The New Work Reintegration Program Transportation Safety Group May 18, 2011 Gail Kovacs, Director and Practice Lead, Work Reintegration Program Development Workplace Safety and Insurance Board WSIB has recently introduced significant change to it's return to work and labour market re-entry programs and policies, now called "work reintegration". These changes are designed to improve quality, satisfaction levels, and employment outcomes. They will also reduce costs. This session will describe the anticipated impacts of the new program."

The Legislative Mandate of the WSIB The WSIB operates within a defined legislative mandate. That mandate is comprised of four key elements, which can be summarised as follows: To promote health and safety in workplaces To facilitate the return to work and recovery of workers To facilitate the re-entry into the labour force of workers and spouses of deceased workers To provide compensation and other benefits The existence of this legislative mandate sets clear parameters in which the WSIB must operate Bill 160 – Education Quality Improvement Act – amendment to WSIA mandate 4 key elements from: 1. To promote health and safety in workplaces and to prevent and reduce the occurrence of workplace injuries and occupational diseases. 2. To facilitate the return to work and recovery of workers who sustain personal injury arising out of and in the course of employment or who suffer from an occupational disease. 3. To facilitate the re-entry into the labour market of workers and spouses of deceased workers. 4. To provide compensation and other benefits to workers and to the survivors of deceased workers

Case for Change Duration had increased at every window The number and level of locked-in LOE awards had been rising The WSIB’s Return to Work (RTW) and Labour Market Re-entry (LMR) programs had limited success with overall poor employment outcomes for injured workers Injured workers concerned about “retraining for jobs that don’t exist” Employers concerned about escalating costs Too many injured workers not being re-employed with injury employer and the cost of LMR was transferred to the Unfunded Liability (UFL): - 77% of workers in LMR had re-employment rights but did not RTW with the injury employer - 48% of LMR cases have SIEF relief, at an average of 66% - most workers enter LMR just before or after the ER window closes

Value for Money Audit Recommendations Integrated Work Re-integration Model Employer Accountability Cost Management Service Quality Worker Input and Choice Complaint Management Integrated Work Re-integration Model – WR Model completed Employer Accountability – Policy 19-02-02 (non-cooperation penalties) and new draft NEER 13-02-02(3->4 yr NEER window) Cost Management - New service level agreements will include greater provider accountability for quality and cost effective services, including secondary provider services. WSIB has implemented fixed fees and outcome based performance incentives Service Quality - WSIB will work with the MTCU, PSPs and SSPs to ensure consistent methods to improve the quality of services for injured workers provided by all parties. The new provider contracts will include improved requirements and enhanced monitoring to ensure service quality. Worker Input and Choice – for SO and school Complaint Management - formal complaint process that is responsive and independent will be developed and implemented by Q2, 2010.

Leading Practices in WR Focus on “ability” rather than “disability” Employer accountability for work reintegration Worker centric work reintegration principles and approaches Worker self-determination Incentive programs for employers to retain or hire injured workers Benefit schemes that remove long-term benefit dependency Enhanced case management approach Professionalization of staff responsible for work reintegration service to injured workers

Work Reintegration (WR) Model The Vision – Reintegration into decent, safe , and sustainable employment, maintaining the dignity of the worker The Goal - Employment. The Principles Maintain the employment relationship, wherever possible, between the worker and the injury employer, all parties have a shared obligation. Provide effective and meaningful input and choice on the part of the worker, Maintain high standards for services provided by WSIB staff, contracted parties, to ensure effective, quality services that achieve desired employment outcomes. Manage the costs of the program but do not be managed by the cost. Ensure workers are fairly compensated for wage loss, recognizing the difference between pre-injury earnings and post-injury earning ability.

