Travis County Commssioners Court
January 20, 2004
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Item 30
We would call up the wellness program now, if we had people here to discuss it with us. That's item no. 30.
>> there's dan.
>> there's dan.
>> dan, do you want to start until your colleagues get here.
>> certainly.
>> 30 is to receive update and take appropriate action on Travis County employee wellness program.
>> good morning judge and Commissioners. We want to bring back the status on how the program standards. We are moving forward on health care festival. We would like the court's permission to purchase some ped meters and to also print some of the journal of medicines that we brought before the court last week. We discovered that we can put together a journal of our own -- pardon me, I'm a little winded. That we could do our own journal for just a fraction of the cost, it would be two to 2.50 a journal. We would like the court's permission to spend a thousand dollars to print those journals.
>> we believe that we have 500 employees who would use the journals.
>> we believe so. We think there will be between four and 500 employees participating in the various programs and in the walking especially, the walking and exercise programs we think will have that kind of participation. Wements would like permission to purchase 200 of the pedometers that we spoke to the court about last week. I believe that would cost about $1,200. So we are talking about spending roughly $2,100 to purchase the pedometers and also print the journals, which -- which we kind of take and revise and design our own journal with Travis County logo. Can you pass that around to the court?
>> alicia, is this the point where you and susan or diana may need to get into the source of the funding? Because I think that you all have briefed some of us about -- about where the money ought to come out of or not come out of.
>> yes. Good morning, alicia perez, administrative operations. I have been working with the auditor and the auditor has been working with us to try to determine the appropriate source for the funding of all of the wellness and later on I think we can talk about risk. We have had meetings with some of the court members that were available and discussed to you the options that were available. And the options that you have is to fund these items from -- from the hospital fund, but right now that is not possible because we would have to amend that fund in order for you to be able to fund these. Then the other is your allocated reserve, which would be general fund. So what we have looked at -- what we had looked at last week when we brought you the issues on wellness was about 54,000. If the court wishes to fund any of these items, we would ask, between 25, 30,000 and then let us then move forward. If the -- if the ideas for funding or the -- or the issues that need funding would not use up all that money, then we would not use it, it would drop to ending fund balance. But if we knew we had a designated pot, a lot less than what we were asking for, clearly then that would facilitate I think moving items forward. In terms of the source, those are the options that -- that you have. I do believe that at this point in time it is not possible to take from the health fund because the resolution as it is written now would not provide for it. We would also want to be very protective of that fund because we would want for there to be a very healthy reserve to cover us in future years.
>> what would keep us from taking this from the health facilities development corporation? If the facility is not necessarily a building but something that facilitates health. This is back to my first year law --
>> there --
>> there could be another possibility if I were a taxpayer, another source were available, maybe I would prefer that the county would use that one first. But it does seem to me that the allocated reserve would be appropriate, also. We are talking about a small amount of money, but if we are to get employees really reved up about participating, then I think a small gesture of this kind probably is a good one.
>> we are not limited-- it can be transferred into the general fund, but I don't know if there are issues after the budget has already been adopted what we can do in terms of a corporation usage of that. Because it's actually a grant, do grants --
>> we don't need to decide today. What you all are here to say, though, is that the risk management fund is not a good source. We ought to think of the allocated reserve or health facilities, let's just take a week to look at that and maybe try to land on exactly what amount of money we are talking about. Last week, we ended up at about 10 or $12,000 total and not the much larger amount.
>> that's correct.
>> right? So we are still, I guess, I mean even if we exceed where we were last week, it would be around 15,000.
>> we were talking more like 25. Just to give us a little leeway.
>> well, plus the incentives.
>> yes.
>> you are coming back to the court before you spend this money anyway, right?
>> oh, yes. Absolutely.
