Division of Policy and Program Development

1. Division of Policy and Program Development New York Workers’ Compensation Board June 2010

2. Division of Policy and Program Development Division endeavors to inform, train and support WCB staff and system stakeholders by providing research, training, project and performance management, process improvement and analysis as well as the data and technologies necessary to continuously improve New York's workers‘ compensation system Includes 6 bureaus: • Management Information Systems • Project Management Office • Office of Continuous Improvement • Staff Development • Research • Data Acquisition Adds new policy analysis and planning function

3. Chairman Beloten’s Vision • To develop high quality data to inform all aspects of policymaking and Board administration • Understand and incorporate best practices • To define and measure performance at the system, agency, and business unit levels • Engage in long term planning to improve workers’ compensation system

4. Policy and Planning Bureaus • Management Information Systems • MIRROR – award winning performance management program • Support executive data inquiries • Project Management Office • Manages portfolio of high level agency investments in technology, business process improvement, and reform • Manages individual projects within portfolio • Current projects include: medical treatment guidelines, information security, FMIS upgrade

5. Policy and Planning Bureaus • Office of Continuous Improvement • Conduct formal process reengineering • Process modeling • Staff Development • Provide internal training throughout the Board • Developing new methods of delivering training – e-learning, webinar, etc. • Includes workplace violence prevention, medical treatment guidelines, new process training.

6. Policy and Planning Bureaus • Research • Draft research papers on important topics in workers’ compensation policy and administration • Projects include • Analysis of 9/11-related claims – Sept. 2009 • PPD Baseline study (ongoing) • Payer performance measurements (ongoing) • WC Claims by Young Workers (ongoing) • Data acquisition • Staff manually reviews and digests claims to capture important health and safety information regarding type of injury, body part, occupation, etc. using national standards

7. Task Forces and Boards • Disability Rating Guidelines Advisory Committee • Compensation Insurance Rating Board (CIRB) Board of Governors and Underwriting Committee • Governor’s Joint Employment Task Force on Misclassification and Underground Economy

8. Current Projects: Medical Treatment Guidelines • 2007 Reform initiative • Governor’s Workers’ Compensation Reform Task Force developed medical treatment guidelines for low back, neck, shoulder and knee • Four major injury sites account for 40% of injuries but more than 60% of medical costs • Evidence based medicine – guidelines define the standard of care • Creates reasonable limits on care and standards for determining when additional care is necessary

9. Medical Treatment Guidelines (cont.) • Goals: • Speed delivery of medical care to injured workers • Improve quality of medical care • Reduce disputes • Reduce or eliminate ineffective care • Medical care that is consistent with the guidelines is presumed necessary, while providers will need to establish good reason to vary • New procedures to expedite medical care • Education program for medical providers, attorneys, carriers/administrative staff, and Board staff • Will develop additional guidelines in the future

10. Data Warehouse • Limited data was a challenge in the 2007 workers’ compensation reform. • Governor Spitzer instructed the Insurance Department to prepare reports on key measures in the workers’ compensation system • Data reports combined multiple data sets including data from carriers, CIRB, Dept. of Labor, and all aspects of the WCB. • Reports’ central recommendation was to build a data warehouse to support the research and policy making needs of the Board and its stakeholders

11. Data Warehouse (cont.) • Data Warehouse is a central repository of workers’ compensation data structured to facilitate reporting and analysis • When combined with business intelligence software, a Data Warehouse can facilitate self-service data analysis • Self-service data fundamentally reshapes how the Board and the system uses data – it will make it easy for non-technical people to ask and answer important policy questions with comprehensive data • Board will begin building a data warehouse over the next 18 months • Data call between Insurance Department and WCB to crosswalk CIRB data and WCB claims data

12. Disability Duration Guidelines • Duration caps were central part of 2007 reform • Buffalo Auto Recovery interpreted the caps, but acknowledged that the Governor’s Task Force was still developing guidelines • Guidelines will help make the transition from a medical impairment focused system to one focused on wage earning capacity • Introduces more objective measures of medical impairment and functional abilities • Ongoing negotiation between business and labor about how to measure wage loss • Board will evaluate and implement guidelines when complete