6.800.3 Employee Assistance & Worklife Referral Program 6.800.3.1 Overview and Purpose 6.800.3.2 Legal Basis and Authorities 6.800.3.3 Definitions 6.800.3.4 Policy 6.800.3.5 Program Components 6.800.3.5.1 Employee Assistance Program (EAP) Services 6.800.3.5.1.1 Changing Counselors 6.800.3.5.1.2 Management Consultation Services 6.800.3.5.2 Work-life Referral Services 6.800.3.5.3 Training and Education Services 6.800.3.5.4 Critical Incident Stress Management (CISM) Services 6.800.3.5.5 Transition Counseling Services 6.800.3.5.6 Wellness Coaching 6.800.3.6 Using Administrative Leave for EAP Services 6.800.3.7 Privacy 6.800.3.8 Confidentiality 6.800.3.8.1 Record Ownership 6.800.3.8.2 Relationship to State Laws and Other Confidentiality Regulations and Requirements 6.800.3.8.3 Electronic Record Keeping 6.800.3.8.4 Period of Maintenance 6.800.3.9 Disclosure 6.800.3.9.1 Disclosure With Consent 6.800.3.9.2 Disclosure Without Consent 6.800.3.9.3 Disclosure Not Covered by Federal Laws and Regulations 6.800.3.9.4 Releases of Information to and from Supervisors and Managers 6.800.3.9.5 Releases of Information to Human Capital Offices, Labor Relations Staff, Union Representatives, and Other Programs and Organizations Who Work with the EAP 6.800.3.9.6 Secondary Disclosure 6.800.3.10 Referrals to EAP 6.800.3.11 Residential and Community Resources 6.800.3.12 Relationship with IRS Drug Free Workplace Program 6.800.3.12.1 Referral and Availability 6.800.3.12.2 Assistance with Safe Harbor Provisions 6.800.3.12.3 Employee Education and Supervisor Training 6.800.3.12.4 Relationship with Drug Testing Provisions Exhibit 6.800.3-1 Contacting the IRS Employee Assistance and Worklife Referral Program (EAP) Exhibit 6.800.3-2 SAMPLE Exhibit 6.800.3-3 Sample Exhibit 6.800.3-4 Sample Exhibit 6.800.3-5 Sample Part 6. Human Resources Management Chapter 800. 0 Employee Benefits Section 3. Employee Assistance & Worklife Referral Program 6.800.3 Employee Assistance & Worklife Referral Program Manual Transmittal May 29, 2013 Purpose (1) This transmits revised IRM 6.800.3, Employee Benefits, IRS Employee Assistance and WorkLife Referral Program. Material Changes (1) IRM 6.800.3.5.3 - Verbiage changed for clarity. (2) IRM 6.800.3.5.5 - Verbiage changed for clarity. (3) IRM 6.800.3.5.6 – Added information on wellness coaching. (4) IRM 6.800.3.8.1 - Verbiage changed for clarity. (5) IRM 6.800.3.9.4 - Added additional clarifying verbiage. (6) IRM 6.800.3.10 - Verbiage changed for clarity. (7) IRM 6.800.3.11 - Verbiage changed for clarity. (8) IRM 6.800.3.12.2 - Verbiage changed for clarity. (9) Exhibit 6.800.3-2 – Added additional clarifying verbiage. (10) Exhibit 6.800.3-5 – Added new exhibit. Effect on Other Documents This IRM supersedes IRM 6.800.3, issued October 7, 2011. Audience All Divisions and Functions Effective Date (05-29-2013) Karen Becton-Johnson Director, WorkLife, Benefits and Engagement Division 6.800.3.1 (05-29-2013) Overview and Purpose This IRM provides broad policy and guidance on the IRS Employee Assistance and Work-life Referral (EAP) Program. It further provides definitions of unique terms and agreements. The IRS EAP is designed to help an employee deal with any personal, family or job related concern that could interfere with performance or conduct at work. Federal agencies have the authority to establish health services for the promotion and maintenance of the physical and mental fitness of employees in the Federal Government. The EAP falls under this authority. The Internal Revenue Service (IRS) recognizes the importance of its employees and realizes employees may experience a wide range issues impacting their worklife balance, families, health/wellness, or job performance. On a voluntary basis, employees may freely use the EAP for access to resources and tools, confidential counseling, health coaches, legal or financial services. The EAP is a formal, non-disciplinary program designed to assist employees and their immediate families in a variety of issues—mental, emotional, familial, financial, legal, drug and alcohol abuse, etc.,— that may adversely affect both an employee’s job performance and personal life. Assistance is provided through consultation, evaluation, counseling, and/or referral to community resources and treatment facilities. Work-life referral services are available to help employees find solutions to the daily challenges of personal, work and family issues. Employees may use work-life concierge services to answer questions on finding child care, finding housing, managing financial stressors, legal guidance or figuring out how to take care of an aging parent who might live far way. 6.800.3.2 (10-07-2011) Legal Basis and Authorities Health services for Federal employees are authorized by Public Law 79-658. These services are provided to promote the physical and mental fitness of Federal employees. The authority for substance abuse programs is found in: Sec. 201 of Public Law 91-616, 84 Stat. 1849, as amended and transferred to Sec. 520 of the Public Health Services Act by Sec. 2(b) (13) of Public Law 98-24 (42 U.S.C. § 290dd-1), and Sec. 413 of Public Law 92-255, 88 Stat. 84, as amended and transferred to Sec. 525 of the Public Health Services Act by Sec.2(b)(16)(a) of Public Law 96-24 (42 U.S.C. § 290ee-1). Public Laws 96-180 and 96-181 authorized agencies to provide counseling services, to the extent feasible, to family members of employees who have alcohol and drug issues, and to employees with family members who have substance abuse issues. Public Law 99-570, The Federal Employee Substance Abuse Education and Treatment Act of 1986, and title 5 Code of Federal Regulations (CFR) Part 792, require Federal agencies to establish appropriate prevention, treatment, and rehabilitative programs and services for alcohol and drug abuse issues for Federal civilian employees and to report annually to Congress on these programs (5 U.S.C. § 7361 and § 7362). 