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May

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2020
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May

Aid is available for unemployed immigrants during the pandemic

Today’s question comes from Arturo R. in the Mission who asks:

Q: “I have lost my job because of the virus. I am not permitted for work even though I have lived here 10 years. My wife lost her job because she has to care for the kids. They tell me that I can’t get unemployment but I read that I can get a check from California. Can I? Can my wife? Thanks.”

A: Dear Arturo, this virus has harmed so many people and its impact seems to fall hardest on one of the hardest working populations, immigrants. As California Governor Gavin Newsom recently stated, “California is the most diverse state in the nation. Our diversity makes us stronger and more resilient … Every Californian, including our undocumented neighbors and friends, should know that California is here to support them during this crisis. We are all in this together.”

The Federal Government, through legislation, created a “stimulus program” under the CARES act which gave one-time payments of up to $1,200 per person, $2,400 per household, and up to $500 per qualifying child. This relief is only available to people with permission to work in the U.S.

Governor Newsom, through an executive order, created the Disaster Relief Assistance for Immigrants (DRAI) project which has authorized up to $75,000,000 in state funding to go to undocumented Californians affected by the coronavirus. An additional $50,000,000 is being raised through private contributions. Eligible applicants can receive up to $500 per adult, with a maximum of $1,000 per household.

A person is eligible if they can provide information demonstrating that they (1) are an undocumented adult (person over the age of 18); (2) are not eligible for federal COVID-19 related assistance, like the CARES Act tax stimulus payments or pandemic unemployment benefits; and, (3) have experienced a hardship as a result of COVID-19.

To be eligible you must provide information and documentation to verify your identity, home or mailing address, and to demonstrate that you have been impacted by COVID-19 (showing you lost your job, couldn’t work because of caring for an sick relative or a child who couldn’t go to school, a member of your household lost their job affecting the ability to pay for the rent, food, etc.).

The program and funds are being administered by 12 non-profits throughout the state. In the Bay Area (Alameda, Contra Costa, Marin, San Francisco, San Mateo and Santa Clara) the program is being administered by Catholic Charities of California which can be reached at (866) 490-3899 and by internet at www.cceb.org (Alameda and Contra Costa) , www.catholiccharitiessf.org (Marin, San Francisco & San Mateo and www.catholiccharitiesscc.org (Santa Clara). They can provide additional information on eligibility and help you make an application.

People are often afraid that receiving public funds may make them a “public charge” and affect their ability to gain legal status and/or subject them to deportation. According to the State of California’s website, “This disaster relief assistance is not means-tested and is one-time assistance. The Federal Government does not list this assistance as a public benefit for a public charge consideration.”

The information you provide to the nonprofit organization will only be used to confirm your eligibility and provide the assistance to you. The nonprofit organizations will provide general information (e.g. age, gender, preferred language, etc.) to the State, but none of your personal information (e.g. name, address, etc.) will be given to any government agency. Money will be distributed through the non-profit agency in the form of “payment cards” which will function like debit cards.

You should apply immediately if you qualify as the money will run out fast. Arturo and everyone else, this is a time for coming together and supporting each other, we are all one family. Stay safe and be kind everybody.

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Protecting doctors who voice concerns about inadequate patient care

Last week’s question was posed by a doctor, who wanted to remain anonymous, who asked what her/his rights were in a situation where they were working around COVID-19 patients, were told to re-use their personal protection equipment (PPE) such as masks, goggles and gowns, in violation of hospital policy.

The reader indicated that they were aware that PPE had been diverted from the treatment floors for the personal use of administrators and, she/he believed, for their families. The reader stated that she/he voiced concerns for patient safety, and her/his safety, caused by the reuse of PPE. Upon expressing those concerns the reader was told that they should, in essence, “mind their own business if they know what’s good for them.” Last week, I addressed the issue of an employer’s responsibility to provide a safe workplace with the required and appropriate safety gear and equipment. This week I am addressing the issue of a physician’s rights to express concerns about patient care without fear of retaliation.

