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### Resources For

          - New / Prospective Employees
          - Federal Employees
          - HR Professionals
          - Managers

# Health & Wellness

# Overview

The U.S. Office of Personnel Management is committed to helping Federal agencies integrate prevention strategies into their workplace. The leading causes of death and disability in the United States are not only preventable but also responsive to workplace interventions. Worksite health and wellness programs help employees modify their lifestyles and move toward an optimal state of wellness. They can also produce organizational and employee benefits, such as lower healthcare costs, increased productivity, improved recruitment and retention, reduced absenteeism and presenteeism, and enhanced employee engagement. Worksite health and wellness interventions include, but are not limited to, health education, nutrition services, lactation support, physical activity promotion, screenings, vaccinations, traditional occupational health and safety, disease management, and linkages to related employee services. Federal agencies are encouraged to develop and sustain programs that address the current and future needs of their employees to produce the healthiest possible workforce.

## Related Information

                      - Work-Life
                      - Health & Wellness Reference Materials
                      - Healthcare & Insurance
                      - Employee Health Services Handbook
                      - Employee Assistance Programs
                      - Health & Wellness FAQs

# Guidance & Legislation

Health services for Federal employees are authorized by Title 5, U.S. Code, Section7901. These services are provided to promote the physical and mental fitness of Federal employees.  Several legislative initiatives have shaped guidance and implementation of health & wellness programs in the Federal Government.

The information provided below is for informative purposes only.  Please seek guidance from the General Counsel’s and/or the policy-making office at your agency before making any determinations related to health promotion programs.

## Employee Wellness Programs (EWPs): A Guide for Agency Leaders

The Employee Wellness Programs (EWPs): A Guide for Agency Leaders establishes parameters for Employee Wellness Programs and provides agency leaders with resources for themselves, as well as resources to share with their coordinators and supervisors, and employees, and to equip agency leaders with the information needed to ensure their employees are aware of and have access to the appropriate resources and aids needed to support them. 

## Health Services Authorized by Title 5, U.S. Code, Section 7901

Agencies are currently offering a wide variety of health services. Your agency chooses the services that best meet its needs. The level of services will vary from agency to agency. Under Title 5, U.S. Code, Section7901, agencies are authorized to offer the following employee health services (as well as those under “Health Promotion and Prevention”):

### Emergency Response/First Aid

Your agency's qualified medical staff may provide first response and Cardiopulmonary Resuscitation (CPR) for emergencies as well as assessment and initial treatment/first aid to employees who are injured, or become ill during work hours.

### Administration of Treatments and Medications

If furnished by the employee and prescribed in writing by his/her personal physician, your agency's qualified medical staff may administer treatment/medication during working hours.

### Physical Examinations

Your agency's qualified medical staff may administer properly authorized pre-placement and periodic physical examinations to assess an employee's health status. Based on the results of the exam and/or testing, medical staff may refer employees to the Employee Assistance Program (EAP), private physicians, dentists, and other community health resources.

### Environmental Health Hazards Appraisals

Your agency may appraise and report work environment health hazards to department management as an aid in preventing and controlling health risks.

### Health Education

Your agency may provide health education to encourage employees to maintain a healthy lifestyle, to understand their risk for disease, and to become aware of appropriate preventive practices. For example, your agency may provide health education through health questionnaires, health risk appraisals, health fairs, newsletters, brochures, and presentations.

### Health Services/Intervention Programs

Your agency may provide health intervention programs to promote and maintain physical and mental fitness and to help prevent illness and disease. Health Services/Intervention Programs encourage and enable employees to initiate healthy behavior changes. Your agency may offer group activities and classes, individual counseling, demonstrations, and self-help materials.

### Common Subject Areas for Health Education and Intervention Programs

                - Smoking Cessation
                - Substance Abuse
                - Diet & Nutrition
                - Exercise
                - Back Care
                - Cholesterol Management
                - Mental Health 
                - Stress Management
                - Weight Control
                - Cancer Prevention
                - Hypertension Control

### Disease Screening Examinations and Immunizations

Specific preventive health screenings or examinations may be sponsored at the workplace to detect the presence or risk of disease. Common workplace screenings include exams for blood pressure, mammography, blood lipids, glucose, vision and hearing. Medical staff may provide employees with immunizations, such as influenza and tetanus.

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## Health Promotion and Prevention

### Fitness

Executive Order 13266 encourages the expansion of opportunities within the Federal Government for individuals to improve their physical fitness.

*Employee Access to Private Fitness Center*:****U.S. Comptroller General decision B-240371, dated January 18, 1991 addresses whether a Federal agency can purchase access to a private fitness center for its Federal employees.

*Interagency Agreement for Providing Health Services*:****The Economy Act, Title 31, U.S. Code, Section 1535,****gives guidance on interagency agreements for health services.

*Employee Welfare and Recreation Organizations/Associations**:*Agency Relationships with Organizations Representing Federal Employees and Other Organizations (5 CFR part 251) provides regulations governing agency relations with managerial, supervisory, professional, and other organizations that are not labor organizations. This includes Employee Welfare and Recreation Organizations/Associations.

*Dues or Fees*: Title 5, U.S. Code, Section 5525 and 5 CFR part 550.311(b) address the allotment of dues for organizations. 

### Bike Commuter Programs

Bicycle Commuter Transportation Subsidies****(Title 26, U.S. Code, Section 132(f)) allow for pre-tax transportation subsidies to cover the cost of reasonable expenses incurred during the calendar year for the purchase of a bicycle and accessories, and for repair and storage of a bicycle that is used regularly for a substantial portion of an employee’s commute to and from the workplace. 

### Tobacco Cessation

Executive Order 13058 establishes a smoke-free environment for Federal employees and members of the public visiting or using Federal facilities.

U.S. Comptroller General decision B-231543, dated February 3, 1989 addresses the use of appropriated funds to pay for agency-sponsored tobacco cessation programs.

### Drug-free Federal Workplace Program

Executive Order 12564 requires agencies to establish a drug-free Federal workplace program.

### Defibrillators

*Defibrillation Program*:****41 CFR part 102-79.115 provides general guidelines for a public access defibrillation program.

Guidelines for Public Access Defibrillation Programs in Federal Facilities provides a basis of knowledge for Federal agencies as they implement a PAD program. 

### Lactation Support

Section 4207 of the Patient Protection and Affordable Care Act requires employers (including Federal agencies) to provide employees who are breastfeeding with a reasonable break time and location. 

For more guidance on the implementation of this policy, please review OPM’s Nursing Mothers in Federal Employment.

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## Physical Space

### Buildings

The Facilities Standards for the Public Buildings Service establishes design standards and criteria for new buildings, major and minor alterations, and work in historic structures for GSA owned or leased buildings. You can follow this link for more information on bicycle racks, locker rooms and fitness centers, outdoor eating areas, walkways, and drinking fountains.

### Concessions and Vending Operations

The GSA Health and Sustainability Guidelines for Federal Concessions and Vending Operations translate the 2010 Dietary Guidelines for Americans into clear and definitive standards that food service operators can follow to make their operations healthier and more sustainable.

### Lactation Support

For more guidance on creating space for nursing mothers in Federal buildings, please review OPM’s Nursing Mothers in Federal Employment.

### Facilities to Support Health Promotion in Federal Buildings

41 CFR part 102–79 governs the basic assignment and utilization of space within an Executive agency. Portions relevant to health promotion are:  
                - §102.79.15: Objectives an Executive agency must strive to meet
                - §102-79.30: Allotment of space for fitness programs
                - §102-79.35: Elements Federal agencies must address in their planning efforts for establishing fitness programs

*Rates and Fees*: For information regarding rates and fees for fitness centers inside Executive agencies, go to Title 40, U.S. Code, Section 490(k) and Title 31, U.S. Code, Section 3302.

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## Incentives

The following are laws and rulings that give guidance on incentives.  Refer to your agency's General Counsel and policies before implementing an incentives program. 

Title 31, U.S. Code, Section 1301(a) specifies that Federal agencies may only use appropriated funds for authorized purposes.

66 Comp. Gen. 356, 359 (1987) applies the “necessary expense” rule and states that agencies have reasonable discretion to determine which expenses are "necessary" as a management tool.

5 CFR parts 451.102 - 451.106 provides guidance for giving awards or incentives to Federal employees. 

Executive Order 13589 highlights the importance of selecting appropriate incentive items and understanding the effective use of incentives in health promotion.

*Tax Implications:* In general, incentives that hold a value low enough so that reporting them for tax purposes would be unreasonable or administratively impractical may be classified as De Minimis Fringe Benefits (Internal Revenue Code (Title 26, U.S. Code, Section 132(e)); 26 CFR part 1.132-6).

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## Use of Time for Health Promotion Activities

The Federal personnel system gives employees considerable flexibility in scheduling their hours of work and taking time off for routine medical examinations and preventive screenings. Agencies should review policies and make maximum use of existing work schedules to encourage employees to take advantage of preventive health services. The following are some examples of the work and leave flexibilities available to employees:
> *Flexible Work Schedules*: Agency officials should encourage employees to use flexible work schedules (non-duty time) to participate in health promotion activities. To the extent possible, agencies should offer health promotion activities before, during and after lunch or in the early mornings or late afternoon/evening to minimize the impact on work.

> *Leave and other Paid Time Off*: Employees may request annual leave, leave without pay, or sick leave (as appropriate) to participate in health promotion programs not sponsored or administered by Federal agencies.

> *Excused Absence*: In limited circumstances, agency officials may provide short periods of excused absence for health promotion programs and activities officially sponsored and administered by the agency.

**Employees are reminded that the decision to grant excused absence (time) is a matter of agency discretion and approval,** based on business conditions at the time. Requests for excused absence must be coordinated with and approved by the agency official in advance. Agency officials must balance the needs of the organization to fulfill their missions when providing employees with appropriate opportunities to participate in health and wellness programs.

For more information on the leave options available to Federal employees, please visit OPM's Leave Administration page.

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## Wellness Memoranda to Agencies

                - Human Resources Flexibilities and Authorities for Federal Employees Affected by the Zika Virus
                - Coping with Severe Heat and Humidity
                - 2016 WellCheck Administration
                - National Prescription Drug Take Back Day, Saturday, April 30, 2016
                - Release of OPM’s Course: Introduction to Leave, Work-Life, and Workplace Flexibilities
                - Notification of CDC Travel Alert Regarding Zika Virus
                - National Work & Family Month
                - Protecting Our Federal Workforce During the 2015-16 Flu Season
                - National Prescription Drug Take-Back Day, September 26, 2015
                - World Breastfeeding Week
                - 2014 WellCheck Results
                - Evaluating Worksite Health & Wellness Programs
                - Valuing Employee Health and Wellness
                - Human Resources Flexibilities and Authorities for Quarantinable Communicable Diseases and Other Communicable Diseases such as Seasonal Influenza
                - Keeping Our Federal Workers Healthy this Flu Season and Beyond
                - National Prescription Drug Take-Back Day, Saturday, September 27, 2014
                - Enhancing Workplace Flexibilities and Work-Life Programs
                - Human Resources Flexibilities and Authorities for Quarantinable Communicable Diseases and Other Communicable Diseases such as Seasonal Influenza
                - Federal Workplace Conversations about Mental Health
                - Coping with Extremely Cold Weather
                - Immunization of Federal Workers with 2013-14 Seasonal Influenza Vaccine
                - Release of OPM's Online Course: "Executive Excellence and Wellness through Strategic Leadership"
                - Presidential Proclamation NATIONAL PHYSICAL FITNESS AND SPORTS MONTH, 2013
                - National Prescription Take-Back Day, Saturday, April 27, 2013
                - Workplace Flexibilities for 2013 Seasonal Influenza
                - Nursing Mothers in Federal Employment
                - The Role of the Employee Assistance Program during Workforce Restructuring

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## On This Page

                      - Health Services Authorized by Title 5, U.S. Code, Section 7901
                      - Health Promotion and Prevention
                      - Physical Space
                      - Incentives
                      - Use of Time for Health Promotion Activities
                      - Wellness Memoranda to Agencies

# Program Administration

Growing evidence suggests that coordinated or integrated approaches that address risks from work (occupational hazards) and individual risk factors (such as smoking and diet) are more effective in promoting and improving worker health than traditional isolated programs. A holistic approach in developing and implementing worksite health promotion programs that incorporate a full complement of worksite health policies and practices is, therefore, desirable. Healthy People 2010 (HP 2010) introduced a framework for comprehensive worksite health promotion programs. Healthy People 2020 (HP 2020) continues to pursue the overarching goal of improving the health of all Americans with specific objectives for worksite health promotion programs. Five elements provide the framework for a comprehensive worksite health promotion program:
                - Health education (seminars, webinars, educational materials);
                - Social and environmental supports (cafeterias, walking paths, lactation rooms);
                - Integration (leadership involvement, employee involvement);
                - Linkages with related programs (safety programs, ergonomics, Federal Employee Health Benefits (FEHB); and
                - Screenings (health risk assessments (HRA), blood pressure checks).

