Implement drug-free measures for home-health workers

Remaining in the home for as long as possible maintains the dignity of our elderly population. Allowing critically ill babies to go home and be with their parents is an invaluable service. Recovering from a serious medical condition in the comfort of the home is priceless.

And although several human resources practices must be in place to ensure safe and proper home care, a critical area is in the provision of a drug-free workplace.

Recognizing a responsibility to implement and take appropriate measures to ensure the well-being of employees and clients includes the establishment of policies against illegal drugs and alcohol in patients’ homes.

In addition to drugs and alcohol, measures also should prohibit workers from taking medication that is prescribed for someone else, or from taking prescription drugs for nonprescribed purposes or in dosages not directed by the health care provider.

Require staff to adhere to certain responsibilities in order to remain employed by the home-care facility. For example, team members must arrive fit for work and perform duties in a safe manor. Prescription medication that may affect work performance must be reported to the associate authorized to know about medical information before beginning work. Staff members must be expected to conduct themselves in a legal and lawful manner while in the home.

Testing for illegal drug and alcohol use should be mandated in three situations.

• First, make prospective workers a conditional offer of employment contingent upon passing a drug screen. Applicants unwilling or unable to complete the screening within a one-day timeframe from the date of the request should be ineligible for employment based upon failure to complete the screening. If a positive, post-job-offer screen is received, withdraw the offer of employment.

• Second, require testing for any work-related injury that requires first-aid treatment, especially when the employee is seen and treated by a licensed professional. Discharge the employee if he will not submit to testing. Remove him from duty without pay pending the drug test results. If the test is positive, terminate employment or require rehabilitation as a condition of remaining employed with the home-care agency.

• Third, test when management suspects that the employee is under the influence of an illegal drug or alcohol and/or if work performance is impaired.

Reasonable suspicion is defined as specific, objective, documented facts, which may be drawn from several sources. Did the patient or a friend or family member directly observe drug use and/or the physical symptoms, such as alcohol on the breath or manifestations of being under the influence of a drug? Is there abnormal conduct in the patient’s home, such as slurred speech, a staggered gait, flushed face, dilated or pinpoint pupils, wide mood swings or a deterioration of work performance?

Did the employee contribute to an accident in the home that necessitated treatment of an injury? Is there evidence that the employee is involved in the use, manufacture, possession, sale, solicitation or transfer of drugs?

Be sure that a company representative transports employees to the testing laboratory. Employees who refuse to be tested should be fired.

Inform employees that once specimens are collected, they will be sent home to wait for results. The company must make arrangements to have the employee being tested taken home. If the employee insists on driving and refuses to accept arranged transportation from the employer, he should be strongly discouraged but not forcibly restrained. If the employee still refuses to comply with the offered transportation, he should be fired. Notify local law enforcement immediately if an employee suspected to be under the influence attempts to drive.

If the test result is positive, terminate employment or, again, require participation in a rehabilitation program as a condition for keeping the job.

The value of home-care services and the serious responsibility of placing an employee in a patient’s home mandate a strong drug-free workplace policy.

Home-care companies should review existing policies to ensure inclusion of current best practices regarding a drug-free workplace.

Lynne Haggerman is president/owner of Haggerman & Associates, a firm specializing in management training, retained search, outplacement and human resource consulting.

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