Your Employees Are Fat - Blame the Wal-Mart Supercenter...

Of course, I don't believe that, but it's interesting to consider the blame game that always seems to land at the front steps of Wal-Mart.  From research entitled "Supersizing Supercenters? The Impact of Wal-Mart Supercenters on Body Mass Index and Obesity":

"Researchers have linked the rise in obesity to technological progress reducing the opportunity cost of food consumption and increasing the opportunity cost of physical activity. We examine this hypothesis in the context of Walmart Supercenters, whose advancements in retail logistics have translated to substantial reductions in the prices of food and other consumer goods. Using data from the Behavioral Risk Factor Surveillance System matched with Walmart Supercenter entry dates and locations, we examine the effects of Supercenters on body mass index (BMI) and obesity. We account for the endogeneity of Walmart Supercenter locations with an instrumental variables approach that exploits the unique geographical pattern of Supercenter expansion around Walmart’s headquarters in Bentonville, Arkansas.

An additional Supercenter per 100,000 residents increases average BMI by 0.24 units and the obesity rate by 2.3 percentage points. These results imply that the proliferation of Walmart Supercenters explains 10.5% of the rise in obesity since the late 1980s, but the resulting increase in medical expenditures offsets only a small portion of consumers’ savings from shopping at Supercenters."

So Wal-Mart comes with cheap food and we get fat.  Somebody else is to blame, but your self-insured Medical plan is the one that has to pay.  What's that?  You're thinking about putting in discounts to employee contributions for healthcare for people who live healthy?  Watch yourself, Spartan - there's plenty of legislation out there that prevents you from doing anything (Hi GINA!) that will actually change behavior.

I've got an idea.  Buy foods with less fat and work out 3-4 times a week. The low fat foods at Wal-Mart are cheaper too.  How about that?

When Wellness Sucks... Nobody Wins, People...

A lot of you out there are haters when it comes to wellness.  You know who you are... You think that there's no ROI in wellness programs, that companies have no right to push, prod or otherwise seek ways to make employees take care of themselves in an effort to control the overall cost of administering a group medical plan...

This video is for YOU!  Smoke 'em if you got em...

Below is one of the most "money" videos you'll ever see related to wellness.  You want wellness stereotypes?  This video has them all, from the over-bearing internal wellness champion, the cliche' fitness instructor who comes in to do a class, the BS shake-type drink, even the girl hooked on crank who wins the weight loss contest as a result.

Because let's face it, the wellness program that focuses on weight loss WINS!  What's your BMI?  Mine's 14.2.  I'm shooting to get it under 14 by the end of the year. Don't hate me because I'm skinny.  HATE THE GAME...

Watch this video and love it - then click out to the companion site called whenwellnesssucks.com and take the quiz designed to tell you - you guessed it - whether your wellness program sucks.  It was bankrolled by a wellness firm headquartered in Portland named Recess, that's led by a disruptive force whom I admire and respect - Tanya Barham.  She rocks. 

If you see any of your company's wellness program in this video, you might want to call Tanya...

Praise to Employees - The Matrix Chart From Hell...

Big idea for the day...  Why do companies talk a lot about employee recognition and praise, but employees get so little of it?  2 reasons in my book below:

1. Managers don't know how to give it (they're not actors, and most are uncomfortable in this role).

2. It's REALLY HARD as a customer to get praise to the right employee in an organization.

Let's focus on #2 in this post.  Why is it so hard to get praise to the right employee in an organization?  Let's say you just had a great interaction with a call center rep who did amazing things to take ownership, calm you down and resolve your issue, even though you were irate at the beginning of the call.  Does the company make it easy to share that feedback?  Most of the time, the answer is no.

More notes on this from a Made to Stick column at Fast Company:

"Imagine you're in a Tex-Mex restaurant, eating an awe-inspiring quesadilla. You may rave about it to the waiter, but chances are, your praise will never make it to the person who counts: the cook. Or maybe you appreciate the extra-deep cup holder in your Toyota, which holds your venti latte snugly. Where do you send the thank-you note? If you're lucky, it'll be read by corporate communications, who'll write a soulless acknowledgment. But the engineer who designed it -- and the product manager who fought for it -- will never know how you feel.

