Recognizing Signs of Domestic Violence at Work

Domestic violence

October is Domestic Violence Awareness month. Unless you or someone close to you has experienced domestic violence, you might think of it as something that only impacts people at home. Unfortunately, abuse is often subtle and happening to people of all socio-economic classes, ages, races, genders, etc.

There’s a fine line to employers getting involved in the personal lives of employees. But often domestic abuse doesn’t stay within the confines of a home’s walls. And the sheer number of people impacted by domestic violence are staggering: Nearly one in three women and one in seven men are victims of domestic violence during their lifetime. Even more numbing is that 53% of people know someone who has been a victim of abuse.

Domestic violence harms the health and well-being of your employees. And it can hurt a company’s bottom line through lost productivity and missed work.

Domestic Violence Network statistics show that 74% of women who are abused were harassed by their abuser while on the job. More than half were late for work at least five times per month because of abuse. Nearly 30% had to leave work early at least five days a month. And 54% missed three or more full days of work per month due to abuse.

Abuse is estimated to cost employers over $5.8 billion a year; $4.1 billion of that is directly related to medical expenses.

In a workforce of 50 people, approximately 27 people know someone impacted by domestic violence. If the employee mix is equal (25 female and 25 male), approximately eight females and three males are victims of abuse. And the U.S. Department of Justice statistics estimate that four women and one man per day are killed by abuse from an intimate partner.

Central Indiana statistics are sobering: agencies received 22,758 calls in 2016 related to domestic violence, according to the State of Domestic Violence Report.

Employers should understand that this violence won’t always be obvious. Abused employees will not always come to work with bruises or other injuries; if they do, it’s a safe bet that they’ve been emotionally abused for much longer.

Here are common abuse signs to watch for in employees:

  • Increase in absenteeism and/or tardiness: abusers may start fights prior to work, take vehicles to prevent the abused individual from getting to work, etc. Or the absences may be due to injuries if the abuse has reached the physical stage
  • Increased distraction: someone may suffer from poor concentration, anxiety and isolation. They may always keep a cell phone nearby and answer it quickly and then appear nervous or upset after answering the call or reading the text
  • Changes in social interaction: employees may stop doing things socially with co-workers. They may stop going to lunch with others and may avoid certain people
  • Increased or frequent visits by the abuser: visits alone aren’t enough to indicate something is wrong, but if the individual has negative reactions when the abuser is there or right after, there could be a problem

What are employers able to do for employees they suspect may be in an abusive situation? If you suspect your employee is a victim of abuse, the first thing you can do is offer a safe place for discussion.

If you suspect an employee is being abused, show kindness in your approach. Ask the employee if there is anything that you can help with and avoid telling him or her you think that abuse is occurring. If the employee is showing up with physical evidence of abuse, an employer should ask, “Is someone hurting you?”

If the answer is no, accept it. The employee may not be ready to share the abuse or may not yet see themselves as victims. Let the employee know you care and that you are there to help if you can. Refer them to a local domestic violence network or shelter if necessary.

100+ Business Leaders Going to D.C. This Week for Chamber Fly-in

A record group of more than 100 of the state’s top business leaders and government affairs executives will be attending the Indiana Chamber’s annual D.C. Fly-in on September 27 and 28. The timing couldn’t be more perfect with a potential health care reform vote, rollout of a tax reform plan and the end of the fiscal year all taking place.

This year, legislative briefings will be conducted by congressional members, who will be highlighting key public policy areas that line up with their committee assignments and expertise:

  • Tax reform – Indiana 2nd District U.S. Rep. Jackie Walorski
  • Regulatory reform – Indiana 9th District U.S. Rep. Trey Hollingsworth
  • Health care reform – Indiana 8th District U.S. Rep. Larry Bucshon
  • Infrastructure and transportation policy – Indiana 4th District U.S. Rep. Todd Rokita
  • Education policy – Indiana 6th District U.S. Rep. Luke Messer

There is still time to register for the D.C. Fly-in; go to www.indianachamber.com/specialevents.

