Appendix_7_11_DOHR_Policy_17-002-Contract_Section_A_8_b_5.pdf

POLICY

Approved by: Juan Williams, Commissioner Policy Number: 17-002 (Rev. 07/01/2024)

Signature: Supersedes: NA Application: Executive Branch Agencies, All Employees Effective Date: August 1, 2017

Authority: T.C.A. § 4-3-1703, T.C.A. § 8-30-104 Rule: NA

Tennessee Department of Human Resources

Guiding “people solutions” to attract, grow, and keep top talent.

Management Referrals to the Emotional Wellbeing Solutions

A management referral occurs when the manager or Human Resources representative refers an employee to the ParTNers Emotional Wellbeing Solutions1 due to workplace issues. Management referrals are available to provide assistance to an employee who is having personal problems, to address problems affecting performance or as part of a performance plan or to address a company policy violation. A referral to EWS may also be needed when an employee exhibits behavior or conduct that may endanger the safety of the employee or others in the workplace. The EWS is typically a voluntary service available to employees to assist with workplace and personal issues. Referring an employee to the EWS allows a manager to fulfill his/her responsibilities, while allowing a trained professional to provide assistance to an employee.

Types of EWS Referrals

There are three kinds of referrals a supervisor can make to the EWS:

1. Informal referral –There are minor issues starting to form but not to the level of needing a management or mandatory referral. An informal referral is a reminder or suggestion to an employee that the EWS is available for an issue of concern or an issue the employee may have disclosed to the workplace. The employee may choose whether he or she will follow through with the referral.

2. Management referral – A decline in work performance exists where the employee’s job may be in jeopardy because of a performance issue, attendance issue, or behavior issue at work. The referral is part of a corrective performance plan and the expectations are for the employee to use the EWS as a tool to correct the performance or other work-related problem. An employee is asked to sign a release of information in order for the EWS to provide information regarding attendance and adherence. Participation in a management referral is a formal, documented referral to the EWS.

However, participation is not mandatory. Therefore, if the employee declines the referral; the manager will continue to manage the employee. Although an employee shall not be disciplined for declining the referral, the employer is not prohibited from taking corrective action regarding the

1 For more information on EWS, please visit see ParTNers for Health’s site, or call 855-Here4TN (855-437-3486).

DOHR Policy:

Management Referrals to the Emotional Wellbeing Solutions

Policy Number: 17-002 (Rev. 07/01/2024) underlying performance, attendance, or behavior issue that prompted the referral or may continue after the referral.

3. Mandatory referral – A mandatory referral requires an employee to consult with the EWS as a condition of continued employment. This type of referral is appropriate only for documented, on-the-job performance issues, policy violations, and/or observed behavior that may pose a potential safety risk in the workplace. Employees are expected to follow through with the EWS referral evaluation, treatment, and service recommendations in full. Employees who refuse to participate in a mandatory referral may be subject to termination based on the underlying job performance or behavioral concerns.

Application to Fitness-for-Duty

A referral to the EWS is not considered a fitness-for-duty evaluation. However, the EWS can facilitate a connection to a fitness-for-duty provider. The EWS plays no role in either the “fitness” determination or the information reported back to the agency. The fitness for duty vendor or provider will send the report directly to the workplace representative. Reports shall be considered confidential and are not a part of the employee’s personnel file. The EWS can provide ongoing consultation to the workplace throughout the Fitness-for-Duty process.

Procedures for Referral to the EWS

Referral to the EWS may occur by the employee contacting the EWS on his/her own, as result of a voluntary self-referral or informal referral. An employee may also be referred to the EWS on a management or mandatory basis as soon as a need becomes evident. In these circumstances, the workplace representative will call the EWS first to provide the referral details and will then ask the employee to call the management consultant. For mandatory and management referrals, employees will be asked to supply written consent for the EWS to release information pertaining to attendance and adherence to the EWS recommendations.

The management consultant will monitor the referral until the treatment recommendations are complete and/or the workplace informs the EWS to close the referral.

Managers and supervisors should consult with the agency’s Human Resources office to discuss the need for the referral prior to informing the employee of the referral. The agency Human Resources division shall review all relevant information to determine if a referral is warranted. When a management or mandatory referral is made, a confidential discussion should be conducted with the employee to discuss the job performance, conduct, or other issues of concern. The Human Resources division should prepare a determination with supporting information to the agency’s appointing authority or designee for review and approval.

The management referral is not intended to replace, or protect an employee from disciplinary or administrative action. Whether the employee accepts or refuses the referral, all relevant information should be monitored and documented. If work performance or conduct does not improve, appropriate disciplinary or administrative action may be warranted. Remember, management consultation and the

Solutions referral process is designed to augment supervisory style and the State's disciplinary processes, not replace them.