That's a tragedy on multiple levels, first for the employees who never receive your warm fuzzies. Pick any non-customer-service employee at random from your company. When was the last time that person received positive feedback directly from a customer? If the answer is "never," that's as cruel as an unwatered plant. Or an ignored Madonna."

The lesson for HR people, in my eyes, is to be more than cheerleaders when it comes to praise.  It's fine to preach to the world the benefits of praise as a HR pro, but from a business standpoint, what are you thinking about from a systems/communications/customer standpoint that can facilitate praise directly to the employee?  Can you develop those types of systems with the proper amount of recognition to the company/manager/team about the employee's performance?

You've got to think like a systems designer to pull it off.  One example pointed out at the Made to Stick column on praise is the "How's My Driving" signs on the back of millions of company trucks on the roads of America:

"For more inspiration, consider Kelmar Safety, which manages those How's My Driving? programs for trucking fleets. Ever wonder if the drivers hear the comments you make when you dial the 800-number? Absolutely, according to Kelmar's CEO and president Christina Kelly. Every single time. At least one company has figured out how to get the right comment to the right person.

We know you're thinking that gratitude may not be foremost among the sentiments expressed on those calls. But take heart, cynical one: 18% of the calls are compliments. (Actual compliment: "He was great. He blinked his lights at me to let me out.") Maybe one out of six isn't such a great hit ratio, but think how much better your organization might perform on this metric if it's in an industry not known for road rage."

You already know praise is important as an HR pro.  You'll have to think like a business person to figure out how it can have an actual impact in your organization.

After the Interview, We'll Just Need You To Jump On The Treadmill....

I'll admit I don't have a lot of hard-core manufacturing experience.  That's why I had one of those "What the..." moments when I read that a Black and Decker plant uses their pre-employment screening package to determine, among other things, whether production candidates have a high probability to develop carpel-tunnel syndrome via the required job responsibilties.

From CNN's Coverage:

"Victor Breehe has filed a class-action suit against Black and Decker in Tennessee, claiming the company violated the Americans with Disabilities Act.

Breehne, who applied for a job last year at a Black & Decker plant in Jackson, Tenn., that manufactures Porter Cable brand power tools, said in a court filing that he was offered the job contingent on passing a medical exam.

A company doctor stimulated forearm nerves that control hand muscles and concluded it would be inappropriate for Breehne to work in a "highly wrist- sensitive job," the filing said.

The U.S. Equal Employment Opportunity Commission has also challenged the tests, which aren't uncommon in manufacturing settings, on ADA grounds. The agency lost a federal lawsuit in 2001 against Rockwell Automation Inc. (ROK) after that company denied jobs to 72 applicants at an Illinois plant.

The EEOC believes the test doesn't reliably predict the likelihood of developing carpal tunnel syndrome, or whether it would pose an imminent threat to the person's safety, Chris Kuczynski, assistant legal counsel and director of the ADA policy division at EEOC, told The Baltimore Sun."

Wow.  "Company doctors stimulated forearm nerves that control hand muscles" kind of caught me off guard.  My first thought is that, positioned the right way, this could be spun as some sort of spa treatment.  My next thoughts are the obvious ones for a HR person and more grounded in reality.   Is having weak hand and forearm muscles a disability and covered by the ADA?   If the employee can do the job today but is simply more probable to develop a condition down the road, can you eliminate them from consideration?  Should the companies using these type of tests conduct them pre-offer, so it becomes one of 10-20 hiring criteria?

So, today, it's testing to limit liability that can be caused by a specific job activity.  With health care becoming more and more expensive, does tommorrow bring testing to see if the company can afford to provide medical coverage to the candidate in question?

Just need you to get on the treadmill after the second round of behavioral interviews.  Don't worry, we'll do it last and then you can go.  If you break 20 minutes in the 5K, there's a signing bonus involved....

