When employers coordinate health and fitness plans for their employees, it's a win-win situation. At Mid America Rehab in Cape Girardeau, clients undergo everything from skills tests to physical therapy and rehab to make sure they are safe before ever setting foot in the workplace. As a result, business and government entities such as the Missouri Department of Transportation have reported a significant decrease in workman's comp issues, as well as a decrease in lost time due to employee injuries.

"It's not about denying people employment, it's about making sure they are safe," explains Robert "Bob" Sherrill, director of Mid America Rehab.

People who have undergone physical therapy but aren't quite ready to go back to work may begin with industrial rehab, a combination of physical therapy and job simulation activities. Mid America also offers WorkSTEPS to test potential employees after a job offer and ensure that they are physically capable of doing the job. Based on results, the job offer may be either extended or withdrawn. The two-hour test includes screening for pre-existing conditions like arthritis and carpal tunnel; job skills tests; muscular and cardiovasular evaluations; and an overall assessment of risk for injury on the worksite. The WorkSTEPS training room even has a semi truck cab, a parts assembly table, a shoveling station, and a boat suspended by chains to test for balance.

Jean Endsley, employee safety and health manager for MoDOT, reported that one year after beginning the WorkSTEPS job testing program in January 2006, the department had reduced lost time incidents by 61 percent and lost workdays by 69 percent. Thanks to the program, MoDOT has saved Missouri taxpayers about $7,000,000. Midway through 2007, MoDOT had reduced lost workdays another 55 pecent and lost time incidents by an additional 36 percent.

"As you can tell, we are very pleased with the results of the program," Endsley told Sherrill in an e-mail. Sherrill believes that saving this extra money has allowed MoDOT to offer new and improved services, such as the electronic road signs displaying Amber Alerts, weather and traffic updates.

"Employment testing has grown incredibly," he adds. Five or six years ago, companies like Mid America had to work hard to sell their program. Now, companies are approaching them first because they know the value of testing. He adds that WorkSTEPS specifically has grown "astronomically" in the past few years.

At Saint Francis Medical Center, over 700 employees participate in the Healthy Rewards program, in which they collect points for healthy activities and trade them in for money to be used toward fitness club membership, pharmacy costs, or even a discount on their insurance.

"It's gone over very well," says Sandy Duncan, operations manager at Fitness Plus. She feels that skyrocketing healthcare and insurance costs have generated further interest in the program and, since people are the most important resource in any company, it's essential to keep them healthy.

Each year, employees meet with a healthcare professional for lab work, a health risk assessment and to set personal goals in the areas of blood pressure, blood sugar, body weight, cholesterol, exercise, safety and prevention, tobacco use and overall wellness. Throughout the year, they engage in company-wide activities ranging from educational sessions on stress to monthly Healthy Bites luncheons. They can track their progress online, and at the end of the year, all employees undergo a follow-up session to measure their results.

"It helps boost morale, and I think employees feel better about the company because they see we care about their health," says Duncan. Research has even shown that healthy employees have lower "absenteeism" and higher "presenteeism," meaning that they miss fewer days and are more in tune with what they're doing at work.

Additionally, Southeast Missouri Hospital offers its employees a health and fitness program called the Wellness Connection.

Meanwhile, the Cape Girardeau Area Chamber of Commerce has combined fun, fitness and competition in its annual Shape Up Cape wellness program. The contest, held each May-August, incorporates teams of two to 10 employees from local businesses like Procter & Gamble, Southeast Missouri State University, Hutson Furniture, United Way, KFVS-12 and the Southeast Missourian. Each team elects a captain to record and report fitness activities completed by team members. Points are awarded, and the top three teams in each division receive cash prizes. Eligibile activities range from golf, yoga and tennis, to basketball, swimming and cycling; seminars are also offered throughout the program and may net points for attending team members.

"It's a very worthwhile and individualistic way to encourage individuals within member businesses to get active," says Tim Arbeiter, vice president for community development at the Chamber of Commerce. "At the end of the day, the goal is to get people active everyday for a three-month period, with the hope that they will form a habit and continue being active after Shape Up Cape." The program will kick off its eighth year this spring.