Chapter 18: Australian Perspectives on the Organizational Integration of Employee Assistance Services

Abstract

This article considers the commonalities and differences between Australian EAPs and their counterparts in the United Kingdom and the U.S.A. The unique characteristics of Australian EAPs are examined, including an account of the approach taken to the integration of EAP services and other employee services such as work-life and wellness. Three case studies illustrate the forms of integration presently being explored in Australia. It is concluded that efforts to engage in the type of “big picture” thinking characteristic of integration are apparent, even though there is little evidence of the type and degree of collaboration seen to be emerging in the U.S.A.     

Chapter 12: Wells Fargo's Employee Assistance Consulting Model

Abstract

Wells Fargo and Company's Employee Assistance Consulting (EAC) is an established and successful internal corporate-based EAP that delivers organizationally congruent services to a diversified financial services company with 80+ businesses and over 146,000 team members. While some elements of traditional EAPs are evident in the services provided by this entity, EAC also provides highly specialized and customized consultations to its corporate partners, business group customers and employees. Using a highly integrated service model that aligns closely with the specific strategy and operations of each Wells Fargo business, EAC is an invited guest at many of the company's most influential tables. EAC collaboratively partners with senior and line management, Human Resources, the Employment Law Department, Disability Management (called WorkAbility at Wells Fargo) and Risk Management, Corporate Benefits, Corporate Security, Learning and Development, and others to provide leadership and organizational influence on such wide ranging issues as threat assessment and management, business incident management, workplace trauma, health and productivity, and organizational and employee effectiveness. This article describes proven methods and strategies for maximizing organizational influence and positioning EAP consultants as effective business partners.     

Chapter 4: Research on the Integration of Employee Assistance,Work-Life and Wellness Services

SUMMARY

This article will focus on the research exploring the degree to which organizational integration of Employee Assistance, Work/Family and Wellness Programs has evolved since the early 1990s. The first study reviewed is the National Study of EAP and Work/Family Programs conducted in 1994 by Boston University's Center on Work and Family in which 100 of the top family friendly companies were inter viewed. Two major studies conducted under the guidance of the Employee Assistance Professional Association (EAPA) are then reviewed. The Phase I research conducted in 2001 was a large-scale survey of the professionals in fields of EAP and Work-life (N = 950). The Phase II research conducted in 2002 was comprised of two stages: A pilot study surveying vendors in the EAP and Work-life fields (N = 213) and a qualitative study consisting of in-depth interviews with vendors from all three professions (N = 79). The overall theme from this body of research is one of dramatically increasing movement and market demand for some form of collaboration/integration of service delivery. Finally, the chapter offers recommendations for further research regarding integration of services as well as implications for the professional fields.     

Chapter 2: The Business Case for the Integration of Employee Assistance,Work-Life and Wellness Services

SUMMARY

Employee assistance programs (EAP), work-life programs and wellness programs are three commonly provided kinds of interventions that have the goals of reducing healthcare costs, improving employee performance and fostering a healthier workplace culture. The integration of these kinds of programs is a recent trend that has the potential to offer additional synergistic benefits. New studies have linked comprehensive delivery services that support human capital needs with bottom-line financial success of the company. This evidence can be used to make the business case for offering EAP, work-life and wellness services in an integrated capacity. However, while promising, the scientific evidence thus far in this area has methodological limitations and there are critical aspects that require further study.     

Chapter 3: Health and Productivity Management

SUMMARY

This article focuses on the emergence of Health and Productivity Management (HPM) as a context for understanding the integration of health and wellness into employee assistance and work-life programs. Major factors influencing the growth of HPM are raising medical costs as well as the rising incidence of obesity. The Wake-up Call to Corporate America underscores the need to manage these costs and improve health through the proactive alignment of health-related benefits and programs. HPM is described as an integrated approach to capture direct medical costs as well as the indirect costs associated with poor health and lost productivity. Critical design and implementation features that are likely to contribute to a successful integrated approach are described and highlighted. An HPM case example of a large pharmaceutical company examines a unique cross referral program including considerations for continuous improvement. Finally, the article concludes with key challenges related to marketplace competition, pricing pressures, concerns regarding the sub-optimization of programs and the influence of current health care system changes.     

