The San Mateo County Employee Wellness Program is an employee service whose primary purpose is to contribute to organizational efforts that ensure a healthy and productive workforce. The program overview, mission statement and values and core competencies are provided as a separate document. Current programs and services are listed on the Event Calendar on the Wellness Program website, and can also be found under the “Browse for Training” tab on the County LMS.
Developed by the County Wellness Committee in 2012.
PROGRAM GOALS & OBJECTIVES
WELLNESS PROGRAM Mission Statement: To contribute towards building a healthy, productive workforce and making San Mateo County a great place to work. Through programs, services, policy development and program planning, Employee Wellness will:
- Improve employee health and well-being
- Empower employees with health education and lifestyle skills that enable them to achieve their best possible health
- Positively affect employee morale and job satisfaction
- Optimize performance and productivity
- Provide a valued, tangible employee benefit
WORK-LIFE SERVICES Mission Statement
To provide work/life services and programs to employees and their family which:
- Promote health and well-being of the family;
- Increase the employee's capacity to resolve family issues; and
- Ease the demands of balancing work and family responsibilities.
- Recognize that the composition of families is changing and that family responsibilities are becoming more complex.
- Establish policies and programs that recognize and anticipate employee needs outside the workplace. Provide equitable benefits to family members including spouse and dependents as well as domestic partners, children of domestic partners and young adult dependents.
- Promote broad policies that assure that selected benefits and services are responsive to their needs.
- Communicate benefits information to employees, retirees and their dependents, which enables them to tailor work/life programs to meet their needs.
- Empower employees and family members with timely information and education that contribute to their optimal health and well-being.
Beginning in February 1981 as a pilot program, the Employee Health & Fitness Program initially functioned with 1 FTE Management Analyst. Initial programs and services included Jazzercise group exercise classes, blood pressure screenings, Weight Watchers classes, selected health club discounts and some recreational services. During these early years, the Board approved several special funding allocations for one-time projects, including the first round of Wellness Screenings. Other notable accomplishments included working with internal partners in 1984 to establish the first smoking restrictions in the County. In 1988, the Program was assigned a modest budget funded from a Trust Fund surcharge which resulted in expanded trainings and services and a variety of screening programs. In the late 1980s, the Program assumed a primary role in the development and implementation of a comprehensive back safety program, working with five high-risk departments.
During the 1990’s, the Program functioned in a traditional risk reduction model, which also included special projects with the County’s three medical plans. Core focus areas included heart health, diabetes, depression, obesity, asthma and medical consumerism. Health plan partners sponsored a number of trainings and initiative during this period, including Healthwise seminars, asthma self-management trainings and a variety of behavior health programs. These initiatives were selected based upon health care claims and cost drivers as well as national trends. The program started working with the Health Department to offer employee flu clinics at various County locations. It aligned with the County Safety Program to establish a comprehensive ergonomics program and assumed responsibility for ergonomics training efforts. Additionally, the County joined the Stanford Corporate Health Project as its only public sector member and began participating in health research projects. Programmatic evaluations were able to successfully document cost-saving benefits for some of these initiatives, including publishing in national health journals of the aforementioned back safety program (American Journal of Health Promotion) and asthma self-management program (Business Insurance). In addition, the County participated in the validation process for the nationally-recognized Stanford Presenteeism Scale.
In 1997, the County aligned with the Stanford Center for Research in Disease Prevention to participate in a multi-year research study to validate the use of nurse health counselors in improving health outcomes and reducing health costs. Over the next 10 years, the County and Stanford worked together in sponsoring the Stanford HEAR2T Program, and were able to demonstrate significant impact of health counseling in helping high-risk employees to improve their health status over time. When the official research / service relationship with Stanford ended in 2005, the County decided to continue the program on its own, calling it the HEAR2T Program.
In 2009 the County began a process to shift its focus from individual risk reduction interventions to population based programming and initiatives. Recommendations of a labor-management committee to reduce County health care costs included short term solutions (plan consolidation, increased co-pays) to reap immediate needed funds as well as long term solutions that included developing a County Wellness Policy and improving workforce health indicators that would reduce the demand for costly health care.
