You never know what can come out of these types of events. I met my fiance at a singles sports night that was run by a local matchmaking/computer dating service as an event for their members. You may not get married, but you have unlimited potential for new members, positive community relations and more advertising exposure as these groups promote the event, and so on.

Pool
Swim team practices. Rent your pool in the afternoon (or other quiet times) to local high school and college teams that need a place to practice.

Day care. Connie Martin, program director of The Cascade Athletic Club in Oregon, gets over 800 day-care children in her pool for lessons and camp activities each summer. She charges per child to the day care which then has a great marketing advantage and promotes the program to parents.

Toys
Consider investing in an inflatable pool toy. The Aspen Hill Club in Maryland has a giant inflatable red hound dog that has helped to push their Sunday family swim program (2 p.m. to 4 p.m.) to the point where the lifeguards let people into the pool in shifts. Other options include rafts and floating basketball hoops. Create a “beachy” atmosphere where the whole family can come and play together. These toys will boost your pool-party revenue when added as an extra value or additional fee on party rentals.

Leagues. Start pool leagues for water polo, water basketball or water volleyball. This gets more people in the pool at one time and generates a lot more excitement than a lone lap swimmer. Not to mention the league fees and eventual competitions among schools and other clubs that can generate publicity and excitement at your club.

Special classes. Consider running special arthritis classes for senior centers in your area. They arrive together, take the class and leave together. The center pays you a flat fee which covers usage, lifeguard and instructor fees.

Red Cross Instructor Training Programs will get your staff certified (or recertified) and bring in additional revenue from other people who are seeking lifeguard positions.

Training. Take advantage of available space to do training. The Aspen Hill Club uses hallways and stairs to do an Intensive Conditioning Class. They have participants do squats with hand weights in a straight line up and down the hallways and on the ramp access to the pool (only do this if your hallways are wide enough for traffic to pass unhindered). They use the step ledge by the racquetball courts for up/down conditioning and calf stretches. Remember those army drills you’ve seen — running up and down and up and down a flight of stairs — it’s fun in a group setting.
Outside your facility. And finally, who says you have to remain confined to your facility to run programs? Here are some easy-to-implement suggestions:

Use the outdoors for walking, hiking and running programs.

Meet your members at parks for special picnics (make sure to display your club banner for some free advertising). This is great for summer corporate events. Your staff can coordinate fun fitness events for corporations or host club “family” days or singles functions, etc.

Have a group of members train for a particular race (running, cycling, triathlon, etc.) and have the whole club cheer on your team (wearing club T-shirts) on the day of the race!

Use your parking lot for in-line skating days and clinics (have a local retailer handle the rentals and lessons).

Use your lobby for frequent-attendance-retention games. Every member can spin a wheel or roll the dice to win potential prizes. There are hundreds of varieties of these games.

Use shopping centers, strip malls and schools to host health fairs and community health/fitness awareness days. Join in at local hospital health fairs.

Take your members on trips to the circus, the theater, professional sporting events, ice skating, etc.

Host larger food-oriented events at a local restaurant or community centers and develop a joint relationship that promotes both facilities.

Maximizing your space and existing staff takes some creative “out-of-the-box” thinking. Remove the walls you see in your mind and stretch the boundaries of your facility to create a “club” without walls. Do your research. Know what your members want. Find out what your community needs. Track your available space and time frames, and create your schedule to accommodate all of these factors.

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Portable basketball. This is recommended for ages 7 to 13. Adjustable hoops with bases that can be wheeled in and out of rooms are available for about $200 at discount stores (watch for sales). A room monitor should watch for conflicts among players — hanging on the net, climbing the poles, etc. If you “coach” and include skill-building — you’ll have a “sports readiness program.”

All of these programs can be implemented as regularly scheduled events, after-school programs or as part of birthday party packages on weekend afternoons. The important thing about using these spaces is to have equipment and supplies that are flexible enough to be carried or moved in and out of the room on a regular basis.

