Travis County Commssioners Court
December 23, 2003
The Closed Caption log for this Commissioners Court agenda item is provided by Travis County Internet Services. Since this file is derived from the Closed Captions created during live cablecasts, there are occasional spelling and grammatical errors. This Closed Caption log is not an official record the Commissioners Court Meeting and cannot be relied on for official purposes. For official records please contact the County Clerk at (512) 854-4722.
Item 15
Now let's go back to the item number 15, consider and take appropriate action on the Travis County wellness program.
>> thank you, judge, Commissioners. We're here to give you today a status on the wellness committee's activities on bring the comprehensive wellness program to Travis County. What we'd like to do is bring you up to date with what we have -- the idea is that we would come up with as a committee, and we're excited about those ideas, and I think from the results of the survey that went out to employees, they're as equally excited about the program. First of all, I would like sandy to give you a final report on the survey results.
>> cindy perkington, human resources. I've attached a summary of the responses from the employees to the wellness survey. We've got 1341 responses, which I think is an overwhelming response. You all have links that you can go in and look and read some of the comments, which is very interesting reading if you haven't done that already. What i'd like to do is summarize the results for you. And you'll find the summary on the blue page that you have in your backup. Over 78% of employees are more likely to attend wellness training if they can do so on county time. As you know, we had discussion on this issue and it was interesting to see what the employees thought. Exercise, nutrition and a healthy diet, stress management and weight management were the four most important topics employees said were important to them. Exercise also led as the type of support group employees said would be most helpful. So see that exercise is on everyone's mind. We asked the employees if on-site health screenings were offered at no cost to employees, what would they be interested in. 85% of employees said they would use a county health clinic staffed by a physician's assistant for minor office visits. Nearly 49% said an annual health assessment should be required of any employee on the health plan. This would facilitate early detection of major illnesses. We asked the employees to describe their current condition. This was interesting. Nearly 65% said they were nonsmokers. 53% said they did not exercise regularly and 34% said they were overweight by more than 25 pounds. Feeling better motivates nearly 95% of the employees to make healthier life-style decisions. And nearly 70% said a workout room with a shower would be useful. Of course, most wanted it right where they worked. While just over 61% said they would be likely to join a gym if the county subsidized the cost. A whopping 92% said they were in favor of the wellness program. And we got a lot of words of encouragement from the employees. That's a summary. I have attached an actual copy of the summary today and there's comments imbedded in the survey. If you go into the link you can click on it and read the actual comments that the employees had made. Any questions on the survey?
>> cindy, nice job on getting the information out to people. I guess the thing that might get my attention out of this, when people were reading the wellness explanation sheet, I think, and this is not something that I think that y'all were trying to lead them because we all as a court I think are in agreement that the thing that motivates people the most -- even beyond personal appearance is money. It was clear to me when we read it that the reason why -- one of the reasons why we can't get raises is because we have this astronomical increase in health care coverage. So that's. I think in most smanss we could go out and find that even though you might embark on some of this, it may not have anything to do with whether or not our premiums are going to continue to go up. And and all of a sudden it's kind of like, do you know what? We've got to use the same excuse. We can't give you raises because we can't keep up with the rising health care costs. So that will be something that I would want people to understand that, listen, if you're going to go out and do these things, don't just assume that all of a sudden you're going to get a raise. For example, if you were to say on number 9, nearly 70% said workout room with a shower, 61% said that they were likely to join something if the county would participate. Where you really kind of get the rubber meet the road on this kind of deal is say, okay, if we were willing to do that with you, help you pay for a gym usage, we would want some guarantee that you were going to stay involved in that program. And if you didn't stay involved in it for 12 months, well, then you're going to have to come back and pay, you know, what we had to put into it. Let's face it. I will tell you that just because I belonged to them for so many years, attrition in that industry is -- it's like motel rooms. I mean, people sign up. I will guarantee you the first two weeks of January after everybody has sat around and bulked up, starting probably -- [ laughter ] [overlapping speakers]. You want to buy stock in a health care facility or in a gym kind of a business, do it at the first of January and sell it before the 20th of January. [ laughter ] that's just the nature of what happens.
>> that's a very good point, Commissioner. [ laughter ] we want to be able to implement programs that can be monitored and that are measurable so that we can see what's happening with our employees, we can measure if we're seeing results because, you're right, a wellness program is not going to make the insurance costs go down. I mean, we need to be very diligent about that.
