EAP Integration Redefined By Mark Attridge in EAPA Journal: Now Let's Run With It

"EAP Integration" should never have meant an EAP mixed with Behavioral Health Care Insurance Benefits. (This was likely an insurance company lexicon concoction from day one.) But, finally, one EAP author has redefined the term, and with some solid discussion of research, unwittingly caused a crack in the wall that could lead to an EAP renaissance.

Certainly, you know that the Property Casualty (P-C) insurance is a world away from Health Insurance and their managed behavioral care partners, correct? P-C insurers are rich--health insurance markets pale in comparison--folks like Lloyds of London, AIG, and Hartford. These folks worry about a fire burning the building down where your EAP office is located. They also worry about things like lawsuits for wrong termination, automobile and truck wrecks, lawsuit payouts for harassment, racial discrimination, and endless workers' compensation payouts. Lawsuits for trips and falls, employment practices liability, and payments for theft of tools--yep, they insure against these types of losses too. And workplace violence, when it happens, and families sue over their grieved relatives...who pays? It's not United Healthcare. It's these big boys with P-C. They have deep pockets, but they need people like, well, EAPs. And they need everything from the Core Technology that you can throw at them. There is only one problem: They don't know you exist!

Now stick with me on this post.

While managed behavioral health care wants one thing from an EAP--assessment and help with avoidance of access to the employee's insurance afforded by the behavioral health plan, a property casualty insurance company would want everything it could possibly wring out of your EAP in order to target as many behavioral risk exposures as possible in an effort to prevent payouts for insurable and "compensable" losses. Human behavior in the workplace contributes to many liabilities and exposures, and all of these risks are born by insurance premiums. They also come with high deductibles--like $25-$50,000 for a lawsuit associated with sexual harassment that the employer must pay first.

Back injury and lengthy periods of time out of work, the P-C pays. Sexual harassment by a supervisor? Yes, the P-C pays the $5 million out of court settlement--and the large jury awards when they happen. A lawsuit for ruining a career with a wrongful disciplinary action? P-C forks over the cash. Insuring Lady GaGa's for being suspended from the sky-ceiling of the Super Bowl (if permitted) -- P-C Insurance!

Now imagine a well integrated EAP able to educate supervisors, detect emerging risks, and go anywhere within an organization (integrated EAP!) necessary to engage and discover, educate, and train, assess and consult, and all with the purpose of reducing losses. How much might this sort of "human factors exposures prevention" be worth? This is REAL EAP folks.

My guess is a lot, because the stakes are enormous. This is could also be a renaissance for EAPs. After all, about 800 members show up at a typical International EAPA Conference, while over 3000 were showing up in 1986 over 30 years ago. The field is not progressing by this definition. ("I'm just sayin'.")

It's time to engage this tremendous and financially liquid world of P-C. There are thousands of brokers nationwide. They know nothing about EAPs (other than the phone number on the back of their insurance card in the event the member has an alcohol or psychiatric issue.) There is a potentially wide open avenue for EAPs to grow and flourish in ways that have not been seen for quite awhile.

Write me at publisher@workexcel.com if you think I am off base about all this. I wouldn't have written this much except for one thing: In 1993, I went to one of the most competitive EAP markets in the U.S. (Denver) and I engaged with a property casualty insurance broker there. I trained insurance agents all about EAPs for about three hours. A week later, I returned and picked up three checks from three different companies averaging 100 employees who had never had a comprehensive EAP. Yes, two weeks later - three company contracts for comprehensive EAPs.

I then flew to Baltimore, MD to the corporate headquarters of billion dollar NSF&G (they closed down soon after) and within their boardroom made a presentation to begin an EAP division. They listened, but their staff turned over, and my funding ran out. But this opportunity is still sitting out there for the EAP field to consider. At least, that is my belief.

