The Brief

Jen Egan is still dealing with the aftermath of the Palisades Fire that damaged the home of her 83-year-old father, Paul, last January.

That has meant more than a year of going back and forth with State Farm, which has assigned three different claims adjusters to their case. Egan also hired a public adjuster to help her navigate the process, who she says has been a “saving grace.”

Egan and her father have received some payouts and are preparing to make repairs to the home. But this week, they received an estimate for compensation that falls tens of thousands of dollars short of what Egan said they have already paid out of pocket to address a brush violation issued by the fire department, and to conduct soil testing.

She is growing more frustrated. “No one’s asking for a new jacuzzi,” Egan said. “We want my father to be able to return to a safe and habitable home.”

Stories like the Egans’ are all too common after last year’s deadly Los Angeles County fires. State Farm says it has paid $5 billion so far on more than 13,500 claims. But survivors express frustration over insurers’ poor and delayed communication.

State Farm customer Rebecca McGrew has no outstanding complaints about her claims after her Altadena home burned down — except that she was “drastically under-insured by hundreds of thousands of dollars.” Many others like her have realized — too late — that their insurance payouts won’t cover all of their rebuilding costs.

Survivors and community organizations that have formed after the fires have asked their local and state elected officials for help in dealing with these varied issues. Some of the bills introduced in response to survivors’ experiences include attempts to address the transparency and timeliness related to insurers’ handling of fire claims.

More stringent requirements for insurers

Senate Bill 876 is a wide-ranging bill that seeks to make various amendments to the state’s insurance code. They include getting insurance companies to share their disaster-recovery plans with the insurance department; doubling penalties from $5,000 to $10,000 for each violation of fair claims practices during declared emergencies; and requiring insurers to notify policyholders within five days when they’re assigned a new adjuster.

In addition, the legislation, proposed by new Senate Insurance Committee Chair Steve Padilla and sponsored by Insurance Commissioner Ricardo Lara:

• Expands policy limits for required payments for additional living expenses by 100% in case of a total loss. 
• Requires upfront, cash-value payments be made within 30 days of a contract to buy or rebuild a home. 
• Requires insurers to offer extended and guaranteed replacement cost coverage when writing policies.
• Applies building-code upgrade coverage at the time of a rebuild.  

“People need a sense, particularly when they face tragedy, that the underwriters they’ve relied on and paid into for decades, will want to help and not get in the way (of recovery),” said Padilla, a Democrat from Chula Vista, in an interview with CalMatters.

He acknowledged that the insurance industry will have objections to his bill, but said the companies know that they need to provide adequate coverage for the health of the insurance market.

Padilla is right about the industry’s opposition. “It appears these measures would worsen the current affordability and availability crisis for Californians just as we are starting to implement the Commissioner’s Sustainable Insurance Strategy to restore a healthy and competitive market,” said Seren Taylor, vice president at Personal Insurance Federation of California, in an email.

Lara’s strategy, which went into effect last January just days before the L.A.-area fires, aims to get insurance companies to start writing policies in the state again, especially in areas at high risk of fires. Many insurers had pulled back from the state in the past few years, complaining of increasing fire risks and state regulations that they said slowed down their ability to match prices to those risks.

Tornadoes and drones

Meanwhile, Senate Bill 877 would require insurance companies to provide claims-related documents to policyholders within 15 days. Co-authored by Democratic Sens. Sasha Renée Pérez of Pasadena and Ben Allen of El Segundo, the legislation would also require insurers to disclose changes to repair estimates, who approved them and why.

Senate Bill 878 would require insurers to pay interest of 20% annually if they fail to meet deadlines for claims payments. The bill, also written by Pérez and Allen, will compel companies to submit to the state’s insurance department a report, signed by a corporate officer under penalty of perjury, that shows the company’s compliance with prompt payments requirements.

