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An eye on EAPs.

AN EYE ON EAPs

DANIEL C. SMITH, DIRECTOR of the employee assistance program at McDonnell Douglas, sounds like a stockbroker when he describes his division's impact on the entire firm. "Our program is working," he remarks. "For 1988, we realized a return of $5.1 million. It's an indication that we're serving both the workers and the company."

At a time when substance abuse, mental health problems, and other stresses beset the American work force, an effective employee assistance program (EAP) can be a wise investment. Through EAPs, distressed workers may get counseling and referrals before their troubles become insurmountable.

Certainly, the need for EAPs is pressing. In survey after survey, CEOs cite alcohol and drug dependency as a major factor in absenteeism, soaring medical claims, and plummeting productivity. Cocaine use in particular has grown tremendously.

David Britt, author of the The All-American Cocaine Story, estimates that 70 percent of the stimulant's users are jobholders, and 35 percent of those people are in managerial positions. But alcohol remains the nation's most misused substance.

According to the Employee Assistance Professionals Association, Inc. an Arlington, VA-based organization representing 6,000 of the nation's EAP professionals, 12 percent of America's 114 million workers are addicted to alcohol, while 7 percent are addicted to drugs like marijuana, cocaine, amphetamines, and barbiturates. And crossaddiction is not uncommon.

Whether they sit behind the steering wheel or in front of a computer terminal, chemically dependent employees are a threat to themselves and their coworkers. The physical hazards of driving while intoxicated are obvious; less apparent is the danger to corporate morale. One disturbed person can undermine an entire department.

"When others in the workplace see drug abuse, it's detrimental," observes Rodney Lowman, director of Houston's Career Development Laboratory, which evaluates career paths for managers, workers, and companies.

EAPs can help businesses contain the damage. "EAPs have originated as policies in an attempt to improve employee performance," explains David Lewin, professor of business at Columbia University. "Typically, EAPs are financed on a capitated basis, for example, $18 to $20 a person," adds Lowman. "It doesn't take too much to see that with several successfully treated cases, the firm has made up the amount of its investment."

Whatever the rationale, by the late 1980s, nearly 80 percent of the Fortune 500 had introduced EAPs. The approach varies from company to company. Some programs combat alcoholism, while others provide personal and marital counseling. The most all-encompassing plans address every phase of psychological needs and direct workers to appropriate clinics and out-patient and residential facilities.

McDonnell Douglas revised its 14-year-old EAP in 1985 after tallying up its failures. For the first three years after drug-dependent employees entered a program, they missed an average of 88 days each, McDonnell Douglas found. During the same period, workers with mental illness were absent an average of 50 days each.

Three years after diagnosis, 40 percent of the employees treated for drug abuse and 16 percent of those treated for psychiatric conditions were no longer on the company payroll. "Our program wasn't as effective as it could have been," Smith comments. "It was decentralized, and it wasn't available in all the units around the country. To support our people, we realized we had to increase our scope."

A broader program and tighter management made all the difference. McDonnell Douglas expanded its programs to all corporate units regardless of size, with increased attention to drug dependence, psychiatric illness, and family problems. Outside consultants contrasted 11,000 EAP clients to 14,000 of their unenrolled coworkers by studying absentee rates and medical claims. Those who were treated for chemical dependence under the plan lost 44 percent fewer days than chemically dependent workers treated outside the plan.

For employees with psychological or psychiatric complaints, statistics were also encouraging. The EAP group had a 34 percent reduction in absences over their counterparts. Meanwhile, four years after treatment, the attrition rate for drug abusers dropped to 7.5 percent, compared to 40 percent for the control group. That represents an 81 percent reduction in turnover.

Other companies are reporting similar figures. HARTline (Hillsborough Area Regional Transit) in Tampa, FL. has 400 employees, including more than 250 bus drivers. Recently, the firm received an award for its dramatically improved safety record - the result of strict substance abuse policies, which include an annual urine test at the time of the physical along with random tests throughout the year for managers as well as workers.

The first time a drug or alcohol problem surfaces, HARTline personnel are suspended without pay for the duration of a mandatory, 30-day detoxification course. Then those employees are on probation for a year. Any relapses are cause for termination.

Comparing the pre-EAP 1984 figures with those of 1986 to 1987, HARTline's accidents declined by almost 50 percent. Worker's compensation claims dropped from 60 to 49; completed arbitration cases fell from 12 to four. Furthermore, liability expenses, such as for bodily injury and property damage, shrunk from over $1 million in 1984 to $29,951 in 1986.

The advantages of EAPs cut across industries. Chicago Bell credits its alcoholism rehabilitation program for slashing its poor performance ratings, according to the EAP Association, from 28 percent to 12 percent. In 1984, the EAP saved the company almost $500,000 in reduced sickness and disability absences.

Detroit Teamsters who entered the General Motors alcoholism program filed drastically fewer medical claims. The General Motors plan also won the company points with the United Auto Workers, which encouraged its members to participate.

