Proposed Revisions to Federal Drug Testing Custody and Control Form, 59196-59205 [E9-27371]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Substance Abuse and Mental Health
Services Administration
Proposed Revisions to Federal Drug
Testing Custody and Control Form
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AGENCY: Substance Abuse and Mental
Health Services Administration, HHS.
ACTION: Notice of Proposed Revisions to
the Federal Custody and Control Form.
SUMMARY: The Department of Health and
Human Services (HHS) establishes the
standards for Federal workplace drug
testing programs under authority of
Section 503 of Public Law 100–71, 5
U.S.C. Section 7301 and Executive
Order No. 12564. As required, HHS
published the Mandatory Guidelines for
Federal Workplace Drug Testing
Programs (Guidelines) in the Federal
Register on April 11, 1988 (53 FR
11979). The Substance Abuse and
Mental Health Services Administration
(SAMHSA) subsequently revised the
Guidelines on June 9, 1994 (59 FR
29908), on September 30, 1997 (62 FR
51118), on November 13, 1998 (63 FR
63483), on April 13, 2004 (69 FR 19644)
and on November 25, 2008 (73 FR
71858) with an effective date of May 1,
2010 (correct effective date published
on December 10, 2008; 73 FR 75122).
The Guidelines establish comprehensive
standards for all aspects of the Federal
workplace drug testing program,
including the requirement for all urine
specimens to be collected using chain of
custody procedures to document
specimen integrity and security from the
time of collection until receipt by the
‘‘test facility.’’ To ensure uniformity
among all Federal agency workplace
drug testing programs and procedures,
the Guidelines require agencies to use
an Office of Management and Budget
(OMB) approved Federal Custody and
Control Form (Federal CCF) for their
programs. Additionally, the Department
of Transportation (DOT) requires its
regulated industries to use the Federal
CCF.
The current Federal CCF is a five-part
form that consists of the following
copies: Copy 1—Laboratory Copy, with
the tamper-evident specimen bottle
seal(s)/label(s) that are attached to the
bottom of Copy 1, Copy 2—Medical
Review Officer (MRO) Copy, Copy 3—
Collector Copy, Copy 4—Employer
Copy, and Copy 5—Donor Copy. The
reverse side of each copy has a Public
Burden Statement. The reverse side of
Copy 5 also has a Privacy Act Statement
(for Federal employees only) and
instructions for completing the Federal
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CCF. The current Federal CCF has been
approved for use by OMB until
September 1, 2012 for all Federal agency
and federally-regulated drug testing
programs that must comply with the
Guidelines.
In the latest revision to the
Guidelines, dated November 25, 2008
(73 FR 71858 with an effective date of
May 1, 2010), the new regulations will
permit the certification of Instrumented
Initial Test Facilities (IITF) and will
expand the drug testing profile to
include new drug analytes:
methylenedioxymethamphetamine
(MDMA) commonly known as
‘‘ecstasy,’’ methylenedioxyamphetamine
(MDA), and
methylenedioxyethylamphetamine
(MDEA) which are close chemical
analogues of MDMA. These new
regulatory actions will require that the
Federal CCF be modified to
accommodate the new rule changes.
This notice provides proposed
changes to the current Federal CCF. It
incorporates changes in accordance
with the latest revisions to the
Guidelines (published November 25,
2008; 73 FR 71858; effective May 1,
2010) and recommendations developed
in a collaborative effort involving HHS
and DOT. The proposed form is
provided in Appendix A.
DATES: Written comments on the
proposed draft should be submitted by
January 19, 2010.
ADDRESSES: Written comments should
be addressed to Robert L. Stephenson II,
M.P.H., Director, Division of Workplace
Programs (DWP), Center for Substance
Abuse Prevention (CSAP), 1 Choke
Cherry Road, Room 2–1035, Rockville,
MD 20857. The public may also send
comments by e-mail to
charles.lodico@samhsa.hhs.gov. All
comments received will be posted
without change to https://
www.drugfreeworkplace.gov.
FOR FURTHER INFORMATION CONTACT:
Charles LoDico, M.S., D–ABFT, Drug
Testing Team, DWP, CSAP, 1 Choke
Cherry Road, Room 2–1039, Rockville,
MD 20857, telephone (240) 276–2600,
fax (240) 276–2610, or e-mail:
charles.lodico@samhsa.hhs.gov.
Discussion
SAMHSA is proposing several major
changes to the Federal CCF. The first
major change is to revise Copy 1 to
permit use by IITFs, in addition to
laboratories. This is in accordance with
the latest revisions to the Guidelines
(published November 25, 2008; effective
May 1, 2010), which allow certification
of IITFs to perform federally-regulated
drug testing. A chain of custody section
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was added in Step 4 of Copy 1 for the
IITF to document receipt of the
specimen and, as needed, to document
subsequent transfer of the specimen to
an HHS-certified laboratory for testing.
The second major change is to add the
new drug analytes required by the
revised Guidelines to the Primary
Specimen Report section in Step 5a of
Copy 1. The new drug analytes are
MDMA, MDA and MDEA. The third
major change is to discontinue
recording split specimen test results on
Copy 1 of the Federal CCF. Instead, Step
5b of Copy 1 will be used to identify the
split testing laboratory (i.e., laboratory
name, city, and State), to indicate that
the split specimen was tested, and to
refer to a separate laboratory report for
the split specimen test results. The
fourth major change is to revise the
MRO reporting sections on Copy 2 for
primary specimens (Step 6) and for split
specimens (Step 7), to facilitate
reporting in accordance with the
Guidelines and DOT Regulations.
Revisions to Copy 2, Step 6 include the
addition of lines for the MRO to specify
positive drug analyte(s), to specify the
adulterant/reason for reporting a
specimen as adulterated, and to report
other reasons for reporting a Refusal to
Test (in addition to Adulteration and
Substitution). Revisions to Copy 2, Step
7 include the addition of lines for the
MRO to specify drug analyte(s),
substitution, or adulteration for
‘‘Reconfirmed’’ or ‘‘Failed to
Reconfirm’’ split specimens, and the
addition of a checkbox to report a
cancelled test.
