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1730 - Resolution - Amending Drug and Alcohol Testing for City EmployeesRESOLUTION NO. 1730 "/ A RESOLUTION OF THE CITY OF PORT ORCHARD, WASHINGTON SUPERSEDING RESOLUTION NO. 1718 AND ESTABLISHING A DRUG AND ALCOHOL TESTING POLICY AND PROCEDURES FOR CITY EMPLOYEES HIRED AFTER MARCH 25, 1996 AND CITY EMPLOYEES WHO ARE REQUIRED TO HAVE AND MAINTAIN A COMMERCIAL DRIVERS LICENSE AS A JOB REQUIREMENT. WHEREAS, the Port Orchard City Council recognizes the obligation to provide employees and citizens of the City of Port Orchard a drug and alcohol free work environment to insure a safety within the workplace and community; and WHEREAS, the Port Orchard City Council is respectful of employees rights to personal privacy. They also recognize that alcohol and dugs can adversely affect job performance and the work environment, by creating a hazard to the safety and welfare of the affected employee, other employees or the community. WHEREAS, effective January 1, 1996 the City of Port Orchard was required to comply with the Federal Omnibus Transportation Act of 1991 (U.S Department of Transportation Federal Highway Administration regulations issued by the United States Department of Transportation, 49CFR) which mandated the City establish urine drug and evidential breath alcohol testing for employees in safety - sensitive positions, including those who are required to hold a Commercial Driver's License. WHEREAS, it is also the desire of the City of Port Orchard to establish a Pre -employment Drug Testing Policy and procedures applicable to all employee candidates who are extended a conditional offer of employment. NOW, THEREFORE, it is hereby resolved by the City Council of the City of Port Orchard that the Drug and Alcohol Policy and Procedures attached hereto as Exhibit "A" does supersede Resolution No. 1718 and is hereby adopted. PASSED by the City Counci of the City of Port Orchard, APPRIVED by the Mayor and attested by the Clerk in authentication of such passage this 25th day of March, 1996. LESLI£ J. WEATHERILL, MAYOR ATTEST: Patricia Parks, City Clerk DRUG AND ALCOHOL TESTING POLICY AND PROCEDURE MANUAL SECTION 1: PURPOSE The purpose of this policy is to establish Drug and Alcohol Testing Policies and Procedures to (1) establish pre -employment drug testing for all employees hired after the effective date of this policy; and (2) establish compliance with the Federal Highway Administration regulations requiring drug and alcohol testing for Commercial Driver's License holders. Regulations issued by the United States Department of Transportation mandate urine drug and evidential breath alcohol testing for employees in safety - sensitive positions, including those who are required to hold a Commercial Driver's License. This policy sets forth the City of Port Orchard alcohol and drug testing program and the testing and reporting requirements to include those requirements as required by those regulations. SECTION 2: APPLICATION This policy applies to (1) all regular, part-time and temporary employees of the City of Port Orchard who are required to have and maintain a Commercial Driver's License in order to perform the duties of the job; (2) All other employees who are hired after the January 1, 1996 shall be subject to pre -employment drug testing; and (3) Contractors performing functions for the City of Port Orchard involving the use of a vehicle requiring a Commercial Driver's License, will be subject to specific alcohol and drug testing as required by federal regulations. SECTION 3: POLICY The City of Port Orchard has a significant interest in the health and safety of its employees and the citizens of the City. In furtherance of that interest, it is the policy of the City of Port Orchard to take those steps necessary to ensure that its employees perform their duties and responsibilities free of the influence of drugs and alcohol. Employees are encouraged to seek confidential counseling on problems associated with alcohol and drug abuse. There will be mandatory drug and alcohol testing for all employees and job applicants under the circumstances outlined in this policy. SECTION A: DEFINITIONS Accident - Accident means an occurrence involving a commercial vehicle use to perform job duties on the public road which results in (1) a fatality; (2) bodily injury to a person who, as a result of the injury, immediately receives medical treatment away from the scene of the accident; or (3) one or more motor vehicles incurring disabling damage requiring the vehicle to be transported away from the scene by a tow truck or other vehicle. Driver - This term includes all employees whose position may require operating a commercial vehicle and that requires the possession of a Commercial Driver's license. Commercial Vehicle - A commercial vehicle is one that either: (1) has a gross vehicle weight of over 26,000 pounds (including combined weight if towed unit weighs over 10,000 pounds); (2) is designed to transport 16 or more persons, including driver; or (3) is used to transport hazardous materials. CITY OF PORT ORCHARD -- DRUG AND ALCOHOL TESTING Resolution No. 1730 POLICY AND PROCEDURE Exhibit "A" PAGE 1 OF 14 Drugs - For the purposed of this policy, in accordance with the applicable federal regulations, "drugs" refers to the following five substances: marijuana (THC), cocaine, opiates, phencyclidine(PCP), and amphetamines. Medical Review Officer (MRO) - The Medical Review Officer is the licensed physician responsible for receiving and interpreting laboratory results from the urine drug tests. Safety Sensitive Position - For purpose of this policy, these are positions associated with the driving of commercial vehicles. Substance Abuse Professionals (SAP) - A Substance Abuse Professional is a licensed physician, or licensed or certified psychologist, social worker, employee assistance professional, or addiction counselor (certified by the National Association of Alcoholism and Drug Abuse Counselors Certification Commission) with knowledge of and clinical experience in the diagnosis and treatment of alcohol and drug -related disorders. The SAP is responsible for evaluating employees with positive test results. SECTION 5: PROHIBITED CONDUCT The following conduct regarding alcohol and drug use or abuse is prohibited: a. Alcohol Concentration An employee may not report for or remain on duty requiring the performance of duties covered under this policy while having an alcohol concentration of 0.04 or greater. b. Alcohol Possession and On Duty Use of Alcohol An employee may not possess or use alcohol while on duty or while operating a commercial vehicle. C. Pre -Duty Use of Alcohol Any employee may not operate a commercial vehicle within four hours after using alcohol. An on -call employee who consumes alcohol within four hours of being called in must acknowledge the use of alcohol and may not report for duty. d. Alcohol Use Following an Accident An employee required to take a post -accident alcohol test may not use alcohol for eight hours following the accident, or until a post -accident alcohol test is given, whichever comes first. e. Use of Drugs An employee may not report for duty or remain on duty which requires driving a vehicle to perform their job duties, when the employee has used a drug or drugs, except when the use is pursuant to instructions of a physician who has advised the employee that the substance does not adversely affect the employee's ability to safely operate a vehicle. Employees who are taking a prescription or over- the-counter medication that may impair their ability to perform their duties safely and effectively should provide written notice from their physician or pharmacist with respect to the effects of such substances. CITY OF PORT ORCHARD -- DRUG AND ALCOHOL TESTING Resolution No. 1730 POLICY AND PROCEDURE Exhibit "A" PAGE 2 OF 14 f. Refusal to Submit to a Required Test An employee may not refuse to submit to a post -accident, random, reasonable suspicion, or follow-up alcohol or drug test as directed by this policy. g. Positive Drug Test An employee may not report for duty or remain on duty requiring the performance of duties covered under this policy if the employee tests positive for drugs or alcohol. h. Tampering With a Required Test An employee may not tamper with, adulterate, alter, substitute or otherwise obstruct any testing process required under this policy. i. Possession, Transfer or Sale No employee may possess, transfer or sell drugs or alcohol while in any position covered by this policy. SECTION 6: TESTING a. Pre -employment Drug Testing All individuals who are covered by this policy must pass a drug test as a post - offer condition of employment. b. Reasonable Suspicion Testing Employees subject to this policy shall submit to a drug and/or alcohol test when the City of Port Orchard reasonably suspects that this policy (except the prohibitions against possession, transfer or sale of alcohol) may have been or is presently being violated. A referral for testing will be based on