Employee Assistance Program Services

Transcription

1 DEFINITION Employee Assistance Programs (EAPs) are employer sponsored workplace-related services provided internally or under a contract or arrangement with an employer, union, or organization designed to address the individual and work-related issues that interfere with a healthy and productive workplace, and support the organization in meeting its productivity goals. EAP services generally include information and referral; assessment and referral; employee education on personal, psychosocial and workplace performance issues; consultation and training for supervisors, managers, and human resource and union representatives; critical incident training and response services, referral for needed services, and follow-up. Note: Depending on the services an EAP provides, the organization may be required to complete one or more additional service sections, such as: Counselling, Support, and Education Services; Case Management; Services for Mental Health and/or Substance Use Disorders; or Crisis Response and Information Services. Note: Please see CA-EAP Reference List for a list of resources that informed the development of these standards. Table of Evidence Self-Study Evidence - Provide an overview of the different programs being accredited under this section. The overview should describe: a. the program's service philosophy and approach to delivering services; b. eligibility criteria; c. any unique or special services provided to specific populations; and d. major funding streams. - If elements of the service (e.g., assessments) are provided by contract with outside programs or through participation in a formal, coordinated service delivery system, provide a list that identifies the providers and the service components for which they are responsible. Do not include services provided by referral. - Provide any other information you would like the peer review team to know about these programs. - A demographic profile of persons and families served by the programs being reviewed under this service section with percentages representing the following: Page 1

2 a. racial and ethnic characteristics; b. gender; c. age; d. major religious groups; and e. major language groups - As applicable, a list of groups or classes including, for each group or class: a. the type of activity/group; b. whether the activity/group is short-term or ongoing; c. how often the activity/group is offered; d. the average number of participants per session of the activity/group, in the last month; and e. the total number of participants in the activity/group, in the last month - A list of any programs that were opened, merged with other programs or services, or closed - A list or description of program outcomes and outputs being measured On-Site Evidence No On-Site Evidence On-Site Activities No On-Site Activities Page 2

3 CA-EAP 1: Access to Service Eligible participants and client organizations receive EAP services promptly and responsively. Table of Evidence Self-Study Evidence - Access and intake procedures - Procedures for addressing life-threatening emergency situations On-Site Evidence No On-Site Evidence On-Site Activities - Interview: a. Clinical or program director b. Relevant personnel c. Clients - Review case records CA-EAP 1.01 Procedures for accessing EAP services: a. minimize barriers to the timely initiation of service; and b. give priority to urgent needs. CA-EAP 1.02 The EAP communicates to customers, individuals, and eligible participants that access to services occurs through: a. self-referral by individuals and eligible participants; b. suggestions or referrals by supervisors, union representatives, human resources, and/or medical personnel; c. formal referrals; and d. mandatory referrals. Page 3

4 (FP) CA-EAP 1.03 Client or host/customer organization problems that occur during and outside of work hours are addressed as follows: a. life-threatening emergency situations are addressed immediately, 24 hours a day, seven days a week, 365 days a year; b. non-life threatening emergencies are addressed by the end of the next business day; and c. counsellors with clinical backgrounds are available by telephone to respond to emergencies and able to access appropriate resources either directly or by referral. Interpretation: Twenty-four/seven access should include access for managers to address difficult workplace situations or crisis situations. CA-EAP 1.04 The EAP adjusts its staffing patterns and availability to accommodate the working hours of individuals at the host or customer organization, and counsellors: a. are available within a reasonable proximity of client homes, work sites, and/or public transportation, unless the geography of the area prohibits such availability; b. offer appointments outside of normal business hours, such as at least one evening a week or on weekends; and c. provide clear directions to the counselling site. CA-EAP 1.05 The EAP direct service staff has access to a description of services, as stipulated under the terms of each contract, that is provided to clients and eligible participants. CA-EAP 1.06 The EAP offers access to services, educational resources, and manager/leadership information through a variety of channels. Interpretation: For example, services may be provided via: Page 4

