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Equal Test Less StressStudent GroupTarleton State UniversityIntroductionSubstance abuse is defined as the use of substances that lead to a higher risk of issues and can result in a loss in control of the usage of the substance (Aging and Health, 2012). Annually in the United States, roughly 740 billion dollars are spent on crime, health care, and loss of productivity associated to substance abuse (National Institute on Drug Abuse, 2017). The Department of Transportation (DOT) created the policy, 49 CFR Part 40, to decrease the cost of loss productivity by creating mandatory drug testing for individuals working with machinery within companies or organizations. However, employees who are working with machinery are mandated to supply a urine sample.Historical BackgroundThe Department of Transportation first published its drug testing program regulation, which required cocaine and marijuana to be screened by federal agencies, 49 CFR part 40 (Part 40) on November 21, 1988 as an interim final rule (Federal Register, 2017). The Department of Transportation published a final rule on December 1, 1989, which incorporated several provisions from the 1988 Health and Human Services (HHS) Mandatory Guidelines. Among these provisions was a five-panel test that included all of the drugs for which HHS authorized testing (Federal Register, 2017). The United States Congress then recognized the need for a drug and alcohol-free transportation industry. In 1991, the United States Congress recognized the need for a drug and alcohol-free transportation industry and passed the Omnibus Transportation Employee Testing Act. The act required DOT agencies to implement drug and alcohol testing of safety-sensitive transportation employees (Federal Motor Carrier Safety Administration, 2014). In 1981, an accident aboard the USS Nimitz killed 14 soldiers, injured 48, and caused property damage estimated at $150 million (MobileHealth, 2014). After the accident, forensic testing conducted found several members of the deceased flight deck crew tested positive for marijuana. The officers on board and the aircraft were never tested, one report claimed (Flight Safety Foundation, 2018). Workplace drug testing article describes the accident as a “firestorm” within the Department of Transportation, leading to several new regulations and policies regarding drug testing and penalties of drug use (MobileHealth, 2014, para. 6). In 1988 the rules were expanded and supplemented existing drug testing rules that mandated drug testing of aviation, interstate motor carrier, railroad, pipeline, and commercial marine employees (Find Law, n.d.). In 1987, 16 people were killed in a collision of Conrail and Amtrak trains in Maryland. Members of the Conrail crew were found to have been smoking marijuana (Presley, 1995). The Omnibus Transportation Employee Testing Act of 1991 was put into legislation as a result of a New York City subway train derailment. The train operator was under the influence of alcohol when the accident occurred and was found to still have a blood alcohol content of 0.21 percent several hours after the crash (Murray, n.d.). Three years later, the Department of Transportation made comprehensive revisions to Part 40 on August 19, 1994 (59 FR 42996), December 19, 2000 (65 FR 79462), and August 16, 2010 (75 FR 49850). The 2010 revision again harmonized our DOT drug-testing program, where necessary, with the HHS Mandatory Guidelines effective October 1, 2010 (73 FR 7185; 75 FR 22809) (Federal Registration, 2017). The policy required mandatory drug and alcohol testing for certain employees holding commercial driver's licenses who operate commercial motor vehicles. This included pre-employment (for drugs only), post-accident, reasonable suspicion, return to duty, and follow-up testing (Higher Education Regulation Study, 2013). They also test for methylenedioxymethamphetamine (MDMA), confirmatory testing for MDA and MDEA, and initial testing for 6- acetylmorphine (6–AM) (Federal Registration, 2017). We are advocating for an amendment to Title 49 DOT 40 Section 40.289. The students want the Department of Transportation to enforce randomized drug tests and require the DOT to implement an Employee Assistance Program, rather than just discharging the employee.Necessitate the Policy/IssueResearch conducted from 1990 to 2010 connected substance abuse and unemployment. The article states within the United States, approximately 42.3% of individuals who were unemployed had experienced binge drinking within the last 30 days compared to 31.9% of individuals who were employed in 2008 (Dieter Henkel, 2011, pg. 6). In 2009, there were 17% of unemployed individuals who had abused drugs in the past month compared to 8% of individuals who were employed between the ages of 18 to 65 (Dieter Henkel, 2011, pg. 7). In the same year, 41.9% of individuals who were unemployed were smoking cigarettes; 25.6% of employed individuals disclosed they were smoking cigarettes (Dieter Henkel, 2011, pg 8). In 2002 to 2004, 12.5% of individuals who were unemployed had used prescription drugs for a nonmedical reason within the last year in the United States, compared to 6.1% of individuals who were employed (Dieter Henkel, 2011, pg. 7). This research showed the different prevalence of substances between employed individuals and unemployed individuals. The research also connected the major health and mortality rates between unemployment and substance abuse. From this research, they were able to gather that unemployed individuals were at higher risk for substance