The Employers Toolkit – Disability Management Kelly Alarie, RN, COHN, CDMP Cowan Insurance Group Ltd.

What is A Healthy Workplace?

What is A Healthy Workplace? Positive and Supportive Organizational Culture Psychological and Social Support Clear Leadership and Expectations Civility and Respect Challenging but not overwhelming psychological demands Growth and Development Recognition and Reward Workload Management Engagement Work/Life Balance Psychological Protection Protection of Physical Safety Source: Mental Health Standards

Signs of an Unhealthy Workplace!

Signs of an Unhealthy Workplace! Absenteeism issues High Employee and Family Assistance Program usage High disability claims Low morale (poor staff perception) Poor work environment Low productivity Higher rate of accidents /incidents (WSIB) Poor company reputation/high turnover

Available Resources for employers Pro-Active Wellness: Available Resources for employers EFAP services Public Health Resources Seminars from your insurance companies / Disability Management (DM) providers On-line resources Professional Resources (associations and memberships Government Resources

Potential Wellness Programs Pro-Active Wellness: Potential Wellness Programs Blood Pressure Clinic Nutritional Sessions Stress Management Sleep Hygiene Mental Health Training Smoking Cessation

Pro-Active Wellness Potential Workshops Parenting Classes Mental Health Awareness Marital /Relationship Strengthening Assertiveness Training Balancing Work & Home Dealing With Workplace Stress

Recent Focus: MENTAL HEALTH The National Standards of Canada for Psychological Health and Safety in the Workplace released on January 16th 2013 Their mandate has been prolonged until 2017! The cost to the Canadian economy is $50 billion/year Presenteeism is related to lost productivity The biggest cause of both Short and Long Term Disability Claims are Mental Health claims

Benefits to Employees Increased job satisfaction Higher Morale Better physical and mental health Enhanced motivation Improved ability to manage stress

Benefits to Employers Improved quality, performance, and productivity Reduced absenteeism and turnover Fewer accidents and injuries Better ability to attract and retain top-quality employees Improved customer service and satisfaction Lower healthcare costs

STRATEGIES COMMIT: Both by upper management and unions PLAN: Utilize the tools; “do not reinvent the wheel” IMPLEMENT: Start with your statement and end with action EVALUATE: Utilize audit tools to see if it’s making a difference REASSESS Set annual dates and improvement dates as needed

What Does This Really Mean? Better accommodation of our employees Overcoming stigma Providing programs towards physically and psychologically healthy workers Psychologically and physically healthier workplaces

Supportive Return to Work Acknowledge the employee: “You are looking better” “How are you doing” Take time to listen “Let me know if you need anything” “It is so nice to have you back” Regular check backs on how the person is doing

The Laws That Guide Canada Labour Code Human Rights Act Return to Work Legislation (Duty to Accommodate) Worker’s Safety and Insurance Board (WSIB) Occupational Health & Safety Act Various Collective Agreements Employment Standards

Workplace Action: Levels of Prevention Primary: Hire accordingly, train, support Secondary: Recognition, provide tools Tertiary: Support the identified problem

Step 1-Are you building the right team Employer’s Toolkit: Step 1-Are you building the right team Present your culture Ensure the qualifications Discuss accommodated work If it is not your practice don’t agree to it Ensure you understand what the candidate’s expectations are Present your team’s personality Ask questions pertaining to personality traits

Step 2- Is the workplace physically safe? Employer’s Toolkit: Step 2- Is the workplace physically safe? Health & Safety Policy Proper training and follow up Proper reporting Proper investigations Proper reviews Employer and employee Input Pro-active with inspections and not reactive with incidents?

Step 3- Is the workplace psychologically safe? Employer’s Toolkit: Step 3- Is the workplace psychologically safe? Policy in place utilizing Mental Health Standards Proper training and follow up Proper reporting Proper investigations Proper reviews Employer and employee input Pro-active steps to acknowledge issues and prevent incidents?

Step 4-Are you managing disabled workers? Employer’s Toolkit: Step 4-Are you managing disabled workers? Employer and employee training Modified work is available and expected HR/Management tracking of disabled worker Ongoing communication with disabled worker Are you aware of the nature of the absence, ongoing treatment and prognosis Ongoing review of the program Employer and employee input ACCOMMODATION

Accommodation Process: Provide the following: Nature of illness Permanent or temporary (i.e. prognosis) Detailed restrictions/limitations flowing from the disability Basis for the medical conclusions (not results) Effects of treatment, including medications

Step 5-Is there modified work in place? Employer’s Toolkit: Step 5-Is there modified work in place? Policy in place for both occupational and non-occupational absences Proper orientation upon hiring Manager and employee training Proper listings of modified work available Managers responsibility of the modified budget Supportive environment for returning workers Ongoing review of the program Employer and employee input

Step 6-Are your workers remaining at work? Employer’s Toolkit: Step 6-Are your workers remaining at work? Recognized Rewarded Compensated Cared for…

Step 7-Proactive Wellness Employer’s Toolkit: Step 7-Proactive Wellness Programs available for management Programs available for employees On-going evaluation of providers Assessment of results Utilization of statistics to focus programming Utilization of existing resources (EFAP, insurers, public health, Cowan) Modify programs as required

Challenges in Disability Management

Disability Management Statistics Overall, since 2000, both the incidence and the number of days lost for personal reasons (illness or disability, and personal or family responsibilities) have shown a rising trend Industries with higher absence rates include: health care and social assistance (14.1 days), transportation and warehousing (13.0) and public administration (12.5) Compared to lowest averages by full-time workers in primary industries (6.5) and in professional, scientific and technical services (6.7) Whether full or part week, overall women's absence rates are higher from 1999 to 2009 (Statistics Canada - Catalogue no. 75-001X)

Culpable vs Non-culpable Distinction between culpable v. non-culpable absenteeism is key AMP should have two approaches/streams: Culpable absences - Disciplinary response Non-culpable absences - Non-disciplinary response “Duty to accommodate to the point of undue hardship”….. (Emond Harnden – Ottawa Ontario)

Attendance Management Program Set out benchmarks for identifying a threshold level of absenteeism which draws employees into the AMP Set out a procedure for counselling employees, and measures that can be taken to improve attendance (supportive) Establish a series of escalating steps (i.e. meetings with higher levels of management) Put employee on notice that dismissal may result from continued unacceptable rates of absenteeism (only after accommodation to the point of undue hardship) (Emond Harnden – Ottawa Ontario)

Disability Management Cases

Resources The Standard - Download CAN/CSA-Z1003-13/BNQ 9700- 803/2013 Standard (http://www.csa.ca/documents/publications/CAN_CSA-Z1003- 13_BNQ_9700-803_2013_EN.pdf) The Guide - http://www.mentalhealthcommission.ca/English/node/505?termini tial=30 Public Health Units in Ontario http://www.alphaweb.org/?page=PHU Cowan Insurance Group – Health & Disability kelly.alarie@cowangroup.ca

Questions?