Travis County Commssioners Court
February 10, 2004
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 8
Number 8, if we have our wellness committee members nearby. Consider and take appropriate action on recommendations for the Travis County employee wellness program. Okay. While the wellness committee is getting together --
>> I'm sure they're walking.
>> there's alicia.
>> are you all ready?
>> trying to get last minute notices out. Good morning, alicia perez, executive manager for administrative operations.
>> good morning.
>> we are here to discuss a budget for the wellness program. And we call it wellness program preliminary budget. It -- just in case there's discussions or suggestions from the court. We can go ahead and amend it. The wellness program is a program initiated by the Commissioners court and it is to assist all county employees to improve their health and promote overall well innocence the organization. -- wellness in the organization. We will be having a festival on Thursday, this coming Thursday, at the granger building, starts at 12:00, runs until about 4:00. We have numerous activities for employees that would like to attend the festival and everyone is invited. We will have the -- the lions club van here, they will be testing hearing, visual acuity, glaucoma, glucose companies levels and blood pressure that will be absolutely free. Also signups for walking groups for individuals that would like to join a support group that would assist them with the -- with their walking and maintaining the exercise. As very important indicator or very important item for keeping healthy. Leroy will be here signing people up who want to mentor school-aged children. We have an ergonomics, a barker furniture company talked about ergonomics and the posture of sitting in the work station, how to be comfortable, I will remind departments that we do have an earthquake no, ma'am micks program -- ergonomics program where if you feel like you need to purchase some furniture that is more in line with the ergonomics and the needs of your employees that we pay half and that's to risk management. We pay 50% of that furniture, then the department pays 50% also. We will have massage therapy, education, support for diabetes. Dental hygiene classes, education and support groups for circulatory problems and anyone who has heart problems, weight loss, we will have -- we will have demonstration to -- culinary condemnation to learn how to cook with less fat, make green beans taste like pork chops just for Commissioner Daugherty, we will learn to manage asthma, classes on asthma and other respiratory illnesses. Learn of course self exam for breast cancer and we will have lee mccormick sitting here to my life doing weight lift training, also demonstrations. So we invite everyone to -- to come out and be with us on Thursday. I will encourage people to use the dillos, there will be a couple of dillos that come to the granger building, every 15 minutes, over there by the Daugherty arts center, another one by Austin high school, also.
>> free park being at both -- parking at both of those places?
>> [indiscernible] going out over the e-mail system, it will have the dillo information as well as the schedule of events and locations and times. Employees can look at that. Massage therapy sessions take about 15 minutes each, we will ask that employees sign up when they come into the granger building, then they can room the-- owe roam events, booths, exhibitors, at their scheduled time come back for their therapy session.
>> can we sign up now, please.
>> > sure. We are taking advanced reservations.
>> prebook that please.
>> all events from 10:00 to 4:00. Does that mean these will take place for the solid six hours or -- or during that time period.
>> the solid six hours. There will be --
>> we will have schedules.
>> schedules will be included in the announcement that's going out.
>> okay.
>> we do have a budget to present to the court today. We passed it out this morning. The total of the budget is about $18,000. And there's several items that -- that are on it. We are prepared to discuss any or all of them if you would like me to go through them, I can. If not, we will field questions.
>>
>> [one moment please for change in captioners]
>>
>> they will have a walk. They will have a walk that brings in people throughout Texas, again to encourage people to take part in wellness programs. We would like to have a team there with a large banner and we would issue the t-shirts also for everyone participating in that. And I know that we had bonnie from purchasing that had helped us -- I mean was going to also help us coordinate that particular program. So those are the sorts of events that we would provide t-shirts for. And also for recognition of individuals maybe that completed programs or completed their goals as they are submitted on an individual basis.
>> so the turn-around time on a t-shirt is two weeks?
>> two weeks. You can have it in two weeks.
>> my advice on t-shirts is this. If we authorize this amount of money, but the number ordered -- that the number ordered be based on the number you need. So if the governor's walk-a-thon or whatever it is, if we have 613 Travis County employees there, no problem. But if we have 61, I mean we don't want to sit here with 500 t-shirts on our hands. We can determine that and if we have two weeks notice we order the number we need and if we exceed that amount, that's fine. My fear is the number may be smaller than this. I would guard against having t-shirts on hand.
>> unless you sell them, judge. You could also sell whatever is left over.
>> and we do have a logo that was designed by lee mccormick. Not only is he a pro-football player and trainer and athlete, he's also an artist.
>> that is a quality t-shirt. Yeah, that's neat.
>> that's cool.
>> that's very cool. That is a quality t-shirt.
>> I prefer [indiscernible]. This cotton blend stuff is -- yuck. 100% cotton.
>> is this a one-color?
>> it's red and black. The trimming around the letters is black.
