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Posted on November 26, 2019June 29, 2023

Please Tell Me Why Worksite Wellness Programs Are a Waste of Time and Money

My father passed away in October 1986 from a heart attack at age 49.

That was his last in a series of major and minor cardiac events. I was 21 years old when he died. At the time I perceived my father to be old (as do most children).

Now, at age 53, it’s an odd perspective to look back at his passing and reflect on where he was in his stage of life and career and consider his outlook on the future.

Gary Cassidy

My family has a history of heart disease and my father was no exception. As an engineer for General Electric, he worked long, hard hours and traveled frequently.

Physical activity, nutrition and doctor’s visits were not high on his priority list. I call this attitude the “I feel fine so I must be fine” mentality.

He enjoyed eating the crispy skin off the Thanksgiving turkey, fat from a well-cooked steak and ladles of cream sauces — all the good-tasting stuff that was loaded with calories, fat, cholesterol and sodium.

When my father had his first heart attack, the doctors found he had extremely high blood pressure and major blockages in all four of his arteries. By that time, too much damage had been done to his heart and there was nothing they could do for him. Still, my father started eating better, took up golf, spent less time at work and focused on reducing his stress.

It’s important to remember that during my father’s lifetime, 1937 to 1986, company wellness programs did not exist. He grew up with exercise guru “The Jack LaLanne Show,” hula hoops, calisthenics, the sauna suit, vibrating belts and other early fitness trends and fad diets. Most centered on the external appearance of fitness but lacked a focus on inner fitness, the biometric and lifestyle measurements that truly determine if one is healthy.

You would think I learned something from his experience, but you’d be wrong. When I was young I felt indestructible.

I had a high metabolism and didn’t gain weight no matter what or how much I ate. The good news: I was physically active in soccer, aerobics, long-distance running, weight lifting, competitive Taekwondo and many other activities.

The bad news: my diet was significantly less than stellar. It wasn’t unusual for me to have fast food for breakfast, lunch, dinner and a late-night snack all in the same day. I inherited my father’s “I feel fine so I must be fine” mentality.

In 1993, after eight years in the Air Force, I returned to civilian life to work at a large insurance carrier, where I learned about health care claims, annual employee benefit renewals and risk management, which drive and control an employer’s health insurance costs. I began to understand that the overall health of a workforce can affect an employer’s health care costs.

I learned about the decisions that organizations must make about health insurance cost sharing, like imposing premium increases, and that employee benefits are a large part of the workforce’s total compensation. I observed how employees who do not take responsibility for their personal health can cause others who do to pay more for their own health care benefits, something that always struck me as unfair.

At age 35, I finally visited my doctor for an annual physical, and the results were not good. My total cholesterol was over 300, my HDL was low and my LDL and triglycerides were high. I was also diagnosed with hypothyroidism.

While this was an “aha!” moment, I should have seen it coming. I knew that I had a family history of high cholesterol and most men on my father’s side of the family died young from cardiac-related causes. But “I felt fine so I must be fine.”

My doctor prescribed cholesterol and thyroid medication. I began to focus on nutrition and continued to be physically active. After one year, my numbers started to improve, but even now I still have work to do. Progress, not perfection.

While conditions like these may take years to produce symptoms and can initially go unnoticed, they are still incrementally causing damage to one’s health and well-being. This is why it’s so important to focus on preventive measures to manage a disease before it has the chance to cause a major medical event.

After my father had his first heart attack, he was released from the hospital and sent home. He walked slowly so as not to raise his heart rate. One day I watched him spend 20 minutes walking up 15 steps in our house. When we lose our health it’s the simple things we take for granted that are impacted the most.

Seeing first-hand the impact of how an undiagnosed heart condition affected my father’s health helps me stayed focus on wellness. In every wellness program participant, I see someone whose life can be positively impacted.

I often reflect on what would have happened if my father’s company had a wellness program. Knowing him, he would have been one of those people who wouldn’t want to participate. Because he was too busy. Because he didn’t have the time. Because it didn’t make sense; he “felt fine.” Because he had too many other things to do. Because it was his choice how he managed his health, not the company’s.

