5 Cost Effective Programs for any Business

5 Cost Effective 5 Cost Effective Programs for any Programs for any

BusinessBusiness

Presented by: Presented by:

Shanna S. Dunbar RN, COHN-S, CCMShanna S. Dunbar RN, COHN-S, CCM

ObjectivesObjectives•Name the 5 cost effective Name the 5 cost effective

programsprograms• Identify 2 strategies that would Identify 2 strategies that would

benefit your workplacebenefit your workplace•Describe the business case for Describe the business case for

implementation of one of these implementation of one of these programs (return on investment)programs (return on investment)

Why Talk about These Why Talk about These Programs?Programs?

• Best BANG for Best BANG for your BUCKyour BUCK

• INTEGRATE INTEGRATE – SAFETYSAFETY– OCCUATIONAL OCCUATIONAL

HEALTHHEALTH– WORKERS’ WORKERS’

COMPENSATIOCOMPENSATIONN

Alphabet SoupAlphabet Soup

What are the 5 What are the 5 programs?programs?

1)1) Pre-placement Health Pre-placement Health ScreeningScreening

2)2) Injury and Illness Prevention Injury and Illness Prevention ProgramProgram

3)3) Drug Free Workplace ProgramDrug Free Workplace Program

4)4) Employee Assistance ProgramEmployee Assistance Program

5)5) Transitional Work /Return to Transitional Work /Return to Work ProgramWork Program

1) Pre-Placement Health 1) Pre-Placement Health ScreeningScreening

• ““Pre-Placement” Pre-Placement” defined (“PPHS”)defined (“PPHS”)

• POSTPOST-offer; -offer; PREPRE--placement –placement –

• BEFOREBEFORE the the employee begins employee begins workingworking

Pre-Placement Health Pre-Placement Health ScreeningScreening

• Parameters should be in writing –Parameters should be in writing –Have a PPHS policy.Have a PPHS policy.

• Apply policy Uniformly and EquitablyApply policy Uniformly and Equitably– ““Uniform application is based on ‘similar Uniform application is based on ‘similar

circumstances’ ”.circumstances’ ”.• Utilize an appropriate Utilize an appropriate

examiner/testing facility examiner/testing facility (Occupational Health specialty)(Occupational Health specialty)

””Legal Parameters with Pre-Employment Physical and Job Placement Legal Parameters with Pre-Employment Physical and Job Placement Assessments” by Glenn Jones Ohio Safety Congress; March 20-22, 2007; Assessments” by Glenn Jones Ohio Safety Congress; March 20-22, 2007; Jones, Funk & Assoc.Jones, Funk & Assoc.

SDunbar


• Utilize Utilize FunctionalFunctional Job Job Descriptions/Descriptions/

Job AnalysesJob Analyses– Identify essential Identify essential

functions of the functions of the jobjob

– Base your exams Base your exams on the essential on the essential functionsfunctions


• During the interviewing process pay During the interviewing process pay attention to applicable laws: Americans attention to applicable laws: Americans with Disabilities Act (ADA), Ohio Civil with Disabilities Act (ADA), Ohio Civil Rights Act (OCRA)Rights Act (OCRA)

• ““It is permitted to ask general questions It is permitted to ask general questions with regard to the applicant’s ability to with regard to the applicant’s ability to perform functions of the proposed perform functions of the proposed employment”employment”

””Legal Parameters with Pre-Employment Physical and Legal Parameters with Pre-Employment Physical and Job Placement Assessments” by Glenn Jones Ohio Job Placement Assessments” by Glenn Jones Ohio Safety Congress; March 20-22, 2007; Jones, Funk & Safety Congress; March 20-22, 2007; Jones, Funk & Assoc.Assoc.


•Utilize Utilize FunctionalFunctional Job Job Descriptions/Descriptions/

Job Analyses Job Analyses – Ask the applicant – “Here are Ask the applicant – “Here are

the essential functions of the the essential functions of the job, can you perform them?”job, can you perform them?”

– Customize the kind of exam to Customize the kind of exam to the jobthe job


•““Withdrawal of the job offer…Withdrawal of the job offer…may only be made when those may only be made when those results impact on the specific results impact on the specific job.”job.”

If you are performing physicals If you are performing physicals are you getting the results you are you getting the results you desire??desire??

””Legal Parameters with Pre-Employment Physical and Job Placement Assessments” Legal Parameters with Pre-Employment Physical and Job Placement Assessments” by Glenn Jones Ohio Safety Congress; March 20-22, 2007; Jones, Funk & Assoc.by Glenn Jones Ohio Safety Congress; March 20-22, 2007; Jones, Funk & Assoc.


•Health Screening: Health Screening: – Medical History (90%)Medical History (90%)– Physical Exam (10%)Physical Exam (10%)

•Goal is Goal is NOTNOT to eliminate to eliminate candidates but to SAFELY candidates but to SAFELY place candidates.place candidates.

