These general guidelines are to assist providers understand the unique requirements of EAP service delivery for covered employees and dependents
The range of EAP services typically includes assessment and referral, problem-solving and/or short-term intervention, depending on the presenting problem(s) and the benefit design selected by the employer.
EAP services should always begin with a careful assessment of the presenting problem(s) to determine if an EAP intervention is appropriate or if a more intensive level of care is indicated.
The assessment should result in the formulation of an EAP Treatment Plan. Goals and discharge criteria should be objective and measurable.
For employees in crisis, the goal of EAP is typically the restoration of the employee’s satisfactory level of functionality.
The role of the EAP therapist is typically active and often directive, particularly during a crisis. Rocky Mountain EAP recommends that sessions be focused on strategizing solutions, building on strengths, accessing support systems, and utilizing community resources when and where appropriate.
EAP counseling is typically present-centered and does not seek extensive exploration or attempted resolution of long-term family of origin issues.
A DSM-IV diagnosis is required through the EAP. Severity and intensity of symptoms and/or presenting problems combined with the available number of sessions under the employee’s benefit design may be an indicator of appropriateness for utilization of EAP services.
EAP Administrator handles all communications with supervisors in the case of management-based referrals for performance problems. Providers should never communicate directly with employers or other persons unless they have written consent from the employee and authorized to do so by Rocky Mountain EAP Administrator.
EAP GUIDELINES
DEFINITION
The specific core activities of EAP services include assessment, brief-focused consultation or referral for appropriate diagnosis, treatment and assistance. Additionally, EAP may assist in the formation of linkages between employees, their families, and available community resources that provide necessary services, follow-up, and a wide range of employee support services.
The following are intended as guidelines only, to assist in the determination of an appropriate candidate for EAP services. Given the wide array of EAP support services available to eligible participants, it should be recognized that while EAP services may not always be the most appropriate intervention, it can and should be considered an adjunct to more intensive levels of intervention.
ASSESSMENT
The provider should complete an initial assessment based upon clinical guidelines by obtaining necessary clinical and non-clinical information to assist in an appropriate referral, including the following:
Presenting problem, including stressors, precipitants, and severity of symptoms;
Psychiatric and substance abuse history;
Relevant medical history;
Provider preferences;
Social and family supports or vulnerabilities;
Assessment of risk to self or others; and
Workplace issues (attendance, work performance, problems with co-workers as well as job jeopardy and disability leave [short or long term] to name a few).
ISSUES APPROPRIATE FOR EAP SERVICES
PSYCHOSOCIAL/ENVIRONMENTAL CONCERNS:
Job/occupational issues
Marital/family problems issues
Relationship issues
Grief/loss
Concern about another’s substance abuse
Compulsive behaviors (e.g., internet use, shopping, gambling, etc.)
CLINICAL PROBLEMS RELATED TO:
Anxiety
Depressions
Mood disorders
Phobias
Gambling
Eating disorders
Psychosis
Hyperactivity
Learning disability
Individuals with the above concerns may, after initial assessment, be appropriate candidates for EAP services, provided:
- The purpose of EAP intervention is time-limited and focused on problem resolution within a given session model, or
- The purpose of EAP intervention is assessment, referral and education of a participant in the process of coordinating alternative levels of sustained care.
SUBSTANCE ABUSE ISSUES
Individuals presenting with certain substance abuse/dependency issues may be appropriate candidates for EAP as the initial service option when an employee receives a formal, mandatory, or regulatory referral (depending on company policies and federal regulations) into the EAP by the employer or supervisor. The referral may result from:
A positive random drug or alcohol screen;
A positive drug or alcohol screen after a for-cause test;
A positive drug or alcohol screen post-accident;
A fitness-for-duty related issue;
Internal policy/procedure requirements of the client company; or
Self-referral
In addition, EAPs can be of assistance when an individual has relapsed and the most appropriate intervention is education and linkage to appropriate support systems.
REFERRAL FOR SPECIALIZED TREATMENT
Individuals with the following problems may, after initial assessment, require a referral for specialized treatment due to the complexity and/or urgency of their clinical situation:
Individuals with psychotic symptoms;
Clinical conditions that require possible inpatient admission;
Individuals presenting with substance dependence requiring stabilization in a structured program setting;
Individuals with unstable medical conditions with behavioral components;
Individuals taking psychotropic medication;
Individuals needing medication follow-up post-hospital;
All chronic relapsing illnesses with a history of previous hospitalization; and
Individuals who have recurrent illnesses and/or a pattern of going from one crisis to another and have not been responsive to short-term intervention.
