Agencies challenge employees to lead a healthier lifestyle

From early in his term, President Obama emphasized his commitment to improving the health and wellness of federal employees. And it wasn't an empty promise.

The first family already is leading by example: The president is a dedicated runner and avid basketball player, and the first lady has involved students in cultivating a vegetable garden at the White House to promote healthy foods. Most recently, Michelle Obama oversaw the opening of a farmers market just minutes from the White House, and the Treasury and Veterans Affairs departments.

"As an employer, we are looking for ways to create a healthier workforce, because we know that if you all are healthy and happy and moving, you'll come to work and you'll work really hard," the first lady said to the market's customers on opening day. "And as many private companies have demonstrated, making employee wellness a priority can save health care costs down the road and make for a stronger workplace."

The president met with industry leaders in May to discuss strategies for improving employee health, and he directed the Office of Personnel Management to develop wellness best practices and a plan for the federal workforce. In response, OPM this summer announced its work-life campus initiative, a joint effort with the Federal Reserve Board, General Services Administration and Interior Department. The four agencies, located within blocks of one another, will develop and share facilities, possibly including green space and a healthy cafeteria.

The initiative is just one of several demonstration projects that will unfold nationwide. The campus concept allows agencies to experiment with cost-effective solutions to making the workplace healthier and to gather feedback from employees.

"We will work hand in glove over the next year to review and improve the services and facilities available to the more than 6,000 federal employees that comprise our campus," OPM Director John Berry said in a statement announcing the program. "By combining our efforts, we can more adequately and economically address the issues of wellness and employee satisfaction."

The administration also has asked agencies as part of the fiscal 2011 budget process to take inventory of their health and wellness programs. In a June memorandum, Office of Management and Budget Director Peter R. Orszag required all agencies to catalog their ongoing efforts with the aim of establishing a baseline of current offerings and helping OPM develop a comprehensive program. The goal is to see 75 percent of employees participating in health and wellness initiatives by 2010.

Agency leaders will be integral to the success of this effort. To set the tone and encourage some healthy competition, Orszag recently introduced an OMB pedometer challenge. Employees can log their steps and other health information on an internal Web site, where they can see how they stack up against the director and colleagues in other OMB divisions. Each month the top employee will be treated to lunch with the director, and the divisions with the highest average steps and the most improved average will receive a "healthy happy hour" of vegetables and red wine. In practicing what they preach, the Obamas and other administration officials are reinforcing the notion that a healthy workplace is a happy one.

A Healthy Investment

Worksite wellness programs have been shown to benefit both employees' health and employers' pocketbooks. In a 2008 review of 50 wellness interventions, the Centers for Disease Control and Prevention's Task Force on Community Preventative Services found that office health programs reduced tobacco use and fat consumption, improved blood pressure and cholesterol levels, and increased productivity. The task force develops a guide to help communities tailor their own health programs and policies.

Many private sector companies already have invested in such initiatives. A 2009 survey by consultancy Watson Wyatt and the National Business Group on Health found nearly 80 percent of large employers offered health risk assessments, 60 percent had lifestyle improvement programs and 52 percent had weight management programs.

Aetna, a health benefits provider, has developed a broad wellness initiative aimed at keeping its own medical costs down. The program begins with a health risk assessment, which allows employees to get a physical and learn their body mass index, cholesterol levels and other vital numbers. Employees then can participate in Wellness Works, an incentive-based fitness initiative that awards points for physical activity and healthy food choices, and earn up to $600 annually in additional pay or premiums. Nearly 60 percent of Aetna employees nationwide participate in the program; many, including company president Mark Bertolini, take part in competitive team fitness challenges. Several Aetna locations also have onsite fitness centers with extended hours and a variety of cardio and strength classes.

Wellness Works serves as a model around which Aetna can design programs for its clients. "We are able to demonstrate to potential customers that there is a benefit to this," said Fred Laberge, a company spokesman. Aetna's annual increase in medical costs is about half the nationwide average of 8 percent to 9 percent per employee.

The goals of lower medical costs and healthier, more productive employees also drive Dell Corp.'s investment in wellness initiatives, said Tre McCalister, senior manager for global benefits. The technology company offers onsite fitness centers, local gym discounts and healthy café choices. In 2004, it launched Well at Dell, a customizable health improvement program that incorporates cash incentive-based exercise and nutrition tracking programs; telephone coaching for smoking cessation, weight and stress management, and physical conditions; and access to a nurse line. Dell also offers monthly webinars on such topics as cancer prevention, travel fitness and "deskercise." Well at Dell has increased employee health and productivity and has reduced medical costs significantly since its inception five years ago, according to McCalister.

Federal agencies also have targeted employee health with a range of initiatives, giving the administration a head start as it develops a governmentwide wellness strategy.

Options, and More Options

Fitness centers and exercise classes already are common across agencies, particularly in areas with large concentrations of federal employees. Many offer basic equipment, aerobics classes and extended hours to accommodate work schedules.

For instance, as part of a comprehensive lifestyle and health program that began in 1978, CDC has professionally staffed fitness facilities on its six largest campuses, as well as smaller gyms in satellite offices. These centers offer instruction ranging from Pilates, tai chi and yoga to spin and body sculpting classes. Employees also have access to softball, basketball and volleyball facilities and measured walking trails.

