Public Risk September/October 22 by Moire Marketing Partners

ALSO IN THIS ISSUE POLICING OUR SCHOOLS: THE PUBLIC RISK MANAGEMENT CHALLENGEPAGE12 BEST OF THE BLOG: POPULAR PRIMA BLOG POSTS YOU MAY HAVE MISSEDPAGE16 PUBLISHED BY THE PUBLIC RISK MANAGEMENT ASSOCIATION SEPTEMBER/OCTOBER 2022 Differently:Thinking New Approaches for Treating First Responder Injury and Trauma

Register for PRIMA’s OCTOBER WEBINAR FREE MEMBERSTO Register at primacentral.org/education/webinars Risk Management in a Time of Volatile Insurance Markets and Ever Increasing Natural Disasters OCTOBER 26 | 12:00 PM – 1:00 PM EST SPEAKER: Andrea Brazil, Executive Vice President, Towne Insurance This presentation will review examples of recent disasters that had a significant impact on the insurance marketplace. Some are natural and others are geo-political. Also up for discussion will be major commercial lines of coverage and trends in each line, providing a connection from disasters to influences. ATTENDEE TAKEAWAYS: 1. Identify trends in various lines of commercial insurance 2. Understand influences behind the trends

The Public Risk Management Association promotes effective risk management in the public interest as an essential component of public administration.

By Dr. Joe Jarret

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Public Risk is published 6 times per year by the Public Risk Management Association, 700 S. Washington St., #218, Alexandria, VA 22314 tel: 703.528.7701 • fax: 703.739.0200 email: info@primacentral.org • Web site: www.primacentral.org

CONTENTS

NON-VOTING DIRECTOR Jennifer Ackerman, CAE Chief Executive Officer Public Risk Management Association Alexandria, VA EDITOR Jennifer Ackerman, CAE jackerman@primacentral.org703-253-1267

Best of the Blog: Popular PRIMA blog posts you may have missed 12 16

SEPTEMBER/OCTOBER 2022 | PUBLIC RISK 1 SEPTEMBER/OCTOBER 2022 | Volume 38, No. 5 | www.primacentral.org

By Pearl Monroe, Karen Thomas and Gerry Stanley, MD

6 Policing Our Schools: The Public Risk Management Challenge

Association IN EVERY ISSUE | 4 NEWS BRIEFS | 20 ADVERTISER INDEX Thinking Differently: New Approaches for Treating First Responder Injury and Trauma

Opinions and ideas expressed are not necessarily representative of the policies of PRIMA. Subscription rate: $140 per year. Back issue copies for members available for $7 each ($13 each for non-PRIMA members). All back issues are subject to availability. Apply to the editor for permission to reprint any part of the magazine.

PAST PRESIDENT Melissa R. Steger, MPA, CRM Asst. Dir., WCI & Unemployment Ins. University of Texas System Austin, TX PRESIDENT-ELECT Laurie T. Olson Sr. Risk Management Consultant City/County Insurance Services Salem, OR DIRECTORS Sean Barham, MBA, ARM Executive Director of Human Resources Las Cruces Public Schools Las Cruces, NM Dana S. Henderson, CWCP Risk TownManagerofMount Pleasant Mount Pleasant, SC Jennifer Hood Safety & Risk Clarksville,MontgomeryDirectorCountyGovernmentTN Steve M. LePock, II Risk VirginiaManagerBeach City Public Schools Virginia Beach, VA Adam F. Maxwell, CLRP Director, Administrative Services City of Westerville,WestervilleOH Ann-Marie A. Sharpe, ARM, RMPE Director, Risk Management City of Miami Miami, FL

PRESIDENT Scott J. Kramer, MBA, ARM County Prattville,AutaugaAdministratorCountyCommissionAL

Register at OctoberManagementTheinstitute.primacentral.orgIndustry’sPremierRiskEducationalProgram17–21 // Old Town Alexandria, VA 2022INSTITUTEPRIMA PRIMA Institute 2022 (PI22) is an innovative educational symposium comprised of fundamental risk management curriculum, outstanding faculty, and excellent networking opportunities. PI22 is aimed at new and seasoned risk management professionals who want to learn more about emerging trends and best practices. BIG SMALLIDEAS.SETTING.

P.S. Speaking of leadership, PRIMA is seeking applicants for the PRIMA board of directors! Watch your inbox for information on how to ScottSincerely,apply.J.Kramer, MBA, ARM PRIMA President 2022–2023 County Prattville,AutaugaAdministratorCountyCommissionAL eadership is not about titles, positions or flowcharts. It is about one influencing another.”life John C. Maxwell

Over the years, I have worked in the private sector, with a city and with a county. During each of these chapters, many leadership styles have produced positive, effective motivation.

“ “ We all have to determine the best leadership styles to influence those we serve and to lead in a positive, effective manner. More often than not, this requires effective managers to assess specific situations and implement appropriate leadership styles accordingly. There is rarely, if ever, a “one size fits all” approach to effective risk management.

“L

John Maxwell is one of my favorite authors regarding leadership. As risk managers, many of us use different styles in influencing people to get the job done. Most of us don’t have large staffs, so we are dependent on other leaders to assist us in promoting safety, getting insurance applications filled out, charting trends to reduce accidents, coordi nating restrictions to bring employees back to work and many other tasks for which we may be Ourresponsible.management styles vary based on the different personalities in the culture of our specific entity, as well as the type of service provided by said entity. I wanted to share three leadership styles that have been helpful to me.

