GO AHEAD AND CALL THE OVERSIGHT
HEARING OF THE JOINT
LEGISLATIVE AUDIT COMMITTEE TO
ORDER TODAY WHICH IS WE WILL BE
DISCUSSING THE FINDINGS AND
RECOMMENDATIONS IDENTIFIED BY
THE STATE HONOR THE AUDIT
REPORT RELEASED IN NOVEMBER. I
JUST TWO MONTHS OLD TWO MONTHS
AGO TITLED- DEPARTMENT OF
INDUSTRIAL RELATIONS ITS
FAILURE TO ADEQUATELY
ADMINISTER THE QUALIFIED
MEDICAL EVALUATION PROCESS- MAY
DELAY INJURED WORKERS ACCESS TO
BENEFITS WANT TO THANK ASSEMBLY
MEMBER RUBIO FOR REQUESTING THE
AUDITS- ENSURING THAT.
CALIFORNIANS WITH JOB RELATED
INJURIES RECEIVE WORKERS
COMPENSATION BENEFITS IN A
TIMELY MANNER IS AN IMPORTANT
WORTHWHILE ISSUE. HI WHAT MANY
OF US HAVE NOT SUFFERED A
SERIOUS. INJURY AT WORK KNOCK
ON WOOD MANY CALIFORNIANS HAVE.
FOR MORE THAN SIX HUNDRED AND
EIGHTY THOUSAND WORKERS
COMPENSATION CLAIMS IN FISCAL
YEAR TWENTY SEVENTEEN EIGHTEEN
HUNDRED THOUSAND OF THESE
CLAIMS INVOLVED A QUALIFIED
MEDICAL EVALUATOR. AS MANY
PEOPLE HERE TODAY MAY KNOW
QUALIFIED MEDICAL EVALUATORS
ARE PHYSICIANS WHO EXAMINE
INJURED WORKERS WHEN DISPUTES
ARISE BETWEEN WORKERS AND THEIR
EMPLOYERS REGARDING MEDICAL
ISSUES. BECAUSE OF THESE
DISPUTES AND DISPUTES WHETHER
WORK BECAUSE THE INJURY. THE
EXISTENCE OR EXTENT OF A
PERMANENT DISABILITY OR THE
NEED FOR FUTURE MEDICAL CARE.
TODAY WE WILL DISCUSS THE
RESULT OF AN AUDIT AT THE
DEPARTMENT OF INDUSTRIAL
RELATIONS REGARDING ITS
ADMINISTRATION OF QUALIFIED
MEDICAL EVALUATORS WILL ALSO
DISCUSS THE DEPARTMENT'S PLANS
FOR IMPLEMENTING CHANGES. AND
CORRECTIVE ACTIONS INCLUDING
THE STATE AUDITOR'S
RECOMMENDATIONS TO HELP INSURE
THAT THERE ARE ENOUGH MEDICAL
EXAMINERS THAT THE DISCIPLINE
PROCESS FOR THE MEDICAL
EVALUATORS. IS APPROPRIATE AND
MEDICAL REPORTS ARE COMPLETE
AND MEET STANDARDS.
ASSEMBLYMEMBER REYES I HAVE.
ALREADY IN. SOME WOMEN REYES I
HAVE A BILL THAT WOULD
IMPLEMENT ONE OF THE STATE
AUDITOR'S KEY RECOMMENDATIONS
A. B. THIRTEEN EIGHTY. WHICH IS
AIMED AT INCREASING THE
INCENTIVE AND PAY FOR MEDICAL
EVALUATORS TO ENSURE WE HAVE
ENOUGH OF THEM. AS OUR REPORT
POINTS OUT OTHER RATES HAVE NOT
BEEN UPDATED OR INCREASE SINCE
TWO THOUSAND. AND AS A STATE
AUDITOR FOUND THE DEPARTMENT
HAS NOT INSURE THAT IT HAS
ENOUGH MEDICAL EVALUATORS KEEP
UP WITH THE GROWING DEMAND FOR
THEIR SERVICES. AS STATED IN
THE REPORT THE LACK OF
SUFFICIENT MEDICAL EVALUATORS
CAN DELAY INJURED WORKERS
ACCESS TO BENEFITS AND ALSO
INCREASED COSTS FOR EMPLOYERS.
MY GOALS FOR THIS OVERSIGHT
HEARING IS THAT WE CAN EXPECT
WHAT THE STATE AUDITOR FOUND
DURING THE AUDITS. ALSO TO SEE
A COMMITMENT FROM THE
DEPARTMENT TO DO WHAT IS
NECESSARY TO MAKE IMPROVEMENTS
TO HELP ACHIEVE MISSION OF
MINIMIZING THE ADVERSE IMPACT.
OF WORK RELATED INJURIES ON
CALIFORNIA EMPLOYEES AND
EMPLOYERS. THE BOTTOM LINE IS
WE WANT TO MAKE SURE THAT IF
PEOPLE WERE INJURED THAT
THEY'RE GETTING THE MEDICAL.
THAT THEY NEED SO THAT HE CAN
GET BACK TO WORK I CAN TELL YOU
THAT ANECDOTALLY I'VE SPOKEN
TO. BOTH INJURED AND ACTUALLY
SOME OF THE DOCTORS THAT WORK
IN THIS FIELD- AND PEOPLE JUST
WANNA GET BACK TO WORK. BUT THE
OUR FIRST WORKERS ARE
FRUSTRATED WHEN THEY HAVE TO
WAIT MONTHS AND SOMETIMES OVER
A YEAR. EVEN SEE A QUALIFIED
MEDICAL EVALUATOR. AND SO
HOPEFULLY TODAY WE COULD NAIL
DOWN SOME OF THESE ISSUES.
WHERE THERE'S- A HURDLE MAYBE
WHETHER IT'S LEGISLATIVELY OR
THROUGH- BUDGET CORRECTIVE
ACTION WE CAN HELP- INSURE THAT
WERE HELPING WORKERS BUT ALSO.
IN DOING THAT. I BELIEVE IT'LL
BRING DOWN COSTS FOR THE ENTIRE
SYSTEM. SO I CAN SEE I COULD
SEE. A PATHWAY WHERE THIS COULD
BE A WIN WIN FOR EVERYONE. SO
WITH THAT I KNOW WE HAVE- SOME
OPENING COMMENTS- LET ME DEFER
TO CENTER IRAQ THANK YOU FOR
JOINING US AFTER WE HAVE A- CAT
OKAY. ALL RIGHT. ASSEMBLY BEAR
ASSEMBLY WOMAN I RUBIO PLEASE.
THANK YOU MISTER CHAIR FOR
CALLING SUPPORT AN OVERSIGHT
HEARING- AND FOR A LONG ME TO
SPEAK TODAY I WOULD ALSO LIKE
TO THINK THAT THE STATE AUDITOR
ELAINE HOWELL AND HER TEAM OP
FOR THEIR DILIGENT A
PROFESSIONAL WORK I'VE WORKED
WITH YOU NOW FOR THREE YEARS
AND- I REALLY TRULY APPRECIATE
ALL OF THE WORK THAT YOU WHEN
YOUR DEPARTMENT DO IT'S REALLY
IMPORTANT FOR US TO BE ABLE TO
COUNT ON. THIS TYPE OF WORK TO
GET ON THE ANSWERS THAT I THINK
CALIFORNIA DESERVE SO THANK YOU
AGAIN- AS THE AUTHOR OF THE
ORIGINAL Q. IN THE AUDIT
REQUEST I WAS CERTAINLY
CONCERNED- WHEN READING THIS
AUDIT REPORT MY NUMBER ONE
CONCERN IS THE INJURED WORKER
IT'S CLEAR THAT THE DELAYS IN
THE SYSTEM HAVE A DIRECT
NEGATIVE IMPACT ON THESE
WORKERS- MORE THAN THAT I WAS A
SCHOOL BOARD MEMBER FOR.
THIRTEEN YEARS AND WE THINK
ABOUT THE INJURED WORKERS AS
JUST FOLKS OUT. YOU KNOW THAT
ARE COLLECTING OR WAR OR TRYING
TO SEE- GET SOME RECTIFICATIONS
FOR IT FOR THEIR THEIR- WORKERS
COMP ISSUES. HOWEVER AS A
SCHOOL DISTRICT BOARD MEMBER
ARE. WORKERS COMPENSATION OF.
BUDGET WAS OVER FOUR MILLION
DOLLARS I AND IT'S GROWING
BECAUSE OF- THE LACK OF
SERVICES AND THE LACK OF-
EXPEDIENCY WITH US OF. FOLKS
ACTUALLY GETTING TO SEE A CURE
ME AND SO THE IMPACT IS FISCAL
NOT JUST TO THE STATE BUT TO A
LOT OF OUR SCHOOL DISTRICTS AND
IF WE TALK ABOUT- THE LACK OF
MONEY IN SCHOOL IN SCHOOLS THIS
TAKES A BIG CHUNK OUT OF
GENERAL FUND FOR A LOT OF THE
SCHOOL DISTRICT SO. THE IMPACT-
I SAW IT AS A FIRST. AS A
SCHOOL BOARD MEMBER BECAUSE I
KNOW THAT OUR GENERAL FUND I
WOULD PAY FOR A LOT OF THE
OTHER WORKERS COMPENSATION
ISSUES AND SO FOR ME OTHER THAN
YOU KNOW AGAIN- THE IMPORTANCE
OF GETTING THE INJURED WORKERS
BACK TO WORK OR AT LEAST THE
COMPENSATION THAT THEY DESERVE-
I ALSO SEE IT AS A FISCAL ISSUE
FOR A LOT OF OUR LOCAL.
GOVERNMENTS IS AND- SCOLDED
THEN I THINK I'VE SHARED WITH
MOST OF THE TEACHERS ARE BACK
MONEY IS NOT GOING INTO THE
ASSEMBLY WERE THE SCHOOL AFTER
SPENDING IT IN OTHER WAYS AND
THE OF THE LATE SHOW THAT-
LACK. EXPEDIENCY I. ALL TOO
BUSY THESE AND I AM YOURS AND
HURTFUL TO THE TO THE YACHT
CHLOE'S SO FIXING THE QUEUE NB
PROGRAM. OF WILL PROVIDE. RAPID
BENEFITS TO ALL STAKEHOLDERS IN
CALIFORNIA WORKERS COMPENSATION
SYSTEM- BUT MOST IMPORTANTLY
THE INJURED WORKER IN OUR GREAT
STATE WHO REALLY WE DESERVE
BETTER- THANK YOU AGAIN MISTER
CHAIR AND I HOPE THAT THIS
AUDIT OR THIS OVERSIGHT HEARING
CAN. CAN GIVE US- UP SOME.
VISION AS TO WHERE WE GOAL-
FORWARD WITH THIS AND I ALSO
WOULD LIKE TO THANK THE
ADMINISTRATION'S WILLINGNESS TO
WORK WITH US I KNOW THAT THERE
THAT WE HAVEN'T- SEEN EYE TO
EYE ON THE ON ALL OF THE
ISSUES. BUT I THINK IF WE SIT
AND WORK TOGETHER- THE GOAL OF
THE ADMINISTRATION IS THE SAME
AS OURS TO MAKE SURE
CALIFORNIANS ARE BEING TAKING
CARE. AND I AGAIN I APPRECIATE
THE ADMINISTRATION'S WILLING TO
SIT DOWN AND TALK. TO US ABOUT-
WHAT WE CAN DO NEXT FOR THE
INJURED WORKERS. AGAIN THANK
YOU TO CHAIR FOR LONG ME TO
SPEAK. THANK YOU WE ASK THERE'S
ADDITIONAL OPENING COMMENTS IF
NOT. LET ME GO AT NIGHT THANK
CENTER ROSSITER MORE ROCK AND
ASSEMBLY WOMAN RUBIO FROM HERE
FOR THE OVERSIGHT AND WE-
EXPECT. SOME OF THE OTHER
MEMBERS IN AND OUT IN THE-
ASSEMBLY WILL. HAVE FOR MATH.
PASSENGER WIENER. CAN MOPPING
OUR- DAUGHTER POP OUT AS WELL
B. THIS TIME LET'S GO AHEAD AND
CALL FIRST PANEL. IT WILL BE
OVERVIEW. FINDING
COMMENDATIONS. MISS ALL OUR
CLAIMS. CALIFORNIA. STATE
AUDITOR AND THE MISSING SENIOR
AUDITOR. THANK YOU. SO THE
REGISTER GIVE US A CERTAIN
BACKGROUND. THANK YOU. THANK
YOU MISTER VOEPEL TONYA YEAH.
THANK YOU MISTER CHAIR AND
MEMBERS FOR THE RECORD MY
NAME'S ELAINE HOWELL THE
CALIFORNIA STATE AUDITOR WITH
ME AS MICHELLE SAUNDERS SHE WAS
THE AUDIT SUPERVISOR ON THIS
PARTICULAR PROJECT AND WHAT
WE'D LIKE TO DO MEMBERS A STEP
YOU THROUGH THE KEY ISSUES IN
THE AUDIT REPORT WE DO HAVE TO
HAND OUT I THINK THE SERGEANTS
HAVE DISTRIBUTED A HANDOUT- AND
WHAT I'LL DO IS I'LL GO THROUGH
THE KEY ISSUES THAT ARE LISTED
ON THE FIRST PAGE. AND THEN THE
REMAINING PAGES OF THE HANDOUT
ARE ACTUALLY. FIX THAT WE LEFT
OF THE ARTERY. YOUR LIST. THE
ISSUES THAT WE'VE IDENTIFIED IN
WHAT WE HAVE CONCERNS AND THEN
WE ALSO. ARE MICHELLE WILL GO
OVER SOME OF THE
RECOMMENDATIONS THAT WE HAVE
NOT ONLY FOR THE LEGISLATURE
BUT CERTAINLY FOR THE
DEPARTMENT. OF INDUSTRIAL ASIAN
SPECIFICALLY THE DIVISION OF
WORKERS COMPENSATION. SO WITH
THAT THERE ARE THREE KEY ISSUES
AS YOU CAN SEE ON THE FIRST
PAGE THREE KEY CONCERNS THAT WE
IDENTIFIED IN THE OUT REPORTS
CERTAINLY THE SUPPLY OF Q.
ENEMIES. THE WE BELIEVE THE
DIVISION OF WORKERS
COMPENSATION NEEDS TO ADDRESS
THE SHORTAGE OF Q. ARMIES IN
CALIFORNIA- TO PROVIDE SERVICES
TO WORKERS TO BE ABLE TO
CONDUCT THOSE ASSESSMENTS. THE
SECOND ISSUE IS THEIR PRACTICE-
THAT THEY'RE FOLLOWING FOR
DISCIPLINING Q. ENEMIES AND OUR
CONCERNS ABOUT WHETHER OR NOT.
IT RAISES DUE PROCESS CONCERNS
AND I'LL EXPLAIN THAT A LITTLE
BIT. AFTER A DISCUSS THE THIRD
ISSUE THIRD ISSUE IS THE
DEPARTMENT WHICH IS A WORKERS
COMPENSATION DIVISION OF
WORKERS COMPENSATION HAS
RESPONSIBILITY. TO MAKE SURE
THAT THE WORK THE Q. ARMIES ARE
DOING I IS HELP HIGH QUALITY
AND SATISFY CERTAIN STANDARDS
THAT ARE SET OUT. IN
REGULATIONS ARE SO THAT A
WORKERS COMPENSATION JUDGE CAN
RELY ON THAT PARTICULAR
INFORMATION IF NECESSARY SO
BATES THERE THE DIVISION HAS
RESPONSIBILITY TO MAKE SURE.
THAT THE REPORTS ARE ARE
MEETING STANDARDS AND ARE OF
HIGH QUALITY. SO THOSE ARE THE
THREE KEY ISSUES FIRST ISSUE AS
FAR AS THE- DIVISION OF WORKERS
COMPENSATION FAILING TO ADDRESS
THE SHORTAGE. WE LOOK AT A FIVE
YEAR WINDOW. ON THOSE FIVE
YEARS WE ARE FISCAL YEAR
THIRTEEN FOURTEEN THREE
SEVENTEEN EIGHTEEN. AND WHAT WE
SAW IS THE SUPPLY OF Q. AMIS IS
DECLINING- IT DECLINED
STEADILY. DURING THAT TIME
FRAME ABOUT 12% SO THERE'S OVER
THREE THOUSAND AND YOU'LL SEE
IT IN A GRAPHIC OVER THREE
THOUSAND Q. ARMIES. I ATE IT
DROPPED DOWN TO LESS THAN THREE
THOUSAND TWENTY EIGHT HUNDRED
Q. AMIS. AT THE SAME TIME FRAME
REQUESTS FOR EVALUATIONS
INCREASED 37% THERE WERE ABOUT-A HUNDRED AND FIVE THOUSAND
ALMOST A HUNDRED SIX THOUSAND
REQUESTS FOR THESE TYPES OF
EVALUATIONS. IN THIRTEEN
FOURTEEN WHEN WE GOT TO
SEVENTEEN EIGHTEEN IT INCREASED
TO OVER A HUNDRED AND FORTY
FIVE THOUSAND REQUEST. OFF FOR
AN EVALUATION SO YOU'RE SEEING
A DECLINE IN THE AND THE SUPPLY
THE INDIVIDUALS WHO CAN CONDUCT
THESE EVALUATIONS. AND A
SIGNIFICANT INCREASE IN THE
NUMBER OF EVALUATIONS BEING
REQUESTED. IT'S PARTICULARLY
IMPORTANT AND I THINK YOU'LL
HEAR THIS FROM SOME OF THE
OTHER PANELISTS WE DIDN'T DRILL
DOWN SPECIFICALLY INTO ALL THE
DIFFERENT SPECIALTIES BUT WHEN
YOU LOOK AT CERTAIN
SPECIALTIES. THE SITUATION IS
EVEN WORSE THERE ARE SOME
SPECIALTIES WHERE THERE HAVE
BEEN A SIGNIFICANT DECLINE IN
THE NUMBER OF Q. AMIS AVAILABLE
TO CONDUCT THESE TYPES OF
EVALUATIONS AND WE DO HAVE
RECOMMENDATIONS TO THE
DEPARTMENT OR THE DIVISION.
THAT THEY NEED TO REALLY DO
THEIR BEST TO RECRUIT AND WE'LL
GET INTO SPECIFICS ABOUT HOW-
WE THINK THEY SHOULD DO THAT IS
GETTING MORE QUEUE UP IN THE
SYSTEM. AND REALLY IDENTIFYING
SCRUPULOUS THE AREAS OF
SPECIALTY. THERE IS A
SIGNIFICANT DECLINE AND WHERE
THERE'S A HIGH A REQUEST FOR
THOSE TYPES OF INDIVIDUALS THAT
TYPE OF EXPERTISE. SO THAT-
THAT- THOSE TWO THINGS REALLY
DO COINCIDE AS FAR AS NUMBER OF
Q. ARMIES GOING DOWN NUMBER OF
REQUESTS INCREASING. WHAT THAT
ALSO IS SEEN IN THE DATA AND
YOU'LL SEE IT IN ONE OF THE
GRAPHICS IS. Q. M. E. R. WORK
SHOULD BE ABLE TO BE SEEN IN BY
A MEDICAL LEAVE BETTER WITHIN
STE DAYS OF REQUEST. IF IT
DOESN'T HAPPEN WITHIN SIXTY
DAYS EVERY SPENT PANEL CAN BE
REQUESTED AND WE HAVE A GRAPHIC
IN THE REPORT THAT WE WILL
SHARE WITH YOU IT'S IN YOUR
PACKAGE. SHOW THAT. SAME FIVE
YEAR WINDOW. THE NUMBER OF REAP
SPENT ALSO THE CIVIC DUE TO THE
FACT THAT A Q. ME WAS NOT
AVAILABLE TO CONDUCT THAT. THAT
EVALUATION WITHIN SIXTY DAYS
MORE THAN QUADRUPLED IT WENT
FROM ABOUT 460-021-9000 AND A
FIVE YEAR WINDOW. SO YOU'RE
SEEING FEWER AND FEWER KEEP Q.
EMMYS AVAILABLE TO BE ABLE TO
SEE THAT WORKER EVE VALUE WAIT
THE SITUATION AND HOPEFULLY
GET. THE INFORMATION. THAT THAT
DIVISION WORKERS COMP NEEDS THE
EMPLOYER NEEDS AND CERTAINLY
THE AN INJURED WORKER NEEDS TO
GET THAT CASE RESOLVED SO
THEIR- DISABILITY AND THEIR
BENEFITS CAN BE PROVIDED BUT-
IF THEY ARE. ULTIMATELY DEEMED
PERMANENTLY DISABLED A DECISION
IS MADE AND BENEFITS AND THAT
THE SITUATION CAN GET RESOLVED.
NOW THE DIVISION OF WORKERS
COMPENSATION ACKNOWLEDGES
THERE'S A DECLINE AND
DECREASING NUMBER OF JIMMY'S
THEY DON'T NECESSARILY AGREE
WITH OUR CONCLUSION THAT
THERE'S A SHORTAGE OF Q.
ENEMIES. THEY FEEL THAT THERE
ARE SOME AND- A NUMBER OF Q.
AND HE'S IN CALIFORNIA AND THAT.
THE REASONS FOR. THE
REPLACEMENT PANELS IS BECAUSE
IT'S CONCENTRATED IN A CERTAIN
NUMBER OF Q. ARMIES OR CERTAIN
GROUP OF Q. AMIS WHO HAVE X.
NUMBER OF OFFICES IN
CALIFORNIA. WE DID ADDITIONAL
ANALYSIS AND WE REALLY WERE
ABLE TO DISPUTE THAT- WE HAD
OUR I. T. FOLKS REALLY LOOK TO
SEE HOW MANY Q. ARMIES WITHIN
CERTAIN ZIP CODES WITH THAT'S
HOW THEY IDENTIFY CUMAE. AND WE
WERE ABLE TO ESSENTIALLY TO PUT
IT IN AND- SUCCINCT TERMS
DISPUTE THAT THAT ASSERTION
THAT THERE IS NOT A SHORTAGE
THERE ABSOLUTELY IS A SHORTAGE
NOT TO MEET IS THE CLUE ENDING
NUMBER REQUIRE IS INCREASING.
NUMBER OF REPLACEMENT CALLS AS
YOU'LL SEE IN THE GRASS.
QUANDARY THEN IF YOU'RE WHAT
I'LL SO THERE IS A SIGNIFICANT
PROBLEM THAT NEEDS TO BE
ADDRESSED CALIFORNIA. WE HAD
SOME- REASONS THAT WE DISCUSS
IN THE REPORT. WE THINK THE
MEDICAL FOR LEGAL FEE SCHEDULE
ABSOLUTELY NEEDS TO BE UPDATED
IT HAS NOT BEEN UPDATED SINCE
TWO THOUSAND AND SIX- THE
DIVISION HAS TAKEN SOME STEPS
TO TRY TO DO THAT BUT- MEDICAL
COSTS HAVE INCREASED OVER 30%
SINCE THAT TIME FRAME YET
YOU'RE NOT SEEING AN INCREASE
IN THAT MEDICAL LEGAL FEE
SCHEDULE. WE DID AN ANALYSIS
ARE. JUST USING- INFLATION
CURRENTLY. THE FEES ARE. ARE
SIX HUNDRED TWENTY FIVE DOLLARS
FOR A BASIC EVALUATION JUST
BASED ON INFLATION THAT WOULD
BE OVER EIGHT HUNDRED DOLLARS-
IF THEY HAD JUST INCREASED IT.
THAT WAY WE ALSO BELIEVE THERE
NEEDS TO BE PROCESS FOR
CREATING TO AYE MEANS THAT THE
DIVISION NEEDS TO BE MORE
PROACTIVE. IN DOING THE
ANALOGIES USING THE STUDIES
HAVE THAT IDENTIFY. OUR SEARCH
SPECIALTIES WERE THERE ARE
SIGNIFICANT SHORTAGES AND TRY
TO WORK WITH MEDICAL GROUPS
WORK. UP INDIVIDUALS KNOWS
DIFFERENT COMMUNITY IS TO TRY
TO GET MORE VISIT IS TO BE
WILLING AND SPECIALIST TO BE
ARE WILLING TO BE Q. ARMIES- SO
THEY REALLY NEED TO EVALUATE
THEIR DATA SO THAT'S- THAT'S
áREA NUMBER ONE AND WE'LL GO
THROUGH THE GRAPHICS. AREA
NUMBER TWO VERY QUICKLY-
DISCIPLINING THE PRACTICES FOR
DISCIPLINING THEY ACTUALLY HAVE
TWO SEPARATE TRACKS FOR.
DISAPPOINTING ACUMEN ME IF
THERE ARE. INACCURATE
INCOMPLETE- POOR QUALITY
REPORTS- AND THEN THERE'S A
SEPARATE TRACK FOR Q. ME TO GET
REAPPOINTED. THE CONCERN WE SAW
AND WE LAY OUT IN THE AUDIT
REPORT IS IF THERE ARE
COMPLAINTS FILED AGAINST THE
QUEUE A MEET WHAT WE WERE
SEEKING IS THAT RATHER THAN.
TAKING THAT THROUGH THE
DISCIPLINARY TRACK THING THAT
CUBA ME THE OPPORTUNITY TO
PROVIDE TENDS TO DISPUTE. OF
THE COMPLAINTS ARE THE
ALLEGATIONS. THE ALLEGED
VIOLENCE. I DID CHEN IS WAITING
A BILL THAT INDIVIDUAL IS UP
FOR RE APPOINT. AND BASICALLY
DIDN'T THE REAPPOINTMENT ON THE
ALLIGATOR. SO WE WERE REYES CAN
IN THE RIVER THAT THERE MAY BE.
A DUE PROCESS. IT HERE AND WE
HAD EXAMPLE THE REPORT. PLEASE
COMING IN AND TWENTY FOURTEEN
THE QUEUE ARMY IS ABLE TO
RESPOND TO THAT. DIVISION OF
WORKERS COMPENSATION LOOKS AT
IT DOESN'T. DENY THAT
REAPPOINTMENT PERSON ISN'T UP
FOR REAPPOINTMENT UNTIL JUNE OF
TWENTY SIXTEEN IS DENIED THE
REAPPOINTMENT. BASEDON SOME OF
THOSE ALLEGATIONS THAT CAME IN
IN TWENTY FOURTEEN- SO
ESSENTIALLY WHAT THAT
INDIVIDUAL. ARE WAS SUBJECT TO
IS NOW HERE SHE I DON'T RECALL
IF IT WAS A MALE OR FEMALE BUT
WAS NOT ABLE TO CONTINUE.
SERVING AS A CUE I ME SO LOSING
INCOME NOT FOR THIS I OF CUBA
MEANS THAT WOULD BE AVAILABLE
FOR INJURED WORKERS TO SEE- AND
REALLY IS PUT IN A POSITION
WHERE. THEIR AN INCENTIVE
THAT'S CREATED FOR THAT SECURE
ME TO TRY TO SETTLE THE CASE SO
HERE SHE CAN GET REAP AND CAN.
SERVICE SO WE REALLY HAVE SOME
CONCERN WITH HOW THE DIVISION
CARRYING OUT DISCIPLINE WHERE
THEY DO HAVE A SPECIFIC TRACK
THEY COULD BE FOLLOWING BUT
THEY ARE USING. THE ABILITY TO
DENY A REAPPOINTMENT. AS
ESSENTIALLY DISCIPLINE AGAINST
SOME OF THESE COMMITTEES AND
THEN THE THIRD ISSUE. IS THE
HIGH QUALITY REPORTS THERE IS
STATUTORY REQUIREMENT STATE LAW
THAT REQUIRES THE DIVISION. TO
EVALUATE A SAMPLE NOW AND
CONTINUOUSLY LOOKING AT A
SAMPLE OF REPORTS TO MAKE SURE
THAT Q. ARMIES ARE DOING A GOOD
JOB OF. OF PROVIDING THE
APPROPRIATE MEDICAL EVIDENCE
NECESSARY. TO MAKE. THE PROPER
DECISION WITH RESPECT TO A
DISABILITY WITH. RESPECT TO THE
pWORKER WOULD BE ENTITLED TO BUT
WE WERE NOT SEEING WE HAVE NOT
SEEN- EVIDENCE OF CONTINUOUS
REVIEW OF THESE MEDICAL REPORTS
PROVIDED BY Q. ARMIES. SAID
ABOUT TWO THOUSAND SEVEN THERE
WAS ONE ATTACK IN TWO THOUSAND
AND FIFTEEN. WHERE THEY STARTED
LOOKING AT SOME REPORTS THEY
PULLED A SAMPLE OF A HUNDRED
REPORTS. UP LOOKED AT ABOUT
SIXTEEN OF THOSE REPORTS AND
85% OF THOSE. REPORTS HAD
PROBLEMS ACCORDING INDIVIDUAL
AT VISION WHO WAS REVIEWING.
FOR SOME THEN THEY SAY YES TO
SEARCH FOR SAY. DID ANY OF ANY
OF THE OTHER REPORTS THEY
HAVEN'T DONE ANY DO. REVIEWS OF
REPORTS SUBSEQUENT TO THAT THEY
DIDN'T FOLLOW UP ON ANY OF THE
ISSUES THEY IDENTIFIED IN THOSE
6985% OF THOSE SIXTY NINE
REPORTS SO ABOUT FIFTY REPORTS-
SO WE REALLY HAVE CONCERNS
ABOUT. OF THE DAY MISSIONS
EFFORTS AND THERE IS STATE LAW
THAT REQUIRES THEM TO DO THESE
EVALUATIONS- AND ALSO TO COME
UP WITH RECOMMENDATIONS FOR
IMPROVING THE PROGRAM. DO THE
Q. ARMIES NEED SOME TRAINING DO
THEY UNDERSTAND THE TYPE OF
REPORTING THAT THE TYPES OF
THINGS THAT THEY SHOULD BE
INCLUDING IN THEIR REPORTS. SO
THAT THIRD ISSUE RELATED TO
THAT THE QUALITY OF THE REPORTS
IS THE FINAL ISSUE THAT WE
DISCUSSED IN THE REPORT
ALTERNATE OVER TO MICHELLE
SHE'LL STEP YOU THROUGH. THE
GRAPHICS IN THE REPORT THAT
WILL ILLUSTRATE- EACH OF THE
EACH OF THESE THREE ISSUES THAT
IDENTIFIED SO. MICHELLE. THANK
YOU. MISTER CHAIR MEMBERS OF
THE COMMITTEE FOR THE RECORD MY
NAME IS MICHELLE SANDERS THE
STATE AUDITOR'S OFFICE AND I
WAS THE TEAM LEAD ON THE ON IT.
THANK YOU SO BEFORE I WALK YOU
THROUGH THE PACKET. IT'S KIND
OF BEEN DESCRIBED A LITTLE BIT
AT A HIGH LEVEL ALREADY BUT ALL
KIND OF GIVE ANOTHER OVERVIEW
OF THE QUEUE MEANS HOW THE
PROCESS WORKS JUST. FOR CONTEXT
AS WE GET INTO THE PACKET. Q.
MEANS OUR PHYSICIANS. ARE
INVOLVED IN THE WORKERS
COMPENSATION PROCESS WHEN
THERE'S A DISPUTE BETWEEN THE
INJURED WORKER AND THE
EMPLOYER. AND AS YOU SAID
EARLIER THAT. THAT COULD BE
ABOUT WHETHER THE INJURY
HAPPENED AT WORK. OF THE EXTENT
OF THE INJURY. AND SO WHEN
THERE IS A DISPUTE TO THE
PARTIES CAN REQUESTED A B. C.
TO PROVIDE A QUEUE IN ME. THEY
PROVIDE A PANEL OR A LIST OF
THREE Q. AMIS. THERE IS A
LITTLE BIT OF A DIFFERENCE
BETWEEN REPRESENTED WORKERS IN
ON REPRESENT WORKERS IN ALL
COVER THAT. IN ANOTHER SLIDE.
BUT ESSENTIALLY THEY SELECT ONE
OF THE Q. AMIS TO PERFORM THE
EVALUATION. AND ESSENTIALLY
THEY'LL PRODUCE A REPORT THAT.
THAT JUDGES ARE OTHER PARTIES
WILL USE TO RESOLVE THE DISPUTE
NOW WITH THE QUEUE IN ME IS NOT
AVAILABLE WITHIN THE FIRST
SIXTY DAYS AS THE STATE AUDITOR
INDICATED- VERY THEY CAN
REQUEST A REPLACEMENT PANEL AND
ESSENTIALLY THE PROCESS STARTS
ALL OVER AGAIN AND THEY'LL END
UP SELECTING A QUEUE IN ME SO
Q. MEANS ARE LIKE WITH SAID
EARLIER VERY IMPORTANT PART OF
THE PROCESS IN RESOLVING THE
DISPUTE SO THAT THESE UNDER
WORKER'S CAM- BENEFITS. SO IF
YOU TURN TO THE SECOND PAGE OF
THE HANDOUT WILL START WITH THE
FIRST ISSUE WHICH WAS THERE'S A
SHORTAGE OF A Q. AMIS AND HERE
REALLY SHOWING THAT THERE ARE
NOT ENOUGH CUTE MEANS TO ME TO
ME AND WHEN THE TOP LINE BRAFF
SEE THE NUMBER THOSE REQUESTS
FOR ME SERVICES IT'S INCREASED
30% OVER THIS FIVE YEAR PERIOD
OF TIME. AT THE SAME TIME IS
THAT THE DEMAND IS INCREASING
SUPPORT INCREASING 12% AT IS
THIS- MENTION WE DIDN'T SEE
THAT CERTAIN SPECIALTY OR WORSE.
THAT AND THE OVERALL SITUATION.
AND SO. AGAIN THIS IS REALLY AN
INDICATOR THAT THERE ARE NOT
ENOUGH Q. MEANS ON THE SYSTEM
AND IF THERE ARE NOT ENOUGH Q.
MEANS I CAN IMPACT THE INJURED
WORKER IN GETTING THEIR
BENEFITS IN A TIMELY MANNER. IF
YOU TURN TO THE NEXT PAGE PAGE
THREE. THIS IS STILL
ILLUSTRATING THAT FIRST ISSUE
THAT WE SAW THAT Q. MEANS A
BECOME MORE FREQUENTLY
UNAVAILABLE. SO LIKE I SAID
EARLIER WHEN THERE'S A QUEUE ME
IS NOT AVAILABLE WITHIN THE
FIRST SIXTY DAYS THEY CAN
REQUEST A REPLACEMENT PANEL SO
THAT'S THIS YELLOW BAR HERE.
AND WE'RE SEEING THAT IT'S
QUADRUPLED ITS STATE WATER
MENTION IT'S QUADRUPLED OVER
THIS FIVE FIVE YEAR PERIOD
WHICH REALLY MEANS THERE ARE
NOT ENOUGH Q. NEEDS TO MEET THE
DEMAND AND THAT HAS AN IMPACT
ON THE INJURED WORKER. SO IN
THE CASE WHEN WE LOOKED AT THE
INTERPRETERS IN THE CASE OF AN
AVAIL. Q. MEANS. THE CASE. IT
BY MORE THAN TWO MONTHS AND SO
AGAIN THAT'S IMPACTING INTO A
WORKER IN GETTING THEIR
BENEFITS. BUT ALSO- WHEN WE
TALK TO AN APPLICANT ATTORNEYS
ASSOCIATION THE PRESIDENT
INDICATED THAT. SOME INJURED
WORKERS MAY ACTUALLY DELAY
GETTING TREATMENT UNTIL THEY
KNOW WHAT THEIR BENEFITS ARE
GOING TO BE. SO THIS DELAYED
CAN IMPACT THAT AS WELL. THE
THING IS THE STATE AUDITOR ALSO
MENTIONED THIS ALSO INCREASES
COSTS FOR THE EMPLOYERS IT'S
NOT JUST THE INJURED WORKERS
ARE IMPACTED SAID. THE
EMPLOYERS AS WELL. AND THAT'S A
STATE WATER MENTIONS DUE TO BE
SEE IS NOT NECESSARILY
ACKNOWLEDGE A SHORTAGE AND HAS
NOT TAKEN ACTION IN THOSE THREE
AREAS. THE UPDATING THE FEE
SCHEDULE. A RECRUITING. AND
USING THEIR DATA SPECIFICALLY
TO IDENTIFY THOSE AREAS OF SAY
THE GEOGRAPHIC AREAS THAT ARE
GOING TO HAVE THE SHORTAGES.
ANDS. THE SPECIALTIES SO OUR
RECOMMENDATION TO D. W. C. IS
pTHAT PLAN FOR HOW IT'S GONNA
RECRUIT WHAT SPECIALTIES IT'S
GOING TO WHAT HAVE THE GREATEST
SHORTAGES AND FOCUSING ON THAT
AREA. YOU CANNOT WE ALSO
RECOMMENDED THAT USE DATA TO
KIND OF FOCUS ITS EFFORTS AND
IT CAN USE THAT DATA TO
IDENTIFY WHERE THE GEOGRAPHICAL
SHORTAGES MAKE SURE THE THIRD
ADDRESSING YOU'LL TARGETED
TARGETED APPROACH. SO WE ALSO
HAVE TWO RECOMMENDATIONS FOR
THE LEGISLATURE. THE FIRST
RECOMMENDATION IS TO REQUIRED
GDC TO REVIEW AND UPDATE THE
FEE SCHEDULE AND WE PUT IN
THERE TO AT LEAST EVERY TWO
YEARS BASED ON INFLATION I
UNDERSTAND THAT YOU HAVE. A
TRANSLATION PENDING EXACTLY. SO
OUR SECOND RECOMMEND. IS TO
INCREASE THE NUMBER OF Q. MEANS
ON THE PANEL. ENDS THAT'S
REALLY TO REDUCE THOSE DELAYS
THAT WE'RE SEEING IN THESE
REPLACEMENT PANELS AND I'M
ACTUALLY GONNA EXPLAIN THAT TO
YOU IN MORE DETAIL ON THE NEXT
SLIDE. IF YOU. SO THE TOP OF
THIS PAGE IS SHOWING WHAT THE
PROCESSES RIGHT NOW AND THE
BOTTOM HALF IS WHAT OUR
RECOMMENDATION ACTUALLY LOOK
LIKE SO LET'S TALK ABOUT THE
PAGE D. W. C. GENERATES THAT
PANEL OF THREE KILOMETERS. AS I
SAID EARLIER THE REPRESENTED IN
ON REPRESENTED THE DIFFERENCE
ON THE LEFT SIDE THE
UNREPRESENTED WORKER THERE'S
THEY'RE GOING TO BE ABLE TO
CHOOSE FROM ANY OF THE THREE ON
THE- ON THE RIGHT SIDE THE
REPRESENTED WORK. WHAT OUT OF
THE THREE THE INJURED WORKER
ELIMINATES ONE THE EMPLOYER
ELIMINATES ONE AND THEN THEY
HAVE ONE TO CHOOSE FROM. NOW
WHEN WE LOOK AT THE DATA WE SAW
THAT REPRESENT A WORKERS IT WAS
THREE TIMES HIGHER THE NUMBER
OF REPLACEMENT PANELS AND THAT
MEANS THEY'RE EXPERIENCING MORE
DELAYS ON THAT SIDE. SO OUR
RECOMMENDATION IS TO INCREASE
THIS PANEL SIZE FOR THE
REPRESENTED SIZE SIDE TO FIVE.
