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Building a Healthy Worksite Toolkit

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    Building aHealthy Worksite

    A Guide to Lower Health Care Costs

    and More Productie Employees

    Bureau o Health Promotion

    Guide

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    3.

    able o Contents

    Foreword: Letter rom Governor Jon Huntsman ..........4

    What is a Worksite Wellness Program? .............................5

    Why Should I Invest in Worksite Wellness? ......... ....... 6-7

    What Do Worksite Wellness Programs Cost? ........... .. 8-9

    How Do I Get Started? ................................................10-19

    Step One: Get Senior Level Support ...........................10

    Step wo: Develop Your Wellness Committee ...10-11

    Step Tree: Assess Your Worksite ...........................11-12

    Step Four: Develop Your Operating Plan .............12-14

    Step Five: Plan and Implement Your Program.....15-16

    Step Six: Create a Supportive Environment .........16-17

    Step Seven: Evaluate & Maintain Your Program 18-19

    Appendices

    A. Online Resources and ools .....................................21

    B. Physical Environment Assessment ....................22-27

    C-1. Worksite Wellness Interest Survey ................28-31

    C-2. WELCOA Needs and Interest Survey ........32-33

    D. Health Risk (HRA) Resources ................................34

    E. Utah Department o Health Resources

    E-1. Arthritis .................................................................35

    E-2. Asthma ...................................................................36

    E-3. Baby Your Baby ..............................................37-38

    E-4. Cancer ....................................................................39E-5. Check Your Health .............................................40

    E-6. Diabetes .................................................................41

    E-7. Family Health History ......................................42

    E-8. Healthy Utah ........................................................43

    E-9. Heart Disease and Stroke ..................................44

    E-10. obacco Cessation Prevention & Control ..45

    E-11. Violence & Injury Prevention ........................46

    G. Screening Recommendations ............................47-48

    H. Policy Examples

    H-1. Wellness Council Bylaws Example ...........49-51

    H-2. Healthy Food Policy Example ...................52-53

    H-3. Healthy Worksite Nutrition Guidelines 54-59

    H-4. obacco-ree Campus Policy Example ....60-61

    H-5. Exercise Release ime Policy Example ....62-63

    H-6. Breast-eeding Release ime Guidelines .......64

    I. Cultural Competence in the Workplace ...........65-66

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    4.

    Foreward

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    5.

    What Is A Worksite Wellness Program?

    Worksite wellness encompasses the education and activities that anemployer may do to promote healthy liestyles to workers and theiramilies. Tese programs ofen oer a variety o services that help

    employees maintain or improve their health.Tere is no perect type o worksite wellness program. Each companyis unique in its needs and must create a program that benets both theemployer and employees. However, the most successul programs havesimilar components:

    Health education1. to build skills, change behaviors, and increaseawareness, tailored to employees interests and needs.

    Supportive social and physical environments2. that promotehealthy policies and behaviors.

    Integration o the worksite program3. into the companys

    structure.Linkage to related programs4. like employee assistance programs(EAPs) and tobacco cessation resources.

    Worksite screening programs5. ideally linked to medical care toensure ollow-up and treatment as necessary.

    Follow-up interventions6. to support individual behavior change.

    Evaluation7. to determine how the program is working and how itcan be improved.

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    6.

    Why Invest In Worksite Wellness?

    Employee health aects your companys bottom line. Worksite wellnessprograms can lower health care costs, increase productivity and staretention, and improve morale. Because employees spend many o their

    waking hours at work, the workplace is an ideal setting to promotehealth and wellness.

    Wellness programs help control health care costs. Employees with riskactors such as being overweight, smoking, and diabetes pay more orhealth care and cost more to insure than people with ewer risk actors.Worksite wellness programs can help healthy employees remain in alower-cost group. Tey can also help high-risk employees make liestylechanges that improve health, enhance quality o lie, and lower costs.

    Wellness programs can increase productivity. Simply put, healthyemployees are more productive. Worksite wellness programs help

    reduce presenteeism, in which employees are physically present on thejob but are not being productive.

    Wellness programs can reduce absenteeism.When employees arehealthy they miss less work. And because healthy behaviors ofen carryover into the amily, employees may miss less work caring or ill amilymembers, too.

    Wellness programs can improve morale and enhance the companysimage. Companies with worksite wellness programs save money byretaining workers who enjoy their wellness benets. Tese companiesare also seen as a better place to work because they care about employeehealth, giving them an edge in recruiting new employees.

    reating employee health care as an investment, rather than a cost, canyield long-term dividends. Consider this:

    Te Rising Cost o Health CareAn investment in your employees health may lower health carecosts or slow the increase in providing that important benet.In act, employees with more risk actors, including beingoverweight, smoking and having diabetes, cost more to insure andpay more or health care than people with ewer risk actors.

    Preventable illnesses account or about 70 percent o all costs

    associated with illness.It is projected that health care costs will nearly double by 2017(U.S. News and World Report, 2008).

    More and more research shows that poor diet and lack o exerciseare major drivers o increases in health care costs or employers.Te number o obese adults has doubled since the 1970s (www.dshs.state.tx.us/wellness).

    Obesity is causing rapid increases in type 2 diabetes andcontributed directly to a 65 percent increase in diabetes treatment

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    7.

    rom 1987 to 2002. Nearly $1 o every $5 spent on health care in the UnitedStates is or a person with diabetes (www.dshs.state.tx.us/wellness).

    Te rise in obesity has a huge impact on health care costs. On average, 2002

    health-care costs or an obese person were $1,244 higher than or a personwith a healthy weight (www.dshs.state.tx.us/wellness).

    A study involving the Chrysler Corporation and the United Auto WorkersUnion showed that smokers generated 31 percent higher claim costs thannon-smokers (Healthy Workorce 2010).

    Workers at an unhealthy weight had 143 percent higher hospital inpatientutilization than those at a healthy weight (Healthy Workorce 2010).

    Worksite Wellness Programs Can Help

    Overall, benet-to-cost ratios o $3.84 in reduced health care costs and$5.82 in lower absenteeism costs per dollar invested (www.dshs.state.tx.us/wellness).

    Companies that support wellness and healthy decisions have a greaterpercentage o employees at work every day.

    Savings rom small decreases in absenteeism can more than oset the cost oa health promotion program.

    Direct costs rom lost time totaled nearly 15 cents o every dollar spent onpayroll (Strum, 2002).

    In short, a wellness program is an investment in human capital. Employees aremore likely to be on the job and perorming well when they are in the best physicaland psychological health. Tey are also more likely to be attracted to, remainwith, and value a company that obviously values them. A companys productivitydepends on employee health (Healthy Workorce 2010).

    Benefts to Employees

    Worksite wellness programparticipants may see a reduction

    in:

    Risk o dying rom heartdisease

    Blood pressure

    Risk o diabetescomplications

    Feelings o depression,anxiety and stress

    Tese workers may also see

    improvements in their:

    CholesterolAbility to manageweight

    Mental health

    Out-o-pocket healthcare costs

    Benefts to Employers

    Companies with worksitewellness programs tend to seeimprovements in:

    Quality and quantity oproduction

    Corporate image

    Community relations

    Job satisaction

    Employee morale

    Tese companies tend to see a

    reduction in:

    Health care costs

    Sta turnover

    AbsenteeismPresenteeism

    On-the-job injuries

    Worker compensationclaims

    Work-related conicts

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    8.

    What Do Worksite Wellness Programs Cost?

    Research shows that well-designed health promotion and diseaseprevention programs provide return on investment (ROI). ROI isachieved through improved worker health, reduced benet expense,

    and enhanced productivity.ypical programs require modest initial expense and continuinginvestment over the lie o the program. Tis continuing investment willincrease at approximately the Consumer Price Index (CPI) rate. Tiscontrasts with health care costs that have historically increased at a ratetwo to three times that o the CPI (CPA Journal).

    Sta imePutting together a successul worksite wellness program will requiresta time and money. Large organizations may spend up to 20 hoursper week or three to six months preparing every step prior to launchinga worksite wellness program. For smaller companies, the timeinvestment may be much less.

    Business CostsCosts can uctuate widely. Tis depends on whether the employer paysall costs, the employees pay all costs, or the costs are shared. WellnessCouncils o America (WELCOA) estimates the cost or each employeeto be between $100 and $150 per year or an eective, comprehensivewellness program that produces a return on investment o $300 to$450. It typically takes three to ve years afer the initial programinvestment to realize these savings. Sample expenditures or various

    levels o programs would be:

    Program ype Cost per Employ

    A minimal program $1 - $15

    A moderate program $16 - $34

    A medium program with several activities $35 - $64

    A airly comprehensive program $65 - $99

    A very comprehensive, most eective program $100 - $150

    Remember that return on investment tends to be greater with morecomprehensive programs. Te higher cost per employee will givea greater return on investment due to lower health care costs, lessabsenteeism, and improved productivity.

