What To Do About MUI: Managing Under the Influence
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Transcript of What To Do About MUI: Managing Under the Influence
Max KoonceSenior Director, Risk Management, Walmart Stores, Inc.
Ron ThackerySenior Vice President, Professional Services, Emergency Medical Services Corporation
Darrell BrownChief Performance Officer, Sedgwick
Tuesday, April 23, 2013Session Time: 2:15 to 3:30 p.m.
Introductions
Max KoonceSenior Director, Risk ManagementWalmart
Ron ThackerySenior Vice President, Professional ServicesEmergency Medical Services Corporation
Darrell BrownChief Performance OfficerSedgwick
Under the influence of?
Federal law - marijuana
• Controlled Substances Act (CSA) • Scheduling and approval of drugs, including marijuana, must be
based on both legal and scientific criteria:• High potential for abuse• Drug not currently accepted for medical use in treatment in U.S• Lack of accepted safety for use of the drug under medical supervision
• Department of Health and Human Services (HHS)• Provided scheduling recommendations• Drug Enforcement Administration (DEA) • Reviewed and denied petition to schedule marijuana• Department of Justice Guidelines (DOJ)• Violation of federal law• Subject to federal enforcement action, including prosecution
State laws
• 18 states and the District of Columbia have laws legalizing medical marijuana• Alaska, Arizona, California, Colorado, Connecticut, District of Columbia,
Hawaii, Maine, Maryland, Massachusetts, Michigan, Montana, Nevada, New Jersey, New Mexico, Oregon, Rhode Island, Vermont and Washington
• 2 states legalized marijuana for adults in 2012• Colorado and Washington
Court cases
Raich v. Gonzales (U.S. Supreme Court, 2005)
Emerald Steel Fabricators v. Bureau of Labor and Industries of State of Oregon (2010)
California Ross v. Raging Wire Telecommunications (2008)
Casias v. Walmart (Michigan, 2012)
What about legal prescription drugs?
Max KoonceSenior Director, Risk Management
Walmart Stores, Inc.
Walmart Stores, Inc. is comprised of:Walmart U.S. (approx. 1,400,000 associates)
• 4,005 Walmart Retail Stores• 620 Sam’s Clubs• 142 Distribution Centers
Walmart International (approx. 800,000 associates)• 6,148 Retail Units• 27 Countries
Alcohol and drug free workplace policy
1. Vital interest in maintaining a safe, healthy and efficient environment for Walmart associates, suppliers and customers
2. Committed to maintaining an alcohol and drug free workplace
3. Alcohol and illegal drug use pose a serious threat to workplace safety, health, and productivity
4. Walmart strictly forbids improper use of drugs / alcohol
Alcohol and drug free workplace policy (cont.)
5. Admission prior to testing request:• If an associate self-reports:
Employed a minimum of 180 days with the company Reports to a salaried member of management Provided a leave of absence Signs last chance agreement which provides:
• Enrollment in a substance abuse treatment program
• Certification that program was completed
• Periodic drug screens for following 12 months
Types of testing
Pre-employment Reasonable suspicion
Post-accident
Promotion screening
Transfer to safety sensitive position
Definitions
• Definition of positive alcohol screens• % blood alcohol concentration
• Definition of positive drug screens• Illegal drug: At or above the detection level for that drug
according to the Federal Substance Abuse and Mental Health Services Admin.
• Prescription drug: At a level in excess of the prescribed amount Other than for the condition for which the drug was prescribed Other than the prescribed method for using the drug; or Without a valid prescription
• Conduct of screens / testing
Consequences of positive test
Legal interaction
Wrongful termination
• Pretext
• Medical marijuana
Workers’ compensation claims
• Impact on benefits / compensability
• Opioid use in medical treatment
Americans with Disabilities Act
• Medical marijuana (CA case)
General liability - impaired while in accident
• Deviation from employment
• Insurance coverage
Additional concerns
• Wireless device use while driving company vehicles:– Comply with state laws:
• Texting while driving• Hands free
– Safety first:• Guidelines on call duration• Traffic congestion• Poor road / weather conditions
Additional concerns
• What happens if the associate is involved in an accident?
• Cell phone records could be requested• Elevated level of accountability if the cell phone was in use at
time of accident
• Medical marijuana
Ron ThackerySenior Vice President, Professional Services Emergency Medical Services Corporation
State reactions
Washington / Colorado
Colorado
Colorado - higher education
Emergency medical services corporation
Medical transportation• 3.4 million transports
• 8% share of total ambulance market
• 21% share of private provider ambulance market
Services offered• 911 emergency
• Inter-facility transfers (non-emergency)
• Fixed wing air ambulance
• Managed transportation
• Disaster response (FEMA)
• International
• Site-based
Outsourced facilities based physicians• 8 million patient encounters
• 8% share of ED services market
• 12% share of outsourced ED services market
Services offered• Emergency department
• Hospitalist / inpatient
• Anesthesiology
• Radiology / teleradiology
• Acute surgery centers
Alcohol and drug free workplace policy
• Pre-employment drug testing• Reasonable suspicion drug & alcohol testing• For cause drug & alcohol (collisions, >2 WC claims in 12 months,
missing or altered drugs, open container, presence of controlled substances/paraphernalia)
• Limited random drug & alcohol testing• Last chance - self disclosure, treatment with follow up testing
Alcohol and drug free workplace policy
• Refrain from alcohol consumption at least 8 hours prior to start of duty• Prohibited use, possession, manufacture, distribution and sale of
controlled substances or illicit drug paraphernalia• Report use of a prescribed or over the counter drug that may impair
behavior, alertness, mental ability, driving, patient care• Prescriptions must be in the name of the user• Notify management if arrested or convicted for criminal use/abuse of
drugs or alcohol
Alcohol and drug free workplace policy
• Testing methods• Saliva based screening• Confirmation - DOT lab based drug screening• Confirmation - DOT BAT testing for alcohol
• Positive tests - follow DOT criteria• Outcome - zero tolerance for positive tests• Reapply after 36 months
Practical application
Outcomes
Logistics - testing, transportation,
communication of results
Difficult time or a new beginning
Self disclosure - facing your peers
Left field - every once in a while