New and Improved Features Employer support with disability management programs Early intervention in RTW and work transition (WT) Retraining to remain with injury employer Active engagement of injury employer Accommodation requirements Penalties for employer non-cooperation More pathways for workers 19-02-02: Accommodation All employers have a duty to modify the work or the workplace to accommodate the needs of the worker to the extent of undue hardship. This duty arises through the obligation to re-employ set out in the Workplace Safety and Insurance Act or the associated Construction Regulation, and/or the Ontario Human Rights Code (the Code) or the Canadian Human Rights Act.   If a job becomes available that can be made suitable through accommodation, and the accommodation does not cause the employer undue hardship, the employer must provide the accommodation. A worker’s accommodation requirements may be temporary or permanent. During the RTW process, employers and, when relevant, unions and workers are expected to comply with human rights legislation and associated policies. The Code guarantees equal access to employment opportunities to any person with a disability, whether such disability is work or non-work-related. Pursuant to the Code, if a person with a disability requires accommodation to perform the essential duties of a job, the employer must provide accommodation unless to do so would cause the employer undue hardship. To assist in determining undue hardship, the WSIB refers to the Ontario Human Rights Commission’s (OHRC) Policy and Guidelines on Disability and the Duty to Accommodate. Since relevant human rights legislation also protects workers from discrimination on grounds such as disability, race, religion and sexual orientation, employers may have accommodation requirements during the RTW or WT process in addition to those related to the work related-impairment.

New and Improved Features Worker choice / motivation and cooperation defined Program time limits Recognition that part-time employment may be the best option Relocation assistance Employment placement and retention support services Expanded Experience Rating window (3 4 years)

Roles within WR Program Case Manager Set RTW and recovery goals and make appropriate decisions based upon legislation, policy and good practices Plan activities in collaboration with the workplace parties, complete with dates, milestones, and best outcomes required to achieve RTW and recovery and create a service plan to achieve the best outcome and enable timely follow-up and effective monitoring Co-ordinate and take action on planned activities and timely interventions and ensure workplace parties are well informed about what is happening, who is accountable, and what to expect Return to Work Specialist Facilitate return to work by educating workplace parties on return to work principles and best practices, the benefits of return to work and services available, the return to work process, the employer's and worker's rights and obligations under the Workplace Safety & Insurance Act and relevant policies and procedures as well as available resources Identify and clarify issues relevant to the RTW process and any other matters that present barriers to RTW or are pertinent to the case Offer dispute resolution services such as mediation when education and guidance has not resulted in a successful return to work Establish the RTW goal and the intervention(s) to overcome obstacles to positive RTW outcomes

Roles within WR Program Work Transition Specialist (New) Provide expert advice, direction, vocational rehabilitation counselling and support workers and employers to coordinate the work transition process Identify appropriate and realistic work transition options for workers, such as direct job entry or skills training, part-time employment, training on the job or direct job placement assistance Employer Liaison Specialist (Refocused) Assisting workplaces in understanding sector profiles and how to use them to improve their disability management and RTW programs Providing workplaces RTW and duration trends, information, data and analyses to assist them in developing and implementing effective programs and approaches which will improve disability management and return to work and positively impact persistency and injury rates. Encourage and assist workplaces to build a network of job opportunities within own industry and identify placement opportunities to link workplaces to each other for disability management and return to work purposes

Work Reintegration Touch-points Initial meeting between worker, CM & WTS – between 6-9 months WTS meeting @ workplace with WPPs Vocational Assessment completed, if needed Vocational Assessment discussed with WPPs WT Plan approved – no later than 1yr Adjust and amend WT plan, as required WT plan closure and RTW outcomes communicated CM addresses RTW barriers RTWS meeting @ no later than 12wks DOI ELS assist with RTW Program Development, as needed CM = Case Manager WTS = Work Transition Specialist ELS = Employer Liaison Specialist RTWS = Return-to-Work Specialist WPPs = Workplace Parties

Work Reintegration (WR) Policy Overview Five interim principle-based WR policies and one draft NEER policy came into effect on December 1, 2010 and were developed to support the WSIB’s new WR program Interim WR policies replace 24 existing policies covering ESRTW, re-employment and LMR Intended to produce better return to work outcomes Emphasis on greater accountability by workplace parties, and early WSIB involvement with ongoing support

