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Keeping Fit Behind the Wheel
Public transportation is not immune to the high costs associated with preventable diseases. Ten
years ago, Capital Metro experienced health care cost increases of 15-25% per year. They
responded quickly by enacting an innovative, holistic, technology-based Employee Wellness
Program aimed at improving employee health and reducing absenteeism while increasing
employee morale and safety awareness. The Program enabled Capital Metro to protect scarce
resources and focus on their core mission - providing quality public transportation for the greater
Austin area. Since its inception, the Program has received local, state and national recognition
for effective and innovative techniques to improve employee health and lower costs.
The Program was initially designed in 2003 to address the specific cost drivers of the
Authorities’ health care claims. Now, after ten years since implementation, the program has
surpassed all expectations, and resulted in millions of dollars in savings on projected health care
costs and lost productivity. Although healthcare and absenteeism costs have continued to rise
around the country, the Program has helped save Capital Metro approximately $4,568,167 year-
over-year and over $27 million versus the national average over the past 7 years, resulting in an
average return of $3.30 for every $1 invested. In 2013, 54% of the eligible population was
considered a “unique” participant, meaning more than half of the entire workforce was actively
engaged in one or more wellness led programs or activities.
Recognition and Awards
The Program’s potential was immediately recognized by the Centers for Disease Control (CDC)
which chose to lend support in a variety of ways, including financially, by offering a five-year
grant and assisting with further development of the program. Capital Metro’s insight into the
needs and backgrounds of its employees, along with the CDC’s expertise in effective health
improvement strategies, combined to create a cost-saving plan specifically tailored to its
workforce and the issues facing the transit work environment. The CDC chose to partner with
Capital Metro in part due to the demographics of its workforce - predominantly African American
and Hispanic employees – two groups who are more prone to obesity, high blood pressure and
heart disease more than other ethnic groups. With obesity rates 35.6% and 36.7%, respectively,
these two groups are at an increased risk of incurring greater health care and absenteeism
costs as well as poor health outcomes.
Over the years, Capital Metro has collaborated with numerous health, safety and risk
management organizations to create a culture of wellness that has been recognized locally and
nationally for its efforts to address the costs and dangers associated with preventable diseases
and low employee morale. Since its inception, the Wellness Program has been awarded with
more than $440,000 in grants and received recognition from such organizations as World at
Work magazine, PBS, the Texas Department of State Health Services, the Center for State and
Local Government, Passenger Transport Magazine, Austin Fit Magazine, Fox News, the City of
Austin and the Mayor’s Health and Fitness Council. In 2010, Texas State Comptroller Susan
Combs applauded Capital Metro for their efforts to combat obesity through workplace wellness
programs in her report “Gaining Costs, Losing Time: The Obesity Crisis in Texas.”
Capital Metro views awards as a measure of program success and peer recognition. We
received PRIMA Risk Management achievement award in 2006 and the Worklife Achievement
award in 2007. In 2012, Capital Metro was chosen as “Central Texas’ Healthiest Employer” by
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the Austin Business Journal and awarded the gold “Fit-Friendly” worksite award by the
American Heart Association. In 2013, Capital Metro was awarded the Texas Mother Friendly
award for their lactation policy as well as the Mayor’s Health and Fitness Council’s Gold
Membership Award for their dedication to comprehensive and innovative wellness programming.
Combining industry recognition and awards with a proven return on investment (ROI), Capital
Metro has consistently led the transportation industry for employee health program innovation
and has made it their mission to share these techniques with other transit agencies. The Transit
Cooperative Research Program has spent the last two years completing a research study on
Capital Metro’s Wellness Program for distribution to every transit agency in the country in 2014.
Examining the Need for Quality Wellness Programming
During the past 20 years, there has been a dramatic increase in obesity in the United States and
rates remain high. More than one-third of U.S. adults (35.7%) are obese, and the obesity rate in
Texas has more than doubled in the last two decades. In 2011, 67% were overweight and 31%
obese. In 2012, Texas claimed two of the top ten most obese cities in the United States. Next
year, Texas could face up to $15.6 billion in health care costs and lost productivity. This plague
promises to shorten U.S. life expectancy for the first time since the Civil War.
