Introduction

Employee assistance programs (EAPs) are an effective vehicle for addressing poor workplace performance that may stem from an employee’s personal problems, including the abuse of alcohol or other drugs.

EAPs are an added benefit to employees and their families and clearly communicate employers’ respect and concern for their staff. They also offer an alternative to dismissal and minimize an employer’s legal vulnerability by demonstrating efforts to support employees.

In addition to counseling and referrals, many EAPs offer other related services, such as supervisor training and employee education.

Overview

Goals of an EAP

Employers implement EAPs to accomplish a variety of goals, including, but not limited to, the following:

• Identify employee personal problems at an early stage before there is a serious impact on the job.
• Motivate employees to seek informal referral through easy access to assessment and referral.
• Direct employees to the best source of aide and high-quality service providers.
• Limit health insurance costs through early intervention.
• Reduce workers’ compensation claims by encouraging easy access to assistance.
• Decrease employee turnover.
• Offer an alternative to terminating valuable employees.
• Provide employees with support and demonstrate that a company is a caring employer.

Essential Components of an EAP

An EAP should include the following essential components:

• A policy statement that defines how employees access the EAP, the services provided, and how confidentiality is protected.
• Consultation and training services for supervisors and managers on how to manage and refer troubled employees to the EAP.
• Promotional activities to ensure the EAP is highly visible and easily accessible to employees.
• Educational programs for employees on relevant issues, such as alcohol and drug addiction.
• Problem identification and referral services provided directly to individual employees (and often to family members).
• Identification and maintenance of a current, annotated directory of qualified providers of treatment or assistance to enable prompt referral of employees to appropriate resources.
• Be available for all employees free of charge.

Some EAPs also offer short-term counseling by licensed professionals.

EAP Services

EAPs provide services to a variety of customers that exist within the work organization. EAPs provide distinct but complementary services to each customer group — the employer or work organization, the supervisors/managers, and the employees.

Organizational services include the following:

• Assistance in developing alcohol and drug policies.
• Consultation regarding legal compliance issues.
• Design and selection of health benefit plans.
• Evaluation of health care providers.
• Compliance with drug-free workplace policies.

Guidance to managers and supervisors includes the following:

• How to make supervisor referrals based on declining job performance.
• Separating performance issues from behavioral health issues.
• Determining the need to intervene with troubled employees.
• Following up on an employee’s progress.

Assistance provided directly to individual employees includes the following:

• General information and referral resources.
• Crisis intervention.
• Easy access to assistance.
• Timely problem identification.
• Short-term problem resolution.
• Substance abuse assessments.
• Referral for diagnosis and treatment or other aide.
• Follow-up contacts or sessions to provide support.
• Educational seminars and workshops.

In addition to addressing alcohol and drug addiction problems, often and at no additional cost, most EAPs also assist employees with the following:

• Marital or relationship problems.
• Job stress.
• Child care issues
• Health issues.
• Grief.
• Financial problems.
• Legal concerns.
• Elder issues.

How an EAP Benefits Employees

EAPs target both:

• Employees whose performance shows a pattern of decline, which is not readily explained by job circumstances; and
• Employees who are aware of personal problems that may or may not be affecting their performance.

Any employee can seek assistance from the EAP to get information or to discuss a personal problem. Approximately 4 to 6 percent of employees will contact the EAP on their own each year. In fact, most employees who use the EAP seek these services on their own. However, employees with job performance problems who do not contact the EAP are of most concern to supervisors. Moreover, when a supervisor refers a troubled employee to the EAP, the supervisor does not have to wait until the problem is job threatening. Thus, having an EAP allows supervisors to combine their offers of assistance with early resolution and/or disciplinary measures to help restore performance.

An EAP systematically and effectively approaches workplace and personal problems. The employee assistance professional will complete the following:

• Meet privately with the employee.
• Discuss the issues with the employee.
• Help identify the problem.

The EAP then explores available options and refers the employee to appropriate resources that may be available in the community or to professional services covered under the employee’s benefit plan.

Most EAPs offer services not only to employees but also to their dependent family members. This proves to be a wise investment because the work performance of an employee may be affected when a parent, spouse, or child is suffering with a problem, such as abusing alcohol and other drugs.

