LEGACY HEALTH HUMAN RESOURCES Origination Date: 11/94 Last...

LEGACY HEALTH

HUMAN RESOURCES

Policy#: LHS.500.702Origination Date: 11/94Last Revision Date: 04/2014Next Review Date: 04/2017

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SUBJECT: ALCOHOL & DRUG-FREE WORKPLACE POLICY

PURPOSELegacy Health is committed to providing and maintaining an alcohol and drug4ree workplace.

Legacy supports problem identification and, in appropriate cases, evaluation and referral froma certified drug and alcohol counselor or other qualified professional for employees whensubstance abuse affects the employee’s ability to perform the work, threatens the safety ofpatients, employees and others, or creates a dangerous work environment.

SCOPE

This policy applies to all employees of Legacy Health.

DEFINITIONS

1. Alcohol - Means ethyl alcohol (ethanol). References to use or possession of alcoholinclude use or possession of any beverage, mixture or preparation containing alcohol.

2. Drug - A drug is defined as a prescription drug, over-the-counter drug or illegal drug.

3. Drug-Free Workplace Act of 1988- This Act covers federal government contractors whoreceive federal contracts totaling $25,000 or more and/or employers who are recipients offederal grants of any amount.

4. Legacy Business or Social Event - Legacy approved conferences, seminars orworkshops, Legacy Health sponsored events including Legacy Health recognition events;Foundation or physician sponsored events; or events an employee is invited to as arepresentative of Legacy Health.

5. Positive Test - A positive test results from the presence of a level of alcohol equivalent toor greater than 0.02%w/v in blood, breath or saliva, or a controlled substance in urine,blood, breath, or saliva at or above designated thresholds.

6. Reasonable Cause - A belief based upon behavioral, physical or performance indicators,an admission of or self-disclosure by the employee, or apparently reliable testimony of aperson claiming to have personal knowledge of the misuse of alcohol or drugs by the

500.702 Alcohol & Drug-Free Workplace Policy of 12

individual, sufficient to lead a reasonable person to suspect that drug or alcohol use hadoccurred or is occurring.

7. Alcohol Screening - The testing of breath, saliva, or other types of testing as deemednecessary to determine use of alcohol.

8. Drug Screening—The testing of blood, urine, breath, saliva or other types of testing asdeemed necessary to determine use of drugs. Screening includes, but is not limited to,screening for the following drugs and/or drug metabolites: amphetamines, barbiturates,cocaine, methadone, opiates, benzodiazepines, codeine, marijuana or PCP.

9. Under the Influence of Drugs or Alcohol

a. A level of alcohol equivalent to or greater than 0.02%wlv or a detectable level of drugsin the urine, blood, breath or saliva above designated thresholds.

b. Altered behavior due to alcohol or drug use.

10. Medical Treatment - Any medical, surgical, chiropractic, dental or hospital treatment. Itdoes not include triage by a registered nurse or designee administering first aid orprotective medications after a disease exposure.

GENERAL POLICY

1. It is the policy of Legacy Health to maintain a workplace that is free from the effects of drugand alcohol abuse.

2. Legacy will initiate an alcohol and drug screen under the following circumstances:

a. After a conditional job offer to an external applicant for all positions (drug screen only).

b. Employees who possess commercial licenses and who operate Legacy vehicles or areotherwise subject to U.S. Department of Transportation regulations will be subject todrug and alcohol testing as required by the US Department of Transportation.

c. On the job accidents.

d. Reasonable cause.

3. Any applicant or employee who refuses to consent to alcohol and/or drug screening,tampers with a sample or otherwise subverts the testing process, tests positive orotherwise fails to cooperate with the MRO (Medical Review Officer) or comply with anyprovision of this policy may be subject to corrective action, up to and including terminationof employment or withdrawal of employment offer. Tampering includes any alteration orsubstitution of urine including dilution or presence of any agents which may mask thepresence of drugs.

4. Legacy Health recognizes that use of alcohol, illegal drugs, or misuse of prescription andnonprescription drugs by employees is a potential problem for job performance and patientsafety.


5. Employees will be subject to corrective action, up to and including termination, forpossession, use, theft, diversion, purchase, sale, transfer, distribution, manufacture,offering or attempting to obtain, or being under the influence of alcohol or drugs whileworking at and/or being present on the premises of any Legacy facility while on Legacybusiness.

