Management Perspective Outcomes/ROI’s

1. ManagementPerspectiveOutcomes/ROI’s Peer Pilot & Management Conference April 26, 2018 Dr. Debra Reynolds P. H. Director EAP/Behavioral Health, United Airlines

2. Substance Abuse Problems are Difficult to Detect

3. United Airlines HIMS Management Structure • Letter of Agreement-LOA-10 • HIMS Policy • Flight Ops Manual • HIMS Benefit • Short term disability- 12 months; Pilot Fund • HIMS Handbook/Manual • Annual UAHIMS Meeting

4. Senior VP Flight Operations HSC HIMS Steering Committee BMC Base Monitoring Committee Additional Support UAL HIMS Structure • “Three Legged Stool” • Provides checks/balances • Fosters teamwork • FLt Ops, ALPA, EAP • Dir. of EAP/Behavioral Health • Designated Chief Pilot • MEC HIMS Chair • Base EAP Mgrs. • Base Chief Pilot/Designee • LEC HIMS Chair • Peer Pilots • HR • Medical Providers

5. Elementsof United HIMS Program (UAHIMS) • Treatment-minimum 30 days • Monthly Base meetings • EAP facilitation and clinical management • Check-ins with Peer Pilot/CPO/EAP • Use external Doctors • Aftercare/continuing care participation, weekly • Participation in 12 step programs, three times a week • Random alcohol and drug testing • Urine screens -10 panel, EtG-PEth • Soberlink, 2x’s Daily

6. Lessons LearnedAbout Drug/Alcohol Testing

7. TESTING OUTCOMESN=100 Pilots (AVERAGE)

8. Relapse Report

9. Lessons Learned • You Don’t Know what you don’t know • Need an Alcohol/Drug testing • Denial is Powerful, Cunning and Baffling • Risk Management/Safety Program • Quantitative/Qualitative Data • Trust-but Verify

10. Return on Investment (ROI) and • Alcoholism/Pilot Sick Leave usage

11. Research Questions • Question 1: • Is absenteeism a useful predictor of a pilot experiencing an AOD disorder? • Hypothesis 1: • Higher absence rates in a 12 month aggregate period put a pilot at greater risk of being identified as having an AOD disorder.

12. Research Questions • Question 2: • If a pilot is diagnosed with an AOD disorder is absenteeism reduced by treating a pilot’s AOD disorder? • Hypothesis 2: • In the year after treatment completion and the pilot returns to work, diagnosed pilots will be absent significantly less than in the year prior to treatment compared to matched controls.

13. Why Pilots? • Absence-Sick leave in pilots • Easy to track • Highly reliable • Well documented • Low turn over in population • Ability to follow over time • Replacement workers

14. Methods • Study Design • Longitudinal study using archival payroll and administrative data to ascertain employee absence rates. • 3 years pre-diagnosis and 5 years post return to work • Commercial airline pilots diagnosed with an AOD disorder (cases) were matched to non-diagnosed (controls)

15. Methods • Data Source • Major US Commercial Airlines • Administrative Records • Human Resources • Flight Operations • Finance-Pay roll records • All records were de-identified • Methodology/data reviewed by Human Subjects Committee-University of Texas

16. Methods • Data Collection 1989-2006 • 52,000 files/records • Data Sources • Microfiche-Data Archive, Jan. 1989-March, 1995; (11,000 records) • On Demand-Web Access, April, 1995-Dec., 1999; • Data Warehouse-Jan., 2000-Dec. 2006.

17. Methods • Controls/Comparison Group • Non diagnosed Pilots from same company • Matched on: • Age • Dater of Hire • Rank-First Officer-Captain • Matched using a Human Resource Data Base • Exclusions-no pay records, check airman status, or management pilot;

18. Methods • Data points of interest: • Actual hours flown (block time) • Minimum of flight hours guaranteed by flying the schedule the pilot bid that month (MPG) • Number of sick hours used during the month

20. Study Outcomes-Pre-Treatment • Examined pay for both groups- • No difference in monthly pay between the cases/controls; • Sick time usage: • Pre diagnosis years for the substance abusing pilots • Using more sick time than the controls; • Substance Abusing pilot uses almost twice as much sick time; • Control (non SA pilot) -60 hours annually (3-20hr trips) • Cases-Substance Abusing pilots -(average) 119 hours annually; • Replacement costs - the company had to spend on pilots calling in sick; • Pre treatment • Estimated replacement cost at $202/hour.

22. Replacement Costs3 Years Prior to Treatment Cost of replacing Chemically Dependent Pilot when they call in sick as compared to Non CD Pilot: • CD Pilot $2,886,784 • Non CD Pilot $2,097,600 • Company Cost $ 789,184

24. Cost SavingsPre/Post Treatment Year of Diagnosis as compared to the First Year Back to Work for the Chemically Dependent Pilot –Only • Year of Diagnosis $1,269,504 • First Year Back $ 335,160 • Savings* $ 934,344 *Implement-Early Identification education • Reduce Barriers of seeking help

25. Pre/Post TreatmentReplacement Costs Comparisons Pre Treatment Post Treatment CD Pilot $2,886,784 $1,516,960 Non CD Pilot $2,097,600 $2,226,804 Company Cost $ 789,184 $1,369,824 - Savings • Does treating any other chronic health related problem yield this type of return for the company?

26. Study OutcomesReturn on Investment • The substance abusing pilots returning to work after treatment use 75% less sick time the first year back to work than before they went to treatment. • Over the five year period after returning to work: (based on the year of diagnosis average replacement costs) • 1st year- 75% less replacement costs; • 2nd year- 60% less replacement costs; • 3rd year- 49% less replacement costs; • 4th year- 27% less replacement costs; • 5th year- 52% less replacement costs.

27. Some Financials/Thoughts to Consider : • Statistically Significant relationship between Pilot Substance Abuse/Sick Leave • Treating the Alcoholic Pilot pays off in lower sick leave usage/replacement costs • If the company terminates • Loss of experience and time invested in the pilot

28. Some Financials/Thoughts to Consider : • Recovered pilots become more honest & grateful • Tend not to abuse sick time or disability insurances • Pilots volunteer to help other pilots • It’s right thing to do

29. Questions?