PROVIDER SELF-REFERRAL
A provider self-referral is defined as a situation in which an EAP provider accepts and evaluates an eligible member in a case originating through the EAP, and then provides ongoing treatment for the member for mental health problems as part of the member’s mental health plan.
Historically, EAPs were designed as assessment-and referral-only programs with a workplace focus. Over time, some programs offered brief treatment models as well. In order to prevent any possible conflict of interest between the needs of patient and the self-interests of the provider, most plans required EAP providers to refer to a different provider any employee who needed care beyond the EAP. Today, even though most referrals into outpatient benefit plans are monitored for medical necessity, many customers still require that EAP providers not refer to themselves for ongoing care.
For that reason it is important that EAP providers clearly understand their role when they accept a case as an employee assistance therapist, and that they explain their role and its limitations at the first meeting with an employee.
REFERRALS REQUIRING MORE EXTENSIVE CARE
Employer organizations are typically presented with a menu of EAP program options and select the benefit design that best fits the needs of their employees and the organization. This means that one employee may be eligible for only a 1-3-session assessment and referral model, while employees of another organization may be entitled to as many as 8 sessions in a brief treatment model. Some organizations make use of the EAP entirely optional, while others use the EAP to provide a “gatekeeper” function, which means that employees must first be evaluated face-to-face by an EAP provider before accessing their behavioral health benefit plan.
Rocky Mountain EAP Administrator briefly assesses incoming calls to the EAP based upon the above program design and the severity of presenting problems before referring into the EAP. Face to face evaluation by the EAP provider may uncover additional needs that clearly exceed the limitations of the EAP. In such cases, EAP providers should contact their referring EAP Administrator sooner rather than later in order to facilitate a referral to the appropriate level of care.
Rocky Mountain EAP strongly discourages EAP providers continuing to see employees through the EAP when it becomes clear that the person is in need of longer-term or specialty care. While it may be appropriate for the EAP provider to utilize an additional session to explain their findings and recommendations to an employee, it is inappropriate to attempt to engage in therapy that cannot reasonably be concluded within the remaining EAP session allowance.
- Adapted from EAPA Standards and Professional Guidelines for Employee Assistance Programs, January 1998.
GETTING STARTED
PARTICIPANT ACCESS
Important, traditional elements of an EAP include the problem-solving nature of the EAP and an immediate response to EAP participant calls for assistance. In order for EAP participant assistance to occur as soon as possible upon the initial call to Rocky Mountain EAP, your role as an EAP provider is essential and critical. A solid link between Rocky Mountain EAP, providers, and EAP participants requires twenty-four hour telephone access for EAP participants – seven days a week – with easy access to a nationwide network of EAP providers.
EAP participants from any payer organization may access a team of Rocky Mountain EAP professional staff during regular business hours. After hours, EAP professionals, at Rocky Mountain EAP call center, will handle calls and redirect as appropriate. EAP participants access Rocky Mountain EAP services via a dedicated toll-free number.
PARTICIPANT REFERRALS
In general, a contracted EAP provider will receive referrals from Rocky Mountain EAP Administrator.
Self-referral – an employee or eligible EAP participant requests EAP services.
Supervisory (job performance based) referral – a referral usually initiated by management with varying degrees of EAP participant compliance. In this type of referral, there are job performance issues, which have necessitated the referral. Generally, the employer will request feedback regarding the outcome. EAP providers should never communicate directly with employers even if contacted by the employer. A signed consent to release information to employers is required.
Positive drug screen referral – a referral from the work location of an EAP participant for a substance abuse assessment and recommendation from the EAP as a result of a positive screen for alcohol or other drugs. A signed consent to release information to the employer is required. EAP providers should never communicate with employers, unless authorized to do so.
ELIGIBILITY INFORMATION
EAP eligibility will be verified prior to referring an EAP participant to you.
