HHS Employee Assistance Program

792-2- 00      PURPOSE AND RESPONSIBILITIES

1. Purpose

   This document describes the policies and procedures of the HHS EAP. The EAP is designed to prevent and respond to issues related to work and living. These issues have the potential to impact or may actually be affecting individual employees, work groups, and/or larger organizations. This program is part of a team of departmental components and programs that are concerned with the creation of a healthy and productive HHS worksite.

2. Responsibilities

   Heads of Operating Divisions (OPDIVs) and Staff Divisions (STAFFDIVs) are responsible for establishing and operating EAPs that service all their employees and for supporting program objectives nationwide. EAPs are required by law and are, at a minimum, run according to the standards in this policy.

   The Assistant Secretary for Administration and Management (ASAM), through the Office of Human Resources (OHR), is responsible for oversight and coordination of the program Department-wide, policy and guideline development, and certain required reports and evaluations.

   All employees of HHS are considered partners of the EAP. It is anticipated that they will support the program's objectives and philosophy. They make use of the program when they have issues of a personal nature related to work and family. Management chooses 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, they support the objectives and policy of EAP.

792-2- 10     LAWS, REGULATIONS, AND POLICIES RELATED TO THE EAP

1. Laws Creating/Reauthorizing the EAP and strengthening the EAP in Federal Settings
   1. 5 U.S.C. 7361-7362 (law-development by OPM of programs for Federal employee drug abuse, and alcoholism/alcohol abuse, respectively)
      
   2. 5 U.S.C. 7901 (law-authorizes health programs for Federal employees)
      
   3. 5 U.S.C. 7904 (law-mandates EAPs for employee alcohol and drug abuse)

2. Laws and Regulations that Protect the Confidentiality of EAP Records
   1. 5 U.S.C. 552a (law-Privacy Act of 1974 insures confidentiality of Federal records)

   2. 42 CFR Part 2 (regulation-confidentiality of alcohol and drug abuse patient records)

3. Other Laws, Regulations, and Policies that Impact the EAP
   1. 5 U.S.C. 7301 (law-established requirements for Federal agency drug free workplace plans)
      
   2. Public Law 102-143 (law-Omnibus Transportation Employee Testing Act of 1991 requires alcohol and drug testing of all employees who hold a Commercial Driver's License and operate certain motor vehicles for HHS)
      
   3. 29 U.S.C. 791 (law-Rehabilitation Act of 1973 requires that agencies make reasonable accommodation for employees with known handicaps)
      
   4. Executive Order 12564 (mandated drug free Federal workplace)
      
   5. HHS Plan for a Drug Free Workplace
      
   6. Understanding and Responding to Workplace Violence (HHS guidelines 1997)
      
   7. HHS EAP Quality Assurance Guidelines (1992)
      
   8. 5 CFR Part 792 (regulation-established guidelines for Federal EAPs)

792-2- 20     ELIGIBILITY AND COST

1. Eligibility

   The EAP is available to all HHS employees, regardless of the nature of their personal or organizational issues related to work and life. On-site contract employees may be seen on an emergency basis in order to stabilize a situation. Under certain conditions described below, employees' family members may also be assisted by the EAP.

   1. When the family member has a problem that is connected with the employee's alcohol or drug abuse, the family member may be seen by the EAP regardless of whether the employee is a client of the EAP. In these situations the family member is the client of the EAP and may receive all services.
      
   2. When the employee has a personal concern that may be helped as a result of the EAP seeing the family member, the family member may be seen by the EAP. The family member may also be seen by the EAP when the personal concern of the family member is affecting the employee's ability to function on the job. In these situations, the employee is considered the EAP client (whether or not the EAP has seen the employee yet) and is the recipient of services.
      
   3. In HHS, a family member is defined as an employee's spouse and parents thereof; children, including adopted children, and spouses thereof; parents; brothers and sisters, and spouses thereof; and any individual related by blood or affinity whose close association with the employee is the equivalent of a family relationship.