contemporaneous, articulable observations. Such referrals will be made by supervisory personnel who have received training concerning the signs and symptoms of drug and alcohol use. If removed from duty based on reasonable suspicion of alcohol use and an alcohol test is not administered within eight hours, the employee will no be allowed to perform or continue to perform covered functions until: 1) an alcohol test is administered and the driver's breath alcohol concentration measures less than 0.02; or 2) 24 hours have elapsed following the determination that there is reasonable suspicion to believe that the employee has violated this policy concerning the use of alcohol. C. Post -Accident Testing Following an accident (as defined above) involving a commercial vehicle, the driver is required to submit to alcohol and drug tests when the driver receives a citation under state or local law for a moving traffic violation, or where a fatality occurs as a result of the accident. Testing should occur as soon as possible, but may not exceed eight hours after the accident for alcohol testing and 32 hours after the accident for drug testing. CITY OF PORT ORCHARD -- DRUG AND ALCOHOL TESTING Resolution No. 1730 POLICY AND PROCEDURE Exhibit "A" PAGE 3 OF 14 d. e. f. 9• A driver who is subject to post -accident testing must remain readily available for such testing and may not take any action to interfere with testing or the results of testing. Drivers who do no comply with post -accident testing requirements will be considered to have refused to submit to testing and will be subject to sanctions for refusal to test as provided in this policy. Random Testing Employees who are required to have and maintain a Commercial Drivers License as covered by this policy will be subject to random, unannounced alcohol and drug testing. Return to Duty Testing Employees who have violated this policy, including those who have tested positive on a drug or alcohol test, and who under the discipline policy are allowed to return to work, must test negative prior to being released for duty. A return to duty test following alcohol misuse may not exceed an alcohol concentration of 0.02. Follow-up Testing An employee who is referred for treatment related to alcohol misuse and/or use of drugs is subject to unannounced follow-up testing for a period not to exceed 60 months as directed by a Substance Abuse Professional and the City of Port Orchard. The number and frequency of follow-up testing will be determined by the Substance Abuse Professional and the City of Port Orchard, but will not be less than six tests in the first 12 months following the employee's return to duty. Re -tests Employees who test positive for drugs may request a second test of the remaining portion of the split sample within 72 hours of notification of a positive test result by the Medical Review Officer. SECTION 7: REFUSAL TO TAKE AN ALCOHOL OR DRUG TEST No employee shall refuse to submit to an alcohol or drug test as directed under this policy. A refusal to submit shall include, but is not limited to: a. a failure to provide adequate breath for testing without a valid medical explanation after the employee has received notice of the requirement for breath testing in accordance with the procedures manual; b. failure to provide adequate urine for drug testing without a valid medical explanation after the employee has received notice of the requirement for urine testing in accordance with the procedures manual; C. engaging in conduct that obstructs the testing process. Refusal to submit to a test shall be considered the same as a positive test result. SECTION 8: SECURING INFORMATION FROM PREVIOUS EMPLOYERS If a person is to be hired into a position subject to this policy and during the previous two years has worked as a driver of a commercial vehicle, that person must authorize a request of all employers of the driver within the past two years to release CITY OF PORT ORCHARD -- DRUG AND ALCOHOL TESTING Resolution No. 1730 POLICY AND PROCEDURE Exhibit "A" PAGE 4 OF 14 information on the following: a. Positive alcohol or drug tests b. Refusal to be tested This information must be obtained before the person is employed by the City of Port Orchard. However, if the information has not arrived by the anticipated start date, and if the person has passed the pre -employment drug test, the person my be hired and the requested information must be obtained from the previous employers within 14 calendar days of the date of hire. If the information has not been received within the 14 calendar days, the person will not be permitted to drive commercial vehicles until the information has arrived. If the information obtained from previous employer indicates either a positive test or that a refusal to be tested occurred within the past two years, that person will not be permitted to drive commercial vehicles unless subsequent information indicates that an evaluation by a Substance Abuse Professional was made and return to duty testing was administered. SECTION 9: CONFIDENTIALITY AND RECORD RETENTION All records related to drug and alcohol testing will be maintained in a secure location with controlled access. These records will be kept separate from records pertaining to all other employees. SECTION 10: CONSEQUENCES OF ENGAGING IN PROHIBITED CONDUCT OR POSITIVE DRUG OR ALCOHOL TESTS a. Termination An employee will be subject to immediate termination in the event an alcohol test indicates a blood alcohol level of 0.10 or greater. b. Discipline An employee will be subject to appropriate disciplinary action as specified in the applicable labor agreement up to and including termination from employment if: 1. the employee tests positive for a drug or drugs; 2. results from an alcohol test indicate a blood alcohol level of 0.02 or greater; and/or 3. the employee has engaged in prohibited conduct as outlined in Section V (Prohibited Conduct. All employees regardless of disciplinary action taken will be advised of resources available to the employee in evaluating or resolving problems associated with drug use or alcohol misuse. The following provisions apply to those employees who are not terminated for their policy violations: a. Positive Test Result and/or Engaging in Prohibited Conduct. If an employee tests positive for drugs or has an alcohol test that indicates a blood alcohol level of .04 or greater from a random, reasonable suspicion or CITY OF PORT ORCHARD -- DRUG AND ALCOHOL TESTING Resolution No. 1730 POLICY AND PROCEDURE Exhibit "A" PAGE 5 OF 14 post -accident test, or engages in prohibited conduct as outlined in Section V, the employee will be immediately removed from duties requiring the driving, or a commercial vehicle. The employee will not be permitted to return to work unless he/she: 1. has been evaluated by a qualified Substance Abuse Professional; and, 2. if recommended by a Substance Abuse Professional, has properly followed any rehabilitation prescribed; and, 3. has a verified negative result on a return -to -duty alcohol (<0.02) and/or drug test. Upon completion of a recommended rehabilitation program and successful return to work, and employee will be subject to follow-up random testing for up to sixty (60) months as recommended by the Substance Abuse Professional and the City of Port Orchard, with a minimum of six such unscheduled tests within the first twelve months of returning to duty. C. Alcohol Concentration of 0.02 but less than 0.04 Employees having a breath alcohol concentration of at least 0.02 but less than 0.04, shall be removed from duty requiring the driving of a commercial vehicle for at least 24 hours. SECTION 11: VOLUNTARY REFERRAL The City of Port Orchard supports employees who volunteer for treatment of alcohol or drug abuse. Employees are encouraged to seek treatment voluntarily. Any employee who comes forth and notifies the City of Port Orchard of alcohol or drug problems will be given the assistance extended to employees with any other illness. Any such program, however, may not interfere with the tests required by these rules. For exampl e, a driver may not identify himself/herself as unfit to drive after having been notified of a random or reasonable suspicion test and expect to avoid the consequences for a positive test or reasonable suspicion test and expect to avoid the consequences for a positive test or a refusal to test. In addition, voluntarily seeking assistance does not excuse any failure to comply with all of the provisions of this policy or other policies of the city. Sick leave, vacation leave or leave of absence without pay as provided by state or federal regulations may be granted for treatment and rehabilitation as in other illnesses. Insurance coverage for treatment will be provided to the extent of individual coverage. Confidentiality of information will be maintained as much as possible at all times. CITY OF PORT ORCHARD -- DRUG AND ALCOHOL TESTING Resolution No. 1730 POLICY AND PROCEDURE Exhibit "A" PAGE 6 OF 14 DRUG AND ALCOHOL TESTING PROCEDURES TABLE OF CONTENTS I. INTRODUCTION A. Requirement to Participate . . . . . . . . . . . . . . . . . 