BILL ANALYSIS
Senate Committee on Labor and Industrial Relations
Mark DeSaulnier, Chair
Date of Hearing: March 24, 2010 2009-2010 Regular
Session
Consultant: Alma Perez Fiscal:Yes
Urgency: No
Bill No: SB 1213
Author: Cedillo
Version: As proposed to be amended
SUBJECT
Electronic access to claims information.
KEY ISSUE
Should a party to a case for workers' compensation benefits be
provided with electronic access to the party's data contained
within the Electronic Adjudication Management System (EAMS)?
Should this access be provided at no cost to the party
requesting this access?
PURPOSE
To stipulate how the Division of Workers' Compensation is to
make information pertaining to a workers' compensation claim
available to parties of a case.
ANALYSIS
Existing law establishes a workers' compensation system,
administered by the Administrative Director (AD) of the Division
of Workers' Compensation (DWC), to compensate an employee for
injuries that arise out of, or in the course of, employment.
Employers are required to secure the payment of workers'
compensation for injuries incurred by their employees. Workers'
compensation insurance provides six basic benefits which include
medical care, temporary disability benefits, permanent
disability benefits, supplemental job displacement benefits or
vocational rehabilitation and death benefits.
Existing law provides that a person or public or private entity
who is not a party to a claim for workers' compensation benefits
may not obtain individually identifiable information, as
defined, that is obtained or maintained by the DWC on that
claim, except as specified. The administrative director of the
DWC is required to adopt regulations allowing reasonable access
to individually identifiable information by specified agencies,
persons, or public and private entities for specified purposes.
However, existing law does not exempt from disclosure any
information that is considered to be public record pursuant to
the California Public Records Act.
This Bill would require the division to provide a party to a
claim for workers' compensation benefits with single sign-on
portal real-time electronic programmatic access, at no charge,
to the party's data contained within the Electronic Adjudication
Management System (EAMS). This bill also makes several findings
and declarations pertaining to the benefits of technological
advancements and government transparency.
COMMENTS
1. Need for this bill?
The intent in implementing the EAMS project was to better
serve injured workers and employers by creating efficiency in
the system and allowing the division to move away from the
burden of paper files. The original vision for EAMS was to
provide all case parties with electronic access to the system
via a logon and password, which gives parties access to the
documents in DWC's case file to which they are a party, as
well as electronic forms and other case data. Currently, there
are over 260 external filing locations (260 user licenses)
that have access to EAMS and are filing all their forms and
documents electronically.
Implementation of the project, however, has not come without
difficulty. In 2009, the Committee heard from stakeholders
Hearing Date: March 24, 2010 SB 1213
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Senate Committee on Labor and Industrial Relations
regarding concerns with EAMS, in particular, with the lack of
access that all parties to a claim need, and should have, when
working on a case. In discussions with DWC staff, the
Committee was able to learn of both successes and continued
challenges facing the division as they move towards full
implementation, among which are the limited number of licenses
available to access the EAMS system. Because of the limited
number of licenses, the system does not allow enough external
users to access the system and most must rely on physically
going to the DWC to request the necessary information. This
bill would expedite the completion of EAMS by requiring that
the division provide a party to a claim with single sign-on
portal real-time electronic programmatic access, at no charge,
to the party's data contained within the system.
2. Background on EAMS :
Beginning in August 2008, the DWC launched the web-based
Electronic Adjudication Management System (EAMS) designed to
simplify and improve the division's case management process.
The goal of the DWC in implementing EAMS was to better serve
injured workers and employers by eliminating stress associated
with maintaining paper files and to help guide policy decision
to better distribute resources.
The primary objectives for the new system included:
Streamlining the process of creating files, setting
hearings, and serving decisions, orders and awards;
Improving access to case records while preserving
confidentiality;
Providing cost and time savings to parties to a case
and to the State;
Reducing delays and eliminate duplication;
Reducing file storage space and shipping costs;
Standardizing the DWC desktop computing environment
across all units; and
Supporting enforcement against uninsured employers.
Implementation of EAMS took place in two stages:
1. The system went live for internal users, which
included DWC and Workers' Compensation Appeals Board
employees at DWC administration and district offices, on
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Senate Committee on Labor and Industrial Relations
August 25, 2008.
2. The division is bringing external users, those who
need to file forms and documents with the district
offices and the Workers' Compensation Appeals Board
Reconsideration Unit, into the full electronic system
over time. The goal of the DWC for phase II is to allow
access to the electronic case file through issuance of
logons and passwords.