5 a. in-person meetings at a private office located at the company; b. in-person meetings at a private office located off-site at an EAP counsellor's office; c. telephone; d. a website for information and education; e. exchange for services; f. video and audio live exchange for services; and g. smart-phone based technology for texting, chat, or other communication tools. Interpretation: EAP providers must be appropriately licensed in the province where the service is being received, or as required by legal, regulatory, and/or contractual requirements. Page 5

6 CA-EAP 2: Internal EAP/Parent Company Relations The internal EAP and its parent company establish in writing: a. the services to be provided; b. budgetary and staffing resources; c. how confidentiality is maintained; d. the legal relationship between the EAP and its parent company; e. roles and responsibilities of other affiliated departments at the organization, such as work-life or wellness; and f. clear lines of responsibility for the EAP and all EAP activities. NA The organization is an external EAP only. Note: This standard does not apply to EAP providers that are contracted to provide services on-site. Table of Evidence Self-Study Evidence - A description of relationship On-Site Evidence No On-Site Evidence On-Site Activities - Interview: a. Parent company President/CEO or his/her designee b. Clinical or program director Page 6

7 CA-EAP 3: Program Implementation and Contract Management The organization's needs and contractual obligations determine the EAP services provided and the content of service utilization reports. Table of Evidence Self-Study Evidence - Procedures for implementation planning - Copy of a sample contract between EAP and customer organization - Narrative describing how client confidentiality is maintained in EAP's reporting process On-Site Evidence No On-Site Evidence On-Site Activities - Interview: a. Program director b. Customer organizations CA-EAP 3.01 The EAP develops an implementation plan in collaboration with the organization to facilitate program design that identifies tasks and responsibilities for the EAP and the organization, and the timeline for completion. Interpretation: Examples of information that may be gathered to develop an implementation plan include, as applicable: a. a confidential survey of individual and management representatives to identify key problem areas; b. employee profiles and demographics; c. employee absenteeism rates; d. employee turnover rates; e. accidental injuries; f. health insurance costs; g. worker's compensation claims; h. previous EAP utilization information; i. transition planning for continuity of care for existing high risk cases and Page 7

8 those requiring ongoing case management; j. regulatory and legislative requirements applicable to the customer organization; k. history of disability insurance claims for mental health and/or addictions; and l. descriptions and utilization figures for other relevant workplace programs at the customer organization, such as work-life, wellness, occupational medicine, and disease management programs, as applicable. CA-EAP 3.02 The implementation or program plan includes mechanisms for promotional and employee communications that include, but are not limited to, the following, as applicable: a. printed communications; b. company website; c. referral resource database; d. listservs, discussion groups, chat rooms, instant messenger, and other electronic communication tools; e. training of supervisors, key management, and union representatives; f. employee orientation; g. coordinating branding for integration of EAP with other relevant programs such as work/life and wellness; and h. other promotional and educational activities. Interpretation: Plans for integration of the EAP with other programs might address, for example, the use of a combined or common web portal for the multiple programs. CA-EAP 3.03 Prior to initiating a contract, and at renewal, the EAP and host or customer organization address the following operational practices and definitions for reporting practices: a. how a case for individual services is defined (i.e., criteria for case open and case closed); b. how a "new" client is defined (i.e., a client is a person who can potentially have multiple case episodes of services); c. the amount (for example, number of hours) of clinical and account management time projected per defined period; d. the outcomes and metrics to be used in evaluating EAP service delivery; Page 8