5 U.S.C. 7901 (law authorizes health programs for Federal employees). 5 U.S.C. 7904 (law mandates EAPs for employee alcohol and drug abuse). 5 U.S.C. 552a (law-Privacy Act of 1974 insures confidentiality of Federal records). 42 CFR Part 2 (regulation-confidentiality of alcohol and drug abuse patient records). Executive Order 12564 requires agencies to establish drug-free Federal workplace programs, including an Employee Assistance Program (EAP) as an essential element in achieving a drug-free workforce. Agencies must refer all employees found to be using illegal drugs to the EAP for assessment, counseling, and referral for treatment or rehabilitation, as appropriate. Additional information is available on the Employee Resource Center (ERC): http://erc.web.irs.gov/Displayanswers/Question.asp?FolderID=5&CategoryID=129&SubCategoryID=214 and the Office of Personnel Management at www.opm.gov website. 6.800.3.3 (05-29-2013) Definitions Alcohol/Drug Abuse - The excessive use of alcohol or drugs in a manner that may impair a person's physical, mental, emotional, interpersonal, occupational, and economic functioning. Assessment - An ongoing process or evaluation in which professional expertise and skills are exercised to collect and analyze data, which in cooperation with the client, results in identifying, defining and prioritizing the client’s physical, mental, and social issues, issues or challenges. An assessment provides for an accurate diagnosis of the client and the basis for a treatment or issue solving plan. Client - An individual who is eligible to receive EAP services, as defined by agency policy or contract requirements. A client might include an employee or the employee’s spouse, dependent child, parent, domestic partner, or a retiree (who meets the requirements of Section 6.800.3.4). Community Resources - Organizations such as treatment and rehabilitation facilities and programs that exist in the community, such as Alcoholics Anonymous and other self-help groups. Critical Incident - An event, usually sudden, unexpected and potentially life-threatening, “in which a person experiences a trauma, i.e., feels overwhelmed by a sense of personal vulnerability and/or lack of control. Examples of a critical incident are a natural disaster, serious workplace accident, a hostage situation or violence in the workplace.” Critical Incident Stress Management (CISM) - The constellation of services or activities that may be used by an organization to respond to and manage a critical incident. Services include, but are not limited to, debriefings, outreach to the workforce, anniversary responses, etc. A critical incident debriefing is a meeting or series of meetings held with the workgroup following a critical incident. Drug Free Workplace Program (DFWP) - Those laws, regulations and policies emanating from Executive Order (EO) 12564 of September 15, 1986, and subsequently the Drug Free Workplace Act of 1988, that ordered Federal employees to refrain from using illegal drugs, whether on or off duty. It mandates that the head of each Executive agency shall develop a plan for achieving the objective of a drug-free workplace. Elements of the plan include establishing a program to test for the use of illegal drugs by employees in sensitive positions; training for managers and employees; and establishment of EAPs that emphasize high-level direction, education, counseling, referral to rehabilitation, and coordination with available resources. Emotional/ Behavioral Issues - issues, such as financial, family, marital issues, etc., that may have an adverse impact on employee performance, conduct, or reliability. Personal issues may impair job performance. Such issues may include financial or marital difficulties, psychiatric or physical illnesses, drug and/or alcohol abuse, death of a family member, etc., and those stemming from personal issues of another person, such as a supervisor, co-worker, or a spouse. Employee Assistance Program - An EAP is a worksite-based program designed to assist in the identification and resolution of work-related and non-work-related issues associated with employees impaired by personal concerns including, but not limited to health, marital, family, financial, alcohol, drug, legal, emotional or other personal concerns which may adversely affect employee job performance. External EAP Service Provider - A company external to the agency providing EAP services on a contractual basis. Family Member - Any member of the employee’s immediate household who is a dependent and/or spouse/domestic partner who shares financial and family caretaking responsibilities. Management Consults - Expert advice given to leaders, supervisors, human resources and/or union representatives regarding the management of potential or actual performance and conduct concerns. One example is coaching a supervisor on how to refer an employee to the EAP. Management Referral - Referrals to the EAP that are initiated by an employee’s manager/supervisor because of performance or conduct concerns. Such referrals can be oral or in writing and are not considered disciplinary actions. Presenting Issues - The personal concern or issue as described by the EAP client prior to assessment by the EAP professional. Release of Information - A document signed and dated by a client, giving the EAP (counselor) permission to release specific information about the client, to a person outside of the EAP. Safe Harbor - A self-referral option which allows any employee to step forward and identify him/herself as an illegal drug user for the purpose of entering a drug treatment program under the EAP. Safe Harbor allows employees to seek rehabilitative assistance from the agency