Employee Assistance Programs

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Employee Assistance Programs

• The evolution of a product and a market

WellPoint Continuing Education CA Course
187298 CO Course 42771 NV Course 12282
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Introduction/Overview and Objectives

• Upon completion of this course participants will
  be able to
• Define employee assistance programs (EAPs)
• Identify the elements that make up a typical EAP
• Describe how EAPs work
• Explain the various types of EAP services
  available
• Identify providers of EAP services
• Discuss employer problems that EAPs can solve
• Describe the prevalence of EAPs
• Explain the effectiveness of EAPs
• Recognize the challenges facing EAPs today

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History of EAP

• EAPs evolved from Internal Industrial Alcoholism
  programs of the 1950s
• Gradually added drugs, mental health, family,
  legal, financial, etc.
• Moved from internal staff programs to external
  vendors
• Moved from large employers to all sectors of the
  market size and type
• International

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What is an Employee Assistance Program?

• An employee assistance program (EAP) is a
  productivity tool designed to help improve
  employee effectiveness and employer risk
  management
• An EAP provides services to assist employees and
  their household members
• An EAP is not an insurance product
• Only regulation occurs in CA

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Current Marketplace Snapshot
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EAP Elements
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Employer Services

• Provides professional expertise and services to
  employers for challenging worksite issues
• Supervisor/manager telephone consultation
• Management training and consultation
• Return-to-work case management
• Workplace trauma response
• Critical incident stress debriefing

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Employer Services (continued)

• Substance abuse policy consultation
  recommendation
• Educational workshops
• Employee wellness training and orientation
• Clinical account management
• Utilization reporting
• Program promotion

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Employee/Household Member Services

• 24/7 telephone crisis service
• Face-to-face counseling with licensed
  professional (number of sessions set by
  agreement)
• Legal
• Financial
• Dependent care child elder
• Web services
• Convenience services

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Program Promotion

• Key to return on investment for employer
• EAP utilization driven by employee awareness
• Employee awareness driven by visibility
• Various tools electronic, paper, in person, web

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Reporting

• Aggregate data to employer on periodic basis
• No identifiers--confidentiality
• calls, types of problems, referrals made,
  follow-up
• Employer services provided CISDs, workshops,
  case management

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Confidentiality

• EAPs are required to ensure confidentiality
• Participants may deny or consent to release of
  identifiable data
• Individual information released with valid
  written consent or authorization for
  psychotherapy notes
• Parents/legal guardians may give consent for
  minors
• Legal guardians may give consent for others
  including, but not limited to, demented elderly,
  those with diminished mental capacity, or
  deceased members
• Exceptions by legal requirements state child
  abuse, elder abuse statutes, or duty to warn
  criteria

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Site Services

• Critical Incident Debriefing services
• Workshops training
• Employee orientations, health fairs
• Account management meetings

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Problem Lists

• Alcohol/drug abuse addiction
• Family parenting
• Marital/relationship concerns
• Personal/emotional concerns
• Child care

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Problem Lists (continued)

• Elder care
• Legal problems
• Occupational stress
• Job/occupational adjustment
• Behavioral concerns
• Other

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What is Not Covered by EAPs

• Medical
• Legal representation
• Legal that conflicts with employer
• Extended psychotherapy or intensive forms of
  treatment

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Variations

• Internal programs
• External vendors
• Stand alone vs. integrated with another product
• Service menu variations (counseling sessions,
  work-life, legal, dependent care, etc)
• Pricing structure covered in capitation or
  fee-for-service

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How EAPs Work
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Program Promotion

• Announcement letters
• Brochures
• Wallet cards
• Refrigerator magnets
• Management orientation CD-ROM or VHS

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Program Promotion (continued)

• Employee orientation CD-ROM or VHS
• Guides for management
• Posters flyers
• Monthly/weekly e-promotions
• Periodic newsletters

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Telephone

• Who answers
• How answers, the open-ended conversation
• Complexity of phone system
• Timeliness of response
• Availability of licensed professional
• Depth of service provided on the phone
• Multilingual TTDY capabilities

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Website

• Information referral tool
• Expected by most of the market
• Vendor relationships
• Branding identity
• Reliability service
• Increasing expectation to move in direction of
  actual service provision online
• Provider services

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Staff

• Phone staff
• Professional staff/degrees, licenses,
  certifications
• Administrative staff
• Networks/credentialing, contracting
• Vendors for specialty services (i.e., CISD, SAP,
  dependent care, legal)

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Network

• CEAPs
• Psychologists
• Social workers
• Professional counselors
• Psychiatric or behavioral health nurse specialists

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Network (continued)

• Marriage family therapists
• Training in brief treatment models
• Knowledgeable about the workplace
• Experience and/or certification as a corporate
  trainer
• Certification and/or experience in critical
  incident stress management services

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Vendors

• Legal
• Financial
• Dependent Care
• CISD
• Web
• SAPs
• Specialty providers (i.e., trainers)

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Structural Variables

• Program value affected by design delivery
• Visits embedded in health plan
• Utilization tends to be lower (lack of promotion)
• Services embedded in another benefit (i.e., life,
  disability)
• Only provides services if there is a death or
  disability
• Telephonic and/or web only services
• May have limited effectiveness in serious cases
• Employee only services
• May not provide level of risk management
  important to employers

