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Vicky Currier may not have shot the sheriff, but she did make sure that the deputy got arrested and that he paid restitution.

The arrest of the former president of the Riverside County Sheriff's Association on workers' compensation fraud charges in 2000 is just one way that Currier, a county workers' compensation manager in Riverside County, Calif., is working to save taxpayers money.

A centralized approach to managing risk, improving employee safety and empowering county employees, has produced tangible workers' comp savings in Riverside. Giving employees more of a stake in the improvement of their own health has also been accompanied by increased wellness.

For its forward-thinking approach, and its commitment to lowering costs, Riverside County is the 2007 Risk & Insurance® magazine Theodore Roosevelt Workers' Compensation and Disability Management Award winner in the nonprofit category. This year, Riverside shares the honor with the Houston Independent School District.

ONE-ON-ONE APPROACH TO WELLNESS

We'll get back to that errant law enforcement officer in a bit.

First, let's look at some other results that Riverside's human resources department has produced and explain how they achieved them.

From 2002 to 2006, Riverside's total incurred cost per claim fell 19.7 percent, from $12,110 to $9,724. Lost time per claim over that same period plunged even more dramatically, from 120 days per claim to 55 days per claim, a reduction of more than 54 percent.

In tracing the roots of this success, Ron Komers, an assistant county executive who also serves as Riverside's human resources director, points to a seminal event that occurred nine years ago, in 1998.

That's the year that he and the county government made the decision to centralize safety operations and the risk management and workers' comp management functions under the umbrella of the human resources department.

That also meant taking the task of conducting county pre-employment physicals away from the county health department and creating an occupational health and wellness unit within the human resources department.

Previously, each county department had its own human resources staff. Komers, with the support of the county executive and the board, ended that circus and created one department. In addition, the county's safety officers, who also had been scattered across several departments, were brought under HR's wing. That created a human resources department that combined 25 risk management and insurance staff members with 30 workers' comp staff and 30 safety department workers.

"There is an interrelationship between human resources, workers' comp claims, safety and risk management that our structure allows us to evaluate and act upon," says Komers.

A key element to making the new structure work is its method of funding. Rather than compete with every other county department at budget time, Komers' department charges each department for its services.

That charge starts with $1,000 per employee to fund HR, plus a cost-allocated charge to fund workers' comp and risk management. The workers' comp and risk management cost-allocation formula for each department is 80 percent of losses and 20 percent of payroll.

HR charges additional fees for such things as physicals and polygraph screenings, which are both done in-house.

Komers reports directly to the county's CEO, which is another reason he's not balled up with the politics of individual departments and can apply solutions to each department on an as-needed basis. Komers says he only gets the results he does because his county government views his position as an important one and doesn't relegate him to some backwater.

"Because my position is at such a high level in the organization, I am able to articulate the needs and get the resources necessary to effect change. From the structure follows the opportunity to have an impact," Komers says.

One of the key deliverers of that impact is the county's Injury Intervention Therapy Program, which was implemented in March 2005. Riverside has an in-house team of occupational therapists who provide on-the-job physical therapy for employees who are having wrist, arm, shoulder or neck pain. The county therapists help employees find ways to manage pain, heal, and avoid yet more costly and painful surgery.

Ryann Turcotte, a Riverside occupational injury and illness specialist, says the centerpiece of the program has been its approach to tackling the scores of repetitive-motion injuries sustained by employees in the sheriff's department.

Let's make no generalized connection between that deputy's fraud case and what dispatchers in the sheriff's department go through. The often thankless nature of sheriff's department dispatch work involves such pleasantries as 12-hour days and mandatory overtime. Then there's the stress involved in dealing with criminals and tightly wound law enforcement officers. Those issues translate directly to repetitive-motion injuries, which Turcotte's team treats with on-the-job therapy.

Under Riverside's IIT program, she says, workers who are experiencing pain in the upper body and get a doctor's referral can get up to 12 on-site therapy visits, though the average number of sessions is eight.

Performed in a private office, the therapy is treated confidentially and includes not only a hands-on massage but instruction on stretching exercises that employees can perform at home and on the job.

The IIT program is augmented by the county's safety department, which visits the worker's job station to ensure that desks, chairs and computer arrangements comply with proper ergonomic standards.

Of the 225 county employees who have been treated by Riverside's IIT program since it was instituted in early 2005, 87--or about one-third--have come from the sheriff's department.

Of the 87, eight chose not to use the IIT program and filed claims. Of the 79 workers that were treated by the program, only one of them went on to file a workers' comp claim.

Turcotte says those kinds of results are achieved by therapists forming relationships with employees. That allows workers to talk through their physical problems or through other work-related issues that could be affecting their health.

"I think by talking about their history and problems and symptoms, they are able to make them real, that it's not in their head like a lot of people might be told," Turcotte says.

"The reason you are there is not to deny their claim or process their claim. You are there to help them, and it's a partnership and it's not forced. It is just a whole different approach to a typical claim," Komers says. From March 2005 through January 2007, the cost of paying Turcotte and an associate, including mileage and supplies, was $338,676.

Over that 22-month period, Riverside estimates that the IIT program has saved $2,124,797 in claims that would otherwise have been filed. Annualized, that's a net savings of $906,978 per year.

"CAN" ... NOT "CANNOT"

Komers and Currier say Riverside has also benefited from an aggressive return-to-work program that involves forming tighter lines of communication with doctors who are overseeing the care of Riverside County employees. "We call the doctor and say, 'Tell us what she can do, not what she cannot do,' " says Komers.

Riverside has a four-member return-to-work team that cooperates with supervisors to find ways for employees to return to work sooner.

Just as with other initiatives implemented by Riverside, the program was spearheaded by getting dispatchers, deputies and other stressed-out workers in the sheriff's department back to work sooner in cases where claims had been filed.

From 2004 through mid-2007, Riverside's return-to-work program has processed 434 of the county's 19,971 employees and saved the county $7,024,952 in work days that otherwise would have been lost.

Speaking of money saved, Currier's efforts in fraud prevention since 1997 have resulted in 16 arrests of county employees in workers' comp fraud cases. "You cannot talk about workers' comp without talking about fraud," says Currier.

Ten of those fraudulent claim arrests have been on felony charges, and six have been misdemeanor cases. The arrests have resulted in the payment of $123,861 in restitution to the county, including $7,500 from Dean Likiardopoulos, former president of the Riverside County Sheriff's Association, who was foiled in trying to parlay a fraudulent workers' comp claim into a permanent disability claim.

He was convicted in November 2001 and, in addition to restitution, was ordered to serve a 120-day sentence on consecutive weekends.

"If you have a claim, we will treat you with respect and get you all the help you need. But if you try to file a fraudulent claim, we will go after you with both barrels," adds Komers.

Because of the fraternity between law enforcement and local prosecutors, Currier says, Likiardopoulos' was "probably one of the more difficult cases to get through the district attorney."

DAN REYNOLDS is senior editor of Risk & Insurance®.

November 1, 2007

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