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Today, leadingspotlight-risk-champion-blog-edge organizations systematically share internal control knowledge across their organization, departments and functions to promote best practices and to minimize loss. Healthcare organizations, especially larger systems with multiple hospitals, clinics, freestanding outpatient surgery centers and urgent care units, are leading the way with this new approach using risk champions. “Risk Champions” help to create and maintain a system-wide risk management culture in all of their activities and departments using an embedded risk management framework to promote decisions that align with their overall risk tolerance strategy. Institutions such as the University of California and New York University have implemented such a program under their enterprise risk management programs and published their successes.1,2

The goal for creating such a system-wide risk-aware culture from a multidisciplinary system-wide staff is to identify, assess, and control risk, and then review the controls that are in place. The objectives are also to prevent and reduce loss, improve quality of care, maximize patient safety, reduce liability, and highlight risk management strategies.

Formation of a risk champion steering committee, consisting of loss control/risk managers, is critical to a risk awareness culture. The steering committee encourages risk management strategies to be shared throughout their healthcare system with the participation of facility-based risk managers and facility-based risk champions – the existing personnel/staff of each department. Embedded unit risk champions become the “boots on the ground” as well as the “eyes and ears” for the facility risk manager and the steering committee. A risk-aware culture can also help nurture a pool of potential future risk managers from existing facility staff.

Program creation process

The process of creating such an awareness culture initially should come from leaders at the highest level who incorporate the program into clearly defined annual goals. The risk champion steering committee should define the charter for the risk champion program. The charter should include the mission of the program, as well as the roles of the steering committee, facility-based risk managers and unit-based risk champion staff.

The steering committee oversees the strategy, tactics and logistics of creating and maintaining a risk management culture, proposes risk initiatives to implement, and monitors a metric tool for program assessment. Additionally, the steering committee creates a common language for managing loss and reducing risk.

Once the charter and general strategy of the implementation phase is well-defined, the steering committee members communicate this information to the respective facility risk managers. By doing so, the culture of system-wide risk awareness and management is communicated from the top down.

The goal for risk managers of each facility within a large healthcare system is to create a network of risk champions from the existing staff in every unit/department, including the emergency department, operating room, medical and surgical units, pharmacy, respiratory, etc. Risk managers would advocate for risk initiatives, communicate and educate champions, and encourage risk issues to be communicated from the specific units/departments.

Risk champion staff members can be volunteers or nominees within each unit/department who are interested in taking on the role of a risk management/loss control advocate. They are not experts in the field of risk management, but should be influential and respected staff members within the departments they represent. They should possess teamwork skills, effective communication skills, be allotted time to devote to the function and the ability to take actions to implement solutions. A good champion is a communication channel between the department staff, the facility risk manager and the steering committee.

Risk champions in action

One large healthcare system embraced the risk champion program by defining and ratifying their charter. Once strategy and logistics were defined in concept, the program was implemented in a pilot study with identified risk managers who, in turn, created a network of risk champions. The risk managers met with the group of champions for initial training, and maintained the program to create a system-wide culture of risk awareness. For this healthcare system, that meant the unit/department risk champions recognized unsafe or risky practices and took steps with the facility risk manager to reduce the risk/potential loss.

An example of risk awareness in the new program involved the dispensing of medications via the Pyxis system. A risk champion observed that two similar medication bottles were stored in sections right next to each other by brand names, potentially leading to a mix-up and medication error. The risk champion worked with pharmacy staff to rearrange bottles by their generic names. Thus, the similar looking bottles were no longer kept next to each other, reducing the possibility of medication errors.

Other areas of potential risk and loss, as defined by the Centers for Medicare & Medicaid Services, sparked initiatives for this healthcare system. Some of these included prevention of pressure ulcers, nosocomial infections, medication errors and falls.

The success for the program was assessed using a survey tool, the number of event reports generated monthly, and a decrease in the number of complaints or claims generated monthly. A pre- and post-risk champion Initiative questionnaire measured the change in the general staff’s awareness of risk and how they could be a part of minimizing loss. By proactively addressing risk issues and taking loss prevention measures before an event occurred, the facility hoped to increase quality of care through the participation of engaged risk champions.

