Tracking Employer Use of Financial Incentives to Reward Healthy Behaviors

Many employers and wellness professionals as well have been keeping an eye on the growing trend of awarding meaningful incentives – not just tee shirts, coffee mugs and other similar tokens for participation in the organization’s wellness program. By meaningful incentives, we’re talking real cash incentives.

We have been conducting a survey on the use of incentives in wellness programs and some 110 wellness managers have responded. We are about to begin reporting on the results of this important survey in our monthly management newsletter – Wellness Program Management Advisor. We will also share the significant survey findings at some point on this blog.

A survey released last year by Watson Wyatt Worldwide and the National Business Group on Health illustrated just how important a subject incentives are as employers are realizing the real benefits resulting from having a healthy workforce.

That survey found that the number of employers offering workers financial incentives to better manage their health was expected to jump sharply this year.

From a ‘sneak peek’ at our every three years survey on incentives results, the Watson Wyatt Worldwide survey results are right on the money.

The survey of 453 large employers found that half currently use incentives to encourage their workers to participate in health improvement activities, such as smoking cessation or weight management programs.

That number was expected to leap to 74 percent this year.

“Some employees need a little extra inspiration to address their own health and develop healthy habits,” said Ted Nussbaum, Watson Wyatt’s director of group and healthcare consulting in North America. “Financial incentives can be a valuable investment that provides that essential push.”

According to the survey, employers are using a wide range of financial incentives to promote healthier lifestyles – from completing health risk appraisals (HRAs) to participating in health improvement and disease management programs.

While the vast majority of employers are rewarding healthy lifestyles, 6 percent are penalizing employees for poorly managing their health conditions.

Companies use financial incentives to encourage a healthier lifestyle.

Employers Offering Financial Employee Action/Behavior Incentives:

• Full coverage of preventive services – 53 percent
• Completion of a HRA – 53 percent
• Participation in health improvement or disease management program – 42 percent
• Participation in smoking cessation program – 40 percent
• Participation in weight management program – 31 percent
• Management of cholesterol level, blood pressure – 21 percent
• Completion of consumer education module – 12 percent
• Maintaining a personal health record – 7 percent

Employers use cash or an equivalent reward most frequently as an incentive for participating in health engagement activities. However, some employers now tailor their programs, matching desired rewards with a specific behavior or activity. For example, premium or deductible credits are more effective than cash at boosting HRA participation.

Seventy-three percent of companies that offer premium credits and 67 percent that offer deductible credits have at least half of their workforce enrolled in an HRA compared with 17 percent that offer cash and 12 percent that offer no incentive.

Employers with a consumer-directed health plan (CDHP) are more likely to offer incentives. Twenty-six percent of companies with a CDHP offer financial incentives for managing health risk levels (e.g., weight, blood pressure) compared with 17 percent of companies without a CDHP.

Similarly, 50 percent of CDHP companies offer incentives for participation in health improvement or disease management programs versus 35 percent of non-CDHP companies.

Address: Watson Wyatt Worldwide, 901 N. Glebe Rd., Arlington, VA 22203; (703) 258-8000, www.watsonwyatt.com.

Wellness Management Information Center, www.wellnessjunction.com/prof

www.healthresourcesonline.com/wellness

www.facebook.com/WellnessManagement

National Employee Wellness Program Participation Numbers

An average 19 percent of employees participate in programs administered by wellness managers who are either subscribers to Wellness Program Management Advisor, or members of the WellnessJunction.com online community.

Employee Participation Rates In Workplace Wellness Programs

* Average Employee Participation — 19%

* Corporate Programs — 22%

* Hospital Programs — 12.5%

Source: Workplace Wellness Management Survey, copyright Wellness Program Management Advisor

A caveat for wellness professionals, these numbers were gathered in 2004. As a result, it can be assumed that participation rates have changed. To determine that, the Wellness Management Information Center is mounting a new survey focused on participation in programs.

There have been other surveys in recent years on the topic of employee participation in wellness programs. But some of those surveys were among employees. The Wellness Program Management Advisor survey was among professional wellness managers whose duties include tracking participation.

The managers reported participation rates that ranged from a low of three percent to a high of 55 percent of total employees, our Workplace Wellness Management Survey found.

In some instances, rates are higher depending on the type of program being offered, a manager said.

