About the Small Business Wellness Tax Credit

In the last blog we looked at Total Worker Health, which describes “a new approach to safeguarding the health and safety of workers.”This month, we want to focus on the Massachusetts legislature General Law Chapter 224: An Act Improving the Quality of Health Care and Reducing Costs through Increased Transparency, Efficiency and Innovation (Chapter 224). The law, which was passed last August, includes key provisions to incentivize employers and insurers to focus on improving health through workplace wellness programs. The Small Business Wellness Tax Credit is available until December 31, 2017.  Businesses must apply for certification with the Department of Public Health’s (DPH) and meet their eligibility requirements.

Here is a brief overview of how the tax benefits work. The Tax Credit is equal to 25% of the implementation costs of a “certified wellness program” as defined by the Department of Public Health’s criteria. The maximum credit is $10,000 in any fiscal tax year. Credits are only available to employers with 500 or fewer employees, and who have not been cited by OSHA in five years.

Companies applying for the credit must have wellness programs that promote physical and mental health, fitness, and behavior change measures. They must offer awareness and education to employees, and offer behavior programs to foster lifestyle changes. To that end, a “wellness champion” should be designated who would be responsible for developing and implementing the wellness program.

Wellness awareness and education would be delivered through a variety of mediums, including signage that supports health behavior, such as healthy vending machine options, taking stairs rather than the elevator, noting the quantity of calories in food options; and through the offering of educational classes. Companies may elect to offer assistance with gym subsidies, tobacco cessation programs, free screenings (cholesterol, skin/derma scans), and lifestyle coaching.

WorkTerrain can assist employers with programs on improving employee health and wellness through workplace wellness programs and with taking advantage of the Small Business Wellness Tax Credit. For more information, contact us directly

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Stress and the Workforce

This year’s American Psychological Association (APA) annual Stress In America survey revealed a very disturbing picture of the American workplace: only 51% percent of employees felt they were valued at work. Additionally, chronic stress at work was reportedly experienced by more than one-third of persons surveyed, and only 36% of employees said that employers  “provided sufficient resources to manage stress. “

With these results in mind, on May 16-19, 2013, the American Psychological Association, the National Institute for Occupational Safety and Health (NIOSH), and the Society for Occupational Health Psychology (SOHP) held a conference on Work, Stress and Health 2013: Protecting and Promoting Total Worker Health™ in Los Angeles, CA. The conference addressed the changing nature of work and the implications of these changes for the health, safety, and well-being of workers, giving special attention to the concept of Total Worker Health.

Total Worker Health, an expression coined by NIOSH, describes “a new approach to safeguarding the health and safety of workers.” Traditionally, workplace programs that address worker health and safety focused on health promotion programs dealing primarily with lifestyle factors that place workers at risk. The health protection activities generally offered centered on reducing worker exposures to risk factors arising in the work environment. However, there is “growing appreciation and evidence that workplace interventions that integrate health protection and health promotion programs are more effective than traditional, fragmented programs.”

The Total Worker Health approach acknowledges that both work-related factors and factors beyond the workplace contribute jointly to many health and safety problems confronting today’s workers. The control of these problems is best achieved by comprehensive workplace health and safety programs that address both sets of factors in a coordinated fashion. (NIOSH)

In our next blog, we will address the Small Business Wellness Tax Credit, designed to encourage employers and insurers to focus on improving health through workplace wellness programs.

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Workplace Wellness Programs Affect the Bottom Line

Health care costs continue to soar, and the effect on a business’ bottom line is staggering. With over 60 percent of Americans getting their health insurance coverage through an employer-based plan, the increasing evidence that wellness promotion may lead to reductions in health care costs, as well as health insurance premiums, has raised employer enthusiasm for workplace wellness programs. There are myriad additional reasons, too, why employers might benefit from employee wellness initiatives, such as reduced absenteeism and increased productivity.

A study conducted on workplace wellness programs by Katherine Baicker, David Cutler, and Zirhui Song found that medical costs “fall about $3.27 for every dollar spent on wellness programs, and absentee day costs fall by about $2.73 for every dollar spent. This average return on investment suggests that the wider adoption of such programs could prove beneficial for budgets and productivity as well as health outcomes.”

