EAPs Can Help Alcoholic Employees on Disability and Others

If you work for a company of any appreciable size, there is probably a disability insurance policy in case employees get sick or injured to the extent they can’t work for an extended period of time. Some organizations are progressive with their disability insurance, while some still live in the dark ages. 

The most progressive insurance plans cover physical injuries and illness, emotional disabilities, and yes, acute chronic alcoholism. The state of South Carolina, for example, covers alcoholism or any condition caused by alcoholism or alcohol abuse for a maximum of 24 months. 

By the way, did you know that prior to the ADA, the federal government recognized acute alcoholism as a disease without restrictions on alcoholism, but after the ADA and its language covering alcoholism, many changes were made that were actually detrimental to the acceptance of alcoholism as a disease? 

Go to the American Society of Addiction Medication, ASAM.org, website and read the policy statement and response to the language of the ADA and how adamantly opposed this organization is to the EEOC interpretation of the law, which increased discrimination against alcoholism in its belief. 

The ADA did not help alcoholics, they claim. It made discrimination worse in many ways. You will stunned at the insight afforded by this statement.  

For example, did you know that the Federal government, Office of Personnel Management issued regulations that "required" use of the EAP for employees suspected of having alcohol problems prior to the institution of any disciplinary action. If the EAP was not used, the disciplinary action would be considered illegal and void. That changed after the ADA.

Sorry for the digression --- Many physically ill patients retire on disability with acute illnesses associated with acute chronic alcoholism. The smartest organizations with disability insurance that cover alcoholism and mental disorders seek to aggressively document that the patient is participating in required treatment to arrest the illness and manage it successfully. You EAP can play this role and possibly save the employer a fortune. You'll have to feel your way into the benefits policies and administration to see if there is a role for you to play in this regard, but it can boost utilization and make your program more valuable. 

The EAP can play a key role in helping these employees who get sick or are injured, and qualify for disability insurance. Only an EA professional is proactive enough to assist employees in dealing with the psychosocial aspects of illness or injury effectively. This could conceivably assist these employees in getting back to work or in having meaningful lives. If you make headway in this area, let me know! I will make a post about it and it could encourage other EAPs to do the same and be more valuable.

I was afraid this would happen.

Depressed employees drive up costs for EAPs. Huh? An official document issued by the American Psychiatric Association states that depression in the workplace takes a financial toll on the work organization. Specifically, "in addition to claims for behavioral health care, costs due to behavioral health problems significantly impact other costs such as productivity, employee assistance programs (EAPs), disability, general medical, and other pharmaceutical claims. While most employers have developed strategies to reduce behavioral health costs, few employers make use of strategies to manage behavioral health treatment quality.

In other words, the EAP is a cost-center and behavioral health problems burden it. This statement is tantamount to saying the fires drive up the costs of fire departments, so we should find a way to put out fires better to save the costs to fire departments.

Let's be more illustrative. If you view an EAP as simply an employee benefit like a gym membership, this statement is completely consistent with how EAPs are more and more being viewed by the business world thanks to a continuing stream of published literature that has redefined them from their original intent. No longer, it appears, are EAPs viewed as management tools to address behavioral risk issues and improve productivity via supervisory and self-referral.

This view of EAPs should change or a different model for the delivery of the Core Technology (which ain't going away) should be created, and then THAT--whatever it is called--should be sold to rescue workers and management and employers from the burden costs associated with troubled employees.

The Report, from the 4th Quarter document "Mental at Work" published by the Partnership for Workplace Mental Health has, in my opinion, a worrisome view in its context of what the benefits industry sees as an EAP. Tell me I am wrong, and I will love you forever.

http://www.workplacementalhealth.org/mhwfourthqtr2010

Value Proposition or Value of Customer Expectations?

There is a lot of talk these days in marketing circles about clarifying the "value proposition" of what we sell. Simply put, this means selling the message of what we believe the value of our wares to be. We want the customer to listen. And if they 'finally' hear what we are saying, they will wake up and sign on to an EAP.

But wait. 80% at least of America's employers have EAPs the research says. So where is the market we are trying to coax into the value proposition?

EAPs have long sought to sell the "value proposition". But there is another side of the coin. The customer's needs. Managed care won this sale. To be more specific, the other side of the coin is selling to the value of the customer's expectations, and not the value proposition we possess necessarily. Mark Hunter, a marketing guru talks about this in an article entitled "Value of Customers Expectations" that he sent me.

If you are still with me on this post, let me ask, should EAPs be doing this more? If so would this cause us to shift our focus to different customers who are not using EAPs now? I think yes.

And these customers happen to be in the property casualty insurance industry spectrum. These big boys don't know about EAPs. But my belief is that they could use whatever they could possibly squeeze out of an EAP that would help them reduce risk and exposures associated with the things they insure against. This is not health insurance. It's everything else -- from employment practices liability lawsuits, suits for wrongful termination, discrimination, workers comp, property damage, the works. Imagine full-bore EAPs reducing these payouts. Hey, the average wrongful termination lawsuit is $150K out of court. It's over $500K in court and companies lose 70% of the time. Imagine an employee who didn't sue the company because his behavior or that of the supervisor was mitigated by EAP involvement. That's sounds like the beginnings of a new profession to me.

Mark Hunter is a sales pro. He speaks to thousands of sales people per year. Here's what he says, "We've all heard the rule of listening to what the customer has to say, and there's not a salesperson who thinks they don't listen to the customer.  Reality, however, is quite the opposite.  I find time after time when I'm working with salespeople across any number of industries that the failure to listen is a huge issue."

Hunter adds, "Too many salespeople believe because they know the products they represent much better than the client, they know exactly what the customer will see as real value.  Yes, you as the agent are going to have a general indication of what a typical customer wants. However, when it comes to interacting with a specific customer, you can't rely on a "general indication" of value."

Here's the thing. Businesses wanted lower costs on health insurance. Managed care sold them their solution. EAPs, unfortunately, got in the way without the ability to collectively say "halt".

