1 risk management office health & wellness 2009 eugene a. jones fire chief

1

Risk Management Office Risk Management Office

Health & Wellness 2009Health & Wellness 2009Health & Wellness 2009Health & Wellness 2009Eugene A. JonesEugene A. Jones

Fire ChiefFire Chief

2

MISSIONMISSIONMISSIONMISSION

“To prevent and manage the occurrence of work place injury, illness and property loss, while maintaining optimal health

and productivity of our employee’s/members.”

“To prevent and manage the occurrence of work place injury, illness and property loss, while maintaining optimal health

and productivity of our employee’s/members.”

VisionVisionVisionVision“The Prince George’s County Fire/EMS Department

workforce will have widespread and spirited advantages through the health and fitness of individuals, prevention and protection from injury, illness, and property loss and

proper medical and rehabilitative care.”

“The Prince George’s County Fire/EMS Department workforce will have widespread and spirited advantages through the health and fitness of individuals, prevention and protection from injury, illness, and property loss and

proper medical and rehabilitative care.”

Eugene A. JonesEugene A. Jones


3

Risk ManagementOffice

Claims Management Wellness/Fitness Administration

Wellness/Fitness Medical Director

Senior AideDisability

FMLA

Light Duty

Recruits/Applicants

Concentra

Infection Control Officer

Safety Management

OperationalSafety Program

Proactive Improvement

Field Training

Safety Committee

Fitness Center/PFT

Annual Medical Evaluations

InformationManagement

RecordsManagement

Red Flag ProgramEmployee

Assistance Program



•Office Hours: M-F 0800 to 16:00 hours

•Available for emergency response during all other hours

4

Problems and ObstaclesProblems and Obstacles Problems and ObstaclesProblems and Obstacles

Adjusting approach to “Cultural Shift” vs. “Only Adding Programs”Departmental “Resistance to Change”

The National and Departmental “Cultural Attitude” Towards Wellness and Fitness

Health Care System Policy and ProcedureFailure Rate of ProgramsAlcoholism/substance abuseAddictive/Extreme behaviorsPsychological Stress of the public safety officerPhysiological Stress of the public safety officerDepartmental Bureaucracy Organizational and Individual WorkloadRecruitment and Hiring ProcessEconomics



5

Performance

Health

Performance and Health

“Disconnect”

Employee



6

Performance

Employee

TotalHealthRiskManagement

Health

The “Connection”The “Connection”



7

Wellness and Fitness

Reality

OUTCOMECHARACTER

HABITS

ACTIONS/WORDSTHOUGHTS



Making the ChangeMaking the Change

8

WELLNESS AND FITNESS CULTURAL MOVEMENTWELLNESS AND FITNESS CULTURAL MOVEMENT“Positively Influencing Everyone”“Positively Influencing Everyone”

WELLNESS AND FITNESS CULTURAL MOVEMENTWELLNESS AND FITNESS CULTURAL MOVEMENT“Positively Influencing Everyone”“Positively Influencing Everyone”

People

SocietyCommunity

Leadership

Retirees

Dependants

Employees



9

Psychological Process of Injury/IllnessPsychological Process of Injury/IllnessPsychological Process of Injury/IllnessPsychological Process of Injury/Illness

Emotional CycleEmotional Cycle

DistressFear, anxiety, anger,

depression, guilt,re-directed anger, self-doubt

bargaining

Denial• Disbelief injury exists

• Minimizing severity of injury and effect to job performance• Avoiding medical treatment

• Unacknowledged feelings of loss and stress of separation from

co-workers

Determined Coping• Investigation (goal setting, seeking support and education, treatment options)• Dedication (cooperation, focus, vision,positive approach to rehab and healing)



10

Wellness and Fitness as a Valued service

“Trust”

Wellness and Fitness as a Valued service

“Trust”

•De-Conditioned•Injured•Poor Health

Office of HumanResource

Management

Risk Management

State of the ArtMedical Care

Family and Friends

Workman’sComp

Attorneys

OtherOfficers

Labor



11

Fitness Centers

Organizational Leadership

Information Management

HR/Benefits

EAP/Behavioral Health

Risk Management

External Vendors

Labor Organizations

Training Academy

12

WELLNESS AND FITNESS CONNECTION TO PERFORMANCE WELLNESS AND FITNESS CONNECTION TO PERFORMANCE “Integrated and Focused Organizational Involvement”“Integrated and Focused Organizational Involvement”