Tennis courts
Carnival tennis. To maximize use of courts and get more than four people on a court at one time, Jocil Rogus of Rochester Hills Tennis and Swim Club recommends the Carnival Tennis program. It can hold up to 24 five-to-eight-year-old children on each court and involves stations that the children move in-between.

Line dancing. Rogus has also tried country line dancing. She suggests using an end court and having the sound system face the wall so that echoing is reduced. With several lines on each side of the net, you can get between 30 to 60 adults on each court. If your courts are empty anyway, this is a great program to bring in local community groups, senior centers, Girl Scouts, existing members, etc. You can offer group rates or charge a per-person participation fee for the dancing.

Nursery
Meeting rentals. If your nursery is large enough to hold groups of people, if you have adult sized folding chairs and you can move kid stuff to the side of the room, you have “meeting space” that can be rented to area businesses, schools, churches and other groups. Rogus uses her nursery for driver’s education classes in the evening. The drivers education company pays for four evenings a week, one-and-a half hours each session, and Rogus grosses $350 a month from space that is normally closed.

Here are some other suggested groups that may pay for meeting space:

associations (boards)

sport teams

youth groups

charitable organizations

committees for community events

Party rentals. If your nursery is well-equipped with fun toys, slides and balls, you may be able to rent it during down times for toddler birthday parties. This would appeal mostly to non-members who don’t use the space all the time. Provide pre-printed invitations with directions to your facility and a “package” for parents or grandparents.

Fitness center
Express workout. Celeste DiMambro, owner of The Works Fitness Center in Massachusetts, borrowed an idea from Australia and adapted a small area of the fitness center into an Express Workout area. She added an instructor/coach and music during prime-time hours and she says her cardiovascular area is now “the hottest social thing going.” Not only that, but she’s using nine pieces of equipment (three lines of express workout) and gets her members through a 30-minute workout with a maximum 10-minute wait. There is no fighting over equipment and she can get up to eight people per line through a 30-minute workout each hour.

Physical education classes. Bring in local schools for their P.E. classes. The school can supply the teachers or you can handle the instruction. Let the school handle transportation. Students come in the middle of the afternoon when you’re quiet anyway. They are your potential summer market and future adult market. The school should pay for the use of your space. (Racquetball, wallyball, and swimming are also popular.)

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Step III: Evaluate your space
Evaluate your facility’s space usage. Rate each area on the “busy” scale. Create your own scale and re-evaluate this every quarter or season. Have staff in each area track usage on a day-by-day, hour-by-hour basis over the course of two weeks (see Figure 1). Find consistent holes of non-usage.

Step IV: Scheduling
Now that you know what your members want, the markets you want to attract and what spaces in your facility are available, you can begin to schedule programs by quarter/season to gauge effectiveness before planning for a full year.

Create a planning grid and complete one grid for each quarter (see Figure 2). Don’t overplan or your members will get overwhelmed with too many options. One major club-wide program every four to six weeks is more than enough. Retention programs in each department should last approximately six to eight weeks and can be executed with minimal fuss, staff and expense all season long. If you work with the grids to track programming and use the information you collected on available space for scheduling, eventually you’ll have every area of your facility active and you’ll be meeting the needs of all your key markets.

Remember when planning programs not to alienate your active members. Do not use space that’s already “active” to create new programs. Take advantage of your unused space and quiet times.

Step V: Program ideas
So you’re ready to program but you don’t know what to do with your space? I’ve collected ideas from some people who have done amazing things in limited space. Here are some of their suggestions broken down by area of the facility. I’ve tried to include a selection of ongoing programs, as well as special events for a variety of age groups. The key to your success is flexibility.

Racquetball court or aerobic studio
Step obstacle course for kids. This can be executed with or without parents present. Use pre-existing equipment (steps, slides, mats) to create obstacles for kids to climb over, under and around (See Figure 3). Put mats wherever jumping and landing is required. This program suits toddlers up to to 5 years of age. Children over six run too much and may get overzealous and either hurt themselves or others near them, if there are not strict controls.

