In 2000, Michael O’Donnell, editor of the American Journal of Health Promotion, and other leaders in the field of health promotion began discussion with health promotion experts, health promotion organizations, and more than 350 congressional offices to identify the most important needs of the health promotion community and to determine which of these needs could be addressed through federal policy.
Health Promotion Advocates was created in 2004 as a 501(c (4) non-profit advocacy organization in integrate health promotion concepts into national health policy in the United States. Its mission is to make health promotion an integral part of all elements of society, including workplaces, schools, clinical settings, families, neighborhoods, and local, state, and federal policy.
The work of Health Promotion Advocates is conducted by a volunteer board of directors, the members of three standing committees (communications, finance, and grassroots), state advocacy leaders, and about 2500 of grassroots advocates across the country. In addition, Health Promotion Advocates collaborates with a number of policy groups, trade associations, and educational organizations to develop, support, and pass legislation that contributes to the mission.
Health Promotion Advocates worked with members of Congress on legislation, which was introduced in Congress ten times between 2004 and 2009. This legislation included the HELP America Act (introduced in 2004, 2005, 2006, and 2007); Health Promotion Finding Integrated Research, Synthesis and Training Act (FIRST, introduced in 2004, 2005, 2007, and 2009); and the Healthy Workforce Act (introduced in 2007 and 2009).
Health Promotion Advocates members sent more than 11,000 letters to Congress in support of the health promotion provisions that were incorporated into the Affordable Care Act that was passed on March 23, 2010.
The Affordable Care Act includes six of the health promotion provisions which Health Promotion Advocates have been advocating for many years:
- Development of a national health promotion plan;
- Enhanced health promotion research;
- Technical assistance to enhance evaluation of workplace health promotion programs;
- Regular periodic surveys on the prevalence and components of workplace health promotion programs;
- Grants to pay a portion of the cost of comprehensive workplace health promotion programs for small employers; and
- Premium discounts of up to 30% for positive lifestyle practices or participation in health promotion programs.
On an ongoing basis the Board of Directors of Health Promotion Advocates monitors the health needs of the American people and the growth needs of the field of health promotion, and the advocacy efforts of other organizations, to identify advocacy efforts that will enhance the health of this country. Advocacy priorities for each Congressional session emerge from these analyses. The advocacy priorities for the 112th Congress (January 2010 – January 2012) are:
Health Promotion Advocates is working with several members of Congress to craft several pieces of legislation that may be introduced in late 2011 or early 2012.
Funding and Appropriations
Small Business Wellness Grants
The Patient Protection and Affordable Care Act (PPaACA) created the Small Business Wellness Grant (SBWG) program and authorized $200 million in funding for 2011-2015. $10 million in funding is announced on June 23, 2011 with a deadline for proposals by August 8, 2011. HPA will work to confirm the remaining $190 million in funding for 2012-2015.
Confirming funding for this legislation is important to Health Promotion Advocates for the several reasons:
- It is a direct extension of our work on Healthy Workforce Act, which Health Promotion Advocates developed with Senator Harkin. Much of the language for the grants was taken directly from Healthy Workforce Act.
- Wellness programs are rare in small businesses because most small business are not self insured, and the medical cost savings they produce through health promotion programs are passed on to their medical insurance carrier, not the small business, thus eliminating part of their financial incentive to create a program. SBWG will provide that financial incentive.
- We have already developed some champions for funding among members of Congress.
- We expect there will be broad support for this program in Congress and the public health community. “Small businesses” are one of the darlings of Congress and the public because they are the primary creator of new jobs and are a symbol of American individualism.
- Grassroots advocates can play a role in bringing visibility to this issue
Health Plan Premium Differential for Achieving Health Goal or Participating in Wellness Program
We are working with several employers groups to ensure that regulations written effectively to guide implementation of ‘SEC. 2705 42 U.S.C. 300gg-4. of PPaACA: Prohibiting Discrimination Against Individual Participants And Beneficiaries Based On Health Status. These provisions allow employers to offer workers a discount on health plan premiums for reaching a health goal or participating in a wellness program.
Working on these regulations is important to Health Promotion Advocates for the several reasons:
- These provisions have the potential to push participation rates in workplace wellness programs close to 100% among all employers who offer medical insurance coverage, and provide full funding for comprehensive health promotion programs.
- The American Heart Association and American Cancer Society are leading an effort to modify these regulations by adding onerous administrative reporting requirements, imposing large fines on employers who do not follow strict rules, and separating the financial incentive from achieving a health goal or participating in a program.
Family History Questions in Health Risk Assessments that Use Incentives
We are working with several employers groups to reverse the 2010 ruling that prohibit employers from giving workers financial incentives to complete health risk assessments (HRA) when the HRA has any questions about family history.
Working on these regulations is important to HPA for the several reasons:
- These regulations have reduced the effectiveness of almost every workplace wellness program in the nation, and adversely effect the work of most of our grassroots advocates.
- The regulations reduce the ability of employers to tailor programs to address the specific health needs of workers, and make it impossible for employers to know how to focus additional resources on engaging and helping workers who need the most help
- Providing financial incentives to complete HRA’s pushes participation rates from 20-40% to 70%-90%, allowing employers to engage almost the entire workforce in programs that improve health and wellbeing.
Health Promotion Advocates monitors the implementation of legislation at the agency level to insure that it is implemented as intended.