GREETINGS! The Workplace Wellness assessment is available online at:

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1 GREETINGS! The YMCA of Greater Fort Wayne and Greater Fort Wayne c. are excited to present the 2014 YMCA Workplace Wellness Awards. As an integral part of supporting our community s health, the YMCA encourages the employers to address employee well-being. The goal of our 2014 YMCA Workplace Wellness Awards is to raise awareness about the importance and benefits of incorporating successful wellness programs at area companies. By participating, you will learn about potential ways to incorporate additional wellness initiatives at your workplace, as well as have the opportunity to share ideas, successes and challenges with other companies in the greater Fort Wayne community. Your workplace does not have to be a wellness expert in order to take part in the 2014 Workplace Wellness Awards. The assessment process is not a matter of winning or losing, nor is it a measure of success or failure. Rather, it is a way of understanding your stage of within the process of creating sustainable change toward healthy living. It s helpful to compare this process to the work of planting an apple orchard. Just as a farmer starts small by planting seeds and then provides appropriate care for each stage of the trees until the harvest, so too can you cultivate the process of change until you create an environment that strongly supports healthy eating and active living. To participate in the 2014 Workplace Wellness Awards, please complete your Workplace Wellness assessment and return along with the $50 application fee to the YMCA Metropolitan office before September 1, The application fee provides your company two seats for the awards presentation on Thursday, October 23, 2014 as well as a consultation with a YMCA Wellness staff member to review your assessment results and make recommendations for developing an improvement plan. The Workplace Wellness assessment is available online at: We look forward to your participation in the 2014 Workplace Wellness Awards and thank you for the opportunity to assist you on a path to a healthy work enviornment. Good Health, Marty Pastura President and CEO YMCA of Greater Fort Wayne Mark Becker CEO Greater Fort Wayne c.

2 HEALTHIER EMPLOYEES HEALTHIER BUSINESS YMCA S WORKPLACE WELLNESS ASSESSMENT Plant the seeds. Nurture for growth. urish the root system. Cultivate healthy fruit. Harvest the rewards. THE PATH TO A HEALTHY WORK ENVIORNMENT.

3 FREQUENTLY ASKED QUESTIONS WHY ARE WORKPLACE WELLNESS PROGRAMS IMPORTANT? Workplace wellness programs have been proven to help employees make healthier lifestyle choices that improve their health and the overall wellness and productivity. Did you know that in the United States, preventable illnesses make up 70% of ailments that are associated with the cost of healthcare and productivity? These illnesses have been directly correlated with poor lifestyle choices. fact, for every 100 employees: 60 are overweight 50 have high cholesterol 25 smoke 24 have high blood pressure HOW WOULD ASSESSING MY WORKPLACE WELLNESS BENEFIT MY EMPLOYEES? Assessing your company can determine what tools and training for promoting employee health and well-being are needed or can be improved upon. HOW DOES THE YMCA WORKPLACE WELLNESS ASSESSMENT WORK? The YMCA has provided a resource to see where your company falls in the basic criteria of Workplace Wellness and implementation. We have partnered with Greater Fort Wayne c. to help provide a process for growing and developing your company s Workplace Wellness program. The YMCA is interested in each company sharing ideas and programs that have been successful in your workplace, and how they contribute to overall health and well-being. We want to celebrate Fort Wayne s Healthy Employers, and promote to our community the good work you do in caring for employees and their families. WHAT ARE THE AWARD LEVELS? Five designations of the Workplace Wellness Awards are possible to achieve Copper, Bronze, Silver, Gold, and Platinum. Application criteria for each of these designations are based upon progressive and implementation of an organization s wellness initiative within the context of several critical benchmarks, shown to produce results in organizations of all sizes and industry types. Copper recognizes organizations meeting the minimum criteria by demonstrating a solid foundation for success. There is very minimal opportunity and support for healthy eating and physical activity at present, but these sites are beginning a change process that can lead to a healthy environment. Bronze recognizes organizations that have just started to develop and offer some opportunities for healthy eating and physical activity, but there is still ample work to be done. Silver recognizes organizations expanding programming and having healthy eating and physical activity available at least half of the time at the site. At this stage, it is still important to continue to grow to reach the next level. Gold recognizes organizations developing comprehensive programs producing results. These programs have changed the environment such that, more often than not, there are opportunities to eat healthy s and be active at these sites, but there is still a few more areas to improve upon. Platinum represents the pinnacle of results-oriented worksite wellness programming. The Platinum Award is granted to organizations with a deep support for a person to be active and eat healthy s everywhere in the environment of sites at this stage.