9 e. the evidence required to assess if service performance standards are being met; f. the methodology used to measure service user satisfaction and outcomes; g. the measurement process for assessing outcomes for cases after using the service (i.e., level of satisfaction with the service, level of overall improvement, level of change in work performance/productivity; level of work performance in absenteeism); h. how the utilization of individual services are counted and calculated (for use of services provided by the counsellors); i. how the utilization of other non-clinical individual services are counted and calculated (for use of services provided by the EAP for financial assistance, legal assistance, work-life services, etc.); j. how the utilization of management consultation and other organizational level services are counted and calculated (i.e., counsellor meetings with supervisors alone and with groups of supervisors and workers, on-site support after a traumatic event or crisis, support for organizational changes, etc.); k. how the utilization of training and educational services lead by EAP staff are counted and calculated (i.e., for onsite trainings on specific topics, lunch and learn sessions, health fairs, etc.); l. how the utilization of Internet and website EAP services are counted and calculated (i.e., for general information, for educational resources, webinars, affiliate counsellor search tools, educational resources downloaded, assessment tools completed, etc.); and m. the format and frequency of reports. Interpretation: The standard requires the EAP to designate the numerator and denominator for purposes of utilization as addressed in each of the utilization rates provided by the company (h, i, j, k, and l from above). For example: The Counsellor Case Rate for h (see above) is calculated by dividing the total number of counsellor cases (including both employees and family/ dependents) by the population count of the total number of covered employees and then multiplying this figure by 100. Training to supervisors and other units are not acceptable factors to be addressed in utilization. CA-EAP 3.04 The EAP abides by formal contractual agreements and stipulates in writing: a. a designated account manager; b. objectives for the contract; c. services to be provided and by whom; Page 9

10 d. financial terms; e. facility, equipment, and staff resources required; f. projected utilization rates; g. mutual indemnification, when appropriate; and h. roles and responsibilities of the EAP and customer organization. NA The organization is an internal EAP only. CA-EAP 3.05 The EAP and customer organization determine the components of data reporting and frequency of reporting. Interpretation: For example, the EAP may provide information, such as: a. the number of new cases opened; b. types of services requested; c. number of sessions provided for counselling services; d. number of educational trainings and associated participants; e. website usage; f. the number of client and/or supervisory consultations; g. the number of management consultations; h. the number of other services to the organization (e.g., crisis response events); i. the number of other administrative activities; j. the standardized level of utilization for individual cases who received counselling from the EAP; k. the standardized level of utilization for non-clinical individual services from the EAP; l. the standardized level of utilization for management consultations and other organizational services; m. the standardized level of utilization for trainings and other educational services; n. the standardized level of utilization of the Internet and web-related services; and o. other utilization trends identified. Interpretation: The EAP ensures that client confidentiality is maintained in its reporting process. Research Note: Many studies now exist that elaborate on the best practices for the measurement and reporting of EAP service utilization and also how it can be combined with outcomes measures to yield evidence for financial return on investment (ROI) for the program. Page 10

11 CA-EAP 3.06 The EAP maintains up-to-date information on each host or customer organization's demographics, business, and covered EAP benefits. Interpretation: Examples of information maintained include, but are not limited to, employee locations; available health coverage, including mental health benefits; products or services provided by the customer organization; and whether it's a unionized or non-unionized setting. Page 11

12 CA-EAP 4: Contractor Accountability The EAP implements a mechanism to ensure that affiliates and subcontractors comply with EAP policies and procedures. Related: CA-RPM 9, CA-RPM 10 Interpretation: The EAP will need to demonstrate implementation of standards that address services provided by subcontractors. Implementation can be demonstrated via the contract that outlines elements of standards, and a mechanism to monitor quality. Subcontracting organizations are not required to be accredited, but as noted in the interpretation to EAP 4.04 accreditation can be used as a quality improvement mechanism. NA The EAP does not use affiliates or subcontractors. Table of Evidence Self-Study Evidence - Sample affiliate agreement - Procedures for conducting random quality improvement reviews of affiliates and subcontractors On-Site Evidence No On-Site Evidence On-Site Activities - Interview: a. Program director b. Affiliates - Review affiliate client records CA-EAP 4.01 Affiliate agreements address: a. compliance with all applicable laws, including health, safety, and accessibility laws; b. record maintenance and destruction; c. access to records; d. transfer of confidential information; e. hours of operation; f. CEU, PDH, and other professional training requirements, including Page 12

