EAP Utilization Tip: Utilization Review & Hospital Social Workers

How many hospitals are in your town? Medical social workers or utilization review nurses might be the busiest occupation on the planet with the most stress. The cut-backs in hospitals and the personnel shortages they face, have made social workers busier than ever--that's if they have not been fired yet. Some hospitals have let all of their hospital social workers go. They have replaced the bulk with utilization review nurses who line up support and medical help post-discharge.

They could use some help. And they would love to refer employees from the company or companies you serve who've ended up in the hospital for one reason or another. You could lighten their load and get the utilization credit for your program. Remember family members could use EAP services too, so make sure your statistics include "employees impacted" by EAP services.

In many instances, medical social workers perform the same kind of  "brokerage" services for patients and their family members that EAPs do. (Brokerage is arranging services for the client without the client's involvement and then passing them off to that service or agency for continuing care or services.) Medical social workers interface with hospice services, meals on wheels, visiting nurse agencies, home health care, medical equipment companies, admission departments of nursing homes and assisted living facilities, social security disability and retirement offices of local government, many other services. If you have done this work as a medical social worker or hospital utilization nurse, you know that burnout is high. You're on the phone constantly.  Help these hospital professionals by letting them know you exist. When a patient is admitted to the hospital, the EAP (that's you) can be contacted to help arrange support or other services. They instantly become a new EAP client referred to your program. Note that you will need to reinforce your availability for assisting the hospital with patients who are also employees of the companies you serve. I would arrange six monthly letters to the person in the hospital who is head of insurance utilization. Send them monthly regardless. After that, your utilization will increase. Let me know what happens. This is a win-win for everyone, including your EAP client, especially.

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Helping EAPs Make a Comeback

The EAP field for about a 20 years has been bombarded with very powerful interests seeking to take what EAPs offer, carve out a piece here or there, and call it their own. Many have borrowed the name EAP and sold it as a service for a secondary purpose like helping contain behavioral health dollars. Few if any other functions are offered in many cases, but the product is still defined as an EAP. 

Although EAPs focus on helping troubled employees and our key activity is the assessment and referral process, the gift within the discovery in the core technology is the ability to manage and intervene with many types of human behaviors and risks the emanate from them. The association, which is us, can shepherd EAPs back to their original value proposition by making it NOT okay to calling anything that sort of smells like an EAP, an EAP.

Although internal EAPs frequently possess the political clout to get behavioral risk projects initiated in an organization – external EAPs still hold the future of the profession in their hands because most American businesses are small and require vendor services.

HR Journals like HR and WorkForce Magazine have not been helpful to EAPs. Even when they mention EAPs and you and I are pleased to see the acknowledgement of what EAPs do, look closer, because almost 100% of the time EAPs are misrepresented as employee benefits, counseling, and clinical services within the 800# context. 

These messages have been consumed by the HR community and benefits consulting industry, and these folks are the primary purchasers and influential persons responsible for making EAP purchasing decisions. A proper definition must begin to be delivered and it would be helpful if the association or a recognized group of "core technologists" would be charged to "codify" the Core Technology so a recognized program represents the spirit and intent of what EAPs were always supposed to be based upon the complete continuum of capability they offer to business and industry. Do you have a copy of the WorkExcel.com Catalog? You can get one here.

EAP Utilization Tip: Partner with Local Gyms & Exercise Merchants

Gold’s Gym and other franchises are privately owned. This means you probably have opportunities in your town to negotiate with such gyms to get free passes for your EAP clients. You'll boost worksite wellness, too. This is a very cool draw to improve your EAP utilization, and it works. I've done it.


The Gold’s Gym in our area (Arlington Virginia) agreed to give us one month passes for clients who we felt needed to take better advantage of opportunities to improve their health. Good preventative health means pursuing an exercise program, and what better way to get started than with a one-month free pass to a local gym. Word of mouth that the EAP offers clients free passes to a local gym can increase your EAP utilization. It doesn't take much. Just make this a quiet way in which your EAP helps employees. Don't promote it. Simply let it happen and watch the vote of confidence your EAP will soon get.

