Early Intervention
Program for Disability
Plan Participants
Support for Those Who Serve
Caring For Those Who Serve
Early Intervention Program
(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
What It
• 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
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Early Intervention Program
(EIP)—Supports Overview
Telephone support with medical
professionals including:
• Registered Nurse(s)
• Certified Case Manager(s)
(CCM)
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Early Intervention Program
(EIP)—Supports Overview
(continued)
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)
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-atwork action plans
Referral to Other Health and
Wellness Services:
• Employee Assistance Program
• Lifestyle/Condition
Management Program
(HealthFlex only)
• Other Conference resources
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When Should An Individual Access
the Early Intervention Program?
When do individual
physical or behavior
“changes” indicate
a potentially greater
underlying physical
or emotional health
condition?
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Possible Categories
of “Change”
A need for the EIP may exist
if significant changes in:
•
•
•
•
Performance of pastoral duties
Interactions and personal relationships
Leadership and administrative style
Personal life
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How Does An Individual Access
the Early Intervention Program?
Encourage participants to call:
1-800-985-0242, use prompt #2
(Same toll-free number as Unum Disability Management
Service Line)
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Early Intervention Program
(EIP)—Process Flow Summary
Case Management
1. Initiate contact
with EIP
2. Assessment
and evaluation
• “Lost time” and condition
expected to last more than
180 days, or
Periodic Coaching
• “Lost time” and behavioral
diagnosis
Condition expected to last less than 180 days
3b. Case Management Activities
3a. Periodic coaching
follow up calls
4a. If it continues to appear
that condition will last
less than 180 days
File will be closed
5a. If it becomes evident that
condition will last more
than 180 days and involves:
• Lost time
4b. As condition reaches
180 days
5b. Hand off to Unum for LTD
disability claim decision
Other health and wellness services referrals
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Early Intervention Program (EIP)—
Wellness Services Referral Process
CCM 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 Scenario
1. Initiate contact
with EIP
• Clergy; male;
age 43
• Out of work or
“lost time”
situation
• Chronic medical
condition,
resulting in back
surgery
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
most likely to last more
than 180 days
5a. If it becomes evident
that will last more
than 180 days and
involves “lost time”
Case Management
“Lost time” and condition expected > 180 days
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
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.
Other health and wellness services referrals
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Or the Following Scenario
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.
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
5a. If it becomes evident
that will last more
than 180 days and
involves “lost time”
Case Management
“Lost time” and Behavioral Diagnosis
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
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.
Other health and wellness services referrals
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Or the Following Scenario
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
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.
Case Management
“Lost time” and condition
expected > 180 days; or “lost
time” and behavioral diagnosis
3b. Case Management
Activities
Periodic Coaching
4b.
Condition 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)
File will be closed
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
As condition reaches
180 days
5b. Hand off to Unum intake
for LTD claim decision
Other health and
wellness services
referrals
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Implementation
Within Conference
Develop implementation plan tailored for
your Conference, which may include:
• 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
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Implementation
Within Conference
(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
Additional Information
Eva Mullinax
(847) 866-4050
[email protected]
Jon Jones
(847) 866-4572
[email protected]
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1-800-851-2201
www.gbophb.org
GENERAL BOARD OF PENSION AND HEALTH BENEFITS
OF THE UNITED METHODIST CHURCH
Caring For Those Who Serve
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