8 B. Covered Employees . . . . . . . . . . . . . . . . . . . . . . 8 C. Designated Contact .. . . . . . . . . . . . 8 D. Testing, Evaluation and Referral Services . . . . . . . . . . 8 II. TESTING PROCEDURES A. Pre -Employment Testing . . . . . . . . . . . . . . . . . . . 9 B. Random Testing . . . . . . . . . . . . . . . . . . . . . 9 C. Reasonable Suspicion Testing . . . . . . . . . . . . . . . 10 D. Post -Accident Testing 11 E. Return to Duty and Fol1ow�Up Testing 11 F. After Hours Testing . . . . . . . . . . . . . . . . . . . . 12 III. TESTING COSTS AND COMPENSATION A. Testing Costs . . . . . . . . . . . . . . . . . . . . . . . 12 B. Pay Status . . . . . . . . . . . . . . . . . . . . . . . . 12 IV. TESTING METHODS A. Drug Testing . . . . . . . . . . . . . . . . . . . . . . . 13 B. Alcohol Testing . . . . . . . . . . . . . . . . . . . . . . 13 V. TRAINING AND EDUCATION . . . . . . . . . . . . . . . . . . . . . . 14 ATTACHMENT A - Testing Methodology CITY OF PORT ORCHARD -- DRUG AND ALCOHOL TESTING Resolution No. 1730 POLICY AND PROCEDURE Exhibit "A" PAGE 7 OF 14 SECTION 1: INTRODUCTION a. Requirement to Participate in Drug and Alcohol Testing Program The City of Port Orchard is required by Federal regulation to administer a testing program for drug and alcohol use for employees who are required to have and maintain a Commercial Driver's License to perform their job duties. b. Covered Employees The following groups of employees are required by law to participate in the drug and alcohol testing program: 1. Regular employees who are required to operate a commercial vehicle as part of their routine job duties; 2. Temporary employees who are required to operate a commercial vehicle as part of their routine job duties, 3. Any employee who possesses a Commercial Driver's License who may at any time operate a commercial vehicle on an on -call, emergency or unscheduled bases (including supervisory employees who may be called upon at any time to operate a commercial motor vehicle); 4. Current employees who transfer or promote to a position requiring operation of a commercial vehicle and possession of a Commercial Driver's License; 5. A pre -employment drug test is required of all persons given a conditional job offer for a position that meets the description outlined above. All other regular, part-time and temporary city employees who are hired after the effective date of this procedures manual are required to participate in pre -employment testing. C. Designated Contact The following individual(s) have been designated by the City to answer questions about the program and program materials and may provide employees with resource materials or referral assistance: Patricia Parks, City Clerk. Phone: (360) 876-4407. d. Testing, Evaluation and Referral Services The City has joined the Association of Washington Cities (AWC) Drug and Alcohol Testing Consortium for much of the administration of this program. The AWC consortium has contracted with Virginia Mason to conduct the random testing services, provide the testing laboratory facilities, arrange the testing collection sites, and provide the Medical Review Officer (MRO) functions. The services of a Substance Abuse Professional (SAP) are also available for employees with positive test results. CITY OF PORT ORCHARD -- DRUG AND ALCOHOL TESTING Resolution No. 1730 POLICY AND PROCEDURE Exhibit "A" PAGE 8 OF 14 Drug and Alcohol Testing Collection Site: Contact: Lorraine Barker (360) 479-5088 Olympic Medical Lab Olympic Medical Lab 450 South Kitsap Blvd Suite 1830 700 Lebo Blvd Port Orchard, WA Bremerton, WA Testing Laboratory: Drug Proof Nordstrom Medical Tower P.O. Box 14950 Seattle WA 98114 (206) 386-2454 Medical Review Officers Robert D. Petrie, M.D. or Samuel Strauss, DO, MPH, FACPM Virginia Mason Occupational Medicine 6720 Southcenter Blvd. Suite 110 Tukwila WA 98188 (206) 242-3651 Substance Abuse Professional Olympic Resources 18720 33rd Ave West, Suite 200 Lynnwood WA 98037 1-800-624-5357 Olympic Resources will refer caller to a Substance Abuse Professional in the local area. SECTION 2: TESTING PROCEDURES a. Pre -Employment Testing Following a conditional offer of employment, all prospective employees will be tested for the presence of drugs as part of the pre -employment physical examination. A positive drug test result for an employment candidate will result in rescinding the conditional offer of employment by the City of Port Orchard. The individual will only be eligible to re -apply for a position after six months. b. Random Testing The names and social security numbers for employees who are required to have and maintain a Commercial Drivers License have been and will be included in the AWC Drug and Alcohol Testing Consortium pool. This pool contains all eligible individuals from all of the consortium members. The pool database is managed by Virginia Mason and is updated monthly as changes in personnel occur. The annual random testing rate required under federal regulations is 50% of the pool for drug testing and 25% of the pool for alcohol testing. This means that if the pool contains 1,000 members, there will be at least 500 random drug tests and at least 250 random alcohol tests conducted throughout the year. CITY OF PORT ORCHARD -- DRUG AND ALCOHOL TESTING Resolution No. 1730 POLICY AND PROCEDURE Exhibit "A" PAGE 9 OF 14 Virginia Mason uses a software program called HEIDI to randomly select individuals for random testing on a monthly basis. Some individuals will be selected for drug testing and others will be selected for both drug and alcohol testing. Each month, Virginia Mason will send the names of individuals selected for random testing to the appropriate consortium member contacts. If the City of Port Orchard has any employees selected for testing, the names will be sent to the designated contact. Employees selected for random testing will be scheduled for a test by the designated contact within ten (10) calendar days of receipt of the name of individual to be tested if available. If the employee is not available during the ten (10) day period, the ten (10) days shall start on the first day the employee returns to work, but must not go beyond the next testing notification period. Employees selected for alcohol testing may only be tested just before, during or after driving a commercial vehicle. Employees will not be notified until just prior to the testing. Upon notification of selection for random testing, the employee will receive an Employee Notification of Scheduled Drug and/or Alcohol Test letter from the designated contact. The employee will be asked to sign this letter and a Testing Consent form. The employee must present the Employee Notification of Scheduled Drug and/or Alcohol Test letter at the collection site along with picture identification at the time of testing. A copy of all of the forms will be retained by the City. After notification, the employee must proceed directly to the collection site for testing accompanied by a supervisor or other designee. The collection and testing procedures are outlined in Attachment A. If an employee scheduled for an alcohol test receives a confirmed test result with a blood alcohol level of 0.02 or above and is unaccompanied at the collection site, a supervisor will be called to the site to transport the empl oyee. Refusing to submit to a test will be considered the same as a positive test result and will subject the employee to the same consequences as receiving a positive test result. c. Reasonable Suspicion Testing According to the federal regulations, reasonable suspicion testing is to be based on "specific, contemporaneous, articulable observations concerning the appearance, behavior, speech or body odors of the employee." Only supervisors who have been trained in detecting the symptoms of alcohol misuse or drug use and who have directly observed behaviors, appearance or physical symptoms can subject an employee to reasonable suspicion testing. Supervisors should complete a Reasonable Suspicion Observation Form and if possible have the form signed by a witness. If a supervisor has reasonable suspicion to believe that an employee who is on duty, about to go on duty or just completed duty is under any influence of drugs or alcohol, the supervisor will remove the employee from duty immediately. The employee will be advised of the reasons for reasonable suspicion and will be transported to the collection site by the supervisor for testing. Reasonable suspicion alcohol testing may only occur just before, during or after CITY OF PORT ORCHARD -- DRUG AND ALCOHOL TESTING Resolution No. 1730 POLICY AND PROCEDURE Exhibit "A" PAGE 10 OF 14 d. e. an employee drives a commercial vehicle. If a reasonable suspicion alcohol test is not conducted within two hours of determination that it is necessary, the supervisor will prepare and maintain documentation of the reasons why it did not occur. Post -Accident Testing All employees covered by these procedures will be subject to post -accident testing if