While all of this may be true, I think that if he had participated in a wellness program, gotten his blood work done and learned about his high blood pressure and high cholesterol before he had a heart attack, he would still be here today.

So I ask you, what’s the downside of participating in a wellness program?

Gary Cassidy is the director of employee education, communication and wellness for Camden, New Jersey-based insurance broker Corporate Synergies.

Posted on November 8, 2019June 29, 2023

Federal Employee Labor Union Files Grievance Against VA’s Smoking Ban

The Department of Veterans Affairs’ new smoking ban took effect on Oct. 1, prohibiting all patients and non-staff from smoking on VA hospital premises. In January the ban will extend to employees.

The smoke-free policy was created to initiate a healthier environment and improve care for veterans, but the American Federation of Government Employees argues that the ban violates the labor union’s contract.

A 2008 contract that is still in effect states that all VA facilities will provide employees with “reasonably accessible designated smoking areas.” However, the ban does not allow any smoking while on VA property, including parking areas.

Because of the conflicting policies, the AFGE filed a national grievance, which the VA’s Office of Labor Management Relations denied. The 670,000-member labor union has invoked arbitration and is waiting to schedule a hearing once the arbitrator is selected.

“Although we believe that the agency violated the law and our contract by implementing the directive for AFGE’s bargaining unit employees, we encourage employees to comply with the directive to avoid the threat of discipline while we continue to challenge the policy,” said Alma Lee, AFGE National Veterans Affairs Council president, in a statement.

In addition to the contractual dispute between the union and the VA, the ban has received pushback from veteran’s and their families who don’t think the policy is necessary.

Alma Lee, AFGE National Veterans Affairs Council president.

Al Lewis, author of “Cracking Health Costs,” said that the ban is only a good idea in theory and questions whether it is a wise decision for the overall productivity of the organization. “Instead of creating a culture of health, you are creating a culture of deceit,” Lewis said.

The idea of taking away all designated smoking areas from veterans using VA facilities is also seen as cruel and unfair. Based on the affiliation between tobacco products and the military, it is common for veterans to rely on smoking as a source of comfort.

Pat Englewood, an organizational psychologist and counselor said that the use of tobacco products can be part of good and bad memories of the military service that a veteran may choose to not let go of, or can’t let go of.

A Centers for Disease Control and Prevention study released in 2018 found that about 30 percent of veterans use tobacco products, which is a much higher rate than most of the non-veteran population. The prior culture of tobacco use in the military is considered a significant influence on this issue.

Englewood said that part of the upset toward the smoking ban may be derived from the veteran’s addiction to these products.

“The craving has become a necessary habit in their daily routine,” said Englewood, who is also a Vietnam era and Gulf War veteran. “If there is any threat that this craving will not be satisfied, then the big guns come out and they blame others through their defensive comments and behaviors.”

Although taking away the designated smoking areas will make it difficult to take smoke breaks, Englewood saw the new policy as a responsible step toward better protecting the health of the VA’s patients and staff.

“It is not an overstepping of power to look out for the health and well-being of all service members and hospital staff,” she said. “No one is taking anyone’s control of their lives away.”

Gary Kunich, a spokesman for the Milwaukee VA Medical Center, also supports the ban as he considers it to be a positive and healthy change toward maintaining a healthy work environment.

“We’ve actually gotten a lot of positive comments from people who are happy that we’re doing this, that there’s not a cloud of smoke outside or that there aren’t cigarette butts on the ground,” Kunich said.

Since the Milwaukee VA Medical Center has undergone this change, Kunich says that the ban has “changed things for the better.” According to Kunich, a majority of the employees and veterans at the Milwaukee facility don’t smoke and have wanted a healthier environment to provide and receive better care.

In the 10 years that Kunich has worked at this facility, he recalls town hall meetings where some of the veterans would ask why they still allowed smoking on the property. “It just seemed to be a logical step forward and the right thing to do for all of our employees and all of our veterans,” he said.

For veterans who are struggling to quit smoking or using other tobacco and nicotine products, Kunich encourages them to take this as an opportunity to find healthier habits by taking advantage of the programs that the VA offers.

