Employees’ work may suffer because of psychological issues, substance abuse problems, marital and family turmoil, or medical, financial, and legal problems.[1] Stressors in one of these areas may lead to problems in another. Emotional and personal problems are associated with increases in injuries on the job, absenteeism, tardiness, property damage, increased medical claims, and employee turnover.[2, 3 ,4, 5, 6]

One way to provide assistance to employees is through employee assistance programs (EAPs). The availability of EAPs has grown dramatically in recent years, with an estimated 20,000 EAPs providing coverage for 55 percent of the U.S. workforce.[7] Organizational support of EAP services shows a commitment to rehabilitating employees rather than turning to punitive measures such as dismissal.[8] Studies show that EAPs are not only good for employees but also for business.[9]

What employee assistance programs do

Employee assistance programs can help employees with personal problems that affect their job performance. EAPs may be sponsored by companies or by unions, and they can enhance the work climate of an organization by promoting the well-being of everyone involved.

EAPs can identify and address a wide range of health, economic, and social issues, including substance abuse and mental health issues. Some EAPs concentrate primarily on alcohol and other drug issues. But most address other employee concerns as well, such as stress, marital difficulties, financial troubles, and legal problems.

To address such issues, EAPs usually offer services such as employee education, individual assessments, organizational assessments, referrals to treatment, and—especially—counseling. EAPs typically offer counseling services to help employees deal with personal problems such as grief, substance abuse, sexual harassment, family violence, long-term illness, and child care. Some EAPs offer services for the promotion of health and wellness. Some offer retirement assistance. And some provide advice for dealing with difficult supervisors or coworkers. Not all EAPs provide all of these services, but the more comprehensive EAPs may provide more.

Major Types of EAPs

When considering which kind of EAP might be most appropriate for the needs of your organization, take a look at the list below of the major types of EAPs:[10]

In-House Program

In an in-house program, the EAP staff are employed by the organization and work onsite with employees. This kind of program is most often found in large companies with substantial resources.

Referral-Only Program

A referral-only program provides supervisors and managers with a telephone number to give to troubled employees. That number gives the employees access to in-person referral or to community resources such as self-help programs and substance abuse treatment providers.

Fixed-Fee Contract

Under a fixed-fee contract, an employer pays a fixed fee to an EAP provider for a variety of services such as counseling, employee assessment, and educational programs. The fees are usually based on the number of employees in the workplace, and the fees remain constant regardless of how many employees use the EAP.

Fee-for-Service Contract

Under a fee-for-service contract, an employer contracts with an EAP provider but pays only when an employee uses the services. Because this system requires employers to make individual referrals (rather than having employees self-refer), care must be taken to protect employee confidentiality.

Consortium

With an EAP consortium, smaller employers can join together to contract with an EAP service provider. A consortium can lower the per-employee cost of EAP services.

Management-Sponsored Program

A management-sponsored program is, as the name indicates, sponsored exclusively by management, as opposed to being sponsored by a union or by both management and a union. Such programs can, however, vary widely in design and scope. Some deal only with substance abuse. Others treat a range of employee and family problems. Some include proactive prevention and health and wellness activities, as well as problem identification and referral. And some are actively linked to the employee health benefit structure.

Member Assistance Program

A member assistance program (or MAP) is provided by a union. Like EAPs, MAPs can vary widely in design and scope. Unions have a long history of addressing member, family, health, welfare, and working condition concerns. MAPs support a wide range of prevention, problem identification, referral, and counseling services and activities for workers and their dependents.

Peer-Based Program

Less common than conventional EAPs, peer-based or coworker-based EAPs offer education, training, assistance, and referrals—all through peers and coworkers. This type of program requires extensive education and training for employees.

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Qualified EAP Providers

Currently there are no national licensure programs for EAP providers, although several States are considering such programs. Two professional associations—the Employee Assistance Professionals Association (EAPA) and the Employee Assistance Society of North America (EASNA)—have developed certification procedures for EAP providers. The Certified Employee Assistance Professional (CEAP) credential indicates satisfactory knowledge about addictions, intervention, and related skills. For a fee, EAPA or EASNA can also provide directories of EAP providers by area or region.

• You may call EAPA at 703–387–1000 between 8:30 a.m. and 5:30 p.m., Monday through Friday, Eastern Standard or Daylight Time. EAPA’s Web site is http://www.eapassn.org/.

