Business of Well-being

Interview with Vicki Robinson, Manager, Insurance Services, City of Las Vegas

Corporate Wellness Magazine: Vicki, tell us a little about yourself and what you do now with the City of Las Vegas.

Vicki: I have an MBA from Syracuse University, an SPHR and recently got my ARMP. I wanted to do that before I retired. In my career I have mostly concentrated on risk management, but as Connie Goss from Wisconsin said it is all risk management even it is group health. She is right because is it claims, is it claims and is it claims? I have been handling all of the city's insurance services including group health, workers comp, liability, FMLA and wellness since 1996.

CWM: How important is corporate wellness? Is it one of the only ways to reduce healthcare costs for a self-funded health plan?

Vicki: I think it is integral to a successful, sustainable healthcare plan, but it certainly is not the only way to reduce costs. There are many others, you can simply cut benefits or you can make the employee shoulder more of the burden. One of the very successful ways that we have been able to cut costs is through a consumer driven healthcare plan, but I think that wellness is one of the best ways because it is simply a win-win.

CWM: What corporate wellness programs have you implemented for the City of Las Vegas?

Vicki: We have a very, very active wellness program. When we went to the consumer driven plan about 5 years ago we saw our costs level off very quickly, but we recognized very soon that our employees were not taking advantage of the electronic, online kinds of tools that we provided for them.

We thought that it was not fair for us to provide coverage based on your being able to take care of yourself and not providing people with the means to do that. You need to not only give them the resources and the tools, but you also need to give them the support. 4 years ago, we went out and started looking for how do we get someone on the ground because we wanted someone who could interact directly with our employees rather than telephonically or online.

So a little over 3 years ago we hired Wellness Coaches USA, they provide 4 wellness coaches for us that are there 4 days a week, 10 hours a day. They divided up our employee base, we have about 3,000 employees and they divide it up so that they say that each coach has about 750 really good friends. They do all the coaching, counseling, one-on-ones and they run our contests like the Biggest Loser, the Walk Nevada and all of the different programs that we have.

They do our promotional activities that we have and they do all of our education programs. If we are going to field a team for Race for the Cure they are the ones who are the captains of the team. They have been captains of different teams for us, like Corporate Challenge which is in Nevada where a number of companies get together and challenge each other on dozens of different activities, from bowling to archery and everything in between.

Basketball, golf and any physical activity and they are ordinarily the captains of a number of teams. Our goal is to provide individual wellness that works for the individual. I don't think that there is a one size fits all answer. What makes me happy and what motivates me intrinsically may not motivate someone else and may make them less inclined to be healthy and so we are not looking for perfect health we are just looking for healthier employees.

CWM: What programs would you say have had the most success?

Vicki:  We do a program that is called Tutti Fruity Tuesday and that is where the first Tuesday of every month the wellness coaches go out and hand out a banana, an apple, pear or whatever the fruit of the month is to our employees and there are signs on the wall that say Tutti Fruity Tuesday is coming, etc.

It gives the coaches an opportunity to talk to and approach people that may not have wanted to be approached before. Employees will stand in line and say, where is my apple? Where is my banana? That person that did not want to talk about their hypertension or maybe has been struggling about the idea that they might talk about weight today will genuinely sit down with a coach and talk.

It is a wonderful door opener and it is also a good reminder that 1 - The city cares about you and 2 - That you don't have to eat the Snickers bar for a snack. We have had a number of Biggest Loser contests which have been very successful and we are now up to over 8,000 lbs. that have been lost in the last 3 years.

Probably 6 of those last 8,000 are the same lbs. that have been lost over and over, but I don't care as long as we aren't going up. If we are going down that is a good thing. We did a really successful program this past fall where instead of looking just at physical wellbeing we also looked at emotional wellbeing. The city of Las Vegas and the surrounding Las Vegas valley has experienced some real financial downturns.

It is no secret that we are one of the worst hit cities in the country in terms of recession so there has been a lot of stress and a lot of worry. A number of charities that have always been able to count on our casinos for donations and contributions were not getting the kind of contributions that they had in the past so we did a program called Wellness for the Soul: Pay it Forward.

