Health Care & Reproductive Rights

LOS ANGELES - Attorney General Kamala D. Harris and 37 other state attorneys general today sent a letter to Congress in support of proposed legislation, the Comprehensive Addiction and Recovery Act of 2015 (S.524/H.R.953), to increase prevention and treatment of heroin and opioid abuse. 

“Drug addiction hurts individual lives, families and communities, posing serious risks to public safety and public health,” said Attorney General Kamala D. Harris.  “Being smart on crime requires a comprehensive response to addiction, including data-driven prevention, education and drug treatment programs.”

The Comprehensive Addiction and Recovery Act will create new evidence-based treatment and intervention programs, increase resources available to first responders and law enforcement to reverse overdoses and save lives, and create more disposal sites for unwanted prescription medications.

The proposed federal legislation would also strengthen prescription drug monitoring programs to help states monitor and track prescription drug diversion and to help at-risk individuals access services.  The California Department of Justice recently launched a 2.0 version of California’s prescription drug database, Controlled Substance Utilization Review and Evaluation System (CURES), which features a variety of performance improvements and added functionality.

According to the Centers for Disease Control and Prevention (CDC), drug overdoses are the leading cause of injury-related death for Americans aged 25 to 64.

A copy of the letter from 38 attorneys general, including Attorney General Harris, is attached to the online version of this release at www.oag.ca.gov/news.

SAN FRANCISCO - Attorney General Kamala D. Harris today announced changes to regulations implementing Proposition 65, the landmark law requiring businesses to provide warnings if they expose individuals to any listed carcinogens or reproductive toxins.    

The proposed amended regulations are the product of nearly five years of analysis and have been drafted in consultation with business and environmental groups.  They are intended to protect public health and the environment while helping to stem abuse of the law’s mechanism to allow for enforcement by private parties.  The amendments mark the first substantial change to the Attorney General’s Proposition 65 regulations since their adoption in 2001-2003. The 45-day public comment period is open until November 9.

“California has led the nation for decades in protecting our residents and the environment from pollutants and toxic chemicals,” said Attorney General Harris.  “These proposed changes maintain the intent of Proposition 65 and our vital legacy of public health and environmental protections while eliminating incentives to abuse the system.  Good public policy means rejecting the false choice that suggests we must sacrifice our commitment to the environment and public health for California businesses to thrive.”

In 1986, California voters approved the initiative to address their growing concerns about exposure to toxic chemicals. These regulatory changes will help restore public confidence that Proposition 65 is used for its proper health-protective purposes and not abused for private gain.  The proposed amendments focus on increased transparency and accountability to ensure that civil penalties in litigation brought by private enforcers under Proposition 65 are used for purposes that are clearly defined, relevant to the violations which prompted the settlement, and beneficial to Californians. 

The proposed regulations would also increase accountability by capping “in lieu of penalties” payments to ensure that the Office of Environment Health Hazard Assessment receives revenues necessary to continue its work of implementing Proposition 65 and protecting public health, as intended by the statute.  The proposed changes also raise the bar for demonstrating that settlements requiring reformulation confer a significant public benefit, instead making individual cases fact-specific and stating that payments under a settlement “may” confer public benefit.

For information on submitting public comments, click here.

Attorney General Harris has a long history of taking action to protect the health and well-being of California communities.  She has filed lawsuits to enforce Proposition 65 and other environmental laws, protecting local communities from diesel emissions, hazardous electronic waste, and other harmful pollutants.  She has also supported the Environmental Protection Agency’s efforts to curb greenhouse gas emissions from coal-fired power plants and led a coalition of states in intervening to defend the EPA from attacks and legal challenges.

SAN FRANCISCO -- Attorney General Kamala D. Harris announced today that her office has filed involuntary manslaughter charges against Montrose, California-based Verdugo Valley Skilled Nursing & Wellness Centre, LLC for failing to provide requisite nursing care to a burn victim resident, leading to his death.

