Workers’ Compensation Reducing risk and cost

1. Workers’ Compensation Reducing risk and cost Supporting School Districts who are creating a better tomorrow

2. What we Strive for • School District Service Objectives • Reduce costs by reducing the frequency and severity of workplace injury • Establish a customized safety and claims management plan • Maintain an open line of communication and trusted working relationships with school district personnel • Provide ongoing training to ensure a safe work environment

3. Services Online Services / Educational Portal Training & Education Return-to-Work Solutions Safety Management Claims Management • Develop educational content and delivery • Creating a competitive advantage by empowering district personnel to identify and control exposures • Develop customized RTW Program • Ensure communication with all stakeholders • Return employees back to work immediately • Mitigating legal exposures (FEHA) • Customized safety management plans • Focused on reducing injury exposures • Developing compliant Cal/OSHA programs • Enhancing communication strategies and training programs • Conducting inspection to reduce hazards • Providing strategies for claim closure • Oversight on indemnity claims • Facilitating communication with all stakeholders • Supplement & compliment efforts • Reducing reserves and controlling the X-mod

4. Solutions that get Results District Goals: Reduce injury frequency and severity Actual results achieved

5. Reduction of claim frequency

6. Reduction of claims severity

7. Training & Education

8. Principal Safety Committee Principal Safety Committee Program: • Develop Principal Safety Committee Guide • Establish committee at each site • Consists of Principal and three – four other designees • Establish general policies and procedures for the safety committee meetings, timeline, expectations, attendance forms etc… • Prepare binder with monthly agenda and guidelines for Principals • Curriculum for school year, including: • Hazard identification presentation based on inspection reports and leading exposures • Inspection checklist based on monthly presentation • Recorded webinar for principal review

9. Training solutions • Customized safety videos • E.g. Principal Safety Program Strategic Plan, IIPP Overview, Slip, Trip, Fall • Legislative Updates • E.g. SB863 • Customized Computer Based Training (CBT) Modules • Develop and host CBTs • Utilize Learning Management System

10. Safety Management

11. Why Safety Management? • Ensure written Cal/OSHA compliance programs • E.g. HazCom, MSDS management, PPE • Provide training based on leading exposures and safety policies (SOPs in hazardous tasks) • Conduct inspections identifying exposure trends • Implement customized scorecard inspection program • Utilize dashboard analytics for management decisions on resource allocation • Optimize District wide safety understanding • Legislative changes including Assembly Bill 2774 • Focus on reducing injuries and injury exposure

12. Interior & Exterior Site Inspections • School Site Inspections • Focused on safety, fire and property / liability exposures. • Conduct inspection program to satisfy IIPP • Development of inspection binder for corrective action • Present findings to District management • Inspections will include all buildings and grounds, which include (but not limited to):   • Alternate each year between exterior and interior inspections • 100% of school grounds: • Gates, fences, parking lots, sidewalks /walkways, fields, buildings, classrooms, locker rooms, gymnasiums, bathrooms etc… • Hazard identification • Electrical hazards • Slip, trip and fall hazards • Structural hazards • School grounds hazards • Housekeeping hazards • Fire hazards/safety • “Fall on” hazards • Life safety hazards • Chemical hazards

13. Playground Inspections • Playground Inspections • Inspect all elementary playgrounds and middle school athletic grounds • Inspections include: • Identifying hazards on playground equipment and the playground • Ranking the hazards according to injury potential • Recommendations on removing/correcting the hazards • Utilize established playground inspection checklist, complying with IIPP & playground inspection requirements • Per the National Playground Safety Institute (NPSI) • Provide summary report to District management

14. Return To Work Reducing Lost Days and Temporary Disability costs

15. Return To Work Benefits • Reduce or avoid temporary or permanent disability payments • Reduce medical costs as injured workers experience faster recoveries when they remain at work in a work environment that is congenial with their physical capacity • Reduce or avoid litigation • Discourage fraudulent claims • Improve productivity and morale among all employees • Eliminate disability discrimination and comply with FEHA

