Fed e r a l em p l o y e e
a
s s i s ta n c e pr o g r a m s
gu i d i n g pr i n c i ple s ,
F
r a m e w o r k , a n d
d
e F i n i t i o n s
September 2008
Table of Contents
Part 1: Guiding Principles for Federal EAPs ...................................................3
Part 2: EAP Framework .....................................................................................8
Individual Services..........................................................................................8
Managerial/Supervisory Services ..................................................................8
Organizational Services..................................................................................9
Administrative Services..................................................................................9
Part 3: EAP Definitions....................................................................................10
1
Introduction
As a result of a Federal Employee Assistance Program (EAP) Summit convened
by the Office of Personnel Management and the Department of Health and
Human Services that included representatives from across Government, we are
pleased to present Federal Employee Assistance Programs, Guiding
Principles, Framework and Definitions. Developed as a guide, rather than a
requirement, for Federal EAP Administrators and other stakeholders, the
information provided is based on participants’ knowledge of best practices in the
EAP field, as well as their own experience and understanding of EAP in Federal
workplaces, and is intended to address the ways in which these programs can
best meet mental and behavioral health needs of the Federal workforce.
2
Part 1: Guiding Principles for Federal EAPs
The Federal Government is a model employer in providing worksite-based
mental and behavioral health services. In delivering these services, Federal
Employee Assistance Programs (EAPs)
1) Deliver effective, efficient services based on the best available
knowledge and practices
2) Provide a safe, secure, and confidential environment
3) Maintain clear, open lines of communication with stakeholders
4) Treat clients equitably and demonstrate flexibility in meeting client
needs
5) Give clients appropriate control over their own care
6) Provide continuity of care to help clients achieve their goals
Further explanation of these Guiding Principles, along with examples of how they
may be integrated into programs, policies, and practices, is provided below.
1) Deliver effective, efficient services based on the best available
knowledge and practices
Current evidence-based practices, based on research from peer-reviewed
professional journals, are considered when decisions are made regarding
the design and delivery of EAP services
EAPs strive to use their resources efficiently in order to offer the greatest
possible access to EAP services
Examples of EAP policies, standards, and practices that align with this
principle
Assessments/analyses are conducted to determine needs of clients and
their employing organizations
EAP personnel/staff requirements and training/continuing education plans
and activities are in line with current evidence-based practices and clinical
standards
EAPs conduct evaluations, including client satisfaction surveys, on
effectiveness and appropriateness of program, and use the feedback to
adjust programs and services
There are management information systems in place that support the
collection of data
3
There are data/feedback/audits and evaluations and they contain certain
items and follow certain formats and timeframes
There are sound administrative structures in place to support an effective
organization
Promotion and outreach efforts are effective in reaching targeted
populations
There is up-to-date information on referral resources and insurance
coverage. Referral resources are regularly reviewed for quality assurance
2) Provide a safe, secure, and confidential environment
Services for all clients should be provided in a safe, confidential, respectful,
compassionate, trusting, and caring environment.
Examples of EAP policies, standards, and practices that align with this
principle
Confidentiality and record keeping (including informed consent and
electronic issues) policies and procedures are in place and adhered to
Complaints, identified risks, and grievances are responded to
There are formal policies and procedures addressing physical safety in the
EAP, if there is an onsite EAP office
There is compliance with all applicable laws, regulations, and case law
Whenever applicable, HIPAA standards/requirements are considered in
creating EAP policies and procedures
3) Maintain clear, open lines of communication with stakeholders
Individual clients have access to their own paper or electronic EAP
records and to any information that will help them make decisions about
their care
Host organizations have access to information that will help them make
decisions about their EAPs (this does not include information about
individual clients)
4
Examples of EAP policies, standards, and practices that align with this
principle
Clients are informed about policies and procedures related to record
keeping, confidentiality, phone monitoring, costs, limits of service
Evaluation and quality assurance efforts are in place and the results are
available
Training and education for EAP staff are parts of on-going EAP operations
Procedures regarding ownership, content, destruction, physical
maintenance, and access to EAP records are clearly stated in program
policies and communicated to all employees. One such policy is that
clients can have a copy of their records, but not the original version
EAP staff is informed about, understands, and supports human resource
policies and procedures
Referral information is up to date
Consideration is given to what standardized information will be found in
each case record. This will include the use of diagnostic categories (such
as the DSM)
4) Treat clients equitably and demonstrate flexibility in meeting client
needs
EAPs meet the most common types of needs and take into account
expressed client preferences