WELLNESS AND FITNESS CONNECTION TO PERFORMANCE WELLNESS AND FITNESS CONNECTION TO PERFORMANCE “Integrated and Focused Organizational Involvement”“Integrated and Focused Organizational Involvement”

External Health Vendors

Information Management

EAP/Behavioral Health

Fitness Centers

Risk Management

Labor Organizations

Wellness and Fitness Cultural Movement

Organizational Leadership

Training Academy

HR/Benefits



13

Total Health Risk Management

The systems of Total Health Risk Management are designed to protect the health and well being of the individuals in the Prince

George’s County Fire/EMS Department. They also decrease the fiscal impact of injury, illness, and sick leave use. The following three major

systems of health and safety are focused:

• Health and Fitness of Individuals• Prevention and Protection from Injury and Illness• Proper Medical and Rehabilitative Care

Wellness and Fitness Program Components and Descriptions

The following are components and task descriptions of the Total Health Risk Management Systems. These are Wellness and Fitness

Program components that are currently implemented and/or completed as of January 2008.



14

Risk Management OfficeRisk Management OfficeRisk Management OfficeRisk Management Office

• Departmental Wellness and Fitness Program Components– Include:

• Departmental Annual Medical Physical Program that administers the Employee Medical Services Contract

• Departmental Injury/Illness Back To Work Program

• Departmental Wellness and Fitness Program Components– Include:

• Departmental Annual Medical Physical Program that administers the Employee Medical Services Contract

• Departmental Injury/Illness Back To Work Program



15

(Departmental Wellness and Fitness Program Components Cont.)

Administer Departmental Peer Fitness Trainer Program

Coordination of Departmental Pre-Hire Medical Screening Program

Administer and Coordinate Departmental Pre-Hire Fitness Preparation Program


Administer Departmental Peer Fitness Trainer Program

Coordination of Departmental Pre-Hire Medical Screening Program

Administer and Coordinate Departmental Pre-Hire Fitness Preparation Program




16


Coordinate Recruit Fitness Training Program

Coordinate Company 30 Fitness Center Operations


Coordinate Recruit Fitness Training Program

Coordinate Company 30 Fitness Center Operations




17

So What?So What?So What?So What?



18

Improvement Improvement Improvement Improvement

0 1 2 3 4 5 6 7

2004 Years 2009

Increased Levels of Health & Safety

Implementation Phase

Maintenance Phase



19

Risk Management – Wellness/Fitness/Injury Tracking System

Goal: To provide tangible and effective information that substantiates the investment of resources towards the Department’s Wellness and Fitness Program.

Objectives: By FY2008 have “real time” technology processes in place to track non-productive hours due to illnesses, failed medical physicals, injuries and orthopedic injuries.

Key Service: Total Health Risk Management will focus on the appraisal, planning and management of the wellness and fitness of personnel. This will improve the Department’s safety, readiness and resources as it protects the community.



20

INPUT# OF EMPLOYEES# OF MEDICAL PHYSICALS# OF FITNESS EVALUATIONS

OUTPUT# OF EMPLOYEES WITH CORONARY RISK FACTORS (overweight, hypertension, smokers, abnormal lipid profile) # OF EMPLOYEES FAILING MEDICAL PHYSICALS# OF EMPLOYEES WITH AVERAGE OR BELOW AVERAGE FITNESS LEVEL

OUTCOMES# OF NON PRODUCTIVE HOURS DUE TO: ILLNESSESFAILED MEDICAL PHYSICALSINJURIESORTHOPEDIC INJURIES

EFFICIENCY% OF REDUCTION OF SICK LEAVE USE DUE TO EMPLOYEE ILLNESS% OF REDUCTION OF OVERALL INJURY RATE% OF REDUCTION OF EMPLOYEES WITH CORONARY RISK FACTORS% OF REDUCTION OF FAILED MEDICAL PHYSICALS% OF INCREASE OF FITNESS LEVEL TO ABOVE AVERAGE% OF REDUCTION ORTHOPEDIC INJURIES% OF REDUCTION OF DURATION EMPLOYEES SPEND ON IOJ AND MODIFIED DUTY

QUALITY% OF REDUCTION OF NON PRODUCTIVE HOURS DUE TO: ILLNESSESFAILED MEDICAL PHYSICALSINJURIESORTHOPEDIC INJURIES



21

Benefits and ProgressBenefits and ProgressBenefits and ProgressBenefits and Progress

Health data from medical physicals indicate that there has been a reduction in cardiac risk factors as of December 2008. In addition, there has been a reduction of career personnel that are positive for three or more coronary risk factors.

