Flashback: The year was 1994, and Washoe County School District's self-insured health plan was on life support. The Reno, Nevada-based district was facing a 45 percent rate increase. Continued, drastic rate hikes would prove fatal to the program and injure the district's bottom line.
So the district did what many school leaders dream of. They heaped the problem right onto the backs of their workers. The surprise here is that this experiment seems to be working.
In 1984, the district's insurance committee recommended an employee wellness program that would focus on individual responsibility, provide incentives to develop and maintain a healthy lifestyle and--here's the clincher--be completely funded by employees.
Ten years later, the program's success can be seen in many ways. It has saved taxpayers millions. Employees have developed healthier lifestyles. Even students have picked up better living habits, as some teachers incorporate wellness into the classroom.
For a program that relies heavily on the carrot-and-the-stick approach, this plan operates mostly on the honor system. Here's how it works: Year round, $40 is deducted from each employee's monthly paycheck. The employees can redeem some or all of this money by participating in various programs, such as stopping smoking, exercising regularly and maintaining or losing weight. Employees track their progress. The program's philosophy encompasses not only physical, but also emotional, financial, intellectual, social and spiritual health.
Every step taken toward improved health reduces the monthly contribution by $10. For example, overweight employees who receive an annual health screening pay $30 each month. If those same employees also participate in one of the program's weight loss activities, they pay $20.
With up to eight annual activities, the program is mostly funded by the 7.5 percent of the district's workforce who don't take any preventive health measures and another 7.5 percent who pay a small contribution--roughly $10 each month--for not addressing a specific health risk, such as high blood pressure. About 6,000 employees wind up paying nothing, while the other 700 foot the bills.
"Only a handful of employees have voiced their concerns," says Superin-tendent Jim Hager. "There's far more support for what it does. We're enhancing people's quality of life and that will have a long-term effect," adds the finalist for the American Association of School Administrators' 2004 Super-intendent of the Year award.
In Washoe County, those who seek wellness head to the Web. After being hired as wellness coordinator in 2000, Aaron Hardy created an online presence, www.washoe.k12.nv.us/wellness, and a bimonthly newsletter. He also began sending daily wellness e-mails, featuring everything from exercise tips to recipes.
Participation, which is tracked by adding the number of people for each activity together, has soared from a few hundred in 1999-2000 to more than 10,500 in 2004, says Hardy. About 3 percent of retirees get involved, as well.
Among the most popular activities last year was the holiday weight challenge. Individuals weighed themselves before Thanksgiving, then again after the New Year. Out of the 2,000 participants, 1,600 received a gym bag for maintaining their weight.
Teacher Michael Connors credits the program for helping him shed close to 70 pounds. While his initial feelings about the contributions were negative, his attitude shifted. "The district was trying to set up an incentive system that was for my benefit," explains Connors, an English literature teacher at O'Brien Middle School. "It provided structure and support that really helped me."
Offerings have ranged from cholesterol screenings and food safety activities to wellness adventures, such as kayaking on Lake Tahoe and weekly bicycle trips. Back-to-back activities are held annually, such as this year's "Exercise for Life" and "Maintain, Don't Gain." Participants who completed the first activity received the top part of an exercise outfit, then the bottoms after finishing the latter.
"It drove participation rates through the roof," says Hardy. "Some people said they would be embarrassed if they only wore part of the outfit because other people would think they failed one of the activities."
The motivation to succeed in wellness has spilled over into some Washoe County classrooms, as well.
In Annalisa Walker's third-grade class at Florence Drake Elementary School, for example, students exercise each morning for 10 minutes and run laps around the playground. Trina Woelfle, a phys ed teacher at Wooster High School, offers students a four-week fitness challenge, requiring daily cardio exercises, a diet full of fruits and vegetables and plenty of water.
Costs and Rewards
Since 2000, the wellness program's costs have risen an estimated 15 percent each year due to increasing participation. The average being spent is $2.70 per employee per month, with $235,000 collected from employees last year. Of that, $176,000 was spent on activities. An estimated $40,000 covers Hardy's salary, and any remaining dollars are rolled into the following year's budget.
With mainly anecdotal success stories, administrators wanted stronger evidence of the program's effectiveness. So researchers at Brigham Young University in Provo, Utah, studied the program's impact on health-care costs and rates of absenteeism between 2001 and 2002.
Although no correlation was found between the program and short-term reductions in health-care costs, it was associated with a decline in worker absenteeism. On average, program participants missed three fewer workdays than non-participants. In the end, the district saved $15.60 for every program dollar spent that year, or more than $3 million total in absenteeism costs.
The program also creates a sense of collegiality and team spirit. Many activities bring together groups of employees that otherwise wouldn't interact with one another, says Laura Dancer, the district's assistant superintendent for human resources.
Ironically, a few years ago, while employees were getting in shape, the program's finances were deteriorating. In 1999, the former wellness coordinator embezzled nearly $40,000 from the program by creating fake invoices, Dancer says. At that point, the district implemented a strict check and balance system in all departments. This helped regain employee trust in the management of their contributions, she adds.
Staff members will soon get more for their money. The plan is to expand the program's mental health efforts beyond the current daily reading requirement.
Meanwhile, the program's success has attracted national attention, with accolades from the Public Risk Management Association and from U.S. Health and Human Services Secretary Tommy G. Thompson.
Ultimately, Dancer says she thinks the efforts will reduce the district's health-care costs. Until then, "It's just a real positive thing to inject into a workforce."
Washoe County (Nev.) School District
Number of schools: 88 (61 elementary, 11 middle and 16 high schools)
Number of Teachers: 3,746
Total number of district staff: 6,657
Student population: 60,411
Per-pupil expenditure (2002-2003): $7,045
Per-pupil expenditure for instruction (2002-2003): $5,000
Dropout rate (2002-2003): 2.8%
Ethnicity: White 60%, Hispanic 27%, Asian/Pacific Islander 6%, Black 4%, American Indian/Alaskan Native 3%
Est. 2003 population within district boundaries: 373,233
Median household income (2000): $45,815
Median price of a single-family home (2000): $161,600
Superintendent: James L. Hager, since 1999
Web site: www.washoe.k12.nv.us
Carol Patton is a freelance writer based in Las Vegas.