Musical bottoms. Marianne Colucci, program director at The Racquet Place in New Jersey, uses musical bottoms for special parties and as a regularly scheduled program at different times of year. Like musical chairs, the children walk around the upside down step platforms (placed in a line) until the music stops. Then they have to rush and sit down. To keep the game fun and non-competitive, none of the steps are removed when the music stops. For older children who have more coordination, you can use the blocks that support the steps as the “seat.” Another version of this has the parent sitting with the child on his/her lap (kids love it because parents can’t fit as easily!).

Have kids stack the equipment afterward so you have less clean-up. They think it’s like stacking blocks and they have fun with it. You can also ask them to coordinate the different colors.

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Imagine this. You’ve been in the health club business for 15 years. Your market has always been adults, ages 18 to 30. Your members have participated regularly in racquetball and aerobics classes and made good use of your fitness center. So long as you’ve kept your facility clean and bought some new equipment every now and then, your members were happy.

Now, all of a sudden (or so it seems), your member’s needs have changed. The same members, but they’re older now and (how did this happen?) they’ve all got kids! These “boomers” are stressed from work and trying to balance their lives. So what happens? They’re not coming to your facility much anymore and your retention figures are slipping.

“Ah ha,” you say, “if I convert my racquetball courts to a kids fitness area, add a few less strenuous classes and bring in family changing areas, I’ll get my members back!” Then the thought occurs to you that this is going to cost a lot of money. How do you even know it will work? Is it worth the investment? What will your active racquetball members say when you take away one of their courts? What will your aerobics members say when you change their schedule? How do you justify it all?

The first step is to maximize your available space before making any major renovations. Use some creative programming and small-scale investments to gauge the response from your membership. Once you’re convinced of the need to make changes or additions, you’ll be more secure knowing you’ve done your research and that you have documented data to explain the changes to members.

To begin the research and trial period, you will proceed with some basic steps:

Step I: Define your markets
Who are you trying to reach? You should have a maximum of two or three key markets and concentrate your advertising, marketing and programming budgets on these markets. Some examples: You may have the mature market (ages 55+), family markets (ages 25 to 45) and the children’s market (ages 2 to 14). You might also have sub-markets (e.g., 25-to 45-year-old women who take aerobics). Now, all of your advertising and special programs can be designed with these markets in mind.

As a goal, it should be your facility that first comes to mind when someone says “kids programs” (or any other market on which you’re focusing). My favorite saying is, “If you try to be everything to everybody, you’ll wind up not being anything to anybody.” I’ve seen too many facilities that have predominantly family memberships run advertisements depicting beautiful bodybuilding types. Few families are likely to think, “That’s where I want to be.” The same thing happens when you try to offer a senior discount at a singles club, or kids programs at a corporate center, just because you have some time in the afternoon that can be filled in. Consistency in your marketing and advertising will increase your retention and referrals for new memberships. Consistency in your programming efforts will help you decide what is the most effective use of your space to retain your main markets.

Step II: Know what your members want
Create a focus group of key members (you know them — they’re there on a regular basis, they talk the most, are part of a “group” and will probably tell you their life stories). Try to include people that represent all of the populations/key markets within your facility: mothers, fathers, racquetball players, pool users, tennis players, aerobics aficionados, cardiovascular equipment users, etc. Keep the group at 8 to 10 people (you’ll need to invite 15 or so to get that many). Take them out for dinner — your treat. Include one or two key staff people. Talk about the things they think would make your facility more appealing. Don’t let it escalate into a gripe session. Keep it focused on the future. Prepare questions and an agenda beforehand. Your agenda should include a review of each area of the club and potential additions or changes in programming or space usage. Note: Make sure you’re clear that you are not promising anything — you’re doing research.