Posted on November 7, 2019June 29, 2023

‘Smoking Gun’ Email Revives Employee’s Disability Discrimination Lawsuit

Jon Hyman The Practical Employer

Maryville Anesthesiologists fired Paula Babb, an experienced certified registered nurse anesthetist, because it thought she suffered from a visual impairment.

How do we know why it fired her? Because the day after Babb’s termination, one of her co-workers confirmed it in an email (written at the direction of one of the employer’s owners).

As most of you know, [Babb] has been having major issues with her eyesight and as of late, it has seemed to be getting even worse. We have had numerous complaints from [hospital] staff regarding her inability to read the monitor, etc. Over the past several months the group has given her several opportunities to provide documentation from her eye specialist saying that she was safe to practice. [Babb] was unable to provide this documentation. This, in addition to a few other issues, has forced the group to make a very difficult decision. As of today, she is no longer with our group. Sorry to be the bearer of bad news. This was one of the reasons that our meeting was postponed. See you all tomorrow.

Despite this email, the district court granted the employer summary judgment and dismissed Babb’s “regarded as disabled” ADA lawsuit.

On appeal, the 6th Circuit had little difficulty in reviving the claim, in large part because of what it described as the “smoking gun” email.

Maryville has never tried to defend its termination of Babb on grounds that Babb’s vision created a safety hazard, and has instead insisted that Babb’s termination occurred solely because of clinical errors unrelated to her vision. But, yet, just hours after Maryville decided to fire Babb, Crystal Aycocke wrote an e-mail to her fellow CRNAs essentially stating that Maryville was firing Babb because of her impaired vision. More striking still, far from being mindless office gossip, Aycocke admits that she composed this e-mail at the direction of Dr. Proffitt—one of the key players involved in Babb’s termination—shortly after Dr. Proffitt informed her of Babb’s termination. And, of course, all of this occurred in a context in which Maryville’s physicians felt concerned enough about Babb’s vision to discuss it at the meeting at which they decided to fire Babb, and on the official evaluations they wrote about Babb. (“I see her questionable ability to see reflect on how surgeons and the medical staff lack accepting her.”). If this kind of “smoking gun” evidence cannot get an employment discrimination plaintiff past summary judgment on the question of pretext, it is hard to imagine what could.

Employers, if you are short-sighted enough to (a) fire an employee because you believe she suffers from a disability, and (b) confirm that belief in writing, then you deserve whatever fate you suffer in litigation.

Posted on November 6, 2019June 29, 2023

Decision on Positive Drug Test Reveals the Future of Medical Pot and Drug Testing

Jon Hyman The Practical Employer

Richard Turner worked as a crane operator for Phillips 66.

The company’s substance abuse policy allowed for random and post-accident drug testing for “Cannabinoids, Cocaine, Opiates, Phencyclidine (PCP) and Amphetamines,” and mandated termination for any positive test.

On April 24, 2017, Turner was selected for a random drug test and provided a urine sample. Three days later he was involved in a workplace accident and was again tested.

The following day, Phillips 66 learned that Turner’s April 24 sample tested positive for amphetamines. As a result, the company fired him.

According to a letter Turner later provided from his physician, Turner had not been prescribed amphetamines, but had taken over-the-counter medications, including Sudafed, for unspecified “medical conditions.” The April 27 sample, and the sample from a retest Turner himself took, both tested negative. The company’s retest of the April 24 sample, however, again tested positive for amphetamines.

In Turner’s subsequent disability discrimination case challenging his termination, the 10th Circuit Court of Appeals concluded that Phillips 66 did not violate the ADA via its drug testing.

Under the ADA, an employer “shall not require a medical examination and shall not make inquiries of an employee as to whether such employee is an individual with a disability or as to the nature or severity of the disability, unless such examination or inquiry is shown to be job-related and consistent with business necessity.” Turner argued that Phillips 66’s drug screen violated this rule because it revealed the potential use of a legally prescribed medication. The 10th Circuit disagreed:

The EEOC has indicated a drug test does not become a medical examination simply because “the results reveal information about an individual’s medical condition beyond whether the individual is currently engaging in the illegal use of drugs,” such as “the presence of a controlled substance that has been lawfully prescribed for a particular medical condition, this information is to be treated as a confidential medical record.” A test for the illegal use of drugs does not necessarily become a medical examination simply because it reveals the potential legal use of drugs.