they are involved in an accident with a commercial vehicle on a public road which results in: 1. A fatality OR 2. The driver receives a citation under state or local law for a moving violation AND a. there is bodily injury to a person who, as a result of the injury, immediately receives medical treatment away from the scene OR b. one or more motor vehicles incurs disabling damage requiring the vehicle to be transported away from the scene by a tow truck or other vehicle. After an accident, employees are responsible for contacting the immediate supervisor or other management personnel. If the above conditions are met, the employee must make themselves available for post -accident testing as soon as possible. Post -accident testing for alcohol should occur within two hours if possible, but may not exceed eight hours. Testing for drugs should occur within 32 hours. Employees subject to post -accident testing are prohibited from consuming alcohol for eight hours following the accident, or until the employee has completed the alcohol test, whichever comes first. An employee who does not comply with the post -accident testing will be considered to have refused testing and will be subject to disciplinary action. An employee in a post -accident situation should cooperate with law enforcement personnel investigating the scene. Supervisors are responsible for determining if the accident qualifies the driver for post -accident testing and should escort the employee to the collection site if possible. If an employee is unable to provide consent to testing due to their medical condition, the supervisor will document the reasons why the employee was not tested. If testing is not completed within the required time following an accident, the supervisor will document in writing why the tests were not administered. Return to Duty and Follow -Up Testing All employees who have engaged in prohibited conduct as defined in the Drug and Alcohol Testing Policy for Employees who Operate Commercial Vehicles, including those who have tested positive for drugs or alcohol, are subject to return to duty and may be subject to follow-up testing. 1. Return to Duty Testing After engaging in prohibited conduct regarding alcohol or drug use, an employee is required to undergo a return to duty alcohol and/or drug test prior to returning to a duty which requires driving a commercial vehicle. A return to duty alcohol test must result in a breath alcohol concentration of 0.02 or less. A return to duty drug test must result in CITY OF PORT ORCHARD -- DRUG AND ALCOHOL TESTING Resolution No. 1730 POLICY AND PROCEDURE Exhibit "A" PAGE 11 OF 14 a verified negative result. 2. Follow Up Testing An employee who returns to work after evaluation by a Substance Abuse Professional (SAP) determining that the employee is in need of assistance in resolving problems associated with alcohol misuse or drug abuse is subject to unannounced follow up alcohol and/or drug testing as directed by the SAP and the City of Port Orchard, but no less frequent than six times in the first year following the return to work. The follow up testing period may not exceed 50 months for each incident. f. After Hours Testing If the need for testing occurs outside of the normal hours of operation of the designated collection site, a supervisor or manager will be responsible for following the procedures established by Virginia Mason for such occurrences. SECTION 3: TESTING COSTS AND COMPENSATION a. Testing Costs 1. The City of Port Orchard will pay for the following alcohol and or initial drug tests: a. Random testing b. Reasonable suspicion testing C. Post -accident testing d. Pre -employment 2. Employees are responsible for the costs associated with the following tests: a. Split sample re -tests made at the employee's request b. Follow-up testing C. Return to duty testing If a split sample re -test returns a negative result, the City of Port Orchard will reimburse the employee for the cost of the test. 3. Substance Abuse Professional and rehabilitation costs will be the responsibility of the employee. b. Pay Status 1. For Time Spent Testing Employees will be compensated for time spent to report to the testing facility and be tested for the following alcohol and/or initial drug tests: a. Random testing b. Reasonable suspicion testing C. Post -accident testing Employees are responsible for taking the following tests on their own time: CITY OF PORT ORCHARD -- DRUG AND ALCOHOL TESTING Resolution No. 1730 POLICY AND PROCEDURE Exhibit "A" PAGE 12 OF 14 a. Split -sample re -tests made at the employee's request b. Return to duty testing C. Follow-up testing 2. Waiting for Results Employees who have been asked to submit to a reasonable suspicion drug test will be placed on accrued leave pending the outcome of the test results. If the employee has no accrued leave, the leave shall be unpaid. If the test result is negative, the accrued leave time used will be credited back to the employee's leave account . 3. Alcohol Concentration of 0.02 but less than 0.04 If an employee receives an alcohol test result of at least 0.02 but less than 0.04, the employee must be removed from duty which requires driving a commercial motor vehicle for at least 24 hours following the administration of the test. The employee may use accrued vacation or sick leave during this absence. If employee has no accrued vacation or sick leave the time will be without pay. 4. Positive Drug Test or Alcohol Test Result of 0.04 or Higher An employee who receives a positive drug test or who tests 0.04 or greater on an alcohol test is not allowed to return to work until all of the applicable requirements are met as outlined in the Policy (see Consequences of Engaging in Prohibited Conduct and Positive Drug or Alcohol Test) . Such employees may use accrued vacation or sick leave during this absence. If employee has no accrued vacation or sick leave the time will be without pay. SECTION 4: TESTING METHODS Ftr b. Drug Testing The drug testing requires candidates to provide a urine specimen of at least 45 ml to be tested for the presence of amphetamines, cocaine, marijuana (THC), opiates, and phencyclidine (PCP). The specimen will be sent to Drug Proof, a laboratory certified by the Substance Abuse and Mental Health Services Administration (SAMSHA) to conduct screening and confirmation tests according to the protocols identified in the Department of Transportation Rules. All test results will be reviewed by the Medical Review Officer (MRO). Specific collection procedures and analytical procedures are covered in Attachment B. Alcohol Testing Alcohol testing will be conducted using an approved evidential breath testing (EBT) device operated by a trained breath alcohol technician (BAT) at the collection site. The first test performed will be a screening test. If the screening test results in an alcohol concentration of less than 0.02, it will be considered a negative test. If the screening test results in an alcohol concentration of 0.02 or greater, a second, or confirmation test is performed within 15 to 20 minutes. Specific alcohol testing procedures are covered in Attachment A. CITY OF PORT ORCHARD -- DRUG AND ALCOHOL TESTING Resolution No. 1730 POLICY AND PROCEDURE Exhibit "A" PAGE 13 OF 14 SECTION 5: TRAINING AND EDUCATION The City will provide all affected employees with copies of these procedures and the Drug and Alcohol Testing Policy. Each employee must sign a receipt upon having been provided the above referenced information. Managers and supervisors designated to determine whether reasonable suspicion exists to require a driver to undergo alcohol or drug testing will receive at least 60 minutes of training on alcohol and 60 additional minutes of training on drug abuse. The training will cover the physical, behavioral, speech and performance indicators of probable alcohol misuse and use of controlled substances. CITY OF PORT ORCHARD -- DRUG AND ALCOHOL TESTING Resolution No. 1730 POLICY AND PROCEDURE Exhibit "A" PAGE 14 OF 14 DRUG AND F ` ^OHOL TESTING PROCEDURES VIRGiidA MASON OCCUPATIONAL MrUICINE ATTACHMENT "A" DOT Urine Testing for Drugs of Abuse Split Specimen Collection Procedures All drug screens for this contract will be collected following the stringent procedures of the Department of Transportation and the Substance Abuse and Mental Health Administration (SAME-1SA) for federally mandated testing. These instructions are intended for use by persons already familiar with the existing detailed urine drug screen single specimen collection procedures for Department of Transportation. The following instructions define how split specimens may be collected using a Split Specimen Cup Pack. The split specimen requirement was implemented on August 15, 1994. Employers with employees subject to drug testing in the following operating administrators SHALL use split specimen collection: Federal Highway Administration, Federal Railroad Administration, Federal Transit Administration, and Federal Aviation Administration. Employers with employees subject to drug testing in the following operating administrations MAY use split specimen collection: Research and Special Program Administration and United States Coast Guard. The collection site person will use the area or areas defined as the designated collection site. The collection will provide an enclosure for private urination, a toilet for completion of urination, a source of water for hand washing, and a clean surface for the collection site person to utilize for writing. 