The Lucas County Employee Wellness Program Health Coaches

1 This document is brought to you by:

The Lucas County Employee Wellness Program Health Coaches:

Alex Davis Amanda Watts Katie Brown Sundaye Moore Taylor Pratt Unity Johnson

One Government Center Suite 440 Toledo, Ohio 43604

2 Table of Contents The Lucas County Wellness Program Response to COVID-19 Chapter One: Introduction to the Lucas County Wellness Program

 Mission ……………………………………………………………………………………………………………………………………...8

 Vision ………………………………………………………………………………………………………………………………….. ..8

 Strategic Priorities ……………………………………………………………………………………………………………..… .8

 2019-2020 Goals and Objectives Outcomes……………………………………………………………….……...9-10

Chapter Two: Reimbursement Programs

 Purpose ………………………………………………………………………………………………………………………………… .12

 Eligibility ……….…………………………………………………………………………………………………………………..….12

 Exclusions …………………………………………………………………………………………………………………………… .12

 Limitations ………………………………………………………………………………………………………………… ………..12

 Forms and Required Information ……………………………………………………………………………………..13-14

 Covid-19 Reimbursement Contract Changes………..……………………………………………………………….14

 Examples of Contracts …………………………………………………………………………………………………… .16-23

Chapter Three: On-Site Exercise Programs

 Overview………………………………………………………………………………………………………………….…………… 25

 Wellness Activity Calendar……………………………………………………………………………….………………… 26

 Yoga Promotional Flyer …………………………………………………………………………..………..……………… 27

 Zumba Promotional Flyer …………………………………………………………………………………………...…… 28

 Pound Promotional Flyer ……………………………………………………………………………………………….…… 29

 Covid-19 Wellness Activity Calendar…………………………………………………………………………...………30

 On–Site Exercise Program Evaluations……………………………………………………………………………..31-32

Chapter Four: Annual Employee Health Fair

 Overview ………………………………………………………………………………………………………………….………… 34

 Vendors and Services………………………………………………………………………………………….…………… 35-36

 Raffle Prizes and Winners ………………………………………………………………………………….……………37-42

 Employee and Vendor Evaluation Analysis ……………………………………………………………………. 43-44

3  Cancellation of 2020 13th Annual Health Fair………………………………………………………………….45

 Improvements ………………………………………………………………………………..………………………………..45

 Health Fair Promotional Flyer…………………………………………………………………………………………..46

Chapter Five: Annual Employee Fitness Expo

 Overview ………………………………………………………………………………………………………………………… .48

 Employee and Vendor Evaluation Analysis ………………………………………………………………….49-50

 Fitness Expo Promotional Flyer ……………………………………………………………………………………… .51

Chapter Six: Annual Lucas County Walking Program -

 Purpose ……………………………………………………………………………………………………………………………. 53

 Sign-Ups, Requirements & Walking Logs…………………………………………... ………………………… 53

 Covid-19 Adaptations ……………………………………………………………………………………………………...53

 Reminders………………………………………………………………………………………………………………………...53

 Find a Health Coach Flyer ……………………………………………………………………………………………… .54

 Walk With a Health Coach ……………………………………………………………………………………………….54

 Virtual Walking Program Flyer…………………………………………………….…………………………………..55

 Commitment Form …………..…………………………………………….…...………………………………………..56

 Walking Log Visual…….……………………………………………………………………………………………………..57

Chapter Seven: Health Promotion and Education

 Weekly Weigh-Ins …………………………………………………………………………………………………………….59

 Health Risk Assessments ………………………………………………………………………………………………….59

 Cooking Demonstrations …………………………………………………………………………………………… …..59

 Health Coach Day …………………………………………………………………………………………………………… .60

 12 Days of Wellness…………………………………………………………………………………………………………..60

 Diabetes Tri-Fold Display ………………………………………………………………………………………………… 61

 Caught Being Healthy ……………………………………………………………………………………………………….62

 Promotional Flyers ……………………………………………………………………………………………………..63-64

4 Chapter Eight: New Developments

 Facts & Snacks and Step Out the Winter Blues……………………………………………...……………..66

 Promotional Flyer Examples ……………………………………………………………………………………… 67-69

Chapter Nine: Communications

 Overview ……………………………………………………………………………………………………………………… ..71

 Wise and Well Monthly Newsletter Example ……………………………………………………..………...72

 Healthy Happenings Newsletter Example……………………………………………………………………….73

 Mental Health Corner Example……………………………………………………………………………………….74

 Staying Healthy on a Budget Example…………………………………………………………………………...75

 Lucas County Wellness Program Facebook Page………………………………………………………… …76

 What Can A Health Coach Do For You?……………………………………………………………………..77-78

Chapter Ten: Health Screenings

 Overview ……………………………………………………………………………………………………………………... 80

 Health Coach Day Screening Participation ………………………………………………………………….….81

 Health Coach Day Promotional Flyer ……………………………………………………………………………...82

 Example of Screening Results Pamphlet ………………………………………………………………………...83

Chapter Eleven: Prescription Drug Use Review Program

 Overview ……………………………………………………………………………………………………………………..… 85

 Services Available ……………………………………………………………………………………………………….……85

 Incentives for Participation in the Program ……………………………………………………………… …..86

 Prescription Drug Review Flyer ………………………………………………………………………………… ….. 87

 Participating Pharmacies ………………………………………………………………………………………… ……..88

Appendix I: Contract Data

 Graphs & Charts ………………………………………………………………………………………………………..90-103

Appendix II: Contract Participant Comparison

 Contract Participation…………………………………………………………………………………………………….105

COVID-19 Impacts and Changes: Due to the global COVID-19 pandemic, the Lucas County Wellness Program was required to make adjustments in how it provided health promotion services to employees. In compliance with government mandates of social distancing, all in-person meetings and scheduled activities were suspended effective March 13, 2020. As a result of national stay-at-home orders, Lucas County health coaches were required to cease all work conducted at One Government Center until the mandates were lifted. In June 2020, health coaches returned to the office working on a rotated schedule with reduced hours (1 day per week). Upon resuming work duties, the health coaches initial focus was contacting employees to provide support, encouragement and to answer any questions. To ensure each employee impacted by the COVID-19 gym closures was reached, the health coaches created a data spreadsheet which contained the names, fitness contract dates and the method in which employees were contacted (ex: email, phone). From June to July 2020, the health coaches made 483 calls to Lu- cas County employees, providing them with information as to how the wellness program will be carried out for the duration of the pandemic.

Social distancing measures required the health coaches to make changes in conducting fitness assessments. In prior years, health coaches met in-person with employees to complete a contract and obtain biometric measurements. Currently, employees are contacted via email to complete an amended contract, which does not include measurements. As a result of these changes, data provided in this annual report will vary from previous years.

In order to facilitate the promotion of physical wellness, health coaches developed alternative activities to engage county employees. A virtual walking program was created as a substitute for the original in-person event. Employees were required to keep a walking log, documenting the amount of time and number of steps taken during intentional walking periods. To make this new version more appealing to employees, the health coaches decided to simulate the virtual walking trail off Route 66. The number of steps obtained from each participant’s walking log was compiled in an Excel spreadsheet. The total steps were converted to miles which was used to determine how far the participants traveled along Route 66. This new alternative for the walking program was well received by employees as a total of 77 signed up, completing 2,526 miles along Route 66 in the first two months.

Along with creating the virtual walking program, the health coaches created a new newsletter called Healthy Happenings. The purpose of the newsletter is to encourage employees to maintain as much physical activity as possible during these unprecedented times. Some of the resources provided include a list of local parks, exercise ideas and socially distanced activities to engage in. It also included updates regarding the employees’ progress in this year’s Walking Program which is being held virtually to ensure the safety of all participants.

Despite the challenges presented by COVID-19, the Lucas County Health Coaches are committed to the contin- ued effort of empowering and educating participants in the Lucas County Wellness program to maintain optimal health and wellness.

6 Chapter 1 Introduction

7 Mission

The mission of the Lucas County Wellness Program is to educate, encourage and empower all Lucas County employees and dependents covered by Lucas County health benefits to maintain optimal health and wellness. The Lucas County Wellness Program provides opportunities for employees and eligible family members to participate in regular physical activity via free onsite fitness classes, healthy eating education through cooking demonstrations, managing stress with the help of Lunch and Learns and staying up to date on their personal health status through various screenings.

Vision

The Lucas County Wellness Program strives to promote and improve the health and wellness of all Lucas County employees.

Strategic Priorities

 Host on-site department health screenings that consist of: blood pressure, blood glucose, body fat percentage, body mass index, cholesterol, waist circumference and pulse rate.

 Coordinate an annual health fair and fitness expo.