>> just so the t-shirts breathe.
>> questions, comments?
>> alicia, you are saying 18,000. I only have one sheet and my says 30. Thousand. I don't have a blue sheet.
>> after discussions with the fiscal health, we brought it down to 18. And the $2,000 there, that's a number that we put in there because we didn't have any specific incentive, recognition or motivaters, but I'm sure as I'm goes on we see some of the successes of the program we would be able to put together some competitive events where we may want to look again at [inaudible].
>> so right now that's just a placeholder. You would come back to the court on specifics.
>> yes.
>> and this would come from where? Where would the $18,000 come from?
>> well, we had talked about a couple of resources, either the -- is it the health -- yeah, the health facilities corporation or the housing. Corporation.
>> housing finance.
>> yeah, housing finance corporation.
>> tell me how you physically -- where do 250 pedometers stay? Is there a room where this stuff will be? Do you check it out? Do you leave it back? Do you leave a i.d.? What -- what happens with 250 pedometers?
>> as individuals sign up either for walking groups or sign up and pledge individually or enroll in one of the projects, they will be given a pedometer. And those that are not issued will be stored in our storeroom for future -- the program initially -- the kickoff is here at the campus area, but we will be taking this program to various locations such as airport precinct 4 in del valle and it will be those locations where these additional pedometers will be used. We fully expect 250 that we've recently purchased will be given out at this festival on Thursday. These are additional pedometers for other events held around the county.
>> it's important to note that the festival we have on Thursday at the granger building is the first of several. Both the sheriff's office and t.n.r. Are putting together their own wellness programs to meet the needs of their particular employees, so we will be taking the van and those sorts of supplies around to other locations. Precinct 4 and hopefully palm square is another area that we've been asked to go to also, and then airport.
>> so who will be in charge of keeping the documentation for expenditures?
>> we will.
>> do we at least [indiscernible] dan mansur. That's what we're hearing?
>> yes, sir.
>> I think housing finance would be a little more appropriate than health facilities. We've been told that legally it's a little bit more general than health facilities, and if you look at these, I assume that equipment could be facility. Speaker's fee, though, maybe stretching it a little bit as well as t-shirts. But swre it in housing finance corporation, don't we? We're looking at $18,068 is what this budget is.
>> harvey Davis, manager for the corporations. And the housing corporation would have sufficient money to budget that amount. In fact, it has a little bit more money than the health corporation.
>> okay. That would be my recommendation. The other thing is basically that we need to try to motivate employees to participate. For taxpayers who wonder if we've lost our mind, this is an effort to promote wellness among the Travis County workforce and if you employ more than 4,000 people, then your health insurance costs really increase dramatically between 203 and 204, really about an 8 million dollars increase. What we're trying to do is control that a lot better and one way to do it is a -- to target the illnesses, diseases that seem to be the drivers of the dramatic increases and basically try to put in place wellness programs to over time try to reduce those costs significantly. Doing nothing seems not to be an option for us. And so the challenge is to get as many county employees as possible, and with court members taking the lead, as we do in many, many county matters, I think employees -- I think it will catch on with the rank and file and basically be a good program for us.
>> I second that, judge. And then the other question that came up is I guess we would want spouses to also participate, right, because that will help curtail the insurance costs as well.
>> yes, and. D on Thursday allthe family is . A lot of our health care, if we real lie and as we have been looking at our health care costs, a portion of health care costs does indeed go to -- it's a good sized portion, ghosts to spouses and to -- goes to spouses and children and the care of children.
>> so whoever is on our insurance.
>> insurance.
>> children, spourbgsz retirees.
>> yes.
>> and incumbent employees.
>> and again, it's from 10:00 in the morning until 4:00 in the afternoon. Somehow that's gotten by employees. And the question is what hours. 10:00 a.m. To 4:00 p.m. Thursday.
>> at the granger building.
>> and bring spouses or members of the family to participate.
>> this is a kickoff, and I guess if we ask supervisesers and managers to participate and encourage others, then I guess on record we're saying we will basically give you an hour or so to participate.
>> right.
>> how is that reflected on time sheets? We just -- we do encourage employees, though, if you are coming to the festival, do not end up at the local barbecue joint.
>> no, that would be contrary to the wellness program.
>> yeah, the date out there, judge, it's not only the cost of the health plan, but it's productivity in the workforce. I mean the evidence out there is that people are healthier, they are absent less. If their families are healthier, they are absent less. Their energy level is higher. They feel better. I mean there are tremendous benefits. Of course, there's the cost of the health plan, but there are tremendous benefits besides that. And it's almost -- since i've been home watching daytime t.v., It's a nationwide movement toward focusing on better health. So we're in sync on that initiative with employees. I'm encouraging everyone in our office to participate and do what they can. And we need to congratulate those who have kept themselves in shape and never got in a bad situation. But I think this is a really good initiative. It's a really a small amount of money for, I think, the benefit that we're going to reap over the long run.