Pamela E. Freiling, RN, BSN, LNC, Professional Liability Sr. Nurse Consultant

References

  1. Enterprise Risk Management: University of California. http://www.ucop.edu/enterprise-risk-management
  2. Enterprise Risk Management: New York University. https://www.nyu.edu/employees/resources-and-services/financelink/insurance-and-risk/enterprise-risk-management.html
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NJ_office_governor-states-opioidsState governments are responding to the opioid epidemic. Recently, the New Jersey governor signed new legislation that limits prescribers’ capacity to provide first-time opioid prescriptions for more than five days. The New Jersey state senate passed a law that went in effect earlier this month also requiring prescribers to document patient education regarding the risks of opioids and pain management plans and evaluate opioid prescriptions quarterly. And last year, the Arizona governor signed a law that required Arizona state-funded programs to limit first-fill opioid medication prescriptions to a 7-day supply in order to curb future drug addiction.

But governmental response is slow and often uneven. Businesses move faster, which is why it is critically important for payers of workers’ compensation benefits to provide resources for provider and patient education, limitations and oversight for comprehensive drug safety. The two key mechanisms for limitation: point-of-sale checkpoints and long-term prescription care intervention.

Point of sale

Responsible payers should have systematic checks and balances in place to identify and refer non-formulary prescriptions for clinician oversight and intervention. Items such as high-dose opioids, compound medications and high-risk drug classes should also be included for referral to a specially trained pharmacy clinician with the skills to identify problematic situations and discuss alternative care.

Long-term intervention

Payers should have arrangements with pharmacy networks in order to identify patients at risk for addiction or unintentional overdose. A team of uniquely trained nurses and doctors must be available to intervene when pharmacy data points to an at-risk situation. It is critical that payers hold patients and providers accountable for safe prescribing and responsible care. Truly connect with the pharmacy benefit management network. Enable automated indicators to identify problematic prescriptions and prescribers who practice outside the guidelines.

Our nation is in the midst of a drug epidemic. Lawmakers are responding, but the wheels of legislation move slowly. Lives are in the balance. Payers must be diligent in making sure that America’s workers are protected from dangerous drugs, prescribers and drug combinations. The right formula is to have systematic identification of dangerous scenarios and reliable, skilled follow up for rapid interventions and education.

Reema Hammoud, PharmD, BCPS, Director, Clinical Pharmacy

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carfentanil-elephantsCarfentanil  is a synthetic opioid that is 80 times more potent than fentanyl and 8,000 times more potent than heroin. Having been created and used as an elephant tranquilizer in China, it has now found its way into the hands of the public. This drug is so deadly to humans that it is considered a terrorist threat and was researched for years as a chemical weapon due to its potency. An amount smaller than a poppy seed is enough to kill a human; in 2002 Russian forces used it to subdue Chechen separatists at a Moscow theater.

The opioid epidemic has impacted the United States more than most other nations. More than 17,000 people die each year due to opioid overdoses. In the past year, carfentanil has hit the streets in our nation. There have been hundreds of law enforcement seizures of mass amounts of this new, super-potent opioid in multiple states. The internet sites that sell this drug abroad normally charge a few thousand dollars per kilogram of carfentanil, with no questions asked. Another dangerous aspect of carfentanil: it is being sold online as fentanyl. Law enforcement agents recently seized what was thought to be normal fentanyl later learned it was actually carfentanil re-labeled. This switch resulted in several deaths in the last three months of 2016.

But there is hope. Earlier this month, China enacted a game-changing law to ban not only carfentanil, but also its three less-potent cousins; furanyl fentanyl, acryl fentanyl and valeryl fentanyl. This move supports getting these drugs off the street and out of the hands of illegal distributors. China made a similar decision in 2015 to ban 116 drugs. As a result, seizures of the banned drugs plummeted in the United States. We can only hope that this same trend will follow the March 1 carfentanil ban.

The war on illicit and abused opioids needs to remain a top priority as scientists and chemists continue research and creation of new potent synthetic opioids.

 
Luke Parnell, pharmacy program liaison

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LMSA-NFMSA-questionsFor the past several years, the Centers for Medicare & Medicaid Services (CMS) has been providing the industry with vague hints about liability Medicare set-aside arrangements (LMSAs). The absence of clarity left the liability community unable to know how Medicare set-aside arrangements (MSAs) would apply in a liability setting.

