Random, on-site tests successful for occupational med program, employer
Idea is unusual for typical workplace, but can be an aid to employers
Drug and alcohol testing usually make up a big portion of any occupational medicine program’s business, but most programs stay away from random, on-site drug testing. One program’s success, however, shows that this type of drug and alcohol testing can be done legally and successfully, with good results for the employer.
Aurora Occupational Health in Sheboygan, WI, has long offered the testing mandated by the Department of Transportation (DOT) and pre-employment testing, but random, on-site drug screens seemed to offer a bit more of a challenge. Random testing can raise tricky legal issues about privacy, and more than with other types of testing, you can encounter difficulties in terms of timing, confidentiality, and the need for an element of surprise.
For all of those reasons, random, on-site testing was not actively pursued by Aurora’s director of occupational health, Jerith Buteyn-Gier, RN. The program is part of Sheboygan Memorial Medical Center, with 125 beds. But when a client came to Buteyn-Gier and requested the service, she took a look at the situation and found that the service wasn’t so daunting after all.
The company was Rockline, a local employer of about 300 that makes coffee filters. Aurora had worked with the company on a regular basis for DOT and pre-employment screens, so Buteyn-Gier knew that the administrators there were proactive and eager to improve workplace health and safety. They knew DOT screens had recently become random, so they began wondering if non-DOT exams also could be randomized and performed on-site.
"They started having some employees coming to them and saying that they needed to do more with drug screening. Employees were saying they knew there was drug abuse in the workplace, so the company asked if we could work out this program," Buteyn-Gier explains. "I like new adventures, so I said we’d give it a try."
Investigate legal issues before proceeding
Once Rockline decided to try the program, Buteyn-Gier started working with the company to investigate the feasibility of random, on-site testing. The practice can be controversial if employees feel they are being unjustly accused by being selected for testing, so the company first wanted to ensure that such a program would be legal. The company spent about a year consulting with attorneys and having them research the various federal and state laws that might apply to the situation, and in the end, administrators determined that there was no legal prohibition.
"This is a unique program because almost nobody does random testing on-site, at least not in Wisconsin. Many companies are still leery about it. Most fear they are stepping on the toes of employees, even if they truly do want a drug-free workplace," Buteyn-Gier says. "We said we could provide the service if their attorneys said there was no problem." (For more on the legal issues, see related story, p. 143.)
Buteyn-Gier did find out from the company’s legal analysis that it would be much more difficult to introduce such a program into a union workplace, and she says she probably would never attempt that. But Rockline is not unionized, so about a year ago, Aurora began providing random, on-site drug and alcohol screens to Rockline employees.
The random testing is conducted on a monthly basis with five-panel drug and alcohol screens. Buteyn-Gier says the testing program has gone extremely well, with no resistance from the employees and good test results that helped the employer screen out some drug abusing workers.
"We do everything by the book as if we were doing DOT testing, but we don’t watch the specimen being collected," she says. "We have detected a number of positives, but so far there has been no tampering that we know of."
Buteyn-Gier is not free to disclose the number of positive test results, and in an illustration of why random, on-site drug and alcohol testing is still a rarity, the company refused Occupational Health Management’s request for information. A company official explained to OHM that the testing program has been a success and will be continued, but that the company does not want publicity for a practice that some workplace advocates (not to mention union organizers) would find an unacceptable intrusion.
(For information on how the employees were prepared before the testing, see related story, p. 144.)
Assess site where testing would be done
After settling the legal issues, one of the first tasks for Aurora was assessing the company’s physical layout. Proper drug and alcohol testing requires a specific type of collection facility that can be monitored and isolated in ways that reduce the opportunity to tamper with specimens. When Buteyn-Gier checked the Rockline facility, she found that it was set up in a way that would facilitate the testing process.
The facility had two bathrooms side by side, and the water could be shut off in one so it could be used as the collection room. With just one bathroom, the staff would have to keep turning the water on and off between specimen collections to keep a toilet functioning. It also was convenient that the two bathrooms were right next to each other and convenient to everyone in the facility.
In preparing for the testing, however, the occupational health staff found a couple of small problems. First, the electrical outlets in the bathrooms and the surrounding area could not handle the load needed by some of the testing equipment. That problem was discovered when Buteyn-Gier and her staff set up the breath alcohol testing equipment on site and found that it would not calibrate properly even though it had tested fine before leaving the clinic.
And second, on-site testing meant some type of refrigeration was needed to store the specimens while others were being collected. The employer solved both problems with some minor rewiring to increase the electrical output and the purchase of a small refrigerator.
Using MRO to check all positive results
Aurora Occupational Health is not a big revenue producer for the hospital. Instead, Aurora focuses more on establishing relationships with employers that will funnel other services into the hospital. For that reason, Aurora does not make much of a profit on the random, on-site testing. The program adds a small surcharge to its usual DOT exam fee, mostly to cover the cost of having a staff person go out to the site.
One occupational health nurse, specially trained in drug and alcohol screening, visits the work site and can complete all 30 screens in six to eight hours.
"That’s essentially one person spending one day’s work at this, including some data entry that is necessary after the testing," Buteyn-Gier says. "That’s everything from beginning to end, from traveling to the work site, doing the screens, and finishing the data entry afterward."
Breath alcohol results are available immediately on site, and Rockline receives the other test results by telephone, followed by a hard copy, usually within 24 hours. The employer uses a medical review officer to review all positive test results.
"This has been such a successful program that we’ve suggested it to other clients, and some of them are looking into it," she says. "We tell them that we’re capable of providing the service, but first we need to check out their arrangements to make sure they meet the testing needs. Some scenarios could require adapting the workplace, but we think this program would work in most settings."
Sources
For more information on on-site, random drug testing, contact:
• Jerith Buteyn-Gier, RN, Director, Aurora Occupational Health, 2629 N. Seventh St., Sheboygan, WI 53083. Telephone: (920) 451-5547. E-mail: [email protected].
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