Transcript Slide 1

Omnibus Transportation
Employee Testing Act
(OTETA)
A Basic Course in DOT Drug & Alcohol Testing Programs
Dr. Donna Smith
FirstLab, Inc.
www.firstlab.com
History & Rationale
• 1991 Omnibus Transportation Employee Testing Act
mandated drug and alcohol testing for all Commercial
Driver’s Licensed (CDL) employees
• Requirements for testing are detailed in FMCSA regulation
49 CFR Part 382 and the procedures for conducting the
testing are found in 49 CFR Part 40
• OTETA was aimed at preventing illicit drug use and alcohol
misuse by employees in public transportation occupations
to promote and protect public safety
Program Basics
• Each employer must:
− Have a written substance abuse policy
− Appoint a Designated Employer Representative (DER)
− Conduct required drug and alcohol testing in accordance with Part 40
procedures
− Conduct Reasonable Suspicion Training for supervisors
− Provide drug and alcohol education materials or training for all CDL
employees
− Maintain records and documents as required by DOT regulations
− Conduct a check for previous drug and alcohol violations with prior
employers for all CDL applicants
Substance Abuse Policy
- Identify prohibited drug and alcohol-related
conduct
- Explain drug and alcohol testing requirements
and testing procedures
- Define safety-sensitive duty and positions
- State consequences and disciplinary actions for
violation of policy
- Provide a copy of the policy to each employee
and maintain documentation that employee has
received and understands the policy
Designated Employer
Representative (DER)
- Serves as point of contact for the testing
program
- Receives test results from the Medical Review
Officer and Breath Alcohol Technician (BAT)
- Ensures that drivers who violate the policy are
removed from driving duties and meet return to
duty requirements, if they return to work
- Ensures that drivers are in a random testing
pool
DOT Testing Procedures
• 49 CFR Part 40
• Applies to Employers. Employees, Service Agents
• Specimen Collection, Laboratory analysis, MRO,
Alcohol Testing
• SAP and Return to Duty Process
• TPA functions
• Confidentiality and Release of Information
Reasonable Suspicion Training
• Required for all supervisors of CDL
employees
• Minimum of 2 hours
− Signs and symptoms of drug/alcohol misuse
− Criteria for reasonable suspicion testing
− Procedures for documenting R/S testing and
getting employee tested
• Training can be classroom, video,
computer-based
Employee Drug and Alcohol
Awareness Information
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Educational materials or training classes must be provided to all CDL
employees
Information must include:
− Prohibited conduct
− Testing requirements and procedures
− Consequences and disciplinary actions
− Employee rights and responsibilities in testing program
− Alcohol and drug abuse awareness information
− Information on getting help with a substance abuse problem
Employee must sign acknowledgment of receipt of information/materials
DOT Employee Booklet
Available at www.dot.gov/ost/dapc
Record Keeping
• Employers or their TPA must keep extensive
records
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Test results, including CCFs
Random testing documents
P/A and R/S testing documentation
Prior Employer checks
Supervisor and employee training records
SAP & RTD documents
Check for Previous Drug & Alcohol Violations
• Required at time of application or transfer to a CDL position
• Applicant must sign release, identifying employers in past
2 years
• Prospective employers must contact prior employers,
provide signed release and request info on D & A violations
• If previous employers report a DOT violation and applicant
is hired, new employer must ensure SAP process is
complete and FU testing is conducted
FMCSA 49 CFR Part 382
• Safety-sensitive positions: CDL drivers
• Pre-employment, reasonable suspicion, postaccident, random, return to duty and Follow-up
testing
− For pre-employment only a drug test is required
• 24 out-of-service for 0.02—0.039 BrAC
Pre-employment Test
• Negative result on a PE drug test required
− Applies to employees transferring into a CDL position, as well as
new-hires
− PE test exception allowed if applicant has been in a DOT testing
program with a prior employer for past 12 mos.
• Applicants who are positive or refuse to test cannot be
hired and must be provided SAP referral information
− If reapplication is allowed, completion of SAP process must be
documented
Reasonable Suspicion Testing
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Based on the observations of a supervisor who has completed R/S
training
Supervisor’s observations must be documented on a form or written
report
R/S tests must be completed ASAP after decision to test is made
− If both alcohol and drug tests are indicated, the alcohol test should be
conducted first
Employee should be escorted to testing site
Employee should not be permitted to return to work after testing;
transportation home should be offered
− RTW only after test results are received
Post-Accident Testing
• Post-Accident testing required if:
− Fatality
− Driver citied for violation and
- Injuries requiring medical treatment away from scene, or
- Disabling damage to vehicle requiring towing
• Law enforcement P/A tests can be used in lieu of
employer’s test
• Post-accident tests must be conducted ASAP
− Alcohol—within 2 hrs, if longer must document and complete
by 8 hrs
− Drug—ASAP—but within 32 hrs.