6. The only exception to paragraph (5) above is for an employee using or possessing amedication prescribed for the employee by a physician, when such use does not impairsafe job performance. It is the employee’s responsibility to notify his/her supervisor of anymedication he/she takes that may impair his/her ability to perform his/her job safely.Failure to do so may result in corrective action. Employee Health is a resource to themanager to assess any concerns regarding the safety of the employee, co-workers orpatients concerning medications. Legacy may require a note from the employee’sphysician stating that the employee can perform the essential functions of the job or otherdocumentation if needed to fully evaluate the use of the medication and the potentialimpact on the employee’s ability to safely perform all job duties. Legacy reserves the rightto obtain independent medical evaluation to determine fitness for duty.

7. On occasions where alcoholic beverages are served in conjunction with certain businessor social events related to Legacy business, employees are expected to appropriatelyrepresent Legacy Health and perform their duties and other responsibilities in a safe andefficient manner at all times. Employees driving company or personal vehicles oncompany business are prohibited from consuming alcoholic beverages before driving.(Refer to LHS.500.802, Alcoholic Beverages at Social Events, for information on alcoholicbeverages at Legacy sites during social events.)

8. If there is reasonable cause to believe that an employee is under the influence of drugs oralcohol while working or in violation of paragraph (7) above, the employee will be subject tocorrective action, which may include termination.

9. Whenever employees or applicants for employment are to be tested for the presence ofalcohol and/or drugs, they are to be informed of the test in advance and will provideconsent for testing on the Lab form. Employees/applicants who have complaints about labor collection site procedural deficiencies must disclose those complaints to HumanResources within 24 hours of the testing.

10. All positive drug screens will be reviewed by the Medical Review Officer (MRO).

11. Legacy will only release the results of an alcohol and/or drug screen to those with a needor purpose for knowing the results or as required by law. Screening and results willotherwise remain confidential.

12. Consistent with the Drug-Free Workplace Act of 1988, if an employee is convicted of anydrug-related crime, the employee must report such to Human Resources within five (5)working days of the conviction and may be subject to corrective action up to and includingtermination.

13. Any employee who has terminated employment and been rehired will be required to pass adrug screen prior to placement in any position.


14. In the case of an on-the-job accident, Legacy will follow the procedures for post-accidentdrug and alcohol screening as provided in Section (C) below.

15. Legacy is committed to promoting the use of a certified alcohol and drug counselor (orother qualified professional) for help with problems related to alcohol and drug use whenappropriate for the individual and Legacy’s business needs.

Legacy will ensure compliance with all applicable laws and regulations.

PROCEDURES

A. Pre-Employment Screening Procedures

1. All applicants who receive a conditional job offer for any position must pass a preemployment drug screen in order to obtain employment at Legacy. Applicants whorefuse drug screening will not be hired.

a. Applicants will be referred to Legacy Employment Services for scheduling a drugtest.

b. The pre-employment drug test must occur within 48 hours of acceptance of the joboffer. If needed, exceptions will be made for out of town candidates. Candidateswho do not comply will not be hired and will be subject to the same terms as apositive drug test.

c. If a specimen is dilute, the applicant will be instructed to limit fluids and be allowedto provide one additional specimen within 24 hours. Only one retake will be allowedfor dilute specimens. If the applicant has a medical condition that may contribute toor qause a dilute specimen, he/she should discuss that information with the MRO.

d. If a specimen is identified as invalid for any reason, the applicant must provide anadditional specimen within 8 hours of notification by Legacy. Legacy HumanResources will contact the applicant and request an immediate return call. Theadditional specimen must be an observed collection by authorized personnel of thesame gender. If the candidate does not return the call in a timely manner and/orcomplete the second test within the designated time period, the candidate will notbe hired and will be subject to the same terms as if the result had been a positivedrug test.

e. Screening results will be sent to the designated contact person (Employee HealthNurse).

2. The applicant’s start date for the position is contingent on the negative results of thedrug screen.

3. Human Resources will notify the applicant of the results and, when a licensed applicanttests positive on a drug screen, will also notify the appropriate licensing board inaccordance with the applicable law.

