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									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?
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