TO HAVING FIVE SOL EXPLAIN WHAT
THAT LOOKS LIKE ON THE BOTTOM
HALF THE PAGE WE NEED MORE Q.
ARMIES FOR THAT. YES AND THAT'S
SOMETHING THAT THAT HE TO BE
SEE SHOULD CONSIDER WHEN IT'S
USING IT'S DATA. TO FIGURE OUT
WELL HOW HOW MUCH HOW MANY Q.
MEANS DO THEY NEED. TO SO
OTHER. THE PAGES ARE PROPOSAL
SO THE UNREPRESENTED WORKERS
SIDE ON THE LEFT IT WOULD STAY
THE SAME THEY WOULD STILL HAVE
THOSE THREE TO CHOOSE FROM. ON
THE RIGHT SIDE THE REPRESENTED
SIDE. OUT OF THE FIVE IT WOULD
STILL BE THE INJURED WORKER
WOULD ELIMINATE ONE. THE
EMPLOYER WOULD ELIMINATE ONE
AND THEN YOU'D HAVE THREE TO
CHOOSE FROM. SO THAT'S REALLY
TO HELP REDUCE THIS PROBLEM
WITH THE- A REPLACEMENT PANELS
AND BETTER ENSURE THAT THEY'RE
AVAILABLE. AND AGAIN THIS IS
THIS IS REALLY IMPORTANT
BECAUSE THE INJURED WORKER
HAVING THEIR BENEFITS DELAYED
GREATLY IMPACTS ON. SO THAT'S
THE FIRST ISSUE THROUGH THE
SLIDES OF YOU TURN TO THE- NEXT
PAGE FIVE. A DELIVERY SEE AN
APPROPRIATELY DISCIPLINE Q.
MEANS AND AS THE STATE AUDITOR
INDICATED THERE'S THESE TWO
TRACKS THAT ARE LAID OUT AND
REGULATIONS THE LET SIDES THE
DISCIPLINARY PROCESS AND THE
RIGHT SIDES A RE APPOINTMENT
PROCESS AND WE FOUND THAT D. W.
C. INSTEAD OF FOLLOWING ITS
DISCIPLINARY PROCESS ALL THE
WAY THROUGH. BEFORE IT GOT TO
THE POINT WHERE THERE WOULD BE
A HEARING TAX DETERMINED THAT
AN ALLEGATION WAS IN FACT
VIOLATION THEY DENIED
REAPPOINTMENT IN SOME CASES
THAT WE LOOKED AT BASED ON
THOSE ALLEGATIONS SO THEY
ACTUALLY USED THE REAPPOINTMENT
PROCESS DISCIPLINE I'M I'M I
INTERRUPTED SO SICK CAN YOU SAY
THAT AGAIN SO. THE PRIOR TO THE
DISK AND WHAT WOULD DIE AFTER
THE HEARING SO THE HEARING WAS
IT HAPPENING EXACTLY OKAY THE
HEARING WAS NOT HAPPENING AT
BUT THEY WERE DENIED THE
APPLICATIONS BASED ON JUST THE
ALLEGATIONS THAT'S CORRECT.
THANK YOU. RIGHT SO. THE
PROBLEM WITH THIS IS ONCE THE
CURE ME IS DENIED AS A STAY
HONOR POINTED OUT EARLIER. THEY
ARE NOT AVAILABLE IN THE QUEUE
ME SUPPLY. MAKES THAT SHORTAGE
WORSE. THEY CANNOT EARN RELATED
INCOME WHICH MEANS THAT THEY
MAY BE INCENTIVIZE TO SETTLE.
SO THAT THEY CAN GET BACK
TURNING THEIR INCOME AND THEN
THAT THEY MAY BE DENIED DUE
PROCESS. AND SO ARE WE O HAVE
A RECOMMENDATION RELATED TO
THIS SUBMIT HELP ENSURE THAT
THE THESE TWO PROCESSES STATE
SEPARATE AND SO WE- OUR
RECOMMENDATIONS TO THE WC. TO
HAVE POLICIES AND PROCEDURES
THAT LAY OUT THESE TWO AS
SEPARATE PROCESSES. AND AGAIN
THAT WAY TO THE WHOLE DUE
PROCESS ARGUMENT. WHAT'S THE
DUE PROCESS ARGUMENT YES.
EXACTLY TO HELP ADDRESS THE DUE
PROCESS HELP MAKE SURE THAT
THOSE CUNY'S STAY IN THE SUPPLY
UNTIL THEY ARE IN FACT YOU KNOW
HAVE A VIOLATION AND THERE
NEEDS TO BE DISCIPLINED. SO IF
YOU TURN TO THE NEXT PAGE PAGE
SIX WILL TALK ABOUT THE THIRD
AND FINAL ISSUE THAT THE STATE
AUDITOR COVERED. SO. TWC IS NOT
REVIEWING A TO ME REPORTS FOR
QUALITY. AND SO THESE ARE THE
REPORTS THAT AFTER VALUATION
THE QUEUE ME RIGHT TO REPORT
AND THE JUDGE IS OR OTHER
PARTIES USE THAT TO RESOLVE
THAT DISPUTE. SO IT'S REALLY
IMPORTANT THAT THOSE REPORTS
ARE HIGH QUALITY HAVE THE
INFORMATION THAT THEY NEED TO
MAKE THAT DECISION. SO D. W. C.
THERE'S TWO DIFFERENT THINGS IN
STATE LAW OF. THAT THE REQUIRED
TO DO WERE IN RELATION TO.
REVIEWING FOR QUALITY IT'S RICK
REVIEWING A RANDOM SELECTION
AND ALSO HAVING AN ANNUAL
REPORT PROVIDED TO THEIR
ADMINISTRATIVE TO DIRECTOR
ABOUT THAT REVIEW THE RESULTS
OF THAT REVIEW ENDS THE
RECOMMENDATIONS TO IMPROVE. AND
WE SAW THAT THEY WERE THEY WERE
NOT DOING THAT EXCEPT FOR THE
ONE CASES THE STATE AUDITOR
MENTIONED. SO THEN. WHEN IT
COMES TO WHAT THE JUDGES ARE
DOING IF IT IF A JUDGE GETS THE
REPORT AND IT DOESN'T HAVE WHEN
IT NEEDS TO HAVE IN IT THE
JUDGE MIGHT THROW IT OUT. OR
THEY MAY ASK FOR SUPPLEMENTAL
INFORMATION WHICH MEANS MORE
DELAYS FOR THE INJURED WORKER
SO THEY MAY HAVE TO WAIT FOR
THE SUPPLEMENTAL REPORT OR THEY
MAY HAVE TO ENTER THE QUEUE IN
THE PROCESS. ALL OVER AGAIN. SO
WHEN WE TALK TO- CHIEF JUDGE
SHE PULLED HER JUDGES AND- THEY
INDICATED THAT. THEY REJECTED
ABOUT SEVENTY REPORTS IN IN THE
LAST YEAR. BASED ON THEM THE
REPORTS I HAVE AN INFORMATION
THEY NEEDED TO HAVE IN THEM.
SERVERS TO RESOLVE THE DISPUTE.
AND SINCE D. W. C. DOES NOT
TRACK THAT THEY CAN ONLY
PROVIDE US WITH ONE OF THE
REJECTED REPORTS. SO BUT
TALKING TO THE JUDGE FOUND A
LOT MORE EXACTLY THIS GOES TO
THE QUALITY OF THE REPORTS. SO
ARE RECOMMENDED WE HAVE I'M
SORRY I DID NOT A QUESTION TO
GET FIT SO SOUL WHY WEREN'T THE
TRACKING THE REPORTS IT IS. IT
WILL BRING HIM UP THERE THE
NEXT PANEL. RIGHT SOLD SO THEY
HAD NO DATA. EXACTLY THE SAME
THE COULD LEAD SOME I GUESS THE
QUESTION IS OUT OF THOSE
REPORTS THAT THE JUDGES CHAU DO
THEY ONLY HAD ONE OF THE REJECT
THE REPORT THEY CAN ONLY
PROVIDE US WITH ONE REJECTED
REPORT IN THE LAST FIVE YEARS
SO THEN THEY WILL THEY'RE NOT
TRACKING HOW MANY WERE THEY
WERE NOT TRACKING. HOW MANY
WERE THERE DO YOU KNOW IF THERE
WAS A SYSTEM FOR THEM TO TRACK
THIS REPORT CARD WHERE DID THEY
GO THEY HAVE NOT THEY DIDN'T
SYSTEM THEY DURING THE AUDIT
THEY STARTED DEVELOPING A
TRACKING SHEET BUT HADN'T
STARTED USING IT. YET. OKAY SO
ARE RIGHT. SO WE HAVE A
RECOMMENDATION OKAY FOR THEM TO
START TRACKING FOR ITS TO
THINK. PARK TWO THINGS. SO FOR
THE JUDGES TO COMMUNICATE TO D.
W. C. THAT THEY REJECTED A
REPORT AND THEN FOR. D. W. C.
TO THAT ALSO TRACK THE REPORTS.
OKAY WALL HAVE MORE QUESTIONS I
THINK BECAUSE HOW OLD TO THE
INJURED WORKERS NOW. SOMEONE
BECAUSE HE OKAY SO LET ME
RETRACT. SO WHEN YOU SAID THAT
WHEN. SOME OF THESE. REPORTS
WERE NOT- COMPLETED THEY WOULD
HAVE TO START ALL OVER AGAIN
SEOUL IF A REPORT WAS REJECTED
WHAT WAS THE REMEDY FOR THE
INJURED WORKER CHIU THEN.
APPEAL MAY BE OR DO ANYTHING A
BASED ON THE REJECTION AND WHO
WOULD THEY GO TO CAN THEY GO
BACK TO THAT THE COURT OR OR TO
THE JUDGE OR WOULD THEY HAVE TO
GO THROUGH. THE W. C. AND THEN
AT THAT POINT THEY DON'T HAVE
THESE REPORT ARE. WHAT IT WHAT
WAS THE REMEDY FOR THE
REJECTION. SO WHEN THEY REJECT
THE REPORT- IT'S REALLY THAT
THE- THE- INJURED WORKER WILL
THEN HAVE TO GO BACK EITHER
THROUGH THE QUEUE ME PROCESS TO
SEE A NEW KILL ME. SO THAT THEY
CAN EVALUATE THEM AGAIN. AND
THEN PRODUCE A NEW REPORT THAT
CAN BE USED OKAY SO THEN THEM
OUT AS FAR AS TIME FRAME- YOU
SAID THAT WITHIN SIXTY DAYS. OF
A REQUEST THEN THERE'S A CURE
ME AND IF THERE WAS NOT AN
AVAILABLE KIMMY THEN WE HAVE TO
START ALL OVER AGAIN SO- IN
TERMS OF TIME WAITING WHAT IS
YOUR ESTIMATE OR IF. IF I'M
AHEAD OF MYSELF PLEASE LET ME
KNOW BY. THEN THEN WE'RE
LOOKING AT YOU KNOW A YEAR TWO
YEARS OF WAITING. BEFORE ANY OF
THESE ISSUES ARE RESOLVED.
BECAUSE THEY DON'T TRACK THE
REJECTED REPORTS WE DON'T HAVE
ABOUT THE WAITING BUT- BUT WHEN
WE DID LOOK AT IN THAT FIRST
SECTION WHEN THERE'S A
REPLACEMENT PANEL THEY OFTEN IT
WAS DELAYED MORE THAN. TWO
MONTHS THAT'S A- GRAPH THAT
QUADRUPLED SINCE TWENTY
THIRTEEN RIGHT. RIGHT BUT BUT
THECONCERN THE CONCERN IS
TWOFOLD DIVISION OF WORKERS
COMPENSATION HAS A
RESPONSIBILITY TO REVIEW THE
REPORTS THEY HAVE A
RESPONSIBILITY TO TRACK THE
REPORTS. BECAUSE STATE LAW
REQUIRES SUGGESTS THAT IF THE
Q. AND ME HAS FIVE REJECTED
REPORTS HERE SHE CANNOT GET
REAPPOINTED AS A CURE ME. SO
THE DIVISION HAS A
RESPONSIBILITY TO UNDERSTAND
THE QUALITY OF THESE REPORTS
AND UNDERSTANDING WHETHER OR
NOT THERE'S INACCURATE
INCOMPLETE ARE THE JUDGES
REJECTING THE WORKERS COMP
JUDGES HAVE A RESPONSIBILITY TO
REPORT TO THE DIVISION. AND SO
THE FAILURE IS ON BOTH SIDES
ITS DIVISION WORKERS COMP AND
ALSO THE PRESIDING JUDGES NOT
REPORTING TO THE CHIEF JUDGE WE
ASK THE CHIEF JUDGE DO YOU
TRACK. REJECTED REPORTS BECAUSE
YOU'RE REQUIRED TO REPORT IT
BACK IN THE DIVISION HAS
RESPONSIBILITY TO SAY THIS
QUEUE NB IS NOT GONNA BE ABLE
TO CONTINUE TO SERVE BECAUSE
HERE SHE'S NOT. TOO MANY REPORT
GETTING REJECTED AND THAT'S-
BAD FOR INJURED WORKERS
CERTAINLY AND CERTAINLY FOR
EMPLOYERS THE CASES AREN'T AND
RESOLVED. SO WEAK WE- WOULD NOT
BE ABLE TO GIVE YOU INFORMATION
TO SAY OF THOSE SEVENTY
REPORTS- BECAUSE AGAIN BUT THEY
THEY PULLED THE JUDGES- AND THE
JUDGES SAID YEAH THAT'S HOW I
AM I PROBABLY REJECTED TEN
FIFTY IT'S AN ESTIMATE. IS ALL
ANECDOTAL INFORMATION AND
THAT'S THE PROBLEM SO- THE
DIVISION NEEDS TO DO A BETTER
JOB THE JUDGES AND THEY THEY
ASSERTED DURING THE COURSE OF
THE AUDIT THEY WOULD START
TRACKING. REJECTED REPORT SO
NOW WOULD BE AN MISSION HOPE
THE DIVISION HAS MEASURE. OF
TWENTY NINETEEN IT'S BEEN SEVEN.
HOW MANY REJECTED ARE YOU
TRACKING IT BY Q. A ME YOU
SHOULD BE ARE YOU IDENTIFYING
ISSUES IN THOSE REPORT WHAT ARE
THE KINDS OF PROBLEMS WITH THE
REPORTS BECAUSE THAT'S GOING TO
TELL YOU YOU NEED TO DO A
BETTER JOB OF TRAINING
ACADEMIES TO PREPARE BETTER
QUALITY REPORTS- SO WE DON'T
HAVE THE ANSWER FOR YOU MS
RUBIO AS FAR AS WHAT THE DELAY
AS AS AS MISS SAUNDERS
INDICATED A REPLACEMENT PANEL
TYPICALLY IS GOING TO DELAY IT
AT LEAST ANOTHER SIXTY DAYS BY-
IF NOT LONGER ALL IN SOME CASES
IF IT'S- THE JUDGE SAYING OUT
WE DON'T NEED ANOTHER Q. ON ME
WE NEED A SUPPLEMENTAL REPORT.
THEN THAT Q. AND ME IS DOING
ADDITIONAL INFORMATION OR THEY-
AND THEY HAVE THE OPPORTUNITY
TO DEPOSE THE CURE ME SO IT
CLEARLY CREATES ADDITIONAL
DELAY AT A MINIMUM IT'S GOING
TO BE A PROBABLY A SIXTY DAY
DELAY IN SOME CASES IT MAY BE
EVEN LONGER WELL AND THEN ON
THE FLIP SIDE YOU SAID THAT
AFTER A CURE ME GETS FIVE
REPORT JACK DEAD AND THEY'RE NO
LONGER. THEY WEREN'T EVEN
PACKING SO EVEN IN THE EVENT
THAT THERE WERE SOME BACK YOU
AND IS WE WERE NEED AND KICKING
YOU KNOW REJECTING THEM.
BECAUSE OF THE OF FAILED
BECAUSE SOMEBODY'S KEEPING
TRACK THAT'S CORRECT AND
THERE'S A STATE LAW THAT ROUTE
THE REGARD REAPPOINTMENT RIGHT
IF I AS A Q. AND ME HAVE HAD
FOR MORE THAN FIVE FIVE I THINK
IT'S MORE THAN FIVE REJECTED- I
CANNOT GET REAPPOINTED AS A CUE
ME SO THEN WE HAVE THE OPPOSITE
PROBLEM THAT SOME OF THE BAG
AND THESE WERE NOT EVEN BEING
REJECTED CORRECT BECAUSE
NOBODY'S KEEPING TRACK OKAY
CORRECT. THANK YOU. I DON'T
KNOW IF YOU'RE DONE WITH YOUR
PRESENTATION OF FINE. OF
SENATOR ROTH AND- UP I WOULD
JUST LIKE AT SOME POINT
SOMEBODY TO ANSWER THE I'VE GOT
OTHER QUESTIONS BUT ON THIS
PARTICULAR POINT. SO WHEN A
QUEUE IN ME HAS A REJECTED
REPORT THAT A JUDGE DETERMINES
IS INSUFFICIENT DOES THE QUEUE
IN ME AND IS THE CURE MAY
ENTITLED TO BE PAID FOR THAT
REPORT. INMATE AT BEST MAYBE
THE QUESTION NEEDS TO GO TO DID
OF YOU SEE. BUT IF PART OF THE
PURPOSE OF THIS HEARING IS
DETERMINED TO DETERMINE
LEGISLATIVE FIXES TO THIS
PROCESS. AND IF SOMEBODY IS
TURNING OUT. REPORTS THAT ARE
REJECTED AND THEY DON'T GET
PAID. THEN I SUGGEST THAT
THEY'LL PROBABLY EITHER FIX THE
REPORTS IN THE FUTURE OR THEY
WILL DROP OFF THE QUEUE IN THE
PANEL WE CAN REPLACE THEM WITH
SOMEBODY WHO KNOWS A TO DO THE
JOB. THIS MADE UP A QUESTION DO
YOU I'M- CONTENT TO WAIT TO THE
NEXT PANEL BUT I'D LIKE FOR
SOMEBODY ANSWERED BEFORE WE
FINISH. THANK YOU SENATOR AND I
APOLOGIZE I DON'T HAVE THE
ANSWER THAT QUESTION I WOULD
ASSUME THAT. HOPE THAT THE
DIVISION WOULD HAVE THAT. GREAT
JEFF ANYTHING ELSE- I WOULD
JUST GOING TO CLOSE IT OUT WITH
JUST OUR RECOMMENDATIONS I
MENTION THAT THE TWO BEFORE TO
SO THAT THE RECOMMENDATION FOR
THE JUDGES WHEN THEY REJECT
THEM TO TRACK TO TELL THE WC
AND THEN FOR D. W. C. TO TRACK
THEM BUT THEN ALSO AS I SAY THE
BEGINNING THE OTHER TWO THINGS
THAT NEED TO BE SEE WAS NOT
DOING WE HAVE RECOMMENDATIONS
FOR THEM TO ESTABLISH POLICIES
PROCEDURES FOR HOW THEY'RE
GOING TO DO THAT RAND SELECTION
YOU FOR QUALITY. AND THEN TO
FOR HOW THEY'RE GOING TO REPORT
THAT TO THEIR ADMINISTRATIVE
DIRECTOR WITH THE
RECOMMENDATIONS AND SO AGAIN
THIS IS REALLY IMPORTANT
BECAUSE YOU THE THESE. FOR
QUALITY REPORTS COULD
ULTIMATELY LEAD TO DELAYS FOR
THE INJURED WORKER AND
INCREASED COSTS FOR THE
EMPLOYERS. OKAY THANK YOU THANK
YOU LET ME ASK JUST ONE FOLLOW
UP BECAUSE I THINK IT'S GOING
TO BE HEARD AND FOR THE NEXT
PANEL. IN THE DEPARTMENT'S
RESPONSE TO THE AUDITS THEY
OBVIOUSLY. I DON'T AGREE WITH.
WITH YOUR ASSERTION THAT
THERE'S A LACK OF TWO EMMYS
RIGHT CAN YOU JUST ELABORATE A
LITTLE BIT MORE ON THAT AND WHY
YOU DISAGREE WITH THEIR
RESPONSE TO THE AUDIT. WELL I
THINK THE INFORMATION IN THE
REPORT CERTAINLY IN THE
GRAPHICS ILLUSTRATE THAT
THERE'S A PROBLEM AS FAR AS THE
NUMBER OF JIMMY'S AVAILABLE
WHEN YOU HAVE. A DECLINE IN THE
NUMBER OF Q. ENEMIES AND YOU
HAVE A SIGNIFICANT A 37%
INCREASE IN THE NUMBER OF
REQUESTS FOR PANELS. ANALYSTS
TO CHOOSE FROM AND THEN YOU SEE
THE STATISTICS WE IDENTIFIED
WHERE YOU'VE GOT REPLACEMENT
PANELS. SPECIFICALLY REQUESTED
BECAUSE AQ ME WAS NOT AVAILABLE
TO PROVIDE TO CONDUCT THAT
EVALUATION QUADRUPLING IN A
FIVE YEAR WINDOW. THAT'S A
PROBLEM- SO I WOULD STRONGLY
DISAGREE WITH THE DEPARTMENT I
KNOW THEY HAVE HAD SOME STUDIES
DONE. WHERE THEY'RE LOOKING AT-
AYE AYE THERE WERE SOME QUEUE
ENEMIES WHO HAVE OFFICES
THROUGHOUT THE STATE OF
CALIFORNIA SO MAYBE THEY'RE
GETTING SELECTED ON A- MORE Q.
AND MEET THEIR THEIR PART OF
MORE Q. M. B. PANELS. AND
BECAUSE THERE ARE MORE. PANELS
THERE AND NOT NECESSARILY
AVAILABLE BECAUSE IF THEY GET
SELECT FOR MY CASE OF
MICHELLE'S CASE AND MS RUBIO
CASE IT'S LIKE I CAN'T DO. I
CAN ONLY DO ONE. WITHIN THE
NEXT THIRTY DAYS SO THESE TWO
INDIVIDUALS HAVE TO GO BACK FOR
A REPLACEMENT PANEL. AND THAT'S
WHY WE DID ANALYSIS BY ZIP CODE
WHICH IS THE WAY THAT IDENTIFY
THE KEY MEETINGS. ES DETERMINE
HAVE IS HAS THERE BEEN A
SIGNIFICANT NUMBER OF Q. AND
FEES IS IT CONCENTRATED LIKE
THEIR ARGUED. AND WHAT WE FOUND
IS THAT IS NOT THE CASE BASED
ON THE DATA WE LOOKED AT AND I
NEED TO LOOK AT MY NOTES
BECAUSE I DON'T WANT TO GET IT
WRONG- BUT WE HAD OUR I. T.
FOLKS. NEAR THE OKAY LET'S SEE
DID DID. THE DECREASE IN AND
THE NUMBER OF Q. AMIS RIGHT AS
I SAID QUADRUPLED THE DATA
SHOWS THAT CASES REQUIRE
REPLACEMENT POUNDS DO AVAILABLE
Q. M. E. NEARLY HALF THE TIME
THE CASE IS DELAYED BY TWO
MONTHS- AND THEN WE DID THE
ANALYSIS BY ZIP CODE I CAN'T
FIND IT IN MY NOTES RIGHT NOW
BUT- BUT THERE WAS AN ANALYSIS
THAT WE DID THAT SAID. THAT IS
NOT NECESSARILY THE CASE AS FAR
AS THE NUMBER OF Q. ENEMIES
THAT THERE BEING A PROBLEM WITH
RESPECT TO THE CONCENTRATION OF
THE QUEUE ARMIES ARE IN
CALIFORNIA SO BUT AND I'VE
LOOKED AT SOME OF THE STUDIES
THEY'VE HAD A LOT OF STUDIES
DONE YOU'LL ALSO IF YOU LOOKED
AT OUR RESPONSE THERE WERE WERE
WILLING TO STE TO STUDY THE-
THE DECLINE WERE WILLING TO
STUDY THIS. THERE HAVE BEEN
ENOUGH STE WITH ALL DUE RESPECT
THERE'S BEEN A LOT OF STUDIES
DONE I THINK WITH OUR
RECOMMENDATION THAT THE
DIVISION NEEDS TO COME UP WITH
A LAN TO ADDRESS THE MEDICAL
FEE SCHEDULE AS YOUR
LEGISLATION DOES. THAT'S
BECAUSE THEY GOT TO BE A
PROBLEM IF THAT HASN'T BEEN
RECENT THIRTEEN YOU JUST ST STE
PI IT WOULD GO UP OVER TWO
HUNDRED DOCTORS. BUT WHAT WE'RE
SEEKING IS. THE USE OF DATA TO
IDENTIFY WHAT SPECIALTIES ARE
DECLINING. WHAT AREAS IN THE
STATE OF CALIFORNIA ARE WE
REALLY STRUGGLING AND HAVING.
MORE AND MORE REPLACEMENT
PANELS JUST BEING STRATEGIC
ABOUT. THE APPROACH IN. IN ART
RECRUITING Q. AND NEEDS TO BE
IN THE SYSTEM THEY HAD REACHED
OUT TO SOME PHYSICIANS IN.
MANAGED CARE PLANS- AND MEDICAL
GROUPS AND SOME OF THE MEDICAL
GROUPS ARE RELUCTANT TO LET
THEIR PHYSICIANS. IN FAIRNESS
TO THE DIVISION THEY HAVE TRIED
THEY REACHED OUT WELL WE'RE
SUGGESTING CONTINUE TO DO THAT.
ARE AND THIS IS RIGHT ABOUT THE
NEEDS WELL I THINK IT'S FOR
SPECIALTIES BUT ALSO FOR ANY
TYPE OF PHYSICIAN BECAUSE THOSE
MEDICAL GROUPS ARE MEN. WANT
THEIR PHYSICIANS TO BE
TREATING. THEIR PATIENTS NOT
NECESSARILY TAKING TIME AWAY TO
CONDUCT THESE EVALUATIONS. SO
RECOMMENDATION IS. BY TWENTY
APRIL OF TWENTY TWENTY WHICH WE
ALWAYS DOING OUR
RECOMMENDATIONS NOW DEVELOPING
A PLAN INCREASE THE NUMBER.
ACTIVELY RECRUIT. YOUR TIE
SPECIALTIES WITH THE GREATEST
SHORTAGES YOU HAVE THAT
INFORMATION START THERE- AND AN
ADDRESS THAT PARTICULAR ISSUE.
NOT CONTINUE NEGOTIATING WITH
MEDICAL GROUPS AS BEST YOU CAN
AND ESTABLISH GOALS TRACK HOW
WELL YOU'RE DOING BECAUSE WE
WEREN'T SEEING EVIDENCE OF THAT
BE THE DIVISION BEING MORE AND
MORE PROACTIVE- EVEN THOUGH
THEY ACKNOWLEDGE THERE'S A
DECLINE. THEY'RE SUGGESTING
THERE'S NO SHORTAGE AND AM I
STRONGLY DISAGREE WITH WITH
THAT ASSERTION I MEAN THEY'RE
ENTITLED TO THEIR OPINION- WITH
RESPECT TO- THAT SOME OF THE
OTHER ISSUES WE HAVE IN THE
REPORT AS FAR AS THE DUE
PROCESS ISSUES. I JUST WANTED
TO QUICKLY GO OVER THEN THE
RECOMMENDATIONS IN THE REPORT
WE DISCUSS- AND WE ASK THEM FOR
POLICIES AND PROCEDURES WITH
RESPECT TO THEIR DISCIPLINARY
PROCESS AND IN OUR- IN OUR- FIX
PACKAGE THAT'S JUST THE- THE AN
ABBREVIATED VERSION I MEAN
THERE'S A POLITE LENGTHY TO.
THE GATE DESPITE PROCESS THAT
THEY FOLLOW WHEN WE ASK NUMBER
POLICIES PROCEED THEY GAVE US A
FLOW CHART. THAT STAFFER
SUPPOSED TO FOLLOW THEY NEED TO
HAVE MORE SPECIFIC. SEASON
PROCEDURE FOR THE VESTED IN.
FACT VERSES THE REQUIREMENTS I
NEED TO KEEP SEPARATE THEY THEY
HAVE FLAYED. SECULAR SO THERE
WAS NO REGULATION OUTLINING
WHAT PROCESS. NO WE DIDN'T SEE
SPECIFIC POLICIES AND
PROCEDURES FOR STAFF TO FOLLOW
OF TO UNDERSTAND- WHAT THEY
SHOULD FOLLOW BUT THE TWO BUT
TO BE CLEAR YOU SAID THAT THEIR
SPECIFIC LAW THAT REQUIRES
THAT. IS THAT CORRECT. WELL
THERE THERE ARE SPECIFIC LAWS
AND REGULATIONS REGARDING WHAT
THEIR INVESTIGATIVE AND REGULAR
OUR OUR DISCIPLINARY PROCESS.
THE AND THE RE APPOINTMENT I
MEAN IT REALLY TIES TO AND OUR
ATTORNEYS IN THE AUDIENCE YOU
CAN ASSIST IF NECESSARY BUT-
WE'RE NOT SAYING DUE PROCESS IT
IT MAY AFFECT DUE PROCESS
BECAUSE- IN SOME CASES. IT
WASN'T A PROBLEM WHEN WE LOOKED
AT THE Q. M. Q. ENEMIES IN
THERE. THE ALLEGATIONS OF
VIOLATIONS THE PROCESS WORKED
WE SAW SOME AND THE MOST
EGREGIOUS ONE. THAT I SAW WAS
THE ONE I ILLUSTRATED WHERE THE
ALLEGATION COMES IN TWENTY
FOURTEEN. AND THEY WAIT UNTIL
YOU KNOW ALL ALMOST TWO YEARS
LATER. TO DENY THE
REAPPOINTMENT OF THAT
PARTICULAR Q. AND ME RATHER
THAN ALLOWING. THE CASTIGATE OF
DISCIPLINARY PROCESS TO PLAY
ITSELF OUT ALLOW THE QUEUE
IMMEDIATE CONTINUE TO. TO
PERFORM SERVICES AND FULLY
RESOLVE THAT SITUATION THE
ALLEGATION WAS SUBSTANTIATED
NOT. IT WAS NOT. THE AND-
WOULDN'T HAVE THE ISSUE OF.
FIFTEEN MONTHS LATER IS NOT
ABLE TO PROVIDE SERVICES THAT
HURTS THAT SPECIFIC INDIVIDUAL
BUT IT ALSO HURTS THE WORKERS
WHO COULD HAVE. RECEIVE
SERVICES FROM THAT PARTICULAR
EVALUATOR SO GREAT WE REALLY
HAD A PROBLEM WITH THAT SO. ALL
OF OUR RECOMMENDATIONS TO THE
DIVISION SUGGEST THAT THEY THEY
GET THESE PLANS TOGETHER
POLICIES AND PROCEDURES AT
CETERA. QUESTIONS WHAT SOUNDS
LIKE WE HAVE A LOT OF QUESTIONS
FOR THE NEXT PANEL. SO WITH
THAT WE'RE GONNA GO WITH US AND
ROTH SINCE SINGER MORE LOCKED
INTO ASSEMBLY MEMBER VOEPEL.
YOU KNOW. YOU KNOW I HAVE- I
HAVE NO PROBLEM WITH THE
RECOMMENDATIONS CERTAINLY WE
NEED TO PAY PEOPLE
APPROPRIATELY FOR THE SERVICES
THAT THEY PROVIDE IT'S
OBVIOUSLY A PROBLEM OBVIOUS
IT'S PROBLEM HERE IN WORKERS
COMP JUST AS IT IS WITH MEDI
CAL ON A FEW OF THE OTHER IS
WHERE. PROVIDERS PROVIDE
SERVICES TO OTHERS. I'M JUST
WONDERING IF THIS. SO CALLED
SHORTAGE ISSUE IN THE
AVAILABILITY OF Q. MAYES AS
PART OF A LARGER ISSUE YOU KNOW
THAT WE'VE BEEN GRAPPLING WITH
HERE IN THE LEGISLATURE
CERTAINLY FOR THE- NOW GOING ON
EIGHT YEARS THAT I'VE- I'VE
BEEN UP HERE. AND THAT IS THE
SHORTAGE OF PHYSICIANS OVERALL
IN THE STATE I DON'T KNOW IF
YOU. TOOK A LOOK AT THAT I MEAN
THE STATISTICS THAT NOBODY
SEEMS TO DISPUTE IS THAT WE'RE
GONNA BE SHORT. OVER EIGHT
THOUSAND PRIMARY CARE
PHYSICIANS BY TWENTY THIRTY AND
SIMILAR STATISTICS FOR
SPECIALTY. PRACTICE AREAS
ORTHOPEDIC SOME OF THE ONES
THAT WE SEE MOST COMMONLY IN
THE WORKERS COMPARABLE- WE ALSO
HAVE A TREND IN. THE HEALTH
CARE PRACTICE FOR INDIES AND DO
IS IN THE LIKE WHERE. THE SOLO
PRACTICE POSITION WITH THE
CRINKLED LEATHER BAG THAT WOULD
COME FOR HOUSE CALLS IS RAPIDLY
BECOMING AS EXTINCT AS THE
DINOSAUR. DUE TO THE COST OF
PRACTICE MALPRACTICE COVERAGE
COSTS OF FACILITY OF OFFICE
OPERATIONS ELECTRONIC MEDICAL
RECORDS IN ALL OF THE REST. ALL
MIGRATING TO THESE MULTI
SPECIALTY PRACTICE GROUPS.
WHICH HAVE THEIR OWN CONTRACTS
WHICH EMPLOY PHYSICIANS WHICH
CONTROL PHYSICIANS IN AND WORK
HOURS IN THE NUMBER OF PATIENTS
THEY HAVE TO SEE EVERY DAY. AND
Q. IN THESE ARE NOT TREATING.
PHYSICIANS THERE LARGELY REPORT
EVALUATION AND SOME. PATIENT
EXAMINATION WERE NECESSARY SO
DID YOU. IN THE IN COMING UP
WITH YOUR CONCLUSIONS NOT THE
GENERAL NOT THE SPECIFIC ONES
WITH RESPECT TO RATE TO RATE
EVALUATION AND DUE PROCESS
REQUIREMENTS BUT THE GENERAL
CONCLUSIONS WITH RESPECT TO
WHAT. DID YOU SEE DID- OR
HASN'T DONE DID YOU CONSIDER
THE OVERALL STATE OF THE HEALTH
CARE PROVIDER POPULATION IN
CALIFORNIA AND THE REASONS FOR
THAT. WE ACKNOWLEDGE THE ISSUE
IN THE REPORT SENATOR WE
ACTUALLY- REFERENCE TO A UC
STUDY THAT TALKS ABOUT-
PHYSICIANS THE NUMBER OF
PHYSICIANS IN CALIFORNIA
ACTUALLY INCREASING HOWEVER THE
NUMBER BEING- NOT NEARLY ENOUGH
BASED ON OUR OVERALL
POPULATION- SO WE ACKNOWLEDGE
IT WE DIDN'T GO INTO DOING US A
DETAILED ANALYSIS OF. PRIMARY
CARE PHYSICIANS VERSUS
SPECIALIST AT CETERA SO WE
ACKNOWLEDGE THAT THAT IS A
CHALLENGE THAT THE DIVISION
CERTAINLY FACES ARE IN
IDENTIFYING Q. AMIS BECAUSE
THERE IS A SHORTAGE OF
PHYSICIANS IN CALIFORNIA AND-
THAT CERTAINLY- WILL LEND
ITSELF TO A SITUATION IN IN
THIS PARTICULAR AREA WHERE.
THERE THERE- IF THERE'S A TICK
THERE ISN'T A DECLINE IN NUMBER
PHYSICIANS AND IN CALIFORNIA
BUT CERTAIN SPECIALTIES
ABSOLUTELY THERE HAS BEEN A
DECLINE- AND WE IDENTIFIED IN
THE REPORT- THAT THE DATA THAT
THE DIVISION HAS THAT IT CAN
USE. TO TRY TO IDENTIFY WHICH
SPECIAL LEASE ORTHOPEDICS
ABSOLUTELY AS ONE THERE ARE
SOME OTHERS THAT THAT WE
ANECDOTALLY MENTION BASED ON
THEIR DATA SO WE DIDN'T GO INTO
A BIG OVERALL DETAILED
ANALYSIS. OF THE SUPPLY OF
PHYSICIANS IN CALIFORNIA THE
SUPPLY OF SPECIALISTS IN
CALIFORNIA AND HOW THAT WOULD
TIED TO THIS PARTICULAR-
WORKERS COMPENSATION PROGRAM
FOR KILOMETERS- BUT WE DO WE DO
ACKNOWLEDGE THAT THAT IS ONE OF
THE CHALLENGES THAT THE
DIVISION FACES ONE OF THE
COMMENTS IN THE DEED OF UC'S
ROUTE RESPONSE WHICH I DON'T
KNOW IF YOU. HAD AN OPPORTUNITY
TO. PROVIDE A DETAILED RESPONSE
TO. DATA AS OUTLINED BELOW
SHOWS THAT ONLY 50% OF OUR
CURRENT Q. IN THE PHYSICIANS
ARE BEING ASSIGNED TO PANELS.
AND THAT JUMPED OUT AT ME AND I
PLAN TO AS CITY TO BE SEE ABOUT
THAT BECAUSE THE NOTE THAT I
WROTE IN THE IN THE MARGIN FOR
ME IS WHY. DID YOU WILL LOOK AT
THAT WAS THAT SOMETHING THAT
YOU ENCOUNTERED DURING YOUR
AUDIT. WELL WE THAT WAS IN
THEIR RESPONSE- SO I DON'T KNOW
THAT IT CAME UP DURING THE
COURSE OF THE AUDIT BUT WHAT WE
DO. SAY IN OUR COMMENTS TO
THEIR RESPONSES THIS STUDY THEY
THEY BASE THAT ON. IT LOOKED AT
ABOUT A SIX MONTH WINDOW IN
TWENTY SEVENTEEN SO WE FEEL
THAT. THAT THAT DOESN'T
NECESSARILY REFLECT. WHAT HAS
HAPPENED OVER THE FIVE YEAR
WINDOW THAT WE LOOKED AT AND
EVEN THAT STUDY ACKNOWLEDGE
THAT. IT WAS A SHORT TIME FRAME
AND THAT PERCENTAGE COULD BE.