The County Wellness Policy was approved by the Board in April 2011, and the County Wellness Committee met for the first time in November 2011. Additionally, the County leveraged its partnership with its two health plans to offer enhanced Wellness Rewards and additional branded activities for employees. As of December 2014, 68% of current, active employees had participated in one or more Wellness Rewards – eligible activities.
During this time, physical activity challenges and weight loss challenges were added to the service delivery mix, resulting in an uptick in participation. Instead of classroom exchanges, participants connected with Employee Wellness Program staff via online health websites, weekly educational tips via email, and more recently, by leveraging Yammer, the County’s social media, to build a supportive social network.
In 2012, the Wellness Program assumed administrative oversight for Work-Life service vendors, including Employee Assistance Program, Child Care Center(s) and Tuition Assistance, and College Coach. These additions greatly enhanced its modest efforts to date in offering lactation services, prenatal education and parenting and eldercare workshops for employees and their families.
In 2013, the Employee Wellness Program began decentralizing wellness trainings and activities, working upon request with interested Department Wellness Champions to bring desired wellness classes to their departments at times/dates/locations that fit best with their operational schedule.
In 2014, the County participated in a pilot project with Jumpstart MD, a local medical weight management program, in which a cohort of high risk employees identified by the County’s health coach were invited to participate in an 8-month program (maintenance phase ends September 2015)
In October 2015, a labor-management committee conceptually agreed to undertake a 3-year wellness incentive pilot program. Up to this point, the health plans assumed the financial cost of providing wellness incentives, and as the program became more popular, this commitment was fast becoming unsustainable. The Committee’s agreement offers a cost-neutral solution with available funds dependent upon favorable County medical insurance increases. When the blended County medical premium increase is below the blended Book of Business increase for the County’s health plans, the difference in funds is available to distribute as “Wellness Dividends” to subscribers and employee-dependents. The County learned in 2015 that the difference in these two rates was 1.5%, and from that, it calculated that the 2016 Wellness Dividend would be $250. The Wellness Dividend is set to be re-calculated annually, based upon trend. The program was implemented in January 2016.
All programs, services and activities are available to any benefits-eligible County or Court employee. Additionally, some programs are available to any County or Court employee, regardless of benefit eligibility. If a program or activity is conducted during normal work hours (001 time), an employee can participate on County time with supervisor’s approval. Alternatively, an employee is encouraged to talk to his/her supervisor and request to adjust his/her work schedule so that s/he can attend the program or activity on personal time.
There is no formal, ongoing communication strategy with retirees and dependents. They are welcome and encouraged to attend classroom based trainings and most activities (except Wellness Screenings). They are responsible for consulting the training calendar posted on the website for class dates, times and locations.
“CULTURE OF HEALTH” – COUNTY WELLNESS COMMITTEE
The County Wellness Committee is a volunteer organization that was formed as the result of the passage of the County Wellness Policy by the Board of Supervisors in April 2011. It held its first monthly meeting in November 2011. The County Wellness Committee is composed of department representatives (“Wellness Champions”), management staff (HR), County technical advisors and program managers (e.g. Facilities staff, Food Services staff, Health Program staff, Safety Manager, Employee Engagement staff), and external vendors (CONCERN:EAP, Blue Shield, Kaiser). Employee organizations are invited to the meetings and receive all general correspondence. There are 80& members listed on the Committee roster, and an average of 30-35 people are in attendance at each meeting.
The Committee’s primary purpose is to oversee implementation and monitoring of the County Wellness Policy by
- engaging employees as partners in their health and well-being;
- providing a supportive work environment;
- committing organizational resources; and
- making the healthy choice the easy choice.
From the onset, the Committee identified a number of projects that it could sponsor to bring greater wellness visibility to the County organization and to collaborate with internal technical experts to get the projects implemented and completed:
- Promoting Countywide / Departmental participation in Wellness Screenings and Wellness Challenges;
- Making stairwells more appealing to use by installing stairwell banners and elevator signage;
- Increasing awareness of the Policy Nutrition Standards by conducting training for food purchasing decision-makers at the department level;
- Improving Wellness Communication through installment of Wellness bulletin boards for departments that wanted them;
- Increasing the number of Lactation Rooms throughout the County;
- Ensuring healthier food choices at vending machines, cafeterias and catering.
