Category: HR-ASSOCHEALTH
POLICY & PROCEDURE
Subject:
Drug Free Workplace: Alcohol, Drug and Controlled Substance Abuse Program
Classification:
Management Approved
Policy Owner:
Senior Vice President, Human Resources
Approved by:
WFH President and CEO
Effective: October 31, 2011
POLICY:
Wheaton Franciscan Healthcare (WFH) prohibits the use and/or possession, sale, purchase,
manufacture, distribution or dispensation of intoxicants, including alcohol or controlled substances
(drugs), other than over-the-counter drugs or lawfully-prescribed drugs, on all worksite premises or
in WFH vehicles. People on the premises of WFH owned or operated facilities are expected to be
free of mood-altering chemicals.
RATIONALE:
This policy is designed to be in accordance with WFH’s Mission, Vision and Values:
Value of Respect. Our Value of Respect calls us to ensure that we treat all people with dignity,
respect and compassion.
Value of Integrity. Our Value of Integrity requires us to understand and comply with State and
Federal laws and regulations that apply to drug and alcohol abuse.
Value of Stewardship. Our Value of Stewardship calls for us to maintain health and safety in the
workplace.
SCOPE:
PROCEDURE:
This policy applies to all prospective employees, associates volunteers, contractors and visitors of
WFH owned and managed regions.
I.
Associates
A.
WFH prohibits the use and/or possession, sale, purchase, manufacture, distribution or
dispensation of intoxicants, including alcohol or controlled substances (drugs), other
than over-the-counter drugs or lawfully-prescribed drugs, on all work site premises or
in corporate vehicles during work hours, including breaks. This prohibition also
includes the consumption of alcohol during meal breaks whether on or off site. Even
though the meal break is the associate's private time, the consumption of alcohol
during that period would cause the associate to return to work with a mood-altering
substance in his/her system and, therefore, be in violation of this policy. The singular
exception to this policy will be for institution-sponsored events where permission for the
consumption of alcohol will be explicitly approved by the Chief Executive Officer
(CEO). Company vehicles, as well as private vehicles parked on Wheaton premises or
worksites, are included in this prohibition. The inappropriate and/or medically
unsupervised use of prescription drugs is also prohibited.
B.
Associates, who unlawfully use, possess, sell or distribute drugs or controlled
substances outside work hours will be subject to disciplinary action up to and including
discharge for the first offense, if such activity has or may have an adverse effect on
WFH, its associates or customers. Adverse effects include, but are not limited to,
impaired work performance, endangered safety of associates, customers and the
public, and undermined public confidence in the corporation and its associates. In
deciding what action to take, WFH will consider the nature of the involvement, the
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associate's job assignment and his/her work record with the organization, along with
other factors.
C.
II.
III.
Prescription Drugs
1.
Anyone taking medication which significantly affects or impairs judgment,
coordination or other senses, or which will adversely affect ability to perform work
in a safe and productive manner, will be expected to notify and meet with an
Associate Health & Wellness nurse to verify the associate is safe to return to
normal duties.
2.
When informed by the associate of medication use, it must be determined if the
associate's job duties and assignments will be affected. Until a determination is
made about the associate's ability to work, he/she is not to be at work. The
Associate Health & Wellness nurse may contact the prescribing physician to
discuss the associate’s job duties and concerns for possible safety and
performance impairment due to the medication. The Associate Health &
Wellness Nurse may also consult with the Medical Review Officer (MRO) as
necessary.
a)
If the associate is allowed to work, the associate is to be told that he/she
must immediately notify the supervisor if he/she begins to have adverse
effects, whether or not the associate thinks he/she can still perform the job.
If other tasks are available that the associate can safely perform, the
associate may be so assigned. If other tasks are not available, the
associate shall be sent home. A friend, relative, security officer, or taxi cab
should transport the associate home.
b)
The supervisor should document this action. The associate may elect to
take PTO (paid time off) if they are eligible for such coverage.
c)
The duration of alternate job assignment, if indicated, will be handled on the
merits of each case. All information is to be kept confidential. When an
associate is on medication such that he/she is not fit to safely and
productively perform their job duties, that individual will not be allowed to
work until cleared by the Designated Management Official (DMO) and an
Associate Health & Wellness Nurse in concert with the MRO or the
associate’s physician. Part of the clearance may be successful completion
of a urine and/or blood analysis.
Contractors / Visitors
A.
WFH prohibits any contractor or visitor from being on WFH premises or worksites while
under the influence of or in possession of alcohol, drugs or controlled substances.
B.
Any contractor or visitor found in violation of the above-stated policy will be refused
entry to or removed from the premises. Depending upon the circumstances, other
action, including notification of appropriate law enforcement agencies, may be taken
against any violator of this policy. Every attempt should be made to secure alternate
transportation for the contractor or visitor being removed from the premises.
Volunteers
A.
WFH prohibits any volunteers from being on WFH premises or worksites while under
the influence of or in possession of alcohol, drugs or controlled substances except
legally-prescribed medication.
B.
Volunteers taking prescription drugs who determine that their performance and/or
behavior may be impaired as a result of such drug use should notify the Volunteer
Director or Supervisor on duty. In concert with the DMO, the Volunteer Director or
Supervisor will make a determination as to the individual's ability to safely and
productively perform their function. The MRO and the individual's physician may be
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consulted as safety and health considerations dictate.
IV.
C.
Until it is determined that the volunteer can safely and productively perform their role,
he/she should not function in a volunteer or auxiliary capacity. Health and safety will
always be the primary concern.
D.
Transportation to the volunteer’s home or an approved medical facility will be
arranged. Transportation will be by a friend, relative, security officer, or taxi cab should
transport the associate home.
Substance Abuse Screening
A.
WFH reserves the right to test to determine use of alcohol, drugs or other controlled
substances. Types of testing will include:
1.
Pre-placement
2.
Post accident
3.
Reasonable suspicion
4.
Random / Unannounced
a. Investigative
b. Drivers
c.
5.
Periodic
Post Treatment / Return to Work
B.
When a prospective or current associate is requested by a WFH member facility to
consent to and provide a sample for screening, the cost of the screening will be borne
by WFH.
C.
Definitions
1.
“Alcohol” means ethanol, isopropanol, or methanol.
2.
“Drug” means a substance considered a controlled substance and included in
schedule I, II, III, IV, or V under the Federal Controlled Substances Act.
3.
“Sample” means such sample from the human body capable of revealing the
presence of alcohol or other drugs, or their metabolites, which shall include only
urine, saliva, breath, and blood. However, in the state of IA, sample does not
mean blood except if the medical provider requires a blood alcohol/drug test in
the event of a post-accident as permitted under the IA Drug Testing Code.
4.
“Dilute Specimen” means a urine sample with creatinine and specific gravity
values that are lower than expected for human urine. This is important because
donors could deliberately dilute specimens by consuming large amounts of water
or other liquid or by adding liquid to their urine sample.
5.
“Adulterated Specimen” is a urine sample containing a substance that is not a
normal constituent or containing an endogenous substance at a concentration
that is not a normal physiological concentration.
6.
“Substituted Specimen” is a urine sample with creatinine and specific gravity
values that are so diminished or so divergent that they are not consistent with
normal human urine.
7.
“Invalid Result” refers to the result reported by a laboratory for a urine specimen
that contains an unidentified adulterant, contains an unidentified interfering
substance, has an abnormal physical characteristic, or has an endogenous
substance at an abnormal concentration that prevents the laboratory from
completing testing or obtaining a valid drug test result.
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D.
8.
