risk management user group thursday, august 26, 2004

Risk Management User Group

Thursday, August 26, 2004

Welcome

Michael L. Hay, CGFM, CPPM

August 26, 2004 Risk Management User Group 3

Meeting Agenda

8:30 – 8:35 – Introduction 8:35 – 9:20 – Reducing the Risk of Workplace Violence 9:20 – 9:50 – Governor’s Executive Order RP36 –

Preventing, Detecting, and Eliminating Fraud, Waste, and Abuse

9:50 – 10:00 – FY04 SORM 200 Reporting 10:00 – 10:10 – SORM’s New Website 10:10 – 10:15 – FY03 Safety Excellence Award Winner


Meeting Agenda

10:15 – 10:30 – Break 10:30 – 11:00 – Terrorist Threats and the

Upcoming Election 11:00 – 11:30 – FY04 Workers’ Compensation

Claims Review 11:30 – 12:00 – Roundtable Discussion of FY04

Workers’ Compensation Claims Remedies

Reducing the Risk of Workplace Violence

Garry L. Parker, Senior Trooper

Public Information and Education Resource Officer

Texas Department of Public Safety


Questions?

Governor’s Executive Order RP36

Preventing, Detecting, and Eliminating Fraud, Waste, and Abuse

Cecile Young, Special Assistant to the Governor’s Office Director of Budget, Planning & Policy

Somaia Farag, MBA, CIA, CGAP, CISAInternal Audit, DirectorOffice of the Governor



Background Information

Governor’s fight against FraudHouse Bill 1743, House Bill 2292, and House Bill 104

Related actions at TDCJRelated actions at TWC

Governor’s Management Council SACC, MACC, and SSATF members

subcommittee

Executive Order How it helps? What it does?



Next Steps: Agency Actions

Designate a Fraud Prevention CoordinatorReview policies, organizational structures and statutes Adopt a fraud prevention and elimination plan based on a risk assessment and common components Report to Governor’s Office statutory changes needed and implementation of program



Next Steps: Governor’s Office Actions

Receive agency reports on statutory changes and implementation of fraud prevention programs

Develop anti-fraud legislation for session

Review plans with assistance of an interagency group to develop a best practices report


Governor’s Executive Order RP36 Why do we need to talk about fraud

prevention?

Financial ReasonsTaxpayer fundedBetter cost controlsReduction of risk of lawsuitsBetter quality of work from contractors

Moral Reasons Taxpayer trustRole modelUpholding reputationBetter employee morale



Fraud can happen anywhere



The Fraud Triangle


Governor’s Executive Order RP36 Fraud Program and Risk Assessment

Key Components for Fraud Prevention and Elimination Program

Creating a Culture of Honesty and Ethics

Antifraud Processes and Controls

Appropriate Oversight Process

Risk Assessment


Governor’s Executive Order RP36 Contractor Fraud – Big Risk Area

Invoices for services/goods which were never

delivered

Low-ball bids, followed by abusive or fraudulent

change orders

Collusion between employee and contractor

Delivery of low quality services and goods and

billing higher

Hundreds of schemes..ever changing



For more information please go to: http://www.governor.state.tx.us/priorities/fraud_prevention

Press Release

Executive Order

Fact Sheet

Examples

Fraud Prevention and Detection Program Key components

Fraud Risk Assessment

Best Practices


Questions?

FY04 SORM 200 Reporting

Annual Reporting of Risk Management Expenditures and

Property/Casualty Claims

Jeff CoxRisk Management Specialist


SORM 200

Required by Labor Code Chapter 412.053 Reference rule 28 TAC 4, 252.203

Start Date – 9/1/2004 (Part 1 and Section 1 of Part 2) Property & Casualty Claims available all year around

Due Date – 10/30/2004, 60 days after the end of the fiscal year

Information reported in SORM’s biennial report to the legislature.


Start Preparing

Communicate with your Budgeting and Accounting Departments to obtain agency expenditure amounts based on Comptroller Object Codes:

Risk Management Expenditures based by SORM categories Insurance payments Property/casualty claims payments

Collect Information on the Number of Notaries

Request Copies of Insurance Policies from agent/broker

Enter & update property and casualty claims. (Available year-round)


Questions?