Guidance, methods, and goals for a holistic approach covered on this page include:
                - Delivery Mechanisms
                Interagency Agreements
Consortia
Employee Welfare & Recreation Organizations
Federal Occupational Health

                - Staffing
                Agency Personnel
Contractors
Volunteers

                - Health Education
                Healthfinder Tool
Supertracker Tool

                - Social and Environmental Supports
                On-Site Health Units
Supports for Nutrition & Weight Management
- Garden Initiatives & Farmers Markets
- Healthy Meetings, Conferences, & Events
Supports for Physical Activity
- On-site Federal Fitness Facilities
- Off-site Commercial Fitness Facilities
- Use of Stairwells Promotion
- Active Transportation
Tobacco-Free Living Support
Alternative Meeting Strategies
Supports for Nursing Mothers
Public Access Defibrillation (PAD) Program

                - Screening Programs
                Health Risk Appraisal (HRA) or Health Assessment (HA)
Biometric Testing
FEHB Preventive Care
On-site Health Clinics
Health Fairs & Special Events
Workplace Health Screenings Fact Sheets

                - Integration into the Organizational Structure
                Wellness Council and Committees
- Worksite Health Promotion Program Implementation/Improvement Plan Guidance
Leave & Workplace Flexibilities
- Alternative Work Schedules & Leave
- Excused Absence
- Telework
Program Branding

                - Linkages to Related Programs
                Federal Employee Health Benefits Program
Federal Flexible Spending Accounts Program
Health Saving Accounts
Employee Assistance Program
Leave & Workplace Flexibilities

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### Delivery Mechanisms

The availability of resources, number of employees, location, and nature of work define the type of worksite health & wellness programs an agency offers and the most efficient and effective delivery mechanism that should be used. Programs may be:
                - Fully funded by an agency—delivered directly by agency staff, facilities, and services or delivered using agency facilities with contracted staff and services
                - Funded by a combination of employee contributions or fees and agency funding
                - Fully funded by employee contributions or fees

When considering possible funding sources and fee structures, consider:
                - Total cost (presently and in the future) of staffing, equipment, facilities, and implementing and administering programs.
                - Agency mission and employee duties.
                - Financial limitations of employees at lower income levels. The size of the employee contribution should not limit or prohibit participation of employees at lower income levels. Consider financing the cost of services to the point where the contribution is reasonable for all employees.

Depending on its size and mission, an agency must determine whether to create its own program or share services with other agencies. While successful programs run on small budgets, sometimes it is more cost effective to share worksite health promotion services and facilities with other agencies in the same building or geographic location. Delivery mechanisms for such programs include interagency agreements, consortia, employee welfare and recreation organizations, and Federal Occupational Health (FOH).

#### Interagency Agreements (Economy Act, 31 U.S.C. 1535)

To share services, Federal agencies may enter into an interagency agreement on a reimbursable basis. This process offers a convenient alternative to contracting and is often quicker and less cumbersome than the contracting process. Agencies may choose to use one interagency agreement to provide either all of its worksite health promotion services or specific services such as periodic physical examinations for those employees with physical examinations as a condition of employment.

#### Consortia

When no single agency can serve as a worksite wellness service provider for similarly situated agencies, the combined employee population may pool resources and establish a worksite health promotion consortium. A lead agency enters into a contract or agreement with a service provider. An interagency agreement links participating agencies to the contract and the combined employee population enjoys access to worksite health promotion services. The lead agency must have authority to provide the services to other agencies.

#### Employee Welfare and Recreation Organizations

An employee welfare and recreation organization (employee organization) is comprised of interested employees who deliver organized activities and programs for their colleagues in a structured format formally recognized by agency management. All activities sponsored by employee organizations must be open to participation by all qualified employees without regard to race, color, sex, religion, national origin, age, disability, marital status, gender identity, sexual orientation, or political affiliation. An employee organization may hire its own staff or use vendors to provide services. The organization collects fees from participating employees/members to cover the costs of operating certain entities and activities, such as sundry shops, fitness centers, and snack bars. An agency may provide Government resources to support employee organizations in accordance with appropriate General Services Administration regulations contained in title 41 of the Code of Federal Regulations. When certain conditions are met, an agency may pay for the rent and maintenance of space, equipment, janitorial services, and the start-up costs of facilities managed by employee organizations. Dues may be collected directly by the organization during non-duty hours, or employee members may set up individual financial allotments to a financial institution. Arrangements for such allotments must be made directly between the employee member and his/her servicing personnel office using a Direct Deposit Sign Up Form, SF 1199A.

#### Federal Occupational Health (FOH)

FOH is a service unit organization within the Department of Health and Human Services' Program Support Center. FOH works in partnership with Federal agencies nationally and internationally to design and deliver comprehensive solutions to meet their occupational health, wellness and fitness needs. Services are provided on a reimbursable basis through interagency agreements. For example, FOH can staff and operate onsite health units, employee assistance programs (EAPs), and fitness facilities.

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### Staffing

Agencies have a variety of staffing options. Options include agency personnel, contractors, and volunteers. Each agency must ensure that personnel delivering health services are fully qualified and trained specifically to the duties assigned. Agency wellness councils or committees should work closely with selected wellness staff to ensure delivery of services that best meet the needs of an agency.

#### Agency Personnel

Agencies may hire employees or use existing agency personnel to develop, manage, and deliver programs. The staff may be employed either full-time or part-time, or may be assigned the duties on an “as needed” basis. Many agencies organize worksite health promotion staff and programs under one component for more efficient coordination.

#### Contractors

Contracted personnel can manage a comprehensive program or provide specific services, such as exercise classes or an annual health fair. Following appropriate procurement procedures, agency contracting officers may identify qualified vendors through:
                - GSA Schedule Approved Contractors List
                - Commercial health clubs
                - Community centers
                - Local hospitals
                - Non-profit organizations
                - Private consultants
                - Universities

#### Volunteers

There are only very limited circumstances under which agencies may accept volunteer (gratuitous) services. Agencies should consult their General Counsel when considering this option. Agencies may provide many health activities through volunteer or no-cost arrangements while ensuring that volunteers have the skills, qualifications, and knowledge to deliver health activities. For example, a trained volunteer might give a presentation on desktop ergonomics. An intern from a local university may conduct fitness evaluations. A volunteer wellness committee may organize a lunchtime walking club. A non-profit health organization may provide free speakers for a wellness education series. Many of these local organizations provide free materials such as pamphlets, videos, and posters, especially if they tie into a national health campaign, such as the Great American Smokeout.

The Centers for Disease Control and Prevention’s Healthier Worksite Initiative (HWI) includes information on ways to provide staffing resources for workforce health promotion programs. The HWI considers an agency’s size and budget and provides information on staffing, continuing education opportunities for worksite health promotion personnel and tips for selecting a worksite health promotion contractor.

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#### Health Education

Health education focuses on skill development and behavior change, in addition to information dissemination and increasing awareness of the importance of good health, preferably tailored to employees’ interests and needs. A key element of health education is to motivate individuals to take action to improve their own health by developing a sense of responsibility for themselves and as members of work and social populations. Agencies may provide health education to encourage employees to maintain a healthy lifestyle, to understand their risk for disease, and to become aware of appropriate preventive practices. Important considerations include accessibility to health education and engagement opportunities for those individuals with disabilities, in accordance with the each agency’s requirements under section 504 of the Rehabilitation Act (similar to accessibility requirements of the Americans with Disability Act), Equal Employment Opportunity Commission (EEOC) guidelines, and section 508 of the Rehabilitation Act.

Health education and engagement opportunities include:
                - Brochures videos, posters, pamphlets, newsletters, or other written or online information that address:
                Physical activity
Nutrition
Weight management
Tobacco-free living
Risks of overweight or obesity
Risks of high cholesterol
Stress management

                - A series of educational seminars, workshops, classes, or webinars on:
                Preventing and controlling high cholesterol
Physical activity
Nutrition
Weight management
Breastfeeding
Tobacco cessation
Stress management

                - Free or subsidized one-on-one or group lifestyle counseling for employees
                - Posters or flyers in the common areas of your worksite (such as bulletin boards, kiosks, break rooms) that identify the signs and symptoms of a heart attack and strokes and also convey that heart attacks and strokes are to be treated as emergencies
                - Any other information on the signs and symptoms of heart attacks and strokes through emails, newsletters, management communications, websites, seminars or classes.

#### HealthFinder Tool

Consider using healthfinder.gov as a health tool for employees. This Federal website offers quick guides to healthy living, personalized health advice, current health news, and tips and tools that streamline searches. Web syndication is available and may be linked with an agency’s website so employees have ready access to reliable health information.

#### USDA SuperTracker Tool

SuperTracker provides users with a practical, personalized web-based application and the “how‐tos” for making healthy food and activity choices in line with the 2010 Dietary Guidelines for Americans. SuperTracker includes tools that easily identify personal nutritional and physical activity recommendations, the ability to compare personal food choices to the Dietary Guidelines for Americans, and the means to assess personal physical activities based on the Physical Activity Guidelines for Americans. The report and graphic functions of SuperTracker enables users to measure their progress over specific periods.

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### Social and Environmental Support

Social and environmental supports establish an environment that encourages an active and healthy lifestyle. These programs, policies, and initiatives relay a powerful message to employees about the agency’s support of healthy behaviors, which results in a positive culture for health. There are many options for both social and physical environmental supports of health and wellness. Agencies should implement supports that are most appropriate and will have the greatest positive impact for your workforce and agency.

#### On-site Health Units

An on-site health unit or occupational health center (OHC) is a convenient place to provide and coordinate comprehensive health and wellness services to Federal employees. Providing services at or near the worksite minimizes employees' time away from work and enhances productivity. Consider establishing an OHC or using the services of an existing OHC when developing a worksite health promotion program.

Depending on the size of the population and needs of the employees, an agency may provide full- or part-time health center services. Smaller agencies within a building or geographic locality may consider sharing a health center and/or services or provide employees with access to a nearby off-site health center. The on-site health unit may assist employees in complying with physician-directed condition management programs.

Designs and plans for new or renovated health units or occupational health centers can be coordinated with General Services Administration (GSA) regional offices (for GSA owned or leased space) or Federal Occupational Health (FOH). FOH can help review space, supplies, and equipment needs based on an agency's population and services. FOH can also provide staff that can work with agencies to develop a comprehensive occupational health program.

An agency or agency vendor may manage the ongoing operations of the OHC, staffed with contracted health professionals. An occupational health registered nurse is recommended; however, occupational health physicians, physician's assistants, nurse practitioners, licensed practical nurses, health promotion specialists and trained technicians may all be appropriate, depending on the size, scope, and complexity of the services an agency is considering providing. The OHC staff should work in conjunction with an agency's on-site fitness facility, employee assistance counselors, human resources, and health and safety professionals wherever possible. The OHC and its staff can play a pivotal role in the effectiveness and integration of an agency's worksite health promotion program.

#### Supports for Nutrition & Weight Management

A strong worksite nutrition and weight management program often pays dividends outside of the worksite as behaviors transfer outside of the worksite and into the family and leisure environment. Coupled with physical activity, sound nutrition is a strong component of health.