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That same doctor did, however, refer the couple to a six-week aging and dementia clinic at New York University. And the results of tests there confirmed Eva’s growing suspicions — although to this day, doctors can’t explain why a man as young as Bent would develop Alzheimer’s. “It’s as maddening as the disease itself,” she added. “We’ll never know why.”

While researchers have yet to find a cause for Alzheimer’s, medical studies show a reduced level of certain brain chemicals in people with the disease. Genetics, along with brain damage from strokes and dietary factors, has also been linked to Alzheimer’s. But the exact triggers remain a mystery.

Life Now
As do many spouses of Alzheimer’s patients, Eva spends most of her day taking care of Bent. Like an infant, Bent needs to be bathed, fed and dressed. Monday through Friday, she walks him to the front door of their Manhattan apartment complex, and a van takes him to an adult daycare center that specializes in taking care of those with Alzheimer’s.

She then goes to work, but must get home in time to meet Bent and the van between 6 and 6:30 p.m. She recently hired a nurse’s aide to help with some of the caregiving. But at night and on most weekends, it’s just the two of them in their upper west-side apartment.

It’s often these times, when they are alone, that he harsh realities of Alzheimer’s hit hardest, Eva says.”How I would love to have a conversation with my husband. To discuss things with him. To just talk,” Eva said. “Sometimes, I forget for a moment that there’s anything wrong with him. That’s one of the worst things about Alzheimer’s. You can’t see it. But at least in my house, it’s there. And all I can do is cope by taking one day at a time.”

“Sometimes, I deal with it by not dealing with it too much,” said Eva, 53, who works full time as executive assistant to the Dean of Columbia University School of Law. “At first, I thought I could outsmart it, by retraining Bent how to do things. But now I realize there’s no beating

Alzheimer’s — and that the handsome, charming man who was my husband is gone because if it.” More than 4 million Americans today suffer from Alzheimer’s disease. It’s a fatal, progressive condition in which brain nerve cells degenerate and brain substance shrinks, affecting the entire body. Impaired thinking, behavior and memory loss are hallmarks of the disease. But what few people realize is that many Alzheimer’s sufferers also experience a severe decline in bodily functions, including difficulty swallowing, moving around and talking. Thus, many patients in the advanced stages of Alzheimer’s, like Bent, require round-the-clock care.

“It’s totally debilitating. It changes everything,” Eva said. “And to be honest, it can be totally exhausting for me.”

In Bent’s case, it also took years to diagnose.

First Clues
It was the late 1980s, when Bent was approaching 50, that Eva noticed there might be something wrong. As the founder of a health-related computer software company, Bent spent busy days at work schmoozing new customers, developing products and trouble-shooting production problems.

Eva worked part time in his office. All of a sudden, it seemed to her as if he spent much of his time daydreaming. He was “unfocused,” as Eva puts it — missing appointments, ignoring mistakes and, in general, showing little interest in his responsibilities. At night, he would come home and complain about how little work he accomplished during the day.

Even though she was worried, Eva kept quiet about Bent’s behavior, chalking it up to the stress and hard work that come with owning your own business. She even thought for a while that he might be going through a mid-life crisis of sorts, unsure of what he wanted or where he wanted to be. “It all just puzzled me,” she recalled.

But then, hints of a more serious problem occurred. Bent couldn’t perform simple math problems anymore, and was unable to learn how to work his e-mail system.

It wasn’t, however, until his business partner asked him to leave their company in 1993 that he realized — or was willing to admit — that he needed medical help, Eva says.

“It was a frustrating time for all of us, and I was really, really angry,” Eva added. “He was a husband and a father, and I felt like he was letting things go, instead of doing everything he could to pull things together.”

Keep low-calorie snacks, such as carrots, celery, fruits and plain popcorn around the house.
Avoid empty foods made with refined carbohydrates (white flour and sugar), such as pastries and cookies.
Cut back on fatty foods (such as whole dairy products and fatty, marbled meats). Choose low-fat cuts of meat, such as skinned poultry, beef tenderloin or flank steak. Substitute low-fat or nonfat dairy products for whole ones.