>> so why don't we do that then? Let's -- but I think we ought to know what the incentives are. The other thought that I had is we have been sort of weight focused. But if I had high blood pressure, by the way I don't, but if I had high blood pressure and I saw this program, I would want to see that there is a drop in high blood pressure component, also. To get me out there to working. And -- and as well as cholesterol and -- we had not discussed that here, I don't know whether the committee had thought about it or not. But I -- I guess seems to me that I would look at the diseases, the problems that seem to be driving health insurance increases and then make sure that whatever little incentive programs that we have in place are designed to address each of them. Right?
>> yes, sir.
>> same thing on smoking. Whatever. If -- I mean if -- and -- by being comprehensive I think that we are likely to get a lot more employees to participate.
>> the -- the pilot projects that we have presented in our backup a couple of weeks ago do outline some of these programs for lowering cholesterol through diet, nutrition, exercise, managing high blood pressure again through diet and exercise. So the community has looked -- the committee has looked at that as a long-term project. The festival is the kickoff for these projects where employees can be oriented as to what the projects include and at that point enroll or sign up to attend the classes. We also anticipate having speakers, physicians, who are experts in the area that you just mentioned, judge, to elaborate on the care and history of the -- of the disease and how it can be treated and also how it can be prevented and managed. So those are some of the aspects that the -- both the festival and the pilot projects are rolling into -- sort of a curriculum type of format.
>> but are we being as comprehensive with our incentive program, though? We haven't talked about that before. Like we had talked about losing weight.
>> right.
>> > when you think about it, though. If you suffer from high blood pressure, serious cholesterol, some of the other diseases, I guess that you are just as likely to cost us a whole lot in health insurance as a person who is overweight.
>> that's why the performance measures that we discussed last week in terms of the debate within the committee do really just measure the pounds lost or do you do a comprehensive blood analysis at the beginning of a pilot and then test it afterwards. Test for blood sugar, cholesterol, blood pressure, weight and -- and fat -- body content were some of the one that's we discussed. And what do you use as the measure of success? So I think we will still working through some of those issues and absolutely agree with you, I would much prefer a comprehensive measure of the success, that will through all of those.
>> we -- that will include all of those.
>> we do have -- the court suggested a pledge or end rollment form that the employees would sign pledging that if they participate they are committed to achieving certain goals. And we have got those in draft form. We would like to bring it back to court next week. And for your review and approval. Those do have performance measures attached to each one. What would be expected, what the commitment would be from the employees who do enroll.
>> I'm glad to hear you say that, dan, because I know that I have been asked a few questions that i've been trying to pass along to the department as far as how do you implement or how do we actually go about looking at the performance measures as far as for an example reducing weight. From what time to what time, if we start here at -- at one month and we end up three months down the road, we lose 30 pounds, whose going to check that out and things of that nature to make sure that the beginning weight is -- is in the right position and also the ending weight as far as incentives are concerned. Of course, have you all been getting phone calls on those particular things, also, as far as determining what -- what some of the measures would be and things of that nature as far as the incentives packets?
>> we have gotten some phone calls and a couple of e-mails. I think employees are waiting to see what comes out in the way of the measures, but there have been some inquiries. I would tell the court that we had some overwhelming results from just our discussions with the court on feedback from the employees. We expected a good number of participating -- we expect a good number of participating employees. So we have gotten some input from employees, what they would like to see if the way of measures. Mainly in the walking and exercise area.
>> who would be the main contact person, in your department, if there are employees that are listening to this now, and maybe have specific questions, that they may need answers to instead of -- who would be the main person to contact in your shop?
>> I guess that would be me.
>> okay.
>> contact me, my extension is 49499.
>> that's good to hear because when you -- of course as I stated earlier, when you get into this program, sometimes people may be sitting in the wrong direction as far as trying to acquire the right information, I'm glad that you stated that so that we can have for the record that source of contact, thank you, dan.
