Report to the San Francisco Workers Compensation Council Peggy - PowerPoint PPT Presentation

Report to the San Francisco Workers’ Compensation Council Peggy Sugarman Workers’ Compensation Director March 4, 2019

Agenda • Accomplishments & Initiatives • Performance Quick Facts • Claim Analytics • Financials Workers' Compensation Council Meeting March 4, 2019 2

Accomplishments & Initiatives Workers' Compensation Council Meeting March 4, 2019 3

Carve Out / “Alternative Dispute Resolution” Tentative agreements with SF Police Officers Association and SF • Firefighters Local 798 signed 12/17/2018 • Agreements approved by the Division of Workers’ Compensation Administrative Director on 1/31/2019 • Board of Supervisors approved resolutions on 2/26/2019 • Implementation Plan in place • Joint Labor Management Committees (“Joint Committee”) established, 2 meetings have occurred • ADR Director & Ombudsperson approved by Joint Committee • Mediators & Arbitrators selected and approved • Lists of physicians for independent medical evaluations approved and ongoing Workers' Compensation Council Meeting March 4, 2019 4

Accomplishments & Initiatives • PUC OSHA Pilot Successfully launched on 2/7/2019 • Electronic Deposit/Banking Project moving forward • Electronic Learning Management Ergonomic Awareness Training Program completed and ready for roll-out • Medicare Reporting Audit completed – Development of clear workflows established – Staff Training scheduled – Examining potential for external organizations to partner with us to improve compliance by integrating with iVOS claims system Workers' Compensation Council Meeting March 4, 2019 5

Updates • Nurse Triage Injury Reporting roll out continuing • MPN Committee actively reviewing physician performance and identifying new physicians for inclusion • Administrative Filing with City Attorney for exposure based on working in or around Building 606 Workers' Compensation Council Meeting March 4, 2019 6

Performance Quick Facts Workers' Compensation Council Meeting March 4, 2019 7

FY19 Q2 Performance Quick Facts Fiscal Health Claim Volume Ratio of Actuals to Budget Count of New Claims in Period 403 Indemnity Claims FY19 Q2: 109.3% 273 Medical Claims FY19 Q1: 92.3% Benchmark: 401 Indemnity Claims/Quarter Benchmark: 95% 275 Medical Claims/Quarter Claim Cost Duration Average Cost of Claims Closed in Period Average Days Open of Claims Closed in Period Indemnity: $13,887 249 Days Medical: $782 Benchmark: 324 Days Benchmark: Indemnity: $15,637 Medical: $611 Notes: All benchmarks based on rolling four-year averages (FY15-18.) Fiscal health metric includes overhead and claim expenditures and is based on revised budget, excluding any carryforward. Duration excludes disability retirement and future medical claims. Workers' Compensation Council Meeting March 4, 2019 8

Claim Analytics Workers' Compensation Council Meeting March 4, 2019 9

Claim Filing Frequency FY15-18 FY19 Q2 FY19 Q2 Increase / Decrease Average Average Average Total Indemnity + Total Total Indemnity Medical Indemnity + Indemnity + Department Medical Indemnity Medical Indemnity Medical Claims Per Claims Per Medical Medical Claims Per Claims Claims Quarter Quarter Claims Quarter Public Health 88 106 194 70 130 200 -18 or -20% 24 or 22% 6 or 3% Police 79 44 123 84 40 124 5 or 6% -4 or -8% 1 or 1% Fire 61 17 78 69 19 88 8 or 13% 2 or 13% 10 or 13% Sheriff 36 8 44 38 11 49 2 or 7% 3 or 31% 5 or 11% Public Works 15 15 30 24 16 40 9 or 59% 1 or 7% 10 or 33% Human -7 or -48% -4 or -12% 22 14 35 24 7 31 2 or 11% Services Airport 19 14 33 22 9 31 3 or 16% -5 or -35% -2 or -6% Recreation & -12 or -58% -12 or -31% 18 21 39 18 9 27 0 or 2% Parks Public Library 6 4 10 9 4 13 3 or 57% 0 or 3% 3 or 35% Water Pollution 7 4 11 9 4 13 2 or 30% 0 or 8% 2 or 22% Control Citywide 401 275 676 403 273 676 2 or 0% -2 or -1% 0 or 0% Workers' Compensation Council Meeting March 4, 2019 10 10

Claims Incurred Per 100 FTE Department 2015 2016 2017 2018 2019 Est. Fire 21 19 19 23 23 Sheriff 21 23 20 20 20 Police 20 23 23 21 20 Public Health 12 12 11 13 12 Citywide 11 11 11 12 11 Public Works 10 11 9 10 11 Recreation & 9 9 9 9 8 Parks Airport 10 10 10 10 8 Human Services 7 6 6 8 7 Water Pollution 2 2 2 3 3 Control PUC-Water 3 3 3 4 3 Notes: 1. 2019 Est. reflects a straight line of Q1 and Q2 claim volume for the whole fiscal year Workers' Compensation Council Meeting March 4, 2019 11

Claims Incurred Per 100 FTE Top 10 Departments 25 20 Fire Sheriff Police 15 Public Health Citywide Public Works Recreation & Parks 10 Airport Human Services Water Pollution Control 5 PUC-Water 0 2015 2016 2017 2018 2019 Est. Notes: 1. 2019 Est. reflects a straight line of Q1 and Q2 claim volume for the whole fiscal year Workers' Compensation Council Meeting March 4, 2019 12

