WELLNESS: NOT JUST CHILD’S PLAY!A HOLISTIC APPROACH TO WELLNESS

PROGRAMS FOR CHILDREN AND ADULTS, BOTH AT SCHOOL AND AT HOME

Presented to the

2013 NAIS ANNUAL CONFERENCE

Philadelphia Convention Center

February 28, 2013

Christopher L. Brigham, Esq. (203) 786-8310 Updike, Kelly & Spellacy, P.C. cbrigham@uks.com

Ben ChantElementary HeadThe Mandell School(212) 222 2925 x 5524ben.chant@mandellschool.org

Cynthia ChalkerDirector of DiversityFriends Seminary(212) 979 5030cchalker@friendsseminary.org

Presenters:

WHAT ARE EMPLOYEE WELLNESS PROGRAMS?

Programs aimed at encouraging employees to take preventative measures to control illnesses and unhealthy behavior while controlling costs

Educational programs for managing health

Health Risk Assessments

Health Screenings

Onsite fitness facilities

Subsidized fitness programs

Smoking cessation programs

WHY ARE EMPLOYERS ADOPTING WELLNESS PROGRAMS?

More than 75% of employer’s health care costs and productivity losses are related to employee lifestyle choicesWorkplace alcohol, tobacco and other drug use: $100 Billion each yearJob stress: $200-$300 billion Obesity: $117 billion in 2000 95% of our nations health expenditures is committed to diagnosing and treating disease after it becomes manifestIn 2004, tobacco use was estimated to cost the United States $193 billion, including $97 billion in lost productivity and $96 billion in direct health care expenditures

BENEFITS OF EMPLOYEE WELLNESS PROGRAMS

Benefits:28% reduction in sick leave absenteeism

26% reduction in the use of health care benefits

30% reduced worker’s compensation claims and reduced “presenteeism”

Rate of return from $1.49 to $4.91 for every dollar spent

MANDATORY VS. VOLUNTARY EMPLOYEE WELLNESS PROGRAMS

The CarrotMany wellness programs focus on encouraging employees to kick unhealthy habits as well as to develop a sustainable plan to maintain their health and wellness

The StickMore employers are seeking legal advice on how to create more aggressive wellness programs that utilize penalties to change employee behavior

FEDERAL AND STATE LAWS TO CONSIDER WHEN DESIGNING AN

EMPLOYEE WELLNESS PROGRAM

Health Insurance Portability and Accountability Act (HIPAA)

Americans with Disabilities Act (ADA)

Age Discrimination in Employment Act (ADEA)

Employment Retirement Income Security Act (ERISA)

Title VII

Genetic Information Non-Disclosure Act (GINA)

Collective Bargaining Agreements

State “Lifestyle Discrimination” Laws

HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)

The HIPAA nondiscrimination requirements, which are found in Section 702 of the Employee Retirement Income Security Act (ERISA) (as amended by HIPAA) generally prohibits ERISA group health plans or group health insurance issuers from denying an individual eligibility for benefits based on a health factor and from charging an individual a higher premium than a similarly situated individual based on a health factor. Health factors include such things as:

Health status

Medical condition

Claims experience

Receipt of health care

Medical history

Wellness programs that do not provide a reward to employees based on satisfying a health factor do not have to satisfy additional HIPAA non-discrimination standards.

HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)

If a wellness program conditions obtaining a reward or providing a penalty on an individual satisfying a standard that is related to a health factor, that wellness program must meet five additional requirements or risk violating the HIPAA non-discrimination regulations.

1. Rewards (and penalties) based on health factors cannot exceed 20% of the total cost of employee only coverage

2. The program must be reasonably designed to promote health or prevent disease

• Not overly burdensome

• Not a strategy for discrimination

3. The program must give individuals eligible for the program the opportunity to qualify for the reward under the program at least once per year

4. The reward under the program must be available to all similarly situated individuals

5. The plan must disclose in all plan materials describing the terms of the program the availability of a reasonable alternative standard.1

1 See Department of Labor Wellness Program checklist for guidance on the types of programs that must comply with the standards of 29 CFR § 2590.702(f) and how to apply these standards to particular wellness programs, available at http://www.dol.gov/ebsa/pdf/fab2008-2.pdf.