The Wellness Committee established a sub-committee to develop a way to measure Wellness Policy compliance across all departments and all work locations. The Department Work Group
developed a “Culture of Health” Checklist that County departments voluntarily complete in return for receiving “Wellness Grants” (unrestricted funds for Wellness activities for their department). The 67-item Checklist aligns with the key specifications of the County Wellness Policy.
Through the “Culture of Health” Checklist process, we established a County Wellness Baseline by identifying specified “mandatory items” on the Checklist which Department had to be in compliance with as a condition of receiving Wellness Grant funds. The theory is that by creating a County Wellness Baseline, an employee visiting any of these County departments/divisions can expect to see, feel and experience wellness in a consistent way.
The Committee is responsible for managing the compliance data and monitoring changes and improvements to the 67 indicators over a three-year period of time.
In 2016, twenty-five County departments / divisions submitted their “Culture of Health” Checklists and Wellness Plans, totaling 76 unique work locations and affecting 4,700& employees. Over $48,000 was disbursed to these departments.
To support the Wellness Grantees, the Employee Wellness Program is working more strategically with Department Wellness Champions to bring wellness programs, trainings and services directly to the departments. In 2015, half of all wellness trainings sponsored by the Employee Wellness Program were scheduled at the department level.
We continue to review the Wellness Policy to identify opportunities for healthy change and to monitor and evaluate the initiatives now underway:
- Sponsor Farmers’ Markets and Mobile Produce Carts to increase access to healthier food during the workday, especially at worksites where access to healthy food is limited;
- Ensure that cafeterias and in-house catering are adhering to the pre-packaged snacks/beverage guidelines. Committee members actively monitor inventory on a quarterly/semi-annual basis. Recently, the vendors were asked to undertake a self-review process to identify healthier options of prepared foods that are served and to create signage on menus and displays to indicate such;
- Designate smoke-free County property by supporting the efforts of the Tobacco Prevention Program to amend the Smoking Control Ordinance. San Mateo County Health and Parks properties are smoke-free and meetings are underway with other targeted departments to set a timeline for making this important transition on a voluntary basis;
- Dedicated a one-mile walking loop around the County Government Center (Redwood City) and a walking loop at the Health Campus (San Mateo);
- Encourage efforts to create Healthy Breakroom environments; recent efforts included “Sweets Sweeps” at the departmental level by collecting unwanted candy during the Holiday season (Halloween, Thanksgiving, Christmas) and donating it to the troops;
- Initiatives under development in 2016 include
- additional activities supporting the Healthy Breakroom Project, beyond Sweets Sweeps;
- implementing education and awareness efforts and supportive department efforts to encourage employees to take daily work breaks (“Take your Work break” initiative);
- Recognizing supervisors and mid-managers who create healthy work environments that support employee health, well-being and work-life balance;
- Developing emotional resiliency and mental well-being initiatives
- Sponsoring family fitness events, in this case, a 5K family fun run / walk at a County park in July 2016
The Committee has a 5-year vision to secure staffing & resources to establish onsite Fitness Center(s) at major County worksite(s) and to enable employees to use County time for physical activity (up to 3 hours/week).
WELLNESS DASHBOARD / EVALUATION
In keeping with the basic tenets of a Health & Productivity Health Management program, there are four core pillars for our efforts:
- Ensuring Dedicated and Demonstrated Organizational Support & Commitment (“Culture of Health”)
- Keeping healthy people healthy (>75% workforce is “low risk”)
- Getting unhealthy people to a healthier state
- Getting everyone involved (>85% participation)
There are seven Health & Productivity Health Management objectives that are measured and reported on a semi-annual basis (2016):
- Workforce Wellness Screening Goal: 2,500 employees or 50% of eligible employees
- Health Plan Engagement Goal: 40% of eligible employees
- Wellness Rewards: 40% of eligible employees
- Medical Triage / Health Coaching Goal: 20% of Wellness Screening participants receive customized follow-up intervention(s) via phone or email.
- Completion Rate: >65% for health coaching
- % Departments with Wellness Champions: 85%
- % Departments receiving Wellness Grants: 60%
There are three Wellness & Work-Life program objectives that are measured and reported on a semi-annual basis:
- Wellness & Work-Life Program Participation Goal – 4,000
- Customer Satisfaction Rating: >90% for classroom trainings and services
- Sustainability Rating: > 90% of classroom training participants indicate that they are applying knowledge or skills learned in the classroom training and services after 30 days
We are working with our broker to develop a robust Wellness Dashboard.
