MEMO

To: Remington Sprague, Chief Medical Officer

From: Summer Pike, ENG 321 student at Ferris State University
Date: July 21, 2014
Subject: A Proposal Supporting Associate Health
Assignment Purpose:
The purpose of this assignment is to persuade the Mercy Health Senior Leadership Team to
support a proposed plan that will meet the need, as discussed in the previous recommendation
report, to hire a full time qualified registered nurse to support and re-develop the current
associate health program.
Problem Summary:
As we continue to evolve as an organization the importance of associate health management will
only become more pronounced. Moving forward, the Senior Leadership Team will need to
properly address the current situation that Mercy Health Muskegon is facing as it lacks a
comprehensive associate health program with the fundamental structure to support and manage
its employees, organization, and the community adequately.
Solution:
Areas like the Human Resource Department and Workplace Health have the potential to support
an associate health position based on the potential to recoup money that is currently being spent
on preventable cost services and warrant being looked into further. By implementing the
proposed phased plan for an associate health program MH can begin structuring the fundamental
building blocks for a comprehensive associate health program that could potentially increase
productivity while reducing healthcare cost. Also, as a more regional infrastructure develops and
future decisions surrounding associate health become more pronounced, the Senior Leadership
Team will have additional support to help make the best informed decision for the organization.

Contact Information:
Summer Pike
O19Summer@aol.com
231-744-5006

A Proposal Supporting Associate Health

Submitted by Summer Pike
Submitted to Remington Sprague, Chief Medical Officer
Mercy Health - Muskegon
July 21, 2014

Abstract
This proposal was prepared through various institutional references, personal
organizational communications, and my general experience and knowledge regarding associate
health and Mercy Health Muskegon to encourage the Mercy Health Senior Leadership Team to
support a proposed plan that will effectively meet the need, as discussed in the previous
recommendation report, to hire a qualified registered nurse to support and re-develop the current
associate health program.
As we continue to evolve as an organization the importance of associate health
management will only become more pronounced. Moving forward, the Senior Leadership Team
will need to properly address the current situation that Mercy Health Muskegon is facing as it
lacks a comprehensive associate health program with the fundamental structure to support and
manage its employees, organization, and the community adequately. Areas like the Human
Resource Department and Workplace Health have the potential to support an associate health
position based on the potential to recoup money that is currently being spent on preventable cost
services and warrant being looked into further. By implementing the proposed phased plan for an
associate health program MH can begin structuring the fundamental building blocks for a
comprehensive associate health program that could potentially increase productivity while
reducing healthcare cost. Also, as a more regional infrastructure develops and future decisions
surrounding associate health become more pronounced, the Senior Leadership Team will have
additional support to help make the best informed decision for the organization.

Overview
The American Association of Occupational Health Nurses (2014) stated, Poor employee
health costs business about $1 trillion annually, so business executives look to occupational and
environmental health nurses to maximize employee productivity and reduce costs through
lowered disability claims, fewer on-the-job injuries, and improved absentee rates (History
section, para. 2). In 2008, the only two hospitals in Muskegon, Michigan, Mercy Health Partners
and Hackley Hospital, merged forming Mercy Health Muskegon (MH). During the time of the
merger, both hospitals varied in practices surrounding associate health policies and procedures.
As the merger continued, the lack of structure and inconsistencies surrounding associate health
would become exacerbated, and the inability to properly support the well-being of MH
associates, the organization, and the community would become an unfavorable gap for Mercy
Health. Currently, Mercy Health Muskegon is lacking a comprehensive associate health
program with the fundamental structure to support and manage its employees, organization, and
the community adequately, due to a lack in ownership for associate health, which currently puts
the organization at risk to pay higher healthcare costs while also suffering from a decrease in
productivity. In the following plan, I will discuss background information, discussion
surrounding the current state including opportunities, a proposed plan supporting the
development of a comprehensive associate health program, resources recommended, and a
conclusion.
The information in the below section is taken from A Recommendation Report for Associate
Health submitted to Remington Sprague on July 14, 2014.
Background
During the merger, when hospital departments began to consolidate, associate health
would unquestionably and consequently be overlooked. Throughout my research, I was able to
identify some historically significant factors that would contribute to the lack of oversight
regarding associate health during the time of the merger. To explain why a gap within the
organization and associate health has occurred I will elaborate on the following contributory
causes: an organizational history that lacks departmental and managerial ownership for associate
health, overlooking of associate health during consolidation planning, and a lack in
communication that defined the new Mercy Health Workplace Health (WPH). Understanding
the background and reasons to why the current situation is presenting to MH is a vital component
to understanding the next steps, as well as identifying the organizations current state.
Ownership
A poor history of previous ownership by any one dedicated department in supporting
associate health would become extremely transparent as the merger progressed. Mercy Health
Partners would consist of approximately 2196 associates, and Hackley Hospital would consist of
approximately 1235 associates. Lori Kinder, Infection Control Practitioner for Mercy Health, in

