2300-792-2 - EMPLOYEE COUNSELING SERVICES PROGRAM
Issuing Office: OD/OHR/DERT 402-8733
Release Date: 6/1/88
_________________________________________________________________
Table of Contents
A. Purpose
B. References
C. Responsibilities
1. Medical Director, OMS
2. Chief, Recruitment and Employee Benefits Branch, DPM
3. ECS Counselors
4. Labor Management Branch, DPM
5. BID* Personnel Officers
6. Supervisors
7. Employees
D. Definitions
E. Policy
F. Referral for Evaluation and Treatment
G. Relationship to Disciplinary Action
H. Confidentiality of Records
I. Illegal Activities
J. Additional Information
K. Additional Copies of this Chapter
*The acronym "BID" no longer means "Bureau, Institute and
Division."As defined in NIH Manual 1122, BID is an "NIH
Organizational term encompassing all research institutes, the
National Library of Medicine, and Divisions and Centers (DRG,
DRS, DRR, DCRT, CC, FIC, NCNR) that report to the Director,
NIH."Table of contents
Illustrations
Illustration 1 Flow Chart for Referral to ECS
Illustration 2 Sample Memorandum of Supervisory Referral to ECS
Illustration 3 Sample Form NIH 2558
Illustration 4 Sample Memorandum from OMS Medical Staff to
Supervisor
Illustration 5 Sample Memorandum from ECS to Supervisor
Regarding Initial Referral
Illustration 6 Sample Memorandum from ECS to Supervisor Regarding
Premature Termination of Recommended
TreatmentA.Purpose
This chapter states NIH policy concerning employee alcohol,
drug abuse and emotional/behavioral problems which result or
could result in deteriorating employee work performance,
conduct, attendance or reliability. It discusses counseling
and rehabilitation services which NIH shall provide, and
describes responsibilities of program officials,
supervisors, employees and personnel staff.
This chapter applies to all NIH civilian employees,
including those outside the Washington Metropolitan area.
It applies equitably at all levels of the organization and
to all grades and pay plans. Those field offices without
adequate health facilities are expected to request guidance
from the Medical Director, Occupational Medical Services
(OMS), Division of Safety, Bethesda, MD, (301) 496-4411, and
to use community resources wherever available.
The Employee Counseling Services Program (ECS) supplements,
but does not replace, existing procedures for dealing with
problem employees through appropriate personnel actions.
B. References
1. 21 U.S.C. 1180 provides that the OPM shall be
responsible for developing and maintaining, through the
National Institute on Drug Abuse and other Federal
agencies, prevention, treatment, and rehabilitation
services for drug abuse among Federal employees.
2. 42 U.S.C. 290dd-3 provides for confidentiality of
alcohol and drug abuse patient records. Implementing
regulations are contained in 42 CFR.
3. 5 U.S.C. 7901 authorizes heads of Federal Departments
to establish health service programs for the purpose of
promoting and maintaining the physical and mental
fitness of Federal employees.
4. GSA building regulations (41 CFR 101-20.307) and NIH
regulations (45 CFR 3.43(d)) prohibit a person from
selling, consuming or using intoxicating beverages,
narcotics or similar drugs, except in connection with
official duties, in the course of professional
treatment, in living quarters, or as otherwise
authorized by the Director, NIH.
5. Federal Personnel Manual Chapter 751 provides guidance
on action to be taken to relieve employees from duty
for emergency reasons or because the employee is not
ready, willing, and able to work.
6. Federal Personnel Manual Chapter 792 provides basic
Office of Personnel Management (OPM) guidance on
Federal Employees Health and Counseling Programs.
7. FPM Bulletin 751-3, dated 9/24/85, provides questions
and answers on performance and conduct problems
involving medical considerations.
8. HHS Personnel Instruction 735-1, dated 1/23/81,
provides guidance on Standards of Ethical Conduct.