“Families who entrust loved ones to the care of a nursing home rightfully expect residents will receive the care and attention they need and that nursing homes have a legal duty to provide,”  said Attorney General Harris.  “We have filed criminal charges because we allege Verdugo Valley and its employees violated that trust and their legal duties in a way that resulted in a senseless, tragic and unnecessary death.  I thank the California Department of Justice’s Bureau of Medi-Cal Fraud and Elder Abuse attorneys and agents working tirelessly to ensure these individuals are held accountable.”

The complaint filed by Attorney General Harris alleges that Verdugo Valley, LLC was grossly negligent in its care of James Populus, a resident with burns on 90 percent of his body from an arson fire two decades earlier.  In the 14 months that Populus was in the care of Verdugo Valley, he was examined by a doctor far fewer times than required by law, despite the respiratory and other health needs of burn victims.   

His declining health led to severe weight loss, sepsis, and pneumonia and on August 30, 2014, Populus died of multiple system failure due to sepsis. At the time of his death, Populus had infections throughout his body.

Charges of dependent adult abuse causing death have been filed against the facility’s director of nursing, Alexiuse San Mateo, who was responsible for Populus’s care at the facility and willfully permitted the patient’s death. Consuelo Policarpio, the supervising nurse, is charged with dependent adult abuse causing great bodily injury due to a delay in calling 911. 

Verdugo Valley Skilled Nursing & Wellness Centre, LLC, San Mateo and Policarpio were arraigned yesterday.

San Mateo faces 9 years in state prison and a $10,000 fine and Policarpio faces a maximum of 7 years in state prison and a $10,000 fine. Verdugo Valley, LLC faces a $10,000 fine and exclusion from any state or federally funded health care program.

The Declaration in Support of Arrest Warrant alleges that staff at Verdugo Valley delayed calling 911 and failed to document critical changes in their patient’s condition, in addition to making false entries in medical records.

In the 14 months that Populus was a patient at Verdugo Valley, 80 change of condition forms required signature by a treating physician, but all 80 forms were void of a doctor’s signature. The facility named the patient’s primary care doctor as his treating doctor from the hospital; however, this doctor did not have a relationship with Populus and never visited him at Verdugo Valley.

The case stems from an investigation conducted by the California Department of Justice’s Bureau of Medi-Cal Fraud and Elder Abuse. Since taking office in 2011, Attorney General Harris has created specialized BMFEA teams in Sacramento and Los Angeles composed of legal and nursing professionals to combat abuse, neglect and poor quality of care in California’s nursing homes.

A copy of the complaint and declaration in support of arrest warrant submitted to the court is attached to the online version of this release at www.oag.ca.gov/news. 

Attorney General Kamala D. Harris issued the following statement on the U.S. Supreme Court ruling in King v. Burwell:

“The Affordable Care Act delivered access to quality, affordable health coverage to millions of Californians who otherwise would not have been able to afford insurance. Today’s decision by the U.S. Supreme Court in King v. Burwell ensures that millions of families can keep their affordable health insurance. Because of this ruling, health insurance continues to be accessible to every American, making our entire nation healthier and more prosperous.”

SAN FRANCISCO — Attorney General Kamala D. Harris today issued a statement on the decision by Prime Healthcare Services, Inc. and Prime Healthcare Foundation, Inc. (collectively Prime) not to follow through on its proposed purchase of the six Daughters of Charity Health System health facilities. 

“The Daughters of Charity health facilities and the emergency, trauma and surgical services, among others that they provide, are essential to the communities who rely on them.  Following an in-depth review by independent health care consultants, 44 hours of public meetings and review of 14,000 comments from concerned community members, I imposed conditions to ensure the continuity of these health care services, including that the most essential health care services remain in place for ten years. In December of last year, the independent health care consultants recommended the ten-year conditions and Prime was notified at that time. Now, after two and a half months, Prime is saying these conditions are a deal breaker. 

Prime is choosing to walk away from this transaction after publicly stating that it had no issue with the ten-year conditions and intended not to close any of the hospitals or end essential services.  By walking away, Prime is confirming many of the concerns heard at multiple community meetings that the continuity of vital healthcare services in these communities is not its priority.” 

