Wellness programs serve as model for other employers

Published June 26, 2006

by JOANNE WOJCIK

jwojcik@BusinessInsurance.com

REDWOOD CITY, Calif.--Wellness has been the primary mission of the San Mateo County Benefits Department since the beginning of Paul Hackleman's tenure there.

When Mr. Hackleman was named benefits manager 23 years ago, the county had just three health and fitness programs: blood pressure screenings performed by public health nurses, a tennis tournament and some aerobics classes.

Since then, the roster has grown to include at least five preventive health screening programs, eight healthy lifestyle and wellness programs, 12 health improvement and risk reduction programs and five family-life education programs (see chart).

"Under his tutelage, it's really matured and evolved," said Pam Gibson, the county's health and fitness coordinator, who joined the department just a few months after Mr. Hackleman was named benefits manager. She oversees seven independent contractors hired on a part-time basis to lead the programs, most of which are offered as classes on county property. They include a nutritionist, physical activity coordinator, massage therapist, clinical screening company, nurse coordinator, computer ergonomics instructor and work/life coordinator.

Many of the San Mateo County health and fitness programs have served as models for other employers, being featured in numerous journals and magazines, including the American Journal of Health Promotion, Public Health Reports, Journal of Occupational & Environmental Medicine and Business & Health. The program even won the California Fit Business Award, which is granted by the state Legislature, in January 2004.

"He's done a lot for the employees here," said Susan Vana, nurse coordinator of the HEAR2T Program, a disease management program focusing on heart health. "I don't think there are a lot of places that have this much going on for the employees." HEAR2T is short for Health Education and Risk Reduction Training.

"Paul's philosophy is to reach out and impact the health of the people who work here," said Rick Salow, senior account executive at Aetna Inc. in San Francisco.

To promote the health, fitness and well-being of county employees, retirees and their dependents, the benefits department also sponsors numerous special events such as health fairs, health club discounts, bowling, basketball, volleyball and softball tournaments and a T.G.A.F. (Thank Goodness It's Alcohol-Free) Holiday Happy Hour.

"He's given me opportunities to make this program be what it is. What his contribution has been is to work on the strategy, to build the support within the organization, the political understanding where the opportunities are, where the pitfalls are," Ms. Gibson said.

Whenever she has an idea, she'll bring it to Mr. Hackleman and "he'll run it up the flag pole," she said. Similarly, the two brainstorm together about program enhancements and fine-tuning.

The HeartCheck clinics, in which about 200 employees participate every six months at three county locations, have been one of the most popular programs to date, according to Ms. Gibson. The clinics also are among the longest running, having begun in the mid-1980s.

Variety attracts interest

But other programs have been catching on as well.

"At one point this year, we had five Weight Watchers classes going, and Weight Watchers requires a minimum of 15 to 18 people per class, so you can do the math and see how many people are going to programs," Ms. Gibson said.

On the recent day that a Business Insurance reporter arrived to interview Mr. Hackleman, 32 employees were scheduled for the ergonomics training program, which is conducted six times each year, training 200 to 250 people annually.

This year, the county introduced a healthier-aging program for individuals over age 50 who are planning to retire in the next three to five years.

The county was one of 10 employers participating in a pilot of Blue Shield of California's Healthy Lifestyle Rewards program. Last year, Aetna Inc. invited the county to participate in its Simple Steps to a Healthier Lifestyle program at no additional charge.

The county also has been offering health risk assessments since the mid-1980s.

Allergy and asthma classes, which are sponsored by Kaiser Permanente Medical Group Inc., are offered once a year, usually at the beginning of allergy season.

The county also has partnered with Kaiser's Redwood City, Calif., office to offer a heart disease and diabetes management program, called PHASE. The acronym stands for "Prevent Heart Attacks and Strokes EveryDay" (see story, page 21).

Most of the health and fitness classes are offered on a rotating basis, usually in spring and fall, to let as many employees as possible participate. Employees also may attend many of the programs on county time. Retirees and dependents also are welcome to join all but the HEAR2T program, which is restricted to employees because of funding constraints.

In 2005, Ms. Gibson documented a total of 3,382 participants in the county's health and fitness programs, or 2,283 individuals, representing 41% of the county's workforce.

"However, there are a number of programs for which we don't capture employee names, either due to the nature of the program or for confidentiality/privacy reasons," she said. Among them are: flu shots, which were given to 1,100 individuals; online health assessments, taken by 368 individuals; the HEAR2T program, in which 69 individuals are receiving counseling; health fairs, which were attended by 1,100 individuals; and health improvement initiatives with the county's three health plans, in which 371 individuals are participating. She did not have figures on participation rates in the various department events and training programs.

"The county tries to eliminate any barriers to access its wellness and risk reduction programs, whether it means making participation more convenient by allowing employees time off from work, or negotiating a discount to make participation more affordable," Mr. Hackleman said.

For example, this year the county introduced a "Heart Healthy Boot Camp," which consolidates the cardiovascular/cholesterol class and the hypertension class and provides blood pressure cuffs to participants for $25 apiece, which is half the usual retail price.

"We don't advertise that very much. We advertise that through our classes because we figured people who are in those classes are dealing with or are at risk for, or are concerned about, cardiovascular-related issues," Ms. Gibson said. "One of the things that I'm really very happy about is the fact that people really want to purchase blood pressure machines for themselves."

In fact, about 40 employees have purchased the monitors in the past two or three months, she said, and not all of them were at the Boot Camp.

"It's spreading by word of mouth," Ms. Gibson said.

In addition, the health plans provide glucose monitors free of charge to diabetics, she added.

This year the county began exploring the possibility of advanced classes for employees who have completed introductory classes and would like to learn more about a particular health condition or wellness activity.

"So people who know the basics about taking care of their heart may want to know more about C-reactive proteins or the calcium supplements or whatever. That keeps those who know the fundamentals engaged so they learn new skills or the latest information because ultimately this goes back to discussions with their doctor," Ms. Gibson said.