1. Multnomah County Employee Wellness Initiative Committee Board of County Commissioners Briefing September 4, 2012

2. Wellness Initiative Committee In FY12, the Chair requested Central HR to convene committee Members include: – Central HR Employee Benefits and Wellness – Health Department’s Community Wellness & Prevention Program – Labor Relations – Finance – AFSCME Local 88 representative Chartered to assess the County’s current wellness program and develop recommendations for an effective program

3. Committee First Steps 1. Analysis of employee health data from the County’s health insurance carriers 2. Development of an employee survey regarding wellness programs 3. Report of the current Wellness offer 4. Report of the current health policy work 5. Review of existing research on best practices and return on investment (ROI) for wellness programs across the Country

4. 1) Analysis of Employee Health Data Rates of overweight/obesity Rates of depression Diabetes management Tobacco use Preventive cancer screenings Childhood immunizations

5. 1) Analysis of Employee Health Data Multnomah County Employer Health Plan Multnomah County as a whole (BRFSS 6 data 2009) Oregon state (BRFSS 6 data 2010) Overweight/Obesity74.7% 1 55.6%60.9% Smoking Prevalence13.1% 2 15.3%17% Diabetes4.5% 3 6.2%7.2% Depression4.2% (ODS) 4 7.1% (Kaiser) 5 N/A7.1% How does Multnomah County compare? Footnotes available in Committee Report

6. 2) Employee Survey Countywide survey conducted in May 2012 19 questions to gauge preference and receptiveness to wellness program changes and demographic data 555 responses received, from all County departments 56.7% are current or past participants in wellness offers 28% were unfamiliar with wellness offers

7. 2) Employee Survey 92% identified one or more health concern

8. 2) Employee Survey 69% reported experiencing a barrier to participating in wellness activities

9. 3) Current Wellness Program 1 FTE providing service to 4500+ employees and 800+ retirees Two fitness centers, eight fitness equipment locations, fitness classes Small-scale wellness resources and incentives

10. 3) Current Wellness Program Embedded in medical plans: – Low/no cost routine physicals and preventive screenings – Disease management and care coordination – Some one-on-one coaching and health resources – Free Health Risk Assessment Some additional integration with dental plans

11. 4) Healthy Worksite Policies 0.5 FTE providing external coordination, planning, and technical assistance to employers across tri- county region Implementation of community-wide “It Starts Here” education campaign Development of internal health promoting policies, such as Tobacco Free Campus Policy and Healthy Food & Beverage Guidelines

12. 5) Review of Research and ROI Most effective programs: – have participation rates at 50% or higher – combine individual change strategies with a supportive cultural work environment – combine multiple components vs. targeting a single condition or risk behavior Average ROI was 3:1 Savings typically take 2-3 years to materialize

13. Committee Key Recommendations 1. Prioritize key health care issues for interventions 2. Implement obesity prevention and weight management interventions 3. Actively promote available resources for tobacco prevention and cessation 4. Increase support for and availability of preventive screenings and evidence-based self-management of stress and chronic diseases 5. Implement a coordinated infrastructure for on-going, sustained employee involvement in wellness activities 6. Implement a worksite wellness communications strategy

14. Future Next Steps Culture change takes multi-year investment in resources and may require realignment Existing FY13 Wellness budget offer: 1 FTE; $337k – funded through Risk Fund Consideration to seek internal/external consultant assistance to develop strategic plan Consideration to invest in staff resources to support initiatives and change effort

15. Questions?