caring for those who serve early intervention program for disability plan participants support for...
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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
Jon JonesJon Jones (847) 866-4572
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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