A desired outcome from the proposed
Federal CCF revision process was to
maintain the same form size (8.5 inch by
11 inch) as the current Federal CCF. The
content and format was redrawn for
conciseness, to conserve space, and to
allow for the needed additional content
while maintaining the overall
familiarity to which collectors,
laboratories and MROs were
accustomed to using.
Appendix A presents the required
format and appearance for each copy of
the proposed Federal CCF. SAMHSA
recognizes that suppliers use different
hardware and software to print forms
and minor differences in appearance
will occur. For example, the size of each
checkbox on the form may be different,
the font sizes and styles used for letters
may be different, or the exact location
of an item on a printed form may vary
slightly from the location indicated on
the sample provided in Appendix A.
These minor changes in appearance are
permitted since they do not significantly
impact on the required format. Other
changes permitted on the printed copies
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include highlighting data entry/
information fields where the collector
and donor would be providing
information and using combs/boxes
(rather than a single line) for the donor’s
identification, to facilitate using optical
readers for transferring that information.
The colors used to highlight the fields
may be different for different fields but
must not prevent making clear
photocopies of the information that is
printed or handwritten in the
highlighted fields. Other required
information (e.g., the name and address
of the test facility, the specimen
identification number appearing on the
top of the form and on the specimen
bottle seal(s)/label(s)) may be printed on
the Federal CCF during the original
printing and assembly process or added
by overprinting the five-part printed
form after assembly.
A detailed discussion of other
proposed changes follows:
Copy 1
To reflect use of the Federal CCF by
IITFs as well as laboratories, Copy 1 has
been redesignated as the Test Facility
Copy (changed from Laboratory Copy).
As on the current form, Copy 1 has a
one-inch space at the top of the page
reserved for: the title of the form
(‘‘Federal Custody and Control Form’’)
that must be printed along the top edge,
the name and street address of the test
facility, the unique preprinted specimen
identification number (i.e., a barcode
with an associated human readable
number or only a human readable
number), the test facility accession
number (if used), and other information
(e.g., accounting) that the test facility or
user of the Federal CCF may want to
include. There are no restrictions on the
font size used for the information
appearing in this one-inch space. Also
as on the current form, the OMB number
must be included, either vertically or
horizontally, in the upper right-hand
corner.
The collector or employer
representative completes Step 1. The
items in Step 1(a), (b), and (c) are
essentially the same as on the current
Federal CCF. Step 1(d) is a new
proposed item to list the acronyms for
the Federal testing authority under
which the specimen is being collected.
The new Step 1(d) would read as
follows: D. ‘‘Specify Testing Authority:
HHS, NRC, DOT—Specify DOT Agency:
FMCSA, FAA, FRA, FTA, PHMSA,
USCG’’ with a checkbox beside each
agency name.
The DOT-regulated testing program
applies to more than 6 million
individuals. Some of the DOT agencies
and the United States Coast Guard
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(USCG) have or anticipate having
reporting requirements for test results.
For example, the Federal Aviation
Administration (FAA) requires the
reporting of test results for pilots and
mechanics, while the USCG requires the
reporting of test results for mariners. We
also expect other DOT agencies (e.g.,
FMCSA) may in the future require the
identification of the ‘‘testing authority’’
in reporting of positive and refusal to
test results which will be entered into
a database. Identifying the Federal
testing authority will facilitate reporting
results to DOT agencies when their
regulations require it and will assist
HHS in identifying the Federal testing
authority when it receives laboratory
data. The information identifying the
specific Federal testing authority
captured on the Federal CCF will make
it simpler for the entity reporting the
result to the DOT agency (usually the
employer or other program participant)
to gather the information to satisfy the
DOT agency reporting requirement.
Knowing which data belongs to HHS,
NRC, the USCG and the DOT agencies
will prove helpful to each of these
entities.
The collector or employer should not
find it difficult or impossible to
complete this new step. HHS and DOT
experience is that employers and
Consortium/Third Party Administration
(C/TPA) currently provide specific
instructions to the collector or
collection site in order to conduct the
collection. For example, C/TPA would
provide the name of the employer, the
date of the collection, the test reason,
whether the test is to be conducted
under direct observation, and employee
information (e.g., name and ID number).
Therefore, we would expect the
employers and C/TPAs to simply add
another data element to what they
already provide. In the event the
information in Step 1(d) is not
completed the test facility must not hold
up processing, or testing the specimen.
Similarly, the MRO must not hold up
reporting a verified result. We believe
this is something the test facility or
MRO should just note and continue
with processing, testing, and reporting
of the specimen result.
Step 1(e) contains the item ‘‘Reason
for Test,’’ with the reasons consolidated
on a single line to conserve space on the
proposed Federal CCF. Items in Steps
1(f) and (g) are essentially the same as
on the current Federal CCF.
The collector completes Step 2 after
he/she has received the specimen from
the donor and has read the temperature
of the specimen. The changes proposed
for Step 2 are intended to gain more
space on the proposed Federal CCF and
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to allow more space for the collector’s
Remarks. One proposed change is to
move the instructions for Step 2 [i.e.,
‘‘(make remarks when appropriate)’’ and
‘‘Collector reads specimen temperature
within 4 minutes’’] to the same line as
‘‘Completed by Collector.’’ Another
proposed change is to revise the
sentence ‘‘Is temperature between 90 °
and 100 °F?’’ to ‘‘Temperature between
90 ° and 100 °F?’’ This will reduce the
space required for the three sections in
Step 2 [i.e., for recording specimen
temperature (Yes/No, Enter Remark) and
collection type (Split/Single/None
Provided, Enter Remark), and to
indicate an observed collection
(Observed, Enter Remark)]. We are
proposing to increase the space for
collector comments in the ‘‘Remarks’’
section to allow additional explanation
and to improve legibility of handwritten
remarks.
