Risk Management Office Health & Wellness 2009 Eugene A. Jones Fire Chief 1 MISSION Eugene A. Jones Fire Chief “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.” Vision “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.” 2 Risk Management Office Wellness/Fitness Medical Director Eugene A. Jones Fire Chief Claims Management Concentra •Office Hours: M-F 0800 to 16:00 hours Infection Control Officer Operational Safety Program Red Flag Program Employee Assistance Program Wellness/Fitness Safety Management •Available for emergency response during all other hours Administration Disability Recruits/Applicants Proactive Improvement Senior Aide Light Duty Fitness Center/PFT Field Training Information Management FMLA Annual Medical Evaluations Safety Committee Records Management 3 Problems and Obstacles Eugene A. Jones Fire Chief 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 Procedure Failure Rate of Programs Alcoholism/substance abuse Addictive/Extreme behaviors Psychological Stress of the public safety officer Physiological Stress of the public safety officer Departmental Bureaucracy Organizational and Individual Workload Recruitment and Hiring Process Economics 4 Performance and Health “Disconnect” Eugene A. Jones Fire Chief Health Performance Employee 5 The “Connection” Eugene A. Jones Employee Fire Chief Performance Total Health Risk Management Health 6 Making the Change Eugene A. Jones CHARACTER Fire Chief HABITS OUTCOME Wellness and Fitness Reality ACTIONS/WORDS THOUGHTS 7 WELLNESS AND FITNESS CULTURAL MOVEMENT “Positively Influencing Everyone” Eugene A. Jones Fire Chief Community Society Retirees People Dependants Leadership Employees 8 Psychological Process of Injury/Illness Emotional Cycle Eugene A. Jones Distress Fire Chief Determined Coping • Investigation (goal setting, seeking support and education, treatment options) • Dedication (cooperation, focus, vision, positive approach to rehab and healing) Fear, 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 9 Wellness and Fitness as a Valued service “Trust” Eugene A. Jones Fire Chief Office of Human Resource Management Risk Management •De-Conditioned •Injured •Poor Health Family and Friends Workman’s Comp Attorneys State of the Art Medical Care Labor Other Officers 10 Fitness Centers Organizational Leadership HR/Benefits Training Academy Labor Organizations Risk Management Information Management External Vendors EAP/ Behavioral Health 11 WELLNESS AND FITNESS CONNECTION TO PERFORMANCE “Integrated and Focused Organizational Involvement” Labor Organizations Eugene A. Jones Fire Chief External Health Vendors Fitness Centers EAP/Behavioral Health Wellness and Fitness Training Academy Cultural Movement Information Management HR/Benefits Organizational Leadership Risk Management 12 Total Health Risk Management Eugene A. Jones Fire Chief 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. 13 Risk Management Office Eugene A. Jones Fire Chief • 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 14 Risk Management Office (Departmental Wellness and Fitness Program Components Cont.) Eugene A. Jones Fire Chief Administer Departmental Peer Fitness Trainer Program Coordination of Departmental Pre-Hire Medical Screening Program Administer and Coordinate Departmental PreHire Fitness Preparation Program 15 Risk Management Office Eugene A. Jones (Departmental Wellness and Fitness Program Components Cont.) Fire Chief Coordinate Recruit Fitness Training Program Coordinate Company 30 Fitness Center Operations 16 Eugene A. Jones Fire Chief So What? 17 Improvement Increased Levels of Health & Safety Eugene A. Jones Fire Chief Maintenance Phase Implementation Phase 0 2004 1 2 3 Years 4 5 6 7 2009 18 Risk Management – Wellness/Fitness/Injury Tracking System Eugene A. Jones Fire Chief 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. 