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    9.

    o estimate your costs and potential cost savings, visit:

    American Cancer Society ROI Calculator or Obesity and Physical Activity,1.

    www.acsworkplacesolutions.com/obesitycalculator.aspMagellan Health Services Obesity Cost Calculator,2.www.magellanassist.com/customer/services/obesitycost/deault.asp

    For more detailed inormation on worksite wellness return on investment (ROI),visit www.pophealth.wisc.edu/UWPHI/publications/issue_bries/issue_brie_v06n05.pd

    ypical programs

    require modest

    initial expense

    and continuing

    investment oer the

    lie o the program.

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    10.

    How Do I Get Started?

    Tere are a number o common elements in successul worksite wellnessprograms. Tese elements have been used to build quality, results-oriented programs in hundreds o companies across the United States.

    Results-oriented programs have been careully researched, designed,and implemented. Tey are ocused not on just oering randomprograms and classes, but on impacting the companys bottom linethrough improved employee health.

    Using the ollowing seven steps will help your program be results-oriented rather than activity-driven. Your worksite wellness programcan attain measurable results.

    Step One: Get Senior Level SupportGetting upper managements buy-in is vital to starting an eectiveprogram. Employees must understand that their management issupportive o the wellness program. Use the inormation rom previoussections o this toolkit to educate management o the importance oworksite wellness, rom both a health and nancial point o view.

    Once support has been cultivated rom all levels o management,it is vital that high-level executives clearly and requently conveythe wellness message. Leadership by example is best. Writtencommunication, public speeches, and incorporation o employeewellness into the companys mission are also very eective and shouldbe encouraged.

    Communicate to all levels o management about the program andhelp them make worksite wellness part o the company culture.Small business owners or top managers who participate in a programencourage others to participate by their example.

    Step wo: Develop YourWellness CommitteeA wellness committee/team is a diverse group o employees who work

    to improve the health and well-being o employees. It is ideal (but notnecessary) to hire a ull-time person to run your program; however,putting only one person in charge o a wellness program is a big mistake.A wellness team will ensure continuation o the program, even i theperson in charge gets burned out, promoted, or takes a new job.

    Not involving key members o your company on your wellness team canmean ailure. Wellness teams are important because it is the people onthese teams who actually get things done. Your wellness team shouldbe comprised o workers rom management all the way to ront lineemployees. It is crucial to have the right people on your team doing theright things.

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    11.

    A wellness committee should be ormed as early in the process as possible andshould include:

    A cross-section o potential program participants.Individuals who may have a role in program implementation or evaluation.

    Someone to represent management.

    Wellness teams implement programs to help workers be healthy, and createenvironmental and policy changes. Tese changes within a company are some othe most cost-eective aspects o a wellness program.

    Established wellness teams provide an organized, systematic business approach tohealth promotion at the worksite.

    Step Tree: Assess Your WorksiteStudies show that when a health promotion program is unocused, it has littlelong-term impact. So choosing the right kind o program is vital to its success,impact on employee health, return on investment, and ability o the program to besustained.

    o be successul, worksite wellness programs should ocus on helping workersachieve and maintain optimal health. Tis typically means improved nutrition,increased physical activity, stress reduction, tobacco cessation, and better bloodpressure and cholesterol levels. Your company may have additional needs such asworker saety, repetitive injury prevention, atigue management, or ergonomics.

    o determine the right ocus or your worksite wellness program, an assessmentshould be completed. Te purpose o completing the assessment is to identiy yourworksites strengths and areas that you need to ocus on. Assessment results canalso be used as a baseline measure or evaluating your program later.

    Dierent assessments will produce dierent types o helpul inormation. In theappendices, you will nd the ollowing surveys and resources to use when assessingyour worksite.

    Worksite Organizational Health Survey

    An organizational health survey is used to obtain inormation on your companys

    environment rom both managers and the general workorce. Tis survey helpsreveal the extent to which opportunities exist in the workplace to pursue andmaintain a healthy liestyle.

    Worksite Wellness Individual Interest Survey

    An employee survey is conducted to get a better understanding o your targetaudience and get an idea o their current health habits and areas o interest.

    When a health

    promotion program

    is unocused, it has

    little long-term

    impact.

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    12.

    Health Risk Assessment (HRA)

    A Health Risk Assessment (HRA) will help you identiy the problems o your

    workorce and establish targets or improvement. By using the HRA, you candiscover risk levels, determine helpul interventions, and measure results. HRAs helpworkers manage their health care and allow companies to control their health carecosts.

    Te three components o an HRA are:

    Questionnaire1.

    Risk calculation2.

    Educational reports3.

    Te results o an HRA are invaluable to a good worksite wellness program. Onaverage, an HRA costs $15-50 per employee. However, many company insuranceproviders include HRAs as part o the benets package. Check with your insurerwhen planning your health risk assessment activities.

    Physical Environment Data

    Examine the physical environment o your workplace, including workstationergonomics, heating/ventilation, stairwell access, and caeteria set-up.

    Employee Data

    Collect baseline inormation such as absenteeism, disability, workers compensation,modiable health care claims, and demographic data.

    Step Four: Develop Your Operating PlanTe operating plan is critical because it keeps everyone moving in the samedirection when key players might want to do their own thing. It lets people perormtheir own tasks while staying aligned with the team. Te plan will also serve asa communication with upper management, and will keep the program stable asmembership turns over within the team. When creating your operating plan, includethe ollowing elements:

    Mission Statement.1. A program mission statement briey lists the general

    values that drive the program and the ultimate goals that the project will striveto achieve. Mission statements do not have to be complicated, but shouldconvey the vision or the program.

    Examples: Te Wellness Council unctions to enhance and oster the healthand well-being o the XYZ Company employees, and Health rom Hire toRetire.

    Goals and Objectives.2. Goals are statements o broad, long-termaccomplishments expected rom the program. Objectives should be specic,measurable, achievable, relevant, and time-based. Each goal has one or moreobjectives established to ensure that the goal will be successully accomplished.

    A Health Risk

    Assessment

    (HRA) will help

    you identiy the

    problems o your

    workorce and

    establish targets or

    improvement.

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    13.

    aking the time to determine goals and objectives is the only concrete wayto demonstrate outcomes. Tey will serve as benchmarks when you evaluateyour program and will help determine where to ocus uture eorts.

    Example:

    Goal: Enhance knowledge and skills among employees to aect and improveweight management capacity.

    Objective 1: By July 2010 a minimum o 100 people will successullyparticipate in an approved weight management program.

    Objective 2: Provide weekly inormation to 100% o employees aboutweight management.

    imeline.3. imelines state what needs to be done and when it needs tobe accomplished. Make sure your timeline is realistic, giving just enough

    pressure to do things but not so much that people burn out.Budget.4. Budgets orce the team to gure out what the program is goingto cost. Consider things like printing, materials, health risk appraisals,incentives, sta time, release time or employees to participate, evaluation,etc. An accurate budget will allow the wellness team to compare programcosts and outcomes during the program evaluation. Remember thatprograms with moderate costs are more likely to achieve cost-savings. Adjustyour budget according to the types o resources you have.

    Low Resource ExamplesLargely paper program.

    Monthly newsletter.

    Posters hung around the o ce promoting health.

    Health education and inormation pamphlets.

    Medium Resource ExamplesHealth air as a program kick-o.

    Preventive wellness screenings.

    Condential health risk appraisals.

    High Resource ExamplesProvide health care coverage or prevention and rehabilitation o chronicdisease.

    Adding weight management, nutrition, and physical activity counseling as amember benet in health insurance contracts.

    Hire a team to do worksite wellness appraisals on-site.

    Oer on-site tness opportunities, like group classes or personal training.

    Te operating plan

    is critical because

    it keeps eeryone

    moving in the same

    direction when key

    players might want

    to do their own

    thing.

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    14.

    Sell the program

    by explaining to

    employees what is in

    it or them.

    Marketing.5. No one will join your program i they dont know what is going onor how they can get involved. You want to let workers know that the programexists and that senior management wants them to participate.

    Use a mix o upbeat methods to promote the program including bulletinboards, pamphlets, payroll inserts, voicemail messages, electronic billboards,email messages, etc. Remember to sell the program by explaining toemployees what is in it or them.

    Te best marketing tool o all is a happy program participant who advertises oryou via word-o-mouth. A creative program name and logo will help create apositive image, too.

    Evaluation.6. Outline how you will evaluate your program. Includeparticipation; satisaction; changes in knowledge, attitudes and behaviors; andchanges in environment and culture. Make sure your evaluation links back to

    your goals and objectives. Below, we build upon our previous goal/objectiveexample to include an evaluation section.

    Example:

    Goal: Enhance knowledge and skills among employees to aect and improveweight management capacity.

    Objective 1: By July 2010, a minimum o 100 people will successullyparticipate in an approved weight management program.

    Objective 2: Provide weekly inormation to 100% o employees aboutweight management.

    Goal Evaluation:

    Document the number o weight management program participants.

    Document the number o total pounds lost among weight managementprogram participants.

    Document the number o employees receiving weekly weight managementmessages.

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    15.

    Ofer programs

    that are consistent

    with your companys

    needs and what our

    workers want.

    Step Five: Plan and Implement Your ProgramResults rom the assessments you perormed during step three are now going

    to be used to determine your wellness programs ocus. Oer programs thatare consistent with your companys needs and what your workers want. obe successul, your program should include educational eorts that addressknowledge, attitude, and behavior change. Te program should also have skillbuilding sessions and social support.

