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LEAD STORY

Outgoing California Gov. Jerry Brown passed the torch to newly elected Gov. Gavin Newsom on Monday.  The former mayor of San Francisco, Gov. Newsom announced big proposals to the state’s health system. Newsom signed an executive order that would make California, the world’s fifth largest economy, the largest single purchaser for prescription drugs and will allow private employers to join the state in negotiating drug prices.

GOVERNOR PROPOSALS

Gov. Newsom sent a letter to Congress and the White House asking them to empower states, like California, to innovate and transform their healthcare systems by developing a single-payer health system to achieve universal coverage, contain costs, and to promote quality and affordability.  Newsom is also proposing to expand Medi-Cal, the state’s program that provides free or low-cost health coverage for low-income individuals, to cover undocumented young adults up to age 26.  Not stopping there, he wants to throw the state’s financial power into an effort to lower prescription drug costs, create an individual mandate for health insurance, and expand the Affordable Care Act subsidies.  (In case you missed it, Newsom’s sleepy son stole the show at his inauguration.) 

SUPERMAJORITY LEGISLATURE

California Democrats regained the legislative supermajority in December, enabling them to pass virtually any legislation without Republican help.  Currently, the nonpartisan legislative analyst projects a budget surplus of nearly $15 billion as well as a “rainy day” fund of about $14.5 billion.  Democratic lawmakers have already introduced bills to provide Medi-Cal healthcare coverage for all illegal immigrants of all ages, a big boost in K-12 school funding, and to offer free community college tuition in a student’s second year.  Outgoing Gov. Brown was seen as a check on the legislature by limiting spending and warned leaders to protect California against a future economic downturn.

DEPT. OF INSURANCE

The new Insurance Commissioner, Ricardo Lara, took the helm at the Department of Insurance on Monday.  In his statement, Lara pledged to protect the victims of wildfires and other disasters, to defeat the threat of climate change and insurance fraud, and promote innovation and technology.  He also announced the creation of a Deputy Commissioner of Climate and Sustainability to work with environmental and industry leaders on innovative solutions to the risk of climate change.  As always, we’ll keep you abreast of all the latest in the Golden State.

First Responders

PRESUMPTION BILLS

The Virginia House of Delegates filed new legislation to add expand the types of cancers that would be covered under workers’ compensation and removes the compensability requirement that first responders prove they encountered a toxic substance in the line of duty.  The proposed bill expands coverage to include colon, brain, or testicular cancer.  The bill is similar to a Senate bill filed in January 2018.  Firefighters are three times more likely to get cancer than non-firefighters.

RISK CONTROL

Fire departments are shifting their focus on preventing exposure to carcinogens with protective masks and clean equipment.  It goes without saying that protective masks protect firefighters from breathing in harmful carcinogens.  But by not cleaning contaminants off their clothing and equipment, it increases the risk of firefighters developing cancer.  A fire station in Burlington, VT, began using a special industrial washing machine that extracts toxic chemicals from clothing, making it safer for firefighters to put it on again.  We can’t say it enough – thank you to all the firefighters.

Making Our Way Around the Country

TEXAS

The Texas Division of Workers’ Compensation (DWC) adopted amendments to the Texas Administrative Code on Self-Insurance.  It amends the definition of certified self-insurer, describes the Texas Department of Insurance (TDI) endorsement of the standard workers’ compensation policy required to withdraw from self-insurance with an insuring agreement, and provides the standards required of an insurance carrier seeking to assume workers’ compensation liabilities from a certified self-insurer withdrawing with an insuring agreement.  The newly adopted section also includes confirmation that the commissioner has discretion to review previously approved certified self-insurer withdrawals and modify the security deposit obligations.

FEDERAL

The U.S. Health and Human Services’ Pain Management Best Practices Inter-Agency Task Force (Task Force) released a new draft report examining opioid exposure and addiction.  The draft report, which proposes updates to best practices and recommendations for pain management, including chronic and acute pain.  The key findings of the task force are that pain management should be balanced, individualized, multidisciplinary, and multi-modal.  The report stresses the need for changes in the treatment of opioid-addicted patients.  Interestingly, the report discusses the unintended consequence of the 2016 CDC opioid prescribing guideline of the forced tapering or patient abandonment that many patients with chronic pain on stable long-term doses of opioid have experienced.  The Task Force is currently accepting public comments on the draft report until April 1, 2019.

ADA

The Queen Bee being sued for not having an ADA-compliant website is a good reminder to make sure your website is up-to-date.  Several federal courts have recently ruled websites are “places” of business much like stores and offices under the Americans with Disabilities Act (ADA), and therefore should have a website design that can accommodate the disabled.  So far the best guidance is that websites should be designed to comply with the Web Content Accessibility Guidelines (WCAG).  Now back to the Beyhive.