Services are provided according to current standards of care and within
the framework of any contractual obligations
Services for the work site and organization (such as supervisor
consultations, trainings, and crisis interventions) are also respectful of the
organizations’ histories, cultures, and unique preferences
Examples of EAP policies, standards, and practices that align with this
principle
EAPs should have knowledge of host organizations’ structures
Evaluations reflect broad satisfaction, across various demographic
populations, with how services meet needs
To the extent possible, physical facilities meet needs of clients and visitors
with disabilities
EAP staff is trained and understand diversity. They also assist the
organization in embracing diversity
As much as possible, quality and comprehensive services and referrals
should not vary because of factors such as the client’s location and choice
of practitioner
Training and education programs delivered by the EAP are customized
according to organizations’ needs
5
EAP may provide unique kinds of services as needed such as Drug-Free
Workplace (DFW), Critical Incident Stress Management (CISM),
Organizational Development (OD), On-line/telephone counseling
There is an advisory function/body available to the EAP
5) Give clients appropriate control over their own care
EAPs provide clients with information needed to make decisions, share
subject-matter expertise, support client self-empowerment, and provide
decision-making support
Participation in EAPs is always voluntary
EAPs also collaborate with host organizations so they can make decisions
about their EAP operations as well as EAP interventions at the
organizational level
EAPs have ongoing partnerships with key organizational units such as
EEO, human resources, medical/health, and work/life. When there are
conflicts between individual clients and host organizations, EAPs facilitate
compromises, as needed and appropriate
Examples of EAP policies, standards, and practices that align with this
principle
Clients are given referral choices
EAPs offer educational programs to managers and employees about EAP
services and about specific EAP-related issues
Policies delineate conditions under which employees can continue their
services
Policies provide that clients are ultimately responsible for decisions
As needed and appropriate, EAP staff consult with key staff in
organizations when developments affect employee well-being
6) Provide continuity of care to help clients achieve their goals
Access to EAP services is uncomplicated and convenient. Services may
be offered in many forms, including face-to-face, over the Internet, by
telephone, and in any other manner that may be available
Whenever referrals to outside sources are suggested, the EAP helps
clients make these transitions seamlessly
Whenever appropriate, the EAP empowers clients to initiate their care with
outside providers
Contact (including follow-up and maintenance activities) with clients,
outside providers of their services, and any others involved with their
cases is continuous until the concern/intervention is resolved
EAPs actively collaborate and communicate with those involved with
cases such as clinicians, practitioners, and outside programs to ensure
information is accurate, information is appropriately exchanged, and care
6
is coordinated
Examples of EAP policies, standards, and practices that align with this
principle
Access to EAPs is assured and is reflected in policies and procedures
related to response time, geographic dispersion of counselors, availability
of staff, and so forth
Continuous consultation is maintained with all involved in the EAP,
including management, leaders, unions, referral resources, and health
insurance providers
Policies (including protections of confidentiality) are in place regarding the
technology of telephone and Internet services
EAPs have policies and procedures delineating their relationships with
other providers such as managed care companies, affiliates, and referral
resources
Follow up is routine
Referral information is reliable
EAPs select referral resources based on availability, services offered, and
access
7
Part 2: EAP Framework
What is an EAP in the Federal Community? What do EAPs do, what is their
purpose, and who receives EAP services? The answers to these basic
questions can be summarized in terms of four types of core services EAPs
provide.
The four types of core services Federal EAPs provide are
1: Individual
2: Managerial/Supervisory
3: Organizational
4: Administrative
Individual Services
Services provided for individuals include
Assessment
Treatment planning
Referral
Short-term problem solving/counseling/facilitating change
Follow-up
Referral and information
Collaboration with others (such as treatment facilities, managed care
organizations, managers, HR staff, etc.) regarding case planning and
outcomes
Managerial/Supervisory Services
Services provided for managers and supervisors include
Assistance in referring employees to the EAP
Guidance about how to appropriately support employees with personal
concerns that may be affecting their health and well-being
Assistance with back-to-work conferences and reasonable
accommodation agreements, in consultation with appropriate human
resources specialists
Performance management guidance/consultation particularly around
issues related to employee conduct and performance, as well as those
related to occupational situations and conditions that affect employee well-
being, as appropriate, in consultation with human resources professionals
Supervisor training and education
8
Management consulting and coaching
Organizational Services
Services provided for organizations include
Violence prevention and crisis management
Traumatic and critical incident services
Group interventions, support groups
Employee orientation
Educational services/programs
Special and auxiliary services (such as work/life, drug-free workplace
training and handling of mandatory referrals, outplacement services,
disability management, change management, organizational development,
etc.)
