Alberta Health Services (AHS) is involved with coordinating the delivery of health supports and services across the province. Their sole mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans. Alberta Health Services has implemented an Ability Management program which is a coordinated and cooperative effort to assist employees who are unable to work due to injury, illness or disability.
The Ability Management Program addresses early intervention, active case management and the creation of opportunities for early safe return to work. Ability Management Program uses modified work, transitional work, rehabilitation strategies, medical duty to accommodate and follow-up to ensure that Alberta Health Services employees either remain at work or quickly return to a safe, productive and meaningful work that they feel comfortable doing. Alberta Health Services provides health care services to the public on a provincial level.
This organization brings together 12 formerly separate health entities in the province: nine geographically based health authorities (Chinook Health, Palliser Health Region, Calgary Health Region, David Thompson Health Region, East Central Health, Capital Health, Aspen Regional Health, Peace Country Health and Northern Lights Health Region) and three provincial entities working specifically in the areas of mental health (Alberta Mental Health Board), addictions (Alberta Alcohol and Drug Abuse Commission) and cancer (Alberta Cancer Board).
The size of the workforce consists of 84,269 plus or minus employees. Consequently, the type of work done by Alberta Health Services employees range from taking diverse responsibilities such as clinical (doctors, nurses, rehabilitation), Information Systems, facility, Workplace/Occupational Health & Safety, Human Resource Services, Emergency Medical Services and many more operational services to provide the optimum patient care for all Albertans. The average age of the employee at Alberta Health Services is approximately 41. 8 years.
Statistically the ratios of men being 14% in comparison with 86% being women are employed by Alberta Health Services. Leah Runge an Ability Management Consultant for Alberta Health Services deals directly with issues regarding occupational and non-occupational illness or injury. Leah takes on diverse and cognizant roles such as being a contact person for all stakeholders, an active supporter of the injured or ill worker and their family members, and an active catalyst for facilitating the return to work of that disabled employee.
As indicated by Leah, her responsibility is to act as a confidential liaison with all the stakeholders (between the employee, their manager, workplace supervisors, co-workers, and union members), insurance companies (third-party insurers) to assist and act as a catalyst for facilitating the reintegration of the disabled employee back into the safe workplace. She works closely with the injured or ill worker to develop a safe return to work plan implemented by the Alberta Health Services.
Moreover, Leah stated that she has a primary obligation to keep things confidential and to safeguard information about individuals obtained in the course of disability management practice information and records and also information pertaining to an employee’s personal health. Consequently, Leah provides assurances of professional ethical responsibility to all parties involved in the Alberta Health Services disability plan.
Leah consistently displays her ethical nature in making judgments and decisions regarding the disability claims she deals with on a daily basis. Leah arranges for workplace modifications or job restructuring for the disabled employee to smoothly transition the individual to a newly developed modified job where tasks are changed in order to coherently match the abilities the employee displays.
The roles and responsibilities of other team members according to Leah can be but not limited to, workplace advisors assisting in ergonomic assessments, job coaching, Hygiene and Occupational Health & Safety advisors that may be required to ensure the working environment is safe, Human Resources for performance based issues and concerns, and Labor Relations may be involved in complex issues regarding workplace bargaining issues. The diverse roles and responsibilities of other team members counteract with the reintegration of the injured or ill workers into the workplace.
Workplace advisors assisting in ergonomic assessments have the distinctive duty to provide the necessary assistive equipment that will help and sustain the health and wellness of the employee in their official quest to return to work in an adjustable and comfortable environment. Hygiene and Occupational Health & Safety advisors are important catalysts to the recovery of the injured or ill employee because they ensure that the workplace environment is safe for all Alberta Health Services employees to return to.
In essence, the Human Resource Services Department has an important role in regards to the benefits, compensation, and labor relation issues that may evolve for the disable employee during the disability claim process. The disability claim management process at Alberta Health Services ensures how occupational and non-occupational illness and injury are managed in an effective and efficient way. As indicated by Leah, the first initial steps involve the notification of the disability claims.
The manager completes the absence form for the employee. The absence form includes a trend, pattern or high usage of sick time that is developing and employee has been issued Letter B; the employee has little or no sick banks and will be off due to a disability; there are concerns whether the absence is medically supported; employee is not able to return to work when initially expected; employee is performing modified work for an extended period of time; employee has requested a permanent accommodation.
Once the claim has been notified to the manager then the Ability Management Consultant steps in where he or she will complete the initial contact; proceed in creating the file; then will counsel employee regarding roles, timelines and consent; obtain the necessary medical documentation; will contact employee as per appropriate timelines; bring medical documentation to the Medical Team Review; will advise Human Resources.
Advisor in regards to refusal of Occupational Health & Safety involvement by the employee; employee’s attendance is requested by the manager or Human Resources in Return to Work meetings; the Ability Management Consultants will counsel employee regarding short-term or long-term disability application process, payments, and timelines; finally their role involves keeping managers advised on the process of the employee. In contrast the Ability Management Assistant Roles involve verifying sick time credits; will input the Premium Waiver on the DEC screen (this is a personal system that the former Capital ; Health region uses with pertinent ersonal/ payroll/ benefit enrollment information); will advise employee’s manager, Benefits and Payroll of claim and any changes in time coding; will contact Benefits re enrollment cards; will report rehabilitation earnings to the insurance providers; update dates for Modified Duties on EZ Track; remove premium waiver flag. After all these tasks that are done by the Ability Management Assistant, the claim management process emerges to the initial application package returned to Ability Management Team.
