For This Award-Winning County, Employee Safety Begins Before the Job Offer
As a man lifts weights over his head, an ergonomist carefully analyzes his movements: Are the feet spread far enough apart to distribute weight evenly? Are there any weak points that seem out of the ordinary? Is the shoulder angle correct?
Rather than watching and taking their best guess, the ergonomist uses motion capture technology that displays a likeness of the man’s skeleton and real-time movements on a computer screen — offering precise information about posture, capabilities and limitations. It’s the kind of technology used in filmmaking and digital gaming — but in Monmouth County, New Jersey, it’s being used to mimic the actual day-to-day tasks of a parks department employee.
The test is one of many innovative solutions implemented by Monmouth County leadership to spur a dramatic turnaround in its workers’ compensation program. Back in 2009, the County saw over 400 new claims and losses of $5.5 million. They hired too many people not physically capable of the job tasks. Injured workers could get full pay and benefits for up to a year. Light duty was underutilized.
Departments hardly communicated. Newly appointed manager of benefits and workers’ compensation William McGuane knew something needed to change — fast.
“When I got here, I saw a workers’ compensation policy that actually lessened the employees’ ability to return to work safely and consistently,” said McGuane. “When you can stay home and make full pay, there’s not a lot of incentive to come back to work.”
Through a combination of safety-and-wellness programs, advanced technology and modernized labor union agreements, Monmouth has seen a dramatic turnaround. From 2009 to 2017, claims dropped by 44 percent and losses dropped 76 percent. The effort led Monmouth County to receive a 2018 Teddy Award, for excellence in workers’ compensation risk management.
First things first — who is getting hurt? There are 4,100 workers in the County doing incredibly varied jobs. There are corrections officers and librarians. There are maintenance workers and nursing home employees. So who’s driving these massive comp claims?
After digging into the data, McGuane found workers in their first 90 days were particularly susceptible to injury — especially those working the most strenuous jobs like building, grounds, corrections, highway, law enforcement and in the parks departments.
“We were hiring people incapable of doing the jobs,” said McGuane. “It became evident that they couldn’t do it safely.”
To combat that, the County had ergonomists and physical therapists from Hackensack Meridian Health measure the dynamic forces employees endured while doing their normal job functions. Then came motion capture.
“We have them do all those job functions in front of a physical therapist, guiding them on proper technique. If they don’t pass, they don’t get the job — and that weeds out a lot of potential injuries down the road,” said Dr. Jared Schulman, corporate medical director, occupational health, Hackensack Meridian Health.
The parks department was a particularly high driver of injuries — generating nearly half of the County’s total incurred costs in some years.
“We consistently saw seasonal injuries. Tick bites in summer are unavoidable, heat exposure and poison ivy are pretty consistent, too,” said Schulman. “Overall, musculoskeletal complaints are most frequent — low back injuries, shoulders, knees.”
So the County piloted a safety-and-loss-prevention program in the parks department, working with risk management solutions firm PMA Companies to teach workers and supervisors how to lift and move ergonomically. They also conducted a safety survey and the results were clear — there were serious discrepancies between employees’ and supervisors’ views of safety policies. And that led to a major lack of communication.
“We helped train their supervisors to understand their role in the safety process,” said Justin Wilkinson, account executive at PMA Companies. “You’re not disciplining an employee by telling them they’re doing something wrong, you’re helping them stay safe.”
“What they’ve been able to do is phenomenal. A big part of that is Monmouth County being transparent with their employees and respectful. It sends a message to the whole organization that health and safety are important to them.” — Dr. Jared Schulman, corporate medical director, occupational health, Hackensack Meridian Health
The safety-and-loss-prevention program is a winner, as new claims volume for the parks department has declined 22 percent from 2011 to 2017. The pilot program will soon be rolled out to other departments in the County.
Another population that represented heavy claims were people returning to work after injuries. Part of the problem was antiquated job descriptions. Revamping them to accurately portray the physicality of each position led to an expansion of light duty. Getting them to light duty greatly increased the chance of a return-to-work success story.
“Bringing them back early hurt them to a greater degree. That’s when claims got out of control and employees didn’t return to work and ugly scenarios emerged that we didn’t want to see,” said McGuane.
Changing a Culture
Another major hurdle: Existing labor union contracts provided full salary continuation for up to a year for an employee’s work-related injury. Workers could then get FMLA leave tacked on afterwards. It damaged morale, strained overtime budgets and — most importantly — kept people out of work far too long.
“They can develop what I call the I Love Lucy syndrome, where sitting on the couch and getting atrophied becomes their lifestyle,” said McGuane. “It’s no way to have a fulfilling life. It does a disservice to the injured worker and a disservice to all levels of the organization.”
Over three years of negotiations with 32 labor unions, they brought that number down to six months.
“We explained the unintended consequence of what was happening. Getting them back in the building in some type of capacity was far more humane than having them sit on the couch someplace,” said McGuane.
Another major initiative was the wellness program — highlighted by the “Pledge 10” initiative aimed at getting employees to lose 10 pounds over a 12-week period. For the naturally thin or people already in shape, they could maintain their ideal weight. They also offered free biometric screenings, flu shots, wellness seminars and an annual physical — where employees were entered into a raffle to win a free personal day.
“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better,” said McGuane. “We’ve had people lose 30 and 40 pounds.”
Monmouth saw tremendous results from its efforts. Overall claims costs fell from over $5.5 million incurred in accident years 2009 and 2010 to under $2.1 million in 2016 and $1.3 million in 2017.
Total new claim volume decreased 44 percent, from 410 in 2009 to 230 in 2017. Lost-time claims decreased from 80 in 2009 to 34 in 2017. Open outstanding claims decreased from 332 in 2010 to 254 claims today. The County’s calendar year paid totals have been trending downward from $5.1 million in 2010 to $4.4 million in 2017.
“Over the course of 10 years, the program has just gotten better,” said Wilkinson. “We hope to drive our clients to have the kind of success Monmouth County is having. We use them as a model when we market to other counties. We’ve had success with other accounts, but this one stands out.”
Schulman is equally impressed: “What they’ve been able to do is phenomenal. A big part of that is Monmouth County being transparent with their employees and respectful. It sends a message to the whole organization that health and safety are important to them.”
For McGuane, the workforce and workers’ comp program he inherited years ago feels incredibly different. It’s a safer place to work. Injured workers are more likely to get better. Claims are no longer out of control.
“I’ve seen people’s lives change as a result of the program we’ve done,” he said. “It’s one of the most gratifying things I’ve ever seen professionally.” &