Administrative Services
Services in support of program operations/program administration
activities include
Development of and adherence to policies and procedures (general
policies as well as compliance with applicable laws and regulations)
Outreach/marketing and publicity
Evaluation, reporting, and quality improvement /assurance
Web development and maintenance
Staffing and professional development/other human resources activities
Development of program structure/design (such as budget, advisory
committees, board of directors, etc.)
Referral (clinical) resource development and maintenance
Involvement with committees/groups/teams within the organization
9
Part 3: EAP Definitions
Accessibility – Those provisions as stipulated by the Americans with Disabilities
Act of 1990, as they apply to the Federal community through the Rehabilitation
Act of 1973, as amended, providing disabled consumers physical and
communications access to services. In addition, it also relates to “the opportunity
of consumers to obtain services based on the location of service, hours of
operation, and affordable fees.”
1
Accreditation – The formal evaluation of an organization against generally
accepted criteria or standards. A professional society, non-governmental
organization or a governmental agency may conduct accreditation activities.
2
Currently, there is no Federal, state or local requirement for an EAP to obtain
accreditation in order to provide services.
Affiliates – “An individual or group of professional mental health practitioners,” or
other service oriented entities “who, through a contractual relationship with the
prime Contractor, provide EAP services to Federal employees.”
3
This
arrangement occurs when the prime contractor, in an attempt to satisfy the
elements of a Federal EAP contract, hires subcontractors to perform some or all
of the requirements of the contract, as part of an external or blended EAP model.
Agency Population – Those Federal employees who are full-time, part-time,
wage-grade, term, and other directly compensated employees, receiving a W-2
for tax purposes, who are not employees of contractors. This count is usually the
number used in tabulating the agency’s EAP utilization rate. (Also see Covered
Lives)
Assessment – An ongoing process or evaluation in which professional expertise
and skills are exercised to collect and analyze data, which in cooperation with the
client, results in identifying, defining and prioritizing the client’s physical, mental,
and social issues, problems or challenges. An assessment provides for an
accurate diagnosis of the client and the basis for a treatment or problem solving
plan.
4
Assessed Primary Problem – An issue or problem determined by the EAP
counselor to be the core issue (such as a mental health concern, work/life issue,
and/or medical manifestations) that, once addressed, should result in the
resolution or mitigation of the symptoms and/or problems of the client.
1
Council on Accreditation (COA) Glossary, 7
th
Edition/Version 1.1
2
Ibid.
3
Federal Occupational Health (FOH) definitions, as modified by the subcommittee.
4
COA Glossary, 7
th
Edition/Version 1.1 and subcommittee language
10
Assessed Secondary Problem – Additional issues that directly affect the
primary problem and are often a consequence of the primary problem.
Assessed Tertiary Problem – Additional problems or issues may need to be
addressed, which may be related to, or be independent of, the primary or
secondary problem.
Assessment and Referral EAP – An EAP that offers services limited to
providing assessment and information and referral to its respective clients.
Sessions are limited to conducting the assessment and providing that information
to the client including a treatment or problem-solving plan.
Back-to-Work Conference – A conference usually arranged by the EAP
counselor with the prior consent of the employee/client, to meet with the client’s
supervisor, EAP counselor, union representative and other appropriate
management and treatment personnel as may be pertinent to the situation, to
facilitate the employee’s successful return to work. (Before involving a union
representative the employee’s supervisor should contact the labor relations office
to determine what, if any, obligation exists to notify/invite representation.) Such a
conference is scheduled following an extended hospitalization or other long-term
medical treatment. The conference agenda usually considers the employee’s
ongoing treatment and aftercare needs in coordination with the agency’s
expectation of the employee’s performance, conduct and attendance.
5
Biopsychosocial Assessment – An assessment based on a model of health
and illness that links the nervous system, the immune system, behavioral styles,
cognitive processing, and environmental factors.
6
The assessment is performed
by a well-trained and licensed mental health professional and is a precursor to
any diagnosis, or any short or long-term mental health counseling or referral.
Blended EAP Model – See EAP Model
Brief/Short-term Counseling/Treatment – Services provided by the EAP
counselor to the employee/client for approximately 1 to 6 sessions. The basis for
the number of sessions is often determined by the philosophy of the agency
and/or financial considerations. When counseling is required beyond the number
of sessions originally provided, the EAP counselor is expected to ensure the
employee is referred out and the linkage to the new counselor is made.