Earlier this month, CMS released a communication to providers, physicians and suppliers indicating that LMSAs and no-fault Medicare set-aside arrangements (NFMSAs) will be implemented October 2, 2017. Aside from learning a new acronym, the communication did not contain any particulars about how this process is going to work, only that new processes and procedures would be forth coming. Until CMS provides more details, stakeholders are left wondering how this is going to affect their liability and no-fault claims. With promised details forthcoming, here are my primary questions and concerns:

  1. How are we going to address liability cases with grave injuries, but low liability? Will CMS see these cases as zero LMSA situations because clearly there was no future medical taken into consideration for the settlement? Or (more likely) is CMS going to price out an extremely high MSA on a low dollar settlement and force the parties to figure it out?
  2. How is CMS going to price MSAs? Is it going to assume that the parties have accepted the responsibility for lifetime medical expense, as in workers’ compensation? Will CMS recognize there is nothing in the law that indicates that the defendant is responsible for lifetime medical expenses when litigating or settling a liability case?
  3. What medical records is CMS going to require? Unlike workers’ compensation, there are no payment histories in liability, so how is CMS going to verify what drugs and treatments are related to the liability case?
  4. How will CMS determine the relevant body parts in a liability setting? In workers’ compensation, there are forms and processes for only litigating a relatively narrow list of body parts. In liability, we have broad injury allegations coupled with medical records that are alleged to relate to the incident. But who and how are these medical records going to be interpreted to determine the reality from the plaintiff’s claims? Will CMS accept deposition testimony, expert witness testimony, interrogatories, etc. to disprove some of the medical treatment?

This is a first list of questions that will grow as Sedgwick continues to evaluate the requirements and create best practices to drive optimal outcomes for our clients and consumers. We will continue to monitor the situation and work with our industry partners (MARC, carriers, clients and CMS contacts) in order to provide additional analysis and revise our best practices. We will watch CMS for additional details and we will continue to share information and recommendations in this area.

Michael R. Merlino II, ESQ, SVP, Medicare Compliance

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ACP logoSedgwick is proud to support the Association of Claims Professionals (ACP) to advance our industry and sustain future growth and positive outcomes. The companies that make up the ACP are leaders in the claims management industry and include independent claims adjusting companies and third party administrators. ACP companies respond every day to individuals and businesses who suffer a loss such as a workplace injury, property or casualty damage, or liability. For the consumers in our industry, the ACP member companies help them recover from such a loss. For carriers and self-insured employers, ACP member companies act as strategic business partners and trusted advisors, providing professional claims services integral to risk management. ACP member companies provide a full range of claims services from claims adjusting to comprehensive claims management.

As the ACP site explains, the organization exists to:

  • Champion the growth of our industry and the recruitment of diverse, workforce-ready talent to meet our future needs.
  • Share best practices, information, tools, and educational resources that support our industry leadership and service excellence.
  • Monitor the national landscape for market shifts and help their membership maintain a sustainable competitive advantage.

In our Insights for 2017, we see regulation transformation as one of the key issues facing the industry this year. The ACP and Sedgwick both support the CLAIM Act that is designed to address inefficiency, redundancy and lack of consistency for claims adjusting by calling on states to adopt uniform, reciprocal licensure where an adjuster license is required. The Act aims to preserve state oversight and regulation to ensure consumers have timely, efficient and cost-effective claims services, and to remove barriers to efficient claim processing.

Sedgwick colleagues are highly trained professionals who are committed to providing the best service to the people we interact with each day. That is why we are a member of the ACP; we encourage you to learn more about ways the association and fellow members are working to ensure our industry stays strong and healthy by visiting the ACP website at www.claimsprofession.org.

Kimberly Brown, SVP, Government Relations

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Health HealthaffairsAffairs is the leading peer-reviewed journal addressing health, health policy and health care – including cost, quality and access. Since the early 1980s, health research published in the journal has been used to shape policy nationally. To my fellow health wonks and I, Health Affairs is a must read. I am proud that Sedgwick sponsored the February 2017 issue of Health Affairs. This special issue is meaningful to Sedgwick and our clients, as it is dedicated to shedding light on The Work/Health Relationship.

As Health Affairs wrote in their February 7 blog, “Work conditions can affect employees’ physical and mental health, and worker productivity can be affected by the demands employees face after returning home from the office.” The collection of papers included in the issue explores the evolving and complex relationship between employers and employee health and specifically the impact of health on work. During the February 7, 2017 briefing at the National Press Club in Washington, D.C., it was refreshing to hear researchers share their interests and insights into health, absence and workplace accommodations – all subjects deeply important to today’s business.