Health and Sustainability Guidelines for Federal Concessions and Vending Operations

The General Services Administration (GSA) developed the Health and Sustainability Guidelines for Federal Concessions and Vending Operations guidelines in partnership with the Department of Health and Human Services; they represent the best practices in nutrition science for improving health and reducing impact to the environment. These new guidelines translate the 2010 Dietary Guidelines for Americans into clear and definitive standards that food service operators can follow to make their operations healthier and more sustainable. The guidelines are designed to make healthy choices more accessible, more appealing, and more affordable. They are not designed to restrict choices. The Health and Sustainability Guidelines are applicable to all food service concession operations and vending machines managed by HHS and GSA.

Garden Initiatives & Farmers Markets

One way to improve the worksite nutrition environment and provide access is to operate a garden market at the worksite, so employees can conveniently shop for fruits and vegetables. A garden market may also reduce price barriers if it provides fresh produce at prices that are competitive with other sources. The CDC created the “Garden Market” demonstration project in 2004. The Garden Market was so successful that it was adopted at other CDC locations. The availability of these types of markets continues to increase throughout Federal agencies.

Additional approaches to building a supportive nutritional environment should be explored by the employer when designing a comprehensive health and wellness program including:
                - Offering nutrition education seminars
                - Offering healthy choices at food sites such as cafeterias and vending machines
                - Offering healthy food choices at meetings
                - Offering weight management programs

Additionally, the People’s Garden Initiative began in 2009 as an effort to challenge employees to create gardens at USDA facilities. It has since grown into a collaborative effort that includes local and national organizations all working together to establish community and school gardens across the country. To be part of the initiative, a garden must meet three goals: sustainability, community involvement and public service. People’s Gardens promote health and wellness by increasing availability and access to fresh fruits and vegetables and encouraging consumption. Gardening provides a low-impact exercise for people within a large range of physical ability. People’s Gardens also enable social and cultural connections by providing a gathering place for social interaction and educational opportunities. Gardens in general promote sustainable practices and improve water quality, soil health, and wildlife habitats.

USDA employees work in their gardens early in the morning before work, after work, during their lunch breaks and even on the weekends. Employees who work on the garden often do not know each other before they start volunteering. This initiative is an excellent example of a supportive social and physical environment that encourages active and healthy lifestyles, community engagement, and a positive workplace culture.

Healthy Meetings, Conferences, and Events

Worksite health promotion leaders should encourage employees to make every effort to offer healthier options at meetings and work-related social gatherings. If food and beverages are brought in by employees as a part of the event, refer them to CDC’s guide: Choosing foods and beverages for healthy meetings, conferences, and events.

#### Supports for Physical Activity

Physical activity programs should be an integral part of an agency's worksite health promotion program. Agencies may operate on-site fitness facilities, use the services of a private facility, or even subsidize memberships. Fitness activities can also be provided without any special facilities. The built environment may encourage physical activity just as readily as access to a formal exercise facility. Managers may use discretion to allow other opportunities for increasing employee physical activity, such as conducting walking meetings and installing mobile work stations.

On-site Federal Fitness Facilities

An agency’s on-site fitness facility may serve as a hub of health promotion activities and services. Safety is the primary principle in any fitness facility design. The majority of accidents can be prevented through adequate supervision, staff training, appropriate screening procedures, and proper facility and equipment maintenance.

Off-Site Commercial Fitness Facilities

Providing health and fitness activities via a private facility may be part of an agency's bona fide preventive program authorized under 5 U.S.C. 7901. Agencies, in exercising this authority to purchase access to private health and fitness facilities, should use the following criteria in making the determination:
                - Providing access to a private fitness facility meets agency health services program objectives and can be carefully monitored as part of a bona fide preventive health program.
                - Providing access to private facilities is more cost-effective than providing an on-site fitness facility.
                - Coordinating with other Federal agencies in the area to provide a multi-agency operated fitness facility is not possible.
                - Other possible resources (such as other Federal fitness facilities) or typically lower-cost facilities (such as community centers or universities) were identified, considered, and determined to be unavailable or inappropriate.

The private health and fitness facility should provide preventive health programs and services that fall within the purview of 5 U.S.C. 7901. Reasonable measures should be taken to ensure the private fitness facility is the most appropriate, convenient, and cost-effective choice, and that it provides reasonable accommodations (accessibility).

When purchasing memberships:
                - Purchase the memberships in the name of the agency, not in the name of the individual employee.
                - Follow Government procurement guidelines when contracting with private fitness facilities to provide access for employees.
                - Choose basic membership packages (if there are such options) and avoid deluxe package options (e.g., spa privileges or activities that are purely recreational and do not contribute to a bona fide preventive health program).
                - Monitor the facility and the employees' use of memberships.
                - Be aware that health club memberships provided to employees may be a taxable fringe benefit.

Use of Stairwells Promotion

In support of section 607 of Public Law 109-115 and the Joint Explanatory Statement for the FY 2009 Omnibus Appropriations Act, GSA is undertaking a stronger effort to promote the use of stairs in Federal buildings. Promoting the use of stairwells requires a multi-faceted approach. First, the physical and aesthetic characteristics of the stairwell should be improved to enhance the attractiveness of the space. According to the Centers for Disease Control (CDC), many employees do not take the stairs at work because they perceive them as unattractive or unsafe. However, a CDC study revealed that physical changes to the staircases can increase stairwell use among building occupants. Internal communications that encourage employees to choose the stairs regularly also are necessary to foster a shift from elevator to stairwell utilization. GSA plays an important role in advancing both of these approaches. The key message is that promoting the use of stairwells can aid in improving employee health and contribute to a reduction in energy costs. Benefits of stairwell use include:
                - Potential improvement in employee health and wellness by engaging in more physical activity throughout the work day.
                - Reduction in utility costs from elevator usage.
                - Reduced wait times at elevators by minimizing single-stop riding.

When promoting stairwell use, consider implementing these options:
                - Transform walls with paint, using bright colors.
                - Add art work, photos, murals, framed cartoons or children‘s art. Rotate the artwork regularly. Test effectiveness with focus groups.
                - Carpet the stairs and use rubber treading.
                - Create themed stairwells, adding slogans and pictures.
                - Place motivational signs inside and outside the stairwell and near the elevators to encourage participation.
                - Install a sound system and set up a rotating schedule of musical selections.
                - Use creative lighting and add an electronic message board.
                - When building energy use is high, send building alerts to encourage employees to take the stairs instead of the elevators.
                - Set up a system to track how many employees are using the stairs and examine barriers to stair usage through questionnaires and conversation with tenants.
                - Interior finishes in exit stairs are required to meet the conditions outlined in the International Code Council’s International Building Code. Therefore, it is recommended that stairwell projects of any kind be reviewed by GSA regional and central office fire protection engineers.

Active Transportation

Agencies can support healthy lifestyles and increased physical activity by creating environments that support safe and convenient commuting to work by bicycling or walking. Such environments can be created by improving the transportation network around the worksite, ensuring appropriate facilities are located within the worksite, and providing programs that support and promote active commuting:
                - Transportation networks
                A key ingredient for active commuting is ensuring that the transportation facilities near worksites are safe and convenient for walkers, bicyclists, and transit users. Sidewalks should be present and well maintained to support pedestrians of all ages and abilities; and appropriate bicycle facilities, such as bicycle lanes, should be provided. If transit facilities are nearby, it may be possible for people to consider walking and bicycling for only part of their commute.
A number of communities have (or are in the process of establishing) bike share programs. Bike share programs are structured to allow users to pick up a bicycle at a self-serve bike station and return the bike to another station. These systems can help commuters incorporate bicycling into part of their trip to work. It may be possible to work with the bike share provider to locate stations near a worksite.

                - Worksite facilities
                The same types of facilities that support physical activity in general, such as fitness centers, also support active commuting. For example, people who jog or bike to work will want access to showers to wash and change. Convenient, plentiful, and secure parking for bicycles is important for bicycle commuters as well. Providing overnight lockers for people to use for storing clothes and equipment (e.g., running shoes and bicycle tubes) is another bicycle-friendly practice. Some agencies, such as the Environmental Protection Agency, have received national recognition for providing exemplary facilities for bike commuters.

                - Support and promotion
                The National Bike to Work Day is a popular annual initiative that encourages people to consider active commuting. Agencies should consider supporting local Bike to Work Day events or promoting National Bike Month.
A bike subsidy for workers who commute primarily by bike is another way to support active commuting. Employers can reimburse bicycle commuters up to twenty dollars each month for expenses related to bike commuting.
Establishing a bike commuter group at the agency can help, too. Such groups can provide training for people who are interested in bike commuting, can provide information about safe routes to work, and help foster a bicycle-friendly community.

#### Tobacco-Free Living Support

Tobacco use can lead to nicotine dependence and serious health problems. Cessation can significantly reduce the risk of suffering from smoking-related diseases. Tobacco dependence is a chronic condition that often requires repeated interventions, but effective treatments and helpful resources exist. The Federal Employees Health Benefits Program (FEHB) and the Centers for Disease Control and Prevention (CDC) provide several resources for tobacco control and cessation available on our Tool & Resources page.

A tobacco-free campus initiative includes a policy and comprehensive cessation services for employees designed not only to protect nonsmokers from secondhand smoke but also to encourage employees to improve their health by quitting the use of tobacco products. Tobacco-free campuses create work environments in which tobacco users find it easier to reduce their consumption or quit altogether. Tobacco-free campuses enjoy additional benefits of reduced cleaning and maintenance costs, improved fire safety, and improved worker productivity. More information can be found in the CDC’s Implementing a Tobacco-Free Campus Initiative in Your Workplace toolkit. Specific social and physical supports to consider include:
                - Actively enforcing a written policy banning tobacco use;
                - Displaying signs with information about your tobacco use policy;
                - Referring tobacco users to tobacco cessation telephone quit lines; and
                - Informing employees about health insurance coverage or programs that include tobacco cessation medication and counseling

#### Alternative Meeting Strategies

Consider alternative meeting strategies to incorporate health promotion activities and concepts throughout the workday. Research shows that brief physical activity breaks during a long meeting increase energy levels, attention spans, and participation, and reduce fatigue, all of which can lead to a more productive meeting. Employees who sit at a desk for 6 or more hours a day increase their risk of heart disease by 64 percent, along with the risk of contracting certain types of cancer, additional weight gain and increased cholesterol. Alternative meeting strategies include holding walking meetings, holding meetings on another floor or building to encourage movement, and using high tables without chairs.

#### Supports for Nursing Mothers

On December 20, 2010, President Obama delegated authority to the U.S. Office of Personnel Management (OPM) to provide guidance to executive branch civilian employees on workplace accommodations for employees who are nursing mothers. This delegation is in support of section 4207 of the Patient Protection and Affordable Care Act (Act), Pub. L. 111-148, which added a new subsection (r) to section 7 of the Fair Labor Standards Act of 1938 (FLSA) (codified as amended at 29 U.S.C. 207). This new subsection requires an employer to provide employees with (1) a reasonable break time to express breast milk for her child for 1 year after the child's birth each time such employee has a need to express milk; and (2) a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public which may be used by the employee to express breast milk. While subsection (r) applies only to employees who are subject to section 7, which sets forth the FLSA overtime pay provisions, the rationale for the policy contained in that section applies to all executive branch employees. In accordance with the authority delegated to OPM by the President on December 20, 2010, and in order to ensure consistent treatment of nursing mothers within the Federal workforce, agencies should also apply the requirements of subsection 7(r) of the FLSA to Executive branch civilian employees who are exempt from section 7 of the FLSA. For more guidance on the implementation of this policy, please review OPM's Guide to Establishing a Federal Nursing Mother’s Program and Memo on Nursing Mothers in Federal Employment.

#### Public Access Defibrillation (PAD) Program

Federal agencies electing to establish a Public Access Defibrillation (PAD) program in a Federal facility should consult the guidelines contained in Federal Register FMR Bulletin 09-B2 "Guidelines for Public Access Defibrillation Programs in Federal Facilities." These guidelines were produced collaboratively by the General Services Administration and the Department of Health and Human Services and provide a basis of knowledge for Federal agencies as they implement a PAD program.