EAP in accordance with Executive Order 12564 prior to being identified through other means. Self Referral - An employee who voluntarily seeks EAP assistance or who seeks EAP assistance at the recommendation of a union representative, co-worker, friend, family member, nurse, etc. Session - A meeting between an EAP counselor and client, usually lasting 45 to 60 minutes. Short-term Counseling/Treatment - Services provided by the EAP counselor to the employee/client for approximately 1 to 4 sessions. When counseling is required beyond the number of sessions originally provided, the EAP counselor is expected to ensure the employee is referred to a Federal Employees Health Benefit (FEHB) plan or additional community resources. Work-life - Consist of practices, policies and programs that support the efforts of everyone in the workforce to achieve success at work and at home. 6.800.3.4 (05-29-2013) Policy The IRS Employee Assistance and Work-Life Referral Program is a voluntary, confidential counseling and referral service provided to all employees and their immediate family members. “Immediate Family Members” is defined as members of the immediate household who are dependents and/or spouses/domestic partners who share financial and family caretaking responsibilities. IRS employees who separate (e.g., retirement, voluntary separation, involuntary separation) from the IRS as a result of agency technology, restructuring, and workforce initiatives are also eligible for six (6) months of coverage after separation. Participation in the EAP is voluntary and confidential and will not jeopardize an employee’s job security or promotional opportunities. The IRS EAP offers short-term counseling and referral services for a variety of issues such as mental health, emotional, family, financial, elder and dependent care, legal difficulties, etc. There is no cost to employees or family members who receive counseling and other services provided directly by EAP. There are times when it is appropriate to refer employees and/or family members to outside community resources or their Federal Employees Health Benefit (FEHB) plan. When employees accept these referrals, they are responsible for the fees charged by the facility and/or health plan. The EAP works with employees and/or their family members to keep the cost within their financial means. EAP counseling helps employees identify and assess issue(s) and also helps employees in issue solving. EAP provides employees with a maximum of four counseling sessions per issue, per calendar year [i.e., for each issue an employee may receive 4 sessions (4 sessions for grief, another 4 sessions for stress, etc.)] All counseling is strictly confidential. The confidentiality of all employees and managers in consultation and debriefings will be adhered to as required under the Privacy Act, Health Insurance Portability and Accountability Act (HIPPA) and Disclosure Laws. Client information may not be released to anyone without their prior written consent, except as required by law. Employees can contact the EAP directly. Their contact, participation in the EAP and any recommended treatment is confidential and will not be disclosed to the organization. No penalty may be imposed upon an employee for accepting or declining to participate in the EAP. The fundamental purpose of the EAP is to enable employees to achieve their full individual potential, even when stress and issues in their working or personal lives present difficult challenges. EAP will make referral, where appropriate, to a community service or professional resource that provides treatment and/or rehabilitation. With the exception of illness or injury directly resulting from employment and compensable under the Federal Employees' Compensation Act (FECA), medical care and treatment are personal to the employee and, therefore, payment may not be made from appropriated funds unless provided for in a contract of employment or by statute or by regulation. All employees of the IRS are considered partners of the EAP and are encouraged to support the program’s objectives and philosophy. Employees are encouraged to utilize the EAP when they have issues of a personal nature related to work and family. Management may utilize the EAP to assist employees who may need guidance in handling personal concerns and to help with organizational issues that may be affecting the mental health of employees. Unions are also regarded as partners of the EAP and whenever appropriate, may support the objectives and policy of the EAP. 6.800.3.5 (10-07-2011) Program Components The Employee Assistance and Work-life Referral Program helps employees and their immediate family members resolve personal and work-related issues. The program has two main components: (1) Employee Assistance Program and (2) Work-life Referral Services. In addition, the Program offers additional support and services to the agency. 6.800.3.5.1 (05-29-2013) Employee Assistance Program (EAP) Services The EAP provides telephonic and in-person clinical services to help employees and their immediate family members address stressful life issues and personal concerns. The program is available to IRS employees and their families, 24 hours per day, 7 days per week, 365 days per year. Employees may meet in person with a counselor in their community or with a member of the EAP telephone counseling staff. Employees are entitled to a maximum of four counseling sessions per calendar year for each presenting issue (4 sessions for grief, 4 sessions for stress, etc.). If further counseling is needed after the four-session EAP limit, EAP counselors will assist employees in arranging care through their own health insurance plan or other community resources. Sessions with an EAP counselor can be over the telephone from the office and/or home or in person with a local therapist. The EAP can help address a variety of concerns, including: Marital and family conflicts Career transitions, job pressures Grief and loss Anxiety and stress Drug and alcohol abuse Physical or emotional abuse Major life change Depression 6.800.3.5.1.1 (10-07-2011) Changing Counselors If an employee is dissatisfied with the professional counseling (either telephonic or face-to-face sessions) received, they have the option of seeing another counselor (at no additional cost or loss of counseling sessions) until the EAP service is provided satisfactorily. Employees are referred to the same telephone counselor for each call unless otherwise requested by the employee. 