SEPTEMBER/OCTOBER 2022 | PUBLIC RISK 3

What's Your Leadership Style? FROM PRIMA PRESIDENT SCOTT J. KRAMER, MBA,

MESSAGE

As such, I have gleaned the following: When a particular department, Engineering for example, is very knowledgeable of their own functions and takes safety seriously with their PPE, equipment used and understands the risks of a construction zone, the delegative leadership style can be effective. A delegative leadership style involves team members in the decision-making process and delegates initia tive to them. Your reliance on their expertise and competence can serve to motivate them to be a partner in risk management. When you are promoting a new concept, like an on-site medical clinic, a participative leadership style may be the most effective way to accomplish your risk management goals. A participative leadership style allows each member of the committee to have a voice. Committee members feel engaged, included, part of the team. This style also promotes creativity.

ARM

The third leadership style that I have used in certain situations is transformational leadership. As risk managers gain respect and value from the senior team, the expectations are for you to carry out the entity’s vision.

We all have to determine the best leadership styles to influence those we serve and to lead in a positive, effective manner. More often than not, this requires effective managers to assess specific situations and implement appropriate leadership styles accordingly.

Part of this vision could include, for example, enterprise risk management. The enterprise risk management strategy would be to monitor performance, identify risks, assess risks, plan a response strategy and implement the mitiga tion strategy. This type of leader inspires his or her followers with a vision and then encourages them and empowers them to achieve it. This leader also serves as a role model to accomplish the transformation.

An Ohio appellate court ruled that a worker was not entitled to an enhanced award of benefits for his injuries from being struck by a car, because the accident did not occur in a In“workshop.”2018,Luis Ybarra was working for vehicle transport company Cassens Corp. at the outdoor lot of the Chrysler Group Yard in Toledo, Ohio, moving cars from the lot to a staging area where they would be loaded onto auto carrier trucks or trains. The parking lot is enclosed by a fence with guarded gates for entry and exit and is not open to the general public, according to State ex rel. Cassens Corp. v. Industrial Commission, filed in Court of Appeals for the 10th District of Ohio, in AfterColumbus.parking a new car in the staging area, Mr. Ybarra was walking in the yard to get another car when he was struck from behind by another car being driven by a co-worker. The car had snow covering its window, and the co-worker was navigating by sticking his head out of the window. The co-worker did not see Ybarra and violated a work rule requiring drivers to clear snow off the windshields. He was later terminated for his misconduct.

Mr. Ybarra received workers compensation benefits and later filed an application for an enhanced award, asserting Cassens had violated a specific safety requirement in Ohio law that applies to “workshops” and “factories.” It requires that all cab glass for motor vehicles be safety glass or equivalent, with the vision unimpaired by its condition. A staff hearing officer granted Mr. Ybarra the enhanced award, and after the Industrial Commission declined further administrative appeal, Cassens sought mandamus relief. A

APPEALS COURT DENIES ENHANCED BENEFITS TO WORKER HIT BY CAR

4 PUBLIC RISK | SEPTEMBER/OCTOBER 2022 NEWS BRIEFS NEWS Briefs

“Here, the portion of the Chrysler Group Yard facility in Toledo where Cassens employees engaged in their work duties is an outdoor, open-air storage lot where newly manufactured vehicles are stored as they await transport to dealers and other sellers,” the court said. The commission relied on the fence around the lot to find it was a workshop, but the court said the presence of a perimeter fence does not automatically compel the conclusion that the lot is a workshop. judge with the Court of Appeals for the 10th District of Ohio recommended that writ be Thedenied.Court of Appeals adopted the judge’s findings of fact but rejected his analysis, ruling Ohio case law has defined “workshop” as used in the administrative code as “a room or place wherein power-driven machinery is employed and manual labor is exercised by way of trade for gain or otherwise.” There is also case law establishing that an outdoor area can be a workshop if it is enclosed by perimeter fencing.

FLOODS, OTHER WATERRELATED DISASTERS COULD COST GLOBAL ECONOMY $5.6 TRILLION BY 2050 Worsening droughts, storms and torrential rain in some of the world’s largest economies could cause $5.6 trillion in losses to the global economy by 2050, according to a report released. In the United States, the world’s biggest economy, losses could total $3.7 trillion by 2050, with U.S. gross domestic product shrinking by about 0.5% each year up until then. China, the world’s No. 2 economy, faces cumulative losses of around $1.1 trillion by mid-century.

SEPTEMBER/OCTOBER 2022 | PUBLIC RISK 5

Of the five business sectors most vital to the global economy, manufacturing and distribution would be hit hardest by disasters costing $4.2 trillion as water scarcity disrupts production while storms and floods destroy infrastructure and inventory. The agricultural sector, vulnerable to both drought and extreme rainfall, could see $332 billion in losses by 2050. Other sectors facing major challenges are retail, banking and energy.

The public safety leaders tasked with managing today’s 911 centers face tremendous pressure—staying on top of these factors can seem like an impossible undertaking.

Common issues with LMR systems include piecemeal construction, with tower sites added incrementally and gradually as they’re needed. And because they weren’t designed together, interoperability or interconnectivity problems could arise. And in large structures like schools and shopping malls, which are constructed with materials that can block radio waves, signalamplification systems are sometimes lacking.

Industry-wide, there’s a shortage of people with expertise in radio systems, and there isn’t enough money to cover maintenance costs or equipment upgrades. There’s also a lack of understanding among county and city leaders about PSAP operations and 911 answering center management, and a resistance to change among officials.

The report groups challenges into categories, such as land mobile radio (LMR), emergency

Darrin Reilly, president and chief executive officer of Mission Critical Partners “ “

“The public safety leaders tasked with managing today’s 911 centers face tremendous pressure— staying on top of these factors can seem like an impossible undertaking,” said Darrin Reilly, president and chief executive officer of Mission Critical Partners, which released a report this week documenting these and other challenges faced by PSAPs titled “2022 Model for Advancing Public Safety Analysis and Insights report.” It’s intended to help leaders “make purposeful decisions based on how their organi zation fares in critical areas,” while enabling the industry at large “to collectively see where efforts should be invested in order to build a thriving and efficient public-safety communications environment for the betterment the communi ties where we live, work and play.”