There is no law requiring installation of automated external defibrillators (AEDs) in Federal facilities. However, AED availability is becoming the standard of care for facilities, grounds, and venues with large populations. An AED is an electronic device that can automatically terminate an erratic heartbeat that would otherwise lead to cardiac arrest, restoring normal cardiac function with an electric shock. AEDs enable minimally trained personnel to safely restore a victim's heart from ventricular fibrillation (an erratic and ineffective heart rhythm) to the victim's previous electrical activity, and in turn, effective pumping activity.

AEDs are designed and intended for use by emergency medical technicians, police, firefighters, and other responders (including trained lay responders). Administration of a PAD program must include periodic training of personnel who may respond to a cardiac emergency with an AED. At a minimum, current certifications should be maintained in Cardiopulmonary Resuscitation (CPR) with AED. Medical oversight is an essential component of PAD programs.

AEDs and medical oversight services are commercially available through many sources. Federal agencies also have the option to use purchasing mechanisms allowed by the Federal Acquisition Regulation, which may include such options as the GSA Schedule (www.gsaadvantage.gov). AEDs may be purchased through an interagency agreement process like that offered by HHS-Federal Occupational Health (www.foh.hhs.gov).

Upon implementation of an AED program, a Federal agency may be required to follow various local laws. Each agency should consult its legal counsel to ensure proper compliance.

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### Screening Programs

Screenings are critical to individual employees and to agencies’ health promotion efforts. A screening can save an employee’s life. For agencies, collectively assessing your workforce’s screening data can help you to strategically design a worksite health and wellness program that addresses the most prominent health risk factors in your workforce; this makes screenings an essential element of realizing positive impacts on health care costs, productivity, reduced absenteeism, recruitment, retention, culture, and employee morale. Even more broadly, agencies, employees, their families, and communities all benefit from the prevention of disease.

According to the Centers for Disease Control and Prevention (CDC), administering an assessment to define employee health risks and concerns and to describe current health promotion activities, capacity and needs is the first step in the systematic process of building a successful workplace health and wellness program. Information from assessments will inform determining goals, selecting priority interventions, building an organizational infrastructure, implementing programs, and evaluating health promotion efforts.

Screening ideas to consider include:
                - Conducting an employee needs and interests assessment for planning health promotion activities
                - Conducting employee health risk appraisals/assessments and provide individual feedback plus health education
                - Providing screenings (beyond self-report) followed by directed feedback and clinical referral when appropriate for:
                Cholesterol
Pre-diabetes and diabetes
Physical Assessments
Body Composition Measurement
Mental Health
Substance Abuse
Osteoporosis
Blood Pressure
Sun Damage

#### Health Risk Appraisal (HRA) or Health Assessment (HA)

A Health Risk Appraisal (HRA) or Health Assessment (HA) is a tool that helps identify risks within a population, monitor progress of those at risk or seeking improvements in their health through interventions, and track and analyze population health trends over time. The tool may simply ask general questions about lifestyle behaviors, such as physical activity levels and types, fruit and vegetable consumption, and tobacco and alcohol use. The HRA may ask more probing questions about seat belt use, sun exposure, symptoms of depression, use of age/gender-appropriate clinical preventive services, routine physicals and dental visits, real or perceived sources of health or safety risks from the workplace, and any work-associated or organizational stress affecting health of workers. Biometric testing may also be part of an HRA.

An HRA can be the single point of entry to an agency worksite health promotion program and serve as a participation tracking tool. Feedback should be given to the individual employee immediately upon completion of an HRA (such as an online HRA) or during an individual coaching session. The HRA can be a useful programming/needs assessment tool for agency representatives, provided proper procedures for protecting personal information are strictly followed, and a representative sample is collected in order to draw sound conclusions at the agency level.

#### Biometric Testing

Biometric testing can be included in an HRA. Biometric testing in worksite health & wellness programs is used to screen for potential medical concerns rather than for diagnosis or treatment of a medical condition. Biometric testing includes measurements for:
                - total cholesterol
                - high-density lipoprotein cholesterol
                - low-density lipoprotein cholesterol
                - triglycerides
                - blood glucose (or HgbA1c)
                - blood pressure
                - Body Mass Index and/or waist-to-hip ratio

#### FEHB Preventive Healthcare

All FEHB plans cover HRAs, biometric testing, and immunizations plus over 70 preventive services with no out of pocket costs. If this approach is taken, agencies can get employees screened at no extra cost, employees learn how to get similar services for their family members, and results get back to the employee’s physician for any follow up that is needed. Many plans are even offering incentives for completion of HRAs and/or biometric testing. Agency worksite health & wellness coordinators should work with their agency benefits officers to promote these FEHB services and encourage employees to understand their specific plans, because there may be limits to networks and frequency. Preventive services that have a rating of A or B from the U.S. Preventive Services Task Force are covered by FEHB plans. You can see the complete list here: http://www.uspreventiveservicestaskforce.org/uspstf/uspsabrecs.htm.

#### On-site Health Clinics

Onsite health clinics can provide convenient access to high quality preventive healthcare. A variety of services can be offered at agencies, such as biometric screenings, primary care, health coaching, disease management, occupational health, and more! These services are intended to reduce agency costs, improve employee health, increase productivity, and reduce long-term risk.

#### Health Fairs & Special Events

Workplace health fairs are a great way to educate employees about health services available to them and the value of participating in preventive healthcare, such as screenings. Health fairs can include exhibitors from FEHB providers and various offices within your agency that have an interest in employee health (e.g., safety department, food service, Flexible Spending Accounts, Employee Assistance Programs, etc.). Agencies may also leverage external resources, including community organizations and universities. The best health fairs have a variety of activities, such as, but not limited to:
                - Screenings
                - Educational Information
                - Chair Massages
                - Yoga
                - Healthy Cooking Demos
                - First Aid
                - Ergonomics

#### Workplace Health Screenings Fact Sheets

These fact sheets include the business case for screenings, descriptions of HRAs & biometric tests, implementation tips, and special considerations:
                - Workplace Health Screenings
                - Common Screenings
                - How to Conduct Screenings
                - Considerations for Screenings

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### Integration into Organizational Structure

The longevity of worksite health promotion programs is related to the degree that health promotion is integrated into an organization’s structure. Successful worksite health promotion programs are designed to help achieve organizational goals and have the support of top management. At a minimum, having dedicated staff, an office and budget are essential aspects of integration into the organization’s structure. Worksite health promotion must also have well-designed programs that attract and retain participants.

Considering the answers to several questions will help to create and measure the integration of a worksite health promotion program into an agency’s organizational structure:
                - Is there a comprehensive health and wellness policy?
                - Is there a champion(s) who is a strong advocate for the worksite health and wellness program?
                - Is there a paid worksite health and wellness coordinator whose job (either part-time or full-time) is to implement a worksite health and wellness program?
                - Is there an active worksite health and wellness committee?
                - Is senior leadership briefed on worksite health and wellness programs and services?
                - Are annual organizational objectives for health promotion set? Are references to improving or maintaining employee health included in the business objectives or organizational mission statement?
Does your program engage in other health initiatives throughout the community and support employee participation and volunteer efforts?
Is a budget or dedicated funding assigned for the worksite health and wellness program?
Are managers trained on the value of worksite health and wellness programs?
Are some worksite health and wellness programs and education materials tailored to the language, literacy levels, culture, or readiness to change of various segments of the workforce?
Is there a policy that allows employees to use flexible scheduling or excused absence to participate in worksite health and wellness activities?
Is an employee needs and interests assessment for planning health promotion activities conducted?
Are employee health risk appraisals/assessments through vendors, on-site staff, or health plans conducted, and are individual feedback plus health education provided?
Are all levels of management involved in the implementation of worksite health and wellness?
Is there an official communications process or strategy to promote and market worksite health and wellness programs to employees?
Are incentives provided, used, and/or combined with other strategies to increase participation and engagement in worksite health and wellness programs?
Are any worksite health and wellness programs available to family members?
Are competitions used when combined with additional interventions to support employees making behavior changes?
Are examples of employee health-related “success stories” used in the marketing materials?
Is data systematically gathered to evaluate worksite health and wellness programs?

It is an agency's responsibility to assure that programs are safe, appropriate, and meet legal and ethical requirements. It is advisable to negotiate or consult with unions, as appropriate, on providing services for bargaining unit employees.
Wellness Council and Committees
A wellness council or committee brings representatives from various offices to integrate services, coordinate, and promote programs. The primary goals of the council and/or committee are to encourage healthy behaviors at the worksite, advocate policy change, and create health-friendly work environments. A wellness committee should be comprised of employees who represent a cross section of the employee population. Multiple committees may be necessary, depending on the size and number of locations of the agency.

Committee Member Responsibilities

Committees should elect a wellness chair or co-chairs to conduct meetings and lead activities. Time commitments will depend on the size of the agency, depth and breadth of the services, and selected delivery option. Planning and implementation of the agency’s strategic wellness plan typically takes the most concentrated amount of time. As appropriate, these activities should be included in an employee’s work plan.

Designated wellness leaders at the management level with direct access to the agency head are recommended to be involved with wellness committees and programs. In collaboration with management and employees, the individual(s) responsible for creating a worksite health promotion infrastructure oversees the development and implementation of employee wellness policies and committees and provides ongoing assessment/monitoring of the effectiveness of the worksite health & wellness program.

Worksite Health Promotion Program Implementation/Improvement Plan Guidance
- Describe the gaps in services based on a needs assessment Describe existing and potential barriers to and opportunities for improvement (e.g., existing processes, systems, partnerships)
Describe changes the agency can make to improve on gaps in services
Define success upon completion of action steps (i.e., what constitutes improvement or achievement of the desired outcome?):
Describe each specific step/task that needs to occur to achieve the desired outcome
Describe each product or output
Develop a program calendar
Develop an ongoing evaluation process
Revise and improve the program

Set a realistic timeframe (timeline) for the completion of each step/task. Indicate dates for progress updates. Identify key stakeholders accountable for completion of each step/task.
Leave and Workplace Flexibilities
The Federal personnel system provides employees considerable flexibility in scheduling their hours of work and taking time off for routine medical examinations and preventive screenings. Agencies should review policies and make maximum use of existing work schedules to encourage employees to take advantage of preventive health services.

Alternative Work Schedules & Leave
- Alternative Work Schedules: Flexible or compressed work schedules, collectively referred to as "alternative work schedules," allow for a variety of working arrangements tailored to individual employee needs.
- Annual Leave: An employee may use annual leave for any purpose, including activities that promote wellness. An employee has a right to take annual leave, subject to the right of the supervisor to schedule the time at which annual leave may be taken.
- Sick Leave: Sick leave is a paid absence from duty. An employee is entitled to use sick leave for many purposes, including activities to promote wellness, such as routine medical, dental, or optical examination or treatment.
- Advanced Leave: An agency may, but is not required to, advance annual and/or sick leave to those employees who do not have sufficient paid leave available for health services, examinations, and follow-up treatments.
- Serious health condition or medical emergency. When an employee needs additional medical attention, e.g., for a serious health condition or medical emergency identified by a screening process, additional leave programs are available.
Sick Leave for a Serious Health Condition. An employee can use unlimited amounts of sick leave for his or her own serious health condition.
The Family and Medical Leave Act of 1993 (FMLA). Under the FMLA, an employee is entitled to a total of 12 work weeks of unpaid leave during any 12-month period for certain family and medical needs, including an employee's serious health condition. FMLA may be used intermittently and is in addition to other paid time off available to an employee. Employees may substitute sick leave, annual leave, or donated annual leave under the leave sharing programs for unpaid leave under the FMLA.
Leave Sharing: Employees who experience a medical emergency and who exhaust their available paid leave may receive donated annual leave from other Federal employees through the voluntary leave transfer and leave bank programs. Employees may not use donated annual leave to participate in employee health programs.

Additional information on Federal leave programs may be found at OPM's website at /oca/leave/HTML/factindx.asp.

