Staff roles

Each COHE will have staff to fulfill the following roles:

  • COHE Medical Director: Health care provider with an active Washington State license who is focused on medical leadership and management.
  • COHE Project Director: Operational leader with project management experience who manages all of the core COHE functions and staff.
  • COHE Health Services Coordinator (HSC): Facilitator and coordinator between provider, employer, injured worker, union (when applicable), and claim manager.
  • COHE HSC Assistant (not a mandatory role): Works under the direction of the HSC.
  • COHE Community Outreach Facilitator: Staff who encourages employers, unions, and community organizations to partner with COHE and implement best practices.
  • COHE Provider Trainer: Trainer of medical providers participating in a COHE and their staff in the implementation of occupational health best practices.

Can a single person hold more than one role?

Yes, COHE staff may fulfill multiple roles, as these roles may not require a full-time equivalent staff person.

As an example, a COHE team member may spend a third of their time doing HSC work, another third doing Provider Training, and a last third doing Community Outreach.  The important thing is that on the COHE Quarterly Report the time is reported appropriately with only the third doing HSC work appearing on the Claims per HSC section.

What are the requirements for each position?

See this printable guide:

How does HIPAA apply to COHEs?

It's important for all COHE team members to be sensitive to claim and health information levels of confidentiality.

The Health Insurance Portability and Accountability Act (HIPAA) requires the health care industry to protect the security of stored health care records and those transmitted electronically.  HIPAA exempts workers' compensation programs from the Act’s Privacy Rule authorization requirement (45 CFR § 164.512(l)). Workers’ Compensation claims information has its own set of legal requirements that take precedence over HIPAA regulations, see RCW site Title 51.  HIPAA allows exceptions for workers’ compensation claims.  HIPAA's "minimum necessary" standard does not apply to workers' compensation or crime victims' compensation claims.

You need to know the following:

  • The insurer (L&I for state fund claims, the self-insured employer or their representative for self-insured employer claims) are entitled to all healthcare related and other information in a claim file.
  • The injured worker signs an authorization for release of this information when he or she submits:
    • Report of Industrial Injury or Occupational Disease form (ROA) to L&I
    • Self-Insurers’ Accident Form (SIF2) and the Physician’s Initial Report (PIR) to the Self-Insured employer.
  • Besides the insurer, workers’ compensation claims require you to disclose personal health information regarding work-related illness or injuries directly to the employer of record, injured worker and attending provider without additional authorization.  This means that you can release information about the worker's physical restrictions to an employer who may have light-duty work available.
  • A HSC or medical providers must have a release from the patient to speak to their union representative unless the conversation occurs with the patient and the representative together.

If, however, the injured worker files a reopening application and has changed employers since the injury, the HSC needs permission from the worker to talk with the new employer about restrictions related to the old injury. Due to Workers’ Compensation and HIPAA regulations, please do not send claim numbers or social security numbers attached to names over the Internet. The L&I standard is that a claim number can be sent in a non-secure email, but worker name and other information cannot be mentioned. L&I email is currently not secure, except through the Claim and Account (CAC) system secure messaging. It makes no difference to whom you are e-mailing; this policy applies to all cases.

It is important to remember that you are viewing, discussing, and handling confidential health care and claim information. You should keep this information secure at your desk location, transmit information through secure lines only, and take care to use secured technology when working with claim-specific information.

More information on HIPAA

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