healthlead: leveraging wellness resources in tough economic times
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TRANSCRIPT
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Health Promotion for Municipal Employees – Leveraging Resources in
Tough Economic Times
HP Career Net WebinarDecember 13, 2012
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Today’s Learning Objectives
Participants will be able to:
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.
1.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.
2.Identify ways in which Monterey County Health Department communicates its programming components, goals, and outcomes to its stakeholders.
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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
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A Long Time Commitment to Employee Wellness• Created in 1985 by the County
Board of Supervisors as a partnershipbetween 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
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Program Model
Quality of Work Life Traditional or Conventional Health & ProductivityManagement
Health focusSome risk reductionWeak personalizationModest incentivesWeak evaluation
Sample Activities Health risk assessments Health screenings Web based health information Wellness newsletter Incentive campaigns
•Add productivity focus•Strong risk reduction•Strong cost management focus•Some required activity•Personalized•Strong evaluation•Site and virtual based
•Sample Activities Health Coaching (telephone/live) Benefit linked incentives Achievement incentives Integrated programming Resiliency initiative for productivity
•Fun activity focus•No risk reduction•Site based•Minimal incentives•No evaluation•No personalization
•Sample Activities Health Fair Workshops/Classes Brochures Wellness Library
Chapman: 2006: Absolute Advantage Planning Wellness—Getting off to a Good Start Vol. 5:4. pp.17-58
MC Program Today
MC Program 1980’s
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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
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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 healthyworkforce and a healthy workplace for all Monterey County
employees
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Provides Programs in 7 Areas
1. Eating & Weight Management
2. Physical Activity
3. Smoking Cessation
4. Stress /Resiliency
5. Healthy Pregnancy &Parenting
6. Managing Work and Life
7. Managing My Health
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Delivery Approach #1: Basic Wellness
• Website/health portal• Workshops • Wellness Library• Employee Wellness Newsletter• Monday Health Tips• Onsite Weight Management, Smoking
Cessation, and Physical Activity programs
• Gym Discounts
• Resiliency Training• Policy Support &Technical Assistance• Health/Wellness Fairs• “Take the Stairs” signage and tool kits• Department specific trainings/workshops
for employees & managers/supervisors
Awareness and Education: workshops, campaigns, and interventionsconstantly evolving to meet the changing needs of employees.
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Delivery Approach #2: “Just for You” 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 conditionmanagement classes/self directed programs
– Educational self study Tool Kits on multiple health topics–– Nutritional Consultation from Registered Dietician
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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.
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The Foundation: Strategic Planning
If You Don’t Know Where You’re Going, You’ll Waste a Lot of Money Getting Anywhere
Step 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
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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
health
a, 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
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Step 2: Gap Analysis5. Marketing is crucial to participation.e
• Need for improved branding, communication
6. Employee/Department needs exceed existing staffing resources.• Operational efficiency & scalability needs to be improved
7. Fiscal resources threaten ability to provide best in class wellness to employees/Department.
• Address/improve fiscal sustainability
8. 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.
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Step 3: PrioritiesIf You Don’t Have a Lot, Spend the Money Where It Counts
1. Health Risk Reduction/Condition Management2. Management Support and Buy-in3. Participation4. Supportive Environment5. Communication, Marketing, & Promotion6. Operational Efficiency & Scalability7. Fiscal Sustainability8. Evaluation
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Step 4: PLAN & Approach:Leading in Business by Leading
in Health
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Plan the Work….and Work the Plan
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Business AlignmentA Critical Step to Getting & Keeping Financial Support
Monterey County Business Priorities: Wellness Alignment:• Service provision Supports all departments/wide menu of services • Cost reduction Fiscal Sustainability Initiative
Health 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
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Health Risk Prevalence Headcount # of EEs Affected (BxC)
Excess Cost per Condition per ee/yr**
Excess Annual Cost(D x E)
Readiness to Change
Opportunity Index (Cost Savings)(F x G)
High Blood Pressure
26% 4543 1181 $1020 $1,204,620 20% $240,924
High Cholesterol
25% 4543 1136 $712 $808,832 10% $80,883
High Blood Sugar
12% 4543 545 $2271 $1,237,695 18% $222,785
Overweight/Obese
74% 4543 3362 $1872 $6,293,664 20% $1,258,732
Sedentary 53% 4543 2408 $1110 $2,672,880 35% $935,508
Tobacco 9% 4543 409 $1117 $456,853 39% $178,172
Stress 45% 4543 2044 $1774 $3,626,056 30% $1,087,817
Depression 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 FindingsSource for County Data: 2009-10 Health Media Health Risk Assessment Executive Report
Monterey County Opportunity Index
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What Can YOU Expect?DepartmentInvestment
What if ONE of your employees….
Avoided cost/savings/yr.*
Savings minus investment
ROI for your Department
$78/ee./yr. + Stops smoking $1117 $454.12 $1 : 1.69
12 hrs. x $48.74= Achieves normal weight?