Mark Attridge's (hats off to him) awesome article in the Jan 2017 Journal of Employee Assistance discusses the obvious difference between a free EAPs and a for-fee EAPs, and the 400% improved utilization that one can expect from the latter. Mark in my humble opinion appears to shy away from calling these "managed-care driven EAPs." This is a disappointment and the elephant in the living room that is stepping (squashing) the EAP field. Marks research is solid content for EAPs seeking a new home in the risk world--one where they will be full appreciated, as well as traditional EAP marketing. See my 2002 article on this topic here that discusses these issues more directly entitled, EAPs Help Limit Behavioral Exposures from the NATIONAL UNDERWRITER INSURANCE MAGAZINE.

Reasonable Suspicion Training, Attendance Patterns, and Intervention

Alcohol and drug using employees who have substance abuse dependencies may in the later stages of their illness demonstrate erratic attendance patterns that lead to their termination. One common pattern that you should discuss in reasonable suspicion training is the problematic performance issues of being absent on Monday, absent on Friday, and absent the day after payday. Alcoholics or drug addicted employees aren’t the only ones who experience this attendance pattern, of course.

Depression affecting employees, for example, can easily contribute to an absenteeism pattern. In fact, oddly, once had an EAP client with attendance pattern caused by her inability to continue on any drive to work because of fear that she had accidentally run over someone when she turned the last corner while driving her car. This necessitated her turning the car around and driving back in the opposite direction to ensure no one was lying in the street injured or dead! This would happen a dozen times on her commute to work.

Despite other personal problems of employees that contribute to absenteeism, the classic pattern above is probably most common among addicts and frequently observed by managers and workforce management professionals with any significant time on the job. Typically when this symptom pattern is discussed in reasonable suspicion training, you will receive a odd chuckle from the crowd because they all know what you are talking about. (Continue to Read More on Reasonable Suspicion Training and Intervention and get the free e-book download PDF on Performance-based Intervention)

Preventing Caregiver Depression - There Are Employees You Haven't Reached

Caregivers suffer depression at three times the rate of other people. And if you do not think that this affects workplace productivity, you're missing the mark on this problem. When employees leave work at the end of the day, their "second" job begins, and like everyone else, the stress and strain of work, care-giving, and home life begin to form a box from which one feels that their is little escape. Some employees may take it a day at a time. And although few will admit it, some may secretly wish--and feel guilty for it--the natural death of their loved one. Combine this with any substance abuse issues, depression, financial problems, or the IRS bill that wasn't paid last year from a squeezed in part time job, and you risk for a seriously troubled employee. You can only reach these employees with what is an EAP newsletter for employees. I hope you have one, and I hope it is monthly. Because if it is not, you're putting on a nice show, but you're not penetrating what is known as "top of mind awareness." You've seen the stats on how many times we are bombarded by commercials and promotions on a daily basis. As I type this blog note, and glance to the right and left of me, I have count 31 such messages. I mean, it is insane! Your EAP is fighting this clutter, but you still have to figure out how to be not a pest, but a welcomed guest. The strategy is knowing the issues in the workforce, issues SHORT, INTENSE, NO FLUFF SOLUTION-ORIENTED CONTENT employees look forward to getting, and frankly, the rest is waiting for the phone to ring. I would like to add one more key. Add in writing, to the bottom of any newsletter, that the EAP is confidential. You are fighting perceptual erosion of confidentiality on a continual basis because fear of whether a program is confidential is a real energy force that is relentless. You can't fight this with a quarterly newsletter sheepishly and apologetically slipped into an employee's inbox once per month. Use this content in your next newsletter that I wrote - you may do so without attribution.