PROGRAM ADMINISTRATION / BUDGET & RESOURCES
The Wellness program is funded by a premium load to the Kaiser and Blue Shield health premiums. Funds are maintained in a Trust Fund.
Additional one-time funds may be approved for special activities or pilot projects. Amounts vary from year to year.
Blue Shield and Kaiser provide additional funding for branded services which are mutually determined on an annual basis.
Work-Life Services are funded through the Employee Benefits Trust Fund.
- 1 FTE Human Resources Manager I
- 1 FTE Human Resources Technician (Term)
- The Wellness Program has functioned in its current configuration for many years, relying on outside contractors with technical expertise to provide all program services and activities, creating a cohesive and multi-disciplinary Wellness team. Independent Contracts for health and wellness professional staff, include but are not limited to Registered Dietitian, Exercise Specialist, Nurse Health Coach, Work-Life Education Coordinator, Massage therapist, Psychologist, Clinic Screening Vendor.
- In-Kind support provided by Public Health Services and Family Health Services for onsite flu clinics and lactation consultation/support.
REWARDS and RECOGNITION
The Employee Wellness Program has been recognized for its efforts to improve employee health.
- C Everett Koop National Health Award (finalist) – 1993
- State of California Fit-Business Award – 2003
- American Heart Association Fit Friendly Business Award
- Gold Level – 2008, 2015
- Platinum Level – 2009, 2010, 2011, 2012, 2013, 2014
- STARS Award (Program Performance) – 2010, 2012, 2014
The program has been featured in a number of journal and business articles. This information is provided on a separate document.
SHORT TERM PROJECTS / IDEAS LIST (1-3 years)
EMPLOYEE WELLNESS PROGRAM
- In partnership with labor management Benefits Committee, implement Benefits Credit / Wellness Dividend Program, as agreed upon for three years (“pilot program”)
- Evaluate Wellness Dividend Program for sustainability; consider adding early retirees as eligible participants; consider phasing to physician-based Wellness Screening instead of sponsoring onsite Wellness Screening clinics.
- Finalize Program Dashboard and associated metrics.
- Support annual priorities as established by the Wellness Committee (see below)
- Ensure ongoing funding for Wellness Grants to Departments beyond initial 3-year cycle
- In partnership with labor-management Benefits committee, support efforts to increase awareness and provide education to employees about wise medical care utilization
- In partnership with Employee Engagement Committee, undertake project(s) of mutual interest
- 2016: Supervisor/Mid-Manager Recognition Program, 5K Family Fun Run
- Work with Contract Compliance staff to include nutrition standards in standard County contract templates; work with Procurement / Controller’s Office to ensure that food purchases made with County credit cards meet nutrition standards;
- Re-establish Fitness Testing Program (FITCheck) on an annual basis;
- Re-establish Thank Goodness It’s Alcohol Free Happy Hours during December, perhaps as a Wellness Committee project
- Apply for C.Everett Koop National Health Award or other national wellness award
- Support and expand farmers’ markets, mobile produce carts, and food delivery services (e.g. online produce delivery, meal delivery and CSAs) to worksites where access to healthy foods is limited;
- Support timeline to establish smoke-free campuses;
- Re-design Wellness Grants Program, based upon 3-year pilot program outcomes and learnings; reduce paperwork and align efforts with Committee’s vision:
- Employees see, feel and experience Wellness during the workday
- The physical work environment supports healthy habits during the workday
- Our organization supports healthy work practices and strives for work-life balance
In February 2016, the Wellness Committee identified five priorities for programs, services and outreach to work on in 2016:
- “Take your Work break” Initiative
- Supervisor / Mid-Manager Recognition Program
- Mental Wellbeing / Emotional Resilience education / awareness
- Family Fun Run – 5K Run / Walk
- Supporting and Furthering 5-year Vision / Goals
- Secure staffing & resources to establish onsite Fitness Center(s) at major County worksite(s)
- Use of County time for physical activity (up to 3 hours / week)
WORK-LIFE SERVICES & EDUCATION
- Secure additional funding for child care tuition assistance program beyond current funding stream
- Develop a series of 3-5 minute videos to educate employees about important benefit and lifestyle decisions associated with key life events
FIVE YEAR VISION
The County Wellness Policy has identified three overarching health issues that it seeks to positively affect. These three health issues were selected by the labor-management health care committee in 2009:
In 2014, the County Wellness Committee identified two 5-year goals that it seeks to accomplish:
- Secure staffing & resources to establish onsite Fitness Center(s) at major County worksite(s)
- Use of County time for physical activity (up to 3 hours / week)
Currently, funding for the wellness incentive program (“Wellness Dividends”) relies completely upon favorable health care utilization. However, the County has not invested any specific staffing nor resources to educate and increase awareness about appropriate utilization of medical care dollars. If the County is intending to continue to tie wellness incentives to favorable medical care experience, it must invest educational and informational resources to help employees become better consumers of health care dollars.