    When planning the interentions or your program, consider these issues:

    Te programs.1. Programs that are generally great or any working populationinclude physical activity, nutrition/weight management, smoking cessation,stress management, ergonomics, disease management, nancial management,and work/amily balance. Your data may point to other specic needs, suchas atigue management, worker saety, or repetitive injury prevention.

    Te timing.2. Determine the best times to oer programs. Some may needto be scheduled monthly or quarterly, while others are best oered annuallyor every couple years. Te activities should be scheduled at times that areconvenient or potential participants. For example, it may be necessary tooer multiple activities beore and afer work to meet the needs o shifworkers.

    Te population3. (spouses, dependents, retirees, part-time workers). Yourbudget and resources will help you determine the extent to which you canreach people. Note that healthy behaviors are most likely to be sustainedwhen they are reinorced at work and home, so spouses can be an importantgroup to include in your program eorts.

    Te incentives.4. Incentives are oered to build motivation by oeringrewards or healthy behaviors. Incentives also create interest in joining/completing the program. When you provide incentives, the company sendsthe message that it is committed to employee health.

    Some examples o incentives could be contributions to a health promotionmedical savings account, merchandise awards, extra time o rom work, travelawards, or discounts to health clubs. A common incentive or important behaviorchanges is discounted health insurance premiums.

    Consider these additional incentie tips:

    Ask workers what incentives they value most.Figure out what incentives the company can provide.

    Integrate your incentives into your benets strategy.

    Oer participation incentives.

    Make sure every participant who achieves a goal receives some recognition.

    Use incentives to promote your worksite wellness program through logosand branding.

    Avoid rewards or biometric changes ( i.e., pounds lost, cholesterolimprovements).

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    16.

    Avoid oering incentives or the best or the most. Tis tends to discourageparticipation by those who are likely to get the most benet rom joining.

    When planning your program, you may nd it useul to pull the goals and objectives

    rom your operating plan and add in your strategies. Strategies are the specicprograms, services, and activities you will oer in order to meet your objectives.Strategies may change rom year to year as you evaluate and adjust your program, butyour goals and objectives are more likely to remain consistent over time.

    Example:

    Goal: Enhance knowledge and skills among employees to aect and improve weightmanagement capacity.

    Objective 1: By July 2010, a minimum o 100 people will successullyparticipate in an approved weight management program.

    Strategy A: Oer an on-site Weight Watchers at Work class.Strategy B: Contract with a registered dietitian to teach a monthlynutrition class.

    Objective 2: Provide weekly inormation to 100% o employees aboutweight management.

    Strategy A: Utilize the company email system weekly to educate memberson a topic related to weight management.

    Strategy B: Include one article on a weight management topic in eachmonthly employee newsletter.

    Once your program is planned, it is nally time to put your plan into action!

    Consider a kick-o event that is un and inviting to all. A good rule to ollow is tobegin the program slowly and lead o with the activities most likely to succeed.

    Step Six: Create a Supportive EnvironmentStudies show that healthy, long-term changes occur only when a worksitesenvironment and policies support employee health. Creating a company culturewhere wellness is encouraged will reinorce healthy behaviors. For instance, teachingworkers about nutrition will have little impact i the only on-site ood choices areunhealthy. Oering smoking cessation classes wont do much good i smoking is

    allowed on campus and in company vehicles.Your company environment can promote participation in your wellness program.Specic policies that address release time to participate in wellness activities duringthe workday can dramatically increase participation. Make sure to include shifworkers and those at remote sites when considering these types o policies.

    Encourage

    employees to consult

    a physician beore

    starting any type o

    exercise or nutrition

    program.

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    17.

    See appendices or

    examples o healthy

    policies you can

    modiy and use.

    Te ollowing are some examples o environment and policy changes that can bedone at your worksite to improve the health o your employees:

    NutritionOer healthy menu choices at each work meeting, conerence, and trainingwhere ood is served.

    Post healthy eating messages in caeterias, break rooms, and vending areas.

    Oer healthy choices at on-site caeterias.

    Set up a break room with microwaves and rerigerators so employees canbring lunches rom home.

    Have ruit and vegetable choices available at the worksite (community ruitbowl, caeteria, and/or vending).

    Adopt a policy that requires healthy choices be oered and labeled in

    vending machines.

    Physical ActivityEncourage workers to exercise by adopting an exercise release policy o 30minutes during lunch breaks, three times per week, with supervisor approval.

    Promote the use o stairs as a way to get more daily physical activity.

    Educate employees about trails and pathways that are sae and nearworksites.

    Hold organized sports activities at work (walking, Ultimate Frisbee,basketball, etc.).

    Sponsor on-site aerobics or yoga classes.

    Hold an annual gol tournament.

    Oer an on-site shower and changing acility.

    Place equipment near gathering areas (break room, copy machines) or o ceworkouts.

    Ensure stairwells are well lit, easily accessible, and inviting.

    Stress ManagementPromote your Employee Assistance Program (EAP).

    Oer on-site massage services.

    Sponsor a healthy employee spotlight/recognition program.

    Develop a worksite relaxation center.

    obacco CessationAdopt a tobacco-ree campus policy (no tobacco use on campus grounds).

    Provide tobacco cessation, counseling, and medication to employees.

    Enorce the Utah Indoor Clean Air Act (including no smoking within 25eet o the building).

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    18.

    Step Seven: Evaluate and Maintain Your ProgramAnnual evaluation is the step that will tell you which parts o your program are

    working and those that need help. Long-term survival o the program will depend onthe ability to show that progress is being made.

    A well-designed evaluation will help you determine 1) how well the program isworking, and 2) i it is achieving expected results. Evaluations will provide you withinormation to improve your program and to measure whether any changes haveoccurred with the participants.

    Te Wellness Councils o America recommends evaluating the ollowing eighttargets (www.welcoa.org). I your company does not have the resources to completeeach type o evaluation, concentrate on the types you have the capacity to do.

    Participation.1. Tis basic measure will tell you how many employees are

    utilizing the wellness program.Participant satisaction.2. Tis type o evaluation is typically given at the end oa specic campaign. Responding to what your participants want gives them asense o ownership in the wellness program. It may also be useul to ask peoplewho are not participating why they choose not to do so.

    Improvements in knowledge, attitudes, and behaviors.3. Tese three itemsare important when discussing the outcomes o results-oriented programs.Standardized tools are available to help evaluate these measures.

    Changes in biometric measures.4. Evaluate changes in measures such ascholesterol levels, blood pressure, body weight, and body mass index (BMI).

    Risk actors.5. Te goal o risk actor evaluation is to identiy individuals at highrisk and help them so they dont develop additional risk actors. With low-riskemployees, try to keep them rom moving to a higher risk status.

    Physical environment and corporate culture.6. Measure changes in thecorporate culture and physical environment to ensure this support oremployee health is happening.

    Productivity.7. Measuring things like absenteeism, turnover, and morale canhelp you determine the impact your wellness program is having.

    Return on investment.8. Tis gold standard o evaluation eorts is an excellentmeasure, and ofen requires outside investment and expert consultation.

    Modiy the Program as NeededEvery wellness program changes along with the needs and interests o employeesand employers. Afer gathering your evaluation data, gure out the elements o yourwellness program that show progress with your employees and areas o the programthat need to be improved. Use your data to make strategy changes while still ocusingon the goals and objectives you set in your Operating Plan.

    I your company

    does not hae

    the resources to

    complete each type

    o ealuation,

    concentrate on the

    types you hae the

    capacity to do.

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    19.

    Maintain Participation and InterestOnce the excitement o a new worksite wellness program has aded, you might ndyoursel needing to bolster interest to increase participation. Consider these toolsto help you maintain interest in your program:

    arget communications.1. Personalized messages to workers have increasedparticipation ve-old in some worksite programs.

    Conduct regular needs assessments.2. Repeat the assessments you completedin Step Tree to ensure that your program is adapting to changing interestsand concerns.

    Oer a variety o intervention options.3. Tis helps to ensure that eachemployee can nd an aspect o the wellness program that works best or himor her.

    Use incentives wisely.4. Well-conceived incentives can be expected to increaseprogram participation rates by 12 to 35 percent. For example, oering anancial incentive can greatly increase the rate o participation in an HRA.

    Create and maintain a worksite culture o good health.5. Tis will help youremployees stick with their health goals.

    Measure participation continuously.6. Document how many people completethe initial assessment, how many drop out o the program, and how manycomplete the ollow-up assessments.

    Involve people in planning.7. Broad employee involvement stimulates interestand ownership o the program. Encourage wellness team members to talk upthe program inormally, even beore the program starts. Word o mouth is

    one o the best marketing tools.Ask people what they want and give it to them.8. A needs assessmentsurvey builds a sense o anticipation and excitement that can help increaseparticipation.

    Make the program un.9. People enjoy doing un things. Create a estiveatmosphere or your program activities.

    Remove barriers.10. Make program activities easy to join, easy to participate in,and conveniently located.

    A needs assessment

    surey builds a sense

    o anticipation and

    excitement that

    can help increase

    participation.