2. Cost

   There is no cost to employees and eligible family members for EAP services. There are times when it is appropriate to refer employees and/or their family members to outside community resources. When employees accept these referrals, they are responsible for the fees charged by the facility. The EAP works with employees and/or their family members to keep the cost within their financial means.

792-2- 30     SERVICES OFFERED BY THE EAP

1. Introduction

   The EAP contributes to a healthy Department by providing quality services to individuals and organizations relating to issues of work and life. One focus of these services is to assist employees, management, and organizations with concerns that have already emerged. The EAP works with clients to find meaningful options for resolving these situations. Prevention of work and life concerns is another primary focus of EAP services. By providing prevention services, it is recognized that mental wellness is an important factor influencing the health and productivity of HHS and all its employees. EAP staff educate and advocate for self-identification and early intervention.

   This section describes in greater detail the nature of the services provided by the EAP. The descriptions are divided according to who is requesting the services: individuals, managers, or organizations. It is understood, however, that in many situations, these distinctions are blurred and services overlap.

2. Services Offered to Individuals
   1. Assessment

      Counseling sessions during which the nature and extent of issues are determined; typically this activity takes 1-6 sessions but the best determinant of the number of sessions is always sound clinical judgment.
      

   2. Referral

      Actions to refer employees to one or more community resource(s) to receive services or treatment, as necessary.
      

   3. Short-Term Problem Solving

      Limited sessions with counselors to resolve problems that are not better resolved by a referral to community resources; this activity is separate from the assessment process described above, although it is recognized the two activities may overlap; typically this activity takes no more than 4-6 sessions but the number of sessions must be based on sound clinical judgment.
      

   4. Follow Up

      Monitoring by EAP staff of employees' progress during and after receiving assistance; the length and type of follow-up will be determined by the needs of the employees using the program.
      

   5. Emergency Information and Referrals

      At all times, the EAP provides information or referrals for handling emergency situations; these services can be provided through a variety of methods such as telephone messages and telephone counselors.

3. Services Offered to Supervisors and Managers
   1. Supervisory Referral Assistance

      Sessions between the EAP staff and supervisors to discuss a potential supervisory referral, to assist a supervisor in dealing and communicating with a potential referral or current EAP client, or to follow up on a referred employee's progress.

   2. Supervisory Training and Education

      Training programs for new supervisors so they know EAP procedures and how to identify, deal with, confront and refer troubled employees; and on-going/refresher education for all supervisors and managers on these issues.

   3. Management Consulting

      Consultations with managers to assess interpersonal issues affecting group performance, facilitate short-term intervention strategies or refer to other available resources (e.g., organizational development specialists).

4. Services Offered to Organizations
   1. Violence Prevention/Crisis Management

      Education of managers and employees on issues of workplace violence; assistance in conflict resolution; when appropriate, involvement with agency crisis management teams and unions.

   2. Critical Incident Stress Debriefing

      A meeting or series of meetings held with witnesses, victims, or co-workers involved in a traumatic incident to gather facts and assist with their immediate emotional needs.

   3. Group Interventions

      Short-term interventions to aid work teams in dealing with interpersonal issues (e.g., conflict, communications) that interfere or have the potential to interfere with individual and group performance.

   4. Education Programs

      Seminars, brown bag lunches, support groups, and other sessions periodically provided for all employees so that they become aware of the EAP services as well as various work and life issues that can be prevented or helped; orientation to the EAP for new employees and those needing a refresher.

   5. Outreach

      Posters, fliers, newsletters, bulletins and other techniques for reminding employees about the program's services.

   6. Special Services

      Provision of specialized services in response to work place issues such as outplacement, downsizing, substance abuse, and HIV/AIDS that fall within the professional purview of the EAP.

792-2- 40     OTHER WAYS OF ASSURING A QUALITY PROGRAM

1. Collaborate with Others Concerned with the Wellness of HHS Employees
   1. The EAP respects and utilizes the skills and knowledge of others inside and outside the EAP community. The program actively collaborates with unions, programs, facilities, organizations, and individuals to bring about the most positive outcome for individuals and organizations experiencing work and life concerns.
      