At this year’s World Economic Forum in Davos, Switzerland, a global group of experts launched a new commission to research the economics of water that aims to advise policymakers on water management. We must “transform how we govern water and the climate together,” said commis sion co-chair Tharman Shanmugaratnam. “The costs of doing so are not trivial, but they are dwarfed by the costs of letting extreme weather wreak havoc.”

FROM INTEGRATING NEW TECHNOLOGIES TO STAFFING SHORTAGES, REPORT HIGHLIGHTS CHALLENGES FACED BY 911 ANSWERING CENTERS communication center (ECC) operations, and cybersecurity and physical security, among others, and suggests solutions. For example, while there’s been a lot of changes in commu nication technology and interoperability over the last few decades, the report found that “many LMR systems still operate largely on analog technology and a large proportion of radios lack advanced features.”

Over the last decade, administrators of public safety answering points (PSAPs) and 911 answering centers have faced innumerable chal lenges—from securing systems against cyberat tacks, to keeping up with the latest technologies and meeting staffing demands in an increasingly stressful environment. It hasn’t been easy.

ThinkingDifferently:

New Approaches for Treating First Responder Injury and Trauma

ILDFIRES. FLOODS. RIOTS. MASS SHOOTINGS. Public health emergencies. This is the short list of potential disasters from which we are protected by first responders police, security guards, firemen, paramedics, and others who ensure our safety in times of crisis.

Public risk managers are usually responsible for managing the workers’ compensation injuries of at least one group of first responders; often, their workforce encompasses multiple first responder teams. While we may be fully committed to helping these invaluable employees heal from injuries and resume their lives, the fact is that their recovery can be more complicated than that of other workers.

SEPTEMBER/OCTOBER 2022 | PUBLIC RISK 7

First responders are a unique group in that they are subjected to daily trauma, danger, and anxiety as they perform their jobs. This chronic stress can eventually lead to mental health issues and even post-traumatic stress syndrome (PTSD). According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 30 percent of first responders develop behavioral health conditions including, but not limited to, depression and PTSD, and at a rate that is 50 percent higher than the general population.

WHY IT’S COMPLICATED

Traditional approaches fall short, hampered by a lack of understanding of the nature of daily trauma, outmoded treatment approaches, and limited resources.

Risk managers are starting to think differently about the special needs of these invaluable heroes and what they need to truly heal. That path leads BY PEARL MONROE, KAREN THOMAS AND GERRY STANLEY, MD to leveraging scientific discoveries in how the brain works and new technologies that make therapy more cost-effective and convenient.

Leveraging digital connectivity to treat patients remotely in the comfort of their homes is another innovation that helps reduce the stigma of “going to therapy.” It also makes coaching convenient and overcomes the challenge of accessing experienced therapists treating these patients’ specific situations.

This constant pressure can build up for years before symptoms suddenly appear. Alternatively, a single incident can be the catalyst for a breakdown. That precipitating event could be, and often is, an injury received during the job. When that happens, recovery is complicated because there is a biological correlation between pain and depression, a relationship that can trigger or exacerbate PTSD symptoms. These employees become discouraged and begin to disengage from treatment. They can become isolated from their previous lives and relationships, sinking deeper into depression and suffering even more physical and emotional pain. Sometimes, this downward spiral leads to long-term disability.

• The availability of mental health services for these patients is often stymied by a lack of available therapists in general, as well as the fact that most therapists don’t understand the special circumstances that create first responder trauma.

The majority of patients also reported reduced depression, fatigue, and sleep disturbance.

Thinking differently starts with recognizing that injuries are a form of trauma and that treating the symptoms of both trauma and the physical injury is necessary for a full recovery.

8 PUBLIC RISK | SEPTEMBER/OCTOBER 2022 THINKING DIFFERENTLY: NEW APPROACHES FOR TREATING FIRST RESPONDER INJURY AND TRAUMA

• The lingering stigma of seeking help for mental health issues also discourages many of these injured workers from acknowledging their situation or being open to treatment. They see themselves as “tough guys and gals” who can handle it. Until they cannot.

A study reported in the peer-reviewed journal, Pain and Therapy, documented results from a regimen using virtual reality therapy combined with behavioral coaching and artificial intelligence for the treatment of debilitating workplace injuries. Patients reported an average 40 percent reduction in pain while utilizing the program and an additional 2.8 hours of continued pain relief at the conclusion of 90 days. In addition, 69 percent of patients reported either a decrease in opioid use or complete cessation after 90 days of treatment.

• Reliance on prescription drugs to suppress symptoms and pain has contributed to a deadly opioid epidemic and dependence on drugs that inhibit performance, a hazardous situation for first responders who cannot perform their jobs if they are not at peak alertness and stamina.

THE PATH FORWARD

• Be open to new ideas. While virtual reality has been used for several decades in health care, its effectiveness in alleviating trauma and its application in workers’ compensation is relatively new. Its use with first responders Thinking differently starts with recognizing that injuries are a form of trauma and that treating the symptoms of both trauma and the physical injury is necessary for a full recovery. From the start, clinicians should be alert to existing or potential mental health issues related to pain and trauma so that they can address them in the treatment plan.