Pay careful attention to that last sentence:

A test for the illegal use of drugs does not necessarily become a medical examination simply because it reveals the potential legal use of drugs.

Assume for a second that Turner tested positive for legally prescribed medical marijuana instead of amphetamines. Would this result be any different? Marijuana remains federally illegal. If an employer drug tests for marijuana, according to Turner v. Phillips 66, a positive test does not become an unlawful medical exam in violation of ADA merely because it could cause the employee to reveal medical information to justify the positive test.

In other words, drug tests remain 100 percent legal, whether or not they cause an employee to reveal medical information in response to the drug screen.

A great result for employers as we continue to figure out the difficult intersection between the lawful use of impairing drugs and the ADA.

Posted on November 4, 2019June 29, 2023

An Employee’s Disability Is Not a ‘Get Out of Jail Free’ Card for Workplace Misconduct

Jon Hyman The Practical Employer

Does a medical leave of absence grant an employee a free pass for pre-leave misconduct discovered during the LOA?

This question is squarely at the center of the court’s decision in Williams v. Graphic Packaging International (6th Cir. 10/31/19) [pdf]

James “Randy” Williams worked as a department manager for Graphic Packaging. In late 2014 or early 2015, Williams told his supervisor, plant manager Eddie Lee, that he had been re-diagnosed with prostate cancer. In September 2015, Williams requested time off for treatment, which the company granted from Sept. 14 through Nov. 23, 2015. During that leave, however, several of Williams’ subordinates lodged complaints against him of inappropriate treatment. The company investigated, and concluded that “Williams had been using manipulative and coercive tactics to control his employees and prevent them from communicating with upper management.” As as a result, shortly after Williams returned to work, the company fired him.

Williams sued, claiming (among other things) that firing on the heels of a return to work after cancer treatment is tantamount to disability discrimination.
The 6th Circuit court of appeals disagreed.

The evidence demonstrates that Graphic Packaging terminated Williams’s employment after receiving complaints from an employee, which were later corroborated by interviews with fellow employees, an internal investigation, and depositions from Graphic Packaging upper management, Human Resources employees, and employees who reported to Williams. The record reflects that Williams violated Graphic Packaging’s Core Values by mistreating employees both publicly and privately, limiting access to upper management, and propagating troubling and salacious rumors concerning upper management. Williams has even admitted that he committed at least some of the acts which so clearly violated Graphic Packaging’s Core Values.

No employee gets a free pass on workplace misconduct just because he or she suffers the misfortune of having cancer (or any other disability). The company concluded that the allegations against Williams (which its internal investigation corroborated, and many of which Williams himself admitted) merited termination. Those allegations included Williams telling his subordinates that he “owned” them; spreading an unsubstantiated rumor that Lee had molested his own daughter; cheating on a mandatory safety exam; and forbidding his subordinates from speaking to plant management.

Cancer and other ADA-protected disabilities are not “get out of jail free” cards for workplace misconduct. Do your due diligence, and treat the employee the same as you would have treated him or her if the disability didn’t exist. If the misconduct warrants termination, so be it. Terminate, and defend your legitimate, non-discriminatory decision. Otherwise, you risk setting a precedent that the misconduct is OK, which will make it that much more difficult to hold others accountable for that same misconduct in the future.

Posted on November 4, 2019June 29, 2023

Personalization Versus Ease of Use

I recently had coffee with a benefits leader who is implementing a new technology platform for her organization’s employees and spouses. Her scenario is much like that of many of our clients: She works for a big organization with employees all over the United States and in many locations around the world. The company’s benefits and HR programs are complex — and getting more so as it seeks to meet the needs of different employee segments and an increasingly diverse population. Data is used for everything in the organization, and HR is catching up to the rest of the enterprise.

Their goal is to provide a better experience for employees, driven by data. Her team is looking at consolidating all benefits information from existing channels (including the intranet, external sites, vendor sites, email newsletters and more) into a personalized portal.

But she has a lingering concern: As we look to offer employees a highly personalized experience, do we unintentionally make it harder to access benefits information?