SAN FRANCISCO—Attorney General Kamala D. Harris today issued her decision granting conditional approval of the change of control and governance of  Daughters of Charity Health System that includes six health facilities to Prime Healthcare Services, Inc. and Prime Healthcare Foundation, Inc. (collectively Prime).  This approval includes strong conditions to ensure continued community access to essential healthcare services.

The transaction includes the following six health facilities:

• St. Vincent Medical Center
• St. Francis Medical Center
• O’Connor Hospital
• Saint Louise Regional Hospital
• Seton Medical Center
• Seton Coastside

The Attorney General approved the transaction with the following key conditions:

• For ten years, Prime must operate St. Francis, O’Connor, Saint Louise and Seton Medical Center as acute care hospitals and offer emergency services.
• For ten years, Prime must operate Seton Coastside as a skilled nursing facility with emergency services.
• For ten years, Prime must be certified to participate in the Medi-Cal and Medicare programs and have or maintain Medi-Cal managed care contracts at each of the facilities.
• Prime must continue to provide essential health care services at the facilities including reproductive health care services.
• Prime must invest $150 million in capital improvement expenditures at the facilities over the next 3 years.
• Prime must continue to provide charity care and community benefits at historical levels.
• Prime will assume and guarantee all pension obligations covering approximately 17,000 current and retired employees.
• At each of the facilities and the medical office buildings, there shall be no restriction or limitation on providing or making reproductive health care services available, and this requirement must be explicitly set forth in the facilities’ policies and procedures.
• Prime must meet seismic compliance requirements until 2030 at all the facilities, including retrofitting the patient tower at Seton Medical Center.
• Prime  must revise its policies, tools, procedures, guidelines and training materials for its debt collection practices to ensure it does not violate state and federal debt collection laws and regulations. 
• At each of the facilities and the medical office buildings, there shall be no discrimination against lesbian, gay, bisexual or transgender individuals, and this requirement must be explicitly set forth in the facilities’ policies and procedures.
• All of the facilities will be required to submit to the Attorney General an annual report describing in detail their compliance with the conditions. 

The sale of the Daughters of Charity facilities is the largest transaction ever reviewed by the California Attorney General’s Office.  The decision to approve the transaction follows an in-depth review that included  five independent Health Care Impact Statements, six public meetings that collectively went more than 44 hours and where hundreds of comments were submitted, receipt and consideration of more than 14,000 comments separately delivered to the Attorney General’s Office, and consultations with  independent health care experts and concerned community members.  

The Attorney General’s decision conditionally approving the transaction with the full list of conditions can be found here: http://bit.ly/17BXffN

Attorney General Kamala D. Harris today issued the following statement on the passage of Senate Bill 1094: 

“SB 1094 is about good public health policy that ensures choice and access to quality, affordable healthcare for underserved communities. I want to thank Senator Lara for introducing this bill and applaud the Assembly and Senate for passing this important legislation.”

LOS ANGELES -- Attorney General Kamala D. Harris issued the following statement on the U.S. Supreme Court ruling in Burwell v. Hobby Lobby:

“A woman’s access to quality, affordable preventive healthcare coverage should not depend on her employer’s beliefs. Every woman should be able to make healthcare decisions for herself and her family. I am deeply disappointed that the Court ruled to limit this important right.  

The decision also opens a perilous loophole that may enable private, for-profit companies to challenge other common-sense laws—including those that protect against discrimination—based on the religious beliefs of their shareholders or managers.”

In January 2014, Attorney General Harris was joined by 13 states and the District of Columbia to file a friend-of-the-court brief that urged the U.S. Supreme Court to overturn the decision by the U.S. Court of Appeals for the Tenth Circuit which held that for-profit businesses may exercise religion and therefore are covered by the Religious Freedom Restoration Act of 1993.

SAN FRANCISCO – Attorney General Kamala D. Harris today announced a $105 million multistate settlement with GlaxoSmithKline, LLC (GSK) to resolve allegations that the company unlawfully promoted its asthma drug, Advair, and antidepressant drugs, Paxil and Wellbutrin. California’s portion of the settlement is the largest of any state, at $7,087,897.

