Tag: 2024 News

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.

Governor Gavin Newsom signed Senate Bill 988, the Freelance Worker Protection Act (FWPA), into law on September 28, 2024. Codified at California Business & Professions Code Section 18100 et seq., the FWPA imposes requirements on individuals and companies that hire freelance workers for specified “professional services.” The companies that use freelance workers are required to comply with this new law starting January 1st.

The law is applicable to a “hiring party” which means a person or organization in the State of California that retains a freelance worker to provide professional services, with certain limited excepts such as the United States or State of California or any foreign government.

Among other mandates, whenever a hiring party retains the services of a freelance worker, the contract between the hiring party and the freelance worker shall be in writing. The hiring party shall furnish a signed copy of the written contract, either physically or electronically, to the freelance worker. The hiring party shall retain the contract for no less than four years.

Certain time limits are specified for making payment. Except as otherwise provided by law, a hiring party shall pay a freelance worker the compensation specified by a contract for professional services on or before the date compensation is due pursuant to the contract. If the contract does not specify when the hiring party shall pay, no later than 30 days after the completion of the freelance worker’s services under the contract.

An aggrieved freelance worker or a public prosecutor may bring a civil action to enforce this new law. A prevailing plaintiff in an action alleging a violation of this law is entitled to reasonable attorney’s fees and costs, injunctive relief, and any other remedies deemed appropriate by the court.

The Legislative Analysis that discussed this new law claimed that “for several decades, the employer-employee relationship was put under pressure due to the increased use of independent contractors and the misclassification of employees. The issue culminated with a 2018 Supreme Court decision, Dynamex Operations West, Inc. v. Superior Court (2018) 4 Cal.5th 903. Under Dynamex, the test for whether a worker is an independent contractor or an employee was simplified to a three-prong test.”

“Freelance workers contribute essential services to our homes and businesses and are one of the fastest growing sectors of the workforce. As noted above, because freelance workers are not employees but independent contractors, they typically do not receive the same protections against wage theft. Efforts to enact laws protecting freelance workers have begun to pass in several states and localities.”

Indeed freelance workers in the City of Los Angeles received more protections with the Los Angeles City Council’s adoption on February 24, 2023 of Ordinance 187782 which was intended to protect the Freelance industry. The City of Los Angeles law became effective on July 1, 2023 and Los Angeles hirers must now comply with the provisions of this ordinance as well as state and federal and any other local ordinance that might cover the hiring.

In 2017, New York City was the first to pass a law, the “Freelance Isn’t Free Act,” which made significant changes to entities utilizing independent contractors for projects costing $800 or more. Specifically, the law requires a written contract, timely and full payment, and protection from retaliation. The law also establishes penalties for violations of these rights, including statutory damages, double damages, injunctive relief, and attorney’s fees.

In 2023, Illinois enacted similar protections by adopting the “Freelance Worker Protection Act,” to take effect July 1, 2024.

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.”

The U.S. Department of Transportation (DOT) announced a $50 million penalty against American Airlines for numerous serious violations of the laws protecting airline passengers with disabilities between 2019 and 2023. DOT’s investigation into American Airlines uncovered cases of unsafe physical assistance that at times resulted in injuries and undignified treatment of wheelchair users, in addition to repeated failures to provide prompt wheelchair assistance. American also mishandled thousands of wheelchairs by damaging them or delaying their return, leaving travelers without the device they need for mobility.

DOT regulations require airlines to timely return wheelchairs and other mobility devices in the condition in which they were received and to provide passengers with disabilities prompt assistance to get on and off aircraft including moving within the airport. The Department also considers violations of these regulations for those traveling on domestic flights to be a failure to provide safe and adequate service. In July 2022, DOT published the first-ever Airline Passengers with Disabilities Bill of Rights to help travelers understand what they’re entitled to when they fly.

In its investigation of American Airlines, DOT reviewed complaints against the airline involving allegations of inadequate wheelchair assistance, including three formal complaints filed by Paralyzed Veterans of America alleging similar issues. DOT also investigated American’s handling of wheelchairs between 2019 and 2023, including an incident captured on video at the Miami International Airport of American’s personnel mishandling a wheelchair by dropping it down a baggage ramp. American had been one of the worst performers among U.S. airlines in terms of both the total number of wheelchairs and scooters mishandling claims and the rate of mishandling claims, and DOT’s investigation revealed a significant number of violations.

These problems are not unique to American Airlines, and allegations of wheelchair mishandling and inadequate wheelchair assistance are far too common. DOT has active investigations into similar violations at other U.S. airlines. Today’s enforcement action is 25 times larger than DOT’s previous largest airline penalty for violations of disability protections and sets a new precedent for how DOT will enforce against such violations going forward.

The U.S. Department of Justice’s Civil Rights Division provided valuable assistance and advice to DOT during the negotiation of this penalty

As part of the $50 million penalty, American Airlines will be required to pay a $25 million fine to the U.S. Treasury. In addition, American Airlines will be credited $25 million towards the total penalty for investments in equipment to reduce incidents of wheelchair damage, investments in a systemwide wheelchair tagging system to reduce incidents of wheelchair delay, deployment of hub control center employees to coordinate wheelchair handling on a systemwide basis at large airports, and compensation for affected passengers during the timeframe covered by DOT’s investigation. If these expenditures are not made, the additional $25 million will be paid as a fine to the U.S. Treasury.

DOT has sought higher penalties that go beyond the cost of doing business to better hold airlines accountable for the mistreatment of passengers and change airline behavior. Between 1996 and 2020, DOT collectively issued $71 million in total penalties against airlines for consumer protection and civil rights violations. During the current Administration, DOT has tripled that amount, issuing nearly $225 million in penalties, including the following:

– – DOT’s largest ever airline penalty: $140 million against Southwest Airlines for its 2022 meltdown during Winter Storm Elliot.
– – DOT’s largest airline penalty for religious discrimination: $4 million against Lufthansa for denying boarding to 128 Jewish passengers.
– – DOT’s largest airline penalty for extreme tarmac delays: $4.1 million against American Airlines for dozens of instances where passengers were kept on the tarmac for 3+ hours.

DOT claims it has also taken historic action to improve transportation for people with disabilities in air travel.

– – Published the Airline Passengers with Disabilities Bill of Rights, which describes the fundamental rights of air travelers with disabilities under the Air Carrier Access Act and its implementing regulation.
– – Established a final rule on accessible lavatories on aircraft, requiring airlines to make lavatories on new single-aisle aircraft large enough to permit a passenger with a disability and an attendant to approach, enter, and maneuver within as necessary to use the aircraft lavatory.
– – Funded accessibility improvements at airports through the Bipartisan Infrastructure Law Airport Terminals Program. Nearly 150 projects funded under this program are improving airport terminal access for people with disabilities and ensuring compliance with the Americans with Disabilities Act.
– – Proposed a new rule to ensure safe and dignified accommodations for air travelers with disabilities using wheelchairs. The proposed rule would set new standards for assistance, mandate enhanced training for airline employees and contractors who physically assist passengers with disabilities and handle passengers’ wheelchairs, and outline actions that airlines must take to protect passengers when a wheelchair is damaged during transport. DOT is currently working towards issuing a final rule.