Teddy Awards: Progress Report

Fit for Duty

2013 Teddy Award winner Miami-Dade County Public Schools is managing comorbid risk factors by getting employees excited about healthy living.
By: | November 2, 2016 • 5 min read

When evaluating Teddy Award applicants, one of the qualities judges look for is a program that’s built to last, with a commitment to continuous improvement.

So it’s no surprise that Miami-Dade County Public Schools (M-DCPS), a 2013 Teddy Award winner, is still aggressively pursuing strategies to reduce its injury frequency, claims costs, medical costs and lost time.

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Case in point: Through regular reviews of claims data, M-DCPS identified a significant volume of claims where comorbidities were compromising the recovery of injured workers, and negatively impacting the severity of claims.

A wellness-focused injury recovery program called Rebuilding Me had been in place since 2007, but it was not having the desired impact on recovery outcomes. Rather than scrap the program, though, M-DCPS wanted to revive it.

The Rebuilding Me program focused on the Transportation department, which had the highest concentration of employees with comorbid conditions such as obesity, diabetes and hypertension.

“We finally thought — we need to take this to a different level,” said Rosa Royo, supervisor, workers’ compensation for M-DCPS. “This isn’t really doing what we want it to, and we need to put some money into it.”

Together with partners Gallagher Bassett and Coventry, M-DCPS rebranded and re-energized Rebuilding Me, what Royo calls a “targeted loss prevention program.” The pilot for the relaunch focused on the Transportation department, which had the highest concentration of employees with comorbid conditions such as obesity, diabetes and hypertension.

“They have range of motion issues, they have strength issues, weight is a real problem,” said Royo, noting that 87 percent of the department is overweight or obese.

An angioscreening of 650 employees revealed that only 98 had blood pressure within the normal range, while 250 tested abnormal and the other 302 registered as morbidly high. The comorbid conditions were taking a toll on claims cost and duration.

Even for something as minor as an employee whacking a knee against a steering wheel, said Royo, “You’re taking someone who’s very heavy and you’re immobilizing the joint. So maybe now you have a pulmonary embolism. You go from what would have been a $500 claim and now it’s a half a million dollar claim.”

Clamoring for More

Rebuilding Me includes the use of dedicated nurses to conduct one-on-one sessions with injured workers who are at increased risk for lost time based upon their health and wellness conditions.

It also features fitness classes, nutritional education and ergonomic awareness activities. The core Rebuilding Me team — comprised of Royo, Naomi Kuker of Gallagher Bassett, and Caroline Sauve of Coventry — is present at all events.

Strength and range of motion are key targets for the program. Royo related a story about an employee who showed up for a class and did an entire workout while clinging to a pillar. A short while later, she approached Royo and said, “Look I can raise my leg now.”

“That’s exactly what the program is for,” said Royo. “If you happen to lose weight, great. But it’s that range of motion and strengthening and those kinds of issues that we were really trying to address.”

“We’re spending $100,000 a year on this. But that wouldn’t even pay for one shoulder repair.” — Rosa Royo, supervisor, workers’ compensation, Miami-Dade County Public Schools

The response has been gratifying, said Royo. The initial pilot was conducted one day a week at the North East transportation depot. But soon, she said, “I had people chasing me in the parking lot saying, ‘You need to come more!’ ” It now runs three days a week with two trainers, and they have maxed out their available space and are seeking space for expansion.

M-DCPS has a solid program running now in five of its eight bus yards, with a sixth launching in January. At another location where lack of space has been a challenge so far, the workers’ labor union is clamoring for the program to be put in place.

The unions, in fact, wholeheartedly support Rebuilding Me, especially now that new U.S. Department of Transportation rules on medical fitness for duty could disqualify workers with significant health risks.

“Some of their members were at peril for losing their jobs,” said Royo. “This is a way for us as an employer to say, ‘We don’t want to throw you away. We don’t want to fire you. Here’s an opportunity for us to help you with this.’ ”

Well Worth the Cost

Because Rebuilding Me is a voluntary program, Royo and her team look for creative incentives to get people through the door initially, including lots of small branded swag items like sunglasses and lip balms.

But once an employee has committed to the program, the incentives ramp up. Employees get a towel after completing their first workout, and a T-shirt after the fifth. By the time they reach their 75th workout, they’re rewarded with a hybrid bicycle worth more than $400.

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“Our offices look really funny right now, because we’ve got stacks of scales and Fitbits and bicycles.”

That may make it sound like an expensive program to pull off, but Royo is quick to put the cost in perspective.

“We’re spending $100,000 a year on this,” she said. “But that wouldn’t even pay for one shoulder repair.”