Chapter 16: Integration of Occupational Health Services in the Federal Sector

Abstract

Federal Occupational Health (FOH) is a federal sector model of the integration and collaboration of occupational health (OH) programs that includes on-site health clinics, and environmental health as well as EAP, work-life, and wellness/fitness programs. This article reviews several aspects of integration at various levels of this public health organization.

The broad objectives of occupational health programs are to promote, support, and provide a healthy and productive, highly functioning workforce to the employer. FOH staff has special expertise and knowledge related to federal procedures, regulations and agency culture, as well as the OH disciplines. With its mission to provide occupational health services to federal agencies and federal employees, FOH has the unique opportunity to provide integrated OH services, thereby providing a more comprehensive approach to the occupational health care of the individual employee, as well as a more comprehensive approach to the health and productivity efforts of the federal agencies.

Although we have made strides and engage in continuing efforts to promote integrated programs and care, a number of additional program enhancements are in discussion and/or in process. FOH is a unique entity and the largest provider of comprehensive OH services within the federal government. It has achieved some notable success with the integration of its services across various levels of the organization with different federal organizations. Efforts have been particularly successful in bringing a coordinated response to various crises and emergency situations. With increasing knowledge and data on the benefits of integration, FOH is working to reduce both internal and external organizational barriers to bring integration of services to their maximum potential.     

Transformation Management and Cultural Diversity Training Through Employee Assistance Programs

ABSTRACT

This article explores motivation of black managers in two different settings. A study was conducted to explore the hypothesis that perception of organizational environment will influence both motivation and locus of control. Tt was further hypothesized that black managers working in a white management dominated organization will have a less positive perception of the organizational environment in comparison with their counterparts working in a black management dominated organization. It was hoped that such a study will help influence the focus of black advancement programs from an individual perspective to a more dynamic person-environment transactions focus. The results confirmed the hypothesis to a significant extent. This article suggests an intervention that utilizes EAP expertise in helping organizations to create and manage diversity for competitive advantage.     

Chapter 5: Perspectives on the Integration of Employee Assistance and Work-Life Programs

SUMMARY

A recent qualitative study explored perceptions of critical issues and challenges from the point of view of experts and key informants working in diverse roles in the Employee Assistance Program (EAP) field (Sharar & Hertenstein, 2005). One of the central themes that came out of the study is that EAPs have become a type of platform for the expansion of integrated collateral services, chiefly work-life (WL) programs. This paper presents a variety of perceptions and opinions from experts in the EAP field, both pro and con, on the growing convergence of EA and WL programs, including the rationale to integrate, segregate, and concerns regarding the diffusion of traditional and core EAPs. The paper concludes with the authors? perspectives on implications for the EA field, along with the need to find ways to measure if and when integration leads to employee and organizational improvement.     

The Structure and Functions of Employee Assistance Programs in Higher Education

Abstract

Workplace stress can be defined as the change in one's physical or mental state in response to workplaces that pose an appraised challenge or threat to that employee. Research has shown that there are a number of factors that contribute to workplace stress. These factors include a toxic work environment, negative workload, isolation, types of hours worked, role conflict, role ambiguity, lack of autonomy, career development barriers, difficult relationships with administrators and/ or coworkers, managerial bullying, harassment, and organizational climate. Should the stressors continue, the employee is at significant risk of developing physiological and psychological disorders that can lead to increased absenteeism, organizational dysfunction, and decreased work productivity. Intervention strategies are discussed to help managers provide support and intervention to employees coping with workplace stress.     