Unfortunately, the typical approach to treating and managing these employees has not been very effective. Until recently, approaches were hampered by a lack of understanding of cumulative and situational trauma and how it impacts recovery and ongoing physical and mental health. Both biologic and behavioral health solutions have significant drawbacks:

To ensure that you are tapping the most powerful tools for restoring well-being in your first responders, consider these guidelines:

From the start, clinicians should be alert to existing or potential mental health issues related to pain and trauma so that they can address them in the treatment plan. This “early awareness” system is achieved through training and screening tools. New technology like virtual reality – combined with behavioral coaching – is a breakthrough in treating and healing trauma and pain WITHOUT drugs or unnecessary surgery. In fact, the ability to create different neural pathways in the brain is changing how we approach injury and recovery for all injured workers.

THINKING DIFFERENTLY

• In addition to training case managers to spot these patients early on, engage in educating physicians on what the unique issues are and the alternative treatments available for care.

Fortunately, Tyler immediately noticed relief with virtual reality and behavioral coaching therapy. The quality and duration of his sleep improved. He experienced an incremental lessening of his anxiety and a reduction in the number and intensity of his panic attacks. His medication use dropped dramati cally — from two tablets daily to ¼ tablet about once every two months when experiencing a panic attack.

Tyler’s goals were to reduce his anxiety level when experiencing a situation that might trigger these emotions and to improve his coping skills so that he could return to his job and his family life.

The ‘pop’ of fireworks on the Fourth of July or even on television triggered flashbacks. He could only sleep about three hours a night, and his anxiety level was high around the clock.

• Cultivate awareness within the organization and with workers’ compensation partners of the hidden cost of untreated trauma, how it impacts recovery from the physical injury and the ability to return to work. Linking depression and anxiety to trauma and the recovery program for the injury will help overcome the stigma around “mental health” and prompt a more positive response and engagement by the injured worker.

With his life and career back on track, he returned to work full-time.

He’s very open about the success of his program and is a huge advocate for mental health treatment.

SEPTEMBER/OCTOBER 2022 | PUBLIC RISK 9 is an excellent example of out-of-the-box thinking: finding an innovative solution to a chronic problem.

• Introduce innovations like virtual reality, behavioral coaching, and remote technology early in the treatment plan to engage workers and get them started on a rapid road to recovery.

For police officer Tyler Wilson, saving children from a burning vehicle, dealing with “suicide by cop” scenarios, or facing hostile demonstrators were all in a day’s work. A 10-year veteran of community policing, Tyler thought he was handling the regular onslaught of life-threatening emergencies as a matter of course. That is until he pulled up in front of a hardware store, and the flashbacks started.

A FIRST RESPONDER

Pearl Monroe is vice president of operations for MC Innovations, Karen Thomas is vice president, Clinical Solutions for CorVel, and Gerry Stanley, MD, is senior vice president and chief medical officer for Harvard MedTech.

Several months after post-traumatic stress disorder (PTSD) threw his life into disarray, Tyler learned about a new treatment for healing trauma. It combines virtual reality, behavioral counseling and artificial intelligence to change how people experience trauma.

• Adopt the philosophy that treatment starts not just with a focus on the specific injury but also with an assessment of the whole patient, their job situation and exposure to trauma, their personal life and pressures, and what they need to be whole again in both body and mind.

• Institute a program in which nurses screen for potential trauma symptoms or vulnerabilities that may complicate recovery at the start of treatment. Case management screening, including automated claims evaluation, can bring potential issues to the fore early in the case.

Unfortunately, Tyler’s symptoms progressed to include panic attacks, obtrusive thoughts of suicide, avoidance of leaving home, depression and anxiety.

Taking medication helped him sleep better and manage the anxiety, but he felt like a zombie during the day. His work schedule was reduced to part-time. His home life also suffered.

The therapy is based on science that shows that the brain has the ability to actually develop new neural pathways to permanently alleviate the experience of pain and stress. With this therapeutic approach, patients are able to re-program their brains to change the sensation of trauma, which in turn alleviates their symptoms on a long-term basis. As a result, they become more resilient to maladaptive signals. Behavioral coaching augments virtual therapy, helping patients to set goals for improvement, learn the habits that help them manage stress and anxiety, and master the tools to be more resilient in the long term.

“I got out of the car, and then I couldn’t move,” he recalls. “The front of the store looked nearly identical to a building I’d been backed up against by protesters. Instantly, I started reliving the whole traumatic confrontation.”

Tyler notes, “I used to consider medica tion as an emergency option. It was my ‘break glass in case of emergency’ therapy. But now, the virtual reality headset has taken the place of phar maceuticals as my emergency tool. I find I can overcome stressful situations pretty easily.”

“The type of therapy I had is particularly appealing to people in law enforcement, who are mainly men,” he concludes. “It’s technology; it’s something they can do on their own — on their own time — and it’s less ‘touchy-feely’ than some of the other options that may be available. And, it works.” FACES DOWN TRAUMA

FINDING HELP FOR RECOVERY

Wilson completed a 90-day program with an 84% overall improvement rate, including a 50% anxiety level reduction while using the headset and legacy anxiety relief of 12 hours, and a 33% reduction in anxiety level when exposed to situations known to be triggers.