4. There will be no opportunities for a repeat drug screen if an applicant tests positive.


5. Applicants who test positive, have a second dilute specimen absent medicaljustification or who do not comply with the 48 hour testing requirement will not be hiredand may not reapply for one year within Legacy Health.

B. Reasonable Cause Alcohol or Drug Screening Procedures

1. Employees may be required to have a drug and alcohol screen at any time forreasonable cause. The manager/supervisor will notify Human Resources immediatelyof the need for a reasonable cause drug/alcohol screening, and will consult with theHuman Resources Department throughout this process. During hours when HumanResources is closed, the manager/supervisor will immediately call the HouseAdministrative Supervisor and will contact Human Resources as soon as possible.

2. Determining Reasonable Cause:

a. Should the manager/supervisor or an employee identify factors such asabsenteeism, tardiness, substandard job performance, decreased accuracy,unusual appearance/behavior, signs of drug or alcohol use or abuse, admitted/self-disclosed or witnessed alcohol or drug use, or improper procedures with patientmedication, these factors may constitute reasonable cause, which will require theemployee to go through the alcohol and drug screening process.

b. The manager/supervisor will prepare the Reasonable Cause Evaluation form(Attachment 1) to document the basis for concern about the employee’s possiblealcohol or drug use or abuse. Whenever possible, the manager/supervisor willseek concurrence from another manager/supervisor or another appropriatewitness.

c. The manager/supervisor will remove an employee from his/her job when behavioror job performance indicates possible alcohol or drug use or abuse. Themanager/supervisor and an Employee Relations Consultant/Nursing Supervisor willthen meet with the employee to discuss the observations or performance problemsin a private location.

d. If reasonable cause is determined to exist, the manager/supervisor will review thispolicy and the screening process with the employee. If the employee refuses to betested after being given the opportunity to review this policy, he/she will besuspended pending further action or continued investigation. A refusal to test maybe grounds for immediate termination.

e. Discussion with the employee shall be documented by the manager/supervisor onthe Reasonable Cause Evaluation Form and this form will be forwarded to HumanResources for placement in the employee’s file.

3. Reasonable Cause Screening Procedures:

a. The employee will be escorted to the Lab patient service center or, if closed orthere is no Lab patient service center at the site, the Emergency Department by themanager/supervisor or designee. (A reference sheet with directions to lab locationsis available on the shared drive.) The drug and alcohol screen will be conducted in


accordance with lab procedures. Employees who test positive on alcohol mouthswab test, will be transported to the central lab (at Holladay Park) to have theconfirmation evidentiary breath alcohol test administered. Screening results will besent to the Employee Health Nurse listed on the Lab’s client service agreement.

b. After screening, the manager/supervisor will arrange for transportation home. If theemployee refuses transportation and chooses to drive, and the employee appearsto be impaired, security will be notified. The manager/supervisor will indicate onthe Reasonable Cause Evaluation form that transportation was offered, and ifrefused, that Security was notified.

4. Procedures After Obtaining the Results of the Drug and Alcohol Screen:

a. If the alcohol and drug screening results are negative, the Employee Health Nurseor designee will notify the manager and the Employee Relations Consultant. Themanager will decide, with Human Resources consultation, whether and when toreturn the employee to work. Job performance and conduct concerns whichresulted in a reasonable cause alcohol and drug screening will be addressed withthe employee by the manager. An evaluation of the employee by a certified alcoholand drug counselor or other qualified professional may be recommended to theemployee.

b. If a specimen is identified as invalid for any reason, the employee must provide anadditional specimen within 8 hours of notification by Legacy. Legacy HumanResources will contact the employee and request an immediate return call. Theadditional specimen must be an observed collection by authorized personnel of thesame gender. If the employee does not return the call in a timely manner and/orcomplete the second test within the designated time period, the employee will besubject to the same terms as if the result had been a positive drug test.

c. If the alcohol and/or drug screening results are positive, the Employee HealthNurse or designee will notify the employee’s manager and the Human ResourcesDepartment. In the case of licensed employees, Human Resources will also notifythe appropriate licensing board in accordance with applicable law.