1. Collect urine specimen from only one person at a time. 2. Document and maintain the chain of custody at all times. 3. Double check the accurate labeling and sealing of the specimens. 4. Have the donor watch the process of completing paperwork and sealing the specimens. 5. Do NOT list the donor's name on the laboratory copy of the chain of custody. Chain of custody shall be properly executed by authorized collection site personnel upon receipt of specimens at the clinics. Handling and transportation of the urine specimens to the laboratory shall always be accomplished through proper chain of custody procedures. Once at The laboratory a strict use of chain of custody is followed. The purpose of these procedures is to maintain control of specimens/aliquots until testing is completed. All specimens received at The laboratory and aliquots derived therefrom are handled with an internal chain of custody from the time of receipt through the final disposition. In addition, all appropriate spaces on external chain of custody documents are filled in as required by DOT. 1. Internal chain of custody. Each transfer of custody must be documented on the chain of custody form in the appropriate space. At each step the person releasing and receiving the sample/aliquot must sign (or stamp and sign) the form, record the date, purpose of transfer, and where appropriate, record the condition of the security seal(s). At this point, the person receiving the specimen/aliquot is responsible or it must be locked in a secure area or container. At no time may the specimen/aliquot be left unattended in a non -secure area. The individual specimen requisition chain of custody form is used to document external chain of custody and for documentation of specimen receipt, accessioning, and storage prior to testing. The handling of individual specimens for any other purpose must be documented on a special Handling Chain of Custody Document. Batch chain of custody forms document aliquoting of specimens for screening, confirmation testing, and disposition of specimens and/or aliquots. The batch chain of custody is signed and dated by all persons releasing and handling or assuming custody of any specimen, aliquot or extracts derived from the aliquots listed on the form. All chain of custody forms are part of the forensic record and are stored with the specimen requisitions in either short or long term storage as appropriate. These forms are part of the forensic record and must be available for access in the event that subsequent testing or handling is needed, or in the even that a legal package is requested. 2. Chain -of custodyLfor send -out s ec�. An NMO (on instruction from the specimen donor) may request that a split specimen be sent to another SAMHSA certified laboratory for reconfirmation. In this case, the split specimen will be sent under chain of custody. A Special Handling Chain of Custody will be used to document the specimen recovery from storage and the packaging for shipment. No unauthorized personnel shall be permitted in any part of the designated collection site where urine specimens are collected or stored. Only the collection site person may handle specimens prior to their being secured in the mailing container. In order to promote the security of specimens and to avoid distraction of the collection site person and ensure against any confusion in the identification of specimens, a collection site person shall conduct only one collection procedure at any given time. For this purpose, a collection procedure is completed when a urine bottle has been 3 sealed and initialed, the urine custody and control form has been executed and the employee has departed the site. f. Privacy The collection site person will be responsible for using procedures for collecting urine specimens which allow the donor privacy unless there is reason to believe that a particular donor may have altered or substituted the specimen to be provided, as further described in this paragraph. For purposes of this plan, the following circumstances are the exclusive grounds constituting a reason to believe that the donor may alter or substitute the specimen: To deter the dilution of specimens at the collection site, toilet bluing agents shall be placed in the toilet tanks wherever possible, so the reservoir of water in the toilet bowl always remains blue. Where practical, there shall be no other source of water (e.g. no shower or sink) in the same enclosure where urination occurs. If there is another source of water in the enclosure, it shall be effectively secured or monitored to ensure it is not used (undetected) as source for diluting the specimen. 2. When a donor arrives at the collection site, the collection site person will ensure that the donor is positively identified as the employee selected for testing (e.g. through presentation of photo identification or identification by the employee's supervisor). If the donor's identify cannot be established, the collection site person shall not proceed with the collection. 3. If the donor fails to arrive at the assigned time, the collection site person shall note the discrepancy and alert the designated employer contact. 1. Collection site person asks the donor to remove any unnecessary outer garments such as a coat or jacket that might conceal items or substances that could be used to tamper with or adulterate the donor's urine specimen. The collection site person shall ensure that all personal belongings such as a purse or briefcase remain with the outer garments. The donor may retain their wallets. 2. Instruct Donor to wash and dry their hands prior to urination. 3. After washing hands, the donor shall remain in the presence of the collection site person and shall not have access to any water fountain, faucet, soap dispenser, cleaning agents or any other materials which could be used to adulterate the specimen. 4. Have donor choose a split specimen collection cup pack. 5. Collection site person completes a custody and control form for each donor. Write the donor's Social Security or ID number in the grid at tape right corner. Verify and complete information requested in Step 1 (up to temperature) of the custody and control form. Write date and donor Social security or ID number on the bottle label AND on split label. 4 6. Collection site person opens the cup pack selected by the donor and applies a bottle label found on the custody and control form to the first bottle (primary specimen) and the split sample label to the second bottle (split specimen). Give the donor the collection cup and show hi/her the approximate level for 45 mL volume to be collected. Have the donor collect at least 45 mL urine. 7. Donor may provide their specimen in the privacy of a stall or otherwise partitioned areas that allow for individual privacy. S. Collection site person shall note any unusual behavior or appearance on the custody and control form. 9. Collection site person pours 30 mL urine into the primary specimen bottle and at least 15 mL urine into the split specimen bottle. Tighten lids securely. ➢ If less than 45 mL urine is collected, the collection site person will instruct the donor to drink not more than 24 oz of fluids and, after a period of not more than two hours again attempt to produce a complete sample using a new fresh cup pack. The original insufficient specimen will be discarded. if the donor is still unable to provide an adequate specimen, discard the insufficient sample, discontinue the test and notify the employer of the donor's inability to provide 45 mL of urine for testing within the allowed time period. 10. Collection site person measures temperature of the specimen from temperature strip on primary specimen and complete the last line of Step 1 on form. 11. Have donor verify accurate labeling of specimens. Donor to initial and date bottle security seals and place over caps and down two sides of both bottles. Do not obscure the labels. 12. Have donor complete and sign Step 3 on Copy 3 of custody and control form. Collection site person completes and signs Step 4 on Copy 1 of custody and control form. 13. Collection site person places each sealed bottle in a seXspecimen shipping bag and fold flap to seal. 14. Collection site person removes shipping bag seal from custody and control form and seal junction of front pouch of specimen shipping bag. Sign and date seal. 15. Collection site person complete Step 2, custody record, on custody and control form. 16. Collection site person separates copies of custody and control form and place copies 1, 2, and 7 in back pouch of specimen shipping bag. Mail Copy 3 to the MRO, give donor Copy 4, keep Copy 5 and mail Copy 6 to employer contact person. 