Random Testing
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Selection for random testing must use a scientifically valid random number
selection process
Selections must be made at least 4 times per year and spread reasonable
throughout the year
All CDL drivers must be in the random pool from which selections are made
Once notified of selection for random test, the driver must proceed
immediately to complete the test
Number of random drug tests conducted must be at least 50% of CDL
population; random alcohol tests must be at least 10%
If a selected driver is not available for testing during the selection period
(month, quarter, etc.), the reason for not testing must be documented
− If alternates were selected, they may be tested instead of unavailable drivers
If drivers are removed from the random pool for more than 30 days, they must
have a pre-employment drug test when they return to driving duties
If a test result is cancelled, the test does not count toward the annual
percentage.
Best Practices for DOT Random Drug &
Alcohol Testing
Return to Duty and Follow-up Testing
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Occur only when there has been a DOT violation (positive, refusal to
test, etc.)
RTD test conducted after SAP has provided follow-up evaluation report
stating that employee has complied with treatment requirements
Follow-up testing determined by SAP
− Begins when employee returns to safety-sensitive duties
− Minimum of 6 FU tests in first 12 months after return to duty
− FU testing may extend for up to 60 months as ordered by SAP
− Number of tests and duration of testing determined by SAP
− Employer sets schedule for “no notice” FU tests
− Employee is also in CDL random pool
Urine Specimen Collection
• All DOT tests require:
− Use of Federal custody and control form (CCF)
− Split specimen collection
− Shy bladder procedure for inability to provide specimen
• Direct observation collections required in specific
circumstances
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Specimen temperature out-of range
Specimen suspected of adulteration
Previous test canceled because specimen invalid
Previous test canceled because split not available
Previous test “very” dilute—creatinine 2-5
Urine Specimen Collection II
• Collectors must complete training and proficiency
demonstration
• Supervisors of employees should not act as collectors
• Most collections conducted at laboratory patient service
centers (PSC) or medical clinics (3rd Party sites)
• Specimens packaged in specimen bottles, sealed, and
placed in plastic bag with CCF
• Collector must distribute CCF copies to MRO, employer,
and donor
Laboratory Analysis
• DOT testing must be conducted at a DHHS/SAMHSA
certified laboratory
• Screening test conducted using immunoassay
• Confirmation required for all positive screens using GC/MS
• Cut-off levels establish positive result (ng/mL)
• Laboratories authorized to conduct specimen validity
testing
• Laboratories must review CCF for flaws prior to testing
specimen
Specimen Validity Testing
• Creatinine & Specific Gravity
− Dilute--creatinine <20; SG <1.0030
- “Ultra-dilute”—2-5 creatinine
− Substituted—creatinine <2; SG <1.0010 or >1.0200
• Adulterated
− Ph: Acid or base added (<3 or >11)
− Nitrites >500 mcg
− Specific substance added (soap. bleach, etc)
• Invalid
− Interfering substance but cannot identify it
− Medication interference
Drugs Detected
• THC
− Metabolite of marijuana and cannabis products
• Cocaine
− Benzaegoline is metabolite of cocaine, including crack
• Amphetamines
− Amphetamine and methamphetamine (MDMA—Ecstasy)
• Opiates
− Morphine, codeine, and heroin (6AM)
• PCP
− Phencyclidine (Angel Dust)
Urine Testing Facts
• Positive does not establish impairment or intoxication
• All drugs except THC are only detected in urine 2-3 days
after use
• THC can be detected in urine up to 20 days after use for
chronic, regular user
• Over half of all positives are for THC
• Cut-off levels rule out passive inhalation or “incidental
exposure” causes
• Laboratories must report results to MRO, not employer or
TPA
Medical Review Officer
• MROs must be physicians who have special MRO
certification
• All results must be verified by MRO prior to release to
employer or TPA
• Must have CCF copy from collection site prior to reporting
results
• Non-negative results must have donor interview with MRO
prior to verification
• MRO cannot give employer (or TPA) any information prior
to final verification of result
MRO Results
• Negative—No drugs present above cut-off level
• Negative Dilute—No drugs present above cut-off level and
low specific gravity & creatinine
• Positive—Drugs present and no medical explanation
• Refusal to Test—Adulterated (contains exogenous
substance or excessive level of endogenous substances)
or Substituted (SG & creatinine not consistent with human
urine)
• Canceled Test—Invalid specimen, flawed
collection/specimen, Shy bladder with medical explanation
MRO Safety Concern
• Issued by MRO when laboratory positive drug test is
due to use of a prescribed or medically administered
drug and MRO believes:
− Use of prescribed medication poses a significant
safety risk, or
− Medical condition for which medication is
