Believe it or not we are having fun with PCoRP's Coverage Document right now. It is one of those "behind the scenes" things we do every year, part of trying to keep a living document relevant, with the goal of being as clear as possible about what PCoRP covers and what it does not. Here's a real life example: a Pennsylvania city had a tragic event a couple of years ago, where a police unit had returned to the station and while cleaning up after some training an officer accidentally discharged his weapon, killing an officer. The family of the victim sued the city, alleging that the city's training was not followed, and the city's insurer denied coverage citing a provision excluding coverage for injuries at work. The city sued their insurance company, and a federal court just upheld the insurer's denial of coverage. The city is planning to appeal. We reviewed the PCoRP Coverage Document and we have the same exclusion. We are going to talk to our reinsurers about it and check to see how this coverage should be provided. It looks to us like the city's workers' compensation coverage should respond as part of the Employer's Liability policy, but we want to double check.

By Christie Ward, Captive Programs Manager

By John Sallade, Managing Director, Insurance Programs

By Christie Ward, Captive Programs Manager 

The eighth annual PELICAN subscriber's meeting will be held on Wednesday, May 4, 2011, at the Sheraton Harrisburg, during the PACAH Spring Conference. The meeting will begin at noon with a buffet luncheon followed by a short business meeting. The agenda will include an election to fill three positions of PELICAN Subscriber Advisory Committee (SAC) members whose terms expire in 2011.
 
PELICAN Insurance subscribers and their producers are invited to attend. There is no charge to attend but pre-registration is required. Look for the meeting notice to arrive by e-mail in late March or contact Susan Horne. 
 
For more information on PELICAN Insurance RRG, please contact Christie Ward at

cward@pacounties.org or (800) 895-9039.

By Linda Rosito, Insurance Training Director

Please mark your calendars for this year's County Administration Conference. This two day event is designed specifically for county employees interested in budget and finance issues, administration issues and personnel and human resource issues. The conference is being held on Wednesday, June 1 and Thursday, June 2 at The Atherton Hotel, State College.

Registration information and a tentative agenda will be available later this month. We hope you can attend this excellent educational opportunity.

PELICAN SAC Returns $1,000,000 Dividend For The Second Year in a Row

By Christie Ward, Captive Programs Manager

For the second year in a row, the PELICAN Subscribers Advisory Committee has released $1 million in surplus as a dividend for subscribers renewing for the March 1 policy year.

The Vermont Department of Insurance, which regulates PELICAN's operations, has approved the SAC's request for the dividend distribution. The actual amount of each Subscriber's dividend is based on their annual Subscriber Surplus Account allocations. This means subscribers who have been part of PELICAN since its inception in 2003 will receive a larger dividend than those who have joined in more recent years. Since the SSA allocations are also based on the amount of premium each subscriber paid to PELICAN, it follows that subscribers with larger premiums will receive a larger share of the dividend.

While this is the second year in a row that PELICAN has declared a dividend, it is important to emphasize that this is not necessarily something that will happen each year. The SAC reviews PELICAN's finances very closely and we are fortunate there is presently sufficient funding to provide this dividend. However, results may be different in other years. We urge members not to budget for or expect a dividend return each year.

The PELICAN SAC has also approved no change to the rates for 2011. The rate will remain $436 per skilled nursing bed. The rating basis for non skilled beds also remains the same, with Independent Living beds rated at 25% of the skilled bed or $109, the Assisted Living bed rated at 50% of the skilled bed or $218 and the Adult Day Care rated at 10% or $44, based on average number of clients per day.

By John Sallade, Managing Director, Insurance Programs

Two resignations and the recent PComp election have resulted in three new members of the PComp Board of Directors.