And, EAPs still aren't doing much to collectively and "officially" point out diminished models of quasi-EAP products that insist on the full title to the word "EAP". I don't see this changing in the new EAP Strategic Plan. I may have read it wrong. If so, I will post my correction if someone lets me know.

Unless this becomes a targeted goal--rejecting products that do not adhere to the spirit and intent of the core technology, along with an ongoing survey and confrontation of freelance writers posting misguided articles about EAPs in over 30 HR and Benefits periodicals, I believe problems will continue. That translates to more suppression of life-saving, risk reducing, fully functioning, loss preventing EAPs in the world of work.
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I referenced Mark Hunter above. You learn more about him here: "The Sales Hunter," is a sales expert who speaks to thousands each year on how to increase their sales profitability.  For more information, to receive a free weekly email sales tip, or to read his Sales Motivation Blog, visit www.TheSalesHunter.com. You can also follow him on www.Twitter.com (TheSalesHunter), on www.LinkedIn.com (Mark Hunter), and on his Facebook Fan Page, www.facebook.com/TheSalesHunter.

More Thoughts about Workers Compensation and EAPs

Employee assistance practitioners have a history of offering services in what may be called the "traditional" areas of their craft ... alcohol abuse, drug use, mental health services, and other personal problems associated with these conditions.

And yet, research has demonstrated a close correlation between "traditional" employee assistance services and indicators not normally considered a part of that total picture--workers' compensation claims, for example.

Workers' compensation claims my, in fact, be among the most significant indicators of workplace health and wellness, as well as very good clues as to the presence or absence of alcohol, drugs, or mental health problems.

If you're marketing employee assistance services, seek to discover the types of industries with the highest accident rates. Also, be sure to turn to OSHA. OSHA maintains a fresh list of high accident troubled companies. This is list is available, and you may discover some of the companies are near you. Why? There are 20,000 of them--at least--every year. So, go for the high accident businesses, not the high numbers of employees. You may find more motivated employers who will be interested in your services.

And approaching prospective clients along the workers' compensation chain can bring into your service orbit the self-insured as well as those who pay premiums, since both can realize substantial savings through the coupling of worker's compensation programs with employee assistance services.

The higher a work organization's accident rate, the higher the premiums it pays for workers' compensation. The organization is therefore motivated to reduce accident rates, on of the jobs employee assistance services are designed to do.

Media Event! We Have An Expert on that Subject!

1. Throughout the year the major media will visit health subjects that have broad appeal to the public. They will also report on major calamities and news stories of many kinds. By and large, however, media outlets choose the stories they will cover based upon their biases and what constitutes public trends of interest.

To illustrate this, imagine how many earth tremors occur in California per year, versus how many are actually reported. Answer: Thousands of tremors occur than are reported. Only certain Rector Scale values will be reported, or where significant damage occurs. The truth is however, that minor tremors knock things off the shelves in people’s houses in quake prone areas of California all the time. But these quakes are never reported. The same quack on the east coast would be huge news.

2. You will notice that specific topics appear in the news periodically, but predictably. For example, you can predict that approximately once a year the topic of alcoholism will emerge. It might be a news event on its cause, a new drug to fight cravings, a story about the genetic brain, or some other related topic. Many other topics related to social problems also will appear in the media. Pay attention.

Listen attentively to the news. When you hear news that relates to your field of expertise, immediately fax to the local television stations your biography (a half page and photo). Fax your photo even though they will not be able to see it. Or have one drawn like you see the photos of people computer drawn in the Investors Business Daily. Also call the news room to say that you are an expert on that subject, you are faxing a bio right now, and you are ready to meet immediately or at their convenience.

You will marvel at how often they will ask you to come to the studio immediately or phone you to visit your office location. This is a great way to get publicity and to get on TV or the radio. And, it will make you instantly visible to your potential clients and EAP customers. Television and news stations scramble to find experts on subjects when the news hits. They don’t have much time and you will be their rescuer. You are doing them a favor, not the other way around. So, act like it on the phone. Act like you have done this all the time and that you "have cleared time from your schedule to make yourself available."

3. If it is national news, you will have extra time to respond because it will take longer for local stations to run "local expert" interviews. National news filters down to local significance to what is relevant in the immediate community. Again, if it is local news, your window of opportunity is much smaller, possibly an hour or less.

DO THIS: Prepare ahead of time by getting phone and fax numbers, and contacts lined up. Then, wait for the "big one." When “it” happens start dialing for dollars and the free publicity.

Note: Everything I discussed above, I have also done numerous times.

Yes, Your Own Blog Can Pay Off! Pay Attention to Marina London

Hi everyone, yes, it is true. Blogging pays. If you are at the EAPA Conference taking place in Tampa right now, and you are participating in the seminar on blogging, pay attention.

Blogging is awesome and it can really, really help the EAP field---and your EAP.

But let me give you a tip. Select a niche!!! Don't blog about anything and everything. Of course, I am blogging about EAP related issues, but I could just as easily blog about EAPs and Workplace Violence.

Let's discuss this for a moment. Can you guess how many times the phrase "workplace violence" is Googled each month? I will tell you.....looking it up now as I type.......the answer is 49,500 times per month.

Impressive? Yes. But let's say you blogged on Workplace Violence every 7 days. No big deal -- just 100 words on how EAPs can play a positive role in reducing the risk of workplace violence. What would happen?

Here what would happen. Because your blog begins to accumlate highly relevant content, you would slowly but almost assuredly find yourself on page one of Google.

Do you realize the implications of this?

It means traffic---and that means anyone interested in the topic would slowly  begin to view you as the expert on this topic and witha  link to your website on your blog, discover you and your EAP. Search engines will rank you high because you are consistently talking about this topic. The rest is your message. But with 49,500 searches and you being on page one of Google, do you think you would get a few interested customers? Duh.

The Official Dietary Bible Every EAP Should Own (FREE)

You probably know more about alcoholism, psychotherapy, and managing job stress than human nutrition, correct? There are many subjects that come up when counseling employees and let's face it, we don't always feel in command of every topic.