Step 3 instructs the collector to seal
the specimen bottle(s), the donor to
initial the bottle seal(s), and the donor
to then complete Step 5 on Copy 2 (the
MRO copy). These are the same
instructions as on the current Federal
CCF.
Step 4 is the chain of custody section
initiated by the collector and completed
by the test facility. The major changes
proposed for Step 4 are to permit use of
the Federal CCF by IITFs, as well as by
laboratories, in accordance with the
revised Guidelines. We are also
proposing format changes to improve
legibility of handwritten entries and
facilitate form completion, while
allowing all required information to be
included. In the collector’s chain of
custody section, we propose to enlarge
the block for the collector’s signature
while reducing the width of the
‘‘Specimen Bottle(s) Released to:’’ block.
We also propose changing ‘‘Initiated by
Collector and Completed by Laboratory’’
to ‘‘Initiated by Collector and
Completed by Test Facility’’. The
‘‘Received at IITF’’ chain of custody
section includes lines/checkboxes for
the accessioner at the IITF to sign and
print his/her name on the Federal CCF,
record the date of specimen receipt,
document the name and address of the
IITF (if different from that printed on
the Federal CCF), document the
condition of the primary specimen
bottle seal, and document the transfer of
specimen custody. If a specimen
received at the IITF cannot be reported
(i.e., as rejected for testing, negative, or
negative and dilute), the remaining
specimen will be resealed using tamperevident tape and forwarded to an HHScertified laboratory for testing. This
handling will be documented in the
‘‘Transfer from IITF to Lab’’ section of
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the proposed Federal CCF. The
laboratory chain of custody section in
Step 4 is essentially the same as on the
current Federal CCF. We are proposing
changes similar to those for the
collector’s chain of custody section: to
enlarge the block for the laboratory
accessioner’s signature while reducing
the width of both the ‘‘Specimen
Bottle(s) Released to:’’ block and the
block for documenting condition of the
primary specimen bottle seal.
Step 5(a) is completed by the test
facility to report the test results of the
primary specimen. Changes are
proposed for this section in accordance
with the revised Guidelines, including:
changing ‘‘Primary Specimen Test
Results—Completed by Primary
Laboratory’’ to ‘‘Primary Specimen
Report—Completed by Test Facility’’;
adding the new drug analytes (MDMA,
MDA, and MDEA); changing ‘‘Test Lab
(if different from above)’’ to ‘‘Test
Facility (if different from above)’’; and
changing ‘‘Certifying Scientist’’ to
‘‘Certifying Technician/Scientist’’ on
both signature and printed name lines.
In addition, for clarity and to facilitate
form completion, we propose to
reposition drug/metabolite names and
checkboxes, and to change the term
‘‘Rejected for Testing’’ to ‘‘Rejected.’’
We also propose to add ‘‘D9–THCA’’
after ‘‘Marijuana Metabolite’’ and ‘‘BZE’’
after ‘‘Cocaine Metabolite’’ to specify
the drug analytes.
We are proposing major changes to
Step 5(b) of the current Federal CCF to
accommodate the additional
information needed on Copy 1 to
address revised Guidelines
requirements as described above.
Laboratories will no longer record split
specimen test results on Copy 1 of the
proposed Federal CCF and be moved to
Copy 2 (Medical Review Officer Copy).
This change is justified by National
Laboratory Certification Program (NLCP)
data obtained from HHS-certified
laboratories in 2008. These data indicate
that only 0.07% of federally-regulated
split specimens were tested (i.e., 3.7%
of the total reported positives). Also, in
many cases, the ‘‘Remarks’’ line of the
current Federal CCF is insufficient to
document all required comments for
reporting split specimen test results.
Laboratories often use a separate
laboratory report to report split
specimen results to the MRO. Therefore,
in Step 5(b) of the proposed Federal
CCF, the split laboratory will record its
name and location (city and State),
indicate that the split specimen was
tested, and reference the separate
laboratory report for the split specimen
test results.
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At the bottom of Copy 1, we propose
to reduce the area available for tamperevident labels/seals to conserve space.
The proposed Federal CCF in Appendix
A shows two 1⁄2-inch wide labels (i.e.,
reduced from 3⁄4-inch on the current
Federal CCF). The reduced size is
sufficient for the required specimen
identification number and should not
affect the legibility of information
printed on the labels/seals. We are also
proposing to change the designation
‘‘Copy 1—Laboratory’’ printed on the
bottom of Copy 1 to ‘‘Copy 1—Test
Facility Copy’’.
Copy 2
Steps 1 through 4 of Copy 2 (Medical
Review Officer Copy) will be the same
as Steps 1 through 4 of Copy 1 (Test
Facility Copy) through the collector
chain of custody section. The changes to
the proposed Federal CCF begin in Step
4 of Copy 2. We propose to delete the
‘‘Received at Lab’’ section in Step 4 of
Copy 2 of the current Federal CCF. The
collector separates the copies of the
Federal CCF and sends Copy 1 to the
test facility with the specimen. At that
time, the test facility resumes chain of
custody documentation. Therefore,
chain of custody sections beyond the
collector section are not completed on
Copies 2 through 5.
The collector instructs the donor to
read the donor certification statement in
Step 5 of Copy 2 and to complete the
entries (signature, printed name, date,
daytime telephone number, evening
telephone number, and date of birth) in
this section. The MRO uses this
information to contact the donor as
necessary during the verification
process. We propose to revise the
instructions to the donor at the bottom
of the section to be consistent with
current Guidelines requirements. The
current statement ‘‘Should the results of
the laboratory tests for the specimen
identified by this form be confirmed
positive, the Medical Review Officer
will contact you * * *’’ will be changed
to ‘‘After the Medical Review Officer
receives the test results for the specimen
identified by this form, he/she may
contact you * * *.’’ Also, for clarity and
ease of viewing, we propose to bold the
lines on the proposed Federal CCF
above and below Step 5 to provide
visual separation of the section
completed by the donor and the rest of
the form.