 Provide confidential one-on-one health assessments with employees to assist in developing health-related goals and provide on-going encouragement towards reaching those goals through follow-up phone calls every 3, 6 and 9 months.

 Create and distribute information about the wellness program such as available programs, free on-site fitness classes and information relating to various health-related topics.

 Facilitate wellness contracts for fitness centers, smoking cessation, Weight Watcher’s, cardiac rehabilitation programs and diabetes/nutrition education classes.

 Provide an annual walking program to encourage employees to increase their daily physical activity.

 Create and distribute information about upcoming wellness program events, healthy eating and physical activity via quarterly newsletters, biweekly e-mails and follow-up phone support.

 Coordinate and schedule on-site fitness classes including, but not limited to; body- sculpting, Country Heat, POUND, Yoga and Zumba.

 Coordinate and schedule healthy cooking demonstrations at all county departments.

2019-2020 Goals & Objectives & Outcomes

Goal 1: Increase the number of Lucas County employees signed up for health and wellness related reimbursement contracts

 Objective 1: Sign up at least 150 new Lucas County Employees for health and wellness related reimbursement contracts. This objective was not achieved. During this annual cycle, the Health Coaches signed 120 new contracts with county employees.  Objective 2: Increase the distribution and promotion of health coach bucks to promote participation and interaction with employees. This objective was achieved. Health coach bucks were promoted and distributed at multiple on-site fitness classes throughout this annual cycle.

Goal 2: Develop new programs to generate additional interest in the Wellness Program This objective was achieved. The Step Challenge was a new program implemented from February 17 - March 17

Goal 3: Increase participation in the Walking Program

 Objective 1: Reorganize filing and documentation for the program. This objective was achieved. All walking program logs were stored digitally for increased organization.  Objective 2: Implement a digital walking log format with pre-filled in location/department for expedited communication for each monthly log. Walking logs required employees to fill out their own location/department. However, the walking logs were 100% digital.  Objective 3: Increase participation and promote other associated programs by including fliers in sign-up packet pro- moting “Walk with a Health Coach” and “Find a Health Coach” Due to COVID-19, sign-up packets were not distributed and “Walk with a Health Coach” and “Find a Health Coach” were canceled.  Objective 4: Designate blocked times each month dedicated to prize delivery. Due to COVID-19, monthly prize deliveries were consolidated into one prize delivery at the end of the program.

Goal 4: Improve the employee experience at the Annual Health Fair

 Objective 1: Invite two new interactive vendors for next year’s health fair. This objective was achieved. Nine new vendors were added to the 2020 Fitness Expo.  Objective 2: Increase vendor experience by addressing suggested changes from past evaluations. This objective was achieved. The foot traffic for flu shots was modified so it did not disturb other vendors or over- crowd an area.  Objective 3: Reorganize prize solicitation process and documentation by organizing companies who require specific rules (mailing, online forms, in-person, etc). This objective was achieved. The excel file that the Health Coaches used to organize prize solicitation listed compa- ny specific requirements if known.  Objective 4: Disseminate informational fliers to advertise the event at every county department. This objective was achieved. Health Fair fliers were distributed to every county department.

Goal 5: Improved communications between Health Coaches and employees

 Objective 1: Increase Facebook followers and number of weekly posts to improve communication between the coaches and employees. This objective was achieved. As of July 31, 2020 the Lucas County Wellness Program’s Facebook page had 496 likes, 520 followers and 100 posts.  Objective 2: Encourage/promote one-on-one appointments if interested in personal goals or increased accountability. Objective was not achieved. Although increased accountability was met through follow-up calls with employees concerning contract, one-on-one appointments regarding personal goals was not met.  Objective 3: Promote referral program to encourage the number of employees participating in the program. This objective was achieved. Employee referral program handouts were given to employees when they signed contracts.

9 Goal 6: Promote healthier food options to county employees

 Objective 1: Provide a healthy bowl to each department including an interactive quiz or game relating to health food options. Due to Covid-19 department closures, this objective was not achieved.  Objective 2: Expand cooking demonstrations into two different times (warm/cold) of the year, corresponding with seasonal food options. Due to Covid-19 department closures, this objective was not achieved .  Objective 3: Provide informative handouts pertaining to the foods used at cooking demonstrations. Due to Covid-19 department closures, this objective was not achieved.  Objective 4: Further education of employees on healthier recipes and food choices through handouts and engaging conversation. Objective was not achieved. Healthy recipes were sent in our monthly newsletter, but we were unable to engage in conversations regarding healthy food choices because cooking demonstrations during the Spring were canceled due to Covid-19.

Goal 7: Promote employee connection with healthy food options and preparation with indoor office plants.

 Objective 1: Plan two different rounds of plant distributions at the beginning and end of summer, each with three different plant/herb options for indoor growing. Due to Covid-19, this objective was not achieved. We are looking to meet this objective in 2021.  Objective 2: Utilize the Wise & Well and Staying Healthy communications to advertise health reasons for the plants, plant options, and cutoff dates. Due to Covid-19, this objective was not achieved. We are looking to meet this objective in 2021.  Objective 3: Provide corresponding recipes and food preparation techniques to employees who receive plants. Due to Covid-19, this objective was not achieved. We are looking to meet this objective in 2021.

Goal 8: Create and update deliverables, calendars and ongoing timelines for Wellness Program to ensure smooth transition between incoming health coaches.

 Objective 1: Each quarter, coaches will create a calendar marking dates of communications, meetings, plans, etc. to ensure accountability. This objective was achieved for quarter 1.  Objective 2: Update documents and timelines for the annual health fair that includes dates, tasks, and specific materials. This objective was achieved. Updates were made in documents for tasks, materials, and dates.

10 Chapter 2 Reimbursement Programs

11 Purpose

The reimbursement program was created to motivate employees to participate in activities that will help them engage in healthier lifestyles. The program provides various levels of reimbursement, depending on the activity. In order to receive reimbursement, participants must meet with a health coach, sign a wellness contract, complete a health assessment prior to starting the program and fulfill attendance requirements. Facility sites and fitness classes must be pre-approved by the Employee Benefits Manager before a contract is signed.

The following activities may be approved for reimbursement:

 Up to 50% (not to exceed $400 per year for individuals or $600 per year for a family):

 Fitness club memberships

 Fitness classes

 Weight loss program (Weight Watcher’s or Hospital Based Weight Loss Programs)

 Up to 100%:

 Smoking cessation

 Cardiac rehabilitation

 Weight loss medications

 Diabetes case management Eligibility

All employees who are eligible and/or enrolled in Lucas County benefits, as well as their spouses and dependents ages 13 years or older, are eligible and encouraged to participate in the wellness program.

Specific Exclusions

Any expenditure incurred that is not included in a Lucas County Employee Wellness contract is specifically excluded from reimbursement under this program. Reimbursement is not provided unless the specific terms of the contract are fulfilled. Reimbursement for any personal property, supplements, vitamins and food items are excluded under this plan. All employees eligible for Lucas County health benefits, but are not actively at work because they have exercised their right under the Family Medical Leave Act, are eligible to participate in this program. All former employees are ineligible for this program, unless the spouse is a current Lucas County employee and former employees are covered on the spouses benefits.

Limitations

Contracts can be renewed every three or six months. Health assessments must be repeated every six months. Fitness and Weight Watcher’s contracts have no renewal limit; smoking cessation contracts are limited to two attempts. Reimbursement for weight loss medications is limited to six months in a lifetime. Employees are allowed to participate in more than one reimbursement program at the same time.

12 Forms and required information:

The following must be completed for a fitness club contract reimbursement:

 Fitness contract

 Physical Activity Readiness Questionnaire (PAR-Q)

 Health Questionnaire

 Physical Assessment

 Proof of attendance (at least 52 days per 6 months)

 Receipt of payment

The following must be completed for a weight-loss program contract reimbursement:

 Weight-loss contract

 Physical Activity Readiness Questionnaire (PAR-Q)

 Health Questionnaire

 Physical assessment

 Proof of attendance (at least 10 of 12 sessions for three months or 20 of 24 sessions for six months)

 Receipt of payment

The following must be completed for a smoking cessation contract reimbursement:

 Smoking cessation contract

 Blood pressure reading

 Pulse reading

 Smoking questionnaire

 Receipt of payment

The following must be completed for a prescription weight-loss medication contract reimbursement:

 Weight-loss medication contract

 Copy of prescription

 Receipt of payment

 Written physician recommendation including validation that the candidate is 60% over ideal body weight

13 The following must be completed for a cardiac rehabilitation contract reimbursement:

 Cardiac rehabilitation contract

 Written physician recommendation

 Receipt of payment

Each contract is similar in layout and contains the same questions, but different requirements.

