STATE OF CALIFORNIA Budget Change Proposal - Cover …web1a.esd.dof.ca.gov/Documents/bcp/1718/FY1718_ORG7350_BCP15… · STATE OF CALIFORNIA Budget Change Proposal - Cover Sheet DF-46

STATE OF CALIFORNIABudget Change Proposal - Cover SheetDF-46 (REV 08/16)

Fiscal Year Business Unit Department Priority No.2017-18 7350 Industrial Relations

Budget Request Name: Program Subprogram7350-100-BCP-2017-GB 6090 -DIVISION OF WORKERS'COMPENSATION

Budget Request DescriptionWorkers' Compensation Reform (SB 1160 and AB 1244)

Budget Request Summary

The Department of Industrial Relations requests 73.0 positions and $14,710,000 in Fiscal Year 2017-18 ($13.6million ongoing) from the Workers' Compensation Administration Revolving Fund to implement and meet theongoing requirements of Chapter 868, Statutes of 2016 (SB 1160) and Chapter 852, Statutes of 2016 (AB1244).

Requires Legislation Code Section(s) to be Added/Amended/Repealed

I Yes Bg No

Does this BCP contain information technology (lT) Department CIO Datecomponents? Ba Yes I No

If yes, departmental Chief Information officer must sign.

For lT requests, specify the project number, the most recent project approval document (FSR, SPR, SI BA,S2AA, S3SD, S4PRA), and the approval date.

Project No. 7350-088;089 Project Approval Document: S2AA Approval Date:

lfproposal affects anotherdepartment, does otherdepartment concurwith proposal? I Yes I NoAttach comments of affected department, signed and dated by the department director or designee.

Prepared By Date Reviewed By Date

Department Director Date Agency Secretary Date

•I]FF;fi liiTFTli lil I i I I r. I I [He]IE=I.Ill LT

Additional Review: I Capital outlay I ITCu I FSCU I OSAE I CALSTARS I Dept. of Technology

BCP Type: I Policy orkload Budget per Government Code 13308.05

PPBA OriginalSignedByEric Stern

Date submitt;d/t30.t;:+egiSlature

Analysis of Problem

A. Budget Request Summary

The Department of Industrial Relations (DIR) requests 73.0 positions and $14,710,000 in Fiscal Year2017-18 ($13.6 million ongoing) from the Workers' Compensation Administration Revolving Fund toimplement and meet the ongoing requirements of Chapter 868, Statutes of 2016 (SB 1160) andChapter 852, Statutes of 2016 (AB 1244). Please see Attachment I for a staffing request detailed bylegislation and function and Attachment ll for an overview of utilization review and other implementationelements.

B. Background/History

The Division of Workers' Compensation (DWC) monitors the administration of workers' compensationclaims, and provides administrative and judicial services to assist in resolving disputes that arise inconnection with claims for workers' compensation benefits. DWC oversees the administration ofworkers' compensation benefits to over 460,000 Californians who are injured on the job each year.One of DWC's core responsibilities is the administration of California's exclusive judicial system forresolution of work injury claims. DWC operates 24 courts from Eureka to San Diego (officially referredto as "Workers' Compensation Appeals Board District offices'') where industrial inJ.ury claims areresolved or litigated.

The workers' compensation system has undergone many changes through reform to improve thesystem including mandating the use of medical treatment guidelines and utilization review. OnSeptember 19, 2012, Governor Brown signed into law comprehensive workers' compensation reformlegislation, Chapter 363, Statutes of 2012 (SB 863), which was an effort to return to the principles ofrelatively certain defined benefits and relatively timely delivery of those benefits. SB 863 madenecessary corrections to permanent disability compensation and endorsed the use of evidence-basedmedicine by establishing Independent Medical Review, a process for resolving "appropriate medicaltreatment" disputes that leaves treatment decisions to medical experts. SB 863 also created a newdispute resolution process for medical billing disputes and attempted to correct the overburdened lienprocess.

Resource History(Dollars in thousands)

Program Budget 2011-12 2012-13 2013-14 2014-15 2015-16Authorized Expenditures 160,721 162,358 200,697 201,827 205,376Actual Expenditures 153,259 160,154 175,786 181,506 188,028

Revenues 130,382 212,507 269,666 254,330 240,423Authorized Positions 1,089.5 1,027.8 1,071.8 1,066.8 1,062.8

Filled Positions 936.1 959.4 940.8 953.3 953.7Vacancies 153.4 68.4 131.0 113.5 109.1

C. State Level Considerations

This proposal is not expected to impact other departments.

D. Justification

on September 30, 2016, Governor Brown signed into law Chapter 868, Statutes of 2016 (SB 1160) andChapter 852, Statutes of 2016 (AB 1244). SB 1160 was a reform bill intended to remove unnecessarylitigation from the workers' compensation system that was exposed by SB 863 reforms. SB 1160expedites medical treatment to injured workers within the first 30 days after their injury by exemptingconservative treatment from utilization review, standardizing utilization review procedures, modernizingdata collection in the system to improve transparency, and implementing anti-fraud measures in thefiling and collection of lien claims for medical treatment.

1

Analysis of Problem

AB 1244 addresses medical provider fraud within the workers' compensation system and creates a newadjudication, stay, and suspension process for dealing with convicted and indicted providers that havemedical lien claims within the system.

Of the positions requested,12.0 positions are needed to support three information technology projectswhich will help facilitate the necessary reform efforts: 1 ) Doctor's First Report of Injury; 2) UtilizationReview Management and Provider Suspensions; and 3) Consolidated Lien Proceedings. Of theremaining 61.0 positions, 50.0 positions are specific to the anti-fraud provisions of these two billsfocused on: 1 ) the work of the Anti-Fraud Unit; 2) Provider Suspension Hearings; and 3) Special LienProceedings.

Anti-Fraud Provisions of SB 1160 and AB 1244

Recent news stories, including coverage by the Center of Investigative Reporting, show that workers'compensation provider fraud is endemic -notably in Los Angeles County -costing stakeholders andthe system over $1 billion in liens that had accumulated in the system at the time of this writing. lnparticular, the current workers' compensation lien claim and litigation system has proven to be highlyexploitable by fraudulent medical providers.

Prior to the SB 1160, a medical provider who was indicted or convicted of workers' compensation fraudwould continue to collect liens arising out of the same fraudulent conduct. The liens could still beadjudicated through a litigation process in which the defendant (employer, insurer, or claimsadministrator) was required to prove fraud in each claimed service or billing under dispute. This in turnmade fraudulent claims cheaper to settle than litigate.

The anti-fraud provisions of SB 1160 address fraud in the following ways. Labor Code (LC) section4615 now requires that when prov.iders are being prosecuted in the criminal courts for fraud against theworkers' compensation system or related types of medical billing or insurance fraud, the liens of thoseproviders must be stayed pending the outcome of the criminal case. This requires research andanalysis to ascertain and track covered prosecutions and to identify all lien claims associated with acriminally charged provider and takes steps needed to implement the stay4. ln enacting this legislationthe Legislature declared:

• Despite prior legislative action to reform the lien filing and recovery process within the workers'compensation system, including SB 863 in 2012, there continues to be an abuse of the lien processwithin the workers' compensation system by some of the providers of medical treatment and othermedical legal services who have engaged in fraud or other criminal conduct within the workers'compensation system or who have engaged in medical billing fraud, insurance fraud, or fraudagainst the federal Medicare or Medi-Gal systems.

• Notwithstanding fraudulent and criminal conduct by some of the providers of medical treatment orother medical-legal services, those providers have continued to file and to collect on liens within theworkers' compensation system, while criminal charges alleging fraud within the workers'compensation system, or medical billing or insurance fraud, or fraud within the federal Medicare orMedi-Cal systems, are pending against those providers.

SB 1160 also amends LC section 4903.05 requiring liens for medical treatment to be accompanied by adeclaration signed under penalty of perjury affirming that the dispute is not subject to independent billreview, and verifying that the lien claim is supported by evidence and that the claimant is qualified to filethat lien. This will ensure there is support for any lien for medical services being filed, and that theprovider who actually rendered the service and incurred the cost will be the person or entity resolvingthe lien filing. This creates a need to design an electronic form and incorporate the requirement for thesigned declaration into the Electronic Adjudication Management System (EArnS), DWC's caseload,court calendaring, and workers' compensation tracking system.

I There is also a requirement that the names of providers whose liens are stayed be posted onto the division's website.

2

Analysis of Problem

1. DIR Antj-Fraud Unit

The Anti-Fraud Unit will serve as DIR's investigative and prosecutorial arm for provider suspensions,lien stays, and special lien proceedings. DIR attorneys and investigators will work collaboratively withother agencies that investigate and prosecute cases involving workers' compensation fraud. The unit'sinvestigative work will include data mining and analysis of over 100 million medical reports, bills, andcase filings within DWC's system, tracking external data, and reviewing court decisions.

LC section 139.21 requires providers be suspended (in effect, terminated) from the workers'compensation system upon conviction of certain crimes such as suspension from the Medicare orMedicaid programs due to fraud or abuse or loss of professional license. The Anti-Fraud Unit willidentify the providers who are subject to suspension pursuant to conditions specified in LC section139.21 (a), a process that involves communicating with prosecutors in 58 counties and 4 federaldistricts, reviewing and retrieving criminal case paperwork, and communicating with and reviewing andretrieving paperwork from the federal and state agencies that regulate participation in the Medicare andMedicaid/Medi-Cal programs or license health care professionals. The unit will provide DWC withdetails of providers subject to suspension. DIR's attorneys represent the department in appeals ofthese suspensions.

LC section 139.21 also provides a new process for adjudicating liens of those providers suspended dueto a criminal conviction. With the assistance of the data analytics team, the Anti-Fraud Unit will assist aspecial lien proceeding attorney by identifying all of the liens filed by or on behalf of the suspendedprovider, including those filed by or on behalf of any clinic, group or corporation in which the suspendedprovider has an ownership interest. This is a complex process of tracing lien claims, which may havebeen filed using different names and then assigned multiple times, back to the provider, as well asascertaining ownership interest, referral relationships, and the various ways a provider or clinic's namemay appear in the EArnS filing system. Ultimately, the unit and special lien attorney will compile amaster list of the liens to be consolidated, including a list of all the workers' compensation cases inwhich those liens were filed and all parties in those cases who may have an interest in the same lien.This list will be provided to the Chief Judge to assign a Workers' Compensation Judge (WCJ) anddistrict office to handle the special lien consolidation proceeding and then send notice to all parties ofthat proceeding.

Anti-Fraud Unit attorneys will be responsible for all proceedings related to the consolidation and speciallien proceedings and any related appeals. These duties include: defending against motions todeconsolidate liens filed by lien claimants, associated medical providers, and claims administrators andhandling any appellate activity related to those decisions; defending against challenges to the stay andconsolidation processes; filing and opposing declarations of readiness; coordinating and consulting withclaims administrators regarding individual liens; conducting discovery; defending against suspendedprovider's attempts to prove that individual liens do not arise from the conduct subjecting the provider tosuspension and handling any appellate activity related those decisions, and; handling consolidationlitigation before the WCJ including any appellate activity. Additionally, it is anticipated that the unitattorneys will handle constitutional challenges that may be raised in opposition to the special lienadjudication process as a whole.

The Anti-Fraud Unit will also be responsible for the following:

• Communicating with various state agencies and researching databases to determine if criminalcharges have been filed against any medical providers for purposes of implementing the stayprovisions of SB 1160;

• Tracking and reporting the status and disposition of the criminal cases against all charged providersand advising the Administrative Director (AD) accordingly so that SB 1160 lien stays can beimplemented and lifted as appropriate;

3

Analysis of Problem

Data mining the various DIR/DWC systems to identify all liens associated with the provider to bestayed under the provisions of SB 1160, dismissed, or consolidated under the provisions ofAB1244;

• Determining ownership interests of criminally-charged providers to determine if there are otherentities whose liens would be subject to either the stay provisions of SB 1160 or the consolidationprovisions of AB 1244;

• Researching and evaluating data to identify linkages between providers, medical groups, and billingentities, for purposes of determining whether those entities liens should be subject to the stay orconsolidation provisions;

• Researching providers' statuses and communicating and coordinating with various state agenciesto determine the existence of bases for potential suspensions, and advise the AD accordingly;

• Analyzing criminal convictions and assisting the special lien proceeding attorneys;

• Assisting the special lien proceeding attorneys in determining if a provider's bills and liens arerelated to the criminal conduct and in preparing for trial in lien consolidation proceedings;

• Identifying fraud within the system, tracking data, and reviewing court decisions;

• Serving as DIR's contact point with other agencies and stakeholders on fraud issues, for purposesof sharing da fa and information, and referring cases based on data analysis for criminalinvestigation; and

• Reviewing medical bills, medical reports and other investigative techniques to confirm the existenceof possible criminal violation surfaced by the use of data analysis.

2. Provider Suspension Hearincis

As mentioned above, the addition of LC section 139.21 in AB 1244 requires the AD to suspendproviders from participating in the workers' compensation system if they have been convicted of fraudor abuse of the workers' compensation system, the Medi-Cal or Medicare programs, any patient, orrelated crimes pertaining to these programs, patient care, or their professional qualifications and duties.LC section 139.21 also requires the AD to suspend providers who have been suspended due to fraudor abuse from the federal Medicare or Medicaid programs, or whose license, certificate, or approval toprovide health care has been surrendered or revoked.2

It is estimated that more than 800 providers are subject to suspension under AB 1244. Afterappropriate proof (guilty verdict in criminal case, Medicare suspension notice, etc.) is obtained, a noticeis issued advising the provider that, absent an appeal, they will be suspended from participating in theworkers' compensation system, effective 30 days later. "Participating" means that they cannot providemedical treatments or evaluations for any workers' compensation claim or be paid or reimbursed forany such treatment or services. A provider has 10 days to appeal the notice and obtain a hearing onthe suspension, which in turn must be provided within 30 days. Hearings are conducted by adesignated hearing officer (a Workers' Compensation Administrative Law Judge -WCALJ), with anAnti-Fraud Unit attorney to represent the department and present evidence, examine witnesses, andmake arguments. Following the hearing, the hearing officer drafts a decision for the AD to adopt ormodify.