Integrating Sexual Health Services Into Primary Care: An Overview of Health Systems Issues and Challenges in Developing Countries

ABSTRACT

Current attempts to address the high burden of sexual health morbidity and mortality in developing countries remain limited in scale due to a range of health system constraints. We conducted a literature review of the policy and programmatic issues that influence the integration of sexual health into primary care services in developing countries. Forty-seven reports were identified from a search of both peer-reviewed and gray literature. Key issues identified were intersectoral and intergovernmental coordination; management and organizational issues including decentralization, health sector reform, logistics, and referral systems; human resources, including training and support required to increase service scope; relationships between the public and private sectors; and scaling-up and financing issues.     

Chapter 4. Older Latinos and Mental Health Services

SUMMARY

This article discusses the biopsychosocial and spiritual aspects related to older Latinos' use of mental health care. It also addresses the environment that older Latinos have to navigate to access mental health services. Structural barriers to mental health services are emphasized as critical to a holistic assessment of the client's situation.     

Chapter 10: Ceridian's Experience in the Integration of EAP,Work-Life and Wellness Programs

SUMMARY

This article considers EAP services, work-life and wellness programs and the implications of integrating these services. The concept of how wellness programs enter into this equation is explored as well as how Web-based services have played a significant role. Ceridian's experience in providing these services is explored through a case study, anecdotal information, and other data. This article reviews why integrated EAP services, work-life and wellness programs offer more value when compared to programs that contain individual components. It is concluded that wellness and the Internet continue to play a key role in programs becoming more integrated. It is also suggested that integration is now larger than traditional EAP, work-life, and wellness programs. Other human resource services are becoming more important components of integrated services.     

Chapter 6: University of Arizona Life & Work Connections

SUMMARY

The concept of integration has emerged in recent years as a strategy considered by providers of employee assistance, wellness and work-life services to meet the changing needs of the organizations they serve. There continues to be much discussion, however, about what exactly integration is, and how to do it. Beginning with a definition of integration, this article seeks to contribute to the discussion by describing the University of Arizona (UA) Life & Work Connections, a program that was conceived from its development to be an integrated service model. The theoretical and philosophical backgrounds of the program are presented and translated into the UA Life & Work Connections model. Advantages of the model and challenges to integration are discussed, and a detailed case study of a critical incident response is presented.     

Coordinating Health,Extended Care,and Community Support Services

Abstract

Under pressure to maximize the cost-effectiveness of programs, efforts to improve coordination have become increasingly central to the development of the broader health and welfare service delivery system in Australia in the past few years. This article reviews recent experience in two related fields: (1) the coordination of different community care services for older people and people with disabilities, funded by the Home and Community Care program; and (2) the attempt to enhance links between community and residential care services, hospitals, and other health care providers. Why coordination has emerged as such an important issue in the field of community care and, increasingly, across the entire system of what the Australian government now terms health and family services is discussed. A number of measures that have been introduced or are proposed to improve a coordination of services are briefly reviewed. These range from individualistic approaches based on information and referral, through schemes involving gatekeeping, case management and brokerage of services, to models involving the reconfiguration of organizational structures, linkages, and finances. These measures are not mutually exclusive and are increasingly likely to be applied in more complex mixed models of service coordination. It is argued that coordination at the level of direct-service provision is difficult if government policies that direct services lack coordination.     

Health Status and Health Care Services Among Older Persons in India

Summary

India is characterized by significant rural-based living, population heterogeneity, financial constraints, and reverse sex ratio. Traditions of joint families, life-long physical activity, vegetarianism, and social and spiritual enrichment, all known to promote healthy aging, are widely prevalent. With the increasing pace of population aging, the health of older persons in India has been the focus of recent attention. Existing data indicate a significant morbidity among the aged, much of which may remain subclinical. Considerable variations in morbidity exist with respect to gender, place of residence (rural vs. urban), and socioeconomic status. Rapid demographic transition without a concomitant epidemiological transition is responsible for the dual load of infections and degenerative diseases in older persons, these being common causes of death. Most age-related morbidity is preventable. Health promotion and cost-effective interventions based on the primary health care approach over a lifelong course, especially at the village level, will greatly help towards achieving the goal of healthy aging. The rapidly changing socioeconomic scenario in India also calls for appropriate policy actions to achieve this goal.     

