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HomeMy WebLinkAboutMINUTES - 04261994 - FC.1 . r TO: BOARD OF SUPERVISORS Contra Costa FROM: Finance Committee Z County DATE: April 26, 1994 rTA�e;K SUBJECT: PROPOSED RESPONSE TO THE 1993-94 GRAND JURY REPORT ON THE EMPLOYEE WELLNESS PROGRAM SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATION: Adopt this report as the Board of SuperGisors' response to the 1993-94 Grand Jury Report #9401 on the Employee Wellness Program. BACKGROUND: On February 2, 1994 the Grand Jury filed report#9401 regarding the Employee Wellness Program. . The report was reviewed and discussed by the Finance Committee on February 14, February 28 and April 18. The attached response is the product of those meetings.. The response accepts four of the Grand Jury recommendations and accepts the remaining two recommendations with modifications. CONTINUED ON ATTACHMENT: —YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE • APPROVE OTHER 10 r SIGNATURE(S): Tom Torlakson Gayle Bishop ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED / Contact: PHIL BATCH LOR,CLERK OF THE BOARD OF CC: Grand Jury Foreman SUPERVISORS AND COUNTY ADMINISTRATOR Presiding Judge of .Superior Court Personnel Director County Administrator. BY DEPUTY Dean Lucas County Auditor s RESPONSE TO GRAND JURY REPORT 9401 ON THE EMPLOYEE WELLNESS PROGRAM AND THE CONTRA COSTA CLUB RECOMMENDATIONS: 1. The Board of Supervisors direct the Personnel Department to immediately Institute a Club financial and membership record keeping system which will result In a true reporting of operational profit/loss. RESPONSE: This recommendation is accepted. The County is governed by law to provide a financial accounting of all expenditures and revenue each fiscal year. As such, the County currently has in place a very elaborate record keeping process to account for expenditures and revenues, as is true with most governmental agencies. There are over fifteen (15) monthly and quarterly finance reports available for use in analyzing the Club's financial status. The data contained in these reports are separated into six (6) major account series including: Salaries and Employee Benefits; Services and Supplies; Other Charges; Fixed Assets; Expenditure Transfers; and Financing. Under the major account series, there are fifty-one (51) accounts in which to further breakdown the allocation of funds for the Club. In addition to this sophisticated record keeping system, the Club currently utilizes both manual and PC-based software systems to track Club membership and financial data such as: member demographics; attendance and activity records; types of memberships; method of payment records; membership fees collected; and number of expired, cancelled and current members. The Personnel Department has and will continue to work with staff from the Auditor's Office in developing a simplified internal accounting process for tracking the Club's operational profits/losses.- 2. rofits/losses:2. The Board of Supervisors direct the Personnel Department to complete a study, within 60 days, to measure the cost and/or the savings to the Club that would be realized by eliminating memberships to local residents, businesses and non- County government agencies. Y (2) 2. (Continued) RESPONSE: This recommendation is accepted. The Personnel Department conducted a study to determine the cost and/or savings that would be realized by eliminating non-County memberships. A review of the current Club membership population revealed that there is a total of the 492 Contra Costa Club members. Of the total membership population, 313 or 64% are County members and 179 or 36% are non-County members. Since there are a variety of payment options for Club members, the Personnel Department first determined the number of members in each of the payment plans available and then calculated the percentage of monthly revenue received for County and non-County members. Although only 36% of the Club members are non-County, approximately 40% of Club revenue generated from membership dues and fees comes from non-County members. This is due to the higher rate structures established for non-County members. If 40% of the Club's revenue or $79,000 per year was eliminated, it would be necessary to increase the membership dues and fee rates significantly in order to meet the fixed costs of Club operations. This could result in a decline in membership and closure of the Club facility. 3. The Board of Supervisors direct the Personnel Department to obtain annual bids, beginning on July 1, 1994, from at least two (2) responsible fitness facilities in the private sector, for user services similar to those provided by the Club. RESPONSE: This recommendation is accepted with modifications. The Personnel Department is unaware of any other fitness facility that is located in the Martinez downtown area from which to obtain bids for user services similar to those provided by the Club. However, the Personnel Department is exploring the possibility of obtaining reduced membership rates from fitness facilities outside the Martinez downtown area for those employees who work in sections of the County where the downtown facility is inaccessible. r (3) 4. The Board of Supervisors direct the Personnel Department to immediately begin to maintain an on-going comparison of Club costs with costs for similar services provided by, or through, facilities in the private sector. RESPONSE: This recommendation is accepted. The Personnel Department recently conducted a survey to compare private sector fitness facility rate structures and services with those of the Contra Costa Club (see attached Fitness Facility Survey). The Personnel Department is committed to surveying private sector fitness facilities on an on-going basis to compare their rate structures with those of the Club, and to adjust our membership fee and rate structures to insure compatibility with private sector rates for non-County Club members. We will continue to explore all opportunities available to reduce operating expenses through information received from other agencies. In addition, the Personnel Department has resolved to provide Club services at the lowest cost possible to attract County employees to join the Club and encourage them to participate in physical fitness programs and activities. 