California Gets a Jump on Health Coverage Expansion

Normally this blog focuses on workers’ comp and workplace health and safety, but the ongoing healthcare debate in California and nationally is front page news almost every other day it seems. And we thought the following report would be of interest to all employers and employees living and working in Golden State.


John M. Gonzales, CHCF Center for Health Reporting

Posted: 06/23/2012 04:12:21 PM PDT

As the Supreme Court nears a decision on health reform this week, more than 360,000 Californians are already receiving medical coverage under a state-administered precursor to the landmark legislation.
But they could find their coverage fleeting if the so-called Affordable Care Act has no future.

The effort, dubbed “The Bridge to Reform,” is part of a sweeping Medicaid expansion unfolding in California. It exists to usher patients to health reform’s planned implementation in 2014.

Bridge to Reform patients are receiving care in 47 participating counties in the state, from Del Norte near the Oregon border, to San Bernardino and Los Angeles.

Bridge to Reform Healthcare enrollment figures by county in CaliforniaSan Bernardino County has 7,807 patients receiving care through the program, according to state enrollment records. Los Angeles County has 137,557 in the program.

California Department of Health Care Services spokesman Norman Williams said even if the Supreme Court renders the Bridge to Reform a bridge to nowhere, just building it has been of value to the state’s health care apparatus.

“Health care delivery infrastructure at the local level is being improved as a result,” he said.

But Williams offered no promises if the U.S. Supreme Court strikes down health reform in opinions expected this week.

The justices could invalidate all or parts of the law, and the Medicaid expansion is among the pieces in jeopardy.

The state department of health care services “does not anticipate seeking other funding,” if the Medicaid expansion is cut down, Williams said.

Continue reading California Gets a Jump on Health Coverage Expansion

Awareness Key To Preventing Injury Among Young Adults Working Summer Jobs

logo for young worker summer job safetyBy 20/06/2012 10:34:00

Many states, like Ohio, make concerted efforts to remind employers and young adults that hazard awareness can reduce the chance for injuries among youth working summer jobs. The state is offering several resources for employers seeking summer help and young workers, whose lack of experience and training can contribute to workplace injuries.

“Summer brings job opportunities for Ohio’s young adults to earn money and develop skills they will carry with them when they enter the job market fulltime,” said BWC Administrator/CEO Steve Buehrer. “There are often hazards lurking that young adults may not consider, and employers may not take the time to explain to temporary or part-time workers. As with any employee, training will better equip youth workers to perform their jobs and return home injury-free at the end of their shift.”

Young adults may be at higher risk for work injuries for a number of reasons, from reluctance to ask questions, to assuming tasks they are either unprepared or incapable of performing safely.

BWC offers a young adult tool kit listing resources that can help young adults prepare for their summer jobs. The tool kit reviews possible risks involved in typical summer jobs and provides simple guidance to injury prevention. There are also tool kits for parents, employers and educators.
The kit includes the Occupational Safety and Health Administration’s job safety wheel, which reviews hazards associated with specific jobs in construction, food service, farm work, landscaping, life guarding and parks and recreation.

The National Safety Council recognizes June each year as National Safety Month in a campaign to promote the importance of safety to reduce unintentional injuries and deaths.

OSHA Inspections Save Companies 26 Percent in Workers Comp Costs

By ReduceYourWorkersComp 15/06/2012 09:30:00

Inspections Increase Safety and Save Money

A recently published study in the journal Science notes that American companies can effectively employ safety procedures without seeing a negative impact when it comes to sales or profits.

According to a report from The Associated Press, the study focused for a decade on hundreds of California employers that had been subject to random safety inspections. Research showed that those employers who were inspected decreased their injury claims by nearly nine and a half percent compared to those businesses that were not inspected.

The same employers on average saw savings of some 26 percent (approximately $355,000 in injury claims and compensation for paid lost work over the next four years) when compared with similar businesses that did not receive visits from inspectors.

Random Inspections Prove Effective

The study was based on an analysis of 409 California single-location businesses in industries, including woodworking and metalworking that had large injury rates and were inspected by that state’s OSHA body from 1996 through 2006. The authors reportedly looked at California because the state’s safety agency conducted some inspections based on random selection, as opposed to just focusing on targets of complaints.

