EAPs More Available In Workplace
By: Joe Hornyak
Where once Employee Assistance Programs were reactive, providing counselling to employees with, for example, alcohol abuse problems, today’s EAPs are being used proactively to help employees make lifestyles changes to ensure better health, thereby helping to reduce employer benefit costs.
EAPs (Employee Assistance Programs) are gaining acceptance at Canadian employers, especially large employers. Indeed, there is a greater acceptance by employers and employees alike, around the value of EAP services. For larger employers with more than 1,000 employees, Rod Phillips, president and CEO of Warren- Shepell, says 80 to 85 per cent have a program of some sort.
There are a number of reasons why EAPs are becoming more available in the workplace.
One of the drivers was the events of 9/11. Throughout North America there was a sudden increase in the interest in EAPs as employers looked for ways to help employees traumatized by the events of that day. At Warren- Shepell, for example, the number of individuals served in the last three years has increased by almost 50 per cent.
Another reason for the rise in EAPs is the increased costs as the burden of healthcare is transferred to the workplace. Recently, Watson Wyatt suggested that the direct and indirect cost for healthcare to Canadian business is $33 billion. And employers can expect to carry even more of this healthcare burden. The aging population means there are more related health risks. Plus, Canadians will be expected to work longer to offset a tightening labour market, says Marcia Buchholz, executive director, Ceridian Lifeworks.
Total Benefits Package
Another noticeable trend in recent years is the development of partnerships between group insurers and EAP providers. Today all of the major insurance providers have partnerships with EAPs as these programs have become part of the total benefits package.
The reason EAPs came into existence back in the 1950s was because of substance abuse issues that were being experienced in organizations, says Charles Benayon, president and founder of Aspiria Corp. EAPs today offer counseling, worklife services, disability management, concierge services, legal services, financial services, and everything else you can think of," including things like dog walking.
Where once the focus was on treatment of specific problems, today, the focus is really on prevention, says Buchholz. “Envision, for example, an employee health continuum. At the early stages of the continuum you’ve got a healthy employee. As they age, illness starts to cause multiple absences and then full disability which requires some sort of return-to-work program. EAPs are moving from the tail end of that continuum to really focusing on early identification of the issues and taking a preventive approach to help control the mounting costs of benefits.”
And another solution was needed, says Phillips. “We’ve had a whole generation of benefits providers focused around plan design. But you can only design a plan so many ways before you need to take a good look at that mounting equation. We looked at some statistics from one of our group benefits partners that showed that you’re seeing increases in benefit costs of thousands of dollars as people move from their 30s to their 40s.”
This upward pressure on overall benefits bills has employers asking ‘what are we doing about this?’
The answer is to try to manage these costs by changing behaviour in employees. EAPs endeavour to do this.
“Yet, the common comment you get, and it’s entirely valid from a human resource leadership perspective, is we don’t have money for this new program. And that’s true in one sense,” says Phillips. “But, in another sense, they’re spending 10s of millions of dollars – in many organizations 100s of millions of dollars – around benefits costs. If you’re going to do that, you want to tell those organizations that there are some areas that they can focus on.”
So if one of the areas of focus is, for example, around obesity, “then we know that eight to 10 per cent of people are going to use the EAP, so let’s promote the nutrition program. Let’s try to have a specific impact. We’ve got a program in place. We know that it works more times than it doesn’t. We know that it doesn’t cost anything close to the cost of medical interventions or treatments related to diseases that are connected to obesity,” says Phillips.
That idea of the relationship between overall benefits costs and what the EAP program can do to address these costs was present even when EAPs were introduced years ago. Now it’s more relevant because the costs are higher.
There are two other shifts occurring here, says Phillips.
First, there has been an overall shift of acceptance of products including counselling. This is more of a societal shift. Individuals are more comfortable with the idea of getting help. Today, employee populations better understand the benefits of EAPs and other wellness programs.
Second, employers see that if they have a problem with obesity in the workplace, for example, and it’s costing a ton of money to pay for anti-cholesterol drugs, not to mention the cardiac drugs that follow or precede a heart attack, an EAP nutrition program – that’s quite inexpensive relative to the drugs – makes sense.