Diabetes, hypertension, sleep apnea, cancer, stroke, among other chronic conditions, require
treatments that routinely cost hundreds of thousands of dollars. These illnesses often lead to
steep decreases in productivity and in many cases prevent an operator from securing or
renewing a commercial driver’s license. In 2010, approximately 34% of Capital Metro bus
operator applicants were unable to obtain the standard medical certification of two years
required for obtaining a commercial license. Of these applicants, at least 98% had previous
transit experience, further highlighting the need for transit companies to offer their employees
opportunities to improve their health in order to obtain work and stay employed.
To combat this trend, the Wellness Department designed a DOT Preparation Program to help
operators and mechanics work to obtain the medical clearance card required to keep their
commercial license in good standing. Participants in the program meet with a Health Fitness
Specialist at least three months before their exam, and are administered the same biometric
exam required by the Department of Transportation. Participants who receive test results
outside the healthy range are given nutrition and exercise prescription and monitored throughout
the course of the program to ensure they receive at least a one year card. Employees and
contractors that do not pass are subject to deferment, resulting in an average loss of 29.5 days
of productivity as well as thousands of dollars in retesting fees. These specific, employee need-
based programs helped Capital Metro save $300,000-$600,000 in costs associated with
absenteeism.
A Holistic Approach to Employee Health
The Capital Metro Employee Wellness Program was designed to address key aspects of
employee health - physical activity, nutrition, safety, weight management, stress reduction
strategies and tobacco cessation.
The foundation of Capital Metro’s Wellness Program are four 24-hour onsite wellness
centers, each staffed with a full time Health Fitness Specialist to provide free personal training,
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individual exercise program design, and group fitness classes. Before the fitness centers were
established, many operators chose to spend their long shift breaks watching television,
sleeping, or playing board games. Now, those same operators and mechanics commit to being
physically active during their breaks.
Social influence is a major factor when keeping employees on track to meet their fitness goals.
Each month, the program chooses a “wellness champion.” This person has shown unmatched
dedication to their own personal fitness as well as the ability to encourage others around them
to be fit. A flyer and picture containing their accomplishments and future goals is distributed
company-wide via email and framed versions hangs in the wellness center foyer and lobby
trophy case.
Most recently, Capital Metro approved a household member policy to allow family members to
participate in personal trainer-led workouts, fitness classes and wellness challenges. This
program was put in place to enhance the social aspect of progressive behavior change, allowing
families to exercise together.
Capital Metro recognizes that healthy employees are safe employees. The Wellness Team
works closely with the Safety Department to design and implement programs specifically
tailored to the needs of each department. Presentations at safety meetings, safety-themed
wellness challenges and free CPR/AED classes are integrated into wellness operations.
Bringing Wellness to Work
Many transit employees face numerous time constraints, such as changing schedules and
extended location layovers. Those unable to make it to the wellness center can participate in
group stretch breaks, exercise band classes, biometric screenings, and walking groups
led by wellness team members several times throughout the day. The wellness team developed
a series of home exercise program brochures for distribution as well as a “stretching on the
bus” video to be broadcast on break room televisions.
To promote physical activity and healthy competition, employees, as well as household
members, participate in a number of educational, guided wellness challenges designed by the
wellness team and offered several times throughout the year. Prizes such as bicycles, exercise
equipment and fitness video-gaming systems are awarded to winners based on participation
and program completion.
Wellness offers on-site health fairs, cholesterol and blood glucose screenings, vision and
hearing checkups, mammograms and stroke scans. Often, these screenings can be life-saving.
John Hodges, Capital Metro Vice President of Capital Projects and Real Estate, credits his on-
site stroke scan with saving his life. The scan revealed an occluded left internal carotid artery.
Further testing discovered that three heart arteries were more than 70% occluded. Mr. Hodges
underwent a surgical procedure to address his issue and was able to avoid a heart attack.