“Negative Specimen” is a urine sample reported by the laboratory to not contain
the tested drugs at a concentration equal to or exceeding the cutoff
concentration, and with normal specimen validity test results.
9.
“Confirmed Positive Test Result” means the results of a sample in which the level
of controlled substances or metabolites in the specimen analyzed meets or
exceeds nationally accepted standards for determining detectable levels of
controlled substances as adopted by the federal substance abuse and mental
health services administration.
10.
“Medical Review Officer (MRO)” means a licensed physician, osteopathic
physician, chiropractor, nurse practitioner, or physician assistant authorized to
practice in any state who is responsible for receiving laboratory results generated
by an employer’s drug and alcohol testing program, and who has knowledge of
substance abuse disorders and has appropriate medical training to interpret and
evaluate an individual’s confirmed positive test result, medical history, and other
relevant biomedical information.
11.
Designated Management Official (DMO)” is a Human Resource professional, or
designee, that has been trained and has expertise regarding this program that
functions in a decision-making and supportive capacity, which is responsible for
receiving laboratory results and facilitating the fair and consistent application of
this program.
Confidentiality
Throughout the screening process, every effort will be made to respect an individual's
confidentiality. All information pertinent to the Drug Free Workplace: Alcohol, Drug &
Controlled Substance Program will be held in confidence and released on a “need to
know” basis only.
E.
See Appendix A for Drug and Alcohol specimen collection sites.
F.
See Appendix C and Laboratory policy for alcohol, drug and controlled substances
laboratory procedures.
G.
Drug or alcohol testing of current associates shall normally occur during, or
immediately before or after, a regular work period. The time required for such testing
shall be deemed work time for the purposes of compensation and benefits for
associates. This does not include prospective/pre-placement associate testing.
H.
WFH will provide transportation or pay reasonable transportation costs to associates if
drug or alcohol sample collection is conducted at a location other than the associate’s
normal work site.
I.
Pre-placement
1.
Post job offer, and prior to beginning employment, prospective associates will be
notified about and given a drug and controlled substance screening test as a
condition of employment. The initial drug or substance abuse screen and
confirmation will be done at the expense of WFH.
2.
The prospective associate is asked to sign the “Pre-Placement Drug and
Substance Screening Consent” form. Should the prospective associate refuse to
sign consent form for such testing purposes, the job offer will be rescinded.
3.
The test results will be used only to detect drug and controlled substance use
and not other medical conditions.
4.
Urine specimens are used.
5.
After the MRO confirmation is completed, results of the drug and controlled
substance screen test will be reported to the organization’s Designated
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Management Official (DMO).
6.
A prospective associate receiving a “dilute” test result will be required to provide
a second urine specimen at a collection site within 24 hours of notification. If the
second urine specimen is not negative or is still dilute, the offer of employment
may be rescinded. WFH will pay the cost of collecting and testing the second
specimen.
The prospective associate is to have the second and final specimen collected
early in the morning. The prospective associate should consume no more than 8
ounces of fluid prior to providing the sample.
If the second specimen test result is “dilute”, the two test reports will be sent to
the MRO for review.
WFH recognizes that in rare cases there may be a medical reason for a dilute
urine specimen, but that dilute specimens are more commonly due to excessive
fluid consumption. If the prospective associate believes that there is a medical
reason for his/her urine being abnormally dilute, the potential associate should
have his/her physician contact the MRO to discuss the potential associate’s
medical situation in confidence.
7.
A prospective associate noted to have a sample with an out of temperature range
will have an immediate direct observation sample obtained. If the prospective
associate is unable to immediately produce an adequate sample, he/she will be
directly monitored until a direct observation specimen is given.
8.
A prospective associate receiving an “invalid result” will be required to undergo
an immediate re-collection with direct observation as arranged by the MRO. The
result of the re-collection will stand as the test of record. WFH will pay the cost of
collecting and testing the second specimen.
9.
An MRO-verified result of a positive, adulterated, or substituted specimen will
usually result in rescinding of the employment offer.
In Iowa, the prospective associate will be notified in writing of the results of the
test, the name and address of the Medical Review Officer who made the report,
and of the applicant’s right to request records.
J.
10.
After the specimen has been reported positive, a potential associate may, at his
or her own request, choose to pay for split specimen testing (test the second half
of the split sample from the original collection that resulted in a positive
outcome.) Such testing must be completed by a Department of Health and
Human Services certified lab with the results received at the WFH organization
within five (5) business days of the positive screen. Should the split specimen
testing show the first positive results to be incorrect, the prospective associate
will again be considered for employment within WFH.
11.
Prospective associates whose job offer has been rescinded due to a reported
positive, adulterated or substituted sample screening result will be provided
information outlining drug abuse services of which they may take advantage, and
may re-apply for a position after twelve (12) months have elapsed.
Post Accident
1.
As soon as possible, the WFH facility shall test each associate whose
performance either contributed to an accident or cannot be completely
discounted as a contributing factor to an accident.
2.
If an associate is injured, unconscious, or otherwise unable to evidence consent
to the drug test, all reasonable steps must be taken to obtain urine and blood
samples.
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3.
In the case of a conscious but hospitalized associate, the manager/DMO should
request the hospital or medical facility to obtain samples. If an associate is
conscious, able to urinate normally, and have blood drawn (in the opinion of the
medical professional), and refuses to be tested, that person must be removed
from duty until a case determination is made taking into account all pertinent
information. Breath alcohol may be utilized when appropriate and available.
4.
An accident may be defined as causing:
a)
5.
K.
L.
Bodily harm to any person resulting in one or more of the following:
(1)
Loss of consciousness;
(2)
Necessity for hospitalization;
(3)
Necessity for treatment in an emergency room or urgent care setting;
(4)
Disability, which prevents the discharge of normal duties or the
pursuit of normal activities beyond the day of the accident;
b)
Estimated property damage of $1,000.00 or more
c)
An event that is significant in the judgment of the facility, even though it
may not meet the criteria above. However minor the accident, if, in the
determination of management, there is sufficient concern as to possible
alcohol or drug impairment, the associate will be requested to provide urine
and blood samples for screening. In Iowa, this will be handled as
Reasonable Suspicion testing, rather than Post-Accident testing.
A urine drug screen and breath or blood alcohol level of the associate are to be
performed as soon as possible post-motor-vehicle accident involving a Wheatonowned vehicle.
Procedure: Post-Accident Testing
1.
The sample collection site is to be notified as soon as reasonably possible of a
planned specimen collection. Notification will be from the appropriate
management representative as the situation dictates.
2.
A Supervisor or security officer will accompany the associate to an approved
collection site. If a security vehicle is not available, a taxi cab (at the institution's
expense) will be called to transport the associate to the collection site and home.
See Appendix A for a listing of approved collection sites, and Appendix B for a
listing of taxi cab services.
3.
If the associate refuses to sign the release for testing and also refuses to provide
a urine and/or blood sample for screening purposes, he/she will be asked to
leave the WFH facility or the specimen collection site. If the associate is
suspected of being unfit for work, call a friend or relative, security officer, or a taxi
cab (at WFH's expense) to take the associate home after the tests. If the
situation warrants, the police should be called to transport the individual.