Some of the findings mirror issues we identified in our Insights for 2017 blog:

  • Employers are offering expansive benefit solutions. Health and benefit managers understand the link between member/patient experience and engagement in health. This issue advances thinking around the impact of health on work and importance of a productive, functional life at work and home as part of healing and general health. Jean Abraham, Wegmiller Professor in the Division of Health Policy and Management, School of Public Health, University of Minnesota presented her paper “Tracking The Changing Landscape of Corporate Wellness Companies.” It describes the business case for wellness and how improvements in worker productivity and engagement translates to business performance.
  • Ron Z. Goetzel, vice president of health and productivity research at Truven Health Analytics, senior scientist at the Johns Hopkins Bloomberg School of Public Health, and Chris Calitz, director of the Center for Workplace Health Research and Evaluation at the American Heart Association, provide a fascinating look at workplace programs, policies and environmental supports to prevent cardiovascular disease. Their research relates efforts to address comprehensive cardiovascular health risks with disease prevalence and medical expenditures.
  • An intriguing study by Robert K. McLellan, section chief of the Department of Occupational and Environmental Medicine at the Dartmouth-Hitchcock Medical Center and professor of medicine at the Geisel School of Medicine at Dartmouth, analyzes “Work, Health, and Worker Well-being: Roles and Opportunities for Employers.” The research appropriately acknowledges occupational hazards while addressing the costs of poor workforce health are collectively shared across workers and business.  A road map to work, health and well-being is included in the paper.

The depth of the papers is impressive and the topics cross a broad spectrum including the relationship between work and health, wellness programs, worker productivity, workers’ use of health services, work effects on health, job retention and health, insurance and ACA. The February issue of Health Affairs, The Work/Health Relationship, challenges us to think beyond work, productivity and health in silos and begin to evolve our thinking around integration of work and health and ultimately their impact on business performance. I encourage you to learn more about the February issue and Health Affairs at www.healthaffairs.org.

Next Wednesday, February 22, 2017, a similar issue briefing will take place in San Francisco. Those interested in attending in person or via webcast can register here.

Thank you, Sedgwick, for supporting The Work/Health Relationship issue alongside our co-sponsors, Integrated Benefits Institute and UnitedHealth Group.

Kimberly George, SVP, Corporate Development, M&A, and Healthcare

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laptop-return-to-workThe power of the process

Consistently using the Official Disability Guidelines (ODG) in workers’ compensation return to work management is a good industry practice, but there’s power in taking a step beyond. Investing additional time to fully understand important factors about the person impacted by injury – and then using that information to foster the right experience tailored for the individual within guidelines – is a best practice and shows how caring counts in the recovery process.

Recovery is generally delayed when an individual with pre-existing personal health conditions has an injury on the job. It is important to document personal health conditions and modify the claims management strategy in order to best meet the injured employee’s needs. The term “comorbidity” is often used in connection with “personal health condition.” Common comorbidities that may impact healing time are diabetes, auto-immune disorders, obesity, cancer, smoking and age. When handling claims, it is critical to know the number of days before the individual can safely get back on the job. A comorbidity calculator combines multiple diagnosis codes and influencing factors to give claims examiners and nurses an evidence-based disability duration.

Successful return to work management must also include the following factors in order to properly guide each injured individual safely back to their pre-injury job:

  • A documented plan with a return to work date on target with disability guideline calculations
  • Routine identification of behavioral health concerns included as part of early investigations and documentation, helping to engage behavioral health services and mitigate recovery delays
  • Treatment provider awareness of any pre-existing and unrelated medical conditions
  • Diligent prescription drug oversight – claims examiners and nurses should document the use of opioids, muscle relaxants and drug combinations from one or multiple prescribers, as these can prolong recovery and return to work
  • Strategic treatment planning and oversight by a clinician in order to keep full recovery on track
  • A claims examiner, nurse or return to work specialist working in one system for continual clarification and confirmation of actions and shared strategies

Claims examiners and nurses should carefully educate the injured employee about the recovery experience and partner with them to set and support return to work goals. Provider education regarding evidence-based care and safe return to work will also help with treatment planning. In addition, claims examiners should use evidence-based decision support for accurate claim reserving.