   2. In addition, the EAP actively collaborates with unions, programs, facilities, organizations, and individuals to prevent emotional concerns from emerging. The program knows it is through connection with all members of the community that total wellness for employees and the Department is achieved.
      
   3. Often, employees seek the EAP's help for sexual harassment, workplace violence, discrimination, and other such actions that are prohibited by other laws, policies, and procedures. In addition to providing regular EAP services in these situations, the EAP will assist employees (when they request) in contacting and seeking out those individuals and programs that are responsible for officially responding to these concerns. The EAP is not considered a "first report" to management for these types of issues.

2. Reporting and Evaluation
   1. The EAP uses creative and innovative ways to continually provide excellent services. One of the ways the program assures this excellence is through the collection of data on program operations. In addition to other data collection activities, OPDIVs and STAFFDIVs report data to the EAP Director in ASAM on an assigned schedule.
      
   2. There are also periodic special evaluations of program effectiveness.
      
   3. Clients provide anonymous feedback through the EAP website and through client satisfaction cards.

3. Quality Assurance
   1. The EAP maintains procedures for assessing and assuring the quality and appropriateness of its services on a day-to-day basis. (See the HHS EAP Quality Assurance Guidelines.) It provides procedures for reviewing program administration and client records.
      
   2. OHR conducts several quality assurance visits per year.

4. Other

   The EAP provides certain educational and clinical services in support of the HHS Drug Free Workplace Plan. See the section on the Drug Free Workplace for more details.

792-2- 50     LEAVE USAGE AND JOB SECURITY

Employees are on official duty when they meet with the EAP, provided they obtain prior consent from their supervisors. In an emergency, supervisory consent may be obtained after using the EAP. Confirmation of attendance will be provided by the EAP according to applicable confidentiality procedures. Employees who do not want their supervisors to know of their attendance must arrange appointments outside official duty hours or while on any leave except sick leave or leave used for sickness. Employees who are referred to community resources for assistance must request approved leave if these sessions occur during their scheduled work hours.

792-2- 60     CONFIDENTIALITY PROCEDURES

1. Introduction

   The EAP is committed to upholding the highest professional standards in maintaining the privacy and confidentiality of client records. EAP staff adheres to the intent and spirit of the laws, policies, and regulations that provide for protection of personal information. Employees who utilize the EAP's services will be informed about confidentiality policies and procedures. Programs and organizations that partner with the EAP will also be informed about these procedures whenever situations arise that have the potential to compromise the integrity of confidentiality standards.

2. General Procedures
   1. Authority for Protecting EAP Records

      The Privacy Act covers all EAP records. In addition, clients with alcohol and drug issues are subject to extra restrictions provided in the "Confidentiality of Alcohol and Drug Abuse Patient Records" regulations. (See legal citations above.) Depending on the location of where the EAP services are provided and the professional credentials of the EAP counselor providing the services, there may be additional protection provided by state and professional association laws, regulations, and procedures. The HHS EAP maintains a Privacy Act System of Records Notice with complete details on confidentiality procedures.

   2. Records Protected by these Procedures

      All records of the EAP, whether written, oral, and electronic are covered by this policy. This applies to records generated and/or maintained by HHS employees who are EAP staff or contractual EAP staff.

   3. Access to EAP Records

      Access to EAP client records is limited to those EAP staff working directly with the program's clients. Additionally, EAP Administrators and EAP headquarters staff may have access to the EAP records for the purposes of:

      • program oversight, evaluation, and quality assurance
        
      • destroying EAP records at the end of their period of maintenance (EAP staff may contract with a private or federal organization for the purpose of destroying records; staff of these organizations must also comply with the confidentiality provisions in this policy)
        
      • transferring them from one contractor to another

      Employees who utilize the EAP may have access to their own records. Written inquiries should be made to the HHS EAP manager for the area where the services were provided. EAP staff will provide employees and their representatives (such as legal or union) with complete details about how to access the records.