This is a critical question. Ease of access and ease of use need to be the highest priority if we are going to get the right people to use their benefits at the right time. It’s also an often-overlooked question when pursuing personalization. And it becomes even more important to consider when you’re using personalization and engagement to drive health strategy. Personalization is among large employers’ top health care initiatives for 2020, according to the National Business Group on Health’s latest survey. Some 26 percent of respondents said they plan to “implement an engagement platform that aggregates point solutions and pushes personalized communications to employees.”

That initiative follows employers’ top three strategies, which are largely focused on changing the health care experience: implementing virtual care solutions, a more focused strategy on high-cost claims, and expanding centers of excellence to include additional conditions.

So, why are personalized tools getting so much attention? Personalized portals and apps are good at doing several important things. They can serve up data-driven content, send just-in-time notifications, and help identify missed opportunities in a very relevant way. They can also deliver recommendations, which helps create the “Amazon” experience so many plan sponsors are looking for.

Amid all this incredible promise, it’s important to remember that these tools can deliver customized content only if and when people use them. By their nature, personalized tools have more access barriers, because all that personal information needs to be protected. It is easy to underestimate the amount of effort it takes to get people to engage frequently with even the most cutting-edge and appealing platforms.  You must have a compelling reason to check anything out. You must have an even better reason to go back.

If you’re asking someone to download an app, authenticate with personal information, keep that app up to date, allow notifications, and go back to it frequently, is that actually easy? Each one of those action steps is a specific user behavior that has to be promoted and encouraged.

Think about when you log in to a website and have forgotten your password. Are you always motivated to track it down? Or do you file that for “do later” and move on to something else? We all have a lot of to-do’s and a lot of distractions — especially on our phones.

When you’re considering a personalized app or platform, you need to take into account the ease of access and the amount of resources you’ll need to drive ongoing use.

Of course, we have clever ways to encourage engagement. And this is where we can really use HR’s unique advantages.

First, we can make something so enticing that you can’t resist going there often. The best example of this that I’ve seen recently is a large retailer that puts their employee discount in their benefits engagement app. The only way they can use their discount is to have the app on their phones. You can bet all their employees are using that app.

You can also make the app so critical to an individual’s day-to-day job that using the platform becomes a de facto job requirement. Some large companies have built their HR apps to include core functions like scheduling and time tracking. If you have to use the app every day you work, it’s an ideal channel for serving up key benefits and HR reminders.

There is tremendous promise with personalization. But that promise can only be fulfilled if people have a good experience with personalized tools and use them frequently. It is our job to use all the tools we have to make that desirable — and most importantly, easy.

Posted on October 24, 2019February 14, 2022

Health Care Surveys Show Employers What to Expect in 2020

association health plans

Recent surveys show that employers are increasingly addressing outside financial and environmental factors in their benefits offerings.

While the Kaiser Family Foundation’s annual survey gives insight into cost trends in employer-sponsored health care, the National Business Group on Health’s new study focuses on what large employers are doing to address these trends.

One noteworthy trend is rethinking impact of cost-shifting and consumer-driven health plans, also referred to as high-deductible health plans.

Employers are bringing back choice, according to the National Business Group on Health’s “2020 Large Employers’ Health Care Strategy and Plan Design Survey,” which was conducted in May and June 2019 among 147 large employers. Collectively, respondents represent a wide range of industry sectors and offer coverage to more than 15.6 million employees and their dependents.

According to the NBGH survey, 11 percent of employers offering an optional HDHP for 2020 previously offered HDHP-only. Employers cited several reasons for this shift, including the desire to be more sensitive to employees with chronic health care conditions and their health care expenses.

The Kaiser Family Foundation also stressed the adverse impact of HDHPs on many employees in its 2019 “Employer Health Benefits” report released in September. Forty percent of non-elderly adults who have employer-based coverage said that either they or a dependent have had difficulties affording health care.

Further, people with HDHPs were worse off. Among all employees surveyed with chronic conditions, 60 percent said they felt confident enough to afford the cost of the major illness. This percentage halved for chronically ill employees with HDHPs. Only 1 in 3 said they feel confident affording this major medical cost.

