Public Risk September/October 2020

PUBLISHED BY THE PUBLIC RISK MANAGEMENT ASSOCIATION SEPTEMBER/OCTOBER 2020

GAUGING EMPLOYEE THOUGHTS, FEELINGS AND OPINIONS THROUGH

SAFETY PERCEPTION SURVEYS PAGE 6

ALSO IN THIS ISSUE

BEST OF THE BLOG

PAGE 11

SLIP, TRIP, AND FALL PREVENTION Reducing Wintry Weather Injuries

PAGE 16

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SEPT/OCTOBER 2020 | Volume 36, No. 5 | www.primacentral.org

CONTENTS

The Public Risk Management Association promotes effective risk management in the public interest as an essential component of public administration.

PRESIDENT Sheri D. Swain Director, Enterprise Risk Management Maricopa County Community College Tempe, AZ PAST PRESIDENT Scott J. Kramer, MBA, ARM County Administrator Autauga County Commission Prattville, AL PRESIDENT-ELECT Melissa R. Steger, MBA, CRM Asst. Dir., WCI & Unemployment Ins. University of Texas System Austin, TX DIRECTORS Forestine W. Carroll Manager of Risk Management Memphis Housing Authority Memphis, TN

6

Gauging Employee Thoughts, Feelings and Opinions through Safety Perception Surveys

By Lori Schroth, D.B.A., M.S., CSP, CIT, CHSP and Brandon J. Hody, M.S., CSP, CHSP

Lori J. Gray Asst. Director of Finance for Risk and Wellness Services County of Prince William Woodbridge, VA JamiAnn N. Hannah, RMPE Risk Manager City of Gallatin Gallatin, TN Laurie T. Kemper Sr. Risk Management Consultant City/County Insurance Services Salem, OR Adam Maxwell Director of Admin Services City of Westerville Westerville, OH Michael S. Payne, ARM, HEM Risk Manager City of Fresno Fresno, CA NON-VOTING DIRECTOR Jennifer Ackerman, CAE Chief Executive Officer Public Risk Management Association Alexandria, VA EDITOR Jennifer Ackerman, CAE Chief Executive Officer 703.253.1267 • jackerman@primacentral.org ADVERTISING Jennifer Ackerman, CAE Chief Executive Officer 703.253.1267 • jackerman@primacentral.org

Best of the Blog IN EVERY ISSUE

11

16

Slip, Trip, and Fall Prevention REDUCING WINTRY WEATHER INJURIES

By Lori Schroth, D.B.A., M.S., CSP, CIT, CHSP and Bradley Renwick, CSP, OHST

| 4 NEWS BRIEFS | 19 ADVERTISER INDEX

Public Risk is published 6 times per year by the Public Risk Management Association, 700 S. Washington St., #218, Alexandria, VA 22314 tel: 703.528.7701 • fax: 703.739.0200 email: info@primacentral.org • Web site: www.primacentral.org Opinions and ideas expressed are not necessarily representative of the policies of PRIMA. Subscription rate: $140 per year.

Back issue copies for members available for $7 each ($13 each for non-PRIMA members). All back issues are subject to availability. Apply to the editor for permission to reprint any part of the magazine.

POSTMASTER: Send address changes to PRIMA, 700 S. Washington St., #218, Alexandria, VA 22314.

Copyright 2020 Public Risk Management Association

SEPTEMBER /OCTOBER 2020 | PUBLIC RISK

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BIG IDEAS. SMALL SETTING.

The Industry’s Premier Risk Management Educational Program Starting October 19, 2020 • Virtual PI 20 is an innovative educational symposium comprised of fundamental risk management curriculum, outstanding faculty, and excellent networking opportunities. PI 20 is aimed at new and seasoned risk management professionals who want to learn more about emerging trends and best practices.

Register at institute.primacentral.org

MESSAGE FROM PRIMA PRESIDENT SHERI D. SWAIN

OVID-19 has presented employers with many different challenges, one of which up until now has rarely been touched upon: remote work/ telecommuting.

The need to ensure continuity of operations while keeping employees safe has been a new learning experience and has created challenges for risk managers across the globe. In Arizona, and many other states, government “Stay at Home” orders abruptly caused a halt to most in-person operations and forced employers to scramble to sustain operations in a vastly foreign environment. Only the essential workers remained on site to keep brick-and-mortar facilities operating and secure. Now, we are hearing in the media that employers are considering moving their operations to permanent telecommuting operations and do away with their brick-and-mortar locations, where feasible.

Some of these challenges included: creating telecommuting policies, computer equipment availability, internet capabilities, meetings/ conferences, telephone/voicemail transfer, VPN/ remote desktop access, employee motivation and accountability and home office ergonomics.

Ergonomics is always challenging because one size does not fit all and the science is subjective based on the worker’s description of the ailment, pain or injury. Now, couple this with the fact that our desks have become dining room tables, countertops, coffee tables, mattresses, etc. and our “office” chairs have turned into dining room chairs, stools, couches, ottomans, etc., employers are seeing additional workers’ compensation claims due to ergonomic issues and repetitive motion injuries (RMI’s).

“

How do employers preempt an increase in these types of workers’ compensation claims during these unprecedented times, especially when the employer has no control/input in an employee’s home office environment?

“

C

The New Normal: Telecommuting

How do employers preempt an increase in these types of workers’ compensation claims during these unprecedented times, especially when the employer has no control/input in an employee’s home office environment? Even OSHA does not regulate, inspect or hold employers liable for employees' home offices nor do they expect employers to inspect the home offices of their employees.

Internal staff policies and acknowledgements regarding acceptable home office work environments can assist in educating employees about your organizations expectations. Making additional computer monitors, keyboards, etc. available for employees to use at home, in conjunction with ergonomic checklist and/or diagram can guide employees in setting up a comfortable, ergonomically friendly home work station and alleviate strain, fatigue and discomfort.

A tip sheet, with common quick fixes that don’t break the bank, can also assist employees in ways to lessen the likelihood of ergonomic-related issues. Be creative when developing tips such as

use of a pillow to elevate the seat pan of the chair in use, or securing hand towels to the armrests to provide support for elbows and forearms, or a crate or sturdy box for feet to rest on.

If your organization has someone well-versed in ergonomics, you can even have them conduct a virtual assessment. We all know that risk managers are by far, one of the most creative groups; we know how to accomplish seemingly impossible tasks and operations, with the least amount of risk.

Stay safe and stay well.

Sincerely,

Sheri D. Swain PRIMA President 2020–2021 Director, Enterprise Risk Management Maricopa County Community College Tempe, AZ

SEPTEMBER /OCTOBER 2020 | PUBLIC RISK

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NEWS BRIEFS

NEWS Briefs

UNEMPLOYMENT LIKELY RISING IN 11 STATES

With new jobless claims still coming in at almost a million a week, states are struggling to cushion the loss of the $600 federal supplemental pay that expired in July, reports the Associated Press.