19 INPUT # OF EMPLOYEES # OF MEDICAL PHYSICALS # OF FITNESS EVALUATIONS Eugene A. Jones 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 Fire Chief OUTCOMES # OF NON PRODUCTIVE HOURS DUE TO: ILLNESSES FAILED MEDICAL PHYSICALS INJURIES ORTHOPEDIC 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: ILLNESSES FAILED MEDICAL PHYSICALS INJURIES ORTHOPEDIC INJURIES 20 Benefits and Progress Eugene A. Jones Fire Chief 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. Age Family Cardiac History Abnormal Cholesterol Levels High Blood Pressure Obesity Sedentary Lifestyles Smoking Diabetes 3+ cardiac risk factors 2005 21% 21% 2006 18% 18% 57% 21% 47% 26% 19% . 08% 54% 20% 45% 26% 17% .1% 52% 39% 2007 16% 16% 2008 2009 11% 10% 12% 10% 53% 46% 42% 18% 12% 14% 42% 36% 32% 28% 23% 19% 16% 13% 9% 1% 1% .8% 34% 25% 22% 21 Benefits and Progress 2005-2009 Eugene A. Jones Fire Chief • 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** 22 Life Threatning Medical Conditions Identified by Medical Physicals Eugene A. Jones Case Outcomes Medical Separation Rate per 100 employee’s – 0.27 2005 to 2009 25 Fire Chief 20 15 10 5 0 Full Duty Disability Normal 23 Positive impact on Health-Related Costs Disability Cost ONLY Eugene A. Jones Fire Chief 2001 2002 2003 2004 $519,386.22 Paid $749,221.31 Paid $893,252.69 Paid $1,035,849.34 Paid 2005 2006 2007 2008 2009 $655,276.73 Paid $475,584.56 Paid $407,680.00 Paid $253,703.00 Paid $467,932.00 Paid 36.5% increase over 2000 30.6% increase over 2001 16.1% increase over 2002 13.7% increase over 2003 -36.7% decrease over 2004 -27.4% decrease over 2005 -14.2% decrease over 2006 -38.8% decrease over 2007 +46.0% increase over 2008 Pre-contemplation Contemplation Preparation Action Maintenance Other Decreasing Costs Disability Backfill (OT) Light Duty Backfill FMLA Salaries FMLA Backfill 24 Disability Claim Performance Eugene A. Jones Average hours/claim 2008 84 hrs/claim 2009 74 hrs/claim 12% Reduction 250 Fire Chief 200 150 100 50 2004-2009 333% Reduction 0 2004 2006 2008 25 Disability Leave Analysis Average Hours/Claim Eugene A. Jones Fire Chief 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 CORRECTIONS NUMBER OF HOURS EMPLOYEES USED CY09 AMT PAID 39 6,042 $162,998 FIRE 172 12,747 $467,932 POLICE 227 38,922 $1,277,516 61 9,678 $271,678 499 67,389 $2,180,125 SHERIFFS SUB TOTAL 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. 26 Disability Leave Analysis Average Hours/Claim Disability Leave Analysis Average Hours/Claim 450 Eugene A. Jones 400 Fire Chief 350 Avg. Hours/Claim 300 250 200 150 100 50 0 CY2004 CY2005 CY2006 CY2007 CY2008 CY2009 Police 345.35 423.34 279.48 186.28 147.96 171.46 Fire 221.63 153.67 139.29 121.25 83.92 74.11 Corrections 160.00 343.71 135.96 173.10 166.47 154.92 Sheriff 213.13 267.80 188.32 170.37 177.85 158.66 185.76 162.75 Average Total 235.03 297.13 131.30 135.05 27 INJURY and ILLNESS LOSS PREVENTION STATISTICS Light duty and Overtime Coverage Stats 2007 Number of injuries that resulted in lost time: 136 How many days (8hr blocks) were lost as a result of these injuries: 2936 lost days Eugene A. Jones Pay for injured employee Pay for OT coverage Fire Chief 2936 X 8 hrs X $36.00 = $845,568 2936 X 8 hrs X $53.00 = $1,244,864 Total = $2,090,432 Stats 2008 Number 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 Pay for OT coverage 1137 X 8 hrs X $36.00 = 1137 X 8 hrs X $53.00 = Total = $327,456 $482,088 $809,544 Stats 2009 Number of injuries that resulted in lost time: 116 How many days (8hr blocks) were lost as a result of these injuries: 1930 lost days Pay for injured employee Pay for OT coverage • • • • 1930 X 8 hrs X $36.00 = $555,840 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 28 Sick Leave Usage Rate 90 Eugene A. Jones Fire Chief Average hours/employee CY 99-03 averaged 89 hours/employee CY 04-09 averaged 64 hours/employee Direct Impact 80 70 60 50 40 30 20 10 0 2004 2006 2008 29 Eugene A. Jones Acting Fire Chief Questions? 30