In the Assembly, lawmakers plan to introduce bills that will “continue to make sure we have oversight (of insurers),” said Assemblymember Lisa Calderon, the Los Angeles-area Democrat who also chairs the Assembly Insurance Committee, in an interview. She said she expects bills to address strengthening and modernizing the FAIR Plan, as well as mitigation efforts for natural disasters.

She mentioned that California has to deal with fires, floods, earthquakes and, last year, something rare: “Last year, we had two small tornadoes in urban Los Angeles. I can’t remember another year when it’s happened.”

A large housing development near Pittsburg on Sept, 2, 2021.

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Anne Wernikoff

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CalMatters

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Calderon is trying again to regulate insurers’ use of drone images by introducing Assembly Bill 1559. Her similar effort last year passed the Assembly and made it through some Senate committees but ultimately didn’t advance. This year’s bill would require companies to notify consumers about when they plan to take aerial images of their properties; ban insurers from ending coverage based on drone images taken more than 180 days before sending notice of that decision to policyholders; and require companies to provide the images to policyholders, allowing them to dispute accuracy and to take action if needed before having their policies terminated.

“We’ve been hearing from consumers that they’ve been blindsided by these images that were inaccurate,” she said. “I believe homeowners should have the right to request an in-person inspection.”

She also intends to introduce legislation to implement recommendations from a forthcoming report about the California Wildfire Fund that she expects to include provisions related to the availability and affordability of property insurance in the state.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

U.S. Health Secretary Robert F. Kennedy Jr. is pursuing federal government access to most Americans’ medical records, in a quest to research a link between vaccines and autism — a connection the medical establishment studied for decades and flatly rejects.

The Department of Health and Human Services is seeking data from little-known state systems that allow hospitals and clinics to exchange detailed, identifiable patient information, KFF Health News has learned.

In private meetings, some public health leaders have objected to giving Kennedy’s team access to such data, raising doubts that it’s legal or that the information would even be useful.

They have also expressed concerns about allowing the federal government to peer into the minutiae of Americans’ medical records, which could mean viewing anything from doctors’ notes to prescription history. HHS has offered no insight into how it will protect or handle the personal health information it obtains.

But Kennedy told KFF Health News that medical records are key to investigating the cause of autism, vaccine safety, and chronic diseases. And millions of dollars in grant money has poured into a Nebraska nonprofit that has assisted Kennedy’s effort, according to state records.

He and his advisers have been frustrated that federal access to Americans’ medical records has been limited.

“We need a good health record system, and one of the things that really surprised me most when I came into office is that there is — that the systems are broken,” Kennedy said in a May interview. “We’ve had to go to the states and, luckily, we’ve got a lot of cooperation from the states, but we now have databases together that we can actually do the studies on. Those studies are in motion.”

HHS has not publicly announced any new projects involving medical records and autism or vaccine research. Kennedy faced blowback last year when he proposed compiling the medical records of people with autism to create a federal disease registry — which health department officials later disputed was underway.

But Kennedy said in May, “We have a whole pipeline of studies that will be done over the next year.”

Though the White House has steered Kennedy away from further changes to U.S. vaccine policy ahead of November’s crucial midterm elections, President Donald Trump has regularly echoed Kennedy’s doubts about vaccine safety and last week signed an executive order calling for the U.S. to reduce the number of vaccines recommended for children.

Kennedy’s political appointees and allies — including William “Reyn” Archer III, a former Texas health official and vaccine critic whom Kennedy hired as a senior adviser — have led the initiative for the health department to collect and examine medical records.

Federal officials met with leaders of the state-run health information exchange systems several times over the past year and asked how the personal medical records they maintain could be used for vaccine research, according to seven people who participated in the discussions or were familiar with them.

Craig Behm, who runs the Maryland health information exchange, said Kennedy’s team asked about how the vast trove of medical records they store from hospitals and health systems could be used to study vaccines.

“If this administration wants to conduct research on the effectiveness of vaccines, are you saying you all can help us conduct that research?” Behm recalled being asked by a top official at HHS’ health information technology office.