4 Community Healthy Living dex WORK SITE ASSESSMENT Assessment Date: / / Please complete the assessment and return before September 1, 2014, along with a check for $50 made to the YMCA of Greater Fort Wayne. The $50 application fee provides your company two seats to the awards presentation on Thursday, October 23, 2014 as well as a consultation with a YMCA Wellness staff member to review your assessment results and make recommendations for developing an improvement plan. Send completed assessment and check to: YMCA of Greater Fort Wayne Attn: Natalie Woods YMCA Workplace Wellness Awards 347 West Berry Street, Suite 500 Fort Wayne, IN Natalie_Woods@fwymca.org I. GENERAL INFORMATION 1. Name of employer/work site: 2. Total number of full- and part-time employees at physical location of work site: employees If a multisite employer, approximate total number of full- and part-time employees at all sites combined: employees 3. Type of employer/work site: Private Public/government t-for-profit 4. Location of work site: 4a. Zip code: 4b. County:

5 5. Work site setting (check the best description): Urban Suburban Rural Rough definitions of urban, suburban, and rural settings are below. Recognize that these are only general guidelines and each situation may be unique. Urban: an area that has an assortment of shopping destinations, a school, a place of worship, park or recreational facilities, or other community destinations less than or equal to a half mile or a 10-minute walk from most homes Suburban: an area that has an assortment of shopping destinations, a school, a place of worship, parks or recreation facilities, or other community destinations approximately one mile or a 20-minute walk from most homes Rural: an area that has an assortment of shopping destinations, a school, a place of worship, parks or recreational facilities, or other community destinations greater than or equal to two miles or a 40-minute or longer walk from most homes 6. Ethnic makeup of the employees at the work site (provide an approximate percentage for each category to add up to 100 percent). te that the federal government considers race and Hispanic origin to be two distinct concepts. This question asks only about Hispanic origin. The following question asks about the race. % Spanish, Hispanic, or Latino (of any race) % t Spanish, Hispanic, or Latino (of any race) 100 % Total 7. Racial makeup of the employees at the work site (provide an approximate percentage for each category to add up to 100 percent). % White % Black or African-American % American dian and Alaska Native % Asian % Native Hawaiian and Other Pacific Islander % Some other race/two or more races 100 % Total

6 ii. PRogRAMS, PHySiCAL environment, PRoMoTion, AnD PoLiCy The CHLI assessment process is not a measure of success or failure but rather an important part of developing a plan for improvement in your community. Please be candid and accurate as you answer the questions below. te: These questions apply to the work site currently undergoing assessment; if you are a multisite employer, consider only the physical site being assessed. A. ADMiniSTRATive SUPPoRT/geneRAL 1. The work site has a wellness committee/wellness coordinator whose efforts focus on enhancing physical activity and healthy eating opportunities at the workplace. 2. The work site has a health-promotion budget that covers the cost of offering employees opportunities for physical activity and healthy eating. 3. The work site s mission statement includes commitment to employee health and well-being. 4. The work site has organizational and performance objectives pertaining to employee health and well-being. 5. The work site offers employees a health insurance plan that covers preventive services, such as annual physical exams and age-appropriate health screenings (e.g., blood cholesterol testing, pap smear, mammography, colonoscopy). 6. The work site (or its health insurance plan) rewards employees for participating in preventive health and wellness activities (e.g., smoking cessation program, weight management program, physical activity program). 7. The work site contributes money, staff, products, or services to community-wide efforts to increase opportunities for physical activity in the community (e.g., donations for building physical-activity-friendly facilities, sponsoring sports teams, staff time for community coalition meetings, etc.). 8. The work site contributes money, staff, products, or services to community-wide efforts to increase opportunities for healthy eating in the community (e.g., donations for farmers markets and banks, sponsoring community gardens, staff time for community coalition meetings, etc.). Covers all/ most costs covers costs Covers half the costs Covers some costs covers costs V8 CHLI Tools Work Site Assessment 131