6.800.3.5.1.2 (05-29-2013) Management Consultation Services Managers who have concerns about a specific employee whose conduct or personal issues are affecting his or her performance and the performance of the work group can call the EAP to request a management consultation. Specially trained consultants will help managers refer their employees experiencing issues to the EAP. 6.800.3.5.2 (10-07-2011) Work-life Referral Services Work-life Referral Services help employees find solutions to the daily challenges of personal, work, and family life through consultation and referral to local and community resources. The program provides information and referral to assist with life events of all kinds. For concerns ranging from workplace stress to caring for a young child or an elderly relative, employees have access to a wide variety of resources to help manage their work-life balance. Work-life consultants address a variety of concerns, including: Family Issues Choosing a day care program Becoming a parent Purchasing a car Repairing your home Planning for college Understanding Medicare Finding quality care for an elderly relative Moving/Relocation Legal Issues Confidential access is available to legal professionals who are dedicated to providing practical, understandable information and assistance to assist employees in resolving legal issues, including: Divorce and family law Bankruptcy Debt obligations Criminal actions Landlord and tenant issues Civil lawsuits Real estate transactions Contracts Financial Issues Financial professionals are available to discuss concerns and provide employees with the tools and information needed to meet financial goals. Employees may consult with financial specialists about personal money management questions and receive the information needed to make the best decisions on issues, such as: Saving for college studies Getting out of debt Retirement planning Estate planning On-line information and research services Expert information, resources and referrals on behavioral health, dependent care, and legal or financial matters are available via the internet at the external EAP service provider’s (contractor’s) website. 6.800.3.5.3 (05-29-2013) Training and Education Services The EAP/Work-life Program provides formal and informal training sessions (e.g. employee orientations, webinars, workshops, brown bag lunches, support groups, manager training, union briefings, wellness and educational sessions) that encourage referral to the program: Orientation sessions to introduce employees to the Employee Assistance/Work-life Program and its provisions. Manager training sessions to provide managers with knowledge on how to use EAP services and how to use the critical incident and referral services for job performance issues. Also provides management training in response to work setting changes—change management, redeployment, workplace stressors—by request of managers for their work groups. Wellness sessions to provide employees with ways to identify issues, encourage help seeking issue resolutions and offer insight and relief from issues by directing them in some cases to EAP. Wellness educational sessions to provide information on specific information on specific topics, e.g., dealing with stress, conflict resolution, managing change, diet, exercise, etc. Education and counseling to employees in partnership with the IRS Smoking Cessation Program. Drug free workplace training/education for employees and managers in partnership with the IRS Drug Free Workplace Program (DFWP). Note: Employees should coordinate participation during business hours with their managers. The sessions are training and management may allow administrative time for employees to attend. 6.800.3.5.4 (10-07-2011) Critical Incident Stress Management (CISM) Services Critical Incident Stress Management Services are available to impacted IRS workgroups. CISMS are available to IRS work groups affected by a critical incident. Examples of critical incidents include deaths, serious injuries, incidents involving children or co-workers, personal assaults, industrial accidents, etc. Managers may contact the EAP directly to arrange for critical incident services. These debriefings usually involve three or more employees. EAP specialists help managers develop an action plan to respond to a specific incident. This can include on-site debriefings as well as counseling services. 6.800.3.5.5 (05-29-2013) Transition Counseling Services EAP Transition counseling services provide support to IRS employees impacted by reduction in force (RIF), technology and organizational changes. Transition Counselors are available at formal meetings/briefings to assist employees as needed. Transition counseling services must be ordered through the IRS EAP Program Manager. 6.800.3.5.6 (05-29-2013) Wellness Coaching EAP provides telephonic one-on-one wellness coaching to help employees toward lifestyle changes such as: Diabetes prevention Exercise Heart disease prevention Nutrition Stress management Tobacco cessation Weight management Note: Wellness coaching is at no cost to employees. Services are available during non-business hours and business hours. Employees must have manager approval to participate during business hours. 