CBIS Business Meeting Presented by: Lori Cockerill & Andrea McNeill September 2010 Agenda WorkSafeBC Information/Stats COT vs. CBIS Referral Process Assessment Process Reporting Format Gym Pass Policy Individuals in Distress Three Month Review Case Manager Contact Key Statistics (2009) BC Injured Workers Men • 66% Women • 34% Average Age • 41 Young workers (age 15–24) • 6,980 (14%) Key Statistics (2009) Claims Injuries reported 141,968 Claims accepted 94,252 Fatal claims accepted 121 Percentage of claims disallowed 6.4% Occupational disease claims accepted 2,610 Days lost from work 28 million Average length of short-term wage-loss benefits 546 days Reported Fatalities & All Reported Injuries Year New injuries Fatalities that occurred Fatalities as a reported in in the year and were reported percentage the year to WSBC by Feb of the of new injuries following year (March 31, 2010 for 2009)* 2000 181,632 186 0.10% 2001 169,492 193 0.11% 2002 156,782 232 0.15% 2003 152,071 219 0.14% 2004 156,762 223 0.14% 2005 164,267 259 0.16% 2006 172,843 274 0.16% 2007 173,385 228 0.13% 2008 168,268 225 0.13% 2009 141,968 174 0.12% *For the years 2000–2008, the deaths included in the table are those that were reported by February of the following year (the exact date varied from February 16 to February 22). For 2009 and subsequent years, the deaths included in the table are those reported by March 31 of the following year. The count of fatalities is slightly more complete for 2009 and subsequent years than it is for 2008 and prior years. Reported Fatalities & All Reported Injuries Fatalities 300 285 270 255 240 225 210 Fatalities 195 180 165 150 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 New Injuries 200,000 180,000 160,000 140,000 120,000 100,000 80,000 New Injuries 60,000 40,000 20,000 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Number and Costs of Claims* During the year 2009, 94,252 claims were paid for the first time. Of those: • 42,960 were health-care-only claims (formerly called medical-aid-only claims) • 47,651 were short-term disability claims (formerly called wage-loss claims) • 3,520 were long-term disability claims (formerly called permanent disability claims) • 121 were fatal claims * The figures on counts and costs for 2009 have been impacted by two factors: a drop in the number of reported injuries (due at least in part to the recession); and business process changes brought about by the implementation of our CMS initiative. Number of Claims and Claims Costs by Provincial Regional District for 2009 DAYS LOST FROM WORK DAYS LOST FROM WORK (CONT’D) Percentage of Female Claimants Claim Analysis: Short-term Disability, Long-term Disability and fatal claims first paid Worker Overall Experience Ratings * Not all columns add up to 100 percent due to rounding. Injured Workers’ Rating of WorkSafeBC Claim Staff Injured Workers’ Rating of Assistance with Their Return to Work1 1 Not all columns add up to 100 percent due to rounding. Employers’ Rating of Their Overall Experience1 1 Not all columns add up to 100 percent due to rounding. COT vs. CBIS Admission Criteria COT CBIS Injured Workers with: Injured Workers with: • Spinal cord injury • Compensable acquired brain • Amputations injuries • Burns • Pressure ulcers • Post traumatic stress disorder • Complex orthopaedic conditions COT vs. CBIS The Contractor is responsible for making sure the following admission criteria are met: COT CBIS The Injured Worker: The Injured Worker: • Has no health concerns which would • Has no health concerns which contraindicate participation would contraindicate participation • Demonstrates a medical and • Demonstrates a need for functional need for COT intervention Community Brain Injury Services intervention • Requests for Time Sensitive Assessments meet the criteria in Clause 2.1.5 – TIME *NOTE -Concurrent Care: The Worker SENSITIVE ASSESSMENTS may receive CBIS services in conjunction with other care (e.g. Speech Language •Each admission to OT Services includes all of Pathology, HIATS, Physiotherapy, Home the Services that are required for that Injured Care, and Community OT) Worker, by that Contractor, prior to the Worker’s discharge COT vs. CBIS Exclusion Criteria • The Contractor must not provide Services to Injured Workers where: COT CBIS • Evidence exists that the Injured Worker is •Evidence exists that the Injured Worker unlikely to benefit from COT Services due is unlikely to benefit from CBIS to barriers beyond the scope of the COT Services Agreement •The Injured Worker is functioning well independently at home and/or in the •The Injured Worker’s needs would be met community more cost-effectively by another service •The condition requiring intervention is not •The Injured Worker’s needs would be compensable under the claim met more cost-effectively by another service •The Injured Worker is currently engaged in another treatment intervention for the •The Injured Worker resides in a group same injury home, care home, family care home, or care facility Referral Process • A written referral (Referral Form 83B150) is required for each referred Worker 1 • WSBC Provider Referrals will call the Contractor before faxing the referral 2 • Contractor must initiate Services within the ten (10) calendar day timeline • Referral Form will be sent via fax from Provider Referrals after 3 determining availability Referral Process If a Board Officer contacts a Contractor directly, the Contractor MUST request a Referral Form to ensure payment Referral Process The OT must contact the Board Officer within one (1) business day of the Contractor’s receipt of a referral to discuss Service requirements The referral only authorizes the OT to complete the Initial Visit Referral Process When scheduling a Worker for the Initial Visit, the Contractor must: Referral Process CBIS Referral Form (83B150) Assessment Process Reporting Format Gym Pass Policy Billing under fee code 1102348 (Pre- authorized expenses) Parks Board Changes OT’s, OTA’s, RA’s will be provided with an “external rehab specialist” card, which will identify them differently than “outside trainers”. Each OT company will have to apply for the card individually The card will be honoured at participating community centers (some may have their own policy) Contact: Warren Coughlin at VPB (604-257- 8615) for more information Impact on WSBC Invoicing: Please state “Entrance Fee to Recreation Facilities” to bill code 1102348 Individuals in Distress Contacts include: Don’t wait to seek help! Three Month Review Has anyone completed this? How did it go? Feedback for us? Questions? Issues?
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