COVID-19 Reimbursement Contract Changes

Due to COVID-19, the process of signing a reimbursement contract has been revised. The health and safety of both the Wellness Program staff and Lucas County employees is our top priority. Eligible employees were not required to meet with a health coach to sign a contract between June 1st and July 31st. Instead, employees completed contracts with contactless signatures to ensure the opportunity for reimbursement was still available. Re- vised contracts did not include a physical assessment, but included all other usual requirements for reimbursement.

Employees and eligible dependents with existing contracts affected by COVID-19 related closures were granted a reasonable extension to meet contract requirements. Fitness contracts that ended or were active between March 16th and May 26th were also eligible for this extension.

14 Fitness Reimbursement Contract

15 Board of County Commissioners Tina Skeldon Wozniak President

Pete Gerken Gary L. Beyers

Lucas County Wellness Program Fitness Contract This contract, entered into this ______day of ______2020, between Lucas County (hereinafter referred to as the Employer) and ______, Employee Identification number ______, (hereinafter referred to as the Employee), represents a commitment on the part of each party to invest in the good health and wellness of the Employee and their eligible spouse and dependent children.

Whereas, the Employee is likewise committed to the Employee’s good health and wellness and whereas, the Employee has conferred with an approved health coach and is committed to the wellness strategy articulated below

I will attend ______at least 52 days in the next 6 months. (Insert fitness facility name here)

In order to obtain the goals listed below:

______

The Employer agrees to reimburse the Employee 50% (up to a maximum of $400.00 per year for individual and $600.00 per year for family) of the Employee’s expenses incurred for the successful completion of the above described strategy. For each period of reimbursement, an employee must complete a health assessment before they are paid reimbursement money. The reimbursement will be limited to membership in one health facility. Employees must attend the requisite number of sessions outlined above within the time frame of the contract. By signing below, the Employee hereby releases the Board of Lucas County Commissioners and its employees, including Health Coaches, support staff, and Wellness Department Employees, from any and all liability associated with this endeavor. Employees should consult with his/her personal physician before entering into any wellness or exercise program. Participants acknowledge that they have been counseled by the Health Coaches to consult with their personal primary care physician and/or have their annual physical completed before entering into any wellness or exercise program. Employer may require the Employee to provide proof of physician approval in writing. Employee also agrees to release the health information gathered by the Health Coaches to Lucas County. This would include wellness strategies and goals and will be released for reimbursement purposes. All reimbursement is subject to Wellness Program guidelines and compliance.

16 ______Date: ______Employee

______Date: ______Health Coach

______Date: ______Lucas County

Goal Fulfillment & Contract Compliance

Date: ______

Employee HAS / HAS NOT fulfilled the terms of the contract.

Portion of Contract Compliance: ______

Total Amount Expended by Employee: $______

Total Amount Reimbursed by Lucas County: $______

______Date: ______Lucas County

17 Physical Activity Readiness Questionnaire (PAR-Q) & You Please read the questions carefully and answer each one honestly: circle Yes or No.

Yes No 1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

Yes No 2. Do you feel pain in your chest when you do physical activity?

Yes No 3. In the past month, have you had chest pain when you were not doing physical activity?

Yes No 4. Do you lose balance because of dizziness or do you ever lose consciousness?

Yes No 5. Do you have a bone or joint problem (for example, back, knee, or hip) that could be made worse by a change in your physical activity?

Yes No 6. Is your doctor currently prescribing drugs for your blood pressure or heart condition?

Yes No 7. Do you know of any other reason you should not do physical activity?

If you answer YES to one or more questions:

Talk with your doctor by phone or in person BEFORE you start becoming more physically active. Tell your doctor about the PAR-Q and which questions you answered YES.

 You may be able to do any activity you want – as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those which are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice.

If you answer NO to all questions:

If you answered NO honestly to all PAR-Q questions, you can be reasonably sure that you can:

 Start becoming much more physically active – begin slowly and build up gradually. This is the safest and easiest way to begin.

 Take part in a fitness appraisal – this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively.

Delay becoming much more active:

 If you are not feeling well because of temporary illness such as a cold or a fever – wait until you feel better, or

 If you are or may be pregnant – talk to your doctor before you start becoming more active.

Please Note: If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

______Date: ______

Employee Signature

18 Questionnaire Physical Activity 1. In the past 7 days, how many days did you exercise? _____ Days

2. On days when you exercised, for how long did you exercise? (in minutes) _____ Minutes per day □ does not apply

3. How intense is your typical exercise? □ Light (ex: stretching or slow walking) □ Moderate (ex: brisk walking) □ Heavy (ex: jogging or swimming) □ Very Heavy (ex: fast running or stair climbing) □ I am currently not exercising

4. Do you usually participate in any of the following activities? a. Climbing stairs instead of taking the elevator? □ Yes □ No b. Walking instead of driving short distances? □ Yes □ No c. Parking away from buildings to walk more? □ Yes □ No d. Walking at lunch, after dinner, or before work? □ Yes □ No

General Health 1. In general, would you say your health is □ Excellent □ Very good □ Good □ Fair □ Poor

2. Do you often feel that you have trouble handling stress, anxiety or depression? □ Yes □ No □ I don’t know

3. If diabetic, have you had your hemoglobin A1c level checked in the past year? □Yes □ No □ N/A

4. Are you currently taking more than two medications (over-the-counter drugs, supplements, and/or prescription drugs)? □ Yes □ No

19 Nutrition In the past 7 days, how many servings of fried or high-fat foods did you typically eat each day? (Examples include fried chicken, fried fish, bacon, French fries, potato chips, doughnuts, mayonnaise) ____ Servings per DAY □ < 1 □ 1 – 2 □ 3 – 4 □ 5 – 6 □ ≥ 7 In the past 7 days, how many sugar-sweetened beverages did you typically consume each day? (Examples include adding sugar to coffee, pop, Kool-Aid, crystal light) ____sugar sweetened beverages consumed per DAY □ < 1 □ 1 – 2 □ 3 – 4 □ 5 – 6 □ ≥ 7 In the past 7 days, how many servings of fruits and vegetables did you typically eat each day? (1 serving= 1 cup of fresh vegetables, ½ cup of cooked vegetables, or 1 medium piece of fruit, 1 cup= size of a baseball.) □ < 1 □ 1 – 2 □ 3 – 4 □ 5 – 6 □ ≥ 7 In the past 7 days, how many servings of high fiber or whole grain foods did you typically eat each day? (1 serving=1 slice of 100% whole wheat bread, 1 cup of whole-grain or high-fiber ready to eat cereal, ½ cup of cooked brown rice or whole wheat pasta) □ < 1 □ 1 – 2 □ 3 – 4 □ 5 – 6 □ ≥ 7 Alcohol use In the past 7 days, how many days did you drink alcohol? □ < 1 □ 1 – 2 □ 3 – 4 □ 5 – 6 □ 7 On days when you drank alcohol, how often did you have ( 5 or more for men, 4 or more for women and those men and women over 65) alcoholic drinks on one occasion □ Never □ Once during the week □ 2-3 times during the week □ More than 3 times during the week Tobacco use In the last 30 days, have you used tobacco? Smoked: □ Yes □ No 2. In the last 30 days, have you used a smokeless tobacco product? □ Yes □ No

20 Physical Assessment

How did you hear about the Lucas County Employee Wellness Program? A. Wellness Flyer / Postcard B. Employee Wellness Website C. Health Screening D. Co-Worker / Family / Friend: ______E. Other: ______

Would you like to be on our mailing list? □ Yes □ No □ Already on the list

Email: ______

Physical Assessment Measurements

1. Height:

2. Age:

3. Weight:

4. Body Mass Index:

5. Body Fat Percentage

6. Blood Pressure:

7. Resting Pulse:

8. Waist Circumference:

9. 6 Minute Walk:

Pulse Before Walk:

Pulse After Walk:

Number of Steps:

21 Which area of your health are you

Eating Weight Stress Healthy

Physical Or is there Smoking Activity another area

List the reasons for your concern. 1.______2.______3.______

On a scale of 0-10, how ready are you to consider making a change in this area?

0 5 10 Not at all Thinking about it Ready to start now

Ask yourself these questions:

Why did you pick this number? What would you need to be different for you to move to a higher number?

What is one small step you could take to move you closer to making a change?

22 Fitness Contract Guidelines

 Reimbursement is up to 50% of the membership cost and is limited to $400.00 per year for individual or $600.00 per year for family at an approved facility.

 In order to receive reimbursement, participant must provide a copy of paid receipt and proof of attendance.

 Employees must sign a new contract every 6 months.

 Payments will be made through the employee’s paycheck and are subject to tax.