(Avoid hazards to the employee or to other (Avoid hazards to the employee or to other employees)employees)

1) Pre-Placement Health 1) Pre-Placement Health ScreeningScreening

Why is it cost effective?Why is it cost effective?• Identify pre-existing Identify pre-existing

conditions impact on conditions impact on work environment work environment (WC)(WC)

• Less risk when work Less risk when work related injury occursrelated injury occurs

• Safer worker ~ work Safer worker ~ work environment interfaceenvironment interface

2) Injury & Illness Prevention 2) Injury & Illness Prevention ProgramProgram

(IIPP)(IIPP)•Another Another

name: name: HEALTH and HEALTH and SAFETY SAFETY Program!!Program!!

•Specific to Specific to work you dowork you do

Injury & Illness Prevention Injury & Illness Prevention ProgramProgram– Management Management commitmentcommitment with with

assignment of responsibilities assignment of responsibilities – Labor/Management safety and health Labor/Management safety and health

committeescommittees – Safe work practicesSafe work practices with system for with system for

assuring employee compliance assuring employee compliance – Scheduled Scheduled inspectionsinspections/evaluation /evaluation

system system – Accident investigationAccident investigation process with process with

procedures for correcting procedures for correcting unsafe/unhealthy conditions unsafe/unhealthy conditions

– Safety and health Safety and health trainingtraining and and instruction instruction

– RecordkeepingRecordkeeping and documentation and documentation

Injury & Illness Prevention Injury & Illness Prevention ProgramProgram• Accident/Incident Accident/Incident

Investigation Investigation & Reporting Procedure & Reporting Procedure

• Asbestos Standard Asbestos Standard • BenzeneBenzene• CadmiumCadmium• Compressed Air PlanCompressed Air Plan• Demolition Plan & Demolition Plan &

Explosive Blasting PlanExplosive Blasting Plan• Disciplinary ProgramDisciplinary Program• Diving OperationsDiving Operations• Electrical Safety and Electrical Safety and

Ground FaultGround Fault Protection Protection • Excavation, Trenching & Excavation, Trenching &

Shoring ProceduresShoring Procedures• First Aid and CPRFirst Aid and CPR

• Hazardous Waste Operations Hazardous Waste Operations and Emergency Response and Emergency Response (HAZWOPER)(HAZWOPER)

• Hydrogen Sulfide Injury Hydrogen Sulfide Injury & Illness Prevention Program & Illness Prevention Program

• Laser SafetyLaser Safety• Lead ProtectionLead Protection• Lock out Tag out Process Lock out Tag out Process • Safety ManagementSafety Management• RadiationRadiation• RF Energy and Microwave RF Energy and Microwave

Radiation SafetyRadiation Safety• Sandblasting Program and Sandblasting Program and

Silicosis PreventionSilicosis Prevention• School Emergency Action PlanSchool Emergency Action Plan• Underground ConstructionUnderground Construction

Injury & Illness Prevention Injury & Illness Prevention ProgramProgram

• Lifting SafetyLifting Safety• Electrical SafetyElectrical Safety• Forklift and Motorized Truck Forklift and Motorized Truck • Landscape and Grounds Landscape and Grounds

Maintenance Maintenance • Respiratory Protection Respiratory Protection

Program Program • Bloodborne PathogensBloodborne Pathogens• ErgonomicsErgonomics• General Shop/Work General Shop/Work

Area and Tool Safety Area and Tool Safety • Machinery Machinery

& Machine Guarding Safety & Machine Guarding Safety • Roof Labor SafetyRoof Labor Safety• Carpentry and Lumber Carpentry and Lumber

HandlingHandling• Excavation and TrenchingExcavation and Trenching

• Hearing Conservation Hearing Conservation ProgramProgram

• Motor Vehicle Safety Motor Vehicle Safety • Safety & Health Signs and Safety & Health Signs and

Tags Tags • Chemical SafetyChemical Safety• Fall ProtectionFall Protection• Heating Systems and Boiler Heating Systems and Boiler • Office Safety Office Safety • Scaffold Safety Scaffold Safety • Concrete and Masonry Concrete and Masonry

ConstructionConstruction• Fire Prevention Fire Prevention • Housekeeping and Material Housekeeping and Material

StorageStorage

Injury & Illness Prevention Injury & Illness Prevention ProgramProgram• BWC’s 10-step business planBWC’s 10-step business plan

1.1. Visible, active senior management leadershipVisible, active senior management leadership2.2. Employee involvement and recognitionEmployee involvement and recognition3.3. Medical treatment and return-to-work practicesMedical treatment and return-to-work practices4.4. CommunicationsCommunications5.5. Timely notification of claimsTimely notification of claims6.6. Safety and health process coordinationSafety and health process coordination7.7. Written orientation and training planWritten orientation and training plan8.8. Written and communicated safe work practicesWritten and communicated safe work practices9.9. Written safety and health statement or philosophyWritten safety and health statement or philosophy10.10.Record keeping and data analysisRecord keeping and data analysis