Last June, Behm and leaders of other state exchanges met with Kennedy’s top advisers to discuss sharing more medical data with federal agencies. The state organizations followed up with a pitch in October for a new surveillance system that would give the federal health department “real-time, 24-hour data feeds on opioid and chronic disease trends” within a year, according to a presentation reviewed by KFF Health News. Under the proposal, HHS would get data from 90% of the population’s medical records by 2028.

Administration officials regularly asked during the meetings how the records could be used to monitor vaccine safety. Kennedy has rejected the federal government’s current vaccine-monitoring systems; decades of research has shown immunizations are safe and effective for most people.

“Vaccine safety, or whatever words you want to use, has come up pretty consistently in those conversations,” said John Kansky, CEO of the Indiana Health Information Exchange.

Kansky sees the potential value of sharing information from the exchanges for public health but is worried about the focus on vaccines: “It’s like, oh man, I wish you would have picked something that pushed fewer buttons for people.”

A system to monitor chronic disease

Nearly every state has at least one health information exchange — often regulated by state laws and run by private companies or nonprofits — that enables hospitals and health systems to immediately share patients’ medical records with one another. The systems allow doctors and nurses to quickly pull up nearly anyone’s medical history and records at emergency rooms or share after-visit summaries and notes with patients’ primary care providers, for example.

In certain circumstances — most often dealing with cases of infectious diseases such as measles or flu — the exchanges notify public health authorities, like the state health department or the Centers for Disease Control and Prevention. Using the exchanges for broader public health purposes is not an unusual idea in itself. But it can present privacy, legal, and ethical complications, health officials say.

In the end, Behm said his organization in Maryland declined to share more data with the federal government for vaccine research, noting that sharing medical records for that purpose would require a rash of approvals from hospitals, state political leaders, and research boards. Any new data-sharing agreement should also have a clear, detailed framework outlining what would be shared and with whom, he added.

“A number of us said, ‘We can’t do anything our agreements don’t allow us to do, so no,’” Behm said. Indeed, most health information exchanges have contractual restrictions on who can access clinical data.

Kansky said Indiana is still weighing whether to provide additional data for Kennedy’s project, and that nothing has yet been shared.

HHS spokesperson Emily Hilliard did not answer questions about how many states are participating in Kennedy’s project, what new data the agency is collecting, how much the federal government is spending on the initiative, how it is protecting patient privacy, or who has access to the data.

“HHS is strengthening public health surveillance and modernizing data systems to better understand and combat the childhood chronic disease epidemic as part of Secretary Kennedy’s Make America Healthy Again agenda,” Hilliard said in an emailed statement. “Americans deserve robust systems to monitor the drivers of chronic illness.”

Kennedy has asserted, without evidence, that vaccines can cause chronic illness.

A Kennedy partner in Nebraska

At least one state has been cooperative.

The former leader of Nebraska’s state health information exchange has led the effort to share data from medical records with the federal government.

Jaime Bland, former CEO of CyncHealth — the Nebraska health information exchange used by most hospitals and health systems in the state — said several states are looking to “open up channels” to provide more analysis to Kennedy’s team.

“They’re looking at the data differently and providing some insights back to the CDC,” Bland told KFF Health News.

Bland was among a group who proposed that CyncHealth would help kick off the initiative, according to a 43-slide PowerPoint presented to federal officials during an October meeting.

CyncHealth and other state health information exchanges would “ingest data from hospitals, clinics, laboratories, pharmacies, payers, and social services agencies,” then “link claims and clinical records through a master patient index.”

Data from the exchanges “will be deidentified where appropriate,” according to one slide.

The federal government would pay the exchanges for furnishing the records, according to the proposal: $3 a person, annually.

Officials would “frame publicly that this is not a new database, but a federated trust model that delivers real-time data for all HHS missions,” the presentation reads.

After the meeting, Nebraska’s health department was awarded a large grant from the CDC, and CyncHealth in turn got millions of dollars from the state.