Excused Absence

Agencies may consider granting brief periods of excused absence to employees to participate in agency-sponsored preventive health activities, such as health fairs, medical screenings, and smoking cessation and stress reduction classes.

Each department or agency has discretion to excuse employees from their duties without loss of pay or charge to leave. Excused absence should be limited to those situations in which the employee's absence, in the department's or agency's determination, is not specifically prohibited by law and satisfies one or more of the following criteria:
- The absence is directly related to the agency's mission;
- The absence is officially sponsored or sanctioned by the head of the agency;
- The absence will clearly enhance the professional development or skills of the employee in his or her current position;
- The absence is brief and is determined to be in the interest of the agency.

Ultimately, it is the responsibility of each agency head to balance support for employees' participation in health promotion activities with employees' work requirements and efficient and effective agency operations. Agencies should review their internal guidance on excused absence and applicable collective bargaining agreements.
Telework
Telework is a work arrangement that allows an employee to perform work, during any part of regular, paid hours, at an approved alternative worksite (e.g., home, telework center). It includes what is generally referred to as remote work but excludes any part of work done while on official travel or mobile work. The health benefits of telework include:

For employees:
- Improvements in general health
- Reduction in adverse health effects from exposure to air pollution
- Improvements in eating habits
- More time to integrate fitness activities
- Enhanced ability to manage sick leave for preventive treatments and/or screenings
- Reduction in stress by 25 percent, on average
- Improved lactation support through greater flexibility and time to breastfeed

For organizations:
- Fewer employees becoming sick and fewer days of work missed
- Employees’ ability to return to work more quickly following surgery or medical issues
- Reduction in health care costs associated with doctor visits and prescriptions through reduction in spread of communicable diseases and increase in healthy behaviors

For community:
- Reduced emissions from commuting that affect air pollution and climate control
- Reduced greenhouse gas emissions from business travel, particularly by airplane
- Enhanced containment of infection during a pandemic outbreak

Sharing ways employees can use the time saved by reduced commutes for health promotion activities such as physical activity, stress management, and community and family engagement can send a powerful message. When planning health promotion activities, ask how employees who telework will be allowed to participate, such as through video conferencing, webinars, or a primary point of contact, so that teleworkers may pick up support material or equipment.
Program Branding
Branding provides instant recognition to an agency’s worksite health & wellness program and helps employees understand all of the program elements. Branding can be a logo, a motto or slogan, or image that captures the essence of the agency’s worksite health & wellness program and provides an opportunity for the agency to consistently convey a message. Concise, clear and well-planned communications use every possible customer (employee) touch point – signage, emails, voice messaging, social media, incentive items, newsletters and even telework agreements – as a branding opportunity. Many agencies offer a range of services that employees may not associate with the agency’s health promotion program. Branding helps employees make this program association, which then provides valuable feedback to the agency when employees are surveyed. Consider asking employees for branding ideas as part of a program marketing schematic and to create buy-in and excitement about a new or rejuvenated worksite health promotion program.

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Linkages to Related Programs
Over the years, worksite health promotion has evolved from and integrated with other worksite programs. Some common linkages include Employee Assistance Programs (EAPs) and programs to help employees balance work and family. When linking worksite health & wellness programs to related programs, agencies may consider:
- Providing flexible work scheduling policies
- Partnering with:
Federal Employee Health Benefits Program (FEHB)
Federal Flexible Spending Account Program (FSAFEDS)
Employee Assistance Program (EAP)
Traditional occupational health and safety programs
Telework
Other work-life programs
Drug Free Workplace Program

- Engaging in other health initiatives throughout the community and support employee participation and volunteer efforts
- Providing employees with health related information, programs, or resources from any of the following organizations:
State/local public health agency
Health insurance plan
Health management program and/or wellness program provider/vendor
Workers compensation provider
Health-related organizations
Hospital

Federal Employees Health Benefits (FEHB) Program
The FEHB Program complements worksite wellness programs by providing coverage for preventive care, immunizations, cancer screenings, diabetes, cholesterol, osteoporosis screening and tobacco cessation resources with no cost shares. Many plans also offer diabetes screening with no co-payment, nutrition counseling, and low-cost generic medications. Cost-sharing and other plan features are applicable based on gender and age recommended services. Providers and services may be limited to in-network and/or preferred drug coverage and office visit cost sharing may apply. See specific plans for details. Completing Health Risk Assessments (HRAs) through an FEHB health plan allows health plans to identify Federal employees as candidates for case management or disease management and offer suggestions on healthy lifestyle strategies, including how to reduce or eliminate health risks. Health plans can provide tips and educational material about good health habits, as well as information about routine care that is age and gender appropriate.
Federal Flexible Spending Account Program (FSAFEDS)
Employees working for an executive branch agency or an agency that has adopted the Federal Flexible Benefits Plan ("FedFlex") may elect to participate in the Federal Flexible Spending Account Program (FSAFEDS). The only exception(s) are intermittent or “when actually employed” (WAE) employees who are expected to work less than six months in a calendar year. Under the Internal Revenue Code, annuitants (other than reemployed annuitants whose employment status is full-time) cannot participate in the FSAFEDS  Program. Participating in a flexible spending account (FSA) is a way to set aside part of pre-tax wages for payment of eligible expenses. An annuity is not a wage. Military personnel are not eligible.

FSAFEDS offers three different FSAs: a health care flexible spending account, a limited expense health care flexible spending account, and a dependent care flexible spending account. An FSA is a program offered by employers that allows their employees to pay for eligible out-of-pocket health care and dependent care expenses with pre-tax wages. By using pre-tax dollars to pay for eligible preventive, secondary, and tertiary health care and dependent care expenses, an FSA gives individuals immediate discounts on these expenses that equal the taxes incurred on that expense.
- The Health Care Flexible Spending Account (HCFSA) can be used to pay for qualified medical costs and health care expenses that are not paid by their FEHB plan or any other insurance.
- The Limited Expense Health Care Flexible Spending Account (LEX HCFSA) is only available to employees who enroll in an FEHB Program under a High Deductible Health Plan (HDHP) with a Health Savings Account (HSA). Eligible expenses are limited to dental and vision care services/products that meet the IRS definition of medical care.
- The Dependent Care FSA uses pre-tax wages to pay for eligible dependent care expenses. Eligible expenses are childcare for children under age 13, or day care for anyone who an enrollee can claim as a dependent on a Federal tax return who is physically or mentally incapable of self-care so that the enrollee (and spouse, if married) can work, look for work, or attend school full-time.

FEHB eligibility is not required to enroll in a Dependent Care FSA. However, employees may only choose one of the FSA options.
Health Savings Account (HSA)
Federal Employees paid through certain payroll offices are eligible to establish pre-tax allotments to their Health Savings Accounts (HSA). The Benefits Administration Letter 07-202 provides more information.

A Health Savings Account is a special type of savings account available to individuals who enroll in a High Deductible Health Plan (HDHP) that allows members to use pre-tax wages to pay for eligible health care expenses, much like an FSA. It is important to understand that there is a significant difference between the two accounts. An HSA requires enrollment in an HDHP and allows the rollover of funds from year-to-year — therefore, there is no risk of losing unused money. With an HCFSA, enrollees can be in any type of FEHB plan, including an HDHP, or no FEHB insurance plan. However, an HSA eliminates eligibility for a “general purpose” HCFSA, because both accounts are used to pay for the same type of expenses. Enrollees in an HDHP with an HSA are eligible for a LEX HCFSA because the LEX HCFSA pays for eligible dental and vision expenses only.

The FSAFEDS Program is separate from the FEHB HDHP and HSA option. For additional information on HDHPs and/or HSAs visit /insure/health/hsa.
Employee Assistance Program (EAP)
An EAP is a business tool used to address personal or work-related problems that may have an adverse effect on one’s performance, conduct, or well-being. Through confidential assessments, referral services, and consultations, EAPs optimize an organization’s culture and success.

EAPs provide strategic analysis, recommendations, and consultation throughout an organization to enhance its performance, culture, and business success. These enhancements are accomplished by professionally trained behavioral and/or psychological experts who apply the principles of human behavior with management, employees, and their families, as well as workplace situations to optimize the organization’s human capital.

The basic services of the EAP include:
- Confidential, free, short-term counseling to identify and assess problem(s) and to help employees in problem-solving.
- Referral, where appropriate, to a community service or professional resource that provides treatment and/or rehabilitation. With the exception of illness or injury directly resulting from employment, medical care and treatment are personal to the employee and, therefore, payment may not be made from appropriated funds unless provided for in a contract of employment or by statute or by regulation.
- Follow-up services to help an employee readjust to his or her job during and after treatment, e.g., back-to-work conferences.
- Training sessions for managers and supervisors on handling work-related problems that may be related to substance abuse or other personal and/or health-related problems.
- Orientation and educational programs to promote the services of the EAP.
- Briefings to educate management and union officials on the role of the EAP.

In addition, the EAP can be extremely important in:
- Preventing and intervening in workplace violence incidents
- Delivering critical incident stress debriefings
- Providing assistance to management and employees during agency restructuring

More information about EAPs is available here: /policy-data-oversight/worklife/employee-assistance-programs/.
Leave and Workplace Flexibilities
For information regarding leave, flexible work schedules, excused absence, and telework, review the information available in the integration section here: Leave and Workplace Flexibilities section on this page above).

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Related Information- Delivery Mechanisms
- Staffing
- Health Education
- Social and Environmental Supports
- Screening Programs
- Integration into the Organizational Structure
- Linkages to Related Programs
Health TopicsHealthfinder.gov
Healthfinder.gov is a Federal Government website where you will find information and tools to help you and those you care about stay healthy.  When making decisions about your health, it's important to know where to go to get the latest, most reliable information.  healthfinder.gov has resources on a wide range of health topics selected from over 1,600 government and nonprofit organizations to bring you the best, most reliable health information on the Internet.
Public Health & SafetyGet Important Shots
Adults need shots (vaccinations) just like kids do. Next time you get a checkup, talk with the doctor or nurse about getting these important shots.
- Get a flu shot every year . The seasonal flu vaccine is the best way to protect yourself and others from the flu.
- Get a Td booster shot every 10 years to protect against tetanus (“TET-nes”) and diphtheria (“dif-THEER-ee-ah”).
- If you are under age 65 and haven’t received it yet, get the Tdap shot instead of your next Td booster. Tdap protects against tetanus, diphtheria, and whooping cough (pertussis).
- If you are age 60 or older, you may need a shot to prevent shingles. Shingles causes a rash and can lead to pain that lasts for months or years.
- If you are age 65 or older,  get a pneumonia shot . This shot is sometimes called PPSV. Most people only need to get the shot once.
Stay Safe at Work
Work can put a lot of wear and tear on your body. Back injuries are the most common type of workplace injury.

Make simple changes to prevent injuries and stay healthy:
- Lift things safely.
- Arrange your equipment to fit your body.
- Take short breaks and stretch your muscles.
- Eat healthy and stay active.
- Get enough sleep.

View more information on important shots, staying safe at work,  or other public health and safety topics (i.e. first aid, preventing infections, protecting against poisons, bike safety).

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Everyday Health & WellnessGet Enough Sleep
Everyone needs to sleep. A good night’s sleep helps keep your mind and body healthy.

*How much sleep do I need?*Most adults need 7 to 8 hours of sleep each night. If you are having trouble sleeping, make changes to your routine to get the sleep you need.

Kids need even more sleep than adults.
- Teens need at least 9 hours of sleep each night.
- School-aged and preschool children need 10 to 12 hours of sleep.
- Newborns sleep between 16 and 18 hours a day.
Protect Your Skin from the Sun
The best way to prevent skin cancer is to protect your skin from the sun.
- Stay in the shade as much as possible between 10 a.m. and 4 p.m.
- Use sunscreen with SPF 15 or higher.
- Cover up with long sleeves, a hat, and sunglasses.

*Why do I need to protect my skin from the sun?*

Protect your skin from the sun today to help prevent skin cancer later in life. Most skin cancer appears after age 50, but damage from the sun can start during childhood.

