Partners In Accident Prevention:
More than avoiding banana peels,
safety management means EAP leveraging.
Behavioral Healthcare Tomorrrow- February, 2000

While most of us think of safety guards or resistant flooring when it comes to accident prevention, the Workers' Compensation industry has begun to laud employee assistance programs (EAPs) as a new safety strategy.  One reason for this attention to accident-free workplaces is disturbing industry performance results over the List decade. While lost-time injury cam declined from 3.9 percent of an injury cases in I 990 to 2 percent in 1997, employer costs for workers' increased from 2.1 to 2.3 percent of all employee compensation.

With cross-currents like these, carriers am finding it's not enough to stem the flow of -worked compensation awards through early injury management or the use of medical doctors, nurses an psychiatrists to get injured workers back on the job. Some have begun to press for even better accident prevention by focusing on support programs and other practices that improve work life for employees.

At first blush it * to be a marriage of incompatible parters. After all, the traditional bastion of EAPs is behavioral health and well-being, while workers' compensation focuses on reducing unsafe conditions in the physical work environment. By following their respective evolutionary trends, however, one finds that today each has much to offer the other. " The mind-body research that we are seeing now has shown us that we need to pay more attention to attitudinal and behavioral risk factors in order to prevent accidents resulting in physical disability," says Daniel S. Cote, vice president of safety consulting for the Portland-based Maine Employers' Mutual Insurance Company (MEMIC).

Meanwhile, 'EAPs are looking more and morte beyond mental health and psychological illness as the basis for their interventions, says Steve Stevens, president and chief executive of Portland-based Stevens Wellspring Group (SWG), a provider of workplace services. "They are increasingly being used for producing improvement and loss prevention.'

Small wonder, then, that MEMIC and SWG have joined forces in a New England-based partnership, one that could become- a model for other parts of die country. Insurers typically have a large pool of relatively healthy customers supporting a smaller pool of higher-risk customers. The better that an insurer controls the incidence and severity of accidents among the higher-risk customers, the more successful it is. Once MEMIC's higher-risk custoemrs are identified, SWG can apply its stock-in-trade to reduce risk.

In effect, SWG is an employer assistance program offering an army of services that easily can be plugged into an organization based an its needs. Those services start with a front-end organizational audit of behavioral problem (performed by either SWG or MEMIC's risk managers), then back-loaded with solutions for problems identified in the audit.

Solutions offered by SWG include individual problem assessment and referral; group -based conflict management; critical-incident debriefings; dependent care services; telephonic screening for depression and alcohol dependency; organizational consultations; and management and employee training.

MEMIC's customers can gain access to help in two ways. " Customers can contact SWG when the yave concerns about workforce problems. Also, MEMIC refers their highest-risk customers to us," said Stevens, noting that premium costs associated with a poor accident record are a powerful incentive for insurance custoemrs to follow through on SWG's reccommended programs and services, which the customers may purchase from SWG or another provider.

Partnering for organizational development

Within work organizations, EAP's have new opportunities to partner due to the workplace reality of perpetual change. Ever since the turmoil created by mergers, acquisitions and downsizing began during the 1980's, the new status quo in business is said to be no status quo.

"Stress and uncertainty are problems facing every work organization," explained Ann Kruse, president of InterDynamics, a Seattle-area organizational development practice. "Today we see a lot of uncertainty about employee's skills, roles and continued employement. While the so-called 'transformational change' causing the uncertainty is praised by managment gurus, it compounds the everyday stress felt by employees."

One of the everyday stressors in many workplaces is working with people of different cultural, occupational and organizational backgrounds. "As a result of trends like diversity mangement and cross-functional teams, employees have to negotiate how they will work together, and in order to do that they first have to negoiate a language they will use to communicate," said Kruse. This creates opportunties for workplace change agents such as organizational development consultants.

"Personal and interpersonal issues will inevitably aris. When these problems don't get resolved on thier own terms, this creates a need for professional intervention." Thus, the EAP as employee problem-solver has the opportunity to partner with organizational development (OD) specialists.

TURNOVER: A defining issue

Another workplace problem that gives many of today's employeres a thumping headache is turnover. "Worker retention is screaming for attention right now," said Jodie Collins, president of Employee Assistance Programs International in Denver. "Employee loyalty is probably at an all-time low right nwo. When you combine that with low unemployment, easy job mobility and plain old supply and demand, employers have a big problem."