GREATER OUT LOOKING AT A LONGER
TIME FRAME IT'S A PROCESS ISSUE
IF. BROUGH CHAIR- RIGHT THAT
THEY NEED TO DEAL WITH I WAS
JUST I'M JUST TRYING NOW I GET
TO GROUND ZERO ON THIS AND OUT
OF. BE SURE TO ASK THEM WHEN
THEY'RE UP HERE. THIS WANTED TO
KNOW IF YOU HAD A PARTICULAR
PERSPECTIVE ON THANK YOU MISTER
CHAIR. THANK YOU CENTER MORE
WITH THANK YOU MISTER CHAIR IS
WHEN CAN I GO FROM THE MICRO TO
THE MACRO IN. OF THE WITH WITH
YOUR PLEASURE I GUESS BUT- THAT
THE MICRO IS ON THE Q. AMIS.
HOW MANY ARE ACTIVE POSITIONS
AND HOW MANY ARE RETIRED. NOW I
DON'T HAVE THE ANSWER THAT
QUESTION CENTER I APOLOGIZE
SELECT JUDGES WORK FOR. WHAT
WOULD YOU CALL IT- NEVER
TRADERS THE YOU KNOW THEY DO
CONSULTING ARE BETTER
REPUTATION ARBITRATIONS BUT I
JUST WONDER IF THERE'S SOME
YEAH POOL OF RETIRED- DOCTORS
THAT WOULD WOULD WORK FOR Q.
ENEMIES YEAH AND AGAIN I THINK
THAT'S SOMETHING THAT HOPEFULLY
THE DIVISION WOULD HAVE THAT
INFORMATION BECAUSE THAT WOULD
BE SOMETHING THAT WE WOULD. BUT
IN WAY IN OUR RECOMMENDATION
THAT MISS SAUNDERS- MENTIONED
IS WHEN WE TALK ABOUT THE PLAN
FOR RECRUITING IT'S ALSO USING
INFORMATION AND PROJECTING- AND
IT AND LOOKING AT THE MIX OF
TWO ARMIES ARE VAST MAJORITY
KIMI'S RETIRED POSITION SO EVEN
THOUGH A PHYSICIAN DECIDES TO
RETIRE DOESN'T WANT. TO SEE
PATIENTS ANYMORE IS HAVE AN
INTERVIEW WE SHOULD RECRUIT
POTENTIALLY BE A U. M. B. FOR A
CALIFORNIA SO I DON'T HAVE THE
ANSWER SPECIFICALLY TO YOUR
QUESTION HOPEFULLY THE DIVISION
DOES. IF NOT THAT ONLY A
SUGGESTION THAT THEY SHOULD.
INCLUDE IN THEIR PLAN WHEN THEY
LOOK AT PROJECTION. LET'S SEE
HOW MANY. HOW PHYSICIANS ARE
WHO ARE RETIRED ARE WILLING OR
ARE HAVE CONSIDERED BECOMING A
CUE I MEET PARTICULARLY IF THE
MEDICAL THE SCHEDULES
INCREASED. ECONOMIST MISS HOW
YOU'VE BEEN. BUSY IN THIS AREA
OF WORKERS COMPENSATION THIS
YEAR SO I WANT TO. KIND OF LOOK
AT THE OVERVIEW IN THE
INTEGRATION SO. IF I COULD STEP
BACK FROM THIS AUDIT- AND LOOK
AT THE OTHERS THAT YOU'VE DONE-
YOU'VE DONE CALIFORNIA
DEPARTMENT OF CORRECTIONS AND
REHABILITATION FOR THEIR
EMPLOYEES. SUBTITLE EMPLOYEES
AND INMATES JOURNAL RECEIVED
NECESSARY MEDICAL CARE FOR WORK
RELATED INJURIES WITHIN.
REASONABLE TIME FRAMES THAT WAS
IN JULY. HE DID THE WORKERS
COMPENSATION INSURANCE AUDIT
FOR ME WHICH I APPRECIATE SOME
STATE AGENCIES ARE PAYING
MILLIONS OF DOLLARS MORE THAN
NECESSARY. TO PROVIDE BENEFITS
TO THEIR EMPLOYEES WERE ROUTE
WE GOT TO LEARN THAT THERE IS
A- A MASTER AGREEMENT RIGHT AND
THERE ARE INDIVIDUAL
DEPARTMENTS PURCHASING. WORKERS
COMP INSURANCE FROM THE STATE
COMPENSATION INSURANCE FUND.
AND WE'VE GOT THIS ONE WITH THE
DEPARTMENT OF INDUSTRIAL
RELATIONS. AND WE JUST HAD THE
LA TIMES COME OUT AND SAY THAT
THE STATE WORKERS COMPENSATION
OR COMPETITION TURNS FUND IS.
PAYING MASSIVE SALARIES AND
THERE'S NEPOTISM AND THERE'S A
LOT GOING ON IN THIS LITTLE
SPACE OF WORKERS COMP IN. AND
MY CONCERN IS. HOW WAS IT ALL
INTEGRATED IS THIS CAL H. R.
MONITORING ALL OF THE STATE'S
DEPARTMENTS DO WE HAVE THIS ORG
CHART. WHERE WE NEED IT BECAUSE
OUR FOR WORKERS COMP OR- IS IT
THE- DEPARTMENT OF FINANCE SAID
OVERSEAS. WORKERS COMP FOR ALL
THE DEPARTMENTS WE DON'T HAVE A
CHIEF OPERATING OFFICER THAT
I'M AARE OF- SO I'M JUST
WONDERING YOU KNOW I I'M GOING
BACK TO MY COUNTY DAYS YOU KNOW
CENTRALIZED VERSES
DECENTRALIZED AND SO I'M
LOOKING AT THE BIGGER PICTURE.
OF YOU KNOW NOW THAT YOU'VE STE
Q. AND YOU HAD MISS SAUNDERS
WORK IN ONE AREA ANDI'VE GOT
THE NAMES OF THE OTHERS AND
OTHER ARTISTS YOU'VE DONE
BUTTON. YOU KNOW MAYBE THERE'S
A- MAYBE THERE'S A BIGGER
ANSWER THAT WE'VE GOT A- PURSUE
AND I'M JUST. IF YOU COULD GIVE
ME THAT NOW GET. OF ADVICE.
WELL. ANOTHER TIES INTO YOUR
HOUSE RIGHT THERE OUGHT WILL YA
LOOK AT IT YEAH YOU KNOW YOU
ASKED FOR NOT IT. RIGHT MISS
RUBIO ASTRONAUT AND IT ADDED IN
HERE AT ALL IS SITTING HERE
IT'S YOU NOW HAVE THIS CHANCE
TO JUST LOOK AT ALL AND HOW
DOES IT ALL IN A GREAT HOW DO
WE REALLY CLEAN THE BEST.
PRACTICES THE- WELL AND I THINK
THAT WHAT THE LABOR AND
WORKFORCE AGENCY THAT THE I. R.
AS UNDER THAT'S THAT'S THE
UMBRELLA. AND SEE THAT OF
COURSE REPORTS DIRECTLY TO THE
GOVERNOR SO. THAT AGENCY I
THINK WOULD HAVE SOME
RESPONSIBILITY CERTAINLY THE
DEPARTMENT- HAS SOME
RESPONSIBILITY BASED ON ON THE
WORK WE DID HERE AND WORK WE
DID FOR MS RUBY ON THE OTHER
AUDIT CCRI IT. CERTAINLY THE-
WE DID FOR YOU I THINK ON YOUR
BUT IF I RECALL. THAT MASTER
AGREEMENT CAL HR WOULD BE AND
THAT AS FAR AS MAKING SURE THAT
SOME OF THESE DEPARTMENTS. ARE
DEEP IN THE ANALYSIS THAT WE
SUGGESTED IN YOUR IN YOUR IN
THE REPORT WE PRODUCED. BASED
ON YOUR REQUEST WHERE. GOTTA DO
THAT COST BENEFIT ANALYSIS IS%
IT IS IT SMARTER FOR US TO. TO
BE PART OF THE MASTER SERVICE
AGREEMENT OR TO BE PAYING
PREMIUMS- ARE YOU KNOW AND THAT
MONTHLY OR ANNUAL BASIS SO. I
WOULD START WITH THE LABOR AND
WORKFORCE AGENCY BECAUSE THEY
HAVE THE RESPONSIBILITY FOR
THIS PARTICULAR DEPARTMENT.
THEY WOULD BE ABLE TO AND THEY
HAVE TO RESPOND TO ALL OF OUR
REPORTS SO I WOULD PRESUME. AS
MANY- ADMINISTRATIONS HAVE DONE
THAT THEIR AGENCY SECRETARY AND
STAFF WITHIN THAT. THAT AGENCY
ARE LOOKING AT THE CROSS
CUTTING ISSUES THAT THE STATE
THERE'S A C. L. A. R. WERE
WHOEVER. HAS DONE- AND-
COMPILING ALL OF THEM TO SEE.
HOW WHAT ARE THE KINDS OF
THINGS THAT WE NEED TO DO AS A
AS AN AGENCY AND THE NEW SOME
ADMINISTRATION TO TRY TO.
ADDRESS SOME OF THESE ISSUES SO
THAT'S WHERE I WOULD START.
WELL IT IT SEEMS TO ME THAT THE
DATA YOU'VE COMPILED. SHOULD
HAVE BEEN. TO A DEPARTMENT HEAD
OR A SECRETARY OR SOMEONE- AND
THIS IS A TREND THAT'S NOT JUST
NEW THIS IS OVER MULTIPLE
YEARS. AND I'M JUST KIND OF
WONDERING. WHO DO I GO TO AND
SAY WAIT A SECOND WHITE WHY
HAVE YOU NOT. INSTITUTED. SOME
INITIATIVES TO TURN THIS CHART
AROUND IN IN AND THE TREND
AROUND- IN SEOUL COMING FROM
COUNTY LAND I'M I'M TRYING TO
SHOWCASE THE STATUS SO MASSIVE
IN YOUR CART MUST BE SO BIG BUT-
GOOD NIGHT YOU KNOW. WE'RE
PAYING YOU GOOD SALARIES YOU
SHOULD BE SEEING. YOU KNOW THE
TRENDS AND YOU HAVE TO BE
PROACTIVE DUMP WAIT FOR AN
AUDIT TO COME ALONG TO TELL YOU
NOW I SPENT SOME TIME AND I SAT
DOWN WITH THIS THE STATE
COMPENSATION INSURANCE FUND.
AND IT TURNS OUT THAT THE
MASTER AGREEMENT IS SORT OF AN
OPEN ENDED PROGRAM WHICH THE
AUDIT DID TOUCH BUT THERE MIGHT
BE LIKE SEVEN BILLION IN
LIABILITIES. THAT WE NEED TO
LOOK AT AND FACTOR RAN FOR
CASES THAT ARE. BEING SORT OF
PAGE YOU GO BECAUSE THAT'S WHY
THE PREMIUM OR THE COST IS
LOWER RATES COULD BE HIGHER
OVER TIME SO I GUESS I KIND OF
FOUND THAT MAYBE I HAVE TO ASK
AGAIN. FOR YOUR FOR YOUR
SERVICES BUT IT SEEMS TO ME
THAT WE'VE GOT TO GET A TEAM.
THAT'S LOOKING AT THAT THE
WHOLE WORK COMP PROGRAM FOR THE
STATE AS A WHOLE TO GETS FROM.
SHION SEASON. OWES SURE I DON'T
KNOW IT GOES YEAH IT JUST SEEMS
LIKE YOU TRY TO. LEGISLATE OUR
ARMS AROUND THE ENTIRE ISSUE
BUT YES A LONGER DISCUSSION
DEFINITELY BUT WE'RE WE'RE
LEGISLATORS WERE NO LONGER
EXECUTIVE SO IT'S IT THE ALL I
GET IS A FIVE MINUTES TO ASK
QUESTIONS AT A- AT A HEARING.
AND BUT- TAKE TEN- WELL YOU
KNOW. IN A ROUGH WE'RE JUST
WE'RE TRYING TO. YOU KNOW. MOVE
WHEN WE'RE DONE. WE WANT TO
LEAVE THE PLACE A LITTLE BETTER
SHAPE CRACK KINDA HOPING. THAT
THERE'S SOME PROACTIVE
INITIATIVE TAKEN. BY OUR STAFF
MEMBERS AND THEIR MANAGERS AND
THEIR SECRETARIES AND THE
GOVERNOR. TO GET THAT DONE YEAH
AND I DON'T KNOW HOW YOU
LEGISLATE THAT BUT- IF THERE IS
SOME WAY- MAYBE WE NEED TO.
LOOK AT THE ORG CHART YEAH LOOK
AT THAT. YOU KNOW WHO IS WHO
WHO OF WHERE DOES THE BUCK
STOP. FOR THE GRAY HUE HANK
YOU. RIGHT WE'RE GONNA GO TO
MISTER VOEPEL AND WE'RE NOW AT
OUR FOR THIS FIRST PANEL WE
KNOW WE HAVE A LOT OF QUESTIONS
FOR THE SECOND PANEL. YOU'RE
BUYING DINNER RIGHT. UNDERSTOOD
THIS ROLE PLACE SO MISTER CHAIR
I SPENT. THIRTY NINE YEARS IN
THE INSURANCE BUSINESS I HOLD I
THINK AT LEAST SIX DIFFERENT
INSURANCE LICENSE. AND I'M NOT
A WORKERS COMP EXPERT WHO WANT
TO MAKE THAT CLEAR. AND MY
MENTALITY HERE IS TO SERVE AS
YOUR INSURANCE BROKER WHICH I
DID FOR THIRTY NINE YEARS OF
VISINE MY CLIENT THE STATE OF
CALIFORNIA AND THE CHAIR OF
THIS COMMITTEE. SO THAT'S WHERE
I'M COMING FROM. FIRST OF ALL.
AUDITOR'S SPOT ON. AND. LET ME
GO THROUGH INSURANCE ONE A ONE
AND THEY GO TO MY QUESTIONS IF
YOU LOSE IT INDULGE ME. SO I
WAS GUEST WANED. WORKERS COMP.
TO MY CLIENTS AS A BURRITO. WHO
EVERYBODY UNDERSTANDS A BURRITO
RIGHT SO. ONE END OF THE BREED-
IS PREMIUM HOW MUCH THE
EMPLOYERS PAY. THE OTHER END OF
THE BREED IS BENEFITS. WHAT
BENEFITS TO THE WORKERS GET NOW
ALL OF US WANT TO TAKE CARE OF.
THE WORKERS. WITHOUT
BANKRUPTING THE EMPLOYER OKAY
WE'RE ALL THEIR- WE ALL AGREE.
NOW THAT'S WHERE OF THE TRICK
COMES SAID. YOU SQUEEZE ONE END
OF THE BREED- THAT'S THE
EMPLOYER'S PREMIUM. AND THE
BENEFITS POP OUT. BETTER
BENEFITS FOR WORKERS THERE BY
GET SET BUT- IF THE EMPLOYER IS
GRIPING. THEN YOU SQUEEZE THE
OTHER END OF THE BREED IN A
BENEFITS TIGHTEN UP. NOW. HOW
TO TIGHTEN UP THE BENEFITS. YOU
DON'T DENY HIM. YOU DELAY THEM.
AND THAT'S WHAT WE'RE SEEING
HERE I BELIEVE SIR. YEAH WE'RE
BY LATE MORNING NUMBER AND
THEY- ARE INCREASES CAN THE
OTHER WAY YOU. BASICALLY DENY
BENEFITS IS TO SQUEEZE THE Q.
AMIS. WE HAVEN'T DONE ANYTHING
SINCE TWO THOUSAND SEX SO THAT.
ALLEVIATES THAT. SO. WHERE I'M
GOING WITH THIS IN I'LL TRY TO
KEEP IT RELATIVELY. PURE. I'M
AN OLD GUY I SAW THE STATE FUND
COME INTO THE WORKERS COMP
MARKET IN NINETEEN EIGHTIES NAY
TOOK OVER 60% OF THE WORKERS
COMP MARKET OKAY AND THEY GOT
BURKE THEY GOT BIRD BAD. THEY
COULDN'T MAKE. THEY'RE BRE REAL.
EITHER RAN IN SEOUL THROUGH THE
YEARS. THE STATE FUND HAS
WITHDRAWN FROM THE MARKET
QUIETLY ON NO. SO. WHERE I'M
GOING WITH THIS IS. STATE FUN
INSURANCE COMMISSIONER JUST
APPROVED A TEN POINT 3%
REDUCTION IN THE ADVISORY.
PREMIUM RATES. IS EVERYONE
AWARE THAT AND CHECK IT OUT YOU
CAN GOOGLE IT. THAT'S MY LATEST
INFORMATION FROM THE INDUSTRY
COULD BE WRONG DON'T KNOW. BUT
THIS COMMITTEE NEEDS A CHECK
THAT OUT. NOW ACCORDING TO MY.
CLAN STEIN INFORMATION IN THE
INDUSTRY WHICH MAY OR MAY NOT
BE ACCURATE BECAUSE- US
INSURANCE BROKERS ARE ALL
CONNECTED. IT'S INTERESTING TO
ME THAT BURKE HATHAWAY
SURPASSED STATE FUND AS LARGEST
WORKERS COMP UNDERWRITER WHO.
SO WE REDUCE THE PURE INSURANCE
RATE. IN A LARGE INSURANCE
COMPANY COMES SWOOPING IN.
COULD THERE BE PROFIT. THAT'S
SOMETHING FOR THIS COMMITTEE TO
LOOK AT AND I'M NOT MAKING ANY
ACQUISITIONS I DON'T KNOW THIS
IS RUMOR IT'S JUST. STUFF
THAT'S ALL THROWN OFF THE REAR
OF THE TRANSOM OF THE BOAT.
COULD BE WRONG BY COULD
ABSOLUTELY BE WRONG. AND IF
YOU'RE MESSING MY BIRTH. YOU
KNOW BERKSHIRE HATHAWAY. THAT'S
A BIG DEAL. SO I'M JUST SIMPLY
REPORTING. IS IN THE TRENCHES
INSURANCE REPORT COULD BE RIGHT
COULD BE WRONG. BUT IT NEEDS TO
BE LOOKED INTO. THAT'S WHERE
YOU COME. SO WHAT'S INTERESTING
IS ON. THE STATE FUN NOW HAS
GONE FROM 506070% IN THE PAST A
FIFTEEN POINT 6% OF THE
WORKER'S COMP MARKET. OKAY NOW
THAT'S NOT NECESSARILY GOOD OR
BAD I DON'T KNOW. BUT. THERE
ARE OTHER FORCES AT WORK IN THE
INSURANCE MARKET THAT WE MAY OR
MAY NOT BE. SURE OF. M. I TRULY
BELIEVE WE NEED TO LOOK AT THE
INSURANCE COMMISSIONERS-
REDUCTION OF TEN POINT 3% TO
CONFIRM THAT OR DENY IT. SO
MORE QUESTIONS THAT'S
BASICALLY. WHAT I HAVE TO
REPORT SIR AS YOUR INSURANCE
BROKER. ALL RIGHT THANK YOU
MISTER VOEPEL- WITHTHE DON'T
BELIEVE THERE'S ANY MORE
QUESTIONS THANK YOU THING
RESERVATION AND GO TO MOVE TO
THE SECOND PANEL. THE SERVER
COMMENTS IN RESPONSE FROM THE
DEPARTMENT OF INDUSTRIAL
RELATIONS WE HAVE- MISTER
DIRECTOR FOR THE DIVISION OF
WORKERS COMPENSATION- MISTER
RAYMOND. MEISTER EXECUTIVE
MEDICAL DIRECTOR DIVISION OF
WORKERS COMPENSATION SO THE
CHEN ITEM NUMBER THREE. GERMAN
THANK YOU FOR JOINING US AND
LET ME JUST ASK THE MEMBERS- ON
THE DíAS IF WE CAN MAYBE
HOLDER QUESTIONS SO AFTER THEY
PRESENT. MAYBE WE COULD. USE
OUR TIME MORE EFFICIENTLY THIS
WAY. SO PLEASE FIGURE THAT
INTRODUCE YOURSELF FOR THE
RECORD AND- PLEASE BEGIN TO
BELIEVE YOU HAVE A OPENING
STATEMENT GOOD AFTERNOON MY
NAME IS GEORGE KERR SAID ON
ADMINISTRATIVE DIRECTOR OF THE
DIVISION OF WORKERS
COMPENSATION. AND I'M JOINED BY
DOCTOR RAYMOND MEISTER WHOSE
EXECUTIVE MEDICAL DIRECTOR OF
THE DIVISION OF WORKERS
COMPENSATION I'D LIKE TO THANK
YOU MISTER CHAIRMAN AND MEMBERS
OF THE COMMITTEE FOR GIVING ME
AN OPPORTUNITY TO PROVIDE AN
UPDATE TO YOU- THE MISSION OF
OUR WORKERS COMPENSATION SYSTEM
IN THIS STATE. IS TO ENSURE THE
CALIFORNIA INJURED AT WORK
RECEIVE APPROPRIATE CARE FOR
WORK RELATED INJURIES IN THE
DISPUTES ARE ADDRESSED AS
EXPEDITIOUSLY AS POSSIBLE.
QUALIFIED MEDICAL EVALUATOR
PROGRAM DOES PLAY A CENTRAL
ROLE IN THE FUNCTIONING OF OUR
STATE SYSTEM. IT RESOLVES
MEDICAL LEGAL DISPUTES. SEVERAL
THE RECENT WORKERS COMPENSATION
REFORMS OF SOUGHT TO ADDRESS
THE KEY WITH ME PROGRAM AND
MAKE IT MORE EFFICIENT AND MORE
STREAMLINED THE MOST RECENT WAS
ADDRESSED THE TWO THOUSAND
TWELVE REFORMS BY SB EIGHT
SIXTY THREE. THE DIVISION OF
WORKERS COMPENSATION AND THE
WORKERS COMPENSATION COMMUNITY
EMPLOYERS LABOR PROVIDERS AND
CARRIERS HAVE STUDIED VARIOUS
ASPECTS OF THE QUEUE IN THE
SYSTEM FOR OVER TWO DECADES TO
TRY TO ENSURE THAT IT ADEQUATE.
THE IT IS ARTICLE YOU WORKING
TO HELP. EFFICIENTLY ADDRESS
DISPUTES ABOUT THE SYSTEM. THIS
IS AN ONGOING EFFORT AND OUR
FOCUS IS NOW SHIFTED TO ADDRESS
THE CURRENT CHALLENGES. DO THIS
IN THE AUDITOR'S IDENTIFIED
THREE MAJOR ISSUES WITH OUR
CURRENT PROGRAM ONE THE NUMBER
OF Q. AND HE'S IN OUR SYSTEM IN
THE DECREASE. CONCERNS ABOUT
THE DIVISIONS POLICIES AND
PROCEDURES REGARDING THE
REAPPOINTMENT OF Q. AMIS AND
THE DISCIPLINE OF Q. AMIS. AND
THEN THIRD ENSURING THE
ADEQUACY IS OF THIS REPORT OF
THE OF THE ADEQUACY OF QB
REPORTS. NO AS SEEN WE WILL
TAKE ALL THE RECOMMENDATIONS OF
THE STATE AUDITOR AND PUT THEM
INTO PLACE AS RECOMMENDED. WE
WANT TO GIVE YOU AN UPDATE ON
THAT IN THE W. C. HAS BEEN
WORKING WITH STAKEHOLDERS
EMPLOYERS AND PROVIDERS. OF TO
WORK ON IMPLEMENTINGTHE STATE
AUTUMN REAL AUDITOR'S
RECOMMENDATIONS WE HAD MEETINGS
WITH OTHER STAKEHOLDERS ON
OCTOBER EIGHTEENTH THIS WAS
BEFORE THE AUDIT FINDINGS CAME
OUT NOVEMBER TWENTY SECOND
DECEMBER SIX. AND WE HAVE A
SCHEDULED MEETING FOR THIS
FRIDAY JANUARY THE TENTH. IN
THE PROCESS OF HOLDING OUR
STAKEHOLDER MEETINGS OTHER
ISSUES THAT ARE RESPONSIVE TO
THE FINDINGS OF THE AUDIT HAVE
EMERGED IN ARE BEING ADDRESSED
IN THE MEETINGS WE ARE LOOKING
AT THE ENTIRE CUBAN THE
PROCESS. OF ITS BE DIFFICULT TO
WILL LOOK AT ONE ASPECT OF IT
NOT REALIZE THEIR OUT TAKES OF
IT ARE BEING AFFECTED IT SEEMS
OUR PROCESS WE WANT TO LOOK AT.
TRY TO MAKE PROFICIENT. ISSUES
OF QUALITY. IT FOR QUALITY
ANGEL TO THE LET ME PROCESS
HAVE BEEN THIS OF SEPARATE
BROUGHT OUT SECTIONS OF THE
STATE. WE WANT TO ENCOURAGE ALL
MEMBERS OF THE COMMUNITY TO
TALK ABOUT THIS AND REACH A.
RESOLUTION SOME OF THE- BEST.
WAY THE. CPAS X. ARE LEGALLY
HE'S GOT. ONE GOING MEETINGS
ARE SCHEDULED TO ARRIVE AT A
FEE SCHEDULE THAT IS FAIR TO
PROVIDERS AND OPERATES TO
REDUCE FRICTIONAL COSTS AND
STEM ABUSES WERE UNCHECKED
INCREASES IN MEDICAL LEGAL
COSTS IN THE WORKERS
COMPENSATION SYSTEM. IT IS TRUE
THIS IS THIS TO ME FEE SCHEDULE
HAS NOT BEEN UPDATED SINCE
SINCE TWO THOUSAND SIX WE HAVE
HAD STUDIES TO LOOK AT IT AND
THEY'LL STUDIES HAVE DETERMINED
THAT THE FEES ARE REASONABLE.
NOW I WOULD TOTALLY AGREE WITH
THE STATE AUDITOR MAYBE IT'S
TIME THAT WE PUT THE STUDIES
DECIDED THAT WE REACH AN
AGREEMENT AS TO WHAT IS A FAIR
AMOUNT. FOR A MEDICAL LEGAL
EVALUATION WE ALSO NEED TO
DETERMINE WHAT IS A QUALITY
MEDICAL LEGAL EVALUATION. AND
IN THAT REGARD PLEASE KNOW MY
STORY IS SOMEWHAT LIMITED AND
DETERMINE WHETHER REPORT IS
ADEQUATE OR NOT- THAT WE HAVE
AN ADVERSARIAL SYSTEM WE HAVE A
COURT SYSTEM TO REALLY TAKE A
LOOK AT THAT. WE BELIEVE. WE
HOPE TO IMPLEMENT A MANDATE TO
REVIEW AND UPDATE THE MEDICAL
LEGAL FEE SCHEDULE EVERY TWO
YEARS AND DEVELOP A STANDARD TO
DETERMINE APPROPRIATE INCREASES
THAT IS TIED TO OBJECTIVE. AND
OBJECTIVE INDEPENDENT STANDARD
FOR REASONABLE ADJUSTMENT TO
MEDICAL LEGAL COSTS WE WANT TO
LOOK AT THE WORK THE DOCTORS
ARE DOING AT THAT THAT WORK
INCREASES THEN THE FEE SCHEDULE
SHOULD CERTAINLY BE INCREASED.
ANY INCREASES MIGHT BE TIED TO
MEDICARE ECONOMIC INDEXES LIKE
THE OFFICIAL MEDICAL FEE
SCHEDULE. OF TYING IT TO
INFLATION CERTAINLY AN OPTION
BUT THERE ARE OTHER OPTIONS OUT
THERE ARE MID LEGAL FEES ARE-
OFFICIAL MEDICAL FEE SCHEDULE
IS TIED TO MEDICARE INCREASES
THAT SHOULD BE CONSIDERED TO
OTHER OPTIONS ALL OPTIONS
REALLY SHOULD BE LOOKED OUT.
THIS PLANNED ACTIVITY WILL ALSO
SERVE TO TAKE INTO ACCOUNT THE
RESULTS OF EMPIRICAL STUDIES
COMMISSION TO ENSURE EVIDENCE
BASED UPDATES TO OUR MEDICAL
LEGAL FEE SCHEDULE. IN TERMS OF
RECRUITING ADDITIONAL- Q. EMMYS
WE ARE LOOKING AT HAS TO HOW TO
ADDRESS THE AUDITOR'S
RECOMMENDATIONS TO RECRUIT MORE
Q. M. IS IN OUR SYSTEM. WE ARE
CERTAINLY LOOKING AT TARGETING
ONE PHYSICIANS THAT HAVE TAKEN
THE CUE IN THE EXAMINATION AND
PASSED AND DID NOT BECOME A Q.
ME AND WE TAKE NEED TO TAKE A
LOOK AT THAT. PHYSICIANS THAT
WORK Q. AMISOM LET THE SYSTEM
AN ENQUIRING INTO MORE DETAIL
AS TO WHY THE LEFT AND SEEING
IF WE CAN RECRUIT THEM BACK.
pPHYSICIANS IT TAKEN THE QUEUE
IN THE EXAM AND HAVE NOT PASSED
THROUGH EDUCATIONAL OUTREACH WE
WANT TO HAVE CONTINUED MEETINGS
WITH THE UNIVERSITY OF
CALIFORNIA AND MAJOR MEDICAL
GROUPS. NO THIS GROUP THAT DID
NOT WANT THEIR PHYSICIANS TO
BECOME . ENEMIES WE WANT TO
SEE HOW WE CAN MAKE THAT WORK
WE THINK THAT'S VERY IMPORTANT.
WE ARE ALSO TRYING TO DETERMINE
WHETHER IS BENEFICIAL FOR THE
DIVISION TO CONTRACT WITH A
VENDOR TO CREATE A SPECIALIZED
MARKETING PLAN TO RECRUIT
PHYSICIANS IF WE NEED EXPERTISE
MARKETING WE NEED TO SHUT WE
NEED TO GO OUT AND GET THAT. WE
WOULD LIKE TO HAVE A NEW FEE
SCHEDULE IN PLACE PRIOR TO
MAKING ANY OFFICIAL RECRUITMENT
EFFORTS BUT DESPITE THIS WE ARE
IN THE PLANNING STAGES AND WE
ARE ASSESSING WHAT RESOURCES WE
HAVE TO FILL THIS AUDIT
REQUIREMENTS. THAT'S THE
LEGALIZATION QB'S CURRENT AT
THE HOW. Q. A- DAY BASIS
UTILIZED STUDIES HAVE SHOWN
THAT ABOUT FIFTY FIVE TO SIXTY
PERCENT. A PANEL REQUESTS ARE
GIVEN 210% OF Q. AND MEANS. THE
TWO THOUSAND TWELVE THE
LEGISLATURE PLACED RESTRICTIONS
ON THE NUMBER OF LOCATIONS ACU
NY COULD LIST. THERE WAS ALL
TOP LIMIT OF TEN. AND IT WAS
EXPECTED THAT THIS WOULD REDUCE
HIGH VOLUME Q. AMIS WITH LARGE
NUMBER OF OFFICE LOCATIONS. AND
WOULD ENCOURAGE MORE DOCTORS
TWO REGISTERS ACU ME BUT WE DID
NOT SEE THIS OF FACT. IN TWO
THOUSAND TWELVE THE LEGISLATURE
ALSO IMPLEMENTED INDEPENDENT
MEDICAL REVIEW. THIS WAS
EXPECTED TO DECREASE THE NUMBER
OF Q. ANY REQUEST BECAUSE Q.
AMIS WOULD BE NO LONGER
ALLOWED. TO EAT WOULD NO LONGER
BE UTILIZED TO RESOLVE
TREATMENT DISPUTES. WHILE THE
OVERALL NUMBER OF CLAIMS IN THE
SYSTEM OF REMAIN STEADY THE
NUMBER OF PANEL REQUESTS HAVE
INCREASED WHICH LEADS ONE. TO
WONDER WHAT IS CAUSING THIS
INCREASE IN PANEL REQUESTS. WE
ARE GOING TO REQUEST THE
COMMISSION ON HEALTH AND SAFETY
WORKERS COMPENSATION ANALYZE
AND RESEARCH THIS ISSUE.
RELATED TO AN UNAVAILABILITY
UNAVAILABILITY UNAVAILABILITY
EXCUSE ME OF ACUTE MAY HAVE
BEEN REYES AND ARE OF A CONCERN
TO US. WE ARE EXAMINING OUR
ALGORITHM IN THE SELECTION
PROCESS FOR Q. AND MEANS WE
HAVE AN ONLINE PANEL FOR Q.
ENEMIES. OF THOSE Q. ARMIES ARE
SIGNED BY RANDOM SELECTION TO
THROUGH THROUGH OUR COMPUTER
SYSTEM. WE'RE GOING TO TRY TO
ASCERTAIN WHY SUCH A HIGH
PERCENTAGE OF AVAILABLE Q. IN
THESE ARE NOT BEING UTILIZED IN
OUR SYSTEM. WILL TAKE WHATEVER
STEPS ARE NECESSARY TO ENSURE
THAT THIS UNTAPPED YOU IN THE
RESOURCE IS INTEGRATED INTO THE
EVALUATION PROCESS. OUR STAKE
HOLDERS ARE CURRENTLY REVIEWING
THE ENTIRE Q. ANY PROCESS WITH
THE GOAL OF ENSURING TIMELY
REPORTS. ELIMINATING DELAYS AND
EVALUATIONS ENSURING THE UNDER
UTILIZATION OF THE CHARACTER
CURRENT Q. ANY PROP-
POPULATION. THE PARTICIPANTS
ARE ALSO EXPLORING IN
DISCUSSING WAYS TO FACILITATE.
YOU ANY REMOVING THEMSELVES
FROM THE DATABASE WHEN THEY ARE
FULLY BOOKED WITH APPOINTMENTS
SO THAT YOU ANY WILL NOT BE
PLACED ON ANY OUTGOING CAMELS.
IS ANTICIPATED THAT THIS STEP
WILL DECREASE THE AMOUNT OF
SECOND PANEL REQUESTS.
PARTICIPANTS ARE ALSO
DISCUSSING INCREASING THE
AMOUNT OF HOURS AND CONTENT OF
P. Q. ANY EDUCATION IN ORDER TO
ENSURE BETTER REPORT QUALITY.
AS TO THE PROCESS THERE IS A
CONSIDERABLE THERE'S
CONSIDERATION OF HAVING AN
OUTSIDE ENTITY COLLECT AND
ORGANIZE MEDICAL RECORDS PRIOR
TO THE SUBMISSION OF DOCUMENTS
TO ACCUSE ME. TO SAVE THEM TIME
AND ALLOW THEM TO SPEND MORE
TIME ON THE EVALUATION ON
EVALUATIONS AND LESS TIME ON
CLERICAL WORK. FINALLY MEDICAL
PROVIDERS ARE EXPRESSING THEIR
INTEREST IN INCREASING THE TIME
ALLOTTED FOR MAKING THE QUEUE
IN THE APPOINTMENT IN MAKING
MORE TIME FOR THE SERVICE OF
THE COMPLETED CURE ME REPORT
ALL THESE MATTERS ARE BEING
DISCUSSED IN STAKEHOLDER
MEETINGS. WITH THE EXPECTATION
THAT WE WILL HAVE CHANGES IN
REGULATIONS THANK YOU AND THESE
WILL BE MADE. AND THE AND THE
TO ME PROCESS WILL BE CHANGED
AS A RESULT. IN TERMS OF
DISCIPLINE D. W. C. HAS AGREED
TO UPDATE OF OUR POLICIES AND
PROCEDURES AND ENSURE THAT THEY
ARE ACTUALLY IMPLEMENTED IN THE
RE APPOINTMENT AND DISCIPLINE
PROCESS. AS TO REPORT QUALITY
SEPARATE STAKEHOLDER MEETINGS
ARE ONGOING DEALING WITH THE
ISSUE OF ADDRESSING QUALITY.
THE RESULTS OF THESE MEETINGS
INCLUDE AN AGREEMENT ON AN
ACCEPTABLE STANDARD FOR THE
DEFINITION OF WHAT CONSTITUTES
A GOOD QUALITY REPORT. MODELS
FOR AUDITING QB REPORTS ARE
BEING DISCUSSED THAT WOULD
INCLUDE COMMUNITY PARTICIPATION
ON COMMITTEES TO REVIEW REPORTS
AND WHO SHOULD SERVE ON THESE
COMMITTEES. WE ARE ALSO
REVIEWING THE PROCEDURES FOR
REPORTING AN ADEQUATE REPORTS
EITHER THROUGH THE PART'S OR
pPROVIDING FEEDBACK TO CUBA
MEANS. DISCUSSIONS ARE ALSO
TAKING PLACE ON WHETHER OR NOT
THESE WC HAS THE RESOURCES THE
ARCTIC TO ME REPORTS SOLELY
WITH THE W. C. PERSONNEL. IS
ANTICIPATED THE FORMAL
STRUCTURE WE BUILD TO WILL BE
DEVELOPED FOR COMPLIANCE WITH
REPORT. QUALITY ARTISTS FOR THE
REPORT QUALITY ALL ITS
DIVISIONS IN THE LABOR CODE YOU
IN SHORT WE ARE TAKING ACTIVE
STEPS TO REVIEW THE ENTIRE
CUMAE PROCESS AND WE ARE IN THE
FALL WE ARE INCLUDING THE
COMMUNITY AND WE HOPE THAT THIS
WILL PRODUCE POSITIVE RESULTS.
AS I SAY WE ARE TAKING THE
RECOMMENDATIONS OF THE AUDITOR
WE ARE LOOKING AT THIS WE'RE
LOOKING AT WHAT WE HAVE DONE
AND WE ARE LOOKING AT WHAT WE
HAVE NOT DONE IN THE PAST AND I
THINK WE ARE A PROCEEDING ON OF
COURSE TO CORRECT. AND
HOPEFULLY REACH AN AGREEMENT
WITH OUR COMMUNITY AS TO WHERE
THE SYSTEM NEEDS TO GO. THANK
YOU. OF THE DIGITAL TESTIMONY
HERE NO THANK YOU FOR SUPPORT.
OKAY GREAT WELL THANK YOU I
APPRECIATE THAT APPRECIATE THE
STATEMENT I KNOW WE HAVE LOTS
OF QUESTIONS SO LET ME JUST ASK
VERY GENERAL QUESTION BASED OFF
THE AUDITOR'S PRESENTATION
EARLIER WHERE SHE WAS SAYING
THAT THE REQUEST FOR Q. AMIS'S
INCREASED THIRTY SEVEN PERCENT.