$1872 $1209.12 $1 : 2.82
$662.88Becomes active? $1110 $447.12 $1: 1.68
*Does not include direct health costs
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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
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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 eventsSchedule 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 Senior Leadership
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• 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 WebsiteProfiled in Wellness NewsletterTrophies 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
Leveraging Middle-Management
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2010 2011
Yes 39.9% 58%No 60.1% 42%
Participation is Growing…
“I appreciate all you do, we really don't know how lucky we are to have a county that actually cares about it's employee's health. Thank you.”
….2011 Wellness Survey
“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
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2010 2011
Yes 35.2% 49.1%No 34.6% 24.4%Don’t 30.2% 26.5%Know
Managers/Supervisors are Making Wellness a Priority for Their Employees!
“As a supervisor, I encourage my staff to take advantageof any (Wellness) programs available to them.”
….2011 Wellness Survey
“He resends the classes that he feels would be good for our department staff andhighly encourages getting out of the office for exercise.”
….2011 Wellness Survey
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• 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
Leveraging POLICY as a ResourceMaking it “easy” to be healthy at work
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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.
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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 resources
3. 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
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• 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
Building a Bridge with HR/Benefits
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Safety Partnerships
• Departmental managers include Wellness education in Safety Meetings
BackWorking in Hot Environments/HydrationSleep HabitsWork Stress
• Wellness promotes annual workstation ergonomics trainings
• Wellness refers employees to annual back safety/back health trainings
• Self-ergonomics assessments, staffed ergonomics evaluations
:
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Facilities & Physical Environment
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Thinking Outside the Box
Digi-Walk: “The Stroll”, “The Hike”, “The Journey”
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Building Relationships w/Employees
• Health/Wellness Fairs• Leveraging existing events• Responding to needs/interests• Wellness Council• Surveys• Table tops/topic related • Recognition • Success stories• Customer Service
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Community Partners
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Objective #3• Identify ways in which Monterey County Health Department
communicates its programming components, goals, and outcomes to its stakeholders.
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Communications MatrixAudience Vehicle Sender Communication
ObjectiveKey Message/ Description
Timing Status
All Employees Home Mailing Booklet Wellness Team Increase Awareness and Utilization
“Do you know” Yearly
Managers Supervisors
Managers Tool Kit Department Head Management awareness/education
“Management Skills and Resources”
Quarterly
UnionBargaining Units
PresentationsOne-on-one meetings Branch Chief
CAO
Awareness, education and buy-in
“Do you know”Benefits for their employee units
Annual update
Departments Presentations at department meetings
Wellness Team Increase Awareness and Utilization
“Do you know” Ad-Hoc
ExecutivesBoard of Supervisors
One-on-one meetings HPCHD Director
Gain buy in and support, be role models
Benefits to the county. Value-add/ROI
Prior to launch and ad hoc
All Employees segmented by areas of interest
Electronic Newsletter Wellness TeamVendors
Targeted Awareness and Promotion of programs and services.
“What’s in it for me”“Be a part of this”
Monthly
All Employees General Delivery email Wellness 411Vendors
Awareness/Promotion “What’s in it for me” As required
All Employees Wellness Web Site Wellness TeamHPC
Awareness/PromotionAdd names to email lists for e-newsletter
“what’s in it for me” Daily
Human Resources
One-on-one meetings HPC Awareness/promotion/support/buy-in
“Do you know”Integration/support of health benefits packages
Prior to launch, open enrollment and quarterly
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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 asseparate section “Marketing”
• Customized for multiple target audiences: age, gender, ethnicity, education, language, work situation and location
• Website
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Employee Website: http://www.mtyhd.org/wellness/
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Employee Communications
• Aligned with preferred learning styles andcommunication preferences of audience based onAnnual 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
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Customize by Delivery Preference
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Customize by Learning Style
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“Why Wellness?”
We asked Monterey County employees, “Why Wellness…. How has it helped you?”
Here are some of their answers……..
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I’ve lost 25 pounds….and dropped my A1C from between 6.2 and 6.8 down to 5.7….Also dropped my blood pressure from 135/80 or higher to 112/60. Simply by beginning to exercise. …….Rich
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I have dropped my body fat percentage, my blood
pressure is normal again…..
…..Anonymous Employee
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“I will to be able to keep up with my kids as they grow up.”
…..John
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I am continuing to walk, and now have a stationary bike that I am NOT using as a clothes hanger, but actually using it as I should, worked my way up to 20 minutes and counting!
……Arlene
……Arlene
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What can Wellness do for you?
get started today……..
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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
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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, DirectorChild Support Services
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Treasurer-Tax CollectorResiliency 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
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Next Steps: ActionIncentivize and recognize
participation
• Proposed Action: Healthy Lifestyle Rewards Program
– Annual wellness activity and incentive tracker.
– Activities organized by categories such as nutrition, exercise, screenings and checkups, etc.
– Each activity has a point value.– Employees record points once a month.– Employees work towards reward levels- Gold,
Silver, and Bronze. – Incentives vary for each level.
• Status: Proposal development
Comprehensive data collection, tracking, reporting, and financial analyses to helpDepartments understand Wellness Program benefit/ ROI.
• Proposed Action: “Working Well” Initiative
– HRAs (Health Risk Assessments)– Onsite Health Screenings– Workforce Health Profile– Risk Based Predictive Modeling Identifies
Savings Opportunities – Quarterly Management Reports– Department Scorecards
• Status: In progress