There are some topics you need to be competent to handle however. One of them is nutrition.

Well there is no reason that you have to be an EAP professional who is an ignoramus about nutrition any longer. You can now download the official federal government bible on all this stuff! Nutrition, Health, Exercise -- it all in the Dietary Guidelines for Americans

I am talking about having a serious grounding in human nutrition that you can offer to your clients and then be sure you are correct and legally safe in offering those dietary recommendations. You can't get that from a book at Borders. (Well you could, but your risk when offering this advice is reduced when you can reference federal government sources, right?)

I am not saying that you should play doctor, by the way.

For example, in your counseling office, could you intelligently comment on things like offering nutritional recommendations for overweight children, being aware of what pregnant women should be concerned about regarding their diet. What the risks there are in weight reduction for new mothers that jeopardize the weight gain of a nursing infant. Knowing that it requires 60-90 minutes of moderate exercise PER DAY to sustain weigh loss?

There are ton of issues regarding diet that arise in the EAP office, and you are a more valuable contributor to workplace wellness and employee productivity if you have a working knowledge or command of this information.

It's easy to get. Download this "bible" of nutrition information from feds. It's usually about $13 at the Government Printing Office, but yours truly found the federal government download (free) at the following link: http://www.health.gov/dietaryguidelines/dga2005/document/pdf/DGA2005.pdf

Check out this outline:

• Background and Purpose of the Dietary Guidelines for Americans
• Adequate Nutrients Within Calorie Needs
• Weight Management
• Physical Activity .
• Food Groups To Encourage
• Fats
• Carbohydrates
• Sodium and Potassium
• Alcoholic Beverages .
• Food Safety
• Eating Patterns
• Eating Plan at 1,600-, 2,000-, 2,600-, and 3,100-Calorie Levels
• USDA Food Guide
• Discretionary Calorie Allowance in the USDA Food Guide
• Food Sources of Selected Nutrients
• Food Sources of Potassium .
• Food Sources of Vitamin E
• Food Sources of Iron
• Dairy Food Sources of Calcium
• Food Sources of Calcium .
• Food Sources of Vitamin A .
• Food Sources of Magnesium
• Food Sources of Dietary Fiber
• Food Sources of Vitamin C
• Glossary of Terms .
• Acronyms

Awesome.

Amazing Drug Injury Lawsuit Case--Employee Loses

Just to see the insanity in action, and have a nice example for marketing your EAP to deal with drug cases,  get this: An employee using Meth was injured on the job. It would have been compensable, but of course, the drug test at the hospital showed he was on Methamphetamine. So, naturally, the company said, "No way" and the Workers' Compensation Insurer said--"no way, buddy, the injury was sustained while you were on Meth."

So, this drug user says, well, the fall was your guys fault. Not mine. I was on Meth, true, but the injury was still because of your negligence. But since the Workers' Comp doesn't cover injuries when someone is using Meth or other drugs, I am suing you! I am suing for thousands of dollars because Workers' Comp doesn't cover this sort of situation anyway! Okay, so I was high as a kite. But, it was your fault I got injured. Let's go to court.

Off to court they went.

How much it cost to defend this lunacy is anyone's guess. I would love to know! However, the court said the case of the injury was in fact "the jurisdiction of the Workers' Compensation plan", the only issue was, drug-related injuries aren't covered. But the WC still protects the employer from lawsuits.

So, it is not that the WC system does not have jurisdiction. It does. It is just that WC won't cover it, even though the injury is the employer's fault. Therefore there is no remedy and you can't sue the employer becuase Workers' Compensatin protects the employer against lawsuits!

The Meth user is stuck with the medical bill. Amazing case.

Could the EAP have helped? You make the call! If this employee was referred to the EAP, the EAP could have played a role in helping this employee get treatment and talked common sense into him. That may have prevented the umteen thousand dollar legal bill to defend this case.

READ IT: http://www.riskandinsurance.com/story.jsp?storyId=510868682

Are You Giving Enough Respect to Respect Training?

If you're conducting workplace violence prevention training, be sure to not overlook subjects tangential to this topic that may be more critical in preventing a workplace violence incident than learning about the signs and symptoms of an employee prone to act violently. You know, the employee who may also have a long history of being harassed, disrespected, involved in conflicts, and who has no appropriate assertiveness skills to confront a supervisors who has bullied him or her. Are you catching my drift?

Too many training programs talk about how to spot the employee who might turn into a shooter, signs and symptoms of troubling behaviors in the workplace, and how to find the nearest exit if the bullets start flying. But preventing workplace violence is much more complex than these packages of the same old information.

There are several critical areas that need attention. Each of the following play critical roles in educating employees and supervisors in prevention of workplace violence -- conflict resolution between coworkers, respectful workplace training in general, training on the supervisor's role in supporting a respectful workplace, and training on avoiding workplace harassment and many behaviors that fall within the scope of this topic.

Then of course, the direct education and awareness about preventing workplace violence should also be include. Consider whether any of the following workplace wellness education products can assist you above.

You know what, I am going to take it one step furth and add Improving Assertiveness Skills. If you are a psychotherapist or other clinical type, you know that assertiveness is not just about asking for the last piece of pie on the table. It's about living proactively.

When one's rights are violated, stepping up to the plate to say "no" and "stop that" and if needed, heading for HR to get help could make the difference between intervention early and SWAT intervention later.

Do you need to deliver all this material at once? Of course not. And you shouldn't. Instead come back over the course of a year an sell the workplace violence prevention message by discussing these topics in their proper context. Employees will get the message, and of course the workplace tragedy you prevent will never be known. Good thing, Still take the credit. You deserve it.

Misuse and Abuse of Drugs Defined

You can be an expert on a subject and stumble over your tongue trying to explain some simple concept if you are under pressure or caught off guard. It happens to all of us. For example, can you explain in seconds the difference between misuse and abuse of drugs? I am sure you know the difference, but unless you have a rehearsed and prepared script in mind, you may back up a few times as you try to clarify the difference. It's at these special times that a handout comes in handy.