With ODG as the driver and personalized planning as the catalyst, delivery of care takes on a much more holistic approach. Following this process can make us more impactful advocates as we help restore injured employees to their daily lives and pre-injury work safely, quickly and effectively.

Robin Moleski, RN, BSN, CCM – VP, Clinical Operations

Read more in the edge magazine: Communication and teamwork: Keys to a successful return to work

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It’s a topic that gets much buzz – how will the cloud of legislation surrounding recreational and medical marijuana use impact businesses, specifically when it comes to compensability for workers’ compensation? I am sure you have all caught up on news about additional states voting to legalize marijuana for medical use and adult recreational use during the Nov. 2016 election. Let’s take a look at those changes, as well as what action they may prompt to shake up the state and federal status quo.

After receiving certified results of a state recount, 2016 closed with Maine Gov. Paul LePage issuing a proclamation of the Referendum Question 1 vote that allows recreational use of marijuana by those at least 21 years of age. Maine joins Alaska, California, Colorado, Massachusetts, Nevada, Oregon, Washington and the District of Columbia in voting to legalize marijuana for adult recreational use. Arizona was the only state where voters rejected a legalization measure during the November election.

With the passage of ballot initiatives in Arkansas, Florida and North Dakota, medical marijuana is now legal in 28 states and the District of Columbia, Guam and Puerto Rico.

An additional 17 states have laws that only allow the use of “low THC, high cannabidiol (CBD)” products for specified medical conditions. The National Conference of State Legislatures provides a summary of those state laws here.

Stickiness in the states

Despite the increase in the number of states that have legalized the medicinal use of marijuana, the impact on workers’ compensation claims was limited until about three years ago.

In 2014, New Mexico became the first state to have a state appellate court order a workers’ compensation insurance carrier to provide reimbursement to an injured worker for medical marijuana. The New Mexico Workers’ Compensation Administration began requiring employers and insurers to reimburse injured workers when the state’s healthcare provider fee schedule took effect Jan. 1, 2016. The trend continues to grow.

In two recent decisions, the Appellate Division of the Maine Workers’ Compensation Board affirmed two different administrative law judge (ALJ) awards reimbursing workers for their medical marijuana expenses, Bourgoin v. Twin Rivers Paper Co. and Noll v. Lepage Bakeries.

On Dec. 15, 2016 an ALJ in New Jersey issued an order in Watson v. 84 Lumber requiring reimbursement of an injured worker for medical marijuana payment. It should be noted that this is a division level case, so this decision is not binding on other New Jersey courts. The case is not being appealed.

It is noteworthy that in each of the above cases:

  • Marijuana was recommended by physicians only after other treatment regimens for chronic pain were attempted without success, and
  • These judges were not persuaded by the fact that marijuana remains illegal under federal law.

Federal haze

While there has been some activity on the federal side over the past year, it has not changed the fact that marijuana, even for medicinal use, violates federal law.

Marijuana remains illegal under federal law because it is listed under Schedule I in the Controlled Substances Act (CSA), along with other drugs such as heroin. Schedule I substances are illegal to distribute, prescribe, purchase, or use outside of medical research due to “a high potential for abuse” and “no currently accepted medical use in treatment in the United States.” As a result of this status, physicians recommend the use of marijuana instead of prescribe.

On July 19, 2016, the Drug Enforcement Administration (DEA) denied two petitions to reschedule marijuana concluding that it continues to meet the criteria for control under Schedule I because:

  • Marijuana has a high potential for abuse. This is based on the Department of Health and Human Services (HHS) evaluation and additional data gathered by DEA.
  • Marijuana has no currently accepted medical use in treatment in the United States. Using an established five-part test, it was determined that marijuana has no “currently accepted medical use” because, as detailed in HHS evaluation, the drug’s chemistry is not known and reproducible; there are no adequate safety studies; there are no adequate and well-controlled studies proving its effectiveness; the drug is not accepted by qualified experts; and the scientific evidence is not widely available.
  • Marijuana lacks accepted safety for use under medical supervision. At present, there are no U.S. Food and Drug Administration (FDA)-approved marijuana products, nor is marijuana under a New Drug Application (NDA) evaluation at the FDA for any indication.

Interestingly, the DEA noted that marijuana could not be placed in a schedule less restrictive than Schedule II in view of U.S. obligations under international drug control treaties.

