PRE EMPLOYMENT DRUG TESTING POLICY
This policy applies only to situations in which individuals have received a conditional offer of employment from [COMPANY NAME], such offer shall be conditioned upon satisfactory completion of the prerequisites forth herein. POLICY PROVISIONS Definitions 1. Adulterated Result- shall mean a specimen that contains a substance that is not expected to be present in human urine, or contains a substance expected to be present but is at a concentration so high that it is not consistent with human urine. 2. Applicants – shall mean only individuals who have received a conditional offer of employment, such offer shall be conditioned upon satisfactory completion of the prerequisites forth herein. 3. Confirmed Positive Result - shall mean that analysis of the sample identifies the presence of one or more Drugs and the Medical Review Officer has confirmed that the Drug(s) identified is an Illegal Drug(s). 4. Diluted Sample- shall mean a specimen with cretinine and specific gravity values that are lower than expected for human urine. 5. Drug - means a controlled substance, as defined in Schedules I through V of Section 202 of the Controlled Substances Act, 21 U.S.C. § 812, which includes, but is not limited to, cocaine, opiates, marijuana, amphetamines, phencyclidine (PCP), barbiturates, benzodiazepines, propoxyphene, methadone and methaqualone. 6. Illegal Drug-shall not mean a Drug obtained and taken under supervision by and in accordance with prescriptions or other instructions issued by a licensed health care professional and other drugs otherwise authorized to be used under the Controlled Substances Act. 7. Negative Test Result- shall mean that the presence Drugs has not been detected. This term does not mean that the presence of Drugs that do not fit the definition of Illegal Drugs have not been detected or identified. 8. Positive Test Results- shall mean the presence of one or more Drugs has been detected and identified. 9. Verified Positive Result- shall mean a Positive Test Result that has been verified by gas chromatography/mass spectrometry.
Non-Discrimination In accordance with the requirements of the Americans with Disabilities Act, [SMALL BUSINESS NAME] does not discriminate against Applicants who are qualified individuals with a disability who are not currently engaged in use of Illegal Drugs, as defined herein, and who do not otherwise violate the provisions of this Policy, including
but not limited to individuals (1) who have successfully completed or who are currently participating in a supervised rehabilitation program and are no longer engaging in such use; or (2) have otherwise been rehabilitated successfully and are no longer engaging in such use.
Implementation All individuals who submit an application for employment shall be informed at the time of the submission of an application that, as a condition of an offer of employment, they will be tested for Drugs and shall be given a copy of this policy. [COMPANY NAME] makes all offers of employment subject to and conditioned on Applicants’: 1) consent to taking a drug test; and 2) a Negative Test Result. The pre-employment test for the presence of Drugs must be conducted within 30 days prior to an Applicant’s expected first day of employment. No Applicant shall be allowed to commence employment at [COMPANY NAME] until after the conditions set forth above have been successfully completed. Applicants will be required to voluntarily submit to urinalysis for the presence of Drugs and sign a voluntary consent form. If the Applicant refuses to undergo pre-employment drug testing or refuses to sign the consent form, the offer of employment will be withdrawn. An Applicant who submits to a pre-employment drug test and receives a Confirmed Positive Result may not reapply for any position at [SMALL BUSINESS NAME] for at least 180 days. The samples provided by Applicants are also analyzed for the presence of adulterants. If an Applicant submits to a pre-employment drug test, and the sample provided by the Applicant is determined by the analysis to be an Adulterated Sample, the offer of employment for that Applicant shall be withdrawn. An Applicant with test results indicating a diluted sample will be requested to provide another urine sample at a collection site within 24 hours of notification. The cost of collecting and testing the new sample will be paid by [COMPANY NAME]. Applicants are not entitled to participate in any Employee Assistance or Rehabilitation Program offered by [COMPANY NAME] to its employees. [COMPANY NAME] reserves all rights and shall maintain exclusive discretion with regards to withholding all offers for any employment opportunity. Confidentiality and Privacy All drug test results reported to [COMPANY NAME] C4 Systems’ Pre-Employment Drug-testing Program Administrator (DPA) shall be considered confidential information and shall be appropriately labeled. Results shall be retained in a secure location with controlled access and shall not be kept as part of the Applicant’s employment record.