I found a great handout that discusses the difference between misuse and abuse of drugs. It was emailed to me by one of my article sources at the U.S. Food and Drug Administration. There's no copyright, so you print and copy this handout and use it in trainings. It would be a good for supervisor training in workplace substance abuse or employee drug and alcohol awareness, for that matter.

http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM220434.pdf

Have you previewed for free the two hour DOT alcohol and drug training web course available from WorkExcel.com? Email me here and I will send you the temporary link that launches the course. This web course has pop up handouts, test questions, a certificate of completion, feedback on wrong answers--the whole nine yards. And it's in sound. Click here to ask me to send it -- Dan, send me that free course link on Reasonable Suspicion

Presidential Memorandum has Linkages to EAP Relevance Big Time

Employee Assistance Programs are proven tools for reducing costs associated with injuries and absenteeism, and on Tuesday, a renewed opportunity for effective EAPs presented itself -- a memorandum issued by President Barack Obama.

What to do: There will be administrative efforts to monitor and encourage the goals of this memorandum, and staff positions will be created to implement and coordinate the implementation of the mandates in this memorandum. Consider discovering who these personalities are are, get on their email lists, mailng list, and find opportunities to issue press releases in your community, talk to the media, and reinforce the EAP message associated with the goals of this legislation. If you do not, EAPs will miss this opportunity for a place at the table. EAPA should establish a liaison collateral duty to confer with the Department of Labor on this initiative.
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The White House
Office of the Press Secretary
For Immediate Release July 19, 2010


Presidential Memorandum--The Presidential POWER Initiative: Protecting Our Workers and Ensuring Reemployment


MEMORANDUM FOR THE HEADS OF EXECUTIVE DEPARTMENTS AND AGENCIES
SUBJECT: The Presidential POWER Initiative: Protecting Our Workers and Ensuring Reemployment

Each year Federal civilian employees are injured or fall ill on the job in significant numbers. Although the Federal Government has made progress in reducing workplace injuries and illnesses in recent years, its workers (excluding those employed by the U.S. Postal Service) still filed more than 79,000 new claims and received over $1.6 billion in workers' compensation payments in fiscal year 2009. Many of these work-related injuries and illnesses are preventable, and executive departments and agencies can and should do even more to improve workplace safety and health, reduce the financial burden of injury on taxpayers, and relieve unnecessary suffering by workers and their families.

Therefore, I am establishing a 4-year Protecting Our Workers and Ensuring Reemployment (POWER) Initiative, covering fiscal years 2011 through 2014. The POWER Initiative will extend prior workplace safety and health efforts of the Federal Government by setting more aggressive performance targets, encouraging the collection and analysis of data on the causes and consequences of frequent or severe injury and illness, and prioritizing safety and health management programs that have proven effective in the past.

Under the POWER Initiative, each executive department and agency will be expected to improve its performance in seven areas

(i) reducing total injury and illness case rates;

(ii) reducing lost time injury and illness case rates;

(iii) analyzing lost time injury and illness data;

(iv) increasing the timely filing of workers' compensation claims;

(v) increasing the timely filing of wage-loss claims;

(vi) reducing lost production day rates; and

(vii) speeding employees' return to work in cases of serious injury or illness.

Executive departments and agencies (except the U.S. Postal Service) shall coordinate with the Department of Labor's Occupational Safety and Health Administration and Office of Workers' Compensation Programs to establish performance targets in each category. The Secretary of Labor shall lead the POWER Initiative by measuring both Government-wide and agency-level performance and reporting to me annually.

Each executive department and agency shall bear its own costs for participating in the POWER Initiative, and nothing in this memorandum shall be construed to impair or otherwise affect the authority granted by law to an executive department or agency, or the head thereof.


This memorandum is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

The Secretary of Labor is authorized and directed to publish this memorandum in the Federal Register.

BARACK OBAMA

Is Behavioral Health Cost Containment Really Worth A Diminished EAP Model?

When I hear in the national news that some employee turned violent in a horrible and tragic incident and shot coworkers, I can't help but wonder if--as the bullets flew--there wasn't in that employee's hip pocket or purse, a health insurance card and a barely visible, small type, "1-800 EAP" number printed on the back of it; a practically invisible, poorly promoted telephone helpline.

Is this sort of cost containment to prevent access to behavioral health benefits really worth it to companies? I think if they knew the real story, and had a different impresssion what risks they really face with a "DEAP" "diminished EAP", they would think twice about it.

A CT-EAP (core technology EAP) can reach out so much more, do more, and be more than what some of these benefits entities have sold or given away to America's employers. Where's the education to change all of this?

If we research the tragedies seen in the news via the Internet, would be discover that there was an EAP, but that it was a diminished model or program that appeared to have a poor promotional plan?

Of course, the next thought is whether a more effective EAP model or promotional effort would have made a difference and saved some lives with effective outreach and solid supervisory referral processes taking place in the organization.

Is health insurance "cost containment" to prevent use of behavioral health benefits, as much as possible, really worth the risk of a diminished EAP delivery model? I don't think it is.

It's simple math. Remove regular EAP promotion, visibility, and the ability to offer "high touch" access to the workforce and you will destroy top-of-mind visibility for the EAP. You will see fewer referrals, less EAP involvement in the organization, less "thinking" about how to use the EAP in new ways, and few supervisor referrals to be sure. You will get more risk to the workplace, coworkers, and the financial well-being of the organization. Only if you have worked for internal EAPs, external EAPs, and office cubicle managed care EAPs, can you truly see the enormous difference in accessibility, utilization, and risk associated with these various contrasting models.

When you get home to tonight, look on the back of your spouse or partner's insurance card. See if there is a 1-800 # to the EAP or leads to an EAP once it is called.

Then ask yourself is this EAP working? And, for whom or what?

