Transcript Drug and Alcohol Program Management

Good Morning~ Welcome!
Today’s presentation is sponsored by the Florida
Department of Transportation
 Our host agency is the Central Florida Regional
Planning Council
 Presenter is:
Diana Byrnes
Substance Abuse Management Specialist; C-SAPA

Center for Urban Transportation Research
University of South Florida, Tampa Campus
Video

Clean Sober and Safe,
Produced by the Center for Urban
Transportation Research
 This portion of the video explains the
background of DOT required drug testing
 Available for download from
http://www.cutr.usf.edu/byrnessamsite

DOT Required
Drug and Alcohol Testing
Program Management
Regulations
 US
DOT Regulations: 49 CFR
Part 40
 FTA: 49 CFR Part 655 (OR)
 FMCSA: 49 CFR Part 382
 Employer Policy
DOT Modes
Department of Transportation
FTA
PHMSA
FMCSA
FRA
FAA
All DOT Modes are subject to 49 CFR Part 40
49 CFR Part 40

US DOT Regulations
All DOT modes must comply with Part 40
 This regulation tells us how to conduct drug
and alcohol testing

 Explains
procedures for collection of specimens;
testing for alcohol; analysis of specimen; MRO
verification process; reporting of results; and the
return to duty (SAP) process
 Part 40 also includes provision for drug and alcohol
background checks (40.25)
Parties Subject to Part 40
DOT Employer
SAP
Collector
MRO
Laboratory
Employer Responsibilities
Substance Abuse Policy
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Each mode has specific policy provisions, but in all cases
your policy must identify which components are conducted
under agency authority and which are conducted under
DOT authority
Okay to reference the regulations, as long as employees
are provided access to the regulations referenced
Policy must be adopted by a governing board or agency
official (in order for it to be legally defensible)
Policy must be disseminated to all covered employees prior
to the performance of safety sensitive duties and each time
there are major revisions made to the policy
Enforcement of policy must be consistent
Employee and Supervisor
Training
FTA requires that all covered employees
receive a min. of 60 minutes of drug
awareness training (Clean, Sober and Safe
will satisfy only 23 minutes)
 If alcohol awareness training is provided,
must be in addition to the 60 min. minimum
 FMCSA requires that employers distribute
information material to all covered drivers
 Policy should be reviewed as one of the
pieces of informational material

Testing Program
Test Types
Pre-employment
 Random
 Post Accident
 Reasonable Suspicion
 Return to Duty
 Follow Up

Pre-employment Testing
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Negative result required before performance of
safety sensitive functions (FMCSA allows for transfer
from one employer to another without pre-employment test,
as long as employee has been in testing program for one
year without violation)
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Urine drug test is required; alcohol test is permitted
for this test type
Extended absence and removal from the random
testing pool requires a pre-employment test upon
return to work (30 days for FMCSA and 90 for FTA)
Pre-employment D& A
Background Checks
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40.25
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FTA requirement is DOT employers two years back
FMCSA extends to DOT employers three years back
Must get employee consent; if employee fails to give
consent– they may not perform safety sensitive duties
If you do not receive reply, employee can remain
working– but you must be able to show that you have
made attempts to obtain the information
If you receive notice that employee has violated the
program; you need to ensure that SAP and RTD
process has been successfully completed. You are
also responsible for continuing any follow up testing
requirements.
Random Testing
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Each DOT mode sets the testing rates for this test
type (FTA: 25/10; FMCSA: 50/10)
Random testing must be spread reasonably
throughout all days of the week and all hours that
safety sensitive functions are performed* FTA
requirement
Random testing schedules should never reveal a
predictable pattern of testing i.e.: NO group
testing
Employee must report immediately to collection
facility– no advance notice should be given
Post Accident
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Each DOT mode defines the criteria for an
accident or incident to be subject to post accident
testing
When criteria is met; both drug and alcohol testing
must be conducted- use of decision and
documentation form is highly recommended
Testing windows are the same for both FMCSA
and FTA: alcohol up to 8 hours, drug up to 32
hours begin documenting delays after first two
hours
Reasonable Suspicion
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Most underutilized test type despite training
requirements
Supervisors must be trained in signs and
symptoms of probable drug use and probable
alcohol misuse
FMCSA: Documentation is required within 24
hours of observed behavior or before drug test
results report
FTA: No documentation is required; but it is highly
suggested. If audited, it will be expected
Best Practice: Keep supervisor training
documentation on file indefinitely
Return to Duty and Follow Up
Test Types