HOW TO DESIGN A SUCCESSFUL WELLNESS PROGRAM

No “one size that fits all” wellness program

Assess your school’s specific health issues

Educate faculty and staff about benefits of participation

Generate buzz and stimulate participation:

trinkets, t-shirts, merchandise or cash

premium reduction

VARIOUS MODELS OF EMPLOYEE WELLNESS PROGRAMS

Pre-packaged incentive campaign

Nationally-recognized provider

Link wellness program to school’s benefits plan

STEP 1 – GETTING STARTED

Gain Management Support - Support from senior management is the key to building a strong wellness program. Assess Resources

Time off for participation Ensure preventive exams are covered under the benefit plan Identify changes in cafeteria and vending options to support healthy food selections.

Collect Data Consider both the demographics (age and gender) and the utilization patterns of your employees when planning for health improvement activities Assess interest in participating

STEP 2 – ESTABLISH GOALS AND OBJECTIVES

A direct relationship to worksite and interest assessment data

Be tied to the organizations overall strategic plan

Be tied to the health promotion program’s evaluation (See step 5 below)

Three levels of programming to consider are Awareness, Education and Behavior Change.

Awareness Level

Posters, Pamphlets, Fact Sheets, Paycheck Staffers, Articles in Company Newsletters and Educational Bulletin Boards.

Education Level

Screenings, Health Risk Appraisal with Interpretation, Safety Meetings, Self-Help Guides and Speakers

Behavior Change Level

Behavior Education Courses, Lifestyle Improvement Courses, Individual Health Counseling Sessions, Support Group Activity, Activity Programs/Challenges and Incentive-Based Programs

STEP 3 – ESTABLISH AN EMPLOYEE HEALTH PROMOTION TEAM

Wellness or Health Promotion Coordinator An Employee Wellness Team

STEP 4 – PLANNING AND PROMOTION

Health Topic - Lifestyle vs. Disease Prevention

What topic(s) will be included?Lifestyle Health (i.e. nutrition, exercise, stress management, weight management, tobacco use)

Disease Prevention (i.e. cancer, heart disease, or diabetes)

Resources/Activities

What approach will be used to deliver a health topic? (i.e. newsletter, payroll stuffer, health fair, speakers, an activity based program such as a walking club, recreational team, etc.)

IMPLEMENTATION PROCESS

Who will be responsible for the activity? Should a subcommittee be formed?When will the activity be scheduled?How much time is needed to plan the activity and what should the timetable be?What facilities and equipment are needed?Is an outside vendor needed? Which one should be selected and why?What kind of budget is needed and where will the money come from?What materials are right for the employees?How will the materials be distributed? (e-mail, to work stations, to employee homes, in company newsletter, etc.)

Post flyers and posters

Personally distribute promotional material

Talk to their supervisors for support

Have senior management send written, voice mail or e-mail messages in support of wellness activities

Discuss the upcoming activities during staff meetings

Talk it up to coworkers

PROMOTION IS VITAL TO PROGRAM SUCCESS

STEP 5 – EVALUATION

Objective Evaluation Subjective Evaluation Cost Analysis Evaluation School Culture Evaluation

School Consortiums

ISBC ProgramGoals:

Insurance rate stabilization

Pro-active risk identification & reduction:

Employee engagement

Sustainability, retention and growth of ISBC

How ISBC collaborates:Steering Committee goals and incentives

School commitment and focus

Faculty & Staff engagement

ISBC Wellness

Resources:

Benefit plan design and wellness strategy

Education and communications

Personal Wellness Profile (survey)

On-site Screenings (participatory)

Preventive Care acknowledgement

School-defined incentives

Easy, Flexible, and Customized forIndependent Schools

ISBC Renewal Results

ISBC Highest Renewals

ISBC Lowest Renewals

Market Trend

ISBC Wellness – Impact!

Increase in Prevention

Impact on disease (earlier detection)

Stabilization of claims experience and loss ratio

People are more focused on their health

Hartford100 Pearl StreetP.O. Box 231277

Hartford, CT 06123-1277Tel. 860-548-2600

New HavenOne Century Tower

265 Church StreetNew Haven, CT 06510-7002

Tel. 203-786-8300

Middletown203 Main Street

300 Plaza MiddlesexMiddletown, CT 06457

Tel. 860-346-3626

• Pre School through Eighth Grade

• Upper West Side in Manhattan

• 546 students

Mandell School Wellness Program

Underlying Principles:

• Mission driven

• Time must be made

• People must take ownership

• Don’t reinvent the wheel

Mandell School Mission• The Mandell School is committed to providing a nurturing educational

environment for our children and their families, which through intellectual stimulation and emotional support, enables them to become responsible active citizens of the world.

