Over the years, a number of organizations have written informative pieces on various standards for the Employee Assistance Program (EAP) industry.
In 2008, the National Business Group on Health created an employer’s guide1 with recommendations for strategically defining, integrating, and measuring EAPs. In 2010, the Employee Assistance Professionals Association updated its standards and guidelines2 including fundamental and essential components required for an effective EAP. And in 2015, the Employee Assistance Society of North America3 published made its detailed case for EAP and elaborated on the value to businesses.
The National Behavioral Consortium (NBC) is a trade association consisting of 14 regional/national EAPs that deliver services to more than 22 million members across the U.S. and internationally. One goal of NBC is to further define the types of services that are available among the wide range of EAPs sold in today’s marketplace.
NBC Survey
Due to changes in the industry, a subcommittee from the National Behavioral Consortium (NBC) decided to revisit basic standards for EAP programs. One change in particular that has been noted, has been the growth in the types of EAPs available and the potential for confusion among employers as they attempt to distinguish between one product and another. The selection of EAP products can be described as ranging from limited service EAPs, often embedded in other ancillary (e.g., life or disability) products to more traditional EAPs that offer high touch services not financially connected to any other benefit offerings.
In some cases, the cost of limited service EAPs can be obscured due to bundling the service with other products and they might be described as “free,” or embedded in such a way that the actual cost cannot be specified and the parent product cannot be purchased without that EAP. In the case of traditional programs, the cost can be seen as high by contrast with sellers pressured to demonstrate a return. Some sellers specialize in one end of the spectrum or the other, while some cover the gamut with a full range of choices.
The NBC sub-committee has initiated a series of internal studies to try to help define this confusing array of product choices that it believes are often misperceived as equivalent except for price. Phase 1 of this effort was to establish standards for basic services for what would be considered a full service EAP.
The first step in this process consisted of a survey of NBC EAP member organizations which will be described here. The survey looked at five basic EAP components: intake, clinical referrals, organizational services, utilization reporting, and marketing.
The Committee drafted a set of 37 questions paralleling these components with the hope of coming to a consensus on basic operational standards for full service EAP products.
Results and Analysis
Of the 37 standards presented, the subcommittee was particularly interested in standards that elicited a response of “agree somewhat” or “agree totally” at the rate of a combined 80 percent or more. More than half of 37 questions elicited responses with that level of agreement:
Intake/Access Center Operations
1. Use bachelor level clinicians (at a minimum) to conduct most intakes as long as licensed clinicians are readily available for possible risk assessment. (87%)
2. Inbound call centers should have minimum performance standards for metrics such as average speed of answer and abandonment rates (for example, <30 seconds and <3 percent respectively.) (83%)
3. All callers requesting EAP counseling services should receive some degree of psychosocial and risk assessment before being assigned to a clinician or network provider. (80%)
Network Providers/Affiliates
1. When callers request or are likely to benefit from ongoing counseling sessions beyond EAP, effort should be made to refer them to an EAP provider who is also in their insurance’s behavioral health network. (87%)
2. Clients with counseling requests should only be referred to providers with known availability. (83%)
3. All clients should be offered a timely follow-up contact by their preferred method (phone, email) for the purpose of seeing how the person is doing. (80%)
4. All clients should be offered follow-up satisfaction surveys. (100%)
5. All clients should be offered pre-post outcome surveys appropriate to the services delivered. (90%)
6. EAP services should be accessible through several entry points such as telephone, chat, and/or email. (97%)
7. EAP network providers used for counseling sessions should be licensed and insured. (100%)
8. EAP networks should include sufficient numbers of providers who can conduct telephone or video counseling to accommodate callers’ requests. (97%)
Organizational Services
1. Mandatory, last chance, or condition-of-employment referrals should be managed by a senior EAP staff consultant. (93%)
2. Requests for critical incident response should be handled immediately. (100%)
3. Requests for critical incident response include needs assessments conducted by a senior EAP staff consultant. (93%)
4. Account managers or representatives of the EAP should proactively contact client organizations, even if the client organization doesn’t respond or take advantage of the outreach. (100%)
5. The EAP should push out some form of newsletter or other monthly content for the purpose of increasing utilization, even if the client organization doesn’t take full advantage of it. (93%)
6. Manager training about problem identification and referral should be readily available, live or recorded. (97%)
7. A minimum set of “core metrics” should be considered standard to allow comparisons between EAP sellers and to facilitate accurate pricing. (83%)
Utilization Reporting
1. One core metric could be an understanding that utilization is based on unique users, not web hits, or sessions. (86%)
2. Without too much work, an organization like EAPA, EASNA, or NBC could set these “core metrics” as standards. (90%)
3. Satisfaction data should be included in utilization reports. (86%)
4. Pre-post outcome data should be included in utilization reports. (82%)
Sales and Marketing
1. EAPs that sell ‘bronze-silver-gold’ products should clearly distinguish what is included or a la carte at each level. (89%)
2. Agents or brokers who sell EAPs should have a minimum level of education or certification, just as is required for selling other health and wellness products. (85%)
3. An organization like EAPA, EASNA or NBC could offer such education/certification to agents or brokers. (93%)
Conclusions:
While preliminary, NBC member organizations expressed a high level of agreement on many standards that could be used to help purchasers identify full service EAP product from those offering limited service. Some standards might be met by all EAPs, while others, such as management consultation, crisis response, outcome reporting or proactive promotional activities could help purchasers distinguish service levels.
References:
1. An Employers Guide to Employee Assistance Programs, National Business Group on Health, Center for Prevention and Health Services (2008)
2. EAPA Standards and Professional Guidelines for Employee Assistance Programs, Employee Assistance Professionals Association, Arlington, VA, (2010)
3. Selecting and Strengthening Employee Assistance Programs: A Purchaser’s Guide, Employee Assistance Society of North America. Arlington, VA (2015)