Staying out of the sun and using sunscreen can also help prevent:
- Wrinkles
- Blotches or spots on your skin
- Other damage caused by the sun
Quit Smoking
Quitting smoking is one of the most important things you can do for your health. The sooner you quit, the sooner your body can begin to heal. You will feel better and have more energy to be active with your family and friends.

*How can I quit smoking?*Start by thinking about why you want to quit. If you’ve tried to quit before, think about what worked and what didn’t. This will help you find the right quitting strategies.

Here are some things you can try to help you quit:
- Make a quit plan.
- Change your routine. For example, go for a walk instead of having a cigarette.
- Eat healthy snacks instead of smoking.
- Get medicine from your doctor or pharmacy .
- Get support from family, friends, and coworkers.

Nicotine is a drug in cigarettes that’s just as addictive as heroin or cocaine. It’s the nicotine in cigarettes that causes the strong feeling (craving) that you want to smoke. Quitting is hard, but it can be done.

*Want more information on getting more sleep, protecting your skin from the sun, quiting smoking, or other everyday health & wellness topics (i.e. managing stress, preventing allergy attacks, taking charge on your health care, talking to your doctor about depression)?*  Check out Everyday Health & Wellness on healthfinder.gov.

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Nutrition & Fitness
To stay at a healthy weight, you need to balance the calories you eat with the calories you burn (use up). To lose weight, you need to use more calories than you eat. A healthy diet and physical activity can help you control your weight.

Calories are a measure of the energy in the foods you eat. You burn calories when you are physically active.

*How do I know if I’m eating the right number of calories?*Use this tool to find out how many calories your body needs each day. This is the number of calories you need to maintain your current weight. If you are overweight or obese, burn more calories than you eat to lose weight.

*Want more information on nutrition and fitness?*  Check out Nutrition & Fitness on Healthfinder.gov.

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Important Screenings
Screenings are medical tests that check for diseases. Screenings can help doctors find diseases early, when the diseases may be easier to treat.

Getting screening tests is one of the most important things you can do for your health. You may need to be screened for:
- Some types of cancer
- High blood pressure and cholesterol
- Diabetes
- Osteoporosis (weak bones)
- Sexually transmitted diseases (STDs)
- Hearing and vision loss

**Use the myhealthfinder tool****to find out which screening tests you may need.******Enter your age, sex, and pregnancy status to get a list of recommendations. Print out the list and take it with you to your next doctor’s appointment.

*Want more information on screenings?*  Check out Important Screening Tests on Healthfinder.gov.

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Heart Health
You can take steps today to lower your risk of heart disease and heart attack. Heart disease is the leading cause of death for both men and women in the United States.

To help prevent heart disease, you can:
- Watch your weight.
- Quit smoking and stay away from secondhand smoke.
- Control your cholesterol (“koh-LEHS-tuh-rahl”) and blood pressure.
- If you drink alcohol, drink only in moderation.
- Get active and eat healthy.
- Take steps to prevent type 2 diabetes.
- Manage stress.

*Want more information on heart health?*Check out Heart Health on healthfinder.gov

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Diabetes
Diabetes is a disease. When you have diabetes, there is too much sugar (called glucose) in your blood.

There is more than one type of diabetes, but type 2 diabetes is the most common form of the disease. People who are overweight and inactive are more likely to get type 2 diabetes. Talk to your doctor about how you can prevent type 2 diabetes.

What do I ask the doctor?

Visiting the doctor can be stressful. It helps to have questions written down before your appointment. Print out this list of questions, and take it with you the next time you visit the doctor.
- Am I at risk for type 2 diabetes?
- Does my weight put me at risk for diabetes?
- Are there any warning signs of diabetes I should look out for?
- How can I find out if I have diabetes?
- What should I eat to prevent or delay diabetes?
- How much physical activity should I do to prevent or delay diabetes?
- If I’m overweight, how many pounds do I have to lose to prevent or delay diabetes?
- What are healthy ways to lose weight and keep it off?
- What are my blood pressure numbers and cholesterol levels? What should they be?
- Do my blood pressure and cholesterol numbers put me at risk for diabetes?
- Can you give me information about preventing diabetes to take home?

Learn about lowering your risk for type 2 diabetes

*Want more information on diabetes?*Check out Diabetes on healthfinder.gov.

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For Older Adults
Getting older doesn’t have to mean losing your health. To stay healthy as you age:
- Choose healthy foods
- Keep your body and mind active
- Get regular checkups
- Take steps to prevent accidents

Remember, it’s never too late to make healthy changes in your life.

**Stay active to live longer and better.**Staying active can help you:
- Reduce your risk for diabetes, heart disease, stroke, and cancer
- Avoid falls and other injuries
- Live on your own longer
- Prevent depression

Plus, staying active may help keep your mind sharp.

*Want more information on health & older adults?*Check out “For Older Adults” on healthfinder.gov.

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ParentingProtect Your Child from Injury
Children are at high risk for injuries. You can help keep your child from getting hurt by taking action ahead of time.

**A few minutes now could save your child’s life.**These simple steps can help prevent injuries inside and outside your home.
- Use the right child safety seat in the car.
- Use smoke alarms and make a fire escape plan for your home.
- Keep medicines, vitamins, and cleaning products out of your child’s reach.
- Teach your child to swim and closely watch your child in or near water.
- Make sure your child wears the right safety gear (like a helmet or pads) when playing sports.

Good habits like these can help protect your family from food poisoning:
- Buy food from stores that look and smell clean.
- Don’t buy food past “sell by,” “use by,” or other expiration dates.
- Wash your hands often with warm water and soap – especially before and after touching food.
- Make sure food is cooked to a safe temperature.
- Keep raw meat and seafood away from cooked and ready-to-eat food.
- Keep cold foods cold. Keep hot foods hot.
Protect Your Family Against Food Poisoning
Food poisoning (foodborne illness) is when you get sick from eating or drinking something that has harmful germs (like bacteria, viruses, or parasites) in it. Two common causes of food poisoning are *E. coli* and *Salmonella*.

Good habits like these can help protect your family from food poisoning:
- Buy food from stores that look and smell clean.
- Don’t buy food past “sell by,” “use by,” or other expiration dates.
- Wash your hands often with warm water and soap – especially before and after touching food.
- Make sure food is cooked to a safe temperature.
- Keep raw meat and seafood away from cooked and ready-to-eat food.
- Keep cold foods cold. Keep hot foods hot.
Talk to Your Kids About Tobacco, Alcohol, and Drugs
Talk to your child about the dangers of tobacco, alcohol, and drugs. Knowing the facts will help your child make healthy choices.

*What do I say?*
- Give your child clear rules.
- Find out what your child already knows.
- Be prepared to answer your child’s questions.
- Talk with your child about how to say “no.”

*When do I start talking with my child?*

Start early. By preschool, most children have seen adults smoking cigarettes or drinking alcohol, either in real life or on TV. Make sure your child knows right from the start that you think it’s important to stay safe and avoid drugs.

Here are more reasons to start the conversation early:
- Many kids start using tobacco by age 11 and are addicted by age 14.
- Between ages 9 and 13, kids begin to think that using alcohol is okay.
- Some children are already abusing drugs at age 12 or 13.

*What if my child is older?*

It’s never too late to start the conversation about avoiding drugs. Even if your teen may have tried tobacco, alcohol, or drugs, you can still talk about making healthy choices and how to say “no” next time.

Get more information on keeping kids healthy and drug free.

*Want more information about injury prevention, food poisoning, talking to your kids about tobacco, alcohol, and drugs, or other parenting topics (i.e., making the most of your child's doctor visits, watching for signs of speech delays, preventing bullying)?*Check out "For Parents" on healthfinder.gov.

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For MenGet screening tests to find diseases early.
Screenings are medical tests that check for diseases. Screenings can help doctors find diseases early, when the diseases may be easier to treat.
- Get your blood pressure checked at least once every 2 years.
- Talk to your doctor about getting your cholesterol checked. Doctors recommend that most men get their cholesterol checked at least once every 5 years.
- Get tested for colorectal cancer if you are over age 50. Ask your doctor what type of screening test is right for you.
- If you are between ages 65 and 75 and have ever smoked, talk with your doctor about abdominal aortic aneurysm (AAA).
- Most men feel stressed, anxious, or depressed from time to time. If these feelings last for more than 2 weeks, talk to a doctor about screening for depression. Most men with depression feel better when they get treatment.
Talk to your doctor if you have questions about your prostate.- Learn more about prostate health .
- Check out this list of questions for the doctor on prostate cancer screening.
Ask your doctor about taking aspirin every day.
If you are over age 45, taking aspirin every day could lower your risk of heart attack. Talk with your doctor about whether daily aspirin is right for you.

Do you know what it takes to stay healthy? Take this men’s health quiz to find out.

*Want more information on health & men?*Check out “Men: Take Charge of Your Health” on healthfinder.gov.

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For WomenGet Tested for Breast Cancer
Mammograms can help find breast cancer early. You have a better chance of surviving breast cancer if it’s found and treated early.
- Women ages 40 to 49: Talk with your doctor about when to start getting mammograms and how often you need them.
- Women ages 50 to 74: Get a mammogram every 2 years. Talk with your doctor to decide if you need one more often.

*What is a mammogram?*

A mammogram is an x-ray of the breast. Mammograms use a very low level of x‐rays (called radiation). A mammogram is very safe.
- When you get a mammogram, the nurse will place your breasts, one at a time, between 2 plastic plates and take pictures of each breast. Mammograms may be uncomfortable for some women, but they don’t hurt.
- A mammogram lasts less than 15 minutes.

*What if the doctor finds something wrong with my breast?*

Mammograms let the doctor or nurse look for small lumps inside your breast. If a lump is found, the doctor or nurse will do other tests to find out if it’s cancer.
- The doctor or nurse may take a small bit of tissue from the lump for testing. This is called a biopsy (“BY-op-see”).
Preventing Osteoporosis
Osteoporosis (“os-tee-oh-puh-ROH-sis”) is a disease of the bones. It means your bones are weak and more likely to break. Anyone can get osteoporosis, but it’s most common in older women.

Ask your doctor or nurse about steps you can take to prevent weak bones and lower your risk for osteoporosis. If you are age 50 or older, talk to your doctor about testing your bone strength.

Screening for osteoporosis is covered under the new Affordable Care Act for some women over age 60. Depending on your insurance plan, you may be able to get screened at no cost to you. Talk to your insurance provider.

*What do I ask the doctor?*

Visiting the doctor can be stressful. It helps to have questions written down before your appointment. Print out this list of questions, and take it with you the next time you visit the doctor. You may want to take a family member or close friend along to take notes.
- What puts me at risk for osteoporosis?
- How can I find out if I have weak bones?
- What foods should I eat to help prevent osteoporosis?
- How active do I need to be to help prevent osteoporosis?
- Am I currently taking any medicines that cause bone loss?
- How much calcium and vitamin D do I need each day?
- How can I get enough calcium?
Getting Enough Folic Acid
Women of childbearing age (typically ages 11 to 49) need an extra 400 micrograms (mcg) of folic acid every day. Folic acid is found in vitamins and foods like breakfast cereals that have 100% DV (daily value) of folic acid.

*Why is folic acid important?*Everyone needs folic acid in their diet. Folic acid is especially important for women who are pregnant or who may become pregnant.

It’s important to get enough folic acid, even when you aren’t planning to get pregnant. Folic acid is a vitamin that can prevent birth defects. It’s needed during the first few weeks of pregnancy, often before a woman knows she’s pregnant.

*Want more information on health & women?*Check out “For Women” on healthfinder.gov.

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Pregnancy
 It’s important to take care of yourself and your baby during pregnancy. To keep you and your baby healthy:
- See your doctor or midwife regularly.
- Get important prenatal (“pree-NAY-tuhl”) tests.
- Don’t smoke or drink alcohol.
- Prevent infections.
- Eat healthy foods and stay active.

To get more tips for a healthy pregnancy:
- Take this quiz to  test your pregnancy know-how .
- Check out these  Pregnancy Do’s and Don’ts .

