Risk Management

Risk Management &Maintenance/Operations Procedures Manual 2016-2017

TABLE OF CONTENTSI. Risk Management Property and Casualty Insurance .................................................................1 Fraud Reporting ..........................................................................................1 Insurance Requirements of Vendors............................................................2 Liability Coverage .......................................................................................2 Student Accident Insurance .........................................................................2II. Employee Benefits Employment Health Insurance ....................................................................3 Other Optional Employee Benefits .............................................................3III. Workers’ Compensation Workers’ Compensation Insurance .............................................................6 Reporting Procedures for Incidents or Injuries ...........................................7 Workers’ Compensation Packet ..................................................................8 Sample of DWC73 (Work Status)...............................................................15IV. Facilities General.........................................................................................................16 Requesting Services.....................................................................................16 Emergencies.................................................................................................16 Routine Maintenance...................................................................................16 Preventive Maintenance ..............................................................................17 Capital Projects............................................................................................17 Priority of Work...........................................................................................17 Work Request Follow Up ............................................................................17

I. RISK MANAGEMENTPROPERTY AND CASUALTY INSURANCEThe District has a broad and complex blanket of property insurance coverage of all fourteen (14) maincampuses as well as support facilities, which have an insured value of almost $285,768,000. The Districtpurchases the following insurance coverage from our contracted vendor:- Automobile Liability- Crime- Equipment- General Liability- Property- Flood InsuranceAny incidents and/or accidents should be reported to the Business Office, Risk Management Department, assoon as the event becomes known.FRAUD REPORTINGSharyland Independent School District prohibits fraud and financial impropriety in the actions of its Trustees,employees, vendors, contractors, consultants, volunteers, and others seeking or maintaining a businessrelationship with the District. Fraud and financial impropriety shall include but not be limited to:1. Forgery or unauthorized alteration of any document or account belonging to the District.2. Forgery or unauthorized alteration of a check, bank draft, or any other financial document.3. Misappropriation of funds, securities, supplies, or other District assets, including employee time.4. Impropriety in the handling of money or reporting of District financial transactions.5. Profiteering as a result of insider knowledge of District information or activities.6. Unauthorized disclosure of confidential or proprietary information to outside parties.7. Unauthorized disclosure of investment activities engaged in or contemplated by the District.8. Accepting or seeking anything of material value from contractors, vendors, or other persons providing services or materials to the District, except as otherwise permitted by law or District policy.9. Inappropriately destroying, removing, or using records, furniture, fixtures, or equipment.10. Failure to provide conflicts of interest as required by law or District policy.11. Any other dishonest act regarding the finances of the District.Any person who suspects fraud or financial impropriety in the District shall report the suspicions immediately to any supervisor, the Superintendent or designee, the Board President, or local law enforcement. Sharyland ISD provides an Anonymous Reporting Fraud Hotline, (956) 584-6453, to employees, citizens and general public who wish to report any incidents. Reports of suspected fraud or financial impropriety shall be treated as confidential to the extent permitted by law.Risk Management & Maintenance/Operations 1Procedures Manual 2016‐2017

INSURANCE REQUIREMENTS OF VENDORSCampus principals should always secure a certificate of insurance (with SISD named as an additionalinsured), (reviewed by the Risk Management Department), and any necessary waivers/releases during theplanning period for a special activity and/or event with a vendor.LIABILITY COVERAGEPublic school districts are immune for bodily injury to students and the public (except for limited liability fornegligent operation and use of a motorized vehicle) as provided in the Texas Tort Claims Act § 101.021 and§101.051. Board Policy CRBSTUDENT ACCIDENT INSURANCEThe District provides student accident insurance coverage plan to students that participate in UIL SanctionActivities.Risk Management & Maintenance/Operations  2Procedures Manual  2016‐2017