Employee participation in wellness programs at one airline was reported at 18 percent, our survey found. And another manager reported “marketing some programs to families.”

For the most part, corporate wellness programs reported greater participation, ranging from 5 percent to 55 percent, the Wellness Program Management Advisor poll found.

The average participation rate among corporate programs is 22 percent, our survey found.

Hospital rates ranged from 10 percent to 25 percent of employees. There were too few participants from the university or government sectors to be included in the calculations.

Address: Wellness Program Management Advisor, 1913 Atlantic Ave., Suite S 200, Manasquan, NJ 08736; (732) 292-1100, www.wellnessjunction.com

HRA Follow-Up Involves Intervention And Monitoring, Survey Finds

The majority of wellness professionals involved in the administration of health risk assessments (HRA’s) follow up on the HRA results, according to the results of a workplace wellness management survey conducted by Wellness Program Management Advisor and Wellness Junction.

Almost 71 percent of survey respondents said they follow up on the HRAs while almost 16 percent do not perform follow-up services, according to the findings.

However, almost 57 percent of the wellness professionals respondenting to the survey intervene immediately and refer employees with serious health problems to physicians, emergency facilities and other care providers, the survey discovered.

Referral Process

Methods of referral to health professionals include onsite and offsite procedures, wellness managers said.

“At the time cholesterol and blood pressure are measured, a doctor’s referral is given to the employee, if needed,” said a provider of wellness services. “We follow up after two weeks to see if these employees actually did see their doctors.”

Others make direct contact with the physician to whom an employee is referred.

“If we refer an employee to a primary care physician (PCP), we mail the PCP a postcard and ask them to send it back if the employee has been seen,” explained a program coordinator. “We do the same thing with our outpatient wellness programs.”

High Risk Situations

Situations involving employees found to be in a high risk status usually prompt immediate action, according to the study.

“Employees determined to be at high risk for cardiovascular events or cancer are referred to their PCPs with a copy of our findings,” said a wellness program director. “Depending on how acute the risks are, we may even call the PCP in the patient’s presence and refer from that moment.”

HIPAA

“With the HIPAA guidelines, we have the participant read and sign an informed consent form that gives us permission to send copies [of the HRA findings] to their PCP and discuss their personal data with designated medical personnel,” a program manager explained.

“If the participant needs referral to outpatient wellness programming, the person is furnished with the name and phone number of the appropriate contact,” the manager continued. “But whatever the process, we are extremely mindful of confidentiality and privacy. There are times when we might even be overly cautious, but this is a very important and emerging area of concern.”

Resources

Wellness professionals primarily rely on the following resources for HRA referrals, the study revealed:

* Onsite nurse care managers.

* Health management summaries that explain aggregate results from HRA responses.

* Onsite medical departments that consist of physicians, nurses and wellness professionals.

* Contact lists of health insurance plan member physicians.

* Telephone counseling.

* In-person health education/behavioral change counseling.

Monitoring Success

Along with intervention comes the monitoring of success rates, and survey respondents track the HRA success rates in a variety of ways.

The use of employee participation and feedback was cited by most respondents, along with:

* Clinical test results.

* Lifestyle questionnaires.

* Onsite education.

* Administration of HRAs on a yearly basis to compare and monitor improvements in employee health status.

* Annual health management summaries that detail aggregate results from HRA responses (the results also are used to evaluate various company wellness programs).

* HRA updates performed at six-month and 12-month intervals.

* Comparison of HRA results to employee use of sick time, workman’s compensation claims, general health claims data and company HMO utilization.

* Baseline health screenings.

* Tracking the percent of employees identified as “at risk” for a serious health condition, along with the percentage who accept and follow through with subsequent referrals for further medical evaluation or care.

* Quarterly reports that measure increases in participation.

* Executive summary reports compiled before and after HRA administration.

* Estimation of cost savings from employees who have lowered their health risks by improving personal health, such as weight reduction, lowering blood pressure, and cholesterol and reduction of tobacco use.

* Sharing of experiences and personal success stories in wellness department newsletters.

“We can’t discriminate based on outcomes, so we monitor compliance,” noted a wellness program coordinator.

“For instance, if you are told to lose weight, we require that you attend eight sessions of Weight Watchers, for which the company pays,” the coordinator said. “But we don’t require that you actually lose the weight. Compliance is all we can legitimately require.”