Capitation Rate – A per-employee dollar amount per year, paid by a Federal
agency to an external EAP provider for EAP services, under the terms of a
contract. In exchange for the payment, the EAP vendor usually provides all
5
Sub-committee language and Employee Assistance Professionals Association (EAPA)
Glossary of Employee Assistance Terminology, 1994, page 4.
6
American Psychological Association (APA) definition of Psychosocial Model
11
contracted services regardless of the level of use (utilization) by agency’s
employees and covered family members.
7
Thus, if only one employee received
services the entire year, the contractor would receive 100% of the agreed-to
payment. If hundreds of employees were to receive services, the contractor
would have to provide the services at the agreed-to price without any additional
consideration.
Capitated Risk – The assumption of responsibility by a clinician or an
organization for providing specific services to clients under a pre-established
reimbursement agreement,
8
and where the contractor assumes the financial risk
should the EAP services delivered exceed the contractor’s cost projections.
Case Represents a discrete unit of contact as defined by the sponsoring
Federal EAP (host organization). A case may be defined by agency policy
and/or within the parameters of an EAP contract. Thus, an agency can have a
counseling (clinical) case, a management/supervisor consultation case, an
assessment and referral only case, or an information & referral only case. When
determining utilization, the reporting EAP should identify what type of cases they
are reporting and report each as an individual incident rate (i.e.: Counseling
cases = 6%, I&R only = 4%, etc.)
Case, Opened – A formal documented client relationship between an EAP
counselor and an employee or covered family member, in which a written or
electronic record is established after contact has been made between the
counselor and the client. As an example, an EAP can report having a specified
number of opened “counseling cases,” “I&R cases,” or “assessment and referral
cases.”
Case Management – The coordinating, monitoring and discharge planning of
overall services, by the EAP counselor for the EAP client and Federal agency, to
ensure treatment gains are realized and that the employee makes the most
benefit of the resources at hand. This is usually a standard component of the
EAP vendor’s service and may or may not be provided at an additional charge,
when provided by a contractor.
Chemical Dependency – Physiological and psychological dependence on a
chemical, such as alcohol, tobacco, barbiturate, or narcotic, which results in a
number of physical and emotional symptoms such as increased tolerance and
withdrawal symptoms when the chemical is removed.
9
7
EAPA Glossary of Employee Assistance Terminology, 1994, page 4, and subcommittee
modification.
8
COA Glossary, 7
th
Edition\Version 1.1, page 2
9
Ibid., page 3 and committee modification.
12
Client – An individual who is eligible to receive EAP services, as defined by
agency policy or contract requirements. A client might include an employee or
the employee’s spouse, dependent child, parent, or domestic partner, or a
retiree.
Client Record – A written and authenticated compilation of information that
describes and documents the assessment and present, prospective, and past
services to the consumer.
10
The content of the record may be defined by the
Federal agency or by the EAP contractor. The format and content of a client
record is usually based on accepted practice standards applicable to the EAP.
Client Satisfaction Survey – An anonymous and confidential measurement
solicited from the EAP client, by the EAP contractor or sponsoring Federal
agency, which reflects client satisfaction with EAP services received. A Federal
agency may design its own survey instrument or have the contracted EAP design
one as part of its contract requirements, with or without the Federal agency’s
input. Such measurements should be routinely taken by an acceptable and
easily administered means. Whenever possible, the survey instrument should
allow for easy tabulation and review. Client satisfaction assessments may
include, but are not limited to, such items as timeliness of initial contact,
timeliness of service delivered, follow-through, effectiveness in resolving the
client’s issues, confidentiality, accessibility, and conformity with the agency’s
culture.
Clinical – Of or pertaining to examination, assessment, and direct counseling or
treatment, as opposed to experimental or laboratory study.
11
Clinical Personnel/Staff – Those persons the Federal agency has designated to
provide assessment and counseling services through its EAP. Such personnel
are usually licensed mental health practitioners or otherwise qualified and trained
professionals who provide the treatment or counseling services.
Clinical Services – Those services offered by an EAP counselor in which an
assessment and counseling are provided.
Counseling Services – Specialized services and therapeutic interventions
provided by both licensed and non-licensed professionals (as permitted by the
sponsoring Federal agency) with the purpose of identifying and mitigating or
resolving clients’ personal, professional, financial, mental health, or addiction
problems or challenges.
12
10
Ibid., page 4.