4.
If the associate is uncooperative, is unfit for work, and leaves the premises or the
specimen collection site to drive his/her private vehicle, security, the DMO and
the police are to be notified.
Reasonable Suspicion
1.
Testing will occur when there is reasonable suspicion to believe that an associate
is under the influence of a prohibited drug or alcohol. The decision to test must
be based on specific, objective facts and reasonable inferences drawn from
physical, behavioral, or performance indicators of probable drug or alcohol use.
2.
Whenever the WFH facility suspects that an associate's work performance or
on-the-job behavior may have been impaired in any way by drugs, cases of drug
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diversion, dilution, theft or possession or that an associate has otherwise violated
WFH's Drug Free Workplace: Alcohol, Drug & Controlled Substance Program
policy, the facility may request the associate submit to a drug and/or alcohol test.
3.
Before an associate may be tested for reasonable suspicion, two individuals from
management must concur on the decision to test. Any supervisor may
substantiate and concur in the decision to test, even though that supervisor has
not observed the behavior of the associate indicating drug use. The two
supervisors may concur by phone.
If available, the DMO should be consulted prior to testing when there is reasonable
suspicion to believe that an associate is using or is under the influence of a
prohibited substance.
4.
M.
Supervisors or other management officials must be alert to detect associate
violations of this policy. The physical appearance of the associate, observed
inability to perform work in a safe and productive manner, or any amount of drugs
or controlled substances detected will usually be factors triggering a reasonable
suspicion of a violation. Suspicion sufficient to justify drug testing may be based
on one of the following circumstances:
a)
Direct observation by a supervisor of signs/symptoms of drug/alcohol use
or impairment such as, but not limited to, slurred speech, unsteady walk,
impaired coordination, poor balance, shakiness, uncontrolled laughing or
crying, or taking needless risks (endangering self or others)
b)
Abnormal conduct or erratic behavior while at work
c)
Unexplained significant deterioration in work performance
d)
Unexplained absences from the work area when there is reason to suspect
drug-related activity
e)
A report of alcohol or other drug use provided by a reliable and credible
source
f)
Evidence that an individual has tampered with any drug or alcohol test
during employment with the current employer
g)
Evidence that an associate has manufactured, sold, distributed, solicited,
possessed, used, or transferred drugs while working or while on the
employer’s premises or while operating the employer’s vehicle, machinery,
or equipment
h)
The odor of alcohol
i)
Physical or violent confrontation with another individual
j)
Ticketed for a moving traffic violation
Reasonable Suspicion Substance and Alcohol Screening Procedure
1.
Confront the associate in a reasonable, quiet manner. Do not use force. If the
associate presents a clear, immediate and substantial risk to the safety and
well-being of himself/herself or to others, then appropriate action may be required
to protect that associate.
2.
Take possession of any suspected substances in plain view. If the associate
refuses to turn over the suspected substance, do not use force, but inform
him/her that refusal may be grounds for discharge. If at all possible, prevent the
associate from disposing of the suspected substance. Put any suspected
substances in containers and mark them for future identification and testing.
3.
If possible, remove the associate from the workplace to a private location. Do
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not allow the associate to continue to work.
N.
4.
Notify the DMO about the situation.
5.
Conduct an interview with the associate about the suspected violation and give
the associate a chance to explain the situation.
6.
The sample collection site is to be notified as soon as reasonably possible of a
planned specimen collection. Notification will be from the appropriate
management representative as the situation dictates. (See Appendix A.)
7.
Have a security officer or alternate means of transport take the associate to the
specified specimen collection site to obtain urine and blood specimens. Breath
alcohol may be utilized when appropriate and available. After this part of the
investigation is complete, suspend the associate pending receipt of the test
results and/or other investigation.
8.
Arrange the associate’s transportation home. A taxicab (at WFH’s expense), a
friend, relative, security officer, or manager may take the associate home. Utilize
all reasonable means (without physically restraining the associate) to prevent the
associate from operating a vehicle. If the associate insists upon driving, call the
DMO and the police.
9.
As soon as possible after the incident, prepare a detailed written report about the
incident and obtain written statements from any witnesses.
10.
The chain of custody form is faxed to the laboratory conducting the testing.
11.
The contracted laboratory will do testing on the samples to determine if drugs or
controlled substances are present. Breath alcohol may be utilized when
appropriate and available. If the test result is negative, additional testing is not
indicated. If the test result is positive, a confirmatory test from the same
specimen will be conducted at a certified lab. (See Appendix C.)
12.
The manager and/or DMO will meet with the associate. If the test results on the
suspected substance and specimens are negative, the situation which prompted
the "reasonable suspicion" testing will be reviewed. The associate may be
referred to the Employee Assistance Program (EAP) for assessment and referral
to help. If the test results are positive, the associate will be subject to discipline,
up to and including discharge. An EAP assessment and referral may be a
condition of the associate’s employment, if the associate is not discharged and
allowed to return to work. See Appendix F for EAP information.
Random, Unannounced Screening
1.
Investigation
When there is concern regarding drug diversion, dilution, theft, sale, or
consumption or other mishandling of drugs or drug paraphernalia on WFH
premises or in WFH vehicles or when performing WFH business, drug screening
will occur. Urine and blood samples are tested. If there is evidence that specific
drugs are missing or appear to be diverted the supervisor or DMO should instruct
the specimen collection site and laboratory to investigate for the presence of
those drugs. In Iowa, testing based upon concerns regarding drug diversion,
dilution, theft, sale, consumption or other mishandling of drugs will be handled as
Reasonable Suspicion testing.
2.
Drivers
a)
Random screening will be initiated for associates who have Commercial
Driver’s License (CDL) and drive vehicles for a WFH entity where such
vehicles fall under the DOT regulations for mandatory testing, i.e., a truck
with a Gross Vehicle Weight Rating (GVWR) of 26,001 pounds or more, a
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bus which carries 16 or more passengers including the driver or any
placarded vehicle. This process is in compliance with CFR Part 40, DOT
Drug and Alcohol Policy and Compliance.
b)
3.
Random screening will be initiated for associates who transport
patients/clients in WHF-owned vehicles.
Periodic random
Unannounced screening of associates for the purposes of detecting drugs or
alcohol may be conducted on a periodic basis, without advance notice of the test
to associates other than associates whose duties include responsibility for
administration of the drug or alcohol testing program.
O.
a)
The selection of associates to be tested from the pool of associates subject
to testing shall be done based on a neutral and objective selection process
by an entity independent from the employer and shall be made by a
computer-based random number generator that is matched with associates’
social security numbers, payroll identification numbers, or other comparable
identifying numbers in which each member of the associate population
subject to testing has an equal chance of selection for initial testing,
regardless of whether the associate has been selected or tested previously.
b)
The random selection process will be conducted through a computer
program that records each selection attempt by date, time, and associate
number.
Random Screening Procedure
When the DMO notifies the individual in question of their random screening time and
refers them to the sample collection site to provide a sample, the DMO will contact the
specimen collection site to alert them that the individual is in route. The notification of
the associate by the DMO should immediately precede the individual’s being sent to
the collection site. The collection site will notify the DMO should the person not arrive
at the expected time.
P.
Q.
Post Treatment/Return to Work
1.
After an associate has gone to treatment for substance abuse, a sample screen