• Mandell challenges each of our students and their families to use their experience with us to determine how and through what means they will pro-actively choose to have a positive and meaningful impact on their world. In turn, it is our responsibility to provide a blueprint for learning, consistently high expectations and a dedicated and exceptionally talented faculty. We provide these in support of the emotional, social and intellectual development of our students and their extended families. This is accomplished through passion and compassion, active exploration and the collaborative use of individual talents.

• In this way, our students can build for themselves a common foundation of moral, emotional and intellectual independence that enables them to meet and exceed their individual goals.

Time must be made2A Day 1 Day 2 Day 3 Day 4 Day 5 Day 6

8:20-8:30 Morning Meeting Morning Meeting Morning Meeting Morning Meeting Morning Meeting Morning Meeting

30-9:15 8:30-9:00 Guided Reading

Fundations Fundations Fundations 8:30-9:00 Guided Reading

Wellness/MandellMeeting

9:15-10:00 Math Recess Writing Workshop Recess Writing Workshop Math

10:00-10:45 Music B/Social Studies A

Drama A/Writing Workshop B

Guided Reading Drama B/Math A Math Drama A&B

10:45-11:30 PEGrade Level

Art B

Science APE Art A

Math BPE Recess

11:30-12:15 Music A

Science BLibrary Science

B/Math A

Language Music B

Science AMusic A/Social Studies B

12:15-12:45 (30)

Tech A/Ag Study B

SSR Reading Workshop

Tech B/Ag Study A

Reading Workshop Writing Workshop

12:45-1:15 (30)

Lunch Lunch Lunch Lunch Lunch Lunch

1:15-1:45 (30)

Reading Workshop

Math Reading Workshop

SSR Reading Workshop Writing Workshop

1:45-2:30 Art BWriting Workshop A

Language Art A/Math B Guided Reading Social Studies

Writing Workshop

2:30-3:00 (30)

3:00 Dismissal Dismissal Dismissal Dismissal Dismissal Dismissal

Day 6, Period 1 Choices

• Mandell Meeting

• Respect curriculum

• Responsive Classroom modeling

• Health/wellness (stress, positive, hygiene, nutrition, sex ed)

Mandell Meeting• Origin

– Preliminary meetings with faculty (desire for community, pride, public speaking)– Tradition

• Organization– Voluntary committee– Specialists and homeroom teachers

• Format– Music

– Students host– Highlight curriculum– Admin as MC

– Special guests– Class plays

Don’t reinvent the wheel!

Connected and Respected Curriculum(a broad flexible book -- cycles grade K-5)

http://www.esrnational.org/

Kdg Making connections

Alike and different

Different feelings

Handling anger

First Making Connections

Exploring our diversity

Identifying feelings

Communicating feelings

Responses to anger

Responsive Classrooman excellent flexible

framework to talk about life in the classroom

– http://www.responsiveclassroom.org/resources-educators

– http://www.responsiveclassroom.org/blog

Health curriculum

Who is involved?

• Homeroom teachers • Nurse• Administration • Food service

• School psychologist

• Specialists – science, PE Department

• Students • Parents

FRIENDS SEMINARY

Co-Educational

Grades K-12

Enrollment 700 students

Our Mission

Friends Seminary educates students from kindergarten through twelfth grade, under the care of the New York Quarterly Meeting of the Religious Society of Friends.

Through instruction and example, students follow their curiosity and exercise their imaginations as they develop as scholars, artists and athletes.

In a community that cultivates the intellect through keen observation, critical thinking and coherent expression, we strive to respond to one another, valuing the single voice as well as the effort to reach consensus.

Silence, Study and Service

The disciplines of silence, study and service provide the matrix for growth: silence opens us to change, study helps us to know the world; service challenges us to put our values into practice.

The World that Ought to Be

At Friends Seminary, education occurs within the context of the Quaker belief in the Inner Light – that of God in every person.

"Guided by the ideals of integrity, peace, equality and simplicity, and by our commitment to diversity, we do more than prepare students for the world that is: we help them bring about the world that ought to be."*

Programs inside and outside the classroom

Reflection and Service

Healthy Menus

Healthy Choices

Cynthia ChalkerDirector of Diversity

Friends Seminary 222 E. 16th St.

New York, NY 10003

cchalker@friendsseminary.org

Wellness to go…The lawyer:

1. Start the dialogue2. Take action

The teacher:1. Have it come from the mission2. Schedule time for it

The counselor:1. Look at programs already in place2. It’s not complicated