COE Template

Condition Of Employment (COE) Template Letter for Supervisors

Supervisor-assisted referrals to the Faculty and Staff Assistance Program (FASAP) can range from offering a gentle suggestion to access FASAP, "which is a confidential and free service", to warning the employee of your concerns that warrant the referral. Remember, though, that a referral to FASAP does not take the place of disciplinary action (i.e., it is often totally appropriate for a supervisor to refer an employee to FASAP while also beginning the progressive steps of disciplinary action, as indicated).

COE referrals are mandated referrals whereby the employee must comply with the referral to FASAP, the FASAP evaluation(s), on-going FASAP monitoring, and the recommendations made by the FASAP clinician for a minimal period of time. If the employee fails to comply with any of these components of the COE process, s/he may be subject to termination of employment.

The philosophy behind COE referrals, and the FASAP program in general, is to support employees by offering resources and services that may be of benefit. Thus, when explaining the COE process to your employee, it is often helpful to keep this philosophy in mind, as it will communicate the Institution's desire to maintain and protect the employee's employment status, as opposed to punishing the employee.

In conjunction with your Human Resources representative, a FASAP clinician will be available to guide you through the process of making a COE referral. It is essential that you communicate with your employee verbally in person and in writing. There are several elements that should be clearly and concretely addressed in this conversation and in the COE letter. You can use the following template as a guide to writing a COE letter. Remember that HR and FASAP are available to assist you during this process, and should always be consulted prior to instituting a COE referral.

FROM:   [Your Name]
             [Your Title]
TO:         [Faculty or Staff member]
DATE:     January 1, 2000
RE:          Referral to FASAP
Dear        [Faculty or Staff Member],

Make some positive statements, then identify specific problems/concerns. As your [insert your title] for the past [x] years, I have known you to be a hard working and dedicated individual. In recent months, however, I have noticed a significant decline in your work performance and interpersonal conduct. or This letter is a follow-up on our meeting of [insert date]. During that meeting we discussed your behaviors at work.
Specifically, [... identify specific problems, concerns and/or observable behaviors]

Distinguish from discipline, but relate it to potential adverse actions. The purpose of this letter is to express my concern for you, to outline specific areas of concern that are in need of improvement, and to present a course of action to attempt to remedy these concerns. This letter does not protect you from further disciplinary action if warranted. This letter may be used as documentation if the problems mentioned persist and/or recur in the future.

Specifically state that this the referral is made as a "condition of continued employment", who s/he will be meeting with, and a time frame. You may also make the appointment directly with FASAP for the employee. Thus, as a Condition Of your continued Employment, you should arrange to meet with [insert the name of the FASAP clinician], with the Faculty and Staff Assistance Program (FASAP) by calling 443-287-7000. or I have scheduled an appointment for you to see [insert the name of the FASAP clinician] with the Faculty and Staff Assistance Program (FASAP). The appointment is scheduled for [insert date, time and office location]. Their telephone number is 443-287-7000.

If the employee is a clinical faculty member or member of the housestaff in the School of Medicine, a referral to the Professional Assistance Committee is required in all situations of Condition of Continued Employment. Because you are a clinical member of the faculty/an intern/resident/fellow in the School of Medicine, the Professional Assistance Committee (PAC) will oversee your Condition of continued Employment. I have notified Dr. Stephen Achuff, Chair of the PAC, about this situation and the referral to FASAP.

I expect that you will have this initial evaluation scheduled within one week of your receipt of this letter. or I expect that you will keep this appointment as scheduled with FASAP.

Be sure to mention the expectation that s/he will follow FASAP/PAC recommendations (e.g., continued monitoring, drug/alcohol screening, referral to another mental health clinician, etc).
The COE monitoring lasts approximately six months to two years.
It is also expected that you will comply with any recommendations made by FASAP and/or PAC. These recommendations may include but are not limited to continued monitoring of your situation, drug/alcohol screening or rehabilitation, psychotherapy and/or referral to another mental health clinician, or hospitalization. FASAP will be responsible for the assessment and monitoring of the recommendations in your situation during the Condition of Employment process.

Address financial responsibility FASAP services are provided at no cost to you. You will be financially responsible for costs of any additional treatments required. The FASAP clinician will work with you to develop a plan that is affordable to you financially.

Assure confidentiality. FASAP services are confidential. The only feedback that will be provided to me will be regarding your compliance with the referral and recommendations, and any concerns of the PAC regarding limiting your clinical responsibilities.

Include a statement about University policy. I want you to succeed in your job. Initially, you may use a reasonable amount of work time for FASAP and other appointments needed. I will be evaluating your work requirements, and you need to know that at some time in the future you may be required to arrange your work schedule to accommodate these appointments. If you are placed off work by FASAP, the time away from work will be charged to accrued time following University policy.

I would be happy to assist you in any way that I can during this period. I will continue to observe and evaluate your performance and interpersonal conduct.

Express your continued concern. Sincerely,

[Your Name]

Include a copy of the FASAP brochure (and PAC brochure, as indicated), or reference the FASAP website for more information.. Attachment: FASAP Brochure and PAC Brochure or Note: For more information about FASAP and PAC, visit www.fasap.org.