 Attendance requirement: 52 days per 6 month period.

 Measurements and questionnaires are required for all new contracts.

Your contract will expire: ______

Your Assessment Results BMI (Body Mass Index) Categories Male Body Fat Percentage

Less than 18.5 Underweight Age Low Normal High Very High 18.5-24.9 Normal 20-39 <8 8-19.9 20-24.9 >25

25-29.9 Overweight 40-59 <11 11-21.9 22-27.9 >28

30+ Obese 60-79 <13 13-24.9 25-29.9 >30

Blood Pressure Guidelines Female Body Fat Percentage Top Num- Bottom Num- Age Low Normal High Very ber Category ber (diastolic) High (systolic) 20-39 <21 21-32.9 33-38.9 >39 Below 120 an Below 80 Normal

120-129 OR Below 80 Pre-hypertension 40-59 <23 23-33.9 34-39.9 >40 Stage I Hyperten- 130—139 OR 80-89 sion 60-79 <24 24-35.9 36-41.9 >42 140 or Stage 2 Hyperten- OR 90 or more more sion

If you have any questions please feel free to contact us. Lucas County Employee Benefits Wellness Program Health Coaches One Government Center Suite 440 Toledo, OH 43604 Phone: 419-213-2088 Fax: 419-213-4830 Email: [email protected]

23 Chapter 3 On-site Fitness Classes

24 Free On-Site Exercise Classes

A variety of free exercise classes are offered to eligible Lucas County employees and eligible dependents as part of the wellness program. Classes are typically offered during lunch time and after work. The classes offered include, but are not limited to: Zumba, Body Sculpting, Pound, RIPPED, and Yoga. These classes may change periodically. To facilitate participation, the wellness program offers these classes at various locations, dates and times throughout Lucas County.

Exercise Classes

Zumba

Zumba is a Latin-inspired dance fitness program that involves both dancing and aerobic elements. Zumba fitness classes incorporate hip-hop, salsa, mamba, samba and belly dancing moves. Squats and lunges are also included.

Body Sculpting

Body sculpting is a light resistance workout. Using your own body weight, exercises such as lunges, squats, sit-ups and arm curls are performed. Attendees are welcome to bring light weights to body-sculpting classes, but they are not required.

Yoga

Yoga is a combination of gentle stretches, meditative breathing and relaxation techniques that focus on strengthening the mind-body connection. The benefits of yoga include: Increased flexibility, strength, balance, focus, relaxation and improved sense of well-being.

Pound

Pound is a full body cardio jam session that is inspired by the infectious and energizing fun of drumming. Using Ripstix®, lightly weighted drumsticks engineered specifically for exercising, POUND® transforms drumming into an incredibly effective way of working out.

RIPPED

Two people created a fitness program that encompasses all aspects of physical fitness which R.I.P.P.E.D. is an acronym for: Resistance, Interval, Power, Plyometrics, Endurance and Diet. The first five components are taught in a 50 minute class. R.I.P.P.E.D. is designed for all fitness levels, allowing a gym novice and trained athlete to both feel an intense full body workout.

COVID-19 Closures

Due to COVID-19, all group fitness classes were cancelled on March 18th indefinitely.

25 Wellness Activity Calendar

The wellness activity calendar is created monthly and outlines all on-site fitness classes. The wellness activity calendar is posted each month on the Lucas County website, as well as our Facebook page.

Samples of the wellness activity calendar, various promotional flyers and an on-site fitness class evaluation follow.

26 27 28 29 30 Evaluations

Date__7/17/19______

Class name/location ___Yoga/Engineering Services______

Has this class helped you to improve your overall level of fitness?

1-not at all 2 3 4 5-very much 5

How would you rate the instructor?

1-poor 2 3 4 5-outstanding 5

What did you like about the class?

”Feel fresh and relaxed”

“The calming presence of the instructor”

What did you dislike about the class?

N/A

What changes (if any) would you like to see with the on-site fitness classes?

Continue classes all year

Additional comments/concerns

“Really like this class and instructor”

“love the class, lets continue”

Thank you! Don’t forget to like us on Facebook: Lucas County Wellness Program

31 Evaluations

Date__7/9/2019______

Class name/location _____Yoga / One Government Center______

Has this class helped you to improve your overall level of fitness?

1-not at all 2 3 4 5-very much 3 4 5

How would you rate the instructor?

1-poor 2 3 4 5-outstanding 4 5

What did you like about the class?

“She changes the class every month—focuses on different styles and activities”

“The instructor, music, stretching”

“Relaxation—stress relief”

“Convenient location, great instructor”

What did you dislike about the class?

“cold in room”

What changes (if any) would you like to see with the on-site fitness classes?

“Pilates”

“More classes at One Gov”

Additional comments/concerns

“Love this class”

“Great class”

Thank you! Don’t forget to like us on Facebook: Lucas County Wellness Program

32 Chapter 4 Annual Employee Health Fair

33 12th Annual Lucas County Employee Health Fair

The 12th Annual Lucas County Employee Health Fair was held on Thursday, October 3, 2019 from 10:00 AM to 3:00 PM in the Conference and Learning Center. Approximately 500 employees and their family members attended this year’s health fair. Eighteen area vendors attended and provided free services including: Cholesterol and blood pressure screenings, DermaScans, hearing and vision screenings, DEXA-scans, flu shots, healthy cooking demonstrations and hand, neck and back massages and many others. This year, there were three new vendors: ProMedica Jobst Vascular Institute, ProMedica Diabetes Education Center, and Lake- wood Greenhouse. Toledo-Lucas County Health Department, with assistance from pharmacy students, admin- istered 248 free flu vaccines to County employees and their family members. The health coaches and 4 Mercy Health nurse volunteers conducted 167 cholesterol screenings.

A total of 233 raffle prizes were donated by various organizations throughout Lucas County for the health fair. All employees who entered the raffle were eligible to receive one of the prizes offered. A list of all the prizes and winners is included after the vendors are listed on the next few pages.

An evaluation form was given to all employees and vendors who attended requesting feedback and recommendations for improvements next year. The majority of the feedback was very positive and the Lucas County health coaches are using the critiques constructively to make changes for next year.

34 Health Fair Vendors and Services BGSU Nutrition Services offered: Healthy cooking demonstration Harbor Behavioral Health Services offered: Information on Employee Assistance Program (EAP) Kenwood Hearing Services offered: Hearing examinations and educational materials Lakewood Greenhouse Services offered: Interactive gardening Lava Wellness Services Offered: Complimentary massages and other relaxation/wellness information Lourdes University Services offered: Measuring blood pressure and body mass index. Lucas County Health Department Services offered: Administering flu shots Lucas County Drug Review Program Services offered: Pharmacist providing information regarding the Lucas County Drug Use Review Program Lucas County Wellness Program Services offered: Wellness Program information and cholesterol screenings Lucas County D.A.R.T Services offered: Drug use treatment and prevention information Massage Bliss Services offered: Complimentary massages Mercy Health Community Health Services Services offered: Cholesterol screenings Metroparks Services offered: Information regarding local parks

35 Health Fair Vendors and Services Cont. Midwest Eye Consultant Services offered: Vision screenings ProMedica Wellness Service: DERMAscan sun damage screening ProMedica Tobacco Treatment Center Services offered: Pulmonary lung screening and tobacco treatment information ProMedica Jobst Institute Service: Vascular screenings ProMedica Diabetes Center Service: Sugar/salt demo, nutrition and diabetes education St. Luke’s Hospital Services offered: Dexascan to measure bone density

12th Annual Employee Health Fair Raffle Prize Winners

9round Connie Durham African Safari Wildlife Park Tom Cherry African Safari Wildlife Park Kristine Worthy African Safari Wildlife Park Julie Drabek African Safari Wildlife Park Michelle Fournier African Safari Wildlife Park Anne Vasko African Safari Wildlife Park Carrie Zimo African Safari Wildlife Park Jodi Walker African Safari Wildlife Park Amy Henry African Safari Wildlife Park Romces Wyche African Safari Wildlife Park Charles McDonald African Safari Wildlife Park Tara Short Alan Jewelers John Navarre Amie's Pizza Factory Marcus Kelly Amie's Pizza Factory Michelle Weiss Appliance Center Mary Jay BG Kris Miller Black Rock (FP Mall) Benjamin Fletcher Blaze Pizza Anna Buschmann Blaze Pizza Amanda Shanteau Blaze Pizza Sydney Ross Blaze Pizza Sheronda Brandon Blaze Pizza Sarah Ryley Blaze Pizza Nicole Thomas Blaze Pizza Janina Andrzejczak Bob Evan's (Dussel) Mike Seegert Buckeye Wolverine Shop Maria Hoffsis Budget Blinds Kathryn Quilter Budget Blinds Regina Kiss Buff City Soap Jana Mowery Cincinnati Reds Dustin Smith Cinemark Franklin Park Nathaniel Pettaway Club Pilates Perrysburg Judge Linda Jennings Coldstone (EAP) Jim Karmol Dick's Sporting Goods TiRhon Sanders Dick's Sporting Goods Birdena Martin Escape Room Madeline Devereaux Expresso Car Wash Buffie Beasley Expresso Car Wash Kat Samples Expresso Car Wash Cathy Hudson

