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### Resources For

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# Guidance for Agency Leaders & Coordinators

**The Environment of Employee Wellness Programs**

In order to provide Federal Employees a welcoming and inviting experience when accessing Employee Wellness Programs, it is important that agency leaders cultivate safe and comfortable environments both in-person and virtually for employees to access these resources. Agency leaders should pay special attention to the following key considerations: 
              - Creating workplace cultures which normalize conversations pertaining to mental health and mental health treatment by consistently and frequently marketing available resources; 
              - Cultivating healthy work-life balance by providing employees equitable access to workplace flexibilities, including alternative work schedules, telework and remote work, as aligned with agency policy and mission requirements;  
              - Providing a safe environment for employees to access Employee Wellness resources by instituting proper confidentiality protocols, and establishing transparency in communicating confidentiality measures afforded to employees; 
              - Creating private, welcoming physical spaces within agencies or within virtual settings for employees to access certain Employee Wellness resources which are separate from the employee’s workstation or shared office spaces; and 
              - Promoting psychologically safe spaces and work environments, where employees can function effectively, as well as express thoughts, emotions, opinions, and concerns without fear of repercussion, retaliation, or rejection. 

It is important to keep in mind that agency leaders play a vital role in cultivating healthy and safe work environments, as they have a responsibility to demonstrate the values of the agency and reinforce behaviors that reflect those values. This means that individuals in leadership roles should utilize their influence to help set the standard for prioritizing employee well-being by using new or existing communications channels, such as newsletters, regular emails to the workforce, employee Town Halls, or other methods to send messages to employees regarding available Employee Wellness Programs. 

**Agency Considerations for Selecting EAP Service Providers**

When selecting a new EAP service provider, agencies should consider the following factors to assess whether an EAP service provider is a proper fit for the agency: 
              - The scope of services offered by the provider; 
              - The current and future needs of agency employees; 
              - The mission of the agency, as services may need to be tailored to effectively meet the needs of agency employee  
              - The budget allotted for contract negotiation and the acquisition of services; and 
              - Location flexibility such that the service provider is able to accommodate employees working on-site, teleworking employees, and remote worker employees equitably. 

When working with an existing service provider, agencies should regularly communicate the evolving needs of their employees to their service providers and review all core EAP services outlined above for consistency in how they are provided and maintained. Agencies utilizing an internal Employee Wellness model should also review their Employee Wellness programs in order to maintain coverage for all services and resources outlined above.  

**Financial Considerations**

A major element of consideration when developing an EAP is the financial investment required. Agencies should carefully consider the return on investment (ROI) building a robust EAP can yield.  A 2020 study estimated the ROI of EAP counseling alone to be 5:1, or 500%, demonstrating strong financial value in employers investing in a quality EAP3. With the average annual operating cost of an EAP typically being between $12 and $40 per employee, operating cost can often represent less than one-third of one percent of the total  cost of employee health care benefits expended within many organizations and offer employees readily accessible preventative care options for their well-being. According to the U.S. Department of Labor, for every $1 invested in an EAP, employers save an average of $5 to $16. This is due in part to the notably low operating cost of an EAP in comparison to the high cost incurred by issues such as lack of productivity, absenteeism, accidents, and negative mental and physical health consequences which employees may experience when not appropriately afforded wellness resources, services, and supports.  For more information on developing strategies to capture the benefits and costs associated with the use of work-life programs, please utilize OPM’s Evaluation Guide. 

**Cultural Competence of Mental Health and EWP Service Providers**

Another critical element to consider both when selecting an EWP service provider or mental health practitioner and when designing organizational programs and trainings is cultural competence. Cultural competence refers to a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.  The term 'Culture' refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups, while the term 'Competence' implies having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities (Adapted from Cross, 1989). 