2 Staff will communicate with other agencies, such as the Departments of Insurance and the Department of Health Care Services, state licensing

boards, federal Department of Health and Human Services, Federal Bureau of Investigation, etc., and local prosecutors to determine who js subjectto suspension from the workers' compensation system, and for providers charged or convicted of crimes to ascertain business relationships and theidentities of other entities that may have lien claims in the workers' compensation system that are associated with the charged or convictedprovider.

4

Analysis of Problem

A determination to confirm or uphold the suspension will constitute the agency's final action, but wouldstill be subject to court appeal through the filing of a writ of administrative mandamus in superior courtpursuant to the Code of Civil Procedure section 1094.5. An attorney (from the Anti-Fraud Unit or DWC)will represent the AD in these proceedings, which require legal briefing, each of which may span two tothree years. Superior court decisions can also be appealed to the Califomia Court of Appeal, and thenthe California Supreme Court.3

Following a provider's suspension, DWC will post the name on its website and notify the provider'slicensing or certification board, Medical Provider Networks, Claims Administrators, Utilization Revieworganizations, and the DWC Medical Unit's Qualmed Medical Evaluation team. For providerssuspended due to a criminal conviction, DWC will also notify the Chief Judge and the Special LienProceeding attorney so the special lien proceedings outlined below can be initiated.

3. special Lien Proceedjnqs Unit

once a provider has been suspended based on a criminal conviction under LC section 139.21(a)(1 )(A),that provider's liens become subject to special lien proceedings under subdivision (e) and following.This process can take one of two tracks. lf the criminal case disposition requires all the provider'sworkers' compensation liens to be dismissed,4 the liens will be identified and all interested parties willbe noticed. Because there may be other parties asserting competing interests in some of the sameliens, and who do not want their own claims and interests dismissed, this likely will lead to somenumber of challenges to otherwise "voluntary" dismissals, that will result in hearings, decisions, andappeals similar to those required for lien consolidations, as discussed below.

The second track, for liens not voluntarily dismissed, is lien consolidation. This starts with the AD'sappointment of a special lien proceeding attorney, who identifies all liens associated with the convictedand suspended provider, including the liens of "any clinic, group, or corporation in which the suspendedphysician, practitioner, or provider has an ownership interest." (LC section 139.21(e)) The Chief Judgethen orders consolidation of those liens into a single proceedings before a WCJ assigned to conductthe special lien proceeding. All defendants (employers, insurers, or claims administrators) and anyother interested parties in every case in which one of these liens has been filed are noticed. In someproceedings this may involve tens of thousands of liens (each lien representing an individual bill orservice), thousands of cases in which those liens have been filed (each case involving a differentinjured worker or injury), and several hundred to thousands of defendants and other interested parties.ln this special lien proceeding, the suspended provider has the burden of proving that the liens did notarise from the fraudulent or abusive conduct that led to the provider's suspension. However, within thisoverall framework, there are likely to be scores of individual challenges that seek to disassociateindividual liens or groups of liens from the presumption of fraud based on individual circumstances ortiming. And these challenges may be raised by other parties with competing interests in the same liens(including co-owners and assignees). Thus the special lien proceeding will resemble a bankruptcy orclass action in which there is one primary party and overarching theme, but in the context of whichthere may be numerous individual and discrete disputes, each requiring an evidentiary hearing beforeand a written decision by a WCJ.

lt is estimated that over 100 providers, with anywhere from a few hundred to over 10,000 liens each,who have already been identified as criminally-convicted or currently on prosecution for covered crimeswill be subject to the consolidation process. Assuming 200 liens are subject to consolidation in one ofthese proceedings, 100 or more cases could be involved with 100 or more defendants and other partieswith a specific interest in one or more of those liens. This could translate into 5,10, or 20 individualevidentiary hearings depending on the issues and interests at stake. Discrete determinations (either todismiss a set of liens or remove them from the consolidation because not associated with fraud) would

3 0f the first 10 providers to be suspended, six have appealed and have raised issues of constitutionality and statutory interpretation that signal

intent to continue pursuing these issues in subsequent court appeals.4 This would usually occur pursuant to a plea agreement in the criminal case.

5

Analysis of Problem

also be subject to appeal to the Workers' Compensation Appeals Board (WCAB), and further review ofa WCAB decision could be sought in the California Court of Appeal.5

4. Disclosure Filina Requirements

AB 1244 requires a completed attorney fee disclosure statement form to be filed with the WCAB underLC section 4906. This will require staff to process and verify the paperwork coming in for compliance.

5. Information Systems and SuDDort

There are three facets of the information systems component of this request which will facilitate theaccomplishment of the objectives of this proposal: 1 ) Provider Suspensions and Consolidated LienProceedings, which will modify the existing system as a Maintenance and operations (M&O) project forwhich a formal reporting exemption is being processed via the California Department of Technology; 2)Project Number 7350-088: SB 1160, Doctor's First Report of Injury; and 3) Project Number 7530-089,SB 1160 Utilization Review Management. These facets are being tracked and managed as threedistinct projects with a total cost of 12.0 positions and $4.5 million ($4.0 million ongoing). A briefoverview of the scope of each project is below:

• Provider SusDensions and Consolidated Lien Proceedinas: DIR will modify the existing EArnSsystem to allow for the consolidation of liens already in the system and to create a new categoryof hearings to extend the existing case management functions of EArnS to track and managehearings to adjudicate those liens. The consolidation of the liens will enable DWC to process ordispose of the cases using their established scheduling and hearing-based business processes.

• Doctor's First Report of lniurv: SB 1160 requires DIR to implement a system allowing UtilizationReview organizations (URO) to submit utilization review determinations electronically. Theproposed solution would allow UROs to submit their data electronically through Electronic DataInterchange (EDl). The data would then be made available for internal analysis throughstandard and ad hoc reperfs.

• utilization Review Manaaement: SB 1160 also requires DIR to create a system for doctors toelectronically submit Doctors First Reports of Injury. The proposed solution would allow doctorsto submit their reports to the department either in bulk through EDl or via a web-based onlineform. lt is anticipated that larger providers will use EDl while smaller providers will more likelyuse the online form. Data will be made available for internal analysis through standard and adhoc reports. An electronic process for the submission of UR determinations and Doctor's FirstReport of Injury will provide for ease of use to providers and claims administrators, facilitatecommunication between parties, and improve the speed at which claims are set up and benefitsdelivered.

Attachment lll provides a high level workload analysis for the processes identified above.

E. Outcomes and Accountability

The followina outcomes are anticipated:

• SB 1160's and AB 1244's anti-fraud provisions will reduce fraudulent providers and liens in theworkers' compensation system. DIR anticipates removing 300-400 providers from the workers'

5 Historically, every workers' compensation reform has led to high profile court challenges, requiring hundreds of hours of high level attorney work

to defend against these challenges in the appellate courts. Two challenges to SB 1160 and AB 1244 have already been filed in the California Courtof Appeal. One challenge to the lien stay, suspension, and lien consolidation provisions was summarily dismissed by the court because theprovider had not yet gone through these proceedings. The other challenge, by an interpreters association against the new lien verificationrequirements, is still pending before the court.

6

Analysis of Problem

compensation system and eliminating liens with an aggregate claim value of over $1 billion over thenext 2 to 4 years.6

DIR estimates that the provisions of the bills will generate about $800 million in savings in theworkers' compensation system.7

• Savings will be derived from the reduction in early denials and appeals of utilization reviewdecisions by allowing more treatment requests to flow through within the first 30 days after the dateof injury.

• Savings may also be realized from the requirement that lien claimants provide a declarationestablishing their eligibility to file the lien, as it will reduce the number of improperfilings and willprovide a basis for dismissal of liens without extensive litigation where the declaration has not beentimely filed or where false representations are made in the declaration.

• Savings will also arise from the imposition of stays on liens belonging to providers who have beencharged with specific crimes, as efforts to litigate these liens and the accrual of associated interestwill cease while the criminal case is being prosecuted.

• The clarification of the law on assignments of liens will also lead to savings. lt is estimated that 25

percent of liens are currently assigned. Beginning in January 2017, lien assignments will beprohibited, with limited exception, and for those assigned liens filed prior to 2017, additionaldocumentation will be required.

F. Analysis of All Feasible Alternatives

Alternative 1: Maintain status quo.

Erg: No additional resources would be required.

£gfl: This alternative is not recommended because it would defeat the intent of the Legislature inproviding more oversight and efficiency as prescribed in the bill. Due to the increased responsibilitiesthere is inadequate staff in DIR to handle the projected increase in workload.

Alternative 2: Redirect resources and reprioritize assignments from other program areas of DIR.

Erg: No additional resources would be required.

QQp: This alternative is not recommended for two primary reasons. Foremost, DIR has manymandated statutory obligations and is unable to direct necessary resources away from mandatedprogram responsibilities. Second, any redirection of resources would negatively impact other programareas and the overall impact would be to impede the effectiveness of this reform.

Alternative 3: Authorize 73.O positions and $14.7 million in FY 2017-18 and $13.6 million ongoing.

Erg: This alternative is recommended. It will insure an adequate number of staff to fulfill the newresponsibilities as required by SB 1160 and AB 1244.

Con: Additional costs to the State.

6 These numbers are difficult to quantify precisely due to how claims are presented and how they are reflected in DWC's EArnS system. The first

group of provider lien stays involved 75 providers and over 200,000 liens with an aggregate claim value of over $1 billion. However, these numbersincluded liens that had already been resolved or that likely were invalid for other reasons, including failure to pay the filing fee mandated by SB 863.Nevertheless, the liens were stayed to forestall further efforts to reopen or continue litigating liens in spite of these defects, which is also known tooccur.7 The settlement value of fraudulent liens is only a fraction of the claim value, but it is a direct cost to employers, employees, and taxpayers for

which no value is received and that is shared across the board. ln addition to what is paid to settle these liens, parties and the system incur coststo receive and store filings, set and conduct hearings, and defer other legitimate business at venues clogged with lien disputes.

7

Analysis of Problem

G. lmplementation Plan

April 2017 -Begin hiring process for key positions.July 1, 2017 -Begin hiring process for remaining positions.

H. Supplemental Information

N/A

I. Recommendation

Approve Alternative 3 for 73.0 positions and $14,710,000 in FY 2017-18 and $13.6 million ongoing fromthe Workers' Compensation Administration Revolving Fund (WCARF) to implement and meet theongoing requirements of SB 1160 and AB 1244. See Attachment lV for a WCARF Fund ConditionStatement.

8

Department of Industrial RelationsFiscal Year 2017-18 Finance LetterWorkers. Compensation Reforms (SB 1160 and AB 1244)Staffing by Function

CLASSIFICATIONS BY DIVISI0NDivision of Workers' Compensation

Presiding Workers' Compensation JudgeIndustrial Relations Counsel Ill (Spec)Workers' Compensation JudgeStaff Services Manager ll (Supv)Research Program Specialist llSpecial InvestigatorHearing ReporterResearch Analyst ll (Gen)Associate Governmental Program AnalystLegal SecretarySenior Legal Typistoffice Technician (Gen)

Office of Information Services (Admin)Systems Soft\^rare Specialist Ill (Supv)Senior lnformation Systems Analyst (Spec)Systems Soft\^rare Specialist ll (Tech)Staff Information Systems Analyst (Spec)

Office of the Director (Admin)C.E.A.

Attorney lVAttorney Ill

Atto rr, eyResearch Program Specialist llAssociate Governmental Program AnalystSpecial InvestigatorLegal Secretary

Human Resources (Admin)Personnel SpecialistPersonnel Technician I

rlf)COTrr®)I-lorC)(O

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SB 1160

sB 1160util ization

' DoctorsFirstReport

Reg u latI-onsFteview of Injury Totals

211

0.5

111

O301100r130001

20.5

1 1 20,5 0.5 130o00o0000

1 2

9 4 3 16

a/ DIR Anti-Fraud Unit' Special Lien Proceeding Attorney and Data Analytics Teams

Page lof1

AB 1244

AB 1244P rovider' al , Special Lied

DisclosureFiling

S uspensj,on Anti-Fraud , Proceedings RequirementHeari ngs Unit unit S Tota ls

12111122

511

16218

1412

8001

302

1

106050001

1

4 41 1

2 2115 1

1

5

ll 21 18 5 55

Attachment I

AdminTota I

Positions

1

15

81

1

1

31

51

10

617

13

01

1

41

21

151

1 1

2 73

Department of Industrial Relations2017-18 Finance Letter

Attachment II

Workers' Compensation Reforms (SB 1160 and AB 1244)Utilization Review and other lmplementation Items

Utilization Review

All medical treatment provided in the system must curre'ntly undergo utilization review (UR) todetermine if it js medically necessary. "Medical necessity," as that term is used, meanstreatment that is recommended by the Medical Treatment Utilization Schedule (MTUS) adoptedby the DWC for the injured worker's specific condition. Generally, the initial review of atreatment recommendation is done by a non-physician, with higher level review(s) beingconducted by a physician or physicians. Only a licensed physician who is competent to evaluatethe specific clinical issues involved in the medical treatment services may modify or deny arequest for medical treatment. An adverse UR decision, one that denies or modifies a treatmentrequest, can be subsequently appealed to the Independent Medical Review (lMR) process,where medical experts selected by an independent organization can review the treatmentrecommendation for medical necessity.

