Overview of The University of Texas Health Science Center at Houston Safety, Health, Environment & Risk Management (SHERM) Robert Emery DrPH, CHP, CIH, CBSP, CSP, CHMM, CPP, ARM Professor of Occupational Health The University of Texas School of Public Health Vice President for Safety, Health, Environment & Risk Management The University of Texas Health Science Center at Houston

Introduction The University of Texas System – 15 component institutions: 6 medical, 9 academic Total of 214,000 students, 90,000 employees Total annual operating budget $15.6 Billion The University of Texas Health Science Center at Houston (UTHealth) – Six graduate schools, psychiatric hospital, and 107 regional clinics 4,500 students, 5,000 employees $224 Million is sponsored research

How SHERM is Aligned Direct reporting to Executive Vice President for Academic and Research Affairs. Dotted line to Chief Business Officer Three main units – Environmental Health & Safety Biological, Chemical, Radiation Safety, Environmental Protection Programs – Risk Management & Insurance – Occupational Health

Safety Committee Guidance SHERM receives guidance and advice from several key committees – Safety Council – Radiation Safety Committee – Chemical Safety Committee – Institutional Biosafety Committee – SHERM staff are members of key committees such as IRB, IACUC, Classified Staff Council

How SHERM is Measured Four key performance indicators (KPI): KPI #1: Losses KPI #2 Compliance Personnel With external agencies Property With internal assessments KPI #3 Finances KPI #4 Client Satisfaction Expenditures External clients served Revenues Internal department staff

KPI #1: Losses Personnel – First reports of injury by employees, residents, students – Employee injury and Illness rate – Workers’ Compensation Insurance experience modifier Property – Losses incurred and covered by UTS Comprehensive Property Protection Program – Losses incurred but covered by outside party – Losses retained by UTHealth

FY14 Number of First Reports of Injury, by Population Type (estimated total population 11,398; employees: 5,868; students: 4,615; resident/fellows: 915) Total (n = 524) Employees (n = 243) Residents (n = 181) Students (n = 100) Oversight by SHERM

Total Number of Employee First Reports of Injury and Subset of Compensable Claims Submitted to UT System, FY03 to FY14 Number of reports without medical claims Number of reports with medical claims Oversight by SHERM

Annual UTHealth Incidence Rate of Reported Employee Injuries and Illnesses Compared to National Hospital and University Rates and Three Major Companies With Acknowledged “Best in Class Safety” Programs (national data source: US Bureau of Labor Statistics) Annual Reported Injury/Illness RatesAnnual Best In Class Rates

Workers’ Compensation Insurance Premium Experience Modifier for UT System Health Institutions Fiscal Years 03 to 15 (premium rating based on a three year rolling average as compared to a baseline of 1.00) UTHSCT (0.15) UTMB (0.13) UTHSCSA (0.11) UTSWMCD (0.13) UTMDACC (0.05) Oversight by SHERM Fiscal Year UTHSC-H (.07)

FY14 Property Losses  Retained Losses  Losses incurred and covered by third party – Auto --10/2013 $7,200 – Auto—11/2013 $22,500 – Auto---04/2014 $4,400  Losses incurred and covered by UTS insurance  Auto—10/2013 $2,300  Auto—02/2013 $2,500  Losses still in process of recovery from 3 rd party  Water---7/2012 $175,000 Retained Loss Cost Summary by Peril (Total FY14 retained losses, $129,000) Fire Auto TypeLocationDateCost Autofield10/07/2013$1,000 Autofield10/25/2013$7,000 AutoUCT11/20/2013$22,000 WaterUTP11/25/2013$93,000 WaterBBS12/26/2013$9,000 WaterNSH1/24/2014$12,000 WaterMSB2/28/2014$2,000 AutoSOD4/01/2014$5,000 Autofield5/11/2014$3,000 AutoMSB6/20/2014$1,000 FireNSH7/5/2014$3,000 LightningSFA8/01/2014$9,000 Misc $ 4,100 TOTAL$129,000 Lightning Strike

KPI #2: Compliance With external agencies – Regulatory inspections; other compliance related inspections by outside entities With internal assessments – Results of EH&S routine safety surveillance activities

External Agencies Inspections (Radiation Safety Program) DateAgencyFindingsStatus September 11, 2013 Texas Department of State Health Services Radiation Control No items of non-compliance (HMC, and Smith Tower, X-ray Registration R10908, two sites) Inspection file closed January 23, 2014 Texas Department of State Health Services Radiation Control No items of non-compliance (GPR dental at UTPB, X-ray Registration R10908) Inspection file closed February 14, 2014 Texas Department of State Health Services Radiation Control No items of non-compliance (UCT, Employee Health Services X-ray R10908) Inspection file closed March 27, 2014 Texas Department of State Health Services Radiation Control No items of non-compliance (Brownsville CRU, X-ray R10908) Inspection file closed July 7-8, 2014 Texas Department of State Health Services Radiation Control No items of non-compliance (two inspections, broad license TMC campus and Increased Controls license L02774) Inspection file closed

External Agencies Inspections (Biological Safety Program) DateAgencyFindingsStatus April 29, 2014Department of Transportation (Pipeline and Hazardous Materials Safety Administration) No items of non-complianceInspection file closed July 8, 2014 Centers for Disease Control and Prevention (Department of Select Agents and Toxins) Minor observations only; corrected collaboratively by EHS and lab personnel (Koehler) All noted deficiencies corrected and CDC inspection report acknowledged as closed August 12-13, 2014 Centers for Disease Control and Prevention (Etiologic Agent Import Permit Program) Minor observations only; corrected collaboratively by EHS and lab personnel (Soto) All noted deficiencies corrected and CDC inspection report acknowledged as closed

