HealthLead: Leveraging Wellness Resources in Tough Economic Times
Health Promotion for MunicipalEmployees – Leveraging Resources in Tough Economic Times HP Career Net Webinar December 13, 2012
Today’s Learning ObjectivesParticipants will be able to:1.Learn how the Monterey County Health Department leveragesresources, operating on a foundation of simplicity…and provideswellness resources and programming to meet the interests and needsof its employees.1.Recall 3-5 ways in which Monterey County Health Department’semployee health initiative partners/builds relationships with the County,its employees and the community.2.Identify ways in which Monterey County Health Departmentcommunicates its programming components, goals, and outcomes toits stakeholders.
County of Monterey• Founded 1850—one of the original counties in California• Industry: Local Government• 4300 employees• Over 80 work locations scattered throughout 3,771 square miles of agricultural, military, recreational/ wilderness/parks, and urban land
A Long Time Commitment toEmployee Wellness• Created in 1985 by the County Board of Supervisors as a partnership between Management, Labor, & Employees• To address employee health and safety, health insurance costs and Workers Compensation claims• All (4300) regular full/part time (benefited) employees eligible to participate, select programs open to family• Program available in 100% of work locations
Program Model MC Program Today Health & Productivity Quality of Work Life Traditional or Conventional Management •Add productivity focus •Fun activity focus Health focus •Strong risk reduction •No risk reduction Some risk reduction •Strong cost management focus •Site based Weak personalization •Some required activity •Minimal incentives Modest incentives •Personalized •No evaluation Weak evaluation •Strong evaluation •No personalization •Site and virtual based Sample Activities •Sample Activities Health risk assessments •Sample Activities Health Fair Health screenings Health Coaching (telephone/live) Workshops/Classes Web based health information Benefit linked incentives Brochures Wellness newsletter Achievement incentives Wellness Library Incentive campaigns Integrated programming Resiliency initiative for productivity MC Program 1980’sChapman: 2006: Absolute Advantage Planning Wellness—Getting off to a Good Start Vol. 5:4. pp.17-58
Our Mission •Increase employees knowledge about health & prevention •Encourage employees involvement in their own health decisions •Encourage employees adoption of healthy habits, and •Facilitate recommendations for organizational change that promote a safe and healthy work environment
Program Goals •Improve employee morale •Increase presenteeism •Improve productivity •Help contain Workers Compensation claims and costs •Reduce absenteeism The Health Promotion Partnership works to create a healthy workforce and a healthy workplace for all Monterey County employees
Provides Programs in 7 Areas1. Eating & Weight Management2. Physical Activity3. Smoking Cessation4. Stress /Resiliency5. Healthy Pregnancy &Parenting6. Managing Work and Life7. Managing My Health
Delivery Approach #1: Basic Wellness Awareness and Education: workshops, campaigns, and interventions constantly evolving to meet the changing needs of employees.• Website/health portal • Resiliency Training• Workshops • Policy Support &Technical Assistance• Wellness Library • Health/Wellness Fairs• Employee Wellness Newsletter • “Take the Stairs” signage and tool kits• Monday Health Tips • Department specific trainings/workshops• Onsite Weight Management, Smoking for employees & managers/supervisors Cessation, and Physical Activity programs• Gym Discounts
Delivery Approach #2: “Just forYou” Wellness• Voluntary health risk assessment s provide customized health report & specific strategies to improve current health behaviors.• For those with chronic health issues, confidential, specific support is provided to help each employee better manage their condition. – Health Risk Assessments & Screenings – Individual health advisement/consultations and referral – Online health improvement and chronic condition management classes/self directed programs – Educational self study Tool Kits on multiple health topics – – Nutritional Consultation from Registered Dietician
Objective #1• Learn how the Monterey County Health Department leverages resources, operating on a foundation of simplicity…and provides wellness resources and programming to meet the interests and needs of its employees.