2005 2006 2007 2008 2009 Age 21% 18% 16% 11% 10%

Family Cardiac History 21% 18% 16% 12% 10%

Abnormal Cholesterol Levels 57% 54% 53% 46% 42%High Blood Pressure 21% 20% 18% 12% 14%Obesity 47% 45% 42% 36% 32%Sedentary Lifestyles 26% 26% 28% 23% 19%Smoking 19% 17% 16% 13% 9%Diabetes . 08% .1% 1% 1% .8%

3+ cardiac risk factors 52% 39% 34% 25% 22%

Health data from medical physicals indicate that there has been a reduction in cardiac risk factors as of December 2008. In addition, there has been a reduction of career personnel that are positive for three or more coronary risk factors.

2005 2006 2007 2008 2009 Age 21% 18% 16% 11% 10%

Family Cardiac History 21% 18% 16% 12% 10%

Abnormal Cholesterol Levels 57% 54% 53% 46% 42%High Blood Pressure 21% 20% 18% 12% 14%Obesity 47% 45% 42% 36% 32%Sedentary Lifestyles 26% 26% 28% 23% 19%Smoking 19% 17% 16% 13% 9%Diabetes . 08% .1% 1% 1% .8%

3+ cardiac risk factors 52% 39% 34% 25% 22%



22

Benefits and ProgressBenefits and ProgressBenefits and ProgressBenefits and Progress

2005-2009

• 67 health related findings from medical physicals needing follow up.

• 28 confirmed serious and/or life threatening medical findings.

• 11 serious cardiac related detections • 8 early cancer detections• 9 previously unknown severe hypertension detections

• 23 returned to full duty• 5 selected retirement

• 2 with disability retirement• 3 with normal 20+ retirement

**No punitive action taken against employee**

2005-2009

• 67 health related findings from medical physicals needing follow up.

• 28 confirmed serious and/or life threatening medical findings.

• 11 serious cardiac related detections • 8 early cancer detections• 9 previously unknown severe hypertension detections

• 23 returned to full duty• 5 selected retirement

• 2 with disability retirement• 3 with normal 20+ retirement

**No punitive action taken against employee**



23

Life Threatning Medical Conditions Life Threatning Medical Conditions Identified by Medical PhysicalsIdentified by Medical Physicals

Life Threatning Medical Conditions Life Threatning Medical Conditions Identified by Medical PhysicalsIdentified by Medical Physicals

0

5

10

15

20

25

Full Duty Disability Normal0

5

10

15

20

25

Full Duty Disability Normal

Case Outcomes

Medical Separation Rate per 100 employee’s – 0.27

2005 to 2009

Case Outcomes

Medical Separation Rate per 100 employee’s – 0.27

2005 to 2009



24

Positive impactPositive impact on Health-Related Costs on Health-Related CostsPositive impactPositive impact on Health-Related Costs on Health-Related Costs

2001 $519,386.22 Paid 36.5% increase over 20002002 $749,221.31 Paid 30.6% increase over 20012003 $893,252.69 Paid 16.1% increase over 2002 2004 $1,035,849.34 Paid 13.7% increase over 2003

2005 $655,276.73 Paid -36.7% decrease over 2004 2006 $475,584.56 Paid -27.4% decrease over 2005 2007 $407,680.00 Paid -14.2% decrease over 20062008 $253,703 .00 Paid -38.8% decrease over 20072009 $467,932.00 Paid +46.0% increase over 2008

Other Decreasing Costs Disability Backfill (OT) Light Duty Backfill FMLA Salaries

FMLA Backfill

2001 $519,386.22 Paid 36.5% increase over 20002002 $749,221.31 Paid 30.6% increase over 20012003 $893,252.69 Paid 16.1% increase over 2002 2004 $1,035,849.34 Paid 13.7% increase over 2003

2005 $655,276.73 Paid -36.7% decrease over 2004 2006 $475,584.56 Paid -27.4% decrease over 2005 2007 $407,680.00 Paid -14.2% decrease over 20062008 $253,703 .00 Paid -38.8% decrease over 20072009 $467,932.00 Paid +46.0% increase over 2008

Other Decreasing Costs Disability Backfill (OT) Light Duty Backfill FMLA Salaries

FMLA Backfill

Pre-contemplation

Contemplation

Preparation

Action

Maintenance

Disability Cost Disability Cost ONLYONLYEugene A. JonesEugene A. Jones


25

0

50

100

150

200

250

2004 2006 2008

Average hours/claim

2008

84 hrs/claim 2009

74 hrs/claim 12% Reduction

2004-2009 333% Reduction

Disability Claim PerformanceDisability Claim PerformanceDisability Claim PerformanceDisability Claim Performance



26

Listed below is a disability leave usage chart showing the number of employees using disability leave/hours used and amounts paid to public safety employees as of December 31, 2009.