PAYER INFORMATION
When an EAP participant is referred to you, the following payer specific information is provided:
The number of EAP sessions available and other specifics
Any appropriate policies regarding substance abuse/compliance with regulatory agency requirements
Information regarding the origin of the referral (i.e., self or supervisory referral)
SCHEDULING APPOINTMENTS
Routine Appointment
Routine appointments should be offered to EAP participants within three (3) business days of the initial referral date.
Emergency and Urgent Appointments
All EAP providers may be asked to handle emergency and urgent appointments. These emergency and urgent assessments should be conducted on an immediate basis
If there are any questions regarding the EAP participant’s eligibility, contact Rocky Mountain EAP Administrator. EAP providers may call the 800 number at any time during regular business hours.
PARTICIPATING PROVIDER RESPONSIBILITIES
ADMINISTRATIVE RESPONSIBILITIES
RE-CREDENTIALING AND INFORMATION UPDATES
To assure accurate and timely changes to our EAP provider records, prompt written notification must be received of any additions, deletions or changes (including the effective dates) related to any of the following:
Re-credentialing
Verification of current state licensure or certification (every two years)
Verification of current individual malpractice liability insurance with limits, dates of coverage and provider’s name
Current resume/curriculum vitae (every two years) with special emphasis on substance abuse assessment and referral and EAP service provision
Any pending legal, administrative or licensure action not previously reported.
Updated Information
Address and telephone numbers
Name changes
Newly acquired areas of expertise
New service sites and/or deletions of others
DIS-ENROLLMENTS AND AGREEMENT AMENDMENTS
Dis-enrollments
Either Rocky Mountain EAP or a participating EAP provider may choose to terminate the EAP Provider Agreement.
If an EAP provider chooses to resign from the network, Rocky Mountain EAP must be notified in writing as specified in the EAP Provider Agreement. Rocky Mountain EAP will acknowledge receipt of the resignation request and confirm the date.
If Rocky Mountain EAP chooses to disenroll an EAP provider, written notification of the disenrollment including the effective date, will be given as specified in the EAP Provider Agreement.
Upon dis-enrollment, EAP providers are obliged to continue to provide EAP services to current EAP participants. All EAP participants currently under a provider’s care will need services completed through the EAP provider, or through another provider that is assigned by Rocky Mountain EAP. Rocky Mountain EAP will notify the dis-enrolled Provider of such an assignment. Upon completion of EAP services, all originals and copies of Rocky Mountain EAP and proprietary documents, including this manual, must be returned immediately to the Rocky Mountain EAP Corporate office.
AGREEMENT AMENDMENTS
EAP providers will be notified in writing of any amendments to the EAP Provider Agreement prior to the effective date of the amendment
PARTICIPATING EAP PROVIDER COVERAGE
ALL participating EAP providers must notify in writing regarding any situation where he or she is unable to take referrals. Failure to notify may result in inappropriate referrals to providers and unnecessary delay for employees seeking assistance. Additionally, providers must contact Rocky Mountain EAP regarding any alternative provider coverage arrangements.
OPEN AND INACTIVE CASE DEFINITIONS
Cases may remain open for three (3) months after the last contact with the EAP participant if no other follow-up is planned. Generally, after this period of time, the case becomes inactive (except for Department of Transportation cases). Cases taken out of inactive status must be updated via the case notes.
Termination of the EAP participant’s employment does not remove the case from inactive status. An EAP participant may refuse services at any time and request that we place their case on an inactive status.
Clinical charts will be retained for a period of seven (7) years from the date the case becomes inactive unless state requirements are longer. The complete chart will be disposed of by a means, which results in its complete destruction. No materials may be retained from the charts for personal/research purposes.
NO SHOW POLICY
The first missed appointment should be documented as such. You may call the EAP participant to reschedule another appointment, depending upon payer specific preferences. Two consecutive “no shows” do not require a call to the EAP participant but will require proper documentation. Job performance and DOT referrals that are “no shows” will always require notification and documentation.
CLIENT SATISFACTION SURVEYS
As part of its Quality Management Program, Rocky Mountain EAP conducts satisfaction surveys of EAP participants who have sought assistance during a specified time period. The purpose of the survey is to obtain input regarding the participant’s EAP experience and his/her perceptions of the quality of care received.