On Dec. 19, the CDC announced new funding under its Epidemiology and Laboratory Capacity program, which sends money to state and local health departments for lab work, health information enhancements, and solutions for outbreaks.

Nebraska’s state health department was awarded $18.7 million — the most of any state last year, though Nebraska is the 38th most populous state. By comparison, Texas received $9.2 million, and California got $10.8 million.

CyncHealth was then awarded three contracts totaling $13.6 million from the state health department just weeks later, on Jan. 9 and Jan. 16, according to a publicly accessible database of state contracts.

Grace McNamara, a spokesperson for CyncHealth, said it retained $2.4 million of the funding for Kennedy’s project; the remaining money was distributed to “other participating states and various vendor organizations for implementation support.”

A former CDC official who was aware of the transaction, but not authorized to speak publicly about it, confirmed the money was intended for CyncHealth to supply data for Kennedy’s initiative to look at vaccines and autism. McNamara said that the “work is focused on improving outcomes related to acute and chronic illnesses.”

“The referenced project is not research, but rather a proof-of-concept project on how health information exchange and public health can work together to improve health outcomes and is not specific to autism,” she said in an emailed statement.

McNamara did not answer questions about what type of medical data is being provided to the federal health department or whether patients’ identifying information is removed.

Bland left her post at CyncHealth — where she was paid nearly $420,000 a year — in December. She was named in April as the chief data strategist for the MAHA Institute — a think tank founded by allies of Kennedy and Trump to advance their Make America Healthy Again movement.

Bland agreed with Kennedy that data from state health information exchanges could provide more insight into autism’s causes or vaccine injuries.

"The data is so fragmented, so modeled when it comes to population health and public health, that we lose sight of the individual stories,” Bland said. She told a story she had heard about a woman who had a seizure after receiving the HPV vaccine.

“You know, the vaccine is safe — it absolutely is — but it wasn’t safe for her,” Bland said. “As public health officials, we say the vaccine is safe. But there are cases where it is not.”

Daniel Jernigan, a former top CDC official who left the agency last summer, said he tried to point Kennedy to data that would help the health secretary study vaccine safety and autism.

After 31 years at the CDC overseeing public health surveillance, emerging infectious diseases, and the influenza divisions, Jernigan thought the solution was simple. The secretary could work with researchers to obtain huge databases pulled from health systems nationwide and maintained by major electronic health records companies.

Those databases are deidentified, meaning they don’t include patient names or other information that can identify individuals. Jernigan said Kennedy didn’t seem interested.

Instead, as The New York Times first reported, the health secretary dispatched two top advisers — Archer and Hannah Anderson, his former deputy chief of staff — to the CDC’s headquarters in Atlanta last July to download millions of identifiable patient records directly from the Vaccine Safety Datalink, the system the health agency uses to investigate complications from vaccines. The records, though, were decades old.

Jernigan said the federal government has limited legal authority to access medical records from state health information exchanges. In any case, examining those records may provide a view of a person’s medical history that will not necessarily produce answers to Kennedy’s questions about vaccines and autism.

“If they’re just using the electronic health record data, there are limits to that,” Jernigan said. “If they’re only looking at electronic health record data, all you’re going to get is what was captured in the encounter. It’s not going to be very satisfying.”

KFF Health News data reporter Maia Rosenfeld contributed to this article.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

This article first appeared on KFF Health News and is republished here under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

The California Supreme Court this week reversed the death sentence of a Los Angeles Bloods gang member convicted of killing a rival Crip in the early 1990s because a prosecutor compared him to a dangerous animal, the first time a death sentence has been overturned under the 2020 Racial Justice Act.

Anthony Bankston represented himself in court in 1991. A jury found him guilty. During the penalty phase of the trial, a prosecutor compared Bankston — appearing in a suit and tie — to a Bengal tiger at the zoo.

