 Thank you for volunteering to become a WorkSite Monitor for the Recovery Program. This brief presentation will cover many aspects of being a WorkSite Monitor in the California Recovery Monitoring Program. The Recovery Program is a confidential and voluntary program that provides monitoring and rehabilitation of healthcare professionals whose practice has been impaired by drugs or alcohol and in some cases mental illness. Our primary mission is to protect the public and return the participant to safe professional practice under the direction of the boards that we serve. Maximus is the administrative vendor under contract to manage the Recovery Program for eight of the California Healthcare Professional Licensing Boards. You may have been asked to provide services as a WorkSite Monitor for a participant who is enrolled in the Recovery Program. The role of the WorkSite Monitor is critical to the success of the monitoring efforts of our program. You are our eyes and ears in the workplace. We appreciate the very important role you play in this process. Our boards support the participant's return to safe professional practice. Employers can contribute to this by choosing to hire or retain a participant who is safely being monitored by the Recovery Program. Before a participant can return to work, the program first determines if they are safe to do so. The program considers several factors in its decision, history and severity of substance use disorder diagnosis and what substances were used, treatment response, compliance with a recovery plan and random drug testing results can all affect the participant's release to return to work. In some cases, a participant's return to work plan may include necessary job accommodations or practice restrictions to ensure safe practice. This will depend on the participant's unique history, work environment, job setting, supervision level, interaction with other professionals, job duties, access to drugs, level of support for the participant and ability for WorkSite Monitoring. As a program participant continues to be successful in their recovery, the program will review and adjust their return to work plan until they are able to perform all aspects of their duties without accommodations or restrictions. Be aware that under the Americans with Disabilities Act, persons with a history of substance use disorder and who are currently in documented recovery have certain protections related to employment such as reasonable accommodations. Employers may consult with their Human Resources Department for specific guidance. Your role as the WorkSite Monitor is vital to the participant's recovery and success through the recovery program. The WorkSite Monitor assists the licensed health professional to return to work in a controlled and safe manner supporting the mission of the recovery program which is to protect the public. WorkSite monitors also provide an open line of communication between the workplace, maximus and the licensing board. Workplace monitors are tasked with watching for changes in behaviors and signs of relapse or return to alcohol or drug use. Unless specifically waived by the board, the WorkSite Monitor must be at least one step higher in the reporting structure of the organization in order to serve in this capacity. Monitors may not be actively enrolled in the recovery program, may not be related to the participant and may not have any financial gain or risk associated with this role. If in recovery themselves, WorkSite monitors must have at least five current and continuous years of sobriety before being able to serve as a WorkSite Monitor in the recovery program. WorkSite monitors do not place their own license in jeopardy by volunteering to monitor a participant. The participant is fully licensed when they return to work. If an individual meets the WorkSite Monitor requirements set out by the board, there are specific duties that they will have to take on. Monitors are tasked with observing a participant at their workplace randomly and unannounced at least once a week. If the board decides that more frequent observations are necessary, monitors will be responsible for completing those observations. Monitors are also tasked with interviewing co-workers as necessary to ensure the participant is practicing safely. If monitors are not able to fulfill their duties for a time period longer than two weeks, they are responsible for identifying an alternate monitor in their absence. Monitors must agree to notify Maximus within one hour of noticing any signs of relapse or suspicious behavior. Monitors must complete and submit reports regarding the participant on a regular basis. All reports are required by the board and must be turned into Maximus through the Maximus Online Documentation System, MAX-CMS. Current WorkSite Monitor reporting requirements include a monthly report for the first three months after a participant returns to work. If this is the first reporting period, you will be asked to submit reports for three consecutive months, beginning with the first full month of employment. For example, if a participant begins working on the 10th of May, the first report will be due to reflect the first full month of employment, the month of June, and should be submitted by July 10th. Reports would be submitted to reflect June, July, and August, and then will be submitted quarterly thereafter. We want WorkSite monitors to observe the participant for signs and symptoms of possible relapse in the workplace. There are many physical signs and symptoms to watch for that include changes in appearance or behavior, such as sensitive or runny nose, smells of alcohol or marijuana on or around the participant, rapid change in weight, dilated or pinpoint pupils, red eyes, glassy eyes, or droopy eyelids, a generalized appearance of not being well, flushing or pale skin, needle marks, skin sores, hot flashes, excessive perspiration, poor coordination, rapid speech and flight of ideas, and slow or slurred speech. Additional signs and symptoms to watch for include changes in behavior or mood or sudden mood swings, acting socially isolated or withdrawn in the workplace, guarded privacy, avoiding eye contact, defensive or secretive actions and communication, seeming irritable, jumpy actions or responses, seeming sleepy, drowsy and moving slowly, increase in on-the-job accidents, increase in errors or change in performance, increase in motor vehicle accidents or other injuries, using gum or mints frequently, wearing long sleeves even in hot weather, leaving the workplace for extended periods, such as to the car, to the bathroom, prescribing or administering more controlled medications than other professionals in the same work environment, more frequent conflicts with coworkers, and coworkers gossiping about the participant. Signs of possible drug diversion in the workplace are also important to watch for in a participant, leaving work frequently to use the restroom, lounge or parking lot, changing priorities, volunteering for extra shifts, volunteering to administer meds for other nurses to help out, discrepancies in drug counts, frequent errors in drug records, poor work performance, patients or families complaining of inadequate pain relief despite records of pain medications having been administered, medicating patients for pain every time medication is due, even if the patient is not asking or is non-responsive, blaming others for errors or problems, giving the appearance of being the best or most helpful, missing prescription pads or missing pages from the middle of pads, missing medication samples, and poor record keeping. If a participant tests positive for a banned substance or misses a daily check-in with the lab, our contract terms with the boards require us to contact you within one hour of receiving the notification. The participant will then be required to stop working and remain off work until we receive two subsequent negative test results. Some boards require the participant to provide 30 days of negative test results. The case manager will advise you when the participant has been approved to return to work. If you have any reason to suspect that a participant is using a banned substance, we ask you to notify the clinical case manager within one hour of identifying the problem. If the instance in question happens after hours, please notify the clinical case manager immediately the next business day by calling 800-522-9198. If you are not sure which case manager works with a participant, ask to speak with any case manager. If you identify that the participant you are monitoring appears to be using drugs or alcohol demonstrating changes in performance, having excessive absences or tardiness, or has been involved in incidents of patient harm or involved in sentinel events, call the Maximus Clinical Case Manager at 800-522-9198 within one hour of identifying a problem or immediately at the start of the next business day. Maximus and the boards appreciate the role you play in supporting the program and our participants. We believe in the ability of our participants to return to safe practice and return to a safe, meaningful and rewarding career as a healthcare professional.