Source: Workplace Wellness Management Leadership Survey conducted online at www.WellnessJunction.com

Tapping Into Your Resources: Cafeteria Personnel

Experts in the workplace wellness and health promotion field often encourage managers to aggressively integrate themselves throughout organizational departments.

This integration serves two purposes. It creates unique opportunities for the wellness department to influence employees’ quality of life at a systemic level. As interdepartmental relationships grow, the wellness staff will gain access to previously untapped resources.

One natural target of opportunity is on-site snack bars and cafeterias. While enhancing the healthfulness of food options is an obvious goal, serving line customers are particularly receptive to nutrition information. Being able to rely on dining facility personnel to answer simple questions and appropriately refer customers with more complex needs is an invaluable asset to the health promotion manager.

Dining facility personnel underestimate the impact they have on their customers’ health. All you need is to provide a little nurturing, a little education, a few resources and some motivation.

Step One: Overcoming Fear

A seven-month study reported in the Journal of the American Dietetic Association demonstrated that when a comprehensive marketing campaign preceded lowering fat and sodium content in food choices in the Kansas Farm Bureau and Affiliated Service employee cafeteria, no significant differences in sales data were observed. Study authors concluded that “customers in worksite cafeterias may be more willing to tolerate changes in flavor attributes when modified entrees are marketed as ‘healthful’ and nutrition information is available.”

It is important for wellness managers to arm themselves with such studies. Dining facility managers are often concerned that modifying food choices to make them healthier may affect the flavor, and thus, their sales. Work with the dining facility staff to develop a comprehensive marketing campaign. This is important for program success and will go a long way to calm any fears.

Step Two: Training

Evaluate the existing nutrition training of dining facility personnel. Offer to conduct a series of nutrition/healthy eating inservices to address any deficit areas in their education. Provide videotapes and other learning tools that can be used during staff breaks. If the budget allows, offer to bring in a nutritionist/dietitian periodically to advise staff, review menus, etc.

In addition to formal inservices, make a practice of providing frequent nutrition quick tips to the staff (at least weekly, if not daily). The “tips” can be included during staff meetings, in an e-mail, or in the form of a poster or flyer. Besides nutrition and food preparation information, include inservices and tips on where to refer customers for more advanced nutrition counseling or other information.

Step Three: Motivation and Reward

As the inservice training gets underway, initiate an ongoing dining facility staff competition. The purpose of this competition is to reward dining facility personnel who learn key information provided in the inservices and training material.

Periodically, a “planted” customer going through the serving line at mealtime asks a nutrition-related question randomly of a server. The question should be challenging and appropriate to real-world customer questions and nutrition decisions facing the server.

If the dining facility staff member correctly answers the question, a wellness staff member or other designated official (discreetly standing nearby) comes forward, publicly congratulates the server and gives him/her an incentive award or prize.

If the dining facility staff member cannot answer the question, avoid embarrassing the server. The “planted” customer quietly hands him/her a card with the question and correct answer, then moves on through the line without comment.

Step Four: Recognition

Once the dining facility education program has been completed, offer the cafeteria and snack bar personnel the opportunity to take a voluntary nutrition test. If they successfully pass the test, provide them with a designation that sets them above the other line servers as a basic nutrition counselor. Give them a pin and certificate that reflects this title. For instance: “Certified by your Health Promotion Office as a ‘Cafeteria Nutrition Counselor.’” Discuss with the department chief making this certification a factor for pay raises or promotions.

Promote the dining facility staff’s cooperation and new expertise in nutritional counseling to the customers. Encourage employees to visit the cafeteria or snack bar and ask questions.

More Ideas

The following suggestions are pulled from the “5-A-Day Worksite Implementation Guide.” The entire guide can be downloaded from the American Cancer Society’s Web site: http://www.cancer.org/docroot/COM/content/div_OH/COM_11_2x_5ADay.asp?sitearea=COM (Click on “For Your Worksite” once you reach this page). A variety of nutrition and promotion material supporting this program is available free of charge.