Get information to include in your EAP Refresher Training Program here. Increase your supervisor reach and effectiveness of supervisor referral processes in your CT-EAP.

Getting Spit On? Call the EAP!

Finally, I found an amazing and dramatic illustration of the topic I like to harp on most -- having EAPs identify and then make use of opportunities that suddenly and dramatically emerge in the workplace where the EAP solution can be applied. When EAPs do this, they grow their value and reputation, and if they are lucky enough, come in contact with major stake holders who have enormous clout. These stake holders -- property casualty insurers are one -- can elevate EAPs dramatically.

Can you guess how days the average bus driver in New York City took off last year after they were spit on by bus riding customers? The average time off was 64 days!!!!! One took off 191 days. No, these are not drivers to be disciplined for gross abuse of leave policies. They are getting paid by workers' compensation!

Amazing you say? Indeed. It's costing tens of thousands of dollars right out of the city coffers. And many of these drivers are claiming they need psychological help as a result of the pedestrian abuse they experience. Here is a link to the story.

What's the issue, and is there an EAP solution for the drivers, the public (indirectly), and the financial crisis associated with this workers' compensation nightmare? I think there is, or at least I hope you walk away from this blog with the idea that you can find untold numbers of opportunities to make yourself more useful and valued in the EAP setting. (And by the way, fear not, you won't have managed care competing with you for these classic applications of the core technology. It is off their "grid" entirely.)

Off the top of my head, the EAP should be included in a round table discussion with top management and review the data associated with these incidents. Specifically, what should be determined are patterns associated with everything from time of day these incidents occur, profiles of the spitting customers, antecedent and provocative events, worker profiles, and other variables that may point to behavioral interventions appropriate for the EAP.

For example - EAPs have skills or can closely coordinate with resources that have the skills to provide stress interventions for these cases, education on managing emotions, behavioral interface with customers, how to diffuse violence (which of course is what we are talking about when it comes to spitting). And, what about customer service? Dealing with angry and abuse customers? (see fact sheet).

How many bus drivers are depressed, alcoholic, or experience other behavioral problems exacerbated by these types of stressful incidents? What about anger management training or examining customer service issues that help employees avoid responding or provoking inappropriate behavior from people? There many more issues to examine here. Are more men than women assaulted. What's the difference? What about processing anger in groups and learning skills.

The violence of spitting on a bus driver surely is a crime. And law enforcement must play a powerful role. However, there are psycho-medical and dynamic behavioral issues at play with the larger problem, and of course, the enormous expense of workers' compensation costs demand a comprehensive attack on the problem.

The EAP is part of the solution. At least, this is much is true before I am willing to say there is not: Completely omitting any consideration of an EAP role in dealing with this problem is financially irresponsible.

Now, if the EAP is being considered at all, and no one has suggested, we need to ask why?

This problem lies at the feet of the profession. And here lies the answer to a new dawn for employee assistance programs. Am I wrong?

Air Force Suicide Prevention Worked

Suicides are down and the intervention program worked. That's the conclusion of a research study just released by the University of Rochester Medical Center and published in the American Journal of Public Health. The program being proclaimed successful dropped the suicide rate by over 20%. The suicide prevention program with the U.S. Air Force began in 1994, but suicide rates were examined from the period 1981 - 2008.

Lessons from the study. To decrease the rate of suicide, the U.S. Air Force concentrated on four key components: 1) Encouraging members of the Air Force to seek help; 2) Promoting the development of coping skills; 3) Fighting the stigma associated with receiving mental health care; and 4) stressing the absence of negative career consequences for seeking and receiving treatment. The Air Force Suicide Prevention Program is included in all military training. Supervisor training is a key component of the program  with leadership getting instruction in how and when to refer subordinate personnel to help. If any traumatic events, especially those related terrorism occur, they are responded to rapidly to address acute and posttraumatic stress, a known major contributing factor to the risk of suicide risk. The number of suicides prior to the study going back to 1994 were 64 in that year. The program low during the implementation period of the program was 1999 with a total of 20 suicides. (Note: There has been no reduction in the suicide rate among the general U.S. civilian population since the 1940s according to the study.)

Blog Note: Currently the U.S. Army is undergoing service wide training in an effort to reduce the suicide rate among its ranks.

Suicide prevention education module in PowerPoint, PowerPoint with sound, Flash video, and DVD, with script notes for the PowerPoint formats can be found at WorkExcel.com, Suicide Prevention Training. (Used by many federal government agencies, Fortune 500 companies, the U.S. Senate, and smaller businesses.)

EAPs to the Rescue with Workers' Compensation Fraud?

One of my favorite subjects is business insurance. I like to watch news, press releases, and blogs reporting on the many aspects of this field. As I have often opined, business insurance is a stake holder of effective, core technology employee assistance programs. The only problem is, they don't know it. That's the fault of EAPs as a group.

Insurance protects businesses and producers sell insurance. Your bridge to meet these employers and establish yourself is one of following three professionals who know a business owner best: the lawyer, the accountant, or the insurance agent. Insurance agents are your best bet because of synergies associated with the their needs, business needs, and the purpose of EAPs are nicely melded. They must all be concerned about human behavior in the workplace that leads to risk and financial loss.

Who pays for the legal bills of employees sued for sexual harassment? Who pays for the workers' compensation costs associated with sexual harassment (yes, harassed workers have often collected money for sexual harassment) and who will lose money if lawsuits come for sexual harassment? The answer is business insurers. Of course, employers pay too, if insured, through high deductibles.

There are many types of business insurance and there are many behavioral risk exposures that business insurance is designed to address. EAPs interface with many of them.

So the logic is there to team up with this group. Get started. Start in Colorado, or at least follow this legislation to see where it goes an how much influence it carries. Here's the news.