Smoke 'Em If You Got 'Em - Or Not...

Some random pickups on smoking from my RSS feed this week suggest cessation programs are worth the money, and maybe the thing to do if ADA expands into this area. 

First, Tanya Barham, CEO of wellness firm, Recess, and a future contributor to a Benefits blog we're  launching in December, riffs on the business case for smoking cessation programs in the Portland Business Journal:

"The Centers for Disease Control estimate that about 23 percent of American adults smoke.  And according to a study in the Journal of Occupational and Environmental Medicine, men who smoke incur $15,800 (in 2002 dollars) more in lifetime medical expenses and are absent from work four days more per year than men who do not smoke. Women who smoke incur $17,500 (in 2002 dollars) more in lifetime medical expenses and are absent from work two days more each year than nonsmoking women.

CDC statistics show that 70 percent of smokers would like to quit, but few are able to do so on their own. The irony is that even though the National Business Group on Health reports that 82 percent of employers state they should take steps to help employees quit smoking, only 24 percent of employers actually offer such benefits.

The numbers show that simply banning smoking in the workplace is not an effective means of enticing smokers to quit. Even though 67 percent of employers enforce a smoke-free workplace policy, employees of such workplaces say:

• Some 78 percent state the company's policy is not effective in motivating them to quit.
• A mere 14 percent claimed to attempt quitting because of their employer's smoke-free workplace policy.
• Another 15 percent report starting to smoke more while not at work.

As to the effectiveness of cessation programs, the U.S. Department of Health and Human Services Clinical Practice Guidelines state that tobacco use treatment doubles the chance that smokers will manage to kick the habit. The guidelines recommend counseling, medications or a combination of both as the most effective means to combat smoking in the workplace."

Next up, friend of the Capitalist Michael Moore explores ADA implications related to smoking, and smoking cessation programs:

"Smokers are feeling the heat in the workplace through smoke-free workplace policies. Jon Hyman at the Ohio Employer’s Law Blog has a post asking Are there legal risks with smoking bans?  He notes that pushing back on these employer initiatives are  29 states which have enacted laws protecting employees who smoke from discrimination.

Pennsylvania has no law protecting smokers from discrimination. To the contrary, Pennsylvania’s new Clean Indoor Air Act mandates smoke-free workplaces and precludes employees from smoking indoors. However, the law allows employers to prohibit smoking anywhere on company property; it does not prevent the continuation of outdoor smoking areas. Employers are left with the sometimes delicate task of crafting a policy concerning outdoor smoking and monitoring the break schedules of employees who wish to smoke. In addition, many wellness programs have targeted smoking with cessation programs coupled with both financial incentives and penalties.

The Americans with Disabilities Act was recently amended to expand the definition of “disability”to the point that it may encompass nicotine addiction. The few ADA cases on “smoking” as a disability have not recognized a claim based on the pre-amendment definition of disability. However, the rationale for denying disability status to “smoking” or “nicotine addiction” is squarely predicated on the remedial nature of the condition exempting it from coverage of the ADA as expounded in Sutton v. United Airlines, Inc."

Smoking covered by the ADA?  What's next, alcohol?  Wait a second...

Shake and Bake! NASCAR Does Random Drug Testing...

Before I get started on this one, I'm not the bogeyman coming to take all your personal rights away.  I know that we've got a LOT of variety in workplaces in America, and not every company needs a random drug testing policy.

Let's go through the list real quick...

-Library - no testing necessary
-Record Shop Dudes - If you're peddling vinyl, we may need you on that wall... no testing necessary
-Wal-Mart Greeter - What makes you happy?  No testing necessary.
-Guys Who Race Cars 200 mph (2 feet apart) - no testing necessary... hold up... maybe we need it there...

In a shocking display of "what were they thinking?", NASCAR (professional stock car racing) finally got around LAST WEEK to putting in a random drug testing policy.  That's right, the guys who race stock cars 200 mph haven't had the possibility of random testing until 2008. 