>> it's a big deal.
>> other governments, they are struggling with the same thing. I just sent alicia a note this weekend from the houston chronicle about what's happening with the city of houston's health program. Their health insuranceis going up 24% and it will cost their government $60 million more if they do not either split cost sharing on this, eliminating certain kinds of programs, or, again, they were also looking for a focus on wellness. So we're all struggling.
>> and then the other story that is starting to come out is that sedentary habits begin with toddlers. So we need to get them to be active and be in motion. Constantly in motion because that contributes to good health.
>> I feel that we're going in the right direction. I feel we've been looking at the way we have our insurance set up, which is six tiered structure type of premium structure versus the standard four-tier structure which a lot of insurance companies offer. Those innovative things I think we did under self-insurance funding is paramount, yet we're seeing increment in the increased cost of premiums. And again, other folks are attempting to put an arm around the rising costs of insurance, and I think this wellnes program I think is something that really -- and I think can help keep the costs down because it has escalated, but at least we do have some type of control to at least get this down to a manageable situation because it's a real expense for all of us. So again, I really applaud everybody what they are doing on this and I know the employees of Travis County taken families of employeep of Travis County are probably very appreciative of what we're trying to do.
>> judge, i'll second the motion.
>> I move approval. Commissioner Daugherty.
>> judge, before I'm ready to applaud anyone, and I am highly supportive of living a healthier lifestyle for everyone. My real problem with this is that we are doing something on the come and I know because I have been involved with health clubs and organizations -- I mean in the 36 years i've been here, and this arena is famous for starting something but not following through with something. And we don't really have a mechanism here or we're not really set up, and I think part of it is because we don't really want to set this thing up this way because it's really hard to get people to commit to things. I've seen some of the offices walking. I've seen, you know, several people taking off and walking down the street and I pull over and said, you know, hurray for you, thanks for doing that. I don't know how often they are doing it. I mean, I would be willing to bet you if I were to go by the office and say how often are you all doing this, well, I mean, we haven't done it for a week or so. I'm just fearful that we are going to, number one, get something started here where this is not going to be a one-time expense. I don't know how often we think that we're going to do this program. I think it's a great kickoff to do this Thursday gig and to see what kind of enthusiasm we can get, but I want us to find a way to say, okay, who has signed up, and then in 90 days for those people to come back and say here is the regimen that we have. This is what we have done and we are continuing to do it. Otherwise this thing will be like a health club. We will spend money from the county only to find out that people don't follow through with things. For example, you know what, I'm sure that they are not going to want to hear this, but we're either going to have to go to the third floor kitchen or get a different menu, because I'm going to tell you buscuits and sausage, we're going to have to say we want you to do something about. I'm going to sit down and talk to my office. They are smiling over here, but I mean if we're going to spend money, I'm going to want some results out of this thing. I'm not wanting do this thing because I want to show people that I really think this is a great thing to do. I don't want the taxpayer out there asking me, I mean because i've had enough e-mails already about what in the world are you all doing. I mean people ought to be doing this for their own good. Now, I'm not for not spending some money on, you know, some blood pressure -- having some professionals come in here and give some people some records and say you know what you ought to do, here's what your blood pressure is, you need to change your eating habits and do this or that. I would like to see us enroll some people, find a way to determine whether or not these people are really doing this on a continuous basis. If you get me kick started that way, I probably will be one of the bigger fans of this. I just fear that we're going to spend money on this, that people will get energized to do it and they won't keep up with it and especially if we don't have a way to say you need to turn something in to our committee. You've done to six months, very good, I'm willing to give you a t-shirt or whatever. But I don't want to see us get into something just because we know that this is something that everybody ought to do. I just don't think that we are going to be able to get people to maintain this. And I would like for them to show me first that they are willing to do this. I would like for them to buy their own pedometer, and if they stay in this for six months, then come to the committee and say, okay, we'll reimburse you for that. You bought it, you are using it, and we'll reimburse you. But you show us the miles that you walked or whatever. That's my receipt sense about -- because $18,000 is not very much money except for the fact that it's $18,000. So that makes me nervous. And I do think that we ought to live it. If we're going to really get behind this thing, you know, the third floor is a good convenient place to eat. But I will tell you that it is not a good -- that it is not what we ought to be eating. Now, me saying that, I may go have a double meat cheese minus onions with mayo nays at lunch. I really do, I think if we're going to do through the emotions, we ought to really say say this is what we're after. I'm not for closing the kitchen. I'm for saying let's find a menu that if people are going to come down here and eat, this is what we're going to do.