13 training on the EAP's policies, procedures, and service delivery model; g. standards for physical facilities, including comfort and privacy provisions; and h. use of standard data collection and client information forms. Interpretation: The organization should establish procedures for affiliate record maintenance that address: a. ownership of records; b. information that must be recorded in client records; c. access to and secure storage of client records; d. destruction of records; and e. whether copies of records may be retained. NA The EAP does not use affiliates. CA-EAP 4.02 Agreements with affiliates require them to carry professional liability insurance in the amount of $1 million/$3 million, or as required by applicable law. NA The EAP does not use affiliates. CA-EAP 4.03 The EAP routinely conducts random quality improvement reviews of a representative sample of affiliates used in the past year to assess: a. appropriateness of protocol and procedures; b. compliance with EAP contract requirements; c. attainment of the requisite credentials required of affiliates providing services, including assessment and referral, information and referral, and short-term counselling; and d. possession of current licensure, certification, or registration. Interpretation: The EAP should determine an appropriate sampling methodology based on the volume of work affiliates produce (e.g., 10% of cases per year). Reviews can be conducted on-site or off-site through another quality improvement mechanism. Research Note: Several recent studies have explored the issue of how well network affiliate counsellors are trained in EAP practices and business goals. Some of this research reveals that such training is inadequate and Page 13

14 lacks the proper workplace focus for EAP network affiliate counsellors. NA The EAP does not use affiliates. CA-EAP 4.04 The EAP routinely conducts random quality improvement reviews of subcontractors to assess, as appropriate: a. appropriateness of service delivery procedures; b. safety of physical facilities; c. possession of current licensure; and d. compliance with EAP contract requirements. Interpretation: Reviews can be conducted on-site or off-site through another quality improvement mechanism. Interpretation: Examples of subcontracted services include, but are not limited to, legal services, work-life services, and financial services. NA The EAP does not use subcontractors. Page 14

15 CA-EAP 5: Record-Keeping Records are maintained in accordance with the EAP's policy. Table of Evidence Self-Study Evidence - Record-keeping procedures On-Site Evidence No On-Site Evidence On-Site Activities - Interview: a. Relevant personnel - Review case records CA-EAP 5.01 A separate and distinct EAP record is maintained for each client that is never part of or stored with any other client related record. Interpretation: Other client related records may include managed care, personnel, medical records, or records of other services provided that are outside of the EAP's scope. CA-EAP 5.02 EAP policy defines a "client," and addresses the following: a. when a new client record is to be created; b. separation of client record contents when services are provided to individuals, couples, and/or families; and c. separation of client record contents when services are provided to minors. CA-EAP 5.03 EAP policy establishes record-keeping practices based upon the definition of "client" and addresses the following: Page 15

16 a. compliance with legal, regulatory, and/or contractual requirements regarding confidentiality of record contents; b. disclosure protocols when the client record includes services provided to couples or families; and c. disclosure protocols when the client record includes services provided to minors. CA-EAP 5.04 EAP policy establishes ownership of client records. Page 16

17 CA-EAP 6: Assessment Clients participate in an individualized, strengths-based, culturally responsive assessment. Note: Refer to the Assessment Matrix - Private, Public, Canadian, Network for additional assessment criteria. The elements of the matrix can be tailored according to the needs of specific individuals or service design. Table of Evidence Self-Study Evidence - Assessment procedures - Assessment tool and/or criteria included in assessment On-Site Evidence No On-Site Evidence On-Site Activities - Interview: a. Clinical or program director b. Relevant personnel c. Clients - Review case records CA-EAP 6.01 EAP counsellors/consultants obtain relevant assessment information including, as appropriate to the service provided: a. demographic information; b. the nature of the request or presenting problem; c. any workplace related issues; d. any immediate safety risks to self or others; e. environment and home situation; f. financial status and health insurance; g. social and peer group support; h. interests, skills, and aptitudes; i. work history and military service; j. medical history; k. physical illness/somatic variables/medical treatment; l. the use of alcohol or other drugs; m. depression screening; Page 17