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    Notes...

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    Appendices

    Appendix A: Online Resources and ools

    Program PlanningWELCOAs Seven Benchmarks o Success. Te Wellness Councils o America (WELCOA) has developed this in-depth description o their seven gold standard steps to developing a results-oriented wellness program.

    www.welcoa.org/contentdelivery/pd/aa_6.1_novdec06.pd

    WELCOAs Free Resources. Find a wide variety o useul inormation that can assist you in your quest to build aresults-oriented wellness program. Includes: ree reports, expert interviews, presentations, surveys and samples, andcase studies.www.welcoa.org/reeresources/

    Cost/Savings Inormationo estimate your costs and potential cost savings, visit:

    American Cancer Society ROI Calculator or Obesity and Physical Activitywww.acsworkplacesolutions.com/obesitycalculator.asp

    Magellan Health Services Obesity Cost Calculatorwww.magellanassist.com/customer/services/obesitycost/deault.asp

    Detailed inormation on worksite wellness return on investment (ROI)www.pophealth.wisc.edu/UWPHI/publications/issue_bries/issue_brie_v06n05.pd

    General Worksite Wellness Program InormationCenters or Disease Control and Prevention (CDC) Healthier Worksite Initiative. Tis site is designed or worksitehealth promotion planners. You will nd inormation, resources, and step-by-step toolkits to help you improve thehealth o your employees.www.cdc.gov/nccdphp/dnpa/hwi/index.htm

    CDCs Guide to Community Preventive Services Worksite. Te topics and their related interventions selected bythe CDC as priorities or worksite health promotion.www.thecommunityguide.org/worksite/

    Te National Institute or Occupational Saety and Health (NIOSH). A site dedicated to preventing work-relatedillnesses and injuries.www.cdc.gov/niosh

    Te Utah Council or Worksite Health Promotion. Your local connection to worksite health promotion andwellness inormation. Te UCWHP provides an annual worksite health promotion conerence, a worksite awardsprogram, resources or implementing wellness programs, and links to the best worksite wellness web services.www.health.utah.gov/worksitewellness/acts.html

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    Appendix B: Physical Environment Assessment Example

    1.0 Preliminary Information

    1.1 Name of Company:

    1.2 Name of Rater:

    1.3 Date of Interview:

    1.4 Name of Interviewee:

    1.5 What is your current position?

    2.0 Organizational Demographics

    2.1 Is the worksite self-insured for employee health and medical benefits? (circle the correct response) 1

    Yes 0 No

    2.2 About what percent of the workforce is unionized? (circle the response)1 0% 2 1-25% 3 26-50% 4 51-75% 5 76-100%

    2.3 As of the last payroll and not counting temporary or seasonal employees, how many employees:

    # #

    2.3.1 work here? 2.3.5 are under 40?

    2.3.2 work full time? 2.3.6 are Caucasian/White?

    2.3.3 work part time? 2.3.7 are African American?

    2.3.4 are female? 2.3.8 are Hispanic?

    2.4 Excluding any security staff, which of the following work shifts does this worksite have? (circle all

    that apply)1 day 2 evening 3 night 4 other:

    2.5 Does the worksite occupy more than one building?

    1 Yes 0 No

    2.6 What percent of your employees are eligible to participate in your health plan?

    1 0% 2 1-25% 3 26-50% 4 51-75% 5 76-100%

    2.7 What percent are enrolled in your health plan?

    1 0% 2 1-25% 3 26-50% 4 51-75% 5 76-100%

    3. Smoking YES NO

    Does the worksite have a written smoke-free work environment policy?

    If no, skip to question 3.2

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    3.1.1 What is the extent of the smoking ban? (circle the most appropriate response from

    the values below)

    1. a partial ban on smoking (designated or de facto smoking areas in the building)

    2. smoking allowed on the grounds but not in the building or jobsite

    3. a total ban throughout the premises (including grounds)

    Is the policy enforced? For example, are there any penalties for individuals who do not

    comply with the policyeither verbal or written?

    3.2 Does the worksite provide any type of incentives for being a non-smoker or quitting

    smoking?

    Incentives could include: improved benefit allowances (discounted health insurance, in-

    creased disability payments, additional life insurance), added vacation well days off,

    direct cash payments or bonuses, material prizes or awards, etc.

    3.3 Can tobacco products be purchased anywhere at the worksite (e.g., vendors)?

    4. Nutrition YES NO

    Does the worksite have vending machines in each building for employees to access food

    during working hours? If no, skip to question 4.5

    4.2 Are there healthy options available in the vending machines? (e.g., low-fat granola

    bars, low-fat yogurt, fresh fruit)

    4.3 Do the people who manage the vending machines provide labels to identify healthy

    foods?* (e.g., Apples are healthy and low fat!)

    Note: This refers to information in addition to what is given on the products label. They

    are not messages attached to commercialized food packages such as statements like lite,

    low fat or sugar free.

    4.4 In the past 12 months, has the worksite had any special promotions or sales of low fat

    foods, fresh fruits, vegetables, etc., in the vending machines?

    Does the worksite have a cafeteria or regular catering service?

    If no, skip to question 4.3

    4.6 Are healthy food options offered in the cafeteria or regular catering service? (e.g.,

    whole grain sandwiches, tossed salads, fresh fruit)

    4.7 Does the worksite provide labels to identify healthy foods in the cafeteria?

    4.8 Does the worksite provide written policies that require healthy food preparation prac-

    tices in each cafeteria (e.g., steaming, low fat/salt substitutes, limited frying)?

    4.9 Did the worksite provide any special cafeteria promotions in the last 12 months to in-crease the sale or consumption of low fat foods, fresh fruits, vegetables, etc.?

    4.10 Does the worksite encourage provision of nutritious food options at

    employee meetings?

    4.11 Does the worksite raise the price of unhealthy foods to encourage employees to pur-

    chase lower priced healthier selections?

    4.12 Does the worksite require caterers to provide healthy food options? (e.g., whole grain

    sandwiches, tossed salads, fresh fruit)

    5. Physical Activity YES NO

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    5.1 Does the worksite have an on-site exercise facility? If no, skip to question 5.2.

    5.1.1 Is the facility open at convenient times (before and after normal work hours,

    weekends)?5.1.2 Does it provide aerobic equipment (e.g., bikes) or facilities (track, pool)?

    5.1.3 Does the worksite promote the availability of the exercise facility?

    5.1.4 Is the facility free for employees?

    5.2 Does the worksite subsidize (pay some of the costs of) an off-site exercise facility

    membership?

    5.3 Does the worksite sponsor any employee sports teams?

    5.4 Does the worksite provide or maintain outdoor exercise areas or playing fields outside

    each building for employees?

    5.5 Does the worksite have a written policy statement supporting employee physical fit-

    ness? (e.g., policies that allow workers additional time off from lunch to exercise, walkbreaks, stretching)

    5.6 Does the worksite have a written flex-time policy which allows employees to be physi-

    cally active during the work shift? (e.g., flex-time means employees can, for example, come

    in early so that they can extend lunch for physical activity)

    5.7 Is the area surrounding each worksite building within one mile of a safe and pleasant

    place to walk, run, or bike?

    5.8 Are there bike racks at each worksite building available for employees?

    5.9 Does the worksite provide any incentives for engaging in physical activity?

    (e.g., improved benefit allowances (discounted health insurance, additional life insurance),

    added vacation well days off, direct cash payments/bonuses, material prizes or awards,etc.)

    5.10 Does the worksite provide a shower and changing facility in each building for em-

    ployees?

    5.11 Are there any stairways at your worksite building? If no, skip to question 6.1

    5.11.1 Are the stairways clean and safe?

    5.11.2 Are the stairways accessible and clearly marked?

    5.11.3 Has stairway use been promoted by the worksite in the last 12 months?

    6. Screening or assessment YES NO

    6.1 During the previous 24 months, has the worksite provided any of the following screen-ings or assessments (beyond pre-employment physicals): (If answering no to 6.1.1-6.1.6,

    go to section 7)

    6.1.1 blood pressure

    6.1.2 cholesterol

    6.1.3 blood glucose

    6.1.4 health risk assessments

    6.1.5 fitness assessments

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    6.1.6 weight, height and BMI

    6.2 If answered Yes to any of the questions in section 6.1, was the program:

    Free to employeesAvailable to employees family members

    6.2.3 Offered at a time that was convenient for employees to attend

    Who conducted the screening?

    Employee of worksite contractor Health Plan Other: ______________

    6.4 Does the worksite administration have access to the aggregate screening or assessment

    information?

    6.5 Does your worksite or health plan offer employees incentives to participate in health

    screenings or assessments?

    7. Programs/Educational Messages YES NO

    7.1 During the previous 24 months, did the worksite provide or promote insurance compa-ny-sponsored programs in the areas listed below?