* Premium Discount for implementation of 10-Step Business plan for * Premium Discount for implementation of 10-Step Business plan for Penalty RatedPenalty Rated companies onlycompanies only

www.ohiobwc.comwww.ohiobwc.com

2) Injury & Illness Prevention 2) Injury & Illness Prevention ProgramProgram

Why cost effective?Why cost effective?• PreventionPrevention is the best risk is the best risk

management toolmanagement tool• OSHA mandates we provide a safe OSHA mandates we provide a safe

and healthful workplace for all and healthful workplace for all employees: Safety Risk to employees: Safety Risk to themselves OR themselves OR othersothers

** BWC offers a Premium Discount for implementation of their ** BWC offers a Premium Discount for implementation of their 10-Step Business plan for 10-Step Business plan for Penalty RatedPenalty Rated companies*** companies***

www.ohiobwc.comwww.ohiobwc.com

3) Drug Free Workplace 3) Drug Free Workplace ProgramProgram

Federal Oversight for any Federal Oversight for any Drug Free Workplace Drug Free Workplace Program is through the Program is through the Department of Health and Department of Health and Human ServicesHuman Services

www.dhhs.govwww.dhhs.gov

Drug Free Workplace Drug Free Workplace ProgramProgram

WHY have a DFWP???WHY have a DFWP??? Substance abuse is widespread in Substance abuse is widespread in

societysociety No workplace is immuneNo workplace is immune Job applicants who can’t pass a drug Job applicants who can’t pass a drug

test apply to companies that don’t testtest apply to companies that don’t test Provides an affirmative defense against Provides an affirmative defense against

a workers’ compensation claima workers’ compensation claim


Categories of Drug Use:Categories of Drug Use:UserUserAbuserAbuserAddictAddict•Impacts on family life, Impacts on family life,

work life and financiallywork life and financially

Drug Use becomes AbuseDrug Use becomes Abuse

HIGH

Function

LOW

Drug Use (Time)

WORK

FAMILY

FINANCIAL

04/19/23

Increased Increased accidentsaccidents

Frequent turnoverFrequent turnoverLower productivityLower productivityInflated health Inflated health

care costscare costsIncreased theftIncreased theft

Workplace Substance Abuse

Costs and Consequences

Increased Increased Workers’ Comp Workers’ Comp claimsclaims

Poor product Poor product qualityquality

Higher Higher absenteeismabsenteeism

Property damageProperty damage

Components of DFWPComponents of DFWP

•Drug Free Workplace Policy*Drug Free Workplace Policy*•Employee Education*Employee Education*•Supervisor Training*Supervisor Training*•Drug and Alcohol Testing Drug and Alcohol Testing (COC (COC

with MRO)with MRO)

•Employee AssistanceEmployee Assistance** BWC offers grants for development and training as well as ** BWC offers grants for development and training as well as

a Premium Discount for implementation***a Premium Discount for implementation***


Why Cost-Effective?Why Cost-Effective? Employers with successful DFWP Employers with successful DFWP

reportreportDecreases in absenteeism, and Decreases in absenteeism, and

accidents accidents Decreases in downtime, turnover, Decreases in downtime, turnover,

and theft; and theft; Increases in productivity, and overall Increases in productivity, and overall

improved moraleimproved morale

4) Employee Assistance 4) Employee Assistance ProgramProgram

• EAP is a EAP is a comprehensive comprehensive program that helps program that helps employees resolve employees resolve personal problems personal problems that may adversely that may adversely impact their work impact their work performance, performance, conduct, health conduct, health and well-being. and well-being.

Employee Assistance Employee Assistance ProgramProgram

• Prevention and Early InterventionPrevention and Early Intervention• Management of Behavioral DisordersManagement of Behavioral Disorders• Reduce the Health Care Costs overall Reduce the Health Care Costs overall

for a companyfor a company

• Maximize human resources: outcome of Maximize human resources: outcome of

Productive and Productive and Healthy EmployeesHealthy Employees


The Business case for EAPThe Business case for EAPFOH study evaluated 16K clients after FOH study evaluated 16K clients after using EAPusing EAP

33% to 71% improvement in……33% to 71% improvement in……– Overall HealthOverall Health– Work attendance Work attendance – ProductivityProductivity– Day-to-day functioning and Day-to-day functioning and – Social activitiesSocial activities

Follow-up study with Follow-up study with 60K60K subjects subjects validated this studyvalidated this study (Selvik, Stephenson, Plaza & (Selvik, Stephenson, Plaza & Sugden, 2003)Sugden, 2003)