Ask the cafeteria to sponsor cooking demonstrations. This can include cleaning, peeling and chopping fruits and vegetables, as well as various cooking techniques (e.g., stir-fry, steaming, microwaving). Provide participants with the opportunity to sample some of the prepared foods. Focus demonstrations on individual skill-building. Provide tip sheets and recipes from the cooking demonstration to reinforce the observed skill.

Cafeteria Labeling Program

Point-of-Purchase Promotion

Frequency Card Program

Offer discounts, such as three-for-two specials, by adding more fruits and vegetables to menu offerings.

Offer fruit and vegetable serving lines or pre-packaged ready-to-go fruits and vegetables.

Post a comparison of caloric and other nutrition information between junk food and fruits and vegetables.

Address: American Dietetic Association, 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995; (800) 877-1600, www.eatright.org.

 The purpose is to influence the consumer at the point of choice. It conveys messages and suggests simple steps that can be taken to increase one’s consumption of healthy food options at a meal eaten in the cafeteria. Some point-of-purchase promotions provide cues that encourage the purchase of fruits and vegetables outside the workplace as well as tips for cooking methods.

Point-of-purchase promotions could include: static cling stickers, floor mats, posters, balloons, flyers, free-standing signs, etc.

Such programs identify foods meeting the 5-A-Day (or other healthy choice) criteria with an identifiable logo and keep the message in front of employees by providing reminders about healthy choices. More importantly, the labeling program will provide a quick and easy way for employees to identify foods that meet 5-A-Day or other nutrition criteria.

– Increase the frequency of healthy food choices by rewarding frequent fruit and vegetable buyers with a free serving of fruit or vegetable after a certain number of servings have been purchased. – –  

Point-of-Purchase Promotion – The purpose is to influence the consumer at the point of choice. It conveys messages and suggests simple steps that can be taken to increase one’s consumption of healthy food options at a meal eaten in the cafeteria. Some point-of-purchase promotions provide cues that encourage the purchase of fruits and vegetables outside the workplace as well as tips for cooking methods. Point-of-purchase promotions could include: static cling stickers, floor mats, posters, balloons, flyers, free-standing signs, etc.

Frequency Card Program – Increase the frequency of healthy food choices by rewarding frequent fruit and vegetable buyers with a free serving of fruit or vegetable after a certain number of servings have been purchased.

Offer discounts, such as three-for-two specials, by adding more fruits and vegetables to menu offerings.

Offer fruit and vegetable serving lines or pre-packaged ready-to-go fruits and vegetables.

Post a comparison of caloric and other nutrition information between junk food and fruits and vegetables.

Address: American Dietetic Association, 120 South Riverside Plaza, Suite 2000, Chicago, IL 60606-6995; (800) 877-1600, www.eatright.org.

Wellness Managers and Issues Surrounding Return on Investment (ROI)

Return on investment or the ROI of a wellness and health promotion topic is always a key concern for wellness managers – proving the ROI of their programs to senior management.

The topic comes up every year on our Wellness Management Leadership Survey.It also has been the subject of numerous discussions on our Wellness Manager Discussion Group.

We have written about the ROI of workplace wellness in Wellness Program Management Advisor and some 17 articles written on the subject have been posted on WellnessJunction.com

Over on the Wellness Manager Discussion Group you can search on the term ROI over all the messages posted by the members and you’ll find more than 250 posts. Many of the messages have valuable information on this topic and on cost savings.

Just go to our Group home page on Yahoo. http://finance.groups.yahoo.com/group/WellnessManager

On the left hand navigation column click on Messages. Use the Search box:

Likewise, on WellnessJunction.com just use the Search box for articles on ROI and cost savings, etc. www.wellnessjunction.com

Understanding Audience Is Key To Incentive Program Success, Say Wellness Professionals

The key to designing a strong wellness incentive program is about “knowing your audience,” wellness management professionals said, according to the results of a workplace wellness management survey conducted by Wellness Program Management Advisor and WellnessJunction.com.

“I believe incentives can work, but you need to ‘know your audience,’” said an operations manager of a corporation responsible for the health promotion program, which offered incentives ranging from T-shirts, to drawings for iPods or airline tickets. “Providing them with a generic incentive doesn’t always motivate them. If you offer them ‘things’ that they don’t need or want, you won’t see any effect.”

And despite the trend in offering cash-based incentives (67.8 percent), the manager said that incentives do not have to be extravagant. “I’ve seen people be motivated by just receiving stickers on a hanging cut-out just because the reward is visible to others they work with.”

