'Unsick Day' proposal would boost paid leave time for preventative care vists for city staff [The New Hampshire Union Leader, Manchester]

Apr. 1—Could "Unsick Days" hours keep Manchester's municipal workers healthy — and lower the city's health care costs?

Officials are proposing an ordinance change that would give full-time city staff additional paid leave time for wellness visits, in hopes of spurring employees to seek more preventive care — and potentially reduce the city's health care costs.

In his fiscal year 2025 budget address last week, Manchester Mayor Jay Ruais said his staff projects a $1.4 million overrun in health care costs this year. The Queen City is not alone, with surrounding communities like Bedford facing an 18% increase in costs, and Londonderry reporting a 19.3% spike.

The city's health care plans cover approximately 2,817 employees per month, data shows. Through December 2023, Manchester spent a total of $12.7 million on health care costs. Twenty percent, or $2.6 million, has been spent on less than 1% of the people covered, Ruais said.

In a memo to aldermen on the Human Resources and Insurance Committee, city Human Resources Director Lisa Drabik wrote that staff has been working with the city's benefits consultant and health care partners to brainstorm ways of simultaneously promoting employee health and well-being and reducing health care costs.

The research, Drabik wrote, suggests there may be something to the adage that "an ounce of prevention is worth a pound of cure."

With support from Ruais, Drabik recommends a revision of the current City Sick Leave Ordinance (33.081) to provide effective permanent employees (not temporary or seasonal) one day of additional paid leave time to be used each fiscal year, beginning July 1, for preventive health care appointments.

"This will allow an employee to identify a health issue earlier, potentially saving their life, while also reducing the financial burden that health conditions inevitably cost when caught at later stages," Ruais said in his budget address. "We will realize a healthier workforce and reduce spending on health care as well as replacement costs for sick employees who are absent."

According to Drabik, the benefits of incentivizing annual physicals and preventive cancer screenings are many, including catching serious health care problems sooner, which can lead to better health outcomes and reduced health care costs in the long run.

Cancer diagnoses

"Unfortunately, there are a number of current cancer diagnoses in the city's covered health pool," Drabik wrote. "The costs of preventative cancer screenings (such as a colonoscopy or mammogram), which may catch cancer in early stages, are far lower than the costs of providing treatment to cancers caught much later."

The health outcomes are much better, too, Drabik wrote. In addition to cancers, screenings can diagnose conditions like high blood pressure, elevated blood sugar and depression, which could lead to future health problems.

"Healthy employees are, of course, happier and more productive," Drabik wrote. "When workers are healthier they are also more engaged, absent from work less often, and less likely to leave or to retire early because of illness — all of which results in lower costs to the city."

The new ordinance also could help with employee retention and recruitment, Drabik said.

Claims doubled

In Manchester, from November 2022 through December 2023, about 55% of covered employees had an annual physical exam, and just under 20% underwent a preventive cancer exam, such as a mammogram, colonoscopy, cervical or prostate screening.

Over the same time frame, the city's medical expenses related to cancer claims more than doubled, from $1.84 million between November 2021 and December 2022, to $4.08 million between November 2022 and December 2023, Drabik reported.

The city's ordinance allows sick leave to be used for absences for an employee's own illness or injury, or that of a spouse, child or other blood relative or ward residing in the same household.

The ordinance does not specify use for preventive care.

"In addition, many employees likely elect not to use sick time for preventive care appointments given such use of sick time may prevent them from earning personal days under certain provisions of union contracts," Drabik reported.

Providing additional leave for employees to attend preventative health care appointments doesn't cost any extra money, Drabik says, because the city already has budgeted to pay the employee for that time.

"In sum, by providing a reasonable amount of additional leave hours for preventative health care appointments, the city can likely realize a healthier workforce and reduce spending on healthcare as well as replacement costs for sick employees who are absent," including recruitment and training costs for new employees, Drabik wrote.

The city's Human Resources and Insurance Committee is scheduled to take up the proposed ordinance change tonight at 6 p.m. at City Hall.

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