[COMPANY NAME] shall contract with a third party service supplier to provide the administration, the collection, testing, verification and reporting of urine samples for preemployment drug testing purposes. The third party service supplier shall be required to ensure that all aspects of the testing process, including specimen or sample collection, are private and confidential. The third party service supplier shall comply with [COMPANY NAME] policies as well as all applicable federal and state laws and regulations. Consent As a condition of submitting to pre-employment drug testing, Applicants shall be required to sign a consent form (a copy of which is attached hereto and made a part hereof). PROCEDURE FOR SAMPLE COLLECTION AND TESTING Sample Collection The third party service supplier will perform the administration, the collection, testing, verification and reporting of urine samples for pre-employment drug testing purposes and shall comply with the terms of this [COMPANY NAME] policy as well as all applicable federal and state laws and regulations. All urine samples shall be collected at facilities that comply with strict DHHS/SAMHSA guidelines. All drug testing will be performed at a U.S. Department of Health & Human Services/Substance Abuse & Mental Health Services Administration (DHHS/SAMHSA)certified laboratory and shall be forwarded to a licensed physician with knowledge of substance abuse disorders a “Medical Review Officer” (MRO). The MRO shall be chosen by the third party service supplier and shall only report the final results to [COMPANY NAME]. The final results shall be reported in writing and in a confidential manner and shall be limited only to the Illegal Drugs for which the Applicant receives a Confirmed Positive Result or a Negative Test Result. Prior to the collection of any sample, the Applicant will be required to read and sign a Pre-Employment Drug Testing Consent Form. All signatures to the consent form shall be voluntary. Strict privacy will be provided during the specimen collection. Under no circumstance will any Applicant be observed, while providing the urine sample. Any observation of Applicants shall be in direct violation of [COMPANY NAME] policy Samples shall be collected using the “split-sample” method to provide a second separate specimen for independent testing in the event an Applicant requests a retest. If the urine sample is quantitatively acceptable, the containers holding the samples will be sealed with security tape. The Applicant will initial and date the sealing tape on each container. Each sample will then be placed in a sealed package for delivery to the appropriate testing facility. The third party service supplier shall ensure that the sample is maintained and labeled in a proper manner for the purposes of establishing a chain of custody.
Testing and Results The collection site will be required to send the sample to a (DHHS/SAMHSA)-certified laboratory for testing. All test results will be forwarded to the MRO. The MRO (or designee) will inform [COMPANY NAME] of Negative Test Results within 24 hours of receipt of the Negative Test Result. All Positive Test Results must be verified by a federally certified laboratory utilizing gas chromotography/mass spectrometry. For all Verified Positive Results, the MRO will contact the Applicant directly within the legally applicable time limitation, which may vary by state, from the MRO’s receipt of a Verified Positive Test Result. The MRO shall inform the Applicant in writing of their test result as well as, the consequences and options available to the Applicant, including but not limited to information related to the Applicant’s right to request a retest of the original sample. Applicants who receive notification of a Verified Positive Test Result will then have five (5) working days from the receipt of such written notification to explain or contest the Verified Positive Test Result and/or request a retest. The MRO will also provide the Applicant with a copy of any Verified Positive Result. All Applicants with a Verified Positive Result have the right to request a retest (the “Retest”). All Re-tests shall be performed on the untested portion of the split-sample of their original specimen. Only one Re-test shall be performed. A DHHS/SAMSHSA-certified laboratory shall perform the Re-test. The Applicant must request a Re-test in writing within five (5) days from receiving notice of a Verified Positive Result. In the Applicant’s request for a Re-test the Applicant must state that he/she is consenting to the release of the sample. If the Re-test does not show a Verified Positive Result, [COMPANY NAME] shall pay the cost of the Re-test. Applicants shall have the opportunity to provide to the MRO information related to the use of prescription or nonprescription medications or other relevant medical information. If the information regarding the explanation of the Positive Test Result provided to the MRO by an Applicant is, based upon the MRO’s professional medical opinion, unsubstantiated or irrelevant, and the Applicant does not request a retest within five (5) days from receiving notice of the Verified Positive Result, the MRO will report a Confirmed Positive Result to [COMPANY NAME]. A Negative Test Result shall be reported to [COMPANY NAME] if the Applicant provides medical information that is determined by the MRO to be valid, substantiated or relevant based on the MRO’s professional medical opinion and/or the Positive Test Result was not caused by an Illegal Drug. Negative Test Results will be forwarded directly to [COMPANY NAME]’ Staffing department. Confirmed Positive Results will be sent to the [COMPANY NAME] DPA or designee(s) only and shall be marked as “Confidential Information”. Upon receipt of any test result from the third party service supplier, [COMPANY NAME] will promptly notify the Applicant of its receipt of the test results. [COMPANY
NAME] shall rely on the test results and shall take appropriate action based on such results, in accordance with this policy. Responsibilities [COMPANY NAME] Pre-Employment Drug-testing Program Administrator (DPA) is the Manager of Staffing. [COMPANY NAME] Human Resources is responsible for developing and implementing this Policy. [COMPANY NAME] reserves the right to interpret and administer this Policy, and at any time and at its sole discretion, amend, supplement, modify, revoke, rescind or change this Policy, in whole or in part, with or without notice. The Policy supersedes and revokes any other [COMPANY NAME] practice or policy relating to preemployment drug testing.