9. HHS Personnel Instruction 752-1, dated 7/19/85,
provides guidance on adverse actions, specifically
removals, suspensions, reductions in grade, reductions
in pay, and furloughs of 30 days or less.
10. HHS Personnel Instruction 792-2, dated 8/13/82,
provides the policy and requirements of the Department
as they relate to the Employee Counseling Services
Program.
11. HHS Circular 751-1, dated 12/2/86, provides a
discussion prepared by the U.S. Office of Personnel
Management, Appellate Policy Division, of rulings
involving the use of enforced leave and suggests
alternatives to be considered.
12. NIH Manual Chapter 2300-339-3, provides the policies
and procedures for reasonable accommodation for
employees who develop a disabling condition while
employed at the NIH.
C. Responsibilities
1. Medical Director, Occupational Medical Services (OMS),
Division of Safety, has the responsibility for ensuring
that evaluation and referral services are available,
that community treatment services are identified, and
that supervisory training and employee awareness
programs are provided in the area of alcohol, drug
abuse, and emotional/behavioral problems.
2. Chief, Recruitment and Employee Benefits Branch (REBB),
Division of Personnel Management (DPM), is responsible
for:
a. providing overall guidance and assistance in the
implementation of the NIH procedures related to
employee alcohol, drug abuse, or
emotional/behavioral problems. Using information
provided by the BID Personnel Offices and other
appropriate sources, REBB will periodically
evaluate the effectiveness of these procedures in
meeting program goals.
b. providing guidance to NIH personnel staff in the
requirements and use of the NIH Employee
Counseling Services Program and for coordinating
the scheduling of ECS training programs with BID
Personnel Offices.
3. ECS Counselors are responsible for:
a. advising the employee of the confidential nature
of the ECS Program, and that a signed consent form
by the employee would be necessary before the ECS
counselor could advise the supervisor regarding
any issues other than expected absences from the
job for treatment and proper expectations for work
performance during the treatment.
b. evaluating and diagnosing employees, referring to
outside or internal treatment resources and
short-term counseling of employees referred to
them for determinations related to alcohol, drug
abuse or emotional/behavioral problems.
c. developing and administering training courses for
supervisors and managers, employee groups and
other appropriate audiences. This should be done
in cooperation with REBB and BID Personnel
Officers. These courses will furnish guidance on
subjects such as:
- Identification of an employee whose poor work
performance or conduct suggest a potential
alcohol, drug abuse or emotional/behavioral
problem.
- Counseling methods.
- NIH policies related to alcohol, drug abuse
or emotional/behavioral problems.
d. maintaining close working relationships with
community resources which offer treatment and
rehabilitative services locally. These resources
may include community psychiatric clinics or
services, Alcoholics Anonymous, etc. Professional
consultation from OMS staff physicians and the OMS
psychiatrist will be available to the counselors.
e. maintaining records and gathering
information/statistics incoordination with other
appropriate offices, for evaluation and reporting
to the Department and the Office of Personnel
Management. Disclosure of such records will be
statistical in nature and shall not identify
individuals.
4. Labor Management Branch will provide overall guidance
and regulatory or the Merit Systems Protection Board
(MSPB) Decision interpretations to OMS and BID
Personnel Offices in those instances where adverse
action may be appropriate.
5. BID Personnel Officers are responsible for furnishing
technical guidance to supervisors on regulations and
procedures related to the ECS program, discussing
available options, and advising them on taking
appropriate personnel action when counseling or
rehabilitation efforts are in process or at their
conclusion.
6. Supervisors are responsible for the work of the
employees under their direction. In relation to
alcohol, drug abuse, or emotional/behavioral problems,
this requires that supervisors be aware of NIH policies
related to these medical conditions and document
specific instances in which employee's work
performance/conduct fails to meet acceptable standards
or where there appears to be a pattern of deteriorating
performance/conduct. Supervisors are responsible for
obtaining assistance from their local personnel office
when dealing with employees who are not ready, willing
and able to work, formally referring an employee to the
ECS program for medical advice and diagnosis, and/or
taking corrective action.