   4. Record Ownership

      All EAP records are the property of this Department, including those generated and/or maintained by contractors. At the completion of any contract, EAP records will be surrendered by the contractors to designated persons in HHS or will be transferred to another contractor with the express permission and instructions from HHS staff responsible for the records.

   5. 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. Informing Employees

      Employees who use the EAP must be told about these confidentiality provisions and furnished with a written summary. A sample summary that meets the requirements of 42 CFR Part 2 and the Privacy Act is included as Exhibit 792-2-A.

3. Releases of Information
   1. Disclosure with Consent

      Except where disclosure without consent is allowed (see paragraphs below), 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. A consent form meeting the requirements of 42 CFR Part 2 is found in Exhibit 792-2-B. There are also times when the EAP must obtain confidential information from other sources. A consent form for obtaining confidential information is found in Exhibit 792-2-C.

   2. Disclosure without Consent

      Disclosure without consent is only permissible in a few specific instances such as to medical personnel in a medical emergency, under certain court orders, to comply with Executive Order 12564, "Drug Free Federal Workplace", and to comply with the Department of Transportation's Alcohol and Drug Testing Program (see sections below). The EAP may also confirm attendance at the program to a direct supervisor, if the employee attended while on official duty status or on any sick leave, if requested. The EAP may also communicate with a qualified organization (such as a contractor) providing services to the program. The exchange is limited to the information needed by the organization to provide required services.

   3. 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:

      • The EAP is required by law to report incidents of suspected child abuse and neglect (and in some states elder and spouse abuse and neglect) to the appropriate state and local authorities. However, other information on the employee maintained in the original EAP record is covered by these regulations and can only be released according to the procedures outlined in this policy.
        
      • 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 and those persons being threatened, but only if the disclosure does not identify the EAP client as an alcohol or drug abuser. The only exception is that if such a crime takes place at the EAP, the EAP can reveal only to law enforcement officers that a client is an alcohol or drug abuser, as long as the information disclosed under this exception is limited to the circumstances of the incident. Any other disclosure about the client may require a special court order.
        
   4. 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 information to supervisors. When they choose to do so, they will sign a consent form allowing the release of information.

      • If employees choose not to sign consent forms, the EAP may not disclose any information to their supervisors, except whether or not employees made or kept appointments during official duty hours or any sick leave.
        
      • When consent is given to disclose to supervisors, the EAP will usually limit its discussion to: 1) attendance at the EAP; 2) cooperation with the program; 3) treatment plans that may interfere with the workplace; and 4) work performance or conduct issues.
        
      • The information provided by the EAP should give supervisors a general idea of the kind of progress employees are making. The best indicator is always whether a person's job performance or conduct has improved.
        
      • Although it is not required, it is a good practice for supervisors to notify the EAP of any changes in work performance or conduct and any corrective actions taken because of the possible impact these decisions may have on an individual's treatment. Since this is not a release of information by the EAP but by the supervisor, a consent form does not apply.

   5. Releases of Information to Personnel Offices, Employee Relations Staff, Union Representatives, and Other Programs and Organizations Who Work with the EAP

      As with all other releases of information, the EAP requires employees' written consents in order to discuss any information with personnel, employee relations, and union representatives.

   6. Secondary Disclosure of Information

      Any information disclosed with employees' consents must be accompanied by statements that prohibit 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 792-2-D. It shall be attached to any written information released or sent separately if the information was released orally. Duplicates shall be maintained for the employees' EAP records.

4. Record Keeping Procedures that Support the Confidentiality of Client Information
   1. Case Coding

      In order to insure confidentiality, all records shall be maintained and retrieved by case numbering systems, rather than by names.
      

      • Each employee using the EAP will be assigned a unique number
        
      • All case materials shall be placed in a folder or computer files labeled with this unique case number.
        
      • A list of code numbers that correspond to the employees' names will be maintained in a locked or secure file separate from the case folders. It shall be secured when not in use and shall be maintained by EAP Administrators, senior counselors, or EAPs' records custodians.
        
