Pinellas County Schools Be Smart Wellness Program 1

The PCS Wellness Team 2 . .

District Employee Wellness Committee 3 Brenda Ball, On-Site EAP Coordinator Dawn Handley, Transportation Wellness Coordinator Peggy Johns, Supervisor, PK-12 Health Education Christina Kempf, Employee Wellness Coordinator Michael Kingsley, On-Site Humana Representative Tom Lechner, Principal Seminole MS Ted Pafundi, Director of Risk Management & Insurance April Paul, Supervisor of Employee Benefits Jeff Ransdell, Pfizer Senior Account Manager Lisa Ross, School Coordinator, Communities Putting Prevention to Work Jane Schultz, p. TEC St. Pete, Wellness Champion Maureen Sullivan-Tevault, On-Site Humana Patient Advocate Leslie Viens, Aon On-Site Representative Wendy Weaver, Humana, Corporate Wellness

Why Staff Wellness? 4 Provides an organized program and opportunities to assist employees and their family members in making voluntary behavior changes Increases productivity & job performance Higher student achievement when regular staff present Boosts morale and improves quality of life Saves money for employer and employee

Primary Health Costs 5 Health benefit cost Group medical plan Dental plan Vision plan Drug plan COBRA payments Administrative cost Presenteeism Workers compensation costs Sick leave costs STD costs Life insurance & ADD costs Wellness can directly and indirectly save on all of the above.

History 6 2002 - Fitness center & weight loss discounts 2008 - Diabetes CARE program 2002 - Initial wellness committee formed 2008 - Employee Wellness Expo 2005 - Wellness champion program began 2009 - Tobacco care with 87 Champions (today we have 130) 2010 - Site-based wellness committees 2006 – Funding from Insurance company to formed support wellness program 2010 – Registered Dietitian & Nutritionist 2006 – Full time Wellness Coordinator hired 2007 – Women's Wellness Retreat (287 participants) 2008 – Part time transportation wellness hired 2006, __ & 2010 – Health Risk Assessment Campaigns (2218 2010 - Health fair screenings began coordinator hired & program started 2011 – District fitness programs began 2008 – onsite Employee Assistance program representative

Resources & Funding 7 Under the terms of our agreement with our health carrier, $500, 000 (approximately. 04% of total premium) is provided annually to support the district’s Employee Wellness Program. Cost are minimal when compared to potential ROI. No district funds are used to fund this program. Funding pays for District wellness coordinator Part time transportation wellness coordinator Part time nutritionist Wellness Champion budgets and supplements Diabetes education and supplies for those enrolled in Diabetes CARE program Program promotions & incentives

ROI 8 Higher health risk levels are correlated with higher health care costs. Lower health risk levels are associated with lower health care costs. Return on investment in wellness programs range from a low of 1: 1 to a high of 1: 6. 5 for every dollar spent on wellness, depending on the wellness program approach (good, better, best) Good – ROI of ~1: 1. Participation 15 -35%. Approximate Cost/EE/Yr. <$45 Better – ROI 1: 1. 5 to 1: 3. Participation 28 -58%. Approximate Cost/EE/Yr: $46 -$150 Best – ROI 1: 2. 5 to 1: 6. 5. Participation 65 -95%. Approximate Cost/EE/Yr: $250 -$450 Source: Web. MD Health Services

The Basis for Wellness 9 If we could keep more of our population in the low-risk categories across the range of lifestyle factors, we could avoid or delay a considerable portion of our health care expenditures in this country even as the baby boomers age. ~ Dr. David Anderson / WELCOA Here is how we address the lifestyle factors that ultimately contribute to additional health costs…

Wellness Champions 10 In 2010 -2011, we had 131 Wellness Champions participating in the Be Smart Worksite Wellness Program, delivering wellness programs to 96% of our worksites!