The Foundation: Strategic Planning If You Don’t Know Where You’re Going, You’ll Waste a Lot of Money Getting AnywhereStep 1: Assessment• Best practices in wellness industry• Best practices in public sector wellness• Monterey County employee health risk data• Monterey County organizational data• Management/HR interviews• Employee surveys• Employee Wellness Council
Step 2: Gap Analysis1. Health risks increase risk of chronic disease.a • MC levels are above national/regional standards.2. Management support/buy-in critical for success.b • Managers do not always have program/outcomes information.3. Participation drives outcomes.c • Current levels make outcomes difficult to achieve.4. Work environment/culture critical(2.5x more health risk reduction).d • Opportunities exist to make workplace more supportive of healtha, http://www.healthypeople.govb. Partnership for Prevention, 2007/ www.prevent.orgc. Edington & Shultz, 2008. The Total Value of health: A Review of the Literature. International Journal of Workplace Health Management 1:1(8-19)d. Terry et al. 2008. Association Between 9 Quality Components & Superior Worksite Health Management Program Results. JOEM 50: 633-641
Step 2: Gap Analysis5. Marketing is crucial to participation.e • Need for improved branding, communication6. Employee/Department needs exceed existing staffing resources. • Operational efficiency & scalability needs to be improved7. Fiscal resources threaten ability to provide best in class wellness to employees/Department. • Address/improve fiscal sustainability8. Evaluation key to maintaining wellness programming.f • Some data not current, has not been recently analyzed, Management not aware of HPP outcome metrics.e. Wong et al 2000. The Influence of Job Stress and Supervisor Support on Negative Affects and Job Satisfaction…Journal of Social Behavior and Personality. 15:85-98.f. Chapman, 2005. Meta-Evaluation of Worksite Health Promotion Economic Return Studies. The Art of Health Promotion 2005 Update.
Step 3: Priorities If You Don’t Have a Lot, Spend the Money Where It Counts1. Health Risk Reduction/Condition Management2. Management Support and Buy-in3. Participation4. Supportive Environment5. Communication, Marketing, & Promotion6. Operational Efficiency & Scalability7. Fiscal Sustainability8. Evaluation
Step 4: PLAN & Approach:Leading in Business by Leading in Health
Business Alignment A Critical Step to Getting & Keeping Financial SupportMonterey County Business Priorities: Wellness Alignment:• Service provision Supports all departments/wide menu of services• Cost reduction Fiscal Sustainability InitiativeHealth Dept. Strategic Plan: Wellness Strategic Plan Initiatives:“Improve health through programs and policy”• Emphasize prevention Population Health/Risk Management• Health in all policies Supportive Environment• Integrated approach Wellness “Connect” Referral Model• Realign/improve efficiency of programs/services Efficiency Initiative• Evaluate systems/changes Evaluation Initiative
Monterey County Opportunity IndexHealth Risk Prevalence Headcount # of EEs Excess Cost Excess Readiness Opportunity Affected per Annual Cost to Change Index (Cost (BxC) Condition (D x E) Savings) per ee/yr** (F x G)High Blood 26% 4543 1181 $1020 $1,204,620 20% $240,924PressureHigh 25% 4543 1136 $712 $808,832 10% $80,883CholesterolHigh Blood 12% 4543 545 $2271 $1,237,695 18% $222,785SugarOverweight/ 74% 4543 3362 $1872 $6,293,664 20% $1,258,732ObeseSedentary 53% 4543 2408 $1110 $2,672,880 35% $935,508Tobacco 9% 4543 409 $1117 $456,853 39% $178,172Stress 45% 4543 2044 $1774 $3,626,056 30% $1,087,817Depression 26 % 4543 1181 $1579 $1,864,799 27% $503,496 *Adjusted for 40% carve out of health costs (Goetzel et al. 1998. Health Costs Worksite Health Promotion Participants/Non-participants. 40(4): 341-346) **Whitmar, Goetzel, & Anderson. 1999. The HERO Study on Risks & Costs: Research Findings Source for County Data: 2009-10 Health Media Health Risk Assessment Executive Report
What Can YOU Expect?Department What if ONE of Avoided Savings ROI for your minusInvestment your cost/ investment Department employees…. savings/yr.*$78/ee./yr. + Stops smoking $1117 $454.12 $1 : 1.6912 hrs. x $48.74= Achieves normal $1872 $1209.12 $1 : 2.82 weight? Becomes active? $1110 $447.12 $1: 1.68$662.88 *Does not include direct health costs
Department of Social &Employment Services“The Monterey County Wellness Program is a wonderful resource for the employees of Monterey County.The upfront cost per employee is a worthwhile investment in the productivity, health, well-being and morale of our employees.” …..Elliott Robinson, Director Social and Employment Services
Leveraging Senior Leadership Lead by example: Participate in exercise challenges Attend wellness workshops with their staff, Schedule quarterly specific trainings for their department Champion staff participation in wellness events Schedule time for wellness activities into trainings, staff recognition days, all department meetings Provide recognition to employees for participating in wellness programs: Host healthy lunches Certificates/department provided incentives Integrate wellness in their work environment: 12 hours Wellness work release time annually Support healthy policies in the workplace CAO Engagement: Wellness included in Labor Negotiations County PPPR Manual wellness content Board of Supervisors Alignment: Established program/release time HHS Committee includes wellness reports BOS champions wellness initiatives
