This workshop is designed to create collaborative problem solving for participants around a hypothetical scenario (See Part 4) to create a small business wellness initiative in the community. Participants are assigned to tables for diversity of composition (employees, employers, providers, insurers, non-profits). The room also has experts from the community available for consultation. The goal is to identify key elements and strategy needed to launch an effective community-based wellness initiative that supports small businesses. This full-day workshop was conducted at the Houston Wellness Association in January of 2010 with about 30 participants This is PART 1 of the slide deck; PART 2 reviews the results of the grant-funded Small Business Wellness Initiative (www.sbwi.org) Please contact OWLS at learn@organizationalwellness.com if you would like technical assistance or training on how to conduct this workshop and launch an SBWI in your community

1. Build it and They Will Come: Launching an Effective Program for Small and Medium Size Companies 2010 WELLNESS SYMPOSIUM Strategies for Companies & Communities to Impact Health in A Changing Economy Facilitator Dr. Joel B. Bennett Organizational Wellness & Learning Systems © 2009; Organizational Wellness & Learning Systems, Inc.—www.organizationalwellness.com

2. WORKSHOP OUTLINE This workshop is designed to create collaborative problem solving for participants around a hypothetical scenario (See Part 4) to create a small business wellness initiative in the community. Participants are assigned to tables for diversity of composition (employees, employers, providers, insurers, non-profits). The room also has experts from the community available for consultation. The goal is to identify key elements and strategy needed to launch an effective community-based wellness initiative that supports small businesses. This full-day workshop was conducted at the Houston Wellness Association in January of 2010 with about 30 participants This is PART 1 of the slide deck; PART 2 reviews the results of the grant-funded Small Business Wellness Initiative (www.sbwi.org) Please contact OWLS at learn@organizationalwellness.com if you would like technical assistance or training on how to conduct this workshop and launch an SBWI in your community

3. Other Presenters Olivia M. Dear, Director TexHealth Harris County 3-Share Plan (Harris County Healthcare Alliance) Ashly Alberto, Corporate Market Director, Houston Heart Walk, American Heart Association SebabiLeballo, Organizational Development Manager, HCSS, Construction Software & Services Daniel Francik , Corporate Ambassador HCSS, Construction Software & Services

4. EMPLOYEES EMPLOYERS or their representative A. Very Small Business Owner/Employee- less than 100 employees (not wellness provider); B. Small Business Owner 100 to 500 employees (not wellness provider) C. Small to Medium larger than 500 employees (not wellness provider) PROVIDER (Wellness Practitioner) INSURER CORPORATE Representative NON-PROFIT agency Participants (YOU): Which best describes you?

5. Each table has good representation?

6. LAUNCHPAD Small Business Wellness Program Workshop Segments Strategy Key Elements

7. What we mean by “SMALL” businesses 26% 87% 11% 46% 1% 24% These data refer to the first quarter of 2004, downloaded from the BLS Quarterly Census of Employment and Wages (QCEW) website http://www.bls.gov/cew/ (accessed June 2005).

8. Why Small Business? Top Ten Reasons SBs significantly less likely to do Health Promotion* SBs are 99% of all employers, w/60% of workforce Have generated 60% to 80% of net new jobs Employ majority of workers in a given community Sickness absence impacts work (replacement issues) 1 person has more social modeling (CEO-ripple effect) With less insurance, prevention more important Many SBs have positive work culture to leverage Entrepreneur/CEOs have humanitarian motives Promising practices exist (CDC SWAT study) * Healthy People 2010 targeted 75% businesses to receive wellness, but <50% do so and some indication this is declining

9. More on the Insurance Problem The principal barrier to small businesses in Texas offering employer-sponsored health insurance is affordability. Recent US Census reports indicate that 1:3 Harris County non-elderly adults are uninsured; almost a quarter of the state’s population. Two-thirds of uninsured adults are employed, with 44 percent working at firms that employ less than 25 workers. Small business employers who depend on health insurance to attract and retain workers are finding it hard to find cost-effective insurance for their employees.

10. Part 1: What are SBs doing?(norms and trends) SIZE MATTERS

11. Society of Human Resource Management 2009 Benefits Survey (% offering benefit) 3,000 HR managers randomly selected from 250,000—www.shrm.org ISBN 978-1-586-44155-5—SHRM 2009 Employee Benefits Report

12. Selected Programs compare with National Survey

13. Five Areas to be Compared Note. Gym membership is 30% to 35%, NO size differences

14. 2004 national worksite health promotion survey Directed by “Healthy People 2010” Initiative Random telephone survey Worksites sample (not organizations) Respondents “directly responsible for health promotion or wellness” or “in-depth knowledge of these types of programs at the worksite” Sample size 730 (60% response rate compares with 19% rate in SHRM survey) Over-sampled small businesses (compares with more corporate focus of SHRM survey) Linnan, L., Bowling, M., Childress, J., Lindsay, G., Blakey, C., Pronk, S., Wieker, S., & Royall, P. (2008). Results of the 2004 national worksite health promotion survey. American Journal of Public Health, 98(1), 1-7.

