Caring For Those Who Serve

Early Intervention Early Intervention Program for Program for Disability Plan Disability Plan ParticipantsParticipantsSupport for Those Who Serve

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Early Intervention Early Intervention Program (EIP)—PurposeProgram (EIP)—Purpose

What It

• Enhancement of disability plans ■ For all Comprehensive Protection

Plan (CPP) and Basic Protection Plan (BPP) participants (enrolled for disability benefits)

• The resource to support participants in the early stages of a physical or emotional condition

• Single entry point for “short-term condition” coaching and case management support

• Voluntary and confidential

• Short-term disability plan • Income replacement plan

or other benefit plan• Required for disability

benefits eligibility • Form of medical care, or

an extension of medical plan or related health programs

What It

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Early Intervention Early Intervention Program (EIP)—Supports Program (EIP)—Supports OverviewOverviewTelephone support with Telephone support with medical professionals medical professionals including:including:

• Registered Nurse(s)Registered Nurse(s)

• Certified Case Manager(s) Certified Case Manager(s) (CCM)(CCM)

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Case Management Activities:• Same case manager from initial call • Ongoing coaching support (similar to B)• Gather medical records & collaborate

with physician, plan sponsor, and participant

• Develop return-to-work or stay-at-work action plans

Initial Assessment and Evaluation Call:• Assessment of the situation - Abbreviated - Comprehensive (including medical,

emotional, social factors)

• Initial coaching support - Information & resources - Action plan development - Referral to other services (D)

Periodic Coaching Follow Up Calls:• Same coach for all calls• Ongoing coaching support - Information & resources - Action plan development & follow-through - Referral to other services (D)

Referral to Other Health and Wellness Services:• Employee Assistance Program• Lifestyle/Condition Management Program (HealthFlex only)• Other Conference resources

Early Intervention Early Intervention Program (EIP)—Supports Program (EIP)—Supports Overview Overview (continued)(continued)

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When do individual physical or behavior “changes” indicate a potentially greater underlying physical or emotional health condition?

When Should An Individual Access the Early Intervention Program?

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Possible Categories Possible Categories of “Change”of “Change”

A need for the EIP may exist A need for the EIP may exist if significant changes in:if significant changes in:• Performance of pastoral duties• Interactions and personal relationships• Leadership and administrative style• Personal life

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Encourage participants to call:

1-800-985-02421-800-985-0242, use prompt #2

(Same toll-free number as Unum Disability Management Service Line)

How Does An Individual Access the Early Intervention Program?

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Early Intervention Program Early Intervention Program

(EIP)—Process Flow (EIP)—Process Flow SummarySummary1. Initiate

contact with EIP

File will be closed

2. Assessment and

evaluation

3b. Case Management Activities

4b. As condition reaches 180 days

5b. Hand off to Unum for LTD disability claim decision

Case ManagementCase Management• ““Lost time” and Lost time” and

condition expected to condition expected to last more than 180 last more than 180 days, ordays, or

• ““Lost time” and Lost time” and behavioral diagnosisbehavioral diagnosis

3a.Periodic coachingfollow up calls

4a. If it continues to appear

that condition will last less than 180 days

5a.If it becomes evident that

condition will last more

than 180 days and involves:

• Lost time

Periodic CoachingPeriodic Coaching

Condition expected to last less than 180 daysCondition expected to last less than 180 days

Other health and wellness services Other health and wellness services referralsreferrals

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Early Intervention Program Early Intervention Program (EIP)— (EIP)— Wellness Services Referral Wellness Services Referral ProcessProcessCCM determines if participant is part of Health Flex conference

or not

•All EIP participants will be referred to UBH EAP services, regardless of condition and whether in HealthFlex or not

•CCM will either warm transfer the participant to UBH or inform them that they will be contacted by UBH

•EIP participants with an existing physical condition, will also be contacted by Healthways for lifestyle/condition coaching (HealthFlex only)

•CCM will also inform participant of other Conference specific services, resources and contact information (if applicable)

CCM will warm transfer participant to UBH; otherwise CCM will notify UBH (and possibly Healthways for HealthFlex only) to reach out to the participant

If notified to reach out, UBH contacts participant within 48-72 hours (24 hours if request is expedited)

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Consider the Following Consider the Following ScenarioScenario

1. Initiate contact with EIP

• Clergy; male; age 43

• Out of work or “lost time” situation

• Chronic medical condition, resulting in back surgery

5a. If it becomes evident that will last more than 180 days and involves “lost time”

4b. As condition reaches 180 days: • CCM will again inform the participant of the need to

apply for LTD (if participant has not already)• CCM sends a EIP closure letter • CCM will electronically transfer all case notes to Unum

system

5b. Hand off to Unum for LTD claim decision:• Consultation between the CCM and the LTD DBS.