It is imperative to “think outside the bus” when inviting local businesses to lead employee
wellness discussions. A diverse group of speakers have been hosted over the years on topics
such as heart disease and women, underage drinking prevention, acupuncture, farm-to-work
programs, diabetes management and sleep apnea.
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Integrating Healthy Food Choices
Recognizing nutrition as an integral part of employee health strategies, Capital Metro employed
a Registered Dietician to provide employees with the tools to make healthy food choices.
Employees have the opportunity to meet with the Dietician for individual counseling sessions or
in a group setting, such as weekly weight management classes, monthly lunch and learns
and healthy cooking demonstrations.
To help make healthy food readily available, the Dietician partnered with the employee cafeteria
to design and implement a healthy options menu and coupon program, which gives
employees the opportunity to purchase foods lower in calories, fat and sodium at a reduced
cost. In addition, the Dietician worked closely with the vending contractor to adopt a healthy
vending program, making healthier food options more abundant at a lower cost. Employees
unable to eat in the cafeteria can stop by Wellness to pick up a map designating all restaurants
in a five-mile radius that offer healthier options.
Stress and Mental Health
Stress and mental health are silent contributors to the high costs of absenteeism and health
care. Many transit employees are often forced to deal with personal issues on and off the job,
many of which can be dealt with if detected early enough. For individuals seeking counseling,
Capital Metro provides an employee assistance program. This program provides counseling
free of charge for a wide array of concerns such as, but not limited to, job performance, anger
management, marital issues, parenting support, depression and anxiety, substance abuse,
bereavement, legal and financial issues, as well as elder care resources.
Reducing stress has a considerable influence on productivity. Daily stress triggers operators
face - traffic jams, road construction, unruly customers and schedule change - often have a
negative effect on transit workers. To help combat these stresses, Wellness initiated bicycle
loan and chair massage programs. Four bikes are available for check out and ridden on
designated bike trails around a nearby lake, taking in the serenity and relaxation only nature can
offer. Two days per week, massage therapists are on site to provide massage services at a
discounted rate.
Tobacco Use
Tobacco is the leading cause of preventable death in Travis County. According to Dr. Phillip
Huang, Medical Director for Austin/Travis County Health and Human Services Department,
“tobacco, kills more people annually than AIDS, crack, heroin, cocaine, alcohol, car accidents,
fire, murder and suicides combined and it’s entirely preventable.”
Capital Metro recognizes that tobacco use is not only the leading cause of preventable death in
Texas, but workers in blue collar and service occupations use tobacco at higher rates than
workers in professional occupations. According to the American Journal of Industrial Medicine,
the transportation industry’s 46% smoking rate is higher than any other industry. With this
knowledge, an employee tobacco coalition was formed to assist with policy changes and
strategies to help employees quit and stay tobacco free.
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Capital Metro is dedicated to helping employees quit tobacco use. The employee health plan
offers 100% cost coverage for all forms of nicotine replacement therapy, and the Wellness
Department offers “Freedom from Smoking” classes for employees, household members and
the community free of charge several times throughout the year. Employees who stop using
tobacco are eligible for a cash incentive of $250 per year for five years.
Capital Metro is the industry leader in eliminating tobacco use from the workplace and transit
facilities. In 2012, Capital Metro extended their commitment to passenger health by requiring all
transit facilities become tobacco free. In 2013, Capital Metro approved a 100% tobacco-free
campus policy eliminating tobacco use from all leased or owned Capital Metro properties and
vehicles. In addition, the Authority implemented a ground breaking tobacco free policy at all bus
stops and park and rides aimed at improving health and creating a better riding experience for
our passengers. These initiatives led to over $300,000 in grants, as well as successful
partnerships with organizations such the Austin Tobacco Prevention and Control Coalition,
Texas Medical Association, Austin/Travis County Health and Human Services Department,
LIVESTRONG, Seton Asthma Center and the American Lung Association. In 2013, thanks to
changes and improvements to their tobacco policies, Capital Metro was awarded the CEO
Cancer Gold Standard award.
