Supervisory Referral Process and Forms
The EAP provides an opportunity for the employee to address job performance issues. Participation with the EAP is voluntary and does not mean an employee is immune from disciplinary actions if job performance issues continue. For any questions about this process, please call EAP Client Services, at 1-866-227-6527.
How Do We Make a Referral?
Step 1: Based upon documented employee job performance issue(s), a determination is made by management/HR that a supervisory referral is needed.
Step 2: HR and/or Supervisor meet with employee to make referral. Employee and HR/Supervisor will sign Supervisor Referral Form (click here for form) and Informed Consent (click here for form). Note: Remind employee that session content is confidential but that you will receive notice about their attendance at appointments & treatment recommendations.
Step 3: HR/Supervisor should fax completed forms and supporting documentation to WellSpan EAP Client Services at (717) 851-4493 (prior to employee calling to schedule their first EAP appointment).
Step 4: Referred employee should call WellSpan EAP Client Services directly (within 72 hours) at 1-800-673-2514 to provide necessary demographic information.
Step 5: WellSpan EAP will coordinate initial appointment with appropriate provider and notify employee of availability. Employee will need to call selected provider and CONFIRM appointment. It is recommended that employee notify WELLSPANEAP of this confirmation.
What Should We Expect After Referral is Made?
Step 1: Via phone, WellSpan EAP notifies primary contact person listed on Informed Consent of the employee’s first scheduled appointment date.
Step 2: The employee will be asked by provider to sign a formal “Release of Information Form” at their first appointment to allow continued follow-up with primary and/or secondary contacts.
Step 3: A WellSpan EAP representative will call primary contact listed on form to provide updates regarding employee’s participation when available.
Step 4: A ‘Client Status Report’ completed by the provider and marked “confidential” will be mailed directly to the primary contact person listed on the release of information form.
We recommend continued discussion about performance issues as needed. Supervisor or HR are strongly encouraged to follow up directly with referred employee for information regarding their attendance at EAP sessions or to continue performance-related discussions.
Supervisor Referral and Informed Consent forms. (pdf) Please complete the referral and informed consent forms. Fax the completed forms to WellSpan EAP Client Services at (717) 851-4493
Complete web-based Supervisor Training which reviews the supervisory referral process.
Frequently asked questions about Fitness For Duty Evaluations
- What is a true Fitness for Duty evaluation?
A psychological FFDE is a formal, specialized evaluation by a qualified, licensed professional to determine whether the employee can safely and effectively perform his or her essential job functions. Evaluations of this type tend to be lengthy and expensive.
- Can I obtain a Fitness for Duty evaluation through WellSpan EAP?
WellSpan Employee Assistance Program does not offer Fitness For Duty evaluations. This is beyond the scope of practice that our licensed mental health therapists perform under the WSEAP. Given the level of detailed assessment procedures and techniques involved, this comprehensive psychological evaluation falls outside of traditional EAP counseling sessions.
- How can WellSpan EAP help?
If you have submitted a Supervisory Referral with the appropriate signed consent form, our EAP Team will communicate the following things with you: Date and Time of employee’s EAP appointment; if the employee has attended those sessions, including cancellations and rescheduling; recommendations by the provider (if any); and if the provider feels the individual is following those treatment recommendations.
- What other options does WellSpan EAP offer?
Trained WellSpan EAP Coordinators can help facilitate “return to work” conversations between any combination of HR, management, affected team members and the employee to help set the stage for successful adjustment of the individual back to full duty. This type of on-site consultation service is available at an additional fee. Phone consultations with questions and helpful suggestions are available at no cost to you.
- What if I have further questions?
If you have any further questions regarding Fitness for Duty evaluations, please give us a call at 1-800-673-2514.