5. The Board of Supervisors direct the Personnel Department to immediately audit, and to audit annually thereafter, all charges made to the Employee Wellness Program and to certify that all charges are directly related to the Program. RESPONSE: This recommendation is accepted. The Personnel Department currently monitors all financial transactions on a monthly basis by reviewing finance reports generated by the Auditor's Office. These reports identify all Wellness Program expenditures and revenue received, and provide a system by which the Personnel Department can insure that all transactions are charged to the appropriate accounts. In addition, the Auditor's Office regularly conducts internal financial audits of all County departments. The Personnel Department welcomes the opportunity to continue to cooperate with the Auditor's Office internal audit team by providing all necessary information and financial records for both the Employee Wellness Program and the Contra Costa Club. T (4) 6. The Board of Supervisors direct the Personnel Department to immediately set up a tracking system designed to evaluate the effectiveness of the Employee Wellness Program. This can be accomplished by maintaining trend analyses associated with such factors as Employee Wellness Program expenditures, County employee absenteeism, Workers' Compensation claims and County employee health care costs. RESPONSE: This recommendation is accepted with modifications. As indicated in the attached Employee Wellness Program Status Report, the findings of many studies reveal that worksite wellness programs generally offer cost avoidance and tend to lower costs in the long run by keeping employees healthy. Employee Wellness Program staff will continue to monitor trends and reports from larger agencies and to work.closely with Risk Management and other County departments in the prevention and reduction in the number of accidents and illness among County employees, which ultimately may reduce workers' compensation costs. The Personnel Department recognizes the need for obtaining and analyzing statistical data to evaluate the effectiveness of the Employee Wellness Program. Unfortunately, due to the County's small sample size and the need to identify and track Wellness Program participants over a number of years,the data obtained from a scientific analysis study of the County's Wellness Program would not prove to be statistically significant. However, larger agencies such as Dupont, Mesa Petroleum, NASA, Union Pacific Railroad, Northern Gas Company, Canadian Life Assurance Company, Coors Brewing Company, Kennecott Copper Company,and Johnson&Johnson have conducted health statistics and cost-:benefit studies, and the results have shown that there is a correlation between lifestyle risks and health care costs. These health risks are not only costly to the employee but also to the employer. If only one (1) Workers' Compensation heart claim was prevented or an employee with high risk for a heart attack is treated through intervention by a worksite wellness program, then the cost savings to the employer prove to be quite substantial. FITNESS FACILITY SURVEY EAST COUNTY. FACILITIES : ♦ DELTA PARK ATHLETIC CLUB Antioch Delta Park offers members a variety of features, including racquet sports, child care services, an indoor and outdoor lap swimming pool , aerobics program, an indoor running track as well as cardiovascular and strength training equipment. MEMBERSHIP TYPE INITIATION FEES MONTHLY MEMBERSHIP FEES Single $30.0 . 00 $ 45 . 00 _ Family $350. 00 $ 70 . 00 ♦ GOLD' S GYM Antioch Gold' s Gym offers members a variety of features , including child care services, aerobics program, cardiovascular and strength training equipment as well as free equipment orientations . Other features which are included at an extra charge are tanning facilities and body composition assessments at $10 . 00 per testing. Gold' s Gym has a variety of options to pay monthly membership fees . MONTHLY MEMBERSHIP AND MEMBERSHIP TYPE INITIATION FEES ADVANCED MEMBERSHIP FEES Single $ 87 . 00 $ 29 . 00 per month $ 0.. 00 $ 55 . 0.0 per month . $ 0 . 00 $135 . 00 / 3 Mo. in Advance $ 0 . 00 . $19.5 . 00 / 6 Mo. in Advance $ 0 . 00 $275 . 00 Yearly Dual $ 0 . 00 .$260 . 00 Yearly - No Monthly Fees Accepted. I WEST COUNTY FACILITIES : ♦ LAKERIDGE HEALTH CLUB E1 Sobrante Lakeridge Health Club offers a variety of racquet sports , including tennis , racquetball, and basketball . They also offer a pool, jacuzzi , saunas, child care, towel service, locker ' and shower facilities with full amenities, an aerobics program, cardiovascular and strength training equipment as well as free equipment orientation and evaluations . Other features which are included at an extra charge are a hair salon and personal trainers at $20 . 00 per hour. Lakeridge Health Club has two different membership fee structures . They offer the Gold Membership which includes access to all club facilities and the Silver Membership which does not include: towel service, child care, and fitness evaluations . MONTHLY MEMBERSHIP AND MEMBERSHIP TYPE INITIATION FEES ADVANCED MEMBERSHIP FEES Gold Membership Single $350 . 00 $ 65 . 00 per month * Dual $550 . 00 $ 99 . 00 per month * Silver Membership Single $250 . 00 $ 65 . 00 per month * Dual $400 . 00 $ 99 . 00 per month * * If membership fees are paid one year in advance, an additional 10 percent discount will be applied. ♦ YMCA Richmond The YMCA 'in Richmond offers members an aerobics program, racquetball, basketball, volleyball , strength training equipment, cardiovascular equipment and a pool . MONTHLY MEMBERSHIP AND MEMBERSHIP TYPE INITIATION FEES ADVANCED MEMBERSHIP FEES Single $240 . 00 $ 49 . 00 per month t i CENTRAL COUNTY FACILITIES: ♦ PREMIERE FITNESS WORLD Concord Premiere Fitness World is the closest private facility in proximity to the Contra Costa Club. Premiere Fitness World offers members a variety of features, including ,free child care . services, an aerobics program, a 20, 000 square foot area of cardiovascular and strength training equipment, wet and dry saunas , and complete shower and locker facilities with amenities . MONTHLY MEMBERSHIP AND MEMBERSHIP TYPE INITIATION FEES ADVANCED MEMBERSHIP FEES Single $ 95 . 00 $ 46 . 00 per month $ 0 . 00 $ 59 . 00 per month $ 0 . 00 $ 59 . 00 / 6 Mo. in Advance Senior $ 0 . 00 $ 49 . 00 per month ♦ CALIFORNIA HEALTH CLUB Pleasant Hill California Health Club features over 10,000 square feet of strength training and cardiovascular equipment. California Health Club does not offer an aerobics program and their shower and locker facilities do not include any amenities . MONTHLY MEMBERSHIP AND MEMBERSHIP TYPE INITIATION FEES ADVANCED MEMBERSHIP FEES Single . $ 30 . 00 $ 20 . 00 per month through Electronic Fund Transfer only. $ 30 . 00 $240 . 00 per year paid in advance by cash or check only. ♦ BIG C Concord The Big C Athletic Club offers members a .variety of free weights with separate men' s and women' s weight rooms, strength training equipment, cardiovascular equipment, tennis courts, racquetball, handball and basketball courts, an aerobics program, locker and shower facilities with steam rooms, saunas and jacuzzis, -laundry service and 'a pool . MONTHLY MEMBERSHIP AND MEMBERSHIP TYPE INITIATION FEES ADVANCED MEMBERSHIP FEES Single VARIABLE $ 89 . 00 per month - MEN $ 79 . 00 per month - WOMEN ♦ SUPREME COURT Pleasant Hill Supreme Court offers members a variety of features including racquetball, Nautilus, weight room, aerobics and swimming. Supreme Court also has two price structures; a Regular Membership which includes full use of the facility, and a Fitness Only Membership which includes everything except racquetball . MONTHLY MEMBERSHIP AND MEMBERSHIP TYPE INITIATION FEES ADVANCED MEMBERSHIP FEES Regular Membership: Single $135 . 00 $ 50 . 00 per month Dual $175 . 00 $ 75 . 00 per month Fitness Only Membership: Single $100 . 00 $348 . 00 Annually $135 . 00 $ 36 . 00 per month Dual $100.. 00 $500. 00 Annually $175 . 00 $ 56 . 00 per month * Price based on Electronic Fund Transfer ♦ FITNESS FOR LESS Concord Fitness For Less offers members a variety of free weights and. strength training equipment, cardiovascular equipment, an aerobics program, separate women' s weight room, locker and shower facilities and equipment orientations . MONTHLY MEMBERSHIP AND MEMBERSHIP TYPE INITIATION FEES ADVANCED MEMBERSHIP FEES Single $ 59 . 00 $ 15 . 00 per month Dual $ 98 . 00 $ 30 . 