>> it's ratcheting up potentially as it has. And that's something that I want people to really understand. As I was reading the letter, and I thought it was very well worded, but it was real clear to me, that, do you know what, the reason that you can't get raises is because we can't get a %andle on health care costs. And if you will do these things -- let's face it, when you've got over 50% or -- 34% say that they are 25 pounds or greater overweight, I mean, that is something -- I mean, weight loss is one of those things that's a very slow process for most people unless you get somebody to lock you up for about a month. And not feed you. And so I want to make sure that people aren't being sent a message that this is going to be -- if you will do this, it will be sort of the predicate of us being able to come in and do something for you that you're going.. .
>> ... Not designed to reduce health care costs. It's designed to control health care costs and steer away from increases as much as we possibly can. What you've said is true. With regard to the gym and the contribution, the committee has talked about this. What we've talked about is using the same technique or processes that's used for tuition reimbursement. You go, you participate, you show evidence of it and then there's some form of reimbursement. We're going to talk in a few moments about the gym, about the costs and what he's been able to find out and negotiate, but that's absolutely true. And the wellness program is an individual benefit that will make an individual feel better about themselves, whether it's their health or whatever it is. Our point to the court today is to lay out some of the ideas the committee has come up with and sort of get your blessing and reaction that this is where we should go. One of the ideas and direction from the court was the newsletter. And nancy from health and human services -- I think she volunteered to handle the newsletter. I'd like her to talk about the first draft that was developed sohat we can get your approval on that.
>> good morning.
>> morning.
>> it's been my pleasure to be a part of this group. It's a very dynamic and creative and motivated gro p. So I think you'll be seeing in the future some pretty innovative and creative programs that will continue to augment the health of Travis County employees. That's one of the primary interests of the newsletter is to be able to have a variety of different mediums and means by which we can continue to encourage and motivate and share information, share ideas on resources so that we can collectively kind of pursue this improvement of health together. It's our hope that we can get this newsletter out every other month and that it will focus on some of the timely issues for that time period, for instance, February is american heart association month, and so we're hoping to, you know, come up with some programs and and kick justify something there and something in the works for that. So it's our hope that this newsletter will contribute to some of the efforts in terms of education, encouragements, resources, sharing of ideas. There's lots of different -- lots of different things that we would like to address. So this is our first stab at it. It hits on a lot of the topics that you all have talked about as well as some of the areas that we found from the survey that were the highlights. There's just a simple reminder on our employee assistance program. Stress reduction was a really large interest on the part of the county employees and we got a lot of feedback to the employee assistance program. So we want to encourage the things that the court is already supportive of and already has purchased these services on behalf of the county employees. But information on exercise, on nutrition and weight reduction and some scientific resources and information on some recent research to try to continue to educate.
>> (indiscernible). I guess if it's monthly and there's a cost associated with it also. I guess I?m trying to determine how does Travis County -- if it's scattered all over the place, how would you do that?
>> we did check with i.t. And we can certainly get this on our internet. So we definitely want to have an strong version that's out there and accessible right on the t.c. Net main page of the website. But not everybody has easy access to computers on a daily or even weekly basis if they're out in the field. So we would like to be able to have appropriate number of hard copies available for those employees that aren't on the computer as much as some of the office workers.
>> it would be available through the personnel -- in the different departments and offices, the hard copy.
>> okay. Thanks.
>> in the same way that you have to go get on to the intranet to go find this, I notice that a lot of times the group wide administrator sends out an e-mail. Is it possible that you can send out an e-mail saying that it's there or can the e-mail have the attachment of this electronic thing so it's like it find your way to your computer screen as opposed to that we've got to press people to go find it because some people don't even get to the intranet hardly ever because that's just not the nature of our jobs.
>> we're checking into all of our electronic options.
>> thanks, cindy.
>> public announcement.
>> right. I think what we can do -- this was created in publisher and not everybody has publisher on their desktop, but what we can do is to use the public address system by attaching the link so that they can click on the link and go there.
>> a lot of good information.
>> so for employees that do not know how to access via the link, can we do like a four h.r. Five-step -- four or five-step description that we distribute with the paychecks maybe one pay period?
>> an instruction on how to access it?
>> right.
>> sure, absolutely.
>> and is the intention that the newsletter be monthly.
>> every other month. Bimonthly.
>> okay. Where do you get blueberries, by the way? Are they at the market?