An official with the AFL-CIO labor federation noted the results indicate that OSHA is effective in promoting safe workplaces.
Despite the positive numbers, critics of OSHA have stated that the agency would be better served spending fewer resources toward inspections and applying more attention to voluntary safety programs.

Author Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  Contact: 

Close Is Not Good Enough in OSHA Compliance

man's hand on horseshoe near the pinBy ReduceYourWorkersComp 13/06/2012 09:00:00

Injuries Require Multiple Government Forms

When a compensable injury occurs, several forms are nearly always required in New York. One is the Workers Comp Board Form C-2 and a second is OSHA’s Form 301 (300-A and 300). The same person often completes these forms on the same day.

Through repetition, it is quickly learned that information on the much fuller C-2 also contains the same information needed to complete OSHA Form 301. These two similar forms are leading to OSHA problems.

OSHA states that many people think that compliance can be met, and employer time and effort saved, by simply sending the C-2 to OSHA instead of completing Form 301. Why not? The required information has been provided, right?

OSHA is Not Workers Comp, Creating Non-Compliance

Wrong. The statutes are different. OSHA is not workers comp. Each has its own law and its own requirements. And each collects and stores information in different ways, for different purposes and with different time limits. Why invite a struggle by using one form for two different laws?

In practical business situations, “close is good enough” usually works for private parties, but it almost never works in dealing with government agencies – which is why this is being written.

In doing research on OSHA, your author had occasion to speak to a New York OSHA official who stated that the most common problem he saw, and he saw it quite often, was many NY employers send OSHA comp C-2s instead of OSHA forms. Computer memories are not nearly as forgiving as human memories and soon enough the employer is creating a record for non-compliance with a federal law.

OSHA, eventually, straightens the problem out – but why put it to the trouble? Fill out ALL the correct forms.

Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100.

Nine of 10 Californians under 65 will be covered under Affordable Care Act, says new Labor Center/UCLA study

By Public Affairs, UC Berkeley | June 14, 2012

Nine out of 10 Californians under the age of 65 will be enrolled in health insurance programs as a result of the Patient Protection and Affordable Care Act (ACA), according to a joint study by the UC Berkeley Center for Labor Research and Education and the UCLA Center for Health Policy Research.

Between 1.8 million and 2.7 million previously uninsured Californians will gain coverage by 2019, when the law’s effect is fully realized, the researchers said.

The report, which uses a sophisticated computer simulation model to project the ACA’s impact on insurance coverage, comes as the U.S. Supreme Court prepares to issue its ruling this month on the constitutionality of the law.

Under the ACA, more than a million Californians with the lowest incomes are set to become eligible as of 2014 for affordable health coverage through an expansion of Medi-Cal (the state’s Medicaid program), while several million more residents from low- and middle-income families will be eligible for subsidies through the new California Health Benefit Exchange, making their coverage more affordable.

Specifically, the researchers project that an expansion of Medi-Cal will result in between 1.2 and 1.6 million new enrollees, while between 1.8 million and 2.1 million state residents will enroll in subsidized coverage through the exchange.

“If the Affordable Care Act is upheld by the Supreme Court and fully implemented, it will significantly expand access to affordable health coverage,” said Ken Jacobs, chair of the UC Berkeley Center for Labor Research and Education and the study’s lead author. “Based on our simulation, millions of Californians stand to gain, either through insurance they wouldn’t otherwise have or from more affordable premiums and increased benefit standards.”

Continue reading Nine of 10 Californians under 65 will be covered under Affordable Care Act, says new Labor Center/UCLA study

Too Much of a Good Thing?

Can Too Much Exercise Be Harmful?

skeleton on an exer-cyclw

By Kathleen Doheny
WebMD Health News

Reviewed by Brunilda Nazario, MD

June 4, 2012 —

“Chronic extreme endurance efforts, like marathons, ultra-marathons, and long-distance triathlons, can cause cardiovascular damage over time,” says researcher James H. O’Keefe, MD, director of preventive cardiology at the Mid America Heart Institute at St. Luke’s Health System, Kansas City.

“Healthier exercise patterns involve not such extreme duration or intensity,” he tells WebMD.

His multi-study review is in Mayo Clinic Proceedings.

In another study, researchers found that running at moderate speeds was linked with a lower risk of death from any cause compared to no running. More intense running didn’t yield additional benefit.

