ITS 835 Chapter 5 ERM in Practice at the University of California Health System Dr. Oussama Saafein Introduction University of California’s ERM Technology Premium rebate program Professional Liability Prescription Program (PLPP) ERM and the Center for Health Quality and Innovation Protected health information value estimator PHIve University of California’s ERM University of California (UC) Health System Clinics, medical centers, schools Over 3 million patient visits annually UC Office of the President’s Office of Risk Services Responsible for ERM UC formally adopted COSO Integrated Framework in 1995 Committee of Sponsoring Organizations Internal Control Newly hired Chief Risk Officer (CRO) Experienced in ERM from industry Key Performance Indicator (KPI) Critical to ERM foundation Technology UC’s approach incorporates technology ERM information system (ERMIS) Initial phases Simple risk assessment tools Dashboards Control, mitigation, monitoring, survey Dashboard system Based on KPIs Visual indicators ERM Process ERMIS Dashboards UC MMR (My Managed Risk) Portal UC’s Approach to Evaluating Incidents, Events, and Claims Premium Rebate Program Program to reduce frequency and severity of loss Professional Liability Prescription Program (PLPP) Encourage risk reduction initiatives Aimed at reducing cost of risk Rewards units for implementing effective initiatives Annual rebates for initiatives that work Driving concept - Everyone is a risk manager ERM and the Center for Health Quality and Innovation Joint venture to award up to $8 million Reduce risk of clinical harm to UC surgery patients PHIve Personal health information (PHI) UC asked Bickmore to develop a software tool Estimates the value of PHI PHI value estimator (PHIve) PHIve steps Process determines the impact of PHI breach Repercussions Reputational Financial Legal and regulatory Operational Clinical Summary Risk is a part of all organizations ERM assists organizations in managing all risk UC deliberately advanced ERM to reduce overall risk UC Office of Risk management updates risk plans in an ongoing effort Technology is a cornerstone of UC’s ERM Saint Leo University ~ CRM 499 Term Project / Situational Report Courtelaney Pass is a mid-sized municipality in the Southeastern United States. It has a population of 80,000 residents made up of: 55% white, 38% black, and 7% Hispanic. The primary industry is agricultural and industrial with the unemployment rate at 8.7%. By national standards the city would be considered “blue collar” with a median household income of $38,000. The school system remains troubled as the drop-out rate is high and, other than the elementary schools, the middle and high schools have perpetual “D” ratings. There is a great deal of “southern pride” evident in this community as confederate flags are frequently flown and unfortunately, the fledgling local KKK is attempting to revitalize itself. Two out of the five city council members ...

1. ITS 835
Chapter 5
ERM in Practice at the University of California Health System
Dr. Oussama Saafein
Introduction
University of California’s ERM
Technology
Premium rebate program
Professional Liability Prescription Program (PLPP)
ERM and the Center for Health Quality and Innovation
Protected health information value estimator
PHIve
University of California’s ERM
University of California (UC) Health System
Clinics, medical centers, schools
Over 3 million patient visits annually
UC Office of the President’s Office of Risk Services
Responsible for ERM
UC formally adopted COSO Integrated Framework in 1995
Committee of Sponsoring Organizations Internal Control
Newly hired Chief Risk Officer (CRO)
Experienced in ERM from industry
Key Performance Indicator (KPI)
Critical to ERM foundation

2. Technology
UC’s approach incorporates technology
ERM information system (ERMIS)
Initial phases
Simple risk assessment tools
Dashboards
Control, mitigation, monitoring, survey
Dashboard system
Based on KPIs
Visual indicators
ERM Process
ERMIS Dashboards
UC MMR (My Managed Risk) Portal
UC’s Approach to Evaluating Incidents, Events, and Claims
Premium Rebate Program
Program to reduce frequency and severity of loss
Professional Liability Prescription Program (PLPP)
Encourage risk reduction initiatives
Aimed at reducing cost of risk
Rewards units for implementing effective initiatives

