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.
Showing posts with label employee assistance programs. Show all posts
Showing posts with label employee assistance programs. Show all posts
Wednesday, January 20, 2010
Tuesday, January 12, 2010
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
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
Sunday, December 6, 2009
Economics and the Management of "Dual-Diagnosis" Alcohol-Drinking Clients: How Murky!
A patient is self-medicating if alcohol is used to reduce symptoms of emotional or physical pain regardless of whether the diagnosis of alcoholism exists. Unfortunately, this definition of self-medication often alters from one clinician to the next. And, of course, we know that some mental health professionals do this for the sake of economics, or maintaining their unshakable model of addiction, regardless of validity.
It is tempting to use "self-medicating" as an exclusionary term to decide the patient isn't simply an alcoholic or not an alcoholic at all. This helps justify the current course of therapy that may not meet the needs of the patient, especially if he or she continues drink. The incentive is usually preventing the loss of client or patient to a traditional course of treatment for addictive disease.
Alcoholics without dual-diagnoses drink to ward of withdrawal symptoms, however. So, as the AAMCO car transmission spokesman says on TV, "How can you tell which is what without mistaking one for the other?"
Why not use the National Council on Alcoholism and Drug Dependence and the American Society on Addiction Medicine's definition of alcoholism. No less that 20 or so authorities labored for a consensus and have amended the definition at least twice. 1990 was the last - 20 years ago. (Can't believe it, geez, time flies.) If you are not using it, why not? Goodness, I hope you know it! Click here!)
Digression: Many people were upset over the finality of the definition and deliberation of this well-credentialed group. Someone went as far to create a dummy website about the definition to load harmful viruses on people's computers who visit it. Talk about resistence. (Google has a warning on the Internet link to keep people away from it. You'll see it if you surf the web.)
A self-medicating patient is alcoholic if tolerance to alcohol as emerged during the course of the patient's drinking career and symptoms of withdrawal exist (even ones subtle enough to be certainly overlooked by non-medical professionals.)
Pathologic organ changes may be present or may coexist, and some of these may be undetectable without a meaningful liver functions work-up.
Obviously, based upon this description, you would need help in deciding for sure if the patient was only self-medicating, and not alcoholic, right? Definitely, especially if you were seeing adaptive and earliest stages of addictive disease.
Of course, it gets murkier.
There is the possibility that your patient is in the early stages of alcoholism. A dual-diagnosis might exist. (Dual-diagnosis was an behavioral health insurance-saving discovery rapidly popularized by mental health professionals, and very quickly, within few years of the explosive thrust to treat alcoholism as chronic disease in the early 70's.)
But here is the punchline: Regardless of why a patient drinks, abstinence is required to properly treat depression or any mental illness, especially if medication is involved, and even if it is a dual-diagnosis.
So this means the patient needs to acquire motivation and a sense of urgency to remain abstinent if he or she does not have it already. And what if you can't get that from your patient? Any non-alcoholic client wouldn't give it a second thought to acquire better mental health functioning. And, of course, an alcohol-using client wanting to stop drinking would be qualified for AA. (And you should use motivational counseling to help him or her do it.)
Consider the following:
In the end, you may have to fight yourself, the law of economics, and your model of alcoholism at the same time.
A drug and alcohol training program with effective and non-confusing language for use in business and industry can be found here.
It is tempting to use "self-medicating" as an exclusionary term to decide the patient isn't simply an alcoholic or not an alcoholic at all. This helps justify the current course of therapy that may not meet the needs of the patient, especially if he or she continues drink. The incentive is usually preventing the loss of client or patient to a traditional course of treatment for addictive disease.
Alcoholics without dual-diagnoses drink to ward of withdrawal symptoms, however. So, as the AAMCO car transmission spokesman says on TV, "How can you tell which is what without mistaking one for the other?"
Why not use the National Council on Alcoholism and Drug Dependence and the American Society on Addiction Medicine's definition of alcoholism. No less that 20 or so authorities labored for a consensus and have amended the definition at least twice. 1990 was the last - 20 years ago. (Can't believe it, geez, time flies.) If you are not using it, why not? Goodness, I hope you know it! Click here!)
Digression: Many people were upset over the finality of the definition and deliberation of this well-credentialed group. Someone went as far to create a dummy website about the definition to load harmful viruses on people's computers who visit it. Talk about resistence. (Google has a warning on the Internet link to keep people away from it. You'll see it if you surf the web.)
A self-medicating patient is alcoholic if tolerance to alcohol as emerged during the course of the patient's drinking career and symptoms of withdrawal exist (even ones subtle enough to be certainly overlooked by non-medical professionals.)
Pathologic organ changes may be present or may coexist, and some of these may be undetectable without a meaningful liver functions work-up.
Obviously, based upon this description, you would need help in deciding for sure if the patient was only self-medicating, and not alcoholic, right? Definitely, especially if you were seeing adaptive and earliest stages of addictive disease.
Of course, it gets murkier.