Studies have identified friction in the UR system and circumstances where uR may only serveas an unnecessary burden or expense. While injured workers and medical providers reportdelays and denials of medical care due to the UR process, it has been found that most medicaltreatment is approved, especially that provided within the first 30 days of the date of injury. Theimplementation of best-practices across the system will lead to improvements for injuredworkers who are having their care delayed or denied.

First, SB 1160 amends LC section 4610 to ease the requirements of UR within the first 30 daysof a worker's injury, with certain exceptions. Employers are still able to conduct retrospectivereview, and SB 1160 provides tools to employers in the event that a medical provider abusesthe workers' compensation system. Second, SB 1160 requires that all uR entities rise to meetthe "best pract.lees" of the industry. This includes utilization Review Accreditation Commission(URAC) accreditation, a voluntary peer-to-peer process between doctors in the event of amedical dispute, and a prohibition on the use of financial incentives to deny or modrty medicalcare. Finally, SB 1160 requires DWC to create a database that captures UR decisions anddocumentation. This capacity will equip the department with data to effectively evaluate howUR impacts claims, both system-wide and for specific employers and UR entities. This data willmake possible targeted audits and legislative initiatives that address unnecessary medicaldisputes, while preserving important protections against unnecessary and abusive medicaltreatment. Staff assigned to the UR function will be required to:

• Audit compensation agreements, payment schedules, or contracts between employers, orany entity conducting utilization review on behalf of employers,

• Conduct a utilization review physician to determine if there are incentive-based payments todeny medical treatment (his measure is to support the integrity and objective of the reviewprocess)

• Establish a new approval standard for utilization review entities, a component of which iscertmcation by URAC, by July 1, 2018.

• Implement procedures must be in place to allow for the exemption from URAC standards forpublic sector internal utilization review programs.

• Capture utilization review decisions and develop regulations for the new uR accreditationprocess

• Develop the new UR accreditation process; track, review, and approve utilization review

plans for denial or modification of treatment requests;

Pagelof3


Attachment lI


• Exercise oversight over expedited UR process for medication disputes under formulary;• Process complaints concerning the requirement that claims administrators provide medical

records to review organizations electronically; and• Conduct outreach and education with claims administrators and employers about required

notifications to review organizations.

ln addition to utilization review, SB 1160 requires several enhancements to the IndependentMedical Review (lMR) program. Such changes include the mandatory electronic submission ofdocuments by claims administrators and the requirement that final lMR determinations forformulary disputes must be issued within five working days from the date of receipt of therequest for review and supporting documentation. DIR staff must coordinate with its designatedIMR organieation, currently Maximus Federal Services, lnc., to confirm compliance with themandates and ensure that all timelines are met.

Doctor's First Report of lniurv

SB 1160 amends LC section 6409 to require that the current Doctor's First Repert (DFR) ofInjury would be electronically filed with both the DWC and the employer's claims administrator.This system will be able to ut.ilize other data sources within DIR.

Medical Treatment Utilization Schedule updates

SB 1160 amends LC section 5307.27 to authoriee the Administrative Director to make updatesto the utilization schedule by order, outside the formal office of Administrative Law (OAL)rulemaking process in order to provide for an expedited, transparent process for updatingexisting medical guidelines and to ensure that UR decisions are based on the best availablemedical science.

Regulations

For general system improvement, regulations will be required to:

a) Notify injured workers that they may access medical treatment outside of the workers'compensation system following the denial of their claim;

b) Increase the amount of administrative penalties -to $10,000 per year -assessed to claimsadministrators for the failure to comply with the reporting requirements of the Workers'Compensation Information System (VVCIS -an electronic data interchange system wherebyclaims data is reported to DWC).,

c) Establish the range of reasonable fees that attorneys can be paid for at depositionsconcurrent with this will be the necessary research to determine deposition fees paid acrossthe state;

d) Establish criteria to verify the identity and credentials of individuals who provide interpreterservices in all necessary settings and proceedings within the workers' compensationsystem; and

Page2of3


Attachment l[


e) Establish the electronic reporting standards for the Doctor's First Report of Injury,

As to the latter, this js the anticipated first step toward moving the workers' compensationmedical treatment system to an electronic, rather than paper, platform. Such a move willexpedite care for injured workers by removing the delay in sending paper reports, and alsoensure the integrity of the system by providing real time structured data for a more immediateassessment of system.

Regarding the UR provisions in the SB 1160, DWC will need to adopt regulations establishingthe 30-day UR exemption process and also augment existing administrative procedures to allowfor petitions to remove treating physicians who, in the first 30 days following the date of injury,do not comply with the treatment requirements set forth in the MTUS. (The physician can alsolose their privilege to treat with the UR exemption or be removed from the claims administrator'sMPN.) The evidence-based MTUS is the critical hinge for delivering medically necessary carein the system. DWC staff will need to monitor on an ongoing basis any possible updates to theMTUS to make certain the guidelines reflect the best, current evidence.

Page3of3

Department of Industrial RelationsDivision of Workers' CompensationWorkload Data -Senate Bill 1160

INDUSTRIAL RELATloNS COUNSEL Ill (SPEC)

Attachment lll(Utilization Review

and Regulations)

Actual * of Actlvitles Pro]eetod Workload

Actlv ify2014/15 2015/16

HoursPerActivfty

SB 1160 ActlVfty

2017/18 2018/19 2019/20 2020/21AssociatedAnnualHours

AdditionalStaffRoquested(1,776hoursperposition)

Provides legal advice and counsel to the Division managers and staff

1414 1414 45.00•45.00 1818 1818 1818 1818 810810

on complex legal issues, specializing in issues regarding medicaltreatment, indemnity benefits, permanent disabilfty ratings. lMR andlBR, the Workers' Compensation lnfomation System, electronic billingand standardked billing, collectively bargained altemative disputeresolution program. public records requests, admin.Istrative penalties,and the official medical fee schedule.

PerforTns legal research and drafts memoranda as requested.

Handles complex rulemaking actions; drafts regulations and supporting668' 668 80.0090.00120.00 888 888 888 888 640720960documents; coordinates economic analysis of regulations.

Convenes and presides over public rulemaking hearings, and perfomsall legal tasks necessary for adoption of regulations.. revise medicalreporting forms

Handles complex lingation involving the Division, in administrativetribunals, state and federal court, and at the trial and appellate level;

Insure certification for utilizati.on review organizations (URO) ; reviewo06 006 20.00120.0050.00 488 .488 488 488 80960400applications for URO approvaVrenewal.

Monitors claims administrator's reporting of util.ization review data.Initiates procedures to assess administrative penalties for UR reportingviolations. Oversight of expedited UR and lMR procedures formedication disputes under formulary.

Drafts, reviews, and signs change of treating physician petitions;

Performs legislative bill analysis, drafts legislation, drafts443 44 50. 0050.00 64 64 64 64 300200correspondence to the legislature and stakeholders.

Communicates wlh the public regarding complex workers'compensation legal issues. conducts training and seminars vuth publicand stakeholders.Perfoms a variety of other highly sensitive and/or complex legal dilties

3 50.00 3 3 3 3 150requiring a high level of skill, iudgment, and diplomacy.

Tota ls : 6,030 3.O

The hours and number of each activity listed above are based on the assumption of the time it takes the cument lRC Ill in the Legal Unit to perfom similar duties. Due to the legislative changes, theincrease will require additional lRC Ills to handle the added duties.

WC Reforms (SB 1160 and AB 1244) Page 1 of35


ASSOCIATE GOVERNMENTAL PROGRAM ANALYST

Attachment Ill(Reg u lations)

Actual # of Actlvitjes Proioctod Worklcad

Activity2014/15 2015/16

HoursPerActivity

SB 1160 Activfty

2017/18 2018/19 2019/20 2020A21

AssociatedAnnualHoursAdd itionalStaffRequested(1,776hoursperposition)

Provide suppon, guidance and information to Division attorneys, managers, and 6 6 10_00 12 12 12 12 120technical staff on compliance with rulemaking procedures

Analyze and summarize public Comments on proposed regulations 6 6 10.00 12 12 12 12 120

Maintain all rulemaking files 12 12 6.00 24 24 24 24 144

Ccordinate public hearings and arrange for court reporters and other staffing of the12 12 10.00 24 24 24 24 240hearing, prepare records relating to attendance at tlie hearings

Maintain rulemaklng checklists 3 3 6.00 6 6 6 6 36

plan and coordinate intrardepartmental resources needed and12 12 10.00 24 24 24 24 240serve as team leader for lower level staff in accomplishing rulemaking tasks

Develop and maintain a variety of electronic files and databases, including utilization12 12 10.00 24 24 24 24 240review data from claims administrators and URO cerdfications

Establish protocols for efficient use of shared folders, common nomenclature and3 3 5.00 6 6 6 6 30procedures

Oversee the development, improvement, and maintenance of web-based automated6 6 8.00 12 12 12 12 96mailing lists to ensure public access to the agency's regulatory process

Ensure timely and user-ffiendly public access to rulemakjng materials on tlie web site 3 3 5.00 6 6 6 6 30

Analyze and coordinate the annual rulemaking calendar and assess resource needs,632626 632626 15.0020.002.502.50 1265252 1265252 1265252 1265252 180120130130including analyzing legislative enactments to plan rulemaking actions necessary to

implement the statutory changes

Draft and periodically revise rulemaking procedure manual to establish effectiveprogram to ensure compliance with all applicable rulemaking laws, including theGovernment Code, the Labor Code and the Califomia Code of Regulations

Coordinate interaction with a variety of public agencies and entities, including the officeof Administrative Law, the Commission on Health and Safety and Workers'Compensation. and the Legislature

Communicate \whh the public regarding workers' compensation rulemaking actions, bytelephone, in person, and through the DWC Rules mailbox

Ccordinate and communicate pre-rulemaking public consultation jnclnding monitoring of 26 26 2.50 52 52 52 52 130the DWC Forum mailbox

Totals : 1,986 1.0

The hours and number of each activity listed above are based on the assumption of the time it takes the current AGPA in the Legal Unit to perform similar duties. Due to the legislative changes, the increase willrequire an additional AGPA to handle the added rulemaking duties.


Deparfroent of Industrial RelationsDivision of Workers' CompensationWorkload Data -Senate Bill 1160


Attachment Ill(Utilization Review)

Actual * of Actlvltlco Pro]®ctod Workload

Activfty2014/15 2015/16

Hou rsP®rActivity

SB 1160 Activity

2017/18 2018/19 2019/20 2020/21Assoc iatedAnnualHours

Add itiona IStaffR®quost®d(1.776hoursperposttion)

Review UR plan applications and verify certifications for compliance with DWC's26 26 16.00 52 52 52 52 832UR regulations.

Communicate with UROs regarding plan deficiencies and comections; update12 12 16.00 24 24 24 24 384plan filings based on URO amendments.

Oversight of the curriculum leading to URO certification; communicate with6 6 24.00 12 12 12 12 288URAC.

Track approved requests (decisions) to modify or deny treatment. 26 26 16.00 36 36 36 36 576Assists in oversight of expedited UR and lMR procedures for medication

26 26 16.00 24 24 24 24 384disputes under fomulary.

Prepare for and conduct UR investigations for compliance with the Labor Code52 52 8.00 72 72 72 72 576and DWC's UR regulations.

Select a UR investigat.Ion subject, using both random and non-randommethods.6 6 8.00 12 12 12 12 96

Issue tlie notice of investigation 6 6 8.00 12 12 12 12 96Draw a random file sample 6 6 8.00 12 12 12 12 96Work with both electronic and physical files, including UR data submitted by

6 6 8.00 12 12 12 12 96claims administrators; review the files

Coordinate with clinical staff as to the validity of a UR medical determination 6 6 8.00 12 12 12 12 96Analyze review findings and present findings and analysis in a written repod 6 6 8.00 12 12 12 12 96Finalize preliminary and final investigation repons 6 6 8.00 12 12 12 12 96

Create, update and maintain investigation files. 6 6 8.00 12 12 12 12 96Maintain UR Unit's complaint processing system. 3 3 16.00 6 6 6 6 96Compile information and statistics on complaint status and create and update

12 12 16.00 12 12 12 12 192complaint files, both electronic and hard files.

Assist in updating the complaint processing system protocol as needed. 3 3 8.00 6 6 6 6 48Update and maintain the Microsoft Access database of UR plans, UR

3 3 16.00 6 6 6 6 96complaints, UR Investigation results] and uR Penalty assessments.

Tota ls : 4,240 2.O

The hours and number of each activity listed above are based on the assumption of the time it takes the current WCCs for the UR program to perform similar duties. The UR program has an increasedresponsjbjlity to analyze data submitted from uROs and claims administrators.

WC Refoms (SB 1160 and AB 1244) Page 3 of 35


STAFF SERVICES MANAGER Il, SUPERVISORY

Attachment Ill(Utilization Review)

Actual # of Activities Projected Workload

Activity2014/15 2015/16

Hou rsPerActivity

SB 1160 Activity

2017/18 2018/19 2019/20 2020/21Associ atedAnnualHours

AdditionalStaffRequested(1,776hoursperposition)

Plans, organ.ra!es, directs, and reviews the work of subordinate staff;N/A N/A 4.00 52 52 52 52 208conducts reviews of UR plans and investigations for accuracy.

Evaluates staff performance N/A N/A 8.00 12 12 12 12 96

Supervises the technical aspects of the work; coordinates with LegalN/AN/AN/A N/AN/AN/A 4.008.008.00 522412 522412 522412 522412 20819296unit regarding interpretations of laws.

Provides assistance or personally handles the more difficult, complexor sensitive cases; communicates with UROs and claimsadministrators regarding factual and legal disputes.

Provides advice to workers' compensation community regarding URprocedures and obligations.

Provides training for new and existing staff as required N/A N/A 24.00 6 6 6 6 144

Provides ongoing training and technical consultation to staff and theN/AN/A N/AN/A 24.0024.00 1212 1212 1212 1212 288288

public.Identfty the need for new or amended polic.ies and in the development

of appropriate policies and procedures.