Notes from the "hey, you think we oughta test the guys for smack since they can kill each other in an instant?" camp courtesy of The Sports Network:

"NASCAR unveiled its upgraded substance- abuse policy over the weekend, to include random testing beginning in 2009. All drivers, crew members and even race officials will be tested prior to the start of next season, and will be subject to random tests throughout the year.

NASCAR's current drug policy has been in place for over 20 years, but has been scrutinized by competitors such as Kevin Harvick in the past months, after former Craftsman Truck Series driver Aaron Fike admitted to using heroin on race days. In July 2007, Fike was arrested and charged with heroin possession in the parking lot of an amusement park in Ohio."

That's right - heroin.  Before you stop shaking your head, NASCAR also believes its new policy is the model for all other sports, mainly because they don't succumb to the administration associated with keeping an actual list of which drugs are illegal:

"NASCAR covered all of its principles in the new substance-abuse policy, with the exception of outlining what is illegal. The sanctioning body provided no list of which drugs are banned.

"We think we have the broadest policy in all of sports," Steve O'Donnell, NASCAR's vice president of racing operations, said during a press conference Saturday at the Dover International Speedway. "The reason we don't have a list is we believe that a list is restrictive. If you've seen a lot of other leagues, the policy is constantly changing. We know that there's new drugs out there every day. By having a broad policy that doesn't list anything, we feel like we can test for any substance that may be abused, no different than our policy is today."

With all this on the record, I can't wait for the drug-free public service announcements that are sure to follow from NASCAR.  I just hope they have a "Talladega Nights" feel to them (email subscribers click through for video):

Big Business Supports Broadening of the ADA... Can Cats Living with Dogs Be Far Behind?

President Bush signed the ADA Amendments Act into law last week without a whole lot of fanfare.  Did you miss it?

In recent years, the ADA -- the world's first human rights law for people with disabilities -- has been dramatically narrowed in the courts, leaving citizens with epilepsy, diabetes, mental illness, HIV-AIDS and other disabilities unprotected from discrimination. The ADA Amendments Act clarifies the intent of Congress and reverses the "judicial activism" that has resulted in more than 95% of employment-related ADA cases being dismissed on summary judgment.

More on the changes to the ADA from the Los Angeles Times:

Millions of Americans with diseases or impairments such as diabetes, epilepsy, heart disease, cancer and carpal tunnel syndrome will be protected from job discrimination under a new disability rights measure set to become law this week.

The measure overturns a series of Supreme Court rulings that sharply limited who was covered by the Americans With Disabilities Act. When it was first passed in 1990, Congress said the anti-discrimination law protected anyone with a "physical or mental impairment" that "substantially limits" them.

But the high court interpreted the law to apply only to people who were truly disabled, not to those with common impairments such as a hearing loss or a medical condition that can be treated.

In another widely cited case, the court ruled in 2002 that an auto worker with carpal tunnel syndrome did not have a disability, even though she could no longer perform the repetitive tasks on the assembly line.

Here's the crazy thing.  The U.S Chamber of Commerce, the arm of big and small business alike, backed the bill, which in turn led to quick passage of the bill:

"Michael J. Eastman, a lawyer for the Chamber of Commerce, agreed that the courts had excluded too many people. "This means many more people will be deemed to have a disability, and some employers are nervous about that."

Nancy M. Zirkin, a longtime civil rights advocate, said it was remarkable that Republicans and Democrats came together to expand the reach of the disability rights law and that the resulting bill won unanimous approval in both houses. "It's a stunning achievement in this partisan atmosphere," she said.

I'm proud of the business community for getting behind this bill.  After all, the measure will not mean people who can show they have a disability will always win a discrimination claim. They still must show they are qualified to do the job. If an employee is deemed to have a disability, an employer must seek a "reasonable accommodation" that would permit him to work.  Nothing's changed in that regard.  It's all stuff most of us would do for any employee, covered by the ADA or not.