Taking employees’ health into account goes beyond health insurance. The NBGH survey found that 60 percent of employers are considering strategies to address food quality/access in the next few years.

“One of the primary things that employers can do is offer nutritious food in on-site cafes and vending machines — and importantly — reduce the cost of these items to make them more desirable than less nutritious ones,” said Steve Wojcik, vice president, public policy at NBGH.

Other ways to address employees’ food quality and access challenges include partnering with local grocery stores to offer employees discounts on healthy foods and offering healthy, prepared take-home meals for purchase, he added.

Macro trends that impact people’s physical or financial health go beyond food deserts. The NBGH report also cited other notable macro trends like stagnant wages, poor public transportation systems and high housing prices.

Bringing an end to the most pressing social and environmental challenges will likely require action and partnership from both public and private sectors, Wojcik said. Companies are increasingly understanding that business performance, employee well-being and community health are intrinsically linked.

“Large employers are uniquely positioned to use their voice to draw attention to issues, advocate for public solutions (potentially in partnership with other employers or nonprofit organizations) or invest corporate social responsibility funds into initiatives that will positively impact their employees, customers and the communities where they work,” he said.

Also read: 4 Myths of Health Care Cost Reduction

Wojcik also suggested that if employers claim a position on some external issue, their internal benefits should be aligned with that. If a company has a corporate social responsibility program or external initiative on affordable housing, for example, it should also make sure that it supports financial well-being program such as employer-sponsored housing programs or homebuyer workshops.

The Kaiser report also stressed the need to keep employees’ financial situations in mind,  comparing the needs of low-wage versus high-wage employees.

“When people talk about the 153 million people with employer-based coverage, they often gloss over the very real cost differences for different groups of workers across the marketplace,” according to the report, which compared companies that have a large share of low-wage workers with companies that have a small share of low-wage workers.

Covered employees in organizations with large shares of lower­ wage workers on average face higher deductibles for single coverage and must contribute a greater share of the premium for family coverage than workers in firms with a smaller share of lower­ wage workers, the study found.

Being eligible for employer-sponsored coverage also is impacted by wages. In companies where at least 35 percent of employees earn $25,000 a year, 66 percent of employees are eligible for the coverage compared to 81 percent of employees in companies with a smaller share of low-wage workers.

The national debate around expanding Medicare was also a major theme in these reports. Most employers have major concerns about Medicare for All, NBGH noted. Fifty-seven percent of those surveyed believe that Medicare for All would increase the country’s health care costs, 69 percent believe it would decrease health care innovation and 56 percent believe it would decrease quality.

While the Kaiser report did not go into attitudes people have about Medicare, it did explore attitudes people have toward employer-sponsored plans. The debates over Medicare and the future of U.S. health care have raised concerns about the performance of employer-based coverage, the report noted. Many employees with chronic conditions, especially people with HDHPs, have issues affording health care, and low-wage workers may very well face higher premiums for health care than employees who earn more.

“Regardless of its outcome, the national debate around expanding Medicare or creating public program options provides an opportunity to step back and evaluate how well employer-based coverage is doing in achieving national goals relating to costs and affordability,” the report stated.

Posted on October 14, 2019June 29, 2023

The 16th Nominee for the “Worst Employer of 2019” Is … the Shameful Wall Builder

Jon Hyman The Practical Employer

worst employer 2019If you’re a health care facility whose employees erect a “wall of shame” of disabled patients, and then you drag your feet when an employee, who was also a patient, reports the misconduct, you might be the worst employer of 2019. From the Bangor (Maine) Daily News:

Employees at St. Mary’s Regional Medical Center in Lewiston created a “wall of shame” where they displayed confidential medical records of patients with disabilities detailing issues with their genitalia and bodily functions, according to an investigation by the Maine Human Rights Commission that found the exhibit had contributed to a hostile work environment.