Muskegon states, Prior to the merger Hackley associates would see Joanne Schwalm, Hackley
Infection Control Practitioner, for exposures and immune tracking or go to Workplace Health,
but there was never any structure. (Personal communication, June 18, 2014) She then goes on to
explain a similar scenario about Mercy Health Partners prior to the merger stating that Kirk
Atton, Infection Control Practitioner, minimally worked with associates regarding exposure and
immune tracking, and that the Human Resource department and the Occupational Health Clinic
kept all associate records. Associate health, has never been managed or been given ownership to
any one department, making it extremely difficult to support and manage.
Consolidation Planning
During strategy and other various merger discussions, an implementation plan was made
that separated associate healths three supporting structures: Workplace Health, Infection
Control, and Human Resources. The first of the three departments to merge within the new
Mercy Health platform would be Human Resources, beginning right away in 2008. Next, in
2010, Hackley Workplace Heath and Mercy Occupational Health would merge to form the
new Mercy Health Workplace Health. Finally, in 2012, the Infection Control department
would merge and join as one office, combining their policies and procedures. The varying levels
of priority and organization around the merger would contribute to the loss of attention
surrounding the future of associate health.
Workplace Health a New Endeavor
Shortly after the merger, the organization began its consolidation planning for Hackley
Workplace Health and Mercy Occupational Health departments, and unbeknownst to most there
was a much larger regional strategic plan would also be in the works. Soon, the newly
consolidated program, Mercy Workplace Health (WPH), would begin planning to serve as a
vendor to local West Michigan businesses, generating revenue by servicing the occupational and
environmental needs of the Grand Rapids and Muskegon workplace market, and specializing in
the treatment of work-related injuries. This type of endeavor would focus more on the
outsourcing of their services to local businesses, and less on a focus for servicing their own
internal workforce.
Discussion
Why Now?
As the Partnership for Prevention organization reports, in Healthy Workforce 2010 and
Beyond (2009), The new consensus is that current and future spending in employee health is not
only unsustainable, but also poses a significant threat to the overall competitiveness of American
businesses within the global marketplace (p. 2). Currently, according to Mike Weesies, Director
of Mercy Health Workplace Health in Muskegon, Mercy Health - Muskegon spends
approximately 8 million dollars per year on short term disability (STD) claims and

approximately $800,000 in workers compensation claims per year (Personal communication,

June 20, 2014). If we want to continue to evolve as an organization, the importance of associate
healthcare prevention and management within Mercy Health will need to be addressed. The fact
that we spend an enormous amount of money, 8 million dollars per year, in short term disability
claims without any rationale to substantiate the cost, is illogical and unsustainable. By providing
our associates with a comprehensive associate health program we will be able to improve our
productivity and reduce our own healthcare costs. Breedlove (2011) wrote a similar supporting
statement in an article for the Centers for Disease Control and Prevention stating,
When we invest in prevention, the benefits are broadly shared.
Individuals benefit: workers stay productive and healthyboth inside and outside
the workplace.
Businesses benefit: a healthier workforce reduces longterm healthcare costs,
increases stability and productivity, and improves global competitiveness.
Communities benefit: a community that offers a healthy, productive, stable
workforce is a more attractive place for families to live and for businesses to
locate.
Departments, such as Human Resources and Workplace Health, have the potential to
support an associate health position based on their potential to recoup the money that is currently
being spent on preventable cost services and warrant looking into further. For example, if Mercy
Health spends 8 million dollars per year in short term disability claims, and hires an Associate
Health Nurse, at $59,000 per year, to reduce those claims by 5% - 10% or $400,000 - $800,000
then, MH could get a 5% reduction rate on its healthcare expenses. So if MH pays 400 million in
salary expenses and 20% of that is for healthcare expenses (80 million), 5% of that is $4 million!
Cost savings isnt the only advantage to an Associate Health Program. Through
passionate dialogue Weesies and I were able to brainstorm some of the pros and cons an
Associate Health Program may present. Below is the list of possible opportunities that present a
low risk when considering the employment of an associate health nurse to develop a
comprehensive managed Associate Health Program.
PROS

Appropriate triage to Emergency Department, Urgent Care, and Primary Care.

An extension of Mercy Primary Care (rotating office)
Increase associate satisfaction (priority scheduling for our own associates, family
services, phone triage, immediate nurse visits, etc.)
Building of physician relationships through Patient Centered Medical Home
Build relationships/supports department/office managers.
Help increase/maintain capacity within the county as the shortage of primary care
providers increase.
Increase in-network referral opportunities.