    7.1.1 High blood pressure control

    7.1.2 High blood cholesterol control

    7.1.3 Diabetes management

    7.1.4 Tobacco cessation

    7.1.5 Weight control or healthy eating counseling/advice

    7.1.6 Fitness (other than use of an exercise facility, e.g. walking programs)

    7.2 If answered Yes to any of the questions in section 7.1, were the program(s): (circle all

    that apply)

    Free Subsidized Full Price

    7.2.1 2 1 0 To employees

    7.2.2 2 1 0 To employee family members

    7.3 In the previous 12 months, has the worksite provided health and wellness messages to

    the general employee population on any of the topics listed below? (e.g., posters, brochures,

    videos)

    7.3.1 Signs and symptoms of heart attack

    7.3.2 Signs and symptoms of stroke

    7.3.3 Blood pressure levels

    7.3.4 Cholesterol levels

    7.3.5 Diabetes Management

    7.3.6 Call 9-1-1 in case of an emergency

    7.3.7 Tobacco cessation

    7.3.8 Healthy eating (weight control)

    7.3.9 Exercise/ Physical fitness

    7.4 If answered Yes to any of the questions in section 7.3, did the insurance provider of-

    fer discounted policy premiums for promoting these messages?

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    7.5 Does the employer or the employer-sponsored health plan provide follow-up risk factor

    counseling and education for the following?

    7.5.1 High blood pressure control7.5.2 High blood cholesterol control

    7.5.3 Diabetes Management

    7.5.4 Tobacco Cessation

    7.5.5 Weight control or healthy eating counseling/advice

    7.5.6 Fitness (other than use of an exercise facility, e.g. walking programs)

    8. Administrative Support YES NO

    8.1 Does the worksite have a wellness committee?

    8.1.1 Does the committee meet at least quarterly?

    8.1.2 Is it represented by a cross section of the workforce?

    8.1.3 Does it include at least one senior manager?

    8.1.4 Is there a written mission or goal statement for the committee?

    8.1.5 Does the committee have a budget?

    8.2 Does the worksite have an individual responsible for employee health and wellness

    programs? If no, skip to question 8.3

    Are at least half of his/her responsibilities devoted to health promotion?

    8.2.2 Does the individual have a budget to work with?

    8.3 Does the worksite link its employee wellness program to the companys overall

    business objectives? (written strategic plan)

    8.4 Does the worksite organizational mission statement contain references to improving/maintaining employee health?

    8.5 Does the worksite provide management support for worksite health promotion?

    For example, does the CEO/manager provide at least annual messages supporting health

    promotion (personal address, memo, newsletter article, etc.)?

    8.6 Does the worksite offer members incentives to participate in lifestyle and behavior edu-

    cation/modification programs (e.g., no cost to members, discounts to fitness centers)?

    8.7 Does the worksite measure the return on investment (ROI) for health and wellness pre-

    vention efforts? If no, Skip to section 9

    8.7.1 How is ROI measured by your worksite? ________________________________

    ________________________________________________________________________________________________________________________________

    9. Cardiopulmonary Resuscitation (CPR)/Automated External Defibrillator (AED)/Blood

    Pressure YES NO

    9.1 Does your worksite offer training in CPR, also called Basic Life Support?

    (If yes, go to question 9.1.1, if no, go to question 9.2)

    9.1.1 Are these classes available for all employees?

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    9.1.2 Are these classes available to family members of employees?

    9.1.3 Is the cost of the class free?

    9.1.4 Is the cost of the class subsidized?9.2 Does your worksite require that at least one person with CPR certification be on-site at

    all times?

    9.3 Does your worksite have at least one AED on each floor/jobsite of your worksite?

    If yes, answer question 9.3.1-9.3.6 If no, go to question 9.4

    Has your worksite registered the AED(s) with your local Emergency Medical Service

    (EMS) and/or other entities required by ordinance, such as a local city AED registry?

    In the event of an emergency, can the AED(s) be administered by a trained employee within

    5 minutes?

    Are trainings available for all employees to learn how to use the AED?Does the worksite have trained, designated employees on each floor/unit who will assist a

    person in need with an AED?

    Does the worksite require that somebody with AED training be on-site on each floor/unit at

    all times?

    Is there a dedicated employee to conduct monthly maintenance of the AEDs?

    9.4 Outside of screening events, does your worksite have permanent on-site access for

    employee to check their blood pressure?

    10. Program Evaluation of Wellness Program/Activities

    10.1 Does the worksite conduct program evaluation of wellness programs/activities?

    10.2 Does the worksite share results of program evaluation with employees?

    10.3 Does the worksite use program evaluation results in future program planning and

    implementation of wellness programs and activities?

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    Appendix C - 1: Worksite Wellness Individual Interest Survey

    1. Which workplace health areas would you like inormation or training on?

    Injury prevention

    Communication

    Stress Management

    Organizing and managing work

    Other, please speciy

    2. What healthy living areas would you like inormation or training on?

    Eating healthier oods

    Easy, healthy cooking

    Weight management

    Physical activity, exercising moreRelieving depression

    Quitting smoking/chewing tobacco

    Alternative health practices (i.e., bioeedback, chiropractic care, meditation, mind/body therapy)

    Other, please speciy

    3. I the wellness council either provided or purchased a monthly newsletter with inormation regarding many types o healthinormation what is the likelihood that you would read it?

    Read it every time 100%

    Read it most o the time 75%

    Read it occasionally 50%

    Read it sometimes 25%

    Never read it

    4. What lie skills areas would you like inormation or training in? Mark all that apply.

    Balancing work and amily

    ime management

    Relationships and communicating

    Conict resolution

    Personal nancial management

    Retirement planning/budgeting

    Other, please speciy5. I am currently participating in (mark all that apply).

    Regular exercise programs either organized or sel-directed

    Organized sports activities

    Weight loss programs

    Counseling or personal issues

    Other, please speciy

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    6. How many times per week do you exercise (a minimum o 30 minutes per session)?

    0 times per week

    1-2 times per week3-5 times per week

    6-7 times per week

    Other, please speciy

    7. Do you eel you get enough physical exercise?

    Yes

    No

    Additional Comment

    8. Do you participate in or use any o the ollowing. Mark all that apply.

    Walking railGym

    Fitness center/weight room

    Home Fitness Equipment

    Other, please speciy

    9. I you do not use any o the above, what are your reasons or not doing so?

    oo busy

    Not enough equipment

    Dont know how to operate equipment

    Dont like to sweat during the work dayChildcare

    Other, please speciy

    10. I a group tness activity was organized (i.e. hiking, walking, sports, etc.) would you participate?

    Yes

    No

    Additional Comment

    11. What wellness seminar topics interest you?

    Physical activity

    Nutrition/healthy ood choices Stress management

    General health

    Mental health

    Elder care/parent care

    Raising healthy children

    Alternative health practices (i.e. Massage therapy, chiropractic care, meditation, bioeedback, etc.)

    Other, please speciy

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    12. What time would you preer a brown bag lunch seminar to start?

    11:00

    11:3012:00

    12:30

    1:00

    Other, please speciy

    13. How ofen to do you go out or lunch?

    0 times per week

    1 time per week

    2 times per week

    3 times per week

    Other, please speciy

    14. In general would you say your physical health is:

    Excellent

    Very Good

    Good

    Fair

    Poor

    15. In general would you say your mental health is:

    Excellent

    Very Good

    Good

    Fair

    Poor

    16. How would you like to get your health and liestyle inormation. Mark all that apply

    1 on 1 counseling in person with a health proessional

    1 on 1 counseling over the phone with a health proessional

    E-mail

    Internet

    Class, workshop or seminarBooks

    Health airs or screenings

    Health incentive programs

    Printed materials (pamphlets, sel directed programs, workbooks, newsletters, magazines)

    Video/DVD

    Other, please speciy

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    17. Which incentives would help motivate you to become healthier? Mark all that apply.

    Money

    Paid leave (Not available or spouses and part-time employees)Competition

    Swimming pool pass or Recreation Center pass

    -shirts/hats

    Recognition

    Drawings or prizes (i.e., gif cards, electronics, massages, DVDs, CDs, etc.)

    Other, please speciy

    18. Other interests, questions, or comments?

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    Appendix C - 2: WELCOA Needs and Interest Survey

    Fort Martin/Albright Region Worksite Wellness Program

    Needs & Interest Survey

    Please indicate how likely you would be to participate in each of the followingprograms if they were offered at work during the next year.