7. Employees are responsible for notifying the supervisor
of any medical condition that may interfere with
satisfactory performance of assigned duties or conduct
on the job.
D. Definitions For purposes of this issuance, certain terms
are defined as follows:
1. Alcohol Abuse A treatable problem in which the
employee's work performance or conduct may be impaired
as a result of the use of alcohol. Alcoholism is a
handicapping condition under Section 501 of the
Rehabilitation Act of 1973, (29 U.S.C. 791), as
determined by the Attorney General of the United
States.
2. Drugs Substances that affect the functions of the body
or the mind when taken into the body or applied to its
surfaces.
3. Drug Abuse A treatable problem in which the employee's
work performance or conduct may be impaired as a result
of use of legal or illegal drugs. Drug abuse is a
handicapping condition under Section 501 of the
Rehabilitation Act of 1973, (29 U.S.C. 791), as
determined by the Attorney General of the United
States.
4. Emotional/behavioral problems Personal problems which
may impair work performance. Such problems include
depression, anxiety, stress and psychiatric illnesses,
and those stemming from alcohol, drug abuse, or
emotional/behavioral problems of another person, such
as a spouse, supervisor, or a co-worker. Such problems
can also result from working conditions or the nature
of the job itself.E.Policy
1. Emotional/behavioral problems and the use of alcohol or
drugs are of concern to NIH as they relate to conduct
and performance on the job. When an employee's use of
alcohol or drugs or emotional/behavioral problems
interfere with the efficient and safe performance of
his/her assigned duties or the duties of other
employees, reduces dependability, or reflects discredit
upon NIH, there must be action in the form of:
a. Following non-disciplinary procedures under which
the employee will be offered referral to the ECS
Program in writing as well as orally. (See
Illustration 1 for steps on referral process);
and/or
b. Invoking the appropriate personnel action if
employee's response to item (a) does not result in
acceptable work performance/conduct; and/or
c. Informing the Security Branch, Division of Safety,
when a drug problem also involves criminal conduct
directed toward or potentially harmful to the
person or property of others.
2. The status of the employee who is not ready, willing,
and able to work will be handled on a case by case
basis in consultation with the BID Personnel Office.
F. Referral for Evaluation and Treatment
1. Supervisory Referral (See Illustration 1)
a. When work performance/conduct is not in question:
The supervisor may encourage an employee to seek
counseling from the ECS Program at any time there
is a noticeable change in an employee's behavior
or if an employee comes to the supervisor with a
personal problem. The supervisor provides the
employee with a copy of the brochure covering the
variety of services provided by the ECS. This can
be done long before there is deteriorating work
performance/conduct.
The supervisor may contact the ECS, if he/she so
desires, for a preliminary consultation before
finalizing his/her decision on which course of
action to pursue. In addition, the supervisor may
seek the guidance of an ECS counselor in coping
with a problem employee or work situation under
the guidelines prescribed in F.2. below
(Self-Referral). (There is a special service
provided through the OMS/ECS to specifically
address/handle employees who are mentally or
physically disabled. This service is available to
the supervisor who may need help in coping with a
handicapped employee, as well as to the employee.)
The supervisor may, at the employee's discretion,
accompany that employee to the ECS as a part of
the initial referral, and may attend any
subsequent meetings/sessions as deemed appropriate
by the counselor and the employee.
b. When work performance/conduct is in question:
The supervisor is the key person in the process
that results in a referral of an employee for
diagnosis and treatment. When an employee
demonstrates an inability or unwillingness to
perform adequately, and the supervisor believes
the employee has an alcohol, drug abuse or
emotional/behavioral problem, the supervisor
should contact the BID Personnel Office and the
ECS for advice about referral.