Register for SEPTEMBERPRIMA’sWEBINAR FREE MEMBERSTO Register at primacentral.org/education/webinars Risk Owners: Who, How and What Do They Do? SEPTEMBER 28 | 12:00 PM – 1:00 PM EST SPEAKER: Dorothy Gjerdrum, ARM-P, Senior Managing Director, ERM Practice, Arthur J. Gallagher The selection and training of risk owners is critical to managing risks across your organization. How do you get the right people on board? What training is most effective and how do you communicate expectations and establish accountability? These are the burning questions attendees will focus on during this webinar. ATTENDEE TAKEAWAYS: 1. Understand the important role that risk owners play 2. Learn how to identify, engage and train risk owners 3. Consider key issues, such as accountability and reporting 4. Learn from the mistakes and good examples of peers

PRIMA Institute (PI) is the premier educational program for new and seasoned public risk management professionals who seek to learn more about emerging trends and best practices. This hands-on learning environment affords attendees the opportu nity to participate in case studies and network with leaders in the field of public risk management. additional information regarding sponsoring PRIMA Institute, please contact PRIMA ’s education director, Shaunda Ragland,

ABOUT PRIMA INSTITUTE

at sragland@primacentral.org. PRIMA INSTITUTE 2022 BIG IDEAS. SMALL SETTING. October 17–21 // Old Town Alexandra, VA PLATINUM $10,000+ GOLD $9,999–$7,000 SILVER $6,999–$4,000 BRONZE $3,999-$2,500 Signage Recognition at PI and PRIMA’s Annual Conference X X X X Complimentary List of PI Attendees Post-Conference for One-Time Marketing Opportunity X X X X Listing on PRIMA Institute Web site with Link to Your Company’s Web Site X X X X Text Recognition during Daily Continental Breakfast X X X X Text Recognition in PRIMA Institute articles and ads in Public Risk Magazine X X Text Recognition in PRIMA Institute Brochure X X Name Recognition during PI Podcast X X Recognition with Company Logo in Attendee Workbook X X Company Logo w/ Link to Company Website Used in PI Email Marketing Pieces X X Number of scholarships sponsored *Scholarship recipients will receive complimentary registration. 3 2 1 0 2 complimentary registrations will be given when a gold or platinum sponsorship is purchased.

SPONSORSHIP OPPORTUNITIES WHY SPONSOR PRIMA INSTITUTE? • Signal your organization’s commitment to continuing public sector risk management education • Promote your organization to an intimate group of influential risk managers • Support young risk managers who are new to the public sector • Introduce and keep your products and services in front of tomorrow’s decision makers via networking events and throughout the educational program • Establish and build loyal relationships with risk managers • Increase your organization’s brand recognition Contributing to PRIMA Institute (PI) is a great way to expose your company to PRIMA members as well as show your support of the public risk management profession! As a PRIMA Institute sponsor, your company will receive formal recognition of your commitment to the future of public risk management via:

• Recognition on signage at PRIMA Institute 2022

For

• Acknowledgement in the PI22 program, marketing materials and certain issues of Public Risk magazine, and on the PRIMA Website.

• Recognition for sponsoring attendee scholarships (quantity and events determined by sponsorship purchased and spon sorship level).

and training

THE PUBLIC RISK MANAGEMENT CHALLENGE

BY DR. JOE JARRET

OURPOLICINGSCHOOLS:

12 PUBLIC RISK | SEPTEMBER/OCTOBER 2022

In a 2021 survey of SROs across the United States conducted by U.S. Department of Justice, Office of Community Oriented Policing Services, 80 percent reported that they had confiscated a weapon from a student in the last school year. The United States Justice Department has reported that SROs assist school administrators with incidents that would have previously been referred to the criminal justice system, and that SROs possess specific training that school administrators often lack when it comes to responding to threats of violence. As a result, schools with an SRO appear to be better equipped to effectively address any threatening situation that might arise in the course of the school day. This doesn’t mean, however, that the presence of SROs in schools is without risk and should not include input from the public risk manager.

On September 6, 2000, the Department of Justice announced that the COPS in Schools program of its Office of Community Oriented Policing Services (COPS) would award $68 million in grants to hire 599 SROs in 289 communities across the Nation. These grants enabled communities to hire new police officers and encourage working relationships between police and schools, thus bringing the principles and philosophy of community policing directly into the school environment. Although these community grants provided the funding needed to hire new SROs, it was soon learned that the SROs multifaceted role—as law enforcement officer, counselor, teacher, and liaison between law enforcement, schools, families, and the community required training beyond that which is traditionally offered in police academies. This dilemma continues as not all states require law enforce ment officers specialized training before they are deployed to schools as SROs.

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SROS VERSES SCHOOL SECURITY Generally speaking, SROs are sworn lawenforcement officers with arrest powers who work, either full- or part-time, in a school setting, but who are employed by a law enforcement agency, such as a sheriff’s or police department. As sworn law enforcement officers, SROs are certified by a particular state’s Peace Officer’s Standards and Training (POST) certification. In the United States, certification and licensure requirements for law enforcement officers vary significantly from state to state.

THE MOU Key to the school system-SRO relationship is the Memorandum of Understanding (MOU).

According to the Center for the Prevention of School Violence at North Carolina State University, the SRO concept evolved during the 1950’s in Flint, MI, where community policing had been implemented and police officers had become involved in schools. The concept flourished during the 1960’s and 1970’s (predominantly in Florida), then languished in the 1980’s, and did not gain momentum nation-wide until the mid-1990’s.

SROS: A BRIEF HISTORY Part Q of Title I of the Omnibus Crime Control and Safe Streets Act of 1968, as amended, defines the SRO as “a career law enforcement officer, with sworn authority, deployed in community-oriented policing, and assigned by the employing police department or agency to work in collaboration with school and community-based organizations.”

Law enforcement agencies tend to maintain SRO programs because they are often viewed as an effective means to reduce the workload of patrol officers, improve the image of officers among juveniles, create and maintain better relationships with the schools, and enhance the agency’s reputation in the community. A school security officer, on the other hand, is trained, supervised, and employed by the school district and most often lacks arrest powers. When a violation of the law or school policies occurs, the school security officer is required to place the student into the custody of the school administrator, the SRO, or another law enforcement officer.