How EAPs Work

As previously mentioned, employees can directly access the EAP voluntarily or be referred by their supervisor in cases of job-performance problems. When an employee uses EAP services voluntarily, there is no need for involvement on the part of the supervisor. However, when a supervisor refers an employee to the EAP because of job performance, the assistance may be combined with progressive discipline, and the supervisor will need to continue to monitor the employee’s performance.

Various Types of EAPs

The most common structures for EAPs are the following:

• Internal Programs. Organizations implement internal EAPs whose staff members are full-time employees of the organizations for which they provide services. Although services may be made available at off-site locations, typically internal programs have on-site offices. This model is most common in large- or medium-sized organizations.
• External Vendors. Organizations can contract with an outside EAP vendor. Although services can be provided on site at the customer location, external vendors are more likely to maintain off-site offices used by various customers. External EAP services cost an average of $15 to $40 per employee annually depending on the size of the firm and services offered. Fees can be assessed on a per capita basis (flat rate based on the number of employees in the organization) or on a fee-for-service basis (charged whenever an employee actually uses the EAP services.) Some states, such as California, regulate per capita EAPs.
• Integrated Models. These EAPs combine features of both the internal and external types of EAPs. There is generally a centrally located internal section of the EAP that manages contracts with external vendors from remote locations. Integrated models may also include the integration of EAP services with the managed care behavioral health care benefits. In this model, EAP services still should be distinguished and offered separately from ongoing clinical counseling benefits.
• Consortia. These arrangements, often sponsored by chambers of commerce, health care coalitions, trade associations, industry groups, or multiple employers, provide a way for small-business employers to benefit from shared costs. However, joining a consortium to purchase EAP services requires that the members are willing to be serviced as one unit.
• Peer Assistance. These models utilize co-workers to deliver EAP services and are often organized by labor unions, employee associations, or joint labor-management groups. Co-workers (peers) are trained to be available to their co-workers and to provide varying types of assistance. Peers perform various functions depending on the structure of the program and their level of training and supervision. Some peers are highly trained and provide the full range of EAP services, while others work in concert with qualified employee assistance professionals. Because peers are trusted by their co-workers, they can be particularly effective in providing outreach, referral, and follow-up/support services for their co-workers. Peers often serve as volunteers, but may be compensated by their union and/or the employer. Many union peer assistance programs are known as member assistance programs.

Across the country, more than 10,000 EAPs are in operation under these various types of service arrangements. Any of these types of EAPs may be provided through labor unions, management, or labor-management cooperation. Likewise, the services may be paid for by the union or employer or funded through negotiations or joint labor-management health funds.

Choosing an EAP Provider

Each organization has its own unique characteristics, dynamics, and culture. Nonetheless, no matter what the special needs of the workforce are, an EAP can be designed to fit those needs.

Most EAP vendors, whether small local companies or international managed-care companies, offer the following basic elements of an EAP:

• Confidential assessment and referral.
• Employee orientations.
• Supervisor training.
• Promotional materials.

There are considerable differences, however, between vendor approaches and expertise.

When evaluating venders, every potential vendor should be asked to respond to the same set of questions. The following are several areas that should be explored when evaluating competing EAP vendors:

