Employee Assistance Programs

TREATMENT November 1994

Two Wall Street Journal articles uncover how some workplace programs designed to help employees may be leaking personal and supposedly confidential information (Ellen Schultz, "Open Secrets: Medical Data Gathered By Firms Can Prove Less than Confidential," Wall Street Journal, May 18, 1994, p. 1; Ellen Schultz, "If You Use Firm's Counselors, Remember Your Secrets Could Be Used Against You," Wall Street Journal, May 26, 1994, p. C1).

Employee Assistance Programs, or EAPs, provide short-term counseling or referrals to help employees maintain physical and emotional well-being. Some large companies hire their own EAP staff and smaller companies contract out for an EAP or join a consortium. As the articles point out, however, companies may have intentions for EAPs other than helping their employees.

While an employee may think that information he or she tells to an EAP counselor may be private and confidential, the articles show that sometimes this information is used against the employee in disability or discrimination suits. The information has even been used to fire employees that may cost the company too much money in sick time and health benefits.

"Companies generally don't start out with Orwellian intentions; they simply want to hold down expenses. But once the medical information is present, so are the temptations to tap it, for a variety of reasons that have nothing to do with keeping employees healthy," the article asserts. Often the release form that most employees sign as a routine matter of enrolling in the company's "wellness plan" gives the EAP the right to release private and personal information to the employer.

EAP information has been used to save companies money on their health insurance premiums. Adolph Coors Company offers a 5% reduction in insurance co-payments if employees fill out a "Health Hazard Appraisal" form that asks about marital or in-law problems, alcohol use, sexual disfunction, mortgage payments, and perceived social status. New companies that have sprung up around the country help to translate these questionnaires into dollar figures. Employers may then shift some of the costs of health insurance to more "expensive" employees. Hershey Foods Corporation charges employees an extra $30 per month for high blood pressure, $30 if they are overweight and $50 if they smoke. "Management can now forecast where the ticking time bombs are in their employee population," according to Joel Kapusta of Medical Strategies in New City, New York. "In the hands of creative CEOs and CFOs, health-promotion programs are new profit centers."

The article discusses how some companies use information in EAP files, such as past use of the EAP for drug or alcohol problems, to guard against workers compensation and disability claims. Bruce Webster, a psychologist from Newport Beach, California said that personal information has been used against employees in unrelated disability claim cases. "If that employee tells the counselor their husband drinks, it gets used against them and affects the amount of the award of the disability claim," Webster said.

At one aerospace company that was not identified in the article, the EAP director said that information is collected by the EAP for the express reason of guarding the company against claims. "The process is like this. The conversation is worked around to the realm of stress. 'So, what do you do to relieve stress outside of work? Do you have hobbies or participate in sports? You say you belong to the softball league' ... Then when you get hurt on the job, this kind of information will be used to call into question when the injury occurred."

Some employers link EAPs with the company's drug testing program. The article discusses one company that uses a two-column chart for EAP counselors to fill out. One column contains the problem that the employee brings to the EAP. The other is for the "assessed" problem as evaluated by the EAP counselor, which often turns out to be a drug abuse problem. In one case, an executive with the company complained to the EAP of financial difficulties, which were recorded in the counselor's notes as a problem with alcohol or drugs.

Many EAPs have problems keeping their information confidential. Large employee databases are easily accessed. Shelly Reciniello, a consultant who sets up EAPs in New York, once called a managed-care facility to ask about a woman's records. Without checking Reciniello's identity, the attendant accessed the files and reportedly said, "Hmm ... I see here that she's depressed. No wonder. She had that hysterectomy two years ago."

The Employee Assistance Professionals Association, Inc., the major trade association of EAPs, sets strict guidelines for its members. Kay Springer of EAPA said that her organization was shocked and outraged by the incidents in the articles. Not all programs that call themselves EAPs are members, she warns, and some of these groups face little or no regulation.

While EAP records, especially medical records concerning drug and alcohol treatment, must be kept confidential by federal and some state laws, information can be released if the employee gives his or her permission. Very often this permission is included in the forms that employees sign to receive treatment. Springer of EAPA urges all employees to find out more about their EAP's client confidentiality policies.

[For more information about EAPs, or about how to assess your EAP, contact the Employee Assistance Professionals Association, 2101 Wilson Boulevard, Suite 500, Arlington, VA 22201-3062, 703-522-6272. They publish the EAPA Consultants Directory ($40). Also see Stephen Rosenzweig and Eric P. Kramer, "Get With the Program," Small Business Reports, Aug. 1992, p. 20.]