Leveraging Middle-Management • WC and injury/disability reviews and remedial wellness programming • Tailored programming and activities for divisional events, employee recognition days, training/development days • Recognition for supporting health initiatives such as Exercise Challenge, Fitness Team events and competitions, and daily exercise for their employees Featured in “What’s New” and “Success Stories” on Wellness Website Profiled in Wellness Newsletter Trophies and certificates of recognition • Education about association between employee health and productivity and relation to their business: “So You Want to Be a Supervisor” “Manager Academy” “He pointed out that he (Probation Services Manager, Joe Whiteford) knows he will get twice the productivity if we stay active and keep in shape.” ……Probation Department Employee
Participation is Growing… 2010 2011 Yes 39.9% 58% No 60.1% 42% “I have been given tools to handle stress at work and home better. I have also been given tools to be a better parent. Most of all I have been given a different outlook on life.” ….2011 Wellness Survey “I appreciate all you do, we really dont know how lucky we are to have a county that actually cares about its employees health. Thank you.” ….2011 Wellness Survey
Managers/Supervisors are MakingWellness a Priority for Their Employees! 2010 2011Yes 35.2% 49.1%No 34.6% 24.4%Don’t 30.2% 26.5%Know “As a supervisor, I encourage my staff to take advantage of any (Wellness) programs available to them.” ….2011 Wellness Survey “He resends the classes that he feels would be good for our department staff and highly encourages getting out of the office for exercise.” ….2011 Wellness Survey
Leveraging POLICY as a ResourceMaking it “easy” to be healthy at work • Smoke/Tobacco Free • Lactation Accommodation • Seat Belt/No Cell/Texting (CA law) • Drug/Alcohol Use and Screenings • Physical Activity in Meetings, Breaks, and During the Workday • Healthy Food at Meetings (selection and compensation for purchase) • 12 Hours Work Release Time for Wellness Activities • Healthy Vending • Workplace Violence • HIV/AIDS
Objective #2• Recall 3-5 ways in which Monterey County Health Department’s employee health initiative partners/builds relationships with the County, its employees and the community.
County Wellness Referral ModelWellness Role Referral Partners (Internal)1. Provide health information, programs & resources Natividad Medical Center• Wellness Workshops -Wt. loss/obesity• Department specific trainings -Preventive physical exams/screenings• Newsletter, Website, Library, Resource Directory -Dieticians/Cafeteria -Physician experts, lactation support/education2. Manage risk reduction campaigns for health/lifestyle change• Health risk assessment/screenings Benefits/Health Plans• Coaching/Personal Health Improvement Plans -HRAs• Topical health information campaigns -24/7 Nurse Lines• Motivate/support healthy behavior change -Disease Management – Stress management/Resiliency -Speakers, e-health tools, behavior change prog. – Nutrition/Weight control – Smoking cessation EAP – Physical Activity -Counseling/system of care• Refer to MD/disease & condition management - Alcohol/drug• Connect to internal/community resources - Stress/crisis resources3. Support healthy work environments for employees Ergonomics• Physical Environment - Ergonomics training/workstation assessments – Bike to Work - RMI prevention – Healthy Back Care -Remedial/preventive equipment – Mother’s Rooms – Health Work Stations Safety – Healthy meetings - Injury prevention – Physical Activity guidelines at work - Online training/courses• Organizational Environment – Manager & Supervisor/new employee training Human Resources and New Hire Orientation - Wellness Release Time – Work stress - Alternative/Flex Work Schedules – Employee development - Policy (lactation, smoking, vending etc) – Healthy foods -Training/Development/Manager Training – Lactation accommodation
Building a Bridge with HR/Benefits• Benefits provides, Wellness promotes avoiding impact on the Wellness budget, and still providing quality services to employees.• HR Link presentations each quarter• One on one meetings with Department HR/Director• HR Specific Needs and Interest Survey• Department Specific Wellness Programming• Cross Promotion – Benefits links on Wellness Website – Periodic Health Benefit Communications – Cross functional task forces• Wellness messaging in open enrollment packets• Partner with “Grow Your Own” training site
Safety Partnerships :• Departmental managers include Wellness education in Safety Meetings Back Working in Hot Environments/Hydration Sleep Habits Work Stress• Wellness promotes annual workstation ergonomics trainings• Wellness refers employees to annual back safety/back health trainings• Self-ergonomics assessments, staffed ergonomics evaluations
Objective #3• Identify ways in which Monterey County Health Department communicates its programming components, goals, and outcomes to its stakeholders.