Make sure to follow us on Twitter at @IndianaChamber or #ICCinDC for up-to-the-minute important information on what’s happening in Washington.

Zimmer Biomet is the Fly-in’s dinner sponsor. Allegion is the cocktail reception sponsor. Build Indiana Council is the legislative briefing sponsor.

Event sponsors are AT&T, The Boeing Company, Duke Energy, The Kroger Co., Old National Bank and Wabash Valley Power.

New Senate Health Care Bill An Improvement for Employers

The U.S. Senate appears to be gearing up for another health care vote, with a measure from Sens. Bill Cassidy (R-LA) and Lindsey Graham (R-SC) headed to the floor as soon as the middle of next week.

At its core, the Graham-Cassidy proposal creates a block grant program, taking much of the funding provided in the Affordable Care Act (ACA) and sending it to the states for them to set up their own health care systems and determine where to direct the funds.

It also does away with several pillars of the ACA, including the mandate for individuals to have insurance or pay a penalty. The true ramifications of that are uncertain, but could mean higher premiums for those in the health care exchanges (aka those who don’t have insurance through their workplace).

From the standpoint of employers, the Indiana Chamber believes Graham-Cassidy is an improvement over the ACA. This is primarily due to two changes:

  1. The removal of the employer mandate to offer coverage. If that goes away, so too does the ACA’s definition of a full-time employee as someone working an average of 30 hours per week; this has negatively impacted businesses and workers – many of whom saw their hours reduced.
  1. The permanent elimination of the medical device tax, which is detrimental to vital Hoosier employers like Cook Medical in Bloomington, Zimmer Biomet in Warsaw and many others.

Overall, those in favor of increased state control are more receptive to the Graham-Cassidy effort.

As Vice President Mike Pence put it on Fox News yesterday: “…The question that people ought to ask is, who do you think will be more responsive to the health care needs in your community? Your Governor and your state legislator, or a congressman and a President far off in the nation’s capital?…”

 What has opponents worked up is two-fold: affordable coverage for pre-existing conditions isn’t specifically guaranteed; and population size will determine the amount of the block grant, which will reduce funding for a number of states – including some in the Rust Belt and more rural states in general.

Republican Sen. Jeff Flake of Arizona told MSNBC on Thursday he has absolute faith that governors will keep pre-existing condition protections, because of the severe political cost if they don’t. Opponents are less convinced.

At this point, Kentucky Sen. Rand Paul is the lone Republican who has sworn opposition to the Graham-Cassidy bill publicly – in part because his state appears to be set to lose funds in this model.

Likewise, Indiana is expected to see less federal dollars, but the Hoosier state has been preparing for what it saw as an eventuality for several years – setting aside hundreds of millions of dollars to subsidize its Healthy Indiana Plan (HIP) 2.0.

The HIP model is unique in the country; it requires participants to have “skin in the game” with their health care decisions and allows for capping the number of participants. Both of these make it an inherently more nimble program. And ultimately, the state Legislature can also determine to put more funds into HIP 2.0, if it’s deemed necessary.

These facts and the lure of more state control were likely factors in Gov. Eric Holcomb’s decision to sign a letter supporting Graham-Cassidy; he was one of 15 state executives to do so. The reality is other states may not be as fiscally prepared for a possible funding reduction as Indiana is.

That leads us to who may end up being the pivotal figure in the floor vote: Sen. Lisa Murkowski of Alaska. She joined Sen. Susan Collins (Maine) and Sen. John McCain (Arizona) in voting no on the last health care reform measure. Collins is seen as a likely “no” again, joining Paul, while McCain is a predicted (or at least hoped for) “yes.”

As a result, the bill authors are pulling out all the stops and making special accommodations for Alaska in the bill to woo Murkowski’s vote – because they can’t lose her and have the bill survive for Vice President Pence to break the tie. If no specific provisions for Alaska are made, the state would be a big loser in the bill in funding because of its size vs. population and geography.