Another respondent also said she believes that incentives cannot be implemented blindly to employees.

“Incentives should be strategically given. If an incentive is always expected with little effort, it does not have the same impact overall,” said Paola Ball, fitness and wellness manager at an education institution focused on employee wellness. “Moreover, it is important for people to be driven by their own commitment as a result of the successful marketing of a wellness program and through encouragement by other staff members.”

“This promotes community and support for long- term behavior change,” Ball continued. “I havefound that some of the most successful programs have been those that do not put the emphasis on the prize, rather the emphasis is placed on congratulating participants for their commitment to wellness and their own health. Fun is also an essential component to a wellness program. If activities are looked at as a ‘fun thing to do’ instead of an imposed behavior change, people are more willing to sign up and try new things.”

Another survey respondent suggested that programs should urge the employees to see their self-improvements as the ongoing incentive.

“In my experience, people are initially motivated by the incentives and later excited and encouraged by the changes they see in themselves,” said Shelly Beall, a self-employed wellness professional.

The Wellness Management Leadership survey on incentives for participation in wellness programs was conducted online among wellness professionals and subscribers to Wellness Program Management Adviser, The Wellness Junction Professional Update and members of the Wellness Managers Professional Discussion Group.

Source: Wellness Program Management Advisor www.wellnessjunction.com

www.healthresourcesonline.com/wellness/18nl.htm

 

 

 

 

 

Wellness Executives Say 2008 Better Than Previous Year For Programs

The majority of wellness professionals thought last year was a better year for their programs, according to the Workplace Wellness Management Leadership Survey conducted by the Wellness Program Management Advisor in conjunction with WellnessJunction.com.

Executives were asked whether 2008 was a better year for their programs than the previous year 75.4 percent said it was and only 15.8 percent said it was not.

Maureen Barte, assistant coordinator of the Health and Wellness Institute at the Washington Hospital, agreed 2008 was a better year and added “this is year four of our employee wellness program and the employees are becoming more accustomed to stopping into our offices and joining different programs that are always on-going.”

Another executive said it was a better year “because the outcome measures are becoming more sophisticated and we are planning for expansion.”

A manager of organizational health and well-being said there was “a lot more support and recognition by executives of the importance of health and productivity.”

For Jason J. Paul of the LifeCore Group, 2008 was also better. He said, “many companies are learning that taking a one-time health analysis does not really create any long-term change.”

Another executive said in 2008 “the [wellness] program was all inclusive. Meaning we ensured consistency throughout the organization’s 17 regional locations. Each site has a wellness coordinator with monthly wellness team steering committee meetings and support.

“The company also dedicated significant budget dollars to support the program. Incentives are being used to gain participation.”

Daniel M. Moriarty, human resources manager for Jewish Geriatric Services Inc., said “By engaging the employees we were able to provide programs that they had an actual interest in and felt some ownership in the programs.”

For Gary Morriston, director of human resources at the Howard Training Center, 2008 was better. “United Healthcare/PacificCare became our health benefits carriers and brought an excellent wellness template that we are able to implement on a low budget but with high impact.”

Another respondent said, “By tying our benefits/wellness together, we realized where we needed to drive our programing going forward into 2009. We had a plan instead of scattered efforts at guessing what was working and what was not.”

Not all respondents agreed. For one executive it was not a better year because of the “administration’s emphasis on online programs which are less effective/interactive than traditional classes. [It is] harder to measure outcomes [and we] don’t have the secondary gain of team building and support in the work environment.”

A paricipant also thought 2008 was a worse year and put the blame on less money and more turnover. “Wellness is not at the forefront of our worries, or at least it doesn’t seem to be.”

“Fewer employees participated in our free wellness screening,” said an executive who felt that 2008 was not a better year.

**************************************************

Was 2008 better than the previous tear for your wellness program?

Yes – 75.4 percent

No – 15.8 percent

Unanswered – 8.8 percent

Source: Wellness Professional Salary and Benefit Survey 2008, Wellness Program Management Advisor.