Only applicable when an employee has violated the
DOT rule
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Violation means: Employee tested positive or refused to
test when required
A negative RTD is required before returning to safety
sensitive functions after a rule violation (After extended
absences use pre-employment test type not return to duty!)
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Follow up testing plan is determined by SAP with a min. of
6 tests in 12 months
Employees are still subject to all other test types during
follow up testing plan
Employer option to conduct these tests under direct
observation (highly recommended)
Urine Collections
Urine Specimen
Collections
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Collector must meet Part 40 qualifications
Collection site must meet Part 40 qualifications
A Federal custody and control form must be used
for all DOT required tests
A split specimen method must be used for all DOT
required tests
Collector must send specimen to a DHHS certified
lab for analysis (cannot use instant test method or
any other method of analysis)
Basic Collection
Procedures
Collector checks identification and explains
process to donor. Collector begins filling in
the CCF
 Collector instructs donor to empty pockets,
remove outer garments, etc.
 Collector instructs donor to wash hands
 Collector secures stall (checking for any possible
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contaminates or water sources)
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Collector instructs donor to fill collection cup
to at least 45 mL
Basic Collection Procedures
Cont.
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Collector checks specimen for temperature and looks for
signs of adulteration or substitution (odor, color, odd
appearance)
Collector splits sample into A and B bottle
Collector asks donor to sign Step 5 and initial seals after
seals are affixed to bottles.***
Collector completes paperwork and packages the lab copy
of CCF with the specimen bottles in bag (in the donor’s
view)
Donor is given the employee copy of CCF and is then
permitted to leave testing site
Collector then disseminates the MRO and Employer copies
of the CCF
Collection Irregularities
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Shy bladder
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If donor is unable to supply a 45 ml of urine on the first
attempt:
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The void is discarded (unless out of temp. range or otherwise
appears to have been tampered with)
Donor is urged to consume up to 40 ounces of fluid and is given
up to 3 hours to provide 45 ml of urine in one single void.
Attempts and fluid consumed are recorded on CCF by collector
After 3 hours; donor is released to employer but must be
examined by a physician within 5 days to determine if legitimate
medical excuse
No medical explanation; deemed as refusal. Failure to comply
with requirement; deemed as refusal
Collection Irregularities
Cont.
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Specimen Temperature out of range
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Specimen falls outside of the 90-100 degree range
Not humanly possible, donor is attempting to substitute
or adulterate the specimen
Collector must initiate an immediate recollection under
direct observation
First specimen is NOT discarded, it is sent to the lab,
with comments in remarks section indicating that it is 1
of 2 specimens for the same donor (specimen ID
numbers should be referenced)

Common error: Collector fails to initiate the DO collection and
follows shy bladder instructions instead
Collection Irregularities
Cont.
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Donor fails to cooperate with any part of the
testing process, for example:
Does not report immediately to testing site in
time allotted by employer
 Refuses to empty pockets
 Refuses to wash hands
 Leaves the site before process is complete
 Is caught with items intended to tamper with or
substitute their specimen
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How are Directly Observed
Collections Conducted?
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Recently enhanced; effective August 25, 2008.
ALL Directly Observed Collections must occur in
this manner:
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Collector/Observer must be same gender as donor
If collector is not same gender, DER or other company
official may be asked to serve as “observer”
Donor must raise clothing above the waist and lower
clothing (including under garments) to mid thigh
Donor must turn completely around to reveal to the
observer that no prosthetic device is being used
Observer must watch the donor’s urine leave the body
and enter the collection cup (this part has not changed)
Directly Observed Collection
Enhancements- Why?
Directly observed collections are only
conducted when there is reason to believe
that an employee or applicant is attempting
to thwart the drug testing process
 The enhancements to the directly observed
collection procedures are intended to deter
employees from attempting to use prosthetic
devices
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Who can order a Directly
Observed Collection?
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As an employer, you can order a directly observed
collection when your policy specifies that return to duty and
follow up testing will be conducted in this manner and when
a test was cancelled due to a fatal flaw and a negative
result is required
A collector can initiate direct observation collection
procedures when a donor exhibits behavior that could be
considered an attempt to conceal an adulterant, a
substituted sample or a prosthetic device
An MRO can initiate recollection under direct observation
when there are irregularities with the specimen- MRO will
instruct employer when this is required
Employer Best Practices For
Collection Procedures
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Use a “Testing Notification Form”
Determine a reasonable time for employees to
report to site– then let collectors know that delays
must be reported to you
Ensure that all collectors are aware of how to
reach you (the DAPM/DER) in the event of an
irregularity in the collection process
Ensure that collection sites are willing and able to
conduct directly observed collections in
accordance with Part 40 (same gender available?)
Alcohol Testing
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Alcohol use is prohibited within 4 hours of
performing safety sensitive duties (both FTA and
FMCSA)
Saliva screening may be used
Confirmation test must always be made with EBT
Alcohol testing must take place following any
accident that meets the criteria to test
An employee with an alcohol level of 0.02-0.039 is
not considered positive– but does require removal
from duty for a period of at least 8 hours for FTA
and 24 hours for FMCSA
Positive result is 0.04 and above
Alcohol Testing Continued
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Following an accident that meets the criteria to
conduct testing; all employees subject to testing
are prohibited from consuming alcohol for a period
of eight hours following the accident or until post
accident tests are completed
Failure to locate a breath alcohol technician or
saliva test technician are not legitimate excuses for
failure to conduct testing following an accident that
meets the criteria to test
Laboratory Process
Prohibited Drugs
Marijuana
 Cocaine
 Amphetamines
 Opiates
 PCP
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These are the only drugs permitted to be
tested for under DOT authority
Lab Analysis