The Indiana Chamber plans to talk about health care reform with Sen. Joe Donnelly, who has announced his opposition to Graham-Cassidy, and Republican Sen. Todd Young during Wednesday’s D.C. Fly-in event.

UPDATE: This afternoon, McCain announced he would oppose the Graham-Cassidy bill, making passage of the bill seemingly very difficult.

Donnelly, Walorski Working to Define Full-Time as 40 Hours Per Week

Since the passage of the Affordable Care Act (ACA), employers in Indiana and across the country have been forced to cut employees’ hours due to the law’s definition of a full-time employee as someone working an average of 30 hours per week.

The Indiana Chamber recognizes this as a significant issue for the Hoosier business community and has been pushing for a change back to the 40-hour work week. We are pleased to see that our delegation is leading efforts to make that happen.

Recently, Sen. Joe Donnelly reintroduced a bipartisan proposal that would change the definition of a full-time employee under the ACA to someone who works an average of 40 hours per week. Donnelly partnered with Sen. Susan Collins (R-ME) on this legislation.

Senator Joe Donnelly and Congresswoman Jackie Walorski greet Vice President Mike Pence as he arrives in South Bend to deliver the May commencement address at the University of Notre Dame (photo courtesy WSBT).

“I believe that we can work together to fix issues with the health care law and improve our health care system. I have heard from part-time workers across many industries, like school cafeteria managers to grocery store employees to adjunct professors at colleges, that have seen their hours cut to comply with the health care law,” Donnelly said.

“In Indiana, common sense holds that a full-time employee is someone who works an average of 40 hours a week, and the health care law should reflect that. I’m proud to partner with my friend and colleague Sen. Collins to reintroduce the Forty Hours is Full Time Act, and I am hopeful the Senate will consider this bipartisan bill soon.”

Meanwhile, a similar effort was introduced Thursday in the House led by Republican Congresswoman Jackie Walorksi (IN-02) and Congressman Dan Lipinski (D-IL).

The Save American Workers Act (H.R. 3798) also would restore the traditional 40-hour work week under the ACA.

“Obamacare’s burdensome employer mandate and its redefinition of full-time workers are hurting middle class American families and crushing our job creators,” Walorski said. “The Save American Workers Act will provide much-needed relief to hardworking Hoosiers who have faced reduced hours and fewer jobs. This bipartisan, commonsense bill will give businesses the certainty they need to create jobs, and it will give workers the opportunities they need to succeed.”

Background
The ACA currently requires employers with more than 50 full-time equivalent workers to offer health insurance to full-time employees (working 30 hours weekly) or face a penalty. This requirement has forced businesses to reduce hours and slow hiring in order to avoid unaffordable new costs or the ACA’s substantial fines. The 30-hour definition has affected workers in the private sector as well as city, state and school employees, with a particularly severe impact on hourly, part-time, and seasonal workers.

National Emergency Declared for Opioid Crisis; Donnelly and Walorski Applaud President’s Action

Building upon the recommendations in the interim report from the President’s Commission on Combating Drug Addiction and the Opioid Crisis, President Trump recently instructed his administration “to use all appropriate emergency and other authorities to respond to the crisis caused by the opioid epidemic.”

Both Sen. Joe Donnelly and Congresswoman Jackie Walorski (IN-02) issued statements supporting the decision:

“I am pleased that President Trump plans to declare the opioid epidemic a national emergency. We know that it will take all of us working together to effectively turn the tide against this public health crisis that has harmed so many families in Indiana and across the country,” Donnelly said. “I hope this declaration will lead to necessary, additional resources for states and local communities to ensure those battling substance use disorders can access treatment.”

Walorski stated: “Opioid abuse is having a devastating impact on our communities, and President Trump’s declaration of a national emergency treats this epidemic with the urgency it requires. I will continue working with my colleagues and the administration to make sure first responders, law enforcement, medical professionals, treatment providers and families in our communities have the tools and resources needed to solve this crisis.”

