Section 1.7 Disability and Worker's Compensation

The subject of employee heath and welfare has always been a high priority to the Department. Firefighter mortality and morbidity are constant concerns due to the dangerous nature of the profession.

The Department continues to look for creative and cost effective mechanisms to safeguard the health and welfare of its members, optimize the use of modified limited duty and reduce the use of overtime used by the Department. The Department has made great advances in the new MOU with 798, is currently developing a Comprehensive Safety Program (CSP), and is investigating the possibility of considering attendance as a criteria for promotions.

We appreciate the opportunity to address the recommendations of the Audit team in this critical section.

· Recommendation of Auditor"s report

1.7.1 Create a comprehensive Safety Program to ensure that activities pertaining to sick leave, disability pay, workers compensation and limited duty are properly coordinated with other Departmental activities-such as recruitment, training and financial management-and administered to reduce the impact on overtime and optimize the use of limited duty.

· Assessment of Department

The Department concurs with the recommendation of the audit.

The concept of the Comprehensive Safety Program (CSP) has been in development for some time. With the myriad of hazardous and toxic materials that our firefighters must contented with on a daily basis, the need to provide additional resources to safeguard their health and safety has never been greater. While there are still a number of important facets of this program that are in development, a number of the seminal elements of the Program have been identified.

The CSP program will, out of necessity, weaves its way through a number of Divisions and Bureaus within the Department. It is envisioned that the CSP would have both operational and administrative responsibilities. There would be a 24 X 7 presence in the form of a safety officer (SO). The SO would be job responsibilities would include but not be limited to:

· Responding to all working fires to ensure fireground safety

· Investigation of all fire ground injuries and the development of preventative recommendations

· Responding to all Hazardous Materials incidents to assure all units adhere to industry standard safety practices

· The completion of after action reports for fires, Hazardous Material, and multi-causality incidents

· Responding to all accidents involving Department vehicles

· Completion of all accident investigations and reports

The CSP will also have a strong administrative component. The administrative responsibilities of the CSP manager will include, but not be limited to:

· Management and oversight of the accident database

· Working with the Office of the Department Physician to identify trends of employee injury and illness

· Development of an aggressive accident prevention program (including recommendations for disciplinary action when appropriate)

· Working with the Division of Training to develop training programs based on Continuos Quality Improvement data for prevention of accidents, injuries and illness

· Development of a comprehensive set of safety policy and procedures

· Participation in Department and City work-groups and committees related to employee health and safety and vehicle accidents

· Oversight of Department OSHA compliance and working with Support Services to develop short and long term goals for facility compliance

· Working with Clothing Depot / BOE personnel to evaluate any new products related to employee health and safety

The CSP must contain a strong Continuing Quality Improvement (CQI) component. It the responsibility of the CQI component to identify those contributing factors to an accident that can be addressed through additional training, equipment modification and / or procedural amendment.

The auditor correctly recommends that the CSP work with other Department units to reduce the impact on overtime and optimize the use of limited duty personnel. In table 1.7.1 the Auditor compares the budgeted to actual overtime use by the Department in 1994 through 2001. The Auditor fails to note that due to changes in the service allocations from 1998-1999 forward, it is difficult to compare expenditures prior to that time. In the beginning of 1997-98, the minimum staffing for the Fire Department was 296 members. On July 1, 1997, ambulance service was transferred from the Department of Public Health to the SFFD. On February 21, 1998, medic units began being deployed on 24 hours shifts. Minimum staffing increased by 32 employees to staff 16 ambulances.

In 1999-2000, through the budget process, the Department was authorized to increase the number of ambulances from 16 to 21. To accommodate the increase in ambulances, the staffing of Station 48 on Treasure Island, and the four (4) Rescue Paramedic Captains, the daily minimum staffing increased to 354. This change represents an increase in daily staffing levels of 20 percent since 1997-98.

In comparing the actual expenditures from 1998-1999 through 2000-2001, the growth in expenditures is similar to the COLA increases in salaries for uniform personnel over the same time period. For example, the COLA increase in 1999-2000 was 5.5 percent. In comparison as the table indicates, the growth in overtime was approximately 5.9 percent. Even in 2000-2001, the COLA was 5.5 percent but the increase in cost was only 2.2 percent.

· Department Action plan and timeline

The CSP in currently in development and will formally begin July 2002.

· Recommendation of Auditor"s report

1.7.2 Establish practicable targets through and in cooperation with the Safety Program for the use of sick leave, disability pay and limited duty assignments in the Department"s staffing model.

