Substance use policy at Interior Health still a concern

“Invasive” approach fails to serve workers - From the Fall 2023 Guardian
Person meeting with counsellor

Workplace incidents involving substance use are taken seriously in health care settings. 

But a punitive, one-size-fits-all policy applied by Interior Health Authority (IHA) has long been the subject of challenges by HEU.

A policy grievance filed in 2014 claimed the policy discriminated against employees with substance use disorders, prescribing a disciplinary approach, failing to assess them as individuals, and intruding on their private, public, and medical lives. 

In 2018, an arbitrator ruled in the union’s favour, saying the policy was flawed and must be suspended immediately pending a major overhaul.

But HEU representatives advise members to remain cautious when confiding in their employer.

“Most of these cases begin with absenteeism,” says Elizabeth Mielke, HEU director of member services for the Interior. “A member will be called in to talk to their supervisor, and if there’s any mention at all of substance use, anywhere in their life, it can trigger this process.”

The policy allows the employer to remove the worker from their job, send them for an assessment with an addictions specialist chosen by the employer, and impose residential treatment, followed by two years of invasive medical monitoring, all under a stringent “return-to-work agreement.” 

Mielke adds that some workers who self-disclose, even when there was no workplace impact, have been forced to follow this procedure to be allowed back to work. 

And members using substances to manage mental health challenges often find themselves forced into a drug or alcohol program instead of being offered more appropriate supports. 

“These are mostly not people who showed up for work impaired,” Mielke says. “Many of them work in positions where they don’t interact with patients or provide care. But they’re being treated like they pose a serious threat to health and safety in the workplace.” 

The arbitrator’s 2018 decision improved IHA’s policy in several ways, although the revisions did not address all requirements. 

The revised 2020 version of the policy and guidelines requires the employer to consult with the worker and the union in choosing an addictions specialist. 

It also improves confidentiality by restricting access to medical information to the employer’s Disability Management department. 

Despite these improvements, there’s still disagreement on “safety sensitive” positions in health care settings – direct or indirect care – which would trigger the policy.

That’s why HEU filed a grievance in 2018 on behalf of a hospital housekeeper, who was subjected to an invasive independent medical assessment, mandatory treatment, and medical monitoring at her own expense, based in part on a presumption that her job was “safety sensitive”.

In a 2023 decision, an arbitrator ruled the employer failed to prove housekeeping is “safety sensitive”. The member’s treatment was deemed “highly intrusive and unnecessary,” as well as discriminatory, and she was awarded lost wages and damages.

But this still didn’t establish a clear definition of a “safety sensitive” job, and left other issues unresolved – including whether the employer should pay for mandatory medical monitoring.

Because the law and the application of IHA’s policy are still unsettled, HEU urges members to contact their union servicing representative before talking to their employer about substance use.

By Elaine Littmann