CCSF WORKERS COMPENSATION COUNCIL MINUTES Regular Meeting September 12, :00 a.m. ROOM 408, CITY HALL 1 Dr. Carlton B.

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1 CCSF WORKERS COMPENSATION COUNCIL MINUTES Regular Meeting September 12, :00 a.m. ROOM 408, CITY HALL 1 Dr. Carlton B. Goodlett Place CALL TO ORDER 9:00 a.m. ROLL CALL Micki Callahan, Human Resources Director Laura for Melissa Whitehouse, Acting Budget Director Peter Goldstein, City Administrator Norm Nickens, Retirement Board Secretary, Retirement System Todd Rydstrom, Deputy Controller, Controller s Office Dyana Lechuga, Deputy City Attorney Not PUBLIC REQUESTS TO SPEAK ON ANY MATTER WITHIN THE JURISDICTION OF THE WORKERS COMPENSATION COUNCIL APPEARING ON THE AGENDA (Item No. 1) Public Comments: NONE APPROVAL OF MINUTES (Item No. 2) Action: Minutes approved for the June 6, 2016 meeting (Vote 4 to 0).

2 REPORTS FROM THE WORKERS COMPENSATION DIVISION Discussion Items: (Item No. 3) Speaker: Peggy Sugarman, Deputy Director, Workers Compensation Division Reported on Claims: Claim Costs, Frequency & Fiscal Year Results Peggy began discussing claim filing frequency between the last two fiscal years. The chart depicted Medical and Indemnity claims filed by the top ten departments as well as the city overall. Filings have been holding fairly steady despite the increase in the number of FTE s. She also commented there was a total increase of Indemnity claims by 18 this fiscal year whereas there was a reduction of Medical Only claims of 59. There was no concern in the increase of Indemnity claims as there are differing definitions of what should be an Indemnity claim. Based on the Audit Regulations, an Indemnity claim is described as lost time or where a permanent indemnity payment is made. Based on SIP regulations, Indemnity claims are defined as a claim in which indemnity may be paid, which includes litigated claims, denied claims, or other factors that could lead to an indemnity payment. For expenditures, the chart showed the increase/decrease of budget numbers for the fiscal year in comparison to the previous fiscal year. There was an increase in spending by almost $1.7 million. Budget was $51 million. There also was a surplus of $2.4 million in the Workers Compensation budgeted costs. DPW remained $1.4 million less than budget amount for their total Workers Comp costs. The budget included large anticipated increase in the State Assessment which only ended up representing $300,000 increase. The overall WC budget including estimated administration costs ended with a $4.785 million surplus. The Workers Compensation Division had reduced their Intercare contract bringing in additional work within the last year and ended up with salary savings as they were able to absorb that work without increase in costs. Peggy then broke down the claim costs by category. Although there was an increase in Indemnity claims and a yearly increase in temporary disability rates, there was a decrease in temporary disability costs by 0.39%. Permanent disability reflects a 16.01% increase as the department is continuing to settle and close many claims and as the 2013 Permanent Disability rate went up in the reforms. There was a 3.6% overall increase all due to Permanent Disability payouts. Micki asked if the grand total of $48,383,335 for included administrative costs. Peggy confirmed the total only included the claim costs, not including administration, City Attorneys, 4850/Disability/Assault Pay. Peggy began to discuss the Top 5 departments in terms of open claims stratification by severity for F/Y Two meetings ago, Todd Rydstrom had requested the department provide a summary of the quarterly experience. Slides of the Top 5 departments were presented, breaking down claims costs of and then broken down by quarter; SF Police Department, SF Fire Department, Sheriff s Department, Department of Public Health and Recreation & Parks Department.

3 Micki asked if the $1 million claims are categorized catastrophic. Peggy stated they are high-value claims and could be catastrophic. She explained some examples are claims settled at 100% as well as Future Medical costs. 40% of medical costs were paid as Future Medical which is paid throughout the lifetime of the claim which can end up being costly. Peggy then continued to discuss the Top 5 Departments in terms of claims causes by severity for F/Y for SF Police Department, SF Fire Department, Sheriff s Department, Department of Public Health and Recreation & Parks Department. Micki asked if the department is sharing the claim costs by severity with the respective departments to review their safety programs. Peggy stated the department is not doing it regularly enough and it is her goal to provide quarterly reports once a Safety Analyst is hired. Micki requested to send quarterly reports to the departments in the meantime. Peggy continued to discuss the Organizational Initiatives and Performance F/Y The Injury Rate per 100 FTE has gone down slightly at Todd Rydstrom asked if it was a trend. Peggy mentioned looking back within the past 3 years, the rate has been going down each year. Department Satisfaction Survey held annually (1-5 scale with 1=Poor; 5=Excellent) o DHR-WCD Services: 4.70 across all satisfaction measures: 4.79 for excellent quality of services, 19 respondents reporting o Intercare TPA Services: 4.48 across all satisfaction measures: 4.80 for excellent quality of services, 5 respondents reporting Workers Compensation claims closing ratios continue to reflect our concerted efforts to provide timely benefits and services o WCD In-House: 109% o Intercare TPA: 105.7% Peggy continued to share the Benchmarked Performance from California Workers Compensation Institute (CWCI). Alex Swedlow had spoken about the program last meeting. The slides showed statistics for medical paid at 12 months for Police/Sheriff and Fire in comparison to other city claims as well as the industry. Average paid indemnity, TD and PD, is higher for safety officers compared to the industry. Todd Rydstrom, mentioned there was a significant number of lost days and asked for further insight. Micki mentioned CCSF integrates sick leave with workers compensation benefits and is not taxed. Most employees receive more money on disability than they do while working. Organizational Initiatives Working on Bill Review/Utilization Review Proposals and are in the final selection process. Working on RFP for SFMTA & DHR TPA. Intercare was selected and draft contract under review. Peggy thanked Mr. Goldstein for being a part of that panel. Excess Liability Insurance-Finalizing data and Broker meeting scheduled for 09/23/16.

