CBIS Business MeetingCBIS Business Meeting

Presented by:Lori Cockerill & Andrea McNeill

September 2010

AgendaAgendaWorkSafeBC Information/StatsCOT vs. CBISReferral ProcessAssessment ProcessReporting FormatGym Pass PolicyIndividuals in DistressThree Month ReviewCase Manager Contact

Key Statistics (2009)Key Statistics (2009)

BC Injured Workers

Key Statistics (2009)Key Statistics (2009)Claims

Injuries reported 141,968

Claims accepted 94,252

Fatal claims accepted 121

Percentage of claims disallowed 6.4%

Occupational disease claims accepted 2,610

Days lost from work 28 million

Average length of short-term wage-loss benefits 546 days

Reported Fatalities & All Reported Fatalities & All Reported InjuriesReported Injuries

Year New injuries reported in the year

Fatalities that occurredin the year and were reportedto WSBC by Feb of the following year (March 31, 2010 for 2009)*

Fatalities as a percentageof new injuries

2000 181,632 186 0.10%

2001 169,492 193 0.11%

2002 156,782 232 0.15%

2003 152,071 219 0.14%

2004 156,762 223 0.14%

2005 164,267 259 0.16%

2006 172,843 274 0.16%

2007 173,385 228 0.13%

2008 168,268 225 0.13%

2009 141,968 174 0.12%

*For the years 2000–2008, the deaths included in the table are those that were reported by February of the following year (the exact date varied from February 16 to February 22). For 2009 and subsequent years, the deaths included in the table are those reported by March 31 of the following year. The count of fatalities is slightly more complete for 2009 and subsequent years than it is for 2008 and prior years.

Reported Fatalities & All Reported Fatalities & All Reported InjuriesReported Injuries

Number and Costs of Claims*Number and Costs of Claims*During the year 2009, 94,252 claims were

paid for the first time. Of those:

• 42,960 were health-care-only claims (formerly called medical-aid-only claims)

• 47,651 were short-term disability claims (formerly called wage-loss claims)

• 3,520 were long-term disability claims (formerly called permanent disability claims)

• 121 were fatal claims

* The figures on counts and costs for 2009 have been impacted by two factors: a drop in the number of reported injuries (due at least in part to the recession); and business process changes brought about by the implementation of our CMS initiative.

Number of Claims and Claims Costs by Number of Claims and Claims Costs by Provincial Regional District for 2009Provincial Regional District for 2009

DAYS LOST DAYS LOST FROM WORKFROM WORK

DAYS LOST DAYS LOST FROM WORK FROM WORK (CONT’D)(CONT’D)

PercentagePercentage of Female Claimants of Female Claimants

Claim Analysis: Short-term Disability, Long-term Claim Analysis: Short-term Disability, Long-term Disability and fatal claims first paidDisability and fatal claims first paid

* Not all columns add up to 100 percent due to rounding.

Worker Overall Experience RatingsWorker Overall Experience Ratings

Injured Workers’ Rating of WorkSafeBC Injured Workers’ Rating of WorkSafeBC Claim StaffClaim Staff

Injured Workers’ Rating of Assistance Injured Workers’ Rating of Assistance with Their Return to Workwith Their Return to Work11

1 Not all columns add up to 100 percent due to rounding.

Employers’ Rating of Their Overall Employers’ Rating of Their Overall ExperienceExperience11

1 Not all columns add up to 100 percent due to rounding.

COT vs. CBISCOT vs. CBISAdmission Criteria

COT CBISInjured Workers with:

• Spinal cord injury • Amputations • Burns • Pressure ulcers• Post traumatic stress disorder• Complex orthopaedic conditions

Injured Workers with:

• Compensable acquired brain injuries

COT vs. CBISCOT vs. CBISThe Contractor is responsible for making sure the

following admission criteria are met:

COT

The Injured Worker:

• Has no health concerns which would contraindicate participation

• Demonstrates a medical and functional need for COT intervention

• Requests for Time Sensitive Assessments meet the criteria in Clause 2.1.5 – TIME SENSITIVE ASSESSMENTS

•Each admission to OT Services includes all of the Services that are required for that Injured Worker, by that Contractor, prior to the Worker’s discharge

CBIS

The Injured Worker:

• Has no health concerns which would contraindicate participation

• Demonstrates a need for Community Brain Injury Services intervention

*NOTE -Concurrent Care: The Worker may receive CBIS services in conjunction with other care (e.g. Speech Language Pathology, HIATS, Physiotherapy, Home Care, and Community OT)

COT vs. CBISCOT vs. CBISExclusion Criteria

• The Contractor must not provide Services to Injured Workers where:

COT• Evidence exists that the Injured Worker is unlikely to benefit from COT Services due to barriers beyond the scope of the COT Services Agreement

•The Injured Worker’s needs would be met more cost-effectively by another service

•The condition requiring intervention is not compensable under the claim

•The Injured Worker is currently engaged in another treatment intervention for the same injury

CBIS•Evidence exists that the Injured Worker is unlikely to benefit from CBIS

•The Injured Worker is functioning well independently at home and/or in the community

•The Injured Worker’s needs would be met more cost-effectively by another service

•The Injured Worker resides in a group home, care home, family care home, or care facility

Referral ProcessReferral Process

Referral ProcessReferral Process

If a Board Officer contacts a Contractor directly, the Contractor MUST request a Referral Form to ensure payment

Referral Process Referral Process

Referral ProcessReferral ProcessWhen scheduling a Worker for the

Initial Visit, the Contractor must:

Referral ProcessReferral Process

CBIS Referral Form (83B150)CBIS Referral Form (83B150)

Assessment ProcessAssessment Process

Reporting FormatReporting Format

Gym Pass PolicyGym Pass PolicyBilling under fee code 1102348 (Pre-

authorized expenses)

Parks Board ChangesParks Board ChangesOT’s, OTA’s, RA’s will be provided with an

“external rehab specialist” card, which will identify them differently than “outside trainers”.

Each OT company will have to apply for the card individually

The card will be honoured at participating community centers (some may have their own policy)

Contact: Warren Coughlin at VPB (604-257-8615) for more information

Impact on WSBC Invoicing: Please state “Entrance Fee to Recreation Facilities” to bill code 1102348

Individuals in DistressIndividuals in DistressContacts include:

Don’t wait to seek help!

Three Month ReviewThree Month Review

Has anyone completed this?How did it go?Feedback for us?