As previously mentioned, the lack of sufficient licenses to
access EAMS has greatly limited the number of external users
who can have access to their files online. A 2009 Special
Project Report on EAMS, states that it would cost $30 million
to $60 million to buy 9,000 to 29,000 additional licenses, at
a cost of $1,212 each, in order to expand access to EAMS and
purchase an additional 115 servers to handle the increased
flow of data over the Internet. EAMS has exceeded its
original $36 million general fund appropriation. To date, the
DWC has spent approximately $55 million as a result of
additional funding needs to maintain EAMS and to address
concerns of accessibility to the system by the workers'
compensation community.
3. Amendment :
The author will be submitting the following amendment in order
to clarify that the bill seeks to require the division to
provide a party to a claim with access to the party's data
only.
"(e) Notwithstanding any other provision of this chapter, the
division shall provide a party to a claim for workers'
compensation benefits with single sign-on portal real-time
electronic programmatic access, at no charge, to the party's
data and any public records contained within the Electronic
Adjudication Management System (EAMS)."
4. Proponent Arguments :
According to proponents, the EAMS project, while relatively
well conceived by the Department of Industrial Relations, has
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Senate Committee on Labor and Industrial Relations
been mismanaged and over budget since inception. Proponents
support the concept of moving towards a paperless system and
continue to work with the DWC to make EAMS fully functional;
however, they argue that faulty design and planning, as well
as limited resources, have complicated implementation of EAMS
and is causing costly delays for employers, further suffering
for injured workers, and exasperation and frustration for all
parties seeking to resolve disputes.
Proponents contend that the DWC has spent approximately $55
million so far on EAMS, and the program has yet to extend
beyond the pilot stage. Further, they argue that only
Workers' Compensation Appeals Board judges and staff, and
approximately 300 external user locations, have the ability to
use EAMS as it was originally intended. Even these
participants, proponents claim, continually encounter problems
that are being resolved on a case by case basis. Proponents
argue that the many thousands of external users, i.e., law
firms, insurance companies, self-insured employers,
third-party administrators, injured workers, and lien
claimants, still must rely on a combination of paper documents
and EAMS filing requirements.
According to the proponents, this bill opens up EAMS to all
users of the Workers' Compensation system in order to fulfill
the goals of efficiency, expediency and elimination of
redundancy. In addition, proponents argue that this bill keeps
privacy protections in place and maintains that all case
information that is statutorily required to be kept
confidential will be accessible only to authorized users in
accordance with the law.
5. Opponent Arguments :
According to opponents, the EAMS system has been under
development for several years and has encountered significant
problems which are typical of a large computer project and
conversion. Some opponents believe that access to online
information is convenient but not critical and they contend
that the cost involved in providing the proposed access will
be significant. Opponents argue that this bill implies that
the people accessing the system would not need to pay for a
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Senate Committee on Labor and Industrial Relations
license and that the employer community, which is paying for
the development of this very costly system, is going to pick
up the costs for this additional access.
Opponents argue that in 2009, overall assessments, including
the one for DWC support, for self-insured public employers
increased 81% over the prior year. Moreover, they argue, these
employer-paid assessments have already included an estimated
$50 to $70 million to implement the current EAMS program and
this bill would require even higher assessments to sustain the
proposed new levels of access and service. Opponents believe
that in light of the harsh economic times that both public
entities and private businesses are facing on a daily basis,
these types of nice but nonessential projects should be put on
hold until there is money to fund them without taking away
from other vital public services and jobs.
Lastly, opponents are concerned that the provisions of this
bill would give hundreds of thousands of users on-line access
for whom the system was not designed and this could, in fact,
cause the entire system to collapse. Opponents contend that
as recently as last year, there were questions about whether
EAMS could support the number of external access on-line users
envisioned in the original plan. In summary, opponents feel
that this bill is premature and any efforts to expand access
to the system should be implemented through the technology
development process rather than the legislative process.
SUPPORT
Hanna Brophy Law Firm (Sponsor)
California Applicants' Attorneys Association (CAAA)
California Nurses Association/National Nurses Organizing
Committee (CNA/NNOC)
California Society of Industrial Medicine and Surgery (CSIMS)
California Society of Physical Medicine and Rehabilitation
(CSPM&R)
VQ Orthocare
OPPOSITION
Hearing Date: March 24, 2010 SB 1213
Consultant: Alma Perez Page 6
Senate Committee on Labor and Industrial Relations
Association of California Insurance Companies (ACIC)
California Association of Joint Powers Authorities (CAJPA)
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Hearing Date: March 24, 2010 SB 1213
Consultant: Alma Perez Page 7
Senate Committee on Labor and Industrial Relations