Implementing a drug and alcohol testing program in your workplace? A Third Party Administrator (TPA) like PROCOM can help you implement a compliant, effective, and seamless drug and alcohol testing program. The below content provides an overview of the value added services we can bring to your testing program:
Why Partner with a TPA? Managing a drug and alcohol testing program is complicated, and the stakes of preventing workplace substance abuse while complying with federal regulations are high. Partnering with an experienced Third Party Administrator (TPA) like PROCOM is an effective and cost-efficient way to help administer your program.
A TPA acts as an extension of an employer’s Human Resources or Safety department to help keep employees safe and compliant. The employer is the “First Party” and the TPA is the “Third Party” that helps manage the “Second Parties” involved in testing program:
TPAs can manage the entire process from start to finish, or manage a specific part of the process, such as random drug screening selection. At PROCOM, our capabilities include:
- Full suite of employee drug and alcohol testing
- Random selections and consortium management
- Nationwide network of DOT certified collection sites
- MRO services with 24 hour turnaround time for negative results
- Scheduling assistance for any test, anywhere
- 24/7/365 after hours support for urgent testing
- Company policy review and development
- Regulatory consulting
- Employee and supervisor training
- Consolidated billing available
What can’t a TPA do? Under DOT regulations, a TPA can’t “administer” certain aspects of your substance abuse program, including:
- Making a reasonable suspicion determination
- Removing an employee from his/her duties
- Being the primary recipient of drug and alcohol test results from the MRO
- Here are some guidelines from the DOT about how to interact with your TPA and other service providers
However, a TPA can consult with you on these activities to ensure you are in compliance and help make your job easier. This includes providing reasonable suspicion training, employee coaching, and helping facilitate result delivery from the MRO.
Consortium / Random Selections
Random drug and alcohol screens are an effective way to combat and prevent abuse in the workplace. Since the early 1990’s, the DOT has required safety-sensitive transportation employees to participate in random drug tests. As of 2016, regulations require that 25% of drivers be tested for drugs, and 10% for alcohol, randomly throughout the year. These regulations change annually and depend on the branch of the DOT.
For owner-operators or companies with only a few DOT regulated employees, the DOT may consider them too small to make a reasonable random selection. This is where a consortium is helpful. A drug screening consortium is an association of companies or groups of employers that join together to combine their employees in a single random testing pool.
Many non-DOT regulated employers also chose to randomly drug test their employees to combat and prevent drug and alcohol abuse in the workplace. Below are links to studies demonstrating the efficacy of random testing in different environments:
At PROCOM, we strive to make the random testing process as simple for our clients as possible. There are two primary considerations for an employer:
- Which employees are eligible for random testing?
- How often are they tested?
For some employers these questions are straightforward. For example, if you have CDL Class A Drivers and only want to meet the minimum requirements of the federal government, then anyone who is eligible for duty should be included in the random selection that DOT mandated 25% drug / 10% alcohol tested annually, in quarterly intervals.
For other employees with many different types of employees, the answer is less simple. Here is an example for a distribution company:
- CDL Drivers – randomly test them per DOT regulations in a DOT compliant consortium
- Warehouse workers – while not regulated by the DOT, these employees perform a safety sensitive function and the employer wants to ensure the warehouse is a drug free work place. These employees are randomly tested in a Non-DOT consortium that is tested less frequently.
- Office Employees - exclude from random tests, don't want to randomly test them
You can pick all classifications under the same % which satisfies both DOT requirements and creates consistency between DOT and NONDOT employees or, if differentiation is acceptable, we can tier the rates specific to the group.
PROCOM can help you design your policy to differentiate between different classes of employees should you choose to treat them differently for drug / alcohol testing purposes.
There are several reasons why it is best to have a TPA manage your random selection process:
- Reduced administrative burden. As the consortium administrator, a TPA updates the selection pool, managing the selection process, reports results, and ensures that you are in compliance your policy and federal regulations – all of which can be very time consuming.
- Documented unbiased testing. Using a third party helps prevent legal risk and relationship risk with your employees by ensuring a truly random selection methodology will be run independently each time, meaning that if someone was selected last time it should have no bearing on whether they are selected again in the future. We provide you documentation that you can provide directly to the employee notifying them that the TPA selected them and not you. Click HERE for an article about our random selection tool.