17. Collection site person secures specimens until shipped to the laboratory via daily courier. 5 1. Employer de�iynated collection site not available. In the exceptional event that an employer collection site is not accessible and there is an immediate requirement for specimen collection (e.g. an accident investigation) a public restroom may be used according to the following procedure: a collection site person of the same gender as the donor accompanies the donor into the public restroom which has been made secure during the collection procedure. If possible, a toilet bluing agent shall be place in the bowl and any accessible toilet tank. The collection site person remains in the restroom, but outside the stall until the specimen is collected. If no bluing agent is available to deter specimen dilution, the collection site person shall instruct the donor not to flush the toilet until the specimen is delivered to the collection site person. After the collection site person has possession of the specimen, the donor shall be instructed to flush the toilet and to participate with the collection site person in completing the chain of custody procedures. 2. Temperature outside range. If the temperature of the specimen is outside the range of 90.5 degrees to 99.8 degrees Fahrenheit (32.5 degrees to 37.7 degrees Celsius), that is reasons to believe that the donor may have altered or substituted the specimen, and another specimen shall be collected under direct observation of a same gender collection site person and both specimens shall be forwarded to the laboratory for testing. The donor may volunteer to have their oral temperature taken to provide evidence to counter the reason to believe the donor may have altered or substituted the specimen caused by the specimen's temperature falling outside the prescribed temperature range. 3. Adulterated specimens. Whenever there is reason to believe that a particular donor has altered or substituted the specimen a second specimen can be obtained as soon as possible under direct observation of the same gender collection site person. All specimens suspected of being adulterated shall be forwarded to the laboratory for testing. 4. Employer notification. The donor's employer shall review and concur in advance with any decision by a collection site person to obtain a specimen under the direct observation of a same gender collection site person based upon the circumstances listed above. Samples will be rejected if: ➢ Specimen bottles lack the unique requisition number. ➢ Specimen. label does not exactly match the unique requisition number of the custody and control form. ➢ Bottles have no security seals, security seals are broken, there is evidence to tampering, or security seals are incorrectly placed on the bottles. M :- The chain of custody is blank. ➢ The specimens arrived at the laboratory without the chain of custody form. ➢ The primary specimen contains less than 30 mL urine. /drugcoll.doc 12194 Breath Alcohol Testing ✓ Check patient's picture I.D. ✓ Explain test procedure ✓ Complete Step 1 of DOT BAT Form ✓ Patient completes and signs Step 2 of DOT BAT Form - If patient refuses to sign the form, it is considered a refusal to take the test. Note the refusal in the "Remarks" section. ✓ Verify sequential test number on the EBT with the patient and document in Step 3 ✓ Insert ticket when EBT message states to do so ✓ Enter required information into EBT ✓ Open sealed mouthpiece in view of the patient and attach to EBT ✓ Collect breath sample by instructing the patient to take a deep breath and blow steadily into the mouthpiece of at least b seconds or until adequate sample has been obtained ✓ Show patient the result displayed on the EBT If Negative: ✓ Date and Sign the certification in Step 3 ✓ Sign Evidence Ticket ✓ Have patient read, sign and date the certification in Step 4 - If patient has already given a breath sample but does not want to sign it is NOT considered a refusal; but you must note that the patient refused to sign in the "Remarks" section. ✓ Attach EBT Ticket copies to the designated space on appropriate copies of DOT BAT Form. ✓ Distribute copies as follows: Copy 1 - Employer (Confidential -Phone Call, FAX, Mail or In Person as noted in protocol) Copy 2 - Employee Copy 3 - Forward to MRO Office (Gl-BH). If done with a SAMHSA drug screen attach to MRO copy of chain of custody. If Positive (.02 or greater): Do confirmation Test as follows: ✓ Observe 15 minute waiting period and explain restrictions to activities during this time period ✓ If patient has not complied with instructions during the waiting period, note in "Remarks" section ✓ Continue with testing procedure ✓ Use a new mouthpiece which has been opened in view of the patient ✓ Collect breath sample and show patient the result displayed on the EBT ✓ Have patient read, sign and date the certification in Step 4 - If patient has already given a breath sample but does not want to sign it is NOT considered a refusal; but you must note that the patient refused to sign in the "Remarks" section. ✓ Attach EBT Ticket copies to the designated space on appropriate copies of DOT BAT Form. ✓ Distribute copies as follows: Copy I. - Employer (Confidential -Phone Call, FAX, Mail or In Person as noted in protocol) Copy 2 - Employee Copy 3 - Forward to MRO Office (Gl-BH). If done with a SAMHSA drug screen attach to MRO copy of chain of custody ✓ Ensure IMMEDIATE transmission of results to employer to allow employer to prevent the employee from performing safety -sensitive function. /batproc-f.• 1 datalboh DRUGIPROOF ffr.iLly-.•rvir�• I rsiel Im�•e•elinr. 1220 1lneli.nn tiuia• -i0il �4e•n1[lr•. WA 0� 1111•} DRUGS OF ABUSE LABORATORY PROCEDURES T•1200.31,0.2`siI 11nu.1;�r1.11 u1n EMIT METHOD INFORMATION The name EMIT stands for Enzyme-Muitiplied Immunoassay Technique. This technique is used for the microanalysis of drugs in biological fluids. Urine is mixed with two reagents. Reagent #1 contains antibodies specific to the particular drug, the coenzyme NAD (nicotinamide adenine dinucleotide) and the substrate G6P (glucose 6 phosphate). Reagent #2 contains a drug derivative labeled with the enzyme G-6PHD (glucose 6 phosphate dehydrogenase). Reagent #1 is added to the sample and the antibody binds to any drug molecule in the donor sample it recognizes. Reagent #2 is added next and the enzyme labeled drug combines with any remaining antibody; the binding decreases the enzyme label activity. The enzyme that remains unbound (therefore still active) relates directly to the concentration of drug in the sample. The active enzyme converts NAD to NADH, resulting in an absorbency change that is measured spectrophotometrically. GAS CHROMATOGRAPHY -MASS SPECTROMETRY (GC/MS) GC/MS is an analytical technique which allows one to separate substances based on their differential migration rate through a gas chromatographic column and then, virtually unequivocally, identify them based on their mass spectrum and the migration time. The technique has been generally accepted as a reference method for legal applications. GC/MS does have limitations related to sensitivity, the range of masses measurable and the requirements for sample volatility and thermal stability. In general, however, for drug analysis, GC/MS is the most specific method available. The GC/MS in use in the Laboratory of Pathology is a Hewlett-Packard model, 5970 B, which uses electron bombardment to produce a "finger print" mass spectrum of each analyte as it elutes from the capillary column in the gas chromatography. An on -board computer correlated the mass spectrum with a stored library of compounds•and produces a report of the probable substances in the sample. GC/MS is used as a confirmation of positive EMIT screens in our laboratory. Ilrrt'-dY.nrl i- n-rr+in. e,1'..� I.u1 .n',urer� 4 I alhl wn VIRGINIA MASON OCCUPATIONAL MEDICINE MRO Review Process and Standard Procedures The Medical Review Officer's single most important function is the review of the laboratory positive test results and the determination of alternative medical explanations for the positive results. Your Virginia Mason MRO is a licensed physician who has knowledge of substance abuse disorders and has appropriate medical training to interpret and evaluate positive drug test results. t 1 . 