Background
In recent years, Americans have experienced a shift of disease control to disease prevention. President George W. Bush and President Barack Obama both established initiatives for Americans to focus on healthy living in order to prevent chronic illness and premature death. These initiatives have prompted private corporations to establish Wellness Programs throughout the United States. As economic conditions decline, employers are looking to find benefits other than salaries to attract and retain employees. This is true for the public sector, as well.
A focus on America's physical health in conjunction with the current health care crisis has also brought employee wellness into the spotlight. With these factors in mind, members of the St. Johns County Sheriff's Office, along with Sheriff David Shoar began an initiative to provide a holistic wellness benefit to all full time employees.
In order to provide the most beneficial program, a committee has been designated to identify specific health risks to law enforcement personnel and to implement programs that will assists with these specific risks.
In one study, a group of police officers worked in Buffalo, New York, for at least 5 years between 1950 and 1979. Vital statistics on 98 percent of these officers revealed 661 deaths. Death certificates were obtained for 93 percent of these deaths. The officers' mortality from all causes combined was similar to the expected rate in the white male population. However, significantly increased mortality caused by cancer was found, particularly cancer of the digestive organs. The suicide rate was almost three times that of another working population. Mortality from circulatory diseases increased with increasing years as a police officer. Occupational factors may account for these findings. Police work involves the risk factors of high stress, irregular sleeping and eating habits, poor health habits, and lack of exercise. Both police officers and police organizations should make improved health a major goal. (Violanti, Vena, & Marshall, 1986)
The Commission for Accreditation for Law Enforcement Agencies also found that as an occupational group, law enforcement officers have greater morbidity and mortality rates than the general public, principally due to cardiovascular disease, colon cancer, and suicide. Various law enforcement agencies have calculated the cost of an in-service heart attack to be between $400,000 and $750,000. Surveys suggest heart disease accounts for 20 - 50% of early retirements and back problems for 15 - 35% (Collingwood et.al., 1988).
In fact, younger officers, under the age of 35, have a lower risk of medical problems than the average American, but those 35 and over have a higher risk. http://www.calea.org/Online/newsletter/No87/healthfitness.htm - _ftn4#_ftn4
One study of a major metropolitan police agency indicated that almost 50% of its officers had at least three of the five major risk factors for coronary heart disease - high cholesterol, smoking, obesity, inactivity, poor cardiovascular fitness, or high blood pressure (Commission of Accreditation for Law Enforcement).
Significance of the Issue in the United States
Wellness initiatives in the United States are steadily proving to be beneficial to the overall economic crisis as it pertains to health care. The St. Johns County Sheriff's Office is to not only attempting to provide benefits to employees to insure healthy and active lifestyles, the agency is also on a mission to minimize the rising health care insurance premiums and overall health care costs, as well as the impact of the expenditures toward Worker's Compensation claims and sick leave. The cost saving measures can be translates to savings to the county.
According to the Bailey Group, more than 81% of America's businesses with over fifty employees have implemented a wellness program. The businesses have continued with these programs because to them it is worth the cost.
Research and Proposed Program
In an effort to provide the most comprehensive program available to law enforcement personnel, the Sheriff's Office will be collaborating with Summit Health, a company that specializes in providing wellness screenings to public safety personnel.
Summit Health offers on-site "Single Station" Health Screenings. These on-site screenings include heart screening and evaluations, cholesterol screenings, diabetes, blood pressure and pulse rate, body mass index (BMI), body composition, waist to hip ratio, bone density, therapeutic massage, skin condition counseling, eye test, pulmonary assessment, fitness assessment, and over one thousand lab tests.
Summit Health in partnering with the St. Johns County Sheriff's Office has committed to a five year on-site program. There will be a designated area within the gym facility for Summit Health to perform the screenings for each employee throughout the year. The St. Johns County Sheriff's Office has agreed to provide the space at designated times in order to allow each employee to go through the screening at times that are convenient to each employee while they are on-duty. Summit Health is committed in assisting employees to become more empowered to make the lifestyle changes to improve their health, and an increased Return on Investment for the Sheriff's Office.
Summit Health is also dedicated in providing quality health screenings as it pertains to the specific needs of law enforcement personnel. Through contractual agreements, Summit has gained the knowledge that law enforcement has specific needs and concerns as it pertains to their health. The company has contracted with several physicians who have a extensive experience in addressing health risks specific to public safety. This will benefit Summit Health, because the St. Johns County Sheriff's Office will be the model for Summit Health in the North East Florida region for all public safety agencies.