18 n. ongoing safety concerns; o. behavioural/cognitive patterns that cause health risks, based on physical, emotional, behavioural, or social conditions; and p. when appropriate, legal, vocational, and/or wellness needs of the client. Interpretation: Workplace related issues can include, for example, co-worker conflicts, conflicts with managers, drug policy violations, manager consultations, performance improvement issues, and critical incidents. Research Note: There is now free or low-cost access to several research-validated brief tools that can be used to assess individual depression, general psychiatric state, substance abuse or misuse, and workplace performance. CA-EAP 6.02 Assessments are conducted in a strengths-based, culturally responsive manner, and identify resources that can increase service participation and support the achievement of agreed upon goals. Interpretation: Culturally responsive assessments can include attention to geographic location, language of choice, and the person's religious, racial, ethnic, and cultural background. Other important factors that contribute to a responsive assessment include attention to age, sexual orientation, gender identity, and developmental level. Page 18

19 CA-EAP 7: Action Planning Each client participates in the development of a plan of action that forms the basis for delivery of appropriate services and support. Interpretation: Some clients that receive only short-term services may not implement a full planning process. Whereas others with more severe clinical issues, such as high-risk cases with depression or an addiction, likely will need a plan for more continued support and monitoring of treatment delivery and improvement/relapse over time. Depending on the severity of the clinical issues and the corresponding action plan, expectations for short and long-term follow-up between the client and the EAP staff may be required. Table of Evidence Self-Study Evidence - Action planning procedures - Policy and/or procedure for case review and consultation On-Site Evidence - Documentation of case review On-Site Activities - Interview: a. Clinical or program director b. Relevant personnel c. Clients - Review case records CA-EAP 7.01 An action plan is developed with the full participation of the client to identify client needs within an appropriate time frame. Interpretation: Action planning is often done within the first or second session, after the initial assessment is completed, safety risks are resolved, and potential resources for support and treatment have been identified to meet the personal and financial needs of the client. Interpretation: Action planning for services is conducted so that the client retains as much personal responsibility and self-determination as possible and desired. Page 19

20 CA-EAP 7.02 At the initial counselling session, the counsellor and the client: a. assess the underlying problem; b. discuss available options; c. identify goals, desired outcomes, and timeframes for achieving them; d. address how the EAP can support the achievement of desired outcomes; e. determine whether to retain the case for short-term counselling or to refer to an outside provider for ongoing treatment; and f. review the benefits, alternatives, and risks or consequences of planned services. NA The EAP does not provide clinical services. CA-EAP 7.03 The EAP establishes a system for review of cases and case consultation. Page 20

21 CA-EAP 8: Service Elements The EAP partners with the host or customer organization to identify the needs of organizations and eligible participants, and to provide services matched to client and organization goals. Table of Evidence Self-Study Evidence - A description of services - Referral procedures - Aftercare/follow-up procedures - Procedures for critical incident planning and response - Table of contents of training curricula for supervisors and union representatives On-Site Evidence - Promotional materials and/or educational newsletters or articles On-Site Activities - Interview: a. Program director b. Relevant personnel c. Clients - Review case records CA-EAP 8.01 The EAP service is designed to: a. help organizations develop and maintain a healthy and productive workplace for their employees; b. help individuals address the personal and work-related issues that interfere with being present and productive at work; c. help clients with relationship, family, addiction, legal, financial, emotional, stress, work-life balance, and other personal problems; d. make referrals to appropriate services as needed; and e. provide preventive strategies to stimulate individual awareness and education and encourage early intervention. Interpretation: The term "addiction" addresses alcohol, drugs, gambling, Page 21