At the end of what is anticipated to be the last session, providers should hand the employee a Rocky Mountain EAP survey, and explain that their confidential feedback will help us to improve the services that are provided. Always ask the employee to please take a moment before leaving the office to complete the survey. Doing so provides an opportunity for closure and dramatically improves the chances of the form being completed. Employees can then seal the survey and return to you, or they can mail the prepaid envelope themselves. If an employee is unable to complete the form in your office, please give them the form and let them know that their responses are appreciated.
CLINICAL RESPONSIBILITIES
WORKPLACE EMPHASIS IN EAP ASSESSMENT
By design, the EAP assessment is structured, broad-based, brief, and very focused. What makes an EAP unique and most valuable, by definition, is its workplace emphasis. Therefore, in addition to the assessment of clinical factors, work location factors (e.g., employment data, job functioning) and non-clinical problems or concerns (e.g., work related issues, financial issues) will also be identified, defined, and prioritized in the EAP assessment.
A thorough EAP assessment helps to ensure that presenting and assessed problems are recorded, compared, and reflected in aggregate reporting. Comparisons will often demonstrate the value of the EAP assessment process.
DEPARTMENT OF TRANSPORTATION REFERRAL COORDINATION
At times employees covered under the federal Department of Transportation (DOT) alcohol and drug-testing regulations will be referred to EAP providers who are Substance Abuse Professionals (SAPs) for face-to-face evaluation within twenty-four (24) hours of initial contact. The EAP provider should not directly communicate with the employer but instead, coordinate ALL related activities throughRocky Mountain EAP. Actual return to work authorization is the responsibility of the employer, not the EAP provider or Rocky Mountain. EAP providers/SAPs must have a working knowledge of the DOT drug and alcohol-testing rules including the illicit use of drugs by safety sensitive employees on or off duty, or as may apply to the payer’s workforce. The assessment/evaluation is considered an EAP visit and will be reimbursed by Rocky Mountain at 100% of the fee schedule or contracted rate.
PROVIDER REFERRAL COORDINATION
If assistance is needed beyond the EAP visits allowed in the session model, the EAP provider should call with the recommended treatment plan. Rocky Mountain will assess the information and make recommendations or will provide any assistance in locating a referral resource covered by the EAP participant’s benefit plan or an appropriate community resource. As required, exceptions to this policy are coordinated through the Rocky Mountain EAP Administrator. Refer to the EAP Provider Agreement for more information.
Referrals made out side of Rocky Mountain provider network or programs, or to a community resource, is facilitated rather than made. This is an important legal distinction that has to do with limits to liability and responsibility over the actions of others that are not contractually agreed to in advance. EAP participants should be made aware of this distinction as it may apply.
If you have any questions regarding the EAP participant’s benefits, please call Rocky Mountain EAP Corporate office
COORDINATING OTHER EAP SERVICES
Upon Rocky Mountain request, and based upon the qualifications of a credentialed EAP provider, other EAP services provided by the provider may include:
Supervisory/management training and employee orientations
Critical incident preparation and debriefing
Topical seminars including stress management, parenting skills, or communications skills
Disability Management Return to Work coordination
Drug Free Workplace Training and Consultation
REIMBURSEMENT
PROVIDER INFORMATION
EAP PROVIDERS will be reimbursed in accordance with their contractual agreement. The following information is required:
Name of individual EAP PROVIDER and signature
Participating EAP PROVIDER group or facility name, if applicable
Name, complete billing address
EAP PARTICIPANT, EMPLOYEE AND PAYER INFORMATION
EAP participant’s full name
EAP participant’s Case Number
EAP participant’s sex and date of birth
Employee’s date of birth if EAP participant is not employee
Employee’s full name
Employee’s social security number
EAP participant’s relationship to the employee
Payer name (e.g., employer name)
SERVICE INFORMATION
Service types used
Dates of the service
Number of hours or sessions
Total due according to EAP provider contracted rate
PARTICIPATING EAP PROVIDER PAYMENTS
EAP provider will be reimbursed by the applicable contracted or negotiated rate for EAP services EAP providers must not bill an EAP participant for any expense incurred Providers should not bill for telephone contacts with or on behalf of the EAP participant. All relevant forms are to be sent on or before the 7th of each month following service. If the forms are received by the 7th, payment will be made by the 20th of the same month. If they are received after the 7th, payment will not be made until the 20th of the month following.Whenever there are specific questions or extenuating circumstances concerning your claim consult the EAP Provider Agreement and then contact the corporate office
BILLING FOR MISSED APPOINTMENTS
Rocky Mountain does not reimburse participating EAP providers for missed or cancelled appointments; nor may an EAP participant be billed.