Always let FASAP know about the referral by sending a copy of the letter.
Always let HR know about the referral by sending a copy of the letter.
Let Occupational Health Services (OHS) know about the referral, as indicated, by sending a copy of the letter.
Let Dr Achuff know about the referral if this involves a PAC referral of a clinical faculty member by sending a copy of the letter.
cc:       [FASAP Clinician Name]
             FASAP
             [Name of Human Resources Manager]
           HR Divisional Office
             [Name of OHS Nurse]
           Occupational Health Services
           Stephen Achuff, MD
           Chair, Professional Assistance Committee

Download and modify the above text as a Word file.

Revised: Sept 11, 2006

	FROM: [Your Name] [Your Title] TO: [Faculty or Staff member] DATE: January 1, 2000 RE: Referral to FASAP Dear [Faculty or Staff Member],
Make some positive statements, then identify specific* problems/concerns.*	As your [insert your title] for the past [x] years, I have known you to be a hard working and dedicated individual. In recent months, however, I have noticed a significant decline in your work performance and interpersonal conduct. or This letter is a follow-up on our meeting of [insert date]. During that meeting we discussed your behaviors at work. Specifically, [... identify specific problems, concerns and/or observable behaviors]
Distinguish from discipline, but relate it to potential adverse actions.	The purpose of this letter is to express my concern for you, to outline specific areas of concern that are in need of improvement, and to present a course of action to attempt to remedy these concerns. This letter does not protect you from further disciplinary action if warranted. This letter may be used as documentation if the problems mentioned persist and/or recur in the future.
Specifically state that this the referral is made as a "condition of continued employment", who s/he will be meeting with, and a time frame. You may also make the appointment directly with FASAP for the employee.	Thus, as a Condition Of your continued Employment, you should arrange to meet with [insert the name of the FASAP clinician], with the Faculty and Staff Assistance Program (FASAP) by calling 443-287-7000. or I have scheduled an appointment for you to see [insert the name of the FASAP clinician] with the Faculty and Staff Assistance Program (FASAP). The appointment is scheduled for [insert date, time and office location]. Their telephone number is 443-287-7000.
If the employee is a clinical faculty member or member of the housestaff in the School of Medicine, a referral to the Professional Assistance Committee is required in all situations of Condition of Continued Employment.	Because you are a clinical member of the faculty/an intern/resident/fellow in the School of Medicine, the Professional Assistance Committee (PAC) will oversee your Condition of continued Employment. I have notified Dr. Stephen Achuff, Chair of the PAC, about this situation and the referral to FASAP.
	I expect that you will have this initial evaluation scheduled within one week of your receipt of this letter. or I expect that you will keep this appointment as scheduled with FASAP.
Be sure to mention the expectation that s/he will follow FASAP/PAC recommendations* (e.g., continued monitoring, drug/alcohol screening, referral to another mental health clinician, etc).* The COE monitoring lasts approximately six months to two years.	It is also expected that you will comply with any recommendations made by FASAP and/or PAC. These recommendations may include but are not limited to continued monitoring of your situation, drug/alcohol screening or rehabilitation, psychotherapy and/or referral to another mental health clinician, or hospitalization. FASAP will be responsible for the assessment and monitoring of the recommendations in your situation during the Condition of Employment process.
Address financial responsibility	FASAP services are provided at no cost to you. You will be financially responsible for costs of any additional treatments required. The FASAP clinician will work with you to develop a plan that is affordable to you financially.
Assure confidentiality.	FASAP services are confidential. The only feedback that will be provided to me will be regarding your compliance with the referral and recommendations, and any concerns of the PAC regarding limiting your clinical responsibilities.
Include a statement about University policy.	I want you to succeed in your job. Initially, you may use a reasonable amount of work time for FASAP and other appointments needed. I will be evaluating your work requirements, and you need to know that at some time in the future you may be required to arrange your work schedule to accommodate these appointments. If you are placed off work by FASAP, the time away from work will be charged to accrued time following University policy.
	I would be happy to assist you in any way that I can during this period. I will continue to observe and evaluate your performance and interpersonal conduct.
Express your continued concern.	Sincerely, [Your Name]
Include a copy of the FASAP* brochure (and PAC brochure, as indicated), or reference the FASAP website for more information..*	Attachment: FASAP Brochure and PAC Brochure or Note: For more information about FASAP and PAC, visit www.fasap.org.
Always let FASAP know about the referral by sending a copy of the letter. Always let HR know about the referral by sending a copy of the letter. Let Occupational Health Services (OHS) know about the referral, as indicated, by sending a copy of the letter. Let Dr Achuff* know about the referral if this involves a PAC referral of a clinical faculty member by sending a copy of the letter.*	cc: [FASAP Clinician Name] FASAP [Name of Human Resources Manager] HR Divisional Office [Name of OHS Nurse] Occupational Health Services Stephen Achuff, MD Chair, Professional Assistance Committee