**************************************************

Source: Wellness management Leadership Survey, Wellness Program Management Advisor, and Wellness Junction Professional Update www.wellnessjunction.com

 

 

 

Staying Healthy in a Tough Economy

With the current economy still in turmoil, it is difficult for many Americans to afford health care. Visits to doctors are down 10 percent to 15 percent and many individuals are not taking their medicines as prescribed. However, there are certain measures that can be taken to lessen the burden while facing tough economic times.

While many individuals are dealing with cutbacks, it is important that health care remain a top priority, says A. Mark Fendrick, M.D., professor of internal medicine at the University of Michigan Medical School and professor of health management and policy at the U-M School of Public Health.

Approximately one in nine individuals is cutting pills, taking them every other day or doing something the doctor did not recommend. Fendrick says, “Cutting back on health care without consulting your clinician is a very risky decision. It may not only have an impact on your health, but also have a worsening economic consequence that will lead to greater costs down the road when minor health concerns become major health issues.”

Fendrick suggests that people continue to follow up with their recommended screenings and immunizations and consult their clinicians before cutting back on health care. Although these preventative measures may cost you now, they are among the most important investments you can make to protect your health and may save you money in the long run.

There are affordable programs available to help individuals facing economic difficulties. Ask your doctor’s office or search online for information about decreasing or eliminating the costs of health insurance and prescription medications.

During an economic crisis, individuals with and without insurance tend to use the emergency room as a form of primary care. However, doing so could take a spot from someone who truly needs emergency care, while also compromising your own care.

“You should really think about going to your primary care physician who knows your medical history, coordinates your follow up care and interacts with other doctors to make sure you’re getting the highest quality care possible at the lowest cost,” says Fendrick.

While the economy is forcing individuals to make difficult choices Fendrick puts it in perspective: “Remember your health is your most important asset, not your money.”

Tips for healthy health care spending:

1. Continue to adopt healthy lifestyles: diet and exercise can help stave off many diseases.
2. Ask your doctor if prescription medications are available in generic forms.
3. Keep up-to-date with recommended screening tests, such as mammograms, colonoscopies or immunizations.

For more information, visit these Web sites:

Resources:
UMHS Financial Assistance: http://www.med.umich.edu/1toolbar/support/FA.htm
UMHS News: Children, adults using discount generic Rx programs: http://www.med.umich.edu/opm/newspage/2008/poll9.htm
UMHS News: Pill-splitting study looks at cost-saving step: http://www.med.umich.edu/opm/newspage/2007/split.htm

Employee Motivation, Program Funding Top List of Wellness Program Obstacles

Motivating employees to participate in wellness programs traditionally tops the list of problems for wellness professionals each, according to our exclusive annual surveys.

Always a significant number of respondents to the Wellness Program Management Advisor survey cite motivation as the biggest obstacle they’ve found in initiating or operating a wellness program.

While some respondents are looking for increased employee participation in programs or boosts to current low participation rates, others said they are combating the problems of “apathy” and maintaining individuals’ interest once they are currently enrolled in programs. Several respondents, for example, said getting people to commit to their program — particularly a comprehensive, multi-session program — was a huge obstacle.

“Short-term, they participate (i.e., flu shots, etc.); long-term, fitness teams, they don’t want to commit,” one respondent explained.

“Participation consistency of employees” is an obstacle, added another respondent.

Adding to the difficulty of motivating employees and generating interest in the program is the struggle to keep things fresh, or as one respondent noted, “creating programs to address the same risks year after year.”

Encouraging participation in programs isn’t the only problem, respondents noted. Some wellness professionals say that encouraging participation in evaluation surveys is a significant obstacle as well.

In conjunction with the participation problem, respondents said, is a lack of time, as employees and potential program participants say they can’t find enough time to commit to these programs. Approximately 10 percent of the survey respondents experienced this problem as a significant obstacle. For example, one respondent said there is a “perception that participation is time-consuming.”

“Ours is a self-paced, self-report program requiring only two hours per year to check in with a wellness specialist!” the respondent added.

Employee buy-in and overcoming “employee suspicion and distrust of motives” also is an obstacle, according to 5 percent of the survey respondents.

More on the survey results in our next post.

Source: Wellness Management Leadership Survey, Wellness Program Management Advisor copyright 2009

www.wellnessjunction.com

Preparing Your Workplace for a Possible H1N1 – Swine Flu Epidemic

The jury is still out on whether the H1N1 – swine flu outbreak will become widespread. However, it’s not too soon for employers to start preparing to prevent influenza spread at work and consider what to do if the illness reaches pandemic status.