• Credibility. Questions to consider regarding a provider’s credibility include the following:
  • Is the vendor an experienced EAP provider?
  • What is its track record with similar employers?
  • What is the vendor’s reputation among employee assistance professionals?
  • Is the organization stable and financially solvent?
  • Is the EAP accredited by the Employee Assistance Society of North America (EASNA)?
• Staff Credentials. Questions to consider regarding staff credentials of a provider include the following:
  • Do the EAP staff members have the proper licenses and credentials?
  • Are EAP staff members Certified Employee Assistance Professionals (CEAPs)?
  • What is the EAP’s experience with similar work groups?
  • Has the EAP previously worked with labor unions (if applicable)?
  • Has the EAP previously worked with safety-sensitive employees (if applicable)?
  • Does the EAP have affiliations with treatment providers that could present a conflict of interest?
• Organizational Services. Questions to ask regarding an EAP’s organizational services include the following:
  • Is the vendor willing and able to help develop the EAP and related policies?
  • How does the vendor suggest the EAP interact with the organization’s disciplinary process?
  • How will the vendor promote union support of the EAP (if applicable)?
• Accountability and Program Control. Questions to ask regarding an EAP’s accountability and program controls include the following:
  • Will the employer know who uses the program? If so, how?
  • How will the employer be able to evaluate the EAP’s impact?
  • Does the vendor use client satisfaction surveys? Will the employer see the results?
• Confidentiality. Questions to ask regarding protecting the confidentiality of employees include the following:
  • How will the EAP vendor protect confidentiality?
  • How will a supervisor know if a referred employee is working with the EAP in cases of supervisor referral?
  • How will information be handled when it involves serious job infractions, safety-sensitive positions, or illegal activity?
• Program Focus. Questions to ask regarding the focus of the EAP program include the following:
  • What problems can the EAP assist with?
  • How will the coordination of a referral to ongoing therapy be handled?
  • Will the EAP conduct any necessary therapy sessions? If so, does the staff have the appropriate credentials required?
• Access. Questions to ask regarding employee access to EAP programs include the following:
  • Where are the EAP’s offices located?
  • What hours are the offices open?
  • How does the vendor handle emergencies?
  • How long does it take to get a face-to-face appointment?
  • How will the program be promoted?
• Employee Education. Questions to ask regarding employee education on EAP services include the following:
  • How often will educational sessions be provided for employees?
  • What topics will be covered in these sessions?
  • Is there any outreach to families?
• Supervisor and Union Representative Training. Questions to ask regarding EAP training include the following:
  • What is the agenda for supervisor training?
  • Does the training include union representatives?
  • Who provides the training?
• Costs. Questions to consider regarding program cost include the following:
  • How is the cost determined (such as, per capita or fee-for-service)?
  • What services are included in the base price?

The best response to some of these questions will depend on what the employer wants to include in the EAP. Ultimately some issues, such as how the EAP handles serious job infractions, will need to be determined by the employer, with input and consultation from the EAP vendor. How the vendor responds to these questions will give the employer a basis for determining not only whether the EAP is qualified, but also whether the vendor is a good fit with the organization’s culture.

Protecting Confidentiality

Employees will support and have faith in the EAP program only if their confidentiality is protected. The assurance of confidentiality means that an employee’s private and personal information will not be released to anyone other than with whom the employee confides.

The following are several areas of the program where employees may have concerns about their privacy:

• What will the supervisor disclose if the employee has a performance problem that may be due to the use of alcohol and/or drugs?
• What will the supervisor disclose if the employee comes forward on the employee’s own and discloses that there is a personal problem?
• What will be released if the employee uses the EAP?
• Who will get the information?
• What will be released if the employee seeks the EAP in response to a supervisor referral?

As with any performance problem, the employee needs to be aware that the issue of the employee’s performance problems will not be made public. Although the employee’s supervisors may share information about disciplinary action with other managers or the human resources department, all information about performance issues, constructive confrontation, and disciplinary actions should be maintained in the employee’s personnel file. In addition, access should be strictly limited to those in management with a need to know.

The EAP should assure employees that their personal information and details of their personal problems will not go beyond the EAP. Private conversations with the EAP should not be shared with supervisors and EAP records must be kept completely separate from personnel records. These records should be protected by the EAP’s confidentiality policy and should not be released without the employee’s expressed, written permission.

In some instances, it may be in the employee’s best interest for information to be shared; however, this information should not be shared without a written release. Some examples of circumstances when an employee may request release of information include the following:

• Releasing information so that benefits can be accessed or insurance companies can conduct reviews. Usually, if reimbursement is requested from a third-party payer, the request contains a waiver of confidentiality.
• Releasing information regarding EAP participation if the employee was referred by the supervisor based on declining job performance.
• Releasing information to support a request for accommodation or recovery support.
• Releasing information of assessment, evaluation, and follow-through after a positive drug test when the employee will be given an opportunity to return to the job.
• Releasing information according to company policy for verification for treatment release time, leave requests, and disability.

There also are limited areas where state laws require disclosure. These are circumstances where someone is in imminent danger, such as in cases of the following:

• Child abuse.
• Elder abuse.
• Serious threats of homicide or suicide.