After the supervisor has received the advice of
the personnel office and ECS, the supervisor
should meet with the employee, describe the
employee's poor work performance/conduct, discuss
specific corrective action to be taken to improve
performance, conduct or attendance, and the time
frame by which corrective action is to be
completed. The supervisor should tell the
employee that, if a personal problem is involved,
he/she should contact the ECS. A copy of the
brochure covering the variety of services provided
by the ECS should be given to the employee. The
supervisor documents the first meeting and gives a
copy of the documentation to the employee.
If performance, conduct, or attendance does not
improve, the supervisor should meet with the
Personnel Specialist to discuss the problem, and
with his/her help should prepare a memorandum
pointing out specific problems, and formally
referring the employee to the ECS program. The
supervisor should then meet with the employee, and
with documentation at hand, point out how
performance, conduct or attendance has not
improved, give the employee a memorandum outlining
these deficiencies (See Illustration 2) and
formally refers him/her to the ECS program. The
employee should be informed that this is not a
disciplinary action, and the memorandum will not
be put in his/her Official Personnel Folder (OPF),
but may be used as documentation if the problems
persist and personnel action becomes necessary.
The importance of firm and consistent application
of corrective procedures to avoid disciplinary
action cannot be overstated; however, if the
employee refuses help and performance/conduct
continues to be unsatisfactory, the supervisor, in
collaboration with the Personnel Office should
pursue the appropriate personnel action.
c. When there is a possibility that the employee may
be under the influence of drugs and/or alcohol:
If a supervisor observes that an employee
demonstrates impairment in performance or
behavior, and substance intoxication is a
possibility, the employee may be escorted to OMS
and evaluated there. Alternatively, if the
employee acknowledges that he/she is incapacitated
by drugs or alcohol, he/she can elect to go home
or to an emergency room if arrangements can be
made for him/her to arrive safely. Employees seen
at outlying OMS health units may be transported to
the main OMS health unit for evaluation when
necessary.
OMS medical assessment will include determining
current ability to perform duties safely,
recommending further evaluation, establishing a
medical treatment plan, and preparing appropriate
communication with the supervisor. Based on the
medical assessment, one of the following options
may be recommended:
(1) Arrange for immediate referral for
emergency room evaluation and/or
hospital admission.
(2) Arrange for employee to be escorted home
(consider family, taxi) because he/she
is too impaired to work.
(3) If acute impairment is not demonstrated,
the employee may be medically cleared to
return to work that day.
OMS will communicate with the supervisor by:
(1) verbally advising him/her on the
employee's ability to perform work
duties;
(2) completing Form NIH 2558, Medical
Evaluation of Work Status (Illustration
3), describing the employee's ability to
perform work duties and need for further
OMS assessment; and
(3) issuing a memorandum (Illustration 4)
documenting the supervisor's referral
and OMS recommendations.
Employees with suspected or proven substance abuse
should always be referred to the ECS counselor by
OMS staff and/or the supervisor (Illustration 2).
The ECS counselor will advise the supervisor of
the employee regarding compliance with treatment
recommendations (Illustrations 5 & 6).
2. Self-Referral
a. When work performance/conduct is not in question:
Employees may voluntarily refer themselves to an
ECS counselor. The above procedures shall not
apply to self-referrals, provided that work
performance/conduct does not become a related
issue.
In the case of self-referral, no information
regarding an employee's entrance into the program
will be communicated to the supervisor unless the
employee signs a Release of Information (ROI) or
the supervisor requests
validation of employee's absence from the
worksite. ECS' philosophy is to encourage
employees to recognize their own coping problems
and seek help as soon as possible for early
intervention.
b. When an employee is self-referred to either ECS or
OMS and acute substance intoxication is a
possibility:
The OMS will conduct a medical assessment to
determine current ability to perform duties
safely, recommend further evaluation, establish a
medical treatment plan, and prepare appropriate
communications with the supervisor.
