Behavioral Health Resources for CFHC Trust Expansion DRAFT General Program Overview Question Title * 1. How many counseling sessions does your department offer through an Employee Assistance Program (EAP) / BH plan? None 6 or Less sessions 7-25 sessions 26 to 52 sessions 53 or more Question Title * 2. Which emergency responder-trained clinician group(s) do you use?Please select all that apply. Responder Strong Building Warriors First Responder Trauma Counselors The Badge Group Nicoletti Flater Associates HealthOne BH & wellness Center Path4EMS IAFF Center of Excellence We have no emergency responder trained clinicians available within 50 miles Other please describe Question Title * 3. What components are included in your EAP/BH plan?Please select all that apply. Outpatient counseling Inpatient counseling Substance abuse assistance Brain Stimulation Therapy Family members Deductible/Copay Travel expenses Chaplaincy program Paid time off Other please describe Question Title * 4. How many firefighters does your EAP/BH program cover? Question Title * 5. How many volunteers are not covered under EAP/BH programs? Program Utilization Question Title * 6. In each of the last 4 years, how many firefighters have utilized outpatient EAP/BH services? 2019 2020 2021 2022 Question Title * 7. In each of the last four years, how many firefighters have utilized inpatient EAP/BH services ? 2019 2020 2021 2022 Question Title * 8. Are your members using out of network BH providers? Yes No Question Title * 9. Does your department have a peer support team? Yes No Financial Information Question Title * 10. In each of the last four years, what have EAP/BH services cost your department, annually? 2019 2020 2021 2022 Question Title * 11. In each of the last four years, how many firefighters have exceeded the allotted EAP/BH benefits? 2019 2020 2021 2022 Question Title * 12. What did we forget to ask about? Any other information that would be useful? Done