Gold Mining Physician Referrals to the EAP

Medical professionals, particularly occupational medicine and physicians on workers’ compensation evaluation and treatment panels are in an ideal position to refer employees to your EAP. Do you know who they are, and do you have an ongoing marketing campaign to reach them and solicit passively their referral of employees to your treatment program. Unfortunately, these physicians like other people suffer from misinformation about how to use the EAP effectively and make referrals. Research into the role of physicians unequivocally shows their effectiveness in motivating alcoholic employees to consider further diagnosis and treatment of addictive disease, reduce the consumption of alcohol, and examine drinking practices. The key is a knowledgeable doc. Consider meeting with occupational medicine physicians in the company or companies you serve, and make sure this includes private physicians in the community chosen by the workers compensation insurer who are part of its examining and treatment panel. Have CME Category 1 credit available and only let a another physician (who is a good friend of your EAP) discuss alcoholism diagnosis and referral. An ASAM doc is ideal. Every EAP should have an ASAM buddy.When injured employees show up to the medical doctor’s office, you can count on these educated doctors giving their patients a closer look. Discuss their role in identifying medical symptoms of alcoholism (or other addictions) and recommending blood work-ups for employees, when appropriate, that include liver function tests that can demonstrate pathologic organ changes due to alcohol consumption. Positive results are powerful tools in encouraging self-diagnosis of alcoholic employees, and opening the window of opportunity that can lead to accepting an EAP referral. Did you know that many late stage alcoholics worry about their liver, despite their denial? Many alcoholics will agree to a liver functions test just to get it off their mind and confirm their belief they aren’t alcoholic—and tell their spouse about it. Positive values on liver function tests mean pathologic organ change. Pathologic organ change is ITSELF diagnostic for addictive disease. You don’t need anything else to corroborate the diagnosis. In my experience, those with a pain in their side are particularly curious. (When I was at the U.S. Central Intelligence Agency’s Occupational Alcoholism Program, we used strategy routinely to identify and refer alcoholic employees in annual examinations. Have fun. This is a very cool EAP utilization improvement strategy.

Supervisor Improper and Reckless Disclosure

Many supervisors are not aware of the legal implications for disclosing personal and confidential information to others who do not have a right to know it. Personnel files are confidential. Medical files are confidential. And, of course EAP files are confidential. Which files are governed by the strictest confidentiality laws? You are right if you guessed EAP files. EAP files are governed by federal confidentiality laws in most cases when they manage alcohol and drug abuse related information and receive federal funding indirectly or directly. You would be surprised how many EAPs fall under this ruling. Most EAPs choose to be governed by these stricter laws or should declare that they follow these strict guidelines for managing information. A supervisor who discloses to other employees, or announces without authorization that an employee has gone to the EAP is not guilty of violating a confidentiality law, but reckless and improper discloser of personal information and violating the employee’s privacy. Of course these issues can kill your employee assistance program utilization. Supervisors who blab about employees referred to the EAP are damaging the perception of the EAP as a confidential service. And, they are holding themselves out at risk for a lawsuit for reckless and improper disclosure. Talk about these supervisor risks during supervisors training. It will help everyone -- employees, supervisors, and the EAP.

You Don't Need to Be a Doctor

Hey, you don't need to be a doctor to help employees learn how to take care of their heart, and you don't have to be a lawyer to talk about reducing the risk of lawsuits to an organization. "I am not a doctor, but you shouldn't eat a lot of chicken skin." Is this how you tell your brother in law to lay off the excesses? No, so let's not get all panicky about talking about employment practices liability and reducing the risk of lawsuits in companies. You don't have to wheel out an employment law attorney to educate supervisors and management. You can do the research and claim the high ground on this risk and loss prevention strategy for the companies you serve. There about 40 different risk areas that can get companies sued. A quick look at Amazon.com will lead you to lots of sources. One of my favorite authors in this area is not an attorney at all, he is a human resources manager. Sometimes these folks know more than attorneys when it comes to employment law because they are living it on a day to day basis. My favorite author is Joseph D. Leveque, and he wrote the book The Human Resource Problem Solvers Handbook. The book is 300 pages thick, but you can get it for $1 at the link on this page.

Remind Supervisors to Keep Mum

Many supervisors are not aware of the legal implications for disclosing personal and confidential information to others who do not have a right to know it. Personnel files are confidential. Medical files are confidential. And, of course EAP files are confidential. But which of these three are the most confidential and have the biggest fines if violated?