3. Annual rebates for initiatives that work
Driving concept - Everyone is a risk manager
ERM and the Center for Health Quality and Innovation
Joint venture to award up to $8 million
Reduce risk of clinical harm to UC surgery patients
PHIve
Personal health information (PHI)
UC asked Bickmore to develop a software tool
Estimates the value of PHI
PHI value estimator (PHIve)
PHIve steps
Process determines the impact of PHI breach
Repercussions
Reputational
Financial
Legal and regulatory
Operational
Clinical
Summary
Risk is a part of all organizations
ERM assists organizations in managing all risk
UC deliberately advanced ERM to reduce overall risk
UC Office of Risk management updates risk plans in an
ongoing effort
Technology is a cornerstone of UC’s ERM
Saint Leo University ~ CRM 499 Term Project / Situational
Report
Courtelaney Pass is a mid-sized municipality in the
Southeastern United States. It has a population of 80,000
residents made up of: 55% white, 38% black, and 7% Hispanic.

4. The primary industry is agricultural and industrial with the
unemployment rate at 8.7%. By national standards the city
would be considered “blue collar” with a median household
income of $38,000. The school system remains troubled as the
drop-out rate is high and, other than the elementary schools, the
middle and high schools have perpetual “D” ratings. There is a
great deal of “southern pride” evident in this community as
confederate flags are frequently flown and unfortunately, the
fledgling local KKK is attempting to revitalize itself.
Two out of the five city council members are considered “good
old boys” that are satisfied with the status quo and are apathetic
towards the civil unrest that has been percolating in the black
community. Within the past twelve months there have been
protests in the black community that have steadily been
growing. Those residents complain that policing is biased
against them and that unnecessary and excessive force is
commonplace; especially amongst young black males. Due to
recent nationwide events surrounding similar claims, the
national media is paying particular attention to Courtelaney
Pass.
The police department is appropriately sized to police this
jurisdiction. The chief is a 42-year-old white male who has been
with the department for twenty years working his way up the
ranks. He has no college degree but is working towards it via
on-line classes. The demographics of the agency do not mirror
the community as 94% of the department is white. The only
minorities in the agency work in non-sworn support roles. The
chief claims that he is attempting to attract minority applicants
but the majority of those interested cannot pass the entrance
exam. He claims that those who can pass end up going to work
for the state police instead where the salary is $12,000 per year
more.
Questionable Enforcement Tactics?
There are eight major intersections in Courtelaney Pass (CP)
and each is equipped with intersection cameras. As
municipalities that employ such devices share the revenue from

5. fines with the manufacturer, the city averages $2.1 million
dollars per year in revenue from these fines. The
constitutionality of this practice is highly debated, and public
support is low according to recent surveys. A local “action
group” has filed a lawsuit against the city in an attempt to
remove these cameras; this lawsuit is pending a court date. A
recent study conducted by a local CP reporter indicated that per
capita, the revenue generated for the city is twice as high as any
similarly situated city in the state that utilizes these cameras.
The reporter also alluded to the fact (not substantiated yet) that
black residents are twice as likely as whites to be ticketed for
intersection violations.
Courtelaney Pass is listed by AAA as the “Biggest Speed Trap
in the South” as a major highway runs north to south through
the town. Particularly, the speed limit reduces from 55 mph to
35 mph in a 50-yard stretch of road and consistently a police
officer is running radar (in a concealed fashion) at the 35-mph
speed sign. The CP reporter has also written that blacks and out
of town travelers passing through receive 87% of the speeding
tickets. This statement is backed up by the reporter’s study of
statistics from the Department of Highway Safety and Motor
Vehicles. The reporter has also spoken to former officers (off
the record) who report that the Chief of Police mandates that
each officer issue at least 12 citations per shift. It is common
that most traffic enforcers allow a motorist 10 mph over the
posted limit, but during a recent interview with the chief he has
stated that he has a “zero tolerance for speed, as it kills” so he
instructs his officers to issue tickets for 5 mph over the limit.
The chief would not comment on the 12-citation minimum per
shift policy.
As Courtelaney Pass has recently seen its violent crime rate
soar by 35%, the chief believes that this is due to the
proliferation of street drugs being sold in open air, drive up,
drug markets. These “markets” are located on the southern edge
of the city where the majority of the population is minority. The
CP Police Narcotics Unit conducts regular and aggressive