II. EMPLOYEE BENEFITSEMPLOYEE HEALTH INSURANCEThe District has a self-funded medical plan and provides employees insurance through a Third PartyAdministrator, Frates Benefit Administrators. The District makes a monthly contribution for every employeeto the plan and the remaining amount is taken by payroll deductions each paycheck run in order to cover thetotal premium amount for the month. Board Policy CRD, DEBPremiums for health insurance coverage may be paid under the IRS Section 125 Cafeteria Plan. In mostcases, coverage becomes effective on the first day of the month following the date of employment or the 1stday of the month if employee’s employed on the 1st and provided the employee is actively at work and hascompleted the enrollment process.For details of the plan structure and benefits payable, contact The Risk Management Department at 956-580-5200 x 1032.OTHER OPTIONAL EMPLOYEE BENEFITSIRS Section 125 Cafeteria Plan:All employees who work at least 30 hours per week may elect to shelter their voluntary benefits under theIRS Section 125 Cafeteria Plan. Please contact The Risk Management Department for more details.Dental Insurance:The District offers a voluntary dental plan. Premiums for this coverage may be paid under the IRS Section125 Cafeteria Plan.Vision Insurance:A voluntary vision program is available through payroll deduction for employees and dependents at theemployee's expense. This plan requires the employee to use a network provider. Premiums for this coveragemay be paid under the IRS Section 125 Cafeteria Plan.Supplemental Term Life Insurance:Supplemental term life insurance is offered. Employees may purchase up to five times their yearly salary inindividual coverage, but not to exceed $130,000, $30,000 for their spouse and $10,000 in coverage for eachof their children. Premiums are age-rated. Group term life is only available during employment. The lifeinsurance policy includes a Conversion Privilege.Disability Insurance:Short-term and long-term disability insurance is available through payroll deduction at the employee'sexpense.Risk Management & Maintenance/Operations  3Procedures Manual  2016‐2017

Legal Shield:Voluntary legal shield plan is available for purchase by employees and is available through payroll deductionat the employee's expense.Air Evac:Air Evac plan is available for purchase by employees and is available through payroll deduction at theemployee's expense.Cancer Plan:Cancer Plan is available for purchase by employees and is available through payroll deduction at theemployee's expense.Critical Illness Plans:Critical Illness plans are available for purchase by employees and is available through payroll deduction atthe employee's expense.Accident Plan:Voluntary accident plan is available for purchase by employees. The policy will pay a scheduled benefit inthe event of an accidental injury.Group Hospital Confinement Indemnity Insurance:Voluntary Group Hospital Confinement Indemnity Insurance plan are available through payroll deduction atthe employee's expense.Information and brochures are available at open enrollment in the Risk Management Office or on the SISDWebsite – Insurance Department website page. The individual insurance company will issue a policy to theemployee directly.Medical Expense Reimbursement:The Medical Expense Reimbursement is a voluntary reduction of salary in the amount of an employee'scurrent expenditures for various medical benefits. The current maximum amount an employee may deductannually is $2,550. Employee contributions toward a medical expense reimbursement plan (MERP) allowsfor medical and other optional benefit bills to be paid by this account. This plan is authorized and controlledunder IRS Section 125 Cafeteria Code. Participation in the SISD Medical Expense Reimburse Plan shouldresult in the employee paying less income tax. The District cannot guarantee favorable tax results due to theuncertainty of Internal Revenue Service guidelines and their effects on the tax exempt status of the plan.Detailed questions should be discussed with your personal tax advisor.Risk Management & Maintenance/Operations  4Procedures Manual  2016‐2017

Dependent Expense Reimbursement:The Dependent Expense Reimbursement is a voluntary reduction of salary in the amount of an employee'scurrent expenditures for eligible dependent care expenses. The current maximum amount an employee maydeduct annually is $5,000. This plan is authorized and controlled under IRS Section 125 Cafeteria Code.Participation in the SISD Dependent Expense Reimburse Plan should result in the employee paying lessincome tax. The District cannot guarantee favorable tax results due to the uncertainty of Internal RevenueService guidelines and their effects on the tax exempt status of the plan. Detailed questions should bediscussed with your personal tax advisor.Information and brochures are available at open enrollment in the Risk Management Office or on the SISDWebsite – Insurance Department website page. The individual insurance company will issue a policy to theemployee directly.Annual Enrollment:Cafeteria Plan year runs from May 1st to April 30th. Annual enrollment of the Cafeteria Plan is administeredduring the month of March for an effective date of May 1st. At this time employees are furnished informationas to how they may elect, add or drop dependents or benefits listed above. These changes will be reflected onthe May paycheck for a May 1st effective date.The Consolidated Omnibus Budget Reconciliation Act (COBRA):COBRA gives workers and their families who lose their health benefits the right to choose to continue grouphealth benefits provided by their group health plan for limited periods of time under certain circumstancessuch as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death,divorce, and other life events.HIPAA:The District complies with all HIPAA rules and regulations and is handled by each health provider.  Risk Management & Maintenance/Operations  5Procedures Manual  2016‐2017

