Congratulations to the State of Delaware for winning the 2008 National Association of State Personnel Executives (NASPE) Eugene H. Rooney Jr. Award for its DelaWELL program.

DelaWELL is the State government’s comprehensive health-management program for all full-time state, school district, charter school, and higher-education employees and pre-65 retirees.  Spouses and dependents over the age of 18 who are covered under the state group health plan are eligible also.

DelaWELL encourages participants to live a healthy lifestyle as a way of controlling health-care costs. The program offerings are quite impressive:

• Confidential, online or paper-based Health Risk Assessment
• Onsite Biometric Health Screenings to include blood pressure, cholesterol, and glucose testing with review of personal results with a Health Coach
• Weight Watchers® offerings to assist employees in their weight management efforts
• Cardio Health Assessments available to employees only, first-come basis, 600 slots available
• Personalized Lifestyle & Disease Management Coaching Programs- delivery options include phone based, mail and online programs.
• Online Health Resources (Health and Safety Education Centers, Self-Care Resources, Wellness Library, Drug Database, Health Quizzes and Calculators, Recipes, Daily Health News, Quarterly Newsletter and Much More)
• Onsite Health Seminars, Events & Activities
• Health Education Campaigns/Communications/Incentives
• Unlimited Access to a HelpLine

Delaware will receive the award during the awards banquet on Tuesday evening, July 15, during NASPE’s 2008 annual meeting. in Oklahoma City.

Information on the DelaWELL is available here.

[H/T to the Capital Comment Blog]

For previous posts on Wellness at Work, use this link.

Off-duty conduct, especially smoking and tobacco use, are often regulated by employers who complain of increasing health-care costs. But not every employer believes that workplace regulations on employee’s off-duty conduct is an appropriate solution.

The Tribune Company, which owns the Chicago Tribune, came under new ownership in December. Sam Zell, the new chairman and chief executive, recently revoked the company’s $100-per-month smoker’s penalty. The penalty, says the new owner, “is inconsistent with the new culture.”

The CAO and Executive VP, Gerry Spector, told employees in an e-mail, “We’d rather you use your own judgment when it comes to tobacco use, not impose ours upon you.”

The company will continue to offer smoking-cessation programs to employees at no cost but will reimburse those employees who had been subject to the penalty.

This certainly a different approach to the way most employers are treating smokers these days. Is this an indication that employers may move towards positive reinforcement instead of penalties to reduce the cost of health insurance?

The relationship between smoking and employability is a familiar topic on this blog. To visit some of our previous posts on the issue, click here.

More on the story can be found at the Chicago Tribune’s website.

Employers and smokers have been making headlines. Just last week, Whirlpool made the news when it terminated 39 employees after they were caught smoking, despite having signed statements when they were hired swearing that they were non-smokers.

Over the past several years, it has become more and more common for employers to have stopped hiring smokers or to require smokers to pay higher premiums for health insurance. But not everyone agrees with the idea of punishing employees based on health-related factors. Some cite privacy concerns and paternalism as reasons why employers should not become involved in what employees do off the job. And others worry about what will come next. Currently, it is socially acceptable to ostracize smokers. And, in most states, including Delaware, there’s nothing unlawful about it.

But what about other health factors, like obesity? Will employers next target overweight and obese employees with higher health care premiums? Will businesses refuse to hire applicants who are over a certain body mass index (BMI)?

Some employers, like Westgate Resorts, a vacation-properties company based in Orlando, Florida, are trying to push employees into healthy lifestyles, which includes reducing obestity. At Westgate, employees aren’t penalized to lose weight but those who do are rewarded with a variety of incentives. Michigan is the only state, in addition to the District of Columbia, to prohibit discrimination based on weight. But, in other states like Delaware, where obesity is not a protected class, there would be little legal risk to implementing a weight-reduction policy. Of course, as my mother would say, “Just because you can, doesn’t mean you should.”