abuse, and they were more likely to need resources such as substance abuse prevention or therapy (Dieter Henkel, 2011, pg. 9). Due to 49 CFR Part 40 under the U.S. Department of Transportation, employers may drug test certain individuals due to their job description, but not other individuals also working for the company or organization (U.S. Department of Transportation, 2018). The DOT 40 allows employers to only drug test individuals working in high-risk or transportation fields due to safety regulations, company liability, or if the employee’s well-being is at danger. However, this limits individuals who are struggling with substance abuse find a stable job to support themselves or their family. DOT 40 limits the availability to individuals to become employed and stay employed due to unequal drug testing. With this research, the link between substance abuse and unemployment is proven.Policy DescriptionThe Title 49 CFR Part 40 covered by the DOT was established to regulate the substance use of drivers and create a safer environment for the public. The DOT requires their employees to follow this policy because they require a safety-sensitive workplace, for example bus drivers, pilots, truck drivers, conductors, etc. DOT 40 was published to grant the ability to drug test employees within the Department of Transportation. The policy, DOT 40, discusses the procedures and rules the DOT is required to follow when giving their employees the drug test (Electronic Code of Federal Regulations, 2018, Subpart A). Throughout the policy, it discusses different forms and regulations the employers must follow when the Title 49 CFR Part 40 is in place. Employees are responsible for complying with the rules and regulations of the drug test policy. Once they have taken the test, the employer cannot release their employee from their job without confirmation of a positive drug test (Electronic Code of Federal Regulations, 2018, Subpart B). If the test comes back as a positive drug test, then the employer must remove the employee from the workplace for their safety. The policy states that only “a collector who meets the training requirements” can receive a urine specimen drug test (Electronic Code of Federal Regulations, 2018, Subpart B). There is a designated site that is issued to conduct the urine drug test collection and it is required to have restrooms, sinks, and drinking water for employees (Electronic Code of Federal Regulations, 2018, Subpart C.).This policy describes that it is required to take a pre-employment drug test and it be received as a negative test. As a current employee, they can also be asked to take a drug test. The DOT 40 also tests for alcohol abuse and the employees are required to take a pre-employment drug test and maybe be randomly chosen to take the test throughout their employment (LaHood, 2010).Objective Analysis (Goals & Feasibility)The primary safety objective of the Title 49 DOT 40 section 40.289 rules is to prevent alcohol and controlled substance users from performing transportation industry safety- sensitive functions (The Substance Abuse Professional Guidelines, 2009). Employees in jobs regulated by the U.S. Department of Transportation who violate rules regarding use of alcohol or drugs must follow certain steps before returning to safety-sensitive work. The steps include starting with evaluation by a US DOT qualified Substance Abuse Professional (SAP), referral to appropriate treatment or education, and return-to-duty assessment with recommendations for follow-up testing and aftercare. This process includes conducting an initial face-to-face clinical evaluation. The evaluation includes standardized testing, developing recommendations for treatment and/or education, sending an initial evaluation report to the employer, also if employee has been released from employment, maintaining information for future employer, assisting the employee in contacting the treatment provider and arranging for services, maintaining regular contact with the treatment provider to monitor the employee's treatment progress, conducting a face-to-face interview, follow-up clinical evaluation to determine if the employee has complied with recommendations, measuring the success of the treatment, and, finally, sending a follow-up report and follow-up testing plan to the employer. Overall, it is up to the employer to determine whether or not the employee returns to work, not The Substance Abuse Professional (SAP). If the employee has been released from employment, this information is held for the future employer (The Substance Abuse Professional Guidelines, 2009). According to Lesley Miller (2018), employee assistance programs (EAP) are aimed to assist employees resolving obstacles/issues that are directly or indirectly affecting their life’s in order to improve work performance. SAMHSA (2017 a) describes EAPs as programs that assist employees in an array of services such as substance abuse, referrals to treatment, wellness programs, short-term counseling, etc. There are six different types of EAPs that organizations and employers can choose from in order to best assist their employees: in-house/ internal, external, blended, management-sponsored, member assistance, and peer-based (SAMHSA, 2017 a). Most often, employers are responsible for paying for EAP’s that not only assist their employees but also the employee’s family. Arguments in FavorAccording to SAMHSA (2017 b), by the year 2020 mental and substance use disorders will surpass all physical diseases as a major cause of disability worldwide. “These disorders, through the course of