© Ceridian Corporation. All rights reserved. BEST PRACTICES FOR DEVELOPING & MAINTAINING A HIGH QUALITY EAP PROVIDER NETWORK Sharon O’Brien, VP, EAP

© Ceridian Corporation. All rights reserved.

BEST PRACTICES FOR DEVELOPING & MAINTAINING A HIGH QUALITY

EAP PROVIDER NETWORK

Sharon O’Brien, VP, EAP / Work-Life Operations US

Patrick Williams, Dir, Provider Network Services US

© Ceridian Corporation. All rights reserved.© Ceridian Corporation. All rights reserved.

Objectives

• Provide the tools to effectively develop and maintain a vibrant EAP Network

• Distinguish between an EAP Network and a Behavioral Healthcare Network

• Build an external and hybrid (internal/external) model Provider Network

• Engage quality providers

• Employ effective communication strategies


Some of our LifeWorks Customers

http://www.chevron.com/

http://www.sodexo.com/

http://www.statefarm.com/








http://www.fdic.gov/index.html


LifeWorks EAP/US Model

EAP Behavioral Health Benefits

Short-term problem resolutionEmployer selects session model

Medical model - diagnosis and treatment

Assess personal issues impacting work

Counseling, not treatment • Inpatient, Partial, IOP• Outpatient, Substance Abuse Treatment

Generally low risk, routine cases Higher levels of care

Solution focused

Pre-diagnostic Longer term treatment model


Select Highly Qualified Network Providers

Provider Screening Criteria• 5 years of post master’s degree direct clinical experience• 3 years of experience providing EAP counseling• Independent license at the highest level of practice in the state of

residence• License in good standing with no sanctions• Malpractice Insurance $1M per occurrence; $3M aggregate• Assess provider’s knowledge of EAP practice through phone interview

and “EAP 101” training module completion.• Assess provider’s understanding of workplace organizations, issues and

cultures• Culturally diverse:

- Generational, gender, ethnic, racial, sexual orientation


Primary Source Verification

Obtain credentials directly from the original or primary sources

• Licensure – state boards

• Insurance – declaration page of insurance policy

• Office of Inspector General – verify that individual is in good standing to work in the U.S.- http://exclusions.oig.hhs.gov/

http://exclusions.oig.hhs.gov/


“Right Sized Network”

• Minimum of 98% match of provider practice addresses with participant zip codes Urban (within 5 miles)

Suburban (within 15 miles)

Rural (within 20+ miles)

Video counseling available

• Providers regularly receive referrals and remain familiar with unique aspects of the EAP and services offered by the local client company.

• Providers matched to footprint of client employee population.

• Different from managed behavioral health and medical plan network

• EAP networks do not include psychiatrists, inpatient facilities or other programs (i.e., partial hospital, IOPs or residential programs)


Network Landscape

• Monthly geographic reports:

• Identify gap areas

• Target recruitment opportunities

• Work with Account Management team to constantly compare and match provider availability to client/employee footprint

• Increase efficiency of Network Development specialists


Guam

PNS Regional Map

Virgin Islands

AK

Hawaii

WA

OR

CA

NV

MT

ID

WY

UT

AZ

CO

SD

ND

NE

OK

KS

TX

MO

NM

IA

MN

AR

WI

AL

LA

FL

MS GASC

NC

KY

TN

IN

MI

NY

PA

MD

OH

VAWV DE

MEMA

ILNJ

CTRI

NHVT

DC

Green States = 96% - 98% Match

Black States = 98% Match

Yellow States = 93% - 95% Match

Red States = ≤ 92%

Provider Concentration by State


Staffing Recommendations

• Director – Masters level, CEAP/licensed

• Clinical Manager – Masters level, CEAP/licensed

• Affiliate Managers – Masters level, CEAP prepared/ license preferred

• Network Development Specialist – Masters level

• Credentialing Specialist – Masters level

• PNS Systems Coordinator


Provider Portal

• Intake• Progress Notes• Case Closure• Linked to Case Management system and Client