Some states appear headed for higher unemployment than the official July figures released last week, according to a Stateline analysis of jobless claims data released by the U.S. Department of Labor.

Eleven states and the District of Columbia had a higher share of workers on unemployment benefits in August than the official July unemployment rate: California, Connecticut, Georgia, Hawaii, Kentucky, Louisiana, Michigan, Minnesota, Nevada, Texas and Vermont.

For instance, 18.3% of Hawaii’s labor force was on unemployment benefits as of mid-August, compared with a 13.1% unemployment rate in July. Hawaii officials had predicted higher unemployment because of more coronavirus cases and fewer visitors than usual.

Georgia had an 11% share of its workforce on benefits compared with the 7.6% July unemployment rate; for Louisiana, the numbers were 12.1% versus 9.4%.

Thirty-five states have enrolled in President Donald Trump’s program to give another $300 weekly to workers. Others including Florida and Oregon plan to join.

Those benefits would last three weeks from Aug. 1 unless the program is extended, or Congress acts on a new weekly benefit.

Only six states already have started paying the benefit, according to the tracking site UnemploymentPUA.com: Arizona, Louisiana, Missouri, Montana, Tennessee and Texas.

To qualify, states must provide at least $100 in weekly benefits to workers, but states can count money they already are providing in benefits. States have an option of kicking in another $100 weekly for workers but only Kentucky, Montana and West Virginia have done so.

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PUBLIC RISK | SEPTEMBER /OCTOBER 2020

“

With new

jobless claims still

coming in at almost a million a week,

states are struggling to cushion the loss

of the $600 federal supplemental

pay that expired in July.

“

The Associated Press

GREATER ACCESS TO MEDICATIONS CAN PREVENT OVERDOSE DEATHS Policymakers should look to global solutions to curb the opioid crisis Drug use affects people from all walks of life each year, resulting in as many as 585,000 deaths globally in 2017. North America has among the highest drug-related mortality rates in the world, accounting for roughly 1 in 8 drug-related deaths worldwide—the majority attributable to opioids.

In recognition of International Overdose Awareness Day—observed on Aug. 31 to raise awareness for how to prevent drug-related deaths—U.S. policymakers should look at how other countries have successfully addressed opioid use disorder (OUD), including by improving access to evidence-based medications such as buprenorphine and methadone. Taking similar action in the United States can ensure greater availability of treatment and ultimately save lives.

Expanded buprenorphine treatment options In the 1980s, France experienced a heroin epidemic, with overdose deaths rising 10% each year over that decade. Health care providers were discouraged from treating people with OUD, and clinicians had to satisfy training and licensing requirements before they could prescribe buprenorphine. Treatment was limited to specialized centers that offered counseling but not medication. Recognizing the need for a policy change, French lawmakers in 1995 allowed primary care doctors to prescribe buprenorphine without any special education or licensing.

Almost immediately, access to buprenorphine increased within both specialized addiction treatment centers and office-based settings.

Clinicians were able to treat about 65,000 patients per year with buprenorphine, resulting in a 79% decline in overdose deaths over four years.

Before 1996, only 15% to 30% of the estimated 150,000 to 200,000 people who misused heroin had access to specialized settings that offered treatment. But by 2006, more than half of the 180,000 people who misused heroin received buprenorphine from either specialized settings or office-based practices.

In the United States, health care providers must undergo training before receiving a waiver

from the Drug Enforcement Administration to prescribe buprenorphine for OUD—a hurdle not required for any other prescription drug.

This federal rule is an unnecessary obstacle for the nearly 20 million Americans who live in counties where no clinician had obtained the waiver to prescribe the drug as of 2017. To address this disparity, Congress should pass the Mainstreaming Addiction Treatment Act, which would remove training and licensing requirements for prescribers and help ensure that more Americans receive evidence-based OUD treatment.

Less restrictive regulations for methadone Despite helping more than 380,000 Americans manage their OUD in 2017, methadone is available only at opioid treatment programs (OTPs), federally regulated health care facilities. However, a majority of states have less than one OTP per every 100,000 people, and between 2008 and 2018, the number of OTPs has increased only incrementally, from 1,132 to 1,519.

Meanwhile, other countries have made methadone available through primary care providers for decades, which has led to substantial increases in treatment capacity and physician involvement. For instance, Australia’s treatment capacity grew from 2,000 to 15,000 patients between 1985 and 1995 after lawmakers made methadone more widely available. And in Edinburgh, Scotland, 60% to 80% of people who injected opioids were enrolled to receive methadone in 1998 and 1999, compared to just 15% in the United States at that time.

Today, methadone remains a highly regulated drug in the United States. To help increase access to this critical medication, American policymakers should consider making methadone available in settings beyond OTPs, including mobile methadone vans, which can help bring treatment to people no matter where they live.

Since 1999, drug overdoses in the United States have continued to climb almost every year.

It’s time for policymakers to consider making evidence-based medications, which are used

around the world and have been proven to reduce overdose deaths and help people achieve recovery, more readily available.

Cyber insurance premiums climbing rapidly: S&P Cyber insurance premiums, which now total about $5 billion annually, will increase 20% to 30% per year on average in the near future, Standard & Poor’s Corp. says in a report.

Small and medium-sized enterprises, “which have a considerable untapped demand for cyber insurance,” will be a key growth avenue, according to the report released Wednesday.

“Cyber insurance growth rates for SMEs (in the U.S.) were more than double those for other industry segments in 2018 and 2019,” the report says. “In our view, this is an important development that will gradually improve the risk diversification of insurers’ exposure.”

The report says accumulation risk is a key challenge for insurers because claims accumulation can expose an insurer to high financial losses.

“Furthermore, calculating appropriate price for cyber insurance is more difficult than other lines of business, given the dynamic nature of cyber risk and increasing sophistication of cybercrime,” the report says.

“We also see a lack of transparency and rigidity from the insurance market, which is not entirely accommodating customer demands,” the report says.

This includes “uncertainties around coverage elements, given non-uniform definition of cyber risk and inconsistent terms and conditions, since cyber is often bundled in liability or property lines of business,” it says.

“In some instances, we also see exclusions for certain industries, such as critical infrastructure or financial service companies and certain claims, including fake president fraud (where criminals impersonate a company leader and order an emergency bank transfer) or cyber extortion payments.”

SEPTEMBER /OCTOBER 2020 | PUBLIC RISK

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GAUGING EMPLOYEE THOUGHTS, FEELINGS AND OPINIONS THROUGH

SAFETY PERCEPTION SURVEYS

BY LORI SCHROTH, D.B.A., M.S., CSP, CIT, CHSP AND BRANDON J. HODY, M.S., CSP, CHSP

A

N ORGANIZATION’S SAFETY AND HEALTH (S&H) CULTURE INFLUENCE the success of the Safety Management System (SMS) and how employees perceive S&H overall. Safety perception surveys provide insight as to how employees feel about S&H within an organization. Utilizing safety perception surveys can help organizations evaluate S&H culture and assess the SMS to identify deficiencies or ways to continuously improve over time. Table 1 shows examples of some information perception surveys can help reveal.