37 Expresso Car Wash Rebecca West-Estell Expresso Car Wash Celine Woods Expresso Car Wash Nadine Gibson Expresso Car Wash Monica Thompson Expresso Car Wash Star Madison Expresso Car Wash Kris Filas Expresso Car Wash Sherry Sampson Fire Nation Evy Jarrett Firehouse Subs Mary Klosinkski Firehouse Subs Hannah McAbee Firehouse Subs Francisco Aguilar Firehouse Subs Kenya Merrell Firehouse Subs (Sylvania) Carolyn Gallatin First Watch Crystal Malino First Watch Becky Johnson First Watch Cheryl Swartz First Watch LaReine Howie Foodology Amber Cox Fowl & Fodder Elisa Boyle Fowl & Fodder Sandra Brown Fresh Thyme Brigid Matthews Fuzzy's Taco Shop Andrea Schultz Fuzzy's Taco Shop Brent Reed Fuzzy's Taco Shop Becky Boughey Fuzzy's Taco Shop Deb Sedlock Fuzzy's Taco Shop Jamie Loyd Fuzzy's Taco Shop Brittany Ford Fuzzy's Taco Shop Frances Hughes Fuzzy's Taco Shop Danielle Hayes Fuzzy's Taco Shop Adrienne Lech Fuzzy's Taco Shop Jami Bettinger Fuzzy's Taco Shop Brandi Meyer Fuzzy's Taco Shop Toyneka Jones Carpenter Georgio's Café International Austin Cole Georgio's Café International Jean Meadows Get air Patricia Daher Get air Amber Piekos GFS Nancy Benedetto Gino's Pizza Lisa Arend Gino's Pizza Mark Dansack Gino's Pizza Linda Ether Gino's Pizza Kelly Yakumuthis Gino's Pizza Sara DeVault Granite City Brenda Krieger Granite City Alan Mutchler Granite City T'Shawn Adair

38 Great American Cookies Christina Ingram Great Clips Donalds McClain Great Clips Siti Dotson-Chambers Great Clips (Secor Square) Paul Jomantas Guitar Center Amy Jones Halfner Florist Nicole Sigg Huntington Center Karen Betz J Foster Jeweler Heather Achenbach Jed's Michelle Carson Jonathan Koi Kelly Mettler Jupmode Victoria Moore Kevin Charles Hair Artistry Lindsay Metzger Libbey Glass Robin Kramer Libbey Glass Jessica Flores Libbey Glass Angie Overton Lulu Lemon Mary Pat King Maddie and Bella's Angela Bodna Manos Greek Restaurant Carrie Molnar Marco's Pizza Deanna Whitehead Marco's Pizza Nichole Roberts Marco's Pizza Laurie Avery Marco's Pizza Angie Enright Marco's Pizza Jill Bergma Maxx Fitness Julie Pommeranz Michael Zerner Yoga Jen Burton Michael Zerner Yoga Kory Koepfer Mr. Hero Jill Naut Mr. Hero Mary Kunckel Mr. Hero Carrie Broshuious Mr. Hero Sue Chapman Mr. Hero Todd Switala Mr. Hero Althea Reshau Mr. Hero Jessica Lupica Mr. Hero Ashley Mowery Mr. Hero Sandy Lewandowski Mr. Hero Alecia Robinson Mr. Hero Julie Stichler Mr. Hero Alexandra Slawinkski Nature's Corner Rose Yglesias Nutri Amy Walker Nutri Jennifer Turk Nutri Elvis Taylor Nutri Julie Meisner Nutri-Toledo Dora Anderson Outback Steakhouse Jean Pierce Outback Steakhouse Pam Jagos

39 Outback Steakhouse Jennifer Walte Outback Steakhouse Karen Lemle Outback Steakhouse Laurie Luce Outback Steakhouse Tammy DeArmond Outback Steakhouse Erica Saldana Outback Steakhouse Rob Claypool Outback Steakhouse Mary McCluskey Outback Steakhouse Janaye McClendon Outback Steakhouse Jackie King Outback Steakhouse Chen Cao Outback Steakhouse Bridet Cassady PF Changs Nicole Fisher PF Changs Karen Bridge PF Changs Kelly Wilson PF Changs Amy Priest Pizza Cat Sheri Hensley Pizza Cat Aimee Bloom Plate One Mark Reiter Portrait Innovations Lauren Carpenter Pure Barre Michelle Thomas Rave Cinema Tim Steedman Red Robin Chelsea Gaudet Red Robin Randa Cheaib Russ' Auto Wash Chanda Beal Russ' Auto Wash Corina Vasquez Russ' Auto Wash Angel Sykes Russ' Auto Wash Angela Barchick Russ' Auto Wash Brenda Meyes Schakolad Becky Hoffman Serenity Wellness Jess Kozak Serenity Wellness Katrina Jones Serenity Wellness Shawn Horton Serenity Wellness Laurie Bayles Shirley's Gourmet Popcorn Susan Hamilton Shirley's Gourmet Popcorn Kelly Jacobs Sky Zone Gianni Carrero Soto Signature Spa Elaine Szuch Splash Universe Deborah Wedding Sportway Toldeo Harold Stevens Sportway Toldeo Matthew Browne Sportway Toldeo Amanda Camp

40 Sportway Toldeo Caitlyn Fuller Sportway Toldeo Darrin Bonds Starbucks Megan Hite Starbucks Stacie Krieg Starbucks Becky Bowland Starbucks Steven Spitler Texas Roadhouse Kantrell Cameron Texas Roadhouse Jazzma Chandler The Blarney Mark Austin The Flying Joe Michelle Upchurch Tireman Jamie Vaughan Tireman Vivian Davis Tireman Vowanda Knowles Tireman Melody Garber Tireman Tabetha Valentin Tireman Shelly Jackson Tireman Mark Bostleman Tireman Roxanne Ervin Tireman Helen Bahlhorn Tireman Christine Woods Tireman Denise Vernon TOL Arts Center Bonita Johnson Toledo Symphony Larry Loutsenhiser Toledo Symphony Dave Glaza Toledo Walleye Chuck Hatch Toledo Walleye Dawn Wexler Toledo Walleye Terry Leonard Toledo Walleye Bob Heckman Toledo Yoga Jennifer Lambdin Trapped Toledo David Karmol Trapped Toledo Amanda Murray Trapped Toledo Tim Tamar Trapped Toledo Tina Tichaton Trapped Toledo Erin Montrie Trapped Toledo Gail Spotts Trapped Toledo Carrie Arnold Trapped Toledo Nico Vargos Trapped Toledo Shantura Bonner Trapped Toledo Frankie Fisher Tropical Smoothie Latrice Mickles Tropical Smoothie Brian Woods

41 Tropical Smoothie Stacy Unum Tropical Smoothie Tracy Maimone Tropical Smoothie Debbie Orlando Tropical Smoothie Claudia Ford True Rest Float Spa Karen Villarreal Uncle Johns Pancake House Kelly Billings Uncle Johns Pancake House Chris Ponzinski Uncle Johns Pancake House Sherrie Twining Uncle Johns Pancake House Dan Boyd Uncle Johns Pancake House Rich Lopez University of Toledo Athletic Department Craig Mays University of Toledo Theatre Dept. Stephanie Lanham Wellness Program Sommer Clayborne Wellness Program Marie Hornyak Wellness Program Luellen Wilkowski Wingate by Wyndham Bob Gutierrez Ye Olde Durty Bird Carolyn Hall Zingos Alice Duck Zingos George Sydlowski

Health Fair 2019 – Vendor Evaluation Results

An evaluation form was given to each of the 18 vendors who participated at the health fair. The evaluation rated the health fair on attendance, pre-planning, management, time/location, booth space and publicity. The results are based on 16 completed evaluations:

All vendors who returned the evaluation indicated that they would attend next year’s health fair if asked to participate.

Excellent Fair Poor

Attendance 15 1 0

Pre Planning 13 3 0

Management 15 1 0

Time/Location 14 2 0

Location of Booth 15 2 0

Booth Space 15 2 0

Publicity 15 1 0

Comments:

 More room and an extra table. Thank you!

 Very well attended

 Would love to come back next year

 Great event

 Nicely run program

 Very successful turnout, very helpful!