SORM’s New Website

Carol Carroll

SORM Webmaster

WWW.SORM.STATE.TX.US

UsabilityAccessibilityMaintainability

A new design for:

Current Website

Current Highlights on Home Page

Links and ContentFor Current Section of Site

Drop Down Menu for Main Sections of Site

Open Style Menu

Questions or Suggestions?

[email protected]

FY03 Safety Excellence Award Winner

Texas Education Agency

Break Time!

See you in

15 minutes!

Terrorist Threats and the Upcoming Election

Steven C. McCraw

Director of Homeland Security

Office of the Governor


Questions?

FY04 Workers’ Compensation Claims Review

Terry G. Myers

Director of Claims Operations


3 Years Medical Accepted Claims

0

1000

2000

3000

4000

5000

6000

09/01

10/01

11/01

12/01

01/02

02/02

03/02

04/02

05/02

06/02

07/02

08/02

09/02

10/02

11/02

12/02

01/03

02/03

03/03

04/03

05/03

06/03

07/03

08/03

09/03

10/03

11/03

12/03

01/04

02/04

03/04

04/04

05/04

06/04

07/04

Number of Claims

Linear (Number of Claims)


3 Year Total Medical Costs

$-

$1,000,000

$2,000,000

$3,000,000

$4,000,000

$5,000,000

$6,000,000

09/0

112

/01

03/0

206

/02

09/0

212

/02

03/0

306

/03

09/0

312

/03

03/0

406

/04

Medical Costs

Linear (Medical Costs)

*August Numbers Projected


3 Year Indemnity Accepted Claims

0

200

400

600

800

1000

1200

1400

1600

1800

09/0

111

/01

01/0

203

/02

05/0

207

/02

09/0

211

/02

01/0

303

/03

05/0

307

/03

09/0

311

/03

01/0

403

/04

05/0

407

/04

Number of Claims



3 Year Indemnity Expenses

$-

$500,000

$1,000,000

$1,500,000

$2,000,000

$2,500,000

$3,000,000

09/0

111

/01

01/0

203

/02

05/0

207

/02

09/0

211

/02

01/0

303

/03

05/0

307

/03

09/0

311

/03

01/0

403

/04

05/0

407

/04

Indemnity Expenses

Linear (Indemnity Expenses)



3 Year Total Accepted Claims

0

1000

2000

3000

4000

5000

6000

09/0

111

/01

01/0

203

/02

05/0

207

/02

09/0

211

/02

01/0

303

/03

05/0

307

/03

09/0

311

/03

01/0

403

/04

05/0

407

/04

Nu

mb

er

of

Cla

ims

Number of Claims



3 Year Total Costs

$-

$1,000,000

$2,000,000

$3,000,000

$4,000,000

$5,000,000

$6,000,000

$7,000,000

$8,000,000

$9,000,000

09/0

111

/01

01/0

203

/02

05/0

207

/02

09/0

211

/02

01/0

303

/03

05/0

307

/03

09/0

311

/03

01/0

403

/04

05/0

407

/04

Total Costs

Linear (Total Costs)



Questions?

Roundtable Discussion of FY04 Workers’ Compensation Claims Remedies

Samuel Arant, Risk Management Specialist

Lisa Bell, Risk Management Specialist

Joseph Deering, Risk Management Specialist

Curt Krill, Risk Management Specialist


0

200

400

600

800

1000

1200

1400

ClientAggression

Slips, Trips, andFalls

Motor VehicularAccidents

PhysicalExertion

All Agencies Workers’ Comp Accepted Claims by Cause of Injury 1st – 3rd Quarters FY04


0

200

400

600

800

1000

1200

1400

1600

ClientAggression

Slips, Trips, andFalls

Motor VehicularAccidents

PhysicalExertion

1-3 Qtr FY03

1-3 Qtr FY04

All Agencies Workers’ Comp AcceptedClaims by Cause of Injury

Feedback Form

Please complete the survey form at the end of your packet and turn it in before

you leave.

We value your comments.

Risk Management User Group

Thank you for attending.

We’ll see you December 9th!

risk management user group thursday, august 26, 2004

Documents

fraud triangle slide

cppm slide

governor slide

risk assessment key

governors office actions

fraud house bill

antifraud legislation

fy04 sorm