Table 1.

EXAMPLES OF INFORMATION REVEALED BY PERCEPTION SURVEYS Information revealed

How to use safety perception surveys

Perceived past and/or current S&H performance

Repeat surveys periodically to measure how employee perceptions change over time, an important indicator of progress within the SMS

Leading indicators of S&H performance

Evaluate the results of questions regarding effectiveness of employed S&H programs, use of hazard controls, perceived effectiveness of corrective actions, etc.

Employee behaviors

Compare what employees say they do versus what employees are supposed to do

Areas of improvement

Use questioning to request potential S&H issues, as well as possible solutions to those issues

Differences in work groups

Compare perceptions between different sets of employees (e.g., management may believe the inspection program is phenomenal, but employees demonstrate an opposing opinion)

Perception survey results help organizations recognize opportunities for improvement, which can influence the growth and success of S&H and the SMS. Additional benefits of distributing perception surveys include: • Encouraging open communication • Making employees feel like they contribute to the workplace, as well as S&H • Giving employees a sense of ownership within the SMS • Giving a feeling that management cares about what employees have to say Organizations can create their own perception survey to gain insight on S&H and the SMS that is most important to their concerns and issues.

This article outlines a 7-step process to develop and implement a perception survey in-house.

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PUBLIC RISK | SEPTEMBER /OCTOBER 2020

KEY STEPS TO CONDUCTING A PERCEPTION SURVEY

The 7-step process to conduct a perception survey includes: Brainstorm, Develop, Distribute, Review & Evaluate, Act, Award, and Reassess (Figure 1).

The steps start with constructing a perception survey and walk through the process of employee completion, how to review and evaluate results, and how to improve the SMS. Figure 1.

7-STEP PROCESS TO CREATE AND DISTRIBUTE A PERCEPTION SURVEY

BRAINSTROM

REASSESS

AWARD

DEVELOP

DISTRIBUTE

ACT

REVIEW & EVALUATE

STEP 1: BRAINSTORM Brainstorming paves the path for constructing the survey. Develop a survey committee and seek volunteers. Survey committees promote employee

involvement, pursue new and diverse ideas and concepts for the survey, and allow for distribution of work in each step.

Gather ideas to identify the objectives of the survey. Leadership or the Safety Department may already know which information to target. If not, consider using the committee members to sample the workforce and gain ideas on what kind of questions to ask in the survey; this narrows the survey’s scope to focus on issues that are important to the organization. Committee members should focus on whether there are any areas employees have differing or negative opinions, or where they think S&H can be improved.

Use the information gathered to define the scope of the survey. What does the organization want to know? What does the organization need to know? Define the target group or specific employees to include in the survey (e.g., the entire workforce, different types of employees, employees from different work centers). For example, why include construction staff in a perception survey geared toward office safety when they do not typically work in the office?

Discuss the confidentiality and anonymity of the survey. Some organizations want to know who completes the survey to award participants, but this is not always the best strategy. Anonymity or confidentiality may lead employees to answer more honestly. If interested in who is participating, consider providing the option of omitting names on survey forms. Nevertheless, sometimes this isn’t easy to accomplish if participants complete the survey using a computer. Review all the options and decide on how to proceed.

Identify how many responses are needed to make the survey meaningful.

If you distribute a survey to 100 employees and only receive ten back, can the results really reflect the entire population of the survey? In short, no.

An organization can determine how many responses are necessary to have significant results using free sample size calculators from popular survey organizations, such as Survey Monkey. Many of these sites have simple explanations and instructions, as well.

Identify a timeframe in which to distribute the survey. Avoid high productivity times or organizational events and holidays, which may impact completion of the survey.

Discuss whether incentives will be offered for survey completion. Organizations may need to review their budget and what monies are available, if any.

Incentives motivate employees to complete the survey and promote survey completion. Determine who is eligible for incentives—the entire population, individuals who complete the survey (which removes anonymity and possibly confidentiality), or individuals recognized in the surveys themselves (if a question asks if anyone has demonstrated S&H excellence) – this is up to the organization. Examples of individual incentives include a certificate of recognition, time-off, gift cards or other monetary awards, or personal acknowledgment from leadership. When the survey completion rate is high, consider awarding the entire targeted employee group; this shows the organization values employee opinions. Examples for groups can include parties, time-off, or some other celebration.

STEP 2: DEVELOP Developing the survey involves creating the questions and choosing response scales for each one. Make a list of questions to include in the survey based on the input gathered during interviews with management and employees.

Table 2 provides some considerations when creating these questions.

Table 2.

CONSIDERATIONS WHEN WRITING PERCEPTION SURVEY QUESTIONS Considerations when Framing Questions

Make sure the question can be interpreted in a consistent manner

Word questions in a manner in which participants will answer honestly

Think about questions participants have the knowledge to answer

Avoid doublebarreled questions

Avoid biased terms or wording

Examples and Justification Poor: “Do you think we have a good safety record?” – Safety record could be a variety of measures, and it is difficult to determine what makes the safety record “good”.

Better: “Do you think enough safety measures are in place to perform your job safely?” – “Safety measures” is a term that should be generally understood by all employees.

Poor: “Do you feel you create hazards when working?” – This seems to insinuate the employee is responsible for S&H hazards being present, which may lead to a reserved response.

Better: “Do you think your job creates a hazardous work environment?” – This associates S&H hazards as a product of the job or work done, rather than employee doing.

Poor: “How much money do you think is provided to help fund safety needs?” – This leads employees to take a random guess at a budget number.

Better: “Do you feel leaders provide enough funding for safety needs?” – This allows employees to provide an opinion based on what they experience in their work area.

Poor: “Do you believe leadership should spend more money on engineering controls and less money on PPE?” – This question has two parts and these two parts may seem to correlate, but employees may believe more money should be spent on both. Make this two separate questions.

Poor: “Do you think our excellent safety website provides enough information?” – The descriptor “excellent” pushes employees to feel the website works well.

Better: “Do you feel our new safety website helps to better communicate safety information?” – Lacks bias descriptors or adjectives.

Question 1: “Do you think ‘X’, ‘Y’, and ‘Z’ resources on our website are useful?”

Ensure questions do not suggest an answer (known as question priming)

Question 2: “Do you feel our website provides enough resources?” – The first question lists several resources and the second question asks whether there are enough resources. Question one may have unintentionally caused positive responses to question two by suggesting there are enough resources.