Of course, broadening the act does open up your HR shop to a broader set of ADA-related claims, most of them occuring/filed after you've taken an employment action, most of the time for good reasons unrelated to a disabilty.

That's OK - just keep doing the right thing for the employees and the business alike, and everything else takes care of itself.

Help Wanted - Witty and Sometimes Jaded Benefits/Wellness Professionals Who Want to Blog Weekly....

HELP WANTED - (4 Positions Available)

Progressive blogging organization is looking for witty and sometimes jaded professionals, in the Benefits/Wellness sector, to blog on a weekly basis, about their life as part of the machine.  New blog, as yet unnamed, to be launched to provide perspective of people conducting benefits management, wellness and associated activities in the field.

Requirements:

-A working position in benefits and wellness industries, focused on acquiring, aligning and maximizing benefits/wellness in your company, or on behalf of clients.

-Writing skills, plus the actual willingness to write and blog on a weekly basis.

-Personality and the ability to merge other resources and pop culture in writing, all in an effort to make it digestible for the commoners (that's me..)

-Ability to tell the world who you are while you are blogging - name, what you do, and where you do it.

-Skin thicker than that of a donkey, for the lashings you'll receive in the comments section.

Successful Applicants Will Come From the Following Areas:

-Inside companies who purchase benefits, inside vendors, inside brokers..
-Medical Plan Design and Utilization
-Consumer-Driven Healthcare
-Rx/Prescription Design and Utilization
-Legal Issues in Benefits Administration
-National Trending
-The World of being a Benefits Broker
-Wellness
-Retirement Plans
-Alternative Work Benefits (telecommuting, job-sharing, etc.)
-Voluntary Benefits

What You Get in Return:

-Membership in an exclusive, yet opinionated team that will undoubtedly make the dysfunction in your extended family look like an episode of "Little House on the Prairie".

-The ability to blog and share your thoughts without having to start your own site.

-Exposure of your ideas and brand in the online property of a cool blog that will have good initial traction.  If you're a current blogger, you'll also get enhanced exposure for your blog.

-A projected stipend per month that will fall somewhere between a night out at Denny's and paying your cable bill.

-The warm feeling of giving back to your profession with the professional distance that only digital media can provide.

Sound like you?  Interested in hearing more?  To apply, please confirm your interest in the comments section or email the Capitalist (that's me) at hrcapitalist@gmail.com.

Bariatric Surgery - Does it Really Pay for Itself in 2-4 Years?

Weight reduction surgery has long been controversial for employers, with healthcare insurers putting up multiple behavioral goals and other gates before providing access to extreme solutions like bariatric surgery to covered individuals.

Is that the right or wrong approach?  I've never had enough information to really have an opinion.

Here's the first research I've ever seen as a HR pro that talks about expected payback to the extreme weight loss procedures.  Follow me after the snippet from the article to talk about what it means for you and me as advocates of healthcare and retention.

From information provided in the Wall Street Journal:

"Health insurers can offset the cost of laparoscopic or traditional bariatric surgery as a weight-loss treatment for obese patients within two to four years as a result of savings on other medical costs, according to a study published this month in the American Journal of Managed Care, the Wall Street Journal reports.

For the study, Pierre-Yves Crémieux, a health economist and principal at Analysis Group, and colleagues analyzed health insurance claims data for 2003 through 2005 for 3,651 severely obese patients who underwent either laparoscopic or traditional bariatric surgery. The patients in large part were female, with an average age of 44; more than one-third of the patients had high blood pressure, and many of them had high cholesterol, diabetes and other health problems.

Researchers matched each patient based on age, gender, geography, health status and baseline costs with a patient who did not undergo either of the surgeries. Researchers tracked claims data for the patients who underwent either of the surgeries for six months of pre-surgical examination and care, the procedures themselves, and about 18 months of post-surgical care; tracked claims data for post-surgical care for some patients for as long as five years; and tracked claims data for the matched patients over the same period.