for prohibited substances may be required before the associate may return to
work.
2.
Random testing will be activated for associates during and after completion of
drug or alcohol rehabilitation.
3.
A person who returns to work after rehabilitation is subject to follow-up testing
without prior notice for twenty four (24) months after his/her return to duty. The
post treatment schedule will be determined by the EAP or treatment agency
professional, who will communicate this to the DMO.
4.
Post-treatment testing will be instituted in compliance with the State Impaired
Professional Program mandates for impaired physicians, nurses, pharmacists,
dentists, etc. when applicable.
Failure or Refusal of an Associate to Cooperate
In the event an associate fails or refuses to provide a sample when directed to do so,
the DMO will determine the disposition of the case. Failure of an associate to
cooperate fully is considered insubordination and a violation of this program. A refusal
to test is considered equivalent to a positive drug test. This is grounds for disciplinary
action up to and including discharge for the first offense. (See Disciplinary and
Corrective Action policy.)
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R.
Screening Tests
1.
Drugs
The initial test shall be an immunoassay, which meets the requirements of the
Food and Drug Administration for commercial distribution. Substances to be
screened will be determined by Human Resources leaders in consultation with
the Medical Review Officers (MRO). The drugs screened and their cut-off levels
may change as a result of changing drug use patterns or advances in the field of
drug testing.
All specimens identified as positive on the initial test shall be confirmed using gas
chromatography/mass spectrometry (GS/MS) techniques.
2.
Alcohol
When available, breath alcohol testing will be used to determine alcohol levels in
the body. A breath alcohol test measures the concentration of alcohol in breath.
This relates directly to the alcohol concentration in the blood and thus provides an
accurate determination of the quantity of alcohol reaching the brain. Results of a
breath alcohol analysis are expressed in terms of weight-to-volume: weight of
alcohol (expressed in grams) per volume of breath (210 liters). Results of a
breath test are read as Breath Alcohol Concentration or BrAC, but often
interpreted as BAC. For example, an alcohol concentration of 0.100 means there
are 0.100 grams of alcohol per 210 liters of breath, which equals 0.100 BrAC or
0.100 BAC.
The number results (although different units) for breath alcohol and blood alcohol
are used interchangeably. For example, a 0.02 grams per 210 liters of breath
alcohol level is equivalent to a 0.02 mg/dl blood alcohol level.
In accordance with Iowa state law, a breath alcohol level of 0.04 or greater is
considered positive for associates working in that state.
Blood or breath alcohol levels considered positive for associates working in all
other states is consistent with current Department of Transportation (DOT)
regulations.
S.
Positive Test Results
1.
All positive results will be automatically confirmed by gas chromatography/mass
spectrometry (GC/MS). If an associate should request a split sample test, the
laboratory could again test the specimen by GC/MS or send a portion of the
original specimen to another certified laboratory that the associate may request.
This reconfirmation at the original laboratory or at another laboratory will be done
at the associate's expense.
2.
See Appendix C “Reporting of Results”.
3.
When a confirmed positive test result for drugs or alcohol for a prospective or
current associate is reported to HR/DMO by the MRO, the employer will notify
the associate in writing by certified mail, return receipt requested, of the results of
the test, the associate’s right to request and obtain a confirmatory test of the
second sample collected at an approved laboratory of the associate’s choice,
and the fee payable by the associate to the employer for reimbursement of
expenses concerning this test. The fee charged an associate shall be an amount
that represents the cost associated with conducting the second confirmatory test,
which will be consistent with the employer’s cost for conducting the initial
confirmatory test on an associate’s sample.
a)
If the individual is a minor either working or applying for employment in
Iowa, the employer shall provide notice by certified mail, return receipt
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requested, to the individual’s parent as defined by Iowa law.
T.
b)
If the associate, in person or by certified mail, return receipt requested,
requests a second confirmatory test, identifies an approved laboratory to
conduct the test, and pays the employer the fee for the test within seven
days from the date the employer mailed by certified mail, return receipt
requested, the written notice to the associate of the associate’s right to
request a test, a second confirmatory test shall be conducted at the
laboratory chosen by the associate. The results of the second confirmatory
test shall be reported to the medical review officer who reviewed the initial
confirmatory test results and report to the employer on whether the results of
the second confirmatory test confirmed the initial confirmatory test as to the
presence of a specific drug or alcohol.
c)
Dilute test results will be handled in the same as outlined in the PrePlacement section (above.)
4.
In the case of a positive, adulterated, substituted or dilute sample screening
result, the DMO will determine the disposition of the case. These are violations
of the Drug Free Workplace: Alcohol, Drug & Controlled Substance Abuse
Program. An associate who has tested positive will be referred to the Employee
Assistance Program (EAP) for assessment, counseling and referral to a
treatment program for drug/alcohol abuse. The associate may not return to duty
until he/she is cleared by the DMO and completed the EAP assessment and
referral to help. At that time the DMO will determine the individual’s employment
status. The response to a positive, adulterated, substituted or dilute screen may
be progressive discipline up to and including termination of employment. (See
Disciplinary and Corrective Action policy.)
5.
In Iowa, upon receipt of a confirmed positive alcohol test, if the associate had
been employed for at least twelve (12) of the preceding eighteen (18) months,
and if the employee has not previously violated this policy, the associate may
elect to enroll in an employer-provided or approved rehabilitation, treatment or
counseling program. This program may include additional drug or alcohol
testing, participation in and successful completion of which may be a condition of
continued employment, and the costs of which may or may not be covered by
WFH’s applicable health plans or policies.
6.
Associates referred to the EAP as a result of a positive test for drugs, or as a
result of a substance-related critical incident at work, must immediately cease
any drug abuse and may be subjected to periodic unannounced tests for a period
of twenty four (24) months following completion of their rehabilitation program.
Employee Assistance Program
1.
The Employee Assistance Program (EAP) is designed to aid all associates and
immediate family members of associates with alcohol, drug or other personal or
lifestyle-related problems. All associates and immediate family members of
associates of the WFH System are encouraged to use the EAP for assistance
when warranted. Participation in the program is confidential.
2.
Voluntary use of EAP services will not be cause for discipline by WFH. However,
use of the EAP and acceptance of alcohol or drug abuse therapy by the
associate will not insulate the associate from disciplinary action, which might
have otherwise occurred.
3.
Return To Work
The DMO, the Human Resource leader and an EAP program consultant will
contribute to setting return-to-work guidelines.
This may be done in concert with the treatment professional involved. This may
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include a clinical recovery plan; an outline of expectations for performance upon
return to work as well as likely consequences should there be another violation of
this policy.
V.
Education
Education will be provided to associates and leaders in accordance with any applicable state
laws.
VI.
Record Keeping
A.
In accordance with applicable state law, an associate who is the subject of a drug test
shall, upon written request, have access to the records relating to his/her drug test,
including records of the laboratory where the testing was conducted and any records
relating to the results of any relevant certification or review by a MRO.
In Iowa, a prospective employee shall be entitled to records only if the prospective
employee requests the records within fifteen calendar days from the date the employer
provided the prospective employee written notice of the results of a drug or alcohol
test.
B.
Information regarding an individual's drug test results or rehabilitation may be released
only upon consent of the individual involved, except that such information must be