Confidentiality

The EWS will not discuss the personal problems of the employee without the written permission of that employee except when the employee is an immediate danger to himself/herself or others, or as otherwise provided by law. Managers and supervisors also shall not discuss the personal problems of the employee with any employee outside of the agency’s Human Resources office or the Department of Human Resources’ Office of General Counsel, unless the employee has provided written permission or the employee is an immediate danger to himself/herself or others. Managers and supervisors should note that unauthorized discussions about the personal concerns of an employee may also result in the violation of other DOHR policies, such as the Workplace Discrimination and Harassment Policy, DOHR Policy 12-008, the Abusive Conduct in the Workplace (ACW) Policy, DOHR Policy 17-001 and/or the State Code of Conduct.

In cases of mandatory referrals when compliance with EWS recommendations have been made a condition of continued employment, the employee will be advised that the EWS will provide information to the agency concerning the extent to which the employee has complied with recommendations.

Americans with Disabilities Act

A referral to EWS alone is not considered a request for an accommodation pursuant to the ADA.

Participants of the EWS are not perceived to be a “qualified individual with a disability” as defined by the ADA. Should an employee request an ADA accommodation for any health-related reason, including being treated by the EWS, the employee should contact the agency’s ADA coordinator, or the Department of Human Resources’ Office of General Counsel.

Questions regarding this policy should be directed to your agency’s Human Resources office or Office of the General Counsel.

Solutions

Confidential Management and Mandatory Referral Form

The purpose of this form is to provide information to the ParTNers Emotional Wellbeing Solutions (EWS) regarding an employee’s poor work performance, or conduct, when there is reason to believe that the cause may be due to a personal/medical problem. Additionally, when an appropriate release of information form has been completed, the EWS will inform the agency’s human resources representative of each instance where an employee fails to attend a scheduled EWS counseling session.

(Please print in ink or type) REFERRAL DATE ______________________________

EMPLOYEE’S NAME____________________________________________________________________________________ (Please circle: Mr./Mrs./Ms.)

ADDRESS__________________________________________________________ HOME PH._____________________ (City/County, State, Zip Code)

TITLE ______________________________________ WK. PH. _____________________ CELL PH. ___________________

DOB ______________________ EMAIL _________________________________________________________________

DEPARTMENT/AGENCY NAME_________________________________________________________________________

WORK ADDRESS_______________________________________________________________________________________

(City, County, State, Zip Code)

WORK HOURS/SHIFT________________________________________ DAYS OFF________________________________ (Please use non-military time)

REFERRED BY__________________________________________ TITLE__________________________________________

PHONE ______________________________________ FAX ___________________________________

EMAIL _________________________________________________________________________________________________

AGENCY EWS REPRESENTATIVE ______________________________________________ PH.______________________

TITLE _________________________________________________ FAX _____________________________________

EMAIL _________________________________________________________________________________________________

AGENCY EWS REPRESENTATIVE’S SIGNATURE __________________________________________________________

Solutions

Reason for Referral

First, check the type of referral. Next, check the corresponding areas that are relevant to this referral; then attach documentation or synopsis supporting areas checked and overall reason for this referral. This is a:

I. SUBSTANCE ABUSE REFERRAL

VIOLATION OF AGENCY POLICY REGARDING SUBSTANCE ABUSE:

______ Failed random drug test ________ Alcohol related conviction

______ Other_________________________________________________________________________________________

II. JOB PERFORMANCE REFERRAL (This area must be impacted for referral eligibility, with supporting documentation attached for items checked):

ATTENDANCE (Please place numbers where numbers are requested):

______ Number of days absent past 12 mos. _____ Number of extended lunches past 6 mos.

______ Pattern (e.g., Mondays, Fridays, after paydays, _____ Number of times late past 6 mos.

before and after holidays)

_____ Other___________________________________________________________________________________________

BEHAVIOR(S) DEMONSTRATED WITH RESPECT TO JOB PERFORMANCE:

________Lower quality of work ________Failure to meet schedules

________Decreased productivity ________Inability to concentrate

________Increased errors ________Impaired judgment/memory

________Erratic work patterns ________Disregard for safety

________Avoids supervisors/coworkers ________Less communicative

________Loss of interest ________Frequent mood swings

Solutions

________Unusually sensitive to advice/constructive criticism

________Unusually critical of supervisor/coworkers/employer

_______ Other _________________________________________________________________________________________

Have the above issues been discussed with employee? (Yes) _______ (No) _______

If yes, when? (Please attach relevant documents) ______________________________________________________

IF EMPLOYEE INTENDS TO PARTICIPATE, THIS REFERRAL CANNOT BE PROCESSED WITHOUT “YES”

INDICATED BELOW AND EMPLOYEE’S SIGNATURE

I understand that my employer is referring me to the ParTNers Emotional Wellbeing Solutions. I also understand that my signature below does not reflect my agreement or disagreement with any of the issues raised. My signature verifies that I have seen this referral and all documentation contained therein.

_______ YES, I will participate in the Emotional Wellbeing Solutions.

________ NO, I will not participate in the Emotional Wellbeing Solutions.

Signature Date