Wellness Champion Program Details – 2010 -2011 11 Some of the events the Wellness Champions facilitated: Nutrition Programs 137 nutrition seminars, over 2620 participants 1830 participants involved in other healthy eating type programs (separate from nutrition seminars). Fitness Programs 2541 participants Programs: 88 Walking programs or walk events, 1505 participants 26 Yoga programs, 205 participants 21 Zumba programs, 212 participants 6 Boot Camp programs, 104 participants Stress / Mental Health Programs 19 Stress/ Mental Health seminars, 559 participants 24 Chair Massage programs (many ongoing), 346 participants CPR/AED programs 17 programs, 256 participants 95 Wellness Committees throughout the district

Transportation Wellness Program 12 6 compounds, 1 part time Wellness Coordinator, 3 Wellness Champions, approximately 180 active transportation employees in wellness program. Participants lost a total of 961 pounds this year, making the 3 year total weight-loss 2, 800 pounds. Programming included: nutrition programs / healthy cooking demonstrations mini health fair(including BP and vision screenings) skin cancer screenings personal and job safety walking clubs hula hooping Zumba / salsa / latin dancing women’s health issues sleep apnea presentation in response to new DOT requirements salad days

Diabetes CARE Program 13 • 519 Diabetics enrolled in Diabetes CARE program since 2008. 229 (44%) compliant and receiving waived co-pays on supplies. • Allows participating PCS Humana members, spouses and dependents to receive prescription diabetic supplies at no charge. • Facilitated by a Certified Diabetes Educator nurse • Diabetic support groups for staff & dependents at WPSC/p. TEC Clearwater and beginning January in the Administration Building.

Tobacco Cessation Program 14 Program includes: Telephonic coaching (specific for tobacco cessation) Web based support Prescription medication benefit Open to benefits eligible employees, spouses, dependents 18 years old and over, as well as retirees on medical plan Other options available for non-benefits eligible employees

Humana / Health Coaching 15 o Health Coaching o. Telephonic & online Includes: üWeight Management / Activity üNutrition üStress üTobacco Cessation üBack Care o Jan-Dec 2010 = 68 participants enrolled

Humana Health Assessment 16 Humana Health Assessment provides participant information on their health status and ways to make improvements 2451 participants completed the assessment and earned a $20 American Express gift card Wellness Team used aggregate data for strategic plan

On-Site Health Fairs 17 2010 - 18 Health & Wellness fairs (High schools) – 817 participants 2011 - 29 Health & Wellness Fairs 1330 participants Middle Schools = 770 p. TECS = 70 Exceptional Centers = 242 Administration Building = 139 Food Service = 109 916+ referrals Screenings included: Skin cancer Blood Pressure & BMI Glucose & Cholesterol Vision & Hearing Also present: Humana, EAP, Wellness 2012 - ½ of elementary schools targeted 2013 – ½ of elementary schools

Skin Cancer Screening – PE staff 18 Skin cancer screening for PE staff beginning of 2010 -2011 school year 104 screened 53 referred for precancerous or suspicious lesions

Special Campaigns 19 In addition to all the programs previously mentioned, we made a special effort to focus on the top preventable health risk behaviors using a three year campaign. Stress Nutrition Movement/Exercise 2011 – ongoing: MOVEMENT 2010 – ongoing: NUTRITION 2009 – ongoing: STRESS

Stress Campaign 20 2009 -2010 Campaign Our EAP provided an onsite Licensed Mental Health Counselor to provide programming re: stress, positive energy, work/life balance, humor, etc. Wellness Champions required to have a program which provided general stress info and info about the EAP. ___ participants during ___ programs (from CCW)

Eat SMART Campaign 21 • 2010 -2011 Nutrition campaign • Registered Dietitian & nutritionist on-site for programs and healthy cooking demos • District salt challenge during the school year • Champions & Wellness Committees provided info on promotion of healthier vending options & healthier meeting guidelines • 137 programs (lecture, cooking demo) with 2620 participants

SMART Moves Campaign 22 2011 -2012 Movement Campaign Includes: More Movement at Work (software & training – in pilot phase at this time) District wide fitness programs (yoga, Zumba, boot camp, train for a 5 K) TRY-IT classes (planning tai chi, paddleboarding, etc. per staff interest) Traveling Bandanas activity recognition program Health Coaching promotion Onsite fitness programs & challenges Fitness Center Discounts Measured walking path at every worksite

SMART START Newsletters 23 • SMART START Newsletter emailed to staff every other week. • Along with our Wellness Champions, this is our most important way to communicate to the majority of our staff. • Includes current promotions and programs, challenges, surveys, community events, testimonials, recipes, tips on navigating My. Humana website, EAP info, wellness websites & apps, and more.

