Rapid Site Access Program A proposed better alternative to Site Access Testing

Rapid Site Access ProgramA proposed better alternative to Site Access Testing

AGENDA

• Safety Moment and Welcoming Remarks – Neil Tidsbury, CLR

2) Overview of RSAP – Sam Kemble, CLR

3) Case Management – Shirley Widlake, Organizational Health Incorporated

4) Prevention Efforts – Ron Beach, AADAC

5) Break

AGENDA

2) Overview of RSAP – Sam Kemble, CLR



5) Break

RSAP development…by industry Stakeholders

Sean CasaultLockerbie & Hole Industrial Inc.

Ron CherletConstruction Labour Relations

Peter DunfieldSyncrude, Syncrude Canada Ltd.

Chester FergussonUnited Brotherhood of Carpenters, Joiners and Allied Workers of America, Local #1325

Shabbir Hakim/Kevin Pretty

Jacobs Catalytic Ltd.

Sam KembleConstruction Labour Relations

Roland LaBossiereKellogg Brown & Root (Canada) Co.

Dan McBrideJacobs Catalytic Ltd.

Carmen MossingKellogg Brown & Root (Canada) Co.

Martyn PiperAlberta Regional Council of Carpenters

Sandy RitchiePCL Industrial Constructors Inc.

Deloris RushtonKellogg Brown & Root (Canada) Co.

Wally SemkowichKellogg Brown & Root (Canada) Co.

Bill SpringInsulators, Local 110

Gary TruhnPCL Industrial Constructors Inc.

Elana Yule

Jacobs Catalytic Ltd.

RSAP development…reliance on expert consultations and professionals

Independent ConsultantsDr. Brendan Adams, MOSTBarb Butler, Butler ConsultantsGeorge Grant, Access ConsultantsRon Beach, AADAC

Legal CounselPhil Ponting, McLennan RossYvon Seveny, Blair Chahley Seveny

Prevention TeamIndustry participants

Training providers AADAC

Wilson Banwell Human Solutions TM Third Party Case Administration

Organizational Health IncorporatedSubstance Abuse Expert Team

Wilson Banwell Human Solutions TM

Testing AdministratorMobile Industrial Health Incorporated

Treatment Team Wilson Banwell Human Solutions TM

AADACCommunity ResourcesTwelve Step FellowshipsAttending Physicians etc

Page 1

RSAP From Worker’s Perspective

$

MICROSOFTCORPORATION

Signs VoluntaryParticipationAgreement

Submits to Pre-enrollmentTest or uses Pre-AccessTest to Qualify for RSAP

Takes Dispatch to Participating Site

Proceeds Directlyto Site

Submits to Random TestNon-Negative

Negative

Substance AbuseAssessment

Third Party Case Administrationrefers to SAE

$

Treatment/Education

Signs Return to Work Agreementwith Third Party Case Administration

StartHere

Safety Controls of the Program

• Prevention

• Communication of expectations

• Education

• Monitoring for compliance

• Treatment and aftercare support

• Consequences

Advantages from Union/Employer and Owner Perspective

• Safety performance expected to improve– random testing is more

effective in achieving safety objective

• Consistent application based on objective standards

• Compliance frameworks– Non-negatives are not

“lost”– Put pressure in individuals

to make a decision• Economics

– Expedited dispatch– Less expense in testing,

more investment in compliance

– Testing on work time, but worker returns to work after submitting sample

AGENDA



5) Break

Organizational Health Incorporated

Organizational Health Incorporated

RSAP Third Party RSAP Third Party

Case Administration Case Administration Leaders in integrated, disability care Leaders in integrated, disability care

management servicesmanagement services..

About OHIAbout OHI

Core Business: DM , EFAP and WellnessCore Business: DM , EFAP and Wellness Multi- disciplinary Health Professionals Multi- disciplinary Health Professionals Privacy and Confidentiality a CornerstonePrivacy and Confidentiality a Cornerstone Focuses on Outcomes and Fitness for WorkFocuses on Outcomes and Fitness for Work Based in Western Canada, work NationallyBased in Western Canada, work Nationally Privately owned and operatedPrivately owned and operated Personal and quality focusedPersonal and quality focused

Our StrategyOur Strategy

Our clients- all RSAP registered partners Our clients- all RSAP registered partners Privacy Protected within RSAP boundariesPrivacy Protected within RSAP boundaries Total case management servicesTotal case management services Linkage between registering participants, testing Linkage between registering participants, testing

administrator, medical review officer, substance administrator, medical review officer, substance abuse expert (SAE) team, and treatment teamabuse expert (SAE) team, and treatment team

Integration with all providers to ensure all partners Integration with all providers to ensure all partners receive RSAP procedural services receive RSAP procedural services

OHI Objective forOHI Objective for

To provide case management services that ensure RSAP To provide case management services that ensure RSAP participants and providers receive...participants and providers receive...

