Wednesday, August 21, 2013

The Wellness Wars at Penn State--Is the Institutional Faculty Splintering?

I have been following the quite heated controversy over Penn State's new wellness program.  Like the Sandusky scandal of 2011, the scandal generated by the roll out of this eugenics program for faculty and staff will have consequences far beyond what would have been an eminently repairable gaff in program implementation (e.g., Susan Berry, Penn State Employees Protest Wellness Mandate over Privacy Concerns, Breitbart, Aug., 21, 2013 (tying wellness efforts to repercussions from Obamacare); Tom Emerick and Al Lewis, The Danger of Wellness Programs: Don't Become the Next Penn State, Harvard Business Review, Aug. 20, 2013 (managerial failures)).  

(Pix (c) Larry Catá Backer 2013)

Beyond the obvious errors one could chronicle relating to the management of the program's roll out (a program the general approach of which was inevitable though not in the form eventually adopted and defended in every detail) through the well known but substantially ignored channels for engagement and participation at the university, the regrettable choices of some in appearing by their choices and actions to make the resulting controversy personal and the strategic missteps in responding to what should have been expected reactions, and the appearance of an unwillingness to reach out in a well focused way to key stakeholders,  it might be argued that some of those charged with the imposition of this program have effectively played into the hands of any number of actors who might seek to use these managerial failures as a way of opening opportunities that will have an impact far more substantial than the benefit program changes that would have been relatively easy to procure acceptance with the right touch. But all of that is water under the bridge.  All actors have staked out their positions and it is now merely a matter of following this aggregated set of strategic calculations, and the choices that followed, to their conclusion.   

This post considers an important though overlooked consequence--the University Faculty Senate's responses in the face of sustained faculty anger and frustration (however misdirected or wrong) has produced one result already, the fracture of faculty cohesion institutionally represented by its University Faculty Senate.  The Faculty Senate may be losing coherence; more worrisome, it may be losing relevance to faculty interested in protecting their interests within the political structures of the university.  The University Faculty Senate may have taken an inadvertent  step toward its transformation into a form of employer union and low level administrative body within the university's management structures.  Most important, it is possible that the pace and form of its response might well have paved the way for something that would have been improbable even six months ago--the establishment of a potentially significant new faculty representative organization (and competitor for faculty loyalty and support) at the university, the American Association of University Professors.  It is far too early to tell whether or to what extent the AAUP chapter will be able to displace or supplement the University Faculty Senate, but its establishment suggests that even the University Faculty Senate is accountable to its members and that members will use what power they have to either work within the organization or if thwarted to seek representation elsewhere. As a former Chair of the University Faculty Senate I view this as regrettable. As a member of the faculty and an AAUP member I can only hope that this new chapter will represent its constituents and the rest of the faculty with honor, sympathy and restraint.    



This on the formation of an AAUP chapter at Penn State: 

Penn State Faculty Form AAUP Chapter
Inside Higher Education
August 21, 2013

Citing concerns about shared governance, faculty members at Pennsylvania State University have formed an advocacy chapter of the American Association of University Professors. The association has two kinds of chapters: advocacy, for non-unionized faculty, and union. It’s unclear whether Penn State’s unique public-private status (it’s state-supported but privately chartered) would prevent future attempts to unionize, given current restrictions on tenure-track faculty unions at private institutions.

Brian Curran, president of the new chapter and professor of art history, said he couldn’t comment on any intent to unionize “at this time.” But through the advocacy chapter, he said he hoped to bring to Penn State a kind of transparency and shared governance that is lacking through the Faculty Senate. For example, he said, the body has no means of sending out mass e-mails to faculty to alert them of decisions.

The Faculty Senate president did not immediately respond to a request for comment on the matter.

Penn State faculty expressed outrage this summer at the university's new “Take Care of Your Health” wellness initiative, which requires that all faculty complete biometric screenings and online wellness profiles that include questions some faculty have said are invasive, such as those pertaining to mental health and frequency of testicular self-exams. Faculty who don’t complete the annual screenings will have to pay a $100 monthly surcharge.

Additional surcharges have been announced for smokers and for coverage for spouses and domestic partners eligible for insurance through their own employers.

The university has said that attempts to control its skyrocketing health care costs through voluntary measures proved unsuccessful. Susan Basso, vice president for human resources, has said the university's new program complies with health care privacy laws and that personal information will be used for health promotion only.

In an e-mail, a university spokesman said Penn State values shared governance "because we do encourage participation in many aspects of decision-making. We balance this with our need for administrative accountability." To that end, members of the faculty and staff were consulted on the health care plan as early as 2011, he said.

In other Penn State news, Harvard Business Review dedicated a blog post to the wellness initiative Tuesday called “The Danger of Wellness Programs: Don’t Become the Next Penn State.”