All labs used for the purpose of DOT urine
drug analysis must be certified by the Dept.
of Health and Human Services
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A list of currently certified labs is published the
first week of each month in the federal register
Labs are heavily monitored by DOT and
DHHS
 Effective August 25, 2008; labs are required
to conduct specimen validity testing
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Specimen Validity Testing
SVT is in addition to immunoassay and
GC/MS
 Purpose: to screen for adulterants and
substitutions used to interfere with specimen
analysis
 Huge market for products that are designed
to “beat drug tests”
 Even prosthetic devices are being sold!

Video
News story explores the use of products
designed to “beat” a drug test
 WZZM ABC local affiliate in Grand Rapids
Michigan
 3:38 in length
 This and other videos on this topic can be
viewed on You-Tube

Thwarting the System
Results 1 - 10 of about 1,130,000 for beat a drug test. (0.16 seconds)
Let’s take a short break
Medical Review Officer
MRO
MRO Process
Medical Review Officer is the gatekeeper of
the DOT drug testing program
 MRO is the only individual that can produce
a drug test result for the employer
 MRO protects employee’s rights by offering
an opportunity for employee to present
legitimate explanations for lab results that
are non-negative
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MRO Safety Concerns
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Medical Miranda
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Interview process is confidential except when employee
reveals information to MRO that could jeopardize public
safety
MRO has a responsibility to report to employer
Employer receives a Negative result, with an attached
medication safety concern
Employee is told that within five days, prescribing
physician must contact MRO to determine alternate
medication- employer must have policy in place in order
to “stand down” an employee in this circumstance
8 MRO Results Employers
Can Receive
1.
2.
3.
4.
5.
6.
7.
8.
Negative
Negative- Dilute
Negative- Dilute with creatinine in the 2-5
range
Invalid
Cancelled
Positive
Positive- Dilute
Refusal to Test- Adulterated or Substituted
Employer Actions following
Each Result
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Negative- applicant/employee may begin, resume
or continue safety sensitive functions
Negative Dilute- employer policy must indicate if
negative dilute results will require retesting. (Note:
employer must be consistent in enforcement and not use direct
observation procedures) § 40.197 Second result is final result

Negative Dilute with creatinine in 2-5 rangeemployee or applicant must undergo a second
collection under direct observation** MRO will report
quantitative data in this instance and instructions to
recollect under direct observation § 40.197

Cancelled or Invalid- actions will differ depending
on circumstances; follow MRO instructions
Employer Actions Cont.
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Positive- applicant/employee must be prohibited
from performing safety sensitive duties upon
receipt of positive result, referral to SAP required
Positive-Dilute- same as above
Refusal to Test (either adulterated or substituted)- same
as above
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Applicants and current employees who test positive
or refuse a DOT required test MUST receive a
referral to a qualified Substance Abuse Professional
(SAP) regardless of second chance or zero tolerance
policy.
Substance Abuse Professional
SAP
Substance Abuse
Professional (SAP)
Regardless of whether employer policy is
Zero Tolerance or Second Chance– all
violating applicants and employees must be
referred to a SAP that meets the
qualifications per Part 40
 Return to duty process includes two face-toface evaluations with SAP and employee
 SAP must provide initial evaluation letter to
employer
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SAP continued
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SAP determines form of treatment needed
SAP provides return to duty release letter upon
employee’s completion of program
SAP prescribes the number and frequency of
follow up testing. Minimum is 6 tests within 12
months.
Employer determines testing dates in accordance
with SAP (employer must never decrease or increase the
follow up testing schedule per SAP)
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Employee is subject to all other DOT testing during
follow up program
Rx and OTC Medications
Prescription and OTC Meds
Some commonly prescribed (and often
abused) medications such as Vicodin, Xanax
Valium and sleep aids are not detected as
part of the DOT urine drug test
 Employers are strongly encouraged to
develop policies and procedures that will
obligate employees to report the use of
prescribed medication and OTC medication
that carries a warning label
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Rx and OTC Awareness
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Employers should develop training materials and
training sessions on the topic of Rx and OTC
Safety Concerns
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Effects of medication on motor functions
Possible adverse interaction of medicines
Importance of communicating job functions to doctors
and pharmacists
Importance of reporting to supervisor when illness or
medication causes impairment
Employers must develop protocol for employees who
report impairment
Resources for Training
Materials
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Substance Abuse and Mental Health
Services Administration
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FTA Rx and OTC Medications Toolkit
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http://www.samhsa.gov/
http://transit-safety.volpe.dot.gov/publications
National Institute on Drug Abuse
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http://www.nida.nih.gov/
Administrative Duties
Records Management
All records pertaining to drug and alcohol
testing program management must be kept
confidential
 Locked file cabinet in locked office with
access granted only to those involved in the
administration of the program
 HR/Personnel records must be kept in a
separate location
 Best Practice is to keep all records for a
period of no less than 5 years

