The act becomes effective April 5, and there have been a lot of misinterpretations about its intent. So, let’s go over –

• What the act doesn’t do. The act does not mandate that your health plan must offer coverage for treatment of mental health or substance abuse. Employers still have the option of including or excluding those types of benefits so long as they offer or don’t offer them on an equal basis to all employees.
• What the act does do. It mandates that if you have a health plan that offers mental health benefits or coverage for substance-abuse treatment, you have to offer those benefits on the same level as is covered by treatment of any other illness.

The reg states, for example, that group health plans cannot impose higher deductibles or caps on hospital-room stays for mental health or substance-abuse treatment. Nor can plans impose tougher preauthorization requirements for such treatments.

In all, the reg — and the mandate for parity — affects six categories of care:

• inpatient in-network
• inpatient out-of-network
• outpatient in-network
• outpatient out-of-network
• emergency care
• prescription drugs

Most importantly, if your firm bans the use of marijuana — medical or otherwise — as a straight safety precaution, such as for vehicle drivers or employees who work around dangerous equipment, you’re probably OK with the ban.

There’s no definitive court ruling on that, but there is a federal directive regarding a Department of Transportation ban on medical marijuana for drivers. In summary the DOT, responding to inquiries resulting from the DOJ ruling, has announced, “DOJ guidelines will have no bearing on the Department of Transportation’s regulated drug testing program. We will not change our regulated drug testing program based upon these guidelines to Federal prosecutors.”

Translation: If it’s a safety issue, we’re still enforcing the regs against marijuana use. (Under DOT’s regs, the ban extends to a wide range of transportation employees, such as pilots, school bus drivers, truck drivers, train engineers, subway operators, aircraft maintenance personnel, transit fire-armed security personnel, ship captains  and pipeline emergency response personnel.)

Employers in states that allow medical marijuana probably can take their cue from that ruling: When safety’s involved, you can test and ban.

The effect of the ruling is less clear if you routinely drug test — with no safety issue attached — in a state that allows medical marijuana.

There are 13 states that allow medical-marijuana use: Alaska, California, Colorado, Hawaii, Maine, Michigan, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont and Washington.

Two states — Arizona and Maryland — don’t fully allow medical marijuana but have laws favorable to its use, such as allowing it as a defense in court.

Site name: Consumer Reports Best Buy Drugs. 

URL: www.consumerreports.org/health/best-buy-drugs/index.htm 

Who runs it: Consumers Union 

What it provides: It’s hard to know where to start, since this site contains so much information. But let’s begin with a neat categorization section where you can search by Condition or by Drug.

So, for instance, if you wgo to Condition and click on Heartburn, you’ll get an essay on all the possible treatments and which one might be best for you.

Or if you go to Drug and click on Ambien, you’ll get information on what types of insomnia are best treated with the drug, what the alternatives are, and what you should expect to pay for the drug.

All in all there are dozens of Condition and Drug categories, arranged alphabetically.

The site also contains a section called Money Saving Guides, consisting of PDFs on varied cost-related topics such as “Generic Drugs” and “Assistance Programs.”

There’s lots more, some of which is taken right from the pages of the company’s subscription-driven magazine. All good stuff on this site – and you can’t beat the price.

Many would say, “Make it a performance issue. If he’s failing on the job, then tell him he has to shape up.”

OK, that’s good advice, but should you wait that long? If you suspect someone’s spaced out, there are costs – financial and social – associated with waiting.

In his best-selling book, “The Boss’s Survival Guide,” Bob Rosner explains how you can be a bit more proactive about the problem:

1. Get professional advice. Sure, you may think you’re pretty hip at spotting the signs of drug abuse, but most likely you’re not a pro at it. So contact a pro – a doctor or a drug counselor, for instance – to learn if you’re seeing the real thing, or just something else that looks like the real thing.

And then explore with the pros the possible courses of action for treatment. What’s available? What has the best record of success?

At the very least, you want some professional opinion and backup before you go to the next steps.

2. Approach the person, but not as an enforcer. You can, if you want, make threats about firing or other drastic measures to address the problem, but that probably won’t solve the problem. Instead, at least in the beginning, approach the person as a concerned colleague.

Explain that you’ve noticed a problem and have consulted with professionals to confirm your suspicions. And then attack the problem from the angle that, first and foremost, you want to help the person.

3. Present the plan and do what you can to implement it. You may be working through and Employee Assistance Program or not, but whatever you do, lay out a plan for the person and your role in it – as a coach or just someone to talk to.

At that point, it’s up to the person to take action. You know how it goes: “You can lead a horse to water, but …”

If the person doesn’t respond properly and performance or on-the-job behavior becomes an issue, you can deal with that under policies and disciplinary rules. But you’ll know that you did your best to keep the problem from getting to that point.

The American Journal of Industrial Medicine warns that the ruling created a greater risk of workplace injuries and lost time because of employees who end up zonked on over-the-counter meds.

It’s not that employees are trying to abuse the medicines. Many don’t know that some OTCs contain antihistamines and other strong ingredients that impair judgment and reaction time.

And because the OTCs come without a prescription and doctor’s orders for dosages, still many more workers think exceeding the recommended dosage on the package won’t have consequences.

 Plus, the plain fact is that if employees have flex money to use up, their first convenient option is OTCs.

One way you can help: Let employees know about the dangers of over-the-counter drugs, especially if you have a flex plan that covers OTCs.

Sending out the alarm can save tons of sick time and maybe prevent
a serious injury in the workplace.