Oversees compliance with policies and procedures and providesN/A N/A 24.00 12 12 12 12 288direction where needed.

Totals : 1,808 1.O

The hours and number of each activity listed above are based on the assumption of the time it takes the current SSMII for the QME, MPN, IMR and lBR programs in the DWC Medical Unit toperfom these duties. The UR program will have additional staff and will be responsible for new data analysis duties.

WC Reforms (SB 1160 and AB 1244) Page4 of35


RESEARCH ANALYST ll -GENERAL

Attachment Ill(utilization Review)

Actual # of Activlties Progived WorkIoad

Activity2014/15 2015/16

HoursPerActivity

SB 1160 Activity


Add itionalStaffRequested(1,776hoursperposition)

Enhance and improve efficient data collection and conduct data26123626 26123626 10.0014.008.0016.008.00 522461252 522461252 522461252 522461252 52033648192416analyses to serve the broad purpose of evaluating the overall

effectiveness of the utilization review program.

Works with other team members, appropriate Department staff, andcontractors to enhance and improve efficient data collection methods.

Provides expen assistance to design funct.tonal databases andintegrate data with existing databases to increase the efficiency and tohelp assess the impact of UR work.

Conducts expert systematic analyses of UR to provide data analyses,ensure excellent programmatic functioning, and suggest additionalanalyses and areas for improvement.

Utilizes research methodology and techniques to conduct analyses ofUR data to identify trends and patterns.

Track approved requests to modfty or deny treatment. 6 6 16.00 12 12 12 12 192

Oversight of expedited UR process for medication d.isputes under6 6 8.00 12 12 12 12 96formulary.

Totals : 1,800 1.O

The hours and number of each activity listed above are based on the assumption of the time it takes the current RA II in the Medical and Research Units to perform similar duties. Due to thelegislative changes, the UR program has an increased responsibility to analyze data submitted from UROs and claims administrators,



RESEARCH PROGRAM SPECIALIST II

At(achment lll(Regulations and Anti-Fraud)

Actual # of Activities Protected Workload

Activity2014/15 2015/16

HoursPerActivity

SB 1160 Activity

2017/18 , 2018/19 2019/20 2020/21AssociatedAnnualHours

Add itionalStaffRequested(1.776hoursperposition)

Research, develop and establish fee schedule for depositions 1226121226 1226121226 20.0016.008.0024.0012.00 2452241224 2452241224 2452241224 2452241224 480832192288288

Monitor indictments and criminal charges against providersregarding workers' compensation fraud; identify and collect relevantdocuments from law enforoement and administrative agencies.

Establish database wi.th purpose of staying lien of providers indictedor charged with fraud, and ordering suspensions of providersconvicted of fraud or suspended from practice.

Directs the construction of data analysis files from multiple datasources and complex record layouts

Plans and implements collection, analysis, interpretation, andreporting of large volumes of data collected.

Tota ls.. 2,080 1.0

The hours and number of each activity listed above are above on the assumption of the time it takes the current RPS II in the Research Unit to perform similar duties. Due to the legislative changesto LC 5710 and LC 4615 an additional RPS ll will be required to conduct research to develop and establish the fee schedule for depositions, as well as to monitor convictions and pleas of providersconvicted of fraud, and those charged with fraud and establish a data base with the purpose of staying their liens.

WC Refoms (SB 1160 and AB 1244) Page 6 of35

Department of Industrial RelationsDivision of Administration -Office of Information SystemsWorkload Data -Senate Bill 1160

SYSTEMS SOFTWARE SPEC Ill -SUPVRY

Attachment [Il(Utilization Review and

Doctors First Report of Injury)

Proj®ct®d Workload

Activity HoursPerActivity

SB 1160 Activity



Review UR system requirements , the outcomes, and integration with existing WCIS100.0040.00120.00 222 222 222 222 20080240and other systems. Meet and discuss with stakeholders the data elements, mode

and format of transmission 1/

Estimate and Identify lT technical/programming resources; Identify, assign and co-ordinate programming tasks with staff; Co-ordinate Go-Live tasks with staff andbusiness 1/

Supervise and represent IT during creation and updates of companion guide for datatransmission and provide relevant inputs. 1/

Design, develop, test and implement EDl translator for ASC X12 transmissions 1/ 300.00 2 2 2 2 600

Provide solutions to import, clean, validate, transform, standardize, aggregate20.0024.008.00 121252 121252 121252 121252 240288416structured and unstructured data from source for the purpose of data analysis. 2/

Review data, identify relationships among data elements within the system,distinguish betveen structured and unstructured data of the source system. Identifyareas and suggest measures for data quality improvements and help to resolve dafaquality problems at source, 2/

Provide solutions to present analysis of data to end users to aid in decision makingthrough meaningful reports and fomats. 3/

Totals : 2,064 1.O

1/ Based on 6 month M&O deployment cycles. Level of effort based on similar systems.2/ Based on monthly iterative improvement of data cleansing and analysis tools and techniques.3/ Based on weekly requests for custom data analysis.



SYSTEMS SOFTWARE SPEC II-TECH

Attachment Ill(Utilization Review and


Projected Workload

Activ ify HoursPerActivity

SB 1 1 60 Activity



Review UR and DFR requirements for UR and DFR systems, the outcomes, and

210.00280.004.00184.0080.00 2216022 2216022 2216022 2216022 420560640368160integration with existing WCIS and other systems. Meet and discuss withstakeholders the data elements, mode and format of transmission; Advise DWC ontechnical issues and questions during the rule making. 1/

Prepare a formal design document of the confirmed requirements including thearchitecture of the UR and DFR systems; Design database, schemas, objects forUR and DFR data. 1/

Troubleshoot, Document, and follow-up on `complex production system problemsand issue, isolate causes, develop solutions, code, test, and document and installrevised applications with UR and DFR requirements. 2/

Lead programming tasks for development of features and changes to UR and DFRsystems. Identify, assign and co-ordinate programming tasks with staff. 1/

Identify approved users for production implementation, coordinate Go-Live taskswith staff, business and external users. 1/

Totals: 2,148 1.0

1/ Based on 6 month M&O deployment cycles. Level of effort based on similar systems.2/ Based on incident frequency and effort required for resolution for similar systems.



SR INFO SYSTEMS ANALYST (SPEC)

Attachment IIl(Utilization Review and

Doctors First Repor( of Injury)

Projected WorkIoad


SB 1160 Activity



Participate during creation and update of companion guide for data transmission and200.00 22 22 22 22 400520provide relevant inputs. Convert BRD to technical requirements document

Create and maintain database schema, objects necessary for UR and DFR data in test260.00and production environments

Create and maintain mapping table for ASC X12 file 80.00480.00400.00 222 222 222 222 160960800

Build, test and implement translator programs for ASC X12 file, programs for structuralvalidation of ASC X12 files and program to generate 999 acknowledgements

Build, test and implement programs for business rule validation of ASC X12 files andgenerate acknowledgements

Support QA and UAT of the UR and DFR system 480.00 2 2 2 2 960

Document UR and DFR system design and architecture 120.00 2 2 22 2 240

Perfom an architecture review and analysis to identify application, network48.00 2 2 2 96infrastructure, and communication security requirements.

Totals : 4,136 2.O

Based on 6 month M&O deployment cycles. Level of effort based on similar systems.



STAFF INFO SYSTEMS ANALYST (SPEC)

Attachment Ill(Utilization Revjow and


ProI®ctod WorkIoad

Act]vify HoursPerActivlty

SB 1160 Activity


Add itiona IStaffRequested(1.776hoursperposition)

Prepare report specification documents. Create. test and Implement Cognos reports of UR and DFR data jn400. 00110.0060.0040.001.00320.00160.00550.00 2222160222 2222160222 2222160222 2222160222 800220120801606403201,tooproduction. 1/

Assure optimum quality of testing at all levels including unit testing, system testing regression testing, UAT andsmoke testing for complex changes made to the applications. Prepare time estimates and schedule complexmanual and automated test activities. Coordinate whh lT, business groups, and vendors, to communicatecomplex test plans to developers and testers. 1/

Develop and improve elaborate test scripts (positive as well as negative), execute tests, and support testerstesting case management functions as well as documents are submitted and processed through UR and DFRsystems` 1/

Use Software testing tools, including Rational Functional Tester and Rational Quality Manager, XML Editing toolslike XML Spy to create and organize test suites, and automate test scripts. 1/

Monitor, evaluate, analyze, investigate, and replicate complex issues reponed by users related to UR and DFRbefore assigning issues to the appropriate developer for fixing. Document problem descriptions and steps toreplicate and assure that the issues are addressed in a professional and timely fashion. Communicate with users,collect necessary information from them. and update them with the progress and/or resolution of their issues.Distribute twork-arounds" when available. 2/

Articulate business opportunities; Define logical business objectives; ldentfty key stakeholders; Analyze as-isprocess for effective baseline of ourrent state; Develop comprehensive business cases with cost, service, benefitdimensions of proposed lT changes for UR and DFR for scope decisions. Apply technical and business knowledgein the analysis of DWC requirements for UR and DFR: Conduct analysis of DWC business processes andfunct.tonal requirements and prepare Business Requirements Documents (BRD); Business Process Diagramsusing Business Process Modeling Notation (BPMN) and other tools to communicate and validate the infomation;Enter. track, and manage requirements in Rational Requirements Composer/DOORS for tracability; Studyalternatives and articulate the validfty of each; perform financial analysis of altematives; study impact on existingprocesses. 1/Conduct and document market research and technology assilmptions; validate solution requirements traceability tobusiness objectives; prepare Statements of Work for technology vendors working on UR and DFR systemfunctionalfty; develop cost worksheets; Create evaluation and selection approach; plan procurement dates and keyaction dates; align budget and deadlines whh solution; Complete administrative requirements in an accurate andtimely manner (e.g. time reponing, status reporting. ) Evaluate existing application products which could addressclient requirements and make recommendations where appropriate; plan contract management; validateorganizational readiness to proceed; confirm stakeholder commitment; refine financial analysis. 1 /

Develop schedules; Issue and Action Item management; ; Develop schedules. and project plans including riskmanagement, scope management, communications, and governance plans;. Report project status and deviationsfrom approved schedules; Identfty risks and issues as well as potential mitigation strategies and contingency plans;Manage schedules, issues, risks, and action items throughout system development; Prepare lntemal and extemaIproject status reports. 1/


Deparfroent of Industrial RelationsDivision of Administration -Office of Information SystemsWorkload Data -Senate Bill 1160

STAFF INFO SYSTEMS ANALYST (SPEC)

Attachment Ill(utilization Review and


P roj®ct®d Workload

Activfty HoursPerActivity

SB 1160 ActMty


AdditionalStaffR®qu®stod(1,776hoursperposition)

Coordinate System Deployment, Migration, Training, and outreach; develop and manage data migration plan;210.00230.00480.0012.004.00100.00 2222506 2222506 2222506 2222506 42046096024200600schedule and track migration activities; articulate training needs; develop training plans; Provide training and

demos; Coordinate outreach activities with external stakeholders, Communications office, and Program SinEs. 1/

Analysis of operational Performance (Analyties): Articulate reporting requirements; facilitate development ofperfomance memcs: Coordinate change requests and continuing improvement to systems based on newlegislative adjustment, feedback from operations, the public comment and rulemaking processes, and discovery ofcurrent unknowns. Ensure continuous improvement of business processes is not constrained by systems; Monitorresults, objectives attained, lessons learned, and corrective actions; Document and manage stakeholder feedbackand future system improvement requirements. 1/

Review and analyze DFR requirements For FileNet P8/IBM Fom/Java/SSO. WebSphere application server andOracle database with internal and external users, lT technicaVprogramming staff, IT service provider (OTech), DIREnterprise FileNet team and representatives/subject matter experts of all interfaces and financial institutions.systems. Perform FileNct P8/IBM Form/Java/SSO/Oracle programming development. system integration. testing,deployment and maintenance in EArnS and DIR Enterprise Document Content Management systems onWebSphere application server for Special Lien Proceedings. 1/

Document approved FileNet P8, IBM Form, Java, SS0 and oracle change requests issue resolution for changesand issues related to DFRs. 1/

Review, analyze and discuss, and resolve DFR form reported issues with internal and extemal users, lTteclinical/programming staff and oTech staff related to IBM Form and its integration into EArnS and DIR EnterpriseDocument Content Management solution. including the interfaces to external financial institutions. systems. 2/

Perform server maintenance support for IBM Form application server and web environment (Windows. Oracle,WebSphere). 3/

Plan and coordinate the procurement of necessary IBM Fom server (Windowrs, Oracle, WebSphere) and network80.00 1 1 1 1 80capability for DFRs. 4/

Totals: 6'184 3.O

1/ Based on 6 month M&O deployment cycles. Level of effort based on similar systems.2/ Based on incident frequency and effort required for resolution for similar systems.3/ Based on 2 month maintenance cycles. Level of effor( based on similar systems.4/ Based on annual renewal cycle and level of effort required for similar procurements.

WC Refoms (SB 1160 and AB 1244) Page ll of35

Department of Industrial RelationsDivision of Workers' CompensationWorkload Datai -Assembly Bill 1244

INDUSTRIAL RELATIONS COUNSEL IIl (SPEC)

Attachment Ill(Provider Suspension Hoarings)

Actual # of Actlvltlos ProJ®ctod WoTkload

Activity2014/15 2015/16

HoursP®rActivity

AB 1 244 Actlvify


AdditionalStaffRequost®d(1,776hoursperpositlon)

Assists with coordination with DIR Fraud Unit, Department of Insurance, andN/A N/A 4.00 12 12 12 12 48outside agencies and law enforcement units.