One of the insurance writers I follow is Gary Boop. He writes for "About.com". Gary reported today on a piece of legislation working its way through the Statehouse in the Colorado. The politicians there are focused on prohibiting workers compensation insurers from spying on or doing clandestine surveillance of employees injured on workers' compensation. This technique of finding employees who are stealing money from employers by faking injuries and collecting fat paychecks has been used for decades to reduce workers' compensation costs. Do you know the ramification of such legislation? They are potentially great and it means news skills and capabilities are going to be important to reducing costs. That's where you come in.

Consider this New Colorado bill H.B. 1012

What does this have to do with EAPs? I hope you see the connection, but let me spell it out clearly for you. Limitation of an employer's ability to investigate fraud means there must be some other way to find it, but even better, a renewed interest in preventing it will obviously be on the horizon.

Instead of ignoring injured employees and then seeking to discover criminal malingering to collect benefits, heading these problems off at the pass will get more scrutiny.

I predict that someday a business service will emerge that will be funded by workers' compensation insurers, and that it will play the following role. It will operate confidentially and

• Meet with employees to assess the emotional impact of their injuries,
• Do a family assessment to determine likely areas of distress and conflict at risk for protracting an injury,
• Conduct an occupational alcoholism assessment,
• Help an employee remain motivated and anticipating a return to work,
• Resolve conflicts between an injured employee and the boss or coworkers back at the worksite,
• Offer support for the injured employee during the period of time they are off work,
• Offer guidance, tips, and support upon return to duty so employees experience reduced anxiety and conflict associated with return to light duty or full duty assignments.

I believe these activities would make a hell of a business opportunity to help reduce costs for workers' compensation managed care and employers. Specialists who would do such work would need the skills of employee assistance professionals. So, why can't EAPs get more involved now before such a service robs the field of an opportunity?

EAPs typically don't do these things now, but they could add these services to their continuum of activities and get enormous credit for doing so.

If you have entertained the idea of looking more at the EAP/Workers' Compensation interface, and you happen to service employees in Colorado, run don't walk, to develop your capabilities of servicing these employees with the goal of monitoring their care so they are less likely to fall prey to the temptation of malingering.

Of course, sometimes injuries are very real, except bogus injuries or injuries that were very real at the time become easy to lie about once their pain and debilitating symptoms disappear.

Any thoughts about this? See the drift?

Resolving Coworker Conflicts - Done

Resolving coworker conflicts is something many employee assistance professionals are well skilled at doing. However, many EAPs don't advertise or promote this service. You should think about doing so to improve your worth and perceived value. Providing education on resolving coworker conflicts can increase your visibility for this service and EAP utilization, but the really good news is that such help to the organization brings with it big returns that may help you stick around. You will notice that many of the products and services at WorkExcel.com are designed to help EAPs be more valuable. For example, doing Stress Management Secrets for Supervisors was not an accident. It was produced to get EAPs closer to the decision makers.

To offer a promotional and educational tool, available in five formats, I recently created new product on Resolving Coworker Conflicts. You can see it here. Feel free to give me a call if you have any questions. This program will elevate the visibility of your EAP and reduce risk to your host organization(s.)

Are you interested in possibly cutting your newsletter expenses in half or more? FrontLine Employee newsletter can do it. In PDF format, or print as needed, it can save you money and give you a completely customizable wellness newsletter program. Learn more about it here.

Are You Doing the Right Kind of Stress Management (link)

About a year and half a go, Watson Wyatt Worldwide, a leading global-wide consulting firm, surveyed employers and discovered that stress was the number one reason employees quit their jobs.

Watson Wyatt is a major benefits consulting firm, so their interest was in learning more about this workplace issue. They discovered that most employers weren't doing much about stress. Two surveys conducted by Watson Wyatt confirmed it.

The strange thing is that most employers did not cite stress as the key reason employees quit. Stress did not make it into the top five reasons. Most employers listed things like insufficient pay, lack of career development, or poor supervisor relationships as the reasons employees quit. Employees were saying it was other things.

The bottom line is that if you are doing stress management in companies and want to make the most impact, you must target the source of stress in your EAP interventions. According to the research from Watson Wyatt, the target sources of stress that increase the risk of employees leaving include the following, some of which you may be able to address, and others, perhaps not.

Note: The second number is the percentage of employers acting to help employees with this stress related issue.

Long hours, doing more with less - 48% of employees say this is a problem. (Only 5% of employers doing anything about it.)
Work/Life Balance - 32% (16%)
Technologies that expand work - 29% (6%)
Manager's inability to recognized stress - 24% (7%)
Manager's inability to find solutions for stress - 20% (14%)
Extra time, hassles related to security - 8% (2%)
Safety fears - 5% (27%)

The numbers give some clues. It may be easy to focus on dealing with security or saftey fears of employees, but there may be nothing employers can do to help employees who are forced to do more with less. The interesting set of numbers above is "Manager's Inability to Recognize Stress". It's rated high as an employee complaint, but it is low as a point of intervention from the employer's perspective.

There is appreciable room to help managers and supervisors understand stress better, its effects, the impact it has on employees, what to do about it, signs and symptoms in employees, and factors associated with supevisor-supervisee communiation that undoubtedly contributed to it.

When doing stress management consider laser targeted interventions to be more effective. Source: Press Release, "Few Employers Address Workplace Stress", contact Steven Arnoff at steven.arnoff@watsonwyatt.com

New EAP Professionals and Orientation to Alcoholism (Ouch!)

It is safe to say that discussing alcoholism with any professional in the treatment field, EAP field, or other helping industry will generate some argument and controversy. Just wait. If you are new to the field, you'll soon be indoctrinated with one of these cocktail conversations.

It's one of the "elephants in the living room" of the helping profession. One out of four people has an addict in their family, and myth and mythology over thousands of years keeps intervention, treatment, and recovery confusing and controversial.

From non-M.D. psychologists who are selected to be the U.S. Supreme Court consultants, who then push the idea that alcoholism is not a disease, to best selling authors telling us how alcoholics can drink safely, there is simply no shortage of information and "new thought" about alcoholism that continues to undermine the legitimacy of this disease and how it should be managed.