Overview of Key Policy Concepts Key Concepts New/Re-emphasized Retained Maintaining pre-injury employment relationship  Timely work transition assessments Increased worker input and choice Part-time or partial work capacity More work transition pathways Reasonable investments in retraining Enhanced WT for young workers Older worker option Relocation assistance WSIB’s role in supporting workplace parties Accommodation support for small business Suitable work (streamlined definition) Available work Accommodation requirements (streamlined) Worker and employer non-co-operation penalties and employer re-employment penalties All of the prior re-employment policies, including 19-04-04, 05, 06, 07, and 10, have been deleted and been replaced by 19-02-02

WPP Non-Co-operation Penalties Initial Penalty Full Penalty Start of Penalty Initial penalty applied seven business days after date of written notice of non-co-operation If non-co-operation continues, full penalty applied 14 calendar days after initial penalty Amount of Penalty —Worker Wage loss benefits reduced by 50% Wage loss benefits suspended, or if worker in WT, reduced to reflect the earnings of an experienced worker in the SO Amount of Penalty —Employer 50% of the cost of wage loss benefits to the worker 100% of the cost of the worker’s wage loss benefits, plus 100% of any costs for providing WT services to the worker Penalty ends Initial penalty ends when workplace party renews co-operation, or after 14 calendar days, whichever comes first* *for employers, initial penalty can also end if no further benefits are payable to the worker Full penalty (worker) continues until worker starts co-operating Full penalty (employer) continues until the earliest of employer starts co-operating date no further benefits are payable to the worker, or 12 months following date written notice comes into effect

Re-employment Penalties Length of Obligation Effective Date and Amount of Penalty Penalty Reduction Worker fit for essential duties of pre-injury job Earliest of two years after date of injury one year after fit for essential, or date worker reaches 65 years of age Penalty applied seven business days after date of written notice Amount of penalty is actual amount of worker’s net average earnings for year before the injury* Penalty reduced by 50% if employer later offers suitable work at no wage loss, or 25% if employer offers suitable work at a wage loss where the employment is maintained for the remainder of the obligation period Worker only fit for suitable work two years after date of injury, or *Apportioned based on time left in obligation period 50% if employer later offers “less” suitable work at no wage loss 25% if employer offers “less” suitable work at a wage loss

Performance Measurement: Introduction: Institute for Work and Health (IWH) assisted in building the performance measurement and evaluation framework Reporting has commenced and more will come Data is building and maturing as more cases enter new program Program is being refined based on early experience Purpose: To know if we’re doing better Understand if our activities and strategies are producing intended results To adjust and make mid-course corrections Ensure success

WR Performance Measurement: Levels of Monitoring and Reporting: Establish accountability for results throughout the organization: At the Corporate level At the Business line/Divisional level At the Team level At the Individual level At the Process level (including provider) Methods: Information/data analysis Audits Case Provider Surveys Annual Ipsos Reid Continuous by WSIB Dimensions: Quality Programs Effective (correct, complete, results-oriented) Efficient (timely and streamlined processes and services) Credible Individualized Responsive Integrated (activities/services) Customer Service Perceived program value Timeliness of service and decisions Responsiveness to issues e.g. complaints Achieved outcomes/quality Transparency Fairness Ongoing engagement and communication Cost Effectiveness Demonstrated value for money Managed costs (accountability) Expenditures within forecast WR Program Performance Measures

Measurement Criteria We have a comprehensive set of performance measures, for all dimensions and levels. Some of the key measures are: # and % of injured workers who RTW with injury employer and overall # and % of injured workers who RTW within 3, 6, 12 months and 2, 4, & 6 years Injured worker and employer satisfaction with WR services Employed rate at end of work transition program Costs of program vs. Benefit costs saved/avoided Average cost of Work Transition programs overall and per employed worker % of 100% LOE and overall average LOE at lock-in Next Steps: We’ll be preparing a quarterly report to share with stakeholders We want to obtain stakeholder input into the Logic Model and will be firming up plans for this in May 2011

WR Program Quantitative Benefits Early Intervention Reduced Volumes Older Worker Pathway Reduced average referral time from 21mths for LMR to 9mths for Work Transition = 12mths LOE Alignment of incentive programs WSIB active support in workplace to locate suitable work = LOE Increased usage of statutory lock-in for workers over 55yrs+ = LOE