Step 6 on Copy 2 is used by the MRO
to report the primary specimen test
results to the employer after completing
the verification. The proposed changes
to this section are intended to facilitate
form completion in accordance with
MRO reporting requirements in the
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Guidelines and in DOT Regulations. The
proposed changes include: changing the
term ‘‘determination/verification’’ to
‘‘verification’’, repositioning results and
checkboxes, adding a line after
‘‘Positive’’ for the MRO to specify the
positive drug analyte(s), adding a line
after ‘‘Adulterated’’ for the MRO to
specify the adulterant/reason, adding
‘‘Other’’ under the ‘‘Refusal to Test’’
grouping to allow additional reasons for
this result, and adding another
‘‘Remarks’’ line for the MRO’s
explanatory comments.
Step 7 is used by the MRO to report
the split specimen test results to the
employer after completing the
verification. The proposed changes to
this section are intended to facilitate
form completion in accordance with
MRO reporting requirements in the
Guidelines and in DOT Regulations. The
proposed changes include: changing the
term ‘‘determination/verification’’ to
‘‘verification’’, adding a line after
‘‘Reconfirmed’’ for the MRO to specify
the reconfirmed test results (i.e., drug
analytes, substitution, adulteration),
adding the result and checkbox to report
‘‘Test Cancelled’’, adding a line after
‘‘Failed to Reconfirm’’ for the MRO to
specify the test results that were not
reconfirmed (i.e., drug analytes,
substitution, adulteration), and adding
another ‘‘Remarks’’ line for the MRO’s
explanatory comments.
Copy 3, Copy 4, Copy 5
Copy 3 (Collector Copy), Copy 4
(Employer Copy), and Copy 5 (Donor
Copy) will be the same as Copy 2
(Medical Review Officer Copy).
Instructions for Completing the Federal
Custody and Control Form
As on the current Federal CCF,
instructions for completing the form are
included on the back of Copy 5 (Donor
Copy). The purpose of these instructions
is to provide the donor with an
overview of the specimen collection
process. We propose to revise and
update the instructions for clarity and
for consistency with the revised
Guidelines.
Public Burden Statement
The Public Burden Statement in
Appendix A must appear on all Federal
Government forms that place a reporting
burden on gathering information. This
statement must be included on the back
of each copy of the Federal CCF (i.e.,
Copies 1 through 5). The reporting
address in this notice has been updated
on the proposed revised Federal CCF
and the word ‘‘laboratory’’ has been
changed to ‘‘test facility’’. Otherwise,
the statement is the same as the
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‘‘Paperwork Reduction Act Notice’’ on
the current OMB-approved Federal CCF.
However, SAMHSA is interested in
receiving public comments concerning
the estimated average times for the
collector, the donor, the test facility, and
the MRO to complete the form.
Individuals commenting on these topics
should include in their estimates the
time to review, print information, and/
or read certification statements on the
form.
Privacy Act Statement
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The Privacy Act Statement in
Appendix A must appear on the back of
Copy 5 (Donor Copy). It applies to all
donors who are Federal employees. The
statement is the same as that on the
current Federal CCF.
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Tamper-Evident Labels/Seals
Availability of the Federal CCF
The size of the two tamper-evident
labels/seals may vary, but they must be
placed within the space provided at the
bottom of Copy 1. It is the responsibility
of the supplier of the specimen bottle
labels/seals to ensure that they are
tamper-evident. Tamper-evident tape is
a tape that is placed on a specimen
bottle which cannot be removed and be
replaced without visible evidence that
tampering has occurred. SAMHSA
believes this single requirement is
sufficient to ensure that the labels/seals
provided with the Federal CCF are
tamper-evident; however, comments are
welcome on recommending other
specifications/requirements that should
be considered.
The proposed Federal CCF, once
approved by OMB, will be available on
the SAMHSA Web site at https://
www.drugfreeworkplace.gov/as an
electronic file (using several different
formats) that can be downloaded.
Photocopies will also be available from
the Division of Workplace Programs
(DWP). SAMHSA believes making the
Federal CCF available using this
approach will ensure that the form is
readily available from different sources.
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Elaine Parry,
Director, Office of Program Services,
SAMHSA.
APPENDIX A—Federal Drug Testing
Custody and Control Forms
BILLING CODE 4162–20–P
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Public Burden Statement
Public Burden Statement: An agency
may not conduct or sponsor, and a
person is not required to respond to, a
collection of information unless it
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displays a currently valid OMB control
number. The OMB control number for
this project is 0930–0158. Public
reporting burden for this collection of
information is estimated to average 5
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minutes/donor, 4 minutes/collector, 3
minutes/test facility and 3 minutes/
Medical Review Officer. Send
comments regarding this burden
estimate or any other aspect of this
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Choke Cherry Road, Room 7–1044,
Rockville, Maryland 20857.
Public Burden Statement
collection of information unless it
displays a currently valid OMB control
number. The OMB control number for
this project is 0930–0158. Public
Public Burden Statement: An agency
may not conduct or sponsor, and a
person is not required to respond to, a
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reporting burden for this collection of
information is estimated to average 5
minutes/donor, 4 minutes/collector, 3
minutes/test facility and 3 minutes/
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collection information, including
suggestions for reducing this burden, to
SAMHSA Reports Clearance Officer, 1
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collection information, including
suggestions for reducing this burden, to
SAMHSA Reports Clearance Officer, 1
Choke Cherry Road, Room 7–1044,
Rockville, Maryland 20857.