Identifies and analyzes data regarding potential basis for provider suspension N/A N/A 8.00 52 52 52 52 416Prepares and issues order to show cause notices for the suspension process. 6 6 16.00 12 12 12 12 192

Schedules evidentiary bearings before hearing officer 6 6 4.00 12 12 12 12 48

Prepares for hearings including gathering necessary evidence 6 6 16.00 12 12 12 12 192

Represents AD in hearings and present evidence 3 3 8.00 6 6 6 6 48

Calls and examines witnesses, introduces exhibits, crossexamines opposing3 3 8.00 6 6 6 6 48witnesses, rebuts evidence

Handles any associated appellate activfty at the WCAB and civil appellate couns 6 6 8.00 12 12 12 12 96

Advises licensing and certification authorities, MPN liaisons, UROs, and QMEN/A N/A 4.00 12 12 12 12 48unit of suspensions

Issues determinations and orders of suspensions N/A N/A 8.00 12 12 12 12 96

Advises lRC IV of the names of suspended providers N/A N/A 3.00 12 12 12 12 36

Performs a variety of other highly sensitive and/or complex legal duties requiring26 26 10,00 52 52 52 52 520high level of skills, judgement, and diplomacy.

Totals: 1,788 1.O

Based on the assumption of the time it takes a ourrent lRC IV to perform similar duties. Due to AB 1244 legislation the legal unit will have increased responsibilities to determine the scope of the Special LienProceeding as well as coordinate with internal and external sources in the adjudication process.


Department of Industrial RelationsDivision of Workers' CompensationWorkload Data -Assembly Bill 1244

INDUSTRIAL RELATIONS COUNSEL Ill (SPEC)

Attachment lll(Disclosure Filing Requirements)

Projected Worklodd

Activ ify HoursPerActivity

AB 1244 Activfty

2017/18 2018/19 2019/20 2020/21Ass ociatedAnnualHours

AdditionalStaffRequested(1.776hoursperposition)

Writes legal decisions in sensitive, complex and difficult cases according to

12.0040.00120.002.009.0030.00 609390103 609390103 609390103 609390103 720.0360.O360.0180.090.090.0

the outcome requested by panels of commissioners in response to appealsfrom trial-level decisions issued by workers' compensation administrativeaw judges; serves as an expert legal resource, providing advioe andrecommendations to the commissioners; performs inrdepth research in thenew and emerging areas of the workers' compensation laws; analyzes andinterprets new laws and rules; assists in the training of attorneys at lesserevels with regard to law, policy and procedures of the Board, and mayperform limited Deputy Commissioner duties in the absence of the Deputyin the Reconsideration Unit.

Drafts en bane and significant panel decisions involving both novel andhighly complex legal issues.

Handles complex rulemaking actions, drafts regulations, convenes andpresides over rulemaking hearings and performs all legal tasks necessaryfor adoption of regulations.

Meets with comm.issioners and deput.ies to discuss issues in particularcases, review proposed drafts and decisions. and make modificat.Ions asreq uested.

Reviews petitions for appellate writ and prepares responses; appears atappellate oral arguments on behalf of the Board, and supervises thepreparation of certified copies of Board case records for review by theappellate couils.

Special assignments, including appearances before the Court of Appealand Supreme Court and prosecution of contempt and disciplinaryproceedings.

Totals: 1,800 1.0

Based on the assumption of the time it takes the current lRC Ill in the Legal Unit to perform similar duties. Due to AB 1244 legislative changes, the increase will require additionallRC Ills to handle the added duties.


Department of Industrial RelationsDivision of Workers' CompensationWorkload Data -Assembly Bi[11244

PRESIDING JUDGE

Attachment IIl(Special Lien Proco®dings Unit)

Actual # of Activities Proj®ctod WorkIoad

Activity2014/15 2015/16

HoursPerActivity

AB 1 244 ActMty



Oversees Special Adjudication Unit staff responsible for the conducting ofN/ANIA6 N/ANIA6 45.0030.008.00 24612 24612 24612 24612 1,08018096lien consolidation hearings.

Oversees the adjudication and determination of the legitimacy of lien claimswithin consolidation proceedings. Coordinates hearings with special lienattorney.plans,organizes, coordinates, and supervises the work of subordinate staff

Trains personnel and evaluates their performance; conducts hiring interviews 2 2 8.00 4 4 4 4 32

Counsels employees; monitors work backlogs and resource availabilfty and2 2 8.00 4 4 4 4 32reassigns work as needed

Takes or recommends appropriate disciplinary action., meets with staff as is2 2 8.00 4 4 4 4 32req uired

Initiates and/or conducts investigations 3 3 8.00 6 6 6 6 48

Uses the Electronic Adjudjcation Management system to work, train, review6 6 16.00 12 12 12 12 192work and investigate.

Confers with administrative officers including the Chief Judge and Associate3 3 4.00 6 6 6 6 24Chief Judge on poliey matters

Prepares reports 3 3 8.00 6 6 6 6 48

Keeps current on case law, and statutory law, rules and regulations, and the2N/A 2N/A 4.004.00 46 46 46 46 1624

poliey and procedure manual.

Interacts with the legal communfty and the community in general regardinglien issues, both informally and fomally through regularty scheduledPresiding Judge and Bar meetings, community events and other educationalevents

Totals: 1,804 1.0

Based on the assumption of the time jt lakes a ouITent PWCJ in the Adjudication Unit to perfom similar duties. Due to the AB 1244 legislation the Adjudication Unit has increased responsibilities to manageand adjudicate consolidated cases of liens from providers that are suspended from the WC system.


Department of Industrial RelationsDivision of Workers. CompensationWorkload Data -Assembly Bill 1244

WORKERS. COMPENSATION JUDGE

Attachment Ill(Provider Suspension Hearings

and Special Lien Proceedings Unit)

Actual # of Activ.ities Projected WorkIoad

Activity2014/15 2015/16

HoursPerActivity

AB 1 244 Activity

2017/18 2018/19 2019/20 2020/21AssocI.atedAnnualHours


Hear and decide judicial matters arising under the Labor Code andCaliforniaCodeofRegulationsrelatingtoworkers'compensation,safetylaws,andrelatedlawsConductslienconsolidationhearingsasassignedbySpecialAdjudicationUnitPresidingJudgeAdjudicateslienclaimsbydeterminingthelegitimacyofthoseclaimswithinconsolidationproceedings;ensuresallpartiesareproperlynotified.Reviews,analyzesandresearchestodecidelawandmotionmatters,settlementrequests,andissuesordersrelatedthereto.Presidesovertrialmatters,coordinateshearingwithspecialIienattorney,admitsevidence,rulesonobjectionsandpreparesaclearrecordofthepresentedcase.ConfirmsrecordsareproperlyenteredintotrèEArnSsystem52N/AN/A208104104 52N/AN/A208104104 8.008.004.008.0016.006.00 104312312416208208 104312312416208208 104312312416208208 104312312416208208 8322,4961,2483,3283,3281,248

Issues orders and decisions in a timely manner as prescribed bytherules208 208 4.00 416 416 416 416 1,664

Totals : 14,144 8.0

Based on the assumption of the time it takes a current WCJ in the Adjudication Unit to perform similar duties. Due to the AB 1244 legislation the AdJ.udication Unit has increased responsibilities toadjudicate consolidated cases of liens from providers that are suspended from the WC system.


Department of Industrial RelationsDivision of Workers' CompensationWorkload Data -Assembly Bi[11244

HEARING REPORTER


and Special Lien Proceedings Unit)


Activity2014/15 2015/16

HoursP®rActivity

AB 1 244 Activfty



Reports dictation of Workers' Compensation Judges in connectionwithhearingsIncludesremotereportingsessionsviatelephoneorvideoconferenceTranscribeslegaldocumentsandgiveabriefsummationofthehearings.Prepares,scans,andmanagesdocuments/exhibitswithintheElectronicAdjudicationManagementSystem(EArnS).EnsureselectronicandpaperstenograptlicfilesareproperlyarchivedManagesinformationwithinEArnSasapplicabletoHearingReporterinteractionintheworkers'compensationhearingprocessVerbatimreportingofworkers'compensationproceedingsheldbeforethedistrictofricesoftheWorkers'CompensationAppealsBoard783678783636156 783678783636156 6.002.003.003.003.005.006.00 156721561567272312 156721561567272312 156721561567272312 156721561567272312 9361444684682163601,872

Totals: 4,464 3.0

Based on the assumption of the time it takes a curl.ent HR in the Adjudication Unit to perform similar duties. Due to the AB 1244 legislation the Adjudication Unit has increased responsibilities toadjudicate consolidated lien matters requiring supportive staff.



OFFICE TECHNICIAN . GENERAL

Attachment lll(Provider Suspension Hearings

and Disclosure Filing Requirements)


Activity2014/15 2015/16

HoursPerActivity

AB 1 244 Activity

2017/18 2018/19 2019/20 2020/21Assoc i atedAnnualHours


Reviews and evaluates complex documents, includ.Ing newdisclosurefilingrequirementsPreparesdocumentsforscanningintoElectronicAdjudicationManagementSystem(EArnS)IndexesdooumentsscannedintoEArnSEntersdocumentsthatareunreadablebyEAMS'opticalscannerintosystemRedactsconfidentialinformationfrompublicrecordsrequestedbynon-parties.15615615615672 15615615615672 4.004.003.003.005.00 312312312312144 312312312_312144 312312312312144 312312312312144 1,2481,248936936720

Inputs and serves documents as directed 36 36 3.00 72 72 72 72 216

Files and retrieves electronic and paper case files as directed 36 36 3.00 72 72 72 72 216

Acts as receptionist for parties appearing for hearings orconferencesAssiststhepublicwithusingEArnSandanswersquestions atcounterandbyphone.156312 156312 2.006.00 312624 312624 312624 312624 6243,744

Totals: 9,888 6.O

Based on the assumption of the time it takes a current oT to perform similar duties. Due to the AB 1244 legislation the Adjudication Unit lias increased responsibilities to adjudicate consolidatedlien matters requiring supportive staff to process and maintain documents.

WC Reforms (SB 1160 andAB 1244) Page 17 of35

Department of Industrial RelationsDivision of Workers. CompensationWorkload Data -Assembly Bill 1244


Attachment Ill(Special Lien Proceedings Unit)


Activity2014/15 2015/16

HoursPerActivity

AB 1 244 Activity


AdditionalStaffRequested(1,776hoursperposfron)

Provide administrative suppon, analysis, guidance and infomationregardingthespecialIienproceedingsandsuspensionprocess;coordinatesactivitiesofassignedjudges.Developandmaintainavarietyofelectronicfilesanddatabases.N/A6 N/A6 10.002.00 10412 10412 10412 10412 1,04024

Establish protocols for efficient use of shared folders, commonnomenclatureandprocedures6 6 2.00 12 12 12 12 24

Creates and audits case files 12 12 1.00 24 24 24 24 24

Maintain databasesCoordinateinteraction with a variety of public agencies andentities,includinglawenforcementagenciesandcountyandfederalauthorities. 1224 1224 1.0012.50 2448 2448 2448 2448 24600

Totals: 1736 1.0

Based on the assumption of the time it takes a current AGPA to perform similar duties. Due to the AB 1244 legislation the Adjudication Unit has increased responsibilities to obtain and analyzedata from external and internal sources.




Attachment Ill(Provider Suspension Hearings)

Actual # of Activities P rojected WorkIcad

Activity2014/15 2015/16

HoursPerActivity

AB 1 244 Activity



Provide administrative support, analysis. guidance and informationtoDivisionattorneysaspartofthesuspensionandconsolidationprocess,DevelopandmaintainavarietyofelectronicfilesanddatabasesN/A6 N/A6 10.002.00 10412 10412 10412 10412 1,04024

Establish protocols for efficient i]se of shared folders, commonnomenclatureandprocedures612 612 2.00 1224 1224 1224 1224 2424

Creates and audits case files 1.00

Track impending suspension dates; monitors ongoing criminalactions.NIA N/A 1.00 24 24 24 24. 24

Track requests for hearings regarding .Impending suspension NIA N/A 1.00 24 24 24 24 24

Assist in issuing suspension notices N/A N/A 1.00 24 24 24 24 24

Maintain databasesCoordinateinteraction with a variety of public agencies andentities,includinglawenforcementagenciesandcountyandfederalauthorities. 1224 1224 1,0012.50 2448 2448 2448 2448 24600

Totals: 1,808 1.0

Based on the assumption of the time it takes a current AGPA to perfom similar duties. Due to the AB 1244 legislation the Adjudication Unit has increased responsibilities to obtain and analyzedata from external and intemal sources.



LEGAL SECRETARY


Actual # of Activltles Pro]eeted Work load

Activity2014/15 2015/16

HoursP®rActiv'rty

AB 1 244 Activfty



Provide legal secretarial support to the DWC attorneys 12012036 12012036 2.002.001.00 24024072 24024072 24024072 24024072 48048072

Type a wide variety of legal doouments including, suspensiondetermination doouments, motions, memoranda of points and authorities,subpcenas, and discovery requests in state and federal trial couds andadministrative tribunals

Type briefs and other legal documents

Review applicable rules of court to detemine required fomats for court36 36 1.00 72 72 72 72 72docu ments

Review applicable style manual to ensure proper citation format 36 36 1.00 72 72 72 72 72

Type correspondence, memoranda, bill analyses, and other documents36 36 1.00 72 72 72 72 72from handwritten drafts and from dictation

Type Administrative Director decisions 36 36 1.00 72 72 72 72 72

Maintain databases 36 36 2.00 72 72 72 72 144

Maintain database to track assignments in the legal unit 36 36 2.00 72 72 72 72 144

Maintain case files and topic files. including filing documents 36 36 1.00 72 72 72 72 72

Sort incoming mail and distribute to the appropriate persons 312 312 0.50 624 624 624 624 312

Schedule hearings for challenges for suspension NIA.156 N/A156 1.001.000.50 24312 24312 24312 24312 24312

Handle a variety of incoming phone calls, return phone calls as requestedby the attorneys, communicate by telephone with a variety of courts andagencies, co-counsel, opposing counsel, and the general public

12 12 24 24 24 24 12Make travel arrangements for attorneys

Prepare travel expense claims 12 12 0.50 24 24 24 24 12

Maintain attorney and legal unit calendar 72 72 0.50 144 144 144 144 72

Assist in maintaining legal library. 6 6 0.50 12 12 12 12 6

Totals: 2'430 1.0

Based on the assumption of the time it takes a ourrent legal secretary to perform similar duties. Due to the AB 1244 legislation the legal unit will have increased responsibilities in the SpecialLien Proceeding. Legal secretarial assistance is necessary as a support function.