prescribed may pose a significant safety risk
• Test result will be reported as “Negative” with MRO
comment of a safety concern
• Employee is informed by MRO that safety concern is
being reported to employer
MRO Notice to Donor
• MRO notifies donor that he/she can submit (within
5 days) documentation from prescribing physician
that demonstrates:
− Medication has been discontinued, or
− changed to one that does not cause concern
• If MRO receives such documentation, employer
will be notified that safety concern is removed
Employer Actions on MRO Safety Concern
• Options for resolving safety-concerns
− Have prescribing physician provide statement that
employee is able to perform safety-sensitive duties
while taking medications
− Have employee undergo “fitness for duty” evaluation
by employer designated physician
• Important for employer to have medication policy and
procedures in place
• MRO cannot make “fitness for duty” recommendation
based on donor interview and urine drug test result
Split Specimens
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MRO must offer split specimen analysis to any donor with a positive,
adulterated or substituted result
Employee cannot be required to pre-pay for split analysis
Employee has 72 hrs to decide if he/she wants split analyzed
MRO processes split request in writing to laboratory
Split musty be tested at a different SAMHSA certified laboratory
Split results reported to MRO
Employee must be removed from duty based on primary specimen
result; cannot delay removal pending split outcome
Split Specimen Outcomes
• Result reconfirmed
− Drugs present at limit of detection
− Adulteration & substitution criteria met
• Failed to Reconfirm
− Drugs not detected
− Adulteration or substitution criteria not met
− Split specimen not available or not suitable for testing
Alcohol Testing
• Pre-employment alcohol testing not required
• 0.04 or greater BrAC is a rule violation (positive test)
• 0.02—0.039 BrAC requires temporary removal from safetysensitive duty
• Screening test uses breath or saliva specimen
• Confirmation test required within 30 minutes of >0.02
screening result
− Confirmation must be an evidential breath test (EBT)
Alcohol Testing II
• Tests must be conducted by trained technicians (STTs or
BATs)
• DOT Alcohol Test Form (ATF) must be used for all DOT
tests
• BAT notifies employer or TPA of result (no MRO review of
alcohol test results)
• EBT detects only ethanol
• Waiting period (15—30 min) between screen and
confirmation test eliminates “mouth alcohol”
• Procedures for “shy lung” or inability to complete test
Third Party Administrator (TPA)
• Service agent for employers in implementing
testing programs
• Can maintain all records for employer
• Can perform all tasks except DER, medical
review and laboratory functions
• TPA must conform to Part 40 and DOT agency
rules
SAP & Return To Duty
• Employers must provide SAP information to all individuals
who violate DOT rules, even if they terminate employment
• Employees cannot return to duty unless they have:
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Been evaluated by a SAP
Complied with recommended treatment/rehab
Undergone a follow-up evaluation by the SAP
Passed a return to duty test
Been prescribed a follow-up testing program (at least 6 tests in
first 12 months)
Significant Compliance Issues
• Random testing
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Must do random selections at least quarterly
Must document reasons for not testing selected employees
Must complete tests within testing period
Cancelled and “late” tests do not count toward percentage
Cannot “discontinue” random testing once the required
percentage is achieved
− Must update random pool to include all safety-sensitive
employees
Significant Compliance Issues
• MIS reports
− Must provide annual statistical data as required by DOT rule
− Jan-Dec calendar year
• Pre-employment tests on all s-s employees before they are
hired or perform s-s duties
• Prior Violations check ( 2yrs) on all new hires
• Post-accident testing documentation on all qualifying
accidents
− Including missed and delayed alcohol and drug tests
Commonly Asked Questions
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What does a “pending” test result mean?
What do I do about a negative-dilute?
Can I change a non-DOT test to a DOT test?
I need a DOT MIS report?
What do I do about employees who are laid off or are on
WC leave and are on my random list?
• One of my employees got a DUI. Do I have to remove him
from duty?
• Do I need to do a drug test with my driver’s physical
exam?
Commonly Asked Questions
• My random list is wrong. How do I get a new one?
• What do I do about an employee who couldn’t provide a
urine specimen at the collection site?
• How do I get a laboratory statistical report?
• My driver’s random test was reported as canceled. Do I
send him in for another test?
• It’s been five days and I don’t have a test result. Is it
pending for the MRO review?
Employer
Guide to DOT
Testing
Available at www.dot.gov/ost/dapc
Stop By FirstLab’s Table
and Meet FirstLab’s Florida
Account Manager
Lisa Busse
1364 Welsh Road
North Wales, PA 19454
800-732-3784 Ext. 297
706-835-1835
www.FirstLab.com
[email protected]