Few Companies Taking a L(EAP) of Faith

Today's benefit managers have their hands full. The Affordable Care Act legislation and its rapidly approaching deadlines and penalties have made issues such as compliance and exchanges top priority. It’s no wonder employee assistance programs seem to have gotten lost in the shuffle.

According to Chestnut Global Partners’ “Trends Report 2015,” the cumulative EAP usage rate is 5.5 percent, which suggests that both employers and employees have placed their attention elsewhere.

This isn’t cause for concern among employers though. Low usage rates are par for the course in EAPs. The National Behavioral Consortium, a nonprofit trade association composed of regional Managed Behavioral Healthcare Organizations — groups that follow evidence-based practices for providing high-quality care, access and consumer protection — and EAP member organizations, conducted a benchmark survey in 2013 to gauge program use and effectiveness among EAP vendors.

Employers are increasingly using employee assistance programs to help employees receive assistance for personal problems that might affect overall job performance. Oftentimes, stress, physical and emotional health, alcoholism, substance abuse and family issues can lead to an employee’s decreased productivity in the workplace.

The purpose of a successful EAP is to provide voluntary services consisting of short-term counseling and referrals for employees facing these difficult issues.

EAPs are almost always free for employees, and they are mostly voluntary. The goal is not to punish an employee but rather to encourage that worker to receive services needed to help deal with personal issues. EAPs should always be confidential. It is only when confidentiality is maintained that employees will fully use the program. 

Confidentiality Key to a Successful EAP

 Here are five tips to implementing a successful EAP.

1. Know your company goals. Employers exploring whether to offer an EAP should analyze company needs and workforce trends. Is there high company turnover that needs to be addressed? Have there been prevalent examples of employee dissatisfaction and work-relationship issues? Is absenteeism or tardiness a recurring problem? Employers should create a working group of qualified human resources practitioners, among others, to discuss whether an EAP would be a worthwhile benefit to employees. 

2. Hire a qualified third-party EAP service provider. To save costs, some employers provide EAP services internally through employee counselors, which can have negative consequences. Confidentiality is key to maintaining a successful EAP. Workers may perceive an internally handled EAP as not confidential in nature. Internal EAP departments also may find themselves in the conflicted position of seeking to help an employee while also cooperating with an employer’s inquiries as to particular employees. Using a third-party EAP provider avoids these problems. Third parties usually have a wide range of experience regarding EAP services. Employers, however, should thoroughly screen any EAP third parties as to qualifications. And, both the employer and the third-party EAP service provider should clearly define their roles regarding each other so as not to create any conflicts or diminished service. 

3. Make sure employees know you have an EAP. This may sound obvious, but one of the main reasons why EAPs are underutilized is that employees oftentimes do not even know they exist. Once an employer has implemented an EAP, it should inform all employees of three things: the EAP’s existence and purpose, the process for employees to use the services, and that it is a strictly confidential process. 

Process and confidentiality are very important. Employees should be able to contact an EAP counselor without any need to first involve a superior. And, EAP counseling should ideally be conducted in a place that is either off-site, or, if on-site, very private. EAP services also should be sensitive to an employee’s time constraints and preferences. Finally, employees should be made aware that EAP counselors are able to provide not only short-term counseling but also referrals, follow-up services and educational programs.  

4. Understand supervisor roles regarding EAPs. EAPs are usually a voluntary process and most effective when employees, themselves, seek services. But supervisors still have a role in this process. Supervisors should be trained to identify workforce issues, and, in appropriate circumstances, discreetly suggest to an employee that EAP services are available. This is especially appropriate where the employee admits to the supervisor difficult personal issues, such as alcoholism, substance abuse or severe depression. 

5. Evaluate the EAP’s success. Finally, employers should track the EAP’s progress and achievement of company goals. A third-party EAP service provider may, as part of its services, assist in this analysis. Both employees and EAP counselors should be allowed to anonymously provide feedback as to the EAP process.

A successful EAP program should result in increased attendance and morale, decreased turnover and labor disputes, and a work force that feels valued. All of these benefits in turn lead to increased productivity. 

Daniel R. Saeedi is an attorney at Taft, Stettinius & Hollister in Chicago. To comment, email editors@workforce.com.

The survey found the average EAP counseling usage rate among the 82 companies surveyed was just 4.5 percent of the 146 million lives they collectively cover.

It’s hard to understand why an employer would continue to pay for a program that is so poorly received by employees until you look at the cost. As part of its 2015 trends report on the state of the EAP industry, Chestnut, a Bloomington, Illinois-based EAP provider, reported that the typical employer allots just 1 percent of its benefits budget for EAP programs. 