• You may call EASNA at 763–765–2385 between 8:30 a.m. and 5 p.m., Monday through Friday, Central Standard or Daylight Time. EASNA’s Web site is http://www.easna.org/.

Various options are available for identifying EAP services. These include contacting organizations that describe themselves as EAPs and contacting other sources of health care. You should consider the following possibilities:

• Consult the Yellow Pages, by looking under "employee assistance programs" or "drug abuse information and treatment centers."

• Call the local chamber of commerce or trade association.

• Call the Center for Substance Abuse Prevention’s (CSAP’s) Workplace Helpline at 1–800–WORKPLACE.

• Call local hospitals, and ask about available EAP services.

• Contact a health maintenance organization that provides alcohol and other drug abuse–treatment services, and ask about EAP possibilities.

• Contact a local mental health or Substance Abuse Professional in private practice, and negotiate a contract for EAP services.

• Inquire whether insurance carriers cover EAP services or can help identify local or regional EAP providers.

• Talk with other employers who have successful EAPs.

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What EAPs need to know

When seeking to purchase EAP services, it is important to compile certain kinds of information that EAP providers will want to analyze and review, such as

• Your drug-free workplace policy statement

• Your health benefits structure

• Services that you want an EAP program to provide

• A preferred budget range for these services

• Characteristics of your workplace and employees, such as worksites, job categories, and the numbers and demographics of employees, supervisors, and covered family members

Once an EAP provider has been able to review this kind of information, the provider will be better able to put together a package of proposed services, with a proposed cost structure and contract, that can address your needs and fit your budget.

What you need to know

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

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

• "Do the staff who will be assigned to my organization hold the CEAP credential?"

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

• "Do you have references that we can contact?"

• "Do you provide onsite employee education and supervisor training services?"

• "What cost/fee programs do you offer?"

• "Will you do onsite 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 why?"

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

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Costs of EAPs

Since alcohol and other drug abuse is an issue of increasing concern in the workplace, growing numbers of individuals and groups are available to help address employers’ concerns. Usually (though not always) you are under no obligation to pay for services until a formal agreement has been reached and a contract signed.

Fees for outside assistance vary considerably. But here are a few things to keep in mind as you explore what an EAP can do for your workplace, and at what cost.

A. Be clear about what you want and can afford for

• Policy development
• Policy critique/legal review
• Implementation planning
• Written materials for employees
• Employee briefing sessions
• Supervisor training
• Forms creation
• Laboratory selection
• Medical Review Officer selection
• EAP selection
• Contracts negotiation

B. Ask questions about

• Fees and how they are calculated
• What work will be done
• Who will do the work and what qualifications they have
• When work will be completed
• What results can be anticipated
• Whom to call for references

C. If the costs seem too high:

• Ask if the work can be done in phases.
• Ask about payment plans.
• Ask what could be done within your budget.
• Get two or more bids.

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Benefits of EAPs

Employee assistance programs offer a variety of benefits:

• They can assist with policy development, employee education, and supervisor training.

• They can take the pressure off supervisors and managers, who feel responsible when employees’ personal problems affect job performance.

• They offer an alternative to firing, thereby saving the costs of recruiting, rehiring, and retraining.

• They offer access to treatment for employees with problems that affect their job performance.

• They can reduce accidents, absenteeism, turnover rates, health benefit utilization, and workers’ compensation claims.

• They can assist employers in complying with drug-free workplace laws.

Costs versus benefits of EAPs

Many employers ask whether the cost of having an EAP is worth the expense. Most studies on EAPs are designed to prove that the program has indeed improved the organization’s bottom line.[11, 12] Cost–benefit analyses compare the money spent on providing the services with the financial value of the changes produced by the services. Ways to measure benefits include increased productivity, decreased absenteeism, and decreased health claims. Indicators of costs include salaries, rent, equipment, and travel.[13] Programs are deemed successful if costs are less than benefits, and if positive effects are observed.[14]

Though the best way to calculate the specific return on investment of EAPs has been debated and the designs of the studies have come into question, indications are that EAPs are worthwhile.[15, 16, 17] In a review of 26 studies of EAP cost–benefit and process evaluations conducted in Canada and the United States and presented in peer review journals over the past 20 years, all found EAPs to have a positive return on investment.[18] Chevron Corporation[19] has been experiencing positive returns on its EAP investments.