d. The manager and Employee Relations Consultant will determine whether to offerthe employee an opportunity for treatment or to terminate employment inaccordance with this p01 icy (see (4.1~ below). The Employee Relations Consultantand the manager will then meet with the employee to discuss the results and thedecision.

e. If the opportunity for treatment is offered, the manager and the Employee RelationsConsultant will require the employee to obtain an alcohol and/or drug evaluation todetermine the need for and level of treatment utilizing a certified alcohol and drugcounselor or other qualified professional. Human Resources will provide a copy ofthe Reasonable Cause Evaluation Form to assist the counselor in assessment.

f. The employee will be required to sign an authorization for release of informationwhich will be sent from Legacy to the certified alcohol and drug counselor andrequired to contact Human Resources with the date and time of the appointment to


confirm that he/she has complied with this policy. Legacy reserves the right torequest that the employee sign an additional release of information to documentcompliance with the assessment recommendations.

g. Prior to Legacy’s referral for the initial assessment with a certified alcohol and drugcounselor or other qualified professional, the manager/supervisor and HumanResources will meet with the employee to communicate expectations regarding thereferral and anticipated return to work. As a part of this discussion, the employeemust sign a Last Chance Agreement. The Last Chance Agreement includesperiodic drug and alcohol screening at the discretion of Legacy during the term ofthe agreement or as may be required by the employee’s licensing board. Thisperiodic screening will be coordinated through Employee Health.

h. An individualized performance plan including work performance standards mayalso be developed between employee and manager/supervisor in consultation withHuman Resources. The employee may be required to accept a work statuschange to achieve the performance plan.

An employee with a positive alcohol or drug screen will be terminated (unless theindividual situation is one in which further accommodation is required) if:

1) He/she is in the introductory period.

2) There is evidence of drug theft/diversion or other misconduct that would subjectan employee to termination.

3) The employee is on a final corrective action that was issued within 12 months ofthe positive drug or alcohol screen.

4) The employee is in violation of a Last Chance Agreement.

5) The employee has previously tested positive for drugs or alcohol at Legacy.

6) The employee fails to comply with the provisions of this policy or is in violationof any other LHS policy for which termination is the appropriate course ofaction.

j. An employee seeking reasonable accommodation from Legacy for participation intreatment for alcohol and/or drugs will provide his/her manager/supervisor withappropriate medical documentation of his/her condition and treatment.Manager/supervisor will then contact the Legacy Leave Program for assistance andconsultation.

5. Procedures for Returning to Work After Decision to Offer Treatment Opportunity

a. The employee must be released to return to work by a certified alcohol and drugcounselor or other qualified professional. The provider will be asked to verify thatthe employee has kept appointments for the assessment. After completion of theassessment, a negative drug screen is required prior to returning to work. This can


be arranged with Employee Health. In cases of marijuana use, the MRO willprovide a recommendation for return to work based on established protocol of THClevels.

b. The employee is expected to use APL for all work missed prior to release.

C. Post-Accident Drug and Alcohol Screening Procedures

1. Employee drug and alcohol screening is required whenever an employee is involved inan accident or incident which results in:

a. Damage to Legacy property or other property.

b. Medical treatment for the employee or others.

c. Other reasonable cause for testing.

2. When an accident occurs, the employee must notify his/her manager/supervisor as soonas possible after the accident, but no later than 24 hours. An employee who fails toreport an accident or incident that might result in a drug and alcohol screen may besubject to corrective action and/or denial of benefits unless sufficient reasons for latereporting can be provided. Accidents or incidents that are not reported within 24 hoursare reviewed to determine the reason for the delay in reporting, which may be noted onthe Employee Incident Report under Manager’s Statement

3. Accidents Requiring Medical Treatment.

a. When an accident occurs that requires medical treatment of an employee, he/shemust go to either Legacy Employee Health or a Legacy Emergency Department foran initial evaluation, unless initial evaluation at a Legacy facility is not feasible due tomedical emergency.

b. All initial medical evaluations include a drug and alcohol screen. Where alcohol useis suspected or indicated during the screening, a confirming breath alcohol testshould be performed.

c. The employee may seek medical treatment from a physician of his or her own choiceafter the initial evaluation in Legacy Employee Health or a Legacy EmergencyDepartment.

d. Any employee who does not receive an initial evaluation at a Legacy facility followingan accident must receive a drug and alcohol screen at a specified collection site nolater than eight hours after the accident or incident.

e. Failure to report for a drug and alcohol screen as outlined above may be considereda refusal to test and may result in immediate termination of employment.