>> it's my understanding it never ceases to amaze me the talent that our county employees have. And one came to our attention a couple of -- a couple of them have come to our attention recently, dr. Crystal roach, who is on the committee, she has a ph.d. In education and recently she introduced us to a young lady named jessica watson, who is working as a law clerk in their office who has an undergraduate degree in new nutrition. She has also taught wellness and weight loss at Austin diagnostic clinic. We know of two success stories where our employees have gone through that program. They have successfully lost sufficient enough weight that now they are either on a reduced amount of medication or in some cases totally eliminated medication altogether.
>> that's great.
>> so we want to use those resources. And dr. Roach had a suggestion that we thought was -- that the committee thought was an excellent idea, that's a health care festival to kick off the wellness program, similar to what the kickoff is for combined charities where the festival would include if you look at your green sheet, there's several ideas that came up when we talked about the festival. The first was to allow all employees and others who are covered by the health plan to attend the festival. We have discussions presented by physicians with expertise in the area of cardiovascular disease, diabetes and other subjects like weight loss, those areas -- two points brought those to the surface. One was interest of employees and second was the cost drivers that our plan has had -- experience with. So we're trying to do two things. We're trying to address the cost drivers, but we're also trying to address the employees' need based on the survey results. We would conduct health care screenings like we have in the past, possibly the lion's club health care screening van, food preparation based on the heart association and diabetic association for food tasting, you might say, put on by a culinary school. I think dr. Welch has worked with the Austin community college culinary school to do this, so they may be a resource. And of course, exercising and walking paths, we would demonstrate some of the areas that can be walked and distances. And we'll talk more about that in a moment. And one of the suggestions was to have massage therapy on site at the festival. And the food tasting stations that you can have healthy nutritious food that really does taste good. I think that would be something that I would want to be sure of. [ laughter ]
>> come on... Brussel sprouts, why is it that they are so good for you, but taste so bad?
>> with a little salad dressing, they're not that bad.
>> if you get it to taste like a pork chop... [ laughter ]
>> we'll have to work on that one. That will be a challenge. That's the idea of our kickoff for the wellness program is a health festival. Of course, we would like to introduce that and be involved in the kickoff ceremony.
>> I know this is just the kickoff, but as we go through the year, we need to make sure we have some focal points that occur at some of our large campus type areas. I?m thinking we've got so many folks out at del valle. And granted you can only have a kickoff festival one place, but to make sure that there are things through the year that we may be able to have occur, say, out at del valle or at east command or west command, someplace where we have a large concentration so that they then get that extra attention.
>> an example, we had designed the programs to initially be offered in the campus area, but thin r. Then we wanted to show them the ropes, so to speak, to our other employees that work in the area, the east-west satellites, the del valle, airport, we'd like to move in that direction once we get a firmer foundation. Shortly after the festival we would introduce wellness projects and we're saying projects because that seems to be the phrase that kind of caught on. Each project would last about six weeks. It would deal with topics such as cardiovascular disease, smoking cessation, weight loss, those types of programs. It would be conducted by individuals with expertise in that particular area, so it might be -- if it's nutrition, it might be like the woman that I mentioned that works in the attorney general's office, maybe a doctor who has expertise in diabetes management. During the course of the project, after a certain number of be recognition of those employees who have participated. And at the end of the project, there would be -- they would be given a reward and a certificate. And we've not yet determined what that reward would be, but it would be something that would be of value to them, maybe a 25-dollar gift certificate to a steak house or maybe a salad -- soup and salad. [ laughter ]
>> cheese stake.
>> that would be.
>> cheesecake.
>> the program would be designed to reach out into the employee population and let employees know we're offering these programs and that they can enroll in them. These would be voluntary, but those who do enroll, they have a recognition and feeling of accomplishment. Along with these programs is a training and exercise session. And we will address that, and I think if you will look at the last page of the handout, there's a map and lee can pick up there and explain what that's about.
>> good morning. For the dper siesing part of the -- exercising part of the wellness program, we would like to implement a walking program. And I have a map here that shows different distances for each employee. Three miles, one mile and two miles. And what we're going to try to make it as a competitive type walking atmosphere where you're walking across america and you kind of log the distances that you walk each time you walk. For he have 45 minutes that you exercise, you would gain maybe 20 miles of credit and you kind of cht that on the map. And with the Austin recreation center, it's there for those who want to take showers and want to freshen up before they come back to work. And as far as the equipment, they have a variety of equipment there. And as far as the cost, they're probably the most affordable out of any of the facilities that I checked out in the city of Austin. I did a variety of background checks on corporate memberships throughout the city, and they range from anywhere from 18 to $55 for corporate membership. And a lot of people suggested the ymca, and the ymca is probably the most conducive because it's a family environment and they have so many programs there. And they're also payroll deducted. And a lot of people don't have checking accounts where you can do that through the county. So we wanted to get some type of program where they could go in and walk in and pay or -- with the county assistance, those type of things. But then again, with the budget being cut back, we don't want the county to up front too much of the funds, so the Austin recreation center prices are very reasonable. They give us $10 a month per membership. And the more months that you pay, the cheaper it gets. So you could go a whole year for $100. And I think most people could afford $100 a month for exercising even if you didn't go exercise. Most of us kind of --
>> 100 a year.
