PROGRAM FOR EMPLOYEE INFORMATION AND REFERRAL  FACILITATOR AGREEMENT

A PEIR Facilitator's primary role, within Qwest, is to provide assistance, education and awareness to employees regarding drug and alcohol abuse. In addition, they may also provide assistance in helping the employee with mental health and other related issues.  The assistance offered by PEIR Facilitators is consistent with the training developed by the Committee on Substance Abuse and may include the following activities:

·         Forming a "bridge" between employees and health professionals and/or their designee, that facilitates appropriate evaluation and treatment.  

·         Encouraging adherence to a treatment plan developed by an appropriate professional.  

·         Assisting employees involved in treatment with matters pertaining to daily life activities. 

·         Participating in return to work conferences, if requested to do so by the employee.  

·         Participating in education/awareness activities as directed by the Committee on Substance Abuse. 

GUIDELINES

PEIR Facilitators are required to exercise sound judgment and lead by example, as they fulfill these responsibilities. The following guidelines are intended to assist each Facilitator in establishing appropriate boundaries for their activities.   

·         PEIR activities are initiated only at the request of the employee. 

·         PEIR Facilitators strictly follow the guidelines for confidentiality and all other functions, as outlined in the training program. 

·         PEIR Facilitators do not represent themselves as counselors or attempt to function as such.    

·         PEIR activities are carefully differentiated and separate from any and all grievance and/or disciplinary activities.  

·         PEIR Facilitator activities are in addition to the performance of their normal job duties as a Qwest employee. 

·         PEIR Facilitators on occasion, may be called away from their normal job duties to respond to a PEIR call. They are required to notify management prior to leaving, and provide timely status of their return to the workplace.    

·         You must stay in contact with your local PEIR network. You can connect with an experienced PEIR or a group of PEIR’s in your area. If there are no PEIR’s in your area, please contact Scott Horn, PEIR Coordinator, for support. This must be done once a month.   

I have reviewed the PEIR Facilitator agreement. I understand what is expected of me. I understand this is a volunteer program.  I have successfully completed the training offered by the Committee on Substance Abuse. I agree to abide by the guidelines stated above as I function in the role of a PEIR Facilitator. I understand that failure to function within these guidelines and my training as PEIR Facilitator could result in removal from the PEIR Program.

 

_____________________________________   ______________________

PEIR Facilitator                                                                  Date

 

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PEIR Coordinator                                                              Date

  

_____________________________          _____________________________

Teri Hanson – Qwest Co-Chair                       Joe Petersen  - CWA Co Chair District 7

Committee on Substance Abuse                    Committee on Substance Abuse

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