Project Results

Public Policy Goal:

To demonstrate that a community-based coalition in a rural setting can improve the quality of care provided to injured workers.

Project Objective:

To provide appropriate and timely access to medical care for injured workers; to expedite return to work; to evaluate results; and to determine if this program has greater applicability by replicating the program in another medically underserved area of New York State.

Project Description:

The North Country on the Job Network (NCOJN) was a voluntary, community-based coalition that began in Clinton County, New York adjacent to the Canadian border. The program grew from concerns of the business community and the local Chamber of Commerce following the closure of the Air Force Base in Plattsburgh, the county seat in 1995. The resulting loss of jobs in the area occurred in conjunction with the devaluation of the Canadian dollar and increasing concerns among the local business community about rising workers compensation costs. The initial project was funded by the Champlain Valley Physicians Hospital (CVPH) Medical Center as a community service with assistance from the Plattsburgh-North Country Chamber of Commerce. This project involved the continued development, evaluation and replication of this unique health care delivery model for management of injured workers in a rural upstate New York community. The School of Occupational and Environmental Medicine at Duke University in Durham, North Carolina did evaluation of the project.

Key Findings or Accomplishments:

Major findings of the study included:

1. Improved and timely access to care is possible when all constituents in a small community are communicating and following the process for injury management which was collaboratively designed
2. The nurse case management model developed through this project is unique. Unlike in most workers' compensation cases, these case managers were not chosen or paid by the insurance carrier or employer and were perceived as being independent from their control. Instead they were employees of the local hospital.
3. The case coordination process appears to be crucially beneficial in areas such as critical task assessment, work restriction communication, patient tracking, liaison between care providers-patients-employers, and problem solving of issues which were not strictly medical
4. This project demonstrated that having a source of funding for case managers independent of the employer or insurer was well received by workers.
5. Few companies were utilizing or had an understanding of the benefits of transitional duty and few network companies were receiving any of the project provided statistics from their insurance companies
6. Replicating this project in other areas will require a better understanding of the local politics and stronger coalition building activities.

Reports and Publications:

Final Grant Report- Evaluation of the North Country On The Job Network: A Rural Coalition Accessing Medical Management for Injured Workers

Kennedy, Margaret.  "North Country on the Job Network Serving Essex County." Essex Economix: publication of the Essex County Business Council (2000).

Lipscomb, Hester J., PhD, Samuel Moon, MD, MPH, Leiming, Li, MS, Lisa Pompeii, RN, MPH, Margaret Q. Kennedy, RN, MS. "Evaluation of the North Country on the Job Network: A Model of Facilitated Care for Injured Workers in Rural Upstate New York." Journal of Occupational and Environmental Medicine 44, no. 3 (2002): 246-57.

Sportini, Michael.  "Local Network Delivers on Rehab." Occupational Hazards (1998).

Presentations:

Hester J. Lipscomb, PhD, Sam Moon, MD, Leiming Li, MS, Lisa Pompeii, RN, MPH, "Evaluation of the North Country on the Job Network," Robert Wood Johnson Workers' Compensation Health Initiative Annual Meeting, September 6-7, 2001, Newport, RI.

Additional Plans:

The project is continuing in Essex and Clinton Counties. Injury and return to work statistics will continue to be provided to participating employers while the project continues to be underwritten by the CVPH Medical Center with support from the Chamber of Commerce.