Prompt Confirmation of active/inactive status for Prompt Confirmation of active/inactive status for dispatchdispatch

Prompt Member Contact & ReferralPrompt Member Contact & Referral Supportive monitoring of in-active members for Supportive monitoring of in-active members for

compliance of SAE recommendationscompliance of SAE recommendations Determination of fitness to safely RTWDetermination of fitness to safely RTW Opt-in, Random pool and follow up list for testingOpt-in, Random pool and follow up list for testing

RegistrationsRegistrations

Profiles received by OHI for all registering Profiles received by OHI for all registering participants: contractors, unions, owners participants: contractors, unions, owners and voluntary opt-in workersand voluntary opt-in workers

Contractor, owner and union information Contractor, owner and union information provided to OHI from CLRAprovided to OHI from CLRA

Registrations cont’d…Registrations cont’d…

Worker registration signed form submitted Worker registration signed form submitted (faxed) to OHI (faxed) to OHI

OHI confirms eligibility as per opt-in OHI confirms eligibility as per opt-in requirements (test results) requirements (test results)

OHI confirms applicant a participant and OHI confirms applicant a participant and registers worker on RSAP listregisters worker on RSAP list

Confirming Active StatusConfirming Active Status

OHI electronically updates Active/Inactive OHI electronically updates Active/Inactive StatusStatus

If not on list and questions contact OHIIf not on list and questions contact OHI

Testing Testing

Testing Administrator contacted for: opt-in Testing Administrator contacted for: opt-in participants with no results, monthly random participants with no results, monthly random draw, return to work and follow-upsdraw, return to work and follow-ups

MRO Test Results Report received by OHIMRO Test Results Report received by OHI Results lead to updating Active/Inactive Results lead to updating Active/Inactive

StatusStatus Test results provided to SAETest results provided to SAE

Case Management cont’d…Case Management cont’d…

Prompt contact made with RSAP members Prompt contact made with RSAP members with non-negative test resultswith non-negative test results

Referrals made to SAE for assessment and Referrals made to SAE for assessment and treatment recommendationstreatment recommendations

SAE recommendations receivedSAE recommendations received Contractor contacted if any time off work Contractor contacted if any time off work

required and estimated time off to comply required and estimated time off to comply with SAE recommendationswith SAE recommendations

OHI Case ManagementOHI Case Management

Also notification is received from testing Also notification is received from testing administrator of any member who has been tested administrator of any member who has been tested on site and deemed unsafe to RTW for that shifton site and deemed unsafe to RTW for that shift

Further information gathered and next steps Further information gathered and next steps

planned, contractor contacted re status planned, contractor contacted re status

MRO results received MRO results received

OHI Case Management cont’d…OHI Case Management cont’d…

Manages delivery of SAE recommendations Manages delivery of SAE recommendations with all treatment providerswith all treatment providers

Develops comprehensive after care program Develops comprehensive after care program to support compliance with Canadian Modelto support compliance with Canadian Model

Develops a signed RTW agreementDevelops a signed RTW agreement Contacts employer re active status and any Contacts employer re active status and any

limitationslimitations Updates Active/Inactive list Updates Active/Inactive list

RSAP Continuum of OHI ServicesRSAP Continuum of OHI Services

Active Status (Negative)Active Status (Negative) Inactive Status (Positive) Inactive Status (Positive)

OHI Referral to SAEOHI Referral to SAE

Return to Active StatusReturn to Active Status

Test ResultsTest Results

Random Pool Random Pool

InactiveInactive ActiveActive

Active if NegativeActive if Negative SAE Report to OHI SAE Report to OHI

Case ManagementCase Management

Follow Up TestingFollow Up Testing

Scenario 1-TomScenario 1-Tom

Sends in signed registration formSends in signed registration form Provides negative testing results (90 days)Provides negative testing results (90 days) Now Active Participant – Dispatch eligibleNow Active Participant – Dispatch eligible Is entered in random pool for testingIs entered in random pool for testing Remains active as long as negativeRemains active as long as negative