In addition, at least two employees looked at the private medical records of a fellow coworker, MyKayla McCann, whom the hospital had previously treated. She ultimately reported her suspicions about their actions, in addition to the wall of shame, to the hospital’s administration. When she did, it took three to four months for the hospital to remove the display, investigate and punish her coworkers, according to the investigation. …

A human rights commission investigator found there are reasonable grounds to believe that St. Mary’s hospital discriminated against McCann, who is a member of a protected class because she has a disability, when it subjected her to a hostile environment created by her coworkers’ conduct. …

McCann discovered the “shame wall” on the inside of a cabinet door on her first day of work as a laboratory technician assistant at St. Mary’s in June 2015. It had been labeled a “wall of fame,” with the word “fame” crossed out and replaced by “shame.” Portions of medical records had been cut and taped to the door. They “included information detailing patients’ sexual activity, genital dysfunction, bowel movements, bodily odors, and other personal maladies,” according to the investigator’s report.

McCann also provided pictures of the wall in her complaint. In one place, someone had attached strips of paper with diagnoses on them: “cramps/bloated/things to do w/intercourse,” stated one. “Drooping eyelids,” “butt wounds,” “unable to insert tampon,” “sour smell of vagina with occasional itching,” stated others.

For its part, the hospital’s parent company publicly apologized to McCann.

Public apology or not, if you permit a working environment in which this “wall of shame” could exist, you might be the worst employer of 2019.

Previous Nominees:

The 1st Nominee for the Worst Employer of 2019 Is … the Philandering Pharmacist

The 2nd Nominee for the Worst Employer of 2019 Is … the Little Rascal Racist

The 3rd Nominee for the Worst Employer of 2019 is … the Barbarous Boss

The 4th Nominee for the Worst Employer of 2019 is… the Flagrant Farmer

The 5th Nominee for the Worst Employer of 2019 is… the Fishy Fishery 

The 6th Nominee for Worst Employer of 2019 Is … the Diverse Discriminator

The 7th Nominee for Worst Employer of 2019 Is … the Disability Debaser

The 8th Nominee for the Worst Employer of 2019 Is … the Lascivious Leader

The 9th Nominee for the Worst Employer of 2019 Is … the Fertile Firing

The 10th Nominee for Worst Employer of 2019 Is … the Exorcising Employee

The 11th Nominee for the Worst Employer of 2019 Is … the ****y Supervisor

The 12th Nominee for the Worst Employer of 2019 Is … the Disguised Doctor

The 13th Nominee for the Worst Employer of 2019 Is … the Excoriating Executives
The 14th Nominee for the Worst Employer of 2019 Is … the Horrible Harasser
The 15th Nominee For The ‘Worst Employer of 2019’ Is … The Disability Demoter
Posted on October 4, 2019June 29, 2023

The Past and Present of Mental Health Treatment

Andie Burjek, Working Well blog

My most recent Workforce print feature story is about mental health parity, and that’s one of the topics I love writing about as a benefits reporter: the need for quality, accessible, affordable mental health coverage.

My preliminary research steered me to a new book, “Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness.” It explores scientists’ ultimately unsuccessful attempts to figure out the cause of mental illness.

The argument is that even though ideas or theories in psychiatry have prevailed in certain moments of history, all of them have been proven inadequate or outright wrong. And we’re still uncertain about both the cause of mental illness and why treatments work on some people but not others.

This sounds cynical, but I love a book that rationally explores the highs and lows of a scientific goal (in this case, to pin down the cause of mental illness). This isn’t discouraging as much as it is proof that people will constantly try to progress their understanding of the world in order to help people with a disorder. It’s more promising to me to see people admit their miscalculations and be determined to move forward than to see people stubbornly hold on to ideas from the past.

There are a few reasons I want to write about this book. The history of mental health treatment and theory is simultaneously fascinating, inspiring and upsetting. Especially in this context, history gives us many examples of how some of the mental health trends we’re now seeing in the workplace may not be exactly new.

I’ve gotten press releases about how people are more depressed or anxious now than ever before — especially millennials (or whatever young generation is being picked apart at the moment). I’ve spoken to people about how prevalent mental illness is and how that has changed over time. I’ve always been skeptical about the idea that it’s more common than in the past. My theory is that it’s more talked about now, more diagnosed now and less stigmatized now, and so the numbers just seem higher. (Feel free to argue against me on this, of course!)

What interested me about “Mind Fixers” was the section about the Cold War Era and how it was seen as the “Age of Anxiety” at the time. Many people relied on the “minor tranquilizer” Miltown, a predecessor of Valium, to deal with that anxiety. Meanwhile, in the 1980s depression became “the common cold of psychiatry.”