TIMELY FILING *
Providers are required to file claims on or before the 7th of each month following service. If received by the 7th, payment will be made by the 20th of the same month. If received after the 7th, payment will not be made until the 20th of the month following. The provider agrees that any billing received more that (2) months after the service was renderedWILL NOT be paid and providers are prohibited from billing EAP participants for such services. The accurate completion and return of all necessary forms facilitates payment.
MAXIMUM VISITS PER DAY
EAP plans provide reimbursement for only one professional service per day.
EAP SERVICES
The provision of such services may differ according to customer specific EAP benefit design requirements.
CRITICAL INCIDENT STRESS DEBRIEFING (CISD)
Employees involved in serious workplace incidents often experience emotional and physical symptoms affecting their work or return to work. A structured process of education and consultation will assist in easing the trauma and help to return personal control to the affected employee. Preparation for key personnel plus this “debriefing” component are part of comprehensive CISD services.
EMPLOYEE ORIENTATION
Employees may not fully understand the connection between the EAP and their own needs for assistance. This orientation will help employees quickly understand the risks associated with personal problems which may be negatively impacting their work performance and describe how the EAP may help. This information emphasizes employees’ self-help for previously ignored or covered-up problems that tend to get worse over time without treatment.
SUPERVISOR/MANAGEMENT TRAINING
Formal training sessions for supervisors, managers, and key leadership will clearly define respective roles and aid in facilitating referrals to the EAP to support positive change in employees with personal and job related problems.
MANAGEMENT CONSULTATION
General guidance is provided on the management of employee performance problems, substance abuse identification and intervention, EAP referrals, conflict resolution, downsizing support, and assistance with design, implementation, operation, evaluation and modification of the EAP.
TOPICAL SEMINARS
Seminars are typically one hour in length and may be customized to cover unique topics of concern to a company’s employees. Seminars may include such topics as stress management, or communication skills, etc.
GLOSSARY OF TERMS
Americans With Disabilities Act (ADA):
A 1992 federal civil rights statute which prohibits discrimination against disabled individuals in the areas of employment, public accommodations and commercial facilities, state and local government services, transportation programs, activities and telecommunications.
Back to Work Conference*:
A meeting designated to facilitate the return to work of an employee who was on leave for the purposes of receiving treatment.
Chain of Custody*:
A detailed protocol for the tracking, handling and storage of breathe, urine or blood specimens obtained by drug or alcohol testing.
Compliance*:
An EAP participant’s adherence to a plan that is mutually established with an EAP professional for resolving the EAP participant’s personal problems.
Constructive Confrontation*
A meeting between an employee, supervisor and if appropriate, union representative to discuss deficiencies in the employee’s job performance, in order to motivate the employee to change behavior and/or improve job performance, as well as to prevent future disciplinary action.
Covered Employee:
An individual who has an employment or other direct relationship with a customer and meets eligibility requirements to participate in such customer’s EAP.
Credentialing:
The review process to approve a therapist, group, program or facility that has applied to participate in the provider network.
Crisis Intervention*:
A rapid, intensive helping process that includes engaging the individual, assessment, building EAP participant support, contracting, follow-up and possibly referral to longer-term treatment.
Critical Incident Stress Debriefing (CISD)*:
A structured 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.
Diagnosis (Dx):
A classification for mental health disorders and substance related disorders, which may be defined on as many as five axes. Rocky Mountain uses the Diagnostic and Statistical Manual of Mental Disorders DSM-IV of the American Psychiatric Association as its standard.
Disciplinary Process*:
A process based on organizational policies and procedures in which an employee is progressively disciplined for inadequate job performance or inappropriate work behavior.
Disenrollment:
The termination of a participating EAP affiliate with or without cause, in accordance with the contract terms.