For success to happen, both the employer and EAP need to work together to develop a targeted, meaningful campaign that will impact lifestyle behaviour change among the employees. And that’s the real goal – behaviour change.
However, rather than looking at just one issue, EAP providers are trying to take a holistic approach to the employee. “We’re looking at all of the influencers that can have an affect on that employee, so it’s not just one program around smoking cessation, but looking at influencers such as personality, genetics, their home life, their lifestyle, their age, and what types of access to services that they have today,” says Buchholz.
“There is also a difference in terms of what we used to do. Rather than just oneoff types of interventions, we’re trying to package all of these together.” These include things such as stress prevention, nutrition counseling, lifestyle coaching, walking programs, education, and trying to affect all the intergenerational type of populations that employers have to try to find effective interventions for all employees.
The delivery of programs in terms of reaching out to employees has also changed. In the 1950s, if an employee had, for example, a drinking problem, their supervisor might take them aside and suggest that they get in touch with the EAP program to get some help.
While the EAP of 2006 still has that element, it may also be targeting lifestyle issues in an effort to prevent health issues which could have an impact on a company’s healthcare benefits costs. But, a supervisor can’t really suggest an employer get help for a weight problem because the employer wants to keep a lid on benefit costs.
So provider and employers now attempt to engage the employee in using the services, not just when they have an issue, but for lots of very positive reasons.
“We find that if we can get the employees requesting information on nutrition counseling, for example, they’ve then accessed our service in a very friendly, non-threatening way. It starts to build their confidence to use our service when they really need us,” says Buchholz.
“What we’ve had to do, when we’re looking at the wide variety of employees that are in the workplace these days, is come up with a lot of innovative ways to access our services. For example, there’s e-counseling where the employee can go in and confidentially use risk assessments on their own time at their own leisure with it remaining confidential and even autonomous in some situations. When you look at Gen-Xs and Gen-Ys, they want to be able to go in 24/7 and use these types of tools.”
However, there is also a responsibility to get management to not only buy into these programs, but to actually use them.
“You can have all the great programs in place, but you’re throwing money hand over fist at a losing proposition if you are not determining root cause,” says Buchholz.
As a result, the focus is not only on employee effectiveness, but on organizational effectiveness. For example, an employee attrition problem may be due to an ineffective supervisor or manager. So any interventions must couple employee and organizational effectiveness.
Managers must also learn that they represent the face of the organization. If they are burnt out or they are not leading by walking the talk, then it’s just words. They need to know how to deal with stress and also how to manage employees in a workplace that’s growing increasingly stressful.
While utilization of EAPs is still less than 10 per cent, this is changing.
“When I first started in this business in the mid-1980s, one of the account manager’s jobs was to promote the services to organizations because the more you promote it, the more people will use the service. We were having a hard time getting employees to use the service. If we reached a five per cent level of utilization over a year, that was significant.
Today, the industry average is running between eight and 10 per cent of an organization’s population over a 12-month period,” says Benayon.
Yet, while utilization rates in general are starting to shift upwards, the reasons for this shift are problematic.
Benayon says the increased usage is due to various reasons, but mostly because things are not great in companies. “People are suffering more from high levels of stress, depression, and from substance abuse. People are finding that their boundaries between their work life and home life are blurred and sometimes don’t even exist. Once, we were able to say ‘no, I’m leaving my work at work.’
Draw The Boundary
“With the advent of technology – computers, blackberries, and the like – the employee is mobile, and with mobility comes the challenge of where do you draw the boundary. Today, everybody we talk to that comes into the EAP, seems to be feeling so much stress because they can’t get home to their families, they can’t leave their work behind.”
However, while employees at large companies can access EAPs to help them deal with these stresses, both Phillips and Benayon believe small to mid-sized organizations need to introduce EAPs into their companies as a way to tackle unhappy employees or employees with high stress.
“They’re the ones who either don’t necessarily have a budget or can’t see the impact of an employee’s mental health on performance and, subsequently, how that’s going to affect the bottom line,” says Benayon. “They don’t necessarily see that by making an EAP available to employees where they can solve their problems, it will free up the manager from having to deal with the issues themselves, when there are so many other priorities management needs to focus on.”
Joe Hornyak is executive editor of Benefits and Pensions Monitor.
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