Employment services offer expansion opportunities
By David l. German, DC

As worker compensation and private health insurance premiums continue to rise, employers are realizing they can effectively lower their operating costs and reduce the liabilities of turnover by conducting employment-screening as part of their hiring process.

Exciting opportunities are available to chiropractic clinics that wish to expand their current services by providing employment-screening services, which may include background screening, substance testing, and pre-employment health assessments. These profitable services are ideally suited to practices that focus on preventative wellness.

According to the “2003 National Survey on Drug Use and Health” conducted by the Substance Abuse and Mental Health Services Administration (SAMSHA), an estimated 74 percent of current illicit drug users are employed full-time. And the National Council on Compensation Insurance estimates 38 percent – 50 percent of all work-related accidents are drug or alcohol involved.

But employers who implement drug and alcohol testing programs have experienced up to a 51 percent reduction in injury rates within two years of program implementation, according to a 1999 study conducted by Cornell University, “An Evaluation of Drug Testing in the Workplace: A Study of the Construction Industry.”

Some companies perform drug screening as part of a pre-employment process; others, following an incident (such as an accident causing damage to persons or property), for cause, or randomly. Most often tested are individuals who are in safety-sensitive positions.

Prior to implementing these services in your clinic you will need to educate yourself with the procedures, terminology, and regulations that govern the industry to ensure you are in compliance.

• Drug testing. Clinics can choose to provide collection services, program management, or both. In order to provide collection services, your clinic should be CLIA certified, and all of your collection personnel will be required to complete a certified urine collection training program.

The U.S. Department of Transportation (DOT) rules, 49 CFR Part 40, describe required procedures for conducting workplace drug and alcohol testing for the federally regulated transportation industry. These rules can be found at the DOT Web site at www.dot.gov. You should understand these regulations and their scope before offering these services to employers.

• Alcohol testing. The alcohol testing industry is closely associated with the drug testing industry and many of the same laws that govern drug testing, apply to alcohol testing as well. In order to provide alcohol testing within your clinic, your collection personnel are required to offer certified alcohol testing services.

Two forms of alcohol testing are accepted — breath and saliva. For further information on certification and testing procedures, visit the Office of Drug and Alcohol and Compliance at the U.S. Department of Transportation Web site, www.dot.gov

• Background screening. Background checks are an essential tool for screening potential employees. As more companies recognize the benefit of pre-employment background checks, the demand continues to grow. Smaller companies often outsource their background screening services.

It is crucial to abide by all federal and state laws regarding background screening, specifically the regulations imposed by the American Disability Act (ADA) and the Fair Credit Reporting Act (FCRA). As a provider of healthcare related services, you are also required to observe the Health Insurance Portability and Accountability Act (HIPAA) concerning client privacy and confidentiality.

• Pre-employment health assessments. Under the ADA, employers are not permitted to screen out job applicants because of health conditions. However, the ADA does allow employers to offer jobs, conditioned on the results of a medical examination.

Prior to offering pre-employment health assessments, you should become acquainted with the provisions of the ADA. You should also become well acquainted with the employer’s job requirements, and preferably have complete job descriptions on file.

Offering pre-employment screening services lets you reach a large segment of the population. Developing solid relationships with area employers also gives you an excellent source of referrals for current services you are presently offering within your clinic.

Implementing pre-employment screening services does involve education, time, and persistence. Your program will become what you make of it. Have fun with it and enjoy the benefits it will provide you.

SIDEBARS:
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David L. German, DC, owns and operates Healthways, a clinic in Bismarck, N.D., that offers a variety of services, including drug testing and pre-employment screening services, in addition to chiropractic care. He can be contacted at 701-223-6613 or through his Web site at www.healthways.cc.