 Steady traffic all day

 Everyone is very friendly and appreciative

 We had a great time! Thank you for having us!

 Everything seemed well planned

 Well organized health fair

43 Employee Evaluation Results

An evaluation form was given to all Lucas County employees who attended the health fair. The evaluation rated the health fair on attendance, management, time/location, vendors/services and advertising. The results are based on 9 completed evaluations:

Excellent Fair Poor Advertising/prior 9 0 0 notifications Time/Location 8 1 0

Layout/Flow 7 2 0

Favorite Booth/Service:

 Massage Bliss

 Lakewood Greenhouse (2)

 Flu Shots (3)

 Cholesterol/Blood sugar (2)

 DEXAscan

 Wellness Program

 Dermascan

 Stroke Info Booth

Employee Comments/Suggestions:

 Extended hours until 4:30

 Post vendor sign above table so it can’t be blocked by people standing at booth

 More giveaways (pens, magnets, etc.)

 Great layout this year!

 Less crowded!

Everyone who returned the evaluation indicated that they would attend the health fair again next year.

44 Improvements added to the 2019 12th Annual Health Fair

Based upon the evaluation responses from 2018, the following changes were made to this year’s health fair:

 New vendors were provided including: ProMedica Jobst Vascular Institute, ProMedica Diabetes Education Center, and Lakewood Greenhouse.

 In order improve the flow and spacing of the Health Fair, we expanded the layout to include the full CLC.

 The vendor evaluation was redesigned in order to get detailed feedback to improve upon.

Covid-19 Cancellation of 2020 13th Annual Health Fair

Due to Covid-19, the 2020 Annual Health Fair was cancelled. All vendors were contacted in July 2020 to inform them of the cancellation. These vendors, along with at least two new vendors, will be invited to the Health Fair in 2021.

Improvements planned for 2021 14th Annual Health Fair

 Provide a separate raffle for all employees who submit an evaluation.

 Prepare 3 prize bags for the separate employee evaluation raffle and allow them to pick which bag they want to be entered in for. Create sign and advertise this separate raffle on table.

 Include two new vendors to keep the Health Fair new and diverse.

45 46 Chapter 5 Annual Employee Fitness Expo

47 2020 Lucas County Fitness Expo

The Lucas County Wellness Program hosted the 2020 Employee Fitness Expo on January 29, 2020. The event was held at the Conference and Learning Center (711 Adams St.) in downtown Toledo from 11:00 am to 2:00 pm. All Lucas County employees were invited to attend the Expo free of charge. Our goal was to promote local gym facilities and fitness studios throughout the County to encourage employees to explore if a membership is right for them. In addition, we encouraged employees to sign a fitness contract with the health coaches to help them stay accountable to participating in physical activity. Attendance for this year’s Fitness Expo included 86 county employees. Seventeen fitness facilities attended this year’s event, compared to eighteen last year. Employees were able to meet with representatives from each facility as well as any of the 6 health coaches. The coaches also offered screenings to all attendees for blood pressure, pulse, BMI, body fat percentage, and waist circumference. The health coaches completed assessments and signed 16 county employees up for fitness contracts.

Fitness Expo Vendors

 TrvFit Perrysburg  Red Line Circuit Training  The Standard CrossFit  Sylvania Fit Body Bootcamp  BOXHOUSE  L.B.’s Circuit Training  Renegade Fitness  Maxx Fitness Clubzz  Mind Over Core  Orange Theory Fitness  Revitalized Fitness  Club Pilates  LA Fitness  Yogaja Yoga  Routines  YMCA

48 Vendor Feedback

Strongly Strongly Agree Agree Neutral Disagree Disagree

The expo was well organized. 6 6 0 0 0

6 6 0 0 0 The facility layout space met my expectations.

6 2 2 2 0 I was satisfied with my booth location.

5 6 1 0 0 I received adequate exposure to the attendees.

3 5 2 2 0 I was satisfied with the number of attendees.

9 3 0 0 0 Staff was helpful and available when needed.

The expo was a beneficial ex- 5 6 1 0 0 perience.

I would participate in next 7 5 0 0 0 year’s expo.

Comments: “You can't control attendance- but foot traffic was way lower than expected.” “The address of the building would have been helpful as I don’t know Toledo well- but I was able to find it after a little search. I would be interested in creating a corporate program/discount several visitors spoke about taking other classes from around the area. I'm not sure who I would speak to in order to set this up.”

“Would like to choose booth location next year” “Maybe just me but clear cut directions or address # would've been nice. Otherwise great event!” “Thank you for including us again!” “There were open tables on the outer edges of the room. I was in the middle against a wall and peo-

49 Employee Evaluation “How would you rate the overall fitness expo?” Excellent Fair Poor No Response Overall 41 11 0 0 Rating

“Do you plan to make changes based on what you learned or participated in at the Fitness Expo?

Plan to Make Change Maybe Will Change No Intention to Change Employee Responses 32 14 6

“I will return to the Fitness Expo.” Will Return Maybe Will Re- Will Not Return No Response turn Employee 47 2 1 0 Responses

Employee Feedback Top 3 Favorite Booths: L.B.’s Circuit Training, BOXHOUSE, and Mind Over Core

Some comments received from employees: “It was setup very nice, good location and time.” “Great expo, very informative, empowering and enlightening.” “I love how each gym was a positive influence on the community.” “It was fun!”

50 51 Chapter 6 Walking Program

52 Purpose The Lucas County Walking Program typically runs from May through September every year. However, due to COVID-19, the health coaches created the 2020 Virtual walking Program. This new program will run from June 15th through October 15th. The program is designed to encourage employees to include walking or any type of physical activity as part of their daily lifestyle. The walking program has proven to be our most popular activity due to its ease and accessibility. This years Virtual Walking Program has given employees a safe way to connect with each other to reach a common goal. The walking program is open to all eligible employees, their spouse and dependents free of charge. As of July 31, 2020, 77 Lucas County participants were enrolled in the 2020 Vir- tual Walking Program.

Sign-ups Information regarding the 2020 Virtual Walking Program was distributed to employees via email and Facebook posts. Participants were also provided with a walking log to record the number of minutes they walk or preformed physical activity that day. Additionally, the walking log includes space for participants to fill in their monthly goals.

Requirements for Walking Program As a new addition this year, participants were required to fill out a commitment form to participate in the 2020 Virtual Walking Program. This form included the participant's contact information, overall goal for the program and a commitment statement acknowledging that they are committing to walk at least 15 days every month of the program.

Walking Logs On the 15th of each month, participants are asked to submit their walking log to the health coaches via email or fax. Employees who submit a copy of their walking log each month and meet the requirements are eligible to be entered in a drawing for prizes at the end of the program.

Covid-19 Adaptations Due to Covid-19, this year’s in-person walking program initial and final assessments were cancelled. Instead, employees submitted a commitment form at the beginning of the program stating their goals and contact information. Due to the difficulties in safely administering prizes, there are no monthly prizes this year. In- stead, employees are eligible to win a prize through a drawing at the end of the program in October.

Reminders

During the week that the logs are due, the health coaches send a reminder to all participants to submit their monthly walking logs.

Find a Health Coach

Due to COVID-19, we were unable to offer our Find a Health Coach program in 2020.

In conjunction with the Lucas County Walking Program, the health coaches hold Find a Health Coach biweekly during the summer months. Find a Health Coach allows employees the chance to get outside, take a walk, ask questions related to wellness, and receive a free prize. The health coaches select different locations in the downtown area and employees are given clues to find them. Previous year’s locations included: The Swamp Shop, Levis Square Kabuki Statue, “Toledo Loves Love” Mural, Red & White Statue, Valentine Theatre, the interactive game at Imagination Station, Fire Station #5 Frog, Promenade Park Blue Echo Statue and the Fifth Third Field “Who’s Up” Statue. Prizes are distributed to all employees who walk and find the health coaches. Last year’s prizes included: travel size dressing containers, infusing water bottles, wristbands, sunglasses, sandwich containers, and travel ear buds.

Walk With a Health Coach

Due to COVID-19, we were unable to offer our Walk with a Health Coach program in 2020.

54 55 56 57 Chapter 7 Health Education

58 Weekly Weigh-Ins Being aware of your weight is important in maintaining a healthy lifestyle. To assist employees in becoming more aware of their weight trends and fluctuation, the Lucas County Health Coaches helped weigh in employees on a weekly or biweekly basis at the request of the department. Scheduled weigh- ins after March 18, 2020 were canceled due to COVID-19.