According to the study, health insurers that covered patients who underwent laparoscopic surgery, which has an average cost of $17,000, offset the cost in about 25 months. Health insurers that covered patients who underwent traditional bariatric surgery, which has an average cost of $26,000, offset the cost in about 49 months. Crémieux said, "The most cost-effective treatment for obesity is bariatric surgery," adding, "If you do that, within two to four years, you will get your money back." In addition, he said, "We have identified the break-even point for insurers."

The 2-4 year break even point is important to me, because it allows me to get my head around payback.  The thing that's confusing to me is that there's a lot of other research that talks about the failure rate of the surgery - meaning employees can have the surgery or procedure, then not do the things they need to do to keep the weight off.  I haven't read the study in full, so I also wonder if the cost of the medical complications so often written about is reflected here.

Still, the concept of payback is good to have.  We're talking about an investment in an employee to help them improve their life, much like tuition aid.  Many tuition aid programs mandate a payback agreement that an employee stay with the company for a year or two once the company has made the investment.

Now that we have payback numbers and companies have to bear the cost of this surgery, I wish companies could short circuit the red tape by allowing the employee to say, "I want to be at this company long term, and I'm willing to sign a payback agreement making that pledge as a part of this optional proceedure".

I know there are a million legal reasons why you can't do this, and I'm not looking to tie payback to other big ticket items. Medical necessity still rules the day on that end, but it seems like the big question with this one is medical necessity and payback.  That said, my take is that a lot of employees who want the optional surgery would be willing to fast track the process and would accept a payback agreement of 2 years for improved access.

Wondering What Your Budget's Benefit Load Should Be For 2009? Here's the Tip Sheet....

If you're an HR executive at any level with budgeting responsibilities, you've dealt with the pleasure of the Benefit Squeeze. 

What's the Benefit Squeeze?  It's the magical number that's attributed to the budget model for all your benefit and payroll tax costs.  In the golden days, the number was pretty fat and you never saw a lot of pressure on the number.  Unfortunately, with healthcare costs up 200% in the last decade, the number takes on a lot more importance.

So, the game goes like this - if you're fully insured, you have a good idea of what your entire benefit load is.  However, if you're self insured, there's some variability in the model that you want to protect yourself against.  Unfortunately, no one else in the organization cares about your needs.  They just need the number you give them to be two things - skinny and predictable. 

The U.S. Bureau of Labor Statistics recently gave some quality stats across the public and private sectors that can help.  The average cost to employers for employee pay and benefits was $28.48 per employee hour worked in June, the U.S. Bureau of Labor Statistics said today.

"The cost of wages and salaries averaged $19.85 an hour, or nearly 70 percent of employers’ total compensation costs.  As usual, there was a pay and benefits gap between average compensation costs in the public and private sectors.

Total compensation costs to employers in the private sector averaged $26.78 per work hour, compared with $38.30 an hour for state and local government workers. The report did not include federal employee compensation costs.  The cost of wages and salaries averaged $18.92 per employee hour in the private sector, versus $25.19 for state and local employees. The cost of employee benefits averaged $7.86 an hour in the private sector, compared to $13.11 an hour on the public side.

Overall, the 30 percent of total payroll costs that went to employee benefits broke down this way:

•$2.39 per employee hour worked for health, life and disability insurance.

•$2.25 an hour for legally required benefits, including Social Security, Medicare, unemployment insurance, and workers’ compensation.

•$1.99 an hour for discretionary paid leave benefits, including vacations, holidays, sick leave, and personal leave.

•$1.25 an hour for employee retirement and savings plans.

•76 cents an hour for supplemental pay, such as shift differentials, premium pay for overtime and weekend or holiday work."

Helpful stats to be sure.  At first, the total cost for health insurance seems light, until you do the multiple and see that the numbers mean a budget of around $5,000 per employee - not a bad figure.

So, take a look and use this in your budgeting sessions to justify your benefit spend number.  Just don't be alarmed when you take a 10% haircut to your budget as an across the board treatment to get to the earnings target.  It's all part of the budgeting process...