Human resource policies that offer EAP services acknowledge that problems such as drug and alcohol addiction are treatable. This strategy, sometimes called a human resource conservation strategy, protects organizational investment.[20] In a survey of 6,400 employees from 84 different worksites who used EAPs, all reports at initial intake, at 18 months, and at 24 months showed favorable results.[21] A series of evaluation studies gave indications that EAPs succeeded at returning employees with alcohol and drug problems to effective performance.[22]

Numerous studies have supported the business case for the purchase of EAP and other workplace services. Specifically, the EAP at Federal Occupational Health (FOH), a service within the U.S. Department of Health and Human Service’s Program Support Center, documented the EAP benefit–cost ratio and the positive outcomes of EAP services for the individuals using them.[23]

• FOH evaluated the health status of 16,055 EAP clients before and after they used the FOH EAP. Improvement rates from 33 percent to 71 percent were found in the following areas: health, work attendance, productivity at work, day-to-day functioning, and social activities.[24]
  
  
• In a follow-up study, during the 3-year period from July 1, 1999, through June 30, 2002, FOH gathered outcomes data from almost 60,000 clients. EAP intervention led to client improvement in emotional and physical health, functioning, and productivity. Unplanned job absence and tardiness decreased by 67 percent after EAP intervention.[25]
  
  
• A prospective cost–benefit estimate of FOH EAP services showed that for every $1 spent on the EAP, the expected savings for the 1st year would be $1.27, rising to $7.21 by the 5th year.[26]
  
  
• Chevron realized savings of $14 for every $1 spent on its EAPs. The savings were based on employee retention, improved job performance, absenteeism, tardiness, safety, quality and quantity of work.[27]
  
  
• McDonnell Douglas saved $5.1 million by instituting an EAP, according to a 4-year study-a return of $4 for every $1 invested, owing to reduced absenteeism, turnover, and medical claims.[28]
  
  
• The City of Los Angeles Department of Water and Power found that alcohol-abusing employees formally referred to their EAP by supervisors demonstrated a 33 percent decrease in sickness absenteeism, with savings estimated at $349,763 over a 3-year period.[29]

• EAP worksite training can also provide measurable benefits. For example, Rutgers University, in a report on the business case for emotional intelligence, cited the results of supervisory training in emotional competencies at a manufacturing plant. Lost-time accidents were reduced by 50 percent, formal grievances dropped from 15 to 3 per year, and the plant exceeded productivity goals by $250,000.[31]

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Checklist for starting an EAP

Here is a checklist you can use when you are starting an EAP:

___ Make sure top managers support and endorse the idea.

___ Review financial resources available for an EAP program.

___ Determine a budget for the EAP program.

___ Identify the needs you want the EAP to address.

___ Identify the rationale and goals for the EAP program in your organization.

___ Identify and select an EAP provider that is right for your organization.

___ Write an EAP policy and procedures statement.

___ Distribute the policy and procedures statement to all employees.

___ Schedule a meeting with employees to discuss the services the EAP program will provide and to address any questions.

___ Arrange for periodic program evaluations, to take an objective look at the EAP’s operation and performance. (For example, address the following kinds of questions: How many employees are using the EAP? How many users are self-referred? How many users are referred by supervisors? What services are being provided? What have been the costs? What have been the benefits?)

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Free EAP information sources  

You Can Call CSAP’s Workplace Helpline, at 1–800–WORKPLACE

The Helpline provides free information and consultation on policy development, drug testing, employee assistance, employee education, supervisor training, and program implementation. Helpline information specialists can refer you to other resources, including free publications. They can tailor the information and consultation they provide to meet the needs of your organization. They can give you free lists of drug testing labs that have been certified by the U.S. Department of Health and Human Services (DHHS). And they can help you network to find a Medical Review Officer (MRO) that is right for your EAP program.

You Can Also Contact Local Drug-Free Business Initiatives and Workplace Coalitions

Local initiatives and coalitions can link employers who want to develop drug-free workplace policies and programs. Coalitions may provide sample policies, technical assistance, low-cost drug testing services, and ongoing training sessions for supervisors. Some have developed low-cost EAPs that have been designed specifically for small-business employers. They may also have information about, and experience with, the services and costs of laboratories and MROs in your area.

