Working Hand in Hand

A wellness program is the logical companion to your safety and health program.

• By Tricia S. Hodkiewicz
• Apr 09, 2007

IMAGINE that upper management has charged you with a brand-new assignment, developing an "employee wellness program." This could be a tall order for anyone. There's no standardized program to follow. However, if you are a safety and health professional, you have one trick up your sleeve: your safety and health program.

Any successful safety and health program will consist of six basic elements:

• Management leadership
• Employee involvement
• Hazard identification and assessment
• Hazard prevention and control
• Information and training
• Program evaluation

You should designate a wellness program administrator to coordinate your program so both managers and employees know what to expect.

Surprisingly, however, the same basic elements may work just as well for any wellness program, with one slight exception. Instead of identifying, assessing, preventing, and controlling "workplace hazards," you will identify, assess, prevent, and control certain "employee health risk factors," such as:

• High blood pressure
• High cholesterol
• Diabetes
• Overweight and obesity
• Physical inactivity
• Poor nutrition
• Tobacco use
• Substance abuse
• Inadequate sleep

These factors not only affect the health and well-being of your employees, but also can eat away your company's profits. Let's walk through the program elements one by one. You'll see that the safety and health program elements can help you structure a wellness program that may reduce employee health risk factors and, in turn, lower the costs--sick leave, health care, and other costs--associated with those factors.

Management Leadership
The success of not only your safety and health program, but also your wellness program, is critically dependent on upper management leadership and support. In fact, your wellness program would not get off the ground without them. Even if you have the "go ahead" from upper management, you still will need financial and staffing support. In addition, management must be willing to add or revise any company policy that affects employees' health and wellness.

You should designate a wellness program administrator to coordinate your program so both managers and employees know what to expect. This administrator must be able to carry out duties on time so program objectives are met and must be provided with the resources to fulfill those responsibilities.

Strong support and accountability from both the program administrator and upper management will help to secure employee involvement, the next element of the program.

Employee Involvement
Your employees may not buy into your wellness program objectives unless they have opportunities to help establish, implement, and evaluate your program. Besides bringing about effective behavior change, employees' involvement in decisions affecting their health and well-being may result in better program decisions. Therefore, while the ultimate decision-making power remains with management, employees should be included in the decision-making process on matters that affect their health and well-being.

To this end, consider assembling a wellness committee consisting of both management and employees to give employees a voice in the program, as well as a sense of ownership. The committee should develop and launch wellness initiatives and encourage healthy behaviors. Also, consider surveying employees on their interest in--and, later, their satisfaction with--your program and its initiatives. This feedback will help you fine-tune your wellness program.

Risk Identification and Assessment
In order to focus your resources on your company's major health risks and highest related costs, you need to identify those risks and costs. Moreover, to later determine the achievements of your program and its objectives, you should have baseline data before you begin.

Where available, your program administrator and wellness committee may wish to consider collecting data related to:

• Health risk appraisals
• Absenteeism and lost workdays
• Health care, insurance, worker's compensation, and disability claims
• Prescription drug claims
• Hospital and preventive care visits
• Company health and wellness policies and benefits

Just make sure the data you collect is not individually identifiable. Then, you should identify and rank major health risks and costs based on the data. However, if you don't have enough health risk data to identify the risks, you may want to start with those mentioned earlier. Most of those health risks are associated with the leading causes of death (heart disease, cancer, and stroke) in the United States.

Once baseline data is established, the same data may be assessed regularly to evaluate program effectiveness and make program changes as necessary.

Risk Prevention and Control
Based on your risk assessment and the latest program evaluation, your program administrator and wellness committee will set out to advance a handful of program objectives for a given timeframe, such as a year. These objectives should aim to prevent or reduce your company's health risk factors and ultimately lower related costs, and they should be specific and quantifiable. Here are some examples:

• Reduce the number of smokers by 5 percent
• Keep prescription drug use from rising
• Raise health risk appraisal participation by 10 percent

To meet objectives, the program administrator and wellness committee will prepare, select, market, and implement initiatives for various wellness topics. Initiatives might include:

• Employee surveys
• Employee medical testing
• Training resources and classes
• Support groups and memberships
• Mentoring and counseling
• Walks, lunches, and games
• Facilities, equipment, and food services
• New or revised company policies, benefits, and incentives

Topics may cover almost any health and wellness subject you can think of but should be selected based on your risk assessment. Popular topics include heart health, healthy weight, diabetes, fitness, nutrition, smoking, substance abuse, sleep, and stress. Your program administrator should examine existing company policies, benefits, and incentives to ensure they do not discriminate or discourage participation.

Information and Training
The commitment and cooperation of employees in preventing and controlling their own health risk factors is important, not only for their own health and well-being, but also for the health of the company. That commitment and cooperation depends on your employees' understanding of:

• What health risks they may have
• Why the health risks pose a threat
• How they can prevent, reduce, or eliminate the risks

Choose communication methods appropriate for your employees and your message. Your options include the old-school modes of communication, such as letters, posters, handouts, wallet cards, or hotlines, or you may elect to go with more modern modes, such as e-mail, blogs, PowerPoint®, or intranet sites. Because information and training could be considered an initiative, there will be some overlap between the information and training and the risk prevention and control elements of your wellness program.

Program Evaluation
A successful wellness program is regularly evaluated to ensure it is effective and appropriate. However, you won't know how effective and appropriate it is until the program administrator and wellness committee obtain employee feedback and compare the latest health risk and cost data to the baseline data.

Finding out your program's actual return on investment is also helpful. Research indicates that there is a $2 to $7 return on investment for every dollar spent on wellness.

Based on the feedback and data analysis, you should be able to determine the effectiveness of each measurable objective and of the wellness program itself. Send the final results to upper management. If the findings identify any deficiency, the program administrator and wellness committee should find ways to correct the program. They also may wish to set new or revised objectives for the current or next timeframe.

Finally, communicate the findings to employees. Positive results encourage employees to continue their healthy behaviors. Negative results, on the other hand, may encourage employees to try harder.

Legal Considerations
Wellness programs are not required, but they are affected by federal and state laws and regulations. Before developing a wellness program, you should brush up on the following federal laws:

• Health Insurance Portability and Accountability Act (HIPAA)
• Americans with Disabilities Act (ADA)
• Age Discrimination in Employment Act (ADEA)
• Title VII of the Civil Rights Act

Generally speaking, all four laws prohibit an employer from discriminating against employees in some protected class. To help avoid legal complications, it's best to keep the program voluntary. Also, ADA and HIPAA require your company to protect medical information.

You should be aware that on Dec. 13, 2006, the Department of Labor and other agencies released a final rule, "Nondiscrimination and Wellness Programs in Health Coverage in the Group Market," that prohibits an employer from having a wellness program that bases rewards on an individual health factor. These rewards could be a premium discount or a waiver of cost-sharing mechanisms such as copays or deductibles. However, if the wellness program meets five criteria, as summarized below, the employer may use such an incentive:

• Has a limited total reward,
• Is designed to promote health and prevent disease,
• Provides an opportunity to qualify for the reward once a year,
• Makes the reward available to all similarly situated individuals, and
• Discloses the availability of any alternative way to obtain the reward for those individuals with difficulties.

See the rulemaking for details.

Conclusion
As you can see, a wellness program is a logical companion to a safety and health program. With similar structures, they can work hand in hand to protect both your employees' health and your company's bottom line. What's more, as a safety and health professional, recycling the familiar safety and health program elements in this way may be a more natural approach for you.

This article appeared in the April 2007 issue of Occupational Health & Safety.

This article originally appeared in the April 2007 issue of Occupational Health & Safety.