For example, fire departments throughout the state have to comply with OSHA regulations as it pertains to their self contained breathing apparatus policies. In order to comply with administrative regulations, specific screenings must be conducted to insure each firefighter has a mask is properly fitted. Summit Health has the expertise and training in Self Contained Breathing Apparatus Training (SCBA).
Scope of Plan and Population Affected
Establishing a wellness program within the St. Johns County Sheriff's Office is an effective proactive measure the agency is taking to assist and support its employee's wellness. This program helps to establish healthier lifestyles in order to reduce health related issues which continue to kill thousands of law enforcement employees each year. The wellness program will include much more than physical exercise programs. In addition to physical fitness routines, the dimensions of the Wellness Program will include stress management, social support, nutrition guidance, and tobacco cessation programs.
Additionally there is a concern about obesity. Not only is obesity an epidemic throughout the United States, many law enforcement personnel facing the challenge of being overweight. This can be attributed to the lack of daily exercise, stress, and eating high fat foods. This is a major challenge because law enforcement officers have unique schedules and demanding jobs. The demand of the job contributes to deputies skipping meals and eating foods that are high in fat content or high caloric foods due convenience and time constraints.
A majority of employees within the agency work shifts and it is feasible for them to live an active lifestyle during the times they are assigned to day shifts, but once they transition to midnights it is common for the employee to go directly to sleep and not awake until it is time for work in the evening. Its difficult to consider an exercise regimen during these times. These factors help set the stage for Obesity. Obesity is not only visually unappealing, it brings negative attention from the community, and it is a major health hazards for law enforcement employees. Obesity has been linked to several health problems, including;
v Heart disease and stroke
v Diabetes
v Cancer
v Gallbladder disease and gallstones
v Osteoarthritis
v Breathing problems, such as sleep apnea
v Pulmonary embolisms
(http://www.webmd.com/cholesterol-management/obesity-health-risks)
Recent research has shows the more obese an individual is, the more likely he or she is to have health related issues. Employees can greatly reduce their risk of being diagnosed with one or more of the listed health related problems by joining the Wellness Program being offered by the St. Johns County Sheriff's Office. Employees who enroll in the Wellness Program will receive focused personalized training to prevent or reduce illnesses linked to obesity.
Another targeted health problem within the Wellness Program will include nutrition. Maintaining an overall healthy diet reduces the risk of heart disease, stroke, high blood pressure, and diabetes. Poor nutrition is a major factor in chronic illness within the agency. Some examples of common illnesses that stem from an unhealthy diet include an increased risk factor for several types of cancers, like endometrial cancer (cancer of the lining of the uterus), prostate, colon, gall bladder, and kidney cancer. A major goal of the Wellness Program is to establish healthy eating habits within the agency to prevent chronic illness.
The Wellness Program will bring in nutritional experts to assist employees in creating a plan to develop an overall better diet for participating employees. Active participants in the Wellness Program will learn the benefits of a better diet and better ways of controlling unhealthy eating habits. Employees will also receive knowledge on the dangers of high fat food and high caloric foods. Employees who already suffer from illness like diabetes will learn how to adjust their diets to further accommodate their own special needs. Individuals with diabetes will learn the importance of keeping up with their active lifestyles, and how to improve their overall wellness.
A health problem that will be targeted within the Wellness Program at the Sheriff's Office will be employee's cardiovascular fitness. A good cardiovascular fitness regimen will assist employees in becoming healthier and meeting fitness goals. Whether employees choose to spend time running, biking, swimming, or climbing stairs, each individual will receive motivation to improve their overall cardiovascular health. Not only will cardiovascular fitness assist with weight loss and improve the overall health of employees, it also greatly reduces the risk of heart disease. Health problems that can be prevented and potentially cured with a well rounded cardiovascular fitness program include:
v Improved blood cholesterol and triglyceride levels
v Improved heart function (blood flow and/or circulation)
v Improved lung function and oxygenation of the body
v Reduced risk of osteoporosis
v Improved muscle mass
http://www.webmd.com/fitness-exercise/guide/kick-up-with-cardio-exercise
Tobacco prevention and cessation is another health related issue within the law enforcement community. Typically law enforcement employees prefer to smoke, but there is an increasing number who choose to use smokeless tobacco. Each of these behaviors has inherent health risks, and the wellness program will assist employees in overcoming tobacco addiction by providing valuable information about the dangers oftobacco use.
With tobacco use being one of the leading preventable causes of disease and death in the United States, it's a major focus for the Wellness Program. Participants who are willing to "kick the habit," will learn tobacco use can lead to shortness of breath, lung diseases such as chronic bronchitis, heart disease, lung cancer, mouth and throat cancer. Additionally, the program will assist employees to resist cravings and provide alternatives to using tobacco; such as exercise. This will assist in revealing the overall emphasis on the holistic approach to the Wellness Program.