00 per month * Both require a 12-month commitment. Y SOUTH COUNTY FACILITIES: ♦ CROW CANYON ATHLETIC CLUB San Ramon The Crow Canyon Athletic Club is a private club which provides physical conditioning and recreation for its members . Facilities include Nautilus, Olympic Free Weights, Universal Equipment, a variety of cardiovascular equipment and an aerobics program. Recreation and sports include: racquetball, handball, basketball and wallyball . Additional facilities include complete locker rooms with whirlpools, saunas, men' s steam room, lockers, towels and laundry. Crow Canyon Athletic Club membership fees are divided into two categories : Full Membership which includes complete use of all facilities; and an Associate Membership which includes use of all facilities except for court sports . ' MONTHLY MEMBERSHIP AND MEMBERSHIP TYPE INITIATION FEES ADVANCED MEMBERSHIP FEES Full Membership Single $250 . 00 $ 62 . 00 per month Family $350 . 00 $ 92 . 00 per month Associate Membership Single $250 . 00 $ 47 .00 per month Family $350 . 00 $ 72 . 00 per month ♦ CLUB SPORT Sari Ramon Club Sport offers members a variety of free weights, strength training equipment, cardiovascular equipment, racquetball, basketball, handball, squash and wallyball courts, an extensive aerobics program with over 100 classes per week, complete locker and shower facilities with whirlpools, steam rooms and saunas . Club Sport also has a heated pool and free supervised child care. Club Sport ' s membership fees also are divided into two categories : a Full Club Membership which includes complete use of all facilities; and a Clubfit Membership which includes use of all facilities except for tennis courts . MONTHLY MEMBERSHIP AND MEMBERSHIP TYPE INITIATION FEES ADVANCED MEMBERSHIP FEES Full Club Single $500 . 00 $ 80 . 00 per month Family $750 . 00 $115 . 00 per month Clubfit Membership Single $500 . 00 $ 70 . 00 per month Family $750. 00 $105 . 00 per month ♦ 24 HOUR NAUTILUS Concord 24 Hour Nautilus offers members a variety of free weights and strength training equipment, cardiovascular equipment, aerobics program, locker and shower facilities with a steam room, saunas and jacuzzi, an indoor running track and a pool . MONTHLY MEMBERSHIP AND MEMBERSHIP TYPE INITIATION FEES ADVANCED MEMBERSHIP FEES Initiation fees vary from zero to $600 . 00 and membership fees vary according to the services utilized. This facility would not disclose specific fee structures on the telephone. However, their monthly fees vary from $19 to $39 a month. ♦ CLAYTON VALLEY ATHLETIC CLUB Concord Clayton Valley Athletic Club offers members a variety of free weights with separate men' s and women' s weight rooms, strength training equipment, cardiovascular equipment, racquet and basketball courts, an aerobics program with 50 - 60 classes per week, locker and shower facilities with a steam room, saunas and jacuzzi, an a pool . * Exercise physiologists , physical therapists and a chiropractor are also on staff for additional fees . MONTHLY MEMBERSHIP AND MEMBERSHIP TYPE INITIATION FEES ADVANCED MEMBERSHIP FEES This facility would not disclose membership fees over the telephone. Contra Costa County Employee , Wellness Program Status Report August , 1993 t THE CONTRA COSTA COUNTY EMPLOYEE WELLNESS PROGRAM STATUS REPORT AUGUST, 1993 TABLE OF CONTENTS I. HISTORY OF THE EMPLOYEE WELLNESS PROGRAM II. BENEFITS OF EMPLOYEE WELLNESS PROGRAMS III. ACTIVITIES THE EMPLOYEE WELLNESS PROGRAM HAS IMPLEMENTED A. Exercise B. Health Education Seminars, Classes and Specialized Educational Programs C. Wellness Newsletters D. Health Screenings and Testings E. Special Events F. Advisory Groups IV. CURRENT AND UPCOMING PROGRAMS A. County Employee Health Fair B. Labor/Management Healthy Lifestyle Committee C. Great American Smokeout D. Contra Costa County Food and Nutrition Policy Consortium E. New Series of Brown Bag Seminars V. CONCLUSION VI. ATTACHMENT A I. HISTORY OF THE EMPLOYEE WELLNESS PROGRAM A. Overview The County Health Services Department began to develop a wellness program for its 2,000 employees in 1983. However, due to substantial budget cuts in the Health Services Department, the implementation of the wellness program was put on hold. Two years later in early 1985, the Board of Supervisors made several referrals to the Office of the County Administrator concerning the establishment of a physical fitness program for County employees and for intensification of anti-smoking efforts and related health concerns. In response to these inquiries, a joint committee representing the Health Services Department and the Personnel Department developed a proposal for a comprehensive wellness program for County employees and presented this proposal to the Board of Supervisors on May 14, 1985 (See Attachment A) . Funding for the Employee Wellness Program was approved for inclusion in the Workers' Compensation budget in as much as the program was designed to prevent and reduce accidents and illness among County employees and thus reduce Workers' Compensation costs. Overall responsibility for the Wellness Program was placed with the Personnel Department in the Benefits Division where the Workers' Compensation Program was managed. Various revisions and specific program planning and goals for the Employee Wellness Program followed the Board approval. Recruit- ment of a Wellness Coordinator began in September, 1985 and a Wellness Coordinator was appointed in January of 1986, the official beginning of the Contra Costa County Employee Wellness Program. B. Employee Wellness Program Mission Statement The purpose of the Employee Wellness Program is to actively support and promote the health and well-being of County employees by providing individuals with the information and the educational tools to help them assess and improve their own wellness and by promoting an environment supportive of positive health habits. The Employee Wellness •Program seeks to implement cost-effective activities, drawing upon the resources within the County and the community, with the eventual outcome of improved personal health for employees and cost savings to the County. 1 . C. Program Rationale The Employee Wellness Program was developed for the following reasons: o A sense of genuine concern for the health and well-being of all employees as expressed by the Board of Supervisors and the County Administrator. ♦ A belief that healthier employees are happier and more fulfilled in both their personal and professional lives and enjoy increased self-esteem, morale and job satisfaction resulting in greater productivity and effectiveness on the job. ♦ The belief that employee wellness programs are cost effective; eventually resulting in decreased absenteeism, Workers' Compensation claims and health care costs D.. Overall Goals of the Employee Wellness Program ♦ To educate employees about the meaning of wellness (physical, mental, emotional and social health) , the methods used to achieve high level functioning in these areas (nutrition, exercise, stress identification and management and positive health habits) and the place individual choice plays in increasing one's individual wellness. ♦ To encourage individual behavior ,. change. in health areas, particularly in the area of -fitness, nutrition, stress management and smoking. ♦ To work within the organizational structure of the County to create an atmosphere supportive of positive health habits. ♦ To incorporate a wellness philosophy in management and to create an attitude which is