The prosecutor’s story was that a journalist observed a Bengal tiger in a zoo, and was told by a hunter “that’s not a Bengal tiger.” Instead, the journalist traveled to India, where he found a tiger, “all flexed out, he sees the claws out, he sees the fangs, . . . he hears the growl.”

The hunter tells him, “now you see a Bengal tiger.” The story was supposed to illustrate that Bankston in court was not the same person as Bankston on the street, whom the prosecutor described as “a killing machine.”

The California Supreme Court justices found that comparison prejudicial in a unanimous ruling with two concurrences. They reversed Bankston’s death sentence but the murder conviction still stands, meaning the high court sent Bankston’s sentencing back down to a trial court.

It was one of four decisions the high court released this week that stemmed from claims under the Racial Justice Act, which allows prisoners to appeal their convictions if they believe racial bias tainted their trials.

The court upheld death sentences for two of the men: Alex Demolle, who was convicted of raping and murdering an 11-year-old girl; and Marcos Esquivel Barrera, who was sentenced to death after being convicted of murdering two of his children.

In the fourth case, the court modified rulings against two condemned prisoners of Southeast Asian descent, but not because of their Racial Justice Act claims.

A spokesperson for the Judicial Council of California confirmed that Bankston’s case was the first reversal of a death sentence by the California Supreme Court because of violations of the Racial Justice Act.

According to the ruling in Bankston’s appeal, the Bengal tiger parable has come up several times in different cases, so much so that the high court called it a “well worn tale.”

In a 2010 case, the high court found that the Bengal tiger metaphor was not a prejudicial statement about a defendant’s Vietnamese heritage. In a 2018 case, a defendant said the Bengal tiger story was used to “dehumanize” him, an argument the California Supreme Court justices rejected.

But in 2020, the Legislature passed the Racial Justice Act, which included a prohibition on certain animal images that pose a risk of appealing to racial bias. The law itself specifically mentions the Bengal tiger example.

“In light of the passage of the RJA, we now make clear that, whatever the intent behind telling the story may be, the Bengal tiger story should no longer be told in California courtrooms,” Justice Leondra Kruger wrote for the majority. “There is no reason to permit prosecutors to continue running the risk of appealing to biases that undermine the very foundation of a system of equal justice, simply to make an unremarkable point about a defendant’s behavior outside a controlled courtroom setting.”

Comparisons of defendants to animals do not automatically qualify as violations of the Racial Justice Act. A case in the 4th District Court of Appeals this year found that comparing a defendant to a dog left in a car with a Slurpee was a fair comparison point to the notion of circumstantial evidence.

The Bankston ruling similarly noted that references like “eager beaver,” “happy as a clam,” “free as a bird,” or “quiet as a mouse” would not rise to the level of Racial Justice Act violations.

Bankston, who is Black, was convicted of two first-degree murder charges and one count of attempted murder for separate shootings in 1991. He was convicted of shooting and killing Benson Jones and attempting to murder Benson’s brother, Benjamin.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

Workers at SoFi Stadium started voting Thursday on whether to authorize a strike, just days before the World Cup launches in Los Angeles.

Some 2,000 unionized food and beverage workers at the stadium have been threatening to walk off the job for weeks over concerns about Immigrations and Customs Enforcement's role in tournament security and other demands, including premium pay for lucrative events like the World Cup.

But they've yet to strike a deal with Legends Global, the company that runs the stadium's bars and food services.

" I think the combination of the World Cup being unable to get their stuff together and the greediness of the stadium owners may end up leading to workers having to call for a strike," said Kurt Petersen, co-president of the union representing SoFi workers, Unite Here Local 11.

The contract between Legends and its workers expired last year, and the two sides are currently negotiating a new agreement. The union has been leveraging its role in the coming World Cup to push for higher wages, especially at mega-events like the World Cup that rake in major profits. Unite Here and Legends were at the bargaining table Wednesday, but Petersen said that they still hadn't made a deal.