Within three years, the new Benefits Credit / Wellness Dividends Program will be evaluated for its financial viability and impact. Three modifications should be considered as additional opportunities to favorably impact associated program and health care costs:
- Adding early retirees (age <65) as eligible participants
- Phasing out onsite Wellness Screening clinics, thereby ensuring that employees see their physician for annual clinic tests.
- Single Vendor Wellness Platform to combine metrics, analytics, online wellness programs/services and telephonic coaching and create a personalized and customized wellness experience for employees.
The re-emergence of onsite employee health centers, ideally coupled with a fitness center or wellness center, has been shown to be a cost-effective employee service for employers who have made this commitment. There are existing examples of California counties where onsite health care services are provided, notably Santa Barbara and Ventura, to further investigate the merits of doing something here. (Limited wellness screening could be offered in this venue).
The Wellness Program has functioned in its current configuration for many years, relying on outside contractors with technical expertise to provide all program services and activities, and creating a cohesive and multi-disciplinary Wellness team. This dynamic is the result of incremental funding increases and commitments over time, and the general reluctance to fund new County positions for the program. Looking ahead, it may be time to create a different staffing pattern to better align with the long-range vision of the program.
Work-Life services and education have been deemed essential in attracting and retaining talent. At present, Work-Life services and education are piecemealed, shared by three HR divisions, and as a results gets afforded less attention and effort. It would be advantageous to better align and integrate current services, assign additional resources and enable the program to fully develop and implement a work-life strategy as defined by life events.
The intersection of wellness and employee engagement has been widely researched and reported on in journals and periodicals. Recognizing a broader perspective that supports and engages employees in meaningful ways requires “de-siloing” single-focus program communication and instead creating an “exceptional employee experience”. Efforts should try to leverage employee-facing programs in such a way that they work together to create a more holistic approach to help employees realize their best potential. Some discussion has already begun on how we can complement, not compete for employee face-time.
The same holds true for how we can more effectively and strategically communicate with supervisor / mid-managers to ensure their support and commitment with wellness initiatives that the County is undertaking. This critical segment of the workforce gets bombarded with messages, communications and expectations from all levels of the County organization, but may be the most constrained in their response due to their frontline responsibility to ensure that the department meets its operational objectives. Just like the holistic approach with employees briefly outlined above, we need a similar de-siloed process with supervisors/mid-managers to manage critical messages and prevent competition for their limited time.
Corporate Stewardship offers an opportunity for employees to serve the greater community. The County currently embraces corporate stewardship activities in an ad hoc fashion, offering charitable contributions, Second Harvest Food Bank, Children’s Fund back-to-school drive and holiday drive, HeartWalk, Tip-a-Cop events, and department foundation outreach. Many private companies have created a corporate strategy around corporate stewardship, by supporting volunteering efforts, fundraising efforts, and branding the experience with t-shirts and clothing that reinforces the connection of the employee to his/her community. Pulling together teams of employees and family members who wish to participate in fundraising events, such as the Bay to Breakers, would offer an exceptional opportunity to expand our organizational presence in much the same way as we currently do at the HeartWalk and provide greater diversity and opportunities that better aligns with the interests and perspectives of our diverse workforce.
Employee Wellness Manager
Updated June 2016