Risks surrounding employment practices continue to evolve and pose difficult challenges for risk managers. Sound policies depend upon identifying these risks and developing mitigation practices to address those exposures. For example, what should a company’s policy be when an employee is arrested for driving under the influence? Does the company fire the employee? Does it matter whether the employee drives a truck or a car or whether the job requires the individual to drive? What happens if the infraction took place during company hours versus on personal time? How does the company handle an employee who was cited for texting or talking on the phone while driving? What if the employee was involved in an accident? Can a company quantify risks associated with different employment practices? In this session, the panel will discuss these issues including the risks associated with different policies as well as what kinds of things a company can do to mitigate these exposures.

1. Max Koonce
Senior Director, Risk Management, Walmart Stores, Inc.
Ron Thackery
Senior Vice President, Professional Services, Emergency Medical Services Corporation
Darrell Brown
Chief Performance Officer, Sedgwick
Tuesday, April 23, 2013
Session Time: 2:15 to 3:30 p.m.

2. Introductions
Max Koonce
Senior Director, Risk Management
Walmart
Ron Thackery
Senior Vice President, Professional Services
Emergency Medical Services Corporation
Darrell Brown
Chief Performance Officer
Sedgwick

3. Under the influence of?

4. Federal law - marijuana
• Controlled Substances Act (CSA)
• Scheduling and approval of drugs, including marijuana, must be
based on both legal and scientific criteria:
• High potential for abuse
• Drug not currently accepted for medical use in treatment in U.S
• Lack of accepted safety for use of the drug under medical supervision
• Department of Health and Human Services (HHS)
• Provided scheduling recommendations
• Drug Enforcement Administration (DEA)
• Reviewed and denied petition to schedule marijuana
• Department of Justice Guidelines (DOJ)
• Violation of federal law
• Subject to federal enforcement action, including prosecution

5. State laws
• 18 states and the District of Columbia have laws legalizing
medical marijuana
• Alaska, Arizona, California, Colorado, Connecticut, District of Columbia,
Hawaii, Maine, Maryland, Massachusetts, Michigan, Montana, Nevada,
New Jersey, New Mexico, Oregon, Rhode Island, Vermont and Washington
• 2 states legalized marijuana for adults in 2012
• Colorado and Washington

6. Court cases
Raich v. Gonzales (U.S. Supreme Court, 2005)
Emerald Steel Fabricators v. Bureau of Labor
and Industries of State of Oregon (2010)
California Ross v. Raging Wire
Telecommunications (2008)
Casias v. Walmart (Michigan, 2012)

7. What about legal prescription drugs?

9. Max Koonce
Senior Director, Risk Management
Walmart Stores, Inc.

10. Walmart Stores, Inc. is comprised of:
Walmart U.S. (approx. 1,400,000 associates)
• 4,005 Walmart Retail Stores
• 620 Sam’s Clubs
• 142 Distribution Centers
Walmart International (approx. 800,000 associates)
• 6,148 Retail Units
• 27 Countries

11. Alcohol and drug free workplace policy
1. Vital interest in maintaining a safe, healthy
and efficient environment for Walmart
associates, suppliers and customers
2. Committed to maintaining an alcohol and
drug free workplace
3. Alcohol and illegal drug use pose a serious
threat to workplace safety, health, and
productivity
4. Walmart strictly forbids improper use of
drugs / alcohol

12. Alcohol and drug free workplace policy (cont.)
5. Admission prior to testing request:
• If an associate self-reports:
 Employed a minimum of 180 days with the company
 Reports to a salaried member of management
 Provided a leave of absence
 Signs last chance agreement which provides:
• Enrollment in a substance abuse treatment program
• Certification that program was completed
• Periodic drug screens for following 12 months

13. Types of testing
Pre-employment Reasonable
suspicion
Post-accident
Promotion
screening
Transfer to safety
sensitive position

14. Definitions
• Definition of positive alcohol screens
• % blood alcohol concentration
• Definition of positive drug screens
• Illegal drug: At or above the detection level for that drug
according to the Federal Substance Abuse and Mental
Health Services Admin.
• Prescription drug:
 At a level in excess of the prescribed amount
 Other than for the condition for which the drug was prescribed
 Other than the prescribed method for using the drug; or
 Without a valid prescription
• Conduct of screens / testing

15. Consequences of positive test

16. Legal interaction
Wrongful termination
• Pretext
• Medical marijuana
Workers’ compensation
claims
• Impact on benefits /
compensability
• Opioid use in medical treatment
Americans with
Disabilities Act
• Medical marijuana (CA case)
General liability - impaired
while in accident
• Deviation from employment
• Insurance coverage

17. Additional concerns
• Wireless device use while driving company
vehicles:
– Comply with state laws:
• Texting while driving
• Hands free
– Safety first:
• Guidelines on call duration
• Traffic congestion
• Poor road / weather conditions

18. Additional concerns
• What happens if the associate is involved in an accident?
• Cell phone records could be requested
• Elevated level of accountability if the cell phone was in use at
time of accident
• Medical marijuana

19. Ron Thackery
Senior Vice President, Professional Services
Emergency Medical Services Corporation

20. State reactions

21. Washington / Colorado

22. Colorado

23. Colorado - higher education

24. Emergency medical services corporation
Medical transportation
• 3.4 million transports
• 8% share of total ambulance market
• 21% share of private provider ambulance market
Services offered
• 911 emergency
• Inter-facility transfers (non-emergency)
• Fixed wing air ambulance
• Managed transportation
• Disaster response (FEMA)
• International
• Site-based
Outsourced facilities based physicians
• 8 million patient encounters
• 8% share of ED services market
• 12% share of outsourced ED services market
Services offered
• Emergency department
• Hospitalist / inpatient
• Anesthesiology
• Radiology / teleradiology
• Acute surgery centers

25. Alcohol and drug free workplace policy
• Pre-employment drug testing
• Reasonable suspicion drug & alcohol testing
• For cause drug & alcohol (collisions, >2 WC claims in 12 months,
missing or altered drugs, open container, presence of controlled
substances/paraphernalia)
• Limited random drug & alcohol testing
• Last chance - self disclosure, treatment with follow up testing

26. Alcohol and drug free workplace policy
• Refrain from alcohol consumption at least 8 hours prior to start of duty
• Prohibited use, possession, manufacture, distribution and sale of
controlled substances or illicit drug paraphernalia
• Report use of a prescribed or over the counter drug that may impair
behavior, alertness, mental ability, driving, patient care
• Prescriptions must be in the name of the user
• Notify management if arrested or convicted for criminal use/abuse of
drugs or alcohol

27. Alcohol and drug free workplace policy
• Testing methods
• Saliva based screening
• Confirmation - DOT lab based drug screening
• Confirmation - DOT BAT testing for alcohol
• Positive tests - follow DOT criteria
• Outcome - zero tolerance for positive tests
• Reapply after 36 months

28. Practical application
Outcomes
Logistics - testing,
transportation,
communication of
results
Difficult time or a
new beginning
Self disclosure -
facing your peers

29. Left field - every once in a while