Return to work service provider information session 23 May 2014 Fit for work Restoration to the community Leanne Ho Manager, Allied Health and Return to Work Services Phil Widdas Manager, Provider Performance
Fit for work service (FFW) Restoration to community service PURPOSE: To provide you an overview of the services “in practice” from 1 July 2014 Agenda 1. Background overview 2. Service overview 3. Outcomes in FFW 4. Understanding the business process – Referral to Closure 5. Performance Management (FFW service) 2
Return to work services 3. 2. 1. 2. Restoration Job Return to Mediation Pre-injury to the placement Fit for work work employer community assessment First Implementation 1 new service – Scaled Oct 2013 implemented 14 th implementation Oct April 2014 2013 Full Full 1 new service – Implemented Implementation Implementation implemented 14 th December 2013 1 st July 2014 1 st July 2014 Full Full April 2014 Implementation Implementation 1 st July 2014 1 st July 2014 Changes July 2014 WorkCoverSA 3
New “new employer” services
How do we improve scheme performance in the NEW EMPLOYER context? Increase worker active participation Barriers to Specialised return to skill sets for work are expected resolved outcomes Improve Scheme Performance (RTW outcomes) WorkCoverSA 5
How do we achieve these objectives in RTW Services? Fit for work service Job placement service • Upgrade worker’s • Achieve durable paid medically certified work suitable employment capacity • Resolving barriers to achieving durable paid • Resolving barriers to suitable employment achieving an upgrade in capacity • Increase the worker’s independent job seeking • Preparing the worker to skills participate in job placement services
Resolving barriers to achieving an upgrade in capacity
Points of consideration Doctor Treatment providers Worker – Suitable employment physical and goal mental health, personal motivators Employability prospects Family WorkCoverSA 8
Upgrading capacity is a negotiation process Treating doctor RTW Consultant Worker WorkCoverSA 9
Consider your interactions with doctors from a different perspective……
When does A doctor’s journey training of the Undergraduate Workers’ Training (6 years Medical School) Compensation or Postgraduate Training (4 Scheme years) happen? GP/Specialty training Ongoing Continuing Professional Development to continue registration with AHPRA WorkCoverSA 11
Range of jurisdictions that a doctor works across….. Motor Third party Accident (various) Commission Medicare Centrelink SA Health Other full fee Department of paying (such Veteran Affairs as overseas visitors) Comcare Comcare WorkCoverSA WorkCoverSA 12
Most common individual problems managed by GPs (BEACH: Bettering the Evaluation and Care of Health 2009 – 10) Depression Diabetes Respiratory Check-ups Hypertension Cardiovascular Arthritis Immunisation/ Lipid disorders vaccination Upper respiratory tract infection Musculoskeletal General or unspecified nature WorkCoverSA 13
GPs in South Australia
Provision of WorkCover Services by South Australian GPs (A helicopter view of SA GPs, 2009) • For 1547 (77%) of all GP providers WorkCover accounted for ≤ 1% of income • WorkCover is estimated to finance less than 2-3% of all GP services provided by SA GPs WorkCoverSA 15
General Practitioners in SA workers’ compensation context (A helicopter view of SA GPs and WorkCover services, 2009) (2) 300-400 (1) 1500-1700 GPs GPs have no considered particular specialists focus on within own WorkCover clinic (3) 15-20 (4) Small special number interest in specialise in WorkCover WorkCover WorkCoverSA 16
Doctors and WorkCover Medical Certificate (1) No particular interest in WorkCover (1) 1500- (2) 300-400 1700 GPs GPs have no considered particular specialists focus on within own WorkCover clinic (4) Small (3) 15-20 number special specialise interest in in WorkCover WorkCover 1/5/2014 1/6/2014 High component of work <1% of workload WorkCoverSA 17
(1) 1500- (2) 300-400 (1) Why do doctors write what they write on the 1700 GPs GPs have no considered particular specialists focus on within own WorkCover Medical Certificate? WorkCover clinic (4) Small (3) 15-20 number special specialise interest in in WorkCover WorkCover Comparatively Lack of greater exposure to experience in Workers completing Compensation sickness Time!! system certificates No prior training Relationship in assessing and with the certifying worker medical capacity WorkCoverSA 18