Scenario 2- JoeScenario 2- Joe

Signed registration form received by OHISigned registration form received by OHI Unable to provide testing results (90 days)Unable to provide testing results (90 days) Referral made to MHIS for testingReferral made to MHIS for testing MRO reports non-negative results MRO reports non-negative results Inactive RSAP StatusInactive RSAP Status OHI contacts Joe and referral made to SAEOHI contacts Joe and referral made to SAE

Scenario 2- Joe …Scenario 2- Joe …

SAE recommendations followed up by OHISAE recommendations followed up by OHI Joe is compliant with recommendationsJoe is compliant with recommendations Return to work testing results negativeReturn to work testing results negative Signed Return to Work Plan with OHISigned Return to Work Plan with OHI Employer contacted and RSAP Status Employer contacted and RSAP Status

updated to Activeupdated to Active Follow up testing-remains active if negativeFollow up testing-remains active if negative

Scenario 3- DonScenario 3- Don

Don has Active RSAP StatusDon has Active RSAP Status On a Random Pool Testing has Non-Negative On a Random Pool Testing has Non-Negative

ResultsResults Contractor notified by MHIS, Don is unsafe Contractor notified by MHIS, Don is unsafe

to RTW and OHI notifiedto RTW and OHI notified OHI case management begins, info gatheredOHI case management begins, info gathered RSAP status changed to InactiveRSAP status changed to Inactive


Don contacted and referral made to SAEDon contacted and referral made to SAE SAE Recommendations followed up SAE Recommendations followed up Cleared to RTW with limitations- ActiveCleared to RTW with limitations- Active Follow up testing done Follow up testing done Third follow up test is non-negativeThird follow up test is non-negative Status changed to inactive and process Status changed to inactive and process

repeated repeated


Don submits written request to opt-out Don submits written request to opt-out Currently not employed with a participant Currently not employed with a participant

contractorcontractor However, Don cannot opt-out as has not However, Don cannot opt-out as has not

complied with program requirementscomplied with program requirements Don remains inactive on RSAP list Don remains inactive on RSAP list until heuntil he

completes requirements completes requirements

OHI contacts for:OHI contacts for:

[email protected]@orghealthinc.com www.orghealthinc.comwww.orghealthinc.com 1-800-476-6640 ext 22291-800-476-6640 ext 2229 Fax 780-429-1747 Fax 780-429-1747 or 1-888-429-1747or 1-888-429-1747

Congratulations to …Congratulations to …

All who contributed to development of the All who contributed to development of the Rapid Site Access Program and Rapid Site Access Program and

Wishing all Participants Success in Wishing all Participants Success in Implementation of this PilotImplementation of this Pilot

Questions?Questions?

AGENDA


5) Break

Workplace Prevention Resources

•Crystal Cleland

Prevention and Addictions Counsellor

AADAC Adult Services

•Ron Beach

AADAC Provincial Prevention Consultant

Outline

AADAC services for the workplace

New resources

New worker orientation

Our Vision: A healthy society that is free from the harmful effects of alcohol, other drugs and gambling.

AADAC: Making a difference

AADAC Services

Confidential

No cost to all Albertans

Out-patient services

Residential Services

Detoxification services

1-866-33AADAC Help Line.

aadac.com

Supporting Fitness for Work

Fitness for Work : The need to show up fit to do your job

Well rested

Wearing required safety gear

Able to focus and work safely

Come to work with no traces of alcohol or drugs in your system

Impairment

A state of body or mind that causes a worker to become a hazard to themselves or others

Some causes of Impairment

Stress

Being tired

Alcohol or other drug use

Alcohol or drug use can affect fitness for work

Ways that substance use can affect the workplace

Individual

Greater risk for injury

Sick more often

Lost wages

Demotion or loss of job

Co-workers

Unsafe work environment

Having to cover for co-worker

Increased stress

Reduced morale

There is a balance between your life and work

Your alcohol or drug use can affect this balance

Drugs

A drug is any substance that can be taken into the body and changes the way the mind or body works

Alcohol

Positives

May relax you

Socially acceptable

legal

Negatives

Affects judgment and vision

Makes you less cautious

Cannabis

Positives

May feel relaxed or high

Negatives

Trouble concentrating

Cocaine

Positives

Increased feelings of energy, well- being and excitement

Negatives

Paranoid thoughts

Violent behavior

Seizures and vomitting

Gambling

Positives

Entertainment

Chance of winning

Negatives

All gambling involves risk

Stress of losing more than intended

Losses add stress to other areas of life including work

Lower your chances of developing a gambling problem

Limit the time and money you spend gambling

Don’t spend your winnings on gambling

Continue with other social opportunities

What is the fastest way to sober up ?

