KICK START ENROLLMENT

Transcription

1 KICK START ENROLLMENT ORGANIZATION INFORMATION This section is used to captue infoation about you oganization and eployee population. Contact Nae Contact Position Contact Phone Contact Eail Nube of Eployees Full Tie (oe than 50% of the tie) Pat Tie (less than 50% of the tie) Contacted How any eployees ae woen? List the nube of eployees in each age ange < 21 yeas old and olde Does you oganization cuently have a wellness poga?, ou oganization cuently has a wellness poga, ou oganization does not cuently have a wellness poga Health Links povides advising suppot to help kick stat o ipove woksite wellness and safety pogas in you oganization. Check yes if you would like to apply fo suppot:, I agee to tes and conditions and would like apply fo advising suppot fo woksite wellness and safety pogas. Kick-Stat Enollent 1

2 ORGANIZATIONAL SUPPORTS One of the fist steps to establishing and pooting a successful woksite wellness poga is to gain owne/leadeship level suppot. To evaluate senio level coitent within you oganization please answe the following questions: What oganization suppot do you cuently have fo you poga: (check all that apply) Copany wide counications acknowledging suppot of wellness pogas Suppot fo paid woksite wellness coodinato(s) Leadeship paticipates in wellness poga Coodination with safety poga We do not cuently have leadeship suppot Have you aleady foed a wellness coittee? This could be a single individual o ultiple individuals. Answe yes if you coittee exists and is involved in planning and coodinating pogas. How any eployees ae on you wellness coittee? Who ae you wellness chapion(s)? This is one o oe people who actively poote pogas to ipove woksite health pootion in you oganization. Senio Executive (CEO, CFO, COO) Manage Eployee Do not cuently have a chapion RESOURCES It is ipotant to develop a clea undestanding of the esouces needed to suppot a woksite wellness poga to eet the needs of you eployees and the oganization. Ove the next 12 onths, what esouces will you oganization dedicate to developing you wellness poga? This could be an annual budget o funds specifically allocated to health pootion pogas o the sevices you povide to eployees. Financial Voluntee staff tie Equipent (execise equipent, facilities) Vendo sevices (Health Risk Assessent, Online coaching, Health sceenings, Fitness classes) Kick-Stat Enollent 2

3 Appoxiately how uch oney has you oganization budgeted to suppot wellness fo the next 12 onths? Povide you budget fo the next 12 onths below. EXPENSE AMOUNT Staff Suppot Wellness Suppot Safety Suppot EVALUATION OF NEEDS A successful woksite wellness poga eets the health and safety needs of all eployees. Tell us about the steps you took to evaluate the needs of you oganization. How will you deteine the health of you eployees? (Check all that apply) CURRENTLY USE ADD TO WISHLIST Eployee suvey Health Risk Assessent though vendos, onsite staff o health plan Physical Woksite Assessent (Identifying ways to ipove you woksite so that people can engage in health behavios) Safety Woksite Assessent Causes of Job Absence Disability clais & costs Healthcae clais & costs Wokes Copensation clais & costs Causes of injuies and accidents Othe _ YOUR HEALTH PROMOTION PLAN Descibe what the goals ae fo the pupose of the Health Links suppot? Kick-Stat Enollent 3

4 List you top thee pioities fo accoplishing these goals in the fist 6 onths. 1. _ List the top thee challenges you face in accoplishing these goals. 1. _ What pogas and sevices do you povide eployees as pat of you wellness poga at this tie? (Check all that apply) CURRENTLY PROVIDE Tobacco Contol Witten Policy Ban tobacco use Povide no soking educational ateials Refe eployees to quit lines Othe Nutition Witten policy o foal counication fo healthie options Povide nutitional infoation ateials Make healthie food and beveage choices available in vending achines Offe o poote on-site fesh fuit and vegetables Povide educational seies, wokshops o classes on nutition Othe Physical Activity Povide on-site execise facility Subsidize o discount the cost of on-site o off-site execise facilities Povide oganized individual o goup physical activity pogas (Fo exaple, you oganization povides oppotunities fo walking, stetching, yoga, weight taining) Povide educational wokshops, classes on physical activity Othe Stess Manageent Povide stess elief theapies onsite (yoga, assage, theapists) Povide financial advising fo eployees Povide faily counseling sevices Othe Kick-Stat Enollent 4