As the profession of law enforcement becomes increasingly demanding, stress management becomes a key issue in the profession. While stress can never be eliminated from everyday life or the workplace, effective coping skills can be developed and enhanced through education and training. Stress management skills lead to decreased rates of absence and more effective and productive workers. Stress has been shown to contribute to such physical conditions such as ulcers, high blood pressure and stroke. Stress reduction has a direct impact on improving physical health. Studies have proven that heart patients who attend stress management initiatives have 42% lower health care costs. Other studies have documented a 50% reduction in medical services use when stress management initiatives are implemented. Employee Assistance Program (EAP) professionals estimate that 20% of any workforce is affected by personal problems that can influence work performance (citation).
http://www.company-wellness-programs.com/corporate-health-promotion-programs-focus-on-stress-reduction/
* The St. Johns County Sheriff's Office will utilize the following stress reduction tactics/programs:
o Offer on-site yoga or meditation classes conducted by SJSO employees
o Organize confidential support groups among peers
o Sponsor stress management classes during the workday
o Utilize the employee assistance program (EAP) which includes both counseling and referral
http://www.company-wellness-programs.com/corporate-health-promotion-programs-focus-on-stress-reduction/
Employees will learn the importance of stress management as a benefit to their overall well-being. The Wellness Program will teach employees to be aware of their stress levels and to avoid potential stressful situations.
Employees will be instructed in relaxation techniques and will be provided with education about the Employee Assistance Program. This program provides counseling to employees and their immediate families. The Employee Assistance Program will also be available to help employees dealing with stressful life events. Seminars will be held throughout the year at the Sheriff's Office during hours that make it possible for all shifts to attend. The seminars will be offered by local psychiatrists and psychologists, who have existing E.A.P. contracts with the Sheriff's Office.
Seminars will be provided quarterly for employees on managing stress. Employees will learn that a poor diet and lack of exercise can attribute to their day to day stress. A major goal of the Wellness Program is to improve the overall quality of life by improving each employee's mental health.
Studies show that the following health related problems that can be associated with stress;
v Physical complaints (stomachaches, headaches, chest pains, nausea, and diarrhea and a sensation of numbness or tingling in your hands, arms, and face)
v Problems getting along with family members, friends, and teachers
v Changes in behavior at home (short temper, unexplained anger, crying for no reason)
v Regression -- behavior that is not age-appropriate
v Dysfunctional sleep patterns, including nightmares, too little sleep, difficulty falling asleep, or even oversleeping
v Communication difficulty or personality changes, such as becoming withdrawn or requiring much more attention than usual
v Impatience
http://www.webmd.com/balance/stress-management/all-stressed-out
As the profession of the law enforcement becomes more stressful employees need to be mindful of their blood pressure. Blood pressure is commonly defined as the force of blood pushing against blood vessel walls. High blood pressure; also called hypertension is dangerous because high blood pressure forces the heart to work harder to pump blood from the heart to the rest of the body's extremities. Common side effects of high blood pressure are hardening of the arteries or atherosclerosis, and the possibility of heart failure. Employees will learn the importance of regularly checking their blood pressure and each employee will have access to on-site blood pressure monitoring stations. Employees will learn the importance of talking with their physician about controlling high blood pressure. Factors that have been known to lead to high blood pressure, include;
v Smoking
v Being overweight or obese
v Lack of physical activity
v Too much salt in the diet
v Too much alcohol consumption (more than 1 to 2 drinks per day)
v Stress
v Age
v Genetics
v Family history of high blood pressure
v Chronic kidney disease
v Adrenal and thyroid disorders
http://www.webmd.com/hypertension-high-blood-pressure/guide/blood-pressure-causes
Scope of plan and population affected
The scope of the Wellness Program being offered by the St. Johns County Sheriff's Office is being offered only to the agency's 600 full-time employees. The Wellness Program will be offered to any full time employee who falls under one of the listed five (5) Divisions based functions:
v Division of Administration Services
v Division of Corrections
v Division of Law Enforcement Services
v Division of Financial Services
v Division of Support Services
The Wellness Program being offered to St. Johns County Sheriff's Office employees will be a voluntary enrollment program providing employees access, support, opportunity and encouragement needed to improve their overall health needs and fitness goals. By the St. Johns County Sheriff's Office establishing an agency wide, holistic approach to wellness. Healthier employees translates to minimizing the rise in health care cost annually as well as; reduced on the job injuries, higher employee productivity, reduced workers' compensation claims, reduced employee turnover, and a positive perception by the community as a whole.