WC Reforms (SB 1160 and AB 1244) Page 20 of 35


SR. LEGAL TYPIST


and Special Li.en Proceedings Unit)


Activity2014/15 2015/16

HoursPerActivity

AB 1 244 ACtivity

2017/18 2018/19 201-9/20 2020/21Assoc iatedAnnualHours


Reviews and evaluates complex documents; extracts detailedinformationfromdocumentsPreparesandscansdocumentsintotheEIectronicAdjudicationManagementSystem(EArnS)52060 52060 2.003.50 1,040120 1,040120 1.040120 1,040120 2,080420

Inputs and serves documents 60 60 3.50 120 120 120 120 420

Retrieves case files as directed 120 120 6.00 240 240 240 240 1,440

Prepares letters, memos, legal orders and awards using EArnSternplates120 120 6.00 240 240 240 240 1 ,440

Prepares and processes wide variety of legal documents 260260 260 12.00 520 520 520 520 6,240

Creates cases and updates status of cases in EIectronicAdjudicationManagementSystem(EArnS)260 5.00 520 520 520 520 2,600

Answers and screens telephone calls 520 520 1,00 1,040 1,040 1,040 1,040 1,040

Prepares statistics 260 260 2.00 520 520 520 520 1,040

Transcribes machine dictation from Workers' CompensationAdministrativeLawJudgesofcomplexlegaldocuments240 240 4.00 480 480 480 480 1,920

Totals: 18,640 10.0

The hours and number of each activity is based on the assumption of the time it takes a current SLT to perform similar duties. Due to the AB 1244 legislation the Adjudication Unit has increasedresponsibilities to adjudicate consolidated lien matters requiring supportive staff to process and manage additional documents.



SPECIAL INVESTIGATOR


Actual # of Activities Ptojected WorkIoad

Activity2014/15 2015/16

HoursPerActivity

AB 1 244 Activity

2017/18 2018/19 2019/20 2020/21Assoc.iatedAnnualHours


Advises and consults with management on criminal actions against122612 122612 4.0012,004.00 245224 245224 245224 245224 9662496providers, employer fraud, advertising fraud, and medical over billing

and violations of the Labor Code

Independently conducts the most difficult and complex administrativeand civil investigations as it relates to medical provider fraud, illegalconduct by Qualified Medical Evaluators (QME), and employer fraud(misclassification of employees, underreporting of claims).

Locates and interviews witnesses

Analyzes and evaluates testimony 12 12 12.00 24 24 24 24 288

Gathers, assembles, preserves and reports facts. 12 12 4.00 24 24 24 24 96

Develops and maintains a variety of electronic files and databases 12 12 4.00 24 24 24 24 96

Establish protocols for efficient use of shared folders, common66 66 8.0016.00 1212 1212 1212 1212 96192nomenclature and procedures

Oversees the development, improvement, and maintenance of web-based automated mailing lists to ensure public access to the ageney'sregulatory process

Totals : 1,584 1.0

Based on the assumption of the time it takes the current investigator for the QME program to perform similar duties. Due to the AB 1244 legislative changes, the increased workload will require anadditional investigator to handle the increased workload.


Department of Industrial RelationsDivision of Administration -Office of Information SystemsWorkload Data -Assembly Bill 1244


Attachment IIl(Anti-Fra ud )

P rojected Workload

Activ fry HoursPe,Activity

AB 1244 Actlvlty


AddltionalStaffRequested(1,776hoursperposition)

Create ad-hoe reports and data extracts as needed for internal and external users. Provide high-level

10,0080.005.0070.004.0040.0040.00240.005.00 724100410044472 724100410044472 724100410044472 724100410044472 720320500280400160160960360data analysis upon request. Assist application development staff with understanding data and datarelationships, and ensure SOL statements used in application are tuned to maximize database reliabilftyand perfomance.

Facilitate the migration of database objects from Development to UAT/Production. Specify, create, andmaintain database instances in Development, Testing, UAT, and Production envii.onments includingconsistency with standards, security, data models and backup strategy for the database,

Troubleshoot complex production system problems related to Lien data, isolate causes, developsolutions, code, test, and document and install revised applications.

Identify, review, and approve approaches/proposed solutions to meeting business requirements forSpecial Lien Proceedings. Enforce best practices and cod]ng standards for utilizing IBM Cdram softwarefor meeting business requirements. Assign and coordinate the work efforts of project team members.

Troubleshoot complex production system problems, isolate causes, develop solutions, code, test, anddocument and install revised applications utiliz.ing SDLC concepts. Lead team efforts to develop solutionsfor maintenance problems.

Provide technical expehise in the review of project plans, designs and system specifications prepared byothers.Actas a technical advisor/resourcefuead for IT staff and the business unit. Act as subject matter expert

in Cdram java coding and provide guidance to other programming staff. Provide technical expertise in thereview of project plans, designs and system specifications prepared by others.

Develop impact assessments of proposed changes to EArnS Cdram, java code, and interfaces in contextof DIR's business enterprise and EArnS infrastructure. Design, develop, test and document Ct]ram,software enhancements and fixes for Special Lien Proceedings. Lead, conduct and participate in peerreview walk-through for design and coding. Lead work assignments with other lT staff, consultants, andvendors.

Troubleshoot complex production system problems, isolate causes, develop solutions, code, test, anddocument and install revised applications. Lead team efforts to test upgrades to the operatingenvironment and application components and lead/participate in system migration activities. Lead teamefforts to develop solutions for maintenance problems.


Department of Industrial RelationsDivision of Administration - Office of Information SystemsWorkload Data -Assembly Bill 1244


Attachment Ill(Anti-Fraud)

Pro]- WorkIoud

ActMty llou rsPerActivity

AB 1244 Actlvfty

2017/18 2018/19 2019/20 2020/21Ass ociat®dAnnualHours

Add itiona IStaffRequestod(1,776hoursperposition)

Review and analyze Special Lien Proceeding requirements For FileNet P8/IBM Form/Java/SSO,

240.0012.004.00100.00 44504 44504 44504 44504 96048200400

WebSphere application server and oracle database with internal and extemal users, lTtechnical/programming staff. lT service provider (OTech), DIR Enterprise FileNet team andrepresentatives/subject matter experts of all interfaces and financial institutions' systems. Perfom FileNctP8/IBM Form/Java/SSO/Oracle programming development, system integration, testing, deployment andmaintenance in EArnS and DIR Enterpn.se Document Content Management systems on WebSphereapplication server for Special Lien Proceedings

Document approved FileNet P8, IBM Form, Java, SSO and oracle change requests issue resolution forchanges and issues related to Special Lien Proceedings.

Review, analyze and discuss, and resolve Lien and DOR form reported issues with internal and externalusers, IT technical/programming staff and oTech staff related to IBM Form and its integration into EArnSand DIR Enterprise Document Content Management solution, including the interfaces to external financialinstitutions' systems

Perform server maintenance support for IBM Form application server and vet) environment (Windo`^rs,Oracle, WebSphere)

Plan and coordinate the procurement of necessary IBM Fom server (Windows, Oracle, WebSphere)80.00200.00310.00 141 141 141 141 80800310and network capability for Special Lien Proceedings.

Ahiculate business opportunities; Define logical business objectives; ldentfty key stakeholders; Analyzeas-is process for effective baseline of cunent state: Develop comprehensive business cases with cost,service, benefit dimensions of proposed lT changes for Special Lien proceedings for scope decisions.Apply technical and business knowledge in the analysis of DWC reqilirements for Special LienProceedings: Conduct analysis of DWC business processes and functional requirements and prepareBusiness Requirements Documents (BRD): Business Process Diagrams using Business ProcessModeling Notation (BPMN) and other tools to communicate and validate the infomation; Enter, track, andmanage requirements in Rational Requirements Composer/DOORS for tracabilfty; Study altematives andarticulate the validity of each; perfom financial analysis of alternatives; confirm alternatives are logical,practical and realistic; study impact on existing processes

Conduct and document market research and technology assumptions; validate solution requirementstraceability to business objectives; prepare Statements of Woik for technology vendors working onSpecial Lien Proceeding system functionalfty; develop cost worksheets; Create evaluation and selectionapproach; plan procurement dates and key action dates; alien budget and deadlines ùth solution;Complete administrative requirements in an accurate and timely manner (e.g. time reporting, statusreporting. ) Evaluate existing application products which could address client requirements and makerecommendations where appropriate; plan contract management; validate organizational readiness toproceed ; confirm stakeholder commitment; refine financial analysis;


Department of Industrial RelationsDivision of Administration -Office of Information SystemsWorkload Data -Assembly Bill 1244


Attachment Ill(Anti-F ra ud)

Projected Workload

Activ ity HoursPerActMfy

AB 1244 Activity


AdditionalStaffRequestod(1,776hoursperposition)

Develop schedules: Issue and Action Item management; ; Develop schedules, and project plans

160.0060.0060.0080.0040.0040.005.00200.00 4444441004 4444441004 4444441004 4444441004 640240240320160160500800including risk management, scope management, communications, and governance plans;. Report projectstatus and deviations from approved schedules; Identify risks and issues as well as potential mitigationstrategies and contingency plans; Manage schedules, issues, risks, and action items throughout systemdevelopment; Prepare internal and external project status repods.Coordinate System Deployment, Migration, Training. and outreach; develop and manage data migrationplan; schedule and track migration activities; articulate training needs; develop training plans; Providetraining and demos; Coordinate outreach activities with extemal stakeholders, Communicat.Ions office,and Program SinEs;

Analysis of operational Performance (Analyties).. Articulate reporting requirements; facilitate developmentof performance metrics: Coordi.nate change requests and continuing Improvement to systems based onnew legislative adjustment, feedback from operations, the public comment and rulemaking processes,and discovery of current unknowns. Ensure continuous improvement of business processes is notconstrained by systems; Monitor results, objectives attained, lessons leamed, and corrective actions;Document and manage stakeholder feedback and future system improvement requ.lrements

Assure optimum quality of testing at all levels including unit testing, sys.tern testing regression testing,UAT and smoke testing for complex changes made to the applications. Prepare time estimates andschedule complex manual and automated test activities. Coordinate with lT, business groups, andvendors, to communicate complex test plans to developers and testers.

Develop and improve elaborate test scripts (positive as well as negative), execute tests, and supporttesters testing case management functions as well as documents are submitted and processed throughEArnS: OCR, E-forms (both structured and unstructured) JET electronic filing system, holding tank,Curam database and FileNet repository.

Use Software testing tools, including Rational Functional Tester and Rational Qualfty Manager, XMLEditing tools like XML Spy to create and organize test suites, and automate test scripts.

Monitor, evaluate, analyze, investigate, and replicate complex issues reported by users relater to SpecialLien Proceedings before assigning issues to the appropriate developer for fixing. Document problemdescriptions and steps to replicate and assure that the issues are addressed in a professional and timelyfashion. Communicate with users, collect necessary information from them, and update them with theprogress and/or resolution of their issues. Distribute twork-arounds" when available.

plan. organize, and coordinate system deployments. Ensure that code, configuration, and datainstallations are done in accordance vwhh the Software Development Lifecycle (SDLC), from development,to test. to UAT, to production with proper sign-ofts and sequencing

Tota ls : 9,718 5.O


Department of Industrial RelationsDivision of Administration -Director.s officeWorkload Data -Assembly Bill 1244

ATTORNEY IV

Attachment Ill(Anti-Fraud Unit)

Projected Wo rkload

Activity HoursPerActivfty

AB 1244 Acevify



Reviews internal sources of information to find possible sources of6.00I5.00 2424 2424 2424 2424 144120medical provider fraud,

Reviews external complaints made to the department pursuant to LaborCode section 3823.

Reviews of referrals received from law enforcement. 5.002.504.509.0025.008.0015.00 24242424242424 24242424242424 24242424242424 24242424242424 12060108216600192360

Conducts consultations with law enforcements concerning oni)oingcases about the application of the relevant workers' compensation lawsand possible criminal violations.

Reviews information requests from law enforcement (for data anddocuments) held by DWC and DIR to determine the existence ofpossible of criminal violations.

Develop requests for data and other information from insurancecompanies to be used in conjunction with internalenforcemenvinvestigations of workers' compensation fraud.

Provides assistance to law enforcement agencies both informally and attrial with respect to expert legal opinions on workers' compensation.

Provides public outreach by making presentations, conducting seminarsand answering questions on workers' compensation fraud.

Advises the Director and Division Chief(s) on rulemaking, legislation,and general policy issues; testifies before legislative bodies; trains othercounsel and staff., and, leads and monitors work of less experiencedstaff in either litigation or as team leader.

Totals : 1,920 1.0

Based on the assumption of the time it takes the current ATY IV in the Director's office to perform similar duties. Due to the AB 1244 legislative changes, the increasedworkload will require an ATY IV to handle the new duties.


Department of Industrial RelationsDivision of Administration -Director`s officeWorkload Data -Assembly Bill 1244

ATTORNEY Ill

Attachment Ill(Anti-Fraud unit)

Projected Workload

ActivityHoursPerActivity

AB 1 244 Activity



Adjudicates lien proceedings in the special lien process. 24.00 52 52 52 52 1,248

Identifies parties to action and ensure that all parties are provided8.008.00 5252 5252 5252 5252 416416notice.