Claim Cause Distribution Top 10 Claim Cause Groups by Frequency - New Claims in FY2019 Q2 200 150 Public Works Fire 100 Sheriff Police All Other Departments Public Health 50 0 Bodily Exposure Cumulative Fall, Slip or Physcial Abrasion Struck Misc Caught In, Stress Motion Trauma Trip Assault By/Against Under, Between Notes: 1. Claim cause group definitions are listed in Appendix 1 Workers' Compensation Council Meeting March 4, 2019 13

Open Claim Stratification 500 450 400 350 300 250 200 150 100 50 0 100K- 150K- 200K- 250K- 300K- 350K- 400K- 450K- 500K- 550K- 600K- 650K- 700K- 750K- 800K- 850K- 900K- 950K- Over 150K 200K 250K 300K 350K 400K 450K 500K 550K 600K 650K 700K 750K 800K 850K 900K 950K 1M 1M Recreation & Parks 11 13 4 5 1 2 3 1 1 2 Sheriff 61 52 20 10 6 3 3 1 1 1 2 Public Health 66 43 14 11 6 7 4 1 2 4 2 2 1 1 1 1 Fire 83 81 45 11 13 8 4 1 1 2 1 3 All Other Departments 113 59 39 19 12 7 6 5 3 2 2 1 2 0 1 4 0 0 4 Police 133 94 74 36 16 15 11 6 2 1 1 1 1 2 3 1 1 2 7 Notes: 1. $100K+ Total Incurred = $308.8 Million 2. All policy years for which incurred costs >=$100k/claim Workers' Compensation Council Meeting March 4, 2019 14

Open Claim Stratification 1,308 Claims >=$100k $308.8 Million $68.1, 22% Data as of 2/25/2019 $101.0, 33% $11.2, 4% Police $32.7, 10% Fire Public Health Sheriff $56.7, 18% $39.0, 13% Recreation & Parks All Other Departments Note: Dollar figures in millions Workers' Compensation Council Meeting March 4, 2019 15

Litigation Statistics Open Indemnity Represented Department Claims Added from Represented % Litigated Claims Litigated % Claims FY15-FY19Q2 Police 375 209 56% 186 50% Fire 291 126 43% 121 42% Public Health 260 101 39% 104 40% Sheriff 202 96 48% 87 43% Human Services 99 46 46% 42 42% Airport 97 32 33% 26 27% Public Works 89 41 46% 39 44% Recreation & Parks 60 35 58% 31 52% PUC-Water 40 12 30% 10 25% Water Pollution 34 22 65% 22 65% Control Citywide 1763 826 47% 764 43% 16 Workers' Compensation Council Meeting March 4, 2019 16

Financials Workers' Compensation Council Meeting March 4, 2019 17

Department Expenditure Trends FY19 Orig. FY19 Rev. FY19 Estimated FY19 Surplus/ Department FY18 Budget FY18 Actuals Budget Budget YE Actuals (Deficit) 15,691,689 20,898,127 17,270,551 18,238,494 22,120,096 -3,881,602 Police 12,026,726 10,831,216 12,001,726 12,545,259 11,996,259 549,001 Public Health 9,354,940 8,817,237 9,154,940 9,623,463 10,990,286 -1,366,824 Fire 5,630,186 5,387,756 5,630,186 5,630,186 5,600,338 29,848 Sheriff 3,598,881 2,362,963 3,709,007 4,259,007 3,883,670 375,337 Public Works 3,569,246 2,637,724 3,569,246 4,920,001 3,545,808 1,374,193 Recreation & Parks 2,901,364 2,629,920 2,876,364 2,876,364 3,262,581 -386,217 Human Services 2,504,098 2,138,127 2,580,723 2,580,723 2,436,107 144,616 PUC-Water 2,494,467 2,344,896 2,570,798 2,720,369 2,896,450 -176,081 SF Airport 1,079,467 929,729 1,029,467 1,029,467 496,997 532,470 Juvenile Probation Total Top Ten 58,851,064 58,977,692 60,393,008 64,423,333 67,228,594 -2,805,261 Departments Total of All City 69,378,135 67,615,222 71,991,903 77,571,049 77,862,793 -291,745 Departments Notes: 1. Expenditures exclude LC4850 salary continuation benefits, and include program admin/overhead 2. All budget figures are Original Budget and do not include carry forwards Workers' Compensation Council Meeting March 4, 2019 18

Costs by Expenditure Category FY17-18 Actuals FY18-19 Actuals YTD FY19 Est. YE Actuals YOY Change (%) INDEMNITY Temporary Disability 8,220,280 4,081,508 8,163,016 -0.7% 15,776,104 Permanent Disability 8,842,701 17,685,401 10.8% INDEMNITY SUBTOTAL 23,996,384 12,924,209 25,848,417 7.2% VOCATIONAL 226,139 81,259 162,517 -39.1% REHABILITATION 26,044,350 MEDICAL 14,922,583 29,845,165 12.7% 3,040,483 EXPENSE 1,611,799 3,223,598 5.7% RECOVERY (692,535) (268,122) (536,244) -29.1% GRAND TOTAL 52,614,822 29,271,727 58,543,454 10.1% Notes: 1. Expenditures reflect benefit payments maintained in the iVOS Financial System, and do not include overhead or LC 4850 salary continuation benefits. Workers' Compensation Council Meeting March 4, 2019 19 19