>> I think your hamburger and fries are under attack. And there are ways that we can all do this in our own way. I went ahead and bought pedometers for everybody in my office. And travis down in p.b.o. Has figured out a little program that can be installed on your c-drive, f-drive, whatever drive it is where you can log in and keep track of the number of steps that you are doing. They are already doing that in p.b.o. Those are kind of low-cost alternatives so that people can do this and you don't necessarily have to be something on the blue sheet. So --
>> that's a good idea, Commissioner. And that's what I'm looking for. I'm looking for somebody needs to show me that, you know what, I'm going to take the initiative and I'm going to show you I'm interested in doing that. If you'll do that, I'm more likely to say i'll sign off on helping you spend some money.
>> I bought for pedometers so everybody in my office has one.
>> if I were designing this for myself, it would be different. I'm trying to design this -- the committee is trying to help us design something that will attract a significant percentage of the 4,000-plus employees of Travis County. For taxpayers, this is not taxpayer money, but it is public money. The housing finance corporation gets fees by issuing funds for various housing programs. And this money would come from fees that the housing finance corporation has received as result of issuing funds. So it's not taxpayer money, but it is public money. The other thing is that at some point you got to start the program. And to me the driving fact is that almost overnight employee health insurance costs went from $24 million to $32 million. $31 million. That's a huge jump. You know, I say overnight, over a year. And so I think that we ought to do what we can to control that. So the 18,000 does in fact pale in comparison to the total cost. I just think we ought to be flexible enough to make changes after we see basically what the results are. I do know -- I mean I don't expect 100% of employee participation up front and I would think over time there would be some dropoff, but I just think we need to try to do everything creatively, innovatively to sustain the effort and energy and to a great extent they will follow our lead. The other thing is we have a whole lot of managers and supervisors, so if we can get them to participate, then I'm thinking we can really make this a total workforce effort. In the end, that's what this amounts to. The other thing is part of what we're doing is as results are figuring out what the cost drivers are, right? What diseases really cost us more than others. And we hopefully are putting in place programs that will help us attract those individuals. We have not given up on the notion of special invitations to those who are special diseases. If there is a diabetes specialist coming, at the same time, you may be diabetic or may not know it or you may be headed toward that and may not know it. So you don't want to exclude anybody interested in coming. I say that is [indiscernible] enough to change the program as we have the facts come: be next I believe enough.
>> this is -- be flexible enough.
>> this is just one effort in the overall issue of health care and the costs of health care. Us a said, that's $31 million. We met last week with united health care and discussed with them the chronic diseases that we're facing, the high cost illnesses. We discussed using a preferred drug list andetting that information to employees. So those preferred drugs are -- cost us less. We're visiting with metco, the pharmaceutical distributor. We are looking at the retiree policy also. So there is a whole gamut, a whole variety of avenues to try to reach the same target of at least having some control and clearly a management and full knowledge of your health care costs. So the wellness program is one sheriff's deputy towards bringing a better understanding and an effort towards trying to control or have some management ability over the rising cost of health care.
>> and with that, with united health care, we have a relationship with as far as the health care, one thing we requested early on and that was changing the timeliness of getting an actuary report based on a quarterly basis as opposed to a six-month basis farther down the line so we can see where we are on things and then also how that may impact the budget. I think it's very important for us to be ahead of it instead of behind these things as far as the direction we're trying to go. I think it's very significant to see maybe like a performance setting on where we are with this, but also tie it and interconnect it with the aubg aerial reporting -- actuarial reporting that has been requested by the court as far as them coming back toous a more timely basis so we can look at those results. I think that's kind of critical also when we look at the overall view of the big picture of all of this.
>> as alicia said, united health care came in Friday and it was about a four and a half hour meeting and they brought people in from their corporate office as well as the local people from all facets, and I know alicia is going to schedule individual meetings to get more information that can be presented here. But it was a real sobering report, and I think you are going to be -- I was very impressed with the quality of information and the data. I was saddened by the state of the claims that we're having here because we talk about numbers and statistics, but these are human beings and we have a lot to do here. I agree with alicia full heart he hadly, the wellness is just part of it, but when you get through with the individual phaoelgts and she gets a chance to share with you what they shared with us, we need to do more. And we have many, many people that are very chronically ill. And the data on some of these diseases, diabetes is one of them, the kinds of things they are leading to, these are serious health things. So it's easy to get hung up on numbers and money, and that's important, but the human element is a big one. I think this isa start. It isn't the whole solution, but it's a start.
>> we ought to stay on top of it. Any more discussion? All in favor say aye. Show Commissioners Davis, Gomez and son light tph-r and yours truly in favor. Commissioner Daugherty opposed. We appreciate the hard work of the committee members. I urge them to keep on keeping on as we pursue this new direction.
>> thank you.
>> thank you very much.
>> thank you.
Last Modified: Tuesday, February 10, 2004 6:44 PM