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Digital Edition2025 Theo Award Winner: The City of Tucson
The City of Tucson faced a daunting challenge in 2020 when its Experience Modification Rating (EMOD) reached an all-time high of 1.37. The municipal government, which employs thousands across diverse departments from public safety to public works, recognized that this upward trend threatened both employee wellbeing and financial sustainability.
Under the leadership of Workers’ Compensation Manager Sara Hussak and her team, including Noemi Mills, Lead Workers’ Compensation Analyst, partnered with a consultant and Vince Tracey, the city’s Safety and Health Loss Control Manager, the City embarked on a comprehensive transformation that would ultimately drive their EMOD down to 0.88 by 2024.
The City achieved its dramatic improvement during a period when no risk manager was in place from June 2023 through September 2024.
Tackling the Problem
The City’s approach centered on identifying and addressing root causes rather than simply managing symptoms. Through careful analysis, the team discovered several critical issues undermining its program: volunteer hours weren’t being captured accurately, salary for law enforcement volunteers was under-reported, physicians were placing employees off-duty when light duty was available, and routine physical therapy was being prescribed without proper evaluation.
“Our risk management safety team helped shift the organizational culture around safety and accountability by reviewing each injury incident submitted, even if it did not result in treatment and made recommendations for targeted training and prevention plans,” said Hussak.
Central to their transformation was the implementation of an actionable injury reductions strategy, a comprehensive framework that addressed incidents through basic discussion, coaching, training updates, equipment improvements and environmental factors requiring facility management involvement. The strategy emphasized that employees must report all injuries by the end of their shift, with supervisors completing injury reports within the same timeframe.
The City strengthened its data accuracy through multiple initiatives. Quarterly training sessions for supervisors and staff focused on proper incident documentation, clear guidelines and follow-up procedures. The implementation of Origami Risk as their workers’ compensation management system allowed them to capture all incidents regardless of severity, including near misses. Enhanced collaboration between risk management, finance and human resources helped verify data and address inconsistencies.
“The most successful tactic we used to gain buy-in from both employees and supervisors was connecting the importance of immediate reporting to personal impact and team accountability – not just compliance,” Hussak said. “We emphasized that immediate reporting leads to faster medical treatment, better recovery outcomes, and few disruptions to team operations.”
The City also revolutionized its approach to physician engagement, recognizing that education and collaboration with medical providers was essential for improving outcomes. They prioritized building strong relationships with providers by clearly communicating program goals, sharing data-driven insights, and fostering mutual understanding. Personal outreach made a significant difference, with the team working to establish consistent points of contact and ensuring physician-based restrictions on functional capacity rather than diagnosis alone.
“One of the biggest lessons was the importance of being consistent in our expectations, documentation and follow up,” Hussak said. “Ultimately, by treating the physicians as partners in the recovery process and showing them how their input affects broader outcome, we built a foundation for ongoing collaboration.”
The City’s partnership with their third-party administrator was also strengthened through more active claims oversight, proper reserves management and prompt closures. Regular bi-weekly meetings with the TPA and quarterly reserve meetings became standard practice. Additionally, collaboration with their Occupational Health provider helped address treatment inconsistencies and track trends in prescription usage and physical therapy, allowing them to target high-risk areas effectively.
Organization: The City of Tucson * Location: Tucson, Ariz. * Number of Employees: 5,068 * Category: Government & Public Sector
To reinforce positive behaviors, the city implemented recognition programs for teams demonstrating strong safety culture, awarding certificates of appreciation for achievements in reducing workplace injuries and promoting proactive safety practices.
Success to Build On
The City’s comprehensive approach yielded dramatic results. Its EMOD reduction resulted in significant financial benefits, with initial insurance quotes coming in seven to ten percent lower than originally projected. This represents substantial savings to the City’s overall self-insurance risk fund and demonstrates improved program integrity.
Sara Hussak, Workers’ Compensation Manager, City of Tucson
Beyond financial metrics, the City achieved a fundamental cultural shift around safety and accountability. Regular monthly audits of injury logs, large loss semi-annual meetings with departments, and dashboard reviews allowed leadership to visualize injury trends and detect anomalies quickly. The improved data accuracy enhanced operational efficiency and enabled evidence-based improvements throughout the program.
Looking ahead, the city is focused on several key initiatives to build upon their success. Plans include expanding their return-to-work program through inter-departmental collaboration, creating more opportunities for meaningful transitional work assignments. Currently operating informally, the city recognizes the need for a more robust, centralized program with clear guidelines and streamlined communication.
The city is also exploring a systematic approach to full and final settlements, targeting cases likely to be successfully resolved while saving money long-term. Additionally, a Nurse Case Triage pilot program for five large loss departments will provide immediate access to registered nurses who can assist injured workers with prompt medical care or appropriate self-care guidance.
An athletic trainer pilot program with the public safety group represents another innovative approach, supporting the physical well-being and performance of Tucson Fire Department and Tucson Police Department personnel to ensure they remain fit for duty and able to perform essential functions effectively and safely.
“What we would add is that while improving our EMOD and workers’ compensation outcomes is a measurable success, the real accomplishment is the cultural shift we’ve initiated,” said Hussak. “We’re fostering a work environment where safety, accountability, and employee well-being are embedded into daily operations — not viewed as afterthoughts.”
The city’s transformation demonstrates that significant improvement is possible even in challenging circumstances. The programs success came through collaboration, transparency and a willingness to challenge established practices while maintaining focus on continuous improvement. &
The Theo Award celebrates its sophomore year, honoring 32 workers’ compensation programs for their excellence and service to workers across the nation. To learn more about the award and amazing qualities each winner possesses, visit here.