Employers should consider non-legal implications of such a policy. For example, how to define “obese.” If BMI is the only determining factor, you might not have many employees–more than two-thirds of Americans qualify under this definition. Or what about the woman who gained 60 lbs during pregnancy and isn’t in a real rush to get lose it right away? And how do you handle an employee who states that his obesity is related to another medical condition. This would sound the alarms of both HIPPA and the Americans With Disabilities Act (ADA). And would gastric bypass or other bariatric surgeries be pushed on employees as a “solution” to weight struggles? How will they regulate weight on a more organic level?

For example, will there be a ban on the sale of Girl Scout cookies?

That announcement would make headlines, for sure.

Last week I posted about a new survey on the lack of commitment by employees to health and wellness programs sponsored by their employers. For those of you who were not deterred by that news, here’s a[nother] helpful (and free) online tool from the Department of Labor (DOL).

In February, the DOL issued its Field Assistance Bulletin 2008-02, which is designed to help employers who are attempting to establish a Wellness Program while remaining compliant with HIPPA regulations.

The Wellness Program Analysis can be found here.

Do You Need the Checklist?

In short, the answer is “yes” if you are an employer with any kind of health-promotion or disease prevention programs. Also known as “Wellness Programs,” these health-focused initiatives became popular early in the decade. Certainly you’ve heard of these programs, even if your workplace hasn’t yet adopted one.

Wellness programs come in every shape and size. Some of the more benign programs promote cholesterol screenings or even advocate flue shots for employees. Others promote an all-around “healthy lifestyle” by giving employees financial rewards for regular attendance at a fitness club. And, as you may have read in some of my previous posts, smoking is also a very popular target of wellness programs.

So why the need for a government-agency-sponsored “checklist?” As with just about everything in the law, we lawyers just can’t hardly stand to let anything be simple. Employers that utilize “wellness programs,” as defined by law, must follow certain practices to avoid violating the anti-discrimination provision of the Health Insurance Portability & Accountability Act (HIPAA). (Be honest, did you even know there was such a thing as an anti-discrimination provision in the HIPAA statute? If you said “no,” you wouldn’t be alone.)

Wellness programs that are subject to the HIPAA regulations must meet either a “benign discrimination” exception or offer a reasonable “alternative standard” in order to be in compliance with the law. Which exception will depend on whether your program is considered a “standard-based” or “participation-based” program.

Standard-Based vs. Participation-Based Programs

Standard-based programs require participating employees to meet the stated objective in order to receive the offered reward. So, for an employee to successfully complete a cholesterol-reduction program, his cholesterol must actually be reduced.

Participation-based programs offer a reward to employees based on their participation, as opposed to their success. The reward cannot be conditioned on achievement of a specific health-related outcome. So, for a smoking-cessation program, employees can receive the reward so long as they complete the program. Whether or not the employee actually quits the habit does not effect their eligibility for the reward.

Discrimination In a Standard-Based Wellness Program

To comply with HIPAA, a standard-based program must satisfy five requirements:

1. The reward offered under the program must be limited to 20% of the applicable cost of coverage.

2. The program must be reasonably designed to promote health or prevent disease.

3. Individuals must be eligible to qualify to participate in the program at least once per year.

4. The reward must be available to all similarly-situated individuals.

5. The wellness program must have a reasonable alternative standard and disclose the alternative standard in all program materials that describe the program.

And what exactly is the “reasonable alternative standard” identified in the fifth prong?

For standard-based wellness programs to avoid a HIPAA violation, it must offer an “alternative standard.” This means that an employee must be offered a reasonable alternative to the stated objective and still be able to achieve the reward. In the cholesterol-screening example, the objective is the attainment of a certain cholesterol target. An alternative standard would be nutrition counseling sessions. The standard must be made available to those for whom it is (1) unreasonably difficult due to a medication condition; or (2) medically inadvisable to satisfy the otherwise applicable standard.