BUT THE NUMBER OF Q. AMIS'S
DECREASED 12% RIGHT AND THEN WE
TALKED A LOT ABOUT THE
QUADRUPLING OF THE PANELS WHICH
YOU MENTIONED YOU'RE TRYING TO
ADDRESS AS WELL- DO YOU AGREE
WITH THOSE NUMBERS AND THAT'S
WHAT'S HAPPENING OR WHAT WE'VE
SEEN I AGREE WITH THE NUMBERS I
MEAN THE NUMBER I THINK THE
NUMBERS SPEAK FOR THEMSELVES-
BUT WE WANT TO DO IS TRY TO
FIGURE OUT TO GET HOW DO WE WHY
DO WE REACH A SOLUTION TO
CREATE A MORE. EFFICIENT SYSTEM
WITH SB EIGHT SIXTY AS I
MENTIONED WE THOUGHT THE NUMBER
REQUESTED GO DOWN TAKE AWAY THE
SPECIFICS AND- WHAT IT MEANS
DECIDED MOVES WERE TREATMENT
DISPUTES AND YOU CAN LOOK AT
OUR INDEPENDENT MEDICAL REVIEW
NUMBERS TO SEE HOW THOSE
NUMBERS OF THOSE NUMBERS ARE
PLAYING UP THOSE NUMBERS ARE
HIGH BUT INSTEAD. INSTEAD OF
SEEING A DECREASE WE SAW AN
INCREASE- AGAIN THERE'S A
TREMENDOUS AMOUNT OF LITIGATION
SYSTEM A LOT OF FRICTION BOB
AND WHEN WE TALK ABOUT SYSTEM
FIXES. WE NEED TO TAKE A LOOK
AT THAT WE NEED TO TAKE A LOOK
AT ALL THE ALL THE OBLIGATION
ALL THE RULES THAT HAVE BEEN
LAYERED OVER AND OVER AGAIN
WORKERS COMPENSATION. THAT'S
RIGHT PEEL BACK. YES THERE'S A
BURRITO BUT- WE'RE DEALING
ONION. HERE WE GOT A LOT OF
LAYERS OF OBLIGATIONS OVER THE
DECADE. WE NEED TO TAKE A LOOK
AT THAT AND SEE HOW DO WE
CREATE A SIMPLER. MORE
EFFICIENT SYSTEM WITH LESS
FRICTION BECAUSE A TREMENDOUS
AMOUNT OF THE DOLLARS THAT ARE
SPENT WORKERS COMPENSATION.
GOES INTO THAT CATEGORY
FRICTION. OF SO I SO I THINK WE
NEED TO LOOK AT REALLY WHAT IS
GOING ON IS THERE AN ADEQUATE
NUMBER OF CUBAN THESE. I DON'T
STE I WOULD SAY THERE IS I WILL
SAY I DON'T KNOW. THERE COULD
BE WE UNDER UTILIZED OUR Q.
AMIS AND I THINK WORK WE WANT
TO TAKE A LOOK A THAT AS I
SAY. THE ALGORITHMS THAT WE
ASSIGN Q. AMIS NOW WHY IS IT
THAT SO MANY Q. M. IS THAT ARE
UNAVAILABLE GET ON THE PANEL
AND YET WE HAVE SOME Q. AMIS.
WHO DON'T GET ON A PANEL- I
TALKED TO ONE PHYSICIAN WHO
BECAME THE Q. M. E. AND HE
DROPPED OUT AFTER A FEW YEARS
BECAUSE HE JUST WASN'T GETTING
ANY PANELS YOU KNOW AND THAT'S
THAT'S- ON US NOT SOMETHING WE
NEED TO RESOLVE. WE ARE LOOKING
INTO THAT YEAH WITH THE
pHEARD THAT DIRECTLY TO FROM
SOME FOLKS ARE NOT EVEN.
INVOLVED IN THE CAPITAL WORLD
APPEARS ANECDOTALLY BACK HOME.
TOLD ME THAT SAME EXACT RIDE
AREA RIGHT I THOUGHT SO CUTS
PROP. AND THAT'S SOMETHING YOU
KNOW THAT'S ON US THAT'S
SOMETHING WE'RE GOING WE'RE
GOING TO MOVE FORWARD WITH.
THAT WHY APPRECIATE THAT AND
YOU SAYING THAT BECAUSE THE
WHOLE PURPOSE OF THE
INFORMATIONAL HEARINGS IS TO.
AND THE AUDITOR'S TO. GRILL
DOWN TO WHAT ARE THINGSTHAT WE
CAN FIX HOW WE MAKE THE SYSTEM
BETTER. OKAY IN MY OPENING
STATEMENTS I THINK THERE'S A
WIN WIN HERE THAT CAN. DECREASE
COSTS FOR THE ENTIRE SYSTEM
BUT- GET WORKERS TREATED FASTER
AND HOPEFULLY BACK ON THE JOB A
LOT SOONER. I AGREE AND WE ARE
WE ARE TAKING STEPS IN THOSE
DIRECTIONS YOU KNOW WE HAVE
OUR- OUR MEDICAL TREATMENT
UTILIZATION SCHEDULED MOVING TO
EVIDENCED BASED GUIDELINES. YOU
KNOW WE ONE INJURED WORKERS TO
GET TREATMENT AS SOON AS
POSSIBLE. AND WE FIND THAT WHEN
THAT TREATMENTS PROVIDED EARLY
ON THEN THAT THEY GET BACK TO
WORK WHICH IS WHAT. EVERYBODY
WANTS TO SEE AND- AND SO YOU
SAID YOU'RE UNSURE WHETHER WE
NEED MORE Q. AND ME'S THE DAY
BUT YOU DON'T DISPUTE THE DATA.
SO CAN YOU JUST TALK TO ME
ABOUT WHAT THE DEPARTMENT'S
DOING TO REPAIRS. A RECRUIT.
MORE QUALIFIED MEDICAL
EVALUATORS. WELL AS I MENTIONED
BEFORE I THINK WE NEED TO REACH
OUT TO Q. TO DOCTOR. PER CUBIC
METER DROPPED OUT OF THE SYSTEM
I THINK WE NEED TO TALK. MEDIC
TO MORE OF MEDICAL GROUPS LONG
TERM MEDICAL GROUPS WE NEED TO
TALK TO THE UNIVERSITY OF
CALIFORNIA TO SEE WHAT WE WHAT.
WE CAN DO TO BRING THEM IN. AND
I THINK WE NEED TO BE. A LITTLE
CREATIVE AS TO HOW WE CAN BRING
IN. I CAN'T FORCE ANYBODY I
CAN'T FORCE ANYBODY TO QUEUE UP
TO BE A QUEUE IN THE I CAN
AUTOMATICALLY. STAY THAT I CAN
INCREASE THE NUMBER. WE CAN FIX
OUR MEDICAL OUR MEDICAL LEGAL
FEE SCHEDULE AND I. HAD A
REALLY APPRECIATE THE EFFORTS
OF ALL OF OUR STAKEHOLDERS.
PROVIDERS EMPLOYERS ATTORNEYS
TO WORK AND WORK IN THAT
DIRECTION. BUT IF I INCREASED
PIZZA DOESN'T MEAN I'M GOING TO
GET MORE Q. ENEMIES AND WE SAW
THAT TWO THOUSAND SIX WHEN WE
INCREASE THE FEE SCHEDULE. AND
WE STILL SOFT DROP IN THE
NUMBER OF KEEP IT MEANS. WE
WILL CERTAIN WE WILL CERTAINLY.
PUT IN THE EFFORT TO DO THAT WE
WILL CERTAINLY REACH OUT TO
GROUPS AND WE'LL- WE'LL HAVE.
BETTER MORE SIMPLER FEE
SCHEDULE FEE SCHEDULE IT'S MORE
PREDICTABLE THAT EVERYBODY CAN
UPSET. THE OTHER BY MULTIPLE
FACTORS AGO. THAT BUT OBVIOUSLY
THINKING CREASING. SCHEDULE
MIGHT. ANSWER LIES OR CUBIES TO
COME FORWARD. AND MAYBE WE NEED
TO TALK ABOUT THE SCENARIO THAT
YOU BROUGHT UP WHERE. PEOPLE A
QUAL. FI'S QB'S ARE GETTING THE
REFERRALS WHETHER IT'S BECAUSE
OF AN ALGORITHM. OUR OTHER FACT
GET A FIGURE OUT HOW WE KEEP
THEM IN THE SYSTEM. BECAUSE IF
THEY'RE STILL. WE'RE STILL
SEEING MORE THAN SIXTY DAY
DELAYS PEOPLE AREN'T BEING SEEN
WE GOT TO FIGURE THAT PROCESS
OUT OF I THINK THAT'S WHERE A
LOT OF THE QUESTIONS. FROM THE
PANEL EARLIER ACTUALLY KINDA
STEMMING FROM AN SUBSTRING
FIGURE OUT. HOW DO WE GET TO
THAT POINT AND WHAT IS IT WE
NEED TO GET DONE TO IT TO GET
THERE. YOU TALKED ABOUT
ADOPTING NEW- RULES AND
REGULATIONS AND THEN ALSO THE
FEE SCHEDULE. BUT I DIDN'T HEAR
A TIME LINE IN ANY OF THAT YOU
GIVE A- KIND OF WHAT YOU'RE
LOOKING AT AT THE DEPARTMENT
AND KIND OF THE TIMELINE OF.
WHEN YOU ANTICIPATE SOME OF
THIS MOVING FORWARD WELL I
WOULD LIKE OUR FOR OUR OUR
STAKEHOLDERS ARE MEETING RIGHT
NOW I WOULD LIKE TO HAVE THAT
PROCESS DONE AND IN THE EARLY
SPRING THAT WE WOULD MOVE AHEAD
WITH REGULATIONS AT THAT POINT.
NO SOME SOME OF OUR
STAKEHOLDERS ARE SAYING DON'T
MOVE TOO FAST. NO BECAUSE AGAIN
YOU KNOW WE'RE TALKING ABOUT IT
WE'RE WE'RE LOOKING AT
SOMETHING OF A GLOBAL SOLUTION.
ON SOME THINK THAT WE'RE NOT
MOVING FAST ENOUGH I THINK WE
JUST HAVE TO SEE WHERE OUR
DISCUSSIONS GO AND WHAT
AGREEMENT BEING REACHED I WOULD
LIKE TO THINK THAT WE ARE ABLE
TO REACH AGREEMENT- BECAUSE I
THINK PEOPLE YOU KNOW PEOPLE'S
BEST. INTEREST IS THAT THAT WE
FIX PROBLEM WE GET WE THINGS
GOING FOR HER THIRD WORLD THAT.
THAT THE THAT IN TERMS OF THE
SCHEDULE WHAT I LIKE TO STAY IN
A- TO. KNOW PUT THAT NUMBER IN
REGULAR. CAN GET THROUGH FAST
AS WE CAN. I'M AND THAT WOULD
ALSO INCLUDE A PLAN FORD FOR
LOOKING OUT FOR POOR QUALITY. I
WILL SAY THAT WE HAVE NOT BEEN
LOOKING AT REPORT ALREADY AND
WE HAVE BEEN LOOKING AT IT FOR
A VERY VERY LONG TIME AS FAR
AS- WHAT I'VE WHAT I'VE LOOKED
BACK YOU KNOW I JUST. I JUST
DON'T SEE THAT AS TO WHY WE
HAVEN'T BEEN DOING THAT. THAT'S
A GREAT QUESTION AND- AND
FRANKLY TO MEET FOR ME TO SIT
HER AN OFFER EXCUSES WERE IS.
IS MEANINGLESS I WANT YOU KNOW
WE NEED TO MOVE AHEAD CORRECT I
THINK WE I THINK WE NEED TO
MOVE WHAT WAS THE LAST TIME
THE- CURE ME YOU. DID SEE A
RACE- WE RAISE THE WE RAISE THE
FEE SCHEDULE IN TWO THOUSAND
SIX- AND I THINK THAT WAS BASED
ON SOME OF THE APPORTIONMENT.
OF IF I IF I RECALL CORRECTLY
SOME OF THE- APPORTIONMENT OF
LAWS THAT WHEN INTO EFFECT WITH
SB EIGHT NINETY NINE- WE
REQUIRED MORE ABOUT. IT AS I
SAY THAT WE HAD WE HAD STUDIES
THE BRANCH CORPORATION OTHER
PEOPLE LOOK AT THAT AND EVERY
TIME WE'VE DONE BUT THEY'VE
COME AGAINST. THE FEES OF
MENIFEE LEGAL FEE SCHEDULE IS
REASONABLE. COMMON FRANKLY WAS
IN FULL ACTUALLY JUST THE YOU
KNOW RECENTLY THAT I'VE HEARD
THAT IT WAS NOT THEY HAVE THAT.
THAT IT WAS WILL- SO. AND I
THINK WHAT I'VE BEEN HERE SOME
OF THE FRUSTRATION AND WHERE
THEY SEE FEE SCHEDULES. UPDATE
BOB FREQUENTLY THE SINCE TWO
THOUSAND AND SIX SO YOU KNOW
YOU LOOK AT OUT. IN HOT OFFICE
POOL OF. MEDICAL. EQUIPMENT FEE
SCHEDULE THE ALL THOSE HAVE
BEEN. UPDATED. A LOT MORE
PERIODICALLY AND- THE QUEUE ME
SCHEDULE RIGHT ONE CAN YOU
EXPLAIN WHAT WHAT WHAT'S OUR
OFFICIAL MEDICAL. SCHEDULE WAS
INVITED TO THE MEDICARE SSTEM.
AND MEDICARE SYSTEM DOES THERE
THOUGH IT DOES THERE A
QUARTERLY ANNUAL UPDATES- THAT
BUT THAT'S JUST BECOME A LOT
MORE AUTOMATIC. BUT YOU KNOW
THAT'S THAT'S YOU KNOW THAT'S
MEDICAL TRIP THAT'S MEDICAL
TREATMENT THAT'S AN EASIER. YOU
KNOW SORT OF APPLES TO APPLES
COMPARISON WITH THEM WITH ARE
MET LEGAL FEE SCHEDULE YOUKNOW
THAT'S YOU. SOMEWHAT UNIQUE TO
CALIFORNIA IN TERMS OF THE
ISSUES THAT WE ENCOUNTER. BUT
IT HAS A DEPARTMENT EVER TALKED
ABOUT WITH. YOU KNOW WHEN MEDI
CAL INCREASES FOR INSTANCE
MAYBE INCREASING THE QB
SCHEDULE AS WELL. WE KNOW THAT
SOMETHING THAT YOU'VE BECAUSE I
MEAN WE HAVEN'T ADOPTED
ANYTHING BUT IS THAT SOMETHING
THAT YOU'RE- LOOKING AT- THAT'S
WHAT WE'RE GOING TO LOOK AT
WITH OUR UPDATING OF THE
MEDICAL LEGAL FEES CONTROL- AS
I SAID BEFORE I HAVE NO
PROBLEMS WITH PERIODIC UPDATES
I THINK WE JUST NEED TO MAKE
SURE THAT WE- YOU KNOW WE
TALKED OUR STAKEHOLDERS AN
AGREED. UPON A REASONABLE
OBJECTIVE STANDARD. GOD OKAY
I'M JUST TRYING TO UNDERSTAND
THE FRUSTRATIONS ON BOTH SIDES
AND TRY TO FIGURE OUT A PATH
FOR US TO GET TO YOU AND THEN-
I THINK MORE THAN ANYTHING
PEOPLE WANT TO KNOW KIND OF
TIME LINE FOR THE DEPARTMENT
THINKING IN TERMS OF ADOPTING
THE SCHEDULES ARE ADOPTING
REGULATIONS ARE WE- I KNOW YOU
SAID YOU BRING TOGETHER
STAKEHOLDER MEETINGS BUT HOW
MANY STAKEHOLDER MEETINGS WE
HAVE BEFORE WE HAVE DECISIONS.
OF THAT ARE I DON'T THINK I CAN
I DON'T THINK I CAN REALLY SAY
AS IF IT SAY SPECIFICALLY AS
WELL AS AS WITH TIMELINE AS AS
I MENTIONED BEFORE I WOULD LIKE
I WOULD LIKE TO SEE YOU I WOULD
LIKE TO SEE AGREEMENT RIGHT NOW
I'M I WOULD HOPE I WOULD HOPE
YOU KNOW WITH THIS WITH THAT
WITH A NUMBER OF MEETINGS WITH
ABOUT EARLY SPRING WE WOULD
HAVE WE WOULD WE WOULD HAVE
THAT- THAT THAT WOULD BE MY
HOPE YOU KNOW WEST AT
EVERYTHING AT THE OF THE IT'S
REQUIRED US TO YOU KNOW TO HAVE
A PLAN IN PLACE. BY APRIL
TWENTY TWENTY WE WILL CERTAINLY
YOU KNOW WE'LL CERTAINLY WORK
ON THAT HAVE A PLAN AND HAVE A
PLAN AVAILABLE- AS TO OUR
DISCIPLINARY PROCEDURES WE WILL
HAVE WRITTEN PROCEDURES- IN IT
IN APRIL OF TWENTY TWENTY-
WE'VE MADE SOME GREAT STRIDES
IN THAT REGARD I THINK A LOT OF
THE TURNS. BY THE DAUGHTER. WE
WILL BE HAPPY PLACE. RECEIVERS
WE HAVE OUR POINT WE HAVE
DISAPPEAR TRACKS. IT'S BUT WE
WILL PUT THAT WE WILL PUT THAT
IN WRITING AND WILL WE WILL
CERTAINLY FOLLOW THAT- NO NO NO
ISSUE THERE US TO AS THE
QUALITY WE WILL HAVE A PLAN IN
PLACE IN THIS PROBABLY WILL BE
PART OF REGULATIONS THAT WILL.
ASK FOR RANDOM SAMPLING OF
REPORTS FROM CUBA MEANS- WE
WILL CERTAINLY TAKE A LOOK AT
THEM AND THAT'S WHERE WE NEED
TO MAKE A DECISION AS TO WHO
WILL TAKE A LOOK AT THEM YOU
KNOW WE DON'T HAVE A YOU KNOW A
TREMENDOUS AMOUNT OF MEDICAL
PROFESSIONALS ON OUR STAFF YOU
KNOW THAT'S JUST KIND OF THE
NATURE OF NATURE TRYING TO
RECRUIT PHYSICIANS FOR STATES
PHYSICIANS AND NURSES FOR STATE
SERVICE. BUT YOU KNOW THE
COMMUNITY CERTAINLY WILLING TO
STEP IN AND SAY LOOK LET'S FORM
A COMMITTEE THAT WE CAN LOOK AT
REPORT QUALITY THEN MAYBE THAT
IS THE BEST PATH FORWARD THEY
CAN LOOK AT REPORT QUALITY THEY
CAN INDICATE WHAT'S LACKING
WHAT'S GOOD AND THEN WE CAN GO
OUT THREE EDUCATION- YOU KNOW
THROUGH OUR TRAINING SYSTEM AND
SAY LOOK. FOR A FEW ENEMIES YOU
HAVE TO LOOK AT THIS SPECIFIC
AREA AND YOU HAVE TO ADDRESS
CERTAIN SPECIFIC WAY HI MOM
AGAIN I THINK YOU KNOW READ YOU
KNOW PEOPLE NEED TO REALIZE
THAT SOME OF THIS IS OUT OF OUR
CONTROL YOU KNOW THERE'S
LITIGATION GOING OFF AND THIS
AND THAT THE STATE AUDITOR
POINTED OUT THERE'S A BIG
DIFFERENCE BETWEEN REP THAT IN
CASES ENOUGH REPRESENTED CASES.
YOU DON'T SEE A LOT OF THESE
PROBLEMS ON THE ON REPRESENTED
I'D REDUCE. THE REP SENATE
SIDE. AND I THINK. I THINK.
WE'LL MAKES IT WILL TAKE
PROGRESS. IN AND OUT. GOT IT
YEAH AND I'M JUST TO FIGURE OUT
I KNOW FROM THE COMMITTEE HOW
WERE USED. WHETHER IT'S A
LEGISLATIVE FIXES IT. RESOURCES
SOUNDS LIKE I'M HER FIGURE OUT
WHY A THIRTEEN YEARS SCHEDULE
HASN'T BEEN UPDATED. AND IT UP.
YOU MENTIONED A LOT OF
DIFFERENT FACTORS BUT I'M
TRYING TO. FIGURE OUT. HOW WE
FIX IT. HOW DO WE GET THERE SO
THAT. INJURED WORKERS CAN. GET
BACK ON THE JOB. WELL
ULTIMATELY WELL IN TERMS OF THE
FEET IN TERMS OF THE FEE
SCHEDULE I THINK OUR
STAKEHOLDERS NEED TO TALK AND
REACH. AND REACH AN AGREEMENT
OR AT LEAST GET THE PARAMETERS
AS TO WHAT. WHAT CONSTITUTES.
REASONABLE PAYMENT FOR A
MEDICAL LEGAL EVALUATION. BUT
TO GET TO THAT POINT I THINK
YOU HAVE TO YOU HAVE TO GET
ALSO WEOFFER ALSO ANSWER THE
QUESTION OF WHAT IS. A
REASONABLE MEDICAL EVALUATION.
KNOW WHAT IS THE WHAT IS THE
ISSUE THAT'S BEING DECIDED. HOW
SHOULD IT BE BEST DECIDED WHAT
SPECIALTY SHOULD. CANDOR SHOULD
DECIDE THE ISSUE- I THINK ONCE
THEY GET TO THAT. PEOPLE
REALIZE WELL LOOK IF I GIVE
FIVE IF I PAY X. AMOUNT I KNOW
I'M GOING TO GET A GOOD QUALITY
REPORT. AND THAT GOOD QUALITY
COULD REPORT CAN RESOLVE THE
CASE. BUT WE ALSO HAVE TO LOOK
AT THE PROCESS TO. YOU KNOW THE
PANEL IS BEING REQUESTED- YOU
KNOW AVAILABILITY OF Q. ENEMIES
YOU KNOW EVERY TO HAVE ME ON
THAT PANEL SHOULD BE AVAILABLE
WE WANT TO. WE WANT TO WE WANT
TO REACH A SOLUTION IN THAT
REGARD. CERTAINLY YEAH I'M
TRYING TO FIGURE OUT WHETHER WE
DO THAT LEGISLATIVELY OR
WHETHER YOU'RE DOING IT
INTERNALLY BECAUSE OBVIOUSLY. I
HAVE LEGISLATION THAT KIND OF
PUSHES TOWARDS. THAT GOAL BUT
I'M. HER FIGURE HOW DO WE HOW
DO WE GET THERE. RIGHT YOU'RE
SAYING WE HAVE THE STAKEHOLDER
MEETINGS AND YOU KNOW IS
NOTHING LIKE LEGISLATION TO
FORCE DISCUSSION. RIGHT WE'VE
SEEN THAT SINCE WE DROP THE
BILL LAST YEAR. THERE'S BEEN A
LOT OF MOVING THE DISCUSSIONS
NOW WHICH I APPRECIATE SEEING-
FROM THE W. C. EVERYONE ELSE.
BUT. FOR SOME REASON THERE'S
STILL GAP AND TRY TO FIGURE OUT
HOW TO. BRIDGE THAT GAP. WELL I
COULD CERTAINLY- THAT'S A
THAT'S A GOOD QUESTION YOU KNOW
I WILL CERTAINLY SAY THAT THERE
WAS LOTS OF THINGS WE NEED TO
THINK ABOUT IN OUR SYSTEM IN
THE KILL ME PROCESS GLOBALLY IS
THE PANEL SYSTEM THE BEST WAY
IS THE BEST WAY TO DO THIS I
MEAN IF WE REALLY WANT TO GET A
Q. I MEAN FOR AN INJURED WORKER
AS QUICKLY AS POSSIBLE WE
SHOULDN'T HAVE A PANEL SYSTEM
OF THREE DOCTORS REGION FIVE
DOCTORS AS THE STATE OUGHT TO
RECOGNIZE WHY NOT JUST HAVE.
ONE DOCTOR RANDOMLY SELECTED BY
COULD BUY IT BY THE D. W. C.
HERE'S YOUR POSITION YOU NEED
TO SEE THIS POSITION I MEAN IF
VOTE SERVE WITHOUT CERTAINLY
SOMETHING THAT SHOULD BE IT
SHOULD BE THOUGHT ABOUT I MEAN
THERE ARE LOTS OF OPTIONS OUT
THERE I THINK AGAIN WOULD THINK
WE NEED TO LOOK AT OUR STATE OR
STAKEHOLDERS TO GET TOGETHER
AND SAY LOOK THIS IS THE BEST
WAY FOR US I THINK EVERYBODY
HAS A VESTED INTEREST IN MAKING
SURE THAT INJURED WORKERS GET
BACK TO WORK AS SOON AS
POSSIBLE. AND I THINK WE REALLY
NEED TO BE A TAKE THEIR AND
TAKE THEIR CONCERNS INTO
CONSIDERATION GOT IT LET ME
INVITE THE STATE AUDITOR BACK
UP IF. YOU WANT TO COMMENT ON
THAT JUST BECAUSE. AND THEN AND
THEN WE'LL MOVED- QUESTIONSBUT
AS I HAVE A BUNCH OF QUESTIONS.
ABOUT THE QUESTION RIVER. GOING
FROM. IT'S KIND OF PIGGY BACK
ON YOUR QUESTION. BECAUSE IT'S
SOI'VE HEARD A LOT ABOUT. IN
YOUR STATEMENT YOU INDICATED.
AND I IS SPECIFICALLY NAY
DIDN'T COUNT THE AMOUNT OF TIME
THAT YOU SAID IF WE HAVE ENOUGH
RESOURCES. WHAT HAPPENS IF YOU
DON'T HAVE ENOUGH RESOURCES
THAT'S NUMBER ONE BUT NUMBER
TWO. YOU'RE SAYING WE SHOULD DO
THIS WE SHOULD DO THIS WHAT
DOES IT TAKE OR WHAT IS IT
GONNA TAKE FROM NOW ON FOR YOU
GUYS TO BE PROACTIVE. AND NOT
FOR IT TO TAKE AN AUDITED. TO
LOOK AT ALL OF THESE ISSUES
BECAUSE YOU'VE INDICATED THAT
YOU KNEW THESE ISSUES WERE
ALREADY A PROBLEM. AND SO.
UNTIL LEGISLATION DROPPED OR
THE AUDIT WAS DROPPED THEN NOW
YOU'RE DOING ALL OF THIS SO
WHAT DOES IT TAKE. BECAUSE THIS
THESE ARE PEOPLE THAT ARE
INJURED. AND SOLD TO THE
TIMELINE OUR QUESTION IS. SO
WHAT WOULDN'T SOLVE THIS WOULD
NOT. HAVE HAPPENED. THEN THEN
WE WOULD BE IN THE SAME. BOAT
SO IT TOOK. LEGISLATION AND IN
ON IT. FOR THIS TO MOVE FORWARD
AND SO WHAT IS IT GOING TO TAKE
TO BE PROACTIVE AND FOR US TO
NOT HAVE TO GO THROUGH THIS. TO
FORCE AND I DON'T WANT TO FORCE
THE DEPARTMENT TO DO ANYTHING
IF THE DEPARTMENT IS ACTUALLY
DOING WHAT THEY'RE SUPPOSED.
BUT WE WERE MOVING FORWARD ON
THE MEDICAL FEE SCHEDULE BEFORE
THE AUDIT WAS REQUESTED- SO WE
WERE TAKING STEPS IN THAT
REGARD- AND THEN. AND AS I
THINK PEOPLE RECOGNIZE THE
PEOPLE YOU KNOW PEOPLE BELIEVE
THAT IF THAT IF THAT'S IF
THAT'S MADE- IF THAT. FEE
SCHEDULE IS UPDATED THAT THAT'S
GOING TO HOPEFULLY BRING IN
MORE. WHAT ON THE GATHERED IN
TERMS OF RECRUITMENT WE HAVE
BEEN TALKING AND WE WE'VE
ALWAYS BEEN TALKING TO PEOPLE
ABOUT YOU KNOW WHAT CAN WE DO
TO GET Q. AND NEEDS A LARGE
MEDICAL GROUPS- BUT THE YOU
KNOW AGAIN. AND WE'RE NOT WE'RE
NOT A MARKETING ARM I KNOW WE
TALK TO PEOPLE WHICH WE TRY THE
BEST THAT WE CAN. NO AGAIN WE
RELY ON PRIVATE DOCTORS TO BE
Q. IT NEEDS. NO I CAN'T BUT I
CAN INCREASE THE NUMBER I CAN
INCREASE THE POOL. WELL YOU
CAN'T INCREASE THE POOL BUT YOU
CAN UGH INCREASE THE YOU CAN
ENTICE FOLKS TO DO IT I WAS A
TEACHER. AND WHEN THERE'S A
LACK OF TEACHERS THERE'S
CERTAIN THINGS THAT WERE BEING
DONE IN THE LOOK THE- YOU KNOW
THE HARD TO FILL- POSITION FOR.
OF SPECIAL EDUCATION FOR
EXAMPLE THERE'S DIFFERENT
THINGS THAT HAVE BEEN TAKING
PLACE TO MAKE SURE TO FILL
THOSE POSITIONS. AND IT I KNOW
YOU'RE WORKING ON IT AGAIN MY
QUESTION. NOW ON AND WHAT ARE
YOU GOING TO DO- TO BE MORE.
ACTIVE SO THAT WE DON'T HAVE TO
DO ANOTHER ARE AN AUDITOR MORE
LEGISLATION AND- AS YOU
INDICATED THAT HAS BEEN GOING
ON SINCE TWENTY THIRTEEN. WELL
AS FAR MORE THAN THAN YOU KNOW
AS- WE'VE GOT WE HAVE A STATE
AUDIT WE'VE HAD THE AUDITOR'S
RECOMMENDATIONS WE ARE GOING
TO. WORK AND WORK ON FILLING
ALL OF THE RECOMMENDATIONS. AND
I AND I WILL AND I WOULD HOPE
THAT THAT I WOULD HOPE THAT
THAT WOULD BE ENOUGH. BUT I BUT
I'M GOING TO FIGURE OUT IS THIS
A SYSTEMATIC ISSUE WHERE WERE
BECAUSE IT'S NOT JUST YOUR
DEPARTMENT WITH THERE'S BEEN A
COUPLE OF. OTHER AUDITS WHERE
IT TAKES US TO FORCE THE HAND
AND I. THINK THAT THAT'S-
COUNTERPRODUCTIVE IF THE
DEPARTMENT OR YOUR DEPARTMENT
IS REALLY LOOKING AT IT THE
CONVERSATIONS ARE GREAT BUT IF
THERE'S NO ACTION AFTER THE
CONVERSATIONS. THEN WE HAVE TO
DO THIS BECAUSE I'VE I ACTUALLY
SPENT TEN YEARS IN HUMAN
RESOURCES DOING WORKERS
COMPENSATION. AND I TALKED
EARLIER ABOUT- THAT I WAS A
SCHOOL BOARD MEMBER. THESE
ISSUES HAVE BEEN GOING ON SINCE
I WAS AN HR THEY HAPPEN AND SO.
AND SO I MEAN WE WILL WE WILL
CERTAINLY WORK THE BEST WE CAN
BUT IN CERTAIN TERMS IT MAYBE
IT JUST MAY BE A STRUCTURAL
ISSUE. MAY BE OR DO YOU THINK
IT IS. I AM IN I'M LOOKING
RIGHT LOOK I'M NOT GOING TO NO
NO NO I UNDERSTAND THAT AND
FRANKLY I REALLY APPRECIATE
THAT IN MY OWN PERSONAL OPINION
IS PROBABLY IT'S A STRUCTURE.
IT'S A STRUCTURAL ISSUE SO THEN
WE MAY NOT WE ORDERED BY THE
DRESS MAYBE WE HAVE SHOULD TAKE
MAYBE WE HAVE TO TAKE A STEP
BACK AND SAY WHAT IS. YOU KNOW
IS THIS REALLY THE BEST WAY TO
MANTA IS THIS THE BEST WAY TO
ACTUALLY OPERATE THIS. NO
BECAUSE I CAN SO I CAN KEEP
TRYING TO. YOU KNOW TO FIX FIX
THE FIX A FLAT TIRE THE GRANT
GETTING FLATTER AND FLATTER
AND- YOU KNOW MY WORK IS GOING
TO GO FROM FOR BANDAIDS- BUT
BANDAIDS ON THE ACTIONS OF ITS
A STRUCTURAL ISSUE I WOULD HOPE
THAT AFTER. TODAY THAT WE DON'T
HAVE TO- PUT LEGISLATION
FORWARD OR OR AN AUDIT FOR
THIS. IN THE AYE WHAT I'M
LOOKING FOR IS FOR IT FOR THE
DEPARTMENT TO BE MORE PROACTIVE
AND LOOK AT THESE ISSUES BEFORE
WE HAVE TO COME IN AND DO IT.
RIGHT AND I THINK THAT'S
SOMETHING WE NEED TO. I
ABSOLUTELY AGREE WITH THAT AND
I THINK THAT AT SOME POINT IF
WE SAY LOOK. YOU KNOW WE'VE
TRIED THIS AND IT'S NOT WORKING
WELL THEN WE NEED SOMETHING
ELSE RIGHT AND THE OTHER
QUESTION THAT. THE PAIN WE HAVE
ENOUGH RESOURCES SO THAT ISSUE
I WOULD HOPE WOULD GET ADDRESS
IF YOU DON'T HAVE ENOUGH
RESOURCES THEN WHY ARE WE JUST
GOING TO DROP IT. BECAUSE WE
HAVE THE RESOURCES IS OUR PLAN.
IN THE EVENT THAT THERE ARE NO
RESOURCES NOW WE'RE TO FIX
RIGHT. RIGHT AND THEN AS I
MENTIONED FOR IN TERMS. IN
TERMS OF REVIEWING REPORTS FOR
QUALITY. KNOW THAT WE DON'T
HAVE MEANT PROFESSION SO THAT
WE THINK REACHING OUT COMMUNITY
FOR FORMER COMMITTEE WERE
WRITTEN BRING PEOPLE IN TO TAKE
A LOOK AT THEM. WHAT THE HELL.
SO I THINK WE KNOW WE DO WE DO
ALSO HAVE TO BE REALISTIC ABOUT
WHAT WE DO HAVE. AND WHAT
REPORT. THESE ARE. WE DON'T
KNOW. ABOUT THAT. THAT'S WE-
WAIVE. BUT. COMMENT ON THAT ARE
LIKE. YOU KNOW WHAT'S A
METHODOLOGY WOULD WE DOING HOW
COME WE'RE NOT SELECTING FROM
THE ENTIRE UNIVERSE OF
PHYSICIANS. WELL THAT'S
SOMETHING THAT WE- THAT WE'RE
LOOKING AT RIGHT NOW AND I
CAN'T. AND I CAN'T PROVIDE AN
ANSWER FOR. NO AS I SAY WE HAVE
AN ONLINE PANEL SYSTEM WHERE WE
WERE THE PARTY REQUESTING A
PANEL GOES ON. NO GOES ON OR
COMPUTER SYSTEM AND GETS A
RANDOM SELECTION OF THREE Q. M.
MEANS. MOM I DON'T. I DON'T
KNOW EXACTLY HOW THAT WORKS
OPEN I APOLOGIZE I'M NOT A TECH
PERSON. I KNOW THAT THERE ARE
ALGORITHMS INVOLVED- AND- AND-
WE VAST R. I. T. UNIT. FROM THE
DEPARTMENT TO REALLY TAKE A
LOOK AT THAT TO MAKE SURE THAT
YOU IN THESE ARE GETTING. NO
ARE. YOU IN THE THROUGHOUT THE
ENTIRE SPECTRUM. ARE GETTING
SELECTED. IF THEY'RE NOT. WELL
THEN WE NEED TO CHANGE OUR
ALGORITHMS TO MAKE SURE THAT
THAT. TO MAKE SURE THAT
EVERYBODY GETS A FAIR SHOT AT A
PANEL. THEN THAT. SEEMS YOU
KNOW FROM YOUR EARLIER EXAMPLE
IN MY EXAMPLE FROM DOWN IN THE
DISTRICT WHERE PEOPLE FEEL LIKE
THEY'RE NOT EVEN BEING
SELECTED. OBVIOUSLY FOR MAKE
THAT PILL. THAT PULL LARGER.
YOU WOULD. JUST THINK THAT. THE
DELAY TIME WOULD BE A LOT LESS.
RIGHT RIGHT IN THE RIGHT. C
YOU KNOW IT'S HARD TO KNOW WHAT
THE RESULTS IS BUT THE BOTTOM
LINE IS THAT WE'VE GOT A
SHRINKING. SHRINKING BODY OF Q.
AMIS WELL. YOU KNOW. HOW DO WE-
SEE THEM IN THEIR QUEUE IN
THESE ARE NOT GETTING. SELECTED
FOR PANELS. THERE'S A PROBLEM.
AND SO THAT PROBABLY TO GET
FIXED. CUT OUR- ICE UP MORE
QUESTIONS I KNOW. A LOT OF.
WORK HERE HAVE QUESTIONS BUT I
MEAN I THOUGHT IF YOU. WANT TO
COMMENT ON ANYTHING THAT WAS
AND IF. AND WHEN THE DOUBLE
QUESTION. NOW I. DON'T HAVE A-
TICKET COMMENT. ANYTHING THAT
WAS SAID BUT I. FOR THE RECORD
A SENATOR ROTH ASKED A QUESTION
ABOUT IF A SUB STANDARD. Q. IN
THE REPORT THAT WAS REJECTED. A
WHETHER OR NOT THAT INDIVIDUAL
GETS PAID AND MY COUNSEL IN THE
AUDIENCE GAVE ME LABOR CODE
SECTION SPECIFIES THAT FAILURE
TO COMPLY WITH THE
REQUIREMENTS. FOR OPT.
PREPARING THE REPORT IF IT'S
NOT ADMISSIBLE IT'S NOT
ACCEPTED BY THE JUDGE THE
MEDICAL LEGAL EXPENSES ARE NOT
PAID SO THE INDIVIDUAL WOULD
NOT BE PAID- GOOD SO THERE IS A
SENSE OF THAT LATELY REPORT I
JUST MEASURE MINTS AND- WILL
COMMENT AND THAT'S- THAT'S
ABSOLUTELY RIGHT BUT E DO YOU
KNOW WE DO SEE SITUATIONS
WHERE. HE'LL REPORT WILL ISSUE
AN UNDER OUR BILLING RULES THE
REPAIR BILL THE REPORT HAS TO
BE PAID WITHIN SIXTY DAYS IT
COULD BE THAT A CARRIER PAYS
THE REPORT BUT THE REPORTS NOT
SUBMITTED IN THE HEARING UNTIL
AFTER THAT IT GETS REJECTED BUT
THE REPORT IS STILL PAID. OUT
ESSENTIALLY THAT IS CORRECT.