Chapter 9: Disaster Consequence Management

SUMMARY

The critical element in a workplace approach to consequence management for disaster, terrorism and other critical incidents is the integrated planning and response across numerous workplace functions including human resources, employee assistance, security and facilities, medical, occupational health, wellness and work-life. These corporate functions ensure the performance, health, safety and human continuity of the workplace. In this model, workplace professionals charged with the human capital and continuity of their organizations play new crucial roles that require an understanding of (1) the integration of mental health into a public health approach for managing the psychological and behavioral implications of terrorism; (2) the integration of operational continuity planning with human continuity resources; and (3) the integration of workplace preparedness into the larger sphere of population health interventions for the 21st century. This new role of workplace health and productivity professionals is necessary to the health and resiliency of our global community and its citizens in the workplace and at home.     

The Relationship Between Sexual Minority Verbal Harassment and Utilization of Health Services: Results from Countywide Risk Assessment Survey (CRAS) 2004

In this article we examine the prevalence of and associations between sexual orientation–based verbal harassment and reported utilization of health services across levels of sexual orientation in a diverse sample of adult recipients of Los Angeles County–funded HIV-related health and social services. Thirty-two percent reported they had experienced verbal harassment, the majority (80.3%) of whom identified as lesbian, gay, or bisexual (LGB). Those who reported being verbally harassed received significantly more services overall than those who were not verbally harassed, and service utilization varied by sexual orientation. These findings inform future efforts to identify and assess social discrimination in health and social service settings.     

A National Survey of the Provision of Sexual Health Clinical Services by Public Health in Canada: First Insights

Objectives: Data documenting the scope of sexual health clinical services offered as public health in Canada are unavailable. This article provides first insights into the scope of STI and clinical sexual health services available nationally. Methods: Data were gathered using an online survey of 113 Canadian public health units. Results: Almost half of the clinics were not providing expedited partner therapy, one third were not providing point of care testing for HIV and one third were not using syndromic management of sexually transmitted infections (STIs). Low rates of physician support were evident. Conclusion: Given the ever-higher rates of STIs, findings from this study identify important challenges to providing comprehensive services.     

Inequitable Access to Health Services for Older Adults with Diabetes: Potential Solutions on a State Level

Diabetes is a serious global public health challenge. The cost for health services for diabetes care has increased 41% over the past 5 years. Despite escalating health expenditure, the United States continues to have higher rates of diabetes than many other developed countries. There is a need for health care reform in the United States not only in reducing health care costs but also in improving the quality of preventative care. This study presents the testing of a multilevel model investigating variables on the individual and state levels to develop a better understanding of the most important contextual pathways that can lead to providing older adults (50+) with type 2 diabetes with the recommended preventative quality care they require. The model was tested using a three-level repeated cross-sectional design with data from various existing data sources, using a national sample of 181,870 individuals aged 50 years and older. Results showed that differences in state health care systems contributed to inequitable access. Specifically, in a state where there was a higher percentage of adults 65 and older coupled with a shortage of health care professionals, the likelihood of receiving the recommended preventative quality care decreased. Also, older adults living in states with a higher percentage of people with diagnosed diabetes but with a lower-than-average annual per capita health care expenditure fared worse in receiving quality preventative care. Last, older adults in wealthy states with higher percentages of uninsured people had the lowest odds of receiving quality preventative care. Health care reform, similar to what is currently promoted by the Patient Protection and Affordable Care Act of 2010, is recommended to improve the performance of all health care systems in all states.