# Presentation: 055517

## Evaluation of FTA Drug Abuse Testing ProgramMarch 2006

- Evaluation of FTA Drug Abuse Testing ProgramMarch 2006

- Jerry Powers, FTA Office of Program Management – Safety & Security

## Evaluation Analysis Opportunities

- Use DAMIS data and external cost measures to develop a cost benefit model
- Compare DAMIS data to SAMIS data to determine safety benefit from the D&A Program
- Raise the bar – provide customer service.  Opportunities to use DAMIS to help agencies justify D&A expenditure apart from it just being a regulatory requirement
- Show where to focus efforts/funding - areas for improvement

## CHARTERProve the Effectiveness of the D&A Program in Achieving FTA Strategic Goal

- Promoting public safety by eliminating transit-related deaths, injuries, and property damage
- USE:
- Maturing DAMIS data together with:
- Safety Data (SAMIS/NTD)
- Audits/Technical assistance experience and data
- Other Industry and Government D&A measures
- Creative analysis

**Notes:**
We used our heads – we got creative.

Think out of the box - don’t bog down in limitations.

## New Measures of Cost and Safety BenefitsMoney, Lives & Mayhem

- Show cost saving to Transit Industry due to elimination or mitigation of D&A using employees
- Second chance programs have significant cost benefit to industry
- Audits are having a positive effect in terms of safety benefits and cost savings
- Use baseline rate (1995 or 1996) and subsequent improvement to prove reduction in accidents, fatalities and injuries

- _Safety Benefit_

- _Cost Benefit_

**Notes:**
I.b and I.c are minor and less developed than I.a and II

## Outline

- Concept and Measures
- FTA and Testing Costs
- Benefits
- Mitigation of Drug & Alcohol positives
- Pre-employment
- Random
- Reasonable Suspicion
- Refusals
- Post-Accident
- Deterrent Effect
- Safety
- Audits
- Second Chance Programs

## D&A Evaluation Concept

- DAMIS
- Data

- Other Industry
- and Government
- D&A Cost
- Measures

**I.**  COST BENEFIT

**II.**  SAFETY BENEFIT

- Merge these
-  baselines into cost benefit spreadsheet
- Of D&A Program

- NTD S&S Data

- DAMIS
- Data

- NTD S&S Data

- Baseline

- Baseline

- Analysis

- Analysis

- Merge these
-  baselines to show D&A contributing to accident avoidance

- Other Industry
- and Government
- D&A Cost
- Measures

- NTD S&S Data

- DAMIS
- Data

- NTD S&S Data

- DAMIS
- Data

## Industry and Government D&A Cost Measures

| Source | Drug Use at Workplace |
| --- | --- |
| SAMHSA
on positive drug |  Overall positive rate trend: 17.5% in ’85; 7.7% in ’97
 10.8%  of Transportation/Material Moving  workers are current drug or heavy alcohol  users
 Full-time workers, age 18 to 49 reporting workplace drug testing
 Post accident rate:  22% in ’94;   29% in ’97
 Random rate:          20% in ’94;   25% in ’97
 At hiring rate:         35% in ’94;   39% in ’97 |
| OSHA 
on safety and health |  47% of all industrial accidents in US related to drug & alcohol
 Drug users filed five times more worker’s compensation claims
 Drug users utilized 300% more medical benefits
 Drug users had 2 to 3 times more absenteeism |
| Stealth Tec
on rate and cost |  10% employees are substance abusers
 It costs business $10,000 a year for each abuser on payroll
 It costs $7,000 to replace a worker |
| Canadian research |  8% positive in trucking industry
 1992 Canada drug use costs 1.37B, or 0.2% of GDP |
| National Institute on Drug Abuse (NIDA) |  Economic cost of Drug and Alcohol Abuse in the US is $246 Billion per year
 45% Gov’t, 43% Abusers household, 7% victims, 3% insurance |
| APBnews  | Marijuana and Cocaine are most commonly used drugs |

**Notes:**
Substance Abuse and Mental Health Services Administration (SAMHSA)

## DAMIS Baseline

** ****Random Positives are on the decline**
**CDL positive rate is higher than other employee categories**

## NTD S&S Baseline

** ****Transit Industry is getting safer.  Incidents, injuries and fatalities are trending down**

## I.  Cost Methodology - Cost Benefit Spreadsheet

**I.**  Cost Methodology - Cost Benefit Spreadsheet

**Notes:**
Have a large spreadsheet and rigorous methodology which will be shown in the report.  Will give you the Readers Digest version here.