released regardless of consent to the proper governmental authorities in the event of
an accident investigation or to professional organizations for licensure purposes.
Statistical data related to drug testing and rehabilitation, which will not specifically
identify individuals by name, along with training records, will be made available to WFH
designated management officials upon request.
C.
All records related to this policy will be retained in accordance with the WFH Record
Retention Policy.
Replaces:
Alcohol, Drug and Controlled Substance Program, All Saints Healthcare
Alcohol, Drug and Controlled Substance Program, II.B.8.0, Covenant – Milwaukee
Alcohol, Drug and Controlled Substance Program, 910, Marianjoy
Substance Abuse Policy-Iowa Procedure, HR024
Substance Abuse - WFSI
Cross reference:
Disciplinary and Corrective Action Policy
Reasonable Suspicion Record
Record Retention Policy (local)
Review Period:
Two (2) years
Original Policy Date:
February 1, 2007
Dates Updated:
May 8, 2009; October 31, 2011
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Controlled Substance Abuse Program
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APPENDIX A
APPENDIX A
DRUG AND ALCOHOL APPROVED SPECIMEN COLLECTION SITES
WHEATON FRANCISCAN HEALTHCARE – ILLINOIS
FACILITY NAME / ADDRESS
 Marianjoy – WFH
Associate Health & Wellness
TELEPHONE NUMBER
630-909-7115
26W 171 Roosevelt Road, Wheaton, IL 60187
After hours:
 Convenient Care Center – Stratford North
235 Gary Avenue, Bloomingdale, IL
Hours: M-F until 8:30 p.m.; S-S 8 a.m. – 6 p.m.
 Convenient Care Center
636 Raymond Drive, Naperville, IL
Hours: M-F until 8:30 p.m.; S-S 8 a.m. – 6 p.m.
 Central DuPage Hospital
Emergency Department
25 North Winfield Road, Winfield, IL
After hours
630-539-5270
If there is any question whether a
drug screen can be done, ask to
have the Central DuPage Business
Health on call person paged.
630-539-5270
If there is any question whether a
drug screen can be done, ask to
have the Central DuPage Business
Health on call person paged.
630-933-1600
If there is any question whether a
drug screen can be done, ask to
have the Central DuPage Business
Health on call person paged.
 Condell Acute Care Center
6440 Grand Avenue., Gurnee, IL
847-249-2800
Open daily 8 a.m. until midnight
 Illinois Valley Community Hospital
925 West Street, Peru, IL 61354
815-780-3202
 Midwest HealthWorks
545 Plainfield Road, Ste B., Willowbrook, IL 60527
Open daily 7:30 a.m. – 5 p.m.
630-286-5300
 St. Francis Hospital – Evanston
800 Austin Street, Evanston, IL 60202-3439
847-316-7000
 Ingalls Occupational Health/Urgent Care
1600 Torrence Avenue, Calumet City, IL 60409
708-915-4806
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APPENDIX A
WHEATON FRANCISCAN HEALTHCARE – IOWA
FACILITY NAME / ADDRESS
 Occupational Medicine & Wellness
TELEPHONE NUMBER
Arrowhead Medical Center
226 Bluebell Road
319-575-5600
Cedar Falls, IA 50613
7:00 a.m. – 5:30 p.m.
 Mercy Hospital-WFH, Laboratory
319-283-6075
201 8th Avenue SE, Oelwein, IA 50662
After hours and reasonable suspicion collection sites:
 Covenant Medical Center-WFH, Laboratory Department **
319-272-8842
3421 West 9th Street, Waterloo, IA 50702
 Mercy Hospital-WFH, Laboratory **
319-283-6075
201 8th Avenue SE, Oelwein, IA 50662
 Sartori Memorial Hospital-WFH, Emergency Room **
319-268-3090
515 College Street, Cedar Falls, IA 50702
**Reasonable suspicion testing is to be conducted at these sites only.
WHEATON FRANCISCAN HEALTHCARE – MILWAUKEE, WI
FACILITY NAME / ADDRESS
 WFH - Elmbrook Memorial
19333 West North Avenue, Brookfield, WI 53045
Pre-placement and post-accident testing.
TELEPHONE NUMBER
262-785-2001 (Main Lab)
262-785-3043 (Outpatient Lab
where specimens are collected)
 WFH-Franklin **
10101 South 27th Street, Franklin, WI 53132
Reasonable suspicion, pre-placement, and post accident testing.
414-325-4725
After hours enter through Emergency Dept.
 WFH - St. Francis **
3237 South 16th Street, Milwaukee, WI 53215
Reasonable suspicion, pre-placement, and post accident testing.
414-647-7171
After hours enter through Emergency Dept.
 WFH - St. Joseph
5000 West Chambers Street, Milwaukee, WI 53210
Pre-placement and post-accident testing.
 WFH – Wauwatosa **
201 North Mayfair Road, Milwaukee, WI 53226
414-447-2229
414-259-7226
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APPENDIX A
After hours enter through Urgent Care
Reasonable suspicion and post-accident testing.
**Reasonable suspicion testing is to be conducted at these sites only.
Police Departments (non-emergency):
Milwaukee 414-933-4444
Brookfield 262-782-6072
Sheriff (non-emergency):
Milwaukee 414-278-4726
Waukesha 262-548-7117
Get car make/model and license number
WHEATON FRANCISCAN HEALTHCARE – RACINE, WI
FACILITY NAME / ADDRESS
 WFH – All Saints
3805 Spring Street, Building B, Suite 260, Racine, WI 53405
7:30 a.m. – 4:30 p.m.
 WFH – All Saints, Emergency Department
3801 Spring Street, Racine, WI 53405
During off hours
TELEPHONE NUMBER
262-687-6150
262-687-4684
This number is for ER Registration
which keeps the schedule for the
on-call Breath Alcohol Technician
(BAT). Call this number and
he/she will give you the pager
number of the on-call BAT to
dispatch them to the ER.
 If Security is needed call 262-687-4835 or pager # 262-399-2082
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APPENDIX B
APPENDIX B
TAXI CAB SERVICE FOR DRUG & ALCOHOL SCREENING
Instruct driver the associate is to be taken directly to the specimen collection site and then home when
collection is complete. If there are delays with specimen collection, the driver may leave and another may
be called by the specimen collection site to transport the individual home. The person has up to three (3)
hours to produce a sample.
WHEATON FRANCISCAN HEALTHCARE – ILLINOIS
 Citizen’s Taxi
630-510-3980
WHEATON FRANCISCAN HEALTHCARE – IOWA
 None
WHEATON FRANCISCAN HEALTHCARE – MILWAUKEE, WISCONSIN
 American United Cab
Note: Tell the dispatcher this is a “Direct Bill” and give them Account#: WF15
(414) 220-5000
WHEATON FRANCISCAN HEALTHCARE – RACINE, WISCONSIN
 None
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APPENDIX C
ALCOHOL, DRUG, AND CONTROLLED SUBSTANCE LABORATORY PROCEDURES
The laboratory contracted to perform alcohol, drug, and controlled substance screening will have rigorous
quality control standards and participates in proficiency exams operated by the various certifications and
licensing organizations in the United States.
The collection and testing laboratories will maintain strict security at their facilities and rigorously follow
the proper chain of custody procedures. The laboratory will satisfy all security and chain of custody
requirements of the Department of Health and Human Services (DHHS) Mandatory Guidelines for
workplace drug testing programs.
A. Drug Testing
In the initial test for drugs, the testing laboratory uses an immunoassay, which has been
approved for commercial use by the U.S. Food and Drug Administration. The testing laboratory
uses cut-off levels established by the DHHS. All positive drug screens will be confirmed by gas
chromatography/mass spectrometry (GC/MS) at a laboratory certified by the United /States
Department of Health and Human Services Substance Abuse and Mental Health Services
Administration or approved under rules adopted by the Iowa Department of Public Health. The
laboratory will use quantitative analysis for all GC/MS confirmation drug testing. With the
exception of Iowa, blood samples will be drawn for alcohol screening purposes. Breath alcohol
screening may be utilized when appropriate and available. The testing will be enzymatic and gas
chromatographic.
The collection of samples shall be performed under sanitary conditions and with regard for the
privacy of the individual from whom the specimen is being obtained and in a manner reasonably
calculated to preclude contamination or substitution of the specimen.
If the sample collected is urine, procedures shall be established to provide for individual privacy in
the collection of the sample unless there is a reasonable suspicion that a particular individual
subject to testing may alter or substitute the urine specimen to be provided, or has previously
altered or substituted a urine specimen provided pursuant to a drug or alcohol test. (See
Reasonable Suspicion Record )
1.
“Individual privacy” means a location at the collection site where urination can occur in
private, which has been secured by visual inspection to ensure that other persons are not
present, which provides that undetected access to the location is not possible during
urination, and which provides for the ability to effectively restrict access to the location during
the time the specimen is provided.
2.
If an individual is providing a urine sample and collection of the urine sample is directly
observed by another individual, the person who is directly observing the collection shall be of
the same gender as the individual from whom the urine sample is being collected.
Individuals having an observed collection must be instructed to raise clothing just above the
navel and lower clothing to mid-thigh. The person is to then turn around to show the same