15. Comparing HR with those more familiar Providers (National Survey) HR Personnel (SHRM)

16. Focus on Small Businesses (2000, California) PHYSICALHEALTH BEHAVIOR MANAGEMENT SAFETYPROGRAMS Violence Prevention Substance Abuse Prevention Stress Manage- ment Counseling Smoking Cessation Cholesterol Screening Physical Fitness Diet or Weight Manage- ment 1,846 Small Businesses Surveyed (sizes 2-14, 15-99, 100-500) [Los Angeles and Orange counties, California] McMahan, S. Wells, M., Stokols, D., Phillips, K., Clitheroe, H. C., (2001, Summer). Assessing health promotion programming in small businesses. American Journal of Health Studies (17.4% Response Rate)

17. The Smallest of the Small (looking at the smallest businesses across the three surveys) For planning, targeting, and marketing small distinctions make a big difference

18. So what? There is promise . . . Need to pay more attention to the very small (< 50) as these are majority of establishments Essential to know who you are talking to: Human Resources CEO Internal Wellness Champion Significant variation by industry Safety may be a lever Humanitarian outcomes (rather than financial) may be more important * Genuine concern for well-being of employees Improve the quality of their life Small businesses can do comprehensive programs * Divine, R. L. (2005). Determinants of small business interest in offering a wellness program to their employees. Health Marketing Quarterly, 22(3), 43-58.

19. Part 2 Many Methods are Available

20. Strategy is a critical

21. Strategic Elements of the Launch Pad CEO/Mgr Engagement Organization (Policy) Individual Health External Support & Community Integration Environment Team/Support © 2009; Organizational Wellness & Learning Systems, Inc.—www.organizationalwellness.com

23. Strategy Matrix for Small Business Wellness Planning © 2009; Organizational Wellness & Learning Systems, Inc.—www.organizationalwellness.com

24. PART 3 SOLUTIONS AND BEST PRACTICES

25. Solutions & Best Practices START: FIT FRIENDLY (Walking Challenges) TEXHEALTH HARRIS COUNTY 3-SHARE PLAN (Accessing Community Healthcare/Insurance) WORKPLACE WELLNESS ‘LIVE UP TO YOUR FULL POTENTIAL’ (HCSS-Heavy Construction Systems Specialists) SMALL BUSINESS WELLNESS INITIATIVE (Evidence-Based Health Promotion)

26. SCENARIO PART 4

27. Scenario Harris County (towns, cities) identified as 1 of 20 areas in the country to receive a Phase I challenge grant (cooperative agreement) for $2 Million 8 counties/areas will move to Phase II (10 years; $5M) Three years to demonstrate: Can match the $2M with private & public monies Deliver health promotion to 100 small businesses that have not received services (industry, diversity, health disparities) 50 of these with less than 50; 25 w/51 to 100; 25 w/ 100+ Demonstrate Insurers and SB CEO collaboration w/community Programs in place for at least 1 year with demonstrable outcomes in four areas Behavior change (health improvement) Environmental and/or culture change Policy changes are effective CEO engagement

28. References Barbeau, E., Roelofs, C., Youngstrom, R., Sorensen, G., Stoddard, A., & LaMontagne, A. D. (2004). Assessment of occupational safety and health programs in small businesses. American Journal of Industrial Medicine, 45, 371-379. Brissette, I., Fisher, B., Spicer, D. A., & King, L. (2008). Worksite characteristics and environmental and policy supports for cardiovascular disease prevention in New York State. Preventing Chronic Disease, Public Health, Research, Practice, and Policy, 5(2), 1-12. Divine, R. L. (2005). Determinants of small business interest in offering a wellness program to their employees. Health Marketing Quarterly, 22(3), 43-58. Eakin, J. M., Cava, M., & Smith, T. F. (2001). From theory to practice: A determinants approach to workplace health promotion in small business. Health Promotion Practice, 2(2), 172-181. Linnan, L., Bowling, M., Childress, J., Lindsay, G., Blakey, C., Pronk, S., Wieker, S., & Royall, P. (2008). Results of the 2004 national worksite health promotion survey. American Journal of Public Health, 98(1), 1-7. Hunnicutt, D. Big steps for small businesses: The art of implementing a great wellness program in a small business setting. Absolute Advantage, The Workplace Wellness Magazine, 7(2), 3-44. McMahan, S., Wells, M., Stokols, D., Phillips, K., & Clitheroe, H.C., Jr. (2001). Assessing health promotion programming in small business. American Journal of Health Studies, 17(3), 120-128. McPeck, W., Ryan, M., & Chapman, L. S. (2009). Bringing wellness to the small employer, American Journal of Health Promotion, 23(5), 1-10. Society for Human Resource Management (SHRM). (2009). Employee benefits: Examining employee benefits in a fiscally challenging economy. Retrieved INSERT DATE, from www.shrm.org/surveys.