Internal Compliance Assessments 4,469 workplace inspections documented – Progression of routine surveillance program emphasis: labs, building fire systems, now mechanical and non-lab spaces – 3,330 deficiencies identified (81% in non-lab spaces) – 2,054 of these deficiencies now corrected to date through improved communications with FPE – Remaining 1,276 deficiencies (predominantly minor issues) subject to follow up correction: » Example: mechanical room deficiencies - unlabeled circuit breakers, missing outlet covers, etc. – Working with FPE to track and report progress and reporting progress to appropriate safety committees – 3,071 individuals provided with required safety training – 76% of PIs submitted required chemical inventories (up from 73% in FY13)

UT Physician Clinic Service Agreement Professional Services Agreement includes: – Training, radiation safety permitting & surveys, general clinic surveys, fire & life safety surveillance, waste management, emergency preparedness & response, IAQ evaluations, asbestos/mold monitoring, accident/incident investigations, CAP/CLIA quality control monitoring, etc. Challenges – Unprecedented growth and rapid expansion of clinical locations and services – Dramatic increase in manpower requirements for CAP/CLIA oversight and compliance, waste collection, occupational health services, training, etc. Opportunities – Possible parallel expansion of EHS services to include clinical safety, infection prevention/control

Dramatic Growth of UT Physicians

KPI #3: Finances Expenditures – Program cost, cost drivers Revenues – Sources of revenue, amounts

Campus Square Footage, SHERM Resource Needs and Funding (modeling not inclusive of resources provided for, or necessary for Employee Health Clinical Services Agreement) Total Assignable Square Footage and Research Subset Modeled SHERM Resource Needs and Institutional Allocations Research area (sf) Non- research area (sf) Institutional Allocation Amount Not Funded Contracts & Training WCI RAP Rebate *FY11 EHS assumed HCPC safety responsibilities.

Annual Hazardous Wastes Volumes Generated (in pounds) (Inclusive of all Hazardous Biological, Chemical, and Radioactive Waste Streams) Total Hazardous Wastes (pounds) Cost per pound associated with each waste stream reflects average cost obligation for offsite disposal

Total Hazardous Waste Cost Obligation and Actual Disposal Expenditures (inclusive of chemical, biological, and radioactive waste streams) Total Hazardous Waste Cost Obligation FY14 savings: $129,823

FY14 Revenues Service contracts – UT Physicians $235,212 – UT Med Foundation $28,474 Continuing education courses/outreach – Miscellaneous training honoraria $6,580 Total $264,344

KPI #4: Client Satisfaction External clients served – Results of safety question in Student Perception Survey for institutional reaccreditation purposes Internal department staff – Summary of ongoing professional development activities

Client Feedback Focused assessment of a designated program aspect performed annually: – FY03 – Clients of Radiation Safety Program – FY04 – Overall Client Expectations and Fulfillment of Expectations – FY05 – Clients of Chemical Safety Program Services – FY06 – Clients of SHERM Administrative Support Staff Services – FY07 – Feedback from Employees and Supervisors Reporting Injuries – FY08 – Clients of Environmental Protection Program Services – FY09 – DMO/ASL Awareness Survey of Level of “Informed Risk” – FY10 – Clients of Biological Safety Program Services – FY11 – Feedback on new UTHealth Alert emergency notification system – FY13 – Clients of HCPC Safety Program Services – FY14 – Student Perception Survey question regarding safety program

Student Perception Survey Total enrollment: 4,615. Number of respondents: 1,183 (26%) Exact Question on Survey: “UTHealth maintains adequate safety controls for possible hazards such as fires, infectious agents, chemicals, and radiation in my academic environment (classrooms or laboratories)”

Internal Department Staff Satisfaction Continued support of ongoing academic pursuits – leverage unique linkage with UT SPH for both staff development and research projects that benefit the institution Weekly continuing education sessions on a variety of topics Participation in teaching of continuing education course offerings Membership, participation in professional organizations Conducting a “Mentoring Day” where any interested staff member could meet with the VP SHERM to discuss professional development – will become an annual event

Other SHERM Activities Teaching – Academic instruction at School of Public Health – Guest academic lectures at other universities – Hosting undergraduate and graduate student interns – Support for student research projects Research – Recipient of grants for training emergency response workers – Listed as participant on other grant-funded research projects – Peer reviewed publications, book chapters, reports Service – Outreach education to practicing professionals – Invited university safety program peer reviews – Public education via mass media interviews

Summary Various metrics indicate that SHERM continues to fulfilling its mission of maintaining a safe and healthy working and learning environment in a cost effective manner that doesn’t interfere with operations: – Injury rates continue to be at the lowest rate in the history of the institution – Despite continued growth in the research enterprise, hazardous waste costs aggressively contained – Client satisfaction continues to be measurably high The major area of current institutional growth is in the clinical setting, so SHERM will need to adjust to support these enterprises, including re-negotiation of the UT Physicians service agreement. A successful safety program is largely “people powered” – the services most valued by clients cannot be automated! Resource needs continue to be driven primarily by campus square footage (total, lab and clinic square footage)