Drug-Free Workplace Act*:
Requires private employers with federal contracts worth $25,000.00 or more to take action against employees prosecuted for illegal drug offenses at the workplace. The employer is also required to establish company drug policies and maintain a drug-free environment through employee prevention education and assistance.
Drug Test*:
A method of detecting and measuring the presence of alcohol and/or illegal drugs in a person’s body.
Duty to Warn:
A clinician’s obligation to alert an intended victim of any potential harm as expressed by an EAP Participant.
EAP Provider:
A practitioner who has met the credentialing criteria for EAP providers and has entered into a currently effective agreement as an independent contractor or as part of a group contracted to provide EAP services to EAP participants.
EAP Assessment*:
A structured process of observation and questions used by the EAP provider to identify, define and prioritize an EAP participant’s personal problem(s) and concerns. Information from other sources such as supervisors, family members, schools or other professionals treating the EAP participant may be utilized in the assessment process if available. Assessment is a core component of the EAP scope of practice.
EAP Case*:
A formal, documented relationship between an employee assistance professional and EAP participant or eligible dependent that is initiated when the employee assistance professional conducts an assessment and/or counsels the EAP participant. More than a casual conversation or informational call, the case entails the opening of a file, the awareness by EAP participant or covered employee and eligible dependent that he/she represents an EAP case, the keeping of case notes of the discussion(s) and a disposition of the problem. A case may also be opened when an EAP participant requests follow-up services from the employee assistance professional. Casual conversation in person or by phone where not all the of the above occurs is not considered a case. Contacts with others such as worksite supervisors who are not seeking personal assistance are not counted as cases.
EAP Case Management*:
The provision of EAP services following EAP participant referral to external community organizations and resources for care that may include facilitating, coordination, monitoring and discharge planning.
EAP Committee:
A committee within the customer’s organization charged with internal marketing of the EAP. The committee representative offers suggestions to improve the effectiveness of the workplace.
EAP Consultation*:
The term has two applications: (1) The act of giving expert advise and guidance to management, human resources and/or union representatives regarding the management of performance problems and referral to the EAP and/or other resources. (2) Guidance for employers on the design and evaluation of EAPs.
EAP Design*:
The structural, logistical and financial elements necessary for successful EAP operations.
EAP Feedback Mechanism*:
Methods of receiving information about employee assistance services from EAP participants. One method used is to have supervisors complete a survey measuring employee job performance after contact with the EAP.
EAP Follow-Up*:
One or more contacts with an EAP participant to monitor progress and/or the impact of the EAP recommendations or referrals to treatment resources and to determine the need for additional services.
EAP Participant:
(See Covered Employee)
EAP Participant Satisfaction*:
A measure of EAP performance based on formal or informal feedback from EAP participants. Feedback may be given to the medical or human resources department or directly to the EAP. Objective measurement of client satisfaction is obtained from anonymous response surveys that are distributed as standard operating procedure upon closure of a case.
EAP Referral*:
The processes of linking EAP participants with appropriate resources to resolve personal problems or concerns.
EAP Self Referral:
A covered employee or eligible dependent initiating the request for EAP service.
EAP Short-term Problem Resolution*:
The process of assisting when indicated by assessment, an individual or family with the resolution of a problem, in a period of time which typically does not exceed two months
EAP Supervisor/Union Training*:
A formal training session for supervisors, managers and labor representatives (if a unionized work setting) to familiarize them with EAP activities.
EAP Supervisory Referral*:
An action in which an employee having job-performance problems is referred to the EAP by the employee’s worksite personnel.
EAP Utilization Rate*:
The percentage derived from the number of active EAP cases divided by the total number of employees over the course of a year. If the reporting period is less than a year, the utilization rate is annualized. Utilization of the EAP by an employee and his/her dependents is generally counted as a single case rather than multiple cases.
Eligibility:
The determination that an employee or eligible dependent meets the requirement to receive healthcare services as defined by the employer.
Emergency:
An emergency exists when an individual in significant distress, is significantly dysfunctional, and is in real and present danger to him/herself or others. An emergency requires immediate direct intervention by a licensed mental health professional that will accept responsibility for emergency evaluation and disposition. An emergency does not necessarily require an inpatient level of care but does require adequate security and medical support to evaluate and treat the emergency without risk to the individual or others.