Records Management Cont.
No news is NOT good news. You must have
a verified MRO result on file to consider a
negative result
 Best Practice is to file by year; separate by
test type
 Best Practice Method of filing results
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Testing Notification Form
 Employer copy of CCF
 Test Result (on top)
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Collection Site Monitoring
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Not a regulatory requirement, however collection
site compliance = your compliance
Inspect site for security risks (ex: water sources not
secured, contaminants available in stall, collector not requiring pockets
be emptied, bluing agent not present in toilet bowl and tank)
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Ask collector to conduct a mock collection
Ask collector how they would handle “problem
collections” such as cold specimens or shy bladder
scenarios
Develop a good rapport with collection sites- keep
lines of communication open
Resources for Program
Management

ODAPC: Office of Drug and Alcohol and
Policy Compliance
http://www.dot.gov/ost/dapc/index.html
 Employer handbook
 Employee handbook
 Links to all DOT modes, regulations
 Link to Part 40
 List of certified labs
 Sign up for auto e-mails
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Let’s take a break!
Supervisor Refresher Training
Reasonable Suspicion Determinations
Training Requirements for
both FMCSA and FTA
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Each employer shall ensure that all persons
designated to supervise drivers receive at least 60
minutes of training on alcohol misuse and receive
at least an additional 60 minutes of training on
controlled substances use. The training will be
used by the supervisors to determine whether
reasonable suspicion exists to require a driver to
undergo testing under
The training shall include the physical, behavioral,
speech, and performance indicators of probable
alcohol misuse and use of controlled substances.
Recurrent training for supervisory personnel is not
required.
Video
Clean Sober and Safe
 This portion of the video covers the five DOT
prohibited substances and alcohol

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Discusses the effects of drugs and alcohol on
the mind and body
Determination and
Documentation Process
Determinations must not be based on
hearsay, gossip or rumor
 Determinations must be based on specific,
contemporaneous, articulable observations
made by at least one trained supervisor
 Documentation of observations is critical(and required for FMCSA)
 See example of Documentation Form

Interview Process
Ensure that all measures are taken to
respect employee’s privacy and dignity
 Conduct interview behind closed doors
 If feasible, ask another trained supervisor to
assist with the determination process
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HOWEVER, if second supervisor does not make
same determination– continue to process under
your own authority
Interview Process Cont.
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Explain to employee the behaviors, speech or
performance indicators that you have observed
Allow employee time to respond
Do not let employee’s “excuses” cloud your
judgment
Explain to employee that the reasonable suspicion
testing is designed to “rule out” possible prohibited
drug use or alcohol misuse as an explanation for the
observations made
Explain that as a supervisor, you have an obligation
to act when you have observed behavior, speech or
performance indicators that could jeopardize the
safety of employees as well as the public
Interview Process Cont.
Do not try to counsel or advise employee.
 Do not try to analyze the drug or drugs that
the employee may be taking
 At all times behave in a professional and
calm manner
 Do not hesitate to contact law enforcement
should an employee’s behavior turn
combative or violent
 Transport or arrange for transport of
employee to testing site and then home
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Group Exercise
Please break into groups of 6-8
Scenarios
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Read each of the scenarios
For each scenario, list as many “errors” in the
scenario as possible
 List the ways in which you would handle the
same situations differently
 Designate two members of your group to roleplay one of the scenarios after our break
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Let’s take a short break
Role-play exercise when we return
Thank You
Thank you for your attendance today
 Please visit the FDOT/CUTR Substance
Abuse Management (SAM) website to
download this presentation

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http://www3.cutr.usf.edu/byrnessamsite/