>>
>> [one moment please for change in captioners]
>>
>>
>> there are other measures. And even if you lose weight right away, it doesn't mean that necessarily these things are going to go down, there may be other things that you need to do and employees really need to be able to monitor that. So that was one of the things that we just talked about is that if -- you know, if we could get that done, I don't know, say for -- I mean, just right off the top of my head, $10 or $12, employees may well be able to pay that to go monitor themselves on an ongoing basis if we could have an arrangement with a testing facility. Is there a way for to us get the lions club to go to maybe four satellite offices four different mornings early like 7:30 to 9:30?
>> I can certainly check with them. One thing that those employees complained about is us sort of favoring those who work at the central location downtown and they happen to be right on that, which is why I feel a little guilty. If we can get them to go out there it may increase participation and promote fairness at the same time. We can do the weight -- can we do the fatness test?
>> [indiscernible]
>> set of scales and privacy.
>> yeah.
>> and with the right instrument fairness, the fatness is fairly easy to do?
>> easy to do.
>> I think that we ought to just go ahead and try to reduce all of this to writing, bring it back to court, implement it and if we are targeting February 12th as the beginning date, that will give us a few more weeks to get this stuff ready, right? The other thing would be fair incentives, the more I think about that, it momma sense to take them from the corporations if they can. We will get legal to look at that, health facilities or the housing finance -- for those listening right now, the price tag for employee health in Travis County is $31 million, a little bit more than 6,000 per employee. We took a big hit this year and what we are trying to do is slow down the rate of growth if not reverse it. At the same time, a healthy workforce is likely to be a lot more productive the health books say, we are trying to do that, also. Judge in the mean team can we go ahead and order the pedometers and booklets, that would definitely be incorporate into a walking program and that we have gotten tremendous response from and commitment.
>> how much is that?
>> the --
>> $2,100.
>> the pedometers would be about 650, the -- the printing on the books we figure were about 250, $2.50, so 250 would be about $625.
>> the total?
>> approximately -- well, about $1,800.
>> why don't we identify the corporation as a source of funding, health facilities, housing finance, in that order. If there's a problem we will deal with that next week.
>> with that understanding I move approval.
>> seems to me that -- that if in fact we have a location where you can come and get tested, then maybe we ought to promote distribution on those occasions. As well as signing of that little pledge form. I guess the question is whether this legally remains county property or whether I guess part of the incentives could well be transfer of ownership.
>> that's right. You get your $6 -- [laughter]
>> I -- I think that the -- that the -- the main question and -- barbara jump in, the incentives I think are that the -- the ifier things and probably the corporation is more appropriate there. But I mean there is a problem with the county purchasing wellness type of things like pedometers? I mean we have done that for the sheriff's office, we have purchased exercise equipment and things like that. It's not as though we have not done that for some departments. We simply haven't done it for the whole workforce. I mean we know why we have fitness facilities for the sheriff, but I think that you can argue that it is in the county's best interests for everyone to -- to be fit to a degree. So, you know, I don't know that this is against public purpose.
>> I think there's two ways to look at something like the pedometer. One is that you can say if you were intending for the employee to be able to keep it and you put a condition on that, say the goal of the program is to do 10,000 steps every day for three months, and at that point once an employee has done that, then they have earned the right to keep the peed meter forever and it requires them to have a pedometer kind of thing, it saves them the problem of having to go out and buy one, which is probably more valuable than the actual pedometer. Because the time it takes to go find one and buy one is --
>> what would the cost for those be?