11
COA, 7
th
edition\Version 1.1, page 3, modified by including the word “counseling.”
12
COA, 7
th
edition\Version 1.1, page 4, and subcommittee language.
13
Counselor, EAP – A specially trained individual, usually licensed in the field of
mental health and addictions, who operates in an occupational setting and whose
clients may be both management and employees in general.
Covered Lives The total universe of persons who are eligible for EAP services
as defined by the sponsoring (host) agency. A Federal agency might define
covered lives as employees and their family members, while another agency may
offer services only to employees.
Crisis Intervention – A brief type of therapy or counseling, offered to persons
involved in a highly emotional or traumatic event, to prevent long-term
psychological harm, with the intention of restoring the clients to at least their pre-
crisis level of functioning, and referring to long-term treatment resources as may
be warranted.
Critical Incident An event, usually sudden, unexpected and potentially life-
threatening, “in which a person experiences a trauma, i.e., feels overwhelmed by
a sense of personal vulnerability and/or lack of control. Examples of a critical
incident are a natural disaster, serious workplace accident, a hostage situation or
violence in the workplace.”
13
Critical Incident Stress Debriefing (CISD) A structured group or individual
intervention that encourages the expression of thoughts and feelings about the
incident, followed by identification and normalization of symptoms, familiarization
with the process of recovery, and referral to appropriate services. The EAP (in
cooperation with the host organization), usually schedules a CISD at the worksite
with a group of employees directly affected by a critical incident as soon as
possible following the traumatic event.
14
15
Critical Incident Stress Management The constellation of services or
activities that may be used by an organization to respond to and manage a
critical incident (core concept was developed by the International Critical Incident
Stress Foundation). Services and activities include, but are not limited to,
debriefings, outreach to the workforce, psycho-educational activities related to
trauma, anniversary responses, etc.
16
13
EAPA Glossary, 1994, page 7, and committee language
14
Ibid., with “in cooperation with the host organization” added.
15
A CISD is a concept coined by Jeffrey T. Mitchell, Ph.D.,
15
and has become an integral
part of the International Critical Incident Stress Foundation (ICISF). It was originally
meant to be applied among public safety, disaster response, and military and emergency
service personnel by a skilled intervention team. The ICISF contends that a CISD can
also be used with virtually any population, including children, when employed by a
skilled intervener. Some researchers contend that “scientific studies have resulted in
numerous calls for caution and restraint in the use of CISD.”
15
16
FOH Definitions
14
Diagnosis The process by which a social, physical, emotional, or mental
problem and its underlying causes are identified by the treating physician,
counselor, etc. The process involves collection and analysis of relevant
information
17
and should be performed by a qualified licensed professional.
Drug Abuse – An individual’s excessive use of substances (either legal or
illegal) that are consumed in amounts hazardous to the health or safety of the
person and/or community.
Drug Addiction A state of physiological dependence that results from the
abuse of chemical substances. In the absence of the substance, an individual
experiences symptoms of withdrawal.
18
(See also Chemical Dependency)
Drug Free Workplace Those laws, regulations and policies emanating from
Executive Order (EO) 12564 of September 15, 1986, and subsequently the Drug-
Free Workplace Act of 1988, that ordered Federal employees to refrain from
using illegal drugs, whether on or off duty. It mandates that the head of each
Executive agency shall develop a plan for achieving the objective of a drug–free
workplace. Elements of the plan include establishing a program to test for the
use of illegal drugs by employees in sensitive positions; training for managers
and employees; and establishment of EAPs that emphasize high-level direction,
education, counseling, referral to rehabilitation, and coordination with available
community resources.
19
Employee Assistance Professional An individual who assists the
organization, its employees and their family members with personal and
behavioral problems including, but not limited to health, marital, family, financial,
alcohol, drug, legal, emotional, or other personal concerns which may adversely
affect employee job performance and productivity. The specific activities of an
EA professional may include any of the services described under the definition of
Employee Assistance Program (below). EA Professionals providing clinical
services must be licensed or certified in their state to provide these services.
20
Additional credentials may be required by the host organization.
Employee Assistance Program An EAP is a worksite-based program
designed to assist in the identification and resolution of work-related and non-
work-related productivity problems associated with employees impaired by
personal concerns including, but not limited to, health, marital, family, financial,
alcohol, drug, legal, emotional, or other personal concerns which may adversely
affect employee job performance. The specific core activities of EAPs include (1)
17
COA, 7
th
Edition/Version 1.1, page 5, (modified with the additional phrase “by the
treating physician, counselor, etc.”