    1. Body Fat Testing 1 2 3 42. Educational Programs:

    a) Back Safety 1 2 3 4b) Cancer Prevention 1 2 3 4

    c) Heart Disease Prevention 1 2 3 4

    d) Stroke Prevention Programs 1 2 3 4

    e) Cholesterol Reduction 1 2 3 4

    f) Home Safety 1 2 3 4

    g) Substance Abuse 1 2 3 4

    h) Headache Prevention & Treatment 1 2 3 4

    i) Cold / Flu Prevention & Treatment 1 2 3 4

    3. Employee Assistance Programs:a) Depression Treatment 1 2 3 4

    b) Financial Management 1 2 3 4

    c) Job Stress Management 1 2 3 4d) Accepting Change 1 2 3 4

    e) Parenting Difficulties 1 2 3 4

    f) Managing Chronic Health Conditions (diabetes, hypertension, ...) 1 2 3 4

    g) Managing Chronic Pain (neck & shoulder injuries, back injuries, ) 1 2 3 4

    h) Controlling Anger / Emotions 1 2 3 4

    4. Fitness Programs:a) Corporate Fitness Membership Rates 1 2 3 4

    b) Exercise Tolerance (STRESS) Testing 1 2 3 4

    c) On-Site, Low-impact Exercise Equipment 1 2 3 4

    d) Prescribed Exercise Programs 1 2 3 4

    e) Stretching Programs 1 2 3 4

    f) Walk-Fit Programs 1 2 3 4

    5. Immunization Programs:a) Flu Shots 1 2 3 4

    b) Tetanus Shots 1 2 3 4

    c) Lyme Disease Vaccine 1 2 3 4

    d) Hepatitis 'B' Vaccine 1 2 3 4

    Ext

    remely

    Lik

    ely

    Somewha

    t

    Unlik

    ely

    Needs &Interest Survey

    1 | 2005 Wellness Councils of America Continued

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    Appendix C - 2: WELCOA Needs and Interest Survey (continued)

    6. Nutrition Education Programs:a) Healthy Cooking (meals/snacks) 1 2 3 4

    b) Healthy Eating (do's & don'ts) 1 2 3 4

    c) Weight Management Programs (diet & exercise) 1 2 3 4d) Onsite Vending Machines with Healthy Choices 1 2 3 4

    7. Screening Programs:a) Blood Pressure Checks 1 2 3 4

    b) Blood Sugar (diabetes) 1 2 3 4

    c) Cholesterol Levels 1 2 3 4

    d) Multiphasic Blood Screenings 1 2 3 4

    e) Cardiovascular (EKG's) 1 2 3 4

    f) Colon / Rectal (cancer) 1 2 3 4

    g) Prostate Checks (PSA) 1 2 3 4

    h) Stool Checks (bowels) 1 2 3 4

    i) Mammograms 1 2 3 4

    j) Vision 1 2k) OtherSpecify_________________ 1 2 3 4

    8. Smoking Cessation Programs 1 2 3 49. Stress Reduction Programs 1 2 3 410. Time Management Programs 1 2 3 411. Visiting On-site Healthcare Nurse 1 2 3 412. Self-Help / Self-Care 1 2 3 4Please indicate how likely you would be to participate in health promotion programs during the following times:

    13. Health Promotion Programsa) Before Work 1 2 3 4

    b) During Lunch at Work 1 2 3 4

    c) After Work 1 2 3 4

    ANY OTHER INTEREST OR SUGGESTIONS (PLEASE SPECIFY) Please list any positive (or negative) comments regard-ing the impact of the current Wellness Program. Include how this program may have affected you personally. List any suggestionson how we can improve the current program or things you would like to see implemented. Your input is an IMPORTANT elementto the success of our program.

    Ext

    remely

    Lik

    ely

    Somewha

    t

    Unlik

    ely

    Needs &Interest Survey

    2 | 2005 Wellness Councils of America

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    Appendix D: Health Risk (HRA) Resources

    Health Risk Assessment ResourcesWellsource: www.wellsource.com

    Wellstream : www.welcoa.org

    Stay Well: www.staywellhealthmanagement.com

    Summit Health: www.summithealth.com

    Well Call: www.wellcall.com

    rale Inc.: www.trale.com

    PreceptGroup: www.preceptgroup.com

    RealAge: www.realage.com

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    Appendix E - 1: Utah Department o Health,ARHRIIS Program Resource Sheet

    What is Arthritis?Te word arthritis means inammation o the joint. Tere are more than 100 types o arthritis. Te most common type,Osteoarthritisalso known as degenerative joint diseaseis caused by worn and/or damaged cartilage. When this happens,bone begins to rub against bone, causing discomort. Te three most common symptoms o arthritis people need to be awareo are:

    Swelling in or around a joint

    Heat and/or redness in or around a joint

    Pain in or around a joint

    Arthritis is more likely to occur i:Youre past age 45

    Youve had a joint injury

    Youre a woman

    Your parents have/had it

    Youre overweight

    Youre inactive

    Ideas or EmployersWellness Messages-risk actors and what to do i you have arthritis

    Arthritis Education and Management Programs with individual goal-settingPhysical Activity Programs or employees that ocus on range o motion

    Low-cost, nutritious ood in caeterias and snack bars; point-o-purchase inormation

    Places or physical activity: marked walking paths, signage to encourage stair use

    Health clubs/gyms

    Incentives to engage in healthy behaviors

    Reerenceswww.health.utah.gov/arthritis

    www.cdc.gov/arthritis/www.arthritis.org

    Contact InormationPhone: (801) 538-9458

    Email: [email protected]

    Website: www.health.utah.gov/arthritis

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    Appendix E - 2: Utah Department o Health, ASHMA Program Resource Sheet

    What are Asthma and Work-related Asthma?Asthma is a chronic inammatory disease o the lungs. During an asthma attack, the linings o the airways become inamedand swell, more mucus is produced, and the muscles around the airway tighten, making the opening in the airway smaller.Work-related asthma is asthma that is caused by, or made worse by, exposures or triggers in the workplace.

    Ideas or EmployersEnsure that ormularies include a wide range o asthma medications and equipment.

    Ensure that health plans are appropriately screening, diagnosing, treating and managing individuals with asthma.

    Educate your employees about asthma.

    Support smoking cessation programs or your employees.Ensure that your worksite has clean and sae air and is asthma-riendly by banning smoking at and around the worksiteand reducing or eliminating sources o mold and mildew.

    Use regular maintenance activities such as cockroach control, leak prevention, heating/cooling system cleaning,and window sealing.

    (Adapted rom: Managing Child Asthma: Prevention and reatment, National Business Group on Health,May 2005)

    Reerences

    www.health.utah.gov/asthma

    www.cdc.gov/asthma

    www.lungusa.org

    www.managedcaremag.com/asthma

    Contact InormationPhone: (801) 538-6141

    Email: [email protected]

    Website: www.health.utah.gov/asthma

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    Appendix E - 3: Utah Department o Health,BABY YOUR BABY Program Resource Sheet

    What is Maternal and Child Health in the Workplace?Women are the astest-growing segment o the U.S. labor orce. Approximately 70% o employed mothers with childrenyounger than 3 years work ull time. One-third o these mothers return to work within 3 months afer birth and two-thirdsreturn within 6 months. Approximately 60% o children and 66% o pregnant women are covered by employer-sponsoredbenets.

    Maternal and child health is important to business. Maternal and child health care services (e.g., labor and delivery,childhood immunizations) account or $1 out o every $5 large employers spend on health care. Furthermore, a substantialproportion o an employees lost work time can be attributed to childrens health problems. And pregnancy is a leading causeo short- and long-term disability and turnover or most companies. Employers who provide evidence-inormed, high-value health benets and innovative amily-riendly work/lie benets can lower their health care costs, improve employeeproductivity, and reduce turnover.

    Working outside the home is related to a shorter duration o breasteeding, and intentions to work ull-time are signicantlyassociated with lower rates o breasteeding initiation and shorter duration. Low-income women, among whom AricanAmerican and Hispanic women are overrepresented, are more likely than their higher-income counterparts to return to workearlier and to be engaged in jobs that make it challenging or them to continue breasteeding. Given the substantial presenceo mothers in the work orce, there is a strong need to establish lactation support in the workplace. Barriers identied in theworkplace include a lack o exibility or milk expression in the work schedule, lack o accommodations to pump or storebreast-milk, concerns about support rom employers and colleagues, and real or perceived low milk supply.

    Ideas or Employers

    Worksite opportunities to support Maternal and Child Health include:Educate employees to help make better health care decisions.

    Provide health care coverage, which includes preventive services.

    Communicate breasteeding support policies to all employees.

    Provide a small, private space or a lactation room (that is not a restroom) with a sink nearby or handwashing andwashing o pump parts. Worksites may also wish to provide a rerigerator or storage o expressed milk.

    Allow exible breaks to allow women to breasteed or express milk.

    Consider exible scheduling options, part-time work, or job-sharing.

    Provide on-site child care.

    ResourcesMarch o Dimes Healthy Babies, Healthy Business

    www.marchodimes.com/hbhb

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    Premature birth is a serious, common and costly problem. Since 1981, the rate o premature birth has increasedapproximately 30%, accounting or more than 500,000 babies a year. Its the leading cause o newborn death and may resultin lielong disabilities. Nearly 50% o the total charges or inant hospital stays in 2002 were or babies who were born too

    soon or too small.

    March o Dimes has created a ree tool to help employees make better health care decisions. Healthy Babies, HealthyBusiness is a multi-dimensional health education program or the workplace. It oers resources to help companies improveemployee health and the health o the companys bottom line, including health and wellness inormation or the companyweb site or intranet and email access to March o Dimes inormation specialists.

    Te Business Case or Breasteedingwww.utahbreasteeding.org/workino.php

    Companies successul at retaining valued employees afer childbirth nd that two components can make a dierence:providing dedicated space or breasteeding employees to express milk in privacy, and providing worksite lactation support.Te Utah Breasteeding Coalition will provide you with direct assistance in developing a lactation support program or youremployees.