“Because it is such a small percentage, I think [employers] are only looking for the best price and may not fully comprehend that there are different levels of services and different levels of quality,” said Todd Donalson, director of training and consultation at Chestnut. “There are different levels of service based on what your organizational goal is. You have to dig deeper into what the product actually delivers.”

EAPs were originally developed to provide assessment and services for addressing a range of personal problems and concerns that interfere with employees’ well-being and work performance. Interventions for issues ranging from depression to substance abuse were delivered in person, by telephone or over the Internet.

To their credit, over the past five years EAPs have been striving to deliver a wider array of useful services to employees. ComPsych Corp., the world’s largest provider of EAP services, has seen the industry expand dramatically from its roots in mental health services over the past few years. The Chicago-based company specifically focuses on integrating EAP services into other corporate wellness initiatives to boost participation and bottom-line results for employers.

“Today, it’s not only mental wellness,” said ComPsych CEO Richard Chaifetz. “It’s absence management. It’s health navigation. It’s a variety of different services to give people the requisite tools and guidance to help them solve their personal problems.”

The integration of EAPs into wellness and health management programs could not have come at a better time. Given the pressure the Affordable Care Act has placed on employers to provide access to quality health care for employees, low-cost programs that keep employees well and cut down on insuranceclaims have made EAPs more popular. According to the Chestnutsurvey, EAP usage in North America increased by 7 percent across all businesses in 2014. 

“If the issue is of a personal nature, people are intimidated by having to go through an employer plan or out onto an exchange, and it becomes a block to care,” said Matt Mollenhauer, managing director at Chestnut. “Given the ACA legislation, the EAP’s value is derived from the fact that it provides an easy and safe place to go and get support.”

Furthermore, a September 2014 ruling by the Labor, Treasury and Health & Human Services departments found that EAPs are an excepted benefit and as such do not need to comply with certain requirements under the ACA. As a result, EAPs don’t need to be in compliance with out-of-pocket limitations; they are not subject to lifetime dollar limits on essential health benefits and they are not subject to pre-existing condition exclusions.

In order for EAPs to live up to their potential, employers must put in the effort to choose the right EAP for them.

Free and Easy

Employers have two options when it comes to choosing an EAP for their company: free and fee-based.

Free, or embedded EAPs as they are formally known, are offered as part of a larger insurance product by insurance giants such as Aetna Inc., Humana Inc. and Optum Inc. Employees don’t need to sign up for it. It comes as part of a suite of services for essentially no additional cost.

According to Winning Workplaces, a nonprofit dedicated to creating better work environments, employers adopted embedded EAPs as a means of offering accessible care to all employees.

Employees must elect fee-based EAPs, but their active choice to participate in the program gives the service more leverage to make an impact. At ComPsych, fee-based EAPs are integrated into wellness programs, Chaifetz said. For example, if an employee calls in saying that they are experiencing stress and depression and it is determined that they are overweight and possibly suffering from diabetes, the employee would not only be referred to a counselor for the depressive symptomology, but also they  would be engaged in wellness coaching to deal with the weight problem and manage their diabetes situation.

“Fee-based EAPs allow us to focus on the entire individual, not just some symptoms they might be presenting,” Chaifetz said.

In this vein of treating the underlying cause of a problem instead of the presenting ailment, many fee-based EAPs are moving into the area of fatigue management.

“In the last five to 10 years, we’ve had researchers come out with studies that link inefficient sleep not only to workplace safety initiatives but also more into public health issues,” Donalson said. “Now it’s linked to more health problems like diabetes, depression and heart disease.”

Fee-based EAPs are now being designed to screen for possible sleep disorders and intervene with techniques to improve employee sleep quality, according to Chestnut. Integrating with largerwellness programs then allows employers to develop technology policies that help employees get better quality sleep.

Intuitive Value

One of the biggest hurdles EAPs face is the lack of hard data to support their value to a company. In a workplace environment where return on investment is everything, the inability to provide hard numbers linking EAP intervention to measurable increases in employee health leaves employers unconvinced that EAPs are something they should invest time and effort in developing.

“We know intuitively that people who are healthier perform better,” Chaifetz said. “If you have a grossly obese person who is smoking, they are going to miss more work, be more lethargic and not be as good of a performer. There is just an inherent return on that.”

Mines & Associates, a Denver-based EAP provider, found that employers can expect anywhere from a $2 to $7 return on their investment in EAP programs.

Right now, one of the greatest perceived values of EAPs is employee engagement. As a result, many EAPs are looking to expand their technology presence so that their services are easier for employees to interact with.

“The EAP industry has been relatively slow to adopt technology into their delivery services,” Chestnut’s Donalson said. “It’s about the ability to connect in a meaningful way. In the next year or two, you’re going to see upwards of 50 to 60 percent of EAPs use technology to collect data to prove to customers that they are actually making an impact on work.”