Five essential elements contribute to an agency's ability to become more culturally competent: 
              - Valuing diversity; 
              - Having the capacity for cultural self-assessment; 
              - Being conscious of the dynamics inherent when cultures interact; 
              - Having institutionalized culture knowledge; 
              - Having developed adaptations to service delivery reflecting an understanding of cultural diversity; 

In addition to the five elements of cultural competence noted above, agency leaders should work diligently to assess providers to determine whether they continuously meet and uphold the following criteria:  
              - A concrete understanding of the values and practices of employees and their families from diverse backgrounds which is rooted in factual information that supersedes stereotypes and generalizations about people from diverse backgrounds and cultures, and people with varying capabilities and limitations; 
              - An ability to utilize knowledge relevant to various cultures, religions, and social groups, and disabilities to tailor services to meet employees’ social, cultural, and linguistic needs without ethnocentric biases; 
              - An understanding of the Agency’s unique mission and the impact of this mission on its workforce in order to appropriately assess and respond to the needs of all employees 
              - A commitment to ongoing personal development in order to remain abreast of changing cultural needs and practices, and the impact of these changes on employees and their families;  

**Measuring the Success of Employee Wellness Programs**

In order to provide Federal Employees with an optimal and robust experience when accessing Employee Wellness Programs, it is integral that agency leaders regularly assess the progress of and engagement with these programs. Defining key parameters and benchmarks will assist agencies in objectively gauging the effectiveness of their EWPs and remaining responsive to the evolving needs of federal employees. 

**Key Performance Indicators**

Key performance Indicators (KPIs) are quantifiable measurements of an organization’s progress towards a particular goal or intended result over a period of time. Defining set KPIs for EWPs enables agency leaders to effectively measure the overall success and impact of the program and highlight areas for growth and improvement. EWP service providers must keep records confidential and remove PII to the extent possible, so that specific employees who are using these services are not identifiable. Examples of KPIs are provided below. 
              - Utilization Rates : Utilization rates track the number of employees who have accessed an Employee Wellness Program Service over a period of time.  
              - Referral Rates : Referral rates track the number of employees who were provided with a recommendation or referral to professional assistance for continued support.  
              - Employee Satisfaction Rates : Employee satisfaction rates track how thorough or beneficial employees believe a wellness service to be.  
              - Re-engagement Rates : Re-engagement Rates track the number of employees who accessed or engaged with a particular Employee Wellness service more than once. 

**Overcoming Barriers to Employee Wellness Program Usage**

An effective and comprehensive Employee Wellness Program can significantly reduce instances of absenteeism, low productivity, employee burnout, and other negative mental and physical complications, health care costs, accidents, and grievances. As such, it is vital for agency leaders to address any potential barriers to EWP usage in order to yield the most positive outcomes and experiences for employees. Many barriers to EWP usage fall into two main categories**: structural barriers** and **attitudinal barriers**. The difference between these barriers as well as ways to overcome them are described below. 

**Structural barriers** include obstacles which negatively impact the efficiency and operation of a program such as policies, complexity in accessing wellness resources, availability of professional service providers (particularly mental health providers), and long wait times9. To promote wellness program usage, the following criteria should be met: 
              - Wellness resources are readily available to employees in an easily accessible and central location (i.e., agency homepage or intranet) such that services and resources are provided in a manner that is accessible to people with disabilities; 
              - Services and resources are available for employees with disabilities using effective communication, reasonable modifications or accommodations, physical accessibility, and compliance with  Section 508 of the Rehabilitation Act of 1973 ; 
              - Clear and concise instructions on how and where to access EWP resources are provided, including contact information of service providers 
              - Employees working at  alternative worksites  have equitable access to Employee Wellness Program services and resources; and 
              - Agency leaders communicate set parameters for the amount of time an EAP service provider is allotted to connect an employee with a service provider Examples of these parameters might include establishing a specified limit on wait times to reach a mental health counselor. 

**Attitudinal barriers** refer to mental interferences that are the product of one's feelings, beliefs, and assumptions, and can include issues such as confidentiality concerns, stigmas associated with program usage (particularly the usage of mental health resources and counseling services), and a lack of understanding or awareness of available resources and services10. To promote wellness program usage, the following criteria should be met: 
              - Confidentiality measures are immediately communicated when an employee accesses relevant wellness services, such as mental health counseling; 
              - Agency leaders inspire workplace environments which normalize conversations surrounding mental health and accessing mental health treatment by frequently promoting wellness tools, resources, and services, supporting diverse workplaces, fostering climates of inclusivity, and supporting employee usage of appropriate  leave  options and  alternative work schedules  to care for their mental and physical well-being or to care for a  family member  with a mental or physical health concern;  
              - The scope of wellness resources available to employees is regularly communicated, including what each EAP service entails and what additional supplementary resources are supported; and 
              - Agency leaders dispel myths associated with EAP usage and communicate that employees with mental health and/or addiction issues are valued and supported, and that employees’ security clearances will NOT necessarily be impacted should they utilize mental health counseling or other wellness services. 

****