WR Program Quantitative Benefits 4. Time limits for retraining 5. Provider Fees 6. Annual Operating Costs Reduces average program length by one month = 1mth LOE Fixed fees for next 2-4 years = cost control Elimination of Primary Service Providers = operating costs

WR Model Qualitative Benefits Better integration with case management; increased agility to respond to performance trends; Significant reduction in perverse influence of profit motivation on program behaviour Increased simplicity of communication and co- ordination of services between WSIB and workers Increased clarity of accountability Greater assurance of workers getting the service they need when they need it

WR Model Qualitative Benefits Significantly improved quality of education and training, giving workers credible credentials to seek employment Provides for workers to have more self determination in vocational choices Increased consistency of services provided in similar circumstances Improved management of expectations and provides for a reasonable level of investment within clear cost parameters

Work Reintegration Division Vice President Judy Geary Exec. Assist. Nicole Lindo Exec. Sec. Christine Servello Summer Student (3) - TBD Director, WRP Development and Practice Lead WRP – Gail Kovacs Director, Program & Provider Effectiveness – Linda Kelly Business Assistant (Shared) - Alana Gregoire Manager Program Development (1) Manager, Labour Market Information(1) Manager, Strategic Adult Education Alliance(1) Manager, Quality Management – Maddy Roppoli Manager, Evaluation – Sophia Voumvakis Quality Management Specialist (8) – Fil Viviani, Nina Hadjas, Denise Chai-Chong, Michelle Beehari Sr. Information Analyst (2) – James Brinker Matthew Griffin Program Development Specialist (3) – Labour Market Information Specialist (4) Program Development Specialist (1) Information Analyst (1) Contract Manager (2) – Program Evaluation Analyst (2) – Complaints Officer (2) – Breda Neher 4/17/2017

Work Reintegration Division approach To do “with” and not “for” or “to” Stakeholder identification and engagement processes Focus on customer service Full transparency and integration Clear and consistent communications Leadership by example

Overview of Program Development Leadership Research and Development Promotion / communications Integration

Leadership Researching and developing best practice Leading on projects / committees Providing Professional expertise / opinion Building positive relationships – internally / externally Providing technical support to service delivery Professionalizing resources Leading by example

Research and Development Identifying emerging trends Identifying gaps, issues and innovations Determining best (better) practice Recommending new programs / services or change to existing ones Setting and reviewing standards Developing guidelines, policies, procedures, briefing materials, formats, templates Responding to sensitive issues

Promotion and communications Developing communication strategies Creating partnerships Educating internal and external stakeholders Promoting service and delivery And with Program and Provider Effectiveness (PPE) Collecting and evaluating data Developing and managing CQI processes Managing risk

Adult Education and Labour Market Strategic roles Keeping current and projecting trends Researching best practice and recommending new programs and processes to external stakeholders to meet worker, employer and WSIB needs Liaising with external stakeholders in order to collect information, develop and share best practice and influence direction Providing guidance and advice based on expertise to Service Delivery and complaints officer

Program Development initiatives Guidelines for EPS Providers and WSIB staff around motivation, cooperation and consent Guidelines related to disclosing worker criminal records Accessibility responsibilities within the Colleges Template for College Progress Reports Guidelines/expectations around Standardized assessments Fine tuning of Transferable Skills Inventory / Analysis Strategy for assisting workers with narcotic related issues Strategy for collaborating with CPP Removal of the stigma attached to “older workers”

Professionalization Professional Definition Scope of Practice Standards of Practice Values Competencies Code of Ethics Disciplinary process Education Credentials Continuous Professional Development Association / Membership

Work Reintegration Contacts Judy Geary – judy_geary@wsib.on.ca Gail Kovacs – gail_kovacs@wsib.on.ca Linda Kelly – linda_kelly@wsib.on.ca Joanne Webb – joanne_webb@wsib.on.ca Mike Curtis – mike_curtis@wsib.on.ca John Mutch – john_mutch@wsib.on.ca

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