The authors of the study conducted a rigorous meta-analysis of the literature on costs and savings associated with employer-based wellness promotion policies and then compiled standardized estimates of return on investment (ROI) from those studies. They found a large positive ROI, “suggesting that the wider adoption of such programs could prove beneficial for budgets as well as health.”

Workplace-based wellness programs that could impact prevention have been showcased by President Obama and in Congressional hearings. Policy-makers, insurers, and employers have shown an increasing interest in methods of improving health while lowering costs. Disease prevention and health promotion are ways of achieving better health outcomes at lower costs.

Health care reform debate has included active discussion of wellness program promotion with the hope that such programs will be a key component in slowing health care cost growth. The authors of the above cited study state that “critical review of the existing evidence suggests that employer-based wellness initiatives may not only improve health, but may result in substantial savings over even short-run horizons. . . . . [T]his is a very promising avenue for improving health and productivity.”

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Being “Lean” Can Benefit Your Business

Lean principles, the brainchild of Henry Ford, was initially tied to manufacturing. However, Lean processes provides some of the best opportunities for productivity improvement in administration, service and support operations in all industries.,

Lean Management is about improved productivity and performance, reduced costs and delivery timeframes, improved quality and customer satisfaction, and heighten employee morale, and reducing layoffs.

While Lean may be a time-tested manufacturing practice, health-care organizations are beginning to implement Lean practices in their organizations in order to eliminate waste, streamline processes, and cut costs.

“Lean is actually the best alternative to layoffs. It’s all about encouraging everyone to participate in process improvement, as well as finding creative and interesting ways to save money for a healthcare organization to avoid those unwanted traditional cost slashing endeavors like layoffs,” explains Mark Graban, a lean expert and author of the book Hospital Kaizen. “Layoffs don’t lead to long-term cost reduction. And if you lay off people and don’t fix any processes, you’re risking patient safety and quality. As a result, more and more healthcare providers are looking at lean to break that cycle.”

Since a primary goal of a Lean culture is to build an empowered workforce, Lean training is designed to deliver tangible business process improvements during the course of the training program. While the fundamentals of Lean are somewhat intuitive, the training provides a common perspective that allows every employee to acquire the right set of Lean skills in order to participate in continuous business improvement. The Lean process influences myriad business areas include productivity, lead time, space utilization, throughput volume, wait times, material usage, and customer satisfaction. Businesses and organizations applying Lean Enterprises achieve improvements in speed, efficiency and profitability.

An important element of Lean Management is creating a set of metrics that provide immediate feedback on how a process is running, to identify trends, and to record progress. Businesses can use these metrics as a basis driving improvements and reviewing performance.

While there are many benefits of Lean training, a significant advantage is an increase in employee involvement. By involving employees in the implementation of Lean processes, they gain a greater appreciation for the effect of the work they do on the business’ bottom line, as well as gaining an appreciation for how the work of other employees and departments also contributes to success.

One of the desired benefits for companies engaged in Lean Management is a reduction in costs associated with processes improvements that decrease defects or errors requiring rework and employee time and resources. By examining processes and understanding value, improving product delivery methods and customer service activities, companies using Lean find that they can decrease costs significantly while maintaining, and often increasing, customer value and satisfaction.

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Injured Workers Fare Better When Treated By Occupational Health Physicians

There is mounting evidence that occupational health physicians get injured workers back on the job more quickly. A study conducted by the University of Washington found that injured workers who were treated by doctors enrolled in the state’s Center for Occupational Health and Education (COHE) were

  • less likely to miss work and collect wage-replacement benefits when treated by occupational health physicians, and
  • had less disability and lower medical costs, saving the state workers’ compensation system an average of $447 per claim.

The study tracked 7,162 injured workers treated by physicians enrolled in Washington’s COHE for twelve months and compared their outcomes to injured workers with similar injuries who were not treated by a COHE doctor. Workers, in particular those with back problems, had better outcomes. In all, the study found that the program saved the workers’ compensation system about $3.1 million, according to the study.

Occupational health physicians are concerned with the health of workers and their environments through clinical care, disability management, prevention, research, and education. They are licensed physicians who specialize in treating patients with work-related illnesses or injuries and have an understanding of the physical hazards people may face on the job. Some doctors might perform a walk-through of a facility to analyze the risks workers may face, such as dangerous machinery, excessive noise, polluted air, and myriad other safety hazards. The Occupational Health and Safety Administration (OSHA) released a White Paper detailing an injury and illness prevention program to help employers find and fix workplace hazards before workers are hurt.