Of course, if you have worked directly with alcoholics in treatment, you are prized material for being hired as an EAP staffer. It means you have been in the trenches, faced the defense mechanisms, and hopefully have been mentored by recovering persons (if you are not recovering yourself) who adhere to abstinence principles and 12-step programming as the most effective way to manage this chronic disease.

(It is truly amazing that when I blog on this topic, I get rabid members of Rational Recovery threatening to turn off my free speech rights with their conspiracy theories about AA.)

If you are new to the EAP field, and have not been in the trenches of alcoholism, there are few things you need to know.

First, don't think that understanding alcoholism or writing about it as new EAP professional will be an easy scrabble. The economics and politics of alcoholism diagnosis, causation, treatment, and ongoing recovery are profound , convoluted, and continue unabated.

Before you get into a discussion about alcoholism, do a few things that are really critical to your edification and orientation.

1. Go to a dozen or so open AA meetings and get oriented to "recovery think". Know what recovering people read, and have your own library of this material. (Also purchase alternative and controversial materials that argue against AA so you can see their rationalization and desperation to avoid what AA is about.) Memorize the twelve steps. You don't want to be caught unable to converse about the 5th step, the 4th step, or the conflict in treatment programs that push patients to go to the 4th step instead sticking with only the first three. (See what I mean?)

Not having this information will also cause issues with your clients who will expect for you to know more than they do about recovery initially.

2. Visit the Web site of the American Society on Addiction Medicine at http://asam.org. There is a ton of stuff on this site. Read their position papers. This association represents about four thousand medical doctors who are the leading authorities on addictive disease, alcoholism, and its treatment. They don't get a lot of press. Probably because they get a lot of folks upset who would otherwise report on their opinions. There is a simple explanation: Science and research simply don't mix well with the popular culture, which has a 5000 year head start ahead of them.

It is popular culture that drives belief systems about the disease. You need to separate the wheat from the shaft if you are going to work in this field effectively.

There a lot of people making money off of alcoholics. Whether it's trying to do psychotherapy with them while they are still drinking or drugging, selling them gimmicks, pushing alternative group therapies and "not-necessarily-abstinence" groups, pop-psych ideas about how to drink normally, etc., there is no end to the influx of confusion and interference that keeps alcoholism from being accepted by everyone (like cancer) that it is an authentic, chronic disease that requires abstinence to arrest its progression.

3. Read "Under the Influence" by James Milam and Katherine Ketchum. Still about $5.95 a paperback copy, it is a fascinating book that explains alcoholism as a chronic, genetically based illness so well, it is hard to put it down. Not sure if the author's original, self-published book, 'The Emergent Comprehensive Concept of Alcoholism" is still around, but if you find it, it will blow your mind about the economics and the forces in our larger society that have a vested interest in your not believing that this is a true disease.

Okay that's enough to blog about today, don't you think!

Link Fixed

A link was broken on my last post. It's fixed, or you can click here.
Preventing Workplace Violence

Workplace Violence Video

I finished Video #3 in the Workplace Media Library 2010 series. This module is entitled Preventing Workplace Violence. It runs 12 minutes and I think it covers all of the bases.

While writing this program for EAP web sites and other workplace services, I took advantage of my experience as a victim of bullying when I was working for the CIA in 1978. (I eventually took a position in the CIA's occupational alcoholism program, but just prior, had a job in the Office of Logistics in Langley, VA doing various types of unclassified building work.)

I was able to stop the bullying permanently in a very satisfying manner. I zapped the perpetrator one day when he was arrested by a Federal police office for throwing lighted matches over the top of his head in an effort to hit me with them while I was walking down a hallway following behind. All for no reason. No reason at all. Just "fun". I was the chosen one--this guy's toy.

Luckily, it was all spotted by a Federal Police Officer guarding the hallway. She approached me and asked if I wanted to file a report. "Absolutely", I said. After numerous other events, it was the perfect opportunity.

The rest is a history of no more stress from this jerk, but the point of this story is that horseplay is illegal in Federal office buildings, and no matter where it is, it often turns violent. It frequently has victims, causes property damage, the clear example should encourage you to mentioned it in your training.

I have never seen horseplay mentioned in violence prevention materials, but this one does include it in one strong slide.

You will see other original content in this violence in the workplace prevention Power Point video. I also encourage employees to attend CISD debriefings offered by the organization after a violent incident, tips on avoiding assault, what the organization's EAP can do, how employees should be "change-agents" in promoting respect and avoid provoking a violent response from an employee who may not react rationally from picked on and bullied.

You can see the Preventing Violence at Work video here. Also, you may be interested in the Workplace Video Web Content Subscription as well. The program is designed to drive the cost down for these new products.

EAPs Can Do Managed Care and Increase Their Value

1. If you work for an internal EAP with a company that is self-insured, consider approaching your human resources and benefits management team to discuss the possibility of getting the mental health component of your EAP "carved out" so you can provide limited managed care services. If you are a very well trusted tenured pro, they just might consider it. Listen up. I am not recommending to you anything that I have not done myself, including this task.

2. If you can achieve this goal, it will increase utilization rates dramatically. Here is the selling angle: 1) The EAP can pre-screen and refer employees to appropriate mental health professionals based upon their clinical evaluations and guidance. This will save money by getting employees to the right provider the first time.

As an incentive, permit 80% coverage for mental health benefits versus 50% for those that don't go through the EAP. Self-insured companies can do this sort of thing. This will also allow the EAP to identify behavioral/medical problems that may underlie existing disorders contributing to the symptoms brought to the EAP session by the client.

3. Even a phone interview with an employee to discuss a referral -- in the event the employee does not perceive the need for a face-to-face interview, or refuses -- can go along way toward identifying primary health problems that can be more effectively treated by the referral source the EAP might suggest.