Policy Values
Policy values reflected in the Wellness Program enacted today can produce a host of benefits for the employee and agency alike. The program will improve employees' personal fitness levels, providing multiple benefits to each employee including; a reduction in chronic illness, improved mental health, reduced risks of injury during required physical tasks, improved tolerance to fatigue, improved overall fitness, and improved mobility.
Policy Goals
Objectives of the Wellness Program include motivating all employees in making healthy life decisions not only pertaining to their duty status, but their entire life. A healthy workforce is a more efficient, productive workforce. The entire workforce in our group is a high risk population due to the nature of the job.
Although the program is aimed at 100% participation, the main target group is going to be the severe high risk group that has existing or potential chronic illnesses. The wellness program will be implemented with the goal of a 15% reduction in the at risk population associated with law enforcement profession.
The highest risk population will be determined by the results of the employee's initial health risk assessment and comprehensive wellness exam. The comprehensive exam for each employee is mandatory, but participation in the wellness program will be optional for employees. It is important to note that each employee's specific examination results will be confidential. However, a generalized benchmark will be made for each employee. During the second year of the program, and after the next comprehensive examination conducted by Summit Health the results will be compared to the results from the previous year. Summit will generate a report that compares employees' results from year to year.
If the employee shows significant improvement in areas such as weight loss, flexibility, cholesterol, and a significant life style change, there may be an incentive. Incentives will not be monetary, but will be in the form of additional vacation days, agency recognition, and preferred employee parking (non certified employees). Additionally, the Sheriff's Office will coordinate with local news organizations to spotlight those employees who have set goals and obtained them through the program. This of course is optional to the employee.
Conversely, if an employee continues with high risk behavior, such as smoking, and activities that lead to obesity, the Committee will move toward imposing any future insurance premium increases being distributed among that specific population.
All employees will be given the results of their initial wellness assessment and provided an opportunity to speak with a personal trainer and physicians while reviewing their results, assisting them with future ways to improve their health. The employee will be offered a wellness and physical fitness program tailored specifically for their lifestyle and overall needs.
Outputs utilized in the program are going to be numerous, including the most important, employee "buy in" in an effort to achieve 100% participation. A certified personal trainer will be on staff and available to employees up to five days a week. The personal trainer will be a full time employee of the Sheriff's Office and properly certified through the Cooper Institute.
Employees may call and schedule appointments with these trainers and the agency will provide employees up to 1 hour daily for wellness training up to a maximum of 3 hours weekly (with pay). The agency will provide a facility for the employee to participate in the program or the employee may utilize a physical fitness facility of their choice. The implementation of tobacco cessation programs, preventive health tests, and immunizations will also be utilized. Employee assistance programs as well as disease management programs will be implemented to assist with preexisting conditions.
Outcomes will be measured first and most important by the improvement of the employees overall wellness. The increase or decrease in wellness will be measured yearly by utilizing the same wellness check up that was performed at the onset of the program. Workers compensation benefits paid during this period is expected to dramatically decrease, and the amount t of workers' hours lost due to sick leave is also expected to decline. Increased productivity will be an obvious, observable goal as well as increased employee morale and satisfaction. Reduction of health care costs of 15% is the optimal goal as compared to other agencies in Florida that are comparable in size. It should be noted the program should be established for at least five years to adequately measure and evaluate the anticipated results.
Policy Formulation
The primary participant in the programs implementation or development would be the agencies' Chief Executive Officer (CEO), or in this case, the Sheriff. It is definitely worth noting that although our CEO supports the wellness program, another obstacle is related to funding. Although in the current budget climate, it is particularly difficult to justify what some would believe are frivolous programs, this initiative is designed primarily to deter long term costs as it pertains to illness.
Therefore, it is important that the agency establishes the goals and anticipated minimized health care costs with the St. Johns County Board of Commissioners. These components can be considered the most significant in implementing this program. The employees play a major part in the program implementation. If the agency employees choose not to take advantage of the wellness program, it is likely the funding can not and will not be allocated. The fact that the Sheriff and County Commission are accepting the program plays a huge role in our programs implementation.
The statistics from other organizations that have implemented similar programs have been able to report a tremendous success. These organizations have reported an average "Return on Investment" (ROI) "for every dollar spent on its wellness program. According to the American Heart Association, the average ROI is "$3.40 to $7.88" for every dollar spent. The bottom line figures speak for themselves, but the overall increased health of the agencies most important asset, its employees, should be the main driving force.
Policy Legitimation
Although Policy Formulation and Policy Legitimation are similar, both influence the program, the major participants involved in influence of the program, the major component. The major component that must be included in Legitimation is active physician participation in this part of the process. The physicians' approval for the wellness program would add a huge "stamp of approval" on the program, especially when it comes to funding and for the participants to realize a physician has reviewed and approved the program.