The post’s authors, well-known benefits experts Tom Emerick and Al Lewis, wrote that “Wellness is supposed to 'empower' employees but instead did just the opposite at Penn State. Ironically, the only thing that has empowered Penn State employees has been fighting back against this misdirected wellness tyranny.” Instead of a “‘culture of wellness,’ Penn State has created a culture of resentment,” they wrote, arguing that “Take Care of Your Health” may not save the university much money after all.

Basic calculations “would have told them that their 43,000 covered lives probably incurred a total of only about 100 wellness-sensitive medical inpatient events, like heart attacks, of which a few might have taken place in people who were not previously diagnosed and were therefore at least theoretically avoidable, saving the tiniest fraction of their healthcare spending. But we'll never know because they embarked on a prevention jihad against their employees without knowing the value of what they were trying to prevent.”

It is possible that this effort will fail, or that it will diminish if it chooses to remain a one issue organization.  The University Faculty Senate might  be able to regain some legitimacy by its future actions.  But this AAUP chapter formation should serve as a warning to the Senate that its failure to be responsive might make it irrelevant to at least a portion of the faculty. 

The Faculty Senate's response is both telling and sadly predictable. The Senate sent the following message to its members:

David Gray, Senior Vice President for Finance and Business/Treasurer and Susan Basso, Vice President for Human Resources have been invited to attend the September 10, 2013 meeting of the University Faculty Senate to discuss the Take Care of Your Health Initiative. The leadership of the Senate Committee on Faculty Benefits and the Joint Committee on Insurance and Benefits, in consultation with the Senate officers, have created a list of questions which have been provided to Mr. Gray and Ms. Basso in advance of the Senate meeting. These questions are posted on the Senate website at http://www.senate.psu.edu/health-care-initiative-questions.pdf and Mr. Gray and Ms. Basso’s responses to those questions will appear in the September 10 Senate Agenda which will be available on September 3. Comments or questions may be submitted to the Office of the University Faculty Senate at senate@psu.edu.
There are many ways of understanding this choice of reaction.  It might be a function of a sense by decision makers of the extent of their effective maneuvering room given the constraints of their place within the organization of university governance. It might be a function of other factors--the exercise of discretion, a polling of faculty leaders or the like, or consultation with others.  Here are the questions:

University Faculty Senate

Questions on the Take Care of Your Health Initiative
Taking Care of Your Health
--Why is a punishment-based, coercive approach necessary? Why is an incentive-based, voluntary approach not used?
--Many of us already get regular, preventive medical examinations. Why do we need to go through the biometric screening or fill out the questionnaire? Can’t our numbers be obtained from our physicians? 

The Survey, Security and Privacy, and Use of Data for Future Purposes
--Why was the WebMD platform chosen for the survey?
--WebMD has been hacked in the past. Why should we believe it would not be hacked again?
--If our health care information is already saved in a secure medical database, then why must our
information be stored in an additional database?
--Will WebMD and/or Highmark share any portion of our information to third parties for marketing or other purposes?
--To whom and in what form will WebMD and/or Highmark report results?
--How will these data be used?
--Will the collected data be used to charge premiums based on health conditions now or in the future?
Value of the Program to Health Outcomes
--What are the health care claims costs, the premiums paid by the employee and Penn State, and the administrative costs for the last five years, compared to those projected for next year?
--Are there studies showing that programs similar to the “Take Care of Your Health” program have produced positive health outcomes and reduced health care costs?
--How will you determine that compliance with the new policy has improved health outcomes and
reduced health care costs at Penn State? 



It will be interesting to see if this planned well managed and public discourse will solve the problems caused by a badly managed program roll out.  I have wondered whether a public apology for the bad handling, an opportunity for complaint venting and a willingness to make changes that do not affect the core (health and financial) objectives of the program might not have worked better. My hope is that the divisions caused by this wellness program will ultimately be resolved to the reasonable satisfaction of all actors.  We will have have to live together for a long while and must all continue to work for the aggregate best interests of the institution without unnecessarily imperiling our own interests as autonomous actors.

For the University Faculty Senate, however, the stakes may be higher. It's legitimacy as faculty representative--at least in fact though not in form--may be in play.  A new faculty representative has now entered the scene.  The Penn State chapter of AAUP will undoubtedly face an uphill battle to establish its credibility and staying power.  It is not clear how effective the AAUP will be or whether it will grow to challenge the University Faculty Senate as the legitimate institutional voice of university faculty.  It may fade away as quickly as it arose. But that after years of unsuccessful efforts a chapter was established at all should raise eyebrows. It suggests that the anger and frustration of faculty may not be adequately channeled by either traditional faculty organizations or administrative bodies.  And it suggests the failures of the University Faculty Senate to lead, and to represent its members with a core fidelity to the values and interests of the university. Those continuing failures will be costly even if the AAUP Chapter fails to become more than a momentary repository of anger over the wellness programs. In the best of all worlds, the two organization could work together--the AAUP chapter serving as a site for monitoring the performance of university administrators (and the Senate itself), and the Senate serving as the voice of the Faculty within the formal shared governance structures of the university.  But that cooperation and those synergies may not be realized soon. Stay tuned.

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