Conducts discovery, depositions, interrogatories, and dooumentproduction.

Negotiates resolutions/mediates lien proceedings. 16.00 52 52 52 52 832

Conducts appeals to lien proceedings within WCAB and civil courts. 24.008.008.00 525252 525252 525252 525252 1,248416416

Collects information from law enforcement agencies regardingmedical providers subject to criminal activities regarding medicalfraud and coordinates with other counsel.

Collects information from federal authorities regarding medicalproviders subject to criminal activities regarding medical fraud.

Handles appeals of stay orders regarding liens. 12.00 52 52 52 52 624

Administers procedures regarding suspension of medical providers16.0012.008.00 525252 525252 525252 525252 832624416from hearing to appeal.

Researches determinations of lien consolidation and all affectedcases at WCAB.

Performs a variety of other highly sensitive and/or complex legalduties requiring high level of skills, judgement, and diplomaey.

Totals: 7 ,488 4.0

Based on the assumption of the time it takes a current ATY Ill to perform similar duties. Due to the AB 1244 legislation the legal unit will have increased respons.ibilitiesand will be required to work with multiple outside agencies and appear at hearings on behalf of the Division.


Department of Industrial RelationsDivision of Administration -Director.s officeWorkload Data -Assembly Bill 1244

ATTORN EY

AIchment [Il(Anti-Fraud Unit)

ProJ.ected WorkIoad

Activ ity HoursPerActivity

AB 1 244 Act-lvity



Collects information from law enforcement agencies regarding29.001.502_006.006.004.008.00 2412-121216012012 2412121216012012 2412121216012012 2412121216012012 69618247296048096medical providers subject to criminal activities regarding medical

fraud_

Collects information from county authorities regarding medicalproviders subject to criminal activities regarding medical fraud.

Collects information from federal authorities regarding medicalproviders subject to criminal activities regarding medical fraud.

Handles appeals of stay orders regarding liens.

Administers procedures regarding suspension of medical providersfrom hearing to appeal.

Researches determinations of lien consolidation and all affectedcases at WCAB.

Performs a variety of other highly sensitive and/or complex legalduties requiring high level of skills, judgement, and diplomacy.

Totals: 2,346 1.0

Based on the assumption of the time it takes a current ATY ll to perform similar duties. Due to the AB 1244 legislation the legal unit will have increased responsibilities inthe Special Lien Proceeding and will be required to research and analyze data as well as determine what matters shall be included in the Special Lien Proceeding.


Department of Industrial RelationsDivision of Administration -Director`s officeWorkload Data -Assembly Bill 1244

SPECIAL INVESTIGATOR


Projected WorkIoad

Act iv ity HoursPerActivity

AB 1244 Activity

2017/18 2018/19 2019/20 2020/21Ass oc i atedAnnualHours


Acquires documents from licensing agencies and other2.001.004.004.008.004.00 338234541042425 338234541042425 338234541042425 338234541042425 676234216416192100agencies as necessary to support fraud investigations.

Acquires documents from licensing agencies and otheragencies as necessary to support field investigations ofmedical provider fraud investigations.

Requests information from insurance companies andothers pursuant to Insurance Code section 1877.3.

Analyzes data and documents a received from insurancecompanies and others to determine the existence orabsence of possible criminal violations.

Writes referrals to law enforcement for violations ofCalifornia law.

Provides information to state and federal agencies asnecessary in furtherance of criminal investigations.

Totals: 1,834 1.0

Based on the assumption of the time it takes the current investigator for the QME program to perform similar duties. Due to the AB 1244 legislative changes,the increased workload will require an investigator to handle the new duties.


Departhent of Industrial RelationsDivision of Administration -Director's officeWorkload Data -Assembly Bill 1244

LEGAL SECRETARY


Prof- Worklold

Activfty HoursPerActivity

AB 1244 ACtivfty

2017/18 2018/19 2019/20 2020/21A6sociatedAnnualHours

Add itionaIStaffFtequested(1.776hoursperpositon)

Provides legal secretarial suppor( to the DWC attorneys, including Industrial Relations Counsels I, Il, and Ill. 80_00 52 52 52 52 4,160

Prepares and files legal documents including special lien proceedings in stae and federal trial couits and administrative tribunals, 5.00 52 52 52 52 260Prepares and files legal documents including suspension determination documents in state and federal trial courts and adminlstratjve tribunals. 5.00 52 52 52 52 260

Prepares and files legal documents including motions in state and federal trial couds and administrative tribunals. 5.00 52 52 52 52 260

Prepares and files legal documents including memoranda of points and authorities in state and federal trial courts and administrative tribunals. 5.00 52 52 52 52 260

Prepares and files legal documents including subpoenas in state and federal trial coufts and administrative tribunals. 5.00 52 52 52 52 260Prepares and files legal dcouments including discovery requests in state and federal tiial courts and administrative tribunals. 5.00 52 52 52 52 260Schedules depositions and examinations of witnesses. 10.00 24 24 24 24 240Prepares and files briefs and other legal documents in state and federal appellate courts. 20.00 24 24 24 24 480

Reviews applicable rules of court to determine required formats for court documents. 5.00 12 12 12 12 60Reviews applicable style manual to ensure proper citation format. 5_OO 12 12 12 12 60Prepares and files correspondence, memoranda, bill analyses, and other documents from handwitten drafts and from dictation. 20. 00 24 24 24 24 480Prepares and files Administrative Director decisions. 10.00 12 12 12 12 120

IVlalntains databases. 10.00 12 12 12 12 120

Generates month ly statistics. 10.00 12 12 12 12 120

Tracks the assignment of cases to ensure timely issuanoe of decisions. 10.00 24 24 24 24 240

Maintains database to track assignments in the legal unit. 10.00 12 12 12 12 120

Maintains case files and topic files, including filing dcouments. 10.00 12 12 12 12 120

Sorts incoming mail and distribute to the appropriate persons. 2.50 104 104 104 104 260

Drafts correspondence. 5.00 52 52 52 52 260

Handles a variety of incoming phone calls, return prione calls as requested dy the attorneys, communicate by telephone with a variety of couits5.00 52 52 52 52 260and agencies, ocLcounsel, opposing counsel, and the general public.

Returns phone calls to members of the pubI.ic seeking status infomation on requests for summary rating reconsideration. 5.00 24 24 24 24 120

Makes travel arrangements for attorneys. 5.00 12 12 12 12 60

Prepares travel expense claims. 2.50 6 6 6 6 15

Prepares requests for out-service training. 2.50 6 6 6 6 15

Maintains attorney and legal unit calendar. 2.50 24 24 24 24 60

Assists in maintaining legal library. 2.50 4 4 4 4 10

Totals : 8.940 5.O

Based on the assumption of the time it takes a ourrent legal secretary to perform similar duties. Due to the AB 1244 legislation ttè legal unit will have increased responsibilities in the Special Lien Proceeding. Legal secretarialassistance is necessary as a support function.


Department of Industrial RelationsDivision of Administration . Director.s officeWorkload Data -Assembly Bill 1244


Attachment IIl(Ant.I-Fraud Unit)

Projected WorkIoad

Act iv ify HoursPerActivity

AB 1244 Activity

2017/18 2018/19 2019/20 2020/21Assoc i atedAnnualHours

Add itionaIStaffRequested(1,776hoursperposition)

Provides administrative support to Department attorneys20.004.002_002.002.004.004.00 527878787810452 527878787810452 527878787810452 527878787810452 1,040312156156156416208as part of the various investigation projects undertaken

by the investigation unit.

Creates and Audits Case Files.

Performs data cleansing of data elicited from internaldata sources.

Performs data cleansing of data elicited from extemaIdata sources.

Performs data cleansing of data of data found via .datasearches.

Coordinates interaction with a variety of public agenciesand entities, including law enforcement agencies andcounty and federal authorities.

Receives and processes documents received as a resultof information requests made to entities pursuant to1877.4.

Totals : 2'444 1.0

Based on the assumption of the time it takes the current WCC for the QME program to perform similar duties. Due to the AB 1244 legislative changes, theincreased workload will require an AGPA to handle the new duties.


Department of Industrial RelationsDivision of Administration -Director's officeWorkload Data -Assembly Bill 1244

RESEARCH PROGRAM SPECIALIST II


Proj®ct®d WorkIoad

Acti vi ty HoursPerActivity

AB 1 244 Activity



Provides research support to Department attorneys as20.008.00 4848 4848 4848 4848 960384part of the various investigation projects undertaken by

the .Investigation unit.

Coordinates the development of incoming data sourcesfrom multiple internal and external data sources.

Maintains a variety of electronic files and databases. 8.00 24 24 24 24 192

Establishes protocols for efficient use of shared folders. 4.004.004.0024.002.00 824484848 824484848 824484848 824484848 32961921,15296

Coordinates data transfer interactions with externalparties, including law enforcement agencies.

Develops research methodologies and coordinates theanalysis of evidence for requests made to entitiespursuant to 1877.4.

Runs data searches across multiple databases forinformation requested by Department Attorneys.

Coordinates internal database improvement for thepurpose of case identification and aggregate dataanalysis.

Totals : 3'104 2.0

Based on the assumption of the time it takes the current RPS Il in the Research Unit to perform similar duties. Due to the AB 1244 legislative changes, theincreased workload will require a RPS II to handle the new duties.


Department of Industrial RelationsDivision of Administration . Director's officeWorkload Data -Assembly Bill 1244

CAREER EXECUTIVE ASSIGNMENT

Ahachment lll(Anti-Fraud Unit)

Projected Workload


AB 1244 Activity

2017/18 2018/19 2019/20 2020/21Ass oc iatedAnnualHours


The incumbent plans, organizes and directs DIR's Anti-480.00240.003.006.001.004.0012.00 112424522452 112424522452 112424522452 112424522452 480240721445296624Fraud Analysis services program.

The CEA is specifically responsible for development ofdepartmental poliey impacting the Anti-Fraud Analysisservices program.

This position serves as the primary liaison for DIR withother agencies and represents the department with theAdministration and constituent groups.

This position is responsible for the identification andanalysis of proposed legislation and development of thedepartment's legislative proposals, related policies,research agendas, and other communication tools.

Develops weekly repolts to the Director on status andperformance metrics.

Prepares presentations and deliverables for the Directorto apprise the Executive branch, the Legislature, and thepublic on the Anti-Fraud Analysis program's progress todate_

Manages a high level team of attorneys, investigators,analysts and researchers.

Totals: 1,708 1.0

Based on the assumption of the time it takes other DIR CEAs to perform similar duties. Due to the AB 1244 legislative changes, the increased workload willrequire an CEA to lead, manage and handle the new duties.


Department of Industrial RelationsDivision of Administration . Human ResourcesWorkload Data -Assembly Bill 1244 and Senate Bill 1160

PERSONNEL SPECIALIST

Activfty

Actual # of Activdes Prqjed Workload

2014/15 2015/16

HoursPerActivity"

AB 1244 a sB iieo Activrty

2017/18 2018/19 2019/20 2020/21Assoc iatedAnnuaIHours

AdditionalStaffR®quested(1.776hoursp®,po®it'on)

use salary rules to dctermine salaries for ne\^r & existing employoes, 1.00 71 71 71 71 71

Process monthly payroll, special pay & ovenime. Process & collect accounts rec®ivables.

692

0.06 852 852 852 852 51

Revie\^/ & process all beneft forms and assist employees vvith questions. Follow up whh SCO

898

0.06 852 852 852 852 51& CalPERS on beneft deductions. Send appeals to CalHR.

Process leave of absence & catastrophie leave requests. 0.03 852 852 852 852 26

Maintain roster for active employees - Enter employee contact, appointmeof, separation &1.50 71 71 71 71 107probationary repoh infomation: 607 processes: run various reports: & verify monthly payroll.

Process all new, transfer & promotional appoimments in SCO'8 payroll system. Contact3.00 71 71 71 71 213certification u nit for appointment clearance.

Process all separations & transfers out of the department & key into SCO'8 payroll System.94 248 3.00 7 7 7 7 21Work with gaining department if necessary. Audit leave balances.

Prcoess all retirements in SCO.s payroll system as well as liimp sum deferrals at time of115 99 5.00 3 3 3 3 15retirement. Work with Savings PIus & CaIPERS. Audit leave balances.

Misce«aneous Transactions . Process position number changes, pay differential updates to0.020.03 852852 852852 852852 852852 1726employee history, range changes, mefft salary increases, time base changes, etc.

Correspondence & Communication - Memos to control agencies, response to grievances,communication with other government agencies, information reduests for adverse actions,em ployment verifications , etc.

Intemittent Em'ployees -Track hours & time keeping 0.01 34 34 34 34 0

Audit, reconcile & manually key attendance to State Cofitrollers' Crmoe (SCO) 0.20 852 852 852 8529 1700

Disabilfty Illness/Injury -Process paperwork for payments. lssu. supplemental pay if0.05 9 9 9necessary & continue benefts for employees. Audit leave balances. Work with EDD on

elieibllfty & process FMIA verification`

Process Wage Gamishments -Verf)/ documents & send gamishment request to SCO 0.02 852 852 852 852 17

Special Projects/Assign ments 2.00 12 12 12 12 24

Conduct Training & Orientations 2.00 12 12 12 12 24

Administration - Receive training. manual updates, filing, time sheets, staff meetings 16.00 12 12 12 12 192

Customer Service . Telephone calls, e-mail, perSonal contact w/ division Attendance60.00 12 12 12 12 720Roponing officers & employees.