>> if it became a form of compensation and an employee benefit as a -- as a function of -- of your authority to set compensation, I think that you could also justify it as employee compensation. You could also say to make it even easier, anyone who participates and reports on what they have done, even if they don't make their 10,000 k a day for three months, but they comply with the reporting requirements of the pilot project, which will give us information on -- in fact more valuable information possibly because then we find out how effective it is in terms of people being -- of having the incentive to move forward on the -- on the wellness activities that we need to have and do. Because if we are doing something and they are not completing the promise, that's as valuable in information as if they are doing something and completing it and doing their 10,000 miles -- I mean 10,000 steps. [laughter] I'm going from --
>> if those that are viewing, the committee looked at, like there are states, like colorado, for instance, that participate in that program and got their people pedometers, we are not talking about sophisticated measuring devices. We are talking when you put on your belt and measure the number of steps that you take. So it's a very inexpensive but simple device that anyone could use with the idea that increasing your activity is better. Some people can increase it a lot. Some just a little bit. Increase in activity is better. So we had looked at what some other states had done where they provided them to all of their employees. And they found some fairly good results from that. The reason that the committee liked that approach is there are people that could afford to join a health club and would or jog for 45 minutes a day and there are people who can't. So the thinking was even if you can't increase the activity throughout the door, walk a little bit further wherever you are going, give you some feedback that it would benefit, everyone could work in more steps, more activity where they may not be able to work in an hour a day. So that we would be benefiting all -- all of our employees. That was kind of the thinking of the committee.
>> and the pedometer really is a tool, basic tool used in measure in really all of the pilot projects are being offered as including the walking and exercise programs. So --
>> judge, you -- judge you made a comment earlier, I guess related to the -- let me go back to the subject matter. Dan, can you tell me exactly when it would require for the employees of Travis County to have the [indiscernible] form in place prior to this February date, date that we are looking at to maybe suggest, well, i'll going to try to lose how many -- how much weight by a certain amount of time. Whatever you need to do to lose weight, whatever. A program that they would like to get involved in. Is there a specific time that these pledge forms must be submitted for incentives in the pledge form with all -- with -- will all coincide with one another and be mutually beneficial to each other, is there any -- any thought into that?
>> there will be a booth set up at the festival for employees to come by and sign up for the walking and exercise or any of the pilot projects. And at that point they will be given the pledge form. Before they initiate involvement with either of the projects or the walking, they will have to complete the pledge form. Provide the -- whatever the -- whatever the particular program requires in the way of weight. So it will be at the initiation of the project or the walking and exercise program, which really follows immediately after the festival. We would also --
>> we would like to go out to some of the satellites, so the pledge forms may be at different times, not all at once, because we heard from employees that they couldn't all come. So they will be initiated in terms of say that we go out to precinct 4, for example. And -- and have a mini festival there. We are able to then have volunteers, for walking in that area, we are able to set up the testing to go to that area. So they may be at different periods of times and not all at one time. We can measure the groups in terms of their goals within that particular group and then measure groups against each other.
>> and we do want to reiterate that we are talking with t.n.r. About their -- their department's health care festival, working with tcso, costs for training officer about their program. We are trying to integrate our wellness, the county wellness program with specific department programs that are ongoing.
>> are we able to -- if we start February 12th, status report, say this is a six-month program, kind of throw us -- that will throw us down to what, August 12th, would be six months later, but a three month go to interim report.
>> yes. We had thought about measuring the success in a three-month period, which would maybe require monthly reports from each of the participants, would want to set it up on the internet will have to develop methods -- a methodology for which to test success or to measure success. At some of the outlying offices. We would hope that at least the pilots are in a three-month period, so that you could measure participation, perhaps weight loss, exercise, time, some of your vital statistics could also be measured in that time. And then out of -- out of the first batch, if we find that some programs are more successful than others, then we carry those forward.
>> my final question is this, when I play golf tournaments for different non-profits and organizations, it amazes me what prizes they come up with. Half of which are probably sort of health-related, a free round of golf, this, that. That are donated by the different companies for marketing purposes, I guess. Do we think that would be too time consuming for us to try to pursue something like that?
>> no. I don't think so. I think a lot of people may have the incentive, if they could play a round of golf with you or Commissioner Daugherty tee or some other activities, if you don't mind us using that, you know, I think that would be a good incentive. Other people in the community, too. But I think that's a great idea, it would not be too time consuming for us. Things that maybe will not be very costly for the county, but will serve as a -- as an incentive for the employees.
>> I had in mind zero cost to the county. [laughter]
>> I think we can probably minimize the cost.