11. f1 I 1r1 r The employer and employee depend on the MRO accomplishing his/her vital duties according to 49 CFR, Part 40 and the DOT agency rules. The list of primary responsibilities below is followed by Virginia Mason operating procedures necessary to carry out those responsibilities: ➢ Receive rest results from the laboratory. ➢ Notify the employee of a confirmed positive test result. ➢ Review and interpret each confirmed positive test result. ➢ Provide an opportunity for employee to discuss positive test result in person or by telephone. _ ➢ Review employee's appropriate medical history. ➢ Review appropriate medical records. ➢ Verify laboratory results. ➢ Notify employer of verified positive test. ➢ Make return -to -duty or decision to hire recommendation. ➢ Ensure return -to -duty or decision to hire requirements are accomplished. i 11 • A W. 9 11 A I , .1 ' Standard procedures for the MRO in carrying out the responsibilities listed in the previous section are described as follows. ' Step 9: Receipt of Laboratory Test Reports A strict chain of custody procedure, initiated at the time of specimen collection, is required for handling all specimens throughout the urine specimen collection, testing, reporting and review process. Employers and certified forensic drug testing laboratories utilize a standard urine custody and control form (carbonless manifold) that accompanies each specimen to the laboratory. The form becomes a permanent record of employee identification, urine specimen collection and laboratory testing data. Part 1 and 2 of the form accompany the specimen to the testing laboratory. After the specimen is tested at the laboratory, Part 1 is retained by the laboratory and Part 2 is sent to our MRO Department with the laboratory results recorded on it. Part 3 goes directly to our MRO Department from the collector. Part 4 is for the employee, Part 5 is retained by the collector, and Part 6 is forwarded to the employer anti -drug program manager. Part 7 accompanies the split specimen. (if one has been collected) to the laboratory or storage site. The order of custody and control form parts as described above may differ, depending on the supplier of the form (i.e. DrugProof, Regional Toxicology Services, Drug Scan, etc.). The MRO copy (Part 3) of the custody and control form, will contain information, including but not limited to: ➢ The type of test conducted (random, post -accident, etc.) ➢ Employee's printed name and signature, daytime telephone number, date of birth, Social Security or employee identification number, and a unique preprinted specimen identification number. ➢ Name of the collector, date of collection, collection site, and signed certification statement by the collector. The Virginia Mason MRO Department has two coordinators who receive all SAMHSA test results directly from the testing laboratory. Some laboratories will additionally transmit a separate report providing test results. The transmittal of results may be by secure electronic means or by mail. Results are never transmitted by telephone. The MRO is not required to substantively interpret negative test results. However, the MRO and the MRO Department shall administratively review the results, ensuring that: I. Employee identification information on the laboratory test report and the custody and control form match so that the individual is accurately identified as having a negative test report. 2 2. Negative test results are reported to the employer representative according to the employer's established reporting procedure. Copy 2 of the custody and control form shall not be provided to the employer. All negative results, whether laboratory negative or negative as a result of the MRO verification process will be reported in an identical manner to the employer representative. Step 2: Positive Test Report • Verification Process The MRO verification process of a positive laboratory report requires several specific actions. Upon receipt of a positive test result from the laboratory the MRO shall: 111• •, 91 - I1� 11'I ➢ Review the documents for completeness (e.g. Are the forms properly tilled out with all relevant information?) and ensure that information on Part 2 matches the already received MRO copy (Part 3). ➢ Review the document for content. If the MRO is not satisfied with the documentation or if information contained in the documents gives rise to doubts about the test analysis, the MRO has two options. These options are: ➢ Requesting the laboratory records regarding the specimen to determine if correct procedures were followed. ➢ Requiring the retest of a specimen should questions arise as to the accuracy or validity of a positive test result. (Only the MRO is authorized to order a reanalysis of the original sample.) The MRO review of a positive laboratory report requires several specific actions. The first responsibility of the MRO is to review the documentary record of the test for completeness and accuracy and to identify any special problems that may require resolution. This will involve review of any standard laboratory report (such as might be received at a remote printer) and Copies 2 and 3 of the custody and control form. The objectives of this review are to ensure: ➢ That the test results reported are those for the specimen collected from the employee identified on Copy 3 of the form; ➢ That the collector, employee and laboratory have completed the required certifications (or any failure has been properly documented); and ➢ That external chain of custody is intact. 3 In addition, careful review of the form may indicate information critical to interpretation of the test. For instance, where an initial sample falls outside the normal temperature range (and oral temperature does not explain the discrepancy), a second specimen should be collected under direct observation. In such a case the MRO would want to ensure that the two results are reviewed together and that, as appropriate, a full adulteration panel is nun on the initial specimen (specific gravity, creatinine concentration, pH). Specimen identification. The following steps will be followed in verifying specimen identity: 1. Compare the specimen identification number contained on Copies 2 and 3. They should be the same, and the same number should also be contained on any separate computer - generated laboratory report. 2. Note that the Social Security number is the same on both copies and on any separate laboratory report (if used). 3. If the specimen identification number or Social Security number is different on any of the three documents, the results will not be reported at this time. If the error appears to be at the laboratory, the MRO will request a full report with supporting documentation. The MRO will not verify the positive until they are fully satisfied that the results reported are those for the specimen identified to the subject employee. If there is any doubt concerning correction of a laboratory clerical error, the MRO will order a retest and have the certifying scientist personally inspect the original specimen container to ensure it was properly accessioned. 11 M: The laboratory will have verified that the numbers shown on the custody and control form are the same numbers on the specimen. The laboratory will leave identifying marks on the specimen bottle for later verification, should any question arise. Certifications. The MRO will inspect Copy 2 to verify that the required certifications were completed by the collector, employee and the laboratory certifying scientist. Signatures are required (stamps and initials are not sufficient). If the employee has not signed the certification on Copy 3, the test will be considered valid only if the collector has properly noted the declination and has recorded any explanation provided. Note that the laboratory will be unaware of any missing signature on Copy 3 or any explanations that may be placed there by the collector. Note further that refusal to sign may indicate a collection site problem that will be discussed with the employee at the time of the medical interview. Chain of custody. The chain of custody block will have been reviewed by the laboratory, and any break in external chain of custody will have resulted in canceling the test. However, the MRO will separately review the chain of custody block. The DONOR entry is preprinted, and the donor should initial or sign the chain of custody block. The most likely defect in the form will be a failure by the collector to show transfer for shipment. This is considered a break in the documented chain of custody since from the paperwork is appears that someone else may have handled the specimen in that interval. 