1	COP NURSE INTERVENTION Improving Early Disability Management
2	Basic Project Objectives To improve nurse intervention services to injured workers and to better coordinate interaction with Federal agencies to reduce Lost Production Days Service Provision Costs Maintain/improve customer satisfaction
3	SRA Findings COP/RN Interviews Like the program Able to identify cases that need early intervention by a field nurse Able to answer questions regarding billing and authorizations, etc. Able to overcome medical barriers such as understanding when an authorization is required, enrollment of provider, etc
4	SRA Findings Employing Agency Interviews Do not understand the COP RN process or results Frustrated by lack of information such as when they are assigned, the results of the assignment, etc. If reports provided them with valuable information they would like the intervention to be even earlier Very positive about FN intervention Frustrated about paying $100 when the EA is well aware that the injured worker has returned to work prior to the end of COP
5	SRA Findings District Office Interviews Lack of clarity about the program and its purpose Lack of understanding about what the COP nurse is permitted to do Need for some cases to be adjudicated more quickly or a FN assigned more quickly than current procedures permit Reduction in number of cases falling into COP case referral universe
6	SRA Recommendations Revise the name Reduce the number of false positives by creating a process to speed RTW reporting Revise the COP/RN report Share info regarding early nurse management referrals with the EAs Streamline the COP RN referral process
7	Recommendations (cont.) Create process by which Adj. unit and SN obtain COP/RN reports immediately when necessary Create written procedures that include roles & responsibilities for all parties Revise responsibilities of COP RN Clarify the policies of who can talk to whom about what Allow COP/RN to authorize some non-invasive treatment Reduce the number of lost work days for initial referral
8	Assessment of Recommendations - First priorities Establish an electronic method for the COP FN to see case data and update iFECS Revise the COP FN closure report and require consistency in its usage Retool the triage levels and establish procedures for COP FN, SN and CE responsibilities with each level Change initial referral to early nurse case manager from 15 days of lost time to 10 days
9	Current Triage Codes Triage Code 1 – Is not working due to surgery, diagnostic testing or PT Triage Code 2 – Is not working for other reasons Triage Code 3 – Has returned to work part-time Triage Code 4 – Is not cooperating with nurse intervention
10	Proposed COP RTW Case Worksheet Triage Code 1 – Catastrophic – Obtain info, notify SN immediately, close case Triage Code 2 – Emergency Hospitalization – Obtain info, notify SN immediately, close case Triage Code 3 – Surgery Imminent – Obtain info, close case Triage Code 4 – Claimant Not Cooperative – Document non-cooperation, close case Triage Code 5 – No Return to Work – Obtain info, close case after 30 day intervention Triage Code 6 – Return to Work Part-Time – Obtain info, close case after 30 day intervention Triage Code 7 – Return to Work Full-Time LD – Obtain info, close case after 30 day intervention
11	First priorities (continued) Return of the new and improved CA-3 Explain the COP FN program to the EAs through inter-agency meeting presentation Share information about the nurse referral as well as the case management report with EAs Target workers’ compensation training at the DO level to explain the process and benefits of the program
12	CA-3 – Report of Work Status Multi-purpose form Capture claims where injured employee stopped work after CA-1 was filed but still during COP Capture post-COP changes in work status Electronic submission through AQS