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Making school wellness programs work

How K12 districts save money by designing health programs that appeal to the employees who will benefit most
How do you design a wellness program that appeals to the employees who stand to gain the most? (Gettyimages.com: Drafter123)
How do you design a wellness program that appeals to the employees who stand to gain the most? (Gettyimages.com: Drafter123)

When Polk County Public Schools started its wellness program back in the late 1980s, the district hoped to get employees moving with weekend fun runs and weight-loss challenges.

“Everybody thought it was fluff,” says Debbie Zimmerman, who today manages the wellness program for the 96,000-student school district in Central Florida. “How are you going to make a difference, because all 11,000 employees aren’t going to come out (for a 5K) every weekend?”

Employee wellness programs have come a long way since then. Today, more schools provide a variety of services—from flu shots and exercise classes to biometric screenings and chronic disease management—to keep workers healthy.

Steps to a healthier district

Find out what your employees want. Before you get started, ask employees what they want out of their wellness program. Ways to save on out-of-pocket costs? Incentives to get moving? Help managing chronic diseases? Make sure the program matches their needs.

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And since 2014, 20 percent of schools offered diabetes screening (up from 12 percent in 2000), 31 percent provided nutrition education (up from 14 percent) and 30 percent offered weight management (up from 15 percent), according to a survey by the Centers for Disease Control and Prevention.

Half the schools surveyed had some sort of physical activity for employees, such as basketball leagues or jogging clubs. In an age of soaring health-care costs and high teacher turnover, successful wellness programs can help keep expenses down, boost productivity and help staff manage stress on the job.

But to reap the rewards, you have to attract the employees who stand to gain the most—as in, the ones who aren’t coming out for the 5K every weekend, who don’t work out regularly and who are at a higher risk for diabetes or heart disease. So how do you design a wellness program that appeals to them?

Steps to a healthier district (cont.)

Think beyond healthy food and fitness. Would employees benefit more from learning strategies to reduce stress or manage their time? Think about the whole person and don’t limit your wellness program to diet and exercise.

Solve real problems

Today the Polk County district supports an extensive wellness program, and Zimmerman leads a six-person team of health analysts and education specialists who teach classes and provide one-on-one coaching.

But the county also faces serious health challenges: Thirty-one percent of adults are obese and 28 percent report getting no physical activity outside of work, according to the Robert Wood Johnson Foundation’s 2016 county health rankings. In 2012, Lakeland-Winter Haven, Florida was ranked the seventh most obese metro area in the country by Gallup.

Or, as Zimmerman puts it, this population lives and breathes sweet tea and fried chicken—hard habits to break.

To be effective, the district’s wellness program had to address real problems.

Steps to a healthier district (cont.)

Be realistic. Even the best wellness program won’t turn everyone into marathon runners. That’s OK. Look for small steps that are attainable and will make a difference.

So when officials learned just 6 percent of age-eligible female employees were getting regular mammograms (which were covered under the district’s health insurance), they started in 2012 offering cancer screenings at schools in partnership with Tampa Bay Mobile Mammography, which provides the equipment and staff.

Five years later, the number of employees getting mammograms regularly had climbed to 85 percent.

And participation in the district’s diabetes management series—which comprises classes, exams and support groups and has no co-pays on medication—increased by 43 percent for the participants who had reported they followed their medication schedules.

Polk County also holds classes on diabetes prevention, tobacco cessation, healthy aging and even financial management to help people cope with the stress of having enough money for necessary expenses.

Steps to a healthier district (cont.)

Make it easy to use. Time-consuming, complicated, hard-to-access programs likely won’t attract much interest. Keep ease of access at the forefront when it comes to planning your wellness program.

It can be a lot to take in, and Zimmerman says her staff is constantly trying to make people aware of the services at health fairs, on Facebook and in a monthly newsletter—a recent story featured a man who lost 45 pounds with help from the wellness staff.

“Some people don’t believe we should be engaged in their health,” Zimmerman says. “For everyone who is perturbed, you have a thousand more lined up who say ‘I really do appreciate what you do.’”

Make it (very) accessible

For the Poudre School District in Fort Collins, Colorado, a comprehensive wellness program acts as a valuable recruiting tool in a health-conscious state, says Ashley Schwader, the district’s wellness manager.

The 29,000-student district provides employees with health and fitness assessments, access to exercise classes, mental health services, and help for people with chronic diseases.

In 2013 it added a walk-in health clinic that is free for employees and dependents on the district’s health plan. The facility, located in a nearby shopping center, is open after school and on weekends. It is run in partnership with University of Colorado Health and staffed by Associates in Family Medicine, a local medical practice.

“Ease of access is huge,” Schwader says. “This has been just a phenomenal way to remove barriers.”

Clinic use has grown every year, as have the savings. In October 2016, for instance, the clinic logged about 740 visits from employees and their dependents at a cost of about $73,900 to the district.

Steps to a healthier district (cont.)

Promote it. Ask yourself what’s more likely to resonate, a mass email or a five-minute presentation from a manager? Make sure employees know what is available to them.

Based on the average cost of an office visit and prescription at a primary care provider, those 740 visits would have cost $132,100 elsewhere, according to a district-commissioned report by University of Colorado Health. Schwader says that such savings have helped keep insurance premium increases low in recent years.

“When you compare what our premiums are to other districts, we’ve been able to keep those lower,” she says. “We know that investing in this will help us save money in the long run.”

The 3,000-student Slinger School District in Wisconsin, took a different approach to making health care accessible when it switched to a high deductible health insurance plan in 2013.

That same year the district began subscribing to HealthiestYou, a telemedicine service that connects users to physicians in a remote location via a smartphone app to diagnose and issue prescriptions, with no appointment or co-pay required.

The service was heavily marketed in the beginning as a way for employees to save on their out-of-pocket costs, says Superintendent Daren Sievers.

“We really bought the product so employees wouldn’t have to pay $200 to $300 for (in-person doctor) visits,” says Sievers, who gave school-by-school presentations on the service that first year. The marketing worked. In Slinger’s first year with HealthiestYou, 89 percent of employees used it.

The move to the high-deductible plan was an effort to save on rising premiums, which had gone up as much as 17 percent in previous years. Now the district pays $40,000 to offer HealthiestYou to all of its 225 benefited employees, and the district’s health insurance premiums have not increased. Sievers says those savings go toward salary increases.

Steps to a healthier district (cont.)

Get feedback. After a few months, check in with employees. What do they like? What hasn’t caught on? Always look for ways to improve.

Healthy snacking, walking

Jill Turley, an employee wellness expert at the Alliance for a Healthier Generation, tells district leaders looking to start wellness programs to conduct an interest survey with employees with these questions such as: What activities are they interested in? What times are most convenient?

Then, develop programs that will appeal to the majority. (If you already have a wellness program but missed this first step, it’s not too late.) “Figure out what’s going to speak to them,” Turley says. “Small steps are always better, especially if we’re wanting to motivate folks.”

That may include serving healthier snacks at staff meetings or starting an after-school walking club. Turley advises against kicking off with a six-week challenge that may scare off some people. Instead, appeal to their sense of community—a “we’re all in this together” model—and their responsibility to the students, she adds.

“We all talk about our personal health a lot,” Turley says, “but that role model piece can be a great motivator.”