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Rehabilitation Mine Health and Safety Council Summit Presentation 19 Oct, 2018

Rehabilitation Mine Health and Safety Council Summit Presentation 19 Oct, 2018. Presented by Dr. Deodat Kritzinger GM: Medical. Outline of presentation. What do we mean with rehabilitation? Policy and legislative framework – Department of Labour RMA practice Closure. Rehabilitation.

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Rehabilitation Mine Health and Safety Council Summit Presentation 19 Oct, 2018

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  1. Rehabilitation Mine Health and Safety Council Summit Presentation 19 Oct, 2018 Presented by Dr. Deodat Kritzinger GM: Medical

  2. Outline of presentation What do we mean with rehabilitation? Policy and legislative framework – Department of Labour RMA practice Closure

  3. Rehabilitation 'Rehabilitation' means measures, in the form of clinical, vocational and social services and facilities, provided with a view to the reintegration of employees exposed to an occupational injury or disease back into work and to enable them to attain and maintain maximum independence, full physical, mental, social and vocational ability, and with full inclusion and participation in all aspects of life;

  4. Social Security Schemes respect the paradigm-shift from only compensating claims and paying pensions to creating structures and processes towards pro-active rehabilitation programs. Return-to-work (RTW) strategies attract disability management programs to the state, the enterprises, insurers and service providers by preventive measures close to the worksite. Objectives of rehabilitation

  5. International practice Social Accident Insurers are successful in return to work because of: their focus on the remaining abilities of workers with disabilities, not on their deficits using experts and financial incentives to assist companies in managing a return to work structure attracting service providers, mainly physicians and medical clinics, to intervene as early as appropriate

  6. Disability Management Professional Ethical behaviour Persuade employers Evaluation Medical aids Legal knowlegde Assessment Networking Case Management Social competence

  7. Overall objective aimed at RTW Rehabilitation Job retention Return to work Disability Management

  8. REHABILITATION POLICY & STRATEGY

  9. REHABILITATION POLICY & STRATEGY

  10. REHABILITATION POLICY & STRATEGY

  11. REHABILITATION POLICY & STRATEGY

  12. CURRENT OPERATIONS OF THE DIRECTORATE

  13. REHABILITATION POLICY & STRATEGY

  14. REHABILITATION POLICY & STRATEGY

  15. REHABILITATION POLICY & STRATEGY

  16. RAND MUTUAL ASSURANCE SERVICES • Electronic notification and submission of claims and required documents through member / employer and service provider portal • Hospital utilisation management • Case management of serious and re-opened claims • Pharmacy Benefit management • Pensioner medical plan • RMA Care facility

  17. MANAGED HEALTH CARE MODEL • Managed care, rehabilitation and disability manager • Case management and hospital utilisation management • Clinical and claims adjudicator • Case managers • Medical advisors • Team leader pensioner care, rehabilitation and care facility • Pension medical case auditors • Pension liaison officers claims adjudicator • PMP program • Scheduled reviews DRG groups • Mobile clinics • Case Manager Care Facility

  18. RAND MUTUAL ASSURANCE PMP • Plan developed with aim to follow up and engage with pensioners in need of ongoing medical care and health needs. • Services rendered through Pensioner medical case auditors who will interview all new RMA pensioners and enrol to the program where indicated or requested • Operate through satellite offices in Maseru, Mthatha and Xai-Xai as well as presence at RMA branches • Pensioner or claimant access through PMCA or RMA contact centre

  19. RAND MUTUAL ASSURANCE PMP

  20. Prosthetic and mobile visits Total number of clinics and visits performed by RMA staff and prosthetic partners since start of PMP in 2006 is 264. Annual schedule Botswana mobile clinic KZN – Ulundi, Ngoma and Mkuzi mobile visit Lesotho 2 mobile visits with 9 monthly assessment and minor repair visits Malawi mobile visit – Lilongwe and Blantyre Mozambique mobile visit – Xai- Xai) Swaziland – mobile visit in Mbabane and Manzini Eastern Cape – 2 mobile visits with 8 monthly assessment and minor repair visits

  21. Malawi visits and community projects

  22. OVERVIEW OF CARE FACILITY

  23. OBJECTIVES

  24. CARE FACILITY

  25. SKILLS DEVELOPMENT AND REHAB • Skills development – formal program started February 2018 • Agreement Mako Institute • Programs • Sewing • Shoe repair and leather works • Rehabilitation – formal program started December 2017 • RTW • Individual assessment and recommendation • Group sessions • Life skill sessions • Recreational and sport session • IT program and training – Sedibeng • Trained 60 learners

  26. Gym Activities

  27. RMA PROMISE AND COMMITTMENT Occupatiaonal Diseases • Caring, Compassionate Compensation 12

  28. Thank You

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