Imagine being able to hand a free monthly pass to an employee suffering with depression. You know reactive depression and milder depressive disorders benefit from exercise, so visit the local gym. Meet with the decision maker and claim the high ground on this improving the EAP utilization strategy.

Training and Reaching Supervisors with EAP Essentials

How do you reach supervisors who are unable to attend supervisor training and other related educational programs offered by the EAP?

Unless your supervisors are communicating regularly with the EAP, they will slowly come to misunderstand it, not trust it, or simply forget to use it as tool to manage difficult behavior and performance problems. The risk to the organization is troubled employees being referred too late or not at all. If one of these employees has serious emotional issues, especially the potential for violence, the organization obviously is at increased risk from an inadequate relationship with the EAP and supervisors. (This is on of the strongest argument for avoiding an EAP "product" wrapped in an insurance plan, largely only a 800# call-in service, that omits an aggressive interface with supervisors.)

So what's the solution for increasing communication and training of supervisors when EAPs can't get "face time" with them? Supervisor training sessions are “iffy” things for companies. Some department managers will work against you, believing they can’t spare the time or give up their supervisors. Frequently, troubled supervisors skip out of training if it is not mandatory. Experienced employee assistance professionals have observed that supervisors with alcohol problems may shy away supervisor training sessions.

Without training in EAP essentials, these managers will remain ignorant about how to use the EAP as a management tool to refer troubled employees. To accomplish this goal, you should subscribe to The FrontLine Supervisor EAP newsletter. The FrontLine Supervisor is the only education tool in the EAP field to educate supervisors continuously about EAP process and supervision skills, while it increases supervisor referrals. A subscription to it increases the rate of supervisor referrals, and the publisher guarantees this outcome.

Supervisors must have ongoing education. One training session won’t cut it. Some HR departments or EAPs may publish their own supervisor education newsletter. Great! It should be distributed on time and it should appear monthly. Quarterly newsletters and the like are simply too infrequent to make an programmatic impact. By default, they tend to be four pages, and therefore too much to read before they are discarded. The FrontLine Supervisor’s question and answer format has proven success rate after 16 years of being irresistible to busy supervisors.

EAP Marketing Tip #2:

This is marketing tip #2. (By the way, the reason I am offering these tips is because they make you think more deeply about how your EAP can help the business customer. More specifically, they allow you to both educate the customer, debunk myths about EAPs, improve the likelihood that the customer will acquire a more effective model, and deprogram the customer from the brainwashing they have thoroughly received via their trade journals and benefits consultants and financial advisors. Hopefully you and especially new staff witll acquire a new appreciation of value of your own product.

MARKETING TIP/DISCUSSION WITH YOUR CUSTOMER #2:
Discuss and provide information and contrast about the experience of your EAP staff, their turnover rate, workload, and pay?

POINTS: Experienced EA professionals are difficult to find and recruit. Have you kept good ones on your staff for awhile? That's a big plus. This stability is a selling point and a product advantage. Certified Employee Assistance Professionals with master's degrees in mental health disciplines are particularly hard to come by, but represent the best pick of those who should be servicing your company. Add a mental health license and/or alcohol and drug counseling certification, and you got yourself a rare find. A recovering alcoholic and addict with any of the forgoing can be worth their weight in gold if their diseases are well-managed.

Most managed care cubicle workers delivering EAP assessment by phone are not experience EAP pros. Many, even if CEAPs, may have no experience outside the phone cubicle on the 14th floor of an office building sitting on the outskirts of town. Most are poorly paid, overworked, and mimic the guy on the Ed Sullivan show you may have seen who spun plates on the top of 24 sticks dashing from one problem to the next with a few smashing to the ground periodically. That is likely to be your EAP customer if they don't choose an effective EAP provider.
 