>> 100 a year, I mean. Sorry about that. But most of us throw away more than a 100 bucks a year doing nothing. I know five or six dollars a weekend, add that up and you've probably got it paid for a couple of time.
>> where is the Austin recreation center, though, in terms of fitness equipment?
>> excuse me?
>> the Austin recreation center has fitness equipment?
>> yes, sir.
>> what kind?
>> they have nautilus machines, they have free weights, they have treadmills, they have eliptic cycles and your basic arobic area and mats and things.
>> and showers.
>> they do have the showers, that was the main concern.
>> would that also extend to any of the city of Austin recreation centers? Because it may be that the closest thing to somebody may be where they work, but the other thing might be where do you live? For me I?m a regular over at the northwest recreation center. That's where I take jazzer sies, another thing I would put a plug in for, $33 a month, and yes, they do check attendance and you would get a feedback.
>> and how that works is each individual center has their own membership. So if you let them know you're with Travis County and they have a networking thing and they keep it in the 10 to 12-dollar range as far as membership. And you can get in other programs like you said with the jazzercise and arobics and you pay a monthly fee tho those things. And also one more thing. With the gold's gym, i've been doing research for those who live north of Austin, because there's not very many recreation centers for the city of Austin going past 183, so I looked into the gold's memberships. And they're about $18 a month for a corporate. And it's assuming that you have anywhere from 50 to 200 employees signing up because they base it on the numbers that they get. Like Commissioner Daugherty said, they end up making the money and if you show up, you show up. Once they get you to sign, they got you. With the gold's gym, they have different locations all over the city, and once you sign up for one location, you're a member at all of them. You don't have to sign up at different locations.
>> I?m looking at your map and I?m having fun with it. It's like okay, go down lavaca down the chilly parlor, back by the pizza up and past the arrest by's and down the subway. Turn -- [ laughter ]
>> into the torture. [ laughter ]
>> okay. The membership corporate with them is based on about 40 bucks, $40 for a membership for a corporate. And they have the automatic withdrawal from your checking account or your savings account.
>> (indiscernible).
>> then it's too expensive. So I was wondering if -- des dis-- I do know, especially with the one off of 183 and 51st, they have some great facilities down there. And you say hey, i'd like to join them, but they're a little too expensive. Is there any room to negotiate with them?
>> the best they could give me was the 40-dollar marker. They can go based on your income if you wanted to go and sign up and they base it on your income and they can do a report on that and they can get back to you and let you know how much you'll pay.
>> on an individual basis it may be worthwhile checking with the ymca because of the reduced rate based on salary, but for a group of employees, based on what we think the utilization would be, I think Austin recreation center and gold's gym gave us the most favorable membership rates.
>> if we handled that, though, the same way we have done with the tuition reimbursement, we don't say, well, we'll pay -- it's based on a per course reimbursement. And whether you take that at a.c.c., Which may be less expensive than going to the university of Texas, you may have to pay more if you choose a more expensive option. So it may be that we talk about a flat per month supplemental. And if you want to apply that flat rate towards Austin rec center, then it might get you more of what you're seeking. And if you still want to choose to do the ymca, it's not going to cover it entirely, but it's still helpful. It seems like that would be a more fair way than the way we've done it on tuition. That it is just a flat per course reimburseme that is brought in as opposed to, well, Margaret, you chose st.ed's wardz, therefore you get more money back as opposed to somebody that chose a.c.c. Or did it by telly commute or something.
>> I think we want to bring back to court that specific information. Our idea was that based on what the commission said earlier, you want to make sure that the employees have used, not just enrolled and joined as a member. So we would go on an active basis where we have evidence that somebody joined, and participated and then they would get their reimbursement.
>> we would have to develop some measurables.
>> right. I guess what we're asking the court today, is this what you want us to proceed with?
>> I think so. I think that if you have specific options to respond to, that would be good. But I do like the idea of the reimbursement from county being based on level of participation and frequency of use.
>> very good.
>> the other thing is I don't know if you ought to receive additional reimbursement becau you chose the most expensive one.