The EAP policy must be very clear about the limits of what information can be shared and with whom it can be shared. If an employee chooses to tell co-workers about the employee’s private concerns, that is a personal decision. However, when an employee tells a supervisor information in confidence, the supervisor is obligated to protect that disclosure.

See the Sample EAP Policy language at the end of this article for sample policy language.

Referring Employees to the EAP

Overview

As previously mentioned, an EAP is one of the most effective tools an employer has available to assist employees with personal issues, performance issues, and other issues in the workplace. Managers may refer an employee to the EAP when they observe that an employee is experiencing significant personal issues, such as a family problem or loss of a loved one, or when they are concerned about an employee’s work performance. Whether the issue is a personal problem or a work-related problem, the EAP can offer assistance to employees.

The EAP is a valuable tool for managers or supervisors as well. It can provide confidential assistance with management issues, such as how to document declining work performance, handle a sensitive situation, or prepare for a difficult conversation with an employee.

Types of Support Provided

The EAP offers support regarding a wide range of personal and work-related issues. These include the following:

• Depression.
• Anxiety.
• Tardiness and absenteeism.
• Job performance problems.
• Productivity problems.
• Diversity issues.
• Separation, divorce, and other relationship problems.
• Alcohol and drug dependency.
• Family concerns.
• Health concerns.
• Job or personal stress.
• Grief and loss.

Referral to Contact EAP

Employees do not need a referral to contact the EAP. Most employees seek assistance from the EAP on their own for help with personal and family issues, work issues, and other concerns. This is called self-referral. Employees may contact the EAP at any time. Employers may also encourage employees to seek help from the EAP by providing them with the EAP telephone number and contact information. Employers should remind employees that the EAP is free and confidential.

Informal Referrals

Managers may make an informal or a formal referral to the EAP. An informal referral is a reminder or suggestion to the employee that the EAP is available to assist. Managers might make an informal referral to the EAP when an employee with a good or excellent performance record is experiencing problems outside of work. The employee may be going through a separation, have a sick child, or be experiencing some other hardship. For example, an employer may have an employee whose father was recently diagnosed with a terminal illness. The employer might informally refer the employee to the EAP, encouraging the employee to make use of the EAP because the employer is concerned.

Employers should take the following steps when making an informal referral:

• Schedule a time to meet with the employee in a private place.
• Express concern for the employee. If the employee’s father is terminally ill, a conversation might begin with, “I am very sorry to hear about your father, and I am concerned about you. I know it has been hard with your father’s illness.”
• Provide the employee with information about the EAP. If the employer has a relationship with the employee where the employer feels it is appropriate, the employer might say, “Have you thought of using the EAP?” Alternatively, “I would like you to be aware that you have a resource — a benefit through work — that you can use to get support.” The employer should follow up by providing the phone number of the EAP and a reminder to the employee that the EAP services are free and confidential.

When an employer makes an informal referral, it is up to the employee whether or not to contact the EAP. No documentation goes into the employee’s personnel file, and the employer does not call the EAP to let them know that a referral was made. The employer does not request any information from the EAP about whether the employee contacted the program.

Formal Referrals

A formal referral to the EAP is used in cases involving ongoing work performance issues. With a formal referral, a manager or supervisor identifies the performance issue and reminds the employee that the EAP is available as a resource to help with personal issues that may be affecting performance. The employee may be a good performer who has developed a pattern of missed deadlines or of handing in unsatisfactory work. Often, performance problems are the result of personal issues outside of work. It is not the employer’s job to diagnose employee problems. That is what the EAP is for. The employer’s job is to strongly suggest that the employee contact the EAP.

Employers should take the following steps when making an informal referral:

