Newsletter Sign-up

Safety/Risk Manager
Rock Hill School District Three of York County
Rock Hill, S.C.

Drilling Her Peers and Students in the Ways of Safety

The Rock Hill District Three of York County in Rock Hill, South Carolina had a fire, safety and crisis plan as the state required. But it never was a front-burner issue. It hardly was even a back-burner issue for the district, which concentrates heavily on providing the best possible education for its student and ensuring that they succeed.

"It was like everything else," said Elaine Baker, public relations director for the district.

"You remembered it when you looked at it. Then it became an old document that you rarely thought about. We've always been very focused on our schools."

That was before Laney Burris became the district's safety/risk manager a couple of years ago. Everything changed after that.

"She takes her job very seriously," Baker said.

"She's like the Energizer Bunny. She keeps safety and crisis management in front of us all the time."

Since becoming safety/risk manager for the district, which comprises 27 schools plus an administration and several other buildings, Burris has set into motion a number of innovations.

She developed a student accident injury review as a way to alleviate injuries and claims. She receives student accident reports daily and reviews them weekly; and Burris alerts the schools or facilities involved of potential risks and exposures. She also follows up to make sure that whatever caused the injury has been corrected.

A new districtwide safety committee meets quarterly to review student accident and workers' compensation claims and to brainstorm ways to control future losses.

Administrators of each department are updated about employee injuries and absences, and whatever corrections were made. Follow-up with employees has been bringing them back to work sooner.

Burris also piloted three schools in a program to use school nurses to deal with minor medical or first-aid cases instead of sending folks with things like bruises, cuts or muscle sprains to an outside clinic.

The result is a decline in workers' comp claims and added claims to the district's loss history--a positive impact on its experience modifier rate and resulting premium.

Although remaining compliant in fire, tornado and earthquake drills is required by state law, Baker said the school administration building had never had a fire drill in the 17 years she worked there, until Burris came on board.

Now, there are monthly fire drills and reports are filed electronically.

Burris' sincerity about keeping staff and students safe reaches beyond the schools.

She has instituted a quarterly safety newsletter, sent to the homes of every student and posted on the district's website, which addresses various safety issues. September's newsletter was about the risks involved with driving to school, and how to mitigate them.

She also maintains a continuing connection with all of the local agencies that deal with crisis management--police, fire and emergency medical services--meeting with them regularly and making sure everyone knows what they're doing.

Whenever a large group convenes, Burris insists that a risk management component be placed on the agenda.

At a recent district leadership meeting, for instance, Burris coordinated an exercise involving local police and district employees in which various crisis scenarios and how to deal with them were discussed.

"In a school system, we always have way too much to think about, but we can't forget for a minute that safety is the key," Baker said.

"Everyone expects their kids to be safe first, and then that they're taught.

"That's what we want, too--safety for our employees and students, and then we can concentrate on the matters at hand in the classroom.

"Laney is really on top of things. She has made a big impression here and throughout the state."

--Julie Liedman

Risk and Benefits Officer
Miami-Dade County Public Schools
Miami

Behold--a Valuable Public Servant

A review of workers' compensation costs in the Miami-Dade County Public Schools caused Scott B. Clark, the district's risk and benefits officer, to take another look at unusually high weekly prescription drug costs in one particular claim.

What he discovered was a trend of flagrantly high prescription costs associated with workers' comp claims statewide due to a loophole in Florida's workers' comp law; it allows physicians to dispense repackaged medications to their patients at inflated prices.

Clark's investigation uncovered this loophole and, during Florida's 2010 legislative session, a portion of the state's workers' comp law was amended. The amendment seeks to return pharmacy costs to a reasonable and predictable level, and is expected to save Florida employers $100 million in workers' comp costs annually.

"He was the first one to really look at what was happening, and went to Tallahassee to see what should be done," said Amanda Vatter, assistant vice president of Gallagher Bassett Services Inc., the school district's third-party administrator (TPA).

School districts across the state are saving hundreds of thousands of dollars as a result, she said. "He didn't just say, 'Naughty, naughty.' He made an industry change that helped everyone in Florida."

Clark took a stand against his own pharmaceutical benefit providers that knowingly were working around the statutory pharmacy fee schedule, and profiting from it. Though technically legal, Clark felt it was unethical.

It began when Clark noticed one particular workers' comp claim in the Miami-Dade district that averaged more than $1,500 a week in prescription drugs. This led him to look at other open claims, and he uncovered a pattern of dramatically escalating drug costs beyond what was usual for the district's injured employees. Even though Florida's workers' compensation code allows injured workers to choose their own pharmacies, Clark, working with a third-party administrator, discovered that many physicians were dispensing repackaged prescriptions from their offices at excessive prices--sometimes more than 400 percent of the original price.

These medications are produced in bulk by manufacturers and repackaged for individual use by doctors' offices. Repackaging can change or eliminate the drug identification number and therefore takes it off the state-mandated fee schedule. The loophole not only cost employers millions of dollars in prescription costs but led to loss of utilization management and medication control because patients were getting medications from a variety of doctors.

"For him, the utilization piece was just as important," Vatter said. "We don't want our workers to get drugged up. These are our teachers, our bus drivers. We need a way to make sure they are not only getting their medication, but they're getting the appropriate medication."

Clark's solution was to institute a Pharmacy Validation Program, in which bills for repackaged prescriptions are revalidated to the proper fee schedules, reducing those bills to the contracted price.

The program utilizes clinical and certified coding expertise to eliminate inappropriate charges or incorrect coding on medical bills. After the standard bill review steps, the eligible bills are routed to the program staff for investigation. Depending on the services rendered on the bill, a certified procedure coder or a nurse inspects the bill, and the associated medical records and claim details to determine whether the codes and associated charges are appropriate. Inappropriate charges are recommended for reduction or denial.

Benefits to the Miami/Dade County Public Schools were immediate. During the initial three-month period in which the prescription revalidation program was launched, prescription costs decreased by $190,000.

Millions of dollars of additional savings are expected to be realized and, ultimately, improved care for the district's injured employees.

--Julie Liedman

Upholding the Traditions of Public Service

Scott B. Clark is just the kind of risk officer that every public sector entity needs. Clark doesn't just look out for the people under him, or the people who pay him, or the people who know him.

Clark's actions have benefited people "above and beyond," his immediate surroundings, and are likely to affect people long after he leaves his job in Miami.

"He didn't just say,'Naughty, naughty,'" said Amanda Vatter, assistant vice president of Gallagher Bassett Services Inc., the school district's third-party administrator. "He made an industry change that helped everyone in Florida."

Clark discovered that one claim averaged more than $1,500 per week in prescription drugs, and on further investigation, he discovered flagrantly high prescription costs associated with workers' comp claims across the state because of a loophole in the law.

Though legal, Clark felt the practice was unethical and took it upon himself to stand up against his own pharmaceutical benefit providers, and Clark's efforts have led to changes in Florida law.