The voting for the six elected positions on the PComp Board of Directors ended on February 18. These individuals were elected to two year terms ending December 31, 2012:

Joe Giles, Erie County Councilmember, 2, 2A, 3^rd & 4^th Class Counties Representative

Bob Gress, Monroe County Chief Clerk, 5^th Class Counties Representative

Donna Hartle, Clarion County Commissioner, 6^th Class Counties Representative

Steve Howsare, Bedford County Commissioner, 6^th Class Counties Representative

Dee Robinson, Union County Chief Clerk, 7^th and 8^th Class Counties Representative

Otis Riden, Mifflin County Commissioner, At Large Representative

Five of the elected representatives were reelected, and one (Commissioner Riden) is new to the board.

In addition, at their February 19 meeting the board filled two vacancies. Derek Williams, Tioga County Chief Clerk, was appointed to fill the remaining year of Tioga Commissioner Sue Vogler's term. Commissioner Vogler resigned from the board. And Ryan Unger, Principal Program Analyst, Management for SEDA-COG, was appointed as one of the County Related Entity Representatives to replace Bonnie Meckley, also of SEDA-COG, who resigned from the board.

Congratulations to those reelected, and welcome to Otis, Derek and Ryan!

By Bob Lauzonis, CCAP Loss Control Specialist

INTRODUCTION

Most people are aware that outdoor air pollution can damage their health but may not know that indoor air pollution can also adversely impact their health. Environmental Protection Agency (EPA) studies of human exposure to air pollutants indicate that indoor air levels of many pollutants may be two to five times, and occasionally more than 100 times, higher than outdoor levels. These levels of indoor air pollutants are of particular concern because it is estimated that most people spend as much as 90% of their time indoors.

Over the past several decades, our exposure to indoor air pollutants is believed to have increased due to a variety of factors. Those factors include the construction of more tightly sealed buildings, reduced ventilation rates to save energy, the use of synthetic building materials and furnishings, and the use of chemically formulated personal care products, pesticides, and household cleaners.

Poor indoor air quality (IAQ) is an increasing concern among building managers and occupants. IAQ problems are often difficult to solve because workers' symptoms are usually diverse and subjective. Common complaints include drowsiness, headaches, nausea, eye and throat irritation, and itchy skin-symptoms that can arise from a variety of causes, not just IAQ issues.

CAUSES OF IAQ PROBLEMS

In most cases, the health effects of poor IAQ are not disabling, and actual workers compensation or disability claims are unusual (but they can occur). Poor IAQ often increases absenteeism, and building-related complaints can convert to real dollar losses in employee downtime, reduced worker morale, business interruption, and depending on the airborne contaminants, potentially devastating medical costs.

The causes of IAQ problems are even more diverse than the complaints. It's rare that a single, causative factor can be identified, isolated and eliminated. An effective IAQ evaluation should consider the following factors, which are the most frequent contributors to poor IAQ.

CONTRIBUTING FACTORS

Inadequate Fresh Air: An inadequate amount of clean, outside air in the building is the factor most frequently associated with IAQ problems. A constant infusion of fresh, outdoor air serves to dilute building pollutants to acceptable levels. The American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE), in their 62.1-2004 Standard, Ventilation for Acceptable Indoor Air Quality, issues recommendations for the amount of outdoor air that should be brought into a building based on the type of occupancy, the number of occupants within the building and the overall square footage of building space being serviced by the affected air handler.

Biological Contaminants: Biological infestations of air conditioning systems and humidifiers have caused some of the most serious IAQ incidents. The first major outbreak of Legionnaire's Disease resulted when a pneumonia bacterium was spread through a ventilation system. Buildings with issues that compromise the building envelope, such as leaky roofs, windows, or other types of issues causing water damage, can harbor microbial growth that can cause reactions among persons who are sensitive to mold spores and other microorganisms. Porous water-damaged building materials such as sheetrock, carpet and ceiling tile provide good mediums for fungal growth. Correctly designed and installed vapor barriers on buildings can help reduce biological contamination potential.

Smoking: Environmental tobacco smoke is typically considered irritating to the nonsmoker. Inadequate control and isolating the smoking can tax an otherwise adequate building ventilation system and cause widespread complaints. Many municipal and PA state laws now limit where smoking is permitted in indoor environments.