A doctor who voices her concerns about inadequate patient care and safety is supposed to be protected against retaliation by California Business and Professions Code Section 2056. It is the public policy of the State of California that a physician is to be encouraged to advocate for medically appropriate health care for his or her patients. To advocate for “medically appropriate health care” includes protesting a decision, policy, or practice that the physician reasonably believes impairs the physician’s ability to provide medically appropriate health care to his or her patients.

Any person who renders a decision to terminate or penalize a physician employee or contractor for advocating for medically appropriate health care is in violation of the law. Section 2056 states: “No person shall terminate, retaliate against, or otherwise penalize a physician and surgeon for that advocacy, nor shall any person prohibit, restrict, or in any way discourage a physician and surgeon from communicating to patient information in furtherance of medically appropriate health care.” So the law goes beyond just advocating for patient care internally, it could also protect a physician who brings those concerns to the attention of the patient, outside regulators, and even the press.

When a physician is retaliated against they can bring a civil action for retaliation and/or termination in violation of public policy, a whistleblower complaint under the Labor Code, and several other common law causes of action. A prevailing physician could receive both past and future economic losses, non-economic damages for emotional distress, shame, humiliation, etc., and, in some cases where malice, fraud or oppression can be demonstrated, punitive damages to deter the individuals or facility from repeating the behavior.

When analyzing what is “appropriate patient care” the determination must factor in the locality and other circumstances under which treatment was given. For example in San Francisco, it may be the standard of care to do an MRI with contrast (radioactive dye). In a very rural urgent care facility, with no MRI, the standard of care would be different.

The same is true with COVID-19. Care and treatment of COVID-19 patients will have to be examined under the conditions which existed at the time of the care. There are circumstances wherein there may not be enough ventilators for everyone who needs one to get one. A doctor may be forced to “triage” the patients and determine who is more likely to survive and withhold treatment from a patient who is more likely to die. In your case, had there truly been a shortage of PPE, as we see across the country, the fact that PPE would be changed between patient visits in pre-coronavirus times, does not set the standard in coronavirus-time. Your question, however, involves members of the administration taking PPE for themselves and their families thereby diverting them from both employee safety and patient care. As I said last week, California Labor Code Section 6406 makes it illegal for anyone to remove, displace, damage, destroy or carry off any safety device, safeguard, notice, or warning, furnished for use in any employment or place of employment. If they are diverting safety equipment from you and patients, for their own personal use, it should not be justified because of COVID-19. In my eyes, it makes it that conduct much more despicable.

You should document all important facts concerning the inadequate patient care, who is taking the PPE home, and any claims or complaints you make, to whom, when, and who witnessed it. You want witnesses or, preferably, a date and time stamped (e-mail) contemporaneous writing. I would suggest that you examine your personnel folder before making a complaint so that if you later see backdated documents, you can identify them. If you feel strongly enough about what’s happening and are principled enough to take action, you should file a written complaint with the Medical Board.

Be aware, hospitals wield a lot of power. Doctors, hospitals and practice groups, will often terminate a doctor who advocates for patient care and then claim it was a result of a physician’s clinical deficiencies, or that they were psychologically unstable. I have handled three such cases. The hospitals’ conduct was despicable. Fortunately, on the whole, there are many more good doctors than that are unscrupulous ones and, if you properly document and escalate your complaint, hopefully proper action will be taken. If you are retaliated against then get yourself a good trial lawyer as the hospitals have legal specialists who do nothing but fight to cover up wrongdoing.

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What rights do physicians have when being denied protection from COVID-19?

This week’s question comes from an Anonymous who asks:

Q: “I work in health care in the Bay Area as a physician. I don’t want to say too much as I am afraid I might get fired. I am frequently exposed to COVID-19 patients. I love my job and I am proud to be on the front lines helping people who are suffering. That’s why I became a doctor in the first place. What is different now is that we are literally laying our lives, and the lives of our families, on the line every day we go into this battle.