      • In addition to active and re-activated records, the case coding and filing systems shall include records that have been closed (but not yet destroyed).

   2. File Contents

      To the extent possible, all recordings in case records shall not contain identifying information. It is recognized that some identifying information may be necessary at times (such as consents for release of confidential information) but shall be kept to a minimum. All contacts regarding employees shall be recorded in their files, with the most recent information filed on top. Entries shall only contain information necessary for handling cases. EAP file contents shall never be part of or stored with Official Personnel Folders, Employee Medical Files, or any other system of records in HHS.

   3. Family Member Files

      Information on family members of employees who use the EAP shall be maintained in the records of the employees. The only exception is when the family members are the clients of the EAP as described above.

   4. Location and Physical Security of Written Records

      All case records will be kept in locked metal filing cabinets preferably equipped with combination padlocks and steel lock bars. Cabinets shall be locked when not in use. All persons having access to the files shall have previous training in the proper handling of records covered by this policy. File cabinets shall not contain the records of other HHS programs or organizations. The last EAP staff leaving each day shall secure file cabinets.

   5. Security of Electronic Records

      The same confidentiality safeguards shall be taken when records are stored electronically. EAP data systems shall be protected from entry by anyone outside the EAP. Computers shall be password protected or discrete from other systems. As with written records, computers containing EAP records shall be secured at the end of each day.

   6. Period of Maintenance

      Records are retained until three years after employees have ceased contact with the EAP, whether or not employees have terminated employment with HHS, longer if required by states where the records are stored, 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.

   7. Record Destruction

      Files will be destroyed only after the required period of maintenance, with a witness present, by either (1) an HHS EAP Administrator or an EAP Administrator from another organization that contracts with HHS for EAP services, or (2) by designated staff of a private or governmental organization under contract with HHS to provide document destruction services. The witness must be trained in the proper handling of records covered by the Privacy Act and 42 CFR Part 2.

      • Paper records will be destroyed by shredding or burning.
        
      • Records stored on hard drives will be destroyed using software tools which ensure the protection of the confidential information by making reconstruction or compromise by reuse impracticable. Records contained on back-up tapes/diskettes will be disposed by either physically destroying the tapes/diskettes or by deleting them using software tools which ensure the protection of the confidential information by making reconstruction or compromise by reuse impracticable.
        
      • Records located away from the destruction site shall be transferred to the destruction site in the confidential manner required by HHS and GSA policies.
        
      • Names of the employees whose EAP records were destroyed shall be added to a record of former EAP participants. This list shall be kept with the case coding number record and the same confidentiality procedures apply. No other information about clients may be maintained once their records have been destroyed.

792-2- 70     STAFF QUALIFICATIONS

1. Introduction

   The provision of quality EAP services in HHS is dependent on the quality of EAP staff. EAP staff meets certain minimum qualifications in order to provide services for HHS. They are trained to professionally assist employees with all types of issues related to life and work. EAP staff reflects the program value of honoring environmental and cultural differences. They embody honesty, integrity and fairness.

2. Qualifications for EAP Staff Who Provide Services to Individuals

   EAP staff who provide services to individuals (as outlined above) must have mental health related degrees and be licensed and certified according to the laws and regulations of the states where they are employed. Recent graduates who do not meet practice requirements for licensure or certification must work under the direct supervision of qualified practitioners. Appropriate licenses and certifications must be obtained within two (2) years of graduation. Interns must be in training at the graduate level and be closely supervised by licensed practitioners.

3. Qualifications for EAP Staff Who Provide Substance Abuse Services

   EAP staff providing services to individuals, supervisors and organizations about substance abuse must have demonstrated proficiency in this area or be certified in this area by local or state governments or another recognized certification board.

4. Qualifications for EAP Staff Who Provide Services to Organizations

   EAP staff providing services to organizations (as described above) must have certification or demonstrated proficiency in the areas of the service (such as critical incident stress debriefings).

5. Other Requirements Related to Staffing
   1. The minimum required staffing pattern is one full time counselor per 3,500 employees in the target population. The EAP Administrator or headquarters staff may grant exceptions to this requirement, when there is sound justification.
      
