Columbus, OH (WorkersCompensation.com) – Similar to many states struggling with this topic, the nationwide opioid epidemic has crippled Ohio’s workforce. It has left many Ohio employers with a shortage of healthy able-bodied workers. According to a recent study from the American Action Forum, the rise in opioid addiction among Ohioans is directly connected to the state’s shrinking labor force, which has suffered a “2.0 percentage point decline in the participation rate of prime-age workers” from the years 1999 to 2015.
The study revealed that in 2015, 49,200 women and 37,500 men were absent from the labor force as a result of opioid abuse. That equals a staggering total of 86,700 prime-age workers absent from Ohio’s workforce as of 2015. And to add to the state’s growing labor woes, recovering addicts who want to rejoin the workforce often have difficulty finding a job due to the stigma attached to their history of substance abuse.
This situation prompted the Ohio Bureau of Workers’ Compensation (BWC) to launch the Opioid Workplace Safety pilot program last month in Montgomery, Scioto and Ross counties, all of which have been hard hit by the opioid epidemic. The program was created to provide support and assistance to employers who hire people in recovery from drug addiction. Its aim is to get more recovering addicts into the workplace and retain those workers.
Under the pilot program, managers and supervisors will receive training on how to manage and retain employees in recovery, according to a release from the BWC. The program will also include reimbursement for “preemployment, random and reasonable suspicion drug testing.” Additionally, the program will provide a forum for second-chance employers to share their success stories and to encourage others to consider hiring people in recovery.
The BWC will provide funding of up to $5 million over two years for the pilot program, according to the release. The Alcohol Drug Addiction and Mental Health Services (ADAMHS) boards from each of the three counties will administer the program.
“The program acknowledges that employers need workers who are fit for duty and that employment is a crucial element of recovery,” said Dr. Terrence Welsh, BWC’s chief medical officer, in an interview with WorkersCompensation.com. “When many of us think of addiction, we still think of things like death and disability and destroyed lives, but there’s a growing community that believes we need to change that mindset and provide things like hope, identity, true employment and recovery through the treatment process and through giving these folks a second chance to reenter the workforce.”
Welsh said that during the program’s discovery phase, second-chance employers who they spoke with were “thrilled to death” to be a part something that gives people in recovery an opportunity to reenter the workforce and help them turn their lives around.
“What we’ve heard from employers who participate in programs like this is that workers are so grateful for being given a second chance, they’re loyal and dedicated and they work really hard,” said Tony Gottschlich, public information officer at the BWC.
Cleveland-based employment attorney Ann-Marie Ahern believes the program is a worthwhile and positive endeavor.
“The program as described is helpful because an employer who chooses to participate is going into it with the understanding of the nature of recovery and addiction and is trying to help within that framework,” Ahern told WorkersCompensation.com. “So the employer presumably would understand their obligation under the ADA (the Americans with Disabilities Act) to that employee and to be sensitive to those issues, more sensitive than an employer who may not know that they’re hiring someone in recovery from addiction.”
Ahern added that that the program could also help remove the stigma associated with people in recovery.
“And the other thing is in terms of getting rid of the stigma or to fight the stigma of addiction and recognizing that addiction is a disease like other diseases, and to be upfront about it and to be able to come out of the shadows and say, ‘This is my history,’ is probably a very worthy goal too,” she said.
Ahern discussed what she felt set the pilot program apart from other second-chance programs.
“I know that there are employers who choose to work with a recovering population, you know that’s specifically saying, ‘We are an employer who hires people in recovery,’” she said. “But in terms of a program where an employer is actually financially incentivized to hire people out of recovery, I’m not familiar with any program that has done that.”
And with regard to HR guidelines under the pilot program, Welsh said the guidelines would vary from employer to employer.
“The whole HR thing is something individualized to employers, so we’re not going to dictate what their HR policies have to say,” Welsh explained. “It’s more of a mindset that we’ll be welcoming in support of the people in recovery. We do expect and hope that employers will support people who have relapsed through their relationships with their local (Alcohol, Drug Addiction and Mental Health Services) boards and treatment centers.”
Another positive aspect of the program is that it has the potential to reduce the number of relapses among those in recovery, according to Welsh. “We do know that people who are connected to employment have lower rates of relapse,” he said.