## Cost Methodology – Unit of Measurement

- Each D&A using employee costs the Transit Industry and the overall society $15-20K per year:
- Health Care Expenditures
- D&A abuse services
- Medical consequences
- Productivity Effects
- Premature Death
- Impaired productivity
- Institutionalization, Incarceration, Crime careers and victims
- Other Effects
- Crime effects
- Vehicle crashes and fire
- D&A Program eliminates or mitigates users at $15-20K per user per year

## Costs

- Costs have ranged from $21M-$34M per year since 1995

## Savings Methodology

- Transit is 0.18% of the US Gross National Product (approximately $19 Billion/year in 2002)
- Cost of Drug use and Alcohol misuse to the US economy is $413 Billion per year – NIDA measure indexed
- Transit portion of that cost is $723 Million per year.  Safety-sensitive are 76% of transit employees.  Thus incur $550 Million of that cost.
- 10.8% of Transportation Workers with drug use and/or alcohol misuse - Substance Abuse and Mental Health Services Administration (SAMHSA) Survey
- Approximately 270,000 safety-sensitive transit employees
- Thus, ~29,000 incur the $550 Million in annual cost
- $550,000,000/29,000 employees = **$19,500 per year per employee in 2002**
- Deterring or mitigating those 29,000 employees is the basic savings opportunity

**Notes:**
The rising costs warrant a strong, consistent, and continuous investment in research on prevention and treatment. We must publicize these cost-to-society estimates to educate people that drug abuse is enormously expensive to the entire Nation, that the cost has been rising steadily, that extensive research shows that drug abuse can be treated, and that drug abuse treatment reduces that cost." 

## Savings Methodology

## Cost MethodologyPre-employment Savings

*Pre-employment testing* - eliminated 11,547 users over the course of the Program.  These users would have cost the Transit Industry **$226 Million** in 2002 (11,547*$19,589 = $226,189,805).

**Notes:**
This $252mil is based on a a cumulative figure of D&A using employees eliminated or mitigated by the program.  Thus, it’s growing each year the program continues

## Cost MethodologyRandom Savings

*Random testing* -  eliminated or mitigated 5022 users over the last 5 years of the program.   These users would have cost the Transit Industry **$98 Million** in 2002 (5022*$19,589 = $98,375,000).

**Notes:**
This $252mil is based on a a cumulative figure of D&A using employees eliminated or mitigated by the program.  Thus, it’s growing each year the program continues

## Cost MethodologyPost-Accident, Reasonable Suspicion, and refusals 

*Post Accident positives* - eliminated or mitigated 962 users over previous 5 years in 2002.  These users would have cost the Transit Industry **$19 Million** in 2002.
*Reasonable Suspicion* - eliminated or mitigated 676 over previous 5 years in 2002.   These users would have cost the Transit Industry **$13 Million** in 2002.
*Refusals* - eliminated 1427 users over the course of the program through 2000.   Refusals are now wrapped in to the overall violation count of each testing area.  These users would have cost the Transit Industry **$28 Million** in 1999.

**Notes:**
This $252mil is based on a a cumulative figure of D&A using employees eliminated or mitigated by the program.  Thus, it’s growing each year the program continues

## Deterrent Effect of Random Testing

- Year to Year calculation – no cumulative effect

- Random  Positive Rate

- If the positive rate remained
- the same as at the beginning
- of the program, each year there
- would be ~2000 more positives
- per year

**Notes:**
In addition:  The real rate before the program is probably a LOT higher than the 3.11 that we’re using from 1995

## Deterrence – Random Program 

- Has saved a total of $220 Million 1995-2002
- From $9M to up to $46M per year

## Cost Methodology 

- Drug and Alcohol Rules Cost Benefit (Regulatory Impact Analysis) called for a $1.39 Billion benefit over 10 years.  An average of $139 million/year.
- Real data from the first 8 years blows this figure away
- $2.158 Billion (or $269 million per year average)

**It’s Up and....     It’s Good!**

- Redskins       27

- Cowboys       14

**Notes:**

The 252 million is growing each year also – in other words the Skins are up by 113 and have the ball first and goal on the 1 yard line.