III. WORKERS’ COMPENSATIONWorkers’ Compensation InsurancePolicy CREThe district, in accordance with State law, provides workers’ compensation benefits to employees who suffera work-related illness or are injured on the job. Benefits help pay for medical treatment and make up for partof the income lost while recovering. Specific benefits are prescribed by law depending on the circumstancesof each case.All work-related accidents or injuries should be reported immediately to one of the following: Workers’Compensation Clerk, Campus Nurse, Campus Administration, Campus Office Personnel, or EmployeeSupervisor. Employees who are unable to work because of a work-related injury will be notified of theirrights and responsibilities under the Texas Labor Code.Risk Management & Maintenance/Operations  6Procedures Manual  2016‐2017

Reporting Procedures for Incidents or InjuriesSharyland ISD employees are covered by provisions of the Texas Workers’ Compensation Law through a self –insurance policy which utilizes its own district 504 medical network.1. If an injury or incident occurs to an employee while he/she is on duty and the incident or injury is an “emergency” call an ambulance or take the employee to the nearest Hospital.2. It is the responsibility of the immediate supervisor, head custodian, or cafeteria manager to immediately report any incident/injury to the campus administrator or director.3. The campus nurse or department secretary is responsible to obtain all the necessary information regarding the “emergency” incident/injury from both the employee and district personnel. The campus nurse/secretary will submit a “First Injury/Incident Report”, “Body Diagram Form”, and “Authorization for Health Information Disclosure” to the Risk Management Office via fax (956-580-5224) or email ([email protected]).4. If the incident is not an emergency, the campus nurse and/or secretary will obtain the necessary first aid and evaluate the need for further medical attention. The employee must verbally report the incident to his/her supervisor as soon as possible but no later than 24 hours after the date of the incident/injury. Maintenance and transportation employees will report incidents to the Maintenance or Transportation department secretary. Failure to comply may result in disciplinary action.5. Employees requiring additional medical treatment must notify the Risk Management Office prior to treatment to qualify for Workers’ Compensation medical benefits. Employees must complete all necessary documentation for a referral to a workers’ compensation approved doctor.6. After the first doctor visit employees must report to Risk Management Office before returning to work.7. It is the responsibility of the employee to report or contact the Risk Management Office after each doctor’s appointment. An employee placed on leave for an extended period of time must make personal contact with the Risk Management Office on a weekly basis through the duration of the medical leave. Should an injured employee be absent for more than five (5) consecutive days, the employee must make contact with the Human Resources Department.8. Employees must acquire a “Return to Work Status” (RTW) from the Risk Management Office prior to returning to work.9. For questions or concerns, contact the Risk Management Office at 956-584-6406. Risk Manager – 956-580-5200 Ext. 1012 Insurance Specialist – 956-580-5200 Ext. 1032 Workers’ Compensation Clerk- 956-580-5200 Ext. 1076Risk Management & Maintenance/Operations  7Procedures Manual  2016‐2017

