Small businesses have not made the same progress as large businesses in developing drug abuse programs due to a lack of information and prohibitive costs. Some small businesses have also had difficulty providing the resources necessary to meet federal requirements for contractors to maintain drug-free workplaces.
Three federal agencies jointly sponsored a national conference to communicate the effects of substance abuse in the workplace, discuss the specific problems of small businesses, and consider the incentives needed to assist small businesses in responding to these problems and implementing effective programs. Representatives from trade associations, chambers of commerce, unions, public/private partnerships, state and local governments, and employee assistance programs attended the conference.
Presentations were made by the sponsoring agencies and members of the small business community in the areas of small business experiences, legislation, treatment/insurance, and drug testing. Workshops were conducted for each type of organization attending the conference. The group workshops focused on ways in which partnerships could be formed between the various organizations and how information, resources, and incentives could best be provided to small businesses. The problems and recommendations discussed in the presentations and workshops are described below.
Small Business Needs
To help design the conference, data on small business problems with substance abuse were obtained in six regional workshops held with small business representatives. Summaries from the regional workshops are contained in appendices to this report.
The first step in assisting small businesses is disseminating information that demonstrates how substance abuse impacts all workplaces. As more and more large businesses initiate drug testing programs, small businesses that do not have programs will become likely places of employment for substance abusers. The best method of getting small businesses involved in anti-drug efforts is through communicating the experiences of other small businesses. This will not only demonstrate the prevalence of drug problems but can also provide information on the costs and successful aspects of the programs of similar organizations.
Resources are a second major concern of small businesses. Technical assistance in the areas of procedure development and evaluation of EAPs, as well as low-cost training and educational material, are in great demand. Finally, small businesses need incentives. Tax credits, insurance discounts, and removal of employer liability are examples of incentives small businesses have stated would be helpful in establishing drug programs.
Legislation
Many small businesses find legislation complicated and confusing. Conflicting federal and state/local regulations, costs of complying with federal contractor requirements, and the fact that there are few incentives for compliance all present unique problems for small businesses. Recommendations in this area included:
- Creating minimum federal standards which preempt other regulations;
- Providing tax or insurance incentives;
- Making the establishment of a drug policy a condition of small business licenses or loans;
- Creating legislation that limits employer liability; and
- Mandating reduced cost incentives for EAP services and drug testing.
Treatment/Insurance
Many small employers cannot afford health insurance, with or without substance abuse coverage. In addition to this problem of access, many small business owners view substance abuse coverage as unnecessary and contributing to higher costs rather than reducing costs. Many small businesses are also unfamiliar with EAP services or believe they are cost prohibitive.
Recommendations included:
- Formation of coalitions or use of trade associations to obtain EAP pricing discounts;
- Premium discounts on insurance;
- Government-offered reductions in workers' compensation premiums for establishing a drug program; and
- Dissemination of clear definitions of EAP services and tailoring of those services to small business needs by providers and associations.
Drug Testing
Legal uncertainty and costs are also the main concerns of small businesses in deciding whether to drug test. A lack of technical knowledge and costs of additional personnel, such as Medical Review Officers (MROs), are further problems. Recommendations included:
- Technical assistance from the government and/or providers;
- Reducing the complexity of federal regulations, such as requiring an MRO only for positive tests; and
- Sponsorship programs involving large businesses and chambers of commerce to help defer costs.