Chapter 5
Employee Assistance Programs and Treatment

Summary

Many firms have adopted a combination prevention/treatment philosophy. This means that persons detected using prohibited drugs or alcohol are offered a medical regimen to help them give up their drug and/or alcohol abusing lifestyle. An Employee Assistance Program (EAP) can help you properly assess an employee and refer him or her to the appropriate treatment program. Even employers who do not offer treatment to employees who are detected using drugs or alcohol usually encourage those employees to voluntarily seek treatment. EAPs provide a valuable resource for employees to turn to in identifying the proper course of treatment.

Most EAPs also include other employee services, such as financial and legal counseling, exercise and weight reduction programs, stop smoking assistance, and marriage counseling. An EAP is conceived to maximize the health and efficiency of the workforce while conveying a caring attitude on the part of the employer. EAPs often help prevent employees from starting to abuse drugs and/or alcohol by addressing personal problems before they become unmanageable by the employee. EAPs are also excellent tools for supervisors to use when dealing with troubled employees.

EAPs are paid for by the employer and make available to employees specified services. Any company considering an EAP should evaluate for itself the financial factors and success actuaries of such programs as well as the number of times an employee would be allowed to participate. Some companies set up their EAPs internally, and they are administered by employees of the company. Other companies contract with an outside entity to privately interview troubled employees and, when appropriate, refer them for treatment or counseling.

Companies that choose not to participate directly in an EAP may still offer employees a firm choice of abandoning their drug and/or alcohol abusing lifestyle in return for continued employment. Under this condition, the employer might offer a reasonable time period off the job for the employee to participate in treatment. In the absence of a formal EAP, it is a good idea for employers to maintain a list of treatment facilities that the employee can refer to for help, and to become familiar with the services the facilities offer.

Most health insurance includes some coverage for drug and alcohol treatment, but the uncovered portion of treatment is typically expected to be covered by the employee just as in the case of any other illness. Most employers offer treatment in lieu of termination only once, because offering more than one chance at treatment is not normally cost-effective.

In weighing the costs of rehabilitation, employers should consider the costs of terminating and replacing employees. When an employer has invested a considerable amount in training an employee, sometimes termination can be much more costly than rehabilitation. Consider the value of your employees. If the violating employee is your top sales person, what will happen to the sales of the company if the individual is terminated? Will he or she take along major clients when he or she leaves the company? If the violating employee has specialized skills, what will it cost the company to train a replacement? If the employee is a long-term veteran and has acquired large amounts of knowledge about the overall operation of the company, what is the cost of losing this valuable and versatile person? What about potential legal challenges of terminated employees, such as unemployment claims?

All of these costs must be weighed. And whatever you decide about one employee, you must apply to all of your workforce. Consequences for violations to your policy, and opportunities for rehabilitation treatment, must be applied consistently and in a non-discriminatory manner.

Details

Various types of EAPs are available to employers. The most common types include:

• Internal/In-House Programs. These are most often found in large companies with substantial resources. The EAP staff is employed by the organization and works on-site with employees.

• Fixed-Fee Contracts. Employers contract directly with an EAP provider for a variety of services, e.g., counseling, employee assessment, and educational programs. Fees are usually based on the number of employees and remain the same regardless of how many employees use the EAP.

• Fee-for-Service Contracts. Employers contract directly with an EAP provider but pay only when employees use the services. Because this system requires employers to make individual referrals (rather than employees self-referring), care must be taken to protect employee confidentiality.

• Consortia. An EAP consortium generally consists of smaller employers who join together to contract with an EAP service provider. The consortium approach lowers the cost per employee.

• Peer-Based Programs. Less common than conventional EAPs, peer, or co-worker-based EAPs give education and training, assistance to troubled employees and referrals, all through peers and co-workers. This type of program requires considerable education and training for employees.

Not every EAP will be right for every organization. To determine whether a particular program will meet your specific needs, ask the EAP provider the following questions:

• Do your staff members hold the Certified Employee Assistance Professional (CEAP) credential?

• Do members of your staff belong to a professional EAP association?

• What is the education level of each member of your staff?

• Do you have references we can contact?

• Do you provide on-site employee education and supervisor training services?

• What cost/fee programs do you offer?

• Will you do on-site visits? Are you able to conduct a needs assessment of our organization?

• What types of counseling services are available to employees? How many sessions?

• How easy will it be for employees to use the EAP? Where and how often is the EAP available to employees?

• To which programs and services do you make referrals, and under what circumstances?

• Does the EAP have a system for evaluating the effectiveness of the program?

Professional EAP officials warn employers to shy from unscrupulous EAPs that:

• Own or manage treatment facilities, creating a possible conflict of interest;

• Refer patients to their own facilities or to the same group of facilities, indicating a hidden contract or unethical relationship exists;

• Refuse to allow clients to audit their business transactions or monitor their referrals;

• Lack the Certified Employee Assistance Professional credential.

When weighing employee assistance programs and treatment options, consider the following suggestions:

• Recognize that the identification of a drug or alcohol abuse problem is only the first step and that rehabilitation is the ultimate and most desirable goal. Provide the opportunity, when feasible and appropriate, for employees who test positive to participate in company-sponsored employee assistance and rehabilitation programs. Ensure that the programs include medical monitoring, treatment, re-testing, counseling, and after-care.

• Provide employees with referrals to local counseling and treatment centers as an alternative to, or as a supplement for, company employee assistance programs.

• Insist on a high level of accountability for employees in company-sponsored or company-referred drug rehabilitation programs. Make such programs available only to those employees who acknowledge the existence of a drug and/or alcohol problem. Stress that strict adherence to the requirements of the program and random retesting are the only alternatives to dismissal.

• Address the family and dependent problems of employees who are drug abusers, with emphasis on group, family, personal and outpatient counseling.