supportive . of wellness philosophy. ♦ To increase participants' feelings of self-esteem, self responsibility, morale and job satisfaction. ♦ To decrease Workers' Compensation, health care costs and sick leave usage costs over time. 2,. II. BENEFITS OF EMPLOYEE WELLNESS PROGRAMS A. Why Wellness at the Workplace? In 1991, American employers paid a staggering 355 billion dollars in health care costs and America's health care costs are increasing at a rate of 21 percent annually. Employers are expected to pay more and more of America's health care bill. Since employers are responsible for a higher portion of the costs of health care, it stands to reason that they want to have a healthier workforce. Since the majority of one's time is spent at work, establishing a wellness environment on the job is critical in helping employees make healthier lifestyle choices. Wellness programs at the worksite is a sound investment both in terms of improvement and quality of life of the employee and in, terms of health care cost containment for the employer. B. Correlation Between Lifestyle .Factors and High Health Care Costs In 1979, the Centers- for Disease Control concluded that lifestyle factors were responsible for about half of all the preventable morbidity and premature mortality in our society. AMERICA'S TOP TEN CAUSES OF DEATH 1 . Heart disease 2. Cancer 3. Stroke 4. Accidents 5. Lung Disease 6. Pneumonia and Influenza 7. Diabetes 8. Suicide 9. AIDS 10. Homicide Source: National Center for Health Statistics More recently, the U.S. Department of Human Services estimates that heart disease and cancer account for nearly 70 percent of all deaths in this country. Further studies suggest that approximately 53 percent of all the cardiovascular deaths are due to the effects of lifestyle factors. Most of the health care dollars are spent on the treatment of preventable disease caused largely by the American workers' lifestyle - sedentary, . stressful, nutritionally . poor. The philosophy of wellness programs is to emphasize the importance of preventing chronic disease before they happen or to halt its progress by encouraging people to make healthier lifestyle choices. 3. Lifestyle behavior change is not easy and cannot be imposed of people. Several factors must be present in order to effectively promote desired changes: a raised awareness of what constitutes a healthy lifestyle, a motivating force for behavior change, tools to assess one's present lifestyle, information and resources through which to make these changes, employer support, recognition and reinforcement of the individual for making these changes. C. Examples of High Health Care Costs The average health care costs to a company for the following lifestyle related illnesses include: ♦ A heart attack $45,000 ♦ A stroke $58,000 ♦ A premature birth $28,000 e A case of diabetes $14,000 The estimated costs of open Workers' Compensation claims for Contra Costa County between July 1, 1991 - June 30, 1992 for heart disease, stress, carpal tunnel and back claims are as follows: Number of Average Cost Open Claims Claims Per Claim * Total Cost 9 Heart Disease $113,000 $1,017,000 20 Stress $ 17,689 $ 353,780 47 Carpal Tunnel $ 19,379 $ 910,813 112 Back $ 13,234 $1,482,208 $3,763,801 * (Includes all medical, legal and attorney fees) According to the County Risk Management Division, the number of claims filed for FY '91/92 was 1,112 while number of claims filed for FY '92/93 was 1,028; a decrease of 7.50. D. U.S. Government Involvement Efforts to address the preventable causes of premature deaths and disabilities is a high priority in the Department of Health and Human Services (HHS) . The Surgeon General's report in 1979 acknowledged the nation's progress in biomedical research and refocused emphasis on health promotion and disease prevention during the decade of the 1980's. As a result of this organized effort by the HHS, many Americans have made behavioral changes to improve their health and well-being and there has been a dramatic increase in the number of corporate and government agencies implementing wellness programs at the worksite. 4. In the mid 1980's, the HHS initiated efforts to improve the health of all segments of our population by the year 2000. This resulted in the publication in 1990 of "Healthy People 2000: National Health Promotion and Disease Prevention Objectives".. This report details the specifics (including measurable goals and programs targeted for the year 2000) of a vision for the health and well-being of the American people. The Office of Disease Prevention and Health Promotion (ODPHP) of the U.S. Public Health Service (PHS) , Department of Health and Human Services, has also played a principal role in stimulating and coordinating efforts in both the public and private sector to reduce the risks of diseases and early death and to promote good health. The ODPHP funded a national survey in 1985 to assess the level of integration of health promotion activities in private worksites with 50 or more employees. In 1992, ODPHP commissioned a second national survey to quantify and characterize evolving trends in the nature and extent of worksite health promotion programs since the 1985 study. Overall, the 1992 survey shows an increase in worksite health promotion activities since 1985 - 81 percent of private worksites with 50 or more employees offer health promotion activities compared with 66 percent in 1985. Ninety-nine percent of the companies surveyed with over 750 employees offered worksite wellness programs to its employees. The year 2000 target is 85 percent of all workplaces with 50 or more employers offering worksite health promotion programs. The 1992 ODPHP study also found that wellness programs were most frequently initiated at worksites for the following reasons: ♦ To improve employee health (41%) s To reduce employee health insurance costs (27%) e To respond to employee requests (13%) ♦ To reduce absenteeism (8%) To assess the benefits of worksite health promotion, the 1992 survey looked at perceived benefits. Following is a list of the eight benefits cited most frequently. ♦ Improved employee health (28%) ♦ Improved employee morale (26%) ♦ Reduced health insurance cost (19%) o Reduced absenteeism (19%) e Increased output/productivity (16%) e Reduced accidents on the job (9%) ♦ Improved education on health issues (7%) ♦ Reduced Workers' Compensation claims (4%) 5. E. Documentation of.Benefits The benefits of an employee health and fitness program are not always as obvious as the costs, and some benefits may be difficult and sometimes impossible to document. However, benefits such as reduced health care costs, absenteeism, turnover, injury rate, and disease risk can be documented and analyzed by scientific methods. Although the process can be quite extensive and time-consuming to obtain accurate records for scientific analysis, these benefits are considered tangible and measurable. It is also widely accepted that other indirect benefits such as increased productivity, energy level, morale and employer image are a result of employer sponsored health programs. ♦ Reduced Health Care Costs The following recent studies demonstrate evidence of lower health care costs: DuPont found that in a three year study, it saved $1.6 million in the first year of their healthpromotion program, $1.5 million in the second year, and $3 million the third year. "American Journal of Public Health, Robert