Occupational health programs can enhance the health and safety of employees by getting injured employees on a manageable course that brings them back to work faster. By meeting with workers regularly, doctors can monitor changes in their health conditions and determine the best ways to prevent illness and injury. Employers who utilize occupational health physicians often see results including increased productivity, decreased absenteeism, higher morale, and overall better health for their employees.

The benefit of utilizing occupational health programs is twofold:

  • to get injured workers back to their jobs, and
  • to make the management of the workers’ compensation system as efficient, fair, and helpful as possible for employers, injured workers and providers.
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The Cost of Presenteeism

Do you know how much presenteeism is costing your business? While most employers focus on the impact of absenteeism on the bottom line, there is no time like the present — with the flu season in full force — to discuss the issue of presenteeism.

The term “presenteeism,” coined by organizational management psychologist Cary Cooper, CBE, refers to the practice of employees coming to work when sick, thus not functioning at their usual level of productivity, whether physical or mental.

According to Crain’s Business, poor worker health and related productivity losses cost U.S. employers “$576 billion annually, including workers compensation, disability and group health program expenses.” Costs for presenteeism are approximately 60 percent of the total cost of worker illness. These costs, particularly the increasing costs related to employer-provided health insurance, are “weighing on the minds of employers, HR managers, brokers and consultants.”

There are numerous contributing factors to the growth of presenteeism, such as dual-earner income families, employer expectations, and little-to-no paid sick days. The USDOL Bureau of Labor Statistics (BLS) reports that in 2012, 52 percent of private industry workers overall had access to paid sick leave, down 5 percent in the past six years. And according to the Families and Work Institute, “BLS reported, among the U.S. workforce overall, only 59 percent of wage and salary workers have access to paid leave at all. That means about 40 percent of U.S. workers don’t get any money when they have to take time off to care for themselves or family members. As a result, a number of workers are reporting to work when ill to avoid loss of pay.”  And, many more employers no longer allow employees to accrue sick days.

The first step in solving any problem is recognizing a problem exists. So what can be done? Here are a few suggestions:

CCH, a leading provider of human resources and employment law information and services, suggests sending sick employees home is the single most common approach employers take to reduce presenteeism. “Employers need to discourage both the ‘hero employee’ – and even more so, the ‘hero boss’ – who show up for work sick, ready to muddle their way through the day . . . . Employees are in tune with the differences between what management says and what it means, and when they see their supervisors coming in sick, they’re convinced that’s what’s expected of them also.”

Establish and communicate a workplace policy on presenteeism: Employees need to understand how coming to work sick can infect others. Clarify under what conditions they should stay home, and when it is best to return to work.

Read more suggestions on dealing with presenteeism at CCH.

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The Time Is Upon Us

Something just has to be done….

I’ve written far too many blogs precipitated by horrific acts similar to the tragedy at Sandy Hook Elementary School in Newtown, Connecticut on Friday December 14. And while I find myself asking once again, when will this madness cease, I know there is no end date . . . and, sadly, there will continue to be more incomprehensible violence and more senseless deaths.

During the vigil on Sunday, President Barack Obama said, “We’ve endured too many of these tragedies in the past few years. . . . And we’re going to have to come together and take meaningful action to prevent more tragedies like this, regardless of the politics.” While I am heartened by President Obama’s words, the reality is that we are steeped in a culture of violence, with far too many guns in the hands of those who pervert our Second Amendment right to bear arms.

So, let’s do a reality check. When our Constitution was written, “arms” meant muskets. Our forefathers had no way of foreseeing that arms would one day mean a high-powered, semiautomatic Bushmaster rifle, the weapon used in Sandy Hook and also by D.C snipers John Allen Muhammad and Lee Boyd Malvo, who in 2002, killed 10 people and critically wounded three.

Our forefathers had no way of foreseeing that arms would mean a semiautomatic Glock 9mm handgun, the weapon found in Sandy Hook and the type used in the 2011 shooting at a shopping center in Arizona that killed six people and wounded then-Rep. Gabrielle Giffords and 12 others, or the 2007 massacre at Virginia Tech where 32 people were killed and 17 wounded, or the .40-caliber Glock used by the gunman in the Colorado movie theater in July, where 12 people were killed and dozens more were wounded.