Humidity: Another guideline (ASHRAE) recommends keeping the designed worst case relative humidity upper limit below 65 percent indoors. The generally recommended workspace humidity control range is 30-60 percent. Some investigators claim that low humidity (less than 30 percent), especially troublesome in cold weather, can contribute to throat and nasal passage dryness, cause generation of static sparks and result in skin irritation that gives the sensation of "bug bites." A hot, humid climate may also be a contributor to IAQ symptoms. High humidity (greater than 60 percent) can promote excessive microbial growth in building ventilation systems and may promote mold or mildew growth on walls and other interior surfaces.

Building Pressure: Proper pressurization within a building is a very important factor that needs to be maintained on a consistent basis for adequate IAQ over a long period. Buildings should be designed to be under a slight positive pressure with relation to the outdoors so that any leaks in the structure can migrate from inside to outside. Negative pressure buildings tend to draw un-tempered and unfiltered air into the building walls allowing contact with building materials that are the same temperature as the interior of the building but vastly different from those outdoors. Under certain conditions, moisture can then condense on these building surfaces, potentially resulting in mold growth.

New Furnishings: The contribution of carpeting and room furnishing materials is sometimes exaggerated, but should not be overlooked when investigating problems. Initial off gassing of organic volatiles from new furnishings can exacerbate existing IAQ problems, even if they are not primary contributors.

Vehicle Exhaust: Parking garages and loading docks with idling vehicles (trucks, forklifts, etc.) can send exhaust into buildings, causing subsequent complaints. The carbon monoxide component of engine exhaust is a potentially serious threat to health and should be investigated thoroughly. If engine exhaust is suspected as a source of building air pollution, immediate corrective action is advised. The outside, air-intake vent for the HVAC system should be located to minimize the intrusion of contaminated air.

Other sources of carbon monoxide should also be considered. Natural gas cooking equipment produces carbon monoxide. Buildings with kitchens should have adequate exhaust ventilation to remove the carbon monoxide that is produced by gas-fired appliances. Portable gasoline or liquid petroleum powered equipment can also produce carbon monoxide. Portable generators, cooking equipment or fuel burning heaters should be placed in well ventilated areas to avoid introducing carbon monoxide gas in the building.

Temperature Extremes: Problems related to a too-cool or too-warm building environment are usually the easiest to identify, but they may be difficult to resolve because of disagreements among workers about what constitutes a comfortable temperature. Since climate comfort is a function of both temperature and humidity, complaints related to temperature extremes may, in fact, help identify problems with building humidification. The two previously referenced ASHRAE guidelines address temperature and humidity issues. 

ASSESSMENT STRATEGY

Below are steps building facilitators can take to ensure that the IAQ in their building is healthy. By taking a proactive approach, counties can lessen the chance that problems will occur and be ready to deal with IAQ issues when they do arise.

Inspect and Maintain the HVAC System: The heating, ventilation, and air-conditioning (HVAC) system is probably the single most important factor affecting IAQ. The HVAC system is not only responsible for providing fresh, outdoor air to a building, it also filters out unwanted particles, such as pollen and dust, and conditions the air to a comfortable temperature and humidity. Regularly inspecting and maintaining this system so that it functions properly is essential. This means more than an occasional filter change.

Identify and Control Sources of Indoor Air Pollutants: Indoor air pollutants in the form of particulates, fibers, mists, bioaerosols and gases can originate within the workplace, or they can come from outdoors. Some potential indoor sources include new building materials and furnishings, microbial growth on water-damaged materials, cleaning products, copy and printing areas, trash and insects and other pests. Some outdoor sources of indoor air pollutants include vehicles parked at loading docks, bird droppings or other debris near air intakes, and building exhausts located near air intakes. Pollen, dust and fungal spores that originate outdoors can also pollute the indoor environment.

Provide Regular and Appropriate Housekeeping: Housekeeping in the workplace is not simply a matter of appearance: it should also improve the IAQ in the building. But if done improperly, housekeeping can contribute to indoor pollution by reintroducing dust and dirt into the air or introducing toxic or irritating cleaning chemicals. Therefore, it is important to ensure that appropriate cleaning methods, equipment and products are used.