time, can have a powerful effect on the health of individuals, their families, and their communities” (SAMHSA, 2017 b, para. 2). According to Lesley Miller (2018), employee assistance programs (EAP) are aimed to assist employees resolving obstacles/issues that are directly or indirectly affecting their life’s in order to improve work performance. SAMHSA (2017 a) describes EAPs as programs that assist employees in an array of services such as substance abuse, referrals to treatment, wellness programs, short-term counseling, etc. Most often, employers are responsible for paying for EAP’s that not only assist their employees but also the employee’s family. There are many benefits when it comes to employers providing EAP for their employees. Another argument in favor of EAPs comes from Hartwell et al. (1996), who states that EAPs are worthwhile for employers to purchase. According to the study, the most popular model of EAP is the external provider. For this model, the median annual cost per employee was $21.83 for internal programs and $18.09 for external programs (Hartwell et al., 1996). EAPs are offered on a fixed-fee basis; therefore, employers pay a fixed rate per employee a month multiplied by the total number of employees for each contract year as stated by SAMHSA (2017 a). It is an investment that companies decide to make in order to improve employees’ well-being while at the same time improving the job performance of their staff. As stated by SAMHSA (2017 a), “numerous studies have supported the business case for the purchase of EAPs and other workplace services, with many employers receiving positive returns on their EAP investments” (para. 25). During the study, “Aiding Troubled Employees: The Prevalence, Cost, And Characteristics of Employee Assistance Programs in The United States,” researchers suggested that worksites that require more skilled labor should more likely have an EAP. (Hartwell et al., 1996, p.808). Therefore, it may “minimize the hiring and training costs associated with replacing a troubled employee” (Hartwell et al., 1996, p. 808).Arguments AgainstIn Title 49 CFR Part 40 subpart 0 section 40.289 it states that the Department of Transportation is not required to provide assistance for their employees if they violate the DOT drug and alcohol regulation. They leave it up to the specific companies within the DOT to pay for their employees to get long-term treatment. U.S Department of Transportation (2016) expresses that “payment for SAP [substance abuse professionals] evaluations and services is left for employers and employees to decide and may be governed by existing management-labor agreements and health care benefits” (para. 3). The DOT helps their employees by providing them with resources to get assistance, but most employees cannot afford these treatments. Employees are not allowed to go back to work until they have completed the requirements that DOT has placed.An argument against EAP’s provided by Ashely Miller explains that most employees are reluctant to use the services provided by their employer. The reasons being is “often a lack of education about the types and availability of EAP services by the employer or human resources professionals” and some employees might not be aware of the services that are provided to them (Miller, 2017, para. 5). Employees may also not seek services due to the “fear of a breach of confidentiality” because some of the services may be provided to the employees within the work place (Miller, 2017, para. 5). This causes some employees to fear being seen going into a counseling office by another munication with LegislatorsOn March 26th, 2018 the student group, along with colleague’s social work students, attended Social Work Advocacy Day at the Capitol in Austin. The student group met with the staff of Representatives Roberts Papierz, Brandon Creighton, and José Menéndez as well as with Senator Jose R. Rodriguez to discuss Title 49 CFR Part 40 Subpart 0 Section 40.289, and to advocate for the Department of Transportation to enforce randomized drug tests and require the DOT to implement an Employee Assistance program, rather than just laying off the employee. The students were only able to meet with the representatives’ staff except for Senator Jose R.Rodriguez. Prior to meeting with the representatives, the students searched for representatives on the Texas Legislature Official Site, looking for representatives who would have interest in Department of Transportation and memberships in certain committees. Meetings were set up via phone calls and email. The first meeting was held with Representative Robert Papierz. Representative Papierz is the Legislative Director Capitol Staff in Charles Perry’s office. Perry represents District 28 which contains two cities, Lubbock and San Angelo and 46 mostly rural counties. During the meeting, each student alternated explaining Title 49 Part 40 section 40.289, discussing the policy brief, the lack of funding treatments, and evidence backing up why it would be beneficial. Papierz was not aware of Title 49 Part 40; for that reason, the students presented him with a summary. After explaining the policy, he highlighted information from the policy brief while students discussed the bill. He briefly advised the students about the importance of having numbers of individuals that had completed the program. Representative Papierz mentioned that it is hard to locate grants that may apply, and they will view to see if they could divert that money to the programs. Papierz informed the students about a Senior Policy Analyst, Shannon Harmon, who is also