QUATRE ART CISCO TO MOVE TO
SENATOR ROTH AND SENATOR MORE
LOCK. AND THEN ASSEMBLY MEMBER
VOEPEL. IF TREATMENT DISPUTES
ARE NO LONGER ADDRESSED BY THE
QUEUE IN ME WHAT TYPE OF
DISPUTE IS ADDRESSED IS A
OBVIOUSLY A WERE THE WORK
RELATED THIS OF THE INJURY IS
THAT THE DISPUTE RIGHT IS A
COVERED CLAIM NUMBER ALSO A
TALKING ABOUT TEMPORARY
DISABILITY- FULL OF THERE'S A
LOT OF DETERMINATIONS ABOUT
PERMANENT DISABILITY SO FOR
TREATING PHYSICIAN SAYS. YOU
KNOW THIS INJURED WORKER IS HAS
A 36% THE WHOLE PERSON
IMPAIRMENT AND PARTY DISPUTES
THAT IT WOULD GO TO A Q. ME. SO
YOU SEE ISSUES LIKE TOP. OF THE
CERTAINLY THE WORK RELATEDNESS
OF THE CLAIM IS SORT OF A-
STARTER NON STARTER FOR THE
WHOLE PROCESS IS. THAT'S RIGHT
SO THIS IS A PRETTY CRITICAL.
ISSUE THE TIMELINESS OF THE
QUEUE IN ME FOR THE RESPECT TO
THE INJURED WORKER WITH RESPECT
TO CERTAIN THE FOR THE CARRIERS
AND ALL THE REST IF WE DON'T
MOVE THE PROCESS ALONG AND
NOBODY. KNOWS WHAT WE'RE
DEALING WITH US CORRECT RIGHT
UP AND THAT PROCESS WE AGREED
NEEDS TO BE FOR A NEEDS TO BE
MORE EFFICIENT. SO WITH RESPECT
TO THE CUMAE REQUESTS CAN YOU
TELL ME WHO WHAT PERCENTAGE OF
REQUESTED BY. LAWYERS AND WHAT
PERCENTAGE YOU REQUESTED BY THE
INJURED WORKERS
REPRESENTATIVES- I WOULD HAVE
TO SAY I HONESTLY OFF THE TOP
OF MY HEAD DO NOT KNOW THAT DO
NOT KNOW THE NUMBER WE CAN
CERTAINLY FIND THAT OUT. WOULD
BE AN INTERESTING. STATISTIC I
WOULD THINK OF HIM. TO GO TO
SOME OF MY COLLEAGUES QUESTIONS
ABOUT TO. THE TIMELINESS OF THE
PROCESS. SO WITH RESPECT TO
THESE. Q. AMIS- HOW MANY DO YOU
HAVE. I THINK OF. TWENTY SEVEN
HUNDRED SEVEN HUNDRED AND HOW
MANY DO YOU NEED. I GUESS IT
WOULD REALLY DEPEND ON WHAT'S
WHERE DID WHERE DID THE NUMBER
OF REQUEST WHERE THAT NUMBER
GOING BUT I MEAN YOU KNOW HOW
MANY YOU WE FOR SO WE KNOW HOW
MANY WORKERS COMP CLAIMS WE
HAVE RIGHT WE KNOW HOW MANY.
ARE INVOLVED REPRESENTED
WORKERS. WE WILL KNOW I GUESS
WHEN YOU CHECK IT WOULD SHOW
MANY REFER TO ME REQUEST COME
FROM EMPLOYERS AND HOW MANY
COME FROM THE REPRESENTED
WORKERS WE SHOULD KNOW BY.
GEOGRAPHY WERE THE CLAIMS ARE
COMING FROM A LOT OF THEM I
ASSUME WITH THE REPRESENTATIVE
WORKERS IN SOUTHERN CALIFORNIA.
SO HOW MANY Q. IN THE- FOR DO
YOU NEED GIVEN THE NUMBER OF
ISSUES THAT ARE OF TYPICAL ON
WORKERS COMP WE DON'T KNOW THAT
NUMBER RIGHT AND THEN ONCE YOU
KNOW HOW MANY YOU NEED VERSUS
HOW MANY YOU HAVE WE SHOULD BE
ABLE TO TELL WHETHER THERE'S A
SHORT FALL ON WHERE THE
SHORTFALL IS WELL WE SEE THE
NUMBER OF PANEL REQUESTS RISING
SO IF YOU LOOK AT THE NUMBER OF
PEOPLE REQUEST WE SHOULD HAVE A
COMPETENT. THE COMP NUMBER OF
Q. AND- YOU KNOW TO ADDRESS
THAT I THINK WE PROBABLY SHOULD
NEED MORE IF WE HAVE TWENTY
SEVEN HUNDRED BOY WOULD BE
GREAT IF WE HAD TEN THOUSAND
BUT YOU SEE OUR PROBLEM HERE-
WE'RE TRYING TO DEAL WITH
SPECIFIC ISSUES THAT IMPACT.
OUR WORKERS COMP SYSTEM AND
DEPENDING ON WHICH SIDE OF THE
AISLE YOU ARE I MEAN WE HAVE
DIFFERENT WE TO THESE ISSUES
FROM DIFFERENT DIRECTIONS BUT
AT THE END OF THE DAY GRETA SO
WHERE YOU ARE AND- IN THE
CHAMBERS. DOWNSTAIRS YOU'RE-
MAKING SURE THAT INJURED
WORKERS GET TAKEN CARE OF.
BECAUSE THERE ARE CONSTITUENTS
MAYBE I CAN ASK CLASSES
QUESTION THIS WAY. OF BECAUSE
WE SAW THAT PANELS QUADRUPLED
BUT MAYBE HOW MANY KILOMETERS
DO WE NEED TO NOT TRIGGER THE
SIXTY DAY. WELL I JUST WANNA
KNOW YOU LISTEN IF YOU KNOW HOW
MANY CLAIMS YOU HAVE RIGHT. AND
YOU KNOW HOW MANY REPRESENTED
CASES YOU YOU'RE INVOLVED WITH
AND Q. IN ME DECISIONS GO TO
THE VERY HEART OF THE WORKERS
COMP PROCESS WHICH IS THE
INJURY WORK RELATED. WE I DON'T
KNOW AND WE KNOW HOW MANY Q. IN
THESE ARE IN YOUR COMPUTER
SYSTEM. YOU OUGHT TO BE ABLE TO
COMPUTE HOW MANY Q. A MAJOR
NEED. IF THERE'S A DELAY IN
GETTING Q. AMAZED TO TAKE ON
CASES. RIGHT I MEAN THAT'S- FOR
PEOPLE WHO ARE GOOD AT MATH
WHICH IS NOT ME. NOT ME EITHER
IN FORT WE OUGHT TO KNOW THAT.
FIGURE AND THEN FROM THAT WE
OUGHT TO BE ABLE TO DECIDE WHAT
THE PROBLEM AS WELL OBVIOUSLY
WE DON'T KNOW THE ANSWER TO MY
QUESTION SO I'LL DROP IT BUT
LET ME AS IS. HAVE WE GONE OUT
TO THE FOLKS WHO USED TO BE Q.
AMIS OR WHO. ARE NOT Q. AMIS.
THROUGH THE CALIFORNIA MEDICAL
ASSOCIATION OR OTHERWISE TO
DETERMINE AND ASK THE QUESTION
WHY. AREN'T PHYSICIANS INDIES
TEO'S. SIGNING UP TO BE.
QUALIFIED MEDICAL EXAMINERS
REVISED WAITERS IN OUR WORKERS
COMP SYSTEM. WE HAVEN'T-
DIRECTLY HAD ASKED THAT
QUESTION BUT WITH THE TIME I
ASK OF PHYSICIANS WHY ARE THEY
NOT Q. IT MEANS THEY COME BACK
AND SAY WORKERS COMPENSATION IS
TOO COMPLICATED- AND FRANKLY WE
DON'T WANTED WE DON'T WANT TO
GO NEAR IT BECAUSE OBVIOUSLY
THE ONES THAT ARE STILL IN THE
SYSTEM ONE HIGHER. PAY AND I
GET THAT AND I AGREE WITH THAT.
BUT THE ONES THAT ARE NOT IN
THE SYSTEM ARE NOT IN THE
SYSTEM FOR REASON I'M WONDERING
IF IT COULD BE THE. YOU KNOW
MAYBE WE NEED TO TAKE A LOOK AT
YOUR STANDARDS YOU KNOW.
LICENSE TO PRACTICE IN
CALIFORNIA WELL THAT'S A GOOD
THING WE WANT THAT. SPEND AT
LEAST ONE THIRD OF THEIR TIME
PROVIDING DIRECT MEDICAL
TREATMENT WITH THAT PROBABLY
GOES TO WHETHER YOU CAN BE
RETIRED OR NOT. REPORT
FINANCIAL INTEREST WE DON'T
WANT CONFLICTS AND TAKE AT
LEAST A TWELVE OUR COURSE AND
WRITING MEDICAL LEGAL REPORTS.
I DON'T YOU'LL HAVE TO TELL ME
WHAT THAT'S INVOLVED. AND PASS
THE COMPETENCY EXAM. YOU KNOW
IS IT THE COPPERS HE EXAM THAT
BOTHERS US. OR BOTHERS THEM WHY
ARE PEOPLE FLUNKING THE
COMPETENCY EXAM IF THEY GET
THROUGH MEDICAL SCHOOL. AND WE
KNOW THE ANSWERS TO ANY OF
THOSE QUESTIONS. BUT I THINK I
THINK A GOOD PART OF THAT
REASON IS THAT HEALTH CARE
PROVIDERS ARE GOOD AT. WRITING
HEALTH CARE BUT TO PASS THIS
TEST THEY NEED TO KNOW SOME OF
THE RULES AND ROEG'S AROUND
WORKERS COMPENSATION CIVIC LAY
AROUND BEING ACCUSED ME. AND
LESS AND LESS YOU STUDY- FOR
THIS TEST AND STUDY THOSE RULES
IN RAGS- IT'S DIFFICULT TO PASS
THIS EXAMINATION YEAH AND I
BELIEVE IT'S NOT A CLINICAL
TEST BECAUSE- AND I BELIEVE THE
AUDITOR Là HOT IT TALKS ABOUT.
THREE FACTORS OF WHY YOU
BELIEVE PHYSICIANS ARE BECOMING
Q. ENEMIES. ARE THOUGHT IT READ
THAT. WELL THE MOST IMPORTANT
THING IS FOR THE DEPARTMENT AND
THE DIVISION TO TELL US WHY THE
DIVISION THINKS THAT. FOLKS ARE
BECOMING Q. AMIS BECAUSE YOU'RE
THE ON THAT'S RESPONSIBLE FOR
MAKING SURE WE HAVE AN ADEQUATE
SUPPLY AND MAKING SURE THAT OUR
WORKERS COMP SYSTEM FUNCTIONS
APPROPRIATELY. YEAH IT IS I
THINK IT'S BEEN DISCUSSED- YOU
KNOW THE EFFECT OF THE PRACTICE
OF MEDICINE HAS CHANGED OVER
THE LAST. FEW YEARS CAN I GET
THAT THAT AND I CAN I THINK I
THINK THAT'S THAT'S THAT'S
THAT'S A BIG REASON AND I
UNDERSTAND THAT THE MULTI
SPECIALTY PRACTICE GROUPS
KAISER AND- YOU KNOW THE X. Y.
Z. MEDICAL GROUP IT'S DOWN THE
STREET THEY HAVE A CERTAIN
EXPECTATION FOR A CERTAIN
NUMBER OF HOURS A DAY ON THEIR
EMPLOYED. EMPLOYEE PHYSICIANS.
OF UFC A CERTAIN NUMBER OF
PATIENTS A DAY THIS IS NOT
TREATING MEDICINE THIS IS
REVIEWING REPORTS AND WRITING
ANOTHER REPORT THAT'S OBVIOUSLY
COMPLICATED ENOUGH BUT I HAVE
TO PASS A COMPETENCY TEST. AS
ALLIES CALIFORNIA XIN SPOKE IF
YOU'RE OF A MEDICAL MULTI
SPECIALTY MEDICAL GROUP YOU'RE
NOT MAKING A LOT OF MONEY. ON
CUBA ME WORK. NUMBER OF SOLO
PRACTITIONERS IN THE STATE OF
CALIFORNIA. DIMINISHING AND HAS
DIMINISHED SIGNIFICANTLY BUT MY
POINT EARLIER. WHEN I MADE YES
THE QUESTION IS STATE AUDITOR'S
THAT'S THE FACT OF LIFE IN THE
STATE OF CALIFORNIA TODAY SO
WE'RE GOING TO HAVE TO FIGURE
OUT HOW TO REINVENT THE WHEEL.
ONCE WE DETERMINE. WHAT THE
DELTA IS BETWEEN THE QUEUE IN
ME IS THAT YOU HAVE. AND THE
NUMBER THAT YOU NEED AND THE
AND LESS WE KNOW THAT IT'S VERY
DIFFICULT TO COME UP WITH OF
SOLUTION WHETHER IT'S
LEGISLATIVE. OR OTHERWISE USE.
YEAH I UNDERSTAND THAT MAKE
BETS. I DON'T I PROBABLY OF
OTHER QUESTIONS BUT I'M GOING
TO SHUT UP AND LET ME ALSO
THANK YOU. THANKYOU. MOVED TO
CENTER MORE LACK. THANK YOU
MISTER CHAIR- MISTER PER SOTO-
COULD YOU EXPLAIN IN A FEW
WORDS YOUR DEPARTMENT AND THE
DIVISION OF WORKERS COMP. JUST
IN CASE SOMEONE TO WALK IN. TO
KNOW WHAT DEPARTMENT OF
INDUSTRIAL RELATIONS IS AND
WHAT IS. HOW MANY STAFF WELL. I
CAN'T TELL YOU THE OVERALL
STAFF OF THE DEPARTMENT OF
INDUSTRIAL RELATIONS YOU KNOW
IT IS THE DEPARTMENT THAT
REGULATES. COMES IN THE
WORKPLACE. IT CONSISTS OF THE
DIVISION OF LABOR- STANDARDS
ENFORCEMENT YOU KNOW THEY LOOK
AT WAGE WAGE AN HOUR. OF OUR
EMPLOYEES GETTING PAID PROPERLY
ON THEIR- ROCKY PATIENT SAFETY
AND HEALTH. LOOKS OUT OF THEM
ORDER COMPLETE YOUR PLAYING
WITH SAFETY STANDARDS AND
OTHERS THE WORKERS COMPENSATION
THAT REGULATES WHAT A REGULATES
WORKERS COMPENSATION- WE HAVE
ABOUT A THOUSAND EMPLOYEES-
MANY- THROUGHOUT THE STATE IN
OUR DISTRICT ALL THIS. THE
PERMIT ON PRACTICALLY ALL MAJOR
CITIES WE HAVE TO THE KITCHEN
STAFF IN THESE ARE IN OUR
DISTRICT OFFICES THAT'S
COMPRISED OF WORKERS
COMPENSATION JUDGES IN THE
SUPPORT STAFF THAT THAT THAT
THEY NEED IN ORDER TO HEAR
CASES. OF AND THEN WE ALSO HAVE
OUR IN A SENSE ARE REGULATORY
ARM WHICH IS TRADITIONALLY BEEN
TRADITIONALLY USED TO REGULATE
THE PRACTICE- OF CLAIMS
ADMINISTRATION SO WE WOULD LOOK
AT DAY WE LOOK AT INSURANCE
COMPANIES CLAIMS ADMINISTRATORS
TO MAKE SURE THAT THEY ARE
COMPLYING WITH OUR OBLIGATIONS-
OVER THE PAST. TWENTY YEARS
PROBABLY STARTING WITH THE S.
B. EIGHT EIGHT NINETY NINE
WE'VE BEEN TAKING ON MORE OF
THE MEDICAL ASPECT OF WORKERS
COMPENSATION WE WERE WE'VE BEEN
INSTRUCTED IN MANDATED TO PUT
IN A MEDICAL TREATMENT
UTILIZATION SCHEDULE- WITH THE
PRACTICE OF UTILIZATION REVIEW
HAS BEEN PUT INTO WORKERS
COMPENSATION- MEDICAL PRACTICE-
MEDICAL PROVIDER NETWORKS- HAS
BEEN PUT IN SO WE'VE BEEN UP.
TAKING ON MORE OF THAT AND I
THINK THAT WAS DUE PRODUCT TO
OUR- TAKING ON THE INDUSTRIAL
MEDICAL COUNCIL AND AGAIN THAT
WAS BACK IN TWO THOUSAND AND
FOUR SO- WE HAVE THE SYSTEM
WHERE WE WERE TRYING TO RECORD
REGULATE- IN REGULATE WORKERS
COMPENSATION CLAIMS
ADMINISTRATION. UNDERSTANDING
THAT A LOT OF CLAIMS ARE
JUDICATA THAN THAT SERIAL ABOUT.
SO YOUR REGULAR- IN THE WORKERS
COMP SPACE AND I WON'T FIND
ANOTHER DIVISION OF WORKERS
COME UP. WITH ANOTHER
DEPARTMENT. NO NO OKAY AND DO
YOU BELIEVE THE AUDIT WAS FAIR
AND PROFESSIONAL I'M- I REALLY
WOULD HAVE TO SAY IT'S A VERY
DIFFICULT POSITION FOR THE
AUDITOR TO COME IN AND
UNDERSTAND WORKERS COMPENSATION
IN THE WHOLE PROCESS YOU KNOW
I'VE BEEN DOING THIS FOR A FEW
YEARS AND I CAN'T SAY I
UNDERSTAND EVERY ASPECT OF IT.
MOM I APPRECIATE THE WORK THEY
DID THEY CAME IN THEY DID AN
AUDIT I. I AM I TAKE NO ISSUE
WITH THE WAY IT WAS CONDUCTED.
EARLIER YOU SAID YOU'RE
IMPLEMENTING ALL OF THE AUDIT
RECOMMENDATIONS THAT'S RIGHT
AND WHILE WE MAY DISAGREE WITH
YOU KNOW WITH SOME
CHARACTERIZATIONS OF WHAT'S
GOING ON YOU KNOW I UNDERSTAND
THAT I UNDERSTAND THEIR
POSITION. NAM Y. UNDERSTAND OUR
POSITION AND WHILE. I WON'T
MAKE THEM AGREE WITH BUT Y.
CAN'T. TAKE A GROUP ME I WON'T
AGREE WITH THEM BUT THAT'S
THAT'S THAT'S UNDERSTANDABLE-
BUT AS I SAY WE'RE GOING TO TRY
TO IMPLEMENT ALL OF THE
RECOMMENDATIONS. BUT IT'S
REACTIVE. I'M A LOT OF A LOT OF
IT IS I WILL SAYS IT YOU KNOW
BUT AS I MENTIONED BEFORE WE
WERE MOVING AHEAD ON THE
MEDICAL LEGAL FEE SCHEDULE YOU
KNOW WE ARE TRYING TO MAKE OUR
SYSTEM MORE EFFICIENT- AND
WE'RE- WERE DOING THE BEST WE
CAN WE'RE AND WE'RE- WE
UNDERSTAND THAT THERE ARE
THINGS THAT WE HAVEN'T LOOKED
OUT. AND THINGS THAT WE HAVEN'T
DONE- AND WE WILL WE WILL MAKE
IT WE WILL. DO BETTER BECAUSE
BECAUSE I THINK AT THE END OF
THE DAY. I ALWAYS TRY TO TELL
MY PEOPLE YOU KNOW WE JUST NEED
TO DO BETTER. SO AND DOING
BETTER- BUT HAVE YOU FOUND
AREAS WHERE YOU'RE SAYING. YOU
KNOW WE'RE UNDERSTAFFED OR WE
DON'T HAVE THE RIGHT SKILL
SETS. AND HAVE YOU APPROACH THE
DEPARTMENT OF FINANCE FOR. MORE
STAFFING OR FOR. BETTER
CLASSIFICATION OF EMPLOYEES FOR
COMPENSATION PURPOSES. WE'VE
BEEN WORKING WITH THE
DEPARTMENT OF LABOR AGENCY YOU
KNOW TO TRY TO MAKE SURE THAT
WE HAVE SUFFICIENT RESOURCES TO
DO YOU KNOW THAT SUFFICIENT
RESOURCES TO DO OUR JOB. AND SO
WHEN YOU SAY THE LABOR AGENCIES
AT THE LABOR AND WORK FOR SATAN
FLEE THAT'S CORRECT SO HOW DOES
HE ORG CHART WORK. YOUR THE
DIVISION OF WORKERS COMP YOU'RE
UNDER THE- DEPARTMENT OF
INDUSTRIAL ACTIONS AND IT IS
UNDER THE LABOR AND WORKFORCE
AGENCY. WHICH IS UNDER THE
SECRETARY WHO IS. NINE ZERO
SECRETARY THAT THEY REPORT TO
AND THEN IT THEN THE GOVERNOR
YES WHO'S THE SECRETARY- IT
JULIE SAID. OKAY. CURRENT THANK
YOU MISTER THANK YOU
ASSEMBLYMEMBER VOEPEL. THANK
YOU MISTER CHAIR I HAVE THREE
SHORT QUESTIONS AND ONE COMMENT.
SO. TO THE DEPARTMENT OF LABOR.
I'M I'M OFTEN CONFUSED BY
STAKEHOLDERS SO COULD YOU
DEFINE YOUR TOP THREE
STAKEHOLDERS THAT YOU TALK
ABOUT. WELL PRIMARILY WEEK WE
HAVE INJURED WORKERS WE HAVE-
THE EMPLOYERS AND THE CLAIMS
ADMINISTRATORS THE INSURANCE
COMPANIES WE HAVE OUR
PROVIDERS. SB EIGHT SIXTY THREE
THE REFORM TWO THOUSAND TWELVE
WAS NEGOTIATED BETWEEN
EMPLOYERS AND ORGANIZED LABOR.
SO I WOULD CONSIDER ALL OF
THOSE GROUPS TO BE OUR
STAKEHOLDERS THANK OU SIR. HOW
MANY PAGES ARE THE QUEUE AND
MAY REPORTS. IT CAN VERY DEPEND
UPON THE COMPLEXITY OF THE
CASE- AND THE IN THE ISSUE AT
HAND YOU COULD SEE REPORTS THAT
ARE ARE EIGHT OR NINE PAGES YOU
COULD SEE REPORTS THAT ARE TWO
HUNDRED PAGES OR MORE IT REALLY
DEPENDS UPON THE COMPLEXITY OF
THE ISSUE. NO KILLER BEES ARE
SUPPOSED TO DECIDE THOSE ISSUES
THAT ARE IN DISPUTE. THANK YOU
SO. AND WHAT IS YOUR DEFINITION
OF AN ALGORITHM IN YOUR
DEPARTMENT. WE'RE THROWING
AROUND WORDS ALGORITHM YOU KNOW.
I'M BORN IN THE NINETEEN
FIFTIES. COMPUTERS AND
ALGORITHMS- WERE INVENTED AFTER
ME SOLD COULD YOU DEFINE THAT
FOR ME MY DAUGHTER HAS TOLD ME
I WAS OLD YOU KNOW I WATCHED
YOU KNOW TO ME I WATCH EPISODES
OF DRAGNET AND THAT'S THE
HEIGHT THE TECHNOLOGY YOU KNOW
AN ALGORITHM IS YOU KNOW IT AS
FAR AS I UNDERSTAND WE HAVE OUR
OUR OUR OUR COMPUTER SYSTEM IN
PLACE THAT PUTS SELECTS Q.
EMMYS RANDOMLY TO BE PUT ON A
PAIR ALL. AND IT'S DONE
ACCORDING TO A COMPUTER PROGRAM
I'M IN THE COMPUTER PROGRAM HOW
IT WORKS LIKE YOU KNOW I'D HAVE
TO SAY I JUST CANNOT SAY- BUT
OUR I. T. THE TO THE-
INFORMATION TECHNOLOGY UNIT OF
THE DEPARTMENT- HAS TOLD US
THERE IS OUR SPECIFIC MEANS OF
WAYS OF DOING THAT AND THAT'S
WHAT WE NEED TO TAKE A CLOSER
LOOK AT. OKAY IN. MY FINAL
COMMENT IT. I BELIEVE THE
AUDITOR- GOES INTO UNKNOWN
TERRITORY CONSTANTLY AND THEN
HAS TO. PUT TOGETHER WHAT THEY
OBSERVE SO IT'S NEVER PERFECT
NEVER CAMPY AND I APPRECIATE
THAT GREATLY THE BECAUSE
WHOEVER THEY AUDIT. AND THE
REACTION OF THE AUDIT. TENDS TO
BE VERY POSITIVE AND I FEEL
VERY COMFORTABLE WITH THAT I
FEEL GOOD- AND THEN I HAVE A
COMMENT FOR THE CHAIR. I'M OUT
THERE NOW OKAY I'M ON THE EDGE.
SO. THIRTY NINE YEARS OF
OBSERVING THE WORKERS COMP
SYSTEM AND IT CHANGES
CONSTANTLY AND NO ONE BUT
EVERYONE'S RIGHT NO ONE REALLY
UNDERSTANDS THE MONSTER WE'VE
CREATED OKAY. I MEAN IT'S JUST
THE WAY IT IS. I HAVE ONE
RECOMMENDATION THAT EITHER THE
COMMITTEE WOULD LIKE TO CARRY
THE INSURANCE COMMITTEE OR ANY
ASSEMBLY MEMBER. IS MANY OF THE
WORK ONCE YOU GET A WORKERS
COMP CLAIM THAT BECOMES LIKE
THE HOLY GRAIL OKAY IT'S GOT TO
GO THROUGH TE WORKERS COMP OF
SAUSAGE MAKING MACHINE. AND
MANY TIMES THE WORKERS ARE NOT
SERVE CORRECTLY I MEAN THIS IS
THE WAY IT IS AND MANY TIMES
THE EMPLOYERS ARE NOT SERVE
CORRECTLY BECAUSE OF THE
LITIGATION SYSTEM. SO HERE'S MY
SILLY IDEA. WHAT IF WE
ESTABLISHED A CERTAIN LEVEL OF
WORKERS COMP CLAIM AND NOW I'M
JUST MAKING THIS UP FIVE
THOUSAND DOLLARS OKAY THAT GOES
TO GROUP HEALTH INSURANCE. MANY
MOST THEM PLEASE HAVE GROUP
HEALTH INSURANCE IF WE HAD A
CONDUIT TO BY PASS THE SMALL
WORKERS COMP CLAIMS IT JUST
SIMPLY CALL YOUR DOCTOR GET
YOUR HAND FIXED HAVE THE GROUP
HEALTH INSURANCE PAY FOR IT.
YOU'RE OUT OF THE SYSTEM ONE
FOR FIVE GRAND- BELOW TRUST ME
THAT WOULD SAVE IN MY
ESTIMATION ONCE AGAIN I'M
MAKING THINGS UP 47% OF WORKERS
COMP PREMIUMS. JUST BY
FUNNELING IT OFF THE HEALTH
INSURANCE. AND HEALTH INSURANCE
IS DESIGNED FOR THE SMALL
CLAIMS ANYWAY THAT'S MY COMMENT
ON DONE THINK YEAH I THINK
THERE'S MIGHT BE A MODEL I WAS
LOOKING AT IN FRESNO THAT
KINDA. DOES THAT IT SENDS
INJURED WORKERS TO GO GET
TREATMENT. AND THEN THEY FIGURE
OUT THE WORKERS COMP CLAIM ON
THE BACK END BUT THEY FOUND IT
ACTUALLY SAVED MONEY TO THE
ENTIRE SYSTEM AND I GOT WORKERS
TO WORK QUICKER WHICH THEN YOU
KNOW ALLEVIATE A LOT OF- THE
FRUSTRATIONS. WITH PEOPLE THAT
WERE INJURED I THINK THEY DID
IT WITH PUBLIC SAFETY- SENATOR
ROBB WHICH IS ONE QUESTION ON
THE PANELISTS. YOU KNOW WHEN I
USED TO DO LABOR WORK LABOR
MANAGEMENT WORK AND WE'D-
SOLICITOR PANELS OF ARBITRATORS
OR MEDIATORS FOR THAT FOR THAT
MATTER FROM THE NATIONAL
SERVICES WOULD GET A PANEL OF
TEN TO FIFTEEN PEOPLE. AND IT
WAS A STRIKE SITUATION AS WELL
ONE SIDE WOULD STRIKE THE OTHER
WHICH STRIKE INTO WE AGREED TO
A PARTICULAR PERSON. I KNOW
YOU'RE TAKING A LOOK AT YOUR
PANEL IS THERE ANY LEGISLATIVE
OR A STATUTORY OR REGULATORY
RESTRICTION ON THE NOT BUILD
THE SIZE OF YOUR PANEL THAT YOU
SEND OUT TO PEOPLE IN THE
WORKERS COMPRESSES I THINK IN
STATUTES REQUIRED TO BE THREE.
OKAY SO THAT TO ENSURE THE
CHAIRS QUESTION THAT IS
CERTAINLY SOMETHING THAT WOULD
NEED TO BE ADDRESSED NUMBER
ONE. AND NUMBER TWO IN TERMS OF
IS THERE ARE. IS THERE ANYTHING
IN THE STATUTE OF THE
REGULATION THAT LIMITS
GEOGRAPHICALLY THE LOCATION OF
pTHE HUMAN MAYES THAT ARE LISTED
ON THE PANEL. SHEET THAT'S
GIVEN TO THE PARTICIPANTS IN
THE PROCESS I DON'T BELIEVE SO.
I DON'T ELIEVE THAT I DON'T
BELIEVE IT'S AN STATURE AND
THEN THE ONLY ISSUE THEN I
ASSUME WOULD BE THE FACT THAT
THE INJURED WORKER WE- MIGHT
NEED TO TRANSPORT HIMSELF OR
HERSELF TO THE QUEUE IN THESE
OFFICE. TO THE EXTENT THAT IN
AN IN OFFICE EVALUATION IS.
NECESSARY REQUIRED IN THAT
CIRCUMSTANCE. AND I ASSUME.
THAT INJURED WORKERS IN THE
TYPICAL CASE WHERE THE CLAIMS
BEEN ACCEPTED WILL BE WOULD BE
COMPENSATED FOR THAT TRANSPORT.
BUT IN A CASE WHERE WORK REAL
THE WORK RELATEDNESS OF THE
INJURY IS AT ISSUE. IS THE
EMPLOYEE ENTITLED TO
COMPENSATION. FOR THAT INITIAL
Q. IN THE VISIT. MILEAGE
COMPENSATION BY I'D I'D I'D
HAVE TO SAY I'M NOT I AM NOT
SURE OF THE TOP OF MY HEAD SO I
BUT THAT'S- OBVIOUSLY A STATUTE
OR REGULATORY GRAPHICS IF
NECESSARY RIGHT AT THE CHAIR
IN. IN HIS EFFORTS WOULD NEED
TO TAKE A LOOK AT AS WELL.
PERFECT THANK YOU MISTER THANK
YOU. ALL RIGHT LET ME- JUST
TOUCH ON TWO MORE THINGS LOS
THE AUDITOR WANTS TO CHIME IN
ON ANYTHING OKAY ONLY BECAUSE
OF THE WAY THINGS ARE BROUGHT
UP EARLIER THAT WE REALLY
HAVEN'T TOUCHED ON AND THAT'S
THE DUE PROCESS. FOR FOLKS THAT
I HAVE- NOT BEEN RESTORED IS IT
RECERTIFIED TO RE APPROVED
POINTED REAPPOINTED SO HE TALK
ABOUT THAT AND WHAT'S THE- WHAT
IS OUR DUE PROCESS WHAT CAN
THEY DO BECAUSE I THINK. THE
AUDITOR IN HER STATEMENT
EARLIER HAD TALKED ABOUT SO
MANY. SO MANY REPORTS WERE RAD
THEY WENT THROUGH LIKE EIGHTY
SIX BUT THEY DIDN'T FOLLOW
THROUGH WITH THE
RECOMMENDATIONS. YOU JUST TALK
TO US ABOUT THAT AND WHAT
HAPPENED AND WHY AREN'T WE-
FIGURE OUT A- BETTER SYSTEM FOR
THAT. WELL OUR FOR TALKING
ABOUT THE DISCIPLINE I AM I
THINK WE ARE WE HAVE REACHED A
BETTER SYSTEM FOR THAT I THINK
OF SOME OF THE DUE PROCESS
CONCERNS- M. HAVE BEEN. HAVE
BEEN ADDRESSED OF WE DO DO DO
WILL TRACKS NOW IN THE PAST.
WHEN WE'VE HAD WHEN WE'VE HAD
ISSUES OF PERSONNEL AND
RESOURCES. YOUR COMPLAINT WOULD
COME IN IN THE COMPLAINT WOULD
GET PUT TO THE SIDE. AND HOPE
POSSIBLY NOT ADDRESSED UNTIL
THE REAPPOINTMENT ISSUE THIS
WAS HAPPENING IN 200-014-2000
SIXTEEN- BUT I WE'VE WE'VE
LOOKED AT THAT- WE THINK WE
HAVE. PUSHED FORWARD- IF A
COMPLAINT COMES IN WE WANT TO
NOTIFY. THE QB RIGHT AWAY ABOUT
THAT AND WE WANT TO INITIATE WE
KNOW WE WANT TO INITIATE THAT I
THINK THAT'S WHAT WE ARE DOING.
RIGHT NOW- THAT'S THE TITLE
TRACK THAT'S A DUAL TRACK OF
THE AUDIT AND THE AUDITOR HAS
ASKED US TO PUT DOWN THOSE
POLICIES AND PROCEDURES IN
WRITING AND WE ARE CERTAINLY
GOING TO DO THAT. THAT AND THAT
IS THAT SOMETHING THAT FLLOWS
THE ADMINISTRATIVE PROCEDURES
ACT WHEN YOU DO THAT.
ADMINISTRATIVE PROCEDURES ACT
WE IF WE FOLLOW THE
ADMINISTRATIVE PROCEDURES ACT
IN BOTH THE DISCIPLINE AND THE
RE APPOINTMENT PROCESS. GOT IT.
OKAY I THINK I'M JUST TRYING TO
PROCESS SAID. OKAY LET ME ASK
ABOUT THE- BECAUSE THE OTHER
THING THAT WAS BROUGHT UP WAS A
CURE ME REPORT QUALITY. READY
WE TOUCHED ABOUT THE FINANCE I
THINK MISTER ROTH HAD BROUGHT
UP SOME ROCK. HOW CAN WE ARE
WHAT IS A PART WAS THE HAVE YOU
SEE DOING TO. HELP COVER THAT
GAP IF YOU KNOW YOUR SPITTING A
REPORT AND IT'S NOT COMPLETE
AND THEN BEING KICKED BACK DOWN
AND WHETHER PEOPLE ARE GETTING
REIMBURSED OR NOT. HOUSE
APARTMENT INVOLVED IN MAKING
SURE THAT WE HAVE QUALITY
REPORT SO THAT WHEN LOOKING AT
TIME EFFICIENCY. AND EFFICIENCY
OVERALL. YOU KNOW WE'RE MAKING
THE SYSTEM BETTER. WELL A
MEDICAL REPORT HAS TO
CONSTITUTE SUBSTANTIAL MEDICAL
EVIDENCE AND WHAT WE NEED TO DO
IS MAKE SURE AT LEAST IN THE
INITIAL TRAINING AND EDUCATION
PROCESS. THE Q. M. IS NO WATER
QUALITY REPORT IS IN OUR
STAKEHOLDER MEETINGS ARE ARE
ARE ARE TALKING ABOUT THAT NOW
WHAT IS THE DEFINITION OF A
QUALITY REPORT- ONCE WE GET
THAT AS A- AS I SAY WE WANT TO
INCREASE THAN THE AMOUNT. OF
HOURS NEEDED FOR PERSON TO TAKE
A REPORT WRITING CLASS SO THAT
THEY CAN UNDERSTAND THAT. NOW
WHAT WE HAVE NOT DONE OF AND I
WILL. READILY SALES LOOKED IN
THE PAST AND THIS HAS NOT BEEN
DONE WAS TAKING A LOOK AT THE
REPORTS TO SEE IF THEY ACTUALLY
MEET THOSE. STANDARDS OF
QUALITY. OF AND THAT'S WHAT WE
NEED TO DO AND WE NEED TO GET
THE REPORTS FROM OUR JUDGES
ABOUT THAT WE NEED TO SEE
WHAT'S GOING ON. AND AT THAT
POINT ONCE WE EVALUATE THE
REPORTS INDETERMINATE THERE'S
AREAS LOT IN AREAS THAT ARE
LACKING. AND WE NEED TO GO OUT
AND ADVICE Q. IT MEANS THAT
THIS IS WHAT'S GOING ON NOW I
CAN'T STICK MY HANDS IN A CASE.
AND SAY THIS IS WHAT THIS IS A
LOUSY REPORT YOU HAVE TO DO
SOMETHING AGAIN LITIGATE CASES.
AND THAT'S NOT THE OWNER I CAN
JUMP INTO INTO ANYTHING ABOUT.
THE EXTENT. OF A JUDGE TELLS ME
WITH A LOOK DONALD DOES HE
REPORT. I CAN'T GO BACK TO THE
Q. AND SAY YOU NEED TO FIX THIS
REPORT. THAT'S A THAT'S AN OPEN
LITIGATED CASES THAT NEEDS TO
BE RESOLVED THROUGH THROUGH
THAT EDUCATION PROCESS. BUT WE
CAN'T CREATE SOME STANDARDS FOR
WHAT A REPORT SHOULD INCLUDE
HELP AND WELL ROOF DATA QUALITY
GOT THAT'S WHAT WE'RE WORKING
ON AND I THINK THAT'S WHAT
THAT'S WHAT WE NEED TO GET I
THINK WE NEED. TO REACH AN
AGREEMENT. IN OTHER WORDS IF
WE'RE GONNA Và I'M GOINGTO
PAY X. AMOUNT REPORT I NEED TO
SEE A REPORT THAT'S GOING TO
HAVE. ALL OF THESE STANDARDS IN
IT OF ALL THAT WOULD MEET ALL
OF THE STANDARD THAT'S WHAT
THAT'S WHAT WE NEED TO HAVE. I
MEAN I WOULD HOPE OUR OR OUR
STAKEHOLDERS WILL WILL WILL
REACH AN AGREEMENT ON THAT.