Based on the medical assessment, one of the
following options may be recommended:
(1) Arrange for immediate referral for
emergency room evaluation and/or
hospital admissions.
(2) Arrange for the employee to be escorted
home (consider family or a taxi) because
he/she is too impaired to work.
(3) If acute impairment is not demonstrated,
the employee may be medically cleared to
return to work that day.
G. Relationship to Disciplinary Action
In relating the ECS Program procedures to disciplinary
policies and practices, there must be a clear understanding
that shielding problem employees by tolerating poor
performance/unacceptable conduct contributes to the
progression of the employee's illness by delaying entry into
the ECS program. The employee should be encouraged to
participate in the ECS program by emphasizing that failure
on the employee's part to correct performance/conduct will
be dealt with through appropriate personnel procedures.
Some instances may warrant concurrent pursuit of ECS
assistance and the appropriate personnel action.
Supervisors should contact the BID Personnel Office for
guidance to assure that proper documentation is prepared and
procedures are followed. The Labor Management Branch may be
consulted by the BID Personnel Office for overall guidance
and regulatory or MSPB Decision interpretations and/or
assistance in identifying any applicable MSPB case(s) which
may provide appropriate guidance or other relevant
information.
H. Confidentiality of Records
The confidentiality of records relating to alcohol, drug
abuse, or emotional/behavioral problems is established by
law. The law and implementing regulations require, among
other things, that a patient must provide prior written
consent for any disclosure of such records. Therefore,
records on employees who have been referred for diagnosis
and treatment will be maintained in the strictest confidence
and security.
Communication of information between OMS staff having a need
for such information in connection with its official duties
does not constitute disclosure under the law and
regulations. Communications from the ECS staff to
supervisors and personnel staff concerning the participation
of individual employees in the program does not constitute
disclosure; ECS staff will provide such information only in
those cases where the employee has given prior written
consent.
I. Illegal Activities
If illegal activities, particularly criminal activities, are
suspected, such activities are to be reported to the
Security Branch, Division of Safety.
J. Additional Information
For further information on the manual chapter, contact the
REBB, DPM, on 496-5979.
K. Additional Copies of this Chapter
For copies of the manual chapter, send NIH Form 414-5, to
the Printing and Reproduction Branch, DTS, in Bldg. 31, Room
B4B-N-09 or call REBB, 496-4973.
FLOW CHART FOR REFERRAL TO ECS
Supervisors may encourage an employee to seek
counseling from the ECS Program at any time there is a
noticeable change in an employee's behavior or if an
employee comes to the supervisor with a personal
problem. This can be done long before there is a
deteriorating work performance. The following steps
are suggested when there is a problem affecting work
performance/conduct:
Refer to Hard Copy Illustration 1
SAMPLE MEMORANDUM OF SUPERVISORY REFERRAL TO ECS
Refer to Hard Copy Illustration 2
SAMPLE FORM NIH 2558
Refer to Hard Copy Illustration 3
SAMPLE MEMORANDUM FROM OMS MEDICAL STAFF TO SUPERVISOR
Refer to Hard Copy Illustration 4
SAMPLE MEMORANDUM FROM ECS TO SUPERVISOR
REGARDING INITIAL REFERRAL
DEPARTMENT OF HEALTH & HUMAN SERVICES
Public Health Service
National Institutes of Health
Date
>From Employee Counseling Services Counselor
Subject (Employee)
To (Supervisor)
You referred your employee, , for
(name of employee)
evaluation by the OMS staff on . This
(date)
employee was evaluated and then referred to the
Employee Counseling Services (ECS). The employee has
been evaluated and a specific treatment plan has been
developed which
(Mr. Mrs., or Ms. and last name only
(has/has not) accepted.
(Counselor)
cc:
(Employee)SAMPLE MEMORANDUM FROM ECS TO SUPERVISOR REGARDING
PREMATURE TERMINATION OF RECOMMENDED TREATMENT
Refer to Hard Copy Illustration 6