The following is copyrighted content that may be used by you the reader of this blog post. No attribution required, but you could put a copyright and link to http://workexcel.com, we would appreciate this very much because it allows us to improve rankings on search engines (and it harder now that ever!) So, you may also edit this article and add your professional expertise to it. However, for an editable, reproducible, web usable, and brand-able EAP Newsletter and articles of this type for your company, EAP, or wellness program, go here.
PREVENT CAREGIVER DEPRESSION
Since depression is a disease and not a moral or character failing, you must be on-guard for its signs and symptoms exactly like you would for the flu during the wintry months. In your case as a caregiver, this may be periods of time when you are under inordinate stress from sort of responsibility. There are many symptoms of depression, and the EAP is at your disposal for a full assessment, but here are five important rules regarding depression and personal awareness especially for caregivers: 1) Don’t dismiss stress you are experiencing and the symptoms you suspect may be depression by using positive "self-talks” and internal lectures to yourself about “handling it better” or “brushing it off.” Instead, get a quick and easy assessment at the EAP. 2) Understand the difference between “caring” and “doing.” This means being open to help from other people who love and care about you, and from services that can ease your burden or encourage independence by your loved one when appropriate. "Meals Without Wheels" may not be as wonderful as your home cooking, but it can help take the edge off of a bad day for a stressed caregiver. 3) Don’t wait to feel strained before asking for help. Learn to see the strain around the corner. If a tough assignment at work is coming soon and you anticipate conflict and added stress in care-giving, consider your options. The EAP can also help you trouble-shoot solutions. 4) Know what activities rejuvenate you and your spirit, so when you get respite care, (any extended break) you know what to choose that will best retool and re-energize your ability to carry forth. 5) Find another caregiver and develop a friend or buddy in that person, someone you can bond with socially, exercise with, or mutually find shared support.

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Learn more or see the tip sheet from WorkExcel.com associated with managing caregiver stress

Co-Dependency: Caring Until It Hurts Tip Sheet Wellness Handout

Co-Dependency: Caring Until It Hurts Tip Sheet Wellness Handout

After Reasonable Suspicion Training Is Completed, Will Referred Employee Be Sabotaged in Treatment?

 After training managers or supervisors in drug and alcohol awareness, including signs, symptoms, impact, and effect on a worker's psycho-motor skills (all required by the DOT for reasonable suspicion training,) be sure so offer a bit of education to all participants about being careful not sabotage treatment in the event an employee is referred following a positive test and assessment.

The sabotage of addicts in treatment is a common dynamic, and demonstrates unfortunately the natural ignorance most persons have about addictive disease and also the powerful bond of enabling as a dynamic that seeks out the addict like a bloodhound with determination to "help" by saying and doing all the wrong things for the right reasons.

Much of this so called AMA prevention responsibility lies with the treatment program of course and the counselor's ability to educate family members and concerned persons about the role of the family in support of recovery -

Gatekeeping is a critical role but not all treatment programs do it well.  Read More

http://www.workexcel.com/blog/after-reasonable-suspicion-training-is-completed-and-referrals-happen-will-employees-in-sabotaged-in-treatment/

The King Has No Clothes: Managed Care's Utter Failure to Harness the Power of EAPs

One of the things I have attempted to do over the past 25 years is help EAPs see themselves as part of the organization's larger risk management strategy. This is no way conflicts with the touchy-feel (aka, program of attraction) model EAPs depend upon. On the contrary it enhances it.

Things like employee newsletters and other utilization and promotion devices are risk management tools and part of the critical continuum of best practices organizations must embrace to reduce loss.

And wow are these tools inexpensive. I would like to see more organizations phoning the EAP and saying, "Hey, make sure your renew the employee newsletter, it is probably saving us thousands or millions by increasing your referrals." 

There are many other tools EAPs can assemble, but this is just one of them. These things are not "nice to haves" as they are often portrayed by uninformed (or misinformed.) Nay, they are essential risk management, and potentially, "going postal" prevention tools.

Until recently, I really could not determine why the value-added argument everyone well-understood in the early 1980's was not working better for EAPs, and why instead EAPs  service vendors and internal programs were closing faster than a creeping forest fire in Gatlinburg.