on their staff. Shannon handles transportation issues and she was not available that particular day. He mentioned that anytime a worker remains unemployed, it is beneficial to the economy instead of having to retrain or train a new person to take that job. He assured the students that he would contact Shannon Harmon and send her the information. The second meeting was with Representative Brandon Creighton, a republican who represents the citizens of district 4, which encompasses parts of Montgomery, Harris, Chambers, Jefferson and Galveston counties. He was not available and the students spoke with Eileen Hernandez. Hernandez is an intern at the University of Texas at Austin in Brandon Creighton’s office. Students stated the purpose of the meeting, and each discussed section in Title 49 Part 40 Section 40.289. Hernandez informed the group that she believes jobs do not provide insurance to be used towards substance use treatments and the importance of this action. The third meeting was with Jose R. Rodriguez, a Democratic who represent Texas Senate District 29 (SD 29), which includes the counties of El Paso, Hudspeth, Culberson, Jeff Davis, and Presidio. He represents both urban and rural constituencies, and more than 350 miles of the Texas-Mexico border. He asked why the students were focusing on the Department of Transportation and was able to advise the students. They are genuinely in favor of the rehabilitation programs and reorient the employee’s goals to assist them adapt and succeed. The fourth meeting was in José Menéndez’s office, a Democratic who represents Texas Senate District 26. The students talked with available staff in his office and she provided them with a brief amount of time. She was not too familiar with the policy and was unaware of if it was at a Federal or State level. She wanted the students to peruse more into the cost of the programs that would be provided. She mentioned the state has a similar issue; several senators and house members have tried to push forward for funding program mechanism to assist people in their recovery. She also advised the students to research at a state level the kind of funding the non-profit is receiving for the programs, and the outcomes. Critical Evaluation of IssueAs stated earlier, the definition of substance abuse is the use of substances that lead to a higher risk of issues and can result in a loss in control of the usage of the substance (Aging and Health, 2012). This loss of control leads to the individual becoming addicted to the substance. Addiction is defined as a chronic disease of the brain where the individual is unable to abstain and craves the substance for reward or relief (Addiction Society, 2011). The disease is not covered by self-bought insurance or employer provided insurance. In recent years, the opioid crisis has caused over 300,000 individuals to lose their lives due to overdoses (Opioid Crisis, 2018). In 2016, two million individuals in the United States had disclosed an addiction to prescription drugs or opioids (Opioid Crisis, 2018).Funding for addiction treatment is scarce in the United States; however, steps are being taken to aid with the crisis. In 2016, Congress passed legislation to give individuals better availability to opioid addiction treatment (Prescription Opioid Misuse, 2018). This legislation also gave one billion dollars to increase treatment and prevention to the states (Prescription Opioid Misuse, 2018). In 2017, President Trump’s administration declared under federal law that the opioid crisis was a national Public Health Emergency (Opioid Crisis, 2018). While at the Texas State Capitol, funding was brought to attention by multiple legislatures. In Texas, it was brought to attention that funding for the growing crisis is difficult to obtain (Luis Figueroa, personal communication, March 26, 2018). With these efforts, however, little has improved for individuals already struggling with substance abuse. Individuals who fail drug test from their employers are likely to be fired, leaving them with no job and the battle of substance abuse to themselves. Without treatment for their addiction, many of these individuals will remain unemployed. Substance abuse and addiction have become a world-wide phenomenon leaving many individuals in poverty and struggling with mental illnesses alone. Employers providing treatment options for their employees could help alleviate this issue further. Petition/Rally EffortsAfter the social work students spoke to the legislators at the Capitol, the knowledge gained was then incorporated into creating a rally with the help from their community partner Rhyland Ramirez, the Director of Prevention Services and Community Partner Recruiter, who assisted with the population at STAR Council. STAR Council is an organization that offers a various amount of services to help clients achieve sobriety through counseling and support groups and provides awareness and prevention by working closely with schools in surrounding areas. In planning the rally, several meetings were made with Rhyland to discuss what the rally should include. As a group, they came up with three different activities and one speaker. Several people were contacted throughout Stephenville who had a connection to the topic. Amy Hattox-Hoag, who is the Prevention Specialist at STAR Council, was the selected speaker. The Speaker discussed how EAP are beneficial nationwide, but also gave statistics on how it would benefit our community. After they decided on the speaker, a brainstorming process began to come up with different activities they could conduct