   2. All contract staff, regardless of position, must have liability insurance coverage.
      
   3. Any staff performing quality assurance and evaluation EAP tasks that are strictly clinical in nature (such as assessment, treatment planning and referral) must meet all the requirements described above for "staff who provide services to individuals" and "staff who provide substance abuse services" or obtain outside clinical expertise.

792-2- 80     RELATIONSHIP WITH HHS' DRUG FREE WORKPLACE PLAN

1. Introduction

   One of the programs that partners with the EAP is the HHS 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 who have concerns related to drug abuse as well as help assure that HHS maintains an environment free of drugs. HHS developed the Drug Free Workplace Plan to set forth the objectives, policies, and procedures for implementation and operation of the program. The HHS EAP was given a number of responsibilities in the Drug Free Workplace Plan. They are:

2. Provision of Regular EAP Services

   The overall objectives of the EAP in relation to the Drug Free Workplace Plan 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.

3. Development of Job Rehabilitation Contracts

   The EAP, in cooperation with appropriate individuals, shall develop a Job Rehabilitation Contract for all employees referred to the EAP as a result of verified positive drug tests or for employees under the provisions of Safe Harbor. The Job Rehabilitation Contract insures that supervisors, the EAP, employees and their union representatives (if requested by bargaining unit employees) are in agreement regarding the steps to be taken in the EAP/rehabilitation process as well as after counseling or treatment has been completed.

   General information and guidelines regarding any necessary drug treatment and rehabilitation will be provided in Job Rehabilitation Contracts. Specific and detailed information about treatment and rehabilitation will be maintained in separate agreements with the EAP and will only be released according to confidentiality guidelines described in this document. The Job Rehabilitation Contract, as mandated by the HHS Drug Free Workplace Plan, is found in Exhibit 792-2-E.

4. Assistance with Safe Harbor Provisions

   Employees may also self-refer to the EAP under the Safe Harbor provision in the HHS 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, and must not use drugs again. Job Rehabilitation Contracts must be completed as noted above. 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 problems. It also cannot protect employees who have been found to use drugs illegally a second time.

5. Employee Education and Supervisor Training

   The EAP will assist the Drug Program Coordinator and training officers with the provision of on going drug education for employees and supervisors.

6. Relationship with Drug Testing Provisions

   The HHS Drug Free Workplace Plan includes provisions for the 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 according to the procedures described below.

   1. The Medical Review Officer notifies the EAP of positive test results and will coordinate with the EAP to inform employees' immediate supervisors of the results.
      
   2. The EAP then performs its normal functions of counseling and assisting employees and supervisors in dealing with the drug problem.
      
   3. Those job applicants from outside of HHS who receive positive test results are entitled to and will be offered assistance from the EAP. This assistance is limited to providing information on the availability of community treatment and rehabilitation services.

We know it is a difficult decision to see an EAP counselor for the first time. Employees are sometimes concerned about the privacy of what they say. We would like to assure you that your EAP record is confidential and explain some of the laws and regulations that protect it. Your EAP counselors are committed to upholding the highest professional standards in maintaining your privacy.

The principal purpose of maintaining information about you is to document your assessment, intervention and follow-up activities. The information is also used to monitor your progress. The information provided by you is voluntary. Limited information, however, may impact the EAP counselor's ability to provide full services.

The Privacy Act covers all EAP records. In addition, EAP records of clients with alcohol and drug problems are subject to extra restrictions described in the "Confidentiality of Alcohol and Drug Abuse Patient Records" regulations. Generally, these laws and regulations prohibit EAP staff from sharing any information about you outside the EAP.

There are some situations, however, when information about you can be released. We are required by law and regulation to inform you about these situations. We can disclose information:

1. when you consent to it in writing.

2. when it is allowed by a court order.

3. when it is made to medical personnel in a medical emergency or when the disclosure is made in a non-identifiable form to qualified personnel for research, audit or program evaluation.