Lucas County Recorder - Continuous weigh-ins every other Thursday from 8/8/19 —3/5/20. 3 participants Lucas County Clerk of Courts - Continuous weigh-ins every other Thursday from 8/8/19 — 3/5/20 13 participants Adult Probation - 8/9/19 and 8/23/19 7 participants

Healthy Cooking Demonstrations The Lucas County Wellness Program typically offers healthy cooking demonstrations onsite at interested departments. Each healthy cooking demonstration focuses on cooking once and creating multiple healthy meals with the leftovers. Recipe cards and evaluations are distributed at each demonstration. Unfortunately, COVID-19 prevented us from holding any cooking demonstrations during spring/summer of 2020.

Health Risk Assessments As part of the employee benefits program, all employees covered under health insurance offered by Lu- cas County are required to complete a health risk assessment once per plan year, March 1st - February 28th (29). The health coaches are able to provide assistance with the assessments for the three different health plans offered. The health risk assessment includes questions regarding health history, eating habits, exercise routines, stress and much more. Once completed, the health program then analyzes the data from the assessment and gives the employee a score regarding their current health status and access to a nurse that can assist them in obtaining a healthier lifestyle. Flyers are distributed to remind employees to complete their health risk assessment.

An example of a flyer is included at the end of this chapter.

59 Health Coach Day

Health Coach Day is an opportunity for employees to receive a variety of on-site wellness services in one setting at no cost. Services included: cholesterol and blood pressure screenings, one-on-one meetings, developing a personal health plan and signing a wellness contract.

The health coaches visited 20 departments. Departments included:

 Children’s Services Board (CSB)

 Child Support Enforcement Agency (CSEA)

 Mental Health & Recovery Services Board

 Facilities Management

 Coroner’s

 Emergency Medical Services (EMS)

 Board of Developmental Disabilities (BDD) Larc Lane Non Admin. & Larc Lane Admin.

 Juvenile Justice Center (JJC)

 Main Courthouse

 Health Department

 Job and Family Services (JFS )

 EduCare

 Road Maintenance/Sanitary Engineers

 County Commissioners

 Criminal Justice Coordinating Council (CJCC)

 Auditors

 Board of Elections (BOE)

A total of 73 employees participated in Health Coach Day. The employees received Health Coach Day very well and even requested that the health coaches return to their department again.

12 Days of Wellness

The Health Coaches created a fun way to help employees stay mentally, physically and emotionally healthy during the holiday season. The 12 Days of Wellness is a challenge for all eligible Lucas County employees to participate in different activities that encourage health and wellness during the busy holiday season such as drinking more water, complementing co-workers, completing a safety test around your house and including 3 servings of fruits and vegetables into your day. The challenge was open to all Lucas County employees and ran from December 5 - 16, 2019. A total of 23 employees participated in the activity.

The winners of this challenge were: Schuyler Beckwith and Donna Fox

60 Trifold Display

The wellness program display board is located in the front window of the Lucas County Employee Benefits office. This board features ways to prevent the development of pre-diabetes and the symptoms that one experiences when they have pre-diabetes. This board is informative and provides tips for employees to reduce their risk for developing pre-diabetes.

Employee Spotlight Caught Being Healthy

Caught Being Healthy is an interactive activity where Derek Williams the health coaches “catch” Lucas County employees preforming positive and healthy behaviors. With the employees consent, a picture is taken and uploaded to the Wellness Programs Facebook page to showcase the employee performing the healthy behavior. This activity was introduced to encourage employees to continue healthy behaviors or begin a new one. Caught Being Healthy included: Walking on a lunch break, drinking water instead of soda, eating a healthy lunch, signing a wellness contract and growing an indoor salad gar- den.

Example of a Caught Being Healthy featured in the Wise and Well is shown here.

Derek’s fitness journey kick started in the midst of the holiday season in De- cember of 2012. He decided that he was tired of being overweight and dealing with the baggage that came along with the extra pounds. He lost a total of 200lbs within a year after making changes to his lifestyle, which included daily exercise and better eating habits. His story was featured on TLC’s show Skin Tight , Season 1 Episode 4. For those just beginning their own road to fitness, Derek suggests taking everything day by day, trusting the process and staying consistent even when things get diffi- cult. Now, he enjoys being able to be more active with his kids. Keep up the good work Derek!

62 63 64 Chapter 8 New Developments

65 Facts & Snacks

The Health Coaches arranged a Lunch and Learn for county employees on January 15th, 2020 at One Gov- ernment Center. A total of 6 employees attended the event which featured a presentation by Super Sup- pers, a local meal prep business. The owner of Supper Suppers, Cassie Egli, educated the employees about their meal prepping business and how it can help employees prepare quick, easy, and healthy meals. Free samples were available to attendees and lunch was available at an additional cost for those who chose to purchase. The meal offered by Super Suppers was Parmesan chicken with sage sauce, wild mixed green salad, cranberry BBQ meatballs and chocolate.

Step Out the Winter Blues

The Health Coaches introduced a new walking program with the goal to help employees engage in physical activity as they made the transition from winter to spring season. The idea was slightly different from our normal walking program as it was roughly a month long and focused on the number of steps taken in general and not activity based. Participants were required to record their total number of steps in a log that was emailed to them at the start of the program. The challenge was open to all Lucas County employees and ran from February 17, 2020 - Mach 13, 2020. A total of 7 employees participated in the activity. Due to COVID-19 related office closures, we believe there may have been more that completed the challenge, but did not turn in their step tracking log.

66 67 68 69 Chapter 9 Communications

70 Follow Up Calls Follow up calls are crucial for one-on-one communication with each contract participant. The follow up calls provide time for questions, personal assistance and motivation. Each employee that signs a contract is called three months after their contract start date and also at their six month completion. The six month follow up call is to confirm expiration of the contract, request proof of payment along with proof of attendance to be submitted and schedule a renewal date. An additional call may be made at nine months after their contract begins if a renewal was not completed at the six month follow up call. From August 1, 2019 to July 31, 2020, 2297 follow up calls were made.

Wise & Well Monthly Newsletter A monthly newsletter is a useful tool for communicating the latest health trends, as well as keeping the employees updated with the most current news within the Lucas County Wellness Program. All Lucas County employees receive the “ Wise & Well” newsletter as a global email monthly. The newsletter highlights national health observances, nutrition questions, upcoming local events in the community, healthy recipes, an employee spotlight and health related articles.

After Covid-19 started, the health coaches re-branded this newsletter and named it “Healthy Happen- ings”. This version was more succinct and allowed for better advertisement of the Virtual Walking Pro- gram.

Lucas County Wellness Program Facebook Page In order to reach employees that are interested in receiving more information regarding a healthy lifestyle, the Lucas County Wellness Program has a Facebook page. Facebook is beneficial because it provides a more interactive forum with employees and their families. Health coaches post new information multiple times a week. Posts include recipes, monthly onsite exercise calendar, updates pertaining to current wellness program events and helpful tips to living a healthier lifestyle. As of July 30th, there were 495 likes on our Facebook page.

“What Can A Health Coach Do For You?” In an attempt to increase awareness of the Lucas County Wellness Program to new employees, an informational flyer was created and is sent to all new Lucas County employees eligible for Lucas County benefits. The flyer is used to inform new hires of Wellness Program services provided and help encourage them to participate in our programs.

Staying Healthy on a Budget

To provide Lucas County employees with useful health and wellness information, the health coaches send a bi-weekly flyer highlighting different health topics. A few examples include: Portion control, mental tips, benefits of blood pressure screening, diabetes education, etc. As of July 31, 2020 we had 1,231 employees signed up for the Staying Healthy on a Budget newsletter.

Examples of the Wise and Well and Health Happenings newsletters, New Hire Outreach and Staying Healthy on a Budget follow.

71 72 73 74 75 76 77 78 Chapter 10 Health Screenings

79 Overview The health coaches provided cholesterol, blood pressure, blood glucose, body mass index and body fat percentage screenings at many county departments throughout the year. Educational material on the importance of preventative screenings was provided to all employees in attendance. Between October 2019 and April 2020, 22 Lucas County departments and their employees participated. These departments included:

 CSB/ CSEA/ MHRSB

 Veteran’s Services/ Coroners

 Educare

 CJCC

 BDD Admin & Non-Admin

 Sheriff’s Office

 Sanitary Engineers

 Building Regulations

 Engineer Road Maintenance

 Health Department

 Facility Management

 Emergency Medical Services

 Family Court

 Engineer Admin

 Juvenile Justice Center

 Main Courthouse

 Adult Probation/Work Release/CTF

All Lucas County employees are invited to attend these free screenings. For each participant, health coaches record various measurements such as height, weight, body mass index, body fat percentage, blood pressure, blood glucose and cholesterol levels. A pamphlet with all of the recorded measurements is provided to each participant to keep for their own records.