Although marijuana is not being rescheduled at this time, on Aug. 11, 2016 the DEA announced a policy change meant to increase research by expanding the number of DEA-registered facilities allowed to grow and distribute marijuana for FDA-authorized research purposes.

Currently, the U.S. Department of Justice (DOJ) marijuana enforcement policy is to allow states to create their own “strong, state-based enforcement efforts,” but DOJ reserves its right to challenge the states’ legalization laws at any time necessary.

Congress passed the Consolidated Appropriations Act (CAA) of 2016 that in Section 542 restricts federal law enforcement activity in states that allow medical marijuana cultivation, distribution, and use. Now that voters in half of the states have voted for legalization of medical marijuana, will Congress take action to change its scheduling?

The new administration may change the broad leeway states have been given to regulate marijuana usage and sales.

  • President Trump has expressed varying views regarding medical and recreational marijuana over the years.
  • Attorney General nominee Sen. Jeff Sessions, a former federal prosecutor, has expressed opposition to medical and recreational marijuana.
  • Tom Price, a physician and nominee for Health and Human Services Secretary, has also been a vocal opponent of legalization.

If the conflict between federal and state law is not resolved politically, the U.S. Supreme Court may have the last word. The high court last weighed in on marijuana in 2005. In an unsigned opinion issued March 2016, the high court refused to hear a request from Nebraska and Oklahoma to declare Colorado’s legalization of marijuana unconstitutional because it is against federal law and therefore violates the Constitution’s supremacy clause, which states federal law trumps state laws. Justices Alito and Thomas dissented. Will President Trump’s nominee to the U.S. Supreme Court make a difference?

Yes, the future of federal marijuana policy and enforcement remains hazy. What is clear is that employers contending with this complex and rapidly changing issue must understand the laws and relevant legal decisions pertaining to marijuana in each of the states where their business operates.

In such an uncertain time, we will continue to provide updates and perspective. We recommend seeking legal assistance to develop a sound company policy addressing the use and reimbursement of medical marijuana for on-the-job injuries.

Darrell Brown, Chief Claims Officer

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Brian Gifford, PhD, Director of Research for IBI, discusses paid parental leave trends.

Brian Gifford, PhD, Director of Research for IBI, discusses paid parental leave trends.

On January 18, I attended the Integrated Benefits Institute (IBI) Paid Parental Leave and LOA Regional Event in San Jose, California. The topic of the day was the emerging trend of adopting paid parental leave policies and how employers are balancing their leave of absence policies with business goals. The event was well attended by employers and service providers and featured some of Silicon Valley’s top employers and leading industry researchers.

As I listened to the research presented by IBI, I was reminded of Sedgwick’s caring countsSM philosophy. IBI’s research revealed that employers are moving toward offering paid parental leave because they want to care for their employees, create family-friendly workplaces and build policies that are in line with prevailing social expectations. These employers care and, as a result, they are confident that offering an enhanced benefit will lead to more committed and loyal employees. Silicon Valley employers have used these policies to win the “war for talent” in a very competitive technology market and early results appear to be positive.

Brian Gifford, PhD, Director of Research for IBI, discussed the emergence of paid parental leave as a corporate priority. Brian opened by showing a map of the world and sharing that the United States is one of the only developed nations to not guarantee paid parental leave for employees. With all of the innovations that American businesses offer, why can’t we lead the charge and support parents in the workplace?

Until recently, research showed that paid parental leave has had limited national attention, yet it seems to remain on the upswing. Tabulating specific major media reports over a seven-year period, the research noted events that provoked and set in motion a more sustained effort to normalize paid parental leave. These events included Yahoo hiring Marissa Mayer as CEO when she was pregnant; the publication of the book Lean In: Women, Work, and the Will to Lead by Sheryl Sandberg, Facebook’s COO; Mark Zuckerberg, Facebook’s CEO, taking two months off when his child was born; and the important White House Summit on Working Families in 2014. Mix in a thriving NASDAQ market, low unemployment in the tech industry, an imbalance in gender representation in science, technology, engineering and math careers, and changing state and local mandates, and it is no surprise that paid leave is gaining traction. With companies such as Netflix, Adobe, Microsoft, Amazon, Spotify and Paypal announcing expansions to their paid family leave policies, and states and municipalities including New York and San Francisco mandating paid parental leave, many employers find themselves assessing what to do to stay competitive and ahead of the regulatory curve.