Public Burden Statement
collection of information unless it
displays a currently valid OMB control
number. The OMB control number for
this project is 0930–0158. Public
reporting burden for this collection of
information is estimated to average 5
minutes/donor, 4 minutes/collector, 3
minutes/test facility and 3 minutes/
Public Burden Statement: An agency
may not conduct or sponsor, and a
person is not required to respond to, a
VerDate Nov<24>2008
20:50 Nov 16, 2009
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Medical Review Officer. Send
comments regarding this burden
estimate or any other aspect of this
Federal Register / Vol. 74, No. 220 / Tuesday, November 17, 2009 / Notices
59203
collection information, including
suggestions for reducing this burden, to
SAMHSA Reports Clearance Officer, 1
Choke Cherry Road, Room 7–1044,
Rockville, Maryland 20857.
Public Burden Statement
collection of information unless it
displays a currently valid OMB control
number. The OMB control number for
this project is 0930–0158. Public
reporting burden for this collection of
information is estimated to average 5
minutes/donor, 4 minutes/collector, 3
minutes/test facility and 3 minutes/
Public Burden Statement: An agency
may not conduct or sponsor, and a
person is not required to respond to, a
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20:50 Nov 16, 2009
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Medical Review Officer. Send
comments regarding this burden
estimate or any other aspect of this
Federal Register / Vol. 74, No. 220 / Tuesday, November 17, 2009 / Notices
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Medical Review Officer. Send
comments regarding this burden
estimate or any other aspect of this
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20:50 Nov 16, 2009
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collection information, including
suggestions for reducing this burden, to
SAMHSA Reports Clearance Officer, 1
PO 00000
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Choke Cherry Road, Room 7–1044,
Rockville, Maryland 20857.
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59204
Federal Register / Vol. 74, No. 220 / Tuesday, November 17, 2009 / Notices
BILLING CODE 4162–20–C
mstockstill on DSKH9S0YB1PROD with NOTICES
Instructions for Completing the Federal
Drug Testing Custody and Control Form
When Making Entries Use Black or Blue
Ink Pen and Press Firmly
Collector ensures that the name and
address of the HHS-certified
Instrumented Initial Test Facility (IITF)
or HHS-certified laboratory are on the
top of the Federal CCF and the
Specimen identification (I.D.). Number
on the top of the Federal CCF matches
the Specimen I.D. number on the
label(s)/seal(s).
STEP 1:
• Collector ensures that the required
information is in STEP 1. Collector
enters a remark in STEP 2 if donor
refuses to provide his/her SSN or
Employee I.D. number.
• Collector gives collection container
to Donor and instructs Donor to provide
a specimen. Collector notes any unusual
behavior or appearance of Donor in the
remarks line STEP 2. If the Donor’s
conduct at any time during the
collection process clearly indicates an
attempt to tamper with the specimen,
Collector notes the conduct in the
remarks line in STEP 2 and takes action
as required.
STEP 2:
• Collector checks specimen
temperature within 4 minutes after
receiving the specimen from Donor, and
marks the appropriate temperature box
in STEP 2. If the temperature is outside
the acceptable range, Collector enters a
remark in STEP 2 and takes action as
required.
• Collector inspects the specimen and
notes any unusual findings in the
remarks line in STEP 2 and takes action
as required. Any specimen with unusual
physical characteristics (e.g., unusual
color, presence of foreign objects or
material, unusual odor) cannot be sent
to an IITF and must be sent to an HHScertified laboratory for testing, as
required.
• Collector determines the volume of
specimen in the collection container. If
the volume is acceptable, Collector
proceeds with the collection. If the
volume is less than required by the
Federal Agency, Collector takes action
as required, and enters remarks in STEP
2. If no specimen is collected by the end
of the collection process, Collector
checks the None Provided box, enters a
remark in STEP 2, discards Copy 1, and
distributes remaining copies as
required.
• Collector checks the Split or Single
specimen collection box. If the
collection is observed, Collector checks
the Observed box and enters a remark in
STEP 2.
VerDate Nov<24>2008
20:50 Nov 16, 2009
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59205
STEP 3:
• Donor watches Collector pour the
specimen from the collection container
into the specimen bottle(s), place the
cap(s) on the specimen bottle(s), and
affix the label(s)/seal(s) on the specimen
bottle(s).
• Collector dates the specimen bottle
label(s) after placement on the specimen
bottle(s).
• Donor initials the specimen bottle
label(s) after placement on the specimen
bottle(s).
• Collector turns to Copy 2 (Medical
Review Officer Copy) and instructs the
Donor to read and complete the
certification statement in STEP 5
(signature, printed name, date, phone
numbers, and date of birth). If Donor
refuses to sign the certification
statement, Collector enters a remark in
STEP 2 on Copy 1.
STEP 4:
• Collector completes STEP 4 on
Copy 1 (signature, printed name, date,
time of collection, and name of delivery
service), places the sealed specimen
bottle(s) and Copy 1 in a leak-proof
plastic bag, seals the bag, prepares the
specimen package for shipment, and
distributes the remaining CCF copies as
required.
or privilege provided by law. Your SSN
is solicited, pursuant to Executive Order
9397, for purposes of associating
information in agency files relating to
you and for purposes of identifying the
urine specimen provided for testing for
the presence of illegal drugs. If you
refuse to indicate your SSN, a substitute
number or other identifier will be
assigned, as required, to process the
specimen.
Privacy Act Statement: (For Federal
Employees Only)
Submission of the requested
information on the attached form is
voluntary. However, incomplete
submission of the requested
information, refusal to provide a urine
specimen, or substitution or
adulteration of a specimen may result in
delay or denial of your application for
employment/appointment or may result
in removal from the Federal service or
other disciplinary action.