SEPTEMBER /OCTOBER 2020 | PUBLIC RISK

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GAUGING EMPLOYEE THOUGHTS, FEELINGS, AND OPINIONS

Safety perception surveys can help an organization gain insight into employee thoughts, feelings, and opinions in regard to the SMS. This insight into employee S&H culture can help an organization overcome plateaus in improving S&H performance.

RATING RESPONSE SCALE – Provide a numerical scale for participants to choose from Advantages

Disadvantages

Example

• Participant recognized; used in many surveys

• Can include too many numerical options to choose from, intimidating respondents

1 through 5

• Easy to understand • Allows quick response times • Provide insight as to if improvements are made over time

Organize the list of questions. An organization should start with the questions they believe to be the most important first. Group questions tied to similar topics, so they flow well and build upon each other, but avoid separating the groups into titled sections.

Each question needs to have a response scale. Response scales are how the participants answer each question. Think about the response scales to use for the survey; organizations should use the same response scale throughout a survey. Table 3 shows common response scales and associated advantages and disadvantages.

Table 3.

CONSIDERATIONS WHEN WRITING PERCEPTION SURVEY QUESTIONS DICHOTOMOUS RESPONSE SCALE – Give respondents two choices that oppose each other Advantages

Disadvantages

• Clear binary answers • Leans toward to choose from answer fatigue, where participants just • Simplifies the survey choose an answer • Makes scoring and because there isn’t analyzing easier one that represents their mixed feelings

Example True/False Yes/No

• Does not show improvements over time

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PUBLIC RISK | SEPTEMBER /OCTOBER 2020

1 through 10

• Not good for measuring attitudes • Occasionally has data limitations in comparing and contrasting items

SEMANTIC DIFFERENTIAL RESPONSE SCALE – Incorporate dichotomous responses and place them at the end of a spectrum; allow participants to slide a scale and show their attitude or satisfaction level Advantages

Disadvantages

• Measures attitudes and satisfaction levels

Once the list of questions is complete, evaluate the length of the survey.

Keep the length reasonable—typically between 10 and 20 questions.

Consider how much time the organization will be able to allocate to employees to complete the survey. If the survey is too long, participants can lose focus, become disinterested, or pencil whip.

1 through 7

• Additional preparatory questions may be needed to lead up • Easy to understand to the question the • Shows improvement organization is really efforts over time trying to answer

Example Ineffective Slightly Ineffective Neutral Slightly Effective Effective

• May not capture the emotional range of the respondent if too little points are used on the sliding scale • Use of a neutral response option may promote an uncertainty of responses, or allow this response by default

In addition to the three response scales in Table 3, organizations can also consider open-ended questions, though these are generally not recommended. Open-ended questions take much more time and effort to analyze survey results. Consider using open-ended areas in the survey on choice questions for respondents to add comments regarding the answers they provide. Also, consider an open-ended question to the end of the survey to ask respondents to call out someone of significance that has done something to support S&H that deserves recognition.

Once the survey has been drafted, pretest the questions with a small sample of employees. Administering a trial run allows the organization to see if it flows, is well-written and understandable, and of adequate length.

STEP 3: DISTRIBUTE Determine the method of distribution—electronic versus paper. Table 4 shows the advantages and disadvantages of each way of delivery.

Table 4.

ADVANTAGES AND DISADVANTAGES OF DISTRIBUTION METHODS FOR A PERCEPTION SURVEY

Electronic Paper

Distribution Method

Advantages • Employees mostly comfortable with taking surveys on a computer or electronic device

Disadvantages • Technical issues • Assurance of anonymity or confidentiality

• Quicker and easier to analyze data • Better promotes anonymity or confidentiality

• Employees may turn in more than one survey anonymously • Takes more time to compile the data

Identify an individual to distribute the survey. The distributor must be a credible, respected, and trustworthy person within the organization or group of distribution. Determine how to send out the survey (e.g., send out an initial email with a deadline, do a stand up call asking targeted employees to complete it). Be sure the distributor communicates the following information: • Purpose of the survey • Instructions for accessing and submitting the survey upon completion • The timeline in which the survey must be completed • Incentives offered for survey completion • If, and how, the survey assures anonymity or confidentiality STEP 4: REVIEW & EVALUATE Form a team or designate an individual to review and evaluate results.

Look at the overall completion rate of the survey and compare it against the number of responses needed to make the survey meaningful (Brainstorming step). If the organization has a high enough completion rate (meets the target sample size), the survey results adequately represent the entire target audience’s thoughts, feelings, and opinions.

If the completion rate is not high enough, the results are still useful! Think of each response as a customer feedback survey. One individual’s survey responses can still provide valuable information regarding the effectiveness or adequacy of an organization’s SMS. Investigate the factors affecting the completion rate to see how to improve it the next time the organization distributes a perception survey. Was the survey too lengthy? Was the survey communicated well enough and employees provided enough time? Were survey reminders sent out?

Review the results for positive or negative trends and middling or surprising results. Take a minute to think of what the results represent— employee thoughts, feelings, and opinions. Sometimes the problem is not a deficiency itself as much as it is the perception that a deficiency exists.

Compile the results into graphs, charts, and tables to provide a visual representation of the data collected. Use visual aids that are simple and easy to understand upon a quick glance. Never let a visual aid stand alone. Always include a summary under the visual aid to highlight the main points and to avoid misrepresentation of the information. Create a survey results report to summarize the main points of the perception survey. The report should include

objectives of the perception survey, survey methods used, and the survey results and visual aids should not overwhelm or bore the readers. Share the report with both leadership and employees to discuss the way forward.

STEP 5: ACT Put together a plan to take action on the survey results. Go through the survey and identify the items that need improvement. Use information from the survey, as well as direction from leadership, top management, and the survey committee to identify the actions to take. Identify the tracking mechanism to enter and track the improvement efforts; many organizations utilize an existing hazard tracking system. Treat the action plan like any other project the organization may employ. Identify a responsible person(s), corrective actions, interim measures implemented, and a timeline. Ensure employees are aware of any implemented actions and provisional measures.

STEP 6: AWARD Take action on the planned incentives to honor employees called out in the survey for S&H excellence and contributions, the entire group for a high completion rate, or individuals who responded to the survey, if you chose not to provide anonymity or confidentiality. Be sure to follow through on the planned incentives communicated initially to employees and do so in a timely fashion.

Following through on the promised incentive helps build trust and allows participants to see the organization cares about their opinions.

STEP 7: REASSESS Reassessment is needed to assess the organization’s S&H culture and SMS improvements continually. Redistribute a survey with the same, or similar, questions 6–18 months later to gain insight on implemented corrective actions, their effectiveness, and if any changes to the S&H culture occurred. Keeping the same questions and ordering allows for easy comparison and avoids changes to questions that may cause employees to feel differently than the original. Follow the same distribution process as the initial perception survey, to include providing another incentive.