Over the years, I have been afforded the opportunity to serve as a public risk manager, a juvenile crimes prosecutor, and a school board attorney. As such, I have observed, firsthand, the risks involved when a poorly drafted MOU governs the relationship between a school and the law enforcement agency providing SROs. Some of the infirmi ties I’ve observed in MOUs included a failure to specify SRO roles and responsibilities, and the lack of a detailed plan for exactly how the SROs were to be utilized. Although most MOUs provide for the SROs’ deployment in the schools, many described the officers’ activities in very general terms, such as noting that the officers worked for the law enforce ment agency and stipulating who paid and supervised them. The MOUs did not elaborate on the SROs’ day-to-day operations, duties, responsibilities, and limitations. The most serious issues I observed that could translate into liability for the school system concerned disagreements that arose regarding where to draw the line between criminal violations and serious incidents meriting SRO attention on the one hand, and disciplinary activities more properly handled by teachers and staff on the other hand. Many MOUs didn’t require any specialized training, necessary for an SRO to be successful in a school environment. Other common areas of disagreement were whether the SROs would be available beyond normal school hours and during the summer, and whether they would direct traffic or routinely teach or give presentations.

HEY HAVE BEEN VALIDATED AND VILIFIED. PRAISED AND PENALIZED. Courted and cancelled. Welcomed and warned off. They are School Resources Officers (SROs), and their presence in public schools continues to be an emotional and political issue, despite the fact that a recent poll revealed that students, parents, staff, and community members rank school safety at the top of their list of concerns. That same poll revealed that when students feel safe at school, they have a greater chance of thriving both academically and socially.

• Have experience as a patrol officer or road deputy; • Have above average integrity;

POLICING OUR SCHOOLS

The United States Justice Department suggests that restraining a student or placing a student in physical custody for any length of time via wrist restraints, frisking, community separation, or other means should only be done to ensure the safety of everyone at the school campus and consistent with applicable laws. SROs should not detain students solely on the direction of a school administrator. Prior to detaining, arresting, or ticketing a student, SROs should use all other appropriate de-escalation techniques and account for the age and size of the student. Because of recent negative interactions between law enforcement and citizens, courts across America are less and less inclined to grant immunity (in its various forms), to SROs and the school system to which they are assigned when sued for violations of civil rights or personal injuries sustained by students.

Dr. Joe Jarret, J.D., Ph.D., is a former public risk manager, school board attorney, and U.S. Army Officer. He is the past-president of the Southwest Chapter of PRIMA, and PRIMA’s “Author of the Year” for 2016.

Something as obvious as whether the SROs are going to be called upon to perform traditional law enforcement duties such as patrolling and responding to calls for service, versus serving as mentors and teachers, guest speakers, involve ment in extracurricular activities and the devel opment of safety programs within the school can have a substantial impact on an entity’s exposure. Also, which entity is responsible for workers compensation costs associated injuries to an SRO, damage to equipment, claims of excessive use of force or civil rights violations, should be clearly outlined in the MOU.

• Have effective teaching skills; • Understand the importance of diversion programs and alternatives to arrest for youth;

• Have knowledge of the specific needs and local concerns of the community;

• Have the ability to competently engage in public speaking;

A WORD ABOUT LIABILITY Regarding liability, it is strongly suggested that SROs not be involved in disciplining students or be directed to resolve student issues that would otherwise be the responsibility of a teacher or school administrator or be subject to the school’s internal discipline procedures or school code of conduct. SROs should not respond to incidents that do not pose a threat to safety or involve typical student behavior that can be safely and appropriately handled by a school’s internal disciplinary procedures.

14 PUBLIC RISK | SEPTEMBER/OCTOBER 2022 POLICING OUR SCHOOLS: THE PUBLIC RISK MANAGEMENT CHALLENGE

• Understand the potential negative impact that SRO programs can have on students;

• Have been thoroughly trained in teaching, mentoring, and properly interacting with students; and, • Carry out their responsibilities in a fair and impartial manner while not discriminating based on race, color, national origin, limited English proficiency, disability, or sex including sexual orientation and gender identity. All of the above attributes have the potential to reduce the frequency and severity of claims asserted against SROs and the entity itself.

It is imperative that public risk managers insist that the law enforcement officers assigned to the schools for which they are responsible, are there voluntarily. Officers who are involun tarily designated to be SROs may have the tendency to express a lower level of commit ment to the program or the school. A recent United States Department of Justice study revealed that school administrators report that the most effective SROs: • Like kids, wants to work with kids, and are able to work with kids; • Want to be SROs and don’t see the position as a demotion, or a glorified babysitting job;

Public risk management is critical in providing a safe and secure learning environment for students, staff and the general public. As such, the posting of SROs in public schools should not be done in a vacuum. Like any other exposure, it is the risk manager who is respon sible for identifying and analyzing exposures and determining what actions to take to avoid, prevent, reduce, retain, or transfer risk. When it comes to SROs, it is the risk manager who is responsible for ensuring that SROs, along with all school staff, follow departmental policies and processes, and that risk management is integrated into other policies and processes necessary to maintain a safe learning and teaching environment.

It is essential that the risk manager (regardless if serving the school system or the law enforce ment agency providing the SROs), be involved in the crafting of the MOU along with input from a variety of sources including the SROs, school officials, law enforcement leadership, community members, school counselors, parents, the entity’s attorney and other stakeholders. The MOU should also include a mechanism for the school district to receive feedback regarding SROs’ activities and actions.

• Have the right demeanor and “people skills,” including being: • calm, • approachable, • able to put up gracefully with guff from kids, and • have infinite patience;

• Have the ability to work effectively with students, parents/guardians, teachers, and school administrators; • Possess strong communicationinterpersonalskills;

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Thirdly, the executive does not have to be the chair but the mere presence provides support, structure and guidance that is often needed to have an effective accident review board. Accident boards should be conducted effectively time wise and efficiently to obtain pertinent information while maintaining a cordial tone. Ineffective boards can be a painful process for both the subject employee and the board. In the situation described in the introductory paragraph, the supervisor acting as the chairperson needed support and guidance that was lacking, not to sway but to have constructive feedback. Hence, managers need to attend accident review boards so that they have provide a meaningful concern for employee safety, that they not only want to know what contributed obviously to the event but find out circumstances and procedures that may have contributed to the occurrence, and finally, to assist in the efficiency and effectiveness of the accident review board but not to control it. An accident review board without senior leader ship sends a negative message to employees and the board, and creates an ineffective process to eliminate reoccurrences.