The authority for obtaining the urine
specimen and identifying information
contained herein is Executive Order
12564 (‘‘Drug-Free Federal Workplace’’),
5 U.S.C. Sec. 3301 (2), 5 U.S.C. Sec.
7301, and Section 503 of Public Law
100–71, 5 U.S.C. Sec. 7301 note. Under
provisions of Executive Order 12564
and 5 U.S.C. 7301, test results may only
be disclosed to agency officials on a
need-to-know basis. This may include
the agency Medical Review Officer, the
administrator of the Employee
Assistance Program, and a supervisor
with authority to take adverse personnel
action. This information may also be
disclosed to a court where necessary to
defend against a challenge to an adverse
personnel action.
Submission of your SSN is not
required by law and is voluntary. Your
refusal to furnish your number will not
result in the denial of any right, benefit,
[FR Doc. E9–27371 Filed 11–16–09; 8:45 am]
PO 00000
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Public Burden Statement
Public Burden Statement: An agency
may not conduct or sponsor, and a
person is not required to respond to, a
collection of information unless it
displays a currently valid OMB control
number. The OMB control number for
this project is 0930–0158. Public
reporting burden for this collection of
information is estimated to average 5
minutes/donor, 4 minutes/collector, 3
minutes/test facility and 3 minutes/
Medical Review Officer. Send
comments regarding this burden
estimate or any other aspect of this
collection information, including
suggestions for reducing this burden, to
SAMHSA Reports Clearance Officer, 1
Choke Cherry Road, Room 7–1044,
Rockville, Maryland 20857.
BILLING CODE 4162–20–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2009–N–0664]
Thermal Aspects of Radio Frequency
Exposure; Public Workshop
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice of public workshop.
The Food and Drug Administration
(FDA) is announcing a public workshop
entitled ‘‘Thermal Aspects of Radio
Frequency Exposure.’’ The purpose of
the workshop is to discuss thermal
sensitivity and heating effects of
different tissues.
Date and Time: The public workshop
will be held on January 11 and 12, 2010,
from 8:30 a.m. to 5 p.m.
Location: The public workshop will
be held at the Gaithersburg Hilton, 620
Perry Pkwy., Gaithersburg, MD 20877.
Contact Person: Victoria Wagman,
Center for Devices and Radiological
Health, Food and Drug Administration,
10903 New Hampshire Ave., Silver
Spring, MD 20993, 301–796–6581, FAX:
301–796–5428, e-mail:
victoria.wagman@fda.hhs.gov.
E:\FR\FM\17NON1.SGM
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Agencies
[Federal Register Volume 74, Number 220 (Tuesday, November 17, 2009)]
[Notices]
[Pages 59196-59205]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-27371]
[[Page 59196]]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Proposed Revisions to Federal Drug Testing Custody and Control
Form
AGENCY: Substance Abuse and Mental Health Services Administration, HHS.
ACTION: Notice of Proposed Revisions to the Federal Custody and Control
Form.
-----------------------------------------------------------------------
SUMMARY: The Department of Health and Human Services (HHS) establishes
the standards for Federal workplace drug testing programs under
authority of Section 503 of Public Law 100-71, 5 U.S.C. Section 7301
and Executive Order No. 12564. As required, HHS published the Mandatory
Guidelines for Federal Workplace Drug Testing Programs (Guidelines) in
the Federal Register on April 11, 1988 (53 FR 11979). The Substance
Abuse and Mental Health Services Administration (SAMHSA) subsequently
revised the Guidelines on June 9, 1994 (59 FR 29908), on September 30,
1997 (62 FR 51118), on November 13, 1998 (63 FR 63483), on April 13,
2004 (69 FR 19644) and on November 25, 2008 (73 FR 71858) with an
effective date of May 1, 2010 (correct effective date published on
December 10, 2008; 73 FR 75122). The Guidelines establish comprehensive
standards for all aspects of the Federal workplace drug testing
program, including the requirement for all urine specimens to be
collected using chain of custody procedures to document specimen
integrity and security from the time of collection until receipt by the
``test facility.'' To ensure uniformity among all Federal agency
workplace drug testing programs and procedures, the Guidelines require
agencies to use an Office of Management and Budget (OMB) approved
Federal Custody and Control Form (Federal CCF) for their programs.
Additionally, the Department of Transportation (DOT) requires its
regulated industries to use the Federal CCF.
The current Federal CCF is a five-part form that consists of the
following copies: Copy 1--Laboratory Copy, with the tamper-evident
specimen bottle seal(s)/label(s) that are attached to the bottom of
Copy 1, Copy 2--Medical Review Officer (MRO) Copy, Copy 3--Collector
Copy, Copy 4--Employer Copy, and Copy 5--Donor Copy. The reverse side
of each copy has a Public Burden Statement. The reverse side of Copy 5
also has a Privacy Act Statement (for Federal employees only) and
instructions for completing the Federal CCF. The current Federal CCF
has been approved for use by OMB until September 1, 2012 for all
Federal agency and federally-regulated drug testing programs that must
comply with the Guidelines.
In the latest revision to the Guidelines, dated November 25, 2008
(73 FR 71858 with an effective date of May 1, 2010), the new
regulations will permit the certification of Instrumented Initial Test
Facilities (IITF) and will expand the drug testing profile to include
new drug analytes: methylenedioxymethamphetamine (MDMA) commonly known
as ``ecstasy,'' methylenedioxyamphetamine (MDA), and
methylenedioxyethylamphetamine (MDEA) which are close chemical
analogues of MDMA. These new regulatory actions will require that the
Federal CCF be modified to accommodate the new rule changes.
This notice provides proposed changes to the current Federal CCF.
It incorporates changes in accordance with the latest revisions to the
Guidelines (published November 25, 2008; 73 FR 71858; effective May 1,
2010) and recommendations developed in a collaborative effort involving
HHS and DOT. The proposed form is provided in Appendix A.
DATES: Written comments on the proposed draft should be submitted by
January 19, 2010.
ADDRESSES: Written comments should be addressed to Robert L. Stephenson
II, M.P.H., Director, Division of Workplace Programs (DWP), Center for
Substance Abuse Prevention (CSAP), 1 Choke Cherry Road, Room 2-1035,
Rockville, MD 20857. The public may also send comments by e-mail to
charles.lodico@samhsa.hhs.gov. All comments received will be posted
without change to https://www.drugfreeworkplace.gov.
