Getting injured workers back on the job earlier was the focus of a pilot program that expanded to Chelan and Douglas counties in 2005.
Working in collaboration with the state Department of Labor and Industries, Spokane-based St. Luke's Rehabilitation Institute was awarded the contract to operate the Eastern Washington Center of Occupational Health and Education pilot project in 2003, at first covering Spokane, Stevens and Grant counties. Chelan and Douglas were among 13 counties added in 2005 after results saw a cost savings in claims.
"It's all about eliminating the barriers to getting an injured worker back on the job," Eastern Washington COHE Director Dan Hansen explained in an article in the September 2005 issue of the Wenatchee Business Journal.
He described the program as an online patient-tracking system that streamlines paperwork and improves communication between injured workers, health care providers, L&I claims managers and employers. The strategy aimed to establish "best practice" standards and encourage employers to consider bringing workers back on "light duty" when appropriate.
Hansen's initial challenge was getting health care providers on board.
After a couple weeks making presentations, he had commitments from 50 health care providers in Chelan and Douglas counties to participate in the program.
The commitment included an agreement to file claims within two days using a secure website. The claims, then, were reviewed by COHE staff to make sure paperwork was complete and forwarded to L&I for processing.
The theory was the review decreased the likelihood that claims would be rejected or delayed because of simple paperwork errors. That, in turn, would speed up the claim process for the worker and more quickly get the employer involved. Under the program, COHE staff continued to track claims to make sure workers received services, whether that was surgery or the opportunity to return to the job in some capacity.
The Eastern Washington Center of Occupational Health and Education has established a satellite office in East Wenatchee and hired Pete Phillips as health service coordinator for Chelan, Douglas and Okanogan counties.
The pool of health care providers participating in the COHE program has grown to more than 200 in the tri-county area, which includes six hospital emergency rooms. More than 200 employers and several unions also participate.
The region produces about 5,000 state Department of Labor and Industries claims each year, with 75 percent of those involving a COHE provider, said Hansen, who continues to direct the program.
The East Wenatchee COHE office officially opened in January, leasing space in the state Department of Labor and Industries office at 519 Grant Road.
"We are excited about opening the office," Hansen said. "A little over a year ago, we opened a satellite office in Yakima and it proved to be a brilliant success, well-received by providers and employers. We are replicating the same thing in East Wenatchee with Pete."
Phillips' job includes face-to-face meetings with health care providers to offer reminders and updates about state-approved "best practices," along with providing orientation for new providers, especially those rotating in from outside the area. That necessitates plenty of travel. Eventually, part of Grant County, more easily accessible from East Wenatchee than Spokane, will be added to the territory, Hansen said.
In addition to improving service to providers, employers and injured workers, Phillips also will be involved in implementing initiatives approved by the workers' compensation reform package approved by the Legislature last year, which included turning the COHE pilot program into a permanent program and expanding it statewide by 2015.
The legislation also calls for establishing a statewide medical network that will launch next year and a new "stay at work" program, along with incentives to encourage network providers to use "best practices" for occupational health.
"Many of those are innovative, very good changes embraced by businesses and providers. To the extent that we can, our team, including Pete in East Wenatchee, is helping providers get accustomed to the new initiatives. He also will be available to talk with employers," Hansen said.
The statewide expansion means the Spokane-based COHE at St. Luke's Rehabilitation Institute, along with two other COHE organizations involved in the pilot program, will have to reapply through a "request for proposal" process sometime next year, Hansen said. The state calls for selecting six COHEs to cover the entire state. Hansen said St. Luke's intends to be one of them.
Phillips, who was hired in November in preparation for the opening of the new office, is familiar with the L&I system and dealing with workers' compensation claims. His job for the previous eight years was as the absence management coordinator at Central Washington Hospital in Wenatchee, handling all things risk management and claims related. His layoff due to a reduction in force at CWH coincided with COHE's advertisement for someone to head the office here.
In addition to his familiarity with the overall process, Phillips also has experience in self-insured workers compensation programs, both from working CWH and from previous employment. And he worked for L&I for several years before that.
All of it will come in handy with the coming program changes.
COHE is starting to work on agreements with self-insured employers to provide a similar streamlining service as that provided to the L&I claims. Self-insured employers provide industrial insurance benefits to their own workers, rather than going through the state. The Department of Labor and Industries, however, oversees the program.
"It's still the same panel of doctors and claim initiative. We have the resources available to assist injured workers. We are enhancing communications between the provider and the employer," Hansen said.
Depending on how the program goes, other large employers might join.
"We're talking the big box retailers, people who make airplanes and city and county governments," he said. "A number of them have expressed an interest. Right now L&I is the middle man in negotiating with the self-insureds. We will watch it for six months and will know by the end of 2012 if the proof is there. I'm not sure what the procedure will be after that," he said.
In this area, he said, several organizations that self-insure have expressed interest including Alcoa and the North Central Educational Service District.