Policy Statement

All Duke University Health System (DUHS) staff will be screened for the presence of illegal drugs and alcohol levels greater than 40-mg %. Selected university positions require substance abuse screening based on federal, state or institutional regulation. Testing will occur through the use of urine (drug) and saliva (alcohol) screening. Staff who do not pass this screening will not be hired and are not eligible to reapply for hire for one year. If you are a new hire and refuse testing, you will not be employed. This includes staff who transfer from the university (including School of Medicine, School of Nursing, Duke Clinical Research Institute, and the Private Diagnostic Clinic) to DUHS who were not included in pre-placement drug testing at their time of hire.

Policy Details

Procedure

applicants will be notified that positions in DUHS and some positions in the university require pre-placement substance abuse screening. Departments will receive a reminder of the screening requirement each time they open a job requisition. When a department makes an employment offer, substance abuse screening for the prospective staff member must be scheduled with Employee Occupational Health and Wellness, as a condition of acceptance of that offer.

Processing of the hire may not take place until the substance abuse screening has been completed with satisfactory results. Upon a successful completion, EOHW will notify the Recruitment Office that the hire may proceed. An unsatisfactory test result (positive), will rescind the conditional offer of employment. This information will be communicated to the applicant by an EOHW health care professional and to the recruitment representative who will notify the department that an alternative candidate needs to be selected. It will take up to five calendar days to process the screening results.

Duke respects personal preferences for lifestyle and values of its staff. However, Duke is committed to maintaining a safe health care setting for patients and a safe workplace for staff members. Conduct on the job affects the services Duke provides for other staff, its patients and their families. Use of alcohol or drugs while at work, or impairment while at work, diminishes a person's ability to perform and may endanger his or her safety and the safety of coworkers.

Duke strictly prohibits the following activities:

• Unauthorized use, possession (including storage in a desk, locker or other repository), manufacture, distribution, dispensation or sale of illegal drugs, drug paraphernalia, controlled substances, or alcohol on Duke premises or business, in Duke supplied vehicles or during working hours
• Any activity that compromises the integrity or accuracy of the Duke drug and alcohol testing program
• Any failure or refusal to abide by the Duke substance abuse policy

If staff violate this policy, corrective action up to and including dismissal will be necessary. Staff have one opportunity to continue employment with Duke after having been determined to be under the influence of an illegal drug, alcohol above the designated percentage or a non-prescribed legal drug or a legal drug purposely misused. Staff will be removed from work and returned to work only after he or she completes an evaluation of fitness for duty.

Through various human resource department services, Duke offers drug education, counseling rehabilitation and coordination with available community resources.

For Cause

A "for cause" risk situation includes, but is not limited to, impaired behavior as defined by your supervisor and evidence of medication diversion.

Staff will be evaluated for substance abuse in all situations in which his or her supervisor and an Employee Occupational Health and Wellness staff member or a Human Resources director agree a “for cause” risk situation exists. If the staff member refuses testing, he or she will be terminated.

Intervention Agreement

An intervention agreement is your only opportunity to continue employment with Duke after having been determined to be under the influence of an illegal drug, alcohol above a designated percentage, a non-prescribed legal drug or purposely misusing a legal drug. The agreement requires evaluation for substance abuse and completion of an approved substance abuse treatment program within three months of signing. The agreement requires a minimum of one year of frequent random screening for substance abuse after you return to work. If you experience a substance abuse relapse during the monitoring period, you will be terminated.

Confidentiality

Employee health and safety activities are governed by the Code of Ethics of the American Occupational and Environmental Medical Association. All information regarding drug testing will be maintained confidentially with the following exceptions:

• Pre-placement: The hiring department will be advised that the individual is "cleared for hire," "not cleared for hire" or "not eligible for re-hire for one year."
• For cause: The supervisor will be advised that the staff member is "acceptable" or "unacceptable" for work.
• For cause-AOB: The supervisor will be advised that the staff member has alcohol on the breath (AOB) or does not have AOB.
• Federal or state law may require notification beyond that defined above. A trained medical review officer (MRO) will evaluate all "positive" drug tests prior to being reported as "positive."