6.800.3.6 (10-07-2011) Using Administrative Leave for EAP Services Administrative leave may be granted to an employee for participation in the agency's EAP. Managers may grant administrative leave for visiting the EAP during duty hours. Employees may be granted up to one hour of excused absence, plus travel time, if applicable for the four free EAP sessions only. If a manager grants administrative leave for visiting the EAP during duty hours, the manager may request, with the employee’s written permission, proof of attendance at the counseling session. Confirmation of attendance will be provided by the EAP according to applicable confidentiality procedures. Employees must request and coordinate scheduling of an appointment during duty hours with their manager. Employees who do not want their managers to know of their attendance must arrange appointments outside official duty hours or while on official leave. During any period(s) of treatment and rehabilitation through an outside resource, employees must request to use their own annual or sick leave or request leave without pay in accordance with applicable law, rules and regulations. Administrative leave may also be granted for EAP employee orientation or education activities (e.g., general orientations, webinars, etc.). 6.800.3.7 (10-07-2011) Privacy The Privacy Act (5 U.S.C. 552a) covers all EAP records. In addition, EAP records of clients with alcohol and drug issues are protected further by 42 CFR 2 Part 2, "Confidentiality of Alcohol and Drug Abuse Patient Records." EAP counselors must provide employees with a written notice concerning the confidential nature of EAP records along with the conditions where information discussed in counseling may be disclosed. Depending on the location of the counseling site and the professional background of the EAP counselor, the EAP records may also be protected by state and professional licensing/credentialing laws and regulations. Generally, these laws and regulations prohibit EAP staff from sharing any information about clients to anyone outside of the EAP, without the specific written consent of the client. Employee participation in the EAP is confidential and strictly voluntary. However, if a manager or union steward recommends an employee seek EAP assistance, then, with the employee’s written permission, the manager or union steward can be notified as whether or not the employee attended the session and request an assessment of how much work time will be needed for continuing counseling or rehabilitation. The counselor cannot discuss any additional information because that information is covered by the Privacy Act. 6.800.3.8 (10-07-2011) Confidentiality All records of the EAP, whether written, oral and electronic are covered by this policy. This applies to records generated and/or maintained by IRS employees who are EAP staff or contractual EAP staff. The contractor is responsible for maintaining confidential records on clients and these records must be maintained in a system of records. Only those individuals working directly with the program's clients have access to EAP client records. Additionally, the agency EAP National Program Manager may have access to the records for the purposes of: Destroying EAP records at the end of their period of maintenance. Transferring EAP records from one contractor to another. 6.800.3.8.1 (05-29-2013) Record Ownership Contractors are custodians of EAP records while under contract to the agency. All EAP records are the property of the Internal Revenue Service, including those generated and/or maintained by contractors. At the completion of any contract, EAP records still in existence will be surrendered by the contractors to designated persons in IRS (i.e., the EAP National Program Manager) or will be transferred to another contractor with the express permission and instructions from IRS staff responsible for the records. 6.800.3.8.2 (10-07-2011) Relationship to State Laws and Other Confidentiality Regulations and Requirements The laws and regulations governing the EAP should not be construed to authorize any violation of state law, in the event that a state law has greater restrictions than these regulations. Also, no state law may either authorize or compel any disclosures prohibited by these regulations. 6.800.3.8.3 (10-07-2011) Electronic Record Keeping Confidentiality safeguards for records stored electronically must be maintained. EAP data systems shall be protected from entry by anyone outside the EAP. Contractors must ensure the security, privacy and confidentiality of all electronic protected health information as required by law (Privacy Act and HIPPA). 6.800.3.8.4 (10-07-2011) Period of Maintenance Records are retained for three years after the employee has ceased contact with the EAP, whether or not the employee has terminated employment with the agency. Records may be kept longer if required by the State where the records are kept, or until any litigation involving the employee is resolved. When applicable, contract staff may retain records past this period, for as long as any relevant state statutes of limitation require. All EAP files shall be destroyed after the required period of maintenance. 6.800.3.9 (10-07-2011) Disclosure Employees who utilize EAP services will be informed about disclosure policies and procedures. 