Prevent Mold by Controlling Moisture and Relative Humidity: For sensitive individuals, exposure to molds can cause symptoms such as nasal stuffiness, eye irritation or wheezing. Some people, such as those with serious allergies to molds, may have more severe reactions. People with chronic illnesses, such as obstructive lung disease, may develop mold infections in their lungs. Mold thrives in the presence of water. The secret to controlling mold is to control moisture and relative humidity. Leaking roofs and pipes, spills, condensation, and standing water can all lead to mold growth. Therefore, controlling potential sources of moisture and responding quickly and appropriately to unexpected events, such as leaks, can prevent the growth of mold.

Anticipate and Minimize the Impact of Renovation and Repair on IAQ: Demolition and construction activities can release dust and other air contaminants. Paint, carpeting, and new furnishings can all emit volatile organic compounds (VOCs). Even outside activities, such as roof repair, can have a negative impact on IAQ. The best time to address the effects of renovation and repair on IAQ is in the planning stage. Selecting low VOC emitting materials and furnishings, scheduling work when the building is empty, isolating the construction activity, and temporarily closing air intakes during roof repair are just a few ways to minimize any negative impact on IAQ.

Establish a System for Responding to IAQ Complaints: Unresolved IAQ complaints can not only affect comfort, health, and productivity, they can also affect employee morale. Therefore, a system for dealing with complaints should be established. Make sure employees know to whom complaints should be reported. All complaints should be referred to the building facilitators. Complaints should be logged, addressed promptly, and tracked until resolved. Follow-up to ensure that the resolution is permanent is also important.

LEARN MORE ABOUT IAQ

The Environmental Protection Agency has a wealth of information on IAQ. To learn more, visit the EPA Web site.

By Bob Lauzonis, CCAP Loss Control Specialist

• When a person is wide awake, alert and mentally active they are still only aware of 25 percent of what various parts of their body are doing.
• What's the safest time in a person's life? Actuarial tables show that a person living in the United States has the greatest chance of staying alive another year at nine, ten and eleven than at any other age. These are the years with the lowest mortality rates. After eleven, it's all downhill.
• Percentage of Americans who report never using a seatbelt--32%.
• According to the American Society for the Study of Headaches, 80 percent of migraine sufferers are women.
• Both flies and frogs have been known to catch athlete's foot.
• Leadership is action, not position. (Donald H. McGannon)
• Action may not always bring happiness, but there is no happiness without action. (William James)
• As I grow older, I pay less attention to what others say, I just watch what they do. (Andrew Carnegie)

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By Dave Harman, Claims Manager

When is the last time your county reevaluated your workers' compensation panel provider list? Were you able to improve it? Are you dissatisfied with your panel doctors?  Are the panel providers giving you a chance to accommodate restrictions given to injured workers or are they just taking the injured employee off work? If these questions sound familiar, consider this: how often do you talk to your panel providers and do they know what you expect from them?

Panel providers are a key component in the initial evaluation of any worker's compensation claim. These providers are the people that your workers must seek out to provide care during the first ninety days after a work injury occurs. It is these providers that are needed to provide a proper evaluation and treatment plan for your workers. And it is this reason that these providers are so important, so your workers can get back to being productive members of your workforce.

Because making sure that your injured employee treats with a panel provider, you need to make sure that your employees are aware of who your providers are. The easiest way to accomplish this is to provide a list of the panel providers when you give the injured employee a copy of their rights and responsibilities form at the time of injury. You also need to make sure that your workers' compensation carrier has an up to date list of your panel so they can help make sure that your employees are using the list appropriately.

Communication is the key to a successful return to work program, and it all starts with the employer and the panel providers. Call your panel physicians and ask to set up a time to speak with them regarding the county and its policies and what you expect from them as your panel physician. Provide them a list of job descriptions and let them know that you are willing to accommodate restrictions to bring injured employees back to work.  While counties are often frustrated that panel doctors keep injured employees off work when they have light duty work available, many times it is because the doctors' do not realize that such positions are available. 