    Centers or Disease Control and Prevention:

    www.cdc.gov/nccdphp/dnpa/hwi/toolkits/lactation/index.htmNation Womens Health Inormation Center: www.4woman.gov/breasteeding

    United States Breasteeding Committee: www.usbreasteeding.org

    Washington Business Group on Health: www.wbgh.org/benetstopics/et_maternal.cm

    LaLeche League International: www.llli.org

    Contact InormationPhone: 1-800-826-9662

    Email: [email protected]

    Website: www.babyyourbaby.org

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    Appendix E - 4: Utah Department o Health, CANCER Program Resource Sheet

    Why is Cancer Prevention Important?Cancer is the second leading cause o death in the U.S., accounting or one o every our deaths. According to the AmericanCancer Society, 1,437,180 new cancer cases are expected to be diagnosed, and about 565,650 Americans are expected to dieo cancer in 2008. About one-third o these deaths will be related to overweight or obesity, physical activity, and nutrition,with another 170,000 caused by tobacco use, all o which could be prevented.

    Te costs o cancer not only aects the individual, but society as a whole. Regular screening or certain cancers can increasethe chances o discovering cancer early, when treatment is more likely to be successul. Here are some tips to help employerscombat cancer in the workplace:

    Ideas or EmployersChoose employee health plans that provide cancer screening and access to cancer careEducate employees on the importance o cancer screening

    Provide easy access to screening by providing employees time o or extime or screening appointments

    Organize on-site screening programs

    Provide inormation on cancer clinical trials

    Reerenceswww.health.utah.gov/utahcancer

    www.health.utah.gov/ucan

    www.ahrq.gov/clinic/USpstx.htm

    www.cancergoldstandard.org

    Contact InormationPhone: 1-800-717-1811

    Website: www.health.utah.gov/utahcancer

    Email: [email protected]

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    Appendix E - 5: Utah Department o Health,CHECK YOUR HEALH Program Resource Sheet

    What is Check Your Health?Check Your Health encourages all Utah amilies to make healthy ood choices, develop a regular amily mealtime, usecorrect portion sizes, and get at least 30 minutes o moderate to vigorous physical activity every day.

    Ideas or EmployersNutrition and Activity racker Provide this guide to employees to help them recognize and manage eating patternsand activity level.

    Guide to Healthy Eating An excellent guide that teaches that with a little planning, substituting, and creativity,

    eating will be more un, avor-lled, and healthy or you and your amily.Medication Management Checkbook Provides individuals a place to collect inormation on the medicines they takeand other important medical inormation.

    Workouts on the Web Workout segments available to watch via computer or podcast. Each exercise is available inPDF ormat to print and keep as well.

    Healthy Cooking Fresh From the Kitchen Cooking segments are available to watch via computer or podcast. Terecipes and nutritional analysis are available online in PDF ormat to print and keep as well.

    Reerences

    www.checkyourhealth.orgwww.kutv.com and click on Workouts on the Web

    Contact InormationPhone: 888-222-2542

    Email: [email protected]

    Website: www.checkyourhealth.org

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    Appendix E - 6: Utah Department o Health,DIABEES Program Resource Sheet

    What is Diabetes?Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed toconvert sugar, starches, and other ood into energy needed or daily lie. Te cause o diabetes continues to be a mystery,although both genetics and environmental actors such as obesity and lack o exercise appear to play roles.

    Diabetes has reached epidemic proportions in the United States, aecting a growing number and percentage o people everyyear. Many people do not recognize that they are at risk or diabetes (or diabetes-related complications i they already havediabetes). However, type 2 diabetes can be prevented or delayed or many o those at high risk or diabetes and diabetes-related complications can be also be prevented or delayed or those with diabetes (American Diabetes Association).

    Ideas or EmployersCreate diabetes management policies or employees who need to administer insulin.

    Implement a wellness program to help employees achieve healthy goals.

    Include a weight management program.

    Include a stress management program.

    Include a nutrition program.

    Include a general diabetes awareness and education program.

    Ensure that health plan benets include diabetes and diabetes-related complication screenings, diagnoses, medicationand equipment, and management and treatment.

    Support smoking cessation programs or your employees.

    Reerences and Resourceswww.health.utah.gov/diabetes

    www.cdc.gov/diabetes

    www.diabetes.org

    www.diabetesatwork.org

    Contact InormationPhone: (801) 538-7013

    Website: www.health.utah.gov/diabetes

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    Appendix E - 7: Utah Department o Health,FAMILY HEALH HISORY Resource Sheet

    What is a Family Health History?Family health history captures the interaction between genetics, behaviors, and environmental actors that impact health.Family health history can serve as a motivating tool or both individuals and amilies to make healthy liestyle choices.

    Ideas or EmployersHold a brown bag presentation on amily health history or other genetics-related topic (e.g., genetics and depression,stem cell research).

    I your worksite has an incentive program, include collecting a amily health history as an activity or goal.

    Sponsor a ell Us Your Story contest in which employees submit a story about what they did to collect their amilyhealth history or how this inormation has impacted their lives.

    Hold an Exercise Your DNA walk and post signs with genetics acts around your building or employees to readwhile getting some exercise.

    Include an article on why amily health history is important in your company newsletter or employee paystubs.

    Reerenceswww.health.utah.gov/genomics

    http://learn.genetics.utah.edu

    www.cdc.gov/genomics

    www.hhs.gov/amilyhistory

    www.geneticalliance.org

    www.code-co.com/utah/code/03/26-45.htm

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    Appendix E - 8: Utah Department o Health,HEALHY UAH Program Resource Sheet

    What is Healthy Utah?Healthy Utah is an employee wellness program sponsored by Public Employees Health Program (PEHP). Healthy Utah isa ree benet or State o Utah and local government employees and their PEHP-covered spouses. Our primary goal is toenhance the well-being o our members by:

    Increasing awareness o health risks and healthy liestyle choices.

    Providing support in making healthy liestyle choices.

    Helping agencies develop supportive workplace environments that support health.

    Healthy Utah oers a variety o programs, services, and resources to help members meet their health and wellness goals. Wehelp them with their concerns about weight, diabetes, cholesterol, blood pressure, stress management, nutrition, physicalactivity, and tobacco cessation.

    Ideas or EmployersOer healthy menu choices in each work meeting, conerence, and training where ood is served.

    Post healthy eating messages in caeterias, break rooms, and vending areas (Visit www.healthyutah.org and go to ourdownloads section).

    Work with vendors to include healthy options in vending machines, based on customer preerence.

    Encourage employees to exercise by adopting a work release policy (see Appendix I-5 or a sample exercise release time

    policy).Promote the use o stairs as a way to get more daily physical activity.

    Encourage employees to walk, bike, or bus to work and, where circumstances permit, provide showers, lockers, bikeracks, discounted bus passes, and exible working schedules.

    Educate employees about trails and pathways that are sae and near worksites.

    Implement a tobacco-ree campus.

    Establish a worksite wellness council to support healthy eating and daily physical activity.

    Reerences

    www.healthyutah.org/workwellwww.health.utah.gov/worksitewellness

    Contact InormationPhone: (801) 538-6261 or toll-ree at 1-(888) 222-2542

    Email: [email protected]

    Website: www.healthyutah.org

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    Appendix E - 9: Utah Department o Health,HEAR DISEASE AND SROKE Program Resource Sheet

    What are Heart Disease and Stroke?Heart disease is a generic term that describes many dierent problems aecting the heart. It can aect your coronary arteries,heart valves, and heart muscle and can also aect your heart rate and rhythm. Heart disease is the number one killer oAmericans. A stroke is ofen reerred to as a brain attack that cuts o blood and oxygen to the brain cells that controleverything we do, rom speaking to walking to breathing. Most strokes occur when arteries are blocked by blood clots or bythe buildup o plaque and other atty deposits.

    Ideas or Employers

    Smoke-ree policies and tobacco cessation services.Health education classes and support groups with individual goal setting.

    Low-cost nutritious ood in caeterias and snack bars; point-o-purchase inormation.

    Places or physical activity: marked walking paths, signage to encourage stair use, health clubs/gyms.

    Wellness messages on the warning signs and symptoms o heart attack and stroke, and when to call 9-1-1.

    Incentives to engage in healthy behaviors.

    Blood pressure monitors, CPR classes, Automated External Debrillators (AED).

    Reerences

    www.hearthighway.org

    www.americanheart.org

    www.nih.gov

    www.nhlbi.nih.gov

    www.cdc.gov/dhdsp/library/toolkit/pds/six_step_guide.pd

    Contact InormationPhone: (801) 538-9209

    Email: [email protected]: www.hearthighway.org

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    Appendix E - 10: Utah Department o Health,OBACCO PREVENION AND CONROL Program Resource Sheet

    obacco-ree Policies and CessationTe U.S. Centers or Disease Control and Prevention (CDC) puts a $3,383 price tag on each employee who smokes: $1,760in lost productivity and $1,623 in excess medical expenditures. Employers can cut those costs and improve employees healthand productivity by helping people quit tobacco.

    Ideas or EmployersDevelop and implement a tobacco-ree workplace policy.