FOR FURTHER INFORMATION CONTACT: Charles LoDico, M.S., D-ABFT, Drug
Testing Team, DWP, CSAP, 1 Choke Cherry Road, Room 2-1039, Rockville,
MD 20857, telephone (240) 276-2600, fax (240) 276-2610, or e-mail:
charles.lodico@samhsa.hhs.gov.
Discussion
SAMHSA is proposing several major changes to the Federal CCF. The
first major change is to revise Copy 1 to permit use by IITFs, in
addition to laboratories. This is in accordance with the latest
revisions to the Guidelines (published November 25, 2008; effective May
1, 2010), which allow certification of IITFs to perform federally-
regulated drug testing. A chain of custody section was added in Step 4
of Copy 1 for the IITF to document receipt of the specimen and, as
needed, to document subsequent transfer of the specimen to an HHS-
certified laboratory for testing. The second major change is to add the
new drug analytes required by the revised Guidelines to the Primary
Specimen Report section in Step 5a of Copy 1. The new drug analytes are
MDMA, MDA and MDEA. The third major change is to discontinue recording
split specimen test results on Copy 1 of the Federal CCF. Instead, Step
5b of Copy 1 will be used to identify the split testing laboratory
(i.e., laboratory name, city, and State), to indicate that the split
specimen was tested, and to refer to a separate laboratory report for
the split specimen test results. The fourth major change is to revise
the MRO reporting sections on Copy 2 for primary specimens (Step 6) and
for split specimens (Step 7), to facilitate reporting in accordance
with the Guidelines and DOT Regulations. Revisions to Copy 2, Step 6
include the addition of lines for the MRO to specify positive drug
analyte(s), to specify the adulterant/reason for reporting a specimen
as adulterated, and to report other reasons for reporting a Refusal to
Test (in addition to Adulteration and Substitution). Revisions to Copy
2, Step 7 include the addition of lines for the MRO to specify drug
analyte(s), substitution, or adulteration for ``Reconfirmed'' or
``Failed to Reconfirm'' split specimens, and the addition of a checkbox
to report a cancelled test.
A desired outcome from the proposed Federal CCF revision process
was to maintain the same form size (8.5 inch by 11 inch) as the current
Federal CCF. The content and format was redrawn for conciseness, to
conserve space, and to allow for the needed additional content while
maintaining the overall familiarity to which collectors, laboratories
and MROs were accustomed to using.
Appendix A presents the required format and appearance for each
copy of the proposed Federal CCF. SAMHSA recognizes that suppliers use
different hardware and software to print forms and minor differences in
appearance will occur. For example, the size of each checkbox on the
form may be different, the font sizes and styles used for letters may
be different, or the exact location of an item on a printed form may
vary slightly from the location indicated on the sample provided in
Appendix A. These minor changes in appearance are permitted since they
do not significantly impact on the required format. Other changes
permitted on the printed copies
[[Page 59197]]
include highlighting data entry/information fields where the collector
and donor would be providing information and using combs/boxes (rather
than a single line) for the donor's identification, to facilitate using
optical readers for transferring that information. The colors used to
highlight the fields may be different for different fields but must not
prevent making clear photocopies of the information that is printed or
handwritten in the highlighted fields. Other required information
(e.g., the name and address of the test facility, the specimen
identification number appearing on the top of the form and on the
specimen bottle seal(s)/label(s)) may be printed on the Federal CCF
during the original printing and assembly process or added by
overprinting the five-part printed form after assembly.
A detailed discussion of other proposed changes follows:
Copy 1
To reflect use of the Federal CCF by IITFs as well as laboratories,
Copy 1 has been redesignated as the Test Facility Copy (changed from
Laboratory Copy). As on the current form, Copy 1 has a one-inch space
at the top of the page reserved for: the title of the form (``Federal
Custody and Control Form'') that must be printed along the top edge,
the name and street address of the test facility, the unique preprinted
specimen identification number (i.e., a barcode with an associated
human readable number or only a human readable number), the test
facility accession number (if used), and other information (e.g.,
accounting) that the test facility or user of the Federal CCF may want
to include. There are no restrictions on the font size used for the
information appearing in this one-inch space. Also as on the current
form, the OMB number must be included, either vertically or
horizontally, in the upper right-hand corner.
The collector or employer representative completes Step 1. The
items in Step 1(a), (b), and (c) are essentially the same as on the
current Federal CCF. Step 1(d) is a new proposed item to list the
acronyms for the Federal testing authority under which the specimen is
being collected. The new Step 1(d) would read as follows: D. ``Specify
Testing Authority: HHS, NRC, DOT--Specify DOT Agency: FMCSA, FAA, FRA,
FTA, PHMSA, USCG'' with a checkbox beside each agency name.
The DOT-regulated testing program applies to more than 6 million
individuals. Some of the DOT agencies and the United States Coast Guard
(USCG) have or anticipate having reporting requirements for test
results. For example, the Federal Aviation Administration (FAA)
requires the reporting of test results for pilots and mechanics, while
the USCG requires the reporting of test results for mariners. We also
expect other DOT agencies (e.g., FMCSA) may in the future require the
identification of the ``testing authority'' in reporting of positive
and refusal to test results which will be entered into a database.
Identifying the Federal testing authority will facilitate reporting
results to DOT agencies when their regulations require it and will
assist HHS in identifying the Federal testing authority when it
receives laboratory data. The information identifying the specific
Federal testing authority captured on the Federal CCF will make it
simpler for the entity reporting the result to the DOT agency (usually
the employer or other program participant) to gather the information to
satisfy the DOT agency reporting requirement. Knowing which data
belongs to HHS, NRC, the USCG and the DOT agencies will prove helpful
to each of these entities.