While Collins sasy employee retention has not historically been a primary EAP concern, it si oe in which programs can leverage their workplace expertise. She cites a situation involving one of her company's clients, a Colorado based mining company. The company was whipsawed by young, second-generation miners preferring to depart for the city, as well as some who turned up positive on drug tests.

"We helped them on several different fronts, because there wasn't a single magic bullet to the problem," Coffins explained. EAPs International consulted with the company's leadership on improving its vertical communication so that employees better understood the company's mission, priorities and expectations. It also provided employee training and facilitation to change management; offered back-to-work conferences for employees on' short-term leave -for general medical and addiction problems; apprised leadership about employee relations concerns, such as gender and diversity issues, and problems caused by shift work and recommended policies to promote flexible work schedules

Collins says EAPs that haw de-emphasized workplace issues such as retention at the expense of clinical case management have been slower to react to new opportunities.

"Many large managed cue conglomerates have acquired EAPs, stuck to 'their primary healthcare orientation, and passed on only watered-down-workplace services," she said. "Like many industries that are overly consolidated this has created rich opportunities for specialty EAPs to capitalize on the frustration among customers who are weary of acronyms,call centers that are a state or even a continent away, and account reps that change on a weekly basis. It forces EAPs to decide whether they are a healthcare provider or a human-resource support system."

This choice, say, many industry experts, will winnow the field over time, leaving those EAPs that become a true support system.

Philip A. Hess, president of Indianapolis-based workplace Services Corp., agrees with the need for EAP solutions to retention problem "The rift in the field has been widening for yew. It was just a matter of time before an issue came along that would clearly expose and define it. That issue is now here."

Studies have shown that employees value interesting work. recog- and involvement in daily operations more than they do com- and benefits The opposite -is ture for supervisors. Knowing this, savvy workplace experts know that "stacking pre-fab- benefits like '1-800' counseling on top of each other in the name: of employee assistance isn't 0% to help employers deal with hard-core business problems like turnover," Hess said.

"It's not that EAPs Amid ignore die behavioral heal& problems they have always dealt with in problem assessments. Its that EAPs now need to take a stronger preventive role by helping improve the environment in which employees work. It's time, we recognize that. the am work environment that leasds to chronic turnover can also

lead to stress patterns and emotional problems." While its one thing to talk about solving organizational problems – as most EAPs do- it's another to deliver according to James M. Oher, a Chappaqua N.Y.-based EAP consultant and author of The Employee Assistance Handbook, published in 1999 by John Wiley & Sons. He offers this advice: EAPs must have greater worksite visiblity and more knowledge of the business, industry and jobs. Supervisors and team leaders will want to know EAP staff on a personal level in order to seek help for serious performance issues. `

"Even more, EAPs must require stronger knowledge of how power relationships and group dynamics influence attitudes and behaviors. This is a major challenge for EAP professionals whose education on has been in addictions and mental health and whose professional experience has been based on employee advocacy. Some EAPs complain that OD folks keep knocking us out of the box with respect to influencing leadership decisions in companies. This tells me that our field needs better skills in organizational assessment and dealing with interpersonal and group problems."

The Internal EAP's Perspective

In the business marketplace there has been a two-decades-long trend toward outsourcing EAPs and other services that are not in an organization's manufacturing or service delivery core. Those in-house programs that continue to survive have leveraged their value through internal consulting and network-building.

According to Bernard Be'" who is currently director of the Office of Employee Assistance in the U.S. House of Representatives, he has partnered with other workplace professionals on projects and task form related to violence prevention, per- management system development employee recognition and quality control, and strategic planning.

"There is a trade-off in the advantages had by internal and external EAPs," Beidel said. "Whereas an external program can fre- take the experiences it has had in one organization a and
apply them to another, an internal program can view issues and problem more closely. This is because being a part of the organization often affords the employee assistance professional the knowl- of the critical partnerships" necessary for organizational change. For example, a corporate reorganization may create opportunites for the EAP to parnter with benefits, compensation, training and others in order to prepare employees for the transistion.

EAPs have discovered the most fundamental rule of marketplace survival:

You can accomplish a lot more by partnering with others than you can by standing alone. As EAPs find new allies for mutual gain and security, they are strengthening their workplace roles and will be better able to roll with the changes in the mercurial world of business.

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