If enough people become infected, it could seriously affect many employers’ operations.

You should begin pandemic planning now. Properly implemented, it can help limit the flu’s impact on employee health—and the economic health of your organization.

A host of possible problems

It’s usually difficult to plan for a crisis and respond to it thoughtfully while it’s occurring. That’s why planning now is so important. You’ll be able to act quickly should the need arise.

Because each business is unique, you must customize your pandemic plan to your particular workforce and business-continuity needs. However, several practical issues may affect almost every employer.

• Attendance could nosedive. Some employees may be unable to work because they are sick. Others may stay away from work because they fear becoming infected.
• The workplace might become contagious. Ill employees may insist on coming to work—because they need the income—even if they should stay home.
• Alternative work arrangements might be needed. You might need to consider having employees work remotely if authorities impose quarantines or employees refuse to or cannot come to your facilities. If you don’t already, consider cross-training employees to perform critical functions.
• Some employees may refuse to perform some of their regular duties because they fear being exposed to the flu. Those who travel frequently or attend large meetings may balk.
• Some employees may not seek healthcare for financial reasons or out of fear of exposure at the doctor’s office.
• Employees may need personal assistance. It might involve finding care for a sick relative. They may need help obtaining food, water or cash during a quarantine.
• Employees may be unable to focus on work (or work at all) due to the emotional fall-out of a pandemic. They may need time off, counseling or other assistance.

Your obligations as an employer

As they plan for a pandemic, employers face competing and complicated legal issues.

Employers are legally obligated to provide a safe workplace. In the face of a pandemic, you may be liable if your infected employees spread the disease.

Your best defense will originate in the prevention and response measures you include in your pandemic plan. It should include:

• A communicable disease policy. Emphasize that employees with flu symptoms must not come to work.
• Employee education on how to prevent spreading the flu. Good hygiene is the key. Remind employees to cover their mouths when they cough and their noses when they sneeze. Throw out used tissues immediately. Wash hands frequently, or use alcohol-based hand sanitizer. Avoid touching your eyes, nose and mouth.
• Other measures to prevent the spread of disease at work. Employers can reduce the risk of workplace infection by providing air ventilation and purifying systems, restricting travel and implementing remote or other work arrangements to reduce personal contact.

Of course, there is no way to anticipate all contingencies, but an employer’s reasonableness often plays a key role in defending against legal claims.

The U.S. Centers for Disease Control and Prevention offers an online Business Pandemic Influenza Planning Checklist that can help you audit your readiness to deal with swine flu.

Employment law issues

Employers must balance their obligation to maintain a safe workplace with other legal obligations. Consult with your attorney for more advice on these important issues. The FMLA, ADA and other laws may apply here.

While you will want to make reasonable efforts to keep contagious workers home, disability laws may limit your right to ask employees about their medical conditions or require them to take medical exams. In addition, you must consider employees’ privacy rights and whether falsely accusing someone of having a pandemic flu could be defamatory.

Employers must also address their legal obligations to employees who must miss work for medical reasons. You may be legally obligated to provide leave and restore employees to their jobs when they return from leave.

Depending on the circumstances, employees may be entitled to worker’s compensation benefits, paid time off, disability or other paid benefits, continued health insurance or unemployment benefits.

As a practical matter, be prepared to voluntarily extend your time-off policies.

You might also want to consider voluntary, special pay policies designed to encourage contagious employees to stay home.

When an employee who isn’t protected by leave or disability law refuses to come to work out of fear, you may have to decide whether to grant the time off or terminate the employee. That decision has legal implications. Consider whether the employee is at-will, as well as the risk of other legal claims. In particular, OSHA law protects employees from retaliation if they refuse to work because of good-faith concerns about workplace safety.

It may seem easiest, particularly during these tough economic times, to defer planning for a pandemic that may not occur. Given the human stakes and the complexities involved in an actual pandemic, however, advance planning is critical to ensure a careful, thoughtful response.

By Megan Anderson, Esq., a principal at the law form of Gray Plant Mooty in Minneapolis. She concentrates her practice in employment law counseling and litigation. Contact her at (612) 632-3000. Additional reporting by HR Specialist.