Solid and professional EA staff turnover fast in managed care companies leaving quickly when not adequately paid. Such turnover is deadly and risky to the well-being of employees and family members who tend to not only use an EAP service but "connect" to the staff member's personality because of their need to bond with the helper. This is an important dynamic to explain.
 
Most private EAP providers and managed care companies are notorious for paying low salaries to their line staff. They need to be adequately paid so the stick around.
 
So, just when everyone in the host company knows the employee assistance professional by name, they leave for few thousand more dollars in their paycheck! This is a serious consequence of commodization. Everyone suffers especially employees.

The Power of Understanding and Using EAPs As "Programs of Attraction"

Is the EAP a place where employees should go to complain about things like harassment, ill-treatment by supervisors, or other injustices, even racial, religious, or sexual discrimination?

Or should the human resources department be the only avenue for such complaints?

If the answer is yes, that EAPs can be avenues of such help, should this be promoted as a parallel avenue of assistance?

Then again, if not, and an employee phones the EAP with one of these complaints, should the EAP reject the appointment and tell the employee only HR deals with those matters? Is there risk in rejecting such inquiries? Could a more serious underlying personal problem exist or be in tandem that needs to be discovered?

Answer: Employees should absolutely be encouraged to seek support and help from the EAP for these types of problems along with HR, even though later they may find redress via the HR department.

What is the justification for this opinion? The answer lies purely in reducing risk to the organization and getting more expedient help to employees who may not trust HR, feel their concerns won’t be held in the same confidence, or don't feel comfortable venting and processing with the HR manager (who may not be an trained empathic listener).

But doesn't my position interfere with traditional HR functions? Is this the EAP doing the HR department's job?

The answer is no, of course not. EAPs are programs of attraction. This is a seldom discussed concept in the EAP field but it was frequently discussed in the 70's and 80's.

A program of attraction model wicks risk from the organization. It draws out opportunities to reduce risk--employees who may be violent in the future, angry with management, or likely to file employment claims or lawsuits for the missteps of the organization.

EAPs help these individuals get their needs met in healthier ways. And the cost-benefit is incalculable.

There are opportunities for attracting more at-risk employees to your EAP. EAPs are underutilized however as tools to reduce risk when they are walled off because of turf issues in the organization.

Promote your EAP as a program of attraction. And explain this dynamic in marketing and promotion to prospective business customers. They will quickly grasp the idea of value in your proposal and your philosophy of how EAP programming can do more for them. Any proposal discussion with the prospect will shine with this discussion.

An EAP, like Alcoholics Anonymous, is a program of attraction when properly installed in an organization. This paradigm has been lost as a discussion point over the past 30 years. Reviving it could be a significant way for the EAP field to regain much of it lost perceived value among business customers who farm it out for an 800 #.. 

Here a product that discuss EAPs in effective ways.

And, here is another.

Confusion about Alcoholism: When Will It End

Tell me if this makes sense to you:  

The risk of an alcohol use disorder, which includes alcoholism and alcohol abuse is higher among those whose parents had an Alcohol Use Disorder. The increased risk is independent of other major predictors, such as gender, parents' social status and the psychiatric hospitalization of parents. The key message for the general public is that there is an increased risk associated with parental alcoholism, but obviously many other factors determine whether an individual develops an AUD.

This is language from a press release I received today. The only difference is that you are only reading the beginning and the end of it to illustrate my point in this post.

Of course this does not make sense, but it is typical double speak I frequently see in research articles about alcoholism where genetics overwhelmingly is evident as the contributing factor, if not the sole factor evident in  acquired alcoholism. These end of the story caveats that contradict research and alcoholism science are not uncommon. It leaves a wonderful opening to the continued psychological treatment of alcoholics and allows the mental health community analyzing why alcoholics drink to breathe a collective sigh of relief. Now, here is link to the rest of the full press release so you can see it in full.

http://www.healthfinder.gov/news/newsstory.aspx?docID=651844

You may want to see this alcohol in the workplace education and awareness tool.