The risk manager and an assistant fire chief of Prince William County, Va., teamed up for a decade to push for a revamp of a health clinic for county public safety employees that they found lacking.

The clinic had provided physicals since the early 1990s, but the exams lacked rigor and didn't include screenings for heart, lung and cancer conditions that Virginia workers compensation law presumes are automatically caused by a public safety worker's job, recalled Tim Keen, assistant chief for the Prince William County Department of Fire and Rescue.

Today, the clinic's improved physical examinations and disease screenings help save lives and reduce workers comp costs through the early detection of such illnesses. It also is likely that the clinic positively affects county health benefit spending because the county self-insures those costs, said Lori J. Gray, the county's risk management division chief.

“Either way, whether its comp or health (care benefits), we are still paying one way or the other out of county funds for employee illnesses,” said Ms. Gray, who recalled many days lobbying for the health clinic improvements.

The Virginia Department of Health previously managed the clinic with oversight by county public safety agencies, she said.

But since 2010, the county's risk management division has managed the clinic and contracts with Falls Church, Va.-based Inova Health System to operate it. The clinic, centrally located near other county facilities, now conducts rigorous stress tests and physicals that adhere to medical evaluation standards set by the National Fire Protection Association for firefighters, Mr. Keen said.

It also provides health services for public works employees and other departments; evaluates workers for exposure to infectious diseases; and conducts pre-employment screening, drug testing and fit-for-duty exams, Ms. Gray said.

The clinic's improved physical exams and screenings have uncovered cancers and other illnesses in their early stages — including finding in 2012 that two of his own coronary arteries were more than 90% blocked, Mr. Keen said.

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“They would not have been found without the (NFPA) protocol in place,” he said. “The cardiologist said that they would never have found it with a normal stress test.”

The clinic has become a model for other local governments, but it's only one of several fire department and risk management collaborations for Prince William County, Mr. Keen said.

Years ago, the fire department found that that many recruits were suffering strains and sprains under its training regimen's physical demands, Mr. Keen said. So the department turned to Ms. Gray for help, taking her staff to its training academy to demonstrate how injuries were occurring.

Together, Mr. Keen and Ms. Gray lobbied the county for a facility designed to administer candidate physical ability tests developed under an international standard for screening job applicants.

“We had to get all of the players within county government involved, which included the county executive's office, the budget office, the finance office, and do numerous presentations, Mr. Keen said. “And Lori and I worked together side by side.”

In 2003, they obtained county funds and grant money totaling about $350,000 for the facility. Ms. Gray and Mr. Keen said they believed the testing facility would help reduce injuries by 30% — but they found it actually has led to a 40% reduction in recruit injuries.

This success is significant because training a recruit costs about $27,000, and the testing facility is now part of the fire department's efforts to prevent loss of its training investment due to candidates washing out or having to redo the training because of injuries, Mr. Keen said.

“A typical knee injury, a shoulder injury or back injury was running about $18,000,” Mr. Keen said. “So reducing those injuries reduced our workers comp costs as well as lost time ... because if (injured trainees) missed 10% of recruit school, they had to cycle back through.”