6. enforcement actions including crack cocaine search warrants
and reverse sales operations wherein undercover officers pose
as drug sellers and customers are arrested for purchasing.
During one of these operations, a shooting occurred wherein a
known dealer shot at the undercover officer who returned fire,
killing the dealer. The ensuing internal affairs investigation
cleared the officer and the day that this report was made public,
rioting erupted in the minority community. This unrest actually
spilled over into the down- town area requiring the chief of
police to call in re-enforcements from neighboring agencies and
the state police. As a result, 13 businesses were badly damaged,
8 officers injured, and 112 rioters and looters were arrested.
The minority community has warned that if relations do not
immediately improve with the police that more unrest was
certain. After this shooting incident and subsequent riots, the
chief has suspended all narcotic enforcement actions in the area.
Political Influences
The 5,600 Hispanic residents are counted only as those who
responded to the census or were property owners. It is estimated
that an additional 5,000 + undocumented immigrants also call
Courtelaney Pass home. The majorities of these folks work in
the immense strawberry fields and orange groves and are paid
$5.00 per hour in cash (off the books). It is very common for
these migrants to be the victims of home invasion robberies on
pay day. Local drug dealers and MS13 gangsters kick in their
doors, take their hard-earned cash, and occasionally even rape
their wives. The CP Police Sergeant that oversees street crimes
reports that these migrants are easy prey as they will not report
these crimes to the police for fear of being deported. The
sergeant addressed this issue at a city council meeting where no
words of wisdom were offered to him. At the conclusion of the
meeting, in the parking lot, a white city councilman told the
sergeant “I couldn’t care less what happens to those people….
they don’t vote!!!”
More Revelations
4 years ago, Kayla Williams disappeared from her bedroom.

7. Kayla, a 9-year-old African American child was sleeping in her
bed in a very small bedroom with no air-conditioning so, as
typical, her window was open. Her mother found her bed empty
the next morning and frantically called the police. The
responding officer from Courtelaney Pass Police Department
downplayed the mother’s fears by stating that Kayla probably
ran away. The officer told her to call back if Kayla did not
come home by the next day and left without documenting the
incident. The horrified mother spoke with her father who told
her that the police would not help them as they are “the wrong
color” and they must help themselves. The family and friends
convened a search party and two days later found Kayla’s body
in a cypress swamp bordering Lake Diemer. She was wearing
her night shirt, no panties, and there were no visible signs of
trauma or injury.
The police were summoned to the scene and two officers
responded. Upon viewing her body, which laid on its back
almost in a peaceful sleeping position, the officers notified the
forensics unit and one technician came to the scene. The body
was photographed, and the area was searched for any sign of
evidence. Numerous footprints, large and small, were detected
in the immediate area which was no surprise; the area is a
favorite fishing spot. Most of the footprints were photographed,
but plaster casts were not made. Kayla’s ripped panties were
discovered on the leaf covered trail that leads to the water’s
edge. The medical examiner responded to the scene and
removed the body. The following day, Det. Singer attended the
autopsy which was to be performed by Dr. Elmer Clausen, a
lifelong resident of CP. Det. Singer was surprised that the
doctor did not perform a full autopsy wherein the body cavity
was opened, and internal organs examined, nor did he perform a
sexual assault examination. When asked by Det. Singer, the
doctor stated that he had already “surmised” that she had died
as a result of a snake bite, probably from a water moccasin. He
pointed out two small puncture type wounds on the back side of
Kayla’s right thigh. He promised Singer that toxicology would