The support of the Sheriff's Office executive staff plays an instrumental role in the successful implementation of the wellness program. The creation of agency policy and procedures requiring the yearly health assessment and wellness exam to become mandatory as a condition of employment will prove vital to the success of the program.
The Agency
The St Johns County Sheriff's Office is the primary agency involved and the agency benefiting from this wellness program. The Sheriff's Office initiated this plan in response to the outrageous healthcare costs and the inherent chronic health problems facing law enforcement.
The St Johns County Health Department is partnering with the Sheriff's Office in order to bring this plan into fruition. The Health Department has the medical expertise (staff) and equipment to greatly assist the Sheriff's Office with the plan. The staff of the Health Department also have specialized training and would assist in free seminars and training on issues such as, tobacco cessation.
The Board of County Commissioners sets the annual budget for the Sheriff's Office. It is important for the County Commissioners to have a full understanding of the goals, outcomes, and outputs of the program in order to gain their support. This is not necessarily important for policy implementation, but it is understood that the Commission's support would be beneficial when communicating the goals of the program to the public. Additionally, gaining BCC support would be key in acquiring additional future funding for more specialized services in this Wellness Program.
Private Sources-
The SJSO has access to a non-budgetary controlled spending account known as the "Four Star Fund." This source of revenue is acquired by private donations made directly to the Sheriff's Office. This fund is a stand-alone source of money set apart from the money allotted to the Sheriff's Office through its annual budget. A portion of the proposed onsite gym will be paid for by this fund.
The SJSO has partnered with Summit Health in order to facilitate the wellness program. Summit Health is a large, professional organization specializing in creating specific wellness programs for an agency's needs. Summit Health will provide and assist with services for health risk assessments, an on-site fitness program, biometric screenings, and health education.
Tools of Public Policy
Legislation such as the Florida Heart and Lung Bill protect Law Enforcement from heart disease and lung disease. Under Florida statute 112.18 "presumption" is given to police and fireman that heart/lung disease was caused by employment so long as their pre-employment physical was normal. This legislation eliminates the normal protocol of having to prove elements pertaining to occupational disease found in FSS 440.151.
Three elements must be met to access this legislation and seek financial assistance. First, one must be an actively employed police/fireman. Second, one must have passed a pre-employment physical showing no health condition for the claim that is being filled. Lastly, the condition must be disabling. Meaning the illness affects one's rate of pay from previous levels. A diagnosis alone is not sufficient in meeting elements of this legislation (Commission of Accreditation for Law Enforcement). * http://lawyertampa.wordpress.com/2009/11/09/understanding-florida-statute-112-181-communicable-diseases/*
The Sheriff's Office annual budget will assist in the completion of this wellness program and funds must be sought within the budget to continue the program. A total cost of $70,796 will come from the annual budget and will be diverted from within the training section's budget of the SJSO during the first year of implementation. An annual cost of $58,006 will come from the annual budget in subsequent years.
Grants will be utilized to offset costs to the county. The SJSO has worked hard to locate and secure a Tobacco Cessation Grant for individuals employees. The program receives its funds through the Florida Department of Health and will be administered through Blue Cross Blue Shield of Florida.
The SJSO will contract out services with Summit Health. Summit Health will provide services such as biometric readings, which will set a baseline health level for all employees. This tool will act as an early warning system with blood tests and scans, which will allow proper goals, be set and a scientific way of comparing the results.
In an effort to be successful with this program, the SJSO has created a wellness committee. The information will be aggressively distributed agency wide. Individuals appointed to the committee will have a sound level of fitness and wellness education. Additionally, the SJSO will send each member to training where they can improve their knowledge and also gain certifications in wellness. This training will be conducted at the Cooper Institute. This committee will be the face of the program and will provide social encouragement and motivation for those participating in the program. There is often no greater encouragement than that from a friend or peer.
Key Definitions
The following definitions were defined by the Commission on Accreditation for Law Enforcement Agencies (CALEA):
* Health- A state of complete physical, mental, and emotional well-being.
* Physical Fitness- The ability to meet life's daily demands, without undue fatigue, while maintaining sufficient energy for leisure time pursuits and to overcome emergency situations that may arise personally and professionally.
* Cardiovascular endurance- Ability to take in and deliver oxygen to the working muscles to produce energy to sustain activity. Crucial to foot pursuits and gaining physical control over another.
* Anaerobic power- The ability to make short, intense bursts of maximal effort. Specifically the ability to run short distances.
* Muscular strength- The muscles ability to generate maximal force.