Each one of the wellness coaches had each of their groups of employees vote on which charity they would like to work on primarily. Then we had a contest for who could come up with the most of something based on a point system. If you brought in food, $5, clothing for schools, contributions to the animal shelter or when they did projects like filling backpacks for the school for the weekend programs where kids take food home over the weekends to eat.

That is just gut-wrenching for me to have to say that. They would spend the afternoon at the animal shelter and literally clean cages. The idea was that the people that work for the City of Las Vegas are so lucky, they are paid very well, the benefits structure is wonderful and there a number of people out there that are a whole lot less lucky than they are.

If you can spend 10-15 minutes or an hour doing something for someone else it makes you feel good, lowers your blood pressure, puts a smile on your face and just makes everyone feel better. From our City Manager down to the people that drive our street sweepers, they all got involved and all loved it. It doesn't necessarily have to be ways to lose weight.

CWM: What is the best way to get employee engagement in wellness programs?

Vicki:  When we started, we thought that the best way was to try to come up with rewards. Here is your $50 gift certificate, here is your jacket, here is your gift certificate to a gym, etc. We have since discovered that those are nice and people like them, but it isn't the only thing that motivates them.

We have found that rewards need to be personal and they need to be intrinsic. I have on a regular basis gotten emails from people that say, I have lost 60 lbs. and I am going to live to see my son grow up, thank you for the Wellness Coaches.' The 6th floor has a walking crew at lunchtime and someone sent me an email that said, I just walked up 6 flights of stairs and I didn't die! Thank you Wellness Coaches!'

They are beginning to do it for themselves, for their families and wanting to be okay. To do it because you want to be a part of the group, because you want your picture in the wellness newsletter standing next to the City Manager, because you want the plaque on the wall that says you were a part of the team that won the Wellness for the Soul challenge.

Although I would love to say that we do a lot of monetary gifts, we don't. As our budget has gotten tighter, we have done less and less of that. We have done a lot more of the recognition of look at how this is going to improve your life.

We have a less than 5% turnover rate, so when we hire someone unless they leave due to some disabling condition or choose to go to another city, up to about a year ago due to the economy, we knew when we hired someone that we had them for life and needed to take care of them so we talk about saving the city one employee at a time.

CWM: What would you say to another employer that is interested in wellness programs, but isn't sure if they will get their return on investment?

Vicki: ROI is such an interesting thing, we have chased it since 2004 when we first went with our consumer driven healthcare plan. We look at how do we deal with concrete numbers, how do we say that this is a payoff for us? The University of Michigan will tell you that it's at least a $3 payoff for every dollar that you spend.

We did not start doing wellness programs or the consumer driven healthcare plan necessarily just to save money, but I will spend no more money this year in my 2010 budget than I did in my 2005 budget for group health. Up until recently we haven't done extensive layoffs, but we probably will be doing them depending on some wage concession discussions with the unions.

We had more people, not fewer, than we did in 2005 so I have a flat trend. I have gone 6 years now without having to ask for an increase in my budget and that is with adding the wellness program, the cost of the coaches and any of the other incentives and/or programs that we do plus a number of things that we have added.

For us, the proof is in the pudding. Our ER visits and our hospitalizations have both been down by 40% over the last 6 years. Is that because of the wellness coaches and because of our consumer driven healthcare plan? It has got to be one or the other, or both, because otherwise our employees until recently thought that it cost $10 to go to the doctor and there wasn't much to it because they went when they wanted to and spent money when they felt like it.

They certainly aren't any younger, our average population age is about 46 so it's not like they are getting younger or they are getting particularly more cost conscious. I think we are getting them culturally, where they live, etc. If they show up in a meeting and there are doughnuts they will ask, where is the yogurt, where is the fruit?

It doesn't mean that they don't eat the doughnuts, but at least they ask for the healthy choice. We don't see nearly the number of muffins the size of your head anymore. Are we the perfect place to work? Absolutely not. Have we pulled together the perfect program? No, I go to conferences and I think of everything that I still have to do before I retire!

But we have genuinely started to move the Titanic, taking a group of very entitlement oriented people and making them start thinking about being responsible for their own health.

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