L. Bertera, Ph.D. , September, 1990. " Mesa Petroleum found that as a result of instituting a corporate health program, health care costs per employee rose 4.8% to the national , average of 105%; health care costs per employee were $1,121 in 1988 compared to the national average of $3,560. "Report on Mesa Corporate Health and Fitness Program, Mesa, Inc. , 1990". ♦ Increased Productivity Although individual changes in productivity are hard to measure, the following companies report improvement in energy level, work performance, concentration levels - all critical factors of enhanced productivity. Improved Efficiency: NASA found that participants in an exercise control program had improved stamina and work performance, and enhanced concentration and decision making powers. When compared to the average office worker whose efficiency decreases 50 percent for the final two hours of the working day, the exercise adherents worked at full efficiency all day. This amounted to a 12.5% increase in productivity. "Company Sponsored Employee Fitness Program, The Association for Fitness in Business, 1991." Improved Concentration: Union Pacific Railroad found that 75 percent of their employees thought that regular exercise helped them achieve a higher level of concentration and relaxation at work. Eighty percent believed that their exercise program helped them be more productive at work. "Health Values, Joe Leutzinger, M.S. , Daniel Blanke, Ph.D. , September/October, 1991 ." 6. e Reduced Absenteeism A number of organizations have reported significant reductions in absenteeism (see Table 1) . TABLE 1 REDUCTION IN ABSENTEEISM Dupont General Mills Dallas Police Mutual Benefit Life General Electric Northern Gas Northern Gas Company employees who are in a corporate exercise program have 80 percent fewer sick days than non-exercising employees "Health Promotion and Education Program, Riverside Occupation Health Services, 1991." The Dallas, Texas, Police Department reported a 29 percent decrease in sick leave for its health program participants, while non-participants' sick leave increased by 5 percent. "Company Sponsored Employee Fitness Programs, the Association for .Fitness in Business, 1991 ." ♦ Reduced Turnover The Canadian Life Assurance Company found turnover among health program participants was 32.4 percent lower over a seven year period compared with non-participants. "Canadian Journal of Public Health, Peter Leatt, et al. , January/February, 1988." 7. 1 e Positive Return on Investment (See Table 2) TABLE 2 RETURN PER DOLLAR INVESTED Coors Kennecott Equitable General Motorola PepsiCo. Life Mills The Coors Brewing Company found that in 1990, it returned $6.15 for every dollar spent on its corporate fitness program. This was the sixth year of its fitness program with annual returns ranging from $1.24 to $8.33. "This is Corporate Wellness - and it's Bottom Line Impact, Wellness Councils of America, 1991 ." Kennecott Copper Company showed that over four years, for every dollar invested in its corporate fitness program, the company returned $5.78. "The Cost/Effectiveness of Corporate Wellness Programs, American Institute of Preventive Medicine, 1991." Johnson & Johnson averaged a 30 percent return on investment from its Live for Life employee fitness program over a 12 year period, 1978 - 1990. "Preventive Medicine, Curtis Wilbur, et al. , January, 1990." F. Analysis As can be concluded from the preceding health statistics and cost- benefit studies, there is a direct and substantial relationship between lifestyle risks and health care costs. These health risks are not only costly to the employee but also to the employer. If only one Workers' Compensation heart claim was prevented or, an employee with high risk for a heart attack is treated through intervention by the Employee Wellness Program, then the cost savings to the County prove to be quite substantial. As many companies (both public and private) are beginning to realize, good health is good business. Worksite wellness programs offer cost avoidance and are proven to lower costs in the long run by keeping employees healthy. 8. III. ACTIVITIES THE EMPLOYEE WELLNESS PROGRAM HAS IMPLEMENTED Over the course of the past seven years, the Contra Costa County Employee Wellness Program has implemented a variety of health and wellness activities for the employees of Contra Costa County. These programs have covered all areas of health and wellness including exercise, nutrition education and weight management, smoking cessation, stress reduction, parenting and child care issues, cardiovascular disease education, cancer awareness, etc. To ensure the most cost-effective programs, the Employee Wellness Program has utilized the resources of many of the local non-profit agencies such as the American Cancer Society, American Heart Association, Child Care Council, as well as resources available within the County (i.e. the County Health Services Department, Employee Assistance Program and the County Health Plans) . For each wellness activity implemented, we strive to increase employees' awareness on health issues and educate them on making healthier lifestyle choices while attempting to make the program fun as well. Each program is also evaluated for effectiveness and its success according to participation levels. A. Exercise o Exercise Challenges What started out as organized lunchtime walks in May of 1986, evolved into a series of walking, stair climbing, bicycling, running and swimming challenges conducted 3 - 4 times per year. These exercise challenges allow County employees to challenge themselves to reach a fitness goal at their own pace. These challenges also enable a greater number of employees to participate since the criteria encompasses all exercise performed before or after work, at home, or at lunchtime instead of participating in Wellness Program sponsored exercise programs. Each participant who reaches their fitness goal and completes. one of our challenges is rewarded with an incentive prize and a certificate of recognition. Examples of exercise challenges include: Winter Walking Challenge, Climb Mt. Diablo Contest, Battle of the Winter Blahs, The Great American Poker Walk and Fitness Jeopardy. ♦ Aerobic Exercise Classes The Employee Wellness Program initiated the County Aerobic Exercise Program in 1987. Low-impact aerobic classes were originally conducted at County worksite locations in Martinez, Concord, Antioch and Richmond. Due to the shifting of employees out of Concord to offices off Highway 4 in Martinez, the Concord class was cancelled and added to the Martinez class schedule. The Richmond class suffered from lack of adequate worksite space and was also cancelled. Currently, the Wellness Program conducts low-impact classes 9. at the Social Service Building in Antioch and, conducts low-impact aerobics, STEP aerobics and stretch and tone classes at the County's health and wellness facility, the Contra Costa Club in Martinez. e The County Health and Wellness Facility - The Contra Costa Club In July 1990, the Employee Wellness Program opened the County's own health and wellness facility, the Contra Costa Club. The 5,300 square foot facility is located in downtown Martinez and offers a variety of cardiovascular and weight training equipment, aerobic exercise classes, wellness activities and health screenings and locker and shower facilities. The Contra Costa Club is available for a monthly fee to all