Congress last year passed into law the Comprehensive Addiction and Recovery Act (CARA), bipartisan legislation to address the nationwide opioid epidemic.

Congresswoman Walorski served on the conference committee that negotiated the final bill, which included two provisions she authored. One requires the Department of Veterans Affairs (VA) to participate in state prescription drug monitoring programs, and the other allows the VA to use FDA-approved medical devices and other non-opioid therapies to treat chronic pain. Donnelly also helped enact CARA, which included several of his provisions. Additionally, Donnelly helped pass the 21st Century Cures Act into law, which includes a $10.9 million federal grant that will support prevention, treatment and recovery services in Indiana.

More recently, in late July, Donnelly introduced a bipartisan package of legislation “aimed at providing the facilities and access to telemedicine needed “to prevent and treat substance use disorder in rural communities.”

Donnelly Urges Market Stability on Health Care; Association Plans in the Offing?

Senator Joe Donnelly is urging the Trump administration to make a public commitment to continue cost sharing reduction (CSR) payments, which lower consumers’ deductibles and co-pays.

Early in the week, Donnelly continued his push for stability in the insurance markets in a letter to Hoosier Seema Verma – the administrator of the Centers for Medicare and Medicaid Services (CMS) – who he partnered with to help establish Indiana’s bipartisan Healthy Indiana Plan (HIP) 2.0 program through the Affordable Care Act. Donnelly’s letter comes as President Trump has declined to commit to continue making CSR payments. Donnelly says if these aren’t maintained, it could cause people to pay at least 15-20% more for health care.

In the letter to Verma, Donnelly wrote: “…It is our job to protect American families from unnecessary increases in the cost of health care, particularly those within our control. That is why I am very concerned by recent comments and actions made by the administration demonstrating a willingness and desire to undermine the health care system, even at the expense of the health and economic security of millions of Americans. These efforts to create uncertainty are harming working people and are already having a detrimental effect in Indiana.

“As we work to improve our health care system, we must first do no harm … The administration has the ability to help provide market stability today, and I respectfully request that the administration make a strong public commitment to continuing the CSR payments so that Congress can work together in a bipartisan fashion in an effort to reduce costs, expand access and strengthen the American health care system.”

Additionally, Donnelly said he’s recently heard from several insurance companies which provide coverage to Hoosiers – including two that have recently left the market – that cited lack of certainty, particularly as it relates to the CSR payments, as a key reason for increasing prices or leaving the market.

White House Press Secretary Sarah Huckabee Sanders said this week that CSR payments were, at this point, bailing out a failed law. She also said no final decision had been made by the President on continuing them.

Read Donnelly’s full letter to Verma.

Meanwhile, Sen. Rand Paul of Kentucky is making a case to President Trump to use his executive authority to permit associations and organizations to offer group health insurance plans. Paul says this could impact tens of millions currently in the individual marketplace. The White House has yet to comment on the possibility. This action would be very helpful to Indiana Chamber members and we have previously discussed this positive policy proposal with members of the Indiana delegation.

Legislation Favorable to Drug, Medical Device Manufacturers Passes Senate, Heads to President

Legislation which passed the Senate Thursday ensures that drug and medical devices can move to the market quicker. Manufacturers of these products would pay higher user fees and the revenue raised would help the U.S. Food and Drug Administration (FDA) review the items in a more expedited process. The law governing this process was set to expire by September 30, so it was imperative that the Senate act before members left for their August recess.

The legislation passed the Senate 94-1 with both Indiana senators supporting the legislation. The bill was not amended in the Senate and so therefore it now heads to the President for final signature.

The Indiana Chamber advocated for the passage of this bill during the Hoosiers Work for Health summit in July.