There is the possibility that your patient is in the early stages of alcoholism. A dual-diagnosis might exist. (Dual-diagnosis was an behavioral health insurance-saving discovery rapidly popularized by mental health professionals, and very quickly, within few years of the explosive thrust to treat alcoholism as chronic disease in the early 70's.)
But here is the punchline: Regardless of why a patient drinks, abstinence is required to properly treat depression or any mental illness, especially if medication is involved, and even if it is a dual-diagnosis.
So this means the patient needs to acquire motivation and a sense of urgency to remain abstinent if he or she does not have it already. And what if you can't get that from your patient? Any non-alcoholic client wouldn't give it a second thought to acquire better mental health functioning. And, of course, an alcohol-using client wanting to stop drinking would be qualified for AA. (And you should use motivational counseling to help him or her do it.)
Consider the following:
- 1) Refer the patient or client to an addiction medicine (certified) physician for the differential diagnosis who will work with the official, and most rigorously formulated understanding of alcoholism that exists.
- 2) Do not accept without question or qualm the patient's explanation for why he or she drinks. I still can't believe how many professionals actually accept a patient's own well-intellectualized conclusions, even as they explain it with alcohol on their breath.
It is natural to begin a diagnostic impression on what is conveyed by patients, but remember, alcoholics are well-practiced at explaining their drinking using the same misconceptions and misunderstandings as the general public. Some may even rely upon explanations provided to them by other health professionals who have attempted to treat in the past. The preferred definition of the actively drinking patient is always the one that will permit continued drinking or offer hope of doing so again one day. - 3) Be prepared to feel anger and resistance at losing your client to traditional alcoholism treatment, because without sobriety, and a stretch of time to overcome protracted withdrawal symptoms and the normal symptoms of recovery (remember those?), you may not be able to determine what you have sitting in front of you in the clinical setting.
In the end, you may have to fight yourself, the law of economics, and your model of alcoholism at the same time.
A drug and alcohol training program with effective and non-confusing language for use in business and industry can be found here.
Tuesday, December 1, 2009
Something's Stirring with Psychologists
Sometimes it is a good idea to know what other occupational groups and professions are planning for the future.
Frequently these decisions are based upon well-researched needs and interests of customers. One such group are Psychologists. They have big plans for reaching out to business and industry in the future. Here's what the Ph.D.s have been focusing on and discussing at their conferences and reporting to their members:
Hey, wait a minute! I thought EAPs dealt with most of these issues? And, hey again, I read recently that there are more EAPs than ever! So, what gives?
One itsy, bitsy, small difference. Managed care now provide most EAPs. The CT (translation - authentic) programs are dwindling. Indeed, manager care 800#'s don't have any practical involvement with the issues discussed above.
Could it be that the decline in the number of solid, core technology-driven, personally visible, and integrated employee assistance programs is causing or allowing to become visible, unmet needs in the workplace? I think they are. I have been observing this trend ever since reading in an HR journal a few year ago that HR managers should start addressing more personal problems of employees when "EAPs" can't do it. Holy cow! You never heard that about the EAPs of the 70's, 80's, or early 90's.
So where do HR managers and customers (decision makers) turn to get these needs met? Themselves? Mental health? Of course, they are turning to mental health professionals. And psychologists are at the waiting--organized, focused, and with clout they have uniformly built for decades.
Frequently these decisions are based upon well-researched needs and interests of customers. One such group are Psychologists. They have big plans for reaching out to business and industry in the future. Here's what the Ph.D.s have been focusing on and discussing at their conferences and reporting to their members:
- Workplace Resilience Training
- Workplace Psychological Well-being
- Military Stress and PTSD/Suicide Prevention (then on to other professions)
- Bullying prevention in workplace
- Presenteeism (employees sick at work and their impact on others/productivity)
- Erratic commuting stress and How It Undermines Productivity.
- Psychological health of untrained disaster responders (as opposed to trained responders)
- Improving personal communication on the job and creating healthier workplaces
- Employees with parental duties and productivity declining while at work, but beginning at the moment school lets out -- i.e. What is Johnny doing? Where's the babysitter?, Etc.
- The study and management of flexible work schedules, employee stress, and related issues.
Hey, wait a minute! I thought EAPs dealt with most of these issues? And, hey again, I read recently that there are more EAPs than ever! So, what gives?
One itsy, bitsy, small difference. Managed care now provide most EAPs. The CT (translation - authentic) programs are dwindling. Indeed, manager care 800#'s don't have any practical involvement with the issues discussed above.
Could it be that the decline in the number of solid, core technology-driven, personally visible, and integrated employee assistance programs is causing or allowing to become visible, unmet needs in the workplace? I think they are. I have been observing this trend ever since reading in an HR journal a few year ago that HR managers should start addressing more personal problems of employees when "EAPs" can't do it. Holy cow! You never heard that about the EAPs of the 70's, 80's, or early 90's.
So where do HR managers and customers (decision makers) turn to get these needs met? Themselves? Mental health? Of course, they are turning to mental health professionals. And psychologists are at the waiting--organized, focused, and with clout they have uniformly built for decades.
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