4. If you succeed in getting a carve-out, the primary services you will provide include: 1) approving therapists; 2) notifying the insurance company who they should approve payment for; 3) re-certifying regularly; 4) selecting providers when a specialist on the managed care panel doesn't exist; and, 5) deciding to pay higher fees than the managed care company is willing to do themselves. This is a good deal for employees and can increase confidentiality. Yes, it will save money for the company, too. That's right, many managed care companies will not require "outpatient treatment reports" and they will accept the EAP's approval of out-of-panel therapists. You decide. You have to be diligent, but remember, "its your money not managed care's money."

5. All of this can limit the amount of clinical information, other than a CPT code, that will go to the massive computer memory at the managed care company. This improves actual and perceived confidentiality. Survey other internal programs nationwide to identify strategies capable of adding this dimension to your EAP services.

If you are interested in seeing the new “Preventing Violence in the Workplace” program (five formats available), reply back here and I will make sure you are on my early release list to view it, and get the limited time discount. This is a reward for being nice enough to sign up for this blog. More to come in the future! The discount won't be as low as the Flash Video Subscription Service (you know about this product, right?) subscripton service, but it will be signficant. The program is in sound in Flash Video for your web site, DVD, PowerPoint, and a self-playing Flash CD.

Is Your Quarterly EAP Newsletter Placing Your Program in Danger of Being Cut?

What a weird question? Well, it's one of the many elephants in the EAP living room, so let's discuss it.

Can an EAP newsletter that you distribute too infrequently make your program less visible and more likely to be cut? After communicating with hundreds of EAPs and watching what happens internally with EAPs that I have managed, I have slowly gravitated to an answer on this question. It’s “yes”.

It’s convenient not dealing with the distribution of a newsletter more often, but still appearing as though you are “doing something” to promote your EAP. Is this your mindset?

This vintage approach to communicating wellness information in a technological era has become almost an apologetic frequency as your newsletter sheepishly slips into employee in-boxes every three months.

I would like to make the argument that this is too infrequent and makes a statement about the importance of this material and your program, in particular.

Do you disagree? Consider why you do this. Is it because there is a history of EAPs always doing it this way because that is all that was initially available from vendor sources? So, by default, did it become the standard for EAPs, and you copied others? I think this is precisely what happened.

Since I joined ALMACA (EAPA’s early name) in 1978 – 32 years ago I have witnessed the evolution of this service. And, I have watched it grow more important.

With all the stress that employees face, and with the degree of importance that you place on your EAP as a life-saving and cost-saving mechanism, isn’t it a bit ironic that you only distribute a quarterly newsletter to employees when you could do it bimonthly or monthly for less, and with less hassle?

You may have a quick comeback — employees have too much to read! Don’t fool yourself. This is your codependency talking. You're giving in to a HR manager’s phone call telling you to slow it down about other material you may have sent. Or it's simply your imagination, because you haven't received such a phone call at all. You're just making this statement to avoid the work and it sounds damn good. I have caught many EAPs in this argument. It's not reality. This, too-much-to-read line is bogus.

If you are hearing this line, it is all about muscling you around and telling the EAP how to do its job. Why is that the most important thing employees read regarding their well-being and perhaps the one thing that they really look forward to most receiving, is the one thing that should be cut back?

What you’re hearing from HR, if indeed at all, is one HR manager’s opinion, or at best a manager’s opinion relayed via HR.

You need to understand something: HR managers don’t argue with top managers. They are their primary customers. Instead HR managers ask how high to jump. Corporations are on a big outsource-the-HR-departmet kick these days, and HR managers -- like EAPs are a threatened species.

I assure you that you are not getting the results of a survey that is supported by employee opinions.

Here’s the problem. Employee newsletters have historically been four pages. The problem begins and ends there.

Quarterly newsletters are always print or sub-links to the vendors own web site destroying your seamless look. They are expensive, with 500-600 word articles, and they are a vintage solution manufactured for EAPs in the early 1980’s when anything more frequent would be over-kill. Employees had more leisure time then to read these "books".

But the problem today is that they sacrifice your EAP or program visibility. You become less competitive with other things in the organization. You don’t want that. It will jeopardize your program.

You are sacrificing visibility and communicating the message that quarterly life-saving health and wellness information is quite enough. Trust me, you do not want to send this message.

An EAP newsletter is a resource, and visibility mechanism, and item of extreme interest to employees. And it is a way to compete against other things in the environment that are targeting the employee’s attention. You must not give in to the “stop distributing this material because our employees don’t have time to read it” mantra.

Instead, stop sending 4-page newsletters. Send two-page newsletters bimonthly or monthly.

Employees do not generally finish or complete four-page newsletters in my experience and in my view. This is another reason that you are locked into a 4-page solution distributed quarterly. It’s nuts to send it more often! And its expensive. So, change the model to the 2010 solution. Get out of the 1980's.

In this era, go for less content, shorter more action-oriented tight copy, and more frequency with the ability to edit the content yourself on the fly. This way your EAP will stay visible, be perceived as being more valuable and relevant, and be more effectively mainstreamed. Anything less and you’re in danger of being seen as expendable during next budget cycle.

Distribute EAP-wellness-productivity newsletters via PDF. Post them on your web site and send a link to employees when they are added to the site.

Distribute print to employees without computers, or send copies to appropriate locations. Your utilization will increase, your visibility will be enhanced, you will spend less, and employees will read more, more frequently. Your EAP will be talked about more often, and this is what you want.

A two-page monthly newsletter is 50% more content than a quarterly four-page newsletter! (Read that again.) And, the two-pager is more likely to be completely read. Are you with me?

You’ll will also reduce waste, motivate more self-referrals, and reduce more risk to the organization with a two—pager, monthly newsletter. Oh, and it will cost less than print. Everything I am writing here is pure logic and it holds up in real life.

Still need paper, make copies from your clean PDF supplied by the vendor. Can’t get permission from the vendor? Dump the newsletter vendor!

FrontLine Employee and WorkLife Excel are your modern day solutions to effective employee and EAP newsletters.

You can get brochures here:

FRONTLINE EMPLOYEE EAP WORKPLACE NEWSLETTER
WORK-LIFE-EXCEL WORKPLACE NEWSLETTER