4. If an employee does not need medical treatment but is involved in an accident orincident involving property damage, injury to others, or other reasonable cause fortesting, the employee must go to a collection site for a drug and alcohol screen as soon


as possible, but no later than eight hours after the accident. The manager shouldtelephone the collection site to provide notice that an employee is being directed to thelab for a post-accident test.

5. The employee may be allowed to return to work pending the results of a post-accidentdrug screen unless reasonable cause, other observed behavior or the smell of analcoholic beverage on his/her breath indicates that returning to work is not appropriate.Arrangements should be made to transport the employee home under thosecircumstances.

6. In the event of a confirmed positive test result, the employee’s manager, RiskManagement, and Human Resources will be informed. They will determine theappropriate course of action in accordance with the procedures outlined underreasonable cause testing (section (B.4) above).

7. For accidents where a worker’s compensation claim is filed, an investigation isconducted to determine the compensability of the claim. The lab and/or the MedicalReview Officer may be consulted in the investigation process. A worker’s compensationclaim that results from an employee’s alcohol or drug use generally is not compensable.

D. Drug-Free Workplace Act of 1988- Under the Drug-Free Workplace Act of 1988, federalcontractors or federal grant recipients must implement the following policies:

1. Copies of this policy must be provided to all employees engaged in the performance ofa federal contract or grant.

2. If an employee of a federal grant or contract is convicted under any criminal drugstatute for a violation of that statute in the workplace, the employee must report thisevent to Human Resources within 5 days of the conviction and will be subject tocorrective action up to and including termination.

3. Legacy must then notify the contracting agency within 10 days of the above conviction.

Approval: Human Resource Leadership,Executive Council,

Originator: Human Resource Leadership


LEGACY HEALTHREASONABLE CAUSE EVALUATION

ATTACHMENT I

Employee: DatelTime:

ManagerlSupervisor: ________________

Observer: _______________

VCheck all that apply, normally reasonabletrends or combinations of behaviors.Observed Manager Observer

cause requires more than one isolated incident. Look for

Manager Manager

PHYSICAL WORK BEHAVIORS!CONDITION PERFORMANCE OBSERVATIONSSlurred Speech *Chronic/Excessjve *Paffern of

Lateness/Absence Absences (e.g.,Friday/Monday)

Odor of Alcoholic Leaves work station FrequentBeverage w/out notice complaints from

co-workersBloodshot Eyes Long or Frequent Increased patient/

• Breaks/Meals customercomplaints

Watery Eyes Fails to meet Avoidance ofdeadlines others

Blank Stares Needs repeated Change ininstruction persona! hygiene

I appearanceFlushed Significant change in Outbursts-tears or

pace-job takes more angertime

Dilated Pupils Rapid/unpredictablemood swings

Constricted Pupils Overreactions to Othercriticism Observations:

Tremors/Shakes Argumentative/Threatening

Excessive Sweating ForgeffulDizziness/Staggering Hyperactive/RestlessIrregular Breathing Dozes/nods off

Body Odor Disoriented/ConfusedVomiting/Nausea Reckless/Disregards

Procedures


Poor Depth *High Error RatePerceptionChronic Runny Nose Frequent Accidents, Name of

on/off the job Observer:

> Observations discussed with employee privately.> Legacy D/A Policy reviewed with employee, employee off on APL pending lab results (48-72

hours).> Employee offered transportation home (circle one) Accepted/Refused.> Employee impaired, security called for assistance in arranging a ride home.> Employee consents to screen, escorted to lab, “Reasonable Cause” testing requested.> Employee refuses screen, suspended pending investigation.> Manager/Supervisor notifies HR and Employee Health of the “Reasonable Cause”

screening.

Manager’s Signature:_____________________________________ Date:

Employee’s Signature:__________________________________________ Date:________(Acknowledges that policy and reasons for screening were reviewed with employee and thattransportation was offered and accepted/refused as noted above.)

LEGACY HEALTH HUMAN RESOURCES Origination Date: 11/94 Last...

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