## Safety Methodology - D&A Accidents are Comparable with Regular Accidents in Lethality

- SAMIS shows and .0071 fatalities per Accident (Collision) 1995 – 1998.
- DAMIS shows .0077 fatalities per D&A Accident.
- Thus, D&A has comparable lethality to Overall Safety figures in fatal accidents (8% higher than non-D&A accidents).
- Fatalities are a function of accidents –  bad luck when they occur

**Notes:**
Nothing about D&A related accidents that makes them different from other accidents in terms of results.  Slightly higher fatality rate in D&A due to incident threshold differences.

Assumption - D&A was a contributing factor in accidents with Post Accident Positive Test

## Safety Methodology - Show that D&A Program Saves Lives and Reduces Injuries

- D&A Program Reduces Accidents and thus, **exposure** to Injuries and Fatalities
- No way of measuring the D&A related accident rate before the program, so...
- Use 1995 as a baseline

## Saving Lives: It’s What’s above the Curve

- Post-Accident Positive Rate (Drug and Alcohol)
- Per Incident

- Post Accident Positive Rate

- Using 1995 as a baseline,
- the dark wedge represents:
-   817 Accidents
-   6.29 fatalities
-   718 Injuries

**Notes:**
In addition:  The real rate before the program is probably a LOT higher than the 3.11 that we’re using from 1995

## Safety Methodology -Less Accidents = Less Mayhem

- DAMIS showed that 3.1% accidents were D&A related in 1995 (Baseline)
- DAMIS showed that 1.7% accidents were D&A related in 1999 (Improvement)
- If the rate had remained at 3.1%, 817 more accidents would have resulted from 1996-2002.
- National Transit Database (NTD) Safety & Security module reveals that .0071 fatalities result per accident (collisions, vehicle going off road, and derailments)
- At an overall DAMIS rate of .0077 fatalities per accident, these 817 accidents would be expected to cause 6.29 fatalities.

**Notes:**
That’s the post accident positive rate at the top
SAMIS counts injuries – they work out to .88 per accident 1995-1998

## Training Cost for New Employees

- Transit employee salary – weighted average from 2000 Bureau of Labor Statistics

## Cost Measures - Is Return-to-duty and Follow-up a Benefit or a Burden?

- It is estimated that to train new employee, it costs 1/3rd of an employee’s annual salary
- $1650 per month – D&A Using employee

- Training
- Costs for
- New Employees

- D&A Abusing
- Employee
- Costs

## Is Second Chance Policy Beneficial to Industry? YES

**Is Second Chance Policy Beneficial to Industry? YES**

**Benefit is 5 times more than the cost ($125M saved in training vs. $25M in costs), or every dollar spent on Second Chance, industry got $5 dollars back.**

## Cost Measures - Audits

- Expect a hump in Random positive rate after audit as testing gets better – random becomes more random.
- And systems are generally brought into compliance
- Good examples: Los Angeles, San Jose, Santa Fe
- 					OR
- Random rate decreases as agency relaxes after audit
- 					OR
- They go up the year of as agency readies for the audit

**Notes:**
We will research these factors further.  Mike provided me with a full set of Audited Agencies and their rates over time with an arrow showing the audit date

## Audits

- Expected result of Audits - Timeline

- Audit

- Goes up
- as result of
- better testing
- (catch more users)

-  Lower
- as result of
- eliminating abusers
- and causing abstinence

## Actual Audit Effect

- Drop in the right of the chart shows that audits are effective in discouraging and eliminating substance abusers

-     Audit cost is ~$25K.  One user mitigated over one year saves ~$20K

## Trends:  Drug Metabolization Time and Positive Rates shows Actual Drug Choices

- Program would seem to be pushing users away from THC (45 days to leave the system) and towards Cocaine (3 days to leave the system)
- Expect that tests catch *actual* THC users at a rate 15 times higher than that of *actual* Cocaine users
- Multiplying Cocaine rate by 15 gives equivalent actual comparable usage rate
- Data shows that Cocaine use is **10 to 12 times higher** than THC use

## Actual Usage Comparison

- If Cocaine was testable out to
- 45 days – the chart would look like
- This.