County employees (permanent, temporary, contract) , their spouses and dependents and County retirees and their spouses. Limited membership are also available to the local residents, businesses and government agencies such as the City of Martinez and the Community College District. Current membership is at 500. B . Health Education Seminars, Classes and Specialized Educational Programs o Brown Bag Lunch Seminars The Wellness Program has conducted a variety of Brown Bag Lunch Seminars presented by health professionals from the following agencies; American Heart Association, American Cancer Society, Family Stress Center, Child Care Council, Kaiser Permanente, Blue Cross, physicians from the County Hospital and the Contra Costa County Employee Assistance Program. Each seminar is presented at convenient worksite locations (Concord, Antioch, Richmond and two locations in Martinez) during the lunch hour. Health topics covered in our Brown Bag Seminars have included: Smoking Cessation, Financial Wellness, Stress Management, Medical Self-Care, Taking Control of Cancer, Latch Key Children, Single Parents -- Going it Alone, Oh, My Aching Back! , The Cholesterol Question, Exercise -- How to Get Started, Healthy Grocery Shopping, Weight Management, Effective Communication and Cold Self-Care. o Weight Watchers At Work Program r The Wellness Program has presented numerous Weight Watchers At Work Programs at several County worksite locations conducted during the lunch hour. Well over 6,000 accumulative pounds have been lost by employees participating in the Weight Watchers At Work Programs. 10. ® Cancer Awareness Month Activities Each year, the American Cancer Society celebrates Cancer Awareness Month in April. The Wellness Program has worked closely with the Contra Costa County Chapter of the American Cancer Society to help them advertise their special programs and activities. County employees have participated in the following Cancer Awareness Activities: The Mammography Project, Colorectal Cancer Project, Mother Was Right -- Eating Well Campaign. s United Way's Adolescent, Substance Abuse and Violence - A Worksite Workshop for Parents The Wellness Program has conducted this four part series in conjunction with the United Way on four separate occasions. Each series was conducted at five worksite locations and was presented by a variety of experts from local crisis intervention and substance abuse programs. These seminars were aimed at providing working parents with the information and tools to assist them communicate effectively with their adolescent children and have a better understanding of the problems they both face. ♦ Distribution of "Raising Parents", a book by Phil Batchelor The Wellness Program assisted with the advertisement and distribution of "Raising Parents" to the County employees through their Department Heads. As set forth in the Board Order approved by the Board of Supervisors on February 17, 1989, funds from the Wellness Program budget were made available to assist in the costs of providing County employees with copies of the book. s Distribution of Health Education Materials The Employee Wellness Program also acts as a distribution center of health and wellness educational materials for County employees. We have an extensive inventory of pamphlets`, videos, books, leaflets and posters on all areas of health. We disperse this information to County employees on special health observances, i.e. , High Blood Pressure Month, Heart Month, National Nutrition Month, or by special requests from County Departments and/or by employees. C. Wellness Newsletters In May of 1986, the Employee Wellness Program published the first issue of of the bi-monthly "Hotline on Health" newsletter. This newsletter was distributed bi-monthly to all County employees 11. 1 through payroll. The "Hotline on Health" newsletters provided information on current and upcoming wellness activities, high- lighted employees who have obtained special health goals, articles on- health and wellness and results of Wellness Program activities. In order to cut costs, we opted to discontinue the bi-monthly newsletter produced outside of the County to an in-house quarterly newsletter that coincides with the seasons (i.e. , Winter, Spring, Summer and Fall quarterly newsletters) . D. Health Screenings and Testings Providing periodic health screenings and testings for blood pressure, cholesterol and body composition to County employees have proven to be an extremely effective way to convince employees to change their bad habits to healthier ones. Many employees had no idea what their health status was until being tested through our screenings. Nothing motivates immediate lifestyle changes than being screened and finding out your blood pressure is dangerously high, your cholesterol levels are at a level which compromises your cardiovascular health or your percentage of body fat is above normal for your age and sex. E Special Events s Great American Smokeout Every November, the American Cancer Society celebrates the Great American Smokeout, the one day out of the year when all smokers are encouraged to quit smoking for the day and hopefully for life. Since 1986, the Employee Wellness Program has highlighted this event by sponsoring extensive programs and activities throughout the County workforce. We have conducted Adopt-A-Smoker campaigns, honored employees who have quit smoking, had volunteer Smokeout Coordinators in each County department assist with the promotion and distribution of Smokeout materials, conducted challenges between County departments and awarded departments with the greatest percentage of smokers who participated in the Great American Smokeout and conducted the "Cold Turkey Trot" Fun Runs and Fun Walks. The first annual "Cold Turkey Trot" Fun Run and Walk was held at the Martinez Regional Shoreline Park in November 1986 with 100 participants. At last year's "Cold Turkey Trot" we had over 1,000 participants and have also included "Cold Turkey Trot" Fun Walks at worksite locations in Antioch and Richmond since 1988. 12. o County Blood Drives In 1986, the Employee Wellness Program took over the responsibility of conducting the County Blood Drives from the Employee Benefits Division. County Blood Drives are held four times per year at the McBrien Administration Building in downtown Martinez. The Employee Wellness Program is also responsible . for the County Blood Donor Group and release credits for units of blood to County employees who request them for themselves or family members for medical treatment. F. Advisory Groups e Employee Wellness Program Steering Committee In the critical first three years . of the. Employee Wellness Program, a Steering Committee, comprised of 20 representatives from various County departments and job classes, assisted the Wellness Coordinator with program planning and implementation. In addition, the Steering Committee members provided input on marketing strategies, specific needs and interests of the County employees in their departments, disseminating information and acting as a communication link between the employees and the Wellness Program. o Contra Costa Club Advisory Committee To ensure the success of the Contra Costa Club, an Advisory Committee comprised of Club members from various County departments and job classes was created. The purpose of this Advisory Committee was to provide a forum for discussion., brainstorming and input on the development and implementation of the Club activities. 