18
COA
19
Executive Order 12564 and committee language.
20
Ibid., page 8-9
15
services for individuals (such as identification and resolution of job-performance
issues related to an employee’s personal concerns, and assessment, referral,
and follow-up); (2) services for managers and supervisors (such as assistance in
referring employees to the EAP, supervisor training, and management
consulting); (3) services for organizations (such as violence prevention/crisis
management, group interventions, and employee orientation); and (4)
administrative services (such as the development of EAP policies and
procedures, outreach, evaluation, and referral resources development).
Employee Assistance Program Administrator – The agency staff person
responsible for managing all EAP related policies, procedures and services. This
may include acting as the contracting officer’s technical representative (COTR),
supervising staff, providing information about the EAP to agency employees and
managers, and ensuring the quality of all services provided. The Administrator is
usually a Federal employee entrusted to look out for the Government’s best
interest and may also act as the EAP Liaison.
EAP Liaison – Those individuals employed by the sponsoring Federal agency
(host) who are responsible for ensuring that the EAP contract is administered in
accordance with established policies and procedures.
21
EAP Model – The method of delivering EAP services. While the types of
services offered through the EAP may vary in breadth from agency to agency,
they are typically delivered through one of 5 basic staffing models. These are:
1. Internal model, where the EAP staff is comprised of Federal employees
and there are no contractors involved.
2. External model, where the sponsoring Federal agency has entered into a
contract for an outside vendor to provide all EAP-related services.
3. Blended model, where both Federal and contract personnel are involved
in the delivery of EAP services. The Federal employees usually have the
role of monitoring the EAP contractor’s services, billing, and performance,
while also providing counseling and other administrative services.
4. Consortium model, where a group of Federal agencies contracting with
one agency or contractor to provide employee assistance services.
5. Peer-Based Programs (or Peer Support Program) – An in-house
program, typically delivered through trained peer/coworker volunteers.
Usually offers education, training, and referrals.
Employee – See Agency Population
21
FOH Definitions
16
Ethics Formal principles or values for evaluating practices that are right or
wrong, good or bad. Most professional organizations have ethical codes of
conduct that define general standards of appropriate professional conduct.
Ethical Standards A specific set of professional behaviors and values (code of
ethics) the employee assistance professional must know and abide by, including
confidentiality, accuracy, privacy, and integrity. A non-licensed EAP professional
or counselor should, at a minimum, abide by the Employee Assistance
Professionals Association (EAPA) Code of Ethics and Employee Assistance
Certification Commission (EACC) Code of Professional Conduct.
Evaluation A qualitative or quantitative measure of EAP performance related
to program goals. A process evaluation measures the activities associated with
the daily operation of the program, such as number of employees seeking
services, the waiting time between initial contact and help, and the number of
consultation services resulting from supervisory referrals. An outcome
evaluation measures the results of EAP activities, such as return on investment
and supervisor rating of employee’s performance after EAP intervention.
22
Fee-for-Service – Payment to providers/contractors, by a Federal agency, only
for those EAP services rendered. Usually based on an hourly fee for services
actually performed, such as counseling time, training hours performed, or time
spent providing information.
Fitness for Duty (FFD) An employer’s determination of an employee’s
preparedness to work. Fitness-for-duty policy and procedures are often
associated with the use of alcohol or illegal drugs, yet may also deal with an
employee’s general physical or mental readiness to perform in a particular
position. FFD procedures may require medical and/or psychological evaluation
of an employee, or drug testing of an employee exhibiting unusual or bizarre
behavior. FFD procedures may be regulated by Federal law.
23
Federal EAPs
must exercise extreme caution in becoming involved in determining an
employee’s fitness for duty, in order to avoid confidentiality, legal and other
ethical entanglements, and should especially refrain from conducting a FFD on
an employee who had previously been an EAP client. To further delineate FFD
reporting, the EAP’s Statement of Understanding should highlight any reporting
requirements the Federal (host) agency has required in this regard and explain it
to each employee/client before EAP services are rendered. For further
discussion on agencies’ authority to require or offer medical examinations see
5CFR §339, “Medical Qualification Determinations.” Fitness-for-Duty
determinations are to be distinguished from a counselor’s “duty to warn.”
22
EAPA page 9
23
EAPA, page 10, with committee narrative added at the end.
