# **Material transmitted**

HHS Personnel Instruction 792-2, Employee Assistance Program

# **Material superseded**

HHS Personnel Instruction 792-2, Employee Assistance Program (all),
dated 9/15/00

# **Background and philosophy**

We live in a time of remarkable transformation, a time for re-thinking
human relationships and structures on every level and of all kinds.
Witness the recent historical workplace changes such as acknowledgment
of the connection between health and productivity in the work
environment, shifting relations between women and men, and growth of a
multi-cultural workforce. At the same time, we are making extraordinary
progress in treating and raising consciousness around mental health
concerns.

These changes signal a very open moment in the history of this
Department as well as the Employee Assistance Program (EAP). It is a
time to take seriously the idea that mental wellness is vital for
individual employees and their families as well as for the well being of
this organization. In fact, today's worldview, which acknowledges
connections between all people, assures that Health and Human Services'
(HHS) good health will contribute to the entire community. The first
Surgeon General's Report on Mental Health acknowledges that the
prosperity and strength of the Nation is dependent on the overall health
and well being of its people.

The EAP is an important partner in the creation of a mentally healthy
workplace in HHS. One way the program contributes to a healthy
Department is by providing quality mental health services for
individuals dealing with issues related to life and work. When it is
best for the individual, the EAP collaborates with other components of
HHS as well as the broader community to achieve the most positive
outcome. The EAP values prevention and our staff educates and advocates
for self-identification and early intervention. When issues cannot be
prevented, the EAP works with individuals to bring meaningful
resolutions.

Another way the EAP supports a healthy workplace is through the
provision of quality services for supervisors or work groups that are
dealing with stressful or potentially stressful organizational issues.
The program understands that these organizational issues are most
effectively resolved when there are early interventions and
collaboration. Managers and organizations realize the value of the EAP
in meeting their organizational goals when they use the EAP to address
issues that are impacting work groups.

EAP services value and acknowledge environmental and cultural
differences. In addition, the program understands the importance of
cooperative and collaborative labor-management relationships in dealing
with issues related to work and life. Our staff upholds the highest
professional standards related to confidentiality, honesty and
integrity.

HHS has provided an EAP Department-wide since 1979. It has maintained
its commitment to the program as it, and the Department, have undergone
a number of changes over the years. HHS values and benefits from a
workforce that is mentally and physically well and supports the efforts
of the EAP in achieving this goal.

# **Filing instructions**

Remove superseded material and replace it with new material. Post
receipt of this transmittal to the HHS Check List of Transmittals and
file it in sequential order after the Check List.

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Roy Tucker

Acting Deputy Assistant Secretary

for Human Resources

INSTRUCTION 792-2

Subject: **EMPLOYEE ASSISTANCE PROGRAM**

2.  00 Purpose and Responsibilities

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10. Laws, Regulations, and Policies Related to the EAP

20 Eligibility and Cost

> 30 Services Offered by the EAP
>
> 40 Assuring the Provision of a Quality Program
>
> 50 Leave Usage and Job Security
>
> 60 Confidentiality Procedures
>
> 70 Staff Qualifications

80. Relationship with HHS' Drug Free Workplace Plan

Exhibit 792-2-A Confidentiality Procedures

Exhibit 792-2-B Consent for Release of Confidential Information

Exhibit 792-2-C Consent for Obtaining Confidential Information

Exhibit 792-2-D Secondary Disclosure Prohibition

Exhibit 792-2-E Model Job Rehabilitation Contract

[792-2- 00]{.underline} **PURPOSE AND RESPONSIBILITIES**

# ***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.

### 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]{.underline} **LAWS, REGULATIONS, AND POLICIES RELATED TO THE
EAP**

# ***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)

### 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)

### 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]{.underline} **ELIGIBILITY AND COST**

### 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.

# ***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]{.underline} **SERVICES OFFERED BY THE EAP**

A.  ***[Introduction]{.underline}***

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.

### Services Offered to Individuals

1.  [Assessment]{.underline}\
    \
    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]{.underline}\
    \
    Actions to refer employees to one or more community resource(s) to
    receive services or treatment, as necessary.

3.  [Short-Term Problem Solving]{.underline}\
    \
    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]{.underline}\
    \
    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]{.underline}\
    \
    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.

### Services Offered to Supervisors and Managers

1.  [Supervisory Referral Assistance]{.underline}\
    \
    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]{.underline}\
    \
    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\
    \
    ]{.underline}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).