Be sure to communicate the reason for duplicating the survey to avoid employee confusion regarding doing the same survey again. Compare the differences in results, if any, to identify further improvements.

CONCLUSION

Safety perception surveys can help an organization gain insight into employee thoughts, feelings, and opinions in regard to the SMS. This insight into employee S&H culture can help an organization overcome plateaus in improving S&H performance. This 7-step safety perception survey process helps organizations create an in-house survey that includes survey questions meaningful to the organization and the forward projection and success of S&H. The process promotes employee involvement and gains critical feedback and information needed from targeted employees to uncover valueadded data and give the organization ideas on improving S&H over time.

Lori Schroth, D.B.A., M.S., CSP, CIT, CHSP is a Senior Safety & Environmental Professional at Concurrent Technologies Corporation in Johnstown, PA. Brandon J. Hody, M.S., CSP, CHSP is a Safety & Occupational Health Professional at Concurrent Technologies Corporation in Johnstown, PA.

SEPTEMBER /OCTOBER 2020 | PUBLIC RISK

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National Cyber Security Awareness Month

DO YOUR PART.

#BeCyberSmart PRIMA’s 2020 Cyber Security Toolkit offers weekly education: OCTOBER 5

If You Connect It, Protect It

OCTOBER 12

Securing Devices at Home and Work

OCTOBER 19

Securing Internet - Connect Devices in Healthcare

OCTOBER 26

The Future of Connected Devices

LEARN WITH: Podcasts Infographics

Videos White Papers

primacentral.org

Quizzes Virtual Cyber Academy

BEST

OF THE

BLOG

This month, catch up on three posts from the PRIMA blog that you may have missed!

SEPTEMBER /OCTOBER 2020 | PUBLIC RISK

11

BEST OF THE BLOG

BEST PRACTICES IN POOL LOSS CONTROL

T

BY MICHAEL FANN, ARM-P, MBA, PRESIDENT, PUBLIC ENTITY PARTNERS here's no question that an effective loss control effort is an essential step in the risk management process. All too often, risk pool management attempts to launch loss control & safety programs before substantially defining the "why"—in other words, knowing the mission of the effort, and fully understanding the business philosophy behind that mission. Therefore, it is critical that an organization "get their thinking right" before establishing a program. Every pool loss control group needs to build a framework for success and then identify the people that can help accomplish the mission. Once the loss control effort is fully mission-driven, the group must prioritize efforts and work to identify the root causes of accidents.

Ultimately, loss control's task is to consistently take a slice out of the loss/claims pie.

Pooling and insurance, in general, is a financial mechanism. This mechanism is based upon a foundation of analyzing, understanding and addressing probabilities of loss. Therefore, loss control is the discipline of reducing those probabilities. It is best to keep loss control solutions simple because implementation happens across a very diverse set of public entities. While your total risk picture will be complex and involve many types of exposures, it is best to begin by focusing on three broad areas: the people (on-the-job safety), the public (liability) and the property (conservation).

The loss reduction effort will require people and tools. People are listed first for a reason as the loss control function in pools is almost entirely dependent on relationship-building. Only developing new policies or drafting procedural improvements may make you feel accomplished, but if you haven't developed a positive working relationship with both your internal and external customers, your success will be limited.

People. To carry out this mission, look to identify people with excellent character and interpersonal skills. Ideal candidates are those that can relate well with others and develop the working relationship needed to implement change in policy and behaviors. Typically, organizations try to identify

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PUBLIC RISK | SEPTEMBER /OCTOBER 2020

loss control candidates with a particular skill set and excellent technical knowledge, but, it is more important to locate a person with good interpersonal skills and high character. Then, teach them the technical side of the industry. In other words, you're not looking for inspectors; you're looking for people who desire to be a valued resource to your internal and external customers. The best candidate would be someone with excellent interpersonal skills and vast technical knowledge, but if you can only find one set of skills, make sure you err on the interpersonal side.

and making staff available for presentations at statewide associations and conferences.

Tools. Once the group has identified the right people, it's time to develop a framework. The plan should include the tools and loss control elements necessary to assist a team in influencing change. While every public entity loss control effort will need to include certain basic things, every loss control framework should be tailored to the specific loss exposures facing the pool. Most good loss control professionals desire to prevent every claim, but that is likely impossible. So, it's best to prioritize efforts and develop a plan to reduce losses in the short term for the entity's high-priority set of claim causes. Do this by identifying the top three to five causes of claims in each line of coverage offered and develop a strategy to reduce losses in those areas. Don't spend too much time in "compliance" areas of safety and loss control if you're not experiencing significant declines in those areas.

Again, within your pool's financial capabilities, fund scholarships, and continuing education opportunities for staff members from the pool membership. In Tennessee, sending pool members to the PRIMA Annual Conference, PRIMA Institute, and state chapter TnPRIMA Annual Conference, as well as police officers to specialized training, focused on the use of force, response-to-resistance, and de-escalation techniques have been very beneficial.

Framework. Each pool loss control effort will be different, but all should have a general framework of five elements.

Build relationships. Sound familiar? Create a process of "being there," including for contact, analysis, and review with members. Accomplish this through onsite surveys, pre-survey and postsurvey analysis of claims history, and telephonic communication and guidance. Further, be active in statewide associations within the functional areas of the pool's public entities.

Create a program for education, training, and information dissemination, including regional training, onsite classes and training,

Within the pool's financial capabilities, fund grant programs within critical exposure areas. For example, in Tennessee, successful grant programs include a workers' comp and safety grant, a driver safety grant for members with Auto General Liability coverage, a Property Conservation grant for those with property and crime coverage, and a police liability supplemental grant for POST-approved online police training.

An excellent underlying service mantra is co-opted from a quote from Abraham Lincoln: Do for your pool members what no one else will do for them, but don't do for them what they can and should do for themselves.

In closing, you want to build a team and an effort designed for implementing change: change in behaviors, change in policy, and change in practices. In Tennessee, the focus is on building a team and a framework within the "Dirty Dozen." Some of the internal Dirty Dozen standards include: Be a resource, not a police force Be a consultant, not an inspector or auditor Be teachable Be diligent Be accountable Be duplicable In the end, your loss control staff shouldn't simply be "on the team" or just "part of the team" with their pool members. They should be essential "teammates" with your membership.

NON-PHARMACOLOGICAL ALTERNATIVES TO OPIOID MEDICATION

BY DR. MICHAEL LACROIX, PH.D., MEDICAL DIRECTOR, THE HARTFORD AND DR. MARK S. WILLIAMS, DC, MBA, DACBOH, MEDICAL DIRECTOR, THE HARTFORD

R

emember opioids? They’ve been overshadowed recently by COVID-19, but the CDC found that opioids were involved in 46,802 overdose deaths in 20181—a very slight improvement over 2017’s 47,600 deaths.