Technology and Wellness - a Fundamental Partnership
Even in the early years, Capital Metro made a commitment to use technology as the foundation
of the program in order to measure, track and record the progress of employee health. The
program was initially based around the Tri-Fit Polar Body Assessment System, which
provides a full biometric body assessment as well as exercise prescriptions and nutrition
recommendations. Heart rate monitor watches designed to coordinate with the system were
issued to participating employees to record workout duration, calories burned and track heart
rate zones. Data from the watches are downloaded into the Tri-Fit to record improvement.
Employees are re-tested every three months to monitor changes in their health.
Many operators are required to stay near the dispatch center for awareness of route updates
and schedule changes. For those employees, wellness staff members perform biometric
assessments in the driver’s ready room that measure and track weight, blood pressure and BMI.
Employees not within the healthy range are provided with coaching on potential health risks
associated with high levels of each category.
To help get employees up and moving while waiting for their work assignments, a program
named Get Up and Kinect was developed. A 42” LCD television and XBOX Kinect gaming
system was installed on a portable media cart and placed in the driver’s ready room to provide
hours of active-based sports and activity games to provide hours of friendly competition and
physical activity.
In 2012, Capital Metro was awarded a $250,000 grant from the American Recovery
and Reinvestment Act for spearheading a movement that combines technology,
cost savings and a commitment to reduce second hand smoke. This federal grant
paid for the design and manufacturing of new signs advising passengers of the
aforementioned tobacco free passenger transit facilities as well as QR codes. A QR
code is a type of barcode programmed with information that a camera-enabled smart
phone can read (see example, right). This technology will replace the long time
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method of using paper to update bus and rail schedule changes, saving Capital Metro hundreds
of thousands of dollars in labor costs and printing materials. Most importantly, this new system
will allow Capital Metro to update passengers with information, promotions and arrival and
departure times, eliminating a large percentage of customer complaints. Initially designed to
reduce tobacco use, this program led to increased customer satisfaction while lowering
marketing overhead.
Measuring the Success of Wellness
The success of the Wellness Program can be linked to several key factors, the most important
being employee feedback. The Wellness Team consistently seeks information from participants
and non-participants alike to help decide which programs are offered and when, in order to
accommodate a wide variety of fitness levels and ever-changing schedules that face
transportation industry workers today. In addition to employee feedback, the wellness team
consists of degreed and certified Health Fitness Specialists, employed by MediFit Corporate
Services, Inc., a national wellness contractor, that specializes in employee health and wellness
programming, injury prevention, special populations training and industry best practices for
employee health.
A major area of importance linked to the success of Capital Metro’s Wellness Program was the
decision to offer personal training and nutrition counseling free of charge. By working with a
Personal Trainer and Dietician, free of financial barriers, participants have the ability to complete
individually designed fitness and nutrition programs with the ongoing support and accountability
required to successfully adopt a healthy lifestyle.
Most importantly, Capital Metro discovered that each of the four wellness centers comes to
represent a positive sanctuary where employees from every department can come together to
share common goals - being physically active, relieving stress and taking a break from the
challenges associated with managing, operating and repairing public transportation. On any
given day, you might hear members of the cleaning crew encouraging department managers to
push hard and finish their final exercises, or union members, contractors and senior leaders
sweating it out in a fitness class together. Success is often measured in dollars and cents, but
breaking down departmental barriers and increasing employee morale are daily, understated
victories.
By looking beyond standard budget-cutting efforts proposed by many agencies, Capital Metro
has established an award-winning, nationally recognized program that serves as a model for
transportation companies looking to improve the physical, mental and emotional health of their
staff. In the past year, we have moved to a contracted labor business model, and insured the
future sustainability of the program by requiring our major contractors to contribute financially to
the wellness program on a per-employee basis.
The future of employee wellness and preventative care is now. By continuing to expand the
wellness program to not only employees and contractors, but household members and the
community as well, we will build upon a dream that Capital Metro can lay claim to be the
originator of one of the most comprehensive and successful transportation wellness programs in
the country.