* Muscular endurance- Muscles ability to sustain sub-maximal force.
* Flexibility- Ability to use the available range of motion at given joint.
* Body composition- Ratio of fat to lean tissue.
Defined by Webster dictionary
* Wellness- The quality or state of being healthy in body and mind.
* Blood Pressure- Pressure exerted by the blood upon the walls of the blood vessels and arteries
o Congestive heart failure- Heart failure in which the heart is unable to maintain an adequate circulation of blood in the bodily tissues or to pump out the venous blood returned to it by veins.
Services Provided and Service Providers
· Health Risk Assessment/On-Site Comprehensive Health Screening will be provided by Summit Health. These screenings will be conducted annually at the St. Johns County Sheriff's Office. The health screenings will be provided to each employee during work hours. Each Comprehensive Health Screening will cost $347.00 per employee (less $250.00 wellness benefit):
http://www.summithealth.com/
* Tobacco Cessation Program will be provided by trained contracted counselors/professionals. This program will be funded through a grant from the Florida Department of Health and administered through Blue Cross Blue Shield of Florida. The Florida Public Employees Retirement System received a grant from the Florida Department of Health to help state employees quit smoking or chewing tobacco. These programs will be available through the St. Johns Public Health Department.
o This program will be administered by Blue Cross Blue Shield of Florida:
* The approved tobacco cessation programs are six to eight weeks
* Grant money will reimburse the tobacco cessation participant for taking a class up to $200 if a fee is charged after you complete the eight-week program
* The program will pay 100% of your out-of-pocket expenses for your office visit up to $200.00 and medication up to $500, for a total benefit of $700
Note: This program is effective on January 01, 2010 and will be fund for 18 months.
https://www.bcbsnd.com/members/wellness/ndpers/
* Physical Fitness activities will be coordinated and overseen by trained SJSO Physical Trainers. The St. Johns County Sheriff's Office will "Train the Trainers" in physical fitness disciplines. A sufficient amount of trainers will be trained to meet the needs of all SJSO personnel. SJSO Personnel will attend the Cooper Institute to obtain their certification.
o Personal training education costs $595.00 per student
o Certified Personal Trainer Examination costs $289.00 per student
o This specialized training will be funded by the SJSO budget allocated from training:
§ The Cooper Institute Certified Personal Trainer (CI-CPT) exam is accredited by the National Commission for Certifying Agencies (NCCA)
§ The CI-CPT exam is a stand-alone exam for persons interested in becoming a Certified Personal Trainer
§ The following personnel (current SJSO training staff) will be trained and educated in these health related disciplines:
* Sgt. Tom Hill
* Cpl. James Priester
* Dep. Chris Barns
* Dep. Eric Morea
* Dep. Craig Harrison
* Dep. Chuck Griffin
* Dep. Mike Plott
* Dep. Catherine Payne
* Dep. Keith Oke
* Dep. Sean Tice
The funding for this training will come from the SJSO annual training budget.
http://www.cooperinstitute.org/
* A physical fitness facility will be located and maintained at the Sheriff's Office. This facility will be funded by private donations from the Four Star Fund, and the budgeted cost will be approximately $62,119.00 (equipment/re-build). The facility will be located on the main property of the SJSO:
o The facility will contain equipment used both for strength training and cardio vascular health.
o Once the Fitness Facility is fully functional, agency members (only) will have 24 hour access to the facility. Note: SJSO Certified Fitness Instructors will be present in the facility Monday through Friday, 0800 hours through 1700 hours and available for consultation.
o Each employee will be provided with one-on-one fitness instruction based on availability. These sessions will need to be scheduled in advance.
· Re-build and Construction (Fitness Facility):
o ABC Construction Inc. evaluated the re-build and provided plans and an estimate. The re-build will occur within the office which was previously occupied by the St. Johns County Emergency Management Center (EOC)
o The Fitness Facility will comprise approximately 1200 sq/ft of this area and will be divided in to two rooms. One room will be allocated for a cardio vascular training and the other room will be dedicated to strength training. There will also be a small locker room with a full bathroom built in close proximity to the fitness area.
o The proposal for the complete project is $20,000.00
o The completion date will be set for June 2010
* Strength Training and Cardio Vascular Equipment: The Equipment will be purchased from Matrix International. The Wellness Committee has conducted research and selected the equipment based on the needs of the SJSO Wellness Program. The cost of the equipment is $42, 119.00. See Appendices for details regarding gym equipment.