Truth is, we have begun to make genuine progress on the opioid front. Some states have drawn legislation or regulations that better control physicians’ freedom to prescribe.

Learned bodies, including the American College of Physicians, the Joint Commission and Health and Human Services have issued guidelines for opioid prescriptions and management. But we are nonetheless still at the beginning of the turnaround: preliminary results indicate roughly the same number of deaths in 2019 as in 2018. Opioid overdoses continue to be a major health problem.

To better understand the appeal of opioids, one must consider the root cause, which is chronic pain. Chronic pain is different from acute pain, both in its physiological basis and in that it is strongly embedded in behavioral/psychological correlates (including depression, anxiety, fatigue, sleep problems, cognitive impairment, etc.) The National Academy of Medicine estimates that over 100 million people suffer from chronic pain in the U.S. These patients naturally ask for relief, and physicians (who do not like to see their patients suffer) feel duty-bound to provide them with medications to help them deal with their pain. And so, a comprehensive approach to the opioid epidemic requires more than that doctors prescribe more judiciously: patients must be given effective alternative options to deal with their pain.

stress reduction (moderate-quality evidence), tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, operant therapy, cognitive behavioral therapy, or spinal manipulation to follow a multi-disciplinary approach and to “initially select non-pharmacologic treatment with exercise, … acupuncture, mindfulness-based stress reduction, tai chi, yoga, … progressive relaxation, EMG biofeedback, low-level laser therapy, … cognitive behavioral therapy, or spinal manipulation.” Should these prove insufficiently effective, pain relievers with less addictive properties, such as NSAIDs, were recommended.

Opioids were to be considered only as a last resort.

For patients with chronic low back pain, clinicians and patients should initially select non-pharmacologic treatment with exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction (moderate-quality evidence), tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, operant therapy, cognitive behavioral therapy, or spinal manipulation.

Following these recommendations requires looking to health professionals beyond traditional medical providers and also policies that allow for payment of treatment with these modalities. Many of these modalities (and their providers) were once considered experimental or even “fringy”, but the American College of Physicians’ report makes clear the extent to which these should now be considered mainstream. Insurance coverage does remain a challenge in many cases. But with the aggregate cost of the opioid crisis estimated at $2.5 billion between 2015 and 2018 by the Council of Economic Advisers,3 covering these modalities would seem an investment well worth making.

FOOTNOTES 1 https://www.cdc.gov/drugoverdose/data/ statedeaths.html 2 https://annals.org/aim/fullarticle/2603228/ noninvasive-treatments-acute-subacute-chroniclow-back-pain-clinical-practice 3 https://www.whitehouse.gov/articles/full-costopioid-crisis-2-5-trillion-four-years/

Are there such alternatives? Emphatically, YES! Indeed, in a comprehensive report based on randomized controlled trials, the American College of Physicians2 specifically admonished physicians with chronic pain patients For patients with chronic low back pain, clinicians and patients should initially select non-pharmacologic treatment with exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based

SEPTEMBER /OCTOBER 2020 | PUBLIC RISK

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BEST OF THE BLOG

ARTIFICIAL INTELLIGENCE WON’T SOLELY PROTECT AGAINST RISK ON THE ROAD

A

BY STEPHANIE FORSTER, DIRECTOR OF INSURANCE PROGRAMS, SMARTDRIVE SYSTEMS, INC. lthough there have been great technological advancements in transportation, advanced driver-assistance systems (ADAS), computer vision (CV) and other forms of artificial intelligence (AI)—on their own—aren’t perfect. Today we have semi-intelligent systems that can “see” but cannot replicate all human sensory risk inputs, limiting their ability to mitigate road risk.

They do not change driving behavior; in fact, most drivers ignore when a semi-intelligent system is wrong, and also tend to ignore when the system is right. If a fleet is solely relying on artificial intelligence, specifically CV, its safety is at risk. Although these systems are part of a well-layered approach to mitigating risk on the road, humans still provide intelligence with the addition of their five senses, historical risk context for optimal road risk mitigation and coaching effectiveness.

Computer vision for transportation risk assessment is used to automate image processing/data capture to identify: • Pedestrians • Facial cues • Traffic signals and signs • Trucks, cars & scooters • Other objects Computer vision is also used in autonomous driving, ADAS (object detection, lane departure and pedestrian detection), parking assist, accident reconstruction/exoneration, claims processing and driver behavior analysis to detect distracted driving, drowsiness, mobile usage, drink/eating while driving and communication

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PUBLIC RISK | SEPTEMBER /OCTOBER 2020

with other passenger and passenger activities.1 However, computer vision faces many challenges. As a result, data, alone, can be limited by the circumstances in which it was captured, limiting the effectiveness of CV in risk detection.

Safety programs that facilitate humanto-human coaching that can reduce risk long-term and modify a driver’s behavior are the solution. Humans bring context, five senses and historical risk intelligence that sensors and CV cannot fully replicate at this point. “When we see, our brain is using the context and experience of our entire lives to help, which is one of the reasons we can see so much better than computers.”2 Humans serve to validate the data so that a safety program is effectively using accurate actionable data for coaching and behavior change. For instance, humans can hear and see greater distances and process that a child with a rolling ball may go into the street after the ball and react proactively vs. a sensor that can only pick up within a specific range to react.

A managed service environment as a tool used by humans for coaching and risk management provides a tremendous advantage over computer vision, alone.

Human review of the

data capture can help eliminate false positives and add needed context for human-to-human coaching to achieve behavior change and risk reduction.

A managed service enables fleets to save time and money by taking the burden off the fleet and providing consistent, unbiased and professional reviewing, scoring and prioritizing of thousands of videos. Only a managed service allows fleets to focus on their business— not on reviewing video.

FOOTNOTES 1 https://appen.com/blog/computer-vision-vsmachine-vision/ 2 https://austinstartups.com/human-versuscomputer-vision-94183d6737f6

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SLIP, TRIP, and FALL PREVENTION Reducing Wintry Weather Injuries

BY LORI SCHROTH, D.B.A., M.S., CSP, CIT, CHSP AND BRADLEY RENWICK, CSP, OHST

I

T’S NEAR THE END OF THE WORK DAY. You sit at your desk quickly trying to make final edits to a report so you can send it to your project manager before you leave. Your eyes keep darting to the clock to see if it’s time to leave and pick up your children—you don’t want to be late! Each minute ticks by as you rush to finish the report. When you notice you can’t wait another minute, you send the email, throw on your coat, and sling your laptop bag over your shoulder. You open the door to head to the parking lot and see a few inches of snow accumulated. You try to tread slightly as you step forward, but you quickly lose your footing, slide across cement, fall, and hit your head. This is a typical incident in organizations that commonly experience wintry weather and this incident could have been prevented. This article emphasizes the importance of considering slip, trip and fall incidents at your organization and preventative measures you can take.