The legislation aligns with the Chamber’s legislative policy regarding the FDA: “The FDA has an important responsibility to make sure consumers get expeditious access to safe and effective products. Thus, the Indiana Chamber supports a well-resourced FDA, especially in the area of drugs and medical devices, through appropriated funds and user fees (tied to specific and measurable performance requirements for the FDA).”

Federal Health Care – Republicans Can’t Do It Alone

Progress on health care reform by Senate Republicans came to a halt very early this morning as the so-called “skinny repeal” of the Affordable Care Act (ACA) narrowly failed 49-51. All Democrats were joined in their opposition by Republican senators Susan Collins (Maine), John McCain (Arizona) and Lisa Murkowski (Alaska).

While Collins and Murkowski’s votes came as no real surprise, the GOP hope was for McCain to allow the bill to proceed to an expected conference committee for further work. But in McCain’s statement explaining his decision, he mentions the lack of complete certainty provided by House Speaker Paul Ryan that the bill wouldn’t be voted on as-is and passed by the House instead – as well as his opposition to voting on what he considered to be a “shell of a bill.”

Essentially, this outcome means the only path to reform now would appear to be a bipartisan approach, as Senate Majority Leader Mitch McConnell (Kentucky) alluded to in his remarks following the defeat.

Indiana’s Democratic senator, Joe Donnelly, has been pushing for this path all along and reiterated those thoughts after today’s vote:

“I still believe that by working together we can improve our health care system and, at a minimum, Congress and the administration should do no harm to the millions of Americans’ whose health and economic well-being are at stake. I share the frustration of Hoosiers and Americans who are tired of partisan proposals that fail to address issues with our existing health care system and the continued legislative uncertainty that is undermining the insurance markets.

“We should do the hard and necessary work to gather the input of doctors, nurses, hospitals and patients, and work in a bipartisan manner to make coverage more affordable and accessible for Hoosier and American families.”

Of note: Donnelly attended a dinner Wednesday evening with a bipartisan group of senators to discuss ways to work together on health care. In May, Donnelly also had a similar meeting.

Our junior senator, Todd Young, voted for the “skinny repeal” bill as “another step towards relieving Hoosiers and millions of Americans from the burdens of Obamacare. Too many Hoosiers have been left with too few options and rising costs. It is more important than ever that we keep our promise to them and fundamentally reform our health care system.”

Like Donnelly, Young is eager to strengthen the ACA and work in a bipartisan fashion to get that done.

“Going forward, I will participate in hearings in the HELP (Health, Education, Labor and Pensions) Committee and continue to work with my colleagues, on both sides of the aisle, to come up with a solution that provides long-term stability to our health care system and gives each and every Hoosier the opportunity to access quality and affordable insurance.”

Additionally, Young has previously looked for ways to find common ground. In the spring, he sent a letter to all Democratic senators urging them to share their views on what’s working and what’s not with the ACA.

Indeed, there are aspects of the ACA that both Democrats and Republicans have acknowledged as problematic; the medical device tax, which needs to be permanently repealed, is among them. So hopefully these areas can serve as a starting point for crafting a bipartisan solution.

From the Indiana Chamber’s perspective, the reality is that the ACA has not made life easier or costs cheaper for businesses (or many Hoosiers).

Separately, the ACA’s pending collapse – with insurers pulling out – isn’t surprising based on its inherently flawed assumptions. Unfortunately, very little of the congressional debate so far has focused on shoring up the ACA at its core, or how to put forth a replacement program that is stronger foundationally. Hopefully, that will occur in future discussions.

Indiana Delegation Talks Affordable Care Act Repeal

The vote to repeal and replace the Affordable Care Act (ACA) couldn’t get off the ground in the U.S. Senate. But President Trump, Vice President Pence and many members of Congress instead have called for a simple repeal of the ACA – with a replacement coming at a later date.

Congressman Luke Messer (IN-06) is on board with that process. “Hoosiers are sick and tired of endless debate on the Obamacare repeal bill, and the failure of Congress to act. This is D.C. politics as usual, and exactly why Americans sent the President to Washington to shake things up and get something done.