4. to a private firm, individual, or group providing EAP functions contractually. The contractor shall be required to maintain all confidentiality safeguards and surrender these records to the EAP Administrator at the time of contract termination.

5. to the Department of Justice for defending HHS and/or its employees in litigation. Records that do not involve alcohol or drug abuse may also be disclosed to a court or another party before the court for this purpose. This is further described in the current System of Records Notice. These disclosures must comply with all other aspects of these regulations and be approved by the EAP headquarters staff.

6. when your direct supervisor needs to confirm that you have made or kept EAP appointments during regular duty hours or sick leave (no other information will be given without proper consent).

7. if you are tested and receive a verified positive drug test result (under the Drug Free Workplace Program), in which case your direct supervisor must be informed.

8. if you commit a crime at the EAP or against any person who works for the EAP or threaten to commit such a crime. Federal laws and regulations do not protect any information about the crime or threat. Information on crimes that may harm other persons or cause substantial property damage is also not protected, as long as the EAP does not identify you as an alcohol or drug abuser.

9. if you provide any information which would lead us to suspect child abuse or neglect (or in some states elder and spouse abuse). In these cases, we are required to report that information under State law to appropriate State or local authorities.

1. I, ____________________________________ , authorize:

2. the HHS Employee Assistance Program

3. to disclose this kind and amount of information:
   __________________________________________________________________
   __________________________________________________________________
   __________________________________________________________________

4. to this person, title, or organization:
   __________________________________________________________________

5. for this purpose:
   __________________________________________________________________
   __________________________________________________________________
   __________________________________________________________________

6. Date consent signed: _________________________________________________

7. Signature of client:
   __________________________________________________________________

8. Signature of parent or guardian (where required):
   __________________________________________________________________

9. Signature of person authorized to sign in lieu of client (where required):
   __________________________________________________________________

10. 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:
    __________________________________________________________________________
    __________________________________________________________________________
    __________________________________________________________________________

1. I, ____________________________________ , authorize:

2. name or title of person/organization from which information is requested:
   __________________________________________________________________

3. to disclose to the HHS Employee Assistance Program

4. the following information:
   __________________________________________________________________
   __________________________________________________________________
   __________________________________________________________________

5. for the purpose of:
   __________________________________________________________________
   __________________________________________________________________
   __________________________________________________________________

6. Date consent signed: _________________________________________________

7. Signature of client:
   _________________________________________________________________

8. Signature of parent or guardian (where required):
   __________________________________________________________________

9. Signature of person authorized to sign in lieu of client (where required):
   __________________________________________________________________

10. 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:
    __________________________________________________________________
    __________________________________________________________________
    __________________________________________________________________

1. Subject: Release of Confidential Information

2. From: HHS Employee Assistance Program

3. To: (name/title of the person/organization to which disclosure is made)
   ___________________________________________________________________

4. Date: ______________________________________________________________

5. 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.

Job Rehabilitation Contracts must be developed in accordance with the requirements listed in Section III.F of the HHS Drug-Free Workplace Plan. They must also be developed consistent with the provisions of negotiated labor agreements.

I, in consideration for my participation in the Department's Employee Assistance Program (EAP), agree to the following provisions of this contract:

1. As a result of a verified positive drug test indicating illegal drug use, I accept referral to the HHS EAP.

2. I agree to fully participate in an assessment conducted by the EAP. I further agree to participate in whatever treatment, rehabilitation, education, and /or short-term counseling recommendations made by the EAP.

3. I agree to execute all necessary Release of Information forms, to allow only the EAP to obtain information on my progress while in treatment.

4. I agree to provide the EAP with the dates and times of my treatment, rehabilitation, education, and /or short-term counseling appointments and with explanations of any absences from these appointments.

5. I understand that two (2) unexcused absences from treatment, rehabilitation, education, and /or short-term counseling will result in my having to make an appointment within three (3) working days with the EAP for re-evaluation. My supervisor will also be notified. My failure to comply with this agreement may result in disciplinary, administrative and/or adverse actions.