during the rally. The first activity was a trivia wheel game which included having a wheel with 12 slots to write trivia questions. The second activity was Simon Says with goggles that made someone see with an impaired vision. The last activity was to pledge to not drink and drive which was important to the rally. Therefore, the rally advocated for people who tested positive for drugs or drinking on the job in transportation to receive EAP treatment, but still wanting to encourage people to not drink or use drugs on the job or while driving. The rally took place on April 10th, 2018 at noon and was located on Tarleton State University campus at the John Tarleton statue. As a team, the social work students came together and worked on the presentation. During the time of the rally preparation, they also went around campus, individually to gain their petition signatures. The group was able to reach out to the community through their work places, family members, and one-on-one conversations about the policy to people throughout the campus. They encountered people who supported the policy and were passionate about what they are fighting for, but there were honest people who did not want to sign the petition. While planning, preparing, and performing the rally, the social work students learned and gained confidence in their speaking skills. Implications for Social WorkEmployees under the DOT are impacted at all three levels of social work by Title 49 CFR Part 40 Subpart O Section 40.289. The three levels that social work practice is divided into are micro, mezzo, and macro. At the micro level, individuals who are offered EAPs by their employers are able to attend one-on-one sessions such as substance abuse treatment and short-term counseling (Employee & Family Resources, 2018; ESI Group 2016). Also at the micro level, those employers who do not offer EAPs to their employees affect them at this level by potentially giving them time off from work or completely laying them off. At the mezzo level, employers who offer EAPs are not only assisting their employees, but they are also providing services to the immediate family of the employee. Such services for the family can include family counseling, budgeting classes, and legal counseling (Life Services EAP, 2018; Employee & Family Resources, 2018). Section 40.289 is a federal law that does not mandate employers under the DOT, a macro level entity, to currently provide EAPs to all of its employees. This policy allows for corporations and employers to decide whether they will offer EAPs to their employees or not. Individuals at the micro and mezzo levels who are currently offered EAPs by their employers are able to take advantage of the services provided to them in order to assist them in their personal problems. A federal law, at the macro level, positively affects individuals who are currently being offered EAPs, and negatively affects those who are not offered EAPs since Section 40.289 does not require all employers to offer these services to their employees. Overall, this policy affects individuals, whether it be positively or negatively, at all three levels of social work practice.ReferencesDepartment of Transportation. (2016, June 17). DOT Rule 49 CFR Part 40 Section 40.289. Retrieved from Department of Transportation. (2017, November 13). Procedures for transportation workplace drug and alcohol testing programs: addition of certain schedule II drugs to the Department of Transportation’s drug-testing panel and certain minor amendments. Retrieved from Department of Transportation. (2009). “The substance abuse professional guidelines [PDF File].” Retrieved from Electronic Code of Federal Regulations. (n.d.). Part 40—procedures for transportation workplace drug and alcohol testing programs. Retrieved from & Family Resources. (2018). A leader in helping individuals and businesses thrive. Retrieved from ESI Group. (2016). Public safety EAP. Retrieved from Federal Motor Carrier Safety Administration. (2014, December 24). Overview of drug and alcohol rules for employers. Retrieved from Find Law. (n.d.). Drug and alcohol testing rules. Retrieved from Flight Safety Foundation. (2018, April 30). Accident Grumman EA-6B Prowler 159910. Retrieved from , T. D., Steele, P., French, M. T., Potter, F. J., Rodman, N. F., & Zarkin, G. A. (1996). Aiding troubled employees: The prevalence, cost, and characteristics of employee assistance programs in the United States. American Journal of Public Health, 86(6), 804-808. Retrieved from LaHood, R. (2010, October 10). What employers need to know about dot drug and alcohol testing. Retrieved from Life Services EAP. (2018). Employee assistance resources for employees and family members. Retrieved from Miller, A. (2017, November 21). Pros & cons of an employee assistance program. Retrieved from Miller, L. (2018). Why your health insurance carrier should not provide your employee assistance program. Retrieved from Mobilehealth. (2014, December 1). Government and private. Retrieved from Murray, L.J. (n.d.). Omnibus Employee Testing Act of 1991. . Retrieved from Presley, B. (1995, January 8). At work - The new deal on drug testing. NYTimes. Retrieved from Substance Abuse and Mental Health Services Administration. (2017 a). Drug-free workplace programs. Retrieved from Abuse and Mental Health Services Administration. (2017 b). Prevention of substance abuse and mental illness. Retrieved from Catholic University of America. (2013, April 4). Summary of federal laws – office of general counsel. Retrieved from ................
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