· Nutrition/Weight Management Consultant/Education: A sufficient amount of SJSO Trainers will be trained so to meet the needs of all SJSO personnel. SJSO Personnel will attend the Cooper Institute to obtain their certification.
o These courses are provided on-line at a cost of $395.00 per student. The course are:
§ Providing Dietary Guidance
§ Weight Management Leadership
o The following individuals (current SJSO training staff) will be trained and educated in these health related disciplines:
* Sgt. Tom Hill
* Cpl. James Priester
* Dep. Chris Barnes
* Dep. Eric Morea
* Dep. Craig Harrison
* Dep. Chuck Griffin
* Dep. Mike Plott
* Dep. Catherine Payne
* Dep. Kieth Oke
* Dep. Sean Tice
Upon request, agency members will have access to one-on-one consultation with trained SJSO Nutrition/Weight Management Counselors. Dietary guidance and supervised weight management plans can be developed to meet the needs of agency members.
The funding for this training will come from the SJSO annual training budget.
http://www.cooperinstitute.org/
* In Service Training: All SJSO employees will attend a four hour block of instruction each year on how to develop and maintain a healthy lifestyle to promote over all wellness. The subject matter will range to how to deal with work place stress to topics related to proper diet combined with regular exercise. This instruction will be provided by trained SJSO employees and other outside medical and/or health related professionals.
Financing
Budget:
* Health Screening: $347.00 per employee * 598 employees ($347.00 is offset by $250.00 annual Wellness Benefit provided by insurance company for full physical)
o Net cost per employee is $97.00. 598 employees * $97.00 = $58,006.00 annually
o $58,006.00 annually for five years: $290,040.00
· Note: As part of the contract with Summit Health Screenings, they agreed to provide the SJSO with $5,000.00 worth of health education brochures at no cost
· Health and Wellness Training:
o Personal training education costs $595.00 per student * 10 trainers = $5950.00
o Certified Personal Trainer Examination costs $289.00 per student * 10 trainers = $2890.00
o Nutrition Consultant/Education cost $395.00 per student * 10 trainers = $3950.00
* Total training expense: $12790.00
Note: Additional money may need to be allocated towards training as current training members rotate out of the Training Section, which would require the above mentioned training for new unit members.
· Physical Fitness Facility:
o Re-model/Construction costs approximately $20,000.00
o Equipment costs approximately $42,119.00
Total: $62,119.00
· It should be noted that the Health and Wellness Training and Gym cost is a one-time expense, whereas the Health Screening costs will incur annually for 5 years
Budget Projection
2010: Initial Investment: $132,915.00
2012: Health Screenings: $58,006.00
2013: Health Screenings: $58,006.00
2014: Health Screenings: $58,006.00
2015: Health Screenings: $58,006.00
Total Projected Investment (5 years): $364,939.00
Private Donations (Four Star Fund): $62,119.00
Total Projected Investment less Private Donation: $302,820.00
Estimated Annual Cost to SJSO Budget: $302,820.00/5 years = $60,564.00
Estimated Annual Cost per Employee: $101.00
Role of Government:
This program will be developed and maintained by the St. Johns County Sheriff's Office for its employees. The program was initiated by a Directive from Sheriff David Shoar and is supported by management at all levels. The cost of this program is minimal therefore no additional budgetary funds will be requested or needed to develop and/or maintain this program. This program will serve as a pilot/model program to be implemented by other law enforcement and/or governmental entities in the future.
The St. Johns County Sheriff's Office is part of a self-funded insurance group comprised of multiple county government entities. Each one of these entities pays an amount (insurance premiums) for each employee into the insurance fund. When medical costs incur, the costs are paid by money from the overall county maintained insurance fund. These funds are administered through Blue Cross/Blue Shield (for an administration fee) so that the group members can be associated with, and realize the benefits of membership within the BC/BS network.
The goal of this wellness program is to reduce the overall health cost incurred by employee claims. These costs should be easily measured over the 5 year duration of the program. The belief is that a wellness program will increase employee health, combined with early detection will lessen overall health cost, requiring less monetary impact to the St. Johns County Sheriff's Office Insurance Fund.
Curtailing these medical costs will allow St. Johns County to maintain insurance premiums when other governmental agencies will be forced to raise premiums to cover the increasing cost of medical care.
The Equipment will be purchased from Matrix International. See Appendices for details regarding gym equipment.
Role of Technology
o Technology is critical in the role of an effective wellness program. Technological advancements have given medical experts the ability to screen individuals for disease and illness, and catch these ailments in an early stage when treatment is most effective.
§ Some of the technologies utilized in an effective health and wellness program are:
· Ultrasound
o This technology allows experts to see inside the human body while causing minimal inconvenience to the patient, zero pain associated with the procedure and zero negative health effects from utilization.
o Ultrasound is utilized to screen for cancers and can be utilized over a large portion of the body. Ultrasound is also used for effective heart screening and gives experts the ability to identify heart problems while they may be in the early stages of progression.