Organizations frequently experience challenges in evaluating slip, trip, and fall (STF) risks since they apply to a vast range of jobs conducted in a wide range of work environments. Identifying STF hazards and evaluating risk is important though since STFs continue to contribute to winter weather-related incidents (Figure 1) and result in severe injuries (e.g., bruises, cuts, strains, fractures) and lost work days (National Floor Safety Institute, 2019). Over 200,000 non-fatal STF incidents involving days away from work in the private industry continue to occur each year (Figure 2). These numbers are much higher when considering incidents not resulting in days away, incidents occurring in the public sector, or even incidents that go unreported by employees. Additionally, ice, sleet, and snow are primary contributing factors to the more than 140,000 winter-related incidents related to floor, walkways, and ground surfaces each year (Figure 3). In more extreme cases, STFs may result in a fatality. In 2018, the U.S. Bureau of Labor Statistics found that 791 workplace fatalities resulted from STFs. Organizations may experience issues due to STF incidents, such as:

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PUBLIC RISK | JULY/AUGUST 2020

• Increased management time devoted toward the incident (e.g., complete incident paperwork, handle delays in production, investigate incidents), • Affects experience modification rates and insurance premiums, • Contributes to an increase of workers’ compensation fees and direct/indirect costs associated with injury, • Jeopardizes relationships with contractors and other interested third-parties, • Adds hurdles to have other employees (or temporary workers) fulfill the duties and responsibilities of the injured employee, • Decreases employee morale and performance when a close co-worker becomes injured, • Interferes with productivity deadlines, • Impacts the organization’s financial performance, and • Raises injury and illness incidence rates above the industry average.

STFs are preventable and need to be a top priority in organization, this is especially true if the organization has identified past STFrelated trends. This article presents strategies your workplace can implement to reduce, and possibly eliminate, winter-related STF incidents.

The suggested strategies are formed around the Occupational Safety and Health Administration’s (OSHA) Safety and Health (S&H) Program Guidelines.

MANAGEMENT LEADERSHIP

Leaders, managers, and supervisors are the leaders of S&H, setting the vision and providing the resources needed to make the vision come to life.

Consider the following initiatives so management can demonstrate their commitment and support to driving down STF-related incidents: • Establish winter campaigns geared toward STF hazard recognition and control • Participate in briefings regarding STF trends and incident investigation findings • Remind employees of organizational policies and procedures regarding winter weather • Brief employees on the hazards of winter weather and how it can impact their safety • Allocate funding toward needed facility improvements to reduce STFs • Set goals and objectives to reduce STF incidents [when a trend shows it is an ongoing concern at the organization] • Provide teleworking opportunities, when possible, so employees do not have to travel during hazardous wintry weather

• Lead by example, following and communicating policies and procedures, especially those related to injury reduction

EMPLOYEE PARTICIPATION

Use employee knowledge and experience to continually evaluate and improve incident reduction efforts. Strategies to increase employee participation include: • Form employee-led working groups to analyze past trends and identify initiatives to combat STF incidents [increases employee participation in S&H and in your organization’s decision making processes] • Link participation to an incentive program, awarding employees for their involvement in helping your organization recognize STF hazards and employ feasible controls

WORKSITE ANALYSIS

Organizations must recognize and assess STF and winter-related hazards. Ideas include: • Conduct hazard analyses for both routine and non-routine tasks (e.g., snow or ice removal), documenting anticipated STF hazards • Assign an individual to monitor winterrelated conditions • Develop processes to ensure employees wear appropriate footwear and personal protective equipment (PPE) while performing assigned job duties • Standardize the review and approval process for new equipment (e.g., mats, flooring materials, footwear) and chemicals (e.g., floor cleaners) • Integrate STF and winter hazard concerns into your change management process to evaluate flooring choices, stairwell design, lighting options, drainage requirements, and electrical outlet placement during pre-construction phases • Include STF hazards in all workplace safety inspections to catch unsafe conditions that may arise (e.g., leaking freezers, blocked drainage systems, hallway obstructions, slippery hallways) • Investigate all STF incidents (even near-misses) and determine causal factors to determine if action is needed to mitigate future incidents • Trend STF-related data periodically, looking at shared causal factors, work environments, and other dynamics to determine if corrective actions are needed, improve

7.6 and higher 4.5 to 7.5 2.2 to 4.4 0.8 to 2.1 0.7 and lower

FIGURE 1 Incidence rate per 10,000 full-time workers for occupational injuries and illnesses from ice, sleet, and snow-related events. The map shows an average 1.8 cases per 10,000 full-time workers that resulted in at least 1 day away from work in 2017. Source: BLS, 2019b.

250,000 245,000 240,000

247,120 240,160

238,610

235,000 230,000

227,760

225,000

229,240

220,000 215,000 2018

2017

2016

2015

2014

FIGURE 2 Number of non-fatal STF incidents involving days away from work, private industry, 2014–2018.

Source: BLS, 2019c; BLS, 2018; BLS, 2017; BLS, 2016; BLS, 2015.

155,000

153,960

150,000

148,650

145,000 140,000

143,770

140,790

142,650

135,000 130,000 2018

2017

2016

2015

2014

FIGURE 3 Number of non-fatal STF incidents related to floor, walkway, and ground surfaces, 2014–2018.

Source: BLS, 2019c; BLS, 2018; BLS, 2017; BLS, 2016; BLS, 2015.

SEPTEMBER /OCTOBER 2020 | PUBLIC RISK

17

SLIP, TRIP, AND FALL PREVENTION

training or S&H communications, or develop goals for reducing STFs • Continually identify the need for parking lot improvements (e.g., additional lighting, potholes, accumulation of rocks and leaves, areas that get icy frequently)

HAZARD PREVENTION & CONTROL

Implementing feasible, effective controls help to address the hazards identified once the workplace is assessed. Strategies to address STF hazards and incidents include: • Create housekeeping plans to mitigate unsafe work conditions, especially in areas that commonly become wet • Know that different shoe sole types have different traction properties, helping your organization choose PPE that aligns with identified hazards and work environments • Reduce the likelihood of a wet walking/ working surface: » Use slip-resistant mats at entryways » Place umbrella bags near entrances » Install wall-mounted spill pad dispensers » Supply high visibility caution signs (some even having flashing lights) » Utilize spill pallets to contain leaks • Fill up discarded plastic water bottles with ice melt so employees can sprinkle the parking lot to and from their vehicles, contributing to parking lot maintenance (Figure 4) • Establish health and wellness programs to promote the physical fitness of employees, which may help them more readily walk on ice and snow

FIGURE 4 A water bottle reused and filled with ice melt in which employees can sprinkle in the parking lot to and from their vehicle, contributing to parking lot maintenance.