13. IV. CURRENT AND UPCOMING PROGRAMS A. County Employee Health Fair The Employee Wellness Program is sponsoring a Health Fair for County employees on Wednesday, September 29, 1993 from 11:00 a.m. - 2:00 p.m. at the Martinez Regional Shoreline Park. This Health Fair is slated to become an annual event and will act as a kickoff for a series of Wellness Program activities and events. Presenters at the Health ' Fair will be comprised of County departments and specialized programs within the County (such as the Sheriff's Department, the Fire Department, Employee Assistance Program, Career Development Program, Prevention Program) , County health and dental plans, outside participants from the local business community and non-profit agencies. Health Fair providers will present information on such topics as vision care, nutrition education, weight management, massage therapy, carpal tunnel care and elder and child care. B. Labor/Management Healthy Lifestyle Committee During the Health Care coalition negotiations concluding in January of 1992, an agreement was reached to establish a joint Labor/Management Healthy Lifestyle Committee to formulate a County response to the smoker/non-smoker issue and counter balance the intent to establish lower health plan contribution rates for non-smokers. The purpose of this committee was to recommend a proactive model program which .includes incentives for developing and maintaining a healthy lifestyle. A final report summarizing the recommendations of the Healthy Lifestyle Committee is completed and will be presented to the Internal Operations Committee and the Board of Supervisors in the near future. Upon Board approval, the smoking cessation activities and programs recommended by the Committee will be implemented by the Employee Wellness Program in November 1993 to coincide with the Great American Smokeout. C. Great American Smokeout The 17th anniversary of the Great American Smokeout will be held on Thursday, November 18, 1993. The Wellness Program has tentatively scheduled the 8th annual "Cold Turkey Trot" Fun Run and Fun Walks for the following days: Tuesday, November 16 at the Social Service Building in Antioch, Wednesday, November 17 at the Bay Municipal Court in Richmond and Thursday, November 18 at the Martinez Regional Shoreline Park in Martinez. The Employee Wellness Program will also host a series of events and special activities throughout the week of the Great American Smokeout. 14. 4 ' D. Contra Costa County Food and Nutrition Policy Consortium The Employee Wellness Program has taken an active role in assisting the Contra Costa County Food and Nutrition Policy Consortium advertise and promote the recently Board adopted Contra Costa County Food Policy. A recent article outlining the Food Policy Guidelines was included in the Spring Wellness newsletter and Food Policy posters developed by the Wellness Program will be distributed to all County departments in the near future to post in prominent worksite locations. E. New Series of Brown Bag Seminars Beginning in January, 1994, the Employee Wellness Program will implement a new series of Brown Bag Seminars to be conducted at various worksite locations. V. CONCLUSION As indicated in this report, the Contra Costa .County Employee Wellness Program has been providing a variety of health and wellness activities for the County employees since 1986.. Although a formal cost-benefit analysis of the County's Employee Wellness Program have not been conducted, this report provides substantial evidence from other companies that worksite wellness programs provide cost savings to the employer through direct economic benefits - lower health care costs, decreased sick leave and absenteeism, lower Workers' Compensation claims, and positive returns on their investment - and more importantly, through indirect benefits - healthier, more productive employees, increased morale and self-esteem, and improved employer image. A wellness programs' main emphasis is on prevention and helping -employees take control of their own health. By providing the Wellness Program to the County employees, the County is demonstrating its commitment to their employees and concern for their health and well-being. The County's most important asset is its employees. Ongoing Wellness Program activities also assist the County workforce reduce stress at a time of downsizing with staff reduction and layoffs. The best way to sum up the effectiveness of the County's Employee Wellness Program would be from the following statement recently received from an employee who participated in the latest exercise challenge. "Thank you for this fun activity. I really enjoyed it. I have begun a new lifestyle that includes healthy eating and lots, of exercise. Since I started this January, I have lost 108 pounds. Playing "Fitness Jeopardy" really helped keep me motivated. Thanks again." 15. s Personnel Department Contra Administration Bldg. Costa 651 Pine Street County Martioez, California 94553-1292 DATE: April 24, 1985 TO: qtr. Philip J. Batchelor, County Administrator FROM: Harry D. Cisterman , Director of Personnel SUBJECT: HEALTH PROMOTION (WELLNESS) PROGRAMS INTRODUCTION The Board of Supervisors has made several referrals to the Office of the County Administrator concerning various aspects of employee fitness programs , exercise facilities and smoking cessation .program. In' response to these inquires and from the recognition that health promotion is the most effective method to contain increasing health care costs., a joint . com- mittee representing Health Services and the Personnel Department has been exploring the feasibility of a Wellness Program for County employees . In reviewing a prior study done by the Health Department in 1983, as well as current literature and existing programs , the group has concluded that our approach should differ from standard corporate programs which rely heavily on outside consultants and vendors . This is because the County has a wealth of resources , particularly in the Health Department, which could be drawn upon to provide a variety of the needed services. In addit.ion, there already exists a number of links with community agencies such as Heart Association, Hypertension Council , Lung Association, Cancer Society and the Red Cross which would be extremely valuable in developing a health promotion program. WHY WELLNESS AT THE WORKPLACE? Employers are beginning to recognize that sponsoring group insurance plans is no longer a sufficient response to employee health care needs, not only because of the spiraling increase in health care costs, but from an understanding of the role an individual ' s lifestyle plays in overall health. This understanding results, in a shift from a passive to an active role in health care delivery and a shift from support of expensive treatment oriented health care toward promotion of prevention oriented programs_ The worksite is also an ideal setting for screening and promotion activities , and can encourage participation from peer support as well as provide oppor- tunities for positive reinforcement . BENEFITS OF A WELLNESS PROGRAM The long term benefit of a health promotion program is to improve the health status of individuals whose use of health care services makes up the health care bill and is founded on two basic premises : -prevention when possible is preferable to curing -the