THAT WE CAN PUT THAT FORWARD SO
THAT WE LOOK AT THESE REPORTS
WE CAN SEE WHETHER OR NOT THEY
MEET THAT. AND IF. WE SEE A
TREND OR WAR OR SOMETHING
INDICATING THAT THE Q. AMIS ARE
NOT DOING THAT THAT WE CAN GO
OUT AND SAY LOOK. YOU KNOW IF
YOU'RE WRITING REPORTS THIS
NEEDS TO BE DONE OR ELSE. IF IT
GETS BEFORE JUDGE WILL BITE
HAVE A PROBLEM. GOT IT YEAH I'M
NOT I'M JUST TRY TO FIGURE OUT
HOW WE- PROVE THAT BECAUSE AS
APPROVED ACCOUNTABILITY AS
WELL. IN THE ENTIRE SYSTEM BUT-
SO YOU WOULD BE IN CHARGE OF
THAT- THE DEPARTMENT WOULD.
RIGHT TO WRITER THAT RIGHT
RIGHT WE ARE TASKED WITH THAT.
WE HAVE NOT DONE THAT WE NEED
TO DO THAT. GOT IT AND TEN WE
GO BACK TO TIMELINE BUT-
STAKEHOLDER MEETINGS AND
HOPEFULLY. YOU'RE SAYING I
WOULD I WOULD I WOULD I WOULD
HOPE THAT THEY WOULD REACH.
REACH SOME TYPE OF AGREEMENT
AGAIN I'D LIKE TO SEE THIS DONE
BY REALLY SPREAD. OUT I KNOW
CENTER ROTH ONE OF ADD ON WELL
I LET ME JUST SAY THIS IF YOU
KNOW I. HAVE HAD SOME
INVOLVEMENT WITH THE WORKERS
COMP SYSTEM AND- AND THE JUDGES
AND ALL THAT BUT- IF THIS WERE
A CIVIL COURT. COURT AND
SOMEONE SUBMITTED AN EXPERT
SUBMITTED A REPORT THAT WAS
INSUFFICIENT. INSTEAD OF GOING
BACK FOR NEW DOCTORS IN NEW
REPORTS AND SIX MORE MONTHS AND
STRIKING ON PANELS. THE JUDGE
WOULD SIMPLY ISSUE IN ORDER FOR
THE PROVIDER TO COME TO COURT
AND ANSWER THE QUESTIONS ABOUT
THE REPORT IN. AND YOU KNOW I
DON'T KNOW I MEAN I SUPPOSE
THAT. IT'S AN ATOMIC EXPLOSION
WORKERS COMP SYSTEM BUT I THINK
OUR PROCESS IS A LITTLE TOO
BUREAUCRATIC- DESIGNED TO
STRETCH OUT ON ON ON ON AND IF
WHAT WE TAUGHT WE'RE WHAT WE'RE
TALKING ABOUT IS A IS AN
INSUFFICIENT REPORT. WERE
HEALTH CARE PROVIDER FAILED
ENDING AN EVALUATOR AN EXAMINER
FAILED TO ANSWER. QUESTIONS
ASSUMING IN THESE VARIOUS AREAS
TEMPORARY DISABILITY PERMANENT
DISABILITY WORK RELATEDNESS OF
THE INJURY WE HAVE A LIST OF
QUESTIONS AND ISSUES THAT AN
EXAMINER NEEDS TO ADDRESS IN A
REPORT. IN THE EXAMINER FAILS
TO ADDRESS IT IT WOULD SEEM TO
ME THAT WE ARE THERE OUGHT TO
BE AN EXPEDITED WAY TO FILL IN
THE GAP. WITHOUT GOING BACK TO
ANOTHER LIST OR ANOTHER
EXAMINER OR NOT- YOU WAITER IF
THAT'S WHAT HAPPENS IN THE
PROCESS AND IF IT IS I'D ASK
YOU TO TAKE A LOOK AT THAT WELL
WE CERTAINLY WELL I WOULD I
WOULD AGREE WITH YOU THAT I
THINK WE JUST NEED TO HAVE. THE
SYSTEM. IT'S VERY THE VERY
STRAIGHTFORWARD THAT'S
UNDERSTANDABLE WHEN AN ADDICT
INADEQUATE REPORT COMES BEFORE
JUDGE ITO JUDGE HAS AN OPTION
TO JUST IN ORDER TO CURE ME ORG
OR GET A SUPPLEMENTAL REPORT.
NO THERE ARE THERE ARE OPTIONS
OUT THERE BUT BUT YOU'RE RIGHT
STANDARDS ARE MET THEN SOME
ACTION NEEDS TO BE TAKEN. WE
JUST DON'T NEED TO KEEP
REINVENTING THE WHEEL OVER AND
OVER. CUT IT RIGHT THIS WAS A
SOUTHERN WARLOCK THANK YOU
MISTER CHAIR JUST MAYBE TO WRAP
UP WITH. SOME OF THE QUESTIONS
I ASKED THE AUDITOR- WE
PURCHASE WORKERS COMP FOR
DEPARTMENTS OR THEY USE A
MASTER AGREEMENT. WE HAVE AN
INSURANCE COMMISSIONER ELECTED
WE HAVE A DIVISION OF WORKERS
COMP. AND I'M JUST WONDERING TO
HAVE SILOS OR DO WE HAVE
SYNERGY. WHY THAT'S A THAT'S A
THAT'S AN INTERESTING QUESTION-
I WHAT IS THE ANSWER THIS FROM
MY OWN PERSONAL OPINION I CAN'T
I'M NOT GOING TO SPEAK ON
BEHALF OF THE DIVISION OF THE
DEPARTMENT I DON'T THINK WE
HAVE SYNERGY. I DON'T KNOW IF
WE HAVE SILOS BUT I DON'T THINK
WE HAVE CENTER. THANK YOU. CUT
DID YOU. OKAY GREAT HELLO
THERE'S NO ADDITIONAL QUESTIONS
I THINK WE'LL MOVE ON TO THE
NEXT PANEL APPRECIATE THAT WE
DO WANT TO- WILL WORK WITH YOU
ON ADDRESSING SOME OF THESE
THINGS I THINK WE'RE JUST
TRYING TO FIGURE OUT WHO WERE
TIMELINE IN THE SCHEDULE AND
WHAT'S GOING TO FOLLOW UP I
REGULAR THROUGH THE API-
MYSTERY PROCEDURES ACT AND
WHAT'S GOING TO JUST BE DONE-
BY THE DEPARTMENT AND I THINK.
WILL BE LOOKING EAGERLY. TO SEE
HOW THAT'S A COMPLAINT. THANK
YOU AND THANK YOU FOR YOUR TIME
THANK YOU. ALL RIGHT WITH THAT
WAS GOING TO MOVE ON TO OUR
NEXT PANEL. AND THAT'S THE
COMMENTS AND RESPONSES TO THE
AUDIT. WE HAVE A ELLEN. LANDEL
GENERAL COUNSEL CAL FOR WORKERS
COMPENSATION IS TO DIANNE
WORLEY STRUCTURE POLICY
IMPLEMENTATION CALIFORNIA
APPLICANTS ATTORNEYS
ASSOCIATION JACOB ROSENBERG.
MARZANO CALIFORNIA'S SOCIETY OF
INDUSTRIAL MEDICINE AND
SURGERY- GABOR VARI BOARD
MEMBER FOR THE CALIFORNIA
SOCIETY OF INDUSTRIAL MEDICINE
AND SURGERY AND- NICHOLAS
ROXBOROUGH CO MANAGING PARTNER
OF ROXBOROUGH POMERANCE NINE
DREAMY. **** IT HAVE YOU GUYS
ALL COME UP AND THEN MAYBE WE
CAN. WHOEVER LIKE TO BEGIN WE
CAN. WE CAN START THERE WE CAN
GO IN THE ORDER THAT YOUR
LISTED ON THE AGENDA. ONE OF
THE FIRST ITEM IS THE FIRST. I
LOVE TO GO FIRST. THE JUST
ANNOUNCED YOURSELF FOR THE
RECORD RIGHT- I'M DIANE WORLEY
AND THE DIRECTOR OF POLICY FOR
THE CALIFORNIA APPLICANTS
ATTORNEYS ASSOCIATION THANK YOU.
GO AHEAD PLEASE OKAY- THANK YOU
MISTER CHAIR AND MEMBERS OF THE
COMMITTEE FOR INVITING ME TO
SPEAK TODAY ON THIS IMPORTANT
ISSUE- I'M WITH THE CALIFORNIA
APPLICANTS ATTORNEYS
ASSOCIATION AN ORGANIZATION
FOUNDED IN NINETEEN SIXTY SIX.
WHICH IS DEDICATED THIS WORK TO
HELPING CALIFORNIANS THAT GET
HURT ON THE JOB RECEIVE THE
BENEFITS AND MEDICAL TREATMENT.
IN A TIMELY MANNER AND GET BACK
TO WORK WE ALSO PROBABLY
AFFILIATED WITH THE
INTERNATIONAL BROTHERHOOD OF
TEAMSTERS JOINT COUNCIL SEVEN
AND FORTY TWO. I WOULD ALSO
LIKE TO MAKE THE STATE AUDITOR
ALAIN HELL FOR EXCELLENT WORK
ON THIS REPORT OF COURSE NONE
OF THE REPORT'S FINDINGS ARE
SURPRISE TO US. IT HAS BEEN IT
BUT IT'S NICE TO HAVE A PUBLIC
ACKNOWLEDGEMENT OF THE CUNY
CRISIS THAT PRACTITIONERS IN
THE WORKERS COMP SYSTEM HAVE
BEEN EXPERIENCING FOR MANY
YEARS. I HAVE TO SAY THAT WE'VE
MET WITH THE ADMINISTRATION
BEFORE MISTER PARIS SOTOS
TENURE. AND MANY TIMES DURING
HIS TENURE TO DISCUSS THE ISSUE
WITH THE SHORTAGE OF CUNY'S.
AND UNFORTUNATE UNFORTUNATE
THAT WE HAD TO GET TO THIS
PROCESS BUT AT LEAST NOW WE
HAVE A PUBLIC ACKNOWLEDGEMENT
THAT WE'RE IN A CRISIS MODE AND
IT'S BEEN LIKE THIS FOR YEARS.
AND HAS HAD A DETRIMENTAL
IMPACT AN INJURED WORKERS. THE
REPORT ITSELF IS CLEARLY AN
INDICTMENT OF THE D. W. SEES
HANDLING OF THE CURE ME SYSTEM
WHICH HAS NECESSITATED THE NEED
FOR THIS OVERSIGHT. THE
AUDITOR'S RIGHT ON. BUT IT
DOESN'T ADDRESS SOME ISSUES-
THEY DON'T TELL THE FULL FOR
THE STORY OF THE FULL NUMBERS
OF THE QUEUE IN A CRISIS.
INJURED WORKERS OFTEN HAVE TO
TRAVEL HUNDREDS OF MILES. TO
SEE A QUEUE IN THE SPECIALIST
AS THEY ARE NOT AVAILABLE IN
THE LIST IN THEIR GEOGRAPHIC
AREA. AND EMPLOYERS HAVE TO PAY
FOR THAT. INJURED WORKERS
CANNOT FIND. AN APPROPRIATE
SPECIALISTS SPECIALISTS TO
EVALUATE SOME OF THE MOST
CATASTROPHIC INJURIES IN THE
SYSTEM. SUCH AS TRAUMATIC BRAIN
INJURIES ARE CANCER. IF YOU
HAVE A SPRAINED ANKLE YOU MIGHT
BE LUCKY TO GET ORTHOPEDIST WHO
WILL SEE YOU IN SIXTY DAYS BUT
YOU WON'T BE ABLE TO SEE A
DOCTOR WHO SPECIALIZES IN
CANCER AN ONCOLOGIST IN THE
STATE WHAT SURVIVOR. THE
AUDITOR WASN'T ASKED
SPECIFICALLY TO LOOK AT THESE
ISSUES. BUT I'M SURE YOU ALL OR
WHERE OR REMEMBER THAT BACK IN
TWO THOUSAND FIFTEEN THAT THE
B. C. ELIMINATED THE QUEUE IN
THESE- SPECIALTY OF
NEUROPSYCHOLOGY FROM THE
PANELISTS. NEUROPSYCHOLOGY IS
THE NUMBER ONE REQUESTED
SPECIALTY FOR AN INJURED WORKER
WHO HAS A TRAUMATIC BRAIN
INJURY. WHEN THE RESPONSE TO
THAT WAS TO INTRODUCE A BILL
WHICH OBTAINED UNANIMOUS
BIPARTISAN SUPPORT AND ENDED UP
ON THE GOVERNOR'S DESK THE D.
WC OPPOSE THAT AND FORMER
GOVERNOR BROWN TO. VETO THAT
BILL. THE AUDITOR HAD DIDN'T
WITH AN ASKED TO LOOK AT WHY
THEY'RE ONLY THREE ON COLLEGES
Q. AMIS IN THE STATE OF
CALIFORNIA TO REVIEW. CANCER
CASES WHICH ARE REQUIRED FOR
CUMAE PENALTY ISSUE AND THERE'S
MANY OTHER SPECIALTIES WERE YOU
CAN'T GET A PANEL. WHILE THE
RECOMMENDATION OF INCREASING
THE NUMBER OF CUBIES IS SUPPORT
AT A WHILE FOUND IT. SOLELY
INCREASING NUMBERS WILL NOT
ADDRESS THE SIGNIFICANT PROBLEM
OF THE LACK OF MUCH NEEDED
MEDICAL SPECIALIST ON THE QUEUE
IN THE LAST AND THE GEOGRAPHIC
AVAILABILITY. WE AGREE WITH THE
AUDITOR'S REPORT EXCEPT FOR IN
ONE AREA. THE RECOMMENDATION
FOR A LIST WITH FIVE NAMES
ISN'T GOING TO SOLVE THE
PROBLEM YOU'RE JUST GONNA HAVE
MORE PROBLEMS WITH THE NOT
BEING ENOUGH DOCTORS. ALSO THE
RECOMMENDATION THAT IF YOU DO A
LIST OF FIVE NAMES THAT THE
PARTY WHO DIDN'T REQUEST THE
PANEL SELECT THE DOCTOR WON'T
WORK IT'S GOING TO PENALIZE THE
INJURED WORKER HE WANTS TO MOVE
THEIR CASE. IT'S GOING TO
PENALIZE THE EMPLOYER
REPRESENTATIVE HE WANTS TO MOVE
THE CASE ANY SUCH
RECOMMENDATION TO THE
LEGISLATURE ON THAT LEVEL. IS
PREMATURE. BUT MOST IMPORTANTLY
IS THE ODYCH CORRECTLY SURMISES
DELAYS HAVE REAL COST FOR BOTH
EMPLOYERS AND THE INJURED
WORKER. THE UNAVAILABILITY
AVAILABILITY OF CUBIES OFTEN
EXACERBATES THE CONDITION OF
THE WORKER LEADING TO FURTHER.
UP COMPLICATIONS AN ADDITIONAL
MEDICAL NEEDS FROM DELAYS I'M
GOING TO CLOSE WITH AN EXAMPLE
FOR ONE OF OUR MEMBERS THAT IS
BEYOND ANYTHING THAT HAS BEEN
EXPRESSED HERE TODAY AND IT'S
TYPICAL AND HAPPENS EVERY DAY.
TO AN INJURED WORKER SO HERE'S
THE CASE. A FORTY YEAR OL MALE
MACHINE OPERATOR WAS A PLATE
FOR THREE YEARS HE STARTED
NOTICING PAIN AND NUMBNESS IN
HIS HANDS. AND WAS DIAGNOSED
WITH CARPAL TUNNEL SYNDROME BY
HIS TREATING DOCTOR. HE FILED A
CLAIM. THE CARRIER DECIDED TO
DENY THE CLAIM AND GET IT Q. ME
EVALUATION. THAT PROMPTED THE
WORKER TO GO OUT AND GET AN
ATTORNEY. THREE MONTHS LATER
THE FIRST KILLING ME PANEL
ISSUES. BUT THAT DOCTOR ISN'T
SETTING FOR SEVEN MONTHS. SO
THE CARRIER OBJECTS TO REQUEST
REPLACEMENT PANEL. THE SECOND
PANEL ISSUES SIX WEEKS LATER.
BUT THAT DOCTOR ISN'T SETTING
FOR FIVE MONTHS. SO THE
DEFENDANT OBJECTS REQUEST
ANOTHER REPLACEMENT PANEL SO WE
GO ON TO THE THIRD PANEL. BUT
THAT DOCTORS NO LONGER DOING
EVALUATIONS AT THE ADDRESS ON
THE PANEL SO YOU WON'T SCHEDULE
LET THEM. HAVE TO GO TO A
FOURTH PANEL. THE FOURTH PANEL
ISSUES OCCUR AGAIN AND THE
REMAINING DOCTORS SETTING
BEHIND BEYOND THE NINETY DAYS.
BUT NOW THE DEFENDANT AGREES TO
WAIVE THE NINETY DAY DEADLINE
BECAUSE THEY'VE GIVEN UP. THE
EVALUATION SAT IT IS TWO MONTHS
AFTER THE FIRST EVALUATION
WOULD HAVE BEEN SET. AND FENCE
SO THEN IN THE MEANTIME THE
INJURED WORKER. HAS BEEN OFF
WORK. BIRD THREE YEAR STATE
DISABILITY INSURANCE. OBTAIN
CARPAL TUNNEL SURGERY ON HIS
PRIVATE GROUP HEALTH INSURANCE
ALONG WITH OTHER TREATMENTS
SUCH AS PHYSICAL THERAPY AND MJ
STUDY ALONE BEHOLD AFTER THE
CARPAL TUNNEL SURGERY HE'S
RETURNED TO WORK AFTER ONE
MONTH HE GOES BACK TO WORK AND
HE'S STILL WAITING FOR THE
REPORT FOR THAT Q. ANY
EVALUATION WHICH IS THE ALL.
OVER A YEAR AFTER THIS WHOLE
PROCESS STARTED. THANK YOU FOR
HAVING THIS HEARING TODAY. WE
APPRECIATE THIS AUDIT AND WE
HOPE IT WILL SPUR AND URGENT
FOCUS ON ADDRESSING THESE
ISSUES BEYOND WHAT WAS
DISCUSSED TODAY THANK YOU THANK
YOU. MISTER CHAIRMAN I MAKE ONE
COMMENT QUICK. A QUICK COMMENT
BECAUSE WE WANT TO HEAR FROM
ALL PANEL UNDER JUSTIN'S ARM
ONE OF THE PROBLEMS I HAVE WITH
THAT EXAMPLE. IS ON THE CLAIM
FORM YOU HAVE TO MARK DOWN
WHETHER IT'S WORKERS COMP OR
NOT IN ORDER TO GET YOUR HEALTH
INSURANCE BENEFITS THROUGH
GROUP INSURANCE. SO THAT
EMPLOYEE WAS FORCED TO
BASICALLY MISREPRESENTED THAT'S
MY COMMENT. CUT CUT LET'S MOVE
ON. I'M IS CHAIR MEMBERS OF THE
COMMITTEE- GOOD AFTERNOON MY
NAME IS ELLEN LANDS ON GENERAL
COUNSEL FOR THE CALIFORNIA
WORKERS COMPENSATION INSTITUTE.
SEE TO BE SEE I IS A NONPROFIT
RESEARCH ORGANIZATION THAT
PROVIDES. OBJECTIVE. VIEWED
PUBLIC POLICY STUDIES. THAT
HAVE BEEN USED BY THE DATE OF
YOU SEE THE D. I. R. THE
LEGISLATURE AND THE GOVERNOR'S
OFFICE TO PROVIDE ANALYSIS
GROUNDED IN SYSTEM WIDE DATA.
AND NOT ANECDOTES OR PERSONAL
OBSERVATIONS. IN KEEPING WITH
OUR MISSION TO IDENTIFY SYSTEM
WIDE TRENDS THE INSTITUTE
PRODUCED A RESEARCH REPORT AND
TWENTY EIGHTEEN ENTITLED
CHANGES IN THE QUEUE ANY
POPULATION. THAT REPORT WAS
REFERENCED BY BOTH THE STATE
AUDITOR IN HER REPORT AND BY
THE DUE TO BE SEE AND ITS
RESPONSE A COPY HAS BEEN
INCLUDED FOR YOU TODAY ALONG
WITH OUR WRITTEN TESTIMONY. OUR
REPORT CONFIRMS THAT A DECREASE
IN THE NUMBER OF CARE MAYES HAS
OCCURRED. BUT THAT DECREASE IS
DUE TO MANY DIFFERENT REASONS
IT'S NOT JUST LOW PAY.
RETENTION OF CERTIFIED CAM IS
MAY BE LINKED TO SOME QUEUE
ARMIES FAILURE TO BE SELECTED
THROUGH THE PANEL PROCESS. OUR
DATA SHOWS THAT OF THOSE KILL
MAYES WHO STOPPED PROVIDING
SERVICES BETWEEN TWENTY TWELVE
AND TWENTY SEVENTEEN. 83%
VOLUNTARILY DID NOT REVIEW WE
KNEW THERE CAN BE
CERTIFICATIONS. AND MORE THAN
HALF OF THOSE PHYSICIANS WERE
NOT ACTIVELY PERFORMING CURE ME
EVALUATIONS IN THE FIRST PLACE.
ONE EXPLANATION FOR THOSE CURE
MAYES NOT BEING SELECTED BY THE
PARTIES DURING THE PANEL
PROCESS COULD BEAT THE POOR
QUALITY OF THEIR REPORTS. IT IS
THE INAUGURAL BALL IN ARE
CURABLE GOAL. OF ALL SIDES
PAYERS INJURED WORKERS CAN AMIR
PROVIDERS TO PROVIDE A QUALITY
FIRST REPORT. BUT THE NUMBER OF
SUPPLEMENTAL REPORTS THAT ARE
ISSUED BY EVALUATORS HIGHLIGHTS
THE INEFFICIENCY OF THE SYSTEM
AS IT PRESENTLY EXISTS. LOOKING
NEXT TO A REASON FOR THE DELAYS
IN THE KILL ME APPOINTMENTS THE
DATA POINT TO A NUMBER OF
OFFICES. THAT EACH PROVIDER
OPERATES FROM. YEARS AGO A FEW
PROVIDERS WERE OPERATING OUT OF
MORE THAN A DOZEN OFFICES
THROUGHOUT THE STATE. WITH THE
RESULT THAT DOES PHYSICIANS
REPLACED ON Q. ANY PANELS MORE
OFTEN THAN PHYSICIANS WHO
OPERATED OUT OF A SINGLE OFFICE.
SO IN TWENTY THIRTEEN THE LAW
CHANGED TO LIMIT TO TEN. THE
NUMBER OF OFFICERS THAT EACH
PROVIDER WOULD BE PERMITTED TO
UTILIZE. BUT THE RESULT WAS
THAT MORE PROVIDERS STARTED
USING MULTIPLE OFFICES AND
SENSE ONE PHYSICIAN CAN STILL
WORK ONLY SO MANY HOURS IN A
WEEK NO MATTER HOW MANY OFFICES
THEY HAVE. THOSE PROVIDERS
APPOINTMENT CALENDARS STARTED
TO FILL UP FASTER. THAN EVER
BEFORE. THAT CAUSED THE SYSTEM
TO BE UNABLE TO MEET THE SIXTY
DAY DEADLINE TO SET AN
APPOINTMENT. WHICH IN TURN
RESULTED IN AN INCREASED NUMBER
OF REQUESTS FOR REPLACEMENT
PANELS. LASTLY WE WOULD LIKE TO
ADDRESS THE RECOMMENDATIONS OF
THE AUDITOR IN HER REPORT. THE
AUDITOR'S FIRST RECOMMENDATION
IS THAT THE MED LEGAL FEE
SCHEDULE BE REVIEWED AND
UPDATED AT LEAST EVERY TWO
YEARS IT IS CRITICAL THAT THE
LEGISLATURE RECOGNIZED THAT ANY
MANDATE TO UPDATE TO THE
MEDICAL LEGAL FEE SCHEDULE
WOULD MEAN MODIFYING THE CODES
AND THE RULES. AND THAT WOULD
INVOKE THE FULL REGULATORY
PROCESS IT SEEMS LIKELY THAT
THE AUDITOR INTENDED TO SUGGEST
THAT THE REIMBURSEMENT RATES BE
UPDATED. TO THIS SENSITIVITY
AYE RECOMMENDS THAT THE MEDICAL
LEGAL FEE SCHEDULE RATES BE
TIED DIRECTLY TO A VALID
INFLATION INDEX SUCH AS THE
MEDICARE ECONOMIC INDEX
REFERENCED BY MR PERSONAS WALL.
THISWOULD OF FACILITATE
REGULAR UPDATES THE ME I HAS
ALREADY BEEN ADOPTED BY THE
DATE OF YOU SEE AS A MEANS OF
MAKING THEIR ANNUAL UPDATES. TO
THE CONVERSION FACTOR FOR
PHYSICIAN IN OPPOSITION-
SERVICES. UNDER THE OFFICIAL
MEDICAL FEE SCHEDULE. THE
AUDITOR HAS FURTHER SUGGESTED
THAT THE DELAYS CAUSED BY
REPLACEMENT PANELS COULD BE
REDUCED. BY INCREASING THE
NUMBER OF KILOMETERS ON THE
PANELS FROM THREE TO FIVE IN
REPRESENTED CASES. AS REFLECTED
IN THE SEA TO BE SEE I REPORT
IN FRONT OF YOU. THERE SIMPLY
WILL NOT BE FIVE Q. M. IS
AVAILABLE IN ANY BUT A FEW
SPECIALTIES. GIVEN THE CURRENT
POPULATION OF KIMI PROVIDERS
THERE IS LITTLE CHANCE OF
GETTING FIVE PROVIDERS IN MOST
SPECIALTIES. OUR STUDY CONFIRMS
THAT ACCESS TO Q. ARMIES IN THE
SYSTEM IS ALREADY GREATLY
IMPACTED BY LOCATION AND
REQUESTED SPECIALTY. THE
PROPOSED CHANGE MAY RESULT IN
EVEN LARGER GEOGRAPHIC SEARCHES
BY THE DUE TO BE SEE IN ORDER
TO GENERATE A FULL PANEL
PERHAPS HALF THE STATE IN SOME
INSTANCES. ONE FINAL
RECOMMENDATION. A PLAN TO
ADJUST THE MED LEGAL FEE
SCHEDULE IS LONG OVERDUE BUT
SUCH REVISION WHETHER IT
CONSISTS OF A 30% INCREASE OR A
50% INCREASE TO THE
REIMBURSEMENT RATE. IT MUST
ENCOMPASS A CHANGE TO THE
OVERALL CURE ME PROCESS THAT
INCLUDES A SPECIFIC PATH
TOWARDS BETTER QUALITY REPORTS.
ON BEHALF OF THE MEMBERS OF
CITY BCI WE THINK COMMITTEE FOR
THE OPPORTUNITY TO PROVIDE YOU
WITH THESE COMMENTS TODAY THANK
YOU APPRECIATE THAT. ADDITIONAL
TESTIMONY THANK YOU MISTER
CHAIRMAN AND MEMBERS. ALLOWING
ME TO SPEAK OF A NUMBER OF
ROLES ON THEPRESIDENT OF THE
CALIFORNIA SOCIETY OF
INDUSTRIAL MEDICINE AND SURGERY
WHICH IS POSITION TO TREAT AND
EVALUATE INJURED WORKERS. I'M
ACUMEN MAY. READING PHYSICIAN
AND I'M THE CHIEF MEDICAL
OFFICER FOR LARGE MEDICAL
GROUP. AND I'VE BEEN INVOLVED
THE STAKEHOLDER MEETINGS AS
WELL. ONE WITH MANY OF THE MY
COLLEAGUES HERE. NIGHT I JUST
WANT TO SAY THAT THE WAY THE WC
AND FORCES OR FAILED TO ENFORCE
REGULATIONS DIRECTLY IMPACTS
THE NUMBER OF POSITIONS
AVAILABLE TO TREAT OR EVALUATE
PATIENTS AND THAT DIRECTLY
IMPACTS THE ABILITY OF PATIENTS
TO RECEIVE TREATMENT OR AN
EVALUATION. CENTER ROTH EARLY
REST OF THE DECREASE IN
TREAING PHYSICIANS- AND CUMAE
POSITIONS RELATED TO THE STATE
SHORTAGE OF A PRIMARY CARE
PHYSICIANS AND NO IT'S NOT
POSITIONS- OUR FAMILY PRACTICE
DOCTORS THEIR INTERNIST- BUT-
THEY DON'T USUALLY TREAT
INJURED WORKERS- THAT'S
UNUSUAL- MOST. PRIMATE MOST
PRIMARY TREATING PHYSICIANS THE
WORKERS COMPENSATION SYSTEM OR
ORTHOPEDIC SURGEONS PAIN
MANAGEMENT POSITIONS AND
OCCUPATIONAL MEDICINE MEDICINE
PHYSICIANS AND THE NUMBER OF
THOSE POSITIONS AVAILABLE TO.
TREAT INJURED WORKERS HAS BEEN
DWINDLING WHEN I STARTED IN
NINETEEN NINETY FIVE EVERY
ORTHOPEDIST I KNOW WAS HAPPY TO
GET TREAT AN INJURED WORKER.
AND NOW- THE CHURCH INTO THAT I
WOULD GO TO PERSONALLY FOR
TREATMENT WON'T TAKE AN INJURED
WORKER ANYMORE THE ONLY WANT TO
TREAT PRIVATE INSURANCE
PATIENTS. THAT'S A SIGNIFICANT
ISSUE. THE W. C. REFUSES TO
CERTIFY MPA ENDS AND I KNOW
THAT'S NOT THE TOPIC THIS
MEETING BUT I MENTION AMBIENCE
BECAUSE- THAT SORT OF. IT'S AN
EXAMPLE HOW THE T. W. C.
APPROACHES ISSUES IT'S
REFLECTIVE OF THE OVERALL
CULTURE THE W. C. APPROACHING
THESE WORKERS COMPENSATION
ISSUES WE RECENTLY CALLED ON
EVERY PAIN MANAGEMENT POSITION
IN THE MPN OF A LARGE INSURANCE
COMPANY THE A TUTOR TWENTY NINE
POSITIONS IN THE ENTIRE STATE
WHO WERE SUPPOSED TO BE ON
THEIR PANEL TO TREAT INJURED
WORKERS ONLY SEVEN POSITIONS OF
THE TWO HUNDRED TWENTY NINE.
WERE AVAILABLE TO SEE A PATIENT
IN TWO WEEKS THAT'S REQUIRED BY
LAW TAT THEY HAVE THREE
POSITIONS IN THE GEOGRAPHIC
AREA AVAILABLE TO SEE PATIENTS
WITHIN TWO WEEKS THEIR MPN HAD
SEVEN PATIENTS FOR THE WHOLE
STATES 50% OF THE POSITIONS ON
THAT PANEL WERE NO LONGER
SEEING INJURED WORKERS THEY
WOULDN'T TREAT THEM AND ANOTHER
10% OF THEIR OF THE REMAINING
POSITIONS WERE ONLY WILLING TO
TREAT SPECIFIC DIAGNOSES BUT
THE D. W. C. WAS UNWILLING TO
LOOK AT THAT- THAT MEDICAL
PROVIDER NETWORK. AND DECERTIFY
IT THERE THEY WILL TELL YOU
THAT THEY DO NOT REVIEW- MPA
ENDS THIS PATTERN IS REPEATED
IN THE D. W. C. APPROACH TO Q.
AMIS IF YOU GO TO CURE ME
CONFERENCE YOU'LL SEE THE
AVERAGE AGE OF SIXTY PLUS. FIVE
ALL OF MY PARTNERS ALL OF MY
CITY TO YOUNGER THAN ME OF THE
TWELVE COLLEAGUES THAT WERE Q.
IN THE SIX HAVE GIVEN UP THEIR
CERTIFICATES BECAUSE OF WHAT
THEY CONSIDERED INADEQUATE
REIMBURSEMENT AND THE TO
COMPLICATED THE SYSTEM I'VE TWO
PARTNERS WHO STILL DOCUMENTS
BECAUSE I BEG THEM TO STAY ON
THE PANELS THE ONLY SEE TO CURE
ME SOME MONTH THAT'S ALL THAT
THEY WANT TO SEE OKAY. I
PERFORM TWENTY TO TWENTY FOUR
VALUATIONS PER MONTH AND I'M
OFF THE PANELS AT LEAST TEN
MONTHS A YEAR BECAUSE I DON'T
WANT MY NAME TO COME UP ON A
PANEL AND FOR ME TO BE
UNAVAILABLE AND SO I SCHEDULE
ALL THE PATIENTSWERE CALL ME
FOR PANEL I NEVER TURN ANYBODY
DOWN SOMEONE CALLS ME THINK MY
NAME CAME UP ON THE TIMES THAT
AMONG THE PANELS TO SEE THEM.
BUT I TRY TO TAKE MYSELF OFF AS
OFTEN AS POSSIBLE I AM INVITE
XIN OF THE OF THE BWC
REGULATIONS I DO THAT I'M
ALLOWED TO BE OFF THREE MONTHS.
IF I DIDN'T GO UP TEN MONTHS. I
BE BOOKED UP I BE BOOKED UP A
YEAR AGO AT THIS STAGE OF MY
CAREER I'M JUST NOT WILLING TO
WORK ANY HARDER THAN THAT OKAY
THERE IS NO LARGE POOL OF UNDER
UTILIZED CUMAE IS TO DO THE
BOOK MAJORITY OF THESE
EVALUATIONS THERE ARE VERY FEW
ORTHOPEDIC- PAIN MANAGEMENT
COMMITTEES WHO WANT MORE CUMAE
WORK DOCTORS ACTUALLY PREFER TO
TREAT PATIENTS AND INADEQUATE
REIMBURSEMENT REALLY DOESN'T
MAKE THEM WANT TO WORK AS
CUNY'S. I CAN TELL YOU THE REAL
ISSUE FOR MANY OF THESE
EVALUATIONS YOU CAN GET SIX
HOURS WORTH OF WORK THAT YOU
HAVE TO. KNOW THAT YOU HAVE TO
DO AND YOU'LL BE PAID SIX
HUNDRED DOLLARS BECAUSE OF THE
WAY THE CURRENT REGULATIONS
WORK. AT A HUNDRED DOLLARS AN
HOUR YOU CAN'T RUN A MEDICAL
OFFICE IT'S JUST NOT POSSIBLE.
AND SO NO EVERY TIME SOMEBODY
GETS ONE OF THOSE EVALUATIONS
NO THEY'RE VERY UNHAPPY IT
MAKES THEM WANT TO DROP OUT OF
THE SYSTEM AND ALSO WANTS TO
MAKE THE GAME THE SYSTEM. AND
WITH THE D. W. C. DID WAS
IGNORE THE FACT THAT. THAT THAT
MANY EVALUATIONS PAID THIS
INCREDIBLY LOW RATE AND THEY
TRY TO INVESTIGATE PEOPLE WHO
THEY THOUGHT WERE CHARGING TOO
MUCH. WIRE QB'S IMPORTANT ONE
EXAMPLE- I RECENTLY EVALUATED
YOUNG MAN WORKING AS A PAINTER
HE FELT TWENTY FOUR EIGHT FEET
OFF THE SCAFFOLD FRACTURES ARMY
LOST CONSCIOUSNESS WOKE UP IN
THE HOSPITAL A FEW DAYS. I SAW
HIS ACUMEN SIXTEEN MONTHS AFTER
HIS INJURY WHY SIXTEEN MONTHS
BECAUSE WE WENT THROUGH THIS
PANEL PROCESS ONE PANEL AFTER
ANOTHER BEING INADEQUATE. WHY
DID I SEE HIM GET A TORN
ROTATOR CUP. THE THAT THE
INSURANCE COMPANY WAS REFUSING
TO AUTHORIZE- TREATMENT FOR HIS
OCCUPATIONAL MEDICINE PHYSICIAN
JUST DIDN'T RECORD THAT HE WAS
COMPLAINING OF SHOULDER PAIN-
TWO OR THREE WEEKS AFTER HIS
INJURY. WHEN HE TRANSFERRED TO
ANOTHER DOCTOR THEY RECORDED AT
THREE MONTHS. BUT THE INSURANCE
COMPANY THOUGHT THAT WAS TOO
LATE. THIS IS A YOUNG MAN WAS A
ROOFER HE WAS HE OBSERVE
PAINTER HE WAS HE WAS. DID
HEAVY WORK YET TO CARRY BUCKETS
OF PAINT HEAT SET UP SCAFFOLDS
HE OBVIOUSLY DIDN'T HAVE A
ROTATOR CUFF TEAR. ANY FELL
TWENTY FEET OFF THE SCAFFOLD
KNOCKED UNCONSCIOUS FRACTURED
HIS ARM CLEARLY THIS WAS A WORK
INJURY BUT HE COULDN'T GET THAT
TREATED. UNTIL HE SAW ME. THAT
DELAYING TREATMENT COST HIM
DEARLY. NEW THIS THE SYSTEM IS
REALLY BROKEN. UP THERE HAS TO
BE A FUNDAMENTAL SHIFT IN THE
WAY THE GW SEE VIEWS ITS ROLES
ORGANISED INCREASING PROBLEMS
IN EVERY ASPECT OF THE SYSTEM.
WE NEED HELP FROM THE
LEGISLATURE TO MAKE SURE THE D.
W. C. ACTUALLY ENFORCES THE
REGULATIONS ARE PRESENT. AND
TRY TO IDENTIFY AND SOLVE
PROBLEMS THE COLLABORATIVE
FASHION. SO WITHOUT THIS CHAIN
TO THE D. W. C. APPROACH
THEY'RE JUST GOING TO BE
INCREASING COST INJURED WORKERS
THANK YOU THANK YOU. ADDITIONAL
TESTIMONY. THE GOOD EVENING MY
NAME IS DOCTOR GOOD WERE VERY
I'M ALSO A BOARD MEMBER OF THE
CALIFORNIA SOCIETY OF
INDUSTRIAL MEDICINE AND SURGERY
IN ADDITION I AM CEO AND CO
FOUNDER OF CALIFORNIA MEDICAL
EVALUATORS WE ARE AN
INDEPENDENT MEDICAL EXAMINATION
COMPANY BASED IN LOS ANGELES
AND WE MANAGE THE PRACTICES OF
OVER A HUNDRED Q. EMMYS
THROUGHOUT CALIFORNIA- I WOULD
LIKE TO FIRST THANK ASSEMBLY
WOMAN RUBIO FOR REQUESTING THE
AUDIT AS WELL AS UP MS HOWL FOR
THE FANTASTIC WORK THAT SHE AND
HER TEAM- PUT TOGETHER. BEFORE
I GO INTO MY PREPARED COMMENTS
I WOULD LIKE TO TOUCH ON A
COUPLE OF THINGS THAT HAVE COME
UP DURING THE QUESTIONING
NUMBER ONE MEDICAL SPECIALTIES
THAT SIMPLY DON'T EXIST- IN THE
QUEUE NB SYSTEM DUE TO A LACK
OF FIVE PHYSICIANS IN THE STATE
OF CALIFORNIA IF YOU ARE
INJURED WORKER WHO IS SUFFERING
FROM A SEVERE INFECTIOUS
DISEASE PROBLEM YOU CANNOT BE
EVALUATED BY Q. ME WHY THERE
ARE ZERO INFECTIOUS DISEASE Q.
