GOVERNANCE - Attributes 1-12
End Result
Desired Outcome
Action Plan
A. The Trusts are well governed by Boards of Trustees who are representative of the members and knowledgeable about and supportive of the work of the Trust.
1. The policy and procedure for selection/ election of Board members is in place.
a) Board members will discuss and determine the policy for selection of Board members, the criteria for Boards membership and the value of tenure vs. turnover.
2. Policies governing Boards orientation and information updates are in place and followed.
a) Develop, review, and update policies for Boards action.
B. The Trusts are governed by two Boards of Trustees, Washington Hospitals (WAH) and Public Hospital District (PHD), which are elected by the members and responsible for the governance of the Trusts in accordance with regulations and in coordination with each other.
1. Boards meetings are scheduled to meet jointly.
a) Draft Boards agendas are developed by the Executive Director and approved by both Trust Chairs.
C. The Boards recognizes its role of leadership in setting policy, funding programs, selecting and supporting the Executive Director, supporting work of Trust with Members, establishing member incentives for effective safety and claims management programs.
1. Bylaws, member agreements, Boards policies, and Boards norms are reviewed biennially and updated, as needed.
a) Executive Director review of documents for recommendation of any needed changes for legal review and/or Boards action.
2. Boards have established incentives for member compliance.
a) Member programs are evaluated by Executive Director and monitored by Boards.
3. Board members hospitals serve as models for Best Practices.
January, 2005
a) Board members model Best Practices
b) Board members outreach to individual hospital/district administrators to encourage more attention to return to work programs and to serve as resource.
c) Board members present opportunities for discussion of Trust programs at Boards meetings.
D. The Boards select the Executive Director and monitors progress toward Boards goals.
1. The Boards establish the attributes of our successful WC program and use these attributes to direct and evaluate the program.
a) Boards establish the policy to govern the evaluation of the program and the Executive Director performance.
2. Succession management plans are in place.
a) Develop steps necessary for succession management planning
E. The Executive Director is accountable to the WC Trust Boards and implements and manages the WC program in accordance with Boards policy and budget.
1. The Executive Director develops and maintains communication with the Boards.
a) Clarify with the Boards the communication needs of the Chairs and the Board Members.
2. There is meaningful communication with members. Communication needs of the members and the Trusts have been evaluated and addressed.
a) Develop specific communication procedures for communication with hospital members for administration, CEO, CFO, designated contact, and safety officer
b) Special attention is given to communication needs of members who do not have their CEO on the Boards.
c) State of the art electronic technology is explored, developed, and utilized for communication with members.
F. The Trust Boards and Members are informed about significant laws and regulations affecting workers’ compensation, self-insurance, and proposals to change them.
1. Create an environment conducive to effective delivery of self-insured workers’ compensation.
G. The Governance of the Trusts includes a long-range plan for the workers’ compensation program.
1. The Boards adopt the Vision, Mission, Values, Attributes, and Strategic Plan for the Trusts and monitors the progress and review annually.
a) Update the five-year staff driven strategic plan with input from Board members, workers’ compensation staff, selected WSHA staff and a consultant.
b) Update the draft strategic plan and present to the Trust Boards for review, revision, and adoption.
II. FINANCIAL ADMINISTRATION - Attributes 4, 6, 7, 8, & 11
A. The Trust is financially stable and Boards of Trustees are accountable and knowledgeable about the financial operations of the Trusts as measured by maintenance of reserves and the meeting of the financial plan.
1. Policies governing finance, investments, and reserves are established by the Boards and reviewed at least biennially by the Boards.
a) Review of and recommendations for policy changes made to the Boards by Staff.
b) Distribution of Boards approved policies to the board, staff and accounting department.
2. Administrative services for the Trust remain consistent.
a) Contract for administrative services is secured.
b. Experience rating.
c. Rate adequacy.
d. Schedule rating/System begins 2006
5) Zero Lift
a) PHD & WAH – Monitor New Member Entry Policy for establishing contribution and new member minimum term and monitoring repeat applicants.
b) Review new policy options with the Boards and actuary.
c) Roll out an incentive program for members in conjunction with the 20th Annual Celebration of the Trust 2004.
d) Announce further incentives in 2005 and implement in 2006.
4. Audit of books by outside auditor achieves unqualified opinion.
a) Financial records are maintained, current and in compliance with generally accepted accounting principles.
5. Trust is in compliance with Federal and State regulations.
a) Remain aware of requirements and secure appropriate resources.
III. MEMBERSHIP - Attributes 6, 7, 9, 10, 11, & 12
A. Members are satisfied with the Workers’ Compensation program.
1. There is meaningful communication with members. Communication needs of the members and the trust have been evaluated and addressed.
a) Evaluate current communication tools.
b) Survey member needs.
c) Establish communication policy and procedure.
2. Enhanced communication with the layers of hospital leadership.
3. Communication is enhanced through teleconferencing video workshops and training sessions on issues such as Claims, Safety, Root Cause Analysis, Return-to-Work and other issues important to the success of the workers’ compensation program.
a) Review and update survey form to reflect program variety and changes as needed.
b) Identify items to be kept similar for comparison with other years and trends.
c) Send survey form to hospital contact.
d) Compile data, inform the board, make adjustments as indicated, share data and follow up with member hospital as appropriate.
