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Cynthia Bryant
Governor’s office
By: Paul Stremple
Cynthia Bryant

Title: Chief Deputy Director for Policy, California Department of Finance
Resume: Prior to joining the administration, Bryant was policy director for the Senate Republican Caucus and legal counsel to the Assembly Republican Caucus.
Schools: Bryant received her juris doctor from University of California Hastings College of the Law and her BA from Lewis and Clark College in Portland, Oregon.
Boards: State Teachers’ Retirement Board (CalSTRS), Commission on State Mandates, Public Works Board, California Infrastructure and Economic Development Bank, State Allocation Board, Pool Money Investment Board

In her position as deputy chief of staff, Bryant has had significant input into the governor’s positions on workers’ comp, including the crafting of SB 899. Bryant has significant experience in Sacramento, having served as director for the Senate Republican Office of Policy, where she was lead policy adviser to the Senate Republican Caucus. She also served as legal counsel to the Assembly Republican Caucus. In addition to her duties as deputy chief of staff, Bryant is director of the Governor's Office of Planning and Research.

What are the top three regulatory challenges facing the workers’ comp system?  
Broadly, medical costs, that’s number one, number two, and number three. The reforms many years ago did a good job reshaping. Focus in the industry needs to surround medical costs, on utilization, access. Paying competitive rates to keep doctors interested, but they need to be affordable for employers. There needs to be access to care for injured workers throughout the state. Utilization review process has been undergoing changes in recent years to look for abuses; it needs constant review

Are we headed for a hard market, and if so, when will it come? How long should we expect it to last? What are the repercussions?  
It’s hard to know; it depends on the costs in the system. We’re happy that since the reforms in ‘04 the costs have stayed low. We do have a potential problem on the medical side.

It’s no longer a question of if but when we enter a hard market, so what is in the future of State Compensation Insurance Fund? Will its market share climb back to historic levels? Do you think that further reforms are needed for the governance of State Fund, for example, does it make sense to have Senate confirmation for board members?  
The reforms did a good job is making changes so it doesn’t go back. They added a lot of transparency to the way [SCIF] does business and they are poised to expand and contract with the market. We’ve really done a lot with the reforms and the board: adding auditing, making it more professional, and allowing them to hire professionals. It has the unique quality of being quasi-governmental. Also, they can’t hide their situation from policymakers as they could before. Reforms and restructuring the board need time to develop so we can see how they work. Legislative appointees are now voting members, which trumps the need for confirmation.

Are medical provider networks a help or a hindrance? How should they be improved?  
They’re a help and a huge part of SB 899, the governor’s plan. We need to provide some balance between the employer and insurer. It’s well documented that if employees have a choice in their doctor, they feel comfortable with the care they are being given, and this improves return-to-work rates.

How should utilization review be improved?  
It’s an important part of the system working as a check and balance in how much treatment is needed for return-to-work, and how much is too much. We must be continually vigilant.

What needs to be done to improve return-to-work?  
This goes back to medical provider networks: Helping employees feel comfortable with their medical care will improve their return-to-work. Also, limiting unnecessary litigation on all sides, not just from applicant attorneys but everyone, as there won’t be any incentive for delaying return-to-work looking for a bigger payout.

What do you see, other than medical, as the next big cost driver?  
It’s litigation. There’s too much litigation on all sides. Medical is always a big elephant in the room.

Is it realistic to deal for more cost-cutting reforms in exchange for increasing PD benefits?  
I think there is a faulty assumption in the question. We should be actively looking to cut costs where appropriate, but at the same time work to make sure PD benefits are adequate for injured workers.

Where do you see applicant attorneys focusing litigation in the future?  
Wouldn’t want to hazard a guess.

Now that the federal health care bill has become law, what impact, if any, do you see on workers’ comp, and what are your concerns?  
We’ll see as it is implemented. There’s always talk around 24-hour care, but it’s a question that’ll be answered after this governor is gone. It’s something to watch, there could be a 24-hour care system down the line. In years to come, we’ll probably see another push for 24-hour care; every few years there’s a legitimate push.

What is the effect of more than $1 billion in payroll being absorbed by self-insured groups? Governor Schwarzenegger signed bills allowing predesignation to continue (SB 186), tweaking utilization review (AB 361), and limiting denial of benefits (AB 1093). There are also several bills currently moving through the Legislature that would extend benefits for specific occupational groups. What impact could these, if any, have on costs?  
SB 899 changed the face of California workers’ comp. The governor has helped workers’ comp become a far better system than it was six or seven years ago. I can’t imagine what the recession would’ve been like without these reforms in place, if we had been paying fees like we were six or seven years ago. The reforms helped ameliorate the effects of the recession. I can’t imagine what would’ve happened to jobs; it definitely saved jobs.