During this period assistants will complete the Employee Statement Form and will copy all forms and courier them to Insurance Provider for adjudication. During the claim process the manager keeps in contact with employee throughout leave of absence and advises Ability Management Consultant of any information in relation to file. Moreover, the Insurance Provider receives and reviews applications of the Disability claims and will decide if either the application should be approved or declined.
If the application is approved by Worker’s Compensation Board the Insurance Provider will notify employee, the Consultants via correspondence, assistants will advise Benefits, updating of EZ track will be required, and finally the manager will be advised on Status and Time coding. In contrast, if the application is declined then the Ability Management Consultant will notify the manager, the Assistant will notify Benefits, standard premium waiver memo will be sent to employee and Benefits. The file is referred to Ability Management Consultant for discussion with employee.
The particular issues that will be dealt with are the appeals process, and the documentation requirements. After the application has been approved or declined, the claim proceeds to the Long-Term Disability application process and the managers may be asked to complete the Manager’s portion of a Long-Term Disability package. A return to work plan that has been implemented by Alberta Health Services will be solely based on the nature and extent of the employee’s disability as well as their expected recovery time.
Thereby this is reflected in accordance with their physician’s recommendations. The Ability Management Consultant will be notified from Managers or Human Resources if a Return to Work meeting is required to discuss the matter. Furthermore, the RTW plan can be completed and proposed by the Ability Management Consultant. By this stage the Ability Management Assistant will remove a Premium Waiver Flag. Consultants will then proceed to monitor the file while the employee is on Gradual Return to Work plan and requests updates from employee and the manager.
The manager needs to notify Ability Management Consultants to ensure verification of the exact date as to when the injured or ill employee has reached Full Return to Work status or if employee is not able to return to work as initially expected. Assistants update and closes EZ Track file when initial step has been completed. In addition, if permanent restrictions are identified then formal Duty to Accommodate process will be initiated.
Respectfully, manager will maintain in contact with employee throughout Gradual Return to Work and communicate with Ability Management Consultant if there are any concerns throughout the process. There are many challenges and barriers that Leah encounters throughout her daily transactions with disability management. One barrier that she encounters is having insufficient medical analysis submitted to support an employee’s absence for medical reasons. Thereby once an employee is off work, to contraindicate a return there needs to be sufficient medical clearance from the attending physician.
Another barrier that typically surfaces is when an employee is fit to return to some form of work and if the home department does not have work at the employee’s current ability level then retrospectively the delay to return to work may become delayed as a search beyond the home department site is required. Moreover, providing managers with an approximate return to work date for an employee when the recovery for a condition is on a monthly basis is critical. This barrier makes it uncertain for the manager to plan for staffing purposes. An example that can display this is posting time lines for hiring replacements on a temporary basis.
The literature indicates many common challenges for disability management personnel assisting employees return to work following injury or illness. The improvements that Leah suggest would like to see made to the ability management process/program is that there should be a mandatory modified work policy implemented in order to cut costs for the organization. Moreover, another recommendation Leah indicated that she would like to see incorporated is to develop a disciplinary policy for those employees that do not comply with safe work practices.
There should be some form of discipline put in place for Alberta Health Services employees who are not conforming to workplace policies and procedures that are in place to actively safeguard employee’s health and safety. For instance, after a manager provides an employee with a letter of expectation for performing unsafe work practices causing injury. Leah would also like to see another improvement regarding an expectation of the employee’s responsibility to follow treatment recommendations of the physician/specialist in order to qualify for disability benefits (as with the insurance carriers).
Improvements that should be considered by Alberta Health Services to help with the process/program should be directed to implementing a modified work plan for older/aging workers to help curb the amount of disability incidents occurring. With the average age of the workforce at Alberta Health Services being 40+ years, the incidence of disability among the employed aged population is expected to rise thereby challenging employees to maintain maximum workplace flexibility and to accommodate the needs of older workers by providing, for example, assistive technology, flexible schedules, and telecommuting options, reduce workload accordingly.
Alberta Health Services should definitely consider implementing aging modified work plans that will help the organization cut disability costs significantly. As indicated by the National Institute of Disability Management and Research (1999), older workers with disabilities can be an imposing force impacting on disability costs and on the economic survival of industries. Furthermore, longer-time periods for rehabilitation among older workers translate into longer periods of work disruption and lost time from the work force. The employer’s financial liability for treatment and rehabilitation services will increase substantially.
As indicated by Diane E. G. Dyck, another recommendation that should be considered to improve the disability management process/program is that AHS should be clear on the vision, goals, objectives and targets for the Disability Management Program so that AHS employees actually know that the program does exist in the organization; regularly monitor and measure them thereby simply updating them accordingly; also should recognize, communicate and commemorate the achieved progress and successes; learn aim for continuous improvement.
Alberta Health Services strives to attain a healthy workplace where employees are insured that the environment is safe and comfortable to be in.