You are right if you guessed EAP files. EAP files are governed by federal confidentiality laws when they manage alcohol and drug abuse information and especially if they receive federal funding indirectly or directly. You would be surprised how many EAPs fall under this ruling. EAPs have to use a release for each person. Personnel and medical releases can employee blanket releases for more than one person. It's prohibited with EAP records management.

Most EAPs don't promote these nuances about confidentiality, and they should because doing so will help win more clients. All EAPs should declare that they follow these stricter guidelines for managing information. A supervisor who discloses to other employees, or announces without authorization that an employee has gone to the EAP is guilty not of violating a confidentiality law, but reckless and improper discloser and violating the employee’s privacy.

The Privacy Act protects privacy rights. Personal information and medical records and EAP records are covered by . Supervisors who blab about employees referred to the EAP are damaging the perception of the EAP as a confidential service. And, they are holding themselves out at risk for a lawsuit for reckless and improper disclosure. Talk about these supervisor risks during supervisors training. You can learn about the most comprehensive supervisor training ever produced for EAPs by going here.

Where Have All the EAP Posters Gone...Long Time Passing

If you put up EAP posters in office buildings and/or plant or industrial locations where employees gather, that's great. But are you keeping the garden weeded?

Chances are if you don't go visit those posters, they're getting taken down, covered up by other announcements, and at the very least are becoming invisible to potential clients who've seen them 400 times walking past them.

You have to refresh your posters. When I was Division Chief for Occupational Alcoholism Programs overseeing the U.S. Department of Agriculture EAP, I think my staff counted 47 bulletin boards at the headquarters of USDA on Independence Avenue in DC. Bulletin boards were a valuable tool for us in promoting the EAP, but we knew we didn't have a big budget to replace those posters. They were getting old, forgotten, and dog-eared. Our solution was to rotate the posters from one bulletin board to the next. Instantly we had refreshed posters.

So, if you want to keep visibility up, simply assign a number to each of the bulletin boards that you have access to, and then walk from one bulletin board to the next moving the posters at you go 1 to 2, 2 goes to 3, 3 goes to 4, etc. Do this about every four weeks. This will also get you out of the house. Here's a very cool poster I created for you. Use it in good health. It's part of the editable set of posters at EAPtools.com. (Hey...I know it will be tempting to hang it on the wall in your office, but it's for employees!)

EAPs AREN'T Wellness Programs: Don't Let'm Say So

A new study released by HR benefits research group Hewitt Associates reports that employers are failing to engage employees in Wellness Programs to any significant degree and that employees really don't want their employers involved in their personal lives telling them how to manage their health. You can read about the research study here at the Hewitt Associates Press Release. Ouch for Wellness. What are the implications for managing EAPs and behavioral risk, which of course have nothing to do with this report. Just that: Don't let management pull the EAP into the vortex of program cuts and lump you in with the "Wellness Program" folks down the hall. EAPs are management tools, pro-employee and pro-company management tools. They aren't part of a Wellness Program, but the folks not like to remember this are the top management decision makers who look for places to cut fat. It ain't you if your running a functional employee assistance program.

Wellness programs sound great, but when reduced to a survey of popularity, only 17% of employees say they want their employer to get involved in their personal lives.

Test Your EAP IQ: Who Should Be for EAP Services

Which of following policy statements supports the view that an EAP is a benefit to employees like any other, and which one supports the view that an EAP is a comprehensive, loss prevention and behavioral risk management tool to control costs, preserve human resources, reduce employment practices liability, and help employees be healthy, happy, and productive.


Policy Statement A: The EAP is available to all full and part-time employees as part of their benefits package offered by the company.


Policy Statement B: The EAP is available to all employees, part-time employees, their immediate family members, all employees paid as contractors, temporary employees (IRS Form 1099), and volunteers.

The limited view is Statement A. The comprehensive view is Statement B.

Statement B costs a company more, but it will protect the organization more.

Statement B will affect the bottom line more in terms of "dollars recovered from loss". The afforded protection will be unknowable because the loss events that may have occurred, won't. There is a way to identify cost-benefit however. That is to look at property casualty losses and claims from on comparable industry to the next, and over a series of years in the company that has decided to make its EAP a loss prevention program.