Workers are also concerned that FIFA's plans for its luxury suites will lock them out of lucrative jobs during the tournament. FIFA has brought in a company called On Location to offer exclusive packages that can cost tens of thousands of dollars or more. Union workers at SoFi say they're worried that those jobs will go to subcontractors without union protections.

Petersen said that workers represented by his union still don't have their schedules for the World Cup, and that the union doesn't have details on the company's agreement with On Location.

" It is kind of a mess," Petersen said. "Which is also adding fuel to people's anger. Like, really? We have this massive event coming, you want us to work super hard and you can't even tell us what we're gonna be doing when we're coming in, what our schedules are?"

Legends Global did not return a request for comment.

SoFi workers have also been pushing for protections from ICE, which will play a "key role" in tournament security, according to the former head of the agency.

Multiple officials including L.A. County Sheriff Robert Luna have said they've received assurances that federal agents won't be conducting immigration enforcement, but Luna said there are no guarantees. Petersen said workers want the option to walk off the job if they feel unsafe because of ICE's presence.

Unite Here filed an unfair labor practice charge with the National Labor Relations Board in April, saying ICE's planned presence at the World Cup threatened the union's ability to collectively bargain. The union has also asked California Attorney General Rob Bonta to investigate FIFA's accreditation process for stadium workers, which requires Social Security numbers and other personal information.

FIFA responded in a statement saying that data would be deleted after the fact, and the accreditation process does "not constitute pre-employment checks."

The sporting body did not respond to a request for comment on how a strike at SoFi Stadium could potentially affect the eight matches in Los Angeles.

The results of Unite Here's strike authorization vote could be out as early as Friday evening. If workers vote yes, fans who attend the first U.S. match in Inglewood on June 12 could show up to a picket line.

The two sides are scheduled to return to the bargaining table on Monday.

This story first appeared on The LA Local.

Wilshire Boulevard between MacArthur Park and Lafayette Park will be transformed into a space featuring screenings of the World Cup games in July and vendors will have the opportunity to set up shop and sell their goods as part of the celebration.

Food vendors, artisans and performers interested in participating in the World Cup-themed event at MacArthur Park have less than a week left to apply for a spot.

Council District 1 is currently accepting applications for the two-day open streets event scheduled for July 10 and July 11.  Interested applicants can apply online here.

Applications are open through June 8. According to CD1, 26 applications have already been submitted for 40 available vendor spaces.

“Vendor interest has been strong,” said Jonathan Romero, a spokesperson for CD1. “Reflecting a great mix of food and drink, arts and crafts, and health and community resources.”

There are no application or vending fees to participate, though vendors must have a valid vending permit by the start of the event. 

For some MacArthur Park vendors, the event represents a potential opportunity to reach new customers during the World Cup.

Rabi Gaidani, a street vendor who sells clothing and shoes near MacArthur Park, said he had not previously heard about the Park to Park opportunity, but now plans to apply. 

“I would love that,” he said. “When the World Cup comes, it’s super good. We have more chances with people coming from all over.”

But not all vendors are convinced the opportunity will be accessible to everyone.

Another vendor, who sells shampoos, soaps and creams near MacArthur Park, said she was  unaware of the event. Her reaction reflects a frustration some street vendors say they have experienced for years: learning about city-sponsored events only after plans are already well underway. 

The vendor, who asked not to be named due to her immigration status, said opportunities often do not reach the people who work around the park every day.

She added that the organizations the city partners with do not directly reach out to vendors like her. 

Council District 1 says it is conducting outreach to businesses surrounding the park and working with community partners to promote the opportunity.

“I think they should improve how they select vendors,” she said.

She added that she worries the World Cup event could even draw customers away from businesses like hers, similar to what she says happens during large Guatemalan community celebrations in the neighborhood. 

She said people tend to gravitate toward wherever the festivities are taking place. 

“People want to go where the excitement is, where they’re showing the World Cup,” she said. “The World Cup isn’t going to bring us anything.”

More information about the event is available at cd1.lacity.gov/p2p.