Schools Take Steps to Get Healthy

Hattie Bernstein

In the battle against obesity, exercise, healthy eating, and stress reduction are considered the most effective weapons.  But these evidence-based strategies also drive down the cost of health care plans for schools, municipalities, counties, and other public agencies that belong to public sector risk pools.

That perspective wasn’t lost on SAU 39 Human Resources Director Carrie James when in late spring she kicked off the annual open enrollment, a time when teachers and other school employees are asked to choose a medical coverage plan for themselves and their families.

SAU 39 purchases its healthcare coverage from the New Hampshire Local Government Center’s HealthTrust, a public sector risk pool that offers a variety of plans to its Risk Pool Groups covering more than 75,000 enrollees across the state. The SAU also works closely with LGC Benefits and Coverage Advisors to provide benefit education and Health and Safety Advisors to provide training and counsel aimed at improving health outcomes and preventing accidents.

When the enrollment period opened, James said, she stressed the connection between employees’ lifestyle choices and their medical costs.

“We asked them to consider, ‘Am I in the right plan? How many times a year do I go to the doctor? How many times do I go to the ER?’” she said.

It wasn’t just cost-containment that was on James’ mind, however. As the May enrollment period was opening, the human resources director and her colleague, School Nutrition Director Danielle Collins, recognized an opportunity to reinforce the health promotion ideas the two had had championed during the school year.

“We began a campaign called “Jazz it Up,” James said, describing an SAU-wide program that aimed to make exercise so much fun participants wouldn’t realize they were working.

Fitness and Zumba classes were held at the high school, the middle school, and each of the SAU’s three elementary schools, two in Amherst and one in Mont Vernon.

“We realized it was not just wellness, that wellness included benefits and safety,” James said, explaining how she used the “Jazz it Up” campaign to promote incentives available through LGC’s HealthTrust, such as the Health Assessment, a questionnaire, that once completed, qualifies an enrollee for a $75 reward, and provides access to the Health Awareness program which allows participants to earn a combined total of $300 if they participate in exercise programs and complete nutrition counseling, driver safety, or other health and safety related classes or counseling.

“We have to give a lot of credit to LGC,” James said.  “They’ve been great in guiding our enthusiasms.”

James said the SAU has also depended on its LGC Health and Safety Advisor, Kerry Horne, for training and support. Horne visits the SAU regularly, bringing ideas for health promotion programs such as “Know Your Numbers,” a push to get employees to understand how blood pressure, cholesterol and blood sugar levels, and other biometrics identify risks for heart disease, diabetes, and other preventable chronic illnesses.

“We had “Know Your Numbers” in May and we’re having screenings for skin cancer in June,” James said, ticking off a list of topics Horne covers during brief, monthly presentations at SAU meetings.

Rises in healthcare costs and medical plans have also been motivators, James said.  “We got excited over a nine percent increase in our healthcare insurance, and we asked, ‘What can we do about our population?’ We realized it doesn’t happen in a vacuum, that teachers and other staff live and work in the community, their children go to the schools. They’re taxpayers. They’ll buy in.”

Nor was SAU 39 alone in its pursuit of improved health and lower healthcare costs during the 2011-2012 school year. In Litchfield, Deb Mahoney, human resources director for SAU 27, coordinated the P.A.C.E. Program, Physical Activity Challenge for Employees, an effort that began on October 1 and ended just before April vacation.  The program was promoted with clever reminders to participants to “Set your PACE” and “Keep up your PACE.”  And it spawned a number of splinter groups throughout the district.

“Many informal walking groups started up,” Mahoney said. “We also had Zumba classes at one school. We offered massage, paid for by employees, aerobics classes, and a volleyball tournament.”

Following April vacation, the SAU challenged employees with LGC HealthTrust’s “Know Your Numbers” promotion, the same program used in Amherst and across the state. In addition, the SAU offered a walking program and encouraged employees to use pedometers, made available during the previous year, to keep track of how far they walked every day.

“We don’t have any statistical data about absenteeism or other indicators,” Mahoney said, adding that the anecdotal evidence is convincing. “This has been a stressful year, and we believe with this initiative, it has helped folks to better handle the stressors that we are all feeling.”

Pam Hausler, the school nurse at the Bluff Elementary School in Claremont, spearheaded a similar program to encourage teachers, staff, and students to get moving.  Indeed, increasing daily activity drove this year’s “Taking Care of Me, Taking Care of You,” a campaign to promote healthy behaviors in teachers and school staff.

Getting school employees to carve out time in their busy schedules for activities many considered luxuries was challenging, however, and often disappointing, said Hausler, a participant in the LGC HealthTrust Health and Safety Coordinator Academy. Attendance at after school Zumba classes, for example, was so low that the school nurse decided to switch gears: instead of asking staff to exercise, she would invite them to dinner.

“We had a healthy barbecue and gave out information about nutrition. It was a chance for them to experience foods they had never eaten before,” Hausler said.

In April, the Claremont school district and the city sponsored a citywide Health Fair, supported by local supermarkets, gyms, and other vendors. About 250 people, including school district and city employees, attended.

“It was a really nice day,” said Hausler, a key player in planning the event. “I think that ‘If you build it, they will come.’”

Administrators and school nurses in SAU 5, which includes the towns of Lee, Madbury, and Durham, learned a similar lesson this year after launching a health promotion program that didn’t catch fire. Like Hausler in Claremont, they also found an alternative that worked.

Using a portion of the $500 grant made available to the SAU through LGC’s Health and Safety Coordinator Academy, the Moharimet Elementary School started the “5, 2, 1, 0” program, a campaign to encourage staff to consume at least five fruits and vegetables daily, limit daily “screen time” to two hours or less, exercise for at least one hour, and eliminate sugary drinks.

“About a quarter of the staff, 20 people, signed up, but by the end of the six weeks, there were only eleven,” said Moharimet Elementary School nurse Tracy Schroeder.  “So the second time, we did straight walking. We started with 27 people and ended with 20, and we got really good feedback.”

Schroeder said it was easy for participants to wear pedometers and fun for them to count their steps at the end of the day. “It was a motivating thing,” she said. “You’d say, ‘I didn’t get to 10,000 steps today. What happened? What did I do today?’”

The school nurse said she also used the walking program to remind employees to take the Health Assessment and participate in the Health Awareness program.

Meanwhile, colleagues at other schools in the SAU were making similar attempts to foster participation.

“At the Oyster River Middle School, the school nurse reimbursed staff for fruits and vegetables they bought, up to $25, if they brought in the receipt,” Schroeder said. “There’s not much you can buy for a school (with the shared $500 grant) but it was a little carrot to get people to participate.”

“When it comes from the top” more employees are likely to listen and participate, added Human Resources Coordinator Theresa Proia, recounting how two school bus drivers learned through the “Know Your Numbers” program that they had coronary blockages. She said both underwent surgery to correct potentially fatal conditions.

“If we didn’t have ‘Know Your Numbers,’ they wouldn’t have known,” Proia said.

James, the SAU 39 human resources director, said working with LGC has deepened her understanding of how “wellness, benefits, and safety” are linked. “We realize they really intersect a lot, that it’s all encompassing,” she said.

Indeed, that connection is reflected in LGC HealthTrust programs based on containing costs while providing public employees and their families with comprehensive health care coverage and opportunities to improve and maintain their health.

Hattie Bernstein is the Communications Specialist for the New Hampshire Local Government Center. Contact Hattie at 800.852.3358, ext. 3342, or