Avoid fried foods, cream sauces, pastries, sweets, nondairy creamers and heavy salad dressings.

Increase your fiber intake. It fills you up without excess calories and helps move wastes through the digestive tract before they form toxic substances. A low-fiber diet is associated with arthritis as well as many other diseases.

Avoid processed and convenience foods, which are usually high in fat and sodium. Keeping them out of the house helps.
Drink plenty of water. Sometimes you’re simply thirsty when you think you’re hungry. Sufficient water also keeps your kidneys and other organs functioning at their best and helps cleanse your system.

The YMCA conducted surveys to determine what non-exercisers needed to begin working out. They found that many people had a “perceived reality,” about health clubs, says Carrie Phelps of the Maryland Farms, Nashville, Tenn., YMCA. People surveyedsaid theyfelt:”everybody’s fit; everybody’s staring at me; I just don’t fit in here.”

In January 2000, the YMCA established its 12-week Physical Fitness program designed to increase the confidence of formerly inactive persons. Each participant meets with a personal wellness coachfour times, and theykeep weekly contact through email, notes and phone calls.

Instead of traditional fitness evaluations, coaches and participants have a seated, 75-minute conference. They assess goals, discuss stages of change, and address barriers and motivation. The goal of the personal wellness coach, says Phelps, is to “assist and monitor [participants] through the process of behavioral change.”

In the initial meeting, the coachsets up a cardio-only exercise plan for the first four weeks. When they meet the second time, they address successes, modify routines and set goals. The coach also introduces four pieces of strength equipment. During week eight, the coach introduces four new pieces of equipment. After week 12, the participant has established a cardio routine and learned how to use 12 different types of weight machines.

One significant aspect of the program is the meeting space. For privacy, the Maryland Farms YMCAoriginally created a separate, 2,000-square-foot space. “We looked at designing our facilities so that people could foster relationships,” says Phelps.Due to increased membership, however, they have integrated the area into the 9,000-square-foot wellness floor, but have kept the overall design consistent with the program goals. Meeting in an area that breaks down barriers, participants get to know each other, support each other and share success stories.

Advertising for the program includes word-of-mouth and mentions during tours. “Eight out of 10 people on our tours are in the inactive population…. People who would never join the YMCA are now joining,” Phelps says.

The program has been extremely successful: YMCAs that previously retained 25 percent of their inactive members now post retention rates that are more than70 percent. Statistics from two branches that implemented the Personal Fitness program show that 75 percent of members rejoin, and 25 percent of people who join do so because they want to enroll in the program.

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It should be noted that as debates over healthcare policy alternately simmered and raged, non-legislative, non-mandated change visited the insurance industry. It was no less than revolution from within. Mergers and acquisitions became commonplace; some “household name” health insurance companies left the market altogether. New players entered, and managed care became the predominant form of coverage for working Americans.

While in 1988 the staff model HMO was still the dominant model of a managed care organization (MCO), by the end of the 1990s hybrids had proliferated, with preferred provider organizations (PPOs) and point-of-service (POS) plans gaining in favor with employers and healthcare consumers. In addition, sophisticated managed care techniques were increasingly applied to fee-for-service (FFS) coverage to contain costs.

The dominance of managed care is reflected now in the policy proposals that are being considered both by states and Congress. Much energy is focused on what some critics call the “managed care backlash,” that is, consumer and provider pressure on certain managed care restrictions.

Indeed, after the passage of HIPAA, the White House appointed a Commission on Consumer Protection and Quality in the Health Care Industry; the recommendations of that Commission include a patient “Bill of Rights.”Commercial insurers, Blue Cross Blue Shield plans, self-funded plans and prepayment plans (such as HMOs) cover 90 percent of those who purchase private insurance. But despite all of the private and public activity centering on healthcare in the United States, it remains the industrialized country with the highest proportion of uninsured. While HIPAA may help certain people from being temporarily uninsured, the problem remains.