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PUBLIC RISK | SEPTEMBER /OCTOBER 2020

• Apply reflective strips or paint to uneven walking/working surfaces to raise awareness of surface changes • Institute a cable and hose management policy, organizing cables and hoses (e.g., retractable cord holders), eliminating them from walkways (e.g., cord covers), and rerouting them when necessary to reduce the STF risk • Work with the facilities department to improve maintenance needs for areas with STF concerns » Develop snow removal schedules, prioritizing which areas to target first, responsible person(s), and methods of removal » Revise maintenance work schedules to remove snow and ice prior to the start of work shifts » Prioritize work orders based on risk, helping address issues and concerns that are more prone to injury first

EDUCATION & TRAINING

Education and training is essential in ensuring employees understand STF and winter-related risks, as well as how to control them and protect themselves against injury. Consider the following education and training strategies: • Incorporate STF information into education and training efforts: » Train employees on how to walk safely on snow and ice, and walking methods to prevent falls » Inform employees of STF hazards, winter risks, preventative measures, and safe work practices during new hire orientation » Instruct employees how to report hazardous conditions » Review footwear policies and expectations » Discuss available prevention equipment (e.g., harnesses, ice cleats, wet floor signs) » Educate those with snow removal responsibilities on equipment use, the need to take breaks during physical snow or ice removal, and signs and symptoms of over-exertion and cold stress • Provide ongoing communications to emphasize the prevention and control of STFs (e.g., organizational policies and procedures, workplace inspection findings, incident investigation findings, reporting methods for unsafe conditions) • Teach employees proper material handling and to evaluate walking paths prior to

material movement; paths can become wet or slippery in the winter • Share ways for employees to provide safety suggestions, helping your organization continually identify feasible and acceptable solutions to mitigate STFs • Provide a lessons learned summary after a STF incident to review the situation, the injury, and what could have been done to prevent the incident

PROGRAM EVALUATION AND IMPROVEMENT

Any action or control measure put into place must be evaluated to determine if it is effective. Organizations need to understand that sometimes implemented controls must be adjusted and even monitored over time to drive improvements. Organizations must utilize an ongoing plan-do-check-act process that aligns with OSHA’s S&H Program Guidelines to recognize STF and winter hazards, identify controls, and provide employees with the information needed to protect themselves against injury. STFs can easily be prevented and application of this process helps organizations proactively assess risks to drive down STF incidents while continuously identifying opportunities for improvement.

CONCLUSION

STFs are preventable. It is important for your organization to understand where the greatest risks for STFs exist, especially in the winter when there is an increased risk of STF incidents. Organizations need to be proactive in recognizing hazards and selecting hazard controls to protect employees against the STFs in which impact an organization’s productivity, performance, and financial success. There are various strategies an organization can employ to address STF hazards and drive down incidents; such as those related to management leadership, employee participation, worksite analysis, hazard prevention and control, and education and training. It is important to constantly re-evaluate employed controls and taken actions to determine if they are effective and feasible for your organization’s work activities and operations. Addressing STF hazards needs to be an ongoing process and the shortcomings and opportunities of improvement must be considered for incident prevention purposes.

Lori Schroth, D.B.A., M.S., CSP, CIT, CHSP is a Senior Safety & Environmental Professional at Concurrent Technologies Corporation in Johnstown, PA. Bradley Renwick, CSP, OHST is a Safety & Occupational Health Professional at Concurrent Technologies Corporation in Johnstown, PA. REFERENCES

National Floor Safety Institute [NFSI]. (2019).

Slip & fall quick facts. Retrieved from https:// nfsi.org/nfsi-research/quick-facts/

Occupational Safety & Health Administration [OSHA]. (n.d.). Recommended practices for safety and health programs. https://www.osha. gov/shpguidelines/

U.S. Bureau of Labor Statistics [BLS]. (2019a, December 17). Census of fatal occupational injuries summary, 2018. https://www.bls.gov/ news.release/cfoi.nr0.htm

U.S. Bureau of Labor Statistics [BLS]. (2019b, March 4). Ice, sleet, and snow-related occupational injury and illness rate down in 2017. https://www.bls.gov/opub/ted/2019/icesleet-and-snow-related-occupational-injuryand-illness-rate-down-in-2017.htm?view_full

U.S. Bureau of Labor Statistics [BLS]. (2019c, November 7). Table R33: Number of nonfatal occupational injuries and illnesses involving days away from work by event or exposure leading to injury or illness and selected source of injury or illness, private industry, 2018. https://www.bls. gov/iif/oshwc/osh/case/cd_r33_2018.htm U.S. Bureau of Labor Statistics [BLS]. (2018).

Table R33: Number of nonfatal occupational injuries and illnesses involving days away from work by event or exposure leading to injury or illness and selected source of injury or illness, private industry, 2017. https://www.bls.gov/iif/ oshwc/osh/case/cd_r33_2017.htm

U.S. Bureau of Labor Statistics [BLS]. (2017).

Table R33: Number of nonfatal occupational injuries and illnesses involving days away from work by event or exposure leading to injury or illness and selected source of injury or illness, private industry, 2016. https://www.bls.gov/iif/ oshcdnew2016.htm U.S. Bureau of Labor Statistics [BLS]. (2016).

Table R33: Number of nonfatal occupational injuries and illnesses involving days away from work by event or exposure leading to injury or illness and selected source of injury or illness, private industry, 2015. https://www.bls.gov/iif/ oshwc/osh/case/ostb4785.pdf U.S. Bureau of Labor Statistics [BLS]. (2015).

Table R33: Number of nonfatal occupational injuries and illnesses involving days away from work by event or exposure leading to injury or illness and selected source of injury or illness, private industry, 2014. https://www.bls.gov/iif/ oshwc/osh/case/ostb4399.pdf

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HAS YOUR ENTITY LAUNCHED A SUCCESSFUL PROGRAM? An innovative solution to a common problem? A money-saving idea that kept a program under-budget? Each month, Public Risk features articles from practitioners like you. Share your successes with your colleagues by writing for Public Risk magazine! For more information, or to submit an article, contact Jennifer Ackerman at jackerman@primacentral.org or 703.253.1267.

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Building a Peer Support Program OCTOBER 14 | 12:00 – 1:30 PM EST SPEAKERS: Mahlon Johnson, Technician II, Fauquier County (VA) Fire & Rescue Jessica Saunders, Lieutenant, Fauquier County (VA) Fire & Rescue Gina Pincosy, Clinical Social Worker, Tanglewood Therapy PLLC DESCRIPTION: Explore the importance of a peer support program for firefighters while examining the importance of mental health education. Learn how to reduce the stigma of a holistic approach to firefighter health, and gain an explanation of how a peer support program is organized and utilized.

ATTENDEE TAKEAWAYS: 1. Purpose of a peer support team 2. Importance of mental health education 3. Need for the reduction of stigma in the fire department 4. Mental health resources that can be utilized

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