The team is highly invested in the program’s success. They work to ramp up excitement within the Transportation centers, and created an online social media presence as well, through Instagram (@rebuildingmemdcps). The Instagram feed includes photos of events and classes, nutrition and fitness tips, recipes and motivational messages.

Royo hopes to build on the program’s success and popularity and keep it growing in order to maximize the impact.

“The hypertension issues, the weight issues, the musculoskeletal issues … I know this program can’t address all of these things as much as we’d like, but the better the penetration, the better the outcomes we’re going to have,” she said.

“We always try to do something that is innovative in our program, and I really think that this is special.” &

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Read more about the 2016 Teddy Award winners:

target-150x150Bringing Focus to Broad Challenges: Target brings home a 2016 Teddy Award for serving as an advocate for its workers, pre- and post-injury, across each of its many operations.

 

hrt-150x150The Road to Success: Accountability and collaboration turned Hampton Roads Transit’s legacy workers’ compensation program into a triumph.

 

excela-150x150Improve the Well-Being of Every Life: Excela Health changed the way it treated injuries and took a proactive approach to safety, drastically reducing workers’ comp claims and costs.

 

harder-150x150The Family That’s Safe Together: An unwavering commitment to zero lost time is just one way that Harder Mechanical Contractors protects the lives and livelihoods of its workers.

 

More coverage of the 2016 Teddy Awards:

Recognizing Excellence: The judges of the 2016 Teddy Awards reflect on what they learned, and on the value of awards programs in the workers’ comp space.

Fit for Duty: 2013 Teddy Award winner Miami-Dade County Public Schools is managing comorbid risk factors by getting employees excited about healthy living.

Saving Time and Money: Applying Lean Six Sigma to its workers’ comp processes earned Atlantic Health a Teddy Award Honorable Mention.

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Caring for the Caregivers: Adventist Health Central Valley Network is achieving stellar results by targeting its toughest challenges.

Advocating for Injured Workers: By helping employees navigate through the workers’ comp system, Cottage Health decreased lost work days by 80 percent.

A Matter of Trust: St. Luke’s workers’ comp program is built upon relationships and a commitment to care for those who care for patients.

Keeping the Results Flowing: R&I recognizes the Metropolitan Water Reclamation District of Greater Chicago for a commonsense approach that’s netting continuous improvement.

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]

R&I Profile

Achieving Balance

XL Catlin’s Denise Balan stays calm and focused when faced with crisis.
By: | January 10, 2018 • 6 min read

In the high-stress scenario of kidnap or ransom, the first image that comes to mind isn’t necessarily a yoga mat — at least, not for most.

But Denise Balan, senior VP and head of U.S. kidnap & ransom, XL Catlin, who practices yoga every day, would swear by it.

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“I looked at these opposing aspects of my life,” she said. “Yoga is about focus, balance, clarity of intent. In a moment of stress, how do you respond? The more clarity and calmness you maintain, the better positioned you are to provide assistance in moments of crisis.

“Nobody wants to be speaking to a frenetic person when either dealing with a dangerous situation or planning for prevention of a situation,” she added.

“There’s a poem by [Rudyard] Kipling on that,” added Balan’s colleague Ben Tucker. “What it boils down to is: If you can remain calm, you can manage through a crisis a lot better.”

Tucker, who works side by side with Balan as head of U.S. terrorism and political violence, XL Catlin, has seen how yoga influences his colleague.

“The way Denise interacts with stakeholders in this process — she is very professional and calm in the approach she takes.”

Yin and Yang

Sometimes seemingly opposite or contrary forces may actually be complementary and interconnected. In Balan’s life, yoga and K&R have become her yin and yang.

She entered the insurance world after earning a juris doctor degree and practicing law for a few years. The switch came, she said, when Balan realized she wasn’t enjoying her time as a commercial litigator.

Denise Balan, senior VP and head of U.S. kidnap & ransom, XL Catlin

In her new role, she was able to use her legal background to manage litigation at AIG, where her transition from law to insurance took place. She started her insurance career in the environmental sector.

In a chance meeting in 2007, Balan met with crisis management underwriters who told her about kidnap and ransom products.

She was hooked.

Because of her background in yoga, Balan liked the crisis management side of the job. Being able to bring the calmness and clearness of intent she practiced during yoga into assisting clients in planning for crisis management piqued her interest.

She then joined XL Catlin in July 2013, where she built the K&R team.

As she became more immersed in her field, Balan began to notice something: The principles she learned in yoga were the same principles ex-military and ex-law enforcement practiced when called to a K&R-related crisis.