·Assessment of Department

The Department is currently analyzing the recommendation of the audit.

Targets cannot be used in the development of the Department"s staffing model. The model must use what is expected to occur in order to project actual expenditures. Such inclusion could lead to false expectations and the need for supplemental funding by the Department. Placing it in the model would reduce the Department"s budget before achieving any goal. However, the Department is always pursuing reductions in the use of sick leave, disability pay and limited duty.

On the whole it is difficult to make accurate predictions regarding use of disability pay, limited duty assignments and sick leave. However, the Department has introduced the new measures in an effort to reduce these costs.

In the negotiation of the Local 798 Firefighter MOU, the Department was able to put forth a new pilot wellness program to reduce the use of sick leave. Per Section 32 of the new MOU:

32.2 Effective July 1, 2002, any full-time employee leaving the employment of the City upon service or disability retirement may receive payment of a portion of accrued sick leave credits at the time of separation.

32.3 The amount of this payment shall be equal to two-and-one-half percent (2.5%) of accrued sick leave credits at the time of separation time the number of whole years of continuous employment times an employee"s salary rate, exclusive of premiums or supplements, at the time of separation...

32.4The number of hours for which an employee may receive cash payments shall not exceed one thousand forty (1040) hours, including any vested sick leave, for employees scheduled to work 40 hours per week or one thousand two hundred seventy two (1,272) hours, including any vested sick leave, for employees scheduled to work 24-hour shifts...

Also, the Department was able to establish a new temporary modified duty policy in Section 44 of the Local 798 MOU. As part of the new policy, members who sustain non-industrial injuries or illnesses are not eligible for temporary modified duty assignments for the following waiting periods after notifying the Department of the injury or illness: twenty (20) calendar days during the first year of employment after graduation from the SFFD Academy; forty (40) calendar days during the second year of employment, and sixty (60) calendar days after the end of the second year of employment, and thereafter. During this waiting period members should use accrued sick leave, or if the member"s sick leave balance is exhausted, other approved leave. Pregnant members are entitled to go on temporary modified duty without any waiting period. This provision is intended to encourage members to reduce the use of sick leave.

The new MOU with 798 clearly defines the limits of Limited Duty assignments. "At the end of thirty (30) days of a temporary modified duty assignment, and every thirty (30) days thereafter, the Department"s physician may review the member"s medical condition and determine, after consultation with the member"s treating physician and or, where appropriate, the City"s independent medical expert, whether the member is able to return to his or her regular assignment. If it is determined that the member is not then able to return to his or her regular assignment, the Department may extend the temporary modified duty assignment for periods of thirty (30) days, up to a maximum of one (1) year. Modified duty assignments may not exceed thirty (30) days with extensions to a maximum of one (1) year1."

The new MOU also prohibits the use of sick pay on or about a holiday without a significant monetary penalty for the member. If the Department member uses sick pay on the day before, the day of, or the day after a legal holiday, the member forfeits the 6% holiday premium for two pay periods otherwise earned.

The Department has already established a medical certification protocol for use of sick pay. In this program, any member who misses a weekend watch or 2.5 watches per year must obtain medical certification for all subsequent use of sick pay. General Order 00A-93 was issued in October of 2000 requiring members to notify the Department verbally and obtain medical certification.

When a member is injured at work, he/she is automatically placed in Sick Pay Industrial (SPI) status. SPI requires the member to use sick leave until verification from the Workers Compensation Division of the Department of Human Resources has been received by the Department reporting that the member has, in fact, incurred a work related injury.

· Department Action plan and timeline

The Department"s wellness program is part of the new MOU between Local 798 and CCSF FY2001-2002 and FY 2002-2003 and begins formally on July 1, 2002.

·Recommendation of Auditor"s report

1.7.3 Utilize its current authority to initiate Industrial Disability retirements, as appropriate.

· Assessment of Department

The Department concurs with the recommendation of the audit.

Currently the Department is meeting with the City Attorney"s Office as part of the new temporary modified duty (TMD) policy to establish a process to initiate Industrial Disability retirements. The Department has never initiated an Industrial Disability Retirement.

· Department Action plan and timeline

The Department anticipates having a policy in place by July 2002

· Recommendation of Auditor"s report

1.7.4 Participate more directly with the Department of Human Resources Workers Compensation Division in the careful review of all retiree claims to ensure in a timely manner that they meet the legal requirements for acceptance and are not improperly approved due to inattention or carelessness.