expense of training people to stay healthy is generally less costly than treating illness Traditionally, health improvement programs have seen positive results in a number of areas : -reduced absenteeism 'greater productivity -enhanced morale - improved recruitment and retention ' impact on health, accident , disabiltiy and workers ' compensation benefit plan costs AN APPROACH FOR CONTRA COSTA COUNTY The foundation of this program will be to identify and develoo cost effective resources both within county government and the community to assist in health promotion efforts directed at the county work-force. The key element to this approach requires a full-time person to coordinate the efforts of the resources identified to provide needed services . This program will be designed to help individuals make informed choices , and facilitate behavior changes while participants retain control over their lifestyles by making their own choices. A comprehensive supervised approach is recommended in an effort to reduce the exposure to liability for injures to employees involved in health promotion activities . In a related area the Personnel Director will present a policy for smoking in the workplace during this year' s labor negotiations . WELLNESS PROGRAM COMPONENTS The recommended program will be comprised of four major elements described below: Orientation - This explanation phase will outline all the various services available and also be used to motivate participation . Screening - This will be designed to both identify potential medical problems as well as provide a minimal clearance before a employee begins an exercise program. Promotion - These comprise the organized activities designed to promote health habit changes . Evaluation - This component is on-going throughout the program to measure results and identify the most effective and needed programs. The following are examples of activities anticipated to be a part of a developed health promotion effort: Screening Activities f Promotion Activities hypertension physical fitness blood chemistry nutrition cancer screening weight reduction health risk assessment profiles smoking cessation hearing tests low back care urinalysis stress management glaucoma tests substance abuse self-testing for medical conditions medical self-care wiser use of health care accident prevention COST TO IMPLEMENT Funding for this program has been included in the budget for the Workers ' Compensation Program as a charge against loss prevention services . The thrust of the program is clearly designed to. prevent and reduce accidents and illness to county employees , and programs of this type have been found to be effective in impacting workers ' compensation costs . Based on the current employee population in county sponsored health plans (which averages 5,000 employees ) , a maximum expenditure of SI .50 per month per employee would generate 590,000.00 which would be an ideal funding level for the first year of a health promotion program. This amount compares favorably with the average 565.00 current spent on a single county employee for health care pre- miums, as a relatively minimal cost for prevention . The major fundingcommitment is the establishment of a full-time position for a health promotion specialist and clerical support, which would cost an estimated 555,000.00. The remainder of the $35,000.00 in the target budget would be used for the following identified areas : administrative support printing - newsletters and brochures contracts for trainers lab test fees promotion incentive items computer costs An additional cost factor will involve the use of staff release time and flexible staffing to permit participation in various aspects of the program at convenient times and locations . 3 - PROGRAM ADMINISTRATION Overall responsibility for the program will reside with the Personnel Department, in the Benefits Division where the Workers ' Compensation Program is managed. Essentially this office will contract with the Health Services Department where the health promotion specialist will be housed. This will per- mit the specialist access to community resources available from the Prevention Section within Health. Services while being dedicated to serving the needs of county employees . MEASURING SUCCESS Evaluating the benefits of health promotion is difficult to perform because: a) it is hard to assign monetary values to health outcomes b) there is a certain unreliability in attributing specific benefits to specific programs . In addition, since the primary goals of a health promotion program are linked to morale and improving the quality of lifestyles for employees, objective measurable results will be difficult to quantify. Generally, this type of effort can be monitored from two perspectives : Outcome Measures : reflect the success of a program (i .e. number of employees who quit smoking) but are difficult to quantify in dollar savings . Cost Benefit Measures: measure success in dollars but are difficult to assign to specific programs (i .e. if health care costs are reduced, the specific reasons may be hard to identify) . RECOMMENDATION Based on the health promotion program outlined in this report, the Personnel Director should return with a detailed program budget as a part of the proposed 1985-86 fiscal year budget . In the interim staff will continue to develop com- munity resources and investigate alternative health promotion models. AKG: sjm 4/22/85 cc: Dr. Wendel Brunner, Health Services _ q _ _ Attachment A _� .BOARD OF SUPERVISORS Phil Batchelor , .Countv_Administrator Contra pM: Costa 7 May 8 , 1985 Count E:, Health Promotion (Wellness ) �Program -' csJECT: " ECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION _COMMENDATION uthorize Personnel Directorto prepare a detailed program budget for stablishment of a wellness Program for consideration as a budget item or the 1985-1986 fiscal year . INANCIAL IMPACT he first year costs for establishment of a Wellness Program are stimated at $90 , 000 based on a maximum expenditure of $1 . 50 per month er employee . Funding for the program is proposed for inclusion in the orkers ' Compensation Budget inasmuch as the program is designed to •revent and reduce accidents and illness among County employees and thus educe Workers ' Compensation costs. ACKGROUND 'he Personnel Director has prepared a report on this subject dated ,pril 24 , .1983 ; a copy of this report is attached. Establishment Of a 'ellness Program appears to be the most orderly way to respond to -icerns which the Board has expressed about establishment of a _chvsical fitness program for County employees , and for intensification of .nu -smoking efforts and related health concerns . :ONSEOUENCE OF NEGATIVE ACTION lithu-uL initiation of remedial efforts , ccntinuatic of he lin nroblem.-, ibout .which the Board has expressed concern may be anticipated, together jith a continued high rate of sick leave usaae . r =ONTINUED ON ATTACHMENT: YES SIGNATURE: — RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE — APPROVE OTHER SIGNATURE(S) V ACTION OF BOARD ON 1`la 14 , '1985 APPROVED AS RECOMMENDED OTHER _ VOTE OF SUPERVISORS X UNANIMOUS (ABSENT ) I HEREBY CERTIFY THAT THIS IS A TRUE AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD OF SUPERVISORS ON THE DATE SHOWN. County Administrator ATTESTED Personnel Director _. Phil Batchelor, Clerk of the Poard of Superb ors and County Administrator �OD hEPUTY