*Want more information about pregnancy?*Check out Pregnancy on Healthfinder.gov.

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On This Page- Healthfinder.gov
- Public Health & Safety
- Everyday Health & Wellness
- Nutrition & Fitness
- Important Screenings
- Heart Health
- Diabetes
- For Older Adults
- Parenting
- For Men
- For Women
- Pregnancy
Tools & Resources
From Governmentwide guidelines to sample resources and information on Federal agencies that play a key role in worksite health & wellness, many tools and resources are available in this section to help understand the basics of worksite health & wellness, explore issues in greater detail, and implement effective program.
Federal Agencies
The following are Federal agencies and their subcomponents associated with the administration of worksite health and wellness programs.
- U.S. Office of Personnel Management (OPM)  OPM's Work-Life & Performance Culture promotes the efficiency of the Federal workforce by providing agencies with guidance, resources and technical assistance on issues related to employee health and well-being. Policies and guidance developed by the Work-Life Group may address issues such as worksite health & wellness, telework, substance abuse, Employee Assistance Program, workplace violence, domestic violence at work, and critical incident stress. 
-  **Internal Revenue Services**  The Tax Exempt and Government Entities Employment Tax Branch serves three very distinct customer segments: Employee Plans, Exempt Organizations, and Government Entities. This branch of the IRS provides information regarding taxable income that may include health promotion incentives offered through worksites and commercial health club memberships provided through agencies. 
- U.S. Department Of Agriculture (USDA)  The United States Department of Agriculture (USDA) works to support the American agricultural economy to strengthen rural communities; to protect and conserve our natural resources; and to provide a safe, sufficient, and nutritious food supply for the American people. The USDA provides nutrition guidance and health promotion tools based on the Dietary Guidelines for Americans, through ChooseMyPlate.gov and the SuperTracker. 
- U.S. Department Of Health And Human Services (HHS)  The Department of Health and Human Services (HHS) is the U.S. government’s principal agency for protecting the health of all Americans and providing essential human services. HHS represents almost a quarter of all Federal outlays and it administers more grant dollars than all other Federal agencies combined. HHS is a major host to numerous agencies that play significant roles in contributing to successful worksite health and wellness programs. 
- Agency for HealthCare Research and Quality   Under HHS, the Agency for HealthCare Research and Quality’s (AHRQ) broad programs of research, clinical guideline development, and technology assessment bring practical, science-based information to medical practitioners, consumers, and other health care purchasers. 
- Center for Disease Control and Prevention  Under HHS, the Centers for Disease Control and Prevention (CDC) provides credible, reliable health information on diseases and conditions, emergencies and disasters, environmental health, violence and safety, workplace safety and health, and more. The CDC has three sites of particular relevance to worksite health and wellness: CDC’s Healthier Worksite Initiative (HWI), the National Healthy Worksite Program (NHWP), and the NIOSH Total Worker Health Program. HWI provides information on program design, policies, toolkits, and other practical resources for worksite health and wellness. The NHWP is designed to assist employers in implementing science and practice-based prevention and wellness strategies that will lead to specific, measureable health outcomes to reduce chronic disease rates. The NIOSH Total Worker Health Program is described below. CDC also has developed a Federal Wellness Resource Guide which provides resources relevant to both employees & employers.    - Division of Nutrition, Physical Activity, and Obesity  Under the CDC, the Division of Nutrition, Physical Activity, and Obesity (DNPAO) utilizes a public health approach to address the role of nutrition and physical activity in improving the public's health and preventing and controlling chronic diseases. The scope of DNPAO activities includes leadership, policy and guidelines development, surveillance, epidemiological and behavioral research, intervention development, technical assistance to states and communities, training and education, communication, and partnership development. 
  - National Institute for Occupational Safety and Health  Under HHS and the CDC, the National Institute for Occupational Safety and Health (NIOSH) is the Federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. NIOSH provides an extensive collection of occupational safety and health information arranged by subject. The NIOSH Total Worker Health effort promotes comprehensive and integrated health, safety and wellbeing programs and practices for America’s workers and workplaces. 
  - Office on Smoking and Health  Under the CDC, the Office on Smoking and Health (OSH) is the lead Federal agency for comprehensive tobacco prevention and control. Originally established in 1965 as the National Clearinghouse for Smoking and Health, OSH is dedicated to reducing the death and disease caused by tobacco use and exposure to secondhand smoke. 
  - Workplace Health Promotion  CDC’s Workplace Health Promotion site is a toolkit for workplace health protection and promotion. It provides information, tools, resources, and guidance to practitioners interested in establishing or enhancing workplace health and safety programs. 
- Federal Occupational Health   Under HHS, Federal Occupational Health (FOH) provides occupational health and wellness services exclusively to Federal employees. FOH works in partnership with Federal organizations nationally and internationally to design and deliver comprehensive solutions to meet their occupational health needs. 
- National Institutes of Health   Under HHS, the National Institutes of Health (NIH) mission is to seek fundamental knowledge about the nature and behavior of living systems and use the application of that knowledge to enhance health, lengthen life, and reduce the burdens of illness and disability. 
- Office of Disease Prevention and Health Promotion  Under HHS, the Office of Disease Prevention and Health Promotion (ODPHP) plays a vital role in developing and coordinating a wide range of national disease prevention and health promotion activities. 
- President's Council on Fitness, Sports & Nutrition  Under HHS, the President's Council on Fitness, Sports and Nutrition (PCFSN) is a committee of 25 volunteer citizens who advise the President through the Secretary of Health and Human Services. PCFSN serves as a catalyst to promote healthy lifestyles through fitness, sports, and nutrition programs and initiatives that engage Americans across the lifespan. 
- Substance Abuse and Mental Health Services Administration  Under HHS, the Substance Abuse and Mental Health Services Administration (SAMHSA) provides leadership and devotes its resources - programs, policies, information and data, contracts and grants- toward helping the Nation act on the knowledge that: behavioral health is essential for health; prevention works; treatment is effective; and people recover from mental and substance use disorders. SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America's communities. 
- U.S. Food and Drug Administration  Under HHS, the Food and Drug Administration (FDA) regulates and supervises programs such as emergency preparedness, food safety, food labeling and nutrition, and has the authority to regulate tobacco products under the Family Smoking Prevention and Tobacco Control Act. 
- U.S. Surgeon General  Under HHS, the Surgeon General serves as America's Doctor by providing Americans the best scientific information available on how to improve their health and reduce the risk of illness and injury. The Surgeon General reports to the Assistant Secretary for Health, who is the principal advisor to the Secretary on public health and scientific issues. 
-  U.S. General Services Administration (GSA)  GSA's Federal Acquisition Service is the lead organization for procurement of products and services (other than real property) for the Federal government, and the Public Building Services provides facilities and workplace solutions to Federal agencies. 
Additional Federal Resources
These are guidelines, policies, and general resources provided by various Federal agencies that can help guide the development of worksite wellness programs.
Governmentwide Guidelines Related To Wellness- The Community Guide to Worksite Health Promotion  The Community Guide, based on a scientific systematic review process, is a credible resource that answers questions critical to almost everyone interested in community health and well-being. 
- Healthy People 2020  Healthy People provides science-based, 10-year national objectives for improving the health of all Americans. For 3 decades, Healthy People has established benchmarks and monitored progress over time in order to encourage collaborations across communities and sectors, empower individuals toward making informed health decisions, and measure the impact of prevention activities. 
- **Physical Activity Guidelines for Americans**  The 2008 Physical Activity Guidelines for Americans published by the U.S. Department of Health and Human Services (HHS) is designed to provide information and guidance on the types and amounts of physical activity that provide substantial health benefits for Americans aged 6 years and older. The main idea behind the Guidelines is that regular physical activity over months and years can produce long-term health benefits. 
- U.S. Preventive Services Task Force List of Recommended Clinical Preventive Health Care Services  The following is a list of preventive services that have a rating of A or B from the U.S. Preventive Services Task Force that are relevant for implementing the Affordable Care Act. The preventive services are listed alphabetically. 
- Health and Sustainability Guidelines for Federal Concessions and Vending Operations (GSA)  In support of GSA’s actions to increase healthy and sustainable food and beverage options and operations at federal workplaces, the U.S. Department of Health and Human Services (HHS) and GSA have worked collaboratively to create this document, which proposes specific food, nutrition, and sustainability guidelines to complement the GSA procurement guidelines. 
- Rehabilitation Act Section 508 Compliance  Section 508 requires that Federal agencies’ electronic and information technology is accessible to people with disabilities. IT Accessibility & Workforce Division, in the U.S. General Services Administration’s Office of Governmentwide Policy, has been charged with the task of educating Federal employees and building the infrastructure necessary to support Section 508 implementation. Using this web site, Federal employees and the public can access resources for understanding and implementing the requirements of Section 508. 
Governmentwide Programs & Initiatives Related To Wellness- Federal Employee Health Benefits Program (FEHB)   The FEHB Program can help you and your family meet your health care needs. Federal employees, retirees and their survivors enjoy the widest selection of health plans in the country. You can choose from among Consumer-Driven and High Deductible plans that offer catastrophic risk protection with higher deductibles, health savings/reimbursable accounts and lower premiums, or Fee-for-Service (FFS) plans, and their Preferred Provider Organizations (PPO), or Health Maintenance Organizations (HMO) if you live (or sometimes if you work) within the area serviced by the plan.  Use this site to compare the costs, benefits, and features of different plans. 
- FSAFEDS Eligible Expenses Juke Box  This website provides a list of services and expenses eligible for reimbursement under flexible spending accounts available to Federal employees. 
- United We Serve Volunteer Network  Serve.gov, the online home of United We Serve, is managed by the Corporation for National and Community Service (CNCS), the federal agency charged with promoting and fostering volunteering and national service in America. 
- America’s Great Outdoors Initiative  President Obama launched the America's Great Outdoors (AGO) Initiative to develop a 21st Century conservation and recreation agenda. AGO takes as its premise that lasting conservation solutions should come from the American people - that the protection of our natural heritage is a non-partisan objective that is shared by all Americans. 
- Let’s Move Program  Let’s Move! is a comprehensive initiative, launched by the First Lady, dedicated to solving the problem of obesity within a generation, so that children born today will grow up healthier and able to pursue their dreams. 
- **Million HeartsTM Educational Campaign**  Heart disease and stroke are the first and fourth leading causes of death in the United States. Heart disease is responsible for 1 of every 4 deaths in the country. Million Hearts® is a national initiative that has set an ambitious goal to prevent 1 million heart attacks and strokes by 2017. The impact will be even greater over time. 
- **National Prevention Week**  National Prevention Week is a SAMHSA-supported annual health observance dedicated to increasing public awareness of, and action around, substance abuse and mental health issues. 
- **People’s Garden Initiative (USDA)**  USDA Secretary Vilsack began the People's Garden Initiative - named in honor of President Lincoln's description of USDA as the "People's Department" - in 2009 as an effort to challenge employees to create gardens at USDA facilities. It has since grown into a collaborative effort of over 700 local and national organizations all working together to establish community and school gardens across the country. 
Information Centers, Research Articles, & Data Sources- **Healthfinder.gov (HHS)**  Healthfinder.gov is a Federal Government website where you will find information and tools to help you and those you care about stay healthy. When making decisions about your health, it's important to know where to go to get the latest, most reliable information. Healthfinder.gov has resources on a wide range of health topics selected from over 1,600 government and nonprofit organizations to bring you the best, most reliable health information on the Internet. 
- **FedScope**   This self-service, online tool allows customers to access and analyze the most popular data elements from OPM's Enterprise Human Resources Integration-Statistical Data Mart (EHRI-SDM). It provides access to 5 years of employment, accession, and separation data. 
- GSA eLibrary (Schedule Approved Contractors List)  GSA eLibrary was created to help customers research and identify commercial businesses that provide high quality products and services offered under GSA and VA acquisition solutions. eLibrary is updated nightly so you can be assured that you are seeing the most accurate and up-to-date award information. 
- **PubMed (HHS)**  PubMed comprises more than 22 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web site. 
- **National Health Information Center (HHS)**  The National Health Information Center (NHIC) is a health information referral service. NHIC links people to organizations that provide reliable health information. 
- National Library of Medicine (HHS)  The world’s largest biomedical library, NLM maintains and makes available a vast print collection and produces electronic information resources on a wide range of topics that are searched billions of times each year by millions of people around the globe. It also supports and conducts research, development, and training in biomedical informatics and health information technology. 
- National Agriculture Library, Food and Nutrition Information Service (USDA)  Nutrition.gov provides easy access to vetted food and nutrition information from across the federal government. It serves as a gateway to reliable information on nutrition, healthy eating, physical activity, and food safety for consumers. 
Worksite Wellness Implementation & Sample Resources- The Veterans Health Administration’s Employee Health Promotion Disease Prevention (EHPDP) Guidebook  The EHPDP Guidebook was written by a multidisciplinary task group to provide information and references appropriate for establishing and expanding EHPDP programs within the VHA. This guidebook is available as an example of an agency-level guidebook and provides templates, sample documents, references, and directives for use and modification by other Federal agencies. 
- Garden Market Toolkit (CDC)  This toolkit provides information on how to establish a garden market in a Federal agency or other organization. 
- Healthy Meeting Toolkit (CDC)   These guidelines can be used for selecting foods and beverages for breaks or meals at meetings, conferences, and other work-related events. When planning menus, consider providing options that accommodate various dietary preferences and needs. 
- StairWELL Toolkit (CDC)  This site will provide the information you need to transform your stairs into StairWELLs for better health. 
- **MAP-IT: A Guide to Using Healthy People 2020 in Your Community**  No two public health interventions are exactly alike, but most interventions share a similar path to success: **M**obilize, **A**ssess, **P**lan, **I**mplement, **T**rack. 
- Introduction to Program Evaluation for Public Health Programs: A Self-Study Guide  This document is a “how to” guide for planning and implementing evaluation activities. The manual, based on CDC’s Framework for Program Evaluation in Public Health, is intended to assist managers and staff of public, private, and community public health programs to plan, design, implement and use comprehensive evaluations in a practical way. 
Tobacco, Alcohol, And Drug-Free Workplaces- **Drug-free Workplace Guidelines (HHS)**  This website provides information on the Federal Drug-free Workplace Program, including the executive order, model comprehensive plan, historical documents and more. 
- Federal Employee Health Benefit Quit Smoking Initiative  There has never been a better time to quit smoking. All FEHB plans now offer 100% coverage to help you quit once and for all. 
- **National Drug and Alcohol Treatment Referral Routing Service (HHS)**  The Substance Abuse and Mental Health Services Administration (SAMHSA) is pleased to provide this online resource for locating drug and alcohol abuse treatment programs. The Substance Abuse Treatment Facility Locator list private and public facilities that are licensed, certified, or otherwise approved for inclusion by their State substance abuse agency and treatment facilities administered by the Department of Veterans Affairs, the Indian Health Service, and the Department of Defense. 
- National Tobacco Education Campaign “Tips From Former Smokers”  Tips From Former Smokers (Tips) encourages people to quit smoking by highlighting the toll that smoking-related illnesses take on smokers and their loved ones. 
- Tobacco Cessation Toolkit (CDC)  This toolkit provides guidance for implementing a tobacco-free campus (TFC) initiative that includes a policy and comprehensive cessation services for employees. It is based on the Centers for Disease Control and Prevention's (CDC) experience with implementing the U.S. Department of Health and Human Services (HHS) Tobacco-Free HHS initiative. 
- Tobacco Free Campus Policy (CDC)  This policy requires all properties owned or leased by HHS agencies to be tobacco free, beginning with limited implementation on January 1, 2005, and achieving full implementation by February 1, 2005, as labor and lease agreements permit. 
Nutrition & Physical Activity- **Active Commuting to Federal Workplaces**  This document was prepared to assist Federal agencies in implementing Executive Order 13514, Federal Leadership in Environmental, Energy, and Economic Performance. To implement the Administration’s goal of establishing a clean energy economy, Federal agencies should pursue efforts to establish and support bicycling and other active commuting and travel at Federal facilities. 
- Body Mass Index Tool (CDC)  This tool will provide you with your Body Mass Index (BMI). Your BMI is a number calculated from your weight and height, and used to screen for weight categories that may lead to health problems. 
- **Eat Smart. Play Hard.TM Healthy Lifestyle (USDA)**  This site is specifically designed for parents and caregivers to provide information to help you eat better, be more physically active and be a role model for your kids. 
- **LEAN Works! – Workplace Obesity Prevention Program (CDC)**  CDC's LEAN Works! is a synthesis of the science and practice-based evidence to guide you in planning, building, promoting, and assessing a worksite obesity prevention and control program. 
- Let’s Move Program  Let’s Move! is a comprehensive initiative, launched by the First Lady, dedicated to solving the problem of obesity within a generation, so that children born today will grow up healthier and able to pursue their dreams. 
- National Agriculture Library, Food and Nutrition Information Service (USDA)  Nutrition.gov provides easy access to vetted food and nutrition information from across the federal government. It serves as a gateway to reliable information on nutrition, healthy eating, physical activity, and food safety for consumers. 
- Nutrition for Everyone (CDC)  While you already know it is important to eat a healthy diet, you may find it more difficult to sort through all of the information about nutrition and food choices. CDC has compiled a variety of resources to help you start healthier eating habits. 
- **Nutritious Eating Toolkits**  The toolkits in this section are designed specifically for work sites to encourage nutritious eating and may contain checklists, step-by-step guides, budgets, and other tools that aid in program planning, design, and management. Before implementing any of these interventions, the toolkits should be selected and evaluated based on the identified needs of your employee population. 
- Physical Activity Guidelines for Americans  The 2008 Physical Activity Guidelines for Americans published by the U.S. Department of Health and Human Services (HHS) is designed to provide information and guidance on the types and amounts of physical activity that provide substantial health benefits for Americans aged 6 years and older. The main idea behind the Guidelines is that regular physical activity over months and years can produce long-term health benefits. 
- **President’s Challenge and Presidential Active Lifestyle Award (PALA +)**  The President’s Challenge is the premier program of the President’s Council on Fitness, Sports, and Nutrition administered through a co-sponsorship agreement with the Amateur Athletic Union. The President’s Challenge helps people of all ages and abilities increase their physical activity and improve their fitness through research-based information, easy-to-use tools, and friendly motivation. 
- **Bicycle Benefit Policy (DOT)**   This document states the guidelines and procedures for the U.S. Department of Transportation (DOT) Bicycle Benefit. 
- Bike to Work  This new Bike to Work Website is funded by the Department of Transportation and maintained by the Pedestrian and Bicycle Information Center. The Website provides helpful resources for planning and holding your bike to work event. The resource section includes downloads for event organizers, tips for individual riders, facts for the news media, as well as information for employers and sponsors. The Website also features a discussion forum that will allow bike commuters to network with one another. Using the Web forum, you can post questions about how to get a bike to work event off the ground or offer your tips for holding a successful event. 
Wellness Memoranda To Agencies- Keeping Our Federal Workforce Healthy this Flu Season and Beyond
- National Prescription Drug Take-Back Day, Saturday, September 27, 2014
- Presidential Memorandum--Enhancing Workplace Flexibilities and Work-Life Program
- Release of OPM’s Online Course: “Executive Excellence and Wellness through Strategic Leadership"
- Presidential Proclamation NATIONAL PHYSICAL FITNESS AND SPORTS MONTH, 2013
- National Prescription Take-Back Day, Saturday, April 27, 2013
- Workplace Flexibilities for 2013 Seasonal Influenza
- Nursing Mothers in Federal Employment
- The Role of the Employee Assistance Program during Workforce Restructuring
On This Page- Federal Agencies
- Governmentwide Guidelines Related to Wellness
- Governmenwide Programs & Initiatives Related to Wellness
- Information Centers, Research Articles, & Data Sources
- Worksite Wellness & Implementation & Sample Resources
- Tobacco, Alcohol, and Drug-Free Workplaces
- Nutrition & Physical Activity
- Wellness Memoranda To Agencies
Program Evaluation
While worksite health and wellness programs vary across agencies because of differences in organizational needs and workforce demographics, the demand for accountability is constant. As a result, program evaluation is imperative to:
- determine if the program is producing desired outcomes;
- monitor progress toward goals;
- find opportunities for improvement;
- justify the need for further funding and support; and
- ensure effective programs are continued and resources are not wasted on ineffective programs.