Notiee of Adverse Action/Stipillations - Prepare & process tranSactionS to b® koyed in SCO's2.00 1 1 1 1 2

payroll system. Prepare stipulations to be sent to SCO for keying. 2/

Totals : 1,747 1.0

Attachment Ill(Transactions Unit)

Notes

1 hour per position

6 hours per 100 employees per month852 --71 positions x 12 months

6 hours per 1 oo employees per month

3 hours per loo employees per month

1.5 hours per position

3 hours per appointment x 71 positions

3 hours per separation1 O% of employees separate annually

5 hours per re6rement4% of employees retire annually



1 hour per 100 intermittent employees per month4% of employees are intermittent x 12 months

20 hours per 100 employees per month

5 hours per 100 employees per month1 % of employees receive IDL or NIDL each month


2 hours per Personnel Specialist per month




2 hours per case2% of employees receive Adverse Action annually

''The Hours Per Activfty are based on a combination of PML 2002.067, Section 14.12 of the 2007 Bargaining Unit ol contract and feedback from the DIR Personnel Specialists (and their supervisors) who perform these duties on a daily basis.

WC Refoms (SB 1160 and AB 1244) Page 34 of 35

Department of Industrial RelationsDivision of Administration - Human ResourcesWorkload Data . Assembly Bill 1244 and Senate Bill 1160

PERSONNEL TECHNICIAN I

Activity

Actual # of Activ.ItI.es Projected Worklcad

2014/15 2015/16HoursPerActivity

AB 1244 a sB iico Acavfty


Ad d itiona IStaffRequested(1.776hoursperposfron)

Entering Exam Control and Exam BulletinReleaseintoSCO(numberofexams)Enteringaccepted&rejectedapplications intoExamControl;print&mailnotices(numberofapplications)Scheduleapplicantsforexam;enterschedules,printandsendnotices,acceptconfirmationsandrescliedules(numberofapprovedapplications)Assembleexampackets,orderingratingsheets(numberofexams)Score/otherrecords(statisticaldata,preferredworklocations)intoSCO,fileexamrecords,sendoutexamresults,closeexamandgenerateeligibilitylist(numberofapprovedapplications)251,24793925939 231,23088623886 0.330.332.0024.002.00 1063048010480 1063048010480 1063048010480 1063048010480 3208960240960

Tota ls : 2,371 1.O

WC Reforms (SB 1160 and AB 1244)

Attachment IIl(Exams Unit)

NotesFour of the classifications requested in the BCPwill require department specific examsadministered by DIR. Two of these exams willbe done quarterly.

Over the last four years, the average number ofapplications received per exam = 63.

Over the last four years, the averagepercentage of applicants accepted andscheduled for exam = 75%.

Based on number of exams needed.Overthelastfouryears,theaverage

percentage of applicants accepted andscheduled for exam = 75%.

Page 35 of35

DEPAR"ENT OF INDUSTRIAL RELATIONSFISCAL YEAR 2017-18 FINANCE LETTER

FUND C0NDllloN STATEMENT(dollars in thousands)

Actual Actual Estimated2014-15 2015-16 2016-17

Proposed2017.18

Proposed2018_19

Proposed2019-20

Attachment IV

Proposed2020-21

Proposed2021 -22

0223 Workers' Compensation Administration Revolving Fund

BEGINNING BALANCEPrior Year Adjustments

Adjusted Beginning Balance

REVENuES, TRANSFERS AND OTHER ADJuSTMENTSRevenues:

4129200 Other Regulatory Fees4129400 Other Regulatory Licenses and Permits4163000 Investment Income -Surplus Money Investments4171400 Escheat -Unclaimed Checks, Warrants, Bonds, and Coupons4172500 Miscellaneous Revenue4173000 Penalty Assessments -Other4173500 Settlements and Judgments -Other

Total Revenues, Transfers, and other Adjustments

Totals, Resources

EXPENDITURES AND EXPENDITURE ADJUSTMENTSExpenditures:

7350 Department of Industrial Relations (State operations)2017-18WC Reforms (SB 1160 and AB 1244) FL8880 Financial Information System for California (State operations)

$281,312 $349,731 $360,6791,725 2,684

$283,037 $352 ,415 $360,679

251,2911,360

551

231,9771,4561,336

174,8461,430

7184

1

1,064 5,643 3,96555

$254,325 $240,413 $180,959

$537,362 $592 ,828 $541,638

187,376 231,589 311,112

255 560 3979900 Statewide General Administrative Expenditures (Pro Rata) (State operations) 8,553

Total Expenditures and Expenditure Adjustments

FUND BALANCE

Reserve for economic uncerfaintles

WC Reforms (SB 1160 and AB 1244)

$187,631 $232,149 $320,062

$349,731 $360,679 $221,576

349,731 360,679 221,576

$221,576

$221,576

318,3921,530

718

3,965

$324,605

$546,181

310,97914,710

40712,489

$338,585

$207,596

207,596

$207,596

$207,596

318,3921,530

718

3,965

$324,605

$532,201

310,97913,575

40712,489

$337 ,450

$194.751

194,751

$194,751

$194,751

318,3921,530

718

3,965

$324,605

$519,356

310,97913,575

40712,489

$337,450

$181,906

181,906

$181,906 $169,061

$181,906 $169,061

318,392 318,3921,530 1,530

718 718

3,965 3,965

$324 ,605 $324,605

$506,51 1 en93,666

310,979 310,97913,575 13,575

407 40712,489 12,489

$337,450 $337,450

$169,061 $156,216

169,061 156,216

Page 1 of1

DF46 (REV 03/13)

Fiscal Summary(Dollars in thousands)

Operating Exp®ns®s and EquipmentAC 5301400 General Expense 0 475 121 121AC 5302900 Printing 0 64 39 39AC 5304800 Communications 0 142 97 97AC 5306100 Postage 0 848 848 848AC 5320490 Travel-ln State 0 185 185 185AC 5320890 Travel-Out of State 0 0 0 0AC 5322500 Training 0 14 14 14AC 5324350 Facilities operations O 1.049 1,049 1,049AC 5326900 Utilities 0 O 0 0AC 5340330 Consulting & Professional Services: nterdepartmental 0 208 108 108AC_5340580 Consulting & Professional Services: External 0 1,086 711 711AC 5344000 Data Center Services O 277 277 277AC_5346390 Information Technology 0 1,799 1,563 1,563AC 5362290 Equipment 0 3 3 3

Other/Special Items of Expense: as as

0 0 0 0AC 5342500 Distributed Administration / Indirect Costs 0 0 0 0

Total operating Exp®nS®S and Equipment $0 $6,150 $5,015 $5,015Total State operations Expendituros $0 $14,710 $13,575 $13,575

Fund Source Itom Number ¥g-as -} ¥^S€£_

Org Ref Fund ``` `.

Special Fund: Wkrs' Comp Admin Revolving Fund 7350 001 0223 SO $14,710 $13,575 $13,575

Total Local Assistance Expendituros $0 SO $0 $0

Fund Source ltem Number RA3>SteFS:+fs,`#SktSS{. _. i.L i _= -_"..?..'-\._ +i-{` ._.::

` ,; £ ^,6i5:l-¢;,` =j,*-ry`,J €`k*§§sÈx>:§%asasf%REse

Org Ref Fund :+T?General FundSpecial FundsFederal FundsOther Funds (Specify)Reimbursements

$13,575

Personal Sorvicos Detallunole dollars)

BCP No.7350-100-BCP.2017-A1

Proposal TitleWorkers' Com nsation Reform SB 1160andAB 1244

Salaries and Wag®8 Detail

CIa8slficatlonPool tion8 SalaryRange Dollars

CY BY BY+1 BY+2 CY BY BY+1 BY+2Division of Workors' ComDensation:NuRSE CONSULTANT Ill (SPECIALIST) 0.0 0.O 0.O 0.0 $6,224-$11,584 O 0 0PRESIDING WORKERS' COMPENSATION JUDGE 0.0 1.0 1.0 1.0 $8,720-$10,867 117,000 117,000 117,000INDUSTRIAL RELATIONS COUNSEL lll (SPECIALIST) 0.0 5.0 5.O 5.0 $8,434-$10,820 577,620 577,620 577,620WORKERS' COMPENSATION JuDGE 0.0 8.0 8.O 8.0 $8,227-$10,348 891,648 891,648 B91,648STAFF SERVICES MANAGER ll (SUPERVISORY) 0.O 1.0 1.O 1.0 $5,830-$7,245 78,456 78,456 78,456RESEARCH PROGRAM SPECIALIST ll 0.0 1.O 1.0 1.O $5,550-$6,947 74,988 74,988 74,988SPECIAL INVESTIGATOR 0.0 1.0 1.0 1.O $4,140-$6,446 63,516 63,516 63,516HEARING REPORTER 0.0 3.0 3.O 3.O $4 , 988-$6, 24 3 202.176 202.176 202,176RESEARCH ANALYST ll -GENERAL 0.0 1.O 1.O 1.0 or.829.$6,048 65,268 65,268 65,268ASSOCIATE GOVERNMENTAL PROGRAM ANALYST 0.0 5.0 5.0 5.0 $4,600-$5,758 310,740 310,740 310,740LEGAL SECRETARY 0.0 1.0 1.O 1.0 $3,176-$4,176 44,112 44,112 44,112

SENIOR LEGAL TYPIST 0.0 10.O 10.0 10.0 $2,707-$3,785 389, 520 389,520 389,520OFFICE TECHNICIAN (GENERAL) 0.0 6.0 6.0 6.O $2,758-$3,455 223,704 223,704 223,704

Office of the Director . Anti-Fraud unit:C. E_A. 0.0 1.0 1.O 1.0 $6,647.$15,129 130,656 130,656 130,656ATTORNEY IV 0.0 1,O 1.0 1,0 $9,316-$11,962 127,668 127,668 127,668ATTORNEY Ill 0.0 4.O 4.O 4.0 $8,434-$10,820 462,096 462,096 462,096ATTORNEY 0.0 1.O 1.O 1.0 $5,130-$8,938 84,408 84,408 84,408RESEARCH PROGRAM SPECIALIST Il a.0 2.O 2.O 2.O $5,550-$6,947 149,976 149,976 149,976SPECIAL INVESTIGATOR 0.0 1.0 1.0 1.0 $4,140-$6,446 63,516 63,516 63,516ASSOCIATE GOVERNMENTAL PROGRAM ANALYST 0.0 1.0 1.0 1.0 $4,600-$5,758 62,148 62,148 62,148LEGAL SECRETARY 0.0 5.0 5.0 5.0 $3,176-or,176 220,560 220,560 220,560

Division of Admin - Office of Information Sorvlces:SYSTEMS SOFTWARE SPECIALIST Ill (SuPERVISORY) 0.0 1.0 1.0 1.0 $6,708-$8,817 100,750 100,750 100,750SENIOR INFORMATION SYSTEMS ANALYST (SPECIALIS 0.O 7.0 7.0 7.0 $5,824-$7,655 594 , 468 594,468 594 , 468SYSTEMS SOFTWARE SPECIALIST ll (TECHNICAL) 0.0 1.O 1.0 1.0 $5,814-$7,642 84,772 84,772 84,772STAFF INFORMATION SYSTEMS ANALYST (SPECIALIST) 0.0 3.O 3.O 3.O $5,295-$6,963 231,676 231,676 231.676

DIvision of Admin - Human Resoureos:PERSONNEL SPECIALIST 0.0 1.0 1.0 1.0 $2,72o-or.380 42,600 42,600 42,600PERSONNEL TECHNICIAN I 0.0 1.0 1.0 1.0 $2,517-$3,690 37,248 37,248 37,248

Total Salaries and Wago8 0.0 73.O 73.0 73.0 SO $5,431,290 $5,431,290 $5,431,290

Staff Boneflt8 Dotall CY BY BY+1 BY+2OAS Dl $0 $336,739 $336,739 $336.739Health/DentalIVision Insurance 0 572,568 572,568 572,568Retirement grit_REi i*

in iscel laneous 0 1,451,675 1.451,675 1,451,675Safety O O 0lnd ustrial 0 O 0Other: 0 0 O

Workers' Compensation 0 368,132 368.132 368,132Industrial Disability Leave O 13,741 13,741 13,741Non.Industrial Disability Leave 0 923 923 923Unemployment Insurance O 2,769 2.769 2,769Otller: 0 380,299 380,299 380,299

Total Staff Boneflts SO $3,126.846 $3.126.846 $3,126,846

Grand Total, Personal Services $0 $8,558,136 $8,558,136 $8,558.136

Supplemental Information(Dollars in thousands)

BCP No.

7350-100-Bop-2017-A1Proposal Title

Workers' Com ensation Reform SB 1160and AB 1244

Equipment CY BY BY+1 BY+2

Total SO SO $0 $0

Consulting & Professional ServicesSubscription to Court Documents 6 6 6C o ntractor 400 25 25Contract -Medical Training and updating Modules 100

Dept of Technology -Information Technology Project oversight Division 108 108 108

System Design and Development Vendor 390 390 390Validation and Verification Vendor 290 290 290

Total SO $1,294 $819 $819

Facility/Capltal Costs

Total SO $0 $0 $0

One-Time/Llmlted-Term Costs Yes I NOE

Description CY BY BY+1 BY+2Positions Dollars Positions Dollars Positions Dollars Posltlons Dol lars

Standard Complement 0 659 0 0

0.0 $0 0.0 $659 0.0 $0 0.0 $0Full-YearCostAdjustment YesE NoHProvide the incremental change in dollars and positions by filscal year.

Item NumberCY BY BY+1 BY+2

Positions Dollars Positions Dollars Posltions Dollars Positions DoI Iars

Total 0.0 $0 0.0 $0 0.O $0 0.0 $0FutureSavings YesH NoESpecify fiscal year and estimated savings, including any decrease in positions.

Item NumberCY BY BY+1 BY+2

Positions Dollars Positions Dol lars Positions Dollars Positions Dollars

Total 0.0 $0 0.0 $0 0.0 $0 0.0 $0

I