For help in finding a local initiative or coalition, you may

• Look in the phonebook, under your city’s name, for entries like "Drug-Free Business Initiative" or "Coalition for Drug-Free Workplaces."
  
  
• Call or write your State or county office for alcohol- and drug-abuse services, and ask if it has a list of groups near your workplace.
  
  
• Call or write your local mayor’s office, police department’s community relations office, office of economic development, or business relations office, and ask for a list of coalitions.
  
  
• Call or write your chamber of commerce or business or trade association, and ask about services to help employers start a drug-free workplace program.
  
  
• Call CSAP’s Workplace Helpline at 1–800–WORKPLACE (1–800–967–5752).
  

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Other EAP Information Sources  

Drug-Free Workplace Consultants

Some employee assistance and management consulting firms specialize in helping employers and employees develop drug-free workplace policies and programs. You can call your State alcohol- and drug-abuse agency for a list of EAPs and treatment programs available locally. That agency can also provide information about drug testing laws.

Attorneys, Arbitrators, and Mediators

Some legal, arbitration, and mediation professionals specialize in helping organizations develop drug-free workplace policies. They also can assist in preventing or resolving policy disputes.

Drug Testing Labs

Many drug testing laboratories provide assistance with writing a policy and creating education programs, while charging only for their drug testing services. Contact CSAP’s Workplace Helpline (1–800–WORKPLACE) for a list of DHHS–certified laboratories.

Health Insurance Carriers

Review your health insurance policy, and consult with your carrier or agent. Coverage for alcohol- and other drug-abuse services can vary widely. Some carriers offer "preferred provider programs," which cover all or part of the costs of alcohol- and other drug-abuse treatment for employees who receive treatment at a preferred provider facility. Ask your carrier about options for treatment coverage.

Implementation Models

One model is provided by the Federal Office of Personnel Management’s Model Employee Assistance Program for all Federal agencies. Another model is provided by DHHS’s employee assistance program specifically for DHHS employees. General information about the Federal Government’s policy and programs is provided in Your Federal Employee Assistance Program: A Question and Answer Guide for Federal Employees.[32]

