CHICAGO — Chicago Public Schools teachers find their blood pressure rising over a new health plan this year that imposes mandatory fines when city employees fail to meet deadlines for wellness screenings, among other requirements.
Yet after the new rules were implemented, some 6,500 people in the plan failed to meet a Feb. 28 deadline to get a biometric screening to register their blood pressure, cholesterol, blood sugar, weight and body-mass index, or another deadline to complete an online well-being assessment.
"They're not happy at all," said Annette Rizzo, the union's health and benefits coordinator. "If you didn't do both, you were fined $60 a month, and it's $30 a paycheck, and that's per spouse."
In families where neither spouse complied in time, that meant a hit of $120 a month. And, once imposed, Rizzo added, the fines continue until the open-enrollment period the next year.
But a spokesman for Mayor Rahm Emanuel said the program, which is also used by another 37,000 city employees, has "been very positive.
"It's a reasonable time commitment," spokesman Tom Alexander said. "People have seen a lot of benefits with it. We've had very few people drop out of the program."
Rizzo was quick to say the ambitions of the wellness program — which sets out to keep people healthy rather than pay for chronic illnesses that develop over time — are admirable and helpful to many members. She said only about a quarter of union members and their spouses even registered a primary-care physician in past plans, where as 84 percent have dones so as part of Chicago Lives Healthy.
"That may be forced participation, but we feel many of these members never get biometrics done for years," she said. "Those are good statistics to be aware of, for your own health.
"Most people, once they're in the program, like the program," Rizzo said. "The problems we have had are not with the program, but with the implementation of the program. The teachers didn't have a clear-cut understanding of the deadlines and exactly what they meant."
No doubt that was due in part to the rancor and suspicion that have characterized relations between the union and CPS — going back well beyond last year's teacher strike. And Rizzo said teachers were also leery about the administrating company, Healthways, possibly sharing confidential information with CPS.
Yet there are strict federal regulations on medical privacy that also apply to wellness programs, and Alexander emphasized the city's commitment to that, saying, "Patient privacy is extremely important."
Another problem, however, is that there are two prevailing trends in wellness, the carrot and the stick: to offer incentives for beneficial behavior, or punishments for bad behavior in the form of fines or increased premiums, for instance, for smokers.
The Vitality Group, for example, a program that originated in South Africa and has its U.S. base of operations in Chicago, allows rewards for those who actively engage in it, but also tends to cost employers more than programs that impose punishments — no doubt an economic concern for the Emanuel administration.
Rizzo said the union argued for a more incentive-based program.
"That was our desire," she added. Yet the union accepted Chicago Lives Healthy as part of other compromises that limited the percentage of health-care costs and co-pays.
"We thought the economic exchange was worth it for the wellness program," she said. Rizzo added that the union also negotiated concessions on smoking cessation and weight loss that are usually part of the wellness program.
Alexander bristled at characterizing Chicago Lives Healthy as a punishment-based program, and Rizzo allowed that "this program will not penalize you for not meeting goals."
Yet those deadlines and the harsh fines are something the union continues to address, she said.
"We are working with them on implementation," Rizzo added. "But moving forward it will be our goal to try to restructure those penalties."