AMIS IN CALIFORNIA. IF YOU HAVE
AN OBGYN ISSUE YOU CANNOT HAVE
THANK YOU IN THE EVALUATION
THERE IS ONE IN CALIFORNIA AND
AS MS WORLEY INDICATED IF YOU
COME DOWN WITH CANCER THAT MAY
BE RELATED TO WORK YOU CANNOT
HAVE I'M COLLEGE OF VALUATION
THERE ARE ONLY THREE IN THE
STATE OF CALIFORNIA THERE IS NO
UNDER UTILIZED POOL OF
PHYSICIANS TO EVALUATE ONCOLOGY
ISSUES OBGYN ISSUES WERE
INFECTIOUS DISEASE ISSUES. THE
REASON THAT SO MANY Q. AMIS DO
NOT RECEIVE EVALUATIONS IS
BECAUSE THERE IS A FUNDAMENTAL
DISCREPANCY BETWEEN THE DEMAND
FOR Q. ME SERVICES ON A
SPECIALTY BASIS AND THE QUEUE
ME POPULATION ON A SPECIALTY
BASIS 54% OF Q. ANY REQUESTS OR
IN THE ORTHOPEDIC SPECIALTY AS
INDICATED IN THE CWC AYE REPORT
FROM TWO THOUSAND EIGHTEEN ONLY
16% OF Q. ARMIES ARE
ORTHOPEDIST'S ORTHOPEDIST'S ARE
VASTLY UNDERREPRESENTED. THE
OPPOSITE IS TRUE IN LOWER
PAYING SPECIALITIES
CHIROPRACTORS AND PSYCHOLOGISTS
ARE. VASTLY OVER REPRESENTED
RELATIVE TO THEIR DEMAND THERE
IS NO TWEAKING TO THE ALGORITHM
THAT WILL GIVE UNDER UTILIZED
PSYCHOLOGISTS MORE WORK THERE
SIMPLY ISN'T ENOUGH DEMAND FOR
THEIR SERVICES. I'D ALSO LIKE
TO SHARE WITH YOU THE EXTREME
DIFFICULTIES THE CUBAN
PHYSICIANS HAVE HAD DEALING
WITH THE CURRENT TWC
ADMINISTRATION FOR THE PAST
SEVERAL YEARS. BUT BEFORE I'D
LIKE BEFORE I DO THAT I'D LIKE
TO MENTION THE IRONY THAT THIS
CONVERSATION IS OCCURRING AT A
HEARING. SOMETHING WHICH TWC
REFUSED TO PROVIDE TO COUNTLESS
Q. AMIS WHICH IT WRONGFULLY
KICKED OUT OF THE SYSTEM. IN
THE SPRING OF TWO THOUSAND
SEVENTEEN DOZENS OF OUR
PHYSICIANS WERE AUDITED BY D.
W. C. AND WERE ALTERNATELY
DENIED REAPPOINTMENT BY DOCTOR
MEISTER. ALL OF THE DENIAL
LETTERS WERE BOILER PLATE AND
ACCUSED THE DOCTORS OF
OVERBILLING AND VIOLATING THE
MEDICAL LEGAL FEE SCHEDULE. NO
DOCTORS WERE ACCUSED OF FRAUD
OR MEDICAL MALPRACTICE. THE
DOCTORS APPEALED THE DENIALS
TIMELY. ONLY THEN TO RECEIVE A
BOILER PLATE LEGAL DOCUMENT
ENTITLED A STATEMENT OF ISSUES.
ALL OF WHICH UPHELD THE DENIALS
ALL WERE SIGNED BY MR PART
PARRIS SOTO AND WERE CARBON
COPIED ON THE STATE MEDICAL
BOARD. THE DOCTORS WENT ON TO
PROVIDE HEARING OR TO REQUEST
HEARINGS THE DOCTORS REQUESTED
THE TWC PROVIDE HEARINGS THE
HEARINGS WERE NEVER PROVIDED.
IN MISTER PURSUED HIS RESPONSE
TO THE AUDITOR'S REPORT HE
STATED THAT WHEN THEY DENIED Q.
ME SUBMITTED A FORM ENTITLED
REQUEST. FOR HEARING. THE WC
DID NOT PROVIDE HEARING. ONLY
AFTER MR ROXBURGH GOT INVOLVED
IN LITIGATION ENSUED AND JUDGE
SHALL FONT IN LOS ANGELES
ORDERED THAT THE D. W. C.
PROVIDE HEARINGS WITHIN NINETY
DAYS D. W. C. OF EVENTUALLY
AGREED TO REINSTATE THE
PHYSICIANS THIS WAS AFTER MUCH
TIME AND COST TO NOT ONLY THE
PHYSICIANS BUT UP PEOPLE TO THE
LIVES OF THOUSANDS OF INJURED
WORKERS WHOSE EVALUATIONS WERE
NEEDLESSLY CANCELED. OR DELAYED.
MANY IN THE QUEUE OF ME
COMMUNITY HAD HOPED THAT THE
RESOLUTION OF THIS LAWSUIT IN
APRIL OF TWO THOUSAND EIGHTEEN.
WOULD PUT AN END TO THIS MATTER.
IT WAS JUST THE BEGINNING. IN
MAY OF TWO THOUSAND EIGHTEEN D.
W. C. ISSUED A PROPOSAL TO
UPDATE THE MEDICAL LEGAL FEE
SCHEDULE AS MR PARRIS OF
INDICATED THEY DID PUT SOME
WORK INTO ATTEMPTING TO UPDATE
THE MEDICAL LEGAL FEE SCHEDULE
UNFORTUNATELY THIS PROPOSAL
SOUGHT TO CODIFY THE VERY
UNDERGROUND REGULATIONS WHICH
TWC HAD JUST AGREED TO STOP
ENFORCING IN SETTLEMENT
DOCUMENTS. THIS PROPOSAL WOULD
HAVE DECIMATED Q. AND THE
REIMBURSEMENT A PUBLIC OUTCRY
FROM CUBA MUEZZIN SUED AND D.
W. C. EVENTUALLY SHELVE THE
PROPOSAL. SEVERAL TIMES SINCE
THEN SYSTEMS HAS MET WITH
MISTER PARIS SOTO AND HIS STAFF
AND REQUESTED AN INCREASE TO
THE CURRENT Q. ON THE FEE
SCHEDULE WHICH HAS NOT BEEN
ADJUSTED SINCE TWO THOUSAND AND
SIX. NO ADJUSTMENT WAS EVER
PROVIDED IT'S BEEN FOURTEEN
YEARS FOURTEEN YEARS WITH NO
CALL INCREASE YET TWC EMPLOYEES
GET REGULAR INCREASES AND THEIR
WAGES. WHY SHOULD Q. AMIS WORK
FOR THE SAME RATE AT THE SAME
RATE. FOR FOURTEEN YEARS AS THE
AUDITOR CLEARLY IDENTIFIED MANY
Q. AMIS HAVE ALREADY VOTED WITH
THEIR FEET AND THEY HAVE A BAND
IN THE SYSTEM. IN JULY OF
TWENTY NINETEEN THE BILL
SPONSORED BY C. SIMS AUTHORED
BY CHAIRMAN SALAS AS WELL AS A
SIMPLY ASSEMBLY WOMAN GOMEZ
REYES. WAS INTRODUCED THE BILL
SEEKS TO ADJUST Q. ANY
REIMBURSEMENT TO CATCH UP FOR
THE PAST FOURTEEN YEARS AND
WOULD REQUIRE. THAT TWC UPDATE
THE FEE SCHEDULE FOR INFLATION
GOING FORWARD TO ENSURE THAT
THE CURRENT SITUATION NEVER
HAPPENS AGAIN. IN AUGUST OF
TWENTY NINETEEN A FEW WEEKS
AFTER AB EIGHTEEN THIRTY TWO
WAS INTRODUCED THE WC ONCE
AGAIN PROPOSED A CHANGE TO THE
FEE SCHEDULE. THIS FEE SCHEDULE
ALSO WOULD SUBSTANTIALLY SLASH
REIMBURSEMENT TO CUBA MEETS
THIS LATEST PROPOSAL SEEKS TO
TAKE AWAY Q. EMMYS ABILITY TO
BILL AT AN HOURLY RATE AND
INSTEAD ONLY BILL A FLAT FEE.
WE SURVEYED THE COMMUNITY THE
QUEUE ANY COMMUNITY AND FOUND
THAT IF TWC IS PROPOSED FEE
SCHEDULE WERE ADOPTED THAN 85%
OF Q. ARMIES WOULD EITHER QUIT
THE SYSTEM. OR SIGNIFICANTLY
REDUCED THEIR QUEUE ME PRACTICE.
THE PROPOSED FEE SCHEDULE IS
BASED ON THE MEDICAL LEGAL FEE
SCHEDULE OF NEVADA HOWEVER THE
FEES WHICH TWC HAS SUGGESTED
ARE 62% LESS THAN THOSE ALLOWED
FOR IN NEVADA. THIS IS ODD
GIVEN THAT CALIFORNIA IS A MUCH
HIGHER COST OF LIVING STATE THE
NEVADA AND Q. ANY EXAMINATIONS
ARE MUCH MORE COMPLEX THAN
ABOUT EVALUATIONS IN ORDER TO
UNDERSTAND WHY THIS HAPPENED WE
SUBMITTED A P. R. A REQUEST TO
WC WE REQUESTED ALL
CORRESPONDENCE D. W. C. HAS HAD
OUTSIDE OF THE AGENCY RELATED
TO THE MEDICAL LEGAL FEE
SCHEDULE. WE OBTAIN SUBMISSIONS
FROM THE INSURANCE INDUSTRY
WHICH DEMONSTRATE THAT THE FEE
SCHEDULE WHICH TWC PROPOSED
CAME DIRECTLY FROM INSURANCE
CARRIERS MEANWHILE A FEW
SCHEDULE WHICH WAS SUPPORTED BY
C. SIMS WHICH HAD GARNERED OVER
TWO THOUSAND FIVE HUNDRED
SIGNATURES IN SUPPORT FROM THE
QUEUE IN THE COMMUNITY IN WHICH
WE HAVE PRESENTED TO MISTER
PARIS SOTO PRIOR TO AUGUST. WAS
IGNORED BY THE WC. THIS CAN BE
FIXED AND IT SHOULD BE FIXED IT
IS IN THIS CONTEXT THAT WE THE
QUEUE UP MUSIC CALIFORNIA PLEAD
WITH THE LEGISLATURE TO
INTERVENE AND DIRECT THE AGENCY
TO MAKE THE APPROPRIATE CHANGES
NECESSARY. TO SAVE THE QUEUE IN
THE SYSTEM AND PROVIDE INJURED
WORKERS WITH THE TIMELY AND
QUALITY MEDICAL LEGAL
EVALUATIONS THEY DESERVE C.
SIMS BELIEVE THAT AB EIGHTEEN
THIRTY TWO IS A NECESSARY A
VITAL STEP TOWARDS THAT GOAL.
THANK YOU VERY MUCH THANK YOU.
PERSONAL TESTIMONY PLEASE YOU
ARE. I CAME WITH PREPARED
REMARKS AND THEN LISTENING TO
ALL OF THE CONVERSATIONS HAVING
READ THE AUDIT ONE TO GIVE LOW
BACKGROUND AND COMMENTARY AND
PUT EVERYTHING IN CONTEXT MY
NAME'S NICK ROXBOROUGH WATCH
FOR PARTS NINETY DRAWN A WE ARE
EMPLOYERS RIGHTS LAW FIRM. I
KNOW PRETTY MUCH ALL THE
PLAYERS IN THIS ROOM. THE
CHAIRS SAID. THAT HE
UNDERSTANDS IMPORTANT ROLE OF
THE CURE ME. SENATOR ROTH YOU
ASKED WIRE Q. AMIS NOT COMING
IN. WE HEARD ABOUT ALGORITHMS
AND WE HEARD IT D. W. C. TALK
AT LEAST ELEVEN TIMES ABOUT
THEY'RE GOING TO LOOK INTO A
WHOLE LOT OF THINGS. THERE WAS
AN OPPOSITION FILED. BY THE
CALIFORNIA CHAMBER IN THE
CARRIERS THAT SAID THIS IS
PREMATURE I RESPECTFULLY
SUGGEST AFTER FOURTEEN YEARS IT
IS NOT PREMATURE AT THE TIME IS
NOW. SO LET ME PROVIDE A LITTLE
BACKGROUND IN TWO THOUSAND AND
SEVENTEEN. I GOT PHONE CALLS
FROM QUALIFIED MEDICAL
EXAMINERS I SPECIALIZED IN
REPRESENTING BUSINESSES AND
WORKERS COMP. THE Q. AMIS ALL
HAD THE SAME STORY. ONE OF THE
PANEL MEMBERS ASK QUESTIONS
ABOUT WELL TO THE Q. MEANS GET
PAID IF THE REPORTS ARE UP HELP
THAT WAS A GREAT QUESTION. BUT
WE NEED TO CLARIFY. EVERYONE OF
MY CLIENTS AND BY THE WAY TO
DATE I HAVE OVER ONE HUNDRED
CURE ME CLIENTS. THEIR STORIES
ARE IDENTICAL THEY WERE ALL
PAID AT THE W. CA BE THE
CARRIERS AND THE SELF INSURED
EMPLOYERS PAID THEIR BILLS AND
PAID THE REPORTS. DIDN'T
QUESTION IT BUT THEY HAVE A
REMEDY THAT NOBODY SPOKE ABOUT
HERE THEY CAN GO TO THE I. B.
R. AT THE WCPO IN DISPUTE. THEY
WHEN THEY WHEN. BUT INSTEAD
HERE'S WHAT I LEARNED AND I
THOUGHT IT'S VERY IMPORTANT FOR
ME TO SHARE WITH YOU I'M
READING STEVE SCHWARZMAN
SUPPORT THE CO BLACKSTONE GROUP
AND WHAT IT TAKES AND HE QUOTED
LAWCENTER READ POLITICIANS
ACROSS THE SPECTRUM WERE JUST
PEOPLE LOOKING FOR ANSWERS IF
YOU CAN HELP. YOU SHOULD. SO
I'M HOPING TO HELP AND PUT
SOMETHING IN CONTEXT. WHY ARE
Q. MISLEADING THE SYSTEM IT WAS
A REAL SIMPLE IN AUGUST TO
SOMEONE WHO WAS NOT FAMILIAR
WITH THE SYSTEM. THEY WERE
BEING AFTER BEING PAID BY THE
CARRIERS THE D. W. C. AND THEIR
QUESTIONS ABOUT WHETHER THEY
HAD ADEQUATE STAFFING. THE TWC
WAS TO PUT IT BLUNTLY HARASSING
CUNY'S. ON WHAT WERE CALLED I
CALLED UNDERGROUND REGULATIONS.
THIS WAS THEIR INTERPRETATION.
THEY SAID THEIR INTERPRETATION
OF REGULATIONS THAT IT EXISTED
FOR DECADES AND ALSO AND THEY
WERE PLAYING A DIFFERENT
STANDARD AND SOME THE DOCTORS
CAME TO MEAN SAID NECK AM I
DOING THIS WHAT I HAVE DONE
ANYTHING DIFFERENTLY I SAID NO
THE STATUTE HASN'T CHANGED
THEY'RE TAKING OUT THE WORD AND
THEN PUT IN THE WORK ORDER. FOR
MAKING MATERIAL CHANGES THOSE
ROCKER GROUND REGULATIONS.
THERE'S A QUESTION ABOUT
BRINGING AN OLDER CUBIES INTO
THE PROCESS I APOLOGIZE TO
FORGET WHICH MEMBER ASKED WHY
CAN'T WE GET SOME OF THOSE
FOLKS BACK CAN'T. MY FIRST YES
MY FIRST POINT WAS DR HOWARD.
EIGHTY YEARS OLD. BEEN IN THE
QUEUE IN THE SYSTEM FOR TEN
YEARS GOT REAPPOINTED EVERY TWO
YEARS LIKE CLOCKWORK. ALL OF A
SUDDEN HE WAS ATTACKED HE
WASN'T DOING IT RIGHT. ALMOST
THE SOLE SOURCE OF INCOME WAS
CURE ME WORK. NOBODY EVER
ACCUSED ANY OF MY CLIENTS OF.
WORKERS COMP FRAUD NONE OF THE
CURE MAYES OVER HUNDRED MINE.
WERE EVER ACCUSED THE
MALPRACTICE IT WITH BILLING
INTERPRETATION THAT'S WHAT THE
D. WC HAS BEEN SPENDING WITH A
LACK OF RESOURCES. DOCTOR
HOWARD LEFT THE SYSTEM HE WON.
HE WON THE WRIT OF MANDAMUS
THAT I WON FOR THE CHURCH CHAO
FAN AND HE SAID NICK I'M DONE.
I DON'T NEED THIS ANYMORE. TO
BE CLEAR I DON'T THINK WITH ALL
DUE RESPECT ALGORITHMS WE NEED
ALGORITHMS TO KNOW WHY CUNY'S
HAVE LEFT I CAN TELL YOU WHAT A
HUNDRED AND EIGHT CUNY'S HAVE
TOLD ME AND THEN SOME. I'M
WORKING AT TWO HUNDRED AND SIX
WAITERS. AND A BEING HASSLED BY
THE WC ON STUFF THAT DOESN'T
EXIST I'M OUT. I'M OUT EUROPEAN
ALGORITHM TO TELL YOU THAT I AM
PRETTY SURE THE BWC DOES NEED A
COMMITTEE THEY DON'T GET A
COMMISSION THEY COULD TALK AT
ANY POINT IN TIME I'D MAKE MIKE
HUNDRED EIGHT KIM IS AVAILABLE
TO TALK TO WE DON'T NEED TO. WE
KNOW WHAT THE ANSWER IT IS
SOMETIMES THAT SIMPLE. AB
EIGHTEEN THIRTY TWO STATE
SOLUTION 50% OUR ONLINE HEALTH
REPORTED 30% THEY BOTH WERE
SAYING THE SAME THING. EVERYONE
RECOGNIZES WHAT'S SOMETHING SO
WHY YES NO ALGORIHM YOU NEED A
RACE. WE'LL GET RAISES. THE
CARRIERS OF THEIR OPPOSITION
SAID THIS IS PREMATURE INFANTS
COMPLEX NO WHAT'S NOT IT TAKES
FOURTEEN YEARS TO GIVE A COLA
INCREASE I'M SITTING IN THE
AUDIENCE WONDERING HOW TO TAKE
FOURTEEN YEARS TO GIVE A CALL
INCREASED I THINK IT'S PRETTY
SIMPLE. LABOR CODE SECTION
FIFTY THREE OH SEVEN POINT SIX
REQUIRES THE ADMINISTRATIVE
DIRECTOR. TO ADOPTING REVIEW
FEE SCHEDULE FOR MEDICAL LEGAL
EXPENSES IT ANYWAY. THEY'RE NOW
PROPOSING EVERY TWO YEARS. MY
COLLEAGUE ON MY LEFT FROM CWC
AYE SHE'S RIGHT THIS TO YOUR
ISSUE IS NOT WHAT THE STATUTE
PROVIDES. THERE HAVE BEEN IN
THE LAST FIVE YEARS. THE TWC IS
UPDATED FEE SCHEDULES SEVEN
TIMES. THEY JUST DID ONE ON
DECEMBER TWELFTH BUT NOT FOR Q.
ARMIES. THESE UNDERGROUND
REGULATIONS BECAUSE TO TWENTY
FIVE PAGE RULINGS FROM JUDGE
CHAO FAN ON RICHMOND AMOS. TO
SUPPORT THE AUDITOR'S FINDINGS
DUE PROCESS RIGHTS WERE DENIED.
ONE OF MY CLIENTS I WON'T
MENTION HIS NAME. BUT I WILL
ALLUDE TO MAKE IT AVAILABLE
PRIVATELY. HE WAS DENIED DUE
PROCESS RIGHTS FOR HEARING AND
JUDGE HEALTH AND SAID TO THE WC
YOU GOTTA GET MY HEARING. HE
HAD NOT BEEN ABLE TO BE
REAPPOINTED HE'S A
CARDIOLOGISTS. HIGHLY EDUCATED.
IT'S MY PERSONAL CAUGHT
CARDIOLOGISTS. HE'S A REALLY
GOOD. BUT HE COULDN'T BE IN
THERE. WHEN WE SETTLED FINALLY.
HE TO NO MONEY. AND THEY PAID
BACK FIVE THOUSAND DOLLARS AS
PART OF THE SADDAM. BUT LET ME
TELL YOU ABOUT ALL THE CUNY'S
AND WHAT REALLY HAPPENED YOU
HAD THE WHITE ELEPHANT IN THE
ROOM. IN SOMEBODY ASKED THE
QUESTION MIGHT HAVE BEEN THE%
CHAIR. WHAT ABOUT THE STAFF
WHO'S THAT YOU KEEP YOUR AND WE
NEED TO DO THIS WE NEED TO DO
THAT. I'LL TELL YOU THE ONLY TO
FOLKS. WE'RE DOING ANYTHING ON
THE SUBJECT ARE THE TWO PEOPLE
WHO WROTE THE UNDERGROUND
REGULATIONS THAT'S MISTER
WINSLOW WEST. AND THE COR
RICHARDSON. TO WORKERS COMP
DEFENSE ATTORNEYS WHO USED TO
WORK AT STATE COMPENSATION
INSURANCE FUND THEY WROTE THE
UNDERGROUND REGULATIONS THEY
WENT AFTER EVERYONE OF MY
CLIENTS AND HERE'S WHAT
HAPPENED I WAS STUNNED THE
NOTICES OUT WORK. THEY WOULD
SAY LISTEN YOU DON'T FOLLOW
THESE UNDERGROUND REGULATIONS
WE WOULD ARGUE MY CLIENTS HAD A
REALLY TOUGH CALL ISSUE THERE
OKAY- EIGHTEEN THOUSAND DOLLARS
TO GET REAPPOINTED. MY FEES FOR
SEVENTY FIVE HUNDRED. I GIVE
MYSELF A RACE FOUR YEARS AGO
OKAY. WHAT ARE THEY GOING TO DO
SO WE CUT A DEAL AND THEN WITH
THE D. WC SAYS IS YOU GET A
LETTER FROM THEM AND SAYS OKAY
WILL TAKE NINE THOUSAND DOLLARS
THREE THOUSAND FOR EXAMPLE TO A
I G. MAKE A CHECK THREE
THOUSAND STATE FUND. AND THREE
THOUSAND IS AN- THEY TOOK THE
COLLECTION WORK. THEY DID THE
COLLECTION WORK FOR THE
CARRIERS WERE ALREADY PAID THE
BILLS AND HAD NO PROBLEMS I
DON'T NEED AN ALGORITHM TO TELL
ME. THAT'S NOT RIGHT. SO WHEN
THE CARRIERS ROAD IN THEIR
OPPOSITION LETTER YESTERDAY.
THAT THIS IS GOING TO COST
MONEY THE RIGHT TIME I CAN GET
THE DID YOU SEE TO WORK FOR
THEM ANYMORE. NOW WHEN I HAD
THE UNDERGROUND REGULATION
BATTLE. IT WAS MY FIRM TOLL
FOURTEEN HOURS A TWO WARS IN
THIS CASE THE WC HAD NO PROBLEM
PUTTING ASSISTANT GENERAL
COUNSEL OF CASE. THREE LAWYERS
FROM NORTHERN CALIFORNIA. THREE
LAWYERS FROM SOUTHERN
CALIFORNIA SIX LAWYERS FIGHTING
TO DEFEND UNDERGROUND
REGULATIONS AND ONLY WHEN I HAD
A OUR LAWN HEARING FOR JUDGE
CHERTOFF AND IT SHOWED THE WITH
THE RULE FOR SARAH. DID THEY
SAY OKAY WE QUIT. BUT THE
CULTURE HASN'T CHANGED. ALAIN
HELL IS COME UP WITH A
SPECTACULAR FAIR MINDED AUDIT
CHIEF HIT ON THE HEAD SHE HIT
THE ISSUES OF SHORTAGE OF CURE
MEETS. THE PRACTICE FOR
DISCIPLINE CUNY'S MIGHT KILL ME
CLASS ROLE DISCIPLINE FOR THE
WRONG REASONS COULD GET HEARING
THEY SAID THEY COULD GET A
HEARING EVENTUALLY I WAS ABLE
THROUGH DEPOSITION TESTIMONY TO
POINT OUT THAT MISTER WEST IS
THE ONLY ONE WHO GIVES. DUE
PROCESS HEARINGS. TO HEARING
SECURITIES IN THREE YEARS. SO
EITHER THE PWC HAS A HUGE
STAFFING SHORTAGE. BUT THOSE
SIX FOUR TO OPPOSE ME THEY
DON'T GET INVOLVED HERE. SO
LET'S MOVE FAST FORWARD WE HAVE
ALL THESE MEETINGS THAT ALL THE
FOLKS TO TESTIFY TO HEAR.
THERE'S NO AGREEMENT WERE NOT
EVEN IN THE BALLPARK. THE CURE
ME FOR THE UMPIRES. WE HAVE
MORE BASEBALL GAMES TO PLAY
THAT WE HAVE UMPIRES SO
BASEBALL GAMES ARE PLAYED
FANSEDGE MONEY GETS SPENT IN
CUBA IS AN UMPIRE TWENTY WARM
PERSON GAME THANK YOU PAY MORE
MONEY THEY COME. BUT YOU GOT
ALSO PRODUCED THE HASSLE. CHEST
ON DECEMBER TWELFTH LET ME
SHARE WITH YOU THAT THE CULTURE
HAS NOT CHANGED BECAUSE MY
FIFTEEN TODAY FROM LISTEN
EVERYTHING READING EVERYTHING
IS. GIVEN A FAIR WAGE 3050% AND
STOP THE CULTURE. I GOT MY
HUNDRED SEVEN CLIENT I THINK
CURE ME. AND E SAYS HEY I'M A
PSYCHOLOGIST AND I GOT A LETTER
FROM ONE OF THESE TWO LAWYERS.
AND THE COMPLAINT MYSTERONS PRO
IS. I DID MEET WITH THE PATIENT
FOR ONE HOUR AND SO THEY GOT
AUDITED WAITING TO MEET WITH
THE PATIENT. FOR AN HOUR. TWEET
THE HIRE ME TO EXPLAIN. TO ONE
OF THOSE TWO LAWYERS WHO WROTE
THE UNDERGROUND REGULATIONS
WERE RUNNING ALL THESE MEETINGS.
BECAUSE THE PATIENT LEFT. SHE
SAID SHE WAS IN SO MUCH PAIN
AFTER FIFTEEN MINUTES BECAUSE
OF A BACK SHE'S LIKE I'M
TERRIBLY SORRY DOC BUT I KELLY.
AND I'M OUT OF HERE NOW. THAT
WAS DECEMBER TWELFTH OF LAST
MONTH. WHY IS THE DELIVERY
SEIZE PENDING VALUABLE
RESOURCES AUDITING A
PSYCHOLOGIST. ON THAT POINT.
AND WHAT IS THE PSYCHOLOGISTS
HAVE TO HIRE NICK ROXBOROUGH.
WHEN THIS ALL GETS FIX I'M
REPRESENTED CUNY'S ANYMORE HE
ALSO ALL LOSE BUSINESS BUT
WHAT'S FAIR IS FAIR EVERYONE
HERE KNOWS THE INJURED WORKER.
IS THE PERSON WHO WE CARE ABOUT
OVER A HUNDRED YEARS AGO WE HAD
A GREAT COMPROMISE PLAYERS MAKE
THAT. CHANGE RIGHT WE SAID WE
WILL TRADE NO CIVIL SUITS FOR
NO FAULT SYSTEM. THIS IS BEEN
RIDDLED THE SYSTEM AND HERE'S
WHAT'S WHAT'S REALLY MISSING
SOMEBODY ASKED ABOUT. THE LABOR
SECRETARY IT MIGHT HAVE BEEN
SENATE ROTH FOR CENTER MORAL A
MORE A MORE LACK. AND. SEC
LABOR SECRETARY JULIE SU IS
NOWHERE TO BE FOUND. THERE'S NO
BOX FOR THE WC SOMEBODY
ATHLETIC WAS ALSOCENTER
MORLOCK WHO'S RUNNING THE SHOW
HERE THEY REPORTED THAT THE I.
R. THERE'S NO DIRECTOR. CHOOSE
TO THE LABOR SECRETARY DIDN'T
COMMENT ON A REPORT ON THE TWC
THIS IS A HUGE DEAL HAVEN'T
TRACTION OVER THIRTY YEARS THIS
IS A BIG DEAL YOUR SITTING ON A
POWER CáC. THIS IS A POWDER
KEG MAKE NO MISTAKE ABOUT IT.
THIS IS A POTENTIAL COLLAPSE OF
THE SYSTEM. NOW I DON'T KNOW
WHAT THE MOTIVATIONS ARE BUT WE
NEED TO GET THOSE FOLKS
INVOLVED I MEAN THAT'S WHAT
THIS PERSON'S JOB ISN'T I
THOUGHT WE WOULD SEE MITSU
HERE. TALK ABOUT THE AUDIT. YOU
WANT TO TALK FINALLY ABOUT THE
IMPACT. ON THE INJURED WORKER
CAL MATTERS JUST DID A ARTICLE
YESTERDAY. WAS UNFAMILIAR WITH
CAL MATTERS THEY CALLED ME UP
BY HOW CAN BE QUOTED ALONG WITH
MISTER OR IN OTHERS. THEY
TALKED ABOUT DURING FORTY
ELLIS. AND THE IMPACT THAT
SHE'S HAD. TO GO THROUGH
BECAUSE CAN'T GET ACUMEN. AWFUL
AND REMEMBER MY CLIENT D.
CARDIOLOGISTS WHO GOT ATTACKED
ON THE UNDERGROUND REGULATIONS.
IT WAS THE CASE HE TOLD ME
ABOUT. WHERE BECAUSE THERE WERE
NO CARDIOLOGISTS. HIS WORK TALK
ABOUT MISTER OF OUR TALK ABOUT
NO CARDIOLOGISTS HE WAS
SELECTED ON COLLEGES HE BECAME
THE CARDIOLOGISTS BUT
UNFORTUNATELY YOU SEE HE WAS
BEING ATTACKED ON THE
UNDERGROUND REGULATION SO HE
NEVER GOT REAPPOINTED SO GUESS
WHAT HAPPENED TO MY CLIENT. HE
WAS REMOVED FROM CUMAE PANEL.
THE HORRIBLE STORY WAS THE
INJURED WORKER EVENTUALLY
PASSED AWAY. LET'S GO FIX THE
SYSTEM I APPRECIATE THE TIME.
THANK YOU. RIGHT LET'S GO TO
THE WRONG. YOU KNOW I
APPRECIATE THE TESTIMONY AND
THE TIME THAT IT TOOK YOU ALL
TO PREPARE AND TO BE HERE AND
TO GIVE US VALUABLE INFORMATION
I I'VE- OBVIOUSLY. FEE
INCREASES I'M ALL FOR THAT I
THINK. THIS CERTAINLY IS A
ELEMENT OF UNDER COMPENSATION
IS A INDICATED BEFORE IN THIS
AND OTHER AREAS. IN TERMS OF
THE SHORTAGE OF PHYSICIANS I
MEAN I'VE CERTAINLY WORK THIS
GENERAL ISSUE FOR THE GOING ON
EIGHT YEARS I'VE BEEN UP HERE
AND- I WOULD I HAVE CERTAINLY
BEEN TOLD BY THOSE OF THOSE OF
YOUR COLLEAGUES IN THE BUSINESS
SAID DEPENDING ON WHERE YOU ARE
IN THE STATE OF CALIFORNIA IT'S
MORE THAN JUST A SHORTAGE OF
PRIMARY CARE PHYSICIANS IS A
SHORTAGE OF SPECIALTY CARE
PHYSICIANS AS WELL. WHETHER
IT'S ORTHOPEDIST'S AROUND
COLLEGES TO WHATEVER AND SO
I'VE BEEN TRYING TO FERRET OUT
FROM THE TESTIMONY WHAT THE FIX
SERIOUS. AND ASSUMING WE'RE
ABLE TO MUSCLE THROUGH SOME FEE
INCREASE AT WHATEVER LEVEL 50%
30% 70% I DON'T KNOW. I GUESS
MY QUESTION IS HOW MUCH MONEY
IS REQUIRED IN ORDER TO- ASSURE
TIMELY ACCESS TO Q. AMIS ON
THESE PANELS AND PEOPLE WHO YOU
CAN'T FIND A QUEUE IN MAY TO
PROVIDE A REPORT ANALYSIS
WITHIN NINETY DAYS OR A HUNDRED
AND TWENTY DAYS OR A HUNDRED
AND EIGHTY DAYS. HOW MUCH MONEY
IS REQUIRED FOR THE HOW MUCH
MONEY IS REQUIRED TO ENSURE
THAT WE HAVE ONCOLOGISTS IN
INFECTIOUS DISEASE SPECIALISTS
IN SUFFICIENT NUMBERS OF
ORTHOPEDIST'S. ANALYSTS AROUND
THE STATE SO WE CAN HAVE
INJURED WORKERS PARTICULARLY
WHERE THE ISSUE IS WHETHER IS
WHETHER THERE THERE IS WORK
RELATED THIS. TO THE PARTICULAR
CASE BECAUSE AGAIN IT'S MY
UNDERSTANDING THAT PROCESS
DOESN'T BEGIN CLAIMS
ADMINISTRATORS ARE NOT
PERMITTED TO PROCEED UNTIL THAT
ISSUE IS DECIDED. AND SO IF I
DON'T HAVE AN ONCOLOGIST- I
DON'T HAVE AN INSPECTION
INFECTIOUS DISEASE SPECIALISTS
OR AN ORTHOPEDIST TO MAKE THAT
DETERMINATION THEN WHAT HAPPENS.
SO I HAVEN'T HEARD AN ANSWER TO
THAT HERE. I'M HOPING AT SOME
POINT I'LL HEAR AN ANSWER I'M
YOU'VE YOU'VE GOT A SUPPORTER
IN TERMS OF FEE INCREASES BUT
I'M JUST NOT. THE DOT STARK
BEING AREN'T CONNECTED SO IF WE
APPROVE A 50% FEE INCREASES
SUING WE HAVE THE AUTHORITY TO
DO SO OR GOING TO BE BACK HERE
IN TWELVE MONTHS. HAVING PEOPLE
TALK TO US ABOUT THE FACT THAT
THEY'RE IN SUFFICIENT NUMBERS
OF Q. IN THESE ON THE PANEL.
THE THEY ARE UNAVAILABLE. CAN
SOMEBODY RESPOND TO THAT.
SENATE ROTH I CERTAINLY CAN THE
FEE INCREASE IS GREAT IT WILL
HELP IT WILL HELP THOSE.
DOCTORS WHO ARE CURRENTLY
PROVIDING SERVICE FOR SURE ARE
CURRENTLY PROVIDING AND WHO
HAVE STAYED OUTSIDE THE SYSTEM
BECAUSE OF THE FEE ISSUE. BUT
IS MISSED PERSONA REFERENCE TO
HAS OUR REPORT ALSO REFERENCES.
IN TWO THOUSAND SIX THEY
INCREASE THE FEES AND NOT THAT
MUCH HAPPENED. THE ANSWER TO
YOUR QUESTION IS PARTLY
INCREASE THE FEES BUT TO SOLVE
THE PROBLEM. I DON'T THINK
ANYBODY IN THIS ROOM CAN SOLVE
THE PROBLEM IN IN IN FIVE
MINUTES MUCH LESS AN HOUR- I
CAN TELL YOU. WE'VE BEEN
WORKING ON FOR A LONG TIME
KIMBERLY AND WE SHOULD HAVE IT
SO THAT'S THE COMPLEXITY OF THE
SYSTEM IS WHAT KEEPS DOCTORS
OUT ITS WHAT. FRUSTRATES THE
EMPLOYERS IT'S WHAT FRUSTRATES
THE CARRIERS IT'S WHAT
FRUSTRATES THE INJURED WORKERS.
THE SYSTEM IS OVERLY COMPLEX
WHEN THE GRAND BARGAIN WAS
FIRST- INITIATED. THE WORKERS
COMPENSATIONRULES COULD BE
CONTAINED IN A PAMPHLET IT IS
NOW OF BIBLICAL PROPORTIONS BUT
COVERS OF THE RULES AND
REGULATIONS AND STATUTES FOR
WORKERS COMPENSATION WILL TELL
YOU FROM AN ATTORNEY STANDPOINT
USED TO HAVE TO DO. REPORTS FOR
WHICH I WOULD WAS PAID I WOULD
MUCH RATHER. BE ABLE TO ANSWER
THE QUESTION ABOUT THE REPORT
THAN TO GET A LETTER WITH MY
REPORT THE TELLS ME TO DO
ANOTHER REPORT. FOR WHICH I'M
NOT GETTING ADEQUATELY PAY I
MEAN I CAN SEE EXACTLY WHAT
YOU'RE SAYING THERE'S A LOT OF
BUREAUCRATIC MUMBO JUMBO THAT
WE BUILT INTO THIS PROCESS. IT
PROBABLY DOES DISSUADE PEOPLE
FROM PARTICIPATING IN PROVIDING
BADLY NEEDED. MEDICAL SERVICES
TO INJURED WORKERS TO GET THEIR
CLAIM MOVING THROUGH THE SYSTEM.
AND I THINK THAT'S A GREAT
POINT AND BUT WE HAVE YET TO
HEAR FROM THE W. C. WHOSE
MISSION STATEMENT HAD HAS BEEN
FOR THE LAST FOURTEEN YEARS TO.
DO ANYTHING ON THE LINES TO
ANSWER YOUR QUESTION
SPECIFICALLY SARAH. I DON'T
KNOW WHAT THE RIGHT NUMBERS. I
PASSED MY CLIENTS I SAID. WHAT
DO YOU NEED. THE BIGGEST THING
HE SAID AS THEY NEED TO BE LEFT
ALONE SO THEY CAN DO THEIR WORK
AND READ THE REPORTS WITHOUT
BEING HOUSEHOLD. AND HE SAID
I'M PROBABLY OKAY IF I MEDICAL
RATE. BACK IN TWO THOUSAND SIX
IF THEY WERE THERE. BUT THAT'S
YOUR CLIENTS THAT ARE IN THE
SYSTEM NO SOME OF THEM LEFT I
HAVE AN ORTHOPEDIC WHO WHO
SIGNED UP BUT DIDNT AND SAID
WITH ALL DUE RESPECT I'M NOT
IN. WHY I GET HASSLED. FORTY
FIFTY THOUSAND DOLLARS IN MY
BUSINESS AND IF THOSE RATES I
DON'T NEED TO DO I. LOOK AT
THEIR FINANCIAL SPENDING THE
CARRIERS UNDERSTAND FINANCIAL
MARKETS BETTER THAN ALL OF US.