Workers’ Compensation Packet: Sharyland Independent School District Insurance Department - Worker Compensation Program Employee’s Report of Injury/Illness (DWC1) ****Print Clearly & Fill Out Completely****1. NAME: 2. SOC. SEC # 3. SEX: 4. DOB: -- M__ / F__ / /5. RACE: 6. ETHNICITY: 7. DOES THE EMPLOYEE SPEAK ENGLISH?WHITE__ / BLACK__ / ASIAN__ HISPANIC__ / NATIVE AMERICAN__ / OTHER__ YES _____ / NO _______8. MAILING ADDRESS: CITY, STATE ZIP CODE 9. COUNTY: , Texas 785____10. PHONE NO.: 11. MAITAL STATUS: 12. NUMBER OF DEPENDENT 13. SPOUSE’S NAME: (956) M_____ S_____ D_____ W____ CHILDREN: ________ __________________14. CAMPUS OR LOCATION: 15. BEGAN WORK AT: 16.WORK PHONE EXTENSION 17.COMPLETE ADDRESS OF CAMPUS OR LOCATION: ___:__ AM / ___:___ PM ext.# , Texas 785____18. OCCUPATION: 19. WAS EMPLOYEE DOING REGULAR JOB? 20. TIME OF INJURY : 21. DATE OF INJURY : YES _______ / NO _______ ______:______ AM___ / PM____ //22. PART(S) OF BODY INJURED OR EXPOSED:23. DESCRIBE IN DETAIL: (1) THE EVENTS LEADING UP TO THE ACCIDENT/INJURY, (2) THE ACTUAL INJURY, E.G., CUT LEFT FOREARM, BROKEN RIGHT FOOT,ETC., (3) THE REASON(S) WHY ACCIDENT/INJURY OCCURRED:24. NATURE OF INJURY: (SLIP, FALL, 25. LOCATION OF INJURY: (CLASSROOM, GYM, 26. CAUSE OF INJURY: (TOOL, BACKPACK, CONTUSION, ETC.) HALLWAY, ETC) CHAIR, ETC)27. NAME OF WITNESS(ES):28. DO YOU WISH TO SEE A DOCTOR? IF YES, NAME OF DOCTOR: DOCTOR’S OFFICE PHONE NUMBER: YES _______ / NO _________ (956)- DOCTOR ‘S OFFICE ADDRESS: , Texas 785____ IF YES, HOW ___________________________________________29. COULD THIS ACCIDENT HAVE BEEN PREVENTED? YES _______ / NO _______Person assisting employee, Nurse, Aide or Secretary Signature:_______________________________________ Date: ___________Employee’s Signature: _____________________________________________________________ Date: ______________________ RETURN REPORT IMMEDIATELY TO THE WORKERS COMPENSATION OFFICE AT FAX# 580-5224 OR SCAN TO THE WORKERS COMPENSATION OFFICE. A BODY DIAGRAM FORM MUST ACCOMPANY INJURY/ILLNESS REPORT EMPLOYEE MUST RECEIVE THE EMPLOYEE RIGHTS AND RESPONSIBILITY INFORMATION. IF EMPLOYEE SEEKS MEDICAL TREATMENT BY DOCTOR THE WORKERS’ COMPENSATION VERIFICATION OF COVERAGE MUST BE GIVEN TO EMPLOYEE TO TAKE TO DOCTOR’S OFFICE AND PHARMACY. REMIND EMPLOYEE: AFTER FIRST DOCTOR VISIT, EMPLOYEE MUST REPORT TO WORKERS COMPENSATION OFFICE BEFORE RETURNING TO WORK.OFFICE USE ONLY: Hire Date: Hourly Rate: Last Pay Check & Date: Hours Worked: Daily Rate: Risk Management & Maintenance/Operations  8 Procedures Manual  2016‐2017

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Authorization for Health Information Disclosure This form complies with the HIPAA Privacy Rule Patient Information (please print)Patient Name:Street Address:City: State: Zip Code: DB:SS#:I hereby authorize:Please disclose the following protected health information to: TRISTAR Risk ManagementStreet Address: P.O. Box 2805City: Clinton State: IA Zip Code: 52733-2805Please indicate the information or types of information to be disclosed:ALL MEDICAL RECORDSSpecify dates (or date ranges) if applicable:This request is for the purpose of obtaining any and all medical records.I understand that I have the right to revoke this authorization at any time. I understand that my revocation must be inwriting and tendered to the privacy officer of the above named facility authorized to make this disclosure. Iunderstand that the revocation does not apply to information that has ahead been released in accordance to thisauthorization.I understand that any disclosure of information may be subject to re-disclosure by the recipient and may no longerbe protected by federal or state law. I understand that I need not sign this authorization to assure treatment. Iunderstand that I may inspect and/or copy the information to be disclosed. I understand that authorizing thisdisclosure is voluntary. I understand that if I have any questions about disclosure of my health information, I maycontact the privacy officer at the facility listed above that is authorized to disclose this information and request acopy of this authorization.I understand that my health record may include information pertaining to the treatment of drug and alcohol abuse,mental illness, acquired immunodeficiency syndrome (AIDS), or human immunodeficiency (HIV), sexuallytransmitted diseases, tuberculosis or genetics.IF YOU DO NOT WISH THIS INFORMATION TO BE RELEASED, PLEASE INITIAL; DO NOTRELEASE ________________________________________________________Signature of Patient or Authorized Representative Date: ___________________________________________________________________Description of Representative’s Authority (witness signature required) Signature of Witness: ________________________This HIPAA Release expires on: _______________________. Specify dates (or date ranges) if applicable: Risk Management & Maintenance/Operations  10 Procedures Manual  2016‐2017