Comments like this make me wonder how current trends compared to other periods of history. This isn’t to minimize the impact that mental illness has on people and communities in the present. I bring this up so that we don’t talk about the history of mental health in a way that romanticizes the past. People in the 1950s, the 1800s, and before that had mental disorders, too. The treatments just weren’t as advanced.

According to the National Institute of Health and the Centers for Disease Control & Prevention, 41.2 percent of adults with a mental illness have received mental health services. And, more importantly, this statistic is very gendered if you dissect the data further. While 47.6 percent of women have received this type of health care, only 34.8 percent of men have.

That’s a big gap. Why don’t men get mental health care as much?

There’s a lot written about this already (see the National Alliance on Mental Illness, National Institute of Mental Health and Psychology Today, for example), but here’s a historical angle that shows how deep this goes. “Mind Fixers” briefly explored a 20th century mental disorder known as hysteria.

It was “associated with women and weakness” and men did not receive this label. Fast forward to the 1970s, when people were talking about a new trendy topic called “stress.” It was thought that women were twice as likely to experience stress and depression than men.

This is just a snapshot. Still, it shows how deep these roots are that may tell men that they’re weak if they admit certain things.

Finally, “Mind Fixers” mentioned the unwillingness of insurance companies to cover psychiatric services in 1970s. Lack of benefits coverage of behavioral health is something that even today — after the passage of the Mental Health Parity and Addiction Equity Act in 2008 — is still sometimes an issue.

Also read: Mental Health Parity Law Successes and Challenges

According to “Workforce Attitudes Toward Behavioral Health,” a February 2019 survey from behavioral health company Ginger, 35 percent of the 1,214 U.S. employees surveyed reported that they had to pay directly for behavioral health services their benefits didn’t cover. Further, 85 percent of people said that behavioral health benefits are important when evaluating a job, and 81 percent of people said they face barriers in accessing behavioral health care. The most common barrier (28 percent) was that providers aren’t available in their benefits plan.

I’d strongly recommend this book to anyone interested in the science behind mental health. It brings up a lot of interesting talking points like, How much has stigma improved in the past 200 years, and where is there still room for improvement? Which issues still exist that caused people problems all those years ago as well?

While this isn’t a book about the workplace, you’ll read about certain historical trends and movements that sound a lot like some of the “innovative” solutions you’re hearing about now. Maybe you’ll learn a couple lessons from history.

Posted on September 30, 2019June 29, 2023

Are Hangovers the Next Frontier of Your FMLA Headaches?

Jon Hyman The Practical Employer

A German court recently ruled that a hangover qualifies as an “illness.”

Which got me thinking … are hangovers the next frontier of your FMLA headaches?

Thankfully, the answer to this question is almost certainly “no.”

But it’s worth reviewing the FMLA’s definition of “serious health condition” to see how I reach that conclusion.

The FMLA defines a “serious health condition entitling an employee to FMLA leave” as “an illness, injury, impairment or physical or mental condition that involves inpatient care …or continuing treatment by a health care provider.”

  • “Inpatient care” means “an overnight stay in a hospital, hospice, or residential medical care facility, including any period of incapacity … or any subsequent treatment in connection with such inpatient care.”
  • “Incapacity” means an “inability to work, attend school or perform other regular daily activities due to the serious health condition, treatment therefore, or recovery therefrom”
  • “Continuing treatment by a health care provider” means “a period of incapacity of more than three consecutive, full calendar days, and any subsequent treatment or period of incapacity relating to the same condition, that also involves” either “treatment two or more times, within 30 days of the first day of incapacity by a health care provider,” or “treatment by a health care provider on at least one occasion, which results in a regimen of continuing treatment under the supervision of the health care provider.”

It’s difficult to imagine a hangover meeting any of these criteria. No hangover should ever require an overnight stay, continuing treatment of three or more days, or a regimen of supervised continuing treatment, even if an employee feels so ill that he or she cannot work or perform other regular daily activities as a result.

HR folks and leave administrators, rest easy knowing that you will not have to grant FMLA to your hungover employees.

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