- Reasonable frequency of testing. For example, suppose you are a company with 1 CDL Class A driver. The DOT mandates that each DOT FMCSA employee be constantly enrolled in a selection which selects 25% annually. If the company only selected random tests from their pool of 1 employee, he/she would be selected every year (at a minimum). This is effectively a testing rate of 100% instead of 25%, implying they have done more testing than is required. If the company enrolled in a Consortium with 99 other drivers, each year that consortium will select 25% participants for testing. Our example company will have their employee selected, on average, once every 4 years. This appropriately tests at 25% and keeps the company compliant at a lower cost and burden.
Employers have a few obligations to ensure the random selection process is successful:
- Keep employee lists up to date. Employee lists can be emailed periodically or as the roster to changes, and we will remind you to do so prior to selections.
- Complete the random testing within the allowed period. We typically allow 10 weeks for each selection and ask our clients to accomplish their random testing within that interval. We remind you when testing is due and notify you with who is still outstanding.
- Help ensure the employee proceeds to the collection site immediately upon notification that they have been selected. We request you do not notify your employees in advance to maintain the integrity of the ‘random test’ and the ability of the employee to influence the test (e.g. dilute results by drinking water or procure a fake urine sample).
A Medical Review Officer (MRO) is an integral part of any testing program. Their involvement is required by the DOT regulations and advisable in the non-regulated environments. They add a layer of integrity to any substance abuse program and are an invaluable consultant for employer questions/concerns. Many legal processes require the review of a MRO for the result to be given credibility.
MROs have extensive training, testing, and certification requirements and must comply with very strict regulations in conducting the medical interview and reporting the results to the employer.
The primary responsibilities of the MRO are:
- Ensure the validity of the test by verifying the Chain of Custody has been completed and not broken at any point along the way
- Review any positive and abnormal results to ensure there aren’t legitimate medical reasons for those results.
The steps a MRO takes to complete their job are straightforward and give employees a fair chance to represent themselves.
- MRO receives positive/abnormal lab result directly from the lab
- MRO pairs with the MRO copy of the chain of custody to ensure there has been no break in the chain and that the test administered is appropriate
- The MRO calls the donor per the phone number they give on the COC and verifies their ID
- They ask if there is any legitimate medical reason why XYZ substance was found in their sample
- They may counsel what types of substances could have caused it (ex. If a donor has tested positive for Amphetamines it is possible that Adderall has caused it)
- If any are provided, the MRO reviews to ensure the prescription is valid and the substances align
- If not contact is made, MRO tries to reach the employee via their DER. After 5 days of no contact the positive result is reported as-is.
- If there is a legitimate medical reason, the MRO will document and overturn the result.
- If no legitimate medical reason is found, the MRO will certify the positive result, offer resources for SAP / rehab and communicate the final result to the employer.
In the event a MRO overturns a positive lab result yet feels there is a safety risk for that individual and those around them, they are encouraged to reach out to the prescribing physician to discuss. Unfortunately, despite the best of intent, the prescribing physicians are seldom incentivized to engage in those discussions and most requests go unanswered. In that instance, the MRO can share their concerns with the employer in the form of ‘Safety Concern Letter’. The employer can choose to do with this what they choose, but the best practice is to either: (a) engage the prescribing physician to get a letter acknowledging the employee’s job description and the appropriateness of the prescribed medication (difficult to obtain!) or (b) get a fitness for duty evaluation done by an independent physician who acknowledges both the prescribed medications and the job description (much more straightforward to obtain!).
The value of the MRO function is illustrated best in the current climate of opioid problems - many of them stemming from legitimate medical utilization. If a donor tests positive for a synthetic opioid (tested for in all DOT tests starting Jan 1, 2018) it is the job of the MRO to determine whether: (1) The donor has any prescriptions for synthetic opioids (2) Whether the substance detected in the sample is consistent with what was prescribed (could be oxycodone, hydrocodone, oxymorphone or hydromorphone), and (3) evaluating whether the drugs and dosage present represent a safety risk to that employee given the safety sensitive nature of their job.