That study was reported Saturday at the American College of Sports Medicine annual meeting.

The message is not to fear exercise, but to practice moderation, say O’Keefe and Carl “Chip” Lavie, MD, medical director of cardiac rehabilitation and preventive care at Ochsner Health System, New Orleans. Lavie was involved in both the review and the running study.

“What we don’t want to lose sight of is: People who exercise do better than people who don’t exercise,” Lavie says.

Hot Rumors: The Future of Workers Compensation

cartoon of a rumor being spreadMany sources we check daily have discussed how the future of how workers compensation will be handled, since many states have revamped the way benefits are handled and how they are paid.

For example, in Michigan the employer previously could control where the claimant was treated for 10 days. After the 10 day period, a claimant was open to treat with anyone of choice, provided that the doctor abided by certain rules. Now, this has changed from 10 days to 28 days. This change is huge, since it adds on another 18 days worth of controlling where the claimant can treat. Since most minor injuries resolve within a few weeks anyway, this statute change was seen as a way for employers to retain more control over the outcome of the workers comp claims. Many other states are following this precedent, making the workers comp system more defense-oriented, and cost effective.

Here are a few more things the industry rumor mill is buzzing about:

Workers Compensation preferred provider networks
Similar to personal medical networks, the workers comp medical payment system has largely abided by the rule of preferred pricing for workers comp services. Seen as “cost containment,” this provides insurers with an incentive to send the injured employees to certain hospitals and clinics at a discounted rate usually run by ICD-9 codes. For example, a routine doctor visit may usually cost about $100, but if this clinic is in a preferred medical network, it may only cost $60 to the insurer.

The downside to this is the medical industry has to slash rates lower and lower tries to become more competitive. Insurers will often make these medical networks bid against themselves in order to try and find the cheapest rate with the medical facility having to scramble to find ways to reduce costs. For example, some clinics have used Physician Assistants instead of actual MD or DO physicians for minor injuries in order to reduce appointment cost. Other discounts include reduced rates for physical therapy, durable medical equipment, patient transportation services, diagnostic tests, and so on.

Continue reading Hot Rumors: The Future of Workers Compensation

And You Thought Walking UNDER a Ladder Was Bad Luck!

man on ladder that's on top of a ladder
Watch your steps

Per the Occupational Safety and Health Administration (OSHA) there were 774 deaths among construction workers on the job in 2011. Falls accounted for 264 fatalities and were the leading cause of death for construction workers. The sad part is most of the fatalities could have been prevented with proper construction site safety. Falls also cause numerous non-fatal injuries. With proper fall prevention incorporated into the safety program, a significant portion of the non-fatal accidents on constructions sites could be avoided as well.

The risk of a fall is presented whenever employees are on an elevated surface – ladders, scaffolds, bridges or roofs.  Employers need to recognize the potential dangers involved and plan the work in a way that will allow its completion while reducing the risk of injury. This includes determining what safety equipment is needed and how it will be used to prevent the possibility of a fall.

OSHA regulations require any worker six feet or higher above the lower level to have “personal fall arrest systems”.  These could include a safety harness or a system of railings around the edges of the work surface to keep the employee protected from the edge and a fall.

The employer needs to be conscientious to provide the right equipment for the job. Ladders that are too short, scaffolding that has seen better days, or worn out safety gear is an invitation to a workers’ compensation claim. The equipment and gear provided to the employees should be appropriate for the job.

Planning the work with safety in mind and providing the proper safety equipment will not prevent injuries if the employees do not know how to use it correctly.Employers often take it for granted that employees know how to use ladders or scaffolding, but improper use of equipment is the most common reason for accidents.

When working at heights of six foot or higher, the most effective “personal fall arrest systems” is a full body harness, a rope-grab lifeline, and connectors. The full body harness uses D-rings to connect the body harness to the rope-grab lifeline. The rope-grab lifeline is securely attached to the roof, scaffolding or other surface that is structurally strong enough to support the employee’s full weight in the event of a fall.

Fall prevention on construction sites will save the employer significantly on the cost of workers’ compensation insurance, as fall prevention will lower both the frequency and severity of the accidents that do happen. By planning the job, providing the right equipment, and training the employees on the its proper use, employers can eliminate most falls, save lives and reduce the number of injuries.