8. support his belief. When Singer questioned him about the ripped
panties, he replied “That’s your job; there is a scratch by her
upper thigh that looks like a tree branch hit her, it probably
ripped her panties and they fell off”. When Det. Singer reported
this to his Sergeant he was told that there is no fighting Dr.
Clausen…. historically what he says goes!! Kayla Williams
“official” cause of death was snake venom poisoning, even
though the toxicological results were still pending, and she was
buried the following week.
The black community was outraged at what it deemed an
insufficient investigation due to the fact that Kayla, and her
family, was poor and black. Det. Singer, who was relatively new
to the police department and area, was invited to lunch with a
reporter from the Courtelaney Journal. The reporter told Singer
that this was not the first time a young minority girl had been
found dead under suspicious circumstances in Courtelaney.
During the past seven years, three other pre-teens, two
Hispanic, one black, were discovered “missing” from their
bedrooms and later their bodies were discovered in wooded
areas. Reportedly, none had obvious signs of trauma and all
were deemed “Death by Non-Homicide” by Dr. Clausen.
Very recently, retired CP police Detective Sid Throtmorten
became terminally ill and called for his best friend and local
plumber Tom Johnson to come to his bedside. Sid, knowing that
he was hours away from death told Tom that he had to make
something right before he died. He asked Tom if Tom remember
Officer Iozzi who worked for the agency for ten years before
being fired for gross insubordination. Tom vaguely recalled
Iozzi. Throtmorten told Tom that Iozzi was attracted to young
girls and that he had raped and killed that “little Kayla girl”. He
further advised that Iozzi, also a former police defensive tactics
instructor, bragged that by utilizing a “carotid choke hold” he
could kill someone without leaving marks on the victim’s neck.
Just before dying, Throtmorten also reported that other officers,
still with the agency, are aware of what Iozzi did. After being
terminated from the department, Iozzi moved to Idaho. Tom

9. reported this revelation to Det. Singer.
One month ago, as a result of continual racial tensions and
allegations of corruption, the Chief of Police resigned under
pressure. Governor Neely has installed an interim Chief of
Police to heal the community, examine and evaluate policy,
practices, and procedures, and restore the faith and trust of the
people. He also appointed a Special Prosecutor to examine all
things of legal relevance to the issues in this community. The
Special Prosecutor must evaluate civil and criminal issues
pertaining to the governance of Courtelaney Pass and utilize
his/her legal power as needed to issue subpoenas, search/arrest
warrants, etc. The Interim Chief of Police has brought with
him/her a special investigator who will hold the rank of Captain
of Investigations. This individual will evaluate, examine, lead,
and investigate all issues pertaining to criminal acts.
Instructions: After carefully reading and studying this
situational report, contemplate which of these three roles/tracks
you wish to assume for your senior project:
Chief of Police- You have full authority to examine all policies
and practices within the agency. As such, you can make policy,
dispose of bad policy, and address employment and hiring
concerns. You will be responsible to effectively deal with the
racial unrest and identify its core. You have the power to hire,
fire, demote, and/or promote.
Special Prosecutor- Your role is to examine, evaluate, and act
upon any and all legal issues, civil and criminal, that may arise
from your research and investigation. This includes hiring
practices, enforcement techniques and strategies, issues relative
to discrimination, excessive force, and evidence handling
issues. You can issue subpoenas, search and arrest warrants,
wire-tap orders, and any and all other legal tactics available.
You would also serve as the prosecutor for any arrests made
under this inquiry.
Captain of Investigations- Lead, and participate in, all criminal
and forensic investigations and issues that arise from the
situational report. Suspect identification, location, arrest,