YOU PAY ENOUGH MONEY PEOPLE
WILL COME SO MAYBE THE POINT IS
AND IT'S NOT WHAT YOU'RE
PROBABLY LOOKING FOR FUN ARE
PRETTY STRAIGHTFORWARD GUY.
MAYBE GIVE THE FIFTY PERCENT.
AND THEN. A YEAR LATER YOU
ORDER THAT THERE'S A STATE IS
HE HAS BEEN AN INCREASE HAS
THAT MADE A DIFFERENCE I DON'T
KNOW WHAT WILL OUR PROSAUROPOD
STUDY FROM THE FOURTEEN YEARS
WELL OR IN THE ALTERNATIVE.
WHOEVER'S RESPONSIBLE FOR THIS
FIGURES OUT HOW MANY OF THESE
YOU GO TO THE GROUP. AND YOU
SAY WHAT WILL IT TAKE IN ORDER
TO GET X. NUMBER OF YOU. TO
COME PROVIDE A SERVICE AND THEN
YOU BUILD WHATEVER THE FIX IS
AROUND THAT INSTEAD OF TRYING
TO THROW DARTS THE BOARD HOPE
YOU AT THE CENTER RIGHT YOU
ASKED THAT QUESTION AND THE
DEBUT SECRET ANSWER THEY NEEDED
TO STUDY ANALYZED RESEARCH. YES
THAT'S BEEN A BASIC QUESTION
FOR FOURTEEN YEARS. I CAN SHED
A LITTLE BIT MORE LIGHT ON THIS
ISSUE- PLEASE MR PARRIS SOTO
MENTIONED THAT THEY DON'T HAVE
A MARKETING ARM THEY DON'T
UNDERSTAND THE MARKET IN TERMS
OF WHAT IT TAKES TO BRING
DOCTORS INTO THE SYSTEM. THAT'S
WHERE COMPANIES LIKE OURS COME
IN BECAUSE OUR MISSION IS TO
PRESENT THE QUEUE AT ME DOC UP
OPPORTUNITY TO PHYSICIANS. AND
HELP THEM BE SUCCESSFUL ADDS
PRACTICING Q. AND MEETS. THE
TYPICAL PHONE CALL WITH THE
PHYSICIAN WHO IS NOT A Q. ME
GOES LIKE THIS. WHAT THE FIRST
QUESTION THEY ASK IS WHAT DOES
THE WORK AND TAIL WE DESCRIBE
THE WORK. FIRST QUALIFYING
CRITERIA IS ARE THEY OPEN TO DO
DOING MEDICAL LEGAL EVALUATIONS
IF THE ANSWER IS YES THE SECOND
QUESTION IS ALWAYS. WHAT DOES
THIS OPPORTUNITY PAY. AND THE
ANSWER IS SOMETIMES YOU'LL EARN
SIX TWENTY FIVE FLAT. SOMETIME
TO LEARN NINE HUNDRED FLAT. AND
ONCE IN AWHILE IF YOU PLAY YOUR
CARDS RIGHT YOU COULD EARN UP
TO TWO HUNDRED FIFTY DOLLARS AN
HOUR. AND IF THEY DON'T HANG UP
BUT THAT POEM. START ASKING
QUESTIONS. THEY SAY WHEN I DO A
GLOBAL EXPERT MISS WORK FOR US-
LINES OF WORK I GET PAID WAY
MORE THAN THAT WHY BUT I STAND
UP. FOR A MORE COMPLEX MORE.
TAXES WE'RE I'M GOING TO BE
PAID NOTHING CLOSE TO MY
BILLING RATE. AND THIS IS
REQUIRED BY STATUTE. STRUCK
PREVENTION FIFTY THREE SEVEN
SIX. ACTUALLY PROVIDES MEDICAL
OFFICE DO NOT. UP TO THE FIGHT.
ALL TO THE REGULAR THE RIVER IS
TO PROVIDE FOR COMPENSATION-
DARK OUR INTEREST IN DOING
MEDICAL. DOLLARS AN HOUR.
THAT'S WHY WE'RE IN THE
SITUATION WHERE INTO THAT THAT
IS THE FEE SCHEDULE
DIFFERENTIATE BY SPECIALTY NOTE
THAT'S WHY YOU HAVE AN OVER
REPRESENTATION OF.
ACUPUNCTURISTS PSYCHOLOGISTS
AND CHIROPRACTORS RELATIVE TO
ORTHOPEDIC SURGEONS A
NEUROSURGEON SO AT A MINIMUM
THE EFFORT. HERE WHOEVER'S
DOING IT NEEDS TO TAKE A LOOK
AND- AT AT ONCOLOGY INFECTIOUS
DISEASE PSYCHIATRY SOME OF THE
OTHER SPECIALTIES THAT OUR-
QUIZ I GENERAL PRACTICE BUT
BUT- OUR- OUR- OUR DIFFICULT.
SITES THAT ARE DIFFICULT TO
FILL BECAUSE- THEIR SHORTAGES
CERTAINLY IN CERTAIN.
GEOGRAPHIC LOCATIONS IN THE
STATE. AND PROVIDE A- A
DIFFERENTIAL TO ENCOURAGE
PEOPLE TO PARTICIPATE IN THE
PROCESS NOW WITHIN THE MEDICAL
COMMUNITY THAT'S PROBABLY NOT
GOING TO BE A POPULAR THING
BUT- OUR JOB IS TO MAKE SURE
THAT INJURED WORKERS ARE TAKEN
CARE OF NOT THAT. EVERYBODY'S
HAPPY TO THE SAME DEGREE. I
AGREE. I CAN TELL YOU THAT
FIFTH OF WOULD NOT OPPOSE THAT
AND YOU KNOW OBVIOUSLY I
REPRESENT PRIMARILY WORKING
SURGEONS AND- TECHNOLOGY. WILL
HAVE TO BE REALISTIC WE NEED TO
RECRUIT SOME ONCOLOGISTS IN THE
SYSTEM. WE NEED TO GET FIVE OF
THE SO THAT WE CAN HAVE A
PANEL. AND THERE'S OTHER
SUBSPECIALTIES AS WELL WE NEED
TO PAY A PREMIUM THAT WE DEAL
WITH. SOME OF THE FRANKLY WILL
BE AFTER YOU. SET THIS PREMIUM
THAT. SOMEBODY GETS OUT THERE
AND EXPLAINS TO THE ONCOLOGY.
BETTER THERE THAT THEY CAN DO
THIS. THE SERVICE TO PEOPLE AND
THEY'RE GONNA BE REIMBURSED
ADEQUATELY AND CURSED ME
SPEAKING OF PANELS OF. THE
SYSTEM NEEDS TO FIGURE OUT A
WAY TO. HAVE FOLKS SELF CERTIFY
THAT IF THEY'RE GOING TO IF
THEY'RE GOING TO CUT MY NAME'S
GOING TO POP OUT ON THE PANEL
THEY'RE AVAILABLE TO DO THE
WORK WITHIN SIXTY DAYS OR
NINETY DAYS SO WE'RE NOT GOING
BACK TO THIS. SECOND PANEL IN
THIRD PANEL IN FOURTH PANEL IN
FIFTH PANEL. CHURNING OUT NAMES
OF PHYSICIANS THAT AREN'T
SIMPLY AREN'T AVAILABLE FOR A
HUNDRED EIGHTY DAYS THAT MAKES
NO SENSE TO ME. AND TO YOUR
POINT ONE OF THE BIG ISSUES WE
SEE NOW IN THE LAST SIX MONTHS
TO A YEAR WITH IS THE SHORTAGE
OF CUNY'S IS NOW THE WC ATTACKS
SECURE MEETS ON WHAT. YOUR
REPORT IS ONE OR TWO DAYS LATE.
STATUS HAS GOT TO BE THERE IN
THIRTY DAYS. IT'S ONE DAY LATE.
WELL AUDIT YOU AND IF YOU'RE
LATE MORE THAN THREE FOUR TIMES
IN YOUR REPORTS. WE GOT A
PROBLEM WITH YOU WELL THERE
LATE BECAUSE WORK IN MY CLIENTS
TELL ME THEY'RE WORKING SIX TO
SEVEN DAYS A WEEK. RIGHT JUST
LIKE THE- NO BUT LONG HOURS IS.
WHAT'S REQUIRED TO DO ALL THIS
WORK AND THEN OF COURSE. TO THE
AUDITOR'S REPORT I WOULD
IMAGINE THE QUALITY. IS GOING
TO SUFFER BECAUSE YOU'RE JUST
WORKING TOWARD OF ALL OF US
WORK. ALL DAY AND NIGHT WE'RE
GOING TO PROVIDE POOR WORK
PRODUCTS. SO IT GOES BACK BRING
IN THE QUEUE ME SENT TO THE
SYSTEM. THE SPECIALTY I MEAN
WHY DOES THE CARDIOLOGISTS GET
THE SAME RATE AS A CHIROPRACTOR.
PRETTY TWENTY NOW BURDEN FOR
THE OUTLOOK SO. CARDIOLOGISTS
AMY THINK IT'S SEVEN FIFTY OR
SOMETHINGLIKE THAT IN OUR
WHERE THEY WORK FOR TWO FIFTY
IT'S REAL SIMPLE ECONOMICS IT'S
NOT COMPLEX. SIGNATURE THANK
YOU THANK YOU THANK YOU BYE THE
MOVE THE ASSEMBLY MEMBER VOEPEL.
YES MISTER CHAIR I HAVE A-
COMMENT THE QUESTION AND THEN A
WRAP UP COMMENT. MY FIRST
COMMENT IS TO THE AUDITOR
EXCELLENT JOB I THINK YOU WERE
VERY IMPARTIAL AND YOU TOLD IT
LIKE IT WAS. TO THE CHAIR.
THANK YOU SIR FOR JUMPING ON
HOT COALS AND TRYING TO DO THE
DANCE YOU'VE DONE YOUR JOB. SO
NOW I CAN REALLY TALK ABOUT
AMERICA. THERE SPEAKERS IN THE
RESTROOM YEAH SENSE THAT
COMMENT NOW. TO THE PANEL HERE.
IN THE MEDICAL FIELD WHICH I.
INSURANCE MEDICAL I. PROCESS
THOUSANDS OF CLAIMS FOR HEALTH
INSURANCE- THERE IS A FACTOR
CALLED NORMAL AND REASONABLE
AND CUSTOMARY CODED MEDICAL.
SERVICE CHARGES. IN OTHER WORDS
YOU GET A PATINT FROM X. Y. Z.
INSURANCE COMPANY YOU CODED
INTO THE INSURANCE COMPANY
DEPENDING UPON YOUR CONTRACT
WITH THAT INSURANCE COMPANY
THEY PAY X. AMOUNT OF MONEY.
NOW. I HAVE TO ASSUME WITH THE
WORKERS COMP SYSTEM. IT'S
SOMEWHAT THE SAME BUT YOU'RE
WORKING IN THEIR WORLD SO.
MEDICARE PAYS BETWEEN FORTY TWO
AND 44% OF THE BILL. MEDI CAL
SOMEWHERE IN THE THIRTIES NOW.
SO CAN YOU ANSWER MY QUESTION
WHAT PERCENT DOES WORKERS COMP
PAY ON THE AVERAGE CLAIM.
COMPARED TO REASONABLE AND
CUSTOMARY CAN ANYONE ANSWER
THAT. TALK ABOUT TREATING
PHYSICIAN WILL GO TO PULL. IT
OFF SPEAK IN 50% OF- OF
MEDICARE RIGHT BUT IN FACT THE
IN ORDER TO BE ON THE M. P.
ENDS OF PHYSICIANS ARE REQUIRED
TO TAKE A 15% DISCOUNT FROM THE
OFFICIAL MEDICAL FEE SCHEDULE
TO HAVE AN OFFICIAL MEDICAL FEE
SCHEDULE IT CITED A- AN EXTRA
PERCENT ABOVE MEDICARE- TO
COMPENSATE FOR ALL THE EXTRA
WORK THAT'S REQUIRED TO TREAT A
WORKERS COMPENSATION PATIENTS.
A LOT OF EXTRA FORMS TO FILL
OUT YOUR TO PUT EXTRA THINGS
NEED REPORT YOU NEED TO BE VERY
DETAILED AND FRANKLY GETTING
TREATMENT AUTHORIZES QUITE
DIFFICULT AND THAT'S WHY A LOT
OF ORTHOPEDIC SURGEONS JUST
DROP OUT IF YOU CAN FOR YOUR
PRACTICE WITH. A BLUE CROSS
THEY HAVE BEEN PATIENTS AT THE
PLACE SINCE AND WHY WOULD YOU
HOUSE SO WITH WORKERS COMP
YOU'RE GOING TO GET YOU'RE
GOING TO GET PAID LESS BECAUSE
YOU HAVE TO TAKE THE DISCOUNT
TO TREAT WITH THEM- THEN YOU'RE
GONNA GET HOUSEHOLD AND YOU'RE
NOT GOING TO TREAT THE PATIENT.
IT'S LIKE WOW I DON'T WANT TO
DO THIS SO YOU KNOW WHAT WITH
THE GUY THAT I GO TO FOR MY
TOTAL KNEE REPLACEMENT I CAN'T
SEND A PATIENT TO BE SYSTEMS
REALLY STAR JACK I JUST. I
CAN'T TAKE ANYMORE WORKERS
COMPENSATION PATIENTS IS JUST
NOT WORTH IT FOR ME. SO I HOPE
THAT ANSWERS THAT QUESTION I
pPRETTY GOOD HEART PUMP THE
OTHER THING THAT I POINT OUT TO
THE CHAIR ONCE AGAIN AS YOUR
INSURANCE BROKER YOU KNOW IT'S
KIND OF LIKE A JOKE. FROM RIGHT
NOW ONE OF THE PROBLEMS ALSO
WITH ALL OF THE PROVIDERS OF
ANY KIND. IS US BABY BOOMER
DOCTORS AND PRACTITIONERS ARE
SAYING SCREW IT WERE RETIREE
WE'RE DONE I'VE LOST MANY
DOCTORS NOW SO THAT'S ONE OF
THE ISSUES THEN I GET BACK. IN
THIS IS MY FINAL COMMENT THIS
IS LATE I UNDERSTAND YOU'VE
BEEN VERY NICE. MYFINAL
COMMENT BRINGS YOU BACK TO THE
BILL READ. HEY THE BREED NEVER
LIFE'S ON ONE END OF THE BREED-
IS PRICE AND IT'S PAID BY THE
EMPLOYER ON THE OTHER END OF
THE BREED ALWAYS BENEFITS YOU
PROVIDE IN THE PRICE PROVIDES
IT. YOU COULD SQUEEZE ONE IN.
AND THE BENEFITS POP OUT YOU
GET LESS BENEFITS BUT THE PRICE
GOES DOWN. YOU SQUEEZE THE
BENEFIT AND- PRICE GOES UP
MONEY POPS OUT THAT WAY. NOW
WHAT I'M LOOKING AT HERE WITH
ALL THE TESTIMONY. IS THE
INSURANCE COMMISSIONER ONCE
AGAIN I GET BACK TO THAT. IS
DOING A TEMP MEANT 3% LOWER IN
OF THE ADVISORY. PREMIUM RATES
NOW ADVISORY MEANS TO THE
INSURANCE COMPANIES WERE
ADVISING YOU TO DROP YOUR RATES.
WHO DO YOU THINK THEY MIGHT.
THIS IS SIMPLY A THIRTEEN POINT
OR TEN POINT 3% REDUCTION OF
PREMIUM RATES ON A PRICE AND OF
THE BURRITO SO Q. A ME SERVICE
LEVELS REPRESENT THE DELAY. AND
DENIAL. OF WORKERS COMP CLAIMS
SIMPLY BY DEFAULT SEE I DON'T
HAVE TO DENY YOUR CLAIM. ALL I
GOTTA DO IS LET IT GO FOR
EIGHTEEN TWENTY FOUR MONTHS.
MAYBE I'LL DIE WHO THAT MEANS
WE MAKE MONEY SERIOUSLY IT'S
BRUTAL THIS IS A BRUTAL SYSTEM
THE WORKERS COMP SYSTEM YOU CAN
DIE IN EIGHTEEN TWENTY FOUR
MONTHS- IF YOU'RE NOT BEING
TAKEN CARE OF YOU'RE NOT
DIAGNOSED CORRECTLY- SON OF A
GUN. YOUR THAT ROOFER. HI. WHAT
DO YOU MATTER IN THE SYSTEM
YOU'RE NOTHING YOU'RE JUST
ANOTHER BLOOD CORPUSCLE IN THE
ECONOMIC- BLOOD STREAM. SO.
WHAT WE'RE DOING NOW MISTER
CHAIR AND PEOPLE WE ARE
SQUEEZING BOTH ENDS OF THE
BURRITO SAME TIME. WHICH IS WHY
IT'S SO IMPORTANT TO BE HERE
RIGHT NOW TODAY. TO LOOK AT
THIS THIS IS GOD'S WORK THANK
YOU YOU HAVE. THANK YOU. RIGHT
WITH THAT LET ME. WELL THINK
THERE'S ANY ADDITIONAL GLOOMY
JUST THANK YOU GUYS BECAUSE I'M
A SAY MY QUESTIONS WHAT I WANT
TO DO IS WITH THE REMAINDER OF
THE TIME IS MAYBE ASK- MR PER
SET UP TO COME BACK UP MAYBE
ADDRESS SOME OF THIS I WANT TO
THANK THE PANELISTS FOR. YOUR
TESTIMONY FOR SHE'D. THANK YOU
FOR STAYING IN LISTENING TO THE
ADDITIONAL- TESTIMONY BUT I
JUST DID WHAT WE DID WANT TO
GIVE YOU AN OPPORTUNITY TO
RESPOND- TO THE LAST PANEL ON
SOME OF THE THINGS THAT WERE
MENTIONED WHETHER. AND I'LL LET
YOU BEGIN WHEREVER YOU'D LIKE
TO BEGIN AND THEN MAYBE WE
CANNOT. GO WITH QUESTIONS FROM
THERE. I DON'T KNOW WHAT TO SAY
I MEAN THERE'S- TERE'S- JUST A
LOT OF WATER I. EAT STRONGLY
DISAGREE WITH. A MIDDLE WHAT I
THINK THAT WAS SAID THAT REALLY
ISN'T RELEVANT TO WHAT'S GOING
ON. WITH THE AUDIT. MMHM WE ARE
TALKING ABOUT FEES. YES WE ARE
REVISING THE MET LEGAL FEES
CONTROL. NO ONE OF THE PRODUCT
PROBLEMS I THINK WE HAD WITH
THE OLD ONE OF IN PLACE WAS
THAT. IT WAS- INTERPRETED IN
MANY DIFFERENT WAYS YOU KNOW WE
NEED SOME WE NEED SOMETHING
SIMPLER. WE NEED TO HAVE FEES
THAT REFLECTS THE WORK THAT'S
BEING DONE. YOU KNOW 50% EIGHTY
PERCENT. THIRTY PERCENT-
WHATEVER THAT IS WHATEVER THAT
IS KIND AND THAT'S WHAT SHOULD
BE PAID. SO LET ME JUST ASK ON
THAT FRONT BECAUSE YOU KNOW.
30% 50% WHATEVER IT IS. IN THE
STAKEHOLDER MEETINGS THAT
YOU'RE CONDUCTING NOW ARE YOU
GUYS TALKING ABOUT MAYBE. SOME
DIFFERENTIATION BETWEEN. I
THINK THEY SAID THE
CARDIOLOGISTS TO THE
CHIROPRACTOR. FOR INSTANCE TO
MAYBE HELP. GET MORE Q. AMIS
INTO THE SYSTEM WELL I WOULD
THINK THAT THAT'S SOMETHING
THEY WOULD TALK ABOUT YOU KNOW
WILL BE PROPOSED ESSENTIALLY IS
A FLAT RATE. NO BECAUSE REALLY
JUST DEPENDS UPON WHAT YOU KNOW
WHAT WHAT DISPUTE IS BEING
PRESENTED WHAT KIND OF
SPECIALTY TO THE ACTUALLY RIVER
IS NEEDED TO RESOLVE THAT KIND
OF DISPUTE- I THINK A FLAT RATE
IS WOULD HELP PEOPLE BECAUSE-
NOTE. THERE KNOW WHAT. PLAYERS
KNOW WHAT THEY HAVE TO PAY AND
THEY KNOW WHAT PRODUCT THEY'RE
GOING TO GET IN RETURN- WE NEED
TO GET QUALITY REPORTS WE'VE
HEARD PEOPLE SAY YOU KNOW THE
WHAT EIGHTY PERCENT- OF HOW
MANY PERCENT OF. REPORTS ARE
NOT GOOD QUALITY. I'M VERY
LEERY OF THROWING MONEY. AT
THIS AT A SITUATION OR TO
SCENARIO OR SYSTEM THAT'S BEING
DESCRIBED AS BROKEN WERE ALL
THE REPORTS ARE BAD. AND WE
HAVE TO BE VERY CAREFUL ABOUT
THAT AND I THINK THAT'S WHAT WE
NEEDED. THAT'S WHAT WE NEED TO
LOOK AT THE WHOLE SYSTEM IN THE
WHOLE PROCESS. WE NEED
CONSISTENCY WE NEED SOMETHING
THAT'S PREDICTABLE NOW WHETHER
THAT NEED TO BE BROKEN DOWN
AMONG SPECIALTIES I THINK I
THINK THAT'S A GREAT DISCUSSION
FOR STAKEHOLDERS AND I HOPE AND
I HOPE THEY HAVE THAT- I THINK
THERE PROBABLY SHOULD BE SOME
DISTINCTION BETWEEN YOU KNOW A
QUOTE ON QUOTE RUN OF THE MILL
CASES IF THERE EVER WAS ONE OR
SOMETHING THAT'S INCREDIBLY
COMPLICATED WHETHER THAT
INVOLVES MULTIPLE BODY PARTS
THAT SOMETHING THAT'S SOMETHING
I THINK THAT NEEDS TO BE PART
OF THE DISCUSSION YEAH LIVE%
OPERABLE WE'RE TALKING YOU KNOW
WE'RE TALKING ABOUT SOMETHING
THAT'S- HAS SO MANY MOVING
PARTS. MANY ON TO FOCUS ON ON
ON ONE IN ON A CERTAIN
PERCENTAGE I THINK- IS A LITTLE
IS A LITTLE DANGEROUS. CAN YOU
KNOW THE ALL THE ALL THE PEOPLE
UP HERE. ON THE PANEL. YOUR
PART OF THOSE STAKEHOLDER
GROUPS. AND I THINK THEY HAVE A
THEY HAVE THE ABILITY TO. PUT
THEIR OPINION SEN. TALK WITH
EMPLOYERS AND SEE IF THEYCAN
REACH AN AGREEMENT. CAUGHT HIM
TOP JUST TRYING TO. FROM MY
UNDERSTANDING IS LIKE WELL IF
WE NEED. MORE ORTHOPEDIC
DOCTORS. HOW DO WE GET MORE OF
THOSE INTO THE SYSTEM WELL AS I
SAY WE NEED TO HAVE THE
SCHEDULE THAT PROVIDES ADEQUATE
REPRESENTATION AND THEN IT'S
REALLY AND THEN ALSO I THINK WE
NEED SIMPLICITY IN THIS WE NEED
MORE SIMPLICITY IN OUR SYSTEM
WE HAVE A LOT OF RULES WE HAVE
A LOT OF OBLIGATIONS THERE HAVE
BEEN STATUTES AND REFORMS THAT
SWING BACK AND FORTH EVERY FOUR
YEARS THAT HAD MORE BUT BUT
ADDED ON TOP. NO INSTEAD
INSTEAD OF SAYING LOOK LET'S
JUST PEELED THIS BACK AND SEE
WHAT'S REALLY NECESSARY
ADEQUATE COMPENSATION I AGREE
SIMPLICITY IN THE SYSTEM AND
THEN YOU KNOW WE RELY ON
PRIVATE ON PRIDE ON PRIVATE
DOCTORS TO JOIN OUR SYSTEM IN
WE COULD SELL IT TO THEM I
WOULD HOPE THEY WOULD I WOULD
HOPE THEY WOULD JOIN GOT IT
RIGHT AND THEN CAN YOU JUST
MENTIONED WE CAN TALK ABOUT IT
AND ALL THE OTHER PANELS BUT-
THE UNDERGROUND REGULATIONS OF
THE COURT CASE SO WHAT HAPPENED
AND FROM YOUR PERSPECTIVE AND-
WHAT GOT ADDRESSED THERE WAS AN
ALLEGATION THAT WE WERE USING
UNDERGROUND REGULATIONS. A
COURT CASE WAS FILED- I THINK A
DECISION WAS REACHED- THAT
THROUGHOUT THE CASE ON ON
JURISDICTIONAL GROUNDS BECAUSE
IT WASN'T RAISED BEFORE THE W.
C. A. B. THERE WAS DICTA IN THE
DECISION SAYING THAT WE
POSSIBLY HAD UNDERGROUND
REGULATIONS. AT THAT POINT I
THINK BOTH SIDES CAME TO THE
TABLE AND SAY LET'S SETTLE THIS
AND WE DID- YOU KNOW I CAN'T
HAVE. THEM AS A MENTION I DON'T
HAVE A BIG STE I DON'T HAVE A
BIG STAFF HERE TO DO A LOT OF
THIS WORK. AND I CAN'T HAVE
THEM SPENDING ALL OF THEIR DEBT
ALL THEIR TIME. FIGHTING
LITIGATION. NO WEEDS WITH SO
THE CASE WAS SETTLED SETTLED ON
BOTH SIDES. FEDERAL OKAY. AND
THEN IT HUNTING THAT STRUCK ME
BECAUSE YOU KNOW WE TALK ABOUT
DUE PROCESS CERTAINLY- BUT THEN
IF. YOU KNOW TO HEARINGS IN
THREE YEARS IT SEEMS HOW ARE WE
ADDRESSING THE DUE PROCESS
ISSUE IF THAT'S THE CASE WELL I
THINK AS THEY SAY WHAT HAVE
WHAT HAPPENED IN 200-014-2000
SIXTEEN. YOU KNOW I THINK CARP
OUR PROCESS IS BEEN- YOU KNOW
WE'VE WE'VE LOOKED AT IT WE
ARE. FOLLOWING THE ADMIN A
THROUGH THE STRAIT OF
PROCEDURES ACT- AND BRINGING
CASES APPROPRIATELY AT THAT THE
AT THIS POINT. LOOK WHAT
HAPPENED IN THE PAST I THINK
JUST IN THE HOUSE- I THINK WHAT
WE'RE DOING NOW IS ENTIRELY
APPROPRIATE. IT WAS INDIVIDUAL
CASES THAT HAVE BEEN BROUGHT UP
HERE WHATEVER I DON'T I. CAN'T
SAY I KNOW ABOUT THEM OFF HAND
I'D HAVE TO ASK ABOUT IT. IF
SOMEONE DIDN'T FIT A- THE
PHYSICIAN WAS TO BEING
DISCIPLINED BY US. BECAUSE OR
OR OR SOME LETTER WAS SENT
BECAUSE THEY DIDN'T SPEND AN
HOUR. THE PATIENT HAD TO GO
HOME EARLY WELL THAT'S
SOMETHING I'D LIKE TO SEE. AND
MAYBE AND I WILL CERTAINLY TALK
TO MY STUFF ABOUT THAT
TOMORROW. OKAY I APPRECIATE
THAT BECAUSE WE JUST TRY TO
FIGURE OUT. NO DUE PROCESS AND
HOW DO WE MAKE THAT MORE
EFFICIENT FOR EVERYBODY AND-
YOU KNOW WHETHER WE TALK ABOUT
FEE SCHEDULE OR- GETTING MORE
Q. ENEMIES INTO THE SYSTEM I
THINK THAT. HELPS PRODUCE MORE
EFFICIENCY RIGHT WELL I THINK
AS YOU SEE YOU KNOW WORKERS
COMPENSATION- REALLY- BRINGS UP
THE VITRIOL. IN PEOPLE- AND I
SEE IT THE ELF FROM FROM ALL
SIDES YOU KNOW I SEE IT FROM
OUR SO YOU KNOW I SEE IT FROM
TO FROM OUR SIDE. AND I THINK
WE HAVE TO CALM DOWN A BIT. AND
THINK ABOUT WHAT WE NEED TO DO
TO MAKE OUR SYSTEM BETTER AND
IF IT'S ACTUALLY YOU KNOW.
THROWING IT IN THROWING THE
BURRITO OUT THE WINDOW WELL. WE
NEED TO LOOK AT THE. OKAY AND
THEN JUST ONE LAST THING IT
JUST ONE CLARIFICATION SO.
LABOR CODE WAS A FIFTY THREE OH
SEVEN POINT FIVE POINT SIX.
WHATEVER WAS ABOUT THE SCHEDULE
BEING UPDATED ANNUALLY IS THAT
WITH IT'S THE LABOR CODE
SECTION IS THERE IT'S BEEN IN
PLACE FOR A LONG TIME IT WAS
THERE AND- IT WAS IN PLACE
BEFORE WE TURN TO THE OFFICIAL
MAP WE FOR WE TOOK THE OFFICIAL
MEDICAL FEE SCHEDULE ONE TIED
TO MEDICARE. AND SO YEARS AGO
YES- THAT WAS REALLY WHAT THE
CASES BUT WE CAN'T YOU KNOW WE
CAN'T UPDATE THE MEDICAL FEET
LEGAL FEE SCHEDULE NOW. AS WE
ARE REQUIRED TO DO WITH THE
OFFICIAL MEDICAL LEGAL FEE
SCHEDULE IT'S- IT'S KIND JUST
REALLY DOESN'T WORK THAT WELL.
GOT IT BUT IT BUT YOU KNOW
WE'VE BEEN OPERATING FOR YEARS
YOU KNOW BASED ON STUDIES THAT
SAID ARE MET LEGAL FEE SCHEDULE
WAS PAYING A REASONABLE AMOUNT-
BUT- AND THEN SO WE KEPT THAT
THE CENTURY THE SAME AS IT WAS-
AND- AND ITS PEOPLE LOOK AT IT
THEY SAID. THEY SAID IT WAS
REASON ENOUGH STUDY SAID IT WAS
REASONABLE. BUT YOU KNOW THAT
THIS POINT I THINK AND WE
REALIZED THIS BEFORE THE AUDIT
BEGAN THAT WE NEEDED TO HAVE
SOMETHING THAT WE HAVE NEEDED
TO HAVE SOME THINGS. OF SIMPLE
SOMETHING PREDICTABLE AND THAT
WE NEEDED TO INCREASE OUR AND
WE NEEDED TO PROVIDE ADEQUATE
COMPENSATION. GOT IT AND WE'RE
SUFFERING AND ARE MOVING IN
THAT DIRECTION. AND I HOPE AND
I HOPE I HOPE OR STAKEHOLDERS
STATE STAY ENGAGED IN OUR
MEETINGS AND I HOPE THEY- THE
THEY TALK THE ISSUES OUT AND I
HOPE THAT THEY CAN COME TO AN
AGREEMENT. CUT AND MAYBE THAT'S
JUST BRING MORE TRANSPARENCY
WHEN PEOPLE SEE RULES AND
REGULATIONS OF THIS WAS
ACTUALLY DISCUSSED EVERY SINGLE
YEAR. PER LABOR CODE. OR OR I
THINK THE BEST WAY TO DO IT IS
FINE THAT OBJECTIVE STANDARD.
FIND OUT REASONABLE OBJECTIVE
STANDARD ANTI THE FEE SCHEDULE
TO THAT SO THAT WE COULD HAVE
REASONABLE INCREASES EVERY
YEAR. THAT'S FINE. I HAD ME UP
WE HAVE NO ISSUE WITH THAT.
YEAH AND I THINK THAT'S WHAT.
PEOPLE WERE THINKING MAYBE
SCHEDULE HELPS. FOR
PREDICTABILITY AND-
UNDERSTANDING WHAT TO EXPECT IN
THE- NEAR FUTURE ANYWAYS. OKAY
GREAT SO ANYTHING ELSE YOU WANT
TO COMMENT ON THAT WAS SAID IN
THE PREVIOUS NIGHT. RIGHT ANY
IN THANK YOU. EIGHT THAT WE
HAVE SPOTTED A FEW HAS ANY
ADDITIONAL COMMENTS NOW. OKAY.
SO WITH THAT LET ME ASK FOR A
PUBLIC COMMENT IF THERE'S ANY
PUBLIC COMMENTS YOU CAN- JUST
ANNOUNCE YOUR NAME YOUR WITH A
PARTICULAR ORGANIZATION OR WHAT
COUNTY RESIDE IN WE'D
APPRECIATE THAT. GIVE THE. ALL
RIGHT PLEASE. REPORTED ON
BEHALF OF THE HEALTH EDUCATION
OF JOINT POWERS AUTHORITY
THAT'S BEEN ONE OF THE MANY
ACTIVE STAKEHOLDERS ON THIS
PROCESS WOULD YOU GIVE ME STEVE
APPERT PERTAINING TO THE LACK
OF KILLING ME WE ALL AGREED
THAT WE WOULD LIKE MORE QUALITY
TO THEM YOU CAN ASSIST IN A
CERTAIN THE INCREASING
COMPENSATION IS A PART OF. AND
THAT THOSE CONVERSATIONS
HOWEVER EQUAL CONSIDERATION
MUST BE GIVEN TO OTHER FACTORS
THAT DELAY INJURED WORKERS HERE
AND BENEFITS SUCH AS THE
QUALITY AND TIMELINESS
PARTICULARLY REPORT. NOT JUST
NINETY SO BY DOING HERE THAT
POINT. SEVERAL PRESENTERS HERE
TODAY. WE FEEL THAT THE ON
GOING REGULATORY EFFORTS ARE
GOING TO LEAD TO BETTER
COMPREHENSIVE REFORMS TO
IMPROVE ACCURATE AND TIMELY
BENEFIT. FOR INJURED WORKERS
ANYBODY COURAGE THE LEGISLATURE
TO SUPPORT. THOSE COMPREHENSIVE
REGULATORY EFFORTS BEFORE
HAPHAZARDLY INTRODUCING
FRAGMENTED AND COSTLY
LEGISLATION WE THANK YOU FOR
YOUR TIME TODAY AND ARE HAPPY
TO REMAIN ENGAGED A COLDER
THANK YOU THANK YOU APPRECIATE
THAT ADDITIONAL TESTIMONY. A
LOOKUP AND PLEASE LOW I'M
DEBORAH RUSSELL I'M
REPRESENTING SCHOOLS INSURANCE
AUTHORITY THE D. W. C. HAS BEEN
SENSITIVE TO THE ISSUES OF
QUALITY OF THE QUEUE IN A
REPORTS PHYSICIAN COMPENSATION
AND THE AVAILABILITY OF
KILOMETERS IN OUR SYSTEM. IN
RECENT MONTHS THE DDC HAS BEEN
HOSTING STAKEHOLDER MEETINGS IN
WHICH DOZENS OF INDUSTRY
PROFESSIONALS HAVE BEEN WORKING
TOGETHER TO BUILD A CONSENSUS
AROUND THESE ISSUES. WE BELIEVE
THESE DISCUSSIONS WILL RESULT
IN CHANGES THAT WILL STREAMLINE
THE QUEUE IN ME PROCESS WITHIN
THE CURRENT STATUTORY FRAMEWORK.
WE AGREE WITH THE COURSE OF
ACTION CURRENTLY BEING TAKEN BY
THE BBC AND WE URGE YOU TO
ALLOW THE STAKEHOLDER PROCESS
TO BE COMPLETED. AN APPROPRIATE
CHANGES TO THE Q. MAY PROGRAM
IMPLEMENTED BY THE D. WC PRIOR
TO TAKING FURTHER LEGISLATIVE
ACTION. THANK YOU THANK YOU.
THIS TIME WE ASK IF THERE'S
ADDITIONAL PUBLIC COMMENT.
HEARING AND SEEING NINE HOLE
TURN IT BACK TO THE DíAS AND
ASK IF ANY MEMBER AS CLOSING
COMMENTS. IF NOT I WILL JUST-
GOOD AND THANK EVERYBODY FOR
TODAY'S INFORMATIVE DISCUSSION
OBVIOUSLY WITH THE JOINT
LEGISLATIVE AUDIT COMMITTEE
WE'RE GONNA CONTINUE TO MONITOR
THE MODERN RESISTORS AND
THERE'S OBVIOUSLY PENDING
LEGISLATION AND WHETHER OR NOT-
WE'RE REALLY. LOOKING FORWARD
TO SEEING WHAT- DEPARTMENT OF
WORKERS COMPENSATION COMES OUT
WITH WITH THE STAKEHOLDER
MEETINGS OBVIOUSLY A LOT OF
CONCERNS WERE ADDRESSED IN
TODAY'S. ALL OVER THREE HOUR
HEARING. ON THE ON THE TOPIC SO
WHETHER WE'RE TALKING ABOUT
BURRITOS ARE NOT. THERE'S A LOT
TO DISCUSS BUT A LOT REMAINS TO
BE SEEN AND SO WE WILL- WANT TO
BE IN ENGAGE STAKEHOLDER AS
WELL IN THAT PROCESS AND
WHETHER SOMETHING NEEDS A
LEGISLATIVE FIX OR WHETHER
WE'RE TALKING ABOUT RESOURCES
OR WHAT WE NEED TO DO TO MAKE
SURE THAT WORKERS- ARE GETTING
THE HELP THAT THEY NEED TO
RETURN BACK EITHER TO THE WORK
FORCE OR JUST. BE BETTER BE
HEALTHY- THAT'S SOMETHING THAT
WE'RE ALL INTERESTED IN AND
WANT TO BE ENGAGED IN- LIKE I
SAID IN MY OPENING COMMENTS I
BELIEVE THERE'S PROBABLY. A
PATHWAY I THINK FOR A WIN WIN
HERE- OR WE CAN DECREASE COSTS
TO THE ENTIRE SYSTEM BY.
CREATING SOME OF THESE
EFFICIENCIES ARE CLEARING UP
SOME OF THESE MISUNDERSTANDINGS
AND WE WANT TO BE IN ENGAGE
PARTNER IN THAT. AND SO- WITH
THAT I'M GOING TO CONCLUDE
THIS. HEARING AT SEVEN EIGHTEEN
PM AND THIS IS THE CONCLUSION
OF THE J. LACKEY THANK YOU