More than 40 million people — many employed by firms that do not offer coverage and many others below the poverty line — are without health insurance. (Many are poor but still do not qualify for Medicaid.) At least 12 million of those without health insurance are children. Reliable sources indicate that the number of uninsured people could increase to as high as 60 million by the year 2011.

In regard to our healthcare system, the United States faces many challenges in the coming century. The mechanisms we choose now to address these issues will determine whether the problems increase or decline over the next decade. Most experts agree that the lack of plan participants’ personal and financial involvement in the healthcare system is largely responsible for inflation within the plans.

However, the debate rages on about how to best resolve the issues. What is certain is that as individuals become more engaged in the healthcare process, they become an integral part of the solution.

The demand for healthcare services starts and ends with individuals. As personal involvement and education increase, people become empowered to make informed healthcare decisions, and that is good medicine for America as a whole.

And while polls showed that a majority of Americans were worried about healthcare coverage and costs, most did not want a government-run system. Nevertheless, affordability and “job lock” (the inability to switch jobs for fear of losing coverage) were significant worries for many. Millions of Americans, including many who were self-employed or who worked for small businesses, remained without insurance.

In response, the insurance industry adopted a policy position centering on reform of the small-employer market. The industry also emphasized private reinsurance (to permit insurers to spread losses for high-risk individuals), state risk pools for the medically uninsurable and tax assistance or increased public coverage (like Medicaid) especially for children.

While these proposals pointed the way to piece-by-piece legislative reform, others repeatedly advanced more broad-reaching positions — variations on the theme of national health insurance. Academics, think tanks, providers, payers and consumers all joined the fray; a multiplicity of policy options filled not just technical journals and the trade press but were the subject of articles and commentary by the media. “Access,” “choice” and “portability” became popular buzz words.

Perhaps inevitably, healthcare started to show up as a factor influencing elections. The stage was set for a truly unique national dialogue on healthcare that began as the newly elected Clinton administration pulled together a healthcare task force and then issued, in 1993, the more than 1,000-page Health Security Act, aka “the Clinton Plan.”

In reality, the Health Security Act (HSA) was one of many plans emerging into the light of day. No fewer than six plans were described, praised and debunked regularly in the major media outlets for almost two years. Americans became familiar with such terms as “employer mandates” and “healthcare purchasing alliance.” Ultimately, the American people sided with business and insurance groups in rejecting wholesale reform.

Why did the HSA fail? Most attributed the failure to a combination of factors, notably the act’s complexity and the fear of a government “takeover.” Be that as it may, pressure mounted for incremental reform, and within two years of the defeat of the Clinton plan, bipartisan legislation — the Health Insurance Portability and Accountability Act of 1996 (HIPAA) — was passed.

HIPAA — previously the Kassenbaum-Kennedy bill — provides a measure of portability of health insurance for people who change or lose their jobs.

Insurers and employers sponsoring self-funded plans now have to credit prior coverage toward pre-existing conditions when an employee (new or current) changes health plans. An employee who maintains continuous coverage only has to serve an exclusion period once for a pre-existing condition.

The legislation also allows insurance companies to offer Medical Savings Accounts (MSAs) to employees of small business (50 or fewer employees) and to self-employed people. Participants must have coverage under a qualifying high-deductible health plan; deductibles can range from $1,500 to $2,250 per person or from $3,000 to $4,500 for families. MSA contributions are tax deductible and balances carry over from year to year; the interest earned is not taxed. Fund withdrawals to pay for qualifying medical expenses and insurance premiums during periods of unemployment or layoff (i.e., COBRA premiums) are not taxed, but withdrawals for any other purpose (before age 65) are taxed and assessed a 15 percent penalty.