gender observers they do not have prosthetic devices for beating the tests. If no device is
detected, the person is permitted to return clothing to its proper observed-collection position.
Then the observed collection will take place. A direct observation form needs to be completed
with every direct observation collection.
A direct observed collection is performed under the following circumstances:
(a) Request by the MRO in response to an “invalid result” reported by the laboratory
(b) In response to an out of range temperature obtained by the collector on the initial
attempt to collect a specimen
(c) In response to the collector observing suspicious behavior by the sample donor or the
donor attempting to adulterate the specimen
Direct observation samples will be obtained immediately post out of range temperature
specimens, or in response to suspicious behavior. If the prospective associate is unable
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APPENDIX C
to immediately produce an adequate sample, he/she will be directly monitored until a
direct observation specimen is given.
3.
The prospective or current associate has up to three hours to produce a urine sample.
B. The following are considered refusals to test:
1.
The individual admits to the collector that he/she adulterated or substituted his/her specimen.
2.
The individual behaves in a confrontational way that disrupts the collection process.
3.
The individual fails to follow the observer’s instructions to raise and lower clothing and to turn
around to permit the observer to determine if the person has a prosthetic or other device that
could be used to interfere with the collection process.
4.
The individual possesses or wears a prosthetic or other device that could be used to interfere
with the collection process.
5.
The individual refuses to wash his/her hands after being directed to do so.
C. Collection of a urine sample for testing of current associates shall be performed so that the
specimen is split into two components at the time of collection in the presence of the individual
from whom the specimen or sample is collected. The second portion of the specimen or sample
shall be of sufficient quantity to permit a second, independent confirmatory test. The sample shall
be split such that the primary sample contains at least thirty milliliters and the secondary sample
contains at least fifteen milliliters. Both portions of the sample shall be forwarded to the
laboratory conducting the initial confirmatory testing. In addition to any requirements for storage
of the initial sample that may be imposed upon the testing laboratory as a condition for
certification or approval, the laboratory shall store the second portion of any sample until receipt
of a confirmed negative test result or for a period of at least forty-five calendar days following the
completion of the initial confirmatory testing, if the first portion yielded a confirmed positive test
result.
D. Sample collections shall be documented, and the procedure for documentation shall include the
following:
1.
Samples shall be labeled so as to reasonably preclude the possibility of misidentification of the
person tested in relation to the test result provided, and samples shall be handled and tracked in
a manner such that control and accountability are maintained from initial collection to each stage
in handling, testing, and storage, through final disposition.
2.
The prospective or current associate shall be provided an opportunity to provide any information
which may be considered relevant to the test, including identification of prescription or
nonprescription drugs currently or recently used, or other relevant medical information. In IA, the
associate or prospective associate will be provided with a list of the drugs to be tested.
3.
Sample collection, storage, and transportation to the place of testing shall be performed so as to
reasonably preclude the possibility of sample contamination, adulteration, or misidentification.
4.
Alcohol testing (including initial and confirmatory) will be consistent with United States
Department of Transportation regulations pursuant to the federal Omnibus Transportation
Employee Testing Act of 1991.
E. Reporting of Results
The testing laboratory will report all test results. Positive test results will be reported to the MRO.
Prior to the results being reported to the employer, the MRO will review and interpret any
confirmed positive test results, to ensure that the chain of custody is complete and sufficient on its
face and that any information provided by the associate is considered. If possible, the MRO will
speak with the associate.
If a prospective or current associate is prescribed a controlled substance, that individual is
required to show a current, active prescription for that substance.
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APPENDIX C
After talking with the associate, the MRO will report his findings to the DMO by coded facsimile
transmission. Pre-placement screening results will be reported by the testing laboratory to the
DMO by coded facsimile transmission or certified mail when fax transmission is not available.
The testing laboratory shall report as negative all specimens that are negative on the initial test or
negative on the confirmatory test. Only specimens confirmed positive shall be reported positive
for a specific drug.
1.
The MRO may request from the testing laboratory and the laboratory shall provide
quantitation of test results. The MRO shall report whether the test is positive or negative, and
may report the drug(s) for which there was a positive test, but shall not disclose the
quantitation of test results to the employer.
2.
The testing laboratory will transmit results to the DMO by various electronic means (for
example, teleprinters, facsimile, or computer) in a manner designed to ensure confidentiality
of the information. Results may not be provided verbally by telephone. The laboratory must
ensure the security of the data transmission and limit access to any data transmission,
storage, and retrieval system.
3.
The testing laboratory shall make available copies of all analytical results for WFH drug
testing programs when requested by WFH institutions.
4.
Unless otherwise instructed by WFH in writing, all records pertaining to a given urine/blood
specimen shall be retained by the laboratory for a minimum of two (2) years.
F. Long-term frozen sample storage ensures that positive urine/blood specimens will be available for
any necessary retesting during the administrative or disciplinary proceedings. The testing
laboratory shall retain and place in properly secured long term frozen storage for a minimum of
one (1) year all specimens confirmed positive, in their original labeled specimen bottles. Within
this one-year period, WFH employers may request the testing laboratory to retain the specimen
for an additional period of time. If no such request is received, the laboratory may discard the
specimen after one year, except that the laboratory shall be required to maintain those known to
be under legal challenge for an indefinite period of time.
G. The testing laboratory shall comply with all applicable provisions of any state licensing
requirements.
H. Specimen Reanalysis
If the MRO determines that there is no legitimate reason for a confirmed positive test result other
than the unauthorized use of a prohibited drug, the original sample must be retested if the
associate makes a written request for testing within 72 hours of receipt of the final test result from
the MRO or DMO. Only the DMO or MRO are authorized to order a reanalysis of the original
sample, and these tests are authorized only at certified laboratories. This reanalysis will be done
at the associate's request and expense. The associate will pay in advance the cost of shipment if
any and the reanalysis of the sample. If the associate specifies split sample testing by a second
laboratory, the original testing laboratory must follow the approved chain of custody procedures in
transferring the portion of the sample.
Since some analytes may deteriorate during storage, detected levels of the drug below the
detection limits established in the procedures, but equal to or greater than the established
sensitivity of the assay, must, as technically appropriate, be reported and considered
corroborative of the original positive results.
I.
In Iowa, the laboratory engaged in the business of conducting drug or alcohol tests shall file an
annual report with the Iowa department of public health by March 1 of each year concerning the
number of drug or alcohol tests conducted on associates who work in Iowa, the number of
positive and negative results of the tests during the previous calendar year. In addition, the
laboratory shall include in its annual report the specific basis for each test, the type of drug or
drugs which were found in the positive drug tests, and all significant available demographic
factors relating to the positive test pool.
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APPENDIX D
APPENDIX D
WHEATON FRANCISCAN HEALTHCARE
DRUG SCREEN - DESIGNATED MANAGEMENT OFFICIALS
REGION
 Site
Designated Management Officials (DMO)
Telephone
Number
MILWAUKEE- WISCONSIN