She said, “They have a warrior mentality — focus, purpose, strength and logic — and I would say yoga is quite similar in discipline.”

“K&R responders have a warrior mentality — focus, purpose, strength and logic — and I would say yoga is quite similar in discipline.” — Denise Balan, senior VP and head of U.S. kidnap & ransom, XL Catlin

Many understand yoga to be, in itself, one type of meditation, but yoga actually encompasses a group of physical, mental and spiritual practices. Each is a discipline. Some forms of yoga focus on movement and breathing, others focus on posture and technique. Some yoga is meant to relax the mind and create a sense of calmness; other yoga types make participants sweat.

After having her second child and working full-time, Balan wanted to find something physical and relaxing for herself; a friend suggested yoga. During her first lesson, Balan said she was enamored with it.

“I felt like I’d done it all my life.”

She dove into the philosophy of yoga, adopting the practice into her daily routine. Every morning, whether Balan is in her Long Island home or on a business trip, she pulls out her yoga mat to practice.

“I always travel with my mat,” she said. “Daily practice is the simplest form of connection to routine to maintain my balance — physically and mentally.”

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She said the strangest place she has ever practiced was in Lisbon. She was on a very narrow balcony with a bird feeder swarming with sparrows overhead.

After years of studying and practicing, Balan is considered a yogi — someone who is highly proficient in yoga. She attends annual retreats with her yoga group, where she is able to rejuvenate, ready to tackle any K&R event when she returns.

In 2016, Balan visited Tuscany, Italy, where she learned the practice of yoga nidra, a very deep form of meditation. It’s described as the “going-to-sleep stage” — a type of yoga that brings participants to a state of consciousness between waking and sleeping.

“It awakens a different part of your brain,” Balan commented. “Orally describing it doesn’t quite do it justice. One has to practice Nidra to fully understand the effect it has on your being.”

Keeping a level head during a crisis is key in their line of business, Tucker said. He can attest to the benefit of having a yogi on board.

“I’ve seen her run table-top exercises where there is this group of people in a room and they run an exercise, a simulation of a kidnap incident. Denise is very committed to what we’re doing,” said Tucker.

“She brings that energy. She doesn’t get flustered by much.”

Building a K&R Program

When Balan joined XL Catlin, she was tasked with creating the K&R team.

Balan during a retreat in Sicily, Italy, 2017

She spent time researching and analyzing what clients would want in their K&R coverage. What stuck out most to Balan was the fact that, in these situations, the decision to purchase kidnap and ransom cover is rarely made because of desire for reimbursement of money.

“I asked why people buy this type of coverage. The answer was for the security responders,” she said.

“These are the people who sit with the family. They’re similar to psychologists or priests,” Balan further explained. “Corporations can afford to pay ransom. They buy [K&R] because it gives them access to these trained and dedicated professionals who not only provide negotiation advice, but actually sit with a victim’s family, engaging deep levels of emotional investment.”

“I’ve learned to appreciate all moments in life — one at a time. The ability to think clearly and calmly guides my work, my practice and my personal life.” — Denise Balan, senior VP and head of U.S. kidnap & ransom, XL Catlin

Balan described these responders as people having total clarity of purpose, setting their intentions to resolve a crisis — a practice at the very heart of yoga. She knew XL Catlin’s new kidnap program would put stock in their responders.

“I’ve worked closely with the responders to better understand what they can do for our clientele. These are the people who run into danger — warrior hearts married to dedication to our clients’ best interests.”

But K&R is more than fast-paced crisis and quick thinking; Balan also spent a good deal of time writing the K&R form and getting the company’s resources in order. This was a huge task to tackle when creating the program from the ground up.

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“A lot of my day-to-day is speaking with brokers and finding ways to enhance our product,” she said.

After a few months, she was able to hire the company’s first K&R underwriter. From there, the program has grown. It’s left her feeling professionally rewarded.

“People don’t often get that opportunity to build something up from scratch,” she said. “It’s been an amazing experience — rewarding and fun.”

“She brings groups of people together,” said Tucker. “She’s created a positive environment.”

Balan’s yogi nature extends beyond the office walls, too. Her pride and joy, she said, are her kids. And while it may seem like two large parts of her life are opposite in nature, Balan’s achieved balance through her passions.

“[Yoga] has given me the ability to see beyond only one aspect of any situation” she said. “I’ve learned to appreciate all moments in life — one at a time. The ability to think clearly and calmly guides my work, my practice and my personal life.” &

Autumn Heisler is a staff writer at Risk & Insurance. She can be reached at [email protected]