Communications Matrix Audience Vehicle Sender Communication Key Message/ Timing Status Objective DescriptionAll Employees Home Mailing Booklet Wellness Team Increase Awareness “Do you know” Yearly and UtilizationManagers Managers Tool Kit Department Head Management “Management Skills QuarterlySupervisors awareness/education and Resources”Union Presentations Awareness, education “Do you know” AnnualBargaining One-on-one meetings Branch Chief and buy-in Benefits for their updateUnits CAO employee unitsDepartments Presentations at Wellness Team Increase Awareness “Do you know” Ad-Hoc department meetings and UtilizationExecutives One-on-one meetings HPC Gain buy in and Benefits to the county. Prior toBoard of HD Director support, be role Value-add/ROI launch andSupervisors models ad hocAll Employees Electronic Newsletter Wellness Team Targeted Awareness “What’s in it for me” Monthlysegmented by Vendors and Promotion of “Be a part of this”areas of interest programs and services.All Employees General Delivery email Wellness 411 Awareness/Promotion “What’s in it for me” As Vendors requiredAll Employees Wellness Web Site Wellness Team Awareness/Promotion “what’s in it for me” Daily HPC Add names to email lists for e-newsletterHuman One-on-one meetings HPC Awareness/promotion “Do you know” Prior toResources /support/buy-in Integration/support of launch, health benefits open packages enrollment and quarterly
Employee Communications• All employee emails 1-2/week announcing events• Monday Health Tips• Wellness Council and Wellness Champions• Bulletin boards and themed posters in departments• Unique brand and identity (logo and tag line) on all communications• Alignment with health and business goals included in Wellness Strategy Plan as separate section “Marketing”• Customized for multiple target audiences: age, gender, ethnicity, education, language, work situation and location• Website
Employee Communications• Aligned with preferred learning styles and communication preferences of audience based on Annual Wellness Survey responses• Program and product specific surveys• Blog: WellnessWorks4You• Health information and resources accessible through plan provider health portals• Newsletter produced internally, tailored to needs from survey/input every other month• Cross-promote using County wide publications e.g. CAO Weekly Report, Health dispatch, NMC Newsletter and Bulletin Boards, New Hire Orientation, Timecard messaging, HR Link
“Why Wellness?”We asked Monterey County employees, “Why Wellness…. How has it helped you?” Here are some of their answers……..
I’ve lost 25 pounds….and dropped my A1C frombetween 6.2 and 6.8 down to 5.7….Also droppedmy blood pressure from 135/80 or higher to112/60. Simply by beginning to exercise.…….Rich
I have dropped my bodyfat percentage, my blood pressure is normal again….. …..Anonymous Employee
“I will to be able to keep up with my kids as they grow up.” …..John
I am continuing towalk, and now have astationary bike that Iam NOT using as aclothes hanger, butactually using it as Ishould, worked myway up to 20 minutes ……Arleneand counting! ……Arlene
What can Wellness do for you? get started today……..
Management Communications• Annual one-on-one meeting with Department Heads• Annual Operating Plan/Report• Spring Department Head/Management Council overview• Annual Board of Supervisors update• Manager Tip Sheets monthly, staff meeting presentations• “Wellness as a Business Strategy” in Leadership and Supervisor Academies• Annual Manager Satisfaction Survey• Technical Assistance on issues important to Departments• Next Steps: Advisory/IHPM Council
Child Support Services“I believe strongly that participation of staff in the….Wellness Program….helps the workforce be as productive as it can be. I have been impressed with the quality of the workshops I have attended and the flexibility of even providing workshops on site, which has helped…..in attitude and overall health of our employees…. The amount of money that is being charged…is very reasonable and the direct and indirect savings…can actually save positions if worker compensation costs go down and absenteeism is minimized.” ….Stephen H. Kennedy, Director Child Support Services
Treasurer-Tax Collector Resiliency Post Training Evaluation• Reported occurrence stress symptoms: average reduction of 25%• 10% increase in productivity indicators• 16% increase in ability to finish difficult tasks• 5% increase in employees who thought their workload was manageable/not excessive• Average 6.3% improvement in job satisfaction indicators• 6.2% increase in morale at work “We want to continue to utilize these services because we have had nothing but success…our department is very excited to continue this type of training” ….Mary Zeeb, Treasurer-Tax Collector
Next Steps: ActionIncentivize and recognize Comprehensive data collection, participation tracking, reporting, and financial analyses to help• Proposed Action: Healthy Departments understand Lifestyle Rewards Program Wellness Program – Annual wellness activity and incentive tracker. benefit/ ROI. – Activities organized by categories such as nutrition, exercise, screenings and checkups, etc. • Proposed Action: “Working Well” – Each activity has a point value. Initiative – Employees record points once a month. – HRAs (Health Risk Assessments) – Employees work towards reward levels- Gold, – Onsite Health Screenings Silver, and Bronze. – Workforce Health Profile – Incentives vary for each level. – Risk Based Predictive Modeling Identifies Savings Opportunities• Status: Proposal development – Quarterly Management Reports – Department Scorecards • Status: In progress
Questions & Thank You! Judy Webster Health Promotion Partnership 831-755-4574 or firstname.lastname@example.org