17
Follow-up One or more contacts with an EAP client to monitor progress and/or
the impact of the EAP recommendations or referrals to treatment resources and
to determine the need for additional services. Follow-up may consist of
telephone contact, in-person interviews, written satisfaction and progress
surveys/questionnaires, and a review of job-performance and attendance
records. Follow-up is a monitoring process, not a therapeutic process such as
aftercare.
24
Host Organization – The Federal agency or sub-agency that provides the
resources to establish and support EAP services.
Information and Referral Data addressing specific subjects or community
services a client has requested (e.g., psychologist, elder care, child care, legal
referrals) and that the EAP has researched and provided to the client.
Intake The entry point at which a potential EAP client’s eligibility is assessed
against established criteria and a preliminary evaluation of the presenting
problem occurs.
25
Usually the first appointment with the counselor is when the
intake occurs. Intake usually begins in the first appointment with the counselor.
Last-Chance Agreement – A signed agreement between an employee and the
employing Federal agency, usually drafted by the employing agency’s Employee
Relations unit, that specifies management’s expectations regarding the
employee’s performance, conduct and attendance over a defined period. The
agreement may require EAP participation and other treatment requirements and
certain reporting requirements to management to demonstrate adherence to the
agreement. Any failure to meet all the requirements of the agreement on the part
of the affected employee may result in the employee’s termination. While such
an agreement may mandate the employee to work with the agency’s EAP, an
employee cannot be forced to accept EAP services. In the event an employee
signs a last-chance agreement and later refuses to work with the EAP as the
agreement requires, the agency may separate the employee for non-compliance.
Management Consults Expert advice given to leaders, supervisors, human
resources, and/or union representatives regarding the management of potential
or actual performance and conduct concerns. One example is coaching a
supervisor on how to refer an employee to the EAP.
Management Referral – Referrals to the EAP that are initiated by an employee’s
manager/supervisor because of performance or conduct concerns. Such
referrals can be oral or in writing and are not considered disciplinary actions.
24
Ibid.
25
COA page 7, with the additional words “a potential EAP client’s” were added.
18
Mandatory Referral – A referral by the supervisor to the EAP for an employee’s
positive drug test or other events designated by the agency. While this referral to
the EAP is mandatory, there is no authority or requirement to compel an
employee to partake of EAP services, which are voluntary. Failure to do so,
however, may have adverse consequences for the employee.
Non-Clinical Staff – EAP staff who typically are not certified, licensed or
authorized to provide assessments, diagnosis or counseling services. They
provide other types of support to the EAP such as conducting triage, providing
referral information to clients, and providing training.
No Show – A failed appointment, where the client failed to meet with the
counselor as was previously agreed to. Usually in fee-for-service contracts, a
“no show” may not be billed by the counselor/vendor.
Opened Case – See Case
Organizational Development – A professional process or activity designed to
assist an organization, agency, or office to move from one level of performance
or mode of operation to another in the shortest time possible.
Outcome Goals – Expected results related to EAP services.
26
Such goals might
be a reduction in sick leave, improved organizational efficiency, etc.
Outcome Measures – Standards by which outcome goals can be evaluated to
determine whether goals have been attained.
Peer Support Personnel – Federal employees who have volunteered to
participate in an agency’s Peer Support Program. Peers are non-professionals
who usually have a limited role in assisting their peers when there are traumatic
events at work or other personal challenges. (See “EAP Model.”)
Per-Employee Cost – The total cost of operating an EAP divided by the number
of persons eligible for services. Total costs would include salaries, benefits,
travel, rent, and other operational costs including contract costs. This is a
measure by which a Federal agency can evaluate its EAP costs relative to the
market place. Current information on pricing norms can usually be found through
EAP professional associations such as the Employee Assistance Professional
Association.
Presenting Problem – The personal concern or issue as described by the EAP
client prior to assessment by the EAP professional.
27
26
EAPA page 13.
27
Ibid.
19
Primary Problem – (See Assessed Primary Problem)
Program Audit and Evaluation – The process conducted by experienced EAP
counselors to review a Federal EAP to ensure that it is performing according to
law, regulation, policy, procurement regulations and accepted standards of
clinical practice. Such audits may be initiated by the EAP itself, by the Federal
agency’s internal audit system or by an external EAP vendor. Federal agency
audits and evaluations must ensure, at a minimum, the confidentiality of client
records and conform to 42 CFR part 2, “Confidentiality of Alcohol and Drug
Abuse Patient Records.”
Quality Improvement – The process that assures an EAP has the means to
evaluate its performance and improve that performance in order to deliver a
quality service or product. The quality improvement plan is defined by the
sponsoring Federal agency, the requirements of an EAP contract, or as may be
developed by the contractor and sponsoring Federal agency.