There isn't one

The only thing that will sober up a drinker is time

If you choose to drink or use substances: take responsibility for your actions

Alcohol and drug use can impair your judgment and reflexes

Makes operation of machinery unsafe

You will be more likely to injure yourself or others

Ways to stay healthy and be fit for work !

Eat well, exercise regularly and get enough sleep

Find healthy ways to deal with stress

Reduce or stop behaviors that puts your health at risk like smoking or alcohol and drug abuse

Learn more by calling

1-866-33AADAC Help Line.

AGENDA

5) Break

6) Assessments and Recommendations – John Streukens, Wilson Banwell Human Solutions™

7) Substance Testing – Eunice Friesen, Mobile Industrial Services Ltd.

AGENDA

6) Assessments and Recommendations – John Streukens, Wilson Banwell Human Solutions™

7) Substance Testing – Eunice Friesen, Mobile Industrial Services Ltd.8) Information Systems and Use of Personal Information – Sam Kemble,

CLR 9) Dispatch – Bill Spring Insulators, Local 11010) Contractor Protocols - confirming active status at point of dispatch and

chain of custody requirements for on site random testing – Roland LaBossiere, KBR

11) Question Period

SAE Protocols/ Process

Wilson Banwell PROACT Human SolutionsTM www.humansolutions.ca

SAE Process

• What Can I Expect?• A qualified expert in addictions• A competent standardized assessment

• MAST/DAST• DSM-IV Diagnostics• Clinical Interview• Recommendations based upon diagnostics• Standardized Reporting


Possible Diagnosis

• Alcohol Social/ Substance Social

• Alcohol Abuse/ Substance Abuse

• Alcohol Dependence/ Substance Dependence


Typical Recommendations: Abuse

1. Abstinence from all illicit or non-prescribed mood-altering substances (as per company policies)

2. One- six session on Alcohol/ Substance Impacts with an appropriately trained clinician or Approved Community Resource

3. Appropriate use of beverage alcohol:3&3 or 2&5 (male) 2&3 or 1&5 (female)

4. Any problems with alteration of alcohol use requires re-assessment

5. Substance Testing: 12 months (place a number based upon level of concern)

6. Obtain a negative drug screen prior to work re-assignment


Typical Recommendations: Dependence

1. Detoxification (if required)2. Inpatient (if required)3. Medical evaluation with GP (if required)4. Abstinence from all illicit or non-prescribed mood-altering

substances (inclusive of alcohol)5. Regular and ongoing attendance at an appropriate 12-

step group at a rate of 2-3 meetings per week for the first year

6. Short-term relapse prevention work with a qualified clinician

7. Substance Testing: 24 months (place a number based upon level of concern)

8. Obtain a negative drug screen prior to work re-assignment


Relapse Processes

• Factors influencing relapse (non-compliance, stresses, lax attitudes)

• Factors influencing the recommended outcomes of a relapse (reason for relapse, stage of recovery)


SAE Process

• What happens when I receive a positive test or performance based referral?• Contact OHI• Call the 1-800 Wilson Banwell Client

Service Center• Attend the assessment• Review the recommendations with the

assessing SAE clinician• Receive a client copy report• Follow the recommendations


SAE Process

• What goes into an SAE report• Name, date, reason for referral• Summary statement & Diagnosis• Recommendations• Fitness for work statement• Substance testing post-assessment (this

information is excluded from the client report)

AGENDA

7) Substance Testing – Eunice Friesen, Mobile Industrial Services Ltd.

8) Information Systems and Use of Personal Information – Sam Kemble, CLR

9) Dispatch – Bill Spring Insulators, Local 110

10) Contractor Protocols - confirming active status at point of dispatch and chain of custody requirements for on site random testing – Roland LaBossiere, KBR

11) Question Period

Mobile Industrial Health Services

Experience ▪ Respect ▪ Integrity

Onsite Collections

Day of Testing

MIHS will contact the contractor site supervisor upon arrival at the site

Site supervisor must immediately escort the individuals down to the collection facility

Supervisor Responsibilities

Escort the requested individual/s immediately to the collection facility

Do not allow the donor/s to eat, drink, or put anything in his or her mouth on the way to the collection facility

Do not allow the donor to stop at his or her locker, or collect anything from a backpack, etc.