• Contact the EAP to let them know an employee will be referred. The first step when making a formal referral is to contact the EAP before meeting with the employee. That way, the EAP knows what the employer’s concerns are about the employee and is better able to offer assistance when the employee calls. An EAP management consultant can provide the employer with expert and confidential guidance on how to document performance issues, develop a performance improvement plan with specific goals and time frames, and prepare for the conversation with the employee.
• If the employer is handling a difficult workplace issue, the employer should be sure to contact their human resources (HR) representative to learn about the organization’s policies and procedures.
• Schedule a time to meet with the employee in a private place.
• Show concern and support when meeting with the employee. Acknowledge both past and present positive job performance. For example, if a valued employee has been late for work and missing deadlines recently, a conversation might start with, “I have noticed you have been late this month, and you missed an important deadline. That is not like you. Your work is usually excellent.”
• Focus on work and performance issues at the meeting and explain what the concerns are in specific terms. The conversation might begin, “I am concerned about your performance. You were more than 30 minutes late five times this month, and the deadline you missed last Wednesday was a very important one.”
• Refer the employee to the EAP. An employer might say, “Performance issues like these may be the result of things going on outside of work. Whether that is the case here is really none of my business. However, I am concerned about your performance. I want to remind you that you have a resource — a benefit through work — that you can use to get help. I encourage you to contact the EAP and to use the resources available to you to address any issues that may be affecting your work performance.” Remind the employee that the EAP is free and confidential. Provide the employee with the EAP telephone number and contact information.
• Explain that the EAP is voluntary. An employer might say, “Whether you call the EAP or not is up to you. I am concerned that these performance issues get resolved. If they are not corrected, I may have to take further action.”
• Let the employee know that there is a time line. Explain that the issue will be followed, and schedule a time for another meeting.

A formal referral may or may not go into the employee’s personnel record and may or may not be part of a corrective action plan. Even if the employee chooses not to contact the EAP, the employer has taken the steps necessary to begin addressing the performance issues. An EAP consultant can discuss with the employer what steps to take next.

Mandatory Referrals

In some cases and at some organizations, a formal referral to the EAP is mandatory and it may be a condition of an employee’s continued employment with an organization. Employers should check with their HR department to determine what the discipline policy is at their organization. Typically, a mandatory referral is made at the same time that an employee is going through the final stages of a progressive discipline action (for example, when an employee tests positive for substance abuse). Employers should always check with the HR department when addressing a difficult workplace issue.

Employer Responsibilities

Employers should remember the following when making any EAP referral:

• Do not assume a problem with an employee will go away. It is best to address problems early, before the situation gets out of hand.
• Do not diagnose employee problems. There may be liability in crossing this boundary.
• Be sure the employee understands that talking with an EAP consultant is confidential (except in cases of mandatory referrals). It will not jeopardize the employee’s job or future prospects within the organization. Explain that all EAP records are confidential and are kept off site, and that they are not made available to the employer without the employee’s written consent.
• Be patient, understanding, and sympathetic when meeting with the employee. Express care and concern for the employee.

Sample EAP Policy

The following is sample EAP policy language that employers may use. It may not suit every employer’s EAP. Employers should not adopt this policy unless they are sure that their EAP operates according to the statements it contains.

“Our organization supports the drug-free workplace program by offering an employee assistance program (EAP). The EAP is designed to assist employees with personal concerns that may impact their job performance. These concerns include, but are not limited to, health, marital, family, financial, emotional, alcohol abuse, and drug use. We believe that all of us, at one time or another, may have serious problems to deal with. It is important to seek help for such problems. Your EAP can help assess the problem, offer guidance, and provide a referral to quality care.

We consider the abuse of alcohol and prescription drugs and the use of illegal drugs to be treatable conditions. We encourage employees to seek assistance for these problems on a confidential self-referral basis.

Participation in the EAP, on a voluntary basis, will not jeopardize an employee’s opportunities for promotion or employment. Employees may contact the EAP directly. Their contact, participation in the EAP, and any recommended treatment is confidential and will not be disclosed to the organization.

Employees may be referred to the EAP by their supervisor on the basis of job performance problems. When the employee follows through with the referral, the supervisor will be notified that the employee has made contact, but the exact nature of the problem will not be disclosed.

EAP services are available to the employee without charge, however, the cost of referrals to treatment or rehabilitation is the responsibility of the employee if the cost is not completely covered by insurance. In support of our drug-free workplace, our insurance plans include some coverage for the treatment of addiction.”

The following language should also be included if drug or alcohol testing is performed by the organization:

“An employee who tests positive on an alcohol and/or drug test may be referred to the EAP for assessment and rehabilitation recommendations. The employee’s decision to participate in the recommended treatment, successful completion of the program, and additional treatment recommendations will be communicated to the organization.”