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Supporting Documentation
The impact and success of Capital Metro’s Wellness Program has been the subject of
numerous print and electronic articles;
“Local public health departments do not traditionally engage in wellness program partnerships
with employers in the community. This is an innovative approach to a common issue for local
public health departments and employers; engaging the workforce in healthy behaviors. Also,
the program staff feels that the use of the assessments at a particular worksite is an outside-the-
box use of a traditional public health tool. The entire practice is one that can be easily replicated
and has proven successful.”
Author unknown. “Reducing Health Care Costs Through Worksite Wellness Programs in
Targeted, Intervention Areas - Capital Metro.” National Association of County and City
Health Officials, 2007.
“Since its beginning in 2003, the wellness program at Capital Metro has shown promising results
in improving employee health and reducing costs associated with health care and absenteeism.
Employees engage in more physical activity, have better knowledge of disease management
(diabetes and asthma), have better eating habits, and smoke less than they did before the
program was implemented. Health care and absenteeism costs have been reduced and are
continuing to decline, most likely as a result of the program. Managerial staff has reported that
employee morale has increased since the program was implemented. Most importantly,
however, we believe that the wellness program has the potential to reduce the prevalence and
severity of chronic diseases, allowing Capital Metro employees to lead longer, healthier lives.”
Davis, Lynn. “A Comprehensive Worksite Wellness Program in Austin, Texas:
Partnership Between Steps to a Healthier Austin and Capital Metropolitan Transportation
Authority.” Centers for Disease Control. 2009.
“A study released in April 2009 found that Capital Metro’s employee health care costs were
reduced dramatically as a result of this program. Starting in 2003 when the wellness program
was launched, until 2006, Capital Metro’s health care costs continued to increase each year, but
at smaller rates each succeeding year and far below the national average. In 2007, when
participation in the program grew dramatically, Capital Metro saw a 4 percent decrease in total
health care costs.
Similarly, rates of absenteeism among bus drivers remained stable at approximately 10 percent
from 2001 through 2005. Rates declined to 8.2 percent in 2006 and declined again to 7.6
percent in 2007, which represented a total savings of $450,000 compared with the cost of the
10.1 percent absenteeism rate in 2004.”
Author Unknown. “Employee and Community Wellness Programs in Austin, Texas.”
Centers for State and Local Government Excellence, 2009.
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“With some 64 percent of Capital Metro employees taking advantage of these healthful living
options, it’s no wonder this fit business has seen employee health costs decrease. Fit business
pays off at Cap Metro!”
Nyfeler, Leah. “Austin's Fit Businesses.” Austin Fit Magazine, 2012.
“It’s an investment that pays big dividends, not the least of which is addressing some of the
chronic health-related issues associated with public transit employment, including obesity.
These ailments often exact a heavy toll in human cost and financial expense (sometimes
hundreds of thousands of dollars), have a detrimental effect on health insurance claims, and
drive up the costs associated with absenteeism and lost productivity. In many cases, they can
prevent an operator from securing or renewing a commercial driver’s license.”
Andrews, Nigel. “The Human Element: Technology and Wellness in Austin, TX”
Passenger Transport Magazine, 2013
“The Capital Metropolitan Transportation Authority (Capital Metro) in Austin, TX, recently
received the CEO Cancer Gold Standard Award from the CEO Roundtable on Cancer,
recognizing the agency’s commitment to the health of its employees, contractors, and their
families. The honor primarily goes to healthcare and pharmaceutical companies. Capital Metro
is unique as a public transit agency to receive recognition.”
Andrews, Nigel. “Capital Metro Honored for Commitment to Wellness Efforts.” Passenger
Transport Magazine, 2013.
“While health care and absenteeism costs have continued to rise around the country, the
Wellness Program has helped save Capital Metro substantially in health care costs and lost
productivity over the past 10 years.”
Author unknown. “Capital Metro (Austin, TX) Cuts Costs and Boosts Wellness.” Centers
for State and Local Government, 2013.