5 Weight Manageent Povide fee o subsidized body coposition easueent, such as Body Mass Index (BMI) scoes Povide fee o subsidized individual o goup lifestyle counseling fo oveweight o obese eployees Povide educational wokshops o classes on weight anageent Othe Mental Health (Such as depession, anxiety, PTSD) Povide fee o subsidized clinical sceening fo depession Povide access to online o pape self-assessent depession sceening tools Povide bochues, educational ateials o online esouces that addess depession Povide fee o subsidized individual o goup counseling eployees with depession Othe Chonic Disease (high blood pessue, diabetes, high cholesteol, heat disease, COPD, astha and othes) Povide fee o subsidized health o bioetic sceening Povide bochues, videos, postes o othe educational ateials that addess the high isk of chonic disease Povide fee, subsidized o efeal to chonic disease self-anageent poga (lifestyle odification, edication adheence, BP onitoing) Povide fee o subsidized chonic disease edications Oganize and host health fais o events on-site Othe Substance Abuse Povide fee o subsidized clinical sceening fo substance abuse Povide access to self-assessent tools Povide fee o subsidized individual o goup counseling Othe Cance Pevention and Suvivoship Povide access to evidence-based infoation about cance Motivate and ewad eployees and dependents who adopt and aintain healthy behavios that help educe cance isk Suppot individuals duing teatent fo and ecovey fo cance though edical, phaacy and othe benefits Povide esouces to help anages and eployees cope with a co-woke s cance Manage disability and leave Othe ADD TO WISH LIST Tobacco Contol Witten Policy Ban tobacco use Povide no soking educational ateials Refe eployees to quit lines Othe Kick-Stat Enollent 5

6 Nutition Witten policy o foal counication fo healthie options Povide nutitional infoation ateials Make healthie food and beveage choices available in vending achines Offe o poote on-site fesh fuit and vegetables Povide educational seies, wokshops o classes on nutition Othe Physical Activity Povide on-site execise facility Subsidize o discount the cost of on-site o off-site execise facilities Povide oganized individual o goup physical activity pogas (Fo exaple, you oganization povides oppotunities fo walking, stetching, yoga, weight taining) Povide educational wokshops, classes on physical activity Othe Stess Manageent Povide stess elief theapies onsite (yoga, assage, theapists) Povide financial advising fo eployees Povide faily counseling sevices Othe Weight Manageent Povide fee o subsidized body coposition easueent, such as Body Mass Index (BMI) scoes Povide fee o subsidized individual o goup lifestyle counseling fo oveweight o obese eployees Povide educational wokshops o classes on weight anageent Othe Mental Health (Such as depession, anxiety, PTSD) Povide fee o subsidized clinical sceening fo depession Povide access to online o pape self-assessent depession sceening tools Povide bochues, educational ateials o online esouces that addess depession Povide fee o subsidized individual o goup counseling eployees with depession Othe Chonic Disease (high blood pessue, diabetes, high cholesteol, heat disease, COPD, astha and othes) Povide fee o subsidized health o bioetic sceening Povide bochues, videos, postes o othe educational ateials that addess the high isk of chonic disease Povide fee, subsidized o efeal to chonic disease self-anageent poga (lifestyle odification, edication adheence, BP onitoing) Povide fee o subsidized chonic disease edications Oganize and host health fais o events on-site Othe Kick-Stat Enollent 6

7 Substance Abuse Povide fee o subsidized clinical sceening fo substance abuse Povide access to self-assessent tools Povide fee o subsidized individual o goup counseling Othe Cance Pevention and Suvivoship Povide access to evidence-based infoation about cance Motivate and ewad eployees and dependents who adopt and aintain healthy behavios that help educe cance isk Suppot individuals duing teatent fo and ecovey fo cance though edical, phaacy and othe benefits Povide esouces to help anages and eployees cope with a co-woke s cance Manage disability and leave Othe Please tell us about the policies and pogas you have that help poote health, safety, and wellbeing in you wokplace. YES NO Policies fo healthy eating, onsite cateing, and vending. Do you have policies fo food and beveages that follow the guidelines set by the USDA (i.e. poviding fuits & vegetables, educing sodiu, liiting suga-sweetened beveages, fee access to dinking wate, etc.) Policies and/o flextie fo physical activity. Does you oganization povide flextie to encouage eployees to paticipate in physical activity? Do you encouage paticipation and anage suppot of physical activity duing the wokday? Does you oganization encouage active fos of tanspotation fo couting to and fo wok? Biking Walking Public Tansit Capooling Policies aound accoodation fo nusing othes. Is you oganization awae of the fedeal and state law equiing accoodation of nusing othes? Does you oganization povide a pivate space (othe than a estoo) that ay be used by an eployee to expess beast ilk at wok? Does you oganization povide flexible and easonable paid o unpaid beak ties to allow othes to expess beast ilk at wok? Is staff awae of the wokplace lactation policy o tained on the policy? Counication pooting chonic disease pevention o anageent. Does you oganization counicate about pediabetes and the isk fo type II diabetes? Does you oganization povide fee o subsidized Diabetes Pevention Poga classes fo eployees at isk fo diabetes? Iunization pogas fo eployees. We offe onsite iunization fo all eployees We offe flextie o suppotive leave policies fo well-cae /peventive visits We povide fee o subsidized iunization fo eployees Kick-Stat Enollent 7