The topic of off-duty conduct has been unavoidable recently.

First there was the wave of large companies who stopped hiring smokers or charged higher health care premiums to employees. Sure enough, this trend resulted in a lawsuit challenging the legality of making employment decisions based on what candidates and employees do outside of work. The conditional-employee sued Scotts when his conditional job offer was revoked when he tested positive for nicotine. (Scotts doesn’t hire smokers).

Next came a wave of talk about GINA, the Genetic Information Nondiscrimination Act, proposed to prohibit employers from basing employment decisions based on genetic information. It would also put limits on the amount of detail employer about an employee’s family medical history and other private data.

And don’t forget the internet! Employees who post on blogs, in chat rooms, or on social network sites like MySpace and FaceBook have a lot to stay. What are employers to do when their employees (current or former) are giving away trade secrets or other confidential information? And what about the bitter employee with lots of complaining to do and an unlimited audience ready to listen.

What’s next? Well, if you ask Governor Spitzer, he might have his own opinionson this topic. His “off-duty conduct” has resulted in his resignation and a great deal of commentary for morning news shows and late night comics alike. Some may argue that the difference between smoking and engaging prostitutes is legality. Smoking, at least for now, is a legal activity. You can pick up a pack of cigarettes at any corner convenience store. Not so with prostitutes. They can be picked up, true, but it is unlawful to do so. Yet, both activities will land you in a similar position–unemployed.

So where should employers draw the line? That’s a question for another day. Some critics claim that weight will be the “new tobacco.” Will employers, who face rapidly increasing health care costs, next turn to overweight employees and make them an offer they cannot refuse–lose weight or lose your job. Or will the same objective be attempted through higher health care premiums?

And will they charge by the pound?

Barry M. Willoughby, our Section Chair, commented on this issue last week in the Wilmington News Journal.

On Monday, the Wilmington News Journal published an article about the effect an employee’s off-duty conduct can have on his or her employment. Our Section Chair, Barry M. Willoughby, was quoted in the article.

“Lifestyle discrimination” is a rapidly expanding area of the law with staunch advocates on both sides of the fence. “Off-duty conduct,” is anything an employee does during his non-working time that is not illegal but not usually “good” for you.

This topic first hit the news when employers began firing and/or refusing to hire smokers. This trend has continued to pick up supporters and is more common than ever. Another ideation of the same idea is to charge smokers a premium for health care. The “carrots and sticks” can vary a great deal and some of the better programs supplement these types of rules with “wellness benefits” where employees are eligible for all sorts of rewards for working towards a healthier lifestyle.

Some opponents of this trend claim that the consideration of non-workplace activity is a violation of employee’s privacy rights. Others express concern that the it won’t be long before “wellness initiatives” expand to other areas of employees’ private lives. For example, many critics worry that weight will be the next area of employer-legislation.

The idea is certainly not unimaginable. If employers want to “encourage” employees to get healthier by quitting smoking, it seems reasonable that they would also want their workers to eliminate the many health risks associated with obesity. On the issue of weight-based regulations in the workplace, Barry had the following to say:

“Weight becomes another issue,” said Barry Willoughby, chair of employment section at Young Conaway Stargatt & Taylor in Wilmington. If a person’s weight is due to a provable medical condition, the Americans With Disabilities Act may offer protections, but failing that, workers are at the mercy of the company.

“I don’t know any employer would actually do that,” he said, though complete worker protection for lifestyle choices would be possible only by an act of the General Assembly.

And it is very unlikely that the Delaware General Assembly will pass any broad-sweeping lifestyle anti-discrimination ban any time soon. This is especially unlikely given the State’s disposition for pro-business legislation. Unlike California, where employees have a vast variety of rights, Delaware tends to take a more conservative approach to its regulation of the workplace.

Until such laws were passed, though, businesses can continue to consider tobacco use, weight, or even alcohol use, in making employment decisions.