    Contact your state or local health department about the Utah Indoor Clean Air Act requirements and assistance in

    developing tobacco-ree policies. (1.877.220.3466).Post appropriate signage on buildings and the premises to inorm workers and patrons about the tobacco-ree policy.

    Provide cessation medications through health insurance.

    Provide counseling through a health plan-sponsored individual, group, or telephone counseling program.

    Develop a policy supporting participation in tobacco cessation activities during work time (ex-time).

    Promote the ree cessation services available through the Utah obacco Quit Line (1.888.567.RUH) and UtahQuitNet (utahquitnet.com).

    Resources

    Keep Your Business Healthy: Utah obacco-ree Workplace oolkit (www.tobaccoreeutah.org/shsworksitekit.pd ).Tis guide outlines three steps an employer can take to help employees quit using tobacco and to protect workers andpatrons rom secondhand smoke.

    Te Utah obacco Quit Line (1.888.567.RUH) and Utah QuitNet (utahquitnet.com). Tese services are oeredree o charge to Utah residents and have been proven to increase the likelihood o quitting tobacco successully.

    Te Utah Indoor Clean Air Act Business Guide (www.tobaccoreeutah.org/uicaa-busguide.htm). Te Business Guideis designed to help business owners and operators understand what the Utah Indoor Clean Air Act requires and howto best accomplish those requirements.

    Utahs obacco Prevention and Control Program website (www.tobaccoreeutah.org). Tis website contains extensiveinormation about policy development, local services, health care resources, tobacco laws, and tobaccodata and reports.

    Contact InormationFor more inormation on how to help your employees quit using tobacco or to request ree promotional materials, please callthe obacco Free Resource Line at 1.877.220.3466.

    Phone: 1-877-220-3466

    Email: [email protected]

    Website: www.tobaccoreeutah.org

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    Appendix E - 11: Utah Department o Health,VIOLENCE AND INJURY PREVENION Program Resource Sheet

    What is Workplace Violence?All worksites want their employees to be healthy and sae while at work. An estimated 1.7 million workers are injuredeach year during workplace assaults; in addition, violent workplace incidents account or 18% o all violent crime in theUnited States [Bureau o Justice Statistics, 2001]. A sae work environment, just like having a healthy employee, can increaseproductivity, increase employee morale, and decrease absenteeism.

    Te National Institute or Occupational Saety and Health denes workplace violence as any physical assault, threateningbehavior, or verbal abuse occurring in the workplace.

    Te workplace may be any location, either permanent or temporary, where an employee perorms any work-related duty.

    Ideas or EmployersWORKPLACE VIOLENCE PREVENION SRAEGIESIn order to prevent workplace violence, a commitment involving both management and sta needs to exist. Tedistribution o adequate prevention resources and the development o a violence-ree culture must be present withinan organization. An organization must take a multidisciplinary team approach where sta members rom dierentexpertise, disciplines, and departments are involved in planning and implementing a violence prevention program.In addition to creating a workplace violence prevention program, an organization should develop a documentedworkplace violence prevention policy.

    WORKPLACE VIOLENCE PREVENION POLICY

    A workplace violence prevention policy should clearly dene workplace violence and provide guidelines as what to doin a dangerous or emergency situation. Te policy should include risk reduction measures, reporting procedures, andenorcement or violating the policy. For a sample o a workplace violence prevention policy, log ontowww.hspolicy.utah.gov/pd/2-13.pd.

    Reerenceswww.health.utah.gov/vipp

    www.hspolicy.utah.gov/pd/2-13.pd

    Contact InormationPhone: (801) 538-6141

    Email: [email protected]

    Website: www.health.utah.gov/vipp

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    Appendix G: Employer Screening Recommendations

    Conducting annual employee health screenings is an important and useul part o your worksite health program. Te

    results rom health screenings can help you identiy the types o health promotion activities to implement. For instance, i alarge percentage o your employees has high blood pressure, you could address that through educational materials. I manyemployees have unhealthy BMIs, you might implement a weight management or nutrition campaign. Regular screenings canalso tell you i your employee wellness program is working over time and i you need to make adjustments.

    Te ollowing tests are recommended annual screenings or the workplace. Please discuss ways to conduct these screeningswith management, human resources, and your insurance carrier.

    otal CholesterolDesirable (240 mg/dL)Persons with these levels who have diagnosed coronary heart disease (CHD) or two or more o the ollowing risk actors areplaced in the High Risk category.

    Coronary Heart Disease Risk FactorsControllable Uncontrollable

    Cigarette Smoking Gender

    High Blood Pressure Heredity

    Low HDL Age

    Obesity

    Physical Inactivity

    Diabetes

    Note: Subtract one risk actor i you hae >60 mg/dL HDL

    HDL CholesterolHigh/Excellent (>60 mg/dL)

    Desirable (>40 mg/dL)

    Low/Less Healthy (

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    Blood GlucoseNon-Fasting

    Desirable (140 mg/dL)

    Fasting

    Desirable (126 mg/dL)

    Body Mass Index (BMI)Underweight (40)

    Blood PressureSystolic (mm/Hg) Diastolic (mm/Hg)

    Normal (120) AND Normal (160) OR Stage 2 (>100)

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    Appendix H-1: Wellness Council Bylaws Example

    AUHORIY and NAME

    Te XYZ COMPANY established the XYZ Wellness Council.

    MISSIONTe XYZ Wellness Council unctions to enhance and oster the health and well-being o the COMPANY employees.

    MEMBERSHIPEligibilityMembers must work in the COMPANY building(s) and maintain an interest in worksite wellness.

    Obligations o MembershipMembers must share a commitment to the mission and goals o the organization.

    Members must be willing to accept duties on assigned projects.

    Members must be able to serve as co-chair, which rotates annually.

    Members must include Wellness Council responsibilities in their Perormance Plans.

    ORGANIZAIONAL SRUCURE

    CompositionMembership will include two co-chairs, a minimum o 10 division representatives, and various members at large.

    Membership RepresentationTe ollowing COMPANY divisions will provide the basic membership:

    DIVISION 1 2 members

    DIVISION 2 2 members

    DIVISION 3 2 members

    DIVISION 4 2 members

    DIVISION 5 1 member

    DIVISION 6 1 member

    DIVISION 7 1 member (non-voting)

    Other COMPANY employees interested in participating on the XYZ Wellness Council are welcomed and will beconsidered Members at Large. Members at Large will not be required to include XYZ Wellness Council responsibilities intheir Perormance Plans.

    erm o O ceTe term o o ce or the co-chairs is one year beginning July 1. Te term o assignment or division representative memberswill be evaluated annually in June, in order to accommodate Perormance Plan changes, which are due in August.

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    Selection o O ceTe co-chair rotation was randomly selected in June 2009. Te rotation will repeatedly occur in the ollowing order.

    FY10 DIVISION 1FY11 DIVISION 2

    FY12 DIVISION 3

    FY13 DIVISION 4

    FY14 DIVISION 5

    Co-chair Responsibilities1. Attend and conduct all meetings.

    2. Oversee the planning o agendas or all meetings and the creation o committees.

    Notiy members o meetings 10 days in advance.

    Coordinate the documentation o meeting minutes and distribute them to members within 10 days.

    Act as a spokesperson or the group, advancing the purpose and positions o the XYZ Wellness Council through allappropriate means possible.

    Work with Human Resources and Division Directors to make committee member or replacement appointments asneeded.

    Submit or oversee the submission o initiative proposals to Human Resources and/or Senior Management.

    Member Responsibilities1. Attend and participate in all meetings or send a representative as necessary.

    2. Assist in the planning and implementation o council initiatives and projects.

    Promote council eorts among division sta.

    Perorm other duties as requested by the co-chairs.

    I unwilling or unable to actively participate as an XYZ Wellness Council member, assist co-chairs and divisiondirector with nding a replacement.

    DECISION MAKINGA. Present members will vote on all major decisions.

    B. Voting will occur only when there is a quorum o at least hal o the membership.

    Decisions made at meetings will be considered nal unless the majority o members choose to amend them.

    Only active and participating members will be called upon to vote.

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    GOALSA. Advise COMPANY Senior Management eam on the development o worksite wellness activities that improve ormaintain the physical, social, emotional, occupational, and environmental health o employees.

    B. Secure approval rom Human Resources and/or Senior Management eam on suggested strategies.

    C. Assess, plan, implement, and evaluate (as appropriate) various activities, policies, and environmental supports thatencourage and acilitate the health and well-being o XYZ employees.

    SRAEGIESA. Identiy gaps in COMPANY wellness programming and services.

    B. Prioritize COMPANY needs through assessments.

    C. Recommend or take actions that will improve employee wellness.

    Follow up to assure appropriate action has been taken.

    Evaluate outcomes and recommend modications to Senior Management eam as needed.

    Prepare an annual report or Senior Management eam.

    Present various project ndings at other meetings as requested.

    PERFORMANCE PLAN RESPONSIBILIIESA. Te COMPANY O ce o Human Resources approved the ollowing verbiage or XYZ Wellness Council members tobe included in their Perormance Plans.

    Responsibility # - XYZ Wellness Council (5%)

    Perormance will be rated as Passing when employee:

    As a member o the XYZ Wellness Council, is respon