Large decrease in healthcare cost/premiums (primary prevention, triage of appropriate

care)
Increase productivity on revenue already spent stewarding resources (supervised on the
job assignments vs. being at home, oversees the return to work process Family Medical
Leave Act and STD).
Potential big impact proposition low risk
Possible regional position for both Grand Rapids and Muskegon
Compliance with Joint Commission, Center for Medicare and Medicaid Services, HFAP,
or Michigan Occupational and Safety Health Administration standards.
CONS

Director/manager buy-in for a no charge for departments accepting transitional duty

associates.
Union bargaining issues
Department allocation and funding
Plan

With current regional strategic planning, a past history of poor associate health
ownership, current budgeting, and the remaining amount of research and planning that is still
needed to effectively support and sustain an Associate Health Program for MH, a draft business
plan for a phased approach was developed. The proposal consists of five phases to be
implemented over the next two years with a continued focus on a regional approach.
Phase 1 (~ 4-8 weeks): Senior Leadership Team (SLT) is to define departmental responsibility
for associate health, develop the organizational reporting structure, develop and approve an
associate health nurse job description (see Appendix), hire an associate health nurse, and define
measurable data to track the jobs return on investment.
*Phase 2 (~ 3-6 months): Associate health nurse is to begin new hire employee tracking of
immunizations (~600 new hires per year) and research and plan for the development of a
Regional Associate Health Program.
*Phase 3 (~ 3 months): Associate health nurse to continue with above duties and begin Family
Medical Leave Act (FMLA)/Short Term Disability (STD) reviews for clarification and
authentication.
*Phase 4 (~ 7 months): Associate health nurse to continue with above duties and begin
researching the current short term comprehensive disability process and present an update based
on previous defined measurable data to show the current return on investment.

*Phase 5 (~ 6 months): Associate health nurse to continue with above duties and begin
developing a proposal for an Associate Health Clinic and further resources.
*After Phase 1 is implemented, the associate health nurse will begin presenting monthly progress updates to the MH
Senior Leadership Team for review.

Resources
Cognizant of resources, regionalization discussions, and the remaining amount of
research and planning needed to support and manage an associate health program, the above plan
would consist of hiring one associate health nurse. The position of an Associate Health Nurse
will be a part-time position, approximately 32 hours per week at $35.00 to $38.00 per hour, or a
salary of $58,240.00 - $63,232.00 a year. Other contributing expenditures include: listing and
advertising the position ($100), payment of benefits for a part-time position at 32 hours per week
($12,000.00), and approximate money spent on hours needed for interviewing and hiring
($2000.00). The initial investment to hire an associate health nurse would cost the organization
approximately $72,340.00 - $77,332.00 the first year.
Conclusion
As we continue to evolve as an organization the importance of associate health
management will only become more pronounced. Moving forward, the Senior Leadership Team
will need to properly address the current situation Mercy Health Muskegon is facing as it lacks
a comprehensive associate health program with the fundamental structure to support and manage
its employees, organization, and the community adequately. Areas like the Human Resource
Department and Workplace Health have the potential to support an associate health position
based on the potential to recoup money that is currently being spent on preventable cost services
and warrant being looked into further. By implementing the proposed phased plan for an
associate health program MH can begin structuring the fundamental building blocks for a
comprehensive associate health program that could potentially increase productivity while
reducing healthcare cost. Also, as a more regional infrastructure develops and future decisions
surrounding associate health become more pronounced, the Senior Leadership Team will have
additional support to help make the best informed decision for the organization.

References
American Association of Occupational Health Nurses. (2014). Careers. Retrieved from
http://www.aaohn.org/careers/profession-of-occupational-environmental-health-nursing.html
Breedlove, B. (2011, May 16). Investing in Prevention Improves Productivity and Reduces
Employer Costs. Retrieved from: http://www.cdc.gov/policy/resources.html
Partnership for Prevention. (2009). Healthy Workforce 2010 and Beyond: An essential health
promotion sourcebook for both large and small employers. Retrieved from
http://www.prevent.org/Topics.aspx?eaID=1&topicID=52

Appendix

EXAMPLE: ASSOCIATE HEALTH NURSE

JOB DESCRIPTION
The position of Associate Health Nurse will be a part-time position, approx. 32 hours per week at
$35.00 to $38.00 per hour. This Associate Health Nurse will provide nursing services and first
aid to employees or persons, who become ill or injured on the premises of Mercy Health. The
chosen candidate will perform the following duties: research and plan for the development of a
Regional Associate Health Program, tracking of new hire immunizations, perform Family
Medical Leave Act (FMLA)/Short Term Disability (STD) reviews for clarification and
authentication, research the current short term comprehensive disability process, perform
presentations as needed to SLT, support in the development and proposal for an Associate Health
Clinic, evaluate physical condition of associates and contact physicians and hospitals to arrange
further medical treatment, when needed, and assist the physician with associate medical
examinations.

JOB REQUIREMENTS
REQUIRED: RN or Nursing Diploma, current license in state of Michigan, MUST HAVE
experience in Associate Health or related field.

JOB SNAPSHOT
Base Pay $53,000.00 - $60,000.00 /Year
Other Pay Benefits
Employment Type Part-Time
Job Type Nurse, Health Care
Education 4 Year Degree
Experience At least 1 year(s)
Manages Others Not Specified
Industry Healthcare - Health Services
Required Travel Not Specified