6. Report Annually amount hospital spent on claims and their rate, the amount they would have spent if they were at trust average rate and indicators of what caused the increase in claims costs.
B. Improve performance of hospitals.
a) Underwriting and/or incentive program:
b) Explore stratification of member contributions
2. Stewardship reports to members.
a) Evaluate annually.
3. A TOP PERFORMER recognition program is in place. The recognition program shows evidence of improved performance on the part of poor performers and continued performance of top performers.
a) Evaluate criteria for recognition of TOP PERFORMERS and update as appropriate.
b) Publicize the recognition program to members.
C. Boards Vision is accomplished.
1. Members coordinate issues between internal safety and claims management programs.
a) Staff in WC Program begins to integrate processes internally and externally to the benefit of the members.
b) Claims and safety elements are integrated for effective management.
D. Each hospital has a return to work (modified duty or transitional work) policy and program in place.
1. Hospital administrators and contacts recognize the importance and benefits of early return to work.
a) Offer ideas to help hospital contacts get return to work program implemented.
b) Include return to work as a topic in hospital training sessions for supervisors and safety officer.
2. Claims cost reduced due to lower indemnity costs.
a) Conduct regional meetings including best practices
E. Membership recruitment and retention is achieved by Trust members recognizing the cost-effective value of membership in the Trusts.
1. Executive Director communicates cost effective value of trust to hospital leadership.
a) PHD - Include information regarding cost effective value of the Trust to the individual hospital in conjunction with annual contribution letter.
2. Interested and eligible hospitals and public hospital districts have joined the trust.
a) Executive Director to consult with selected hospitals using third party administration/self-administered.
b) Contact and market all prospective members for membership in the Trust.
F. Members (CEOs) place increased focus and emphasis on employee safety issues.
1. Hospitals realize benefit from safety programs emphasis as evidenced through less occupational injuries, illnesses and incidents.
IV. PROGRAM ENHANCEMENT – TRUST SAFETY AND CLAIMS - Attributes 2-6, & 8-12
A. Claims managed in a timely and efficient and cost effective manner.
1. Hospitals are filing claims and all related paperwork timely to allow time to investigate and manage claims.
a) Create a better system to collect more complete claims information from the hospital.
b) Track timely response.
c) Use e-mail as an alternative way to communicate with the hospital.
2. Claims audits have good results.
a) Conduct periodic independent audit of claims program.
b) Prepare claims department for Department of Labor & Industries audit (every 3 years).
B. Claims managed consistently with a personal approach.
a) Update a written manual of policy, procedure, and protocol; provide training as necessary.
b) Periodically update status reports as needed.
C. Improved efficiency in claim filing methods.
1. Use of technology is explored.
D. Improved member safety and health, as evidenced by fewer hazards, reduced exposures, and fewer injuries, illnesses and potential for fatalities.
1. Trust performance is improved as measured by reduced rate of numbers of claims and severity of claims.
2. Members perform root cause analysis of claims.
a) Staff provides training and encouragement to assist members in root cause analysis.
3. Membership is informed of significant changing legal mandates in safety and health as measured by frequent information from the Trusts to the members’ safety contact.
a) Monitor developments, inform membership of changes, and promote understanding of compliance issues and assist in developing training and sample programs.
E. Individual members have an effective safety program in place.
1. Trust has systematic and objective methods to evaluate member safety program content and efficiency. (This is different from self-insured mock audit.)
a) Utilize industry standards and best practices to evaluate employee safety programs.
b) Provide on-site support to individual members to meet safety standards set by the Boards.
2. Improved effectiveness of the safety officer.
a) Training is utilized for development of WC Safety Officer at each member site.
3. Compliance with Safety activities is included in annual performance evaluation of supervisors.
a) Establish pilot program at select Board member facilities.
4. Member safety awareness is enhanced by making appropriate information readily available
a) Develop easy-to-produce and easy to understand reports and performance measures.
5. Increased worker involvement in member safety programs
a) Provide tools to establish effectiveness of joint employee / management safety committees.
6. Hospitals are prepared for a Department of Labor and Industries audit.
a) Provide training programs and review audit requirements and materials.
F. Lower Trust claims experience.
1. Recognize the needs of the health care facilities and the many hats worn by some of their staff. Identify hospital needs and report back to board.
a) Explore financial ability of hospital to provide needed assistance or the need for Trust help.
b) Outreach to all members on “Zero Lift” Program
c) Expand Trust supported safety program to all hospital departments
d) Expand program to other hazards; i.e. slips, trips and falls, bloodborne pathogens, etc.
e) Seek other grant funds to assist members with equipment costs for safety program
f) Explore possibility of producing Zero Lift comprehensive training manual.
G. There is an effective Trust Safety Program.
1. Safety audits show favorable results.
a) Conduct periodic independent audit of the Safety Program.
H. Trusts have available a variety of resources and/or partners for strengthening the Program.
1. Companies knowledgeable about workers’ compensation, safety, and hospitals are utilized for consultation and collaboration.
a) Explore opportunities for collaboration.
2. New hospital construction and renovation projects use ergonomic principles of health and safety to address employees and patients safety issues.
a) Explore working with architects or student architects to update healthcare facilities handbook. 2005.