8 SAFETY The wellbeing of eployees depends upon both thei health and safety. As pat of this application, tell us about how you oganization addesses the safety of eployees. Do you cuently have a safety poga in place? If you do have a safety poga, descibe the goals and objectives of you safety poga. (Liit to 3 sentences.) If you do not have a safety poga in place, what does you oganization do to keep wokes safe on the job? (Liit to 3 sentences.) What effots has you oganization taken to contol and pevent physical injuy? (check all that apply) CURRENTLY ADDRESS PLANNING TO ADDRESS Eliinated hazadous ateials fo wokplace Replaced hazadous ateials with safe ones Changed the way we do ou wok to educe the isk of injuies Engineeing contols (Exaples: exhaust ventilation, fie detection syste) Adinistative contols (Exaples: Adjusted wok tasks o schedules to educe isk of injuy o hazadous exposue) Povided Pesonal Potective Equipent to eployees (Exaples: Respiatos, had hats, safety glasses) Ceated an witten accident pevention plan Othe _ We haven t addessed this in ou oganization yet Do you have a witten safety policy? Kick-Stat Enollent 8

9 Do you have a safety coittee o safety coodinato? Do you have a witten Retun-to-Wok Modified Duty policy? Do you have a violence and haassent pevention poga? In the last 12 onths, what has you oganization done to pevent chonic injuies and usculoskeletal disodes? (check all that apply) CURRENTLY USE ADD TO WISHLIST Conducted egonoic assessent Liited aount of tie wokes pefo epetitive tasks Modified copute wokstations Modified wokstations o wok tasks (othe than coputes) Othe _ We haven t done this yet Have you developed a plan fo disaste and eegency pepaedness? Is you oganization Cost-Containent Cetified though the State Depatent of Labo, Division of Wokes Copensation? COMMUNICATION ABOUT THE PLAN Does you oganization poote and aket woksite wellness and safety pogas to eployees? Answe yes if, fo exaple, you wellness and/o safety pogas use ultiple channels of counication, o send fequent essages to eployees. WORKSITE WELLNESS SAFETY Kick-Stat Enollent 9

10 Do you tailo pogas and education ateials to the language, eading levels, cultue o eadiness to change of vaious segents of the wokfoce?, we cuently tailo pogas t yet, but it is ou goal to tailo pogas, we do not tailo pogas PROGRAM REACH Do you have a poga that includes eployees who wok off-site? Answe yes if, fo exaple, you poote health pootion and safety pogas to eployees that wok eotely, on the oad o telecoute. Does you oganization ake any health pootion pogas available to faily ebes? If you cuently have a wellness poga, what pecentage of eployees paticipate? INCENTIVES What type of incentives do you offe? (check all that apply) CURRENTLY OFFER PLANNING TO OFFER Discounted health insuance peius Contibutions to edical spending o health savings accounts Recognition/Awads Pizes/Dawings Cash Incentives Wellness Picnics / Luncheons / Celebations Paid tie fo paticipating in wellness activities Othe _ Do not cuently offe incentives Kick-Stat Enollent 10

11 PROGRAM EVALUATION In the next 12 onths, how will you evaluate you woksite wellness and safety pogas? (check all that apply) Conduct an eployee satisfaction suvey Tack eployee paticipation Collect data on eployee health outcoes Collect data on eployee safety outcoes (Such as tacking injuies, accidents and nea isses) How will you use the data that you collect to ipove you pogas? (50 wod ax) OPERATIONS Successful woksite wellness and safety pogas ipove the health of you eployees and you oganization. In the past 12 onths, has you copany expeienced gowth in evenue? Inceased evenue copaed to last yea Deceased evenue copaed to last yea change in evenue copaed to last yea Don t know Does you copany offe health insuance coveage to its eployees? Does you copany offe health cae coveage fo spouse, faily and dependents? How uch does you oganization pay in health cae peius (annual peiu cost fo the cuent yea)? Does you oganization povide woke s copensation coveage? Kick-Stat Enollent 11

12 How uch does you oganization pay in woke s copensation peius? (Cost fo the cuent yea) On aveage, how poductive ae you eployees? Low poductivity Mediu poductivity High poductivity In the past 12 onths, how any days did eployees take off fo wok? Days away due to disability Days away due to PTO Days away due to sick tie COST IMPACT Tell us how the health and safety of you eployees affects you cost of doing business Please indicate how uch each of the following factos ipacts you costs: HIGH IMPACT MEDIUM IMPACT LOW IMPACT NO IMPACT Lost wok days due to poo health Lost wok days due to illness (not elated to wok) Lost wok days due to disability (not elated to wok) Lost wok days due to wok-elated injuy o wok-elated illness Health insuance costs Wokes copensation costs Lost poductivity Eployee job satisfaction THANK YOU. Kick-Stat Enollent 12