Preconference Monday, 4:00-5:00 pm

Transcription

1 What Experts Know About IDAM and How They Apply It Presented by Adrienne Paler, CPDM Loyd Hudson, CPDM Mike Moses, CPDM Gina Magee What Experts Know About IDAM and How They Apply It Adrienne Paler Role: Director, Integrated Disability and Absence Management - THPM Sutter Stats: ~55,000 employees, ~43 entities, 300+ locations, 6 states 18,000 leaves 7,000 accommodations 3,600 early RTW via Connect to Work program 300+ policies and collective bargaining agreements 1,000+ different pay practices Self-administered for leave, disability, WC & accommodation 47 IDAM employees

2 What Experts Know About IDAM and How They Apply It Loyd Hudson Role: Manager, Integrated Disability & Absence AEP Annual Transaction Activities: 6,699 sick leaves 507 workers compensation claims 789 non-employee FMLA Absences (alternate employer) 97 Military Leaves Employee experience rating: 4.3 out of 5 (86% approval) What Experts Know About IDAM and How They Apply It Mike Moses Role: Disability Case Manager

3 Kaiser Permanente NW 2 state region Oregon/Washington 2 Hospitals, multiple facilities 12,000 employees TPA s for LOA, WC, Insured for STD/LTD IDAM Program Leaves, WC, TWA, ADA 9 IDAM employees - 1 Manager 6 DCM, 2 Coordinators What is Integrated Disability? An approach to manage absence and disability Improves employee experience Unifies strategy and tactics with a common vision Adheres to laws, regulations and guidelines Delivers company-provided benefits for qualifying situations Unifies employer tools, plan designs, policies, processes and practices Maximizes investment on dollars spent, increases productivity, and boosts morale IDAM Applied Knowledge Presented through use cases

4 Person Level: The Tale of Two Claims Employee 1 Employee 2 < 2 Years of Service Was in a vehicle that got struck and caught on fire The driver died and the employee had 3 rd degree burns to both hands, legs and face 30% of his body < 4 Years of Service Had electrical contact was resuscitated via CPR Employee had left rotator cuff injury and burns on both hands Employee 1 Positive attitude Self motivated to return Conflict with RN; 2 nd RN assigned Secured emergency treatment with onsite nurse Coordinated sick pay and workers compensation benefits (100% pay) Provided FMLA notifications and approval Provided daily updates to leaders during in patient care Not positive Not motivated to return Employee 2 Brought in additional conditions Employee 1 Provided appropriate time coding Employee 2 to supervisors Coordinated accommodation for family members while they were inpatient care Brought in additional conditions Notified excess Insurance carriers Worked with TPA to approve treatment Provided LTD application and coached on LTD process

5 Employee 1 Employee 2 Offered vocational rehabilitation Received work abilities Worked with managers on return to work plan with restricted duty Employee wanted to returned and perform the modified duty plan supporting his restrictions Employee did not want to do the modified duty plan supporting his restrictions Employee 1 Employee 2 Obtained full duty release Offered Vocational Rehab through LTD plan Passed functional capacity exam and returned to full duty Terminated LTD and employee medical benefits Did not cooperate with LTD rehab plan Employee 1 Employee 2 Employee still working Hired an attorney Paid PPD award Added right shoulder into claims Offered employee alternative position, employee said was unable to do the job Attempted mediation to settle WC claim and employment Xxxxxxxxx Xxxxx

6 Case Summary: Frequent FMLA Use Trigger: LOA report showed employee with high use Action: Flagged for outreach service 1 st Meeting: Met to discuss root issues/help. Did not bring/address department impacts 2 nd Meeting: Employee s LPN job duties were physically demanding causing her to be absent Short-Term: Focused on can-do abilities, provided ergo eval, equipment, adjusted schedule Long-Term: Placed in alternate job fitting abilities Case Summary: High Intermittent Use Trigger: Frustrated manager called Situation: Call center employee, migraines, high absences rate and when at work had delivery/quality issues Action: Outreach to employee 1 st Meeting: Met to discuss root issues/help. Employee had light sensitivity and difficulty focusing. Impacting patient care, not keeping up with call volume. Supports: Employee obtained rose-colored glasses, lighting changed, extra training, and new work station Outcome: Eventually went on continuous leave Program Level: It all seems right Background 16 year employee, loyal and diligent in all work activities. Employee suffers a stroke and is off work for 28 days. He has 300+ hours of PTO and 700+ hours of internal sick pay. The employee wonders why full pay is not received. When it is not resolved by the case manager there is an sent to senior leaders of company. Research Identified language barrier, computer literacy and availability, doesn t understand how pay is derived with state disability program (SDI), timely response and answers, case notes, and internal alert notification Meeting Reveals their experience through their lenses, loop with no action, misunderstanding of what was expressed, and opportunities

7 Integrate Your Story and Data Know your story to be able to explain your: Total program costs Correlate costs to a unit of measurement and PEPM (per employer per month cost) Prove your value to the organization Build support based upon past success Integrate Experience Stories with Change Pay Integration Experiences Working with a vendor for a leave planning tool that also is under pilot with development for state disability filing. Estimated cost: $250,000 End of Leave and Return to Work Adjusted workflow, created simple instructions and moved from 11% failed to show up to only 2 employees in pilot of 5,000 employees. Cost to implement system-wide: $1,000 Contact Us Gina Magee, IEA or Adrienne Paler, Sutter Health palera@sutterhealth.org or Loyd Hudson, AEP lahudson@aep.com or Mike Moses, Kaiser Permanente Michael.l.moses@kp.org or

8 Questions and Answers Open Discussion