Welsh also touched on how the program would handle any workers’ compensation issues that might arise in the event that an employee in recovery suffers a relapse and injures him or herself on the job. He said this would probably fall under a statute known as “rebuttable presumption,” which became effective in Ohio in October 2004. Under this statute, the burden falls on the employee to prove that alcohol or a controlled substance wasn’t the “proximate” cause of a work-related injury. An employee who tests positive or refuses to submit to a drug test may be disqualified for benefits and compensation under the Workers’ Compensation Act.
However, there would have to be “reasonable cause” to suspect that the employee was under the influence of alcohol or a controlled substance at the time of the accident to warrant a drug test. In other words, the employee needs to have demonstrated behavior that indicated he or she may have been intoxicated when the accident occurred — and this would require eyewitness affidavits from coworkers.
And in the event that an employee has a relapse on the job and injures a coworker, and the coworker wants to file a workers’ compensation claim, Ahern said that person could file a claim under Ohio’s no-fault policy. Under this policy, injured workers are able to collect workers’ compensation regardless of who caused the work-related injury.
Additionally, Welsh said that if an employee suffers a relapse and requires treatment, BWC regulations do not allow them to pay for treatment that’s not a work-related illness or injury. However, he doesn’t think funding for treatment will be a problem for employees in the program.
“During our discovery process, we spoke with treatment centers and found that funding isn’t usually a big issue,” he said. “In other words, most of those folks in Ohio are covered by Medicaid treatment program(s). Others have commercial insurance programs.”
Welsh added that there are other funding sources available as well, such as the local alcohol, drug addiction and mental health boards, which can provide funding for treatment in emergency situations.
Los Angeles workers’ compensation and immigration attorney Nikki Jacobson shared her thoughts on the pilot program.
“A program that basically gives addicts who are in recovery a second chance to get on their feet and build something of themselves is great and positive,” she said. “However, it also puts extra responsibilities on the employer such as the random drug testing and training. It’s not monetarily more expensive for the employer because the program is paid for, but it’s that concept of now you as an employer have more responsibility.”
And Jacobson cautioned that the pilot program — or any second-chance program — has the potential of creating an exploitative relationship between the employer and employee if certain issues aren’t addressed early on and everyone is not fully aware of their rights.
“The employee needs to understand that although they’re a part of this program, not to allow the employer to take advantage of them, to bully or to scare them into anything, you know like making them to do things like, ‘You’re lucky to have me. I hired you even though you’re an addict, and how you owe me AB and C,’” she explained. “We need to make sure that people are aware of their rights, so does the employer and the employee, and that they’re educated about the program, so neither takes advantage of the other. Again, I think it’s a great program; I’m not saying that we shouldn’t have it; I think we should definitely have it, but we should also make sure that there are guidelines and details in place for both the employee and the employer.”
Kate Sidora — communications specialist at Texas Department of Insurance, Division of Workers’ Compensation (DWC) — discussed how the DWC in Texas has been handling the opioid crisis.
“The main focus in Texas has been to address the issue of opioid misuse where it begins,” Sidora said via email. “We believe the Texas workers’ compensation system has helped reduce opioid use among injured employees and the overprescribing of opioids to treat pain. DWC has done this through several initiatives such as adopting evidence-based treatment guidelines and the pharmacy-closed formulary, and through system monitoring.”
Sidora added that since they’ve adopted their pharmacy-closed formulary in 2011, the Texas system has significantly reduced the number of claims, prescriptions, and costs associated with opioids.
“There was a two-year transition period built into the formulary adoption that allowed physicians and insurance carriers to review and discuss the most appropriate treatment plan moving forward,” said Sidora. “In many cases, this resulted in weaning injured employees from opioids and other medications that put them at risk of addiction. The formulary has also reduced the number of claims that are receiving high dosages, which reduces the potential for overdoses and possible deaths.”
Sidora said that they are aware of Ohio’s new pilot program but are unable to comment on any programs outside of the Texas workers’ compensation system.
Welsh stressed the importance of having second-chance programs like the Opioid Workplace Safety pilot program in the wake of the opioid crisis, that has destroyed so many lives across the United States.
“The epidemic has touched all of us,” he said. “For instance, we lost more than 18,000 Ohioans to the crisis since 2012. It affects the workplace; it affects families; it affects us all in a lot of different ways. We want to help grow this community of second-chance employers, because these are the folks that believe they can make a difference in people’s lives by giving them an opportunity to rejoin the workforce.”