· Electrocardiogram (EKG)
o This technology measures the hearts rhythm and identifies abnormalities which may indicate heart related issues or illness.
· Laboratory testing
o These tests check blood and urine samples to evaluate cholesterol and glucose levels as well as identify several markers that may indicate the presence of disease.
· Fitness equipment
o Numerous pieces of fitness equipment will be available to every individual associated with this program. This equipment will not only help the individual improve his or her overall health, but also help target specific areas identified by the individual as needing improvement. Some of the equipment employs additional technologies to measure individual heart rates as well as gives an estimate of calories burned during exercise.
Timeline for Program Implementation and Analysis
Evaluation of program:
The evaluation of this program is based on objectives established for the successful implementation of the program, outputs utilized to achieve these objectives and finally, outcomes of the program measured against the objectives and outputs. This evaluation also takes into consideration, access, cost and quality of services as well as employee satisfaction with these measures. Utilizing these qualitative and quantitative measures, the evaluation of the Wellness Program proved it was not only cost effective, but capable of improving the health of the program participants.
The Wellness Program for the St. Johns County Sheriff's Office began on June 1, 2010. Approximately six hundred employees of the Sheriff's Office participated in the program and the results were analyzed on an annual basis, over a five year period. A baseline was established for the organization as a whole. This baseline measured each individual in the program and identified illness, disease and risk factors associated with common health problems. These ailments were combined into percentages of the programs participants and were re evaluated every year.
The first measure evaluated is cost. The initial startup cost associated with this program was $132,915.00. The annual cost to the Sheriff's Office is $100.94 per participant. The total cost to the Sheriff's Office associated with this program over the five year period is $302,820.00. The Sheriff's Office was also able to offset start up costs associated with this program by receiving federal grant money and donations from private sources. The annual costs associated with this program were maintained through contractual obligations with service providers as well as the Community Rating Status utilized by the St. Johns County Sheriff's Office insurance provider. This rating system evaluated the overall health of Sheriff's Office employees on an annual basis utilizing the same baseline performance measures identified in this wellness program. The wellness program was able to establish noticeable improvements in these categories and thus was able to minimize increases in the group insurance rate paid by the St. Johns County Sheriff's Office. The overall cost of health insurance provided to individual employees is fifteen percent lower than other Florida Counties. This percentage was established after evaluating the average increase in insurance premiums for Florida based insurance providers. This savings realized in dollar amounts was equivalent to $688,500.00 annually and $3,442,500.00 over the five year period. Utilizing these amounts, the program was able to achieve a return on investment of approximately $11.00 for every $1.00 spent. This return is well ahead of the averages established by the American Heart Association.
The second performance measure is access. The St. Johns County Sheriff's Office has made this program available to all employees and allows employees to visit their doctor while utilizing sick time. The Sheriff's Office also established an on site training facility incorporating full time Sheriff's Office staff, already assigned to the training division, to assist employees with their physical fitness needs.
The third performance measure is quality. The program was able to establish noticeable improvements in the overall percentage of individuals with recorded ailments. These improvements were based on annual base line testing done measuring health statistics of each individual involved in the program. Better than half of all participants showed improvement in body composition and approximately forty percent of participants improved their cholesterol, blood pressure and blood glucose levels. Nearly forty individuals involved in the program were identified to have early signs of heart disease as well as an additional twenty participants identified early stages of cancer. Surveys have been conducted with employees involved in the wellness program and over ninety percent indicate they are very satisfied with the program.
Using the Cost Effectiveness Analysis to evaluate this program, the results are clear. The marginal benefits realized from the implementation of this program plainly exceed the costs associated with the program. This program should be immediately adopted county wide.
Conclusion
The Wellness Program for St. Johns County Sheriff's Office employees has exceeded expectations. A large percentage of individuals involved with the program have received positive results and improved the quality of their health. This wellness program relies on primary and secondary prevention to control costs and improve or maintain a participant's quality of life. In addition, the program is largely popular amongst employees and ninety percent have a positive opinion of the program.
The Sheriff's Office has realized significant savings in insurance premiums since instituting this program. These savings more than pay for the minimal costs associated with running this program. Using the previously mentioned Cost Effectiveness Analysis, the program has exceeded the optimum point where marginal benefits clearly outweigh marginal costs.
This wellness program has realized significant gains, increasing employees overall health while reducing costs associated with their health care. Utilizing the "carrots and sticks" approach, employees have embraced this program and have thus realized its success. The program should be continued and implemented county wide. This program could also be implemented into any organization with minimal adjustment to the parameters already established.
