beneficiaries’ experiences with the AHCAH initiative.

Overall, the information collected and detailed in the study suggests that patients and caregivers had positive experiences with the care provided in the home setting through the AHCAH initiative. The feedback was generally consistent with evidence concerning patient experience with HaH programs more broadly. This positive feedback was mirrored by clinicians’ experiences providing care to patients under the AHCAH initiative. More detailed findings on the patient experience of care under AHCAH and the interpretation and limitations of the underlying data and analysis are presented in the report.

The American Hospital Association has considerable information about providing HaH services for it’s members, as does the California Hospital Association.

Milton C. Grimes, a long-time Los Angeles lawyer, pleaded guilty to evading the payment of more than $4 million in federal taxes over a 21-year period.

Grimes pleaded guilty to one count of tax evasion relating to his 2014 taxes, admitting that he failed to pay $1,690,922 to the IRS. He was the man who served as the lead attorney for Rodney King about three decades ago has been payed close attention to the events that led to the death of George Floyd.

Grimes was responsible for winning a $3.8 million civil claim on behalf of King, the Black motorist who became the most infamous victim of police brutality in the history of America.

It is not the first time tax charges have been leveled against Grimes. Not long after the lawyer made national headlines representing accused murderer Sheryl Lynn Massip – who was charged with running over her infant son with the family Volvo in 1987, Grimes pled guilty in 1988 to three counts of willfully failing to file a tax return. (Rev. & Tax. Code, § 19401.)

According to his plea agreement, Grimes did not pay federal income taxes due for 23 years, 2002 through 2005, 2007, 2009 through 2011, and 2014 through 2023 – a total of $4,071,215 owed to the IRS. Grimes also admitted he did not file a 2013 tax return with the IRS.      

From at least September 2011, the IRS attempted to collect Grimes’ taxes by issuing more than 30 levies on his personal bank accounts. However, from at least May 2014 to April 2020, Grimes willfully evaded the payment of the outstanding income tax owed to the IRS by not depositing income he earned from his clients into his personal bank accounts that were subject to levy.

Instead, Grimes purchased approximately 238 cashier’s checks totaling $16 million to keep the money out of the reach of the IRS. Grimes would routinely purchase cashier’s checks and withdraw cash from his client trust account, his Interest on Lawyers’ Trust Accounts (IOLTA), and his law firm’s bank account, rather than pay the IRS.

For example, on December 5, 2018, Grimes purchased nine cashier’s checks worth approximately $1,001,961, following the deposit of the same amount and on the same date into his IOLTA bank account.

United States District Judge Stanley Blumenfeld Jr. scheduled a February 11, 2025, sentencing hearing, at which time Grimes will face a statutory maximum sentence of five years in federal prison. Prosecutors have agreed to seek a prison sentence of no more than 22 months for Grimes.

IRS Criminal Investigation investigated this matter.

Assistant United States Attorneys Valerie L. Makarewicz and Sarah S. Lee of the Major Frauds Section and Trial Attorney Sara A. Henderson of the Justice Department’s Tax Division are prosecuting the case.

Back in 2012, a blistering study titled “Rogue Rehabs: State failed to police drug and alcohol homes, with deadly results” took no prisoners. It was done by the California Senate Office of Oversight and Outcomes and the department overseeing addiction treatment was dismantled in its wake — and DHCS was born. To, like, fix things. Perhaps it’s time to examine how well that’s worked out?

The State Auditor released a long-awaited study on how California regulates its (fraud-prone) addiction treatment industry. It confirmed that there are serious issues, and that Orange County in particular and Southern California in general are the epicenters, and that there are steps lawmakers can and should take to make things better.

While the audit didn’t mention the many federal prosecutions for body brokering and insurance fraud currently underway in O.C. and L.A., it did back up some general assertions. Key Findings of the State Auditor:

– – There were approximately 500 small facilities in California in 2023, and we identified groupings of such facilities in specific geographic areas throughout the State. For example, we found several small facilities with the same owner located next door to or across the street from each other in residential neighborhoods in Orange County and in San Diego County.
– – State law mandates that small facilities must be considered a residential use of property for purposes of any zoning ordinance. Because local authorities may use zoning requirements to regulate facilities serving more than six residents (large facilities) more strictly than small facilities, some facility operators may avoid certain zoning regulations by intentionally grouping small facilities in the same geographic area instead of establishing one large facility.
– – Although required to assign a complaint to an investigator within 10 days, Health Care Services frequently does not assign complaints on time. The audit found that it took Health Care Services an average of 183 days to assign the complaints when it did not meet its 10-day required time frame.
– – The department’s internal guidelines generally identify that investigative reports must be submitted by the analyst to a supervisor within 30 to 60 days. However, the audit found that it took Health Care Services analysts nearly one year on average to submit investigative reports for low – and medium – priority complaints.
– – Health Care Services completed high – priority investigations, such as those relating to resident deaths, within an average of less than three months but still did not meet its guidelines.
– – Health Care Services did not always conduct site visits when investigating unlicensed facilities and did not always follow up after completing investigations of unlicensed facilities that were unlawfully advertising or providing services to ensure that they ceased doing so.

For Sen. Tom Umberg, D-Santa Ana, the audit confirms what he and other lawmakers have been saying for years: DHCS is seriously under-sourced, takes forever to investigate complaints, can’t do frequent-enough inspections or enforce the laws.

The Auditor had recommendations to improve oversight. “Legislature could potentially change state law if these facility concentrations are not consistent with the law’s intent, which we believe was to integrate residents of these facilities into the communities and to provide for sufficient numbers and types of treatment services to meet local needs.”

The auditor also recommended that DHCS fill its vacant positions, improve the timeliness of inspections and complaint investigations, do additional site visits and follow up with unlicensed facilities to ensure they stop providing or advertising services beyond their reach.

“We have a road map here,” said Assemblymember Diane Dixon, R-Newport Beach, who requested the audit more than a year ago. “It confirms key concerns that are now validated by third-party analysis: Investigations take too long, sometimes don’t even happen, and there can be infrequent follow-up. It will help us shape legislation based on these facts.”

Dixon quickly assembled lawmakers after the report to push the governor and Department of Health Care Services (DHCS) Director Michelle Baass for greater accountability and an increase in the number of inspectors. “We’re coming together for solutions,” she said. “We want people to get well.”

In its response, Baass said the department is already implementing many of the auditor’s recommendations and “is committed to robust oversight of residential treatment facilities to ensure Californians receive safe and high-quality care.” According to the Audit Report “Health Care Services agreed with our findings and, in some cases, has already begun implementing the recommendations that we directed to it.”