(1) 1500- (2) 300-400 How can you influence this group of doctors….. 1700 GPs GPs have no considered particular specialists focus on within own WorkCover clinic (4) Small (3) 15-20 number special specialise interest in in WorkCover WorkCover Able to lift up to 15kg, avoid above shoulder height activity, working 6 hours, 5 days per week 1/5/2014 1/6/2014 WorkCoverSA 19
(1) 1500- (2) 300-400 Doctors and WorkCover Medical Certificate 1700 GPs GPs have no considered particular specialists focus on within own WorkCover clinic (4. Specialising in WorkCover) (4) Small (3) 15-20 number special specialise interest in in WorkCover WorkCover Greater Greater experience in exposure to certifying WorkCover medical system and capacity processes If doctor is not providing an upgrade in capacity, what is the reason….. WorkCoverSA 20
Fit for work service Finding the right key To unlock the doctor’s mindset…. WorkCoverSA 21
Finding the right key can range….. WorkCoverSA 22
Effective negotiation is about understanding the doctor No Specialist in Special Specialising particular practice interest in in interest in WorkCover WorkCover WorkCover Effective negotiation is about adapting your approach….. WorkCoverSA 23
Achieving upgrade in certified medical capacity….. Adapt your Treating approach doctor RTW Consultant Leveraging Worker off worker WorkCoverSA 24
Preparing the worker for active participation in job placement services
Points of consideration Doctor Treatment providers Worker – Suitable employment physical and goal mental health, personal motivators Employability prospects Family WorkCoverSA 26
Worker’s journey to new suitable employment….. Motivational support Non- Worker vocational preparation barrier resolution Work experience Job seeking skills Training Certified medical capacity Durable paid suitable employment WorkCoverSA 27
Job placement services Is the worker able to independently job seek to gain suitable paid employment? YES NO Independent job seeking support Intensive job placement services Worker is ABLE to job seek and gain paid Worker is NOT able to job seek and gain employment independently paid employment independently (self-directed) Worker requires assistance to develop job Worker will not require assistance in seeking skills identifying suitable employment WorkCoverSA 28
Job placement services Intensive job placement Independent job seeking services support (26 week program) (13 week program) Activities to gain employment Individual job seeking support Group based job-search activities Reverse marketing and job carving Preparing a worker for interviews Arranging work trials Independent job seeking activity Assistance to overcome non-vocational barriers Preparation for prospective employment Aids, assistance to support employment WorkCoverSA 29
Prepare worker for Job placement service
Fit for work Service overview
Expectation of Fit for work service • Short term intervention (up to 15 weeks maximum) • No further extensions approved • Goal is to achieve a durable upgrade in certified medical capacity in a timely and cost effective manner • Does not include any job seeking assistance • Targeted and specific intervention
Fit for work service purpose Worker engagement Upgrade the worker’s Effective doctor consultation medically certified work Durable paid capacity to maximum suitable hours, ideally pre-injury employment Worker preparation for level JPS Durable certifications WorkCoverSA 33
Reaching the FFW goal will be different for individual workers…… Individual intervention Individual program Worker worker motivation Individual contact worker contact Training Doctor consultation Non- vocational, non-medical Doctor barriers consultation Upgrade in medically certified capacity Upgrade in medically certified capacity Individual worker contact Upgrade in medically certified capacity WorkCoverSA 34
The duration of Fit for work service will differ for each workers… 3 weeks 8 weeks Fitness Fitness 4 weeks upgrade Fitness upgrade assessment upgrade program and report extension WorkCoverSA 35
Recommend
More recommend