Be sure to ask the right questions. Instead of asking the panel provider to check off a list of what the injured employee CAN'T do, provide the panel provider with a copy of the employee's job description and allow them to decide what the employee CAN do! Ask the panel provider what you, as the employer, can do to get the injured employee back to work. Show them you are committed to treating your employees fairly and are providing transitional work for your employees so they can stay productive while they recover.

If you, as the employer, have concerns about the injured employee and their current situation, tell the panel provider. Schedule time with the them, prior to the injured employee's appointment, to discuss your concerns and tell them this employee has been seen dancing, bowling or doing whatever activity seems inappropriate given their injury.  Reiterate to the panel provider that you have transitional duty available and are committed to supporting the injured employee.

Another important part is talking to the injured employee. Don't let an injured employee who is off work think that they are "out of sight and out of mind." Neglect breeds resentment! Injured employees who don't feel as though they are part of a team have little incentive to recover quickly and get back to work and will then be more willing to tell the panel providers that they are not feeling any better. Encourage the injured employee to talk to you and be available to them for questions they may have. Let the injured employee know you care about them and are willing to accommodate restrictions. Try to be flexible and allow them to make up time they may have to take for the work injury related doctor appointments or physical therapy sessions.

You also want to make sure that you have a wide variety of services available to your employees on your panel list. Make sure, if possible, that you list more than just local doctor offices and hospitals on your panel provider list. Rehabilitation centers, Ophthalmologists, Chiropractors and other specialists should be on your panel. By doing this, your workers are required to go to these specialists for their initial treatment. And hopefully these providers already know about your willingness to get your employees back to work as soon as possible, whether it is full time or in a modified duty position. Remember, if you do not have a specialist on your panel and your worker needs that type of specialized treatment for their injury, they have the right to go wherever they want from day one!

Communication is the key to the success of any program. By asking the right questions of your panel providers, having a wide selection of providers for your employees to choose from and making your injured employees know you care, you can get your employees back to work more quickly.

However, if you have a panel provider who cannot or will not work with you, you have every right to replace them on your provider list with another provider who may be more than willing to work with you. So review your panel list on a yearly basis. Make sure that you are satisfied with not only the treatment they are providing to your injured employees, but also with their willingness to work with you in getting your employee back to work.

CCAP Insurance Programs
PO Box 60769, Harrisburg, PA 17106-0769
Phone (800) 895-9039 - FAX (717) 526-1020
Claims Fax (888) 692-2368
Click here to go the Insurance Section of the CCAP Website.

email: jsallade@pacounties.org

Insurance Matters is published monthly by CCAP Insurance Programs for the use of members of CCAP's UC Trust, PCoRP, PComp, PIMCC, COMCARE, COMCARE PRO, BEST Flex, PELICAN and other insurance programs, and insurance producers of these members.

Advice contained in this publication is not legal advice and members are encouraged to seek the opinion of their solicitor.

The information provided in this publication is not intended to take the place of professional advice. Readers are encouraged to consult with competent legal, financial, or other appropriate professionals. Statements of facts and opinions expressed in this publication, by authors other than Association staff and officers, are the sole responsibility of the authors and do not necessarily represent an opinion or philosophy of the officers, members and staff of the County Commissioners Association of Pennsylvania (CCAP). No endorsement of advertised products or services is implied by CCAP unless those products or services are expressly endorsed, or are owned or managed by the Association programs, or our affiliates. This publication may not be reproduced, modified, distributed, or displayed in part or in whole, by any means, without advance written permission of CCAP. Please direct your requests to John Sallade, Managing Director, CCAP Insurance Programs, jsallade@pacounties.org.

Note: As part of its copyright agreement the CCAP grants the author the right to place the final version of his/her manuscript on the author's homepage, subject to CCAP's standards, or in a public digital repository, provided there is a link to the CCAP website.

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