10. forensic analysis, setting strategies for needed criminal
investigations, and execution of search warrants, arrest
warrants, etc. are some of the typical duties involved.
Deliverables Identification of Research and Investigative Issues
and Questions: From the situational report, comprise a list of
concerns and issues that are relative to your position. Hint:
There are a least a half dozen issues and concerns for each
position. You must articulate why your issue is a concern and
not simply list it without explanation. For example: Do not
simply list “Ticket Quotas”. If you feel this is an issue, explain
why you feel ticket quotas may be problematic for the city. List
those issues very specifically as this will be the launch pad for
your over-all inquiry. This is due in Module 2.
Annotated Bibliography: Utilizing the Saint Leo Library and
any other supplemental resources, locate at least ten (10) peer
reviewed articles regarding your inquiry. During this
assignment you will have the opportunity to examine what the
experts have researched, studied, and written about in your
specific discipline. There is a plethora of articles related to civil
and criminal law, as well as case law, leadership issues
regarding hiring, promotion, anti-discrimination, civil unrest,
forensic science, DNA analysis, exhumation procedures, etc.
Your assignment requires 10 annotated bibliographies relative
to your situation report position. This is due in Module 3.
Literature Review: Utilizing your annotated bibliography, create
a brief literature review that synthesizes what you have learned
from your research. Your literature review will be 500 words.
This is due in Module 4.
Preliminary Report – Executive Summary: Create an executive
summary for the Governor. In this summary, you will synopsize
what you have determined and accomplished thus far and what
you anticipate discovering and accomplishing in the future.
Remember, the Governor is counting on you to execute your
duties with precision. Your executive summary will be 500
words. This is due in Module 5.
Formal Presentation: You will be reporting to the Governor all

11. of your findings, actions, and remedies during this PowerPoint
presentation. It is vitally important to focus on issues that you
identified and why/how you dealt with those issues. Your
presentation must be professionally presented with appropriate
transitions, animations, video (if utilized), notes from
interviews you may have had with real-life experts, and highly
detailed with specificity. This will be an in-class presentation
and you should have 10 slides. The draft of this is due in
Module 7 (6 slides) and the final version is due in Module 8 (10
slides).
Note: Feel free to exercise as much creative license as you
need. You are expected to improvise and create effects from
your inquiry such as recruiting informants, obtaining subpoenas,
executing search warrants, or partnering with a community civic
leader. You may add to the situational report, i.e.: You
identified two officers who were aware of Throtmorten’s
crimes, but you cannot take out or disregard any facts that are
contained within the report. So, feel free to be very creative in
what you discover from your inquiry!
*PROFESSOR’S NOTE: While Saint Leo has suggested that you
can be “creative” when writing your papers, “creative” does not
mean making up statistics, facts, or other issues that are not
listed in the report.
For example, a student cannot decide that Courtelaney Pass is a
college town and has college campuses in its perimeter, as that
is not information listed within the report.
Another example: some students try to proclaim that all the
speeding violations issued were “illegal” or made-up because
the drivers were not speeding. That is not stated anywhere in
the report. The report specifically states that anyone driving 5-
mph over the limit was issued a citation, so they were, in fact,
speeding.
If you have any questions about being “creative” in any of your
papers, please email me. I am happy to help and that is what I
am here for!

12. ITS 835
Chapter 3
ERM at Mars, Incorporated: ERM for Strategy and Operations
Dr. Oussama Saafein
Introduction
Mars’ ERM history
Global rollout
Reporting
Operating workshops
Conclusion
Mars ERM History
Mars, Incorporated
Migration to non-family management
Leadership had legacy commitment to risk management
ERM was viewed as an evolution
COSO versus bespoke approach
COSO – Committee of Sponsoring Organizations structure
Bespoke approach won
Phase 1
Failed due to being impractical and overly complex

13. Phase 2
Simpler and targeted
Planning Workshops
Alignment between Senior goals and ERM
Started with simple template
Operating plan initiative sheet
Objective
Score
Risk column
Risk treatment column
Management team met to define and rank
Risks
Risk treatments
Changed label from “mitigations”
Global Rollout
Used lessons learned from pilot
Workshops helped to identify
Gaps in risk management readiness
High-risk initiatives
Ongoing activities with unexpected high risk
Reporting
Color-coding adds
Urgency
Clarity
Score represents
Confidence of meeting
goals

14. Reporting, cont’d.
Reporting, cont’d.
Reporting, cont’d.
Operating Workshops
Several ongoing changes
Technology
Word -> Excel
Excel -> purpose-built software
ERM supports aggregation
More complete view of organizational impact of risk
Continual template evolution
Added risk treatment owners and due dates
Summary
Mars received an award for their ERM
Corporate Executive Boards’ “Force of Ideas Award” for ERM
Key factors for ERM success
Alignment with Mars’ goals and objectives
Flexiblility
Being Realistic