### Services Offered to Organizations

1.  [Violence Prevention/Crisis Management\
    \
    ]{.underline}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]{.underline}\
    \
    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\
    \
    ]{.underline}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]{.underline}\
    \
    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]{.underline}\
    \
    Posters, fliers, newsletters, bulletins and other techniques for
    reminding employees about the program\'s services.

6.  [Special Services\
    \
    ]{.underline}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]{.underline} **OTHER WAYS OF ASSURING A QUALITY PROGRAM**

### 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.**

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A.  ***[Reporting and Evaluation]{.underline}***

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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.

***C.*** ***[Quality Assurance]{.underline}***

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.

***D.*** ***[Other]{.underline}***

> 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]{.underline} **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]{.underline} **CONFIDENTIALITY PROCEDURES**

A.  ***[Introduction]{.underline}***

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.

## B. [General Procedures]{.underline}

1.  [Authority for Protecting EAP Records\
    \
    ]{.underline}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\
    \
    ]{.underline}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\
    \
    ]{.underline}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\
    \
    ]{.underline}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\
    \
    ]{.underline}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\
    \
    ]{.underline}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.

***C.*** ***[Releases of Information]{.underline}***

1.  [Disclosure with Consent\
    \
    ]{.underline}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\
    \
    ]{.underline}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]{.underline}***\
    \
    ***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]{.underline}, 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\
    \
    ]{.underline}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\
    \
    ]{.underline}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\
    \
    ]{.underline}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.

***D.*** ***[Record Keeping Procedures that Support the Confidentiality
of Client]{.underline}\
[Information]{.underline}***

1.  [Case Coding\
    \
    ]{.underline}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\
    \
    ]{.underline}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]{.underline}***\
    \
    ***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\
    \
    ]{.underline}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]{.underline}***\
    \
    ***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]{.underline}***\
    \
    ***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]{.underline}\
    \
    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]{.underline} **STAFF QUALIFICATIONS**

A.  ***[Introduction\
    ]{.underline}***

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.

B.  ***[Qualifications for EAP Staff Who Provide Services to
    Individuals]{.underline}\
    \
    ***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.

C.  ***[Qualifications for EAP Staff Who Provide Substance Abuse
    Services]{.underline}\
    \
    ***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.

D.  [***Qualifications for EAP Staff Who Provide Services to
    Organizations***\
    \
    ]{.underline}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).

### 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]{.underline} **RELATIONSHIP WITH HHS' DRUG FREE WORKPLACE
PLAN**

A.  ***[Introduction]{.underline}***

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:

B.  ***[Provision of Regular EAP Services]{.underline}\
    ***\
    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.

C.  ***[Development of Job Rehabilitation Contracts]{.underline}***\
    \
    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.

D.  ***[Assistance with Safe Harbor Provisions]{.underline}\
    \
    ***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.

E.  ***[Employee Education and Supervisor Training]{.underline}\
    \
    ***The EAP will assist the Drug Program Coordinator and training
    officers with the provision of on going drug education for employees
    and supervisors.

F.  ***[Relationship with Drug Testing Provisions]{.underline}\
    \
    ***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.

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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.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

**EMPLOYEE ASSISTANCE PROGRAM**

**CONFIDENTIALITY PROCEDURES**

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]{.underline} 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.

The authority for maintenance of your record is 5 U.S.C. 7361, 7362,
7901, 7904, and 44 U.S.C. 3101. See also HHS Personnel Instruction
792-2. Violation of the Federal laws and regulations by the EAP is a
crime. Suspected violations may be reported to appropriate authorities
in accordance with Federal regulations.

**U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES**

**EMPLOYEE ASSISTANCE PROGRAM**

**CONSENT FOR RELEASE OF CONFIDENTIAL INFORMATION**

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:
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES**

**EMPLOYEE ASSISTANCE PROGRAM**

**CONSENT FOR OBTAINING CONFIDENTIAL INFORMATION**

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:
    \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES**

**EMPLOYEE ASSISTANCE PROGRAM**

**SECONDARY DISCLOSURE PROHIBITION**

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.

**U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES**

**EMPLOYEE ASSISTANCE PROGRAM**

**MODEL JOB REHABILITATION CONTRACT**

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)\_\_\_.]{.underline}

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]{.underline}
    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 Date

(if requested by bargaining unit

employee)

#