Friday, September 7, 2012

Reform, Resignation, Revelation

The drama in the California workers' compensation reform novella heated up yesterday when the news that Division of Workers' Compensation Administrative Director, Rosa Moran, resigned was widely and rapidly circulated.

Rumors and speculation about her resignation abound - from dissatisfaction with the back room dealings nature of reform negotiations to uneasiness with potential Constitutional issues. Neither Moran, the DWC nor the Brown Administration would provide  comment to WorkCompCentral.

Moran has her reasons and whether she desires to let the work comp community know is certainly up to her - but the difficult job of implementing the massive regulatory schemes necessary to make SB 863 operative, in my opinion, just got much, much more difficult.

The AD job is a very difficult one in good times. The AD must be a strong leader, able to deal with a broad range of different classes of employees and personalities all knowledgeable and passionate about work comp, fend off special interests in the rule making process, deal with challenging media reporters, orchestrate new resolutions to ongoing problems, manage a budget that at times is near the brink of chaos - and all of this while trying to perform the ultimate function: protecting the rights of injured workers while ensuring that the costs of doing so remain politically acceptable.

But these aren't good times for the DWC. While some provisions of SB 863 do not have to be implemented for another 16 months, most provisions need immediate attention, and immediate work.

And the appointment of a replacement AD now requires immediate attention.

I have no doubt that the Director of the Department of Industrial Relations, Christine Baker, can deal with the sudden departure of Moran - Baker has proven extremely resilient in the face of adversity, a strong leader and adept at navigating a difficult course.

She is going to need unbridled support from her boss, Governor Jerry Brown, to get a replacement AD in place on an emergency basis.

The bigger question is whether Baker can actually find someone willing to step into the SB 863 caldron of controversy and labor, for SB 863 is going to require an extraordinary effort and an AD taking on this chore will see very little in return - certainly the pay scale is way below what a public corporation executive with similar responsibilities would get, and the risk of failure could be a career destroyer.

Look at all the AD must now accomplish:
  • contract with independent medical review organizations to settle disputes over medical treatment and establish a fee system to pay for the service and administrative costs.
  • enable independent medical review to take effect for injuries occurring on or after Jan. 1, 2013, albeit the administrative director can use an interagency agreement to establish contracts with independent review organizations currently under contract with the Department of Managed Health Care - this still takes time to review and implement.
  • prescribe the information that an employer must provide when refusing to pay part or all of a medical bill.
  • implement a system to conduct random review of medical provider networks. 
  • promulgate regulations by July 1, 2013, to implement a provision requiring networks to have assistants who can help injured workers schedule appointments.
  • adopt regulations to implement a new system of administering job retraining vouchers that applies to all injuries occurring on or after Jan. 1, 2013.
  • develop rules and implement an electronic system to collect a $150 lien filing fee and a $100 lien activation fee that take effect Jan. 1.
  • implement rules and a process for certifying interpreters ready for Jan. 1, 2013.
  • adopt a new medical fee schedule.
  • adopt a new interpreter fee schedule.
  • adopt a fee schedule for home health care services by July 1, 2013, and a copy service fee schedule by Dec. 31, 2013.
  • adopt a new permanent disability rating schedule.
  • figure out a system and adopt regulations for the distribution of $120 million in supplement income benefits to the most severely disabled.
The human factor is one element that legislators often fail to understand - there have to be people to enact the legislation, otherwise no matter how good the ideas may be, inability to implement them makes them functionally worthless.

But, this is California. We have a lot of talented, intelligent, dedicated people in this state.

Earthquakes, wild fires, floods, economic turmoil and workers' compensation dysfunction. It's just a part of living in the Golden State. We'll get through it.

1 comment:

  1. Everyone is ignoring the fact that the bill lowers the amount of deposit require from self insured employers. I believe the employers who drafted the bill, Grimmway Farms, Disney and Safeway, are self insured. This is direct payback to these employers for their support of the governors tax initiative. I bet workcomp central could figure out how much money these employers are going to save.