7 A. ADMiniSTRATive SUPPoRT/geneRAL (ConTinUeD) 9. The work site offers a smoke-free environment. Rate your confidence in your answers for this section: Very high High Medium Low Very low b. HeALTH PRoMoTion 1. The work site conducts health promotion and wellness needs assessments/surveys to understand the wellness needs of the employees and to plan work site health promotion activities accordingly. 2. The work site offers one or more health promotion services (e.g., fitness assessments, health risk appraisals, healthy eating classes, weight management programs, individually adapted behavior-change programs, physical activity classes, smoking cessation programs): 2.a. To the employees 2.b. To the employees family members if you chose any of the yes responses in questions 2.a and/or 2.b, answer question 2.c. if you chose no, not offered, for both 2.a and 2.b, skip to question 3. 2.c. The work site evaluates its health promotion programs and seeks feedback. 3. Frontline managers, middle managers, and/ or supervisors actively support employee participation in health promotion activities by allowing them to participate during work hours. 4. The work site offers preventive health services/ screenings on-site or access to services/ screenings off-site (e.g., blood sugar measurement, cholesterol measurement, flu shots): 4.a. To the employees 4.b. To the employees family members 5. The work site regularly provides educational materials/messages that promote healthy living through posters or brochures, promotional campaigns, health fairs, videos, paycheck stuffers, fliers, newsletter articles, and/or routine communication., offered free, offered free, offered free, offered free 4x / yr 3x / yr, offered fee-based, offered fee-based, offered fee-based, offered fee-based 2x / yr 1x / yr, not offered, not offered, not offered, not offered < 1x / yr or 132 Work Site Assessment CHLI Tools V8

8 b. HeALTH PRoMoTion (ConTinUeD) 6. The work site informs employees about the availability of health promotion programs, services, or classes at the work site, through multiple communication channels such as newsletters, bulletin boards, postcards, and/or s. 7. The work site provides incentives through the health benefits plan or through cash rewards for engaging in physical activity and/or healthy eating. Rate your confidence in your answers for this section:, both benefit plan and cash incentives Very high High, either benefit plan or cash incentives Medium Low, neither benefit plan nor cash incentives Very low C. PHySiCAL ACTiviTy opportunities 1. The work site allows flexible work/ break time for employees to more easily engage in physical activity. 2. The work site conducts or sponsors sports teams, walking clubs, or events to encourage physical activity among employees. 3. The work site supports physical activity during meetings (e.g., fun, physically active group work is incorporated in the meeting, and the dress code enables physical activity). 4. Work site management/leaders model the importance of physical activity by participating in group physical activity at meetings or conferences. 5. The work site schedules regular breaks for physical activity (e.g., 5 minutes of each hour, 10 minutes of every two hours, or 15 minutes of every three hours) during meetings and events. 6. The work site provides programs or incentives to promote non-motorized/ active commutes to work (e.g., walking, biking, or use of public transportation). 7. The work site has written guidelines or rules or policies related to: 7.a. Flexible work/break time to engage in physical activity N/A ( group physical activity at meetings) V8 CHLI Tools Work Site Assessment 133

9 C. PHySiCAL ACTiviTy opportunities (ConTinUeD) 7.b. Active meeting options and regular breaks for physical activity during meetings and events Rate your confidence in your answers for this section: Very high High Medium Low Very low D. PHySiCAL environment ReLATeD To PHySiCAL ACTiviTy 1. The work site provides facilities that promote physical activity, such as a changing room and/or locker rooms with showers accessible to all employees. 2. The work site provides workout facilities with exercise equipment (or provides access to workout facilities through a subsidized or discounted membership): 2.a. To the employees 2.b. To the employees family members 3. The work site has a safe area outside for exercise (e.g., trails, walking paths, sidewalks)., offered free, offered free 4. The work site has stairwells. if you chose yes in question 4, answer questions 4.a and 4.b. if you chose in or no, skip to question 5. 4.a. The stairwells are easy to find, attractive, safe, clean, and accessible (e.g., with light, color, decoration, and safe surfaces). 4.b. The use of stairs as an alternative to elevators is promoted (e.g., signage to promote stairwell use). 5. Secure bicycle parking is available for employees. Rate your confidence in your answers for this section: Everywhere/ everywhere, available and secure Very high High, offered fee-based or discounted, offered fee-based or discounted the places Available but not secure Medium Some places Low, not offered, not offered nowhere, not available Very low 134 Work Site Assessment CHLI Tools V8