For the first time in a settlement with a large pharmaceutical manufacturer, GSK is prohibited from providing incentive payments to its salespeople, which serve to encourage off-label promotion of drugs, and from using paid doctors to promote its products.

“Patient care is undermined when pharmaceutical companies promote uses for drugs that have not been approved by the FDA or pay medical professionals to promote certain drugs,” Attorney General Harris said. “This settlement requires GSK to pay a significant penalty and imposes strong new rules designed to prevent future misrepresentations of GSK products.”

The Complaint and Stipulated Judgment, submitted today to the San Diego County Superior Court, alleges that GSK violated state consumer protection laws by misrepresenting the uses and qualities of certain drugs. Specifically, GSK shall not:

• Make, or cause to be made, any written or oral claim that is false, misleading, or deceptive about any GSK product;
• Make promotional claims, not approved or permitted by the FDA that a GSK product is better, more effective, safer, or has less serious side effects or contraindications than has been demonstrated by substantial evidence or substantial clinical experience;
• Present favorable information or conclusions from a study that is inadequate in design, scope, or conduct to furnish significant support for such information or conclusions, when presenting information about a clinical study regarding GSK products in any promotional materials;
• Provide samples of GSK products to those health care professionals who are not expected to prescribe the sampled GSK products for an approved use, but who would be expected to prescribe the sampled product for an off-label use; or
• Disseminate information describing any off-label use of a GSK product, unless such information and materials are consistent with applicable FDA regulations and FDA Guidances for Industry. 

The Stipulated Judgment also requires GSK to continue its Patient First Program at least through March 2019.  The Patient First Program reduces financial incentives for sales representatives to engage in deceptive marketing. In addition, the Judgment requires scientifically trained personnel to be ultimately responsible for developing and approving responses to health care provider questions and for these responses to be unbiased and non-promotional.

Forty-three additional states and the District of Columbia participating in the settlement include: Alabama, Arkansas, Colorado, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Wisconsin, and Wyoming.

Copies of the documents filed with the court are attached to the electronic version of this release at: http://oag.ca.gov/news

SAN FRANCISCO – Attorney General Kamala D. Harris today filed a friend-of-the-court brief in the U.S. Supreme Court asking the court to strike down a lower court’s ruling that would allow for-profit companies to deny essential healthcare to female employees based on the religious beliefs of the company’s owners.

“Every American deserves access to quality, comprehensive healthcare,” Attorney General Harris said. “A woman’s access to essential services, including contraception, should not be restricted because of the religious views of her employer—particularly when the right to these services is protected under federal law.”

Attorney General Harris’ brief, co-authored by Massachusetts Attorney General Martha Coakley, urges the U.S. Supreme Court to overturn a ruling from the U.S. Court of Appeals for the Tenth Circuit in Kathleen Sebelius v. Hobby Lobby Stores, Inc. that held that for-profit businesses may exercise religion and therefore are covered by the Religious Freedom Restoration Act of 1993. The ruling would deny women coverage for contraception, which is protected under the Affordable Care Act (ACA) as a critical preventive service.

The brief further asks the Court to affirm the U.S. Court of Appeals for the Third Circuit’s ruling in a companion case (Conestoga Wood Specialties Corp. v. Kathleen Sebelius) that came to the opposite conclusion and held that for-profit companies could not claim religious exemptions from the ACA coverage requirement.

Thirteen states and the District of Columbia joined Attorney General Harris and Attorney General Coakley’s brief, including Connecticut, Delaware, Hawaii, Illinois, Iowa, Maine, Maryland, New Mexico, New York, Rhode Island, Oregon, Vermont, and Washington.

“Measures adopted by States, and now the federal government, to expand affordable access to contraceptives through health plan coverage provisions are narrowly tailored to further compelling public interests in promoting gender equity and achieving significant health, social, and economic benefits,” the brief states.

A copy of the brief is attached to the electronic version of this release at oag.ca.gov/news.