Welcome to the WOEMA WINDOW, our e-newsletter sent to members by email on a monthly basis. The newsletter links to this page. Below are the items that appeared in the May 2017 issue.
- Join us in Congratulating and Thanking Dr. Paul Papanek
- Legislative Affairs Committee Update
- Western Occupational Health Conference 2017
- In Case you Missed It…
- Initiative for keeping Injured Workers in the Game
- Useful Resources for Occupational Health Professionals
WOEMA would like to send our warmest congratulations and give our sincerest thanks to Dr. Paul Papanek, the 2016 recipient of the Rutherford Johnstone Award Lecture. Dr. Papanek was presented an award honorarium which he has graciously donated to the Resident Scholarship Program. It is through the generosity of our donors and sponsors that WOEMA is able to continue the Resident Scholarship Program, an invaluable opportunity that sends highly qualified resident physicians to the Western Occupational Health Conference (WOHC). Every year WOEMA receives applications and examples of study and research from across the nation from leading OEM residency programs. The top contenders are then invited to WOHC to present their research as posters before a panel of judges. The top candidates are awarded first and second prize and their projects published in WOEMA’s monthly newsletter.
The Resident Scholarship Program remains an important part of our annual health conference. Not only does it foster the growth of tomorrow’s leading OEM physicians, but it also gives our residents the chance to meet and network with established Occ Med physicians and possible future employers. Many of our residents have gone on to work as directors of major health systems, consultants, or professors imparting their knowledge to the next generation of OEM professionals – and many are actively involved in WOEMA whether serving on the Board of Directors, on one of WOEMA’s many committees, or helping to plan the next WOHC!
May 5, 2017
The California Department of Workers’ Compensation (DWC) held a public hearing in Oakland on May 1st to accept oral testimony and written comments on the proposed formulary regulations. Details on the Medical Treatment Utilization Schedule (MTUS) Formulary can be found on the DWC website. The DWC submitted the application to serve on the Pharmacy and Therapeutics committee, which will consist of a medical director, three physicians, and three pharmacists. There is no submission deadline, and it is too early to apply, as the rules are not yet finalized.
AB 578 (Gonzalez-Fletcher):
Already opposed by WOEMA, AB 578 was amended to prohibit permanent termination of disability benefits based on pregnancy.
AB 1316 (Quirk):
Proposes that it be required for every child to be screened for lead levels, was amended to require a new standard of care in California for pediatric lead exposure to be at least as strong as the federal standard; children would only be tested if their physician follows that standard of care and identifies the child as being at risk. The committee will read the amended version before deciding on a position.
SB 419 (Portantino):
SB 419 was originally written to prohibit oxycodone prescriptions to minors, was amended to require education if prescribing to minors. The CMA opposed it. The bill is finished for the year, becomes a two-year bill.
American Healthcare Act:
The committee reported that there will be a large effort to lobby the U.S. Senate for better language in the proposed American Healthcare Act. The issue for WOEMA: how to frame its prevention effort as allied to coverage for pre-existing conditions.
The committee discussed the idea that WOEMA or ACOEM consider developing an opioid dashboard for occupational and environmental medicine to track various threads including treatment guidelines, policies, benefits, coding, formularies, resources, and various implementation in different states, perhaps helpful in encouraging a coordinated approach to advocacy and to push some states toward implementation. ACOEM could prepare the dashboard; WOEMA and other components would be its users.
The committee discussed the issue of the standard for work related lead exposure, a renewed interest for several WOEMA members, wondering what is happening with Cal/OSHA. A possible meeting with Director Christine Baker was suggested. The committee decided to have an internal discussion to decide on next steps.
May 12, 2017
The DWC invited some of the leaders in the industry to further discuss the drug formulary roll out. The focus of the meeting was to discuss some of the concerns raised in the last public hearing on May 1, 2017. The two main concerns were the July 1st roll out date and the format of the formulary. The DWC will consider the option of the formulary being finalized in July 2017, but to be implemented in January 2018. The current suggested format includes preferred/non-preferred lists with an additional column stating whether the drug is recommended/not recommended per the ACOEM guidelines. This is confusing to providers as the preferred list is not always the recommended medication, and many representatives at the meeting recommended removing the recommended/non-recommended column. The WOEMA Leg Committee reports that another iteration of the regulations will be issued before July, with a 15-day comment period. At the DWC meeting it was also suggested that there would be some benefit if the drug formulary and SB 1160 UR reform regulations became active at the same time.