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References

1. Sterling T. Shumway, Richard S. Wampler, Charette Dersch, and Rudy Arredondo. 2004. "A Place for Marriage and Family Services in Employee Assistance Programs (EAPs): A Survey of EAP Client Problems and Needs." Journal of Marital and Family Therapy 30(1):71–79.
2. Royer F. Cook and William E. Schlenger. 2002. "Prevention of Substance Abuse in the Workplace: Review of Research on the Delivery of Services." Journal of Primary Prevention 23(1):115–42.
3. Arthur T. Johnson and Nancy O’Neill. 1989. "Employee Assistance Programs and the Troubled Employee in the Public Sector Workplace." Review of Public Personnel Administration 9:66–81.
4. Thomas W. Mangione, Jonathan Howland, Benjamin Amick III, Jennifer Cote, Marianne Lee, Nicole S. Bell, and Sol Levine. 1999. "Employee Drinking Practices and Work Performance." Journal of Studies on Alcohol 60(2):261–70.
5. Paul M. Roman, Terry C. Blum, and Nathan Bennett. 1987. "Educating Organizational Consumers About Employee Assistance Programs." Public Personnel Management 16:299–312.
6. James V. Trudeau, Diane K. Deitz, and Royer F. Cook. 2002. "Utilization and Cost of Behavioral Health Services: Employee Characteristics and Workplace Health Promotion." Journal of Behavioral Health Services and Research 29(1):61–74.
7. 7. Nan Van Den Bergh. 2000. "Where Have We Been? Where Are We Going?: Employee Assistance Practice in the 21st Century." In Nan Van Den Bergh (ed.). Emerging Trends for EAPs in the 21st Century. Binghamton, New York: Haworth Press.
8. Hannah K. Knudsen, Paul M. Roman, and J. Aaron Johnson. 2004. "The Management of Workplace Deviance: Organizational Responses to Employee Drug Use." Journal of Drug Issues 34(1):121–44.
9. Kathleen E. McDonough. 2005. " Internal EAPs and the Low-Wage Worker: Practitioners’ Perceptions of Services." Dissertation. Pittsburgh, Pennsylvania: University of Pittsburgh, School of Social Work.
10. Adapted from Thomas E. Backer. 1994. Strategic Planning for Workplace Drug Abuse Programs, Second Edition. Bethesda, Maryland: National Institute on Drug Abuse.
11. Richard Csiernik. 1995. "A Review of Research Methods Used to Examine Employee Assistance Delivery Options." Evaluation and Program Planning 18(1):25–36.
12. Kathleen E. McDonough. 2005. " Internal EAPs and the Low-Wage Worker: Practitioners’ Perceptions of Services." Dissertation. Pittsburgh, Pennsylvania: University of Pittsburgh, School of Social Work.
13. Jeremy W. Bray, Michael T. French, Brad J. Bowland, and Laura J. Dunlap. 1996. "The Cost of Employee Assistance Programs (EAPs): Findings From Seven Case Studies." Employee Assistance Quarterly 11(4):1–19.
14. Richard Csiernik. 1995. "A Review of Research Methods Used to Examine Employee Assistance Delivery Options." Evaluation and Program Planning 18(1):25–36.
15. Michael T. French, Gary A. Zarkin, and Jeremy W. Bray. 1995. "A Methodology for Evaluating the Costs and Benefits of Employee Assistance Programs." The Journal of Drug Issues 25(2):451–70.
16. Jeremy W. Bray, Michael T. French, Brad J. Bowland, and Laura J. Dunlap. 1996. "The Cost of Employee Assistance Programs (EAPs): Findings From Seven Case Studies." Employee Assistance Quarterly 11(4):1–19.
17. Rick Selvik, Diane Stephenson, Chris Plaza, and Brian Sugden. 2004. "EAP Impact on Work, Relationship, and Health Outcomes." The Journal of Employee Assistance April:18–22.
18. Richard Csiernik, David Hannah, and James Pender. 2006. "A Review of the University of Saskatchewan Employee Assistance Program." Report to the University of Saskatchewan. Saskatoon, Saskatchewan.
19. Kenneth R. Collins. 1999. "Workplace Safety, Drug Testing, and the Role of the EAP Professional." In James M. Oher (ed.). The Employee Assistance Handbook. New York, New York: Wiley, 387–404.
20. Paul M. Roman and Suzanne C. Baker. 2002. "Alcohol and Drug Problem Management in the Workplace." In Jay C. Thomas and Michel Hersen (eds.). Handbook of Mental Health in the Workplace. Thousand Oaks, California: Sage, 371–80.
21. Ibid.
22. Ibid.
23. U.S. Department of Health and Human Services, U.S. Public Health Service, Federal Occupational Health. 2003. "Documenting the Value of Employee Assistance Programs." Available at http://www.foh.dhhs.gov/whatwedo/EAP/EAPvalue.pdf/.
24. Rick Selvik and David B. Bingaman. 1998. "EAP Outcomes from the Client’s Point of View." EAP Digest September/October:21–23.
25. Rick Selvik, Diane Stephenson, Chris Plaza, and Brian Sugden. 2004. "EAP Impact on Work, Relationship, and Health Outcomes." The Journal of Employee Assistance April:18–22.
26. James T. Wrich. 1999. "An Employee Assistance Program Benefit to Cost Ratio: A Prospective Estimate." Unpublished study prepared for U.S. Department of Health and Human Services, U.S. Public Health Service, Federal Occupational Health.
27. Kenneth R. Collins. 1998. "Cost/Benefit Analysis Shows EAP’s Value to Employer." EAP Association Exchange 28:16–20.
28. The Almacan. 1989. "McDonnell Douglas Corporation’s EAP Produces Hard Data." August:18–26.
29. Rudy M. Yandrick. 1992. "Taking Inventory." EAP Association Exchange. July:22–31.
30. Terry C. Blum and Paul M. Roman. 1995. Cost-Effectiveness and Preventive Implications of EAPs. Rockville, Maryland: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.
31. Ronald J. Lechnyr. 1993. "The Cost Savings of Mental Health Services." EAP Digest November/December:22–23.
32. U.S. Office of Personnel Management. N.d. Your Federal Employee Assistance Program: A Question and Answer Guide for Federal Employees. Available at https://www.opm.gov/Employment_and_Benefits/WorkLife/OfficialDocuments/handbooksguides/EAP_QandA/index.asp/.