Federal Occupational Health (DHHS) www.foh.dhhs.govFederal Occupational Health (DHHS) www.foh.dhhs.gov


The Business case for EAPThe Business case for EAPFor every $1 invested in EAP the For every $1 invested in EAP the expected savings for the first year expected savings for the first year would be $1.27 rising to $7.21 by would be $1.27 rising to $7.21 by Year 5 (Wrich, 1998)Year 5 (Wrich, 1998)


The Business case for EAPThe Business case for EAP• Chevron Corporation realized a Chevron Corporation realized a

savings for $14 for every $1 spent on savings for $14 for every $1 spent on EAP (Collins 1998)EAP (Collins 1998)

• McDonnell Douglas saved $5.1 McDonnell Douglas saved $5.1 Million by instituting an EAP Million by instituting an EAP according to a four-year study (ROI according to a four-year study (ROI 4:1) due to reduced absenteeism, 4:1) due to reduced absenteeism, turnover and medical claimsturnover and medical claims

4) Employee Assistance 4) Employee Assistance ProgramProgram

Cost Effective for Cost Effective for small business?small business?

Less research on this….Less research on this….• Positive results using Positive results using

EAP and Case EAP and Case Management Management combinedcombined

• (manage work (manage work related and non-related and non-occupational occupational conditions)conditions)

5) Return to Work 5) Return to Work ProgramProgram

• Process for identifying returning to work Process for identifying returning to work SAFELYSAFELY– Accommodating modifications in workAccommodating modifications in work– Re-evaluation of job performance Re-evaluation of job performance

abilitiesabilities– Procedures should be based on:Procedures should be based on:

•ESSENTIAL FUNCTIONS OF THE JOBESSENTIAL FUNCTIONS OF THE JOB•Functional Job Descriptions/AnalysesFunctional Job Descriptions/Analyses

• Can be used for both WORK related Can be used for both WORK related and Non-Occupational Conditionsand Non-Occupational Conditions

Return to Work ProgramReturn to Work Program

• Transitional Work Programs (TWP)Transitional Work Programs (TWP)– Work Related InjuriesWork Related Injuries– Non-Occupational Injuries and IllnessesNon-Occupational Injuries and Illnesses– Reasonable Accommodation (ADA)Reasonable Accommodation (ADA)

• Case Management for RTWCase Management for RTW– FMLA or Workers’ Compensation IssuesFMLA or Workers’ Compensation Issues– Oversee medical side of the claimOversee medical side of the claim

Iceberg AnalogyAccident Cost

•Medical Payments•Compensation

Supervisor time to investigate

Breaking in substitute

Poor efficiency due tobreak-up of crew

Damaged tools/equipment

Down-timeOverhead $ while work disrupted

Failure to meet deadline/fill orders

Loss of production

Loss of good will

Overtime to make up production

Hiring costs

Lost time by fellow workers

Direct Costs

Indirect or HiddenCosts

Return to Work ProgramReturn to Work ProgramWork related:Work related:

Medical ClaimsMedical Claims

Average cost =Average cost =

Indemnity (LT) Indemnity (LT) ClaimsClaims

Average cost =Average cost =$37,500

$750

•Medical CostsMedical Costs•TTemporary emporary DDisability Costsisability Costs

What happens when What happens when TDTD is paid???? is paid????

A Reserve is Set A Reserve is Set for the LIFE of the claim!for the LIFE of the claim!

≈ $1,000 per DAY off

Workers’ Compensation Workers’ Compensation BenefitsBenefits

Return to Work ProgramReturn to Work Program

• Written policy and Written policy and proceduresprocedures

• JOB SpecificJOB Specific• Educate from the Educate from the

beginning: beginning: RTW is part RTW is part of healing processof healing process

• Utilize an appropriate Utilize an appropriate OH facility for injury OH facility for injury care and RTW examscare and RTW exams

5) Return to Work 5) Return to Work ProgramProgram

Business Case for RTW programs:Business Case for RTW programs:•Reduce Lost Time Claims/ WC CostsReduce Lost Time Claims/ WC Costs•Employee RetentionEmployee Retention

–Return to Routine = healingReturn to Routine = healing–Keep moving – Less de-conditioningKeep moving – Less de-conditioning–Reduce Litigation (less dispute)Reduce Litigation (less dispute)

Alphabet SoupAlphabet Soup

ObjectivesObjectives•Name the 5 cost effective Name the 5 cost effective

programsprograms• Identify 2 strategies that would Identify 2 strategies that would

benefit your workplacebenefit your workplace•Describe the business case for Describe the business case for

implementation of one of these implementation of one of these programs (return on investment)programs (return on investment)

WRAP UPWRAP UP

Shanna Dunbar, RN, COHN-S, CCMWorkplace Health, Inc.

(440) 463-6921(866) 325-3085

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5 Cost Effective Programs for any Business