16. Return To Work Implementation Phase 1 Phase 2 Phase 3 Foundation Assessment Launch Coordinate communication Train supervisors and managers Launch RTW program to all employees Review and Revise Job Descriptions Identify Temporary Alternative Duties (TADs) Document physical requirements Write a management plan and policy statement Build a support team and assign roles and responsibilities Establish process and procedures Evaluate Business Benefit ROI

17. Return To Work Development Process Program Introduction Current RTW Plan and/or Policy Recent work status report from designated Medical Provider Job descriptions Alternative duties Loss Runs X-Mod Worksheet/WCIRB Collect Background Information Program Engagement RTW Evaluation Questionnaire Phase 1 - Foundation Write Management Plan and Policy Statement Assign Roles and Responsibilities Establish Process and Procedures Build Support Team Planning Checklist Assign RTW Coordinator Identify Temporary Alternative Duties (TADs) Document Physical Requirements Review & Revise Job Descriptions to include Essential Functions Phase 2 - Assessment Phase 3 - Launch Roll out to all Employees Coordinate Communication Coordinate with Employee Train Supervisors/Managers Coordinate with Medical Provider Coordinate with Claims Administrator Flyer PPT Letter to employees Support ESM Member

18. Claims Advocacy Proactive Claims Management reduces the cost of injuries

19. Why Claims Management? • Reform results continue to erode • Medical cost inflation • Increase in Medicare Set Aside • Abuse of medical lien process • Increase in cost containment factors • Legislative changes • New case law impact • Increasing litigation • Turnover in claims examiners • Recent Result: $61,000 reserve reduction on two claims for a District that is Self Insured!

20. Claims Mgmt Service Schedule Policy Year Milestones Policy Year Application

21. Claims oversight and support • Ongoing Communication • Phone call, email and webinar communication for District claims management staff • Develop written claims handling procedures • Work in conjunction with CUSD Workers’ Compensation coordinator to develop written policies and procedures. • Ongoing claims Oversight & Direction • Ensure examiner has positioned claim for speedy, cost-effective resolution • Analyze reserves for accuracy and negotiate potential reduction • Act as liaison on all delayed claims, ensuring denial decision is met timely • Obtain current status of claim including work status, medical prognosis and recommend a resolution strategy • Ensure appropriate California laws and regulations are applied • Recommend litigation strategies to resolve claims • Create vendor list (e.g. Defense Attorney, Nurse Case Management etc..) • Create First Aid policy

22. Claims Management Reporting & Oversight Process Carrier processes claim Claims Management MO claim processed, closed in 90 days Begin RTW coordination with medical provider and client ESM analyze at 90 days for potential problems Claim is classified as MO or IND Continue 30 day ongoing oversight and direction IND claim: 3 point contact, provide benefits Begin RTW coordination with medical provider and client Disputed Claims If ACCEPTED, manage claim to conclusion Determination is made to accept or deny Monitors Carrier for investigation process and strategizes decision Claim is delayed and investigated for 90 day compensability determination If DENIED and UNDISPUTED Close in 30 days Oversees resolution strategy If DENIED and DISPUTED Develop litigation strategy for resolution Large Loss Claims ( >$25,000 ) Strategize best practices for resolution Monitor strategy for effectiveness and accountability Monitor settlement and any future medical award Develop a POA for resolution ESM District Carrier

23. Your Service Team Expert advocates that get your District results

24. ESM is YOUR Advocate • Expertise in school district risk management • Designations: • Associate in Risk Management – ARM • Worker’s Compensation Claims Professional - WCCP • Associate in Management - AIM • Certified Playground Safety Inspector – CPSI • Certified Professional Disability Manager – CPDM • Self-Insured Professional – SIP • ESM’s consultants are fingerprinted for criminal compliance per the educational code, sections: 45125.1 & 45125.2 • Established relationships with school districts • Results driven • Always raising the BAR • Benefits from Activities that get Results

25. Where there are risks…there are Solutions… “ “ www.executivesm.com