22 sexual, internet, and other chemical and behavioral addictions or addictive behaviours. Research Note: Literature suggests that organizations with EAP use by employees tend to have fewer accidents, higher staff retention rates, and improved staff performance and morale. CA-EAP 8.02 The EAP has the capability to provide the following core EAP services to the organization and individuals: a. information and referral to support services; b. assessment and referral; c. employee education on personal, psychosocial, and workplace performance issues; d. training on the EAP for supervisors, managers, and human resource and union representatives; e. critical incident advance planning and training and post-incident response services; f. development of referral options for needed services not provided under the contract or not available at the EAP; and g. capability for follow-up with more severe cases as appropriate. CA-EAP 8.03 The EAP demonstrates a rapid and effective response in linking clients with appropriate EAP resources and supportive interventions. Interpretation: The EAP should maintain up-to-date information on referral resources for treatment and other kinds of support services available in the community. CA-EAP 8.04 The EAP makes a referral when: a. it cannot promptly provide services; b. the client requires services beyond the stated or contractual mandate of the EAP; or c. specialized resources are not available through the EAP. Interpretation: For example, in the case of a short-term counselling model, Page 22

23 it may be appropriate to refer the client for alcohol or drug rehabilitation or psychiatric care. Research Note: Several studies show that most EAP cases do not need a referral for further care after use of the EAP counsellor. For example, the National Behavioral Consortium EAP Vendor Study found an average of only 18% of cases that were referred on after EAP use for additional services. CA-EAP 8.05 When making referrals, the EAP informs clients that they will be responsible for the cost of services beyond those provided by the EAP, and/or of any liabilities that may be incurred. CA-EAP 8.06 The EAP emphasizes the importance of prevention in its activities and offers client organizations: a. promotional materials or educational newsletters or articles; and b. at least one prevention activity quarterly. Interpretation: Topics addressed in prevention activities are changed and updated to reflect the needs and feedback of the host or customer organization and its employees. Research Note: Recent research conducted on professionals in the EAP field has found renewed interest in the area of prevention of behavioural health issues in the workplace. A 2008 study found that forty percent of EAPs offered opportunities on at least a quarterly basis for preventative services for screening and training on alcohol and drug issues and about one-fourth of EAPs offered preventative screenings for depression, work violence, and other mental health issues. CA-EAP 8.07 The EAP, at the discretion of the host or customer organization, offers training which includes, but is not limited to: a. the philosophy of the EAP; b. confidentiality procedures and protections; c. the range of services provided; Page 23

24 d. contact and accessibility information; and e. roles and responsibilities of management, supervisors, and union representatives, as applicable. CA-EAP 8.08 The EAP offers appropriate education to individuals and management at the client organization on the following, as appropriate: a. crisis intervention; b. managing change; c. workplace violence prevention and response; d. tobacco, alcohol, and other drug related issues; e. availability and appropriate use of benefits and services; and f. supporting employees as they return to work from disability claims for mental disorders, addiction and other cases with behavioural health comorbidities. Interpretation: Management consultation should address how to help clients reintegrate into the workplace, as needed. Research Note: EAPs can play a significant supporting role in the case management of disability cases for mental disorders, addiction, and other cases with behavioural health comorbidities. Many of the difficulties facing individuals who are returning to work (RTW) center on the relationship with the supervisor and the work team and also the coordination of care needed from multiple sources within medical benefits, mental health counselling, HR benefits and other areas. The RTW process can take several months and often includes periods of relapse as well as clinical improvement. Support programs that encourage partial return to work and specific training on work-related performance aspects of making accomodation to job tasks have a high chance of success. CA-EAP 8.09 The EAP has the capability to provide training for supervisors and union representatives on: a. the use of the EAP as a management tool; b. how to recognize signs of deteriorating job performance and the proper means of documenting this in the personnel record; and c. how to make referrals to the EAP for individual job performance and behavioural problems. Page 24