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A) Whether employee has agreed to participate in the Assistance Program. <br />B) List of all appointments of employee kept and missed, together with reason, if any, for <br />missing the appointment. <br />C) Submission of the employee's anticipated treatment plan as a participant in the Program. <br />This plan shall consist of the following: <br />1) The anticipated number of visits, appointments, or sessions requested of the <br />employee. <br />2) The type of therapeutic procedures in general terms that the employee is to <br />receive during the employee's participation with the REACH Program or the <br />treatment provider(s). <br />3) Description of the treatment service provider the employee is referred to by <br />REACH. <br />4) Any other information not contained in the employee's treatment service <br />provider medical record deemed appropriate by the City to evaluate the employee's <br />participation in the Assistance Program. <br />D) Any conclusion or opinion of REACH or employee's treatment service provider that the <br />employee is limited or restricted in his/her ability to perform the employee's job duties, such <br />limitation may be, but not necessary, limited to physical, psychological, or medical reasons. <br />E) Any conclusion or opinion of REACH or employee's treatment service provider that <br />employee's participation may necessitate employee's absence from the City. <br />F) That employee has failed, refused, or otherwise has discontinued to proceed with the <br />REACH Program or any treatment service provider. <br />G) Report consisting of the following: <br />1) Diagnosis <br />2) Summary of treatment or therapeutic procedures <br />3) Disabilities, limitations, or restrictions of employee <br />4) Recommendation on further treatment. <br />The above information shall be considered confidential information not subject to disclosure by <br />REACH unless the City employee has on file with REACH and any treatment service provider in <br />the REACH Program an irrevocable authorization(s), RELEASE OF INFORMATION to the City. <br />On receipt of the City's request for the above information, REACH shall notify in writing, the City <br />employee of the City's request. <br />25A-40 <br />