6. I agree to the following general treatment, rehabilitation, education, and /or short-term counseling plan. Specific plans such as names of facilities, therapists, and so forth are contained only in the EAP record.(to be completed by the EAP, if applicable):
   ______________________________________________________________
   ______________________________________________________________
   ______________________________________________________________
   ______________________________________________________________
   ______________________________________________________________

7. I understand that any treatment, rehabilitation, education, and/or short-term counseling outlined in this contract will cover a period not to exceed __________ (date).

8. I understand that the following administrative and/or disciplinary actions will be initiated by my supervisor and/or higher-level supervisors as a result of any other verified positive drug test result (delete if not applicable).
   ______________________________________________________________
   ______________________________________________________________
   ______________________________________________________________
   ______________________________________________________________
   ______________________________________________________________
   ______________________________________________________________

9. I further understand that implementation of these actions will be postponed or otherwise modified while I am undergoing treatment, rehabilitation, education, and/or short-term counseling as noted below.
   ______________________________________________________________
   ______________________________________________________________
   ______________________________________________________________
   ______________________________________________________________
   ______________________________________________________________
   ______________________________________________________________
   (#8 and #9 to be completed by the EAP in consultation with the supervisor and Employee Relations Specialist)

10. I understand that, notwithstanding the provisions of #9 above, I may be subject to other disciplinary or administrative actions for performance or conduct problems that occur during the period that I am participating in treatment, rehabilitation, education, and /or short-term counseling.

11. I understand that if I am in a sensitive position, I will be removed administratively from sensitive duties (unless the Secretary specifically restores them) at least until I successfully complete the plan outlined in #6 and #7 above. As an employee in a sensitive position, I also understand that if I am under the provisions of Safe Harbor all administrative actions will be canceled if I successfully complete treatment, rehabilitation, education, and /or short-term counseling.

12. I understand that I will be exempt from the HHS random drug testing program during the period cited in #7 above while I am undergoing treatment, rehabilitation, education, and /or short-term counseling. I further understand that at the end of this period I will be returned to the testing pool. (Delete if employee is not in random pool.)

13. I understand that I am required to complete my treatment, rehabilitation, education, and /or short-term counseling program successfully. I understand that I will have done this if I do the following:
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    (to be completed by the EAP in conjunction with the treatment specialist)

14. I understand that non-compliance with this contract, including refusal to cooperate with the EAP or other treatment, rehabilitation, education, and /or short-term counseling service providers, may result in disciplinary or administrative actions against me. Indications of non-compliance include, but are not limited to:
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________

15. I understand that treatment, rehabilitation, education, and /or short-term counseling service providers may require drug testing in order to monitor my progress, but that such tests are not part of the Department's drug testing program. A positive test result as part of the treatment, rehabilitation, education, and /or short-term counseling program can only subject me to disciplinary action if it is considered evidence of non-cooperation as noted in #13 above.

16. I understand that following the treatment, rehabilitation, education, and /or short-term counseling period cited in #6 and #7 above, I will be subject to a year of follow-up testing under the Department's Drug Free Workplace Program. A verified positive test result during this follow-up year or at any time thereafter will result in the initiation of action to remove me from Federal service.

17. I understand that the EAP is required to provide my supervisor with regular progress reports regarding my adherence to this contract, but that information regarding the nature of my treatment condition, my treatment, rehabilitation, education, and /or short-term counseling, and any other related information will not be disclosed outside the EAP without my specific written permission. The reports to be provided will include the following information and be provided according to the following schedule.
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    (to be completed by the EAP)

18. I understand that as a result of my successful completion of this contract, the following administrative and/or disciplinary actions may be canceled:
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    ______________________________________________________________
    (to be completed by the EAP in conjunction with the supervisor and Employee Relations Specialist)

The undersigned hereby agree to and adopt the provisions of this contract.

____________________________
Employee

____________________________
Immediate Supervisor

____________________________
EAP Representative

____________________________
Higher-Level Supervisor

____________________________
Union Representative (if requested by bargaining unit employee)

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Date

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