Program fees vary. CDC appropriates funding for its facilities and classes so it can offer them free of charge. The Environmental Protection Agency, which has fitness centers at its headquarters in Washington and all regional offices, subsidizes memberships. Federal employees in the San Francisco area can join a central gym where rates vary according to pay grade, starting at $85 for GS-6 and below, and reaching $210 annually for GS-14 and above. Some agencies, including the State Department, partner with area fitness clubs to provide discounted membership rates. Fifteen gyms in the Washington area offer such deals to State employees, and participation ranges from three to 40 people, depending on the club.

Where gyms are not cost-effective, agencies have developed innovative alternatives. The Defense Contract Management Agency has a virtual fitness program employees can access by phone, Internet and e-mail. Components include workout planning and weight management tools, attendance logs, risk assessments, an incentives program and fitness center reimbursement.

To encourage physical activity, some agencies allow employees to visit fitness centers during work hours. CDC employees can negotiate flex time with supervisors. Coast Guard military personnel and Secret Service law enforcement officers are allowed three hours per week for physical activity and DCMA employees can use duty time to exercise.

Though fitness is a key feature of overall employee wellness, agencies also are developing facilities and programs to address other aspects of health, such as nutrition, stress relief and access to "green" space.

The Interior Department is revitalizing its headquarters, which includes a new cafeteria. "We want it to feature a variety of foods in a range of economical prices -- especially organic, nutritional food from local sources -- and we will work to make the facility itself green," said Rhea Suh, assistant secretary for policy, management and budget. "The work-life campus initiative also ties into broader federal efforts on healthy food choices and reducing the carbon footprint of federal facilities."

The Agriculture Department is making strides toward a greener workplace with the inaugural People's Garden, a project to turn paved surfaces to grass, plant trees and promote energy efficiency. The goal is to build similar gardens at USDA facilities worldwide.

CDC hosts rotating farmers markets on its campuses and encourages employees to bring only healthy foods to meetings. The National Oceanic and Atmospheric Administration's headquarters in Silver Spring, Md., offers a meditation group with nearly 70 participants monthly, as well as chair massage appointments and holistic nutrition lunch seminars. And in July, State began a six-month trial providing 10 bikes at its headquarters in Washington for employees to check out during work hours. According to officials, more employees than expected have taken advantage of the program and often ride between buildings in suits and loafers.

Raising Awareness

Part of the challenge in fostering a healthier workforce is making employees aware of their unhealthy habits and motivating them to change their behavior. To create a culture of wellness, agencies reach out to employees through educational activities. A number have onsite clinics that offer health services, allowing employees to minimize time and resources spent seeking basic care and to learn about disease prevention and treatment.

The State Department's Office of Medical Services coordinates a health program for domestic and overseas offices. Employees can participate in smoking cessation programs, and breast cancer and bereavement support groups. The office organizes monthly programs on topics such as travel medicine, meditation and arthritis, posting videos of the sessions on the department's intranet. The office also offers day-long health fairs in Washington with yoga classes and health screenings. State maintains primary care and health screening facilities and programs for employees posted abroad as well.

Other agencies offer health classes, screenings and immunizations free of charge to employees. The Securities and Exchange Commission hosts nutrition seminars and osteoporosis checks, and CDC organizes first aid, CPR and ergonomics courses.

A number of special events governmentwide aim to increase interest in health and fitness. EPA hosts an annual "Walk to Wellness," a two-mile summer event in the Washington area. The agency plans to sponsor the walk quarterly and expand it to other regions. At the Homeland Security Department, the Federal Law Enforcement Training Center sponsors a weight-loss competition among its offices, based on the TV program Biggest Loser, and Customs and Border Protection organizes a "HealthierCBP" fitness challenge.

In fall 2008, State's Office of Medical Services/Health Promotion sponsored a series of four free hour-long nutrition and cooking seminars. The sessions, held over lunch and organized by The Cancer Project, a nonprofit for cancer prevention and health promotion, focused on incorporating low-fat foods, fiber, dairy alternatives and antioxidants into meals. Employees participated in discussions about nutrition, observed a cooking demonstration and sampled healthy dishes.

Recently, OPM launched FedsGetFit, a wellness campaign focused on fitness, nutrition, making healthy choices and prevention. The first event will be a fitness expo on Oct. 27, where agency leaders will join Congress members and National Football League players to promote work-life programs and participate in a one-mile walk.

In implementing new initiatives or growing current ones, agencies will face funding challenges. Work-life programs receive money directly from agency budgets, but agencies have made varying commitments to these initiatives. In the private sector, best practices suggest that comprehensive wellness programs cost $500 to $800 per employee annually.

As they determine the best places to make investments, agencies are looking for feedback and ideas from employees at all levels. "Not every idea is one you decide to implement," said Mike Weber, an official at the Nuclear Regulatory Commission's Office of Nuclear Material Safety and Safeguards. "But the tensions [among competing ideas] help channel enthusiasm."

In July, OPM outlined elements agencies should include in their wellness programs. Designated points of contact will report on agency health and wellness programs, services, costs and participation through an online WellCheck system. The goal is to bring agencies up to the standards outlined in July, while allowing them flexibility to tailor their offerings based on employee needs. Many programs are administered by human resources staffs, and OPM's Berry chairs monthly meetings with the Chief Human Capital Officers Council to facilitate communication and cross-agency initiatives.

According to Wesley Carpenter of EPA's Office of Administration and Resources Management, the administration's involvement in employee health is an important promotional tool. "The [OPM] initiative is a catalyst and a great opportunity to expand our tentacles and reach more people," he said.