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The City of Montgomery, Ohio – Employees Take the Lead in Health Care Committee

One example of what can happen when employees, union and non-union, and management work together, can be found in Montgomery Ohio, a small city not far from Cincinnati.  Several years ago the City implemented a Health Care Committee that relies upon labor, union and non-union, and management to work together to guide the city health care policy and program. Recently I spent some time talking with Wayne Davis, the Assistant City Manager, about their program.

Note: The Center for State and Local Government published a case study on the City of Montgomery Ohio, titled Employee Leadership in Health Insurance and Wellness Programs.

You can find that link here:

The goal of the committee was to

  • represent employee health care concerns,
  • negotiate favorable rates and coverage with insurance providers,
  • provide cost effective and comprehensive coverage for the City’s taxpayers and the employees, and
  • communicate with work units about key health care issues

The results have been

  • A decline in sick leave usage
  • Containment of health care premiums (they have experienced 1/3 of the average premium rate increases in the Cincinnati region.)
  • A drop in average annual medical claims

The City of Montgomery has successfully developed a culture of employee engagement that works well with both their union and non-union employees. Early on management recognized the need to make deep structural changes in its organization, and worked with the Commonwealth Centers for High Performance Organizations to develop creative paths to a new way of working together in an environment steeped in local government politics and traditions.

The union environment here consists of the FOP (Fraternal Order of Police), the IAFF (International Association of Firefighters) and AFSCME (American Federation of State, County and Municipal Employees). As Wayne puts it, “everyone has skin in the game” meaning everyone has something at stake, and gains and losses are felt by all. The City has spent significant time (over 7 years) and energy working on building this culture which values emotional intelligence, relationship building and keeps the organization vision focused on high performance.

Wayne explains that although it is not easy to alter values within an established hierarchical system, they were able to realize success by essentially creating a parallel organization within the organization, represented by the committee structure, where a different set of rules and values flourishes. In this alternative “team” structure, manifest in the health care committee, title and rank don’t mean anything, and the normal rules governing reporting relationships are suspended in the interest of participation and contribution by everyone on the committee.

When engaged in the team, the focus is on working together to complete a task while sharing commitment to values. He notes that the “values” question is raised whenever needed to keep the team focused. For example, every idea is scrutinized for its benefit to the whole organization, not just one part, and the team holds itself responsible for not just coming up with an idea, but creating a realistic plan for what it would take to make it happen. Although consensus building is valued, the team will base outcomes on majority rule when necessary.

The team is made up of five people, one from each of the following groups:

  1. 1.       Public Works
  2. 2.       Fire
  3. 3.       Police
  4. 4.       Non-union, non-management employees
  5. 5.       Management (appointed by City Manager)

The team is given parameters to work within and has the authority to create recommendations that are then carried to City Council. Although the City Manager or the Council has the authority to reject these, they have not because over time the team has earned a reputation for building value and also saving the City money.

One of the significant steps along the way involved educating the team about the budget so that decisions could be based on meaningful data. This also raised the level of accountability for all involved to produce improved outcomes.

Interesting, and an important lesson from this case study, is that in the beginning, Wayne modeled the role of facilitator and led the agenda setting process, but over time, as responsibilities were delegated to various members, the team become more involved in the agenda setting. So, the transfer of skills allowed the team to function with shared leadership. A key component of successful teams is the recognition of individual skills and learning from group members, as in this case, where the whole team became skilled at facilitating topics, setting goals and creating a plan for implementation.

Some additional areas of interest: each team member attends training twice a year to learn new skills and knowledge.  They meet once a month, and are all active in gathering feedback through surveys or informal interviews.  One important role of the committee is to keep people informed and presentations are prepared and delivered by a minimum of three members of the committee to various parts of the organization. Another skill that has emerged from the committee involves drafting legislation for Council. This has allowed the City Manager to step back from the direct ownership of the product and produced a greater degree of acceptance by the organization.

Overall, management has not allowed what has always been to dictate what might be, and has remained committed to the effort, despite challenges and naysayers. When asked about the labor contracts, Wayne indicated that the contracts contain language that effectively supports labor participation in the committee.  He did not seem concerned about abridging management rights or indicate that this represented any great concession on the part of labor or management.  In particular, I was impressed by his final thoughts. He said with respect to the union, they value discussing things as adults, and each side being heard.

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