I’m willing to do that as long as I have the proper equipment. You wouldn’t send a soldier into war with a gun and no bullets, but we are being sent into work with inadequate PPE [Personal Protective Equipment] every day. I get that we have to make do with what we have but I know that there are stores of supplies which senior medical and administrative staff have diverted for themselves and their families.

I am also fearful that we are putting patient safety at risk. I brought this up and I was told to mind my own business if I knew what was good for me. I was told that I should not get involved with things that don’t concern me and that we had to re-use our PPE. My work brings me into contact with COVID and Non- COVID patients. I am afraid that the lack of PPE is placing patients, and health care workers, at an increased threat of COVID and its complications. I am afraid that I may get fired or disciplined if I keep asking for PPE. What rights do we health care workers have under these circumstances?”
P.S. Please tell your readers to take this seriously, follow all safety precautions, and socially distance. Once you are a patient, the distance you worry about is the distance between life and death, and that’s out of your control.”

A: Thank you for the years you spent studying and training to be prepared for this emergency, reporting to duty and placing your life on the line for us all. Your question involves two areas of law:

  1. the right to a safe workplace, and
  2. freedom from retaliation for advocating for patient care.

The first question invokes the California Labor Code; the second invokes the Business and Professions Code. This article will address the application of the Labor Code. Next week’s column will address the Business and Professions Code.

  • California Labor Code § 6401, Duty to furnish safety devices and adopt safe practices and procedures, reads as follows: “Every employer shall furnish and use safety devices and safeguards, and shall adopt and use practices, means, methods, operations, and processes which are reasonably adequate to render such employment and place of employment safe and healthful. Every employer shall do every other thing reasonably necessary to protect the life, safety, and health of employees.”
  • California Labor Code § 6403, Failure to furnish safety devices or adopt safe practices and procedures, reads as follows: “No employer shall fail or neglect to do any of the following:

(a) To provide and use safety devices and safeguards reasonably adequate to render the employment and place of employment safe.
(b) To adopt and use methods and processes reasonably adequate to render the employment and place of employment safe.
(c) To do every other thing reasonably necessary to protect the life, safety, and health of employees.

This code provision requires your employer to provide you with PPE and an environment, which under the circumstances, are reasonably adequate to render your workplace safe. Healthcare employers and facilities are also required to have a set of practices and policies in place to provide for workplace safety including policies dealing with the handling contagious patients and the use of PPE to protect employees and others.”

  • California Labor Code § 6406, Unlawful acts states: “No person shall do any of the following:

(a) Remove, displace, damage, destroy or carry off any safety device, safeguard, notice, or warning, furnished for use in any employment or place of employment.
(b) Interfere in any way with the use thereof by any other person.
(c) Interfere with the use of any method or process adopted for the protection of any employee, including himself, in such employment, or place of employment.
(d) Fail or neglect to do every other thing reasonably necessary to protect the life, safety, and health of employees.

There is “no private right of action” to sue an employer to force compliance with these safety standards. An employee can call CAL-OSHA and report an unsafe work environment and they can inspect and enforce them. However, if an employee is retaliated against, in any way, for opposing violation of these laws, disclosing the violations to a supervisor or government agency, or demanding a safe workplace, an employee can maintain a legal action for what we refer to as the “wrongful termination, or retaliation, in violation of public policy” and for “whistleblowing” under California Labor Code Section 1102.5. This provides for a potential for recovery of lost wages, past and future, damages for emotional distress and, in some circumstances, punitive damages.

I suggest that you document your concerns so if you are retaliated against it is clear that it was in response to your exercising your rights to have a safe work environment. These are trying times. Hopefully nothing retaliatory will happen to you as all of our energies need to be focused on supporting you on the front lines and not in fighting legal battles. If something untoward does happen, contact an experienced employment trial lawyer to help you navigate the legal system.

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