Employee Assistance Professional Ethics:
Codes of conduct requiring the placing of EAP participants’ interest above self-interests. Rules of conduct include proper workplace communication and interaction, service delivery without conflict of interest, proper on-going interaction in the community, proper professional interactions and continued proficiency as an EAP professional
Employee Assistance Program*:
A work-site based program designed to benefit covered employees and their dependents in the identification and resolution of personal problems or concerns, which may adversely affect job performance.
Employee Orientation*:
A meeting to acquaint employees with assistance services offered by the employer.
Equal Employment Opportunity*:
Title VII of the Civil Rights Act of 1964, as amended by the Civil Rights Act of 1991, prohibit discrimination on the basis of race, color, religion, sex or national origin by employers (both public and private) engaged in industry affecting commerce and that have fifteen or more employees.
Fee For Service:
A form of reimbursement for health services, in which a provider is paid a specific amount for, a service provided.
Fitness For Duty*
An employer’s determination of an employee’s preparedness to work.
Last-Chance Agreement*:
A signed agreement between an employee whose job is in jeopardy and supervisor or other representative of management. The agreement specifies the performance expectations and other conditions of employment and can require compliance with EAP recommendations.
Medical Review Officer*:
A licensed physician knowledgeable of substance abuse disorders and trained in interpretation and evaluation of positive test results, who is responsible for analyzing laboratory results generated by an employer’s drug testing program.
Non-Compliant:
Failure of an EAP participant to commit to the goals or procedures prescribed in the treatment plan.
Outcome Goals:
Expected results related to employee assistance service delivery.
Payer Specific Requirements:
Those requirements included as a part of a specific payer’s plan
Plan:
Any EAP sponsored by a payer that has entered into a contract or other agreement to arrange for the provision of certain EAP services.
Presenting Problem*:
The personal concern or problem as described by the EAP participant prior to assessment by the EAP professional.
Primary Assessed Problem*:
The problem assessed by the EAP counselor as the core-underlying problem causing other problems when multiple concerns are presented. The primary problem is one that must be addressed before secondary problems can be effectively resolved.
Problem Resolution*:
In self-referrals, problem resolution is the EAP participant’s achievement of personal goals developed in conjunction with the EAP professional. In management/supervisor referrals, it is an employee’s return to his/her previous level of satisfactory job performance or termination following continued unsatisfactory job performance.
Quality Assurance:
A formal set of activities used to measure services actually provided against set standards of service quality.
Re-credentialing:
The review process to determine if a provider continues to meet the criteria for inclusion as a provider
Reduction in Force*:
The process by which a work organization reduces its work force by eliminating jobs, such as closing subsidiaries or departments. Also called downsizing.
Release of Information:
The legal form signed by an EAP participant allowing the provider to share specific information regarding the EAP participant to a specific person.
Safety-Sensitive Position*:
A work assignment that entails high safety risk to self, property or general public and is with an industry that is subject to federal regulations requiring compliance with safety regulations.
Secondary Assessed Problem*:
(See Primary Assessed Problem.)
Sexual Harassment:
As specified in Title VII of the 1964 Civil Rights Acts, amended in 1972, sexual harassment can be unwelcome sexual advances, requests for sexual favors or other verbal or physical conduct of a sexual nature.
Substance Abuse**:
Impairment in social and occupational functioning resulting from the pathological and “compulsive use of a substance. The concept is closely related to the definition of substance dependence, which has similar symptoms of impairment but may include evidence of physiological tolerance or withdrawal. Typical symptoms of abuse include failure to fulfill major role obligations at work, school or home; recurrent use of the substance in situations where such use is physically hazardous; substance-related legal problems and continued use even though it causes or exaggerates interpersonal problems.
Topical Seminar:
Seminars are typically one hour in length and may be customized to cover unique topics of concern to a payer’s employees.
Urgent:
Those services required to provide a diagnosis of recent onset that are not considered to be life threatening to the client but are of sufficient severity to necessitate prompt intervention.
Worker’s Compensation*:
A means of insurance providing medical rehabilitation and wage replacement benefits to employees after an injury or the onset of disease arising out of and in the course of employment.
* EAP definitions adopted from EAPA glossary, Arlington, Virginia 1994
** Definition from the American Psychiatric Glossary, 1994, American Psychiatric Press, Inc., Washington DC.