Corporate Services Associates in
Wisconsin
Anna Zizzo, HR Director, Corporate Services &
CCCO
Becky Kieso, HR Rep
414-465-3112
414-874-6265
262-785-2248

Franciscan Ministries, Milwaukee
Teresa Chapman, VP HR
Tricia Hibma, HR Manager
630-909-6921
630-909-7112

The Wisconsin Heart Hospital
Heather Yops, Sr. HR Rep
Christopher Morris, HR Director, North Market
414-778-7807
414-447-2186

Wheaton Franciscan Laboratory
Anna Zizzo, HR Director, Corporate Services &
CCCO
Becky Kieso, HR Rep
Christopher Morris, HR Director, North Market
414-465-3112
414-874-6265
262-785-2248
414-447-2186

WFH - Elmbrook
Christopher Morris, HR Director, North Market
Becky Kieso, HR Rep
414-447-2186
262-785-2248

WFH - Franciscan Woods
Anna Zizzo, HR Director, Corporate Services &
CCCO
Becky Kieso, HR Rep
Christopher Morris, HR Director, North Market
414-465-3112
414-874-6265
262-785-2248
414-447-2186

WFH – Franklin & MOSH
Cindy Szymanski, HR Manager, Central Market
Rob Bauer, HR Director, Central Market
414-325-4524
414-647-7119

WFH - Home Health & Hospice Services
Anna Zizzo, HR Director, Corporate Services &
CCCO
Becky Kieso, HR Rep
Christopher Morris, HR Director, North Market
414-465-3112
414-874-6265
262-785-2248
414-447-2186

WFH - Medical Group
Rob Bauer, HR Director, Central Market
Christopher Morris, HR Director, North Market
Becky Kieso, HR Rep
414-647-7119
414-447-2186
262-785-2248

WFH - St. Francis
Rob Bauer, HR Director, Central Market
Lisa Garcia, HR Rep
Cindy Szymanski, HR Manager, Central Market
414-647-7119
414-647-7077
414-325-4524

WFH - St. Joseph
Christopher Morris, HR Director, North Market
Heather Yops, Sr. HR Rep
414-447-2186
414-447-3889

WFH -Terrace St. Francis
Anna Zizzo, HR Director, Corporate Services &
CCCO
Becky Kieso, HR Rep
Christopher Morris, HR Director, North Market
414-465-3112
414-874-6265
262-785-2248
414-447-2186
Christopher Morris, HR Director, North Market
Heather Yops, Sr. HR Rep
414-447-2186
414-447-3889

WFH – Wauwatosa
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APPENDIX D
WHEATON FRANCISCAN HEALTHCARE
DRUG SCREEN - DESIGNATED MANAGEMENT OFFICIALS
REGION
 Site
Designated Management Officials (DMO)
Telephone
Number
Racine Wisconsin

Franciscan Ministries, Racine
Jenny Dang, HR Manager
Tricia Hibma, HR Manager
Teresa Chapman, VP HR
630-909-7116
630-909-7112
630-909-6921

WFH – All Saints
Mary Jo Wodicka, HR Director, South Market
Mike Becker, HR Rep
Stephanie Folk, HR Rep
262-687-4154
262-687-4545
262-687-4218

WFH - Home Health & Hospice
Anna Zizzo, HR Director, Corporate Services &
CCCO
Becky Kieso, HR Rep
Christopher Morris, HR Director, North Market
414-465-3112
414-874-6265
262-785-2248
414-447-2186
Mary Jo Wodicka, HR Director, South Market
Mike Becker, HR Rep
Stephanie Folk, HR Rep
262-687-4154
262-687-4545
262-687-4218

WFH - Medical Group - South
ILLINOIS

Corporate Services Associates in Illinois
Tricia Hibma, HR Director
Teresa Chapman, VP HR
630-909-7112
630-909-6921

Corporate Services Office – Wheaton
Tricia Hibma, HR Director
Teresa Chapman, VP HR
630-909-7112
630-909-6921

Franciscan Ministries, Illinois
Tricia Hibma, HR Director
Teresa Chapman, VP HR
630-909-7112
630-909-6921

Oakbrook Terrace
Tricia Hibma, HR Director
Teresa Chapman, VP HR
630-909-7112
630-909-6921

Marianjoy Rehabilitation Hospital
Tricia Hibma, HR Director
Teresa Chapman, VP HR
630-909-7112
630-909-6921

Providence Central and West
Tricia Hibma, HR Director
Teresa Chapman, VP HR
630-909-7112
630-909-6921

Wheaton Franciscan Sisters
Tricia Hibma, HR Director
Teresa Chapman, VP HR
630-909-7112
630-909-6921
Vicki Parsons, VP HR
Missy Santman, HR Director
Suzanne Burt, HR Director
Debbie Tyler, HR Rep.
Kris Marmie, HR Rep.
Maureen Nolan, HR Manager
319-272-7336
319-272-7339
319-272-5174
319-272-7327
319-272-7347
319-283-6115
Vicki Parsons, VP HR
319-272-7336
Missy Santman, HR Director
Suzanne Burt, HR Director
Debbie Tyler, HR Rep.
Kris Marmie, HR Rep.
Maureen Nolan, HR Manager
319-272-7339
319-272-5174
319-272-7327
319-272-7347
319-283-6115
IOWA

Corporate Services Associates in Iowa
 Covenant Medical Center
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APPENDIX D
WHEATON FRANCISCAN HEALTHCARE
DRUG SCREEN - DESIGNATED MANAGEMENT OFFICIALS
REGION
 Site
Designated Management Officials (DMO)
Telephone
Number
IOWA - CONTINUED
 Franciscan Ministries, Iowa
Tricia Hibma, HR Director
Teresa Chapman, VP HR
630-909-7112
630-909-6921
 Mercy Hospital (in Oelwein)
Vicki Parsons, VP HR
Missy Santman, HR Director
Suzanne Burt, HR Director
Debbie Tyler, HR Rep.
Kris Marmie, HR Rep.
Maureen Nolan, HR Manager
319-272-7336
319-272-7339
319-272-5174
319-272-7327
319-272-7347
319-283-6115
 Sartori Hospital
Vicki Parsons, VP HR
Missy Santman, HR Director
Suzanne Burt, HR Director
Debbie Tyler, HR Rep.
Kris Marmie, HR Rep.
Maureen Nolan, HR Manager
319-272-7336
319-272-7339
319-272-5174
319-272-7327
319-272-7347
319-283-6115
Tricia Hibma, HR Director
Teresa Chapman, VP HR
630-909-7112
630-909-6921
COLORADO

