Operating a Successful Second Chance Policy and Program

(Winter 2017 [updated Spring 2020]) Employers across the country are feeling the effects of the increasing number of positive workplace test results for the last six years. Not being able to find workers and the threat of losing seasoned employees due to substance misuse has forced many employers to consider or reevaluate their willingness to offer a second chance to employees who test positive.

Issues around safety, public image and productivity certainly enter the discussion. But often at the heart of the issue is the debate about whether treatment works, whether someone can be forced to get help, and if offering a second chance is even “worth it.”

“What are the chances he’ll be successful?”
“What if she’s not ‘ready’ to get help?”
“Can he be trusted not to use again?”

These questions, focused solely on the employee and his or her readiness to accept and follow through with assistance, are certainly worthy of consideration. Modern theories around addiction treatment, for example, describe stages a person needs to move through to embrace and maintain long-term behavior change. It is certainly a process and not everyone who fails a drug test and is offered a second chance will be ready to change.

However, whether offering a second chance is successful depends on more than employee readiness, namely

• the readiness of the employer, particularly in relation to their drug-free workplace policy/program, and
• the readiness of the assistance provider to work with the business community.

Employer Readiness

Simply having a solid, comprehensive drug-free workplace can motivate an employee who’s engaged in the harmful use of substances to move toward change.  A positive drug test, for example, can serve to break through an employee’s denial of a problem – which is one of the “must do” accomplishments in the initial stage of change.

When an employee does test positive, however, there are other things an employer can do to increase the likelihood that offering a second chance will be worth it.

• Understanding addiction as a medical condition – According to the National Institute of Drug Abuse, addiction is a chronic, relapsing brain disease that can be effectively treated with recurrence rates “no higher than those for other chronic illnesses such as diabetes, asthma and hypertension.”Having this science-based understating of addiction reduces the stigma of the disease – stigma that for years has kept people from reaching out for treatment, and others, including employers, from supporting their recovery.
• Having a pre-existing relationship with an employer-friendly assistance provider – If an employer offers a second chance following a positive test, they need to know where to send that employee for an alcohol/drug assessment and related services.
  
  According to a 2017 survey administered to employers participating in the Working Partners® Drug-Free Workforce Community Initiative (DFWCI), 40% of businesses do not have (or don’t know if they have) a professional resource identified for when an employee needs help with a drug and/or alcohol problem. And one in three is not familiar with such services in their county that are funded by state and local tax dollars.
• Administering a detailed assistance agreement with the policy-offending employee – An employer’s DFWP policy/program should include a formal assistance agreement that is signed by an employee who is offered a second chance after a positive test in lieu of termination. This agreement outlines details of the referral and lists the expectations of the employee and the consequences of violating the agreement.
  
  Having this type of agreement, in writing, not only helps keep the employee on track, but it also provides structure to the employer in terms of managing the referral and return-to-work process.

Provider Readiness

An unmet need identified in the DFWCI was for businesses who were a part of the Initiative to have access to cost-affordable employee assistance services to support their second-chance agreements. While businesses were made aware of the community behavioral health agencies that could provide assessment and treatment services to their employees, there were two main barriers identified around offering those services in the context of an employer-mandated referral:

1. lack of financial assistance for the employee (making the services inaccessible)
2. minimal case management services for the employer

The primary payor sources for most community behavioral health agencies are Medicaid and subsidies from local alcohol/drug funding boards. Neither of these avenues for financial subsidy are typically available to a working adult (because of their income level), which means the worker is responsible for 100% of the fees. While some community behavioral health agencies are in the position to accept private insurance reimbursements, employees still find themselves responsible for 100% of the fees due to their high deductible plans.

At the same time, many community behavioral health agencies are not equipped or funded to provide case management services to employers who mandatorily refer an employee for assessment/treatment. These necessary activities include cost-manageable assessments, proactive and business-appropriate follow-up reports, return-to-duty recommendations and referrals to other needed services.

A successful second chance policy and program has far-reaching implications for both the employee and the employer. For the employee, research indicates that employer-supported and monitored treatment yields better sustained recovery rates than treatment initiated at the request of friends and family members.

And for the employer, a second chance policy and program can be a wise and financially-sound business investment. The cost of replacing an employee ranges from 25-200% of their annual salary.  And these costs don’t include losses in company knowledge, continuity and productivity. In terms of absenteeism, an employee in recovery from a substance use disorder actually misses less work than the general workforce, and there are also savings in terms of healthcare costs. On top of that, the loyalty of an employee who has been supported by their employer to get healthy is immeasurable.