>> that's what I said. Just a flat rate.
>> the Austin rec option is new to me. I've passed that a thousand times and never knew what it was and never even wondered about it, but it's not that far from where we are.
>> I think they offer an excellent program and their equipment really is good. It's up to date.
>> do they have somebody there who will show someone how to use the equipment?
>> yeah, they have somebody that comes in at certain times, but i've talked to dan about that because I?m a certified trainer, so maybe after work if we s up a schedule where they can come in at the same time, I can meet them there.
>> sometimes people get hurt.
>> yeah, we don't want them to get hurt.
>> they need to use it properly.
>> this is new downtown, kind of west. Is the crime rate down there all right? [ laughter ] we want to worry about going west of -- [ laughter ]
>> it's at house park and -- [ laughter ] [overlapping speakers].
>> we're excited about the direction that this is going, and we -- in addition to what we've shared with you, we want to tell you that there are other resources out there. We think the Austin diagnostic program for weight loss has merit and is worth looking at in more detail, and we also have some other resources with seton hospital and we're planning to present our program. So we'll be bringing specific -- I?m going to try to meet with dr. Roash and jessica watson so we can formulate some specifics on the sessions and we'll bring this back to the court for direction. In the meantime we'll start working on the health care festival to get that organized.
>> I think that will work. It will work.
>> why don't we look at taking final action on some of these recommendations two weeks from today.
>> very good.
>> in addition to --
>> in line with the Daugherty suggestion, our employees ought to be ready for action, right?
>> that's right.
>> post holiday fitness.
>> and we should be ready for the first baitdzing suit sessions by may.
>> we're also wondering if we might be able to take a look at something that would be a fun group kind of thing. We are enough months out from the capital 10,000 that someone who has never wowkd or -- walked or run the cap 10, that starting now in terms of -- I know this has happened over at the state because I know that the attorney general has had training groups and the governor's office as well of basically kind of a group gig of okay, we're going to meet once or twice a week after work to get slowly but surely ready -- and I know that run tex does a lot of work with folks to try and help out and get people going on that kind of a track. But it seems like that might be a fun thing as well in terms of huge group of Travis County folks who have never run the cap 10 or walked it or whatever. That's a reasonable goal. It's in may.
>> we talked about some competitive between departments and walking groups and so forth. That would be an excellent idea. We have two individuals who have offered to be helping on the walking sessions, and that is jane franks and (indiscernible) both with its. And they're willing to participate and help. We also have a couple of individual who have been teaching aaerobics after work. And as I said, the geese are just as excited about this as we are. So we're looking forward to building some good relationships with different employees, different resources for this program.
>> do we need to approve the newsletter for distribution?
>> please.
>> so move.
>> second.
>> discussion? All in favor? That passes by unanimous vote. In addition, directions to proceed on the other recommendations.
>> that's correct. With the health care festival and developing the education sessions.
>> okay. Any objection to those directions from the court?
>> and trying to flesh out more potential reimbursement programs related to gyms, programs, anything to get people into an activity mode.
>> and we'll bring back specifics on the reimbursement.
>> that will include the ymca?
>> yes.
>> they can go apply anywhere.
>> I want to make sure that's included.
>> three dollars a month, unlimited -- $33 a month, jazzercise, unlimited classes.
>> what I would like to say, judge, is that the flu vaccinations that we've been asked if we could conduct additional sessions, and what we found out is --
>> no basically. Girling health care is out of the flu vaccine. We're advising our employees to check with their doctor because some individual practitioners still have flu vac teen available, you just need to call your doctor and see if they do. H.e.b. Has held the last of their flu clinics that we're aware of; however, they do -- the nasal version of the flu vaccine is still available. It's a bit more expensive; however, the manufacturer is currently offering a 25-dollar rebate. The cost of the flu mist at h.e.b. Is about $55. And if you count the rebate, then you would end up paying 25, $30, depending on where you got it. And that amount would be reimbursible under your flex account if you are doing flex. One thing if you are interested in the flu mist vaccine, it doesn't work exactly the same way as a shot, but you do need to call ahead and make an appointment with the pharmacist wherever you're going to go get it because they have to be certified in order to administer that to you. So you want to call ahead and make an appointment.
>> and employees should remember that they can apply this against their flexible spending.
>> thank you. Anything else today?
>> no, sir.
>> appreciate your work. Moving in the right direction.
>> thank you.
>> did we vote on that?
>> all in favor? We have now. It passes unanimously. [ laughter ]
Last Modified: Wednesday, December 24, 2003 7:26 AM