Representatives from Intuit, Adobe and Facebook answered questions and offered advice. All of these employers have policies focused on caring. Although the policies vary in scope and scale, they all started by trying to achieve a business goal and balancing new parents’ time off from work with other business imperatives. It seems simple to “do the right thing” and be a company that cares, but the challenges come when it is time to formalize and administer the policies.

Key lessons from the panel and others participating in the research included:

  1. Design the policy for what your business is trying to accomplish
  2. Leverage FMLA and disability experiences to help maintain business performance
  3. Focus on improving return to work experiences

A paid parental leave policy can be a win-win when it comes to employee benefit enhancements. Sedgwick’s absence management platform is designed to help employers administer various types of leave and support employees as they return to work. The key is to ensure that all programs and policies are designed with a primary focus – taking care of the employee. As a husband and father, I believe that employers moving toward paid parental leave will win…because caring counts.

Is your company considering adopting a paid parental leave policy? We are happy to work alongside you and find ways to address your challenges. If you already offer paid parental leave, we would like to hear about the benefits your business is seeing. Please share your comments with us.

Todd J. Squiers, Director, Client Development

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On December 8, I hosted a webinar along with Donna Hardaker, former Director, Wellness Works Mental Health America of California and Heather Holladay, Integrated Health Manager Pacific Gas and Electric Company. It was a fantastic discussion on a topic which needs much more attention: stigma and social prejudice toward employees with mental health challenges. If you were not able to attend, you can revisit the recorded webinar and our presentation slides.

The statistics and research findings are compelling: Approximately 1 in 5 people is dealing with a mental health situation on a daily basis, and studies show that people with depression have a 2.5 times higher risk of on-the-job injury. [1] Mental health challenges, regardless of whether they are situational or chronic, are fraught with societal stigma, which stifles diagnosis, treatment, open dialogue and awareness of mental health and caring for those impacted.

The workplace is no different, and some argue even greater stigma occurs at work among peers and leadership, which in turn impacts absence and productivity. In fact, in 2015 the National Survey on Drug Use and Health found that just over 35% of respondents cite social concerns as reasons for not receiving mental health services, second only to cost of care at over 45%. Even more specifically, 9.5% indicate getting care might create a negative image of them in the workplace. [2]

Employers have begun to address cultures of health and well-being in a variety of ways to improve workforce and employee health, impacting health and disability costs and employee engagement and experience. Eliminating mental health stigma and social prejudice is just one step in this broader initiative. Increased education and awareness in the workplace can help eliminate labeling and misconceptions that create barriers to those seeking mental health treatment or other accommodations.

As an employer, what steps can you take as you examine your workplace culture? I offer three areas we can begin to dialogue about in today’s blog. As the year progresses, we will address these and explore even more ways we can break down the barriers.

  • Integrating physical and mental well-being. Separate silos for physical and mental health are dissolving: benefits managers and risk managers alike are promoting a culture of health and tapping prevention-oriented strategies commonly available in group health plans (i.e. stress reduction, work/life balance, EAP). Education campaigns are raising awareness, and putting mental wellness on equal footing with physical health.
  • Educating managers and supervisors. Organizations are training managers and supervisors to better understand mental health conditions, to identify and address behaviors that might warrant outreach, and to reduce stigma surrounding mental health needs.
  • Stamping out stigma. Employees need to feel that requests for help will not be penalized and will produce real benefits. Some organizations are implementing peer advocate and peer support programs, positioning people who have successfully overcome stigma, societal predjudice and other challenges in their own lives as inspiring champions for their co-workers.

I encourage you to take the first step in understanding – download the Disability Management Employer Coalition (DMEC) “Mental health in the workplace” white paper we discussed on the webinar in December.  Sedgwick partnered with DMEC and Pacific Resources to create a great resource of information to help your organization get started on its journey.

http://dmec.org/wordpress/wp-content/uploads/Mental-Health-in-the-Work-Place_FINAL.pdfI hope part of your 2017 work resolutions will be to address this important issue and join us in our work to eliminate stigma and prejudice toward employees with mental health challenges. Think about it: what barriers and issues do you see in organizations? What ideas do you have for addressing them? Please leave me your comments, questions and suggestions, and we will try to incorporate them into a future post.

Bryon Bass, SVP, Disability and Absence Practice & Compliance