Franciscan Ministries, Colorado
Updated: RB-01.31.12
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APPENDIX E
APPENDIX E
MEDICAL REVIEW OFFICERS (MRO)
WHEATON FRANCISCAN HEALTHCARE – ILLINOIS
 MRO Plus / Sensia Healthcare
Dr. Edward Cooney
1-414-359-9433
Dr. Andrew Seter
1-414-359-9433
Dr. Shannon Muderlak
1-414-359-9433
Marcia Hebbring (MRO Plus Client Support Specialist)
1-414-359-9433
John Lerand (Director of Business Development, MRO Plus/Sensia Healthcare)
1-414-359-9440
Mobile: 1-414-379-6190
Fax chain of custody forms to 1-414-465-3401
Clinical Reference Laboratory (CRL) Toxicology Customer Service
1-800-452-5677 or
1-800-773-7214
WHEATON FRANCISCAN HEALTHCARE – IOWA
 Occupational Medicine & Wellness
(Contact Dr. Kirkle through
Lisa Kriz)
Dr. David Kirkle
1-319-575-5611
Lisa Kriz (Drug and Alcohol Testing Coordinator – contact for questions
regarding test results, etc.)
1-319-575-5611
Employer Solutions (Customer Service Department at Quest Laboratory)
1-800-877-7484
WHEATON FRANCISCAN HEALTHCARE – WISCONSIN – MILWAUKEE
 Occupational Health Department
Dr. Lawrence Tolson
1-262-687-6150
Dr. Stephen Mawn
1-262-687-6150
Amy Nash (RN – MRO Assistant)
1-262-687-6151
Eric Hauke (Supervisor/Account Executive)
1-262-687-6146
Fax chain of custody forms to 1-262-687-6157
Clinical Reference Laboratory (CRL) Toxicology Customer Service
1-800-452-5677 or
1-800-773-7214
WHEATON FRANCISCAN HEALTHCARE – WISCONSIN – RACINE
 Occupational Health Department
Dr. Lawrence Tolson
1-262-687-6150
Dr. Stephen Mawn
1-262-687-6150
Amy Nash (RN – MRO Assistant)
1-262-687-6151
Eric Hauke (Supervisor/Account Executive)
1-262-687-6146
Fax chain of custody forms to 1-262-687-6157
Clinical Reference Laboratory (CRL) Toxicology Customer Service
1-800-452-5677 or
1-800-773-7214
HR-ASSOCHEALTH
Drug-Free Workplace: Alcohol Drug and
Controlled Substance Abuse Program
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APPENDIX F
APPENDIX F
EMPLOYEE ASSISTANCE PROGRAM (EAP)
WHEATON FRANCISCAN HEALTHCARE – ILLINOIS AND CORPORATE OFFICE
 Horizon Health (www.horizoncarelink.com)
800-843-1327
WHEATON FRANCISCAN HEALTHCARE – IOWA
 Covenant Clinic EAP – Iowa
319-272-8920
WHEATON FRANCISCAN HEALTHCARE – MILWAUKEE, WI
 The Center for Employee Assistance
800-227-7696
WHEATON FRANCISCAN HEALTHCARE – RACINE, WI
 All Saints Performance Plus
262-687-2777
Updated 01.06.11
HR-ASSOCHEALTH
Drug-Free Workplace: Alcohol Drug and
Controlled Substance Abuse Program
Page 24 of 25
APPENDIX G
APPENDIX G
FLOW CHART OF REASONABLE SUSPICION TESTING PROCEDURE
DRUG SCREENING
REASONABLE SUSPICION or POST-ACCIDENT
(INDICATED BY BEHAVIOR, APPEARANCE, OR PERFORMANCE)
1.
2.
3.
4.
5.
6.
7.
9.
10.
11.
12.
13.
14.
15.
ODOR OF ALCOHOL
1. LOSS OF CONSCIOUSNESS
SLURRED SPEECH
2. TREATMENT IN E.D. OR URGENT CARE
UNSTEADY WALK
3. HOSPITALIZATION
IMPAIRED COORDINATION
4. DISABILITY BEYOND DAY OF THE ACCIDENT
POOR BALANCE
5. PROPERTY DAMAGE GREATER THAN $1000
SHAKINESS
6. TICKETED FOR MOVING VIOLATION
UNABLE TO WALK
7. SIGNIFICANT EVENT; POSSIBLE IMPAIRMENT
UNCONTROLLED BEHAVIOR
TAKING NEEDLESS RISKS
ABNORMAL CONDUCT/ERRATIC BEHAVIOR
UNEXPLAINED DETERIORATION IN WORK PERFORMANCE
REPORT OF ALCOHOL OR OTHER DRUG USE FROM A RELIABLE/CREDIBLE SOURCE
PHYSICAL OR VIOLENT CONFRONTATION WITH ANOTHER ASSOCIATE
TICKETED FOR A MOVING TRAFFIC VIOLATION
COMPLETE “OBSERVED BEHAVIOR:
REASONABLE SUSPICION RECORD”
CONCUR WITH ONE OTHER MGMT OFFICIAL
(OVER THE PHONE OR IN PERSON)
REITERATE POLICY;
ASSOC. SUSPENDED
PER DMO’S
DISCRETION;
USE REASONABLE
MEANS TO PREVENT
ASSOCIATE FROM
OPERATING A VEHICLE
(CONTACT POLICE,
DMO)
UNCOOPERATIVE
REMOVE FROM WORKPLACE;
CONFRONT/INTERVIEW & EXPLAIN
CONSEQUENCES/PROCEDURES FOR
SCREEN/PICTURE ID REQUIRED;
NOTIFY DMO/COLLECTION SITE
**SEE APPENDIX A FOR COLLECTION
SITES
TEST SHOULD BE DONE JUST BEFORE,
DURING OR IMMEDICATELY AFTER
WORK.
COOPERATIVE
ASSOCIATE
SUSPENDED PER
DMO’S DISCRETION;
CONTACT SECURITY/
TAXI FOR
TRANSPORTATION TO
COLLECTION SITE
ARRANGE TRANSPORTATION TO
COLLECTION SITE, IF INDICATED.
INFORM COLLECTION SITE OF ASSOCIATE’S
INFORMATION (name, dob, ss) & WHAT TO
TEST FOR (outside of the normal panel, if
indicated ).
INFORM COLLECTION SITE OF WHO TO
CONTACT IN CASE OF QUESTIONS.
LAB WILL COLLECT URINE, BLOOD &
PERFORM BAT, IF AVAILABLE.
LAB WILL ORDER ALL REQUESTED TESTS &
FOLLOW CHAIN OF CUSTODY PROCEDURES
SEND ASSOCIATE HOME WITH RELATIVE, FRIEND,
SECURITY OR TAXI, IF ASSOCIATE IS SUSPECTED OF
BEING UNFIT FOR WORK (UNABLE TO SAFELY DRIVE)
SUPERVISOR TO WRITE FULL INVESTIGATIVE NOTES
REGARDING SITUATION. GET WITNESS STATEMENTS ON
BEHAVIORS. COMPLETE “OBSERVED BEHAVIOR:
REASONABLE SUSPICION RECORD” (IF NOT COMPLETED
ALREADY)
HR-ASSOCHEALTH
Drug-Free Workplace: Alcohol Drug and
Controlled Substance Abuse Program
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