4a. If it continues to appear that condition will last less than 180 days

2. Assessment and evaluation

• Certified Case Manager (CCM) obtains demographics and contact information

• CCM completes abbreviated assessment

• CCM determines need and conducts comprehensive assessment

• CCM evaluates condition and situation; determines most likely to last more than 180 days

Case ManagementCase Management““Lost time” and condition expected > 180 Lost time” and condition expected > 180

daysdays

3a. Periodic Coaching Follow-Up Calls

Other health and wellness services Other health and wellness services referralsreferrals

3b. Case Management Activities• Ongoing collaboration and coordination with the

Participant, Physician(s), and plan sponsor (if applicable)

• Stay at work or return to work action plans developed (with DS or CBO involvement, if applicalbe)

• Ongoing coaching, action plan, resources, etc.• Referrals to wellness services (see flowchart)• Guide on how to apply for LTD

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Or the Following Or the Following ScenarioScenario

1. Initiate contact with EIP

• Clergy; male; age 49

• Struggling with depression.

• Unable to keep up with work duties.

• Diminished energy in all activity.

• Advised by physician to cease work activity.

Case Management

“Lost time” and Behavioral Diagnosis

5a. If it becomes evident that will last more than 180 days and involves “lost time”

4b. As condition reaches 180 days: • CCM will again inform the participant of the need

to apply for LTD (if participant has not already)• CCM sends a EIP closure letter • CCM will electronically transfer all case notes to Unum

system

5b. Hand off to Unum for LTD claim decision:• Consultation between the CCM and the LTD DBS.

3a.Periodic Coaching Follow-Up Calls

4a. If it continues to appear that condition will last less than 180 days

2. Assessment and evaluation

• Certified Case Manager (CCM) obtains demographics and contact information

• CCM completes abbreviated assessment

• CCM determines need and conducts comprehensive assessment

• CCM evaluates condition and situation; determines behavioral diagnosis, with “cease work” direction < 180 days

Other health and wellness services Other health and wellness services referralsreferrals

3b. Case Management Activities• Ongoing collaboration and coordination with the

participant, physician(s) and plan sponsor (if applicable)

• Stay at work or return to work action plans developed (with DS or CBO involvement, if applicalbe)

• Ongoing coaching, action plan, resources, etc. • Referrals to wellness services (see flowchart)• Guide participant on how to apply for LTD

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1. Initiate Contact with EIP• Clergy; female; age 54• Noticeable change in interactions with

others • Less engaged when talking with others• Becomes visibly frustrated with increased

regularity• Reduced ability to counsel or console with

care and compassion

4b. As condition reaches 180 days

5b. Hand off to Unum intake for LTD claim decision

2. Assessment and Evaluation• Certified Case Manager (CCM)

obtains demographics and contact information

• CCM completes abbreviated assessment

• CCM determines need and conducts comprehensive assessment

• CCM evaluates condition and situation; determines no lost time.

Or the Following Or the Following ScenarioScenario

Case Management“Lost time” and condition

expected > 180 days; or “lost time” and behavioral

diagnosis

Other health Other health and and

wellness wellness services services referralsreferrals

Periodic CoachingCondition not causing “lost time”

3a. Periodic Coaching follow-up calls• Ongoing assessment, coaching, action plan,

information, resources, etc.• 30 days following the initial call• 30-90 days after first follow-up call & thereafter (if

necessary and depending on situation)• Refer to wellness services (see flowchart)

4a. If it continues to appear that will last less than 180 days:

• Ongoing coaching supports and calls as needed (similar to 3a.)

• Refer to wellness services (see flowchart)

5a. If it becomes evident that condition will last more than 180 days, or is a behavioral diagnosis, and involves “lost time”:

• Elevate to case management

• Guide participant on how to apply for LTD

3b.Case Management Activities

File will be closed

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Implementation Implementation Within ConferenceWithin Conference

• Cabinet buy-in and support■ Active role of district superintendent

• Communications directly to clergy and lay workers (from conference office, DS, etc.)

• Communication and training with Staff Parish Relations Committees

Develop implementation plan Develop implementation plan tailored for your Conference, which tailored for your Conference, which may include:may include:

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Implementation Implementation Within Conference Within Conference (continued)(continued)

• Integrate EIP materials and supports within conference processes

• Leverage General Board resources■ For communication materials

■ To attend meeting(s); participate on conference calls

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For Any Questions or For Any Questions or Additional InformationAdditional Information

Eva MullinaxEva Mullinax (847) 866-4050

emullinax@gbophb.org

Jon JonesJon Jones (847) 866-4572

jjones@gbophb.org

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1-800-851-2201www.gbophb.org

GENERAL BOARD OF PENSION AND HEALTH BENEFITS

OF THE UNITED METHODIST CHURCH

Caring For Those Who Serve