10 e. HeALTHy eating opportunities 1. Work site outlets (e.g., cafeterias, snack bars, vending options, and/or service) provide healthy eating opportunities to employees in the following ways: 1.a. Offering a wide variety of healthy options on a daily basis, including: Vegetables and fruits Whole-grain s Low-fat dairy (e.g., fat-free or low-fat yogurt or cheese) N/A ( Low-fat protein items (e.g., lean meat sandwiches, broiled or baked meats, or fish) Low-sodium items Items containing little or no sugar Food items free of trans fat 1.b. Offering healthy beverage options on a daily basis (e.g., water, 100 percent vegetable/fruit juice) N/A ( 1.c. Offering regular moderate serving sizes (i.e., no super size portions) N/A ( 1.d. Serving any high-fat sauces, salad dressings, gravies, or condiments on the side or offering reduced-fat versions N/A ( 1.e. Using healthy preparation practices in the cafeteria (e.g., steaming, using low-fat and low-salt ingredients, limited frying) for the majority of menu items N/A ( cafeteria) 2. The work site has written guidelines or rules or policies related to the following: 2.a. Offering healthy options (listed in E.1.a) on-site through the cafeteria, snack bar, vending machines, and/or service N/A ( 2.b. Offering healthy beverage options (listed in E.1.b) on-site through the cafeteria, snack bar, vending machines, and/or service N/A ( 2.c. Providing moderate serving sizes (e.g., no super size portions) N/A ( V8 CHLI Tools Work Site Assessment 135

11 e. HeALTHy eating opportunities (ConTinUeD) 2.d. Employing healthy preparation practices in the cafeteria (e.g., steaming, limited frying) 2.e. Providing healthy and beverage choices at companysponsored meetings/events 3. Primarily healthy and beverage choices (described above in E.1.a and E.1.b) are provided at companysponsored meetings/events. Rate your confidence in your answers for this section: Very high High Medium Low Very low N/A ( cafeteria) F. PHySiCAL environment ReLATeD To FooD/nUTRiTion 1. The work site promotes consumption of healthy s and beverages that are rich in vegetables, fruits, and whole grains and low in fat, sodium, and added sugars at work site outlets (e.g., cafeterias, snack bars, vending machines, and/or service) in the following ways: 1.a. Providing specific labeling to identify healthy options, such as low-fat s te: Labeling refers to messages that have been placed on or near prepared s or vending machines, not the messages the manufacturer prints on the item itself. 1.b. Providing nutrition information for served on-site (e.g., service provides nutrition listings that are placed on tables or in the serving area) 1.c. Providing preferred placement (e.g., appears sooner in line or in more prominent positions) and signage that promotes healthier and beverages 1.d. Providing price incentives (e.g., lower prices) for the purchase of healthier and beverage items 2. The work site has written guidelines or rules or policies related to: 2.a. Identifying/labeling healthy and beverage options available at the work site (e.g., low fat) N/A ( N/A ( N/A ( N/A ( N/A ( 136 Work Site Assessment CHLI Tools V8

12 F. PHySiCAL environment ReLATeD To FooD/nUTRiTion (ConTinUeD) 2.b. Providing nutrition information for served in work site outlets 2.c. Providing price incentives for healthier and beverage options in work site outlets 2.d. Providing preferred placement and signage to promote healthier and beverage options in work site outlets 2.e. Providing nutrition information for /meals served at events 3. The work site provides nutrition information for /meals served at events. 4. The work site provides access to a kitchen area with a refrigerator and a sink to enable safe and hygienic handling of healthy. 5. The work site offers an on-site garden or farmers market. 6. The work site offers a clean, private space, with an electrical outlet, for employees to pump/express breast milk or breastfeed babies. Rate your confidence in your answers for this section: Very high High Medium Low Very low N/A ( N/A ( N/A ( N/A ( / meals served at events) N/A ( / meals served at events) V8 CHLI Tools Work Site Assessment 137

13 YMCA 2014 WORKPLACE WELLNESS AWARDS Please submit at least one paragraph that shares successful ideas and programs that your workplace has incorporated to contribute towards an overall successful and unique wellness program. Also include any pictures that depict employees taking part in your wellness programs and events. The information shared will be highlighted at the awards presentation and/or included in the slideshow presentation. Please submit photos via to in JPEG format (.jpg).