6.800.3.9.1 (10-07-2011) Disclosure With Consent Except where disclosure without consent is allowed (see section 6.800.3.9.2), the employee’s written consent must be obtained before any release of information can be made. This applies to all releases, including those to supervisors, treatment facilities, and family members, without regard to the type of issue the individual is experiencing. See Exhibit 6.800.3-2 for a sample consent form that contains all the elements required by current confidentiality regulations (42 CFR Part; Privacy Act 1974, 45 C.F.R. §164.524, Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and HHS Instruction 792-2). There are also times when the EAP must obtain confidential information from other sources. A sample consent form for obtaining confidential information is found in Exhibit 6.800.3-3. 6.800.3.9.2 (10-07-2011) Disclosure Without Consent Disclosure without consent is only permissible in a few specific instances, such as: To medical personnel in a medical emergency In response to an order of a court of competent jurisdiction To comply with Executive Order 12564, "Drug Free Federal Workplace." 6.800.3.9.3 (10-07-2011) Disclosure Not Covered by Federal Laws and Regulations In certain situations, information provided to the EAP is not protected by the confidentiality regulations and policies and, due to the nature of the information, must be reported to the appropriate people. The situations are: Under 42 CFR Part 2, the EAP is required by law to report incidents of suspected child abuse and neglect (in some states, elder and spouse abuse) to the appropriate state and local authorities. These disclosures are limited to information about the abuse. If the client commits or threatens to commit a crime that would physically harm someone or cause substantial property damage, disclosures may be made to appropriate persons, such as law enforcement authorities. 6.800.3.9.4 (05-29-2013) Releases of Information to and from Supervisors and Managers In some cases, employees are referred to the EAP by supervisors because of work performance and/or conduct issues. Except as discussed above, no information will be released to supervisors without the employee’s written consent, regardless of the nature of the referral. Employees are not compelled to release personal and/or health information to supervisors. When they choose to do so, they will sign a consent form allowing the release of such information. When consent is given to disclose the information to supervisors, the EAP will usually limit its discussion to: 1) date of the initial appointment 2) treatment recommendations; 3) compliance/non-compliance with recommendations 4) completion of treatment recommendations; and 5) other (if other information is being requested, it must be specified). However, there may be instances where it will be in the employee's best interests to sign a release of information, e.g., when an employee is seeking accommodation for a certain physical or emotional issue or as part of a last chance agreement. Another example might be when an employee is involved in a potential disciplinary situation and wishes to demonstrate his or her sincerity in seeking assistance with the issue. Based on this information regarding an employee's involvement in the Employee Assistance Program, a supervisor might decide to hold a disciplinary action in abeyance pending a positive change in the employee's performance and/or conduct. 6.800.3.9.5 (05-29-2013) Releases of Information to Human Capital Offices, Labor Relations Staff, Union Representatives, and Other Programs and Organizations Who Work with the EAP As with all other releases of information, the EAP requires the employee's written consents in order to share any information with human resources, labor relations, and union representatives, etc. 6.800.3.9.6 (10-07-2011) Secondary Disclosure Any information disclosed with the employee's consent must be accompanied by a statement that prohibits further disclosure unless the consent expressly permits further disclosures. A sample form for this purpose that meets the requirements of 42 CFR Part 2 is found in Exhibit 6.800.3-4. It shall be attached to any written information released or sent separately if the information was released orally. 6.800.3.10 (05-29-2013) Referrals to EAP Self-Referrals—Self-referrals occur at the employee's own initiative. When an employee recognizes a issue with alcohol, drugs or emotional stress that is affecting work performance and would like help, he or she may contact the EAP provider. No one is notified of the employee's participation in EAP services, unless the employee requests that a third party be notified. Management Referrals—If a manager observes certain patterns of behavior and/or work performance issues, or has some other reason to believe that the EAP could provide needed assistance to an employee, he or she may make an offer of the EAP services to the employee. The manager should not attempt to diagnose the perceived issue, nor should they counsel the employee on personal issues. Managers should support the use of IRS EAP by their employees. Managers should not try to counsel the employee on personal issues. The EAP counselor is better equipped to help an employee who is experiencing personal issues. The employee has the option to refuse the referral, and the employee cannot be disciplined for lack of participation in EAP services. Mandatory Referral—A referral by the manager to the EAP for an employee’s positive drug test or who is identified as using or abusing drugs in accordance with Executive Order 12564. This type of referral is in writing, and the EAP counselor should receives a referral memo addressed to the EAP. While this referral to the EAP is mandatory, there is no authority or requirement to compel an employee to partake of EAP services, which are voluntary. Failure to do so, however, may have adverse consequences for the employee. See Exhibit 6.800.3-5 for sample release of information form for a mandatory referral. Referrals from Others—Union representatives, employee health units, human resource staff, etc. may also refer employees to the EAP. They will be informed that written consent must be obtained from a referred employee before EAP will proceed with the referral. 