BY DAN HURLEY, CSP, ARM-P, MS, MPA

Some time ago, while attending a division’s recent accident review board for a vehicle accident involving significant loss from a single vehicle accident, I was struck by the fact that even though the loss was significant with serious potential for injury, neither the division head or the assistant were in attendance. The committee was chaired by a first line supervisor who seemed to struggle with the consequences before him, a large loss that initially appeared preventable barring any contributions from failed road maintenance. The process in this example was lacking while there was so much opportunity for manage ment to participate, to positively impact employees by attending and participating in the accident investigation process. First, the attendance of senior leadership demonstrates to employees that the leadership If conveyed effectively, not utilizing the investigation merely as fault finding, the presence of senior leadership demonstrates that managers do care about employees and that managers do want to utilize the investigation as a mutual commitment to prevent injuries.

has a vested interest in their personal safety. If conveyed effectively, not utilizing the investiga tion merely as fault finding, the presence of senior leadership demonstrates that managers do care about employees and that managers do want to utilize the investigation as a mutual commitment to prevent injuries. Of course, it is most meaningful when managers follow up and act and make changes as needed.

THE CRITICAL IMPORTANCE OF EXECUTIVE PARTICIPATION IN ACCIDENT REVIEW BOARDS

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Secondly, participation in accident reviews provides senior staff first-hand information not only on the accident’s initial causes but also circumstances that may have contributed to the unfortunate event. Could it be that policy contributed to an injury? Or inadequate equipment or an ineffective process? Is wearing a plastic hard hat at all times in a Virginia summer outdoors reasonable if there are no inherent hazards? What is the employees “black box” process, what they really do instead of following the policy? There are other forms of communication for senior staff to engage employees but where a critical incident occurs, the accident investigation provides an interactive opportunity to learn more to prevent re-occurrence while engaging staff.

On the third visit, about three weeks to a month later, if things have not improved, the physician may recommend some form of an injection to provide limited improvement to the pain and inflammation and continued therapy and home exercises.

At the fourth visit at around six weeks, in 30% of cases, the physician will do some form of imaging to diagnose tendonitis, bursitis or other soft tissue problems. Finally, after three months, if conservative treatment is not proving effective, the physician may recommend a more aggressive treatment such as surgery or arthrograms. Applying general guidelines rooted in evidence-based medicine can be an effective way to help reduce the risk of having poor outcomes in terms of the diagnosis and treatment of issues involving the shoulder.

For someone presenting with a shoulder injury, the physician should return to basics and spend time inspecting, palpating, and comparing both shoulders to understand the bone structure and any types of degenerative changes that may exist, rule out other diagnoses and address fractures and dislocations.

TREATING SHOULDER INJURIES WITH EVIDENCE-BASED MEDICINE

BY FERNANDO BRANCO, MD, FAAPM&R When treating shoulder injuries, keep the P.R.I.C.E. principle in mind. First, Protect the area and use Relative Rest to minimize utilization of the joint for the first 24 to 48 hours. Apply Ice to active injuries to help with swelling. After 48 hours, alternate use of ice and heat. Compression, using supportive wrapping, should be applied to the shoulder area to help with instability. Finally, use Elevation to decrease inflammation. These guidelines are all evidence-based from ODG and ApproximatelyACOEM. 90% of shoulder injuries will require mild to moderate treatment. The first physician visit immediately following the injury may involve changing activity a little and using acetaminophen or an anti-inflammatory. During the second visit, typically a week or two later, the physician may recommend physical or occupational therapy, or a combination, at two to three visits a week for two weeks.

The shoulder joint is a complex area that can be prone to injuries, particularly for employees working in the healthcare, construction and manufacturing industries. There is no bone connection between the shoulder blade and the humerus, just cartilage, ligaments, and tendons. The area is fragile and susceptible to injury due to repetitive or monotonous work that constantly utilizes the same arm movement, trauma and disease. Other factors that can increase the risk of a shoulder injury include heavy lifting, stress and depres sion. Because of these variables, it is crucial that treating physicians use evidence-based medicine to make proper care determinations. With any shoulder pain, the initial diagnosis is most important. Best practice guidelines for occupational-based medical and disability care, like those established by the Official Disabilities Guidelines (ODG) and the American College of Occupational and Environmental Medicine (ACOEM), provide a good starting point.

Workers who are fatigued or sleep deprived simply will not be as safe or productive as workers who are not. Employers can play a critical role in keeping their employees safe by fostering a company culture that supports employee well-being — including sleep.

Supervisors will likely need to rely on observa tion and experience to identify when workers are experiencing fatigue and possible presenteeism. Signs of fatigue include acute or chronic sleepiness, yawning, irritability, reduced memory or concentration, low motivation, mistakes and lapses in communication and judgment. Supervisors should be trained on how to spot these signs and intervene.

Creating a culture in the workplace that recognizes the importance of fatigue manage ment is critical. As we consider the future of work, now is the time for employers to address sleep deprivation and fatigue to support their employees’ well-being — and ultimately their organizations’ success.

Supervisors should also clearly reinforce with employees that it is their responsibility to arrive at work rested and ready to provide full effort. Employees need to evaluate their sleep and seek help for sleep disorders. If they are having problems obtaining adequate amounts and/or quality of sleep, they should follow up with a healthcare provider to seek assistance.