“We’ve had more than enough time to deliver on this promise to Americans, who have sent us here for three election cycles to repeal this failed law. I agree with President Trump that we must repeal Obamacare NOW and then work together on a plan to ensure Hoosiers get the health care they want and deserve.”

Meanwhile, Sen. Joe Donnelly urged bipartisanship in finding common ground. “The proposed Senate health care bill would have been disastrous for Hoosiers. The latest plan to repeal without any replacement is downright reckless, playing politics with the health and economic well-being of millions of American families.

“It is time to do the hard work of forging a bipartisan bill to strengthen our current health care system, so that we can reduce costs for Hoosier families, continue to protect people with pre-existing conditions, and preserve the good work states like Indiana have done to expand affordable health care. The American people are counting on us to take a thoughtful approach together, and I urge the Senate to take this path in the coming days.”

Congressman Larry Bucshon (IN-08) had a different take. “Obamacare is collapsing and as a result patients across the country are at risk as premiums skyrocket and insurers flee the exchanges. In Indiana, premiums have increased an average of 74% and two of our state’s four insurers recently announced their departure from the Obamacare exchanges. Hoosiers are being priced out of the insurance market, if they can find insurance at all. This is not the health care Americans were promised by President Obama and congressional Democrats when they passed Obamacare, and certainly not what they deserve.

“To me, this is personal. I spent more than a decade as a surgeon before coming to Congress. This is about the well-being of my constituents who are struggling to access quality, affordable health care under Obamacare. That’s why I made a promise to repeal and replace this failed law to help drive down costs, expand access, and get the federal government out of decisions that should be left up to patients and their doctors. The House did its job to fulfill our promise. I’m extremely disappointed that, thus far, the Senate has failed to live up to its commitment to the American people. It’s time for the Senate to act.”

Chronic Diseases Top of Mind for New Wellness Council Executive Director

Chronic disease management is a costly challenge in Indiana. Due to high rates of tobacco usage and obesity and the resulting health issues (diabetes, lung cancer, heart disease, etc.), Indiana finds itself again near the bottom of recent national health and fitness rankings.

As the new executive director of the Wellness Council of Indiana (WCI), Jennifer Pferrer is ready to help tackle those challenges and spread the message of comprehensive wellness programming to Hoosier employers.

“Some of the goals in the Indiana Chamber’s Indiana Vision 2025 economic development plan target reducing smoking rates and obesity levels in Indiana, and the role of the WCI is to bring that conversation to a broader space and make an impact in health care costs and the health of Hoosiers,” she explains.

“I’m passionate about health care and I am looking forward to adding my mark on the Wellness Council of Indiana, as it really fits my background.”

Pferrer joined the WCI – a program of the Indiana Chamber of Commerce – in April and previously worked for the American Diabetes Association (ADA) for 10 years, serving in roles that included executive director for Indiana and Kentucky, and regional vice president of a six-state region. Prior to the ADA, she studied consumer-physician relationships as marketing manager at St. Vincent Hospital.

Pferrer’s goal is to continue proving the value of the WCI as an investment for Hoosier employers.

“Wellness is so much broader than Fitbit programs. This is not just food and fitness. There is a data-driven business case for wellness. Wellness needs to be seen as an investment and it goes back to managing chronic diseases,” Pferrer notes. “For example, health education for employees with pre-diabetes can reduce the annual health care spend by the employer by thousands of dollars.”

Through the WCI’s AchieveWell company-based wellness program certification and the Indiana Healthy Community Initiative – which encourages a community-based approach to wellness to increase economic development potential – Pferrer says the infrastructure is in place for wellness success.

“I want employers to know – if wellness is on their radar, they don’t have to recreate the wheel. We can convene and share best practices and be that resource for them,” she concludes.

For more information on the WCI or to connect with Pferrer, visit www.wellnessindiana.org or call (317) 264-2168.