AGENCY

NUMBER OF HOURSCY09

AMT PAIDEMPLOYEES USED

CORRECTIONS 39 6,042 $162,998

FIRE 172 12,747 $467,932

POLICE 227 38,922 $1,277,516

SHERIFFS 61 9,678 $271,678

SUB TOTAL 499 67,389 $2,180,125

In CY08, 434 public safety employees used a total of 56,983 hours at a cost of $1,687,893. In CY09, 499 employees used 67,389 hours at a cost of $2,180,125, an increase of $492,232.

Disability Leave AnalysisDisability Leave AnalysisAverage Hours/ClaimAverage Hours/Claim




27





Average Total 235.03 297.13 185.76 162.75 131.30 135.05

28

INJURY and ILLNESS LOSS PREVENTION STATISTICSINJURY and ILLNESS LOSS PREVENTION STATISTICSLight duty and Overtime CoverageLight duty and Overtime Coverage

INJURY and ILLNESS LOSS PREVENTION STATISTICSINJURY and ILLNESS LOSS PREVENTION STATISTICSLight duty and Overtime CoverageLight duty and Overtime Coverage

Stats 2007Number of injuries that resulted in lost time: 136How many days (8hr blocks) were lost as a result of these injuries: 2936 lost days

Pay for injured employee 2936 X 8 hrs X $36.00 = $845,568 Pay for OT coverage 2936 X 8 hrs X $53.00 = $1,244,864

Total = $2,090,432

Stats 2008Number of injuries that resulted in lost time: 76 How many days (8hr blocks) were lost as a result of these injuries: 1,137 lost days

Pay for injured employee 1137 X 8 hrs X $36.00 = $327,456 Pay for OT coverage 1137 X 8 hrs X $53.00 = $482,088 Total = $809,544Stats 2009Number of injuries that resulted in lost time: 116How many days (8hr blocks) were lost as a result of these injuries: 1930 lost days

Pay for injured employee 1930 X 8 hrs X $36.00 = $555,840 Pay for OT coverage 1930 X 8 hrs X $53.00 = $818,320

Total = $1,374,160

• Injury Reduction from 2007 to 2008 = 60• Direct Cost Savings from 2007 to 2008 = $1,280,888• Injury Increase from 2008 to 2009 = 40 • Direct Cost Increase from 2008 to 2009 = $564,616

Stats 2007Number of injuries that resulted in lost time: 136How many days (8hr blocks) were lost as a result of these injuries: 2936 lost days

Pay for injured employee 2936 X 8 hrs X $36.00 = $845,568 Pay for OT coverage 2936 X 8 hrs X $53.00 = $1,244,864

Total = $2,090,432

Stats 2008Number of injuries that resulted in lost time: 76 How many days (8hr blocks) were lost as a result of these injuries: 1,137 lost days

Pay for injured employee 1137 X 8 hrs X $36.00 = $327,456 Pay for OT coverage 1137 X 8 hrs X $53.00 = $482,088 Total = $809,544Stats 2009Number of injuries that resulted in lost time: 116How many days (8hr blocks) were lost as a result of these injuries: 1930 lost days

Pay for injured employee 1930 X 8 hrs X $36.00 = $555,840 Pay for OT coverage 1930 X 8 hrs X $53.00 = $818,320

Total = $1,374,160

• Injury Reduction from 2007 to 2008 = 60• Direct Cost Savings from 2007 to 2008 = $1,280,888• Injury Increase from 2008 to 2009 = 40 • Direct Cost Increase from 2008 to 2009 = $564,616



29

Sick Leave Usage RateSick Leave Usage RateSick Leave Usage RateSick Leave Usage Rate

0

10

20

30

40

50

60

70

80

90

2004 2006 20080

10

20

30

40

50

60

70

80

90

2004 2006 2008

Average hours/employee

CY 99-03 averaged 89 hours/employee


Direct Impact

Average hours/employee



Direct Impact



30

Questions?Questions?Questions?Questions?Eugene A. JonesEugene A. Jones

Acting Fire ChiefActing Fire Chief

1 risk management office health & wellness 2009 eugene a. jones fire chief

Documents

chief slide

employee eugene

change slide

performance health performance

chief office hours

connection eugene

healing eugene

optimal health