18 PUBLIC RISK | SEPTEMBER/OCTOBER 2022 BEST OF THE BLOG: POPULAR PRIMA BLOG POSTS YOU MAY HAVE MISSED

There are many causes of fatigue that result from workplace factors and those related to personal lives. Categorically, causes of fatigue include physical, mental and environmental loads. Forceful exertion, repetitive motion and awkward postures are examples of physical loads that can result in fatigue, while stressful coworker relationships, lack of decision autonomy, shift work and irregular work hours can drive mental fatigue. Temperature extremes, noise and low lighting are examples of environmental loads. Shift work is another area of focus. Employers should be aware that the beginning and ending of shifts are the most dangerous. Occupations that involve non-traditional work hours comprise about 15% of US workforce, so careful assessment of the timing of shifts and rotations is essential. Allowing time for use of caffeine has been shown to be effective — especially when combined with 10 to 15 minutes of napping. Use of caffeine just before a short nap can allow sleep before the caffeine begins to have affect. Other steps can include providing adequate lighting and temperature control when possible.

BY MARK S. WILLIAMS, DC, MBA, DACBOH

It has been estimated that 13% of all workplace injuries are related to sleep deprivation and fatigue.[1] And, according to the National Safety Council, highly fatigued workers are 70% more likely to be involved in incidents that result in injury, and workers who report disturbed sleep are nearly twice as likely to die in a work-related incident. This is because mental fatigue leads to distortions that influence decision-making. For example, making decisions automatically, without conscious thought. Our brains are very selective on what to focus on and this is more limited with fatigue. We think we see everything in view, but we don’t. Also, when we’re cognitively fatigued, we are more likely to find easier paths. We believe we can multitask, but when we try, we make more errors.

Sleep hygiene techniques include maintaining a regular sleep schedule, avoiding stimulants and other substances that impact sleep before bedtime and getting adequate exercise.

Management may perceive fatigue as a behavioral problem — an employee’s lack of commitment to the job, a poor attitude, or lack of willpower. Our pervasive cultural mentality embraces the notion that fatigue can be conquered by sheer will or perhaps that it is a badge of honor. This position, of course, ignores the growing body of research demonstrating the safety and productivity consequences of fatigue and sleep deprivation.

SAFETY RISKS ASSOCIATED WITH SLEEP DEPRIVATION AND RESULTING FATIGUE

Sleep is a biological need for life and health. Like the need for food, too little or too much has significant mental and physical health consequences. Most adults need seven to nine hours of good-quality sleep every 24 hours to perform during well. When you lose sleep, you build up sleep debt that will seriously impair your performance at work, and the only way to pay off this debt is to get enough sleep.

Register for NOVEMBERPRIMA’sWEBINAR FREE MEMBERSTO Register at primacentral.org/education/webinars Active Shooter: Prevention and Preparedness NOVEMBER 16 | 12:00 PM – 1:00 PM EST SPEAKER: Paul Timm, PSP, Vice President, Facility Engineering Associates, P.C. Shots fired! The specter of an active shooter incident is one of the top issues that causes administrators to lose sleep. Years ago, schools adopted lockdown procedures designed to delay the shooter’s access to students and staff until law enforcement officers could affect the situation. In response to more recent incidents, this session will bring attendees up-to-date on pertinent developments regarding active shooter preparedness. ATTENDEE TAKEAWAYS: 1. Learn about ways to improve emergency preparedness 2. Attendees will receive helpful web-based resources 3. Attendees will be informed about specific and current active shooter protocols

20 PUBLIC RISK | SEPTEMBER/OCTOBER 2022 FIND US ON FACEBOOK! Keep up with what’s happening at PRIMA and connect with your risk management peers!

PRIMA’s calendar of events is current at time of publication. For the most up-to-date schedule, visit www. primacentral.org. PRIMA ANNUAL CONFERENCES June 4–7, 2023 PRIMA 2023 ANNUAL CONFERENCE Long Beach, California Long Beach Convention Center June 16–19, 2024 PRIMA 2024 ANNUAL CONFERENCE Nashville, Tennessee Gaylord Opryland Hotel June 1–4, 2025 PRIMA 2025 ANNUAL CONFERENCE Seattle, WashingtonWA State Convention Center

Visit at linkedin.com/company/prima-central/.

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September 28 Risk Owners: Who, How and What Do They Do? October 26 Risk Management in a Time of Volatile Insurance Markets and Ever Increasing Natural Disasters

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Register for PRIMA’s DECEMBER WEBINAR FREE MEMBERSTO Register at primacentral.org/education/webinars The Power of Partnerships in a Continuously Connected World DECEMBER 14 | 12:00 PM – 1:00 PM EST SPEAKER: Kelvin Coleman, Partner, IBM Consulting As the technology landscape evolves, products and processes are becoming faster and more accessible. What about the partnerships to help secure our data in a continuously connected world? In this session, the presenter will discuss resources and human-centric focus on best practices for implementing public and private sector partnerships to mitigate the risk of cyber threats. ATTENDEE TAKEAWAYS: 1. Learn how to identify key resources to address key issues 2. Learn best practices to facilitate public-private partnerships with regards to cybersecurity

VISIT ENTERPRISEPRIMACENTRAL.ORG/ERMTRAININGRISKMANAGEMENT TRAINING VIRTUAL SCHEDULE Create an ORGANIZATIONALCULTURE that proactively MANAGESRISK DAY 1: NOVEMBER 29 12 – 2 PM EST DAY 2: DECEMBER 1 12 – 1:30 PM EST DAY 3: DECEMBER 5 12 – 2 PM EST DAY 4: DECEMBER 7 12 – 2 PM EST