4 Administrative items. The custody and control form contains additional information that is of an administrative nature or that documents the circumstances of the collection. Improper completion (or failure to complete) of these items may give rise to concern over the quality of the collection as whole, but they are not fatal to the integrity of the testing process and will not ordinarily provide the basis for treating the test as a negative. As noted, the laboratory will also follow standard procedures to verify the quality of the collection documentation that is receives, including markings on the specimen bottle. If the records from the collection sites or laboratories raise doubts about the handling of a sample, the MRO may deem the urinary evidence insufficient, the MRO will conclude that the test result is negative. Administrative errors in chain of custody documents can result in inappropriate attribution of a positive test result. It is imperative that no employee suffer unwarranted accusations because of a mislabeled specimen or because of errors in the chain of custody. Should any question arise as to the accuracy or validity of a positive test result, the MRO is authorized to order a reanalysis of the original sample. In reanalyzing a specimen to determine the accuracy of the reported test result, it must be noted that some analytes deteriorate or are lost during freezing and/or storage. Therefore, quantitation for a retest is not subject to a specific cutoff requirement, but must provide data sufficient to confirm the presence of drug or metabolite. �i Eli i •• '� i• The MRO's notification to an employee of a positive test results will occur promptly after the MRO has received the positive laboratory test report. The MRO may initiate contact with the employee immediately after test results are transmitted electronically from the laboratory. However, the MRO will not complete the verification process until both Copy 2 and 3 of the chain of custody form have been received. MRO contact with a positive test employee will be made directly between the MRO and the employee only. Interview. Regulations Require that the MRO must provide an opportunity for an interview of an employee testing positive as part of the verification process. This can be in person or via telephone. If the employee declines the opportunity for an interview, the MRO will proceed with the verification. If the MRO is unable to locate the employee or the employee does not return the telephone calls after a reasonable attempt from the MRO; the MRO may contact the employer representative. Reasonable attempt The employer representative must contact the employee and inform him/her to contact the MRO ASAP, prior to the employee performing his/her next safety - sensitive function. If the employer representative is unable to contact the employee, the employer representative may place him/her on medical leave or temporary medically unqualified status. Please note that the test is still not a verified positive. In order to prevent undue delays by a n employee's refusal to contact the MRO, the MRO could verify a confirmed positive result, only if five days after documented contact of the employer representative has passed. E By declining to contact the MRO after being informed to do so, the employee has waived the opportunity to present information concerning possible explanations of the test results. This action will also result in a verified positive. The MRO, however, could reopen the verification process if the employee could demonstrate circumstances (i.e. the employee produced medical reports indicating an injury that prevented a response to the MRO/employer attempted contacts.). The DOT agency rules provided an employee who tests positive the right to retest hi/her original specimen. The employee may be required to pay the cost of the retest, including handling and shipping costs. The MRO will be careful to note for the employee that the retest will be conducted using GC/MS confirmation and ONLY a SAMHSA certified laboratory. The result will be reported positive if any detectable drug metabolite is found. Retest/reanalysis is not subject to cut-off levels. Furthermore, the MRO is not required to withhold notification of the positive result to the employer, pending the outcome of the retest. d. Split Samples Testina: A split specimen procedure is one in which the employee provides a minimum of 45 mL of urine, with 35 mL as the primary specimen and 15 mL as the secondary specimen, at the time of the collection. The first specimen is tested at the laboratory, the second specimen bottle is stored for testing at a later time should the first specimen the test positive. Upon notice of a positive test on the first specimen bottle, the employee may requested within 72 hours (or longer if specified in DOT agency rules) that the second specimen bottle be tested, in accordance with the employer's policy. The MRO will authorize the testing of the split specimen. Testing of the split specimen is performed ONLY at a SAMHSA certified laboratory by GC/MS for the presence of drug metabolite only, and is not subject to specific cut off levels. In the event the split sample is found to contain no drug metabolites, the MRO will declare the test results negative. Actions required by the DOT regulations as a result of a positive test are not stayed pending the result of the test on the second specimen. Step 3: Reporting of a Verified Positive Test Result If after appropriate review, the MRO concludes that no legitimate medical reason exists for a positive test, and that the chain of custody and laboratory procedures were correct, the MRO must report a verified positive test according to the established company procedure. In addition to reporting a verified positive test result to the employer representative, the MRO will refer to the employee to the employer's employee assistance or rehabilitation program if applicable. ;•�� �� a 11�1•�'i�•1 After the MRO reviews the laboratory positive test results and related matters and verifies that the positive report is evidence of unauthorized drug use, the MRO will sign the verification statement on Part 2 of the custody and control form. The MRO may notify the Q employer representative of a verified positive by telephone, electronically, or in writing. The Copy 2 of the custody and control form may be sent to the employer, or another form providing the employee's name, identification number, specimen ID number, date of test, result and substance found in the urine, may be used. In making a determination of either verified positive or negative, the MRO will document, for his or her own files, a summary statement of the basis for determination. 1 , -me Except as provided in this paragraph, the MRO will not disclose to any third parry medical information provided by the individual to the MRO as part of the verification process. 1. The MRO may disclose such information to the employer, a DOT agency or other Federal safety agency, or a physician responsible for determining the medical qualification of the employee under an applicable DOT agency regulation, as applicable, only if: ➢ An applicable DOT regulation permits or requires such disclosure; ➢ In the MRO's reasonable medical judgment, the information could result in the employee being determined to be medically unqualified under an applicable DOT agency rule; or ➢ In the MRO's reasonable medical judgment, in a situation in which there is no DOT agency rule establishing physical qualification standards applicable to the employee, the information indicates that continued performance by the employee of his/her sensitive -safety function could pose a significant safety risk. 2. Before obtaining medical information from the employee as part of the verification process, the MRO shall inform the employee that information may be disclosed to third parties as provided in this paragraph and the identity of any parties to whom information may be disclosed. Any employee who is subject to a drug test conducted under the DOT rules shall, upon written request, have access to any records to his/her drug test and any records relating to the results or any relevant certification, review, or revocation -of -certification proceedings. /mroproc 7 VIRGIIVIA MASON OCCUPATIONAL MEDICINE MRO/EMPLOYEE INTERVIEW CHECKLIST 1. Identify yourself as a Medical Review Officer (MRO) for (Employer) _, with the duty of receiving and reviewing drug test results. Clearly state that you are acting as an agent for (Employer. 2. Establish identity of the employee i.e., full name, social security number, employee I.D. number, address/station. 3. If the employee holds a certificate under Part 67 FAR, advise the employee that the information regarding the drug test results and information supplied by the employee will be given to the FAA as required by the regulations. 4. Tell the employee you are calling about the specific drug test he/she underwent on the specific date and at the specific location. 5. Briefly explain the testing process, discussing screening and confirmation testing, and laboratory reporting. 6. When appropriate in the interview process, give the employee the specific result. 7. Asir for the recent medical histopy: Inform him/her that medical information may be disclosed to third parties and identify all third parties involved. Prescription drugs OTC drugs Dental, ENT, ophthalmologic, or other medical procedures ., Food ingestion 8. Request medical records for review if applicable. 9. Give the employee an opportunity to discuss the results by phone or in person. Set a specific date and time for an interview. 10. When appropriate, request an exam or interview. 11. Notify the employee that he/she - may request a retest, and explain this process to him/her. Explain that the cost will be the responsibility of the employee. Tell the employee that a retest will not delay verification of the initial result. 12. If the verification process is complete, notify the employee that the appropriate management will be notified. ____ 13. Offer to answer any questions. Give employee your name and phone number.