Referral
1. Self-referral – voluntary and confidential use of the EAP by an employee
who suspects that he or she has an alcohol, other drug, emotional, and/or
other personal concern.
2. Formal or informal referral – referral to the EAP by a supervisor or other
management official of any employee who has deteriorating job
performance, time, attendance and/or conduct problems, either orally or in
writing.
3. Other referral - referral to the EAP of an employee by a union official,
medical review officer, health unit, or through any means other than a self-
referral or a supervisory referral.
28
Release of Information – A document signed and dated by a client, giving the
EAP (counselor) permission to release specific information about the client, to a
person outside the EAP. The release format should, at a minimum, reflect the
provisions of 42 CFR part 2, subsection 2.31, Form of written consent. Some
agencies may also be covered by HIPAA requirements.
Return to Work Agreement – An agreement among an employee, the
employee’s supervisor, the EAP, treatment provider and other parties as may be
appropriate, to establish a set of conditions for the employee’s return to work. It
is usually issued following extended leave for treatment for substance abuse or
physical or mental illness. The conditions found in the agreement are usually
related to duties, conduct, attendance and treatment scheduling. The agreement
also states any consequences, if agreed-upon conditions are violated and what
action the supervisor may take. A Return to Work Agreement should be drafted
in consultation with the agency’s Employee Relations staff.
28
FOH Definitions
20
Risk Management – A systematic process for evaluating and reducing potential
harm that may befall personnel, consumers of service, an organization, or a
facility.
Session – A meeting between an EAP counselor and client, usually lasting 45 to
50 minutes.
Short-Term Counseling – See Brief/Short-term Counseling/Treatment
Statement of Understanding – A document that describes the limits of
confidentiality and the services available through the EAP. It is given to the
employee at the beginning of the first session and must be signed prior to the
employee receiving counseling. The elements of the statement must contain
those reflected in 42 CFR part 2, subsection 290.ee-3, the Health Insurance
Portability and Accountability Act (if applicable to the agency), and other unique
circumstances about the EAP that should be disclosed to the employee.
Supervisory Referral – See Referral
System of Records Notice – A notice published in the Federal Register by a
Federal agency with an EAP records system, announcing it has established and
will retain EAP records. The Privacy Act (5 U.S.C. 552a) and OMB Circular A-
130 require a Federal agency to alert the public that it has established a system
of records about individuals. “The term ‘system of records’ means any records
under the control of any agency from which information is retrieved by the name
of the individual or by some identifying number, symbol, or other identifying
particular assigned to the individual.”
29
The notice must explain what records are
retained, how long they are retained, who the records holder is, and how EAP
clients may access their EAP records, among other things.
Telephonic Counseling – Counseling performed over the telephone either at
the request of the EAP client, due to situational circumstances, or based on the
EAP model offered by the sponsoring (host) Federal agency.
30
Treatment – The process through which a patient receives services designed to
resolve mental health and/or substance abuse problems.
31
Treatment is the
29
The Privacy Act of 1974; 5 U.S.C. ss 552a, as amended
30
Telephonic counseling allows for quick and timely services, but lacks human
interaction and fails to assess body language which can affect clinical conclusions. When
licensing is an issue it raises additional confusion when the client being served is out of
state and the license held by the counselor is issued by a different state. This is more of
an issue when the EAP client is not an employee (family member or significant other)
and raises liability concerns for the Federal agency and other affected entities.
31
EAPA Glossary, 1994, page 6
21
22
application of some form of intervention to mitigate or eliminate some identified
ailment. Traditionally, in mental health it is in the form of medication or talk
therapy (counseling). In the EAP context, treatment and counseling are
interchangeable terms, since mental health counseling also is designed to
resolve mental health and/or substance abuse problems. (See also Counseling
Services).
Unit Cost A calculation of the price or value of a fixed amount or unit of service
that takes into account the sum of all organizational expenditures involved in the
provision of that service.
32
Utilization Rate – The annual rate at which EAP services are being utilized by
those eligible for services. There are separate utilization rates for each of the
services offered by the EAP (such as assessments of individuals, family member
use, training attendance). There are formulas for determining utilization rates in
each of these areas. In the first example (individual employee utilization), the
formula would be: Number of employee cases opened in this reporting year
divided by the number of employees who were eligible to participate in the EAP
during this reporting year x 100. These rates are typically compared to
benchmarks in the EAP industry.
32
COA, page 12.