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By Cathleen O'Connor Schoultz
With flu season once again upon us, health and wellness experts interviewed by BNA agreed that vaccinations are the No. 1 way to avoid the flu and that HR can play a key role in getting that message out to employees.
According to an issue brief from the National Business Group on Health, the indirect costs of the flu for businesses in absenteeism, presenteeism, and other expenses run $76.7 million annually, while the direct medical costs of the flu average $10.4 billion a year.
Influenza can occur at any time, but most of it happens from October through May, according to the Centers for Disease Control and Prevention.
Despite the importance of the vaccination, even when they are free, flu shots can be a tough sell with employees. In fact, the average employee participation rate in getting the shots is just 20 percent, and what is considered a good rate is still only 30 percent, Roslyn Stone, chief operating officer for Corporate Wellness Inc., told BNA Sept. 21.
Even in the face of an impending pandemic a couple of years back, the rate was only up to 50 percent, Stone added.
Meantime, many employers face a new federal requirement this year with regard to flu shots. The Patient Protection and Affordable Care Act requires all non-grandfathered employer health care plans to cover the entire cost of a flu shot given by an in-network provider, management attorney Ilyse Schuman told BNA Sept. 8. By flu season 2014, all employer plans will be required to cover them, said Schuman, who works in Littler Mendelson's government affairs practice in Washington, D.C.
A critical component of getting employees vaccinated is making it convenient for them, said Stone, who chairs the National Flu Summit Workplace Working Group, a joint venture of CDC and the American Medical Association.
Companies can do that by organizing both onsite and off-site clinics, Stone said, something that her Mount Kisco, N.Y.-based firm does for its corporate clients. But on-site and free is the gold standard, she said, ideally without employees being required to take sick leave while getting the vaccination. Even adding a small copay diminishes participation rates, Stone said.
Stone said last year some corporate clients offered their employees vouchers to be used at the nearest Costco or public clinic, but at a pre-designated time and location for each person. “But the employees just didn't go,” she said.
This year, Stone said, many companies that are not providing on-site shots are mailing “flu cards,” a type of gift card, to employees. The cards can be used at a much wider array of drug stores and clinics than the vouchersand often on a drop-in basis, she added.
She offered other specific tips for how HR can encourage flu prevention:
• Stone advises having a “flu champion” at every location to get the ball rolling—from developing and distributing informational materials to sending broadcast e-mails about on-site vaccinations and other offerings, and seeing that department heads keep the company's anti-flu mission on their agendas.
• Both employees and their family members should be encouraged to get vaccinated and to practice good health habits, such as covering their mouths when coughing and washing their hands frequently. Stone noted that employees who are home with sick children or spouses lose a lot of work time and productivity, and are exposed to the flu themselves, with the stress of it all making them more vulnerable to other illnesses such as pneumonia.
• Managers should be reminded to set an example and stay home when they are sick. “What is an employee supposed to believe or do when you come in to work sick?” asked Stone. Never discourage employees from calling in sick, she said.
Common sense goes a long way in slowing down flu infection, Alan Baker, interim executive director of the American Public Health Association, told BNA Sept. 16.
For example, he said, if employees are not able to get their shots on the weekend, let them take time off during the work day.
When employees are sick or think they are, they should be permitted and advised to stay home, Baker said. Otherwise, he said, they risk getting other staff sick and if the company deals with the public, getting customers ill as well. Companies should provide sick leave and not punish employees who take it, Baker stressed.
And for companies whose employees interact with the public, it is neither good public health policy nor good public relations to have sick workers “hacking away” on the front line, Baker said. If customers get sick later they will assume they got it at that place of business, and they may well be correct, he said.
Both employees and their family members should be encouraged to get vaccinated and to practice good health habits, such as covering their mouths when coughing and washing their hands frequently, said Roslyn Stone of Corporate Wellness Inc.
Baker would strongly concur with Stone on the importance of making vaccinations as easy and inexpensive as possible. APHA covers the entire cost of shots for its employees, without requiring a copay, “a very small investment if it pays off in having employees come to work,” he said.
Stone said most large companies do cover flu shots, often including the copay because they tend to follow the policies of Medicare, which picks up the entire tab.
Baker said the association has been especially mindful of helping employees stay well, in advance of its annual conference and exposition in late October. The company arranged for one of its providers to offer flu shots at no charge during late September, he explained. Especially under the demands of carrying off a conference and similar work challenges, he said, employees could be more prone to catching the flu from people who are sick.
Cigna Medical Group, the medical practice division of Cigna HealthCare of Arizona, puts a major focus on preventing the flu in both employees and patients, the group told BNA in a Sept. 23 e-mail.
Cigna has a Flu Committee chaired by registered nurses Marianne Young and Marcia Hick, the group's health service manager.
“We emphasize ‘Community Immunity,' ” they said in the e-mail. “The … theory is that if more members of a community are immunized there is less likelihood for the influenza organism to take hold.”
Hick and Young told BNA that Cigna Medical has been offering free flu vaccine to its employees for many years and achieved a staff immunization rate of 49 percent last year.
“This is the secret,” wrote Hick and Young. “We go to the employee. Even in our health care centers, we have carts travel from department to department, or set up in a convenient location. There is no cost. Wait times are usually less than 5-10 minutes (including paperwork completion).”
Flu season may begin in the fall, but the company's Flu Committee works all year, with a kickoff luncheon in August to update key flu coordinators from all the locations about the upcoming season.
More information on preventing and managing seasonal influenza, including CDC's Flu IQ test and a toolkit for businesses, is available at http://www.flu.gov .
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