4 Electronic Deposit/Pay Care-US Bank needs payment export file in a certain format however, the specs are over 300 pages to get into that format. Working with ivos representatives to try and develop a simpler format and while meeting US Banks format. Peggy has been ing them about every two weeks to get updates. Working with Ventiv who runs ivos system on a pilot project with PUC to develop a way to track data directly into ivos systems eliminating their need to have a separate system for CalOSHA reporting Implementing an outside contract to audit Section 111 Federal Medicare Reporting obligations Medicare reporting-peggy and Tamara Jones will be presenting the TTWA Program for PUC at the California Self Insurer s Association Annual Conference in October. Micki requested to share the slideshow with council. TTWA Program for Juvenile Probation Department proposed WC Carve Out assessment completed. Peggy continued to discuss the details of the WC Carve Out. Labor Code section allows for Labor/Management alternative dispute resolution for any WC dispute processes, appealable to 7 Member WCAB. Baseline study of safety officers predicts savings based on two types of statistical modeling: Reduction of 30 days across all types of delays estimated annual saving and using models related to potential impact of new, more efficient processes. Peggy is speaking with departments such as City of Fresno, City of Richmond and City of Hanford to get their insights. Micki commented after reviewing reports with Aon, will be pursuing a WC Carve Out with our Deputy Sheriff s Association. Public Comment: Speaker: Rocky Lucia, Lawyer representing Deputy Sheriffs Association (DSA) Carve out has been dormant until the issue of overtime had been brought up. Carve out is a partnership with employer and union negotiated in union setting which can change the culture of Workers Compensation. Speaker: Scott Osha, Deputy Sheriff and Treasurer for DSA 101 deputies are out on disability. The department paid $1 million dollars in overtime costs this past June due to employee shortage. Due to the shortage of deputies and the 101 deputies on disability, overtime is necessary for the remaining. It can result in injuries as overtime can cause deputies to be a little less attentive and lethargic. Speaker: Kevin McDonald, Deputy Sheriff and Board member of the DSA WC paperwork can be difficult to understand. Carve out can be helpful in answering deputy s questions and also helps out the Personnel Deputy Officer.

5 Peggy concluded her presentation with an MPN Update. SB 1160 would expand medical preauthorization for 1 st 30 days of injury Pacific Coast Psychiatric Associates pilot launched MPN Committee quarterly meeting met with them in July to follow up on issues with reporting, billing and practices. REPORT FROM THE MTA WORKERS COMPENSATION DIVISION Discussion Item: (Item No. 4) Speaker: Dan Roach, Municipal Transportation Agency Dan Roach began by presenting the claim volumes within the past 12 months. He explained they had a downtick in claims of 41 for the month of August due to great efforts. He mentioned there were only 9 Medical Only claims which has been a historical problem with the SFMTA Agency. Dan continued to report that SFMTA has 1643 open claims, 12 reopens and a 100% closing ratio. He continued to explain the reasons behind the Lag Time Report. There were delays in reporting claims due to the spread out nature of the SFMTA. The agency has many significant locations in the city with a lack of access to the internet. There can also be supervisorial and managerial delays in submitting claims. In reviewing the report, it shows a lag time of 49 days in reporting skewed by many outliers such as an applicant attorney filing a cumulative trauma claim a year after. Micki asked why the lag time for Admin, Taxis & Accessible Services was days before it was reported to the TPA. Dan explained an employee had went out on a non-industrial leave for 7-8 months and then decided it was a work related injury as soon as their leave ran out. Reporting on Financials, Dan stated $24 million dollars in benefits were issued last year; about $2 million per month. The department was slightly better in August 2016 issuing $1.995 million of benefits considering the growth of the agency. For litigation statistics, they had a slight uptick in litigated claims for the month of August of 34.81%. Dan discussed cause analysis. Continuous trauma, repeated motion and physical assaults have been the top causes within the past year. The most expensive claims were claims of continuous trauma, repeated motions and physical assaults. Vehicle accidents also made the list as they have had a couple large injuries. For cost analysis, Dan breaks down the cost of claim based on the description of the injury. Ultimately, the average cost per claim is currently about $32,000. Dan continued to break down the injury rate per 100 employees for the prior 12 months. The numbers for August had decreased from to which included an upward trend in employees. The agency currently has a number of 5,906 employees.

6 Dan also mentioned there was an increase in denied claims however it is fairly common as it is within range the past months. TPA contract is in negotiations with Intercare. A general agreement has been reached and pending final approval. They are on track with the renewal of the contract however will need to request for a 3 month extension to get it completed. Part of the contract includes two new additions: Nurse Triage Program Looking to bring in a Clinical Registered Nurse to provide immediate clinic guidance resulting in a rebalance between Medical Only and Indemnity claims. Pharmacy Benefit Management - Issuing of pharmacy cards to facilitate employees in filling their prescriptions as well as help track to avoid any issues. The Division has new program called "Keep Them Safe" focusing on operator safety. Dan concluded with an update on the Wellness Program. Individual participation is up to 50%. Public Comment: None OPPORTUNITY TO PLACE ITEMS ON FUTURE AGENDAS Speaker: Micki Callahan Discussion Item: (Item No. 5) Council Comment: None OPPORTUNITY FOR THE PUBLIC TO COMMENT ON ANY MATTERS WITHIN THE COUNCIL S JURISDICTION Discussion Item: (Item No. 6) Council Comment: None NEXT REGULAR MEETING: TBD (Tentative date: December 5, 2016) ADJOURNMENT 10:10 a.m.