Thursday, May 1, 2014

Communication: First Step in Trust

The New York Workers’ Compensation Board forwarded to Gov. Andrew Cuomo recommendations from Deloitte Consulting which was contracted to identify ways to make the state's workers' compensation system more efficient to get speedier, fairer results for injured workers.

The actual Deloitte report isn't yet available for public consumption, but the WCB does have on line the firm's presentation for download and viewing.

Though Deloitte identified technological issues that need updating (of course the much criticized document scanning contract was cited), the most profound finding of the consultant's $2.8 million report was that trust in the system had deteriorated.

Deloitte cataloged the following “common themes”:
  • “The system is rife with delays for treatment, initial payments, reporting, decisions, appeals."
  • “Lack of trust throughout the system; participants can no longer rely on good faith."
  • “Lack of respect and dignity for the injured worker.”
Breakdowns in the independent medical examiner process and “excessive” scheduled loss-of-use award payments have fostered this mistrust along with other action (or lack of) in the state's system.

And the WCB seems to recognize these criticisms as real.

On its Business Process Re-engineering web page the board says that New York “is historically slow to pay injured workers and produces poor medical outcomes in comparison to other states.”

The board boldly states what might seem obvious, but for a governmental entity to admit publicly is rare: “Improving a system that has decayed for decades is not easy. Not every vested interest will agree on every recommendation. Interest groups that profit from dysfunction will defend the status quo.”

And even though the ink hasn't dried yet, WorkCompCentral interviews with various interest groups confirm the board's conclusions.

For instance, an employer group representative says that the board's conclusion that New York needs to speed up payments to injured workers is based on anecdotes and that there is no "hard data" to support the board's statements.

But this ignores the many studies from disinterested research groups who have studied and ranked state's costs associated with timely payments and other benefit delivery measures.

I'm sure there are other objections to observations being delivered by Deloitte and the board.

All of these go back to the common theme identified in these early disclosures - mistrust in the system.

This mistrust starts from the top - as many institutional trust issues do.

Internal denial is a strong indicator of overall trust, because if the institution can not be honest with itself, how can the public trust it.

For example, the board has lagged on posting to its extensive website any pages on the BPR. K. Brian Collins, the board’s BPR project head, posted monthly updates for October, November, January and February, but not for March or April.

His February update included a graphic that indicated BPR implementation would begin in late March.

Yet Rachel McEneny, a spokeswoman for the board, said “We are on schedule. There is no delay due to the transition of the executive director,” referring to the rather abrupt and inopportune departure of Jeffrey Fenster as the board’s executive director. Giving only two weeks' notice, Fenster left in early April for a job in the insurance industry.

It's a good start that McEneny speaks to the press. But let's not brush over that the BPR initiative is behind the published schedule.

If New York is going to "fix" its system it first has to be honest with itself and admit to the problems and issues it faces, including a derailed document scanning program, closed hearing sites, and the missed self-imposed deadlines.

And if the board IS honest with itself, then it must communicate with the public, whether triumphant successes or embarrassing failure. Lack of honest communication, or artificially controlled communications, spreads rumors and instigates suspicion.

For instance, one person interviewed in the WorkCompCentral story this morning said he had heard the board may attempt to make it more difficult to obtain a hearing in order to reduce system costs.

Maybe that's true, or maybe that's just a bad rumor. The point is that what the board may do and why was "heard" - though frankly to me the rumored action doesn't make sense.

The easiest way to diffuse criticism and instill trust is to admit to short comings and communicate when error occurs.

In the past the board would not communicate with the press (or at least not WorkCompCentral), which stems from some critical reporting a couple of years ago.

I sense that perhaps this reticence is slowly lifting. Obviously the board's admissions on its BPR FAQ page is indicative of new found honesty.

If that's true, then trust in the system can be recovered.

If not, then no matter what recommendations Deloitte makes, no matter how much money the state spends on document scanning, no matter how many district offices are opened or closed, won't make a difference.

The recent change in heart by the board's communications department is a good step in the right direction. It's a difficult first step, but it makes it easier to take the next step and perhaps the people will start trusting the system again.

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