Dashboard reporting of outcome measurements and ROI• EAP Training


Network Quality Monitoring

• Credentialing Committee- Director, VP Operations, Corporate Attorney, PNS Staff- Sanction monitoring/review

• Identified both through credentialing process and weekly sanction monitoring through Council on Affordable Healthcare (CAQH)

• Appeals Committee- Director, VP Operations, Cooperate Attorney, PNS Staff- Review any written request from a provider

• Process- Provider placed on temporary inactive while reviewed and investigated


Network Communication

• Provider Advisory Committee

• Survey Provider Network – to assess level of satisfaction with LifeWorks

• Quarterly newsletter

• Email blasts

• Targeted Trainings/Ceridian LifeWorks Products Updates

• Phone and one-on-one support/clinical case consultation


Affiliate Comments

“Thanks so much for your help with this, Carolyn! It is much appreciated. You have accomplished this so quickly, compared to other companies that I work with.”

“Thank you and please let your supervisor know that you have been great to work with. So uncommon these days!!!”

“You have made a very difficult situation for me almost a dream come true. I wish there were more customer service people like you that understand what real customer service is really about. Tell your boss that I said so, too!”

“Just wanted to say ‘Thank you so much!’ for your patience, assistance and hanging in with me to get his done. You must be a great asset to your company!”


EAP SERVICE MODELS


EAP Service Models

Internal (Staff Model)

External

Hybrid

EA provider is employed by the company. Member Assistance programs. Services offered by trained union members/employees.

Comprehensive EAP/Work-Life vendor supplied services offering all of the standard elements through a full service call center(s) and contracted provider affiliates.

Both vendor supplied services with regularly scheduled in person, onsite services. Onsite may be employed by vendor or contracted.


Session Models and Employer Oversight

• Determined by the client company:

- Average 3 sessions to 8 sessions – with few exceptions

- Economics, workforce, behavioral health benefit, culture

- Possibly managed out of the employer’s: • Corporate/Regional Benefits Department• Health and Wellness Department• Occupational Health/Medical/Wellness Department


EAP SERVICES


EAP and Work-Life Services

20

SERVICES FOR PARTICIPANTS

(client employee/caller)

Counseling

Legal / Financial

Health Coaching and Wellness services

Research

Comprehensive website: Lifeworks.com

SERVICES FOR EMPLOYER (HR, all levels of management)

Management Consultation, Referral

Formal and Mandatory Case Management

Substance Abuse Assessment and Case Management

Consultation on employee issues and sensitive workplace situations

Onsite Support – Routine EAP Counseling

Onsite Support - Crisis Response

Risk and Threat Assessment


Top 10 Presenting Issues

1. Stress Management

2. Couples Relationship Issues

3. Depression

4. Family Relationship Issues

5. Divorce/Separation

6. Grief and Loss

7. Anxiety

8. Custody, Visitation and Child Support

9. Budgeting and Basic Money Management

10. Work Related Stress


Supervisors and EAPs – Different Views

What the Supervisor sees: Observable workplace behaviors

• Poor job performance

• Absenteeism / Tardiness

• Presenteeism

• Work accidents/injuries

• Poor workplace relations

• Workplace disruption

• Interpersonal

• Marital/Family

• Substance use

• Vocational

• Emotional

• Financial

• Legal

What the EAP sees: Underlying personal concerns


Top 10 Issues Selected on Website

1. Emotional Well-Being

2. Legal

3. Financial

4. Work

5. Parenting & Child Care

6. Managing People

7. Addiction & Recovery

8. Older Adults

9. Legal Issues

10. Health Management


Documents

© Ceridian Corporation. All rights reserved. BEST PRACTICES FOR DEVELOPING & MAINTAINING A HIGH QUALITY EAP PROVIDER NETWORK Sharon O’Brien, VP, EAP