The Legislative Affairs Committee discussed the recent budget revision proposal by the California governor. With the passing of the new proposition 56 in California (increased tobacco tax by $2), a discussion will be continued as to where the newly raised tax fund will be utilized. The revision may be a concern for providers, as a portion of the fund was initially going to assist in medical reimbursement, but the new revision would transition the tax fund towards assisting in providing healthcare for low-income families. More to follow.
SB 1160 (Bradford):
SB 1160 looks at creating report cards for WC providers. WOEMA supports this bill, while a few legislative committee members will work on amending the bill. The challenge is to create a monitoring system that would best reflect the management of workers compensation claims by the providers. Further discussion to be held.
SB 772 (Leyva):
The committee continued its discussion of the Cal/OSHA lead standard and the slow regulatory process, which has been slower in the last five years by the addition of the Standardized Regulatory Impact Assessment process (SRIA). The SRIA process, in which pending regulations are sent out for an analysis of their economic impacts prior to adoption, now adds more than a year to the process. A new bill, SB 722, proposes to eliminate the SRIA process when the proposed regulations involve worker safety. It was noted that the economic impacts of Cal/OSHA regulations get studied at several other steps in the process. The WOEMA Legislative Committee will be recommending a Support position on SB 772, which is backed by organized labor.
Post-Grad Sessions: Thursday, September 14
- AMA Disability Text: Real World Examples & Case Discussions of Disability, Impairment, & Return to Work (PG-1)
- Power Ortho – Everything You Ever Wanted to Know About Orthopedics but Were Afraid to Ask (PG-2)
- How to Excel as an Independent Medical Evaluator: Secrets to Success (PG-3)
Special Events & Receptions:
- WOEMA Signature Event: Tastes of Polynesia* • Friday, September 15
WOEMA invites you to join us for our Signature Event, Tastes of Polynesia. You’ll enjoy a fresh farm-to-table meal sourced from local Hawaiian producers, have an opportunity to taste local liquors, learn how to make a lei, and meet with local crafters to learn about the local traditions of Hawaii and the Pacific Islands, all while enjoying local music and a gorgeous 180° view of the Pacific. Let us show you the way of Aloha!
*Advance ticket purchase required
Earn FREE CME credit while touring the Hawaiian National Guard Civil Support Team (CST) Headquarters on the Island of Oahu.
Wednesday, September 13 • 8:00 am – 1:00 pm
Resident Scholarships and Poster Competition:
WOEMA invites resident physicians to apply for scholarships to attend WOHC and to present posters or projects on occupational and environmental conducted research. A panel of judges will award 1st prize ($250) and 2nd prize ($150) to the top presenters. Deadline to submit an application is June 30th!
The California Medical Treatment Utilization Schedule: The New Guidelines and Formulary
Presented by: Raymond Meister, MD
Doctors in California’s workers’ compensation system are required to provide evidence–based medical treatment. The Medical Treatment Utilization Schedule (MTUS) provides this evidence-based framework for the evaluation and treatment of injured workers. It includes a set of guidelines covering which treatments are effective for most work–related injuries and illnesses as well as a method for providing care outside of the MTUS treatment guidelines. Additionally, this presentation will cover the MTUS Formulary that was recently submitted for public comment. Use of the MTUS is not only required by law, but will facilitate the approval of your treatment plans and improve outcomes for your patients.
by Troy Ross, MD, MPH, WOEMA Newsletter Committee Chair
Workplace injuries are a challenge on many different levels. The first issue to be dealt with is: “Does the employee need first aid or medical care?” Without dedicated medical personnel available on-site, the call to protect the worker often leads to minor injuries being sent for formal medical evaluation. This causes lost work time, increased costs, and disruption of productivity.
WorkPlace Medical Services (WMS) offers a solution to this common occurrence. This innovative Northern Nevada company has teamed up with the Regional Emergency Medical Services Authority (REMSA) to offer employers a better option. WMS, with its experienced occupational medicine physicians, and REMSA, as a premier provider of emergency medical services, now provide 24 hour per day on-call/on-site first aid service to Northern Nevada employers.
Through this service, employers sign up to have access to immediate response by a team of community paramedics who will evaluate minor workplace injuries without having to take the employee off the job. Should there be a question of whether the condition requires more than the first aid standards established in protocol, a WMS physician is available for consult or the response team will transport the injured person to the appropriate medical facility.
People using the service are already giving positive feedback, and employer and insurance groups are showing great interest in expanding its reach.
More information can be found here:
Submitted by Steven Feinberg, MD, MPH, WOEMA Member
How does a medical professional stay current with trends in the Workers Compensation world? Bookmark the following links and check these resources regularly. They can help you to keep up with non-medical trends that impact your practice.