>> do we give the committee two weeks then to report back and hopefully we will have all of the documents.
>> yeah. By then?
>> yes.
>> anything further on this item today?
>> I would like to ask a couple of questions. Are we talking about 200 pedometers for $650.
>> yes.
>> so we have gotten that pedometer price down to $3?
>> no.
>> a little over 3 bucks.
>> no, it's $5.60.
>> for 200.
>> so that's $1,300?
>> yes.
>> not 650?
>> then we got planners at 250 each, we are going to do 500 of them.
>> I have 250.
>> you have 250. That's for 90 days. Those are 90-day planners, so at 90 days, if somebody uses them they have to have another one.
>> I think it's longer than that.
>> this one is --
>> with the 90-day planner, you keep the book and just recycle it, we can reboo those over at the print shop. We have it at the county. We have all of the materials and everything set up already.
>> I don't have -- I don't have, you know, a -- a big issue with -- with embarking on this wellness program. But I made the comment early on, I stand by it. That is exercise is something that's personal. And there probably isn't anything in the world that -- that has a more -- has a greater dropoff rate than what people are willing to start but how long will they continue? I mean, I would much rather see a program where you were reimbursed for a pedometer or a planner if that's something that you got involved with -- I mean you bought it. I mean you bought your pedometer and you bought -- if you stayed with it six months, nine months or whatever, I mean, maybe we would have some sort of a program where we would buy it. But -- but, you know, I will tell ya, you will eventually not have 200 pedometers after a while I will guarantee you won't have 200. I don't know how many days that will be. And if you collect the books and look at the books and see what they are filled out, you will find that most of them are not going to be used. Now, I'm willing to challenge somebody on that. I mean, hey, if you want to play golf with me, just ask me, you know, i'll play golf with you any time that you want to. That I'm not in court. But I'm -- I don't want us to I don't want to see us getting to a point where we are spending money on something that I fear that -- that we are not going to really see people follow up with. I think that it's a great idea. We have always said this is a personal thing. If you personally can't get motivated and activated by the fact that it's your body, it could be a raise. I mean if that's -- if we really are talking about it, I think this is really what we are talking about, what can we give people the incentive to do to live healthier lives so that we don't have to watch escalating health care costs and -- but I really am more of a show me that you are really going to do this, I will be more inclined to vote for spending moneys up front, but I'm very apprehensive. About that, I just wanted you to know that. You are going to bring us back information, so thank you, judge. Any more councilmembers or questions? There is a motion outstanding, right? What was that total cost again?
>> $1,745.
>> okay. The motion is to take it from the health facilities development corporation or housing finance corporation in that order. One or the other if there's a problem with health facilities, we take it from -- from housing finance, which we have been told is we may use a lot more generally. Than health facilities. If there's an issue with that, we will have it back on next week. Any more discussion of the motion?
>> I think that it's worth a try. Let's see where we can get. But let's not forget whether we do it by ourselves individually or we do it as a group, it comes down whether we are going to have enough money or raises for employees or do we need to continue investing that money in health care costs. Rising health care costs.
>> even if we just -- even if we go back to what used to be our -- our usual increase of -- of 12 to 15%. It's a lot better than double that. Which it was this last time. Which is a lot of money over a year's time.
>> we can't do both things. Raises and address health care costs. And but I think that it's worth it. I think that it's -- it really feels good to be healthy.
>> we are told that these are the kinds of diseases for individual -- where individual effort would help a whole lot. And these programs have worked at some places. But I guess in the end it really boils down to the individual. You ought to have incentive, but if a little more incentive will help, I don't see any problem with us providing that. Any more discussion? We will have it back on in two weeks. All in favor? Show Commissioners Gomez, Davis, Sonleitner, Biscoe voting in favor. Commissioner Daugherty voting against.
>> thank you.
>> thank you.
>> see you in a couple of weeks.
Last Modified: TUesday, January 21, 2004 8:25 AM