Worker Responsibilities

Cooperate with testing process as directed by collector Identified by supervisor Removing bulky outerwear Emptying pockets Fluids as directed Patience during shy bladder protocol

Collection Procedure

Complete in about 15 minutes unless shy bladder

Breath alcohol test will be completed first

Urine drug collection completed last

Breath Alcohol Test

Evidentiary Breath Tester (EBT) If alcohol level is greater than .020, a

confirmation test will be done not less than 15 minutes after the first Donor may not eat, drink, smoke, put anything in

his/her mouth during the 15-minute wait time The confirmation result will be reported

Positive Alcohol Confirmation

The collector will inform the company contact that the employee Requires safe transportation back to his or her

lodging Is not to return to duty until contacted by OHI

The collector will inform OHI as soon as is reasonably practicable

Urine Drug Collection

Minimum of 45 mL is required Specimen discarded if insufficient quantity

Standard integrity check will be applied temperature, behaviour, sounds, colour, odour,

consistency of the specimen Donor and collector maintain visual contact

with the specimen until it is sealed

Urine Drug Collection cont’d

Specimen is split into two containers and sealed with tamper-evident , numbered seals

Donor and collector maintain visual contact with the specimen until it is sealed

Donor and collector sign Chain of Custody form (COC)

Donor is given copy 5 of COC Donor may leave collection site

Integrity Fail

Specimen is split into two containers and sealed with tamper-evident , numbered seals

Donor and collector maintain visual contact with the specimen until it is sealed

Donor and collector sign Chain of Custody form (COC)

Shy bladder protocol initiated

Shy Bladder Protocol Total of three hours will be given (four

attempts) Donor may be given 10 – 15 oz of water after

each attempt Donor will be asked to attempt to provide a

specimen approximately hourly Donor must not leave the collection facility

until the collection is complete

Refusal to Test

Failure to cooperate with the testing process Refusal to empty pockets, remove outerwear

Leaving the collection facility before completion of the testing process

Refusal to provide a sample Adulterated or substituted sample, or no

medical reason for providing insufficient quantity (MRO will determine)

Laboratory Testing

Maxxam Analytics SAMHSA certified Follows strict chain-of-custody procedures

Non-negative results are verified and quantified using gas chromotography/mass spectromatography (GC/MS)

Result is reported to Medical Review Officer (MRO)

Final Reporting

MRO has 48 hours to contact the donor to discuss result

MRO reports final result to OHI

AGENDA

8) Information Systems and Use of Personal Information – Sam Kemble, CLR



11) Question Period

Privacy

• Privacy impact assessment

• Against RSAP Procedural Rules to use, disclose, or retain information collected through the program for any purpose other than RSAP administration

AGENDA



11) Question Period

AGENDA

10)Contractor Protocols - confirming active status at point of dispatch and chain of custody requirements for on site random testing – Roland LaBossiere, KBR

11) Question Period

Contractor Responsibilities to RSAP

•Register

•Identify company designated contact

•Check log in page

Contractor Responsibilities to RSAP

•Only hire individuals from the Active List

•Assist in facilitating testing–Random testing

–Follow-up testing

Contractor Process for Testing

•Notification of random test list

•Provide supervisor contact information

•Collector contact supervisor to start collection process

Contractor Supervisor Responsibilities

•Supervisor meet with worker confidentially to advise that their name has been drawn in the RSAP random pool list

•Formally request the worker to participate in the request to provide a random alcohol and drug sample

Worker AGREES to test

• If the worker agrees, escort the worker to the collection site

•The worker must remain in the care and control of the designated supervisor who will turn over the care and control to the facilitating collector

–Training of participating supervision is required

– Individual not to leave the supervisor to go to the lunchroom, bathroom or into an office

•Worker provides sample and returns to work

Worker AGREES to test

•Supervisor reports to Company Administrator completion of test

•Third Party Administrator reports non-compliance and required follow up to the Company Administrator

Worker REFUSES to test

•Supervisor advises worker they are in non-compliance of the RSAP program

•Worker is taken off site

•Referred to Third Party Administrator

•Supervisor advise facilitating collector and company administrator

Worker REFUSES to test

•Company administrator advises Third Party Administrator

•Third Party Administrator will register the worker as inactive and continue with their process

Contractor Responsibilities

•Testing on work time

•Honor the requirements to remove worker from site

•Use care on issuing record of employment

• Last employer given first opportunity to re-employ worker

AGENDA

11)Question Period

12) Break for Lunch

Rapid Site Access ProgramA proposed better alternative to Site Access Testing

Documents

Rapid Site Access Program A proposed better alternative to Site Access Testing