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Sharyland I.S.D. Insurance Department/ Workers’ Compensation Program 1106 North Shary Rd, Mission, TX 78572 956-580-5200 x 1076 or x 1032 WORKERS’ COMPENSATION VERIFICATION OF COVERAGETake this Form to Doctor’s, Hospital Visit or Pharmacy with Prescription_________________________________SS# __________________________ has reported awork-related injury/illness that occurred on _________________________. This may becovered under Workers’ Compensation benefits. Contact Tristar Risk Management at theaddress below to authorize reasonable and necessary medical treatment, and to file expensesincurred for this claim. Mail Claims to:  Tristar Risk Management  PO Box 2805  Clinton, Iowa 52733‐2805    Phone:  800‐593‐0020      Fax:  361‐857‐0123    Elsa Gaitan ‐ [email protected] x 3016  or Jimmy Dyer, Jr. ‐ [email protected] x 3014 orMaria C. Trevino [email protected] x3015Attention Doctor’s Office: Fax DWC 73 to 956-580-5224 as soon as possible.Risk Management & Maintenance/Operations  12Procedures Manual  2016‐2017

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Sample of DWC73 (Work Status):Risk Management & Maintenance/Operations  15Procedures Manual  2016‐2017

IV. Facilities/OperationsGeneral:The Facilities Department is responsible for maintaining all school buildings in the district to provide a safe,secure, comfortable, and functional environment for the students and staff and protects the capital investmentmade by Sharyland ISD taxpayers.The Facilities Department is organized into two functional areas: building maintenance/construction andcustodial services.Maintenance activities include scheduled preventive maintenance, integrated pest management and routineand emergency repair of all building systems, weekend building checks and on call emergency responseservices. Responsibilities include defining the scope of work for capital projects, procuring and managingdesign services, reviewing design document, bidding projects, and construction contract management.Requesting Services:With the exception of emergencies and high priority work, all requests for service are made using the “SchoolDude” maintenance management system. For emergencies and urgent requests call the Maintenance FacilitiesOffice. DO NOT e-mail requests to the Director of Facilities nor the Maintenance Facilities secretary. If youhave a question about your service request please call the Facilities Office (956) 580-5246.Emergencies:Emergencies are situations that have or may result in personal injury or property damage.All emergencies should be immediately reported to the Principal’s Office or custodian on duty.In the case of fire, gas leak or other event that threatens the students’ safety contact 911.Notify the Facilities Department of the emergency by calling (956) 580-5246. If the emergency occurs afterhours or no one answers call the Custodian/Grounds Supervisors or Director of Facilities. In reporting anemergency, be prepared to provide the following information: Your Name, Building Address, Location (floorand room number) and Nature of the problem.Routine Maintenance:Routine maintenance is all repair work except emergencies and building improvement projects.Routine maintenance is requested using the web based maintenance management system “School Dude.” Adesignated person at each campus enters the request into the web based maintenance management system. Inentering a maintenance request, the designated person will be prompted to select the following: Location(name of campus), Building, Area, Area Number (room number), Description (explanation of what isneeded), and Required Completion Date. Our district has set up a password when submitting requests. Thedesignated person has been made aware of this.Risk Management & Maintenance/Operations  16Procedures Manual  2016‐2017

Preventive Maintenance:The Facilities Department has an on-going program to identify building systems and equipment that needperiodic lubrication, adjustment and inspection. A schedule and checklist is established for each system orpiece of equipment.Capital Projects:Renovations, alterations and enhancements are typically projects funded and scheduled as part of theFacilities Department Capital Program. Capital projects are identified during the annual building inspectionand through meetings with the Building Administrator. Specific requests for a project can be made via e-mail.The request should include the requestor’s name, contact information, building, location, description of work,and explanation of need. Requests should be submitted no later than January for the next budget year.Priority of Work:High – Problems that are not an emergency as defined above which prohibit the occupants from using a spacefor its intended purpose. Examples are no lights or power, heating and cooling problems effecting one ormore classrooms, entire building system is not working, inoperative door hardware, etc.Medium – Problems that limit the occupants from using a space for its intended purpose. Examples are onerow of lights is out, heating, cooling and ventilation problems effecting offices, seldom used spaces, storageareas, and door hardware sticks.Low – An annoyance problem that does not limit the occupants from using a space for its intended purpose.Examples are painting, window sticking, missing screw, furniture move, etc.Work Request Follow Up:Call the Facilities Office at (956) 580-5246 or e-mail the Director of Facilities to upgrade the priority orfollow up on a work request.Risk Management & Maintenance/Operations  17Procedures Manual  2016‐2017