The idea the EAPs can grow and grow to capture more unmitigated risks associated with human workplace behavior should have overwhelming acceptance by now. I have theory: "The King has No Clothes" . Managed care wants nothing to do with the property-casualty risk market, (which is what we are discussing here), its issues, and the work and integration required to penetrate it. It simple does not meet its business goals of reducing health insurance costs and increasing profits. But EAPs did not start out this way. In yesteryear, they targeted the whole ball of wax of risk in business organizations. If you are retired from the EAP field by now, but as you read this, you know something dramatically degrading has happened to the EAP field.

If a better linkage between EAPs and their powerful risk management reduction capacity where ever truly codified, managed care would risk losing control of EAPs and the simplistic model they depend upon for their uni-polar purpose. Managed care depends on the large majority of EAPs thinking and behaving as they do, and they spend millions on publicity, educational forays, and press releases at every turn to educate the human resources continuum and public at large to buy into their understanding of EAPs as they wish them to be seen. That is, more or less counseling and assessment services with a predominant self-referral path. When the time comes, as  it seems to do almost every day, traditional EAPs bite the dust. Actually, a better way to put it would be that they are more easily assimilated like the Borg in Star Trek. ("resistance is futile.")

I helped secure Arlington County Government's EAP and the School System's EAP against
managed care contagion 15 years ago by capturing the high ground and allowing the EAP core technology to work its magic by reaching out into any area of the organization where human behavior and trouble employees became exposures that threatened the financial well-being of the organization. Arlington County/Public Schools now has a six person staff for 7,500 employees and a very healthy budget. No vendor or managed care organization can touch it (many have tried) with the large swath of EAP services it provides.

Below is an amazing Web site which contains many arguments and appropriate phraseology for EAPs to use in arguing for their larger purpose, value, and ability to manage more behavioral risks within the confines of the EAP core technology. If you face the ever-present jeopardy of closure and takeover by managed care, you may find help here. Delve deep into it, and start identifying unmitigated risks and exposures during the year. Present an annual "risk mapping report" and recommend additional growth for your EAP, not budget cuts.

The successful end result, of course, is more lives saved and more organizational costs contained. Be aggressive with risk management and program growth to help your EAP and the EAP profession itself. It has shrunk 60% in 25 years despite growth in what are called "EAPs."

The real story of successful EAPs is still be written, or re-discovered, but it is not one that will sit well with managed care. When it comes to the "lead, follow or get out of the way" approach to the EAP field (as I heard at a recent EAPA conference), be sure the one you are following has clothes.

https://erm.ncsu.edu/library/article/current-state-erm-2015

Increasing EAP Utilization Hack #16: Use a Good Health Supply Line

I want to share with you an employee assistance program utilization improvement hack I created that will help boost your EAP utilization nearly overnight. It is called the "Good Health Supply Line®". I created this service as part of the EAP program I owned in the early 90's, but since I have never seen it duplicated, I thought I would share it and let you consider it for your EAP. You are welcome to use this idea by changing the name of the service to one you find suitable, but different than mine. The following background and rationale for this utilization hack is obvious. Many employees will never phone the EAP, and so you need to make every reasonable attempt to reach them. This does the trick. Create an order form with a large menu of wellness topics that include handout titles, tip sheet titles, or booklets on workplace wellness topics, such as those distributed by Abbey Press using their product called "CareNotes." Or, you can use the workplace wellness tip sheets from WorkExcel.com (purchase the entirely library here). On the order form, allow employees to confidentially choose five topics/titles. The form should be mailed via U.S. Postal mail to the EAP office. The EAP then fills the order and mails it back to the employee or family member. Distribute a postpaid envelope with it the order form for best results. Emphasize confidentiality. Only the EAP will receive the order from the employee. Postal mail is confidential of course. The beauty of this outreach technique is the opportunity to promote your EAP with a cover letter designed to encourage the employee or family member to visit the EAP for the issues or problems that concern them, identified in the titles they chose. Do this once per year. Have the employer to reimburse the EAP directly or make it a part of your service. The titles of the booklets distributed to employees are not shared with the employer. This is also an important part of the service and key to its effectiveness.