Our forefathers had no way of foreseeing that arms would mean a 9mm SIG Sauer pistol, the weapon found in Sandy Hook and which was used also in the Standard Gravure shooting that left eight people dead and 12 wounded; or the 9 mm semiautomatic handgun with multiple ammunition magazines used to kill six people and wound three at the Sikh temple in Wisconsin and in the execution-style massacre at the Amish school in Pennsylvania.

The list of disturbing examples is far too long and far too sickening to my stomach to continue.

So what can be done? What “meaningful action” does the President have in mind? As Pierre Thomas said, “The genie is out of the bottle.”

“Meaningful action” must be multifold. We, as citizens, must raise our voices and demand by our votes a federal a ban on assault weapons. We, as citizens, must raise our voices and demand by our votes that legislators turn their backs on gun lobbyists and turn and face instead those they represent with a commitment to safety; we, as a society, need to address the gaps in the treatment of mental health in this country; and we, as human beings, need to question our ethics when it comes to accepting as normal brazen violence in our movies, our videos games, our music.

Meaningful action . . . . Let us as a nation resolve in the New Year to define what the meaningful action will be, devise an actionable plan, and commit to not giving up on this goal until a safer America is a reality.

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ADHD and the Workplace

Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) are terms familiar to most and are usually ascribed to children. Yet, many adults, particularly those in their late 30s and older, may suffer from one of these disorders and not even know it. ADD and ADHD were not widely studied, discussed, debated, and diagnosed until the 1990s, long after many adults were out of the school system.

For adults with ADHD, the workplace can be stressful and challenging. “If these challenges are not recognized and coping strategies not developed, people with ADHD may find themselves jumping from job to job, being terminated, and becoming increasingly frustrated and unhappy” wrote psychologist Janet Frank.

In the workplace, ADHD adults may encounter “ADHD traps” such as distractibility, impulsivity, boredom, time management and organization problems, procrastination, difficulty with long-term projects, and interpersonal difficulties.

Dr. Edward Hallowell, founder of The Hallowell Center, writes that “external structure” is key. He suggests using lists, color-coding reminders, and notes to self. “Prioritize. Avoid procrastination. When things get busy, the adult ADHD person loses perspective. . . . Take a deep breath. Put first things first. Procrastination is one of the hallmarks of adult ADHD.”

Dr. Hallowell writes a blog where he offers suggestions, tips, and techniques for understanding and dealing with ADD and ADHD. Most of all, he wants people to remember that “treatment of adult ADHD begins with hope.”

Adults with ADD and ADHD may have legal protections under the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990 which prohibit discrimination against individuals with disabilities in higher education and the workplace. Some state laws may go further than these federal laws in prohibiting discrimination. Check with your state government or an attorney who practices in your jurisdiction to determine your rights under state law and federal laws.

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Compassion Fatigue

I recently had the opportunity to conduct a resilience workshop with staff from 15 different social services agencies in the Portland area. The program focused on the skills and attitudes of resilience and how these could be integrated into the work that these individuals do with their clients each day.

As the participants told stories about themselves and their clients, it was clear that they needed resilience as much as the people with whom they work. These are very hard times for people that provide social services in our society. It is a time when their services are needed more than ever, but there is less money and staff to do the job. What is most disturbing to me is the lack of understanding and support that they receive from the general public.

Like the veterans coming back from the war in Iraq or Afghanistan, these people who are on the front line of the battle in our society against the forces that could destroy it, e.g., violence, drug abuse, poverty, ignorance, need the same kind of support and recognition for the hard and dangerous work that they do.

Ron Breazeale, Ph.D.
Author, Duct Tape Isn’t Enough

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Thinking Clearly

Emotions often act as a filter on our thinking. Anyone who has been in love knows that we often do not think very clearly about the person that we are in love with. We may minimize or deny the differences that we have with them. And when it comes to such emotions as anger and fear, we may demonize the individual, or the group or the political party that is scaring us or making us angry.

Unfortunately, when we make decisions, such as marriage or how we vote when we are wearing these emotional filters, we often make poor decisions. The lesson is this: we must be able to think clearly about what is best for us, our families, and our nation rather than to act out of emotion.

Ron Breazeale, Ph.D.

Psychologist and Author of Reaching Home

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