6.800.3.11 (05-29-2013) Residential and Community Resources A variety of other outside programs and resources (e.g. Alcoholics Anonymous, Domestic Violence Hotline) are available for recommendation to employees and family members. EAP counselors maintain a current list of community programs and resources, and assist with initial arrangements and appointments. The cost of any such programs or resources is borne by the employee if it is not covered by the employee’s health insurance. In cases for which hospitalization is recommended, the employee may request sick leave, leave without pay, annual leave, or advanced sick leave in accordance with applicable law, rules and regulations. 6.800.3.12 (10-07-2011) Relationship with IRS Drug Free Workplace Program One of the programs that partners with the EAP is the IRS Drug Free Workplace Program. The Drug Free Workplace Program was established in response to Executive Order 12564 and its’ implementing legislation. The program is intended to assist employees with concerns related to drug abuse as well as help assure that IRS maintains an environment free of drugs. The IRS developed the Drug Free Workplace Plan to set forth the objectives, policies, and procedures for implementation and operation of the program. The IRS EAP was given a number of responsibilities in the Drug Free Workplace Plan. They are: 1) to assist supervisors and managers in dealing with the consequences of their employees’ illegal drug use and 2) to assist employees in their efforts to overcome current drug use and refrain from future use. The EAP will provide its regular services in response to these objectives. 6.800.3.12.1 (05-29-2013) Referral and Availability Any employee found to be using illegal drugs may be referred to the EAP. The EAP is administered separately from the drug testing program, and is available to all employees without regard to a finding of drug use. The EAP provides counseling or referral for rehabilitation, as well as education and training regarding illegal drug use. The EAP is available not only to Service employees, but when feasible, to the families of employees with drug issues, and to employees with family members who have drug issues. 6.800.3.12.2 (05-29-2013) Assistance with Safe Harbor Provisions Employees may also self-identify as illegal drug users to management under the Safe Harbor provision in the IRS Drug Free Workplace Plan. This provision protects employees from disciplinary actions that may otherwise be taken against employees found to be using drugs illegally. These employees must voluntarily admit their drug use before being identified through other means; must complete counseling/rehabilitation as determined and monitored by the EAP (or other counseling/rehabilitation entity), agree to random follow-up drug testing and must not use drugs again. The Safe Harbor provision cannot protect employees from disciplinary actions or random testing if they refuse to notify their supervisors that they are seeking help for their drug issues. It also cannot protect employees who have been found to use drugs illegally a second time. 6.800.3.12.3 (10-07-2011) Employee Education and Supervisor Training In partnership with the DFWP, the EAP provides on-going drug education for employees and supervisors. 6.800.3.12.4 (05-29-2013) Relationship with Drug Testing Provisions The IRS Drug Free Workplace Plan includes provisions for testing of employees for illegal drug use. The EAP is not responsible for the implementation or operation of the drug testing program, but will provide counseling and assistance in dealing with drug issues. Exhibit 6.800.3-1 Contacting the IRS Employee Assistance and Worklife Referral Program (EAP) The IRS has contracted with an independent firm—ComPsych Corporation®—to provide counseling, support and information services to employees on a confidential basis. To contact the IRS Employee Assistance and Work-Life Program simply dial the toll-free number 1-800-977-7631 (TDD: 800-697-0353). A counselor is available to speak with you 24 hours a day. Access Numbers for Overseas Employees Below is a list of the International Toll Free Numbers that can be accessed by IRS employees globally. These numbers will link you directly to an Employee Assistance and Work-Life Referral Program specialist. In the event that there is not a toll free number for your specific location, you can dial 1-312-595-0074 (collect internationally) and you will be linked to the Employee Assistance and Work-life Referral Program. If you encounter difficulties with any of the toll-free numbers, please use the 1-312-595-0074 collect number. Listing of foreign IRS locales and corresponding toll-free numbers: Dar Es Salaam, Tanzania: 1-312-595-0074 (collect internationally) Ontario, Canada: 1-800-314-4685 Bogota, Columbia: 01-800-700-1551 Virgin Islands: 1-312-595-0074 (collect internationally) Paris/Lyon, France: 0800-915-346 Tbilisi: 1-312-595-0074 (collect internationally) Germany: 0800-182-6076 Agana, Guam: 1-312-595-0074 (collect internationally) Italy: 800-787-245 United Kingdom: 0800-032-4416 Japan: 00531-13-0841 Skopje, Macedonia: 1-312-595-0074 (collect internationally) Mexico: 001-800-314-4685 Romania: 1-312-595-0074 (collect internationally) Singapore: 800-1301-279 Port of Spain, Chad: 1-312-595-0074 (collect internationally) Kiev: 1-312-595-0074 (collect internationally) Guidance Resources OnlineSM With Internet access, you can research a topic before seeking professional help. Go online to receive expert information, resources and referrals on behavioral health, dependent care, and legal or financial matters. To access Guidance Resources OnlineSM just click www.guidanceresources.com, Guidance