Drug Screen Results

Shara

We have a new employee that will be working as a paramedic with our facility. When we did her drug screen, she listed a prescription for hydrocodone and/or cough elixir with codeine. After it was deemed further testing was required from the initial UDS, it was sent off to the MRO. The physician requested that our employee health nurse contact him. She did so, and he told her that he was going to give a negative decision based on the discussion he had with the employee, because he verified that she did have a prescription for this medicine. However, he told our employee health nurse that he was “very concerned for her in dealing with safety sensitive manners.”

I’m not sure what to do with this info! I’m not normally provided with anything other than a positive or a negative drug screen from the MRO. But since the physician did provide this information to our employee health nurse I feel like if something happened with this employee (especially working as a paramedic – she’s performing patient care and driving) that we would have a certain liability if something happened after knowing this information. Am I breeching HIPAA if I were to talk to her about this?

davids

We are a municipality that employs paramedics, so I relate to your concerns. The MRO's "negative" finding means there are no illegal substances in the employee's system. However, a separate issue is whether or not the legal drugs being used by the employee will impair her ability to perform the tasks. Does your hiring process include a medical exam? If it does, and the physician certified her as fit for duty, then there is really nothing for you to act on. If you have not done a medical exam, you might want to consider that for future paramedic hires.

Our attorney has beat into us that HIPPA only applies to health "plans." Talking about an employee's medical information outside of the context of your health plan, while not wise, is not a HIPPA violation. So, your talking to the employee is not a HIPPA violation. If anything, the MRO talking to your nurse was a breach of confidentiality.

joannie

This is a perfect example of why I am glad I drug test under DOT requirements. My MRO has the authority to disqualify a employee if he thinks the employee is not medically fit to operate in a safety sensitive postion.

Your drug testing policy should name a representative of the company authorized to receive the drug test information. if that person is your employee health nurse, the MRO was within his rights to discuss his concerns. I would meet with the employee with the nurse in attendance, have the nurse explain the MRO' concerns, then ask the employee to refrain from using the products during the shift and within 4 hours prior to the start of the shift.. I would also check the drug testing policy to see if reasonable suspicion testing is allowed, and, if so, keep a close watch. Good luck.

ACU Frank

David makes a good point... One of my pet peeves is organizations (or doctors, etc.) that hide behind HIPAA. It probably doesn't apply in this case... nor does it generally apply in FMLA or work comp situations.

Shara

Thanks to all of you! I have had few dealings with these types of issues, and just wanted to make sure I understood what and if my boundaries might be. I appreciate your input.