There are several ways Federal agencies can evaluate their worksite health and wellness programs. Because there is not one right way, we encourage you to review the list of Federal resources below and use those that best meet the needs of your agency.
WellCheck
WellCheck is an online needs assessment based on HealthyPeople 2010’s Elements of a Comprehensive Worksite Wellness Program.  Implemented in 2009 by the Office of Personnel Management (OPM), this web-based tool collects information on Federal agencies' worksite health and wellness programs at specific work locations.  Annually, agency designated points of contact gain access to WellCheck to report data about their worksite health and wellness programs, services, policies, costs, and metrics.  This data is used to analyze program efforts and allows agencies to identify program strengths and areas that need improvement.  Email worklife@opm.gov to find your agency’s POC. 
FedScope: Access to Statistical Information
Understanding agency demographics will help coordinators to establish a baseline and starting point for health promotion initiatives and activities.

OPM provides statistical information about the Federal civilian workforce through FedScope. This online tool allows customers to access and analyze the most popular data elements from OPM's Enterprise Human Resources Integration-Statistical Data Mart (EHRI-SDM). Customers include Federal government agencies, researchers, the media, and the general public.

This self-service tool provides access to five years of employment, accession, and separation data. Access to detail level data is provided while protecting employee privacy and EHRI-SDM security.

The following workforce characteristics ("Who", "What", and "Where" of Federal Civilian Employment) are available for analysis:
- Who (about the employees)   - Age (5 year interval)
  - Gender
  - Length of Service (5 year interval) 
- What (about their positions)   - General Schedule and Equivalent Grade
  - Occupation
  - Occupation Category
  - Pay Plan and Grade
  - Salary Level ($10,000 interval)
  - Type of Appointment
  - Work Schedule 
- Where   - Agency
  - Location (foreign, U.S. state and county)
  - Metropolitan Statistical Area  
CDC’s Framework for Program Evaluation in Public Health
The Centers for Disease Control and Prevention (CDC) provides a “how to” guide for planning and implementing evaluation activities in worksite health promotion programs. The *Introduction to Program Evaluation for Public Health Programs: A Self-Study Guide* is based on CDC’s Framework for Program Evaluation in Public Health. It can provide practical assistance to managers and staff of worksite health promotion programs in planning, design, implementation, and use of comprehensive evaluations. The premise of CDC’s Framework is that to ensure usage, evaluation design must match the purpose of the evaluation and the intended user of the results thus maximizing payoffs and minimizing evaluation costs.  
MAP-IT: A Guide to Using Healthy People 2020 in Your Community
This guide is provided by the Department of Health and Human Services (HHS) as a framework for implementation and tracking progress towards achieving Healthy People 2020 objectives. The framework recognizes that while no two health interventions are exactly alike, most interventions can follow a similar path to success: **M**obilize, **A**ssess, **P**lan, **I**mplement, **T**rack (MAP-IT). 
Veterans Health Administration’s Employee Health Promotion Disease Prevention (EHPDP) Guidebook
Chapter 12 of the Veterans Health Administration’s (VHA) guidebook provides the basis for program evaluation and several examples of qualitative and quantitative evaluation processes. The chapter describes three methods of qualitative evaluation: process measures, key informant interviews, and focus groups and several quantitative evaluations.  The chapter also provides sources of and methods for incorporating institutional data into an evaluation and descriptions of several instruments available to measure presenteeism in the workplace. 
On this Page- WellCheck
- FedScope: Access to Statistical Information
- CDC’s Framework for Program Evaluation in Public Health
- MAP-IT: A Guide to Using Healthy People 2020 in Your Community
- Veterans Health Administration’s Employee Health Promotion Disease Prevention (EHPDP) Guidebook
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