· Assessment of Department

The Department concurs with the recommendation of the audit but is unable to comply as this recommendation is outside the operations and authority of the Department.

· Department Action plan and timeline

This issue will be forwarded to the Worker"s Compensation Department /Department of Human Resources since they are the governing and responsible bodies for retiree claims. The Department focuses it energy on active employees, as it will directly impact other areas of the budget.

· Recommendation of Auditor"s report

1.7.5 Assist in the vigorous scrutiny of all new industrial injury claims by active uniformed personnel for assurance of adequacy before acceptance.

· Assessment of Department

The Department concurs with the recommendation of the audit.

The Department agrees that uniform personnel should adequately document the reporting of new industrial injury claims and will continue to work with the Workers Compensation Division of the Department of Human Resources to closely monitor all claims.

· Department Action plan and timeline

The Department continues its activity its on this issue on an on-going basis.

· Recommendation of Auditor"s report

1.7.6 Continue working with the Department of Human Resources Workers Compensation Division to enhance the Fire Department"s information system applications for purposes of a comprehensive safety program, tracking claims and more effectively dealing with industrial injuries and illnesses.

·Assessment of Department

The Department concurs with the recommendation of the audit.

· Department Action plan and timeline

The Department continues to work with the Department of Human Resources on this issue.

· Recommendation of Auditor"s report

1.7.7 Establish two positions (H30 Captain or equivalent civilian and 6137 Assistant Industrial Hygienist) to manage a comprehensive and strategic safety program that addresses the full range of human and environmental factors in a proactive and systematic way.

· Assessment of Department

The Department will analyze the recommendation of the audit.

The Department is currently developing its Comprehensive Safety Plan (CSP) and anticipates the formal implementation of the program in July 2002. While the plan is still in development, it is clear that there needs to be both a strong operational and administrative component to address the "full range of human and environmental factors in a proactive and systematic way." In order to provide the supervision, oversight and critical operational component that the program requires to be successful, the Department will use a work flow analysis as part of the development of the program to determine the staffing requirements and the appropriate rank for members assigned to this unit.

· Department Action plan and timeline

The CSP in currently in development and will formally begin July 2002.

· Recommendation of Auditor"s report

1.7.8 Convert uniform positions to civilian positions where appropriate to reduce disability pay exposure (please refer to Section 2.3 of this report).

·Assessment of Department

The Department is currently analyzing the recommendation of the audit.

While the Department always seeks to evaluate changes that benefit the organization, wholesale changes solely based on budgetary concerns are not desirable. The Department endorses a critical and systematic approach to each position recommended for civilization, and a cost benefit analysis that acknowledges more than just the differential savings inherent in their civilization. Questions of operational expertise, redundancy for mission critical positions, retention of personnel, chain of command, and concern about the multiplicity of unions must be answered before positions are transitioned to civilian classifications.

Please refer to response in Section 2.3 for the analysis of individual positions.

· Recommendation of Auditor"s report

1.7.9 Vigorously enforce the Department"s existing policy of a one-year limit on limited-duty assignments.

· Assessment of Department

The Department concurs with the recommendation of the audit.

· Department Action plan and timeline

Completed.

The Department completed this project as part of newly ratified MOU with Local 798.

Per the new Local 798 MOU Section 44, at the end of thirty (30) days of a temporary modified duty assignment, and every thirty (30) days thereafter, the Department"s physician may review the member"s medical condition and determine, after consultation with the member"s treating physician or, where appropriate, the City"s independent medical expert, whether the member is able to return to his or her regular assignment. If it is determined that the member is not then able to return to his or her regular assignment, the Department may extend the temporary modified duty assignment for periods of thirty (30) days, up to a maximum of one (1) year. The Department has already embarked upon weekly meetings to monitor the industrial and non-industrial injuries and illnesses.

· Recommendation of Auditor"s report

1.7.10 Work cooperatively with the Department of Human Resources and establish internal procedures to monitor sick leave use against the Pilot Incentive Wellness Program to validate its effectiveness.

· Assessment of Department

The Department concurs with the recommendation of the audit and has completed the planning for the Department"s wellness pilot program.

· Department Action plan and timeline

Completed.

The pilot program formally begins on July 1, 2002. As with all incentive programs, the Department will evaluate its effectiveness.

1 Section 44 of MOU between the CCSF and Local 798 FY 2001-2002 and FY 2002-2003.