Communication 24 SMART START Newsletters New posters at beginning of school year for diabetes, smoking cessation, health coaching, onsite wellness programs. New EAP poster quarterly. QR code t-shirts for Champions – directing staff to the wellness website “Chalkboard” Magnets with phone numbers for Humana’s Nurse Advice line, Health Coaching, Diabetes CARE program, Humana Claims Advisor & Nurse Advocate, EAP, benefits/retirement/workers compensation/disability Promoted wellness program at Food Service Manager meeting in August 2010 Promoted wellness program at HPO’s meeting on June 2010 and June 2011 Reviewed wellness program at SHAC meeting in May 2010 & August 2011.

Acknowledgements 25 Chosen by the Tampa Bay Business Journal as one of the Healthiest Employers for 2010 (ranked #9 in the Tampa Bay area) Step Up, Florida walking challenge in Pinellas County (public & private sector) – 2 nd place Overall Average Steps per Participant

Strategic Planning 26 What are other employers doing?

Strategy #1 (all strategies can be found in the public and private sectors) 27 Tier plan design o Participants in the plan pay according to their level of involvement o Rolled out over 1 -3 years (adding one requirement each year to get lower premiums o Example: 1 st year- smoking surcharge, 2 nd year- annual exam required and/or biometric screening, 3 rd year- HRA with completion during open enrollment for discount Ø Companies such as: Ø Palm Beach School District ($50 discount per month on 2012 medical premium Ø Ø for participating in the wellness rewards program consisting of biometric health screening, online health assessment, online tobacco user status form) Manatee County Government Collier County Schools Florida Hospital Healthcare System Other worksites to be added…

Strategy #2 28 Tobacco Surcharge o Tobacco users pay an additional surcharge. Those who quit using tobacco for a specified period of time or those that are actively engaged in a tobacco cessation program are not charged. Tobacco cessation programs available and promoted before this is instituted. Ø Companies such as: Ø Palm Beach School District ($600 surcharge added to health insurance premium in 2012) Ø Humana Ø Clarion Health (midwestern hospital operator) Ø Other employers to be added…

Strategy #3 29 Hiring Non-Smokers o Must be smoke free for a pre-determined period of time before applicants will be considered. o May be on the honor system (signing they are compliant) or must pass a nicotine test o Benefits of hiring non-smokers: lower health care cost, use fewer financial resources to help smokers quit, lower utilization of sick days Ø Companies such as: Ø Pinellas County Sheriffs Department (6 months) Ø Union Pacific, Omaha Nebraska Ø Westgate Resorts (largest private employer in Central Florida) Ø Other employers to be added…

Strategy #4 30 Drug Testing Drug free workplace policy communicated & implemented Pre-employment drug testing Drug testing with accidents Companies such as: Publix Other employers to be added…

Ideas / Thoughts 31 Moving from a passive program (voluntary) to a more active program (pay if don’t play). Beginning to move staff from entitlement to wise health care consumers. Providing staff with a healthy and supportive environment becomes the foundation of decision making and fosters a culture of wellness. Several employee health behaviors are counterproductive to living a long, healthy, and productive life. Some wellness programs are finding it more effective to use a combined carrot and stick approach.

Creating a True Culture of Wellness 32 Must Haves: Senior Level Support Cohesive Wellness Teams Data to Drive Health Efforts Operating Plan Appropriate Interventions Supportive Environment Evaluating Outcomes Belief That Small Changes Matter

Testimonials 33 Comments being pulled from surveys, emails for presentation (from wellness)

Closing Thoughts 34 “If we do nothing, if we just follow the same pattern and treat one disease after another, we’ll continue to pay and pay. So instead of focusing on pulling people out of the water, lets go up and see why they are falling in the water in the first place and see if we can fix those bridges across the stream, so they don’t fall in. ” ~ Dr. Dee Edington, Director Health Management Research Center, University of Michigan

Be SMART, Be WELL! 35