The health coaches also provided cholesterol screenings at the Lucas County Annual Employee Health Fair.

An example of a health screening flyer used to promote the screenings and the employee’s personalized health screening results pamphlet are included at the end of the chapter.

80 Department Date Number of Participants

Health Fair October 3, 2019 166

CSB/ CSEA/ MHRSB February 6, 2020 1

Veteran’s Services/ Coroners February 7, 2020 1

Educare February 10, 2020 8

CJCC February 10, 2020 4

BDD Admin & Non-Admin February 13, 2020 6

Sheriff’s Office February 19, 2020 1

Sanitary Engineers February 19, 2020 9

Building Regulations February 19, 2020 2

Engineer Road Maintenance February 19, 2020 10

Health Department February 20, 2020 3

Facility Management February 21, 2020 1

Emergency Medical Services February 24, 2020 2

Family Court February 25, 2020 4

Engineer Admin February 26, 2020 2

Juvenile Justice Center February 28, 2020 0

Main Courthouse March 2, 2020 12

Adult Probation/ CTF/ Work March 5, 2020 6 Release

Total 238

81 82 83 Chapter 11 Prescription Drug Use Review Program

84 Prescription Drug Use Review Program Overview

The Prescription Drug Use Review Program (DUR) provides private and confidential sessions between the patient and a participating pharmacist. National data indicates patients feel better when they take their medications as prescribed. These sessions are designed to educate the participant on the proper usage of their medication. While the pharmacist cannot alter the physician’s prescribing wishes, these sessions assist the physician in monitoring for negative interaction and unwanted side effects with other prescription medications, supplements and over-the-counter products. Employees enrolled in the DUR program have 19 different pharmacies to choose from throughout Northwest Ohio. These pharmacies are listed at the end of this chapter.

This program is popular with employees and has resulted in improved patient outcomes.

Employees are a prime candidate for this program if they are:

 Taking multiple prescription medications

 Combining prescription medications with supplements or over-the-counter medications

 Being seen by multiple physicians who are prescribing medications

 Do not feel as if they are getting the full benefits of their medications

This program is free and completely confidential. Employees, spouses and dependent children enrolled in the Lucas County Prescription Drug Plan are eligible to participate. The program duration is 12 months, however the out of pocket maximum resets March 1st each year.

Services Available

 Regular private sessions with a pharmacist to discuss medications, supplements and over-the- counter drugs.

 During each visit with the pharmacist or nurse, blood pressure will be taken and cholesterol and blood glucose levels may be checked.

 Certain participating pharmacies have agreed to forward results to physicians directly. This may save employees the cost of a lab test when visiting their physician.

Pharmacists cannot alter or override a prescription. Only the participant’s physician can change their medication. This program is not intended as a substitution for the professional judgment of the prescribing physician or any other health care professional providing services to the employee.

Some county elected officials have agreed to allow up to an hour of work release time for the initial. Prescrip- tion Drug Use Review session. If an employee uses work time for the initial session, they must show documentation of attendance from the participating pharmacy.

85 Incentives to Participate in the Program

 Lowest cost on prescription drugs.

 A 90-day supply of Tier I and Tier II prescription medications at the 30 day supply co-payment. Note: Tier III medications are not available for a 90-day supply.

 Each enrollee who completes the program may receive up to $50.00 worth of coupons toward their Tier II prescription drug co-payment at the participating pharmacy.

 Enrollees who complete the program will have their annual out-of-pocket maximum for Tier II brand name medications limited to $350.00/year and a $500.00/year out-of-pocket maximum for Tier III medications.

 For patients with diabetes, free test strips and lancets are provided each month and blood sugar readings are reviewed and recorded. Results may be forwarded to your physician at your request.

 If an enrollee has four (4) Tier II brand name medications each costing $25.00 in co–payments per month, they will spend $400.00 in twelve months. If that same enrollee completes this program, they will be limited to an out-of-pocket maximum of $350.00; a savings to the enrollee of $50.00.

 Patients currently using a NON-DUR Pharmacy or the mail order program may benefit from routine access to a pharmacist and other medical professionals. Note: While enrolled in the Drug Use Re- view Program, the mail order program is suspended.

87 88 Appendix I Contract Data

89 Appendix I – Fitness & Weight Loss Program Contract Information

The following information depicts physical data obtained from all wellness program participants with either a fitness membership or weight loss program reimbursement contract from August 1, 2019 - July 31, 2020. In addition to health club reimbursement contracts, other exercise classes such as ZUMBA, body sculpting, Pilates and yoga may also be eligible for reimbursement. All data contained within this appendix refers to Lucas County employees, eligible spouses and dependents and depicts their health standing with regards to the following health guidelines. Out of the total number of fitness and weight loss contracts, 28 were spouses or dependents. Data is reported as a physical number and percentage of participants in each category.

Due to COVID-19, physical data couldn't be gathered from employees after March 1, 2020. Therefore, Part A physical data only includes contract data from August 1, 2019 - March 15, 2020. However, Part B Physical Activity data includes all contracts signed between August 1, 2019 - July 31, 2020.

Guidelines for each measure are as follows:

Body Mass Index Guidelines

Low <18.5

Normal 18.5 – 24.9

Overweight 25 – 29.9

Obese 30+

Body Fat Percentage Guidelines

Gender Age Low Normal High Very High

20 – 39 <21.0 21.0 – 32.9 33.0 – 38.9 39.0+

Female 40 – 59 <23.0 23.0 – 33.9 34.0 – 39.9 40.0+

60 – 79 <24.0 24.0 – 35.9 36.0 – 41.9 42.0+

20 – 39 <8.0 8.0 – 19.9 20.0 – 24.9 25.0+

40 – 59 <11.0 11.0 – 21.9 22.0 – 27.9 28.0+ Male 60 – 79 <13.0 13.0 – 24.9 25.0 – 29.9 30.0+

Blood Pressure Guidelines

Systolic Diastolic

Normal <120 AND <80

Pre-hypertension 120 – 129 OR Below 80

Stage I Hypertension 130 – 139 OR 80 – 89

Stage II Hypertension 140+ OR 90+

Part A—Physical Data Body Mass Index

Blood Pressure

91 Body Fat Percentage

92 Part B-Physical Activity

93 Physical Activity

94 Physical Activity

The following data depicts information collected from the activity questionnaire. It is completed by all participants with a fitness or weight loss contract. The data portrays the types of physical activities performed, the number of employees who responded and how often they were participating.

95 Part C- General Health

96 General Health

97 General Health—Tobacco Use

98 General Health—Alcohol Use

99 Part C - Nutrition Questionnaire Data

The following data depicts responses to the nutrition questionnaire filled out by all participants with a fitness or weight-loss contract.

100 Nutrition

101 Other Reimbursement Contracts

Smoking Cessation

Participants are eligible for 100% reimbursement of approved smoking cessation methods, up to a two time maximum reimbursement of $195.00 with an approved smoking cessation contract. There is 1 smoking cessation that was signed during period of August 1, 2019 to July 31, 2020.

Cardiac Rehabilitation

Participants participating in Phase III or Phase IV of cardiac rehabilitation are eligible for 100% reimbursement with approved cardiac rehabilitation contract. There is 1 smoking cessation that was signed during period of August 1, 2019 to July 31, 2020.

Weight Loss Medication

Participants 60% over their ideal body weight (documented by a physician) are eligible to be reimbursed 100% for approved weight loss medications for a maximum of six months in a lifetime under strict physician supervision. There is 1 smoking cessation that was signed during period of August 1, 2019 to July 31, 2020.

Diabetes Management

Participants with a signed diabetes management contract are eligible for 100% reimbursement for diabetes and nutrition education classes. There were 2 diabetes management contracts in the period of August 1, 2019 to July 31, 2020.

102 Total Number of Contracts

The following data depicts the total number for each type of contract signed during the period of August 1, 2019 through July 31, 2020.

Number of Contracts

Type of Contract Participants

Fitness 397

Weight Watchers 50

Smoking Cessation 1

Cardiac Rehabilitation 1

Weight Loss Medication 1

Diabetes Management 2

Total 452

Total Contracts by Gender

Male 127

Female 322

Total New Contracts 120 Total Renewed Contracts 330

103 Appendix II Contract Participant Comparison

104 Appendix II – Contract Comparison

Contract Participant Comparison

Type of Contract 8/16-8/17 8/17-8/18 8/18-8/19 8/19-8/20

Fitness 554 643 622 397

Weight Watchers 30 92 92 50

Smoking Cessation 13 0 3 1

Cardiac Rehabilitation 2 1 2 1

Weight Loss Medication 2 3 1 1

Diabetes Management 3 2 0 2

Total Contracts 604 741 706 452

105 106