Explanation of PR-FFD Process

Performance and Fitness for Duty Referrals

CONCERN Services contracts with employers calls for a clinical service regarding performance and fitness for duty referrals. These cases are considered high priority and require timeliness and clinical efficiency in providing services. As a CONCERN affiliate or provider, you may be asked to provide clinical evaluation or treatment for such cases. In case you are contacted, the following information will assist you in providing either evaluative or treatment services in a performance or fitness for duty case.

Definitions

Performance Referral

This level of referral may be either mandatory (a condition of employment) or non-mandatory. The employee remains on the job while engaging in treatment which focuses on changes in behavior, quality and quantity of work. The goal is to improve the employee's performance until it meets company standards.

Fitness for Duty Referral

This level of referral is directly related to a employee's ability to perform his/her work in a competent and safe manner. The employee is usually removed from the workplace and will require a thorough psychological and/or psychiatric examination before being returned to work. This type of referral is usually mandatory and compliance may be positioned as a condition of employment.

1. Recommended Performance Referral Guidelines

   Providers asked to deliver services to clients designated as performance referrals will be contacted by a CONCERN representative, usually a clinician or team supervisor. Information regarding the desired areas of improvement will be provided per the employee's company. Using the performance and/or behavioral issues as a treatment plan and guideline, the provider will be asked to engage the client in treatment and see the client on a regular basis until treatment goals have been reached. The provider would report clinical progress, attendance, cooperation and the specific addressing of performance/behavior issues to the CONCERN representative. The provider would also immediately report treatment disconnect or any other issues of non-compliance to the CONCERN representative. Under no circumstance would the provider have contact with the referring company. The provider should expect regular contact with the CONCERN representative and can indicate when all treatment goals have been reached, or the CONCERN representative may report such to the provider via feedback from the company. Ultimately, decision to terminate the process rests with the employee's company.

2. Fitness For Duty Referral Guidelines:

   Providers may be asked to evaluate or treat employees designated by their company as a fitness for duty referral. This means that there are concerns regarding the employee's ability to function on the job and perform job related responsibilities, or that the employee's behaviors indicate the possibility of a threat to co-workers and the safety of the workplace. The employee is usually removed form the workplace until a thorough evaluation has been performed and clearance to return to work issued by the evaluation professional. Often, the evaluator may recommend a respite period in which the employee remains off work while engaging in recommended treatment. Return to work in those cases usually means clearance given by the treating professional or a re-evaluation by the original evaluate or or collaboration by the evaluating and treating professional regarding return to work.

   1. Fitness for Duty Evaluations: Fitness for Duty evaluations usually consist of psychological testing and clinical interviews performed by a licensed Clinical Psychologist or Psychiatrist. Testing instruments should include the MMPI-2 and the current version of the MCMI Million Multi axial Inventory, as well as other instruments designed to assist in determining ability to function and risk to commit violent acts. In cases where there is clearly stated threat to be violent or harm others, the services of a psychologist or psychiatrist certified in forensic evaluations would be preferred. CONCERN recommends that the referring company be responsible for the cost of the evaluation and that the evaluating provider indicate total cost for his/her services prior to the evaluation. The evaluating provider should have contact only with CONCERN, and the provider will not provide treatment to the evaluated employee. The evaluation will result in 2 separate written reports, both submitted to CONCERN within 2 weeks of the interviews and testing. One written report gives DSM-IV-TR 5 Axis diagnostic impressions, addresses treatment, legal and other histories and provides a clear summary and conclusion including treatment and return to work recommendations. The second report is an executive summary, which indicates the course of testing and interview process. The second report does not include diagnosis, but does give a summary, conclusions and recommendations regarding conditions for return to work.
   2. Fitness for Duty Treatment: Providers asked to treat fitness for duty clients should expect to receive from CONCERN a complete description of the problems in the workplace, any documentation provided by the referring company and any written reports generated as the result of a fitness for duty evaluation. Providers are asked to provide timely and regular clinical sessions to the referred employee. Providers are also asked to provide regular clinical updates to CONCERN including immediate notification in the event of treatment disconnect or any other act of non-compliance. Providers should expect to treat until there is no longer clinical indication of need for treatment or until the referring company discontinues the process. Providers are expected to address the primary issues related to the fitness for duty referral and to collaborate with the evaluating clinician regarding the client's ability and readiness to return to work. Providers do not have any direct contact with the referring company.