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Typical EAP Services
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EAP Components

• Plan designs evolved from original need to
  address substance abuse in the workplace to
  include many types of assistance services
• Employee/household member services, employer
  services, administrative services
• EAP components vary by carrier or vendor
• Expect to see many variations of services within
  components (apples to oranges)

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Telephone Counseling

• Toll-free, 24/7 access to crisis assistance,
  information counseling
• Ease of access
• Qualifications of staff providing service
• Not ongoing psychotherapy/counseling
• Special services (i.e., hearing-impaired
  languages)
• Some exceptions nationally

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Short-term Face-to-Face Counseling

• Session models vary from 3 to 8 sessions
• Definition of limitations on counseling service
  (annually, episode, authorization of limited
  sessions, etc.)
• Networks typically are non-medical providers
  (i.e., Ph.D, masters-level licensed providers),
  not psychiatrists
• Selection
• Via program referral
• Client-selected from lists or directory
• Members may or may not have continuity of care
  between EAP medical (psych) providers

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Work/Life Services

• Legal and financial services
• Consultants (typically telephonic)
• Discounted services
• Referrals to community resources
• Dependent care (child and elder)
• Referrals, education, consultations
• Typically includes web-based information
  work/life provider services
• Offered separately or included

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Website and Other Resources

• Primary entry point for new generation
• Self-assessments
• Internet resources links
• Relationship family issues
• Workplace issues
• Legal financial concerns
• Well-being mental health

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Employee Orientation and Supervisor/Manager
Training

• Onsite/in-person
• Web casts
• CD-ROM/VHS
• Employee orientations typically ½-hour
• Supervisor trainings discuss EAP as a risk
  management tool interface with policies
  protocols
• Offered as fee-for-service or built into
  capitated rate

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Workshops and Ongoing Education

• Targeted manager/supervisor or employee level
• Usually part of service menu
• Focus on employee topics (i.e., stress, time
  management, workplace violence prevention,
  balancing work life)
• Fee-for-service or part of capitated rate

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Workplace Trauma Response and Critical Incident
Stress Debriefing

• Workplace trauma response
• Telephonic counseling for tragic or upsetting
  worksite or community situation (i.e., employee
  death, crime, natural disaster)
• Critical incident stress debriefing (CISD)
• Onsite support service 24-72 hours of incident
• One or more specially trained counselors
  providing debriefing services in group setting

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Return-to-Work Case Management

• Transition plan assistance for employees
  returning to work (i.e., substance abuse)
• Interdependent on organizations policies
  procedures
• The EAP becomes probation officer for troubled
  employees

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Substance Abuse Consultations and
Recommendations/Networks

• Some employers need to meet federally mandated
  regulations set by DOT, DOE, DOD, DFW
• Some employers want a drug/alcohol free workplace
• Policy
• Implementation, training
• Testing
• Case management of positive cases
• Return to work management

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Utilization Reports

• No recognized industry standards
• EAPA standards
• Number of calls
• Types of calls
• Services provided
• Referrals
• Management services
• ROI

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Convenience Services

• Access services that make life easier for
  employees
• Reduces time employees spend regarding personal
  services
• Services vary widely
• Typically offered for an additional fee

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Other Services

• Adoption reimbursement program
• Lactation program
• Geriatric care management
• Identity theft program
• Financial coaching
• Onsite services

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EAP Providers
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Types of Providers

• Mom Pop
• Regional Independent
• National/International Independent
• Part of larger service organization i.e.
  Insurance company
• Union based

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Solving Employer Problems
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EAP Solves Employer Problems

• Risk management
• Drug-Free Workplace policy procedures
• Department of Transportation alcohol drug
  testing standards
• Safety-sensitive job descriptions
• Fitness for duty circumstances
• Workplace violence prevention
• Sexual harassment policy implementation
• Americans with Disabilities Act accommodation
  requests
• Family Medical Leave Act issues
• Productivity
• Human Resources tool

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EAP Effectiveness
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Return on Investment

• A well-run EAP provides employers with savings
• 33 less sick leave benefits
• 65 lower incidence of workplace accidents
• 30 reduction in workers compensation claims
• 35 decrease in health insurance expenditures
• (Fisher Vista, 2003)

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Utilization Drivers

• Program promotion
• HR other key players
• Managers/supervisors
• Culture
• Proactive persistence, creativity of EAP provider
• Account manager

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Goals and Outcomes

• Cost-effective benefits solution
• Benefits for full part-time employees
• Increased employee productivity
• Good employer-employee relations

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Goals and Outcomes (continued)

• Improved risk management
• Reduced workers compensation claims
• Reduced behavioral health costs
• Attract retain good employees

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EAP Challenges
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EAP Challenges

• Service menu definition (creativity vs. chaos)
• Commoditization (volume vs. custom)
• Quality (defining standards)
• Lack of universal standards for
• Service menu
• Utilization reporting
• Return on investment

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The Future of EAPs
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A Look at the Future of EAPs

• Continued effects of commoditization
• International growth
• Providers management/reaction to commodity
• Web as service delivery platform
• Defining ROI for purchaser
• Defining quality standards
• Defining EAP

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Summary

• EAP was defined by professionals who invented it
• EAP now defined by the marketplace
• EAP now defined by capabilities of large
  platforms, marketing, sales, service delivery
• EAP is being defined by technology

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Questions
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