But EAPs have their limitations. "We haven't seen a decline in mental health care costs or absenteeism," admits Rowland L. Austin, director of the General Motors EAP and member of the company's industrial relations staff.

"Health care includes many items, and absenteeism isn't necessarily a way of measuring the EAP," says Career Development Laboratory's Lowman.

"Many employers are not just concerned with showing a dollar for dollar return. There's the concern for the human factor. Programs are open to workers and families, so it's difficult to determine the full contribution of the EAP. But improving family life can help life at the workplace."

Where drug or alcohol dependency is involved, permanent cures remain elusive. With or without an EAP, recidivism is relatively high. Terence T. Gorski, director of the CENAPS Corp., an Illinois treatment training firm, says that alcoholics with a stable job and family life have recovery rates ranging from 32 percent to 68 percent.

In contrast, less than two in 10 of those whose jobs are in doubt recover. And within the first three months of treatment, as many as six out of 10 recovering alcoholics experience a relapse.

Fortunately, Gorski observes, "The vast majority - more than 80 percent - of relapse-prone patients recognize their alcoholism. Our relapse prevention therapy teaches people how to recognize the early warning signs leading them back to chemical use."

Although recovery is a long-term process, insurance policies restrict residential treatment of relapsed patients.

"Coverage is shrinking," comments Jan Smith, vice president at CENAPS. "A person may be sent back the second time, but it will be for a shorter stay - about 10 days instead of 28."

Thus a business is well advised to spend money on an intensive detox program, followed by outpatient therapy and prolonged aftercare. That is the formula used by General Motors.

"Outpatient visits per year, or lifetime visits, are limited, but in the employee benefit plans, not in the EAP," summarizes Austin. "Many of the programs we deal with will keep a person as long as necessary in the outpatient follow-up groups." Aftercare is crucial to the person's development. We have voluntary self-help groups, such as Alcoholics Anonymous or Narcotics Anonymous. For the past three years, this accent on peer support and professional followup has been part of the program."

Still, all this medical attention costs money. Firms have to draw the line somewhere. "Many companies now say they will pay for up to two substance abuse treatments and then the worker is on his or her own," notes Lowman. "Spending $8,000 to $12,000 is a substantial investment in a person."

Since the odds favor recidivism, firms face the dilemma of whether to reinstate recovering addicts in high-risk positions. In September 1989, after the Exxon Valdez oil tanker ran aground in Alaska, Exxon classified 10 percent of the company's jobs as safety-sensitive. Workers in those slots are subject to random drug tests; "positives" are either transferred or terminated.

"We might speculate that some scapegoating is going around when we see Exxon beginning to demote people," Lewin asserts. "Because people fall back after treatment is no argument against reinstatement; it's one of the risks management has to take. Management cannot reduce risk to zero. Work injuries can't be reduced to zero, and dependency can't either. Whenever a cargo ship is sent to sea, risk exists."

At the very least, employees should receive written warnings about their behavior. "If a worker returns from treatment, especially into a safety-sensitive position, it's important to spell out the consequences of future slips," Lowman emphasizes.

"If the employee signs such a statement, then the company may be protected with written documentation should management want to check with a random drug test, take disciplinary action, or terminate in the future."

The legal issues surrounding reinstatement have yet to be resolved. Can people be required to take drug tests after undergoing treatment? Are employers liable to third parties for accidents caused by a troubled worker? What about possible future accidents? And does an EAP represent a contract with a worker, thus shielding him or her from disciplinary action?

The Vocational Rehabilitation Act of 1973 defines substance abuse - including alcoholism and drug addiction - as a "handicap," and contractors have to "make a reasonable accommodation" to workers with this disability. But this law affects only federal employees.

A new bill, the Americans with Disabilities Act (ADA), could extend such protection to alcoholics - (but not drug addicts) - in the private sector. ADA won Senate approval in 1989 and was passed by the House last May.

Confidentiality is another concern. According to some attorneys, records can be disclosed without a patient's written consent if a condition requires immediate action or poses an immediate threat to the health of another party.

In Tarasoff v. Regents of University of California, state supreme court judges ruled that health care personnel are obliged to warn third parties of foreseeable dangers posed by a patient. A Vermont decision broadened this precept to include counselors who are neither physicians nor psychologists.

Ironically enough, many leaks may be traced to the affected employees themselves. "Perhaps the last person to know about a drug problem is the person [involved], due to the nature of the condition," Austin explains. "But others can see the way a person is behaving; workers can still be aware of a condition. Sometimes employees breach their own confidentiality when they return from their treatment center because they are so excited about their progress."

About the Author ... Tom Pope is a health and business writer who covers management issues in New York City.
COPYRIGHT 1990 American Society for Industrial Security
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1990 Gale, Cengage Learning. All rights reserved.

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Title Annotation:includes information on two crucial factors; employee assistance programs
Author:Pope, Tom
Publication:Security Management
Date:Oct 1, 1990
Words:1848
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