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Client Spotlight: Houston Independent School District
By Susan Koblasz, ARM, AIC, Account Manager, Atlanta, GA
In 2010, Tom Dolan, Workers Compensation Claims Manager for the Houston Independent School District, will be faced with the sobering reality of a $7.4 million funding reduction for the next academic year. As Claims Manager, Dolan is responsible for the workers’ compensation program covering HISD’s staff of 31,000 people, making his both the largest school district in Texas and the largest employer in Houston, the nation’s 4th largest city. But, HISD has more at stake than just dollars and cents when one of its employees suffers an occupational injury. “Our mission is to provide our student body with a top-tier education, and to do that, HISD requires its teachers, bus drivers, custodians, food service, police officer, trades, and administrators on the job every day,” says Tom.
So what does HISD plan to change in 2010 in order to accommodate their shrinking revenue base? “Nothing,” says Tom. “With the support of our actuary and administration, it was my decision to significantly reduce our budget based upon a growing fund surplus. We don’t need the $7.4 million, so it will be reallocated to other departments and programs in the district. It is my hope that the reallocated funding will serve to further our mission to deliver the highest quality education possible to the youth of our city.” Considering that the District has the authority to raise local property taxes in order to meet its funding needs, this turn of events is not only remarkable, it’s a relief since Texas presently ranks 12th in national foreclosure rates. Most economists agree that when foreclosures increase, home values decrease and so too do the revenue streams of programs sourced by property taxes.
So how did Tom Dolan and his team reduce their annual budget by such a remarkable amount? The formula was simple really, reduced claim costs, but not by conventional means. He didn’t decrease staff then increase adjuster caseloads. He didn’t eliminate risk management programs either. In fact, even the district’s claim counts have remained steady for the past eight years.
Ten years ago when Tom Dolan joined the Houston Independent School District as Workers Compensation Manager, he rolled up his sleeves, got down to business and discovered that with challenge there was tremendous opportunity. On any given week in 1998, 170 of the district’s 31,000 employees were off work and receiving temporary income benefits due to an occupational injury. Four years later, that figure had been reduced to 110, and today it stands at 56. During this same period, claim and medical costs have continued to trend downward, while the average disability duration shrank from 22 weeks to less than five. So, how did Tom Dolan, his staff and the Broadspire HISD Client Dedicated Unit accomplish so much over the course of one decade? They started by looking at their data for the answers to some basic questions: Who was getting injured and how? When and where were injuries typically occurring?
The results revealed both problems and deficiencies but more importantly signaled the start of an ongoing quest for more and better information to identify opportunities for improvement. One such opportunity partnered HISD with a Denver-based organization specializing in functional capacity evaluations. The team was able to document, in great detail, the physical demands of most critical positions in the district. “The report on each position is highly detailed, focusing on the essential physical demands of the position,” Tom explains. “Many of the employees themselves were surprised to learn the physical requirements of their own jobs. In some cases, the facts revealed that some employees had to be reassigned or risk serious injury to themselves or others.”
Some organizations would have been satisfied with such level of improvement, but the HISD team wanted more, so once again they looked to their data to for direction. Fortunately for Tom, Rondy Spardella, Dedicated Unit Manager, and their respective teams, HISD’s current and historical data had been placed on RSG’s Oracle® platform from the very first. “I didn’t rely upon many of the reports in the RSG Standard Library. It wasn’t that the reports were lacking in any way,” Tom explains, “I just didn’t want to constrain our imagination of “what if“s and “I wonder“s. In this case, I found that Oracle® Discoverer (a user friendly ad-hoc report builder that RSG supports) was the best choice for me.”
After creating reports showing every data relationship he could imagine, Tom reached a simple conclusion. “The source that exercised the most influence over our loss experience was the treating physician.” His claims could be managed by the most capable adjusters and nurse case managers, but “left in the care of a doctor who does not share our goals to minimize lost work days and unnecessary medical expenditures, the outcome would still be unfavorable,” says Tom.
Fortunately, in the fall of 2005, the state passed House Bill 7, Chapter 1305, which authorizes carriers to establish certified occupational networks similar in concept to a PPO. While there were no shortages of companies willing to provide HISD access to their network, they did not always share HISD’s commitment to quality service and accountability. Early on, Tom recognized that to ensure their objectives were met, HISD would have to establish a network of its own. Step one: Complete the mammoth 1,700 page application and response. Fast-forward 27 months to December 22, 2008, and just in time for Christmas, HISD’s “Workers Care Network” (WCN) received its certification from the state of Texas; presently, the only municipality or employer to do so.
So how is WCN different from other networks? Tom’s reply is simple: “Outcomes.” Using all the data they could find and continually searching for more, Tom and his RSG Account Managers Robin Forrester and Erin Gunn together were able to create multiple queries and reports that identified medical providers whose treatment outcomes on earlier HISD claims demonstrated a commitment to early return to work and the avoidance of unnecessary medical treatment. Presently, HISD has admitted more than 520 doctors, 17 hospitals and ancillary services to its network; no small feat considering that HISD’S employees live across 22 counties, with some logging more than 200 miles during their daily round-trip commutes. “If our network does not reach a community where an injured employee resides, then he or she is free to choose any doctor in the area,” explains Tom. “It wasn’t easy, but we were ultimately successful in finding providers to serve our employees without lowering our standards for quality care.”
How is HISD faring three months after certification? Just ask Tom; he’s sure to have a report to measure that!
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