Resources Online log on as a new user and enter our IRS ID (IRS112) when prompted. Register yourself as a first time user and then select your own user name and password. Once registered, access the site anytime using the user name and password you selected. Exhibit 6.800.3-2 SAMPLE INTERNAL REVENUE SERVICE EMPLOYEE ASSISTANCE PROGRAM CONSENT FOR RELEASE OF CONFIDENTIAL INFORMATION I, _______________________________________, authorize the IRS Employee Assistance Program to disclose this kind and amount of information: Date of my initial appointment Treatment recommendations Compliance/Non-compliance with recommendations Completion of treatment recommendations Other: To the following person: __________________________________ ______________________________________________________________ Date consent signed: __________________________ Signature of client: ___________________________ Signature of parent or guardian (where required): ________________________________________________________ Signature of person authorized to sign in lieu of client (where required): ________________________________________________________ This consent is subject to revocation at any time except to the extent that the EAP has already taken action in reliance on it. If not previously revoked, this consent will terminate upon this specific date, event or condition: _________ ____________________________________________________________ I understand that I have the right to inspect and copy the information that I have authorized to be used or disclosed as provided for under the 42 CFR Part 2, the Privacy Act 1974 and the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) regulations found at 45 C.F.R.§164.524. Exhibit 6.800.3-3 Sample INTERNAL REVENUE SERVICE EMPLOYEE ASSISTANCE PROGRAM CONSENT FOR OBTAINING CONFIDENTIAL INFORMATION I, _______________________________________, authorize: Name or title of person/organization from which information is requested: __________________________________________________________ to disclose to the IRS Employee Assistance Program the following information: ______________________________________________________________ ______________________________________________________________ for the purpose of: _______________________________________________ ______________________________________________________________ Date consent signed: __________________________ Signature of client: ___________________________ Signature of parent or guardian (where required): ________________________________________________________ Signature of person authorized to sign in lieu of client (where required): ________________________________________________________ This consent is subject to revocation at any time except to the extent that the EAP has already taken action in reliance on it. If not previously revoked, this consent will terminate upon this specific date, event or condition: _________ ____________________________________________________________ I understand that I have the right to inspect and copy the information that I have authorized to be used or disclosed as provided for under the 42 CFR Part 2, the Privacy Act 1974 and the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) regulations found at 45 C.F.R.§164.524. Exhibit 6.800.3-4 Sample INTERNAL REVENUE SERVICE EMPLOYEE ASSISTANCE PROGRAM SECONDARY DISCLOSURE PROHIBITION SUBJECT: Release of Confidential Information FROM: Internal Revenue Service Employee Assistance Program TO: (name/title of the person/organization to which disclosure is made) ________________________________________________________ Date: __________________________________________________ In accordance with Federal laws and regulations, we have released information to you on _________________________________________. We are required to inform you that this information has been disclosed to you from records protected by Federal confidentiality rules (42 CFR Part 2). The Federal rules prohibit you from making any further disclosure of this information unless further disclosure is expressly permitted by the written consent of the person to whom it pertains or as otherwise permitted by 42 CFR Part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose. The Federal rules restrict any use of the information to criminally investigate or prosecute any client. Exhibit 6.800.3-5 Sample INTERNAL REVENUE SERVICE EMPLOYEE ASSISTANCE PROGRAM CONSENT FOR RELEASE OF CONFIDENTIAL INFORMATION - MANDATORY REFERRAL I, _______________________________________, authorize the IRS Employee Assistance Program to disclose this kind and amount of information: Date of my initial appointment Treatment recommendations Compliance/Non-compliance with recommendations Completion of treatment recommendations Other: To the following person: __________________________________ ______________________________________________________________ Date consent signed: __________________________ Signature of client: ___________________________ Signature of parent or guardian (where required): ________________________________________________________ Signature of person authorized to sign in lieu of client (where required): ________________________________________________________ This consent is subject to revocation at any time except to the extent that the EAP has already taken action in reliance on it. If not previously revoked, this consent will terminate upon this specific date, event or condition: _________ ____________________________________________________________ I understand that I have the right to inspect and copy the information that I have authorized to be used or disclosed as provided for under the 42 CFR Part 2, the Privacy Act 1974 and the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) regulations found at 45 C.F.R.§164.524.