Justice Department Settles Claims Against California Supermarket Chain and Affiliated Money Lender for Discriminating Against Asylee Worker

The Department of Justice today announced that it signed a settlement agreement with Northgate Gonzalez Markets Inc., a California-based supermarket chain, and Northgate Gonzalez Financial LLC d/b/a Prospera Gonzalez, an affiliated payday loan company (collectively, Northgate).

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    GAO's analysis of Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) data show that in fiscal year 2018, 287,547 Medicare fee-for-service beneficiaries had inpatient stays that included care for severe wounds. These wounds include those where the base of the wound is covered by dead tissue or non-healing surgical wounds. About 73 percent of the inpatient stays occurred in acute care hospitals (ACH), and a smaller percentage of stays occurred in post-acute care facilities. Specifically, about 16 percent of stays were at skilled nursing facilities (SNF), and about 7 percent were at long-term care hospitals (LTCH). CMS data show that Medicare spending on stays for severe wound care was $2.01 billion in fiscal year 2018, representing a decline of about 2 percent from fiscal year 2016, when spending was about $2.06 billion. Spending declined as a result of decreases in both the total number of these stays, as well as spending per stay, which both decreased by about 1 percent. The decrease in per stay spending was likely driven, in part, by a change in where beneficiaries received care. CMS data show fewer severe wound care stays in LTCHs, which tend to be paid higher payment rates. At the same time, more severe wound care stays were at two other types of facilities that tend to be paid lower payment rates: ACHs and inpatient rehabilitation facilities. GAO's analysis of CMS data also show that, while the number of LTCHs that billed Medicare for severe wound care decreased by about 7 percent from fiscal years 2016 to 2018, Medicare beneficiaries continued to have access to other severe wound care providers. For example, CMS data show that most beneficiaries resided within 10 miles of an ACH or SNF that provided severe wound care in fiscal year 2018. Figure: Percentage of Medicare Fee-for-Service Beneficiaries Residing within 10 Miles of a Health Care Facility That Provided Any Severe Wound Care, by Facility Type, Fiscal Year 2018 Note: The “other” category includes facilities such as psychiatric hospitals or units. There is limited information on how or whether the decrease in LTCH care for severe wounds may have affected the quality of severe wound care Medicare beneficiaries receive. For example, CMS collects information on the percentage of patients with new or worsened pressure ulcers at post-acute care facilities, but it does not measure the quality of care they receive. Medicare beneficiaries with serious health conditions, such as strokes, are prone to developing severe wounds due to complications that often lead to immobility and prolonged pressure on the skin. These beneficiaries may require a long-term inpatient stay at an ACH or a post-acute care facility, such as an LTCH. LTCHs treat patients who require care for longer than 25 days, on average. In 2018, LTCHs represented about $4.2 billion in Medicare expenditures. Prior to fiscal year 2016, LTCHs received a higher payment rate for treating Medicare beneficiaries than ACHs. Beginning in fiscal year 2016, a dual payment system was phased in that paid LTCHs a rate similar to ACHs for some beneficiaries and a higher rate for beneficiaries that met certain criteria. As this payment system has moved from partial to full implementation, lawmakers had questions about how it may affect beneficiaries' severe wound care. The 21st Century Cures Act included a provision for GAO to review severe wound care provided to Medicare beneficiaries. This report describes facilities where Medicare beneficiaries received severe wound care, Medicare severe wound care spending, and what is known about the dual payment system's effect on access and quality. GAO analyzed Medicare severe wound care access and spending data for fiscal years 2016 and 2018 (the most recent data available); reviewed reports; and interviewed CMS officials, researchers, and national wound care stakeholders. HHS provided technical comments on a draft of this report, which were incorporated as appropriate. For more information, contact James Cosgrove at (202) 512-7114 or cosgrovej@gao.gov.
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    According to data from the most recent Merit Systems Protection Board (MSPB) survey in 2016, an estimated 22 percent of Department of Veterans Affairs (VA) employees, and 14 percent of federal employees overall, experienced some form of sexual harassment in the workplace from mid-2014 through mid-2016. VA has policies to prevent and address sexual harassment in the workplace, but some aspects of the policies and of the complaint processes may hinder those efforts. Misalignment of Equal Employment Opportunity (EEO) Director position: VA's EEO Director oversees both the EEO complaint process, which includes addressing sexual harassment complaints, and general personnel functions. According to the Equal Employment Opportunity Commission (EEOC), this dual role does not adhere to one of its key directives and creates a potential conflict of interest when handling EEO issues. Incomplete or outdated policies and information: VA has an overarching policy for its efforts to prevent and address sexual harassment of its employees. However, some additional policies and information documents are not consistent with VA's overarching policy, are outdated, or are missing information. For example, they may not include all options employees have for reporting sexual harassment, which could result in confusion among employees and managers. Delayed finalization of Harassment Prevention Program (HPP): VA has not formally approved the directive or the implementing guidance for its 4-year-old HPP, which seeks to prevent harassment and address it before it becomes unlawful. Lack of formal approval could limit the program's effectiveness. VA uses complaint data to understand the extent of sexual harassment at the agency, but such data are incomplete. For example, VA compiles information on allegations made through the EEO process and HPP, but does not require managers who receive complaints to report them to VA centrally. As a result, VA is not aware of all sexual harassment allegations across the agency. Without these data, VA may miss opportunities to better track prevalence and to improve its efforts to prevent and address sexual harassment. VA provides training for all employees and managers, but the required training does not have in-depth information on identifying and addressing sexual harassment and does not mention HPP. Some facilities within VA's administrations supplement the training, but providing additional information is not mandatory. Requiring additional training on sexual harassment could improve VA employees' knowledge of the agency's policies and help prevent and address sexual harassment. In June 2020, GAO issued a report entitled Sexual Harassment: Inconsistent and Incomplete Policies and Information Hinder VA's Efforts to Protect Employees (GAO-20-387). This testimony summarizes the findings and recommendations from that report, including (1) the extent to which VA has policies to prevent and address sexual harassment of VA employees, (2) how available data inform VA about sexual harassment of its employees, and (3) training VA provides to employees on preventing and addressing sexual harassment. GAO made seven recommendations in its June 2020 report, including that VA ensure its EEO Director position is not responsible for personnel functions; require managers to report all sexual harassment complaints centrally; and require additional employee training. VA concurred with all but the EEO Director position recommendation, which GAO continues to believe is warranted. For more information, contact Cindy S. Brown Barnes at (202) 512-7215 or brownbarnesc@gao.gov.
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