The collector or employer should not find it difficult or
impossible to complete this new step. HHS and DOT experience is that
employers and Consortium/Third Party Administration (C/TPA) currently
provide specific instructions to the collector or collection site in
order to conduct the collection. For example, C/TPA would provide the
name of the employer, the date of the collection, the test reason,
whether the test is to be conducted under direct observation, and
employee information (e.g., name and ID number). Therefore, we would
expect the employers and C/TPAs to simply add another data element to
what they already provide. In the event the information in Step 1(d) is
not completed the test facility must not hold up processing, or testing
the specimen. Similarly, the MRO must not hold up reporting a verified
result. We believe this is something the test facility or MRO should
just note and continue with processing, testing, and reporting of the
specimen result.
Step 1(e) contains the item ``Reason for Test,'' with the reasons
consolidated on a single line to conserve space on the proposed Federal
CCF. Items in Steps 1(f) and (g) are essentially the same as on the
current Federal CCF.
The collector completes Step 2 after he/she has received the
specimen from the donor and has read the temperature of the specimen.
The changes proposed for Step 2 are intended to gain more space on the
proposed Federal CCF and to allow more space for the collector's
Remarks. One proposed change is to move the instructions for Step 2
[i.e., ``(make remarks when appropriate)'' and ``Collector reads
specimen temperature within 4 minutes''] to the same line as
``Completed by Collector.'' Another proposed change is to revise the
sentence ``Is temperature between 90 [deg] and 100 [deg]F?'' to
``Temperature between 90 [deg] and 100 [deg]F?'' This will reduce the
space required for the three sections in Step 2 [i.e., for recording
specimen temperature (Yes/No, Enter Remark) and collection type (Split/
Single/None Provided, Enter Remark), and to indicate an observed
collection (Observed, Enter Remark)]. We are proposing to increase the
space for collector comments in the ``Remarks'' section to allow
additional explanation and to improve legibility of handwritten
remarks.
Step 3 instructs the collector to seal the specimen bottle(s), the
donor to initial the bottle seal(s), and the donor to then complete
Step 5 on Copy 2 (the MRO copy). These are the same instructions as on
the current Federal CCF.
Step 4 is the chain of custody section initiated by the collector
and completed by the test facility. The major changes proposed for Step
4 are to permit use of the Federal CCF by IITFs, as well as by
laboratories, in accordance with the revised Guidelines. We are also
proposing format changes to improve legibility of handwritten entries
and facilitate form completion, while allowing all required information
to be included. In the collector's chain of custody section, we propose
to enlarge the block for the collector's signature while reducing the
width of the ``Specimen Bottle(s) Released to:'' block. We also propose
changing ``Initiated by Collector and Completed by Laboratory'' to
``Initiated by Collector and Completed by Test Facility''. The
``Received at IITF'' chain of custody section includes lines/checkboxes
for the accessioner at the IITF to sign and print his/her name on the
Federal CCF, record the date of specimen receipt, document the name and
address of the IITF (if different from that printed on the Federal
CCF), document the condition of the primary specimen bottle seal, and
document the transfer of specimen custody. If a specimen received at
the IITF cannot be reported (i.e., as rejected for testing, negative,
or negative and dilute), the remaining specimen will be resealed using
tamper-evident tape and forwarded to an HHS-certified laboratory for
testing. This handling will be documented in the ``Transfer from IITF
to Lab'' section of
[[Page 59198]]
the proposed Federal CCF. The laboratory chain of custody section in
Step 4 is essentially the same as on the current Federal CCF. We are
proposing changes similar to those for the collector's chain of custody
section: to enlarge the block for the laboratory accessioner's
signature while reducing the width of both the ``Specimen Bottle(s)
Released to:'' block and the block for documenting condition of the
primary specimen bottle seal.
Step 5(a) is completed by the test facility to report the test
results of the primary specimen. Changes are proposed for this section
in accordance with the revised Guidelines, including: changing
``Primary Specimen Test Results--Completed by Primary Laboratory'' to
``Primary Specimen Report--Completed by Test Facility''; adding the new
drug analytes (MDMA, MDA, and MDEA); changing ``Test Lab (if different
from above)'' to ``Test Facility (if different from above)''; and
changing ``Certifying Scientist'' to ``Certifying Technician/
Scientist'' on both signature and printed name lines. In addition, for
clarity and to facilitate form completion, we propose to reposition
drug/metabolite names and checkboxes, and to change the term ``Rejected
for Testing'' to ``Rejected.'' We also propose to add ``[Delta]9-THCA''
after ``Marijuana Metabolite'' and ``BZE'' after ``Cocaine Metabolite''
to specify the drug analytes.
We are proposing major changes to Step 5(b) of the current Federal
CCF to accommodate the additional information needed on Copy 1 to
address revised Guidelines requirements as described above.
Laboratories will no longer record split specimen test results on Copy
1 of the proposed Federal CCF and be moved to Copy 2 (Medical Review
Officer Copy). This change is justified by National Laboratory
Certification Program (NLCP) data obtained from HHS-certified
laboratories in 2008. These data indicate that only 0.07% of federally-
regulated split specimens were tested (i.e., 3.7% of the total reported
positives). Also, in many cases, the ``Remarks'' line of the current
Federal CCF is insufficient to document all required comments for
reporting split specimen test results. Laboratories often use a
separate laboratory report to report split specimen results to the MRO.
Therefore, in Step 5(b) of the proposed Federal CCF, the split
laboratory will record its name and location (city and State), indicate
that the split specimen was tested, and reference the separate
laboratory report for the split specimen test results.
At the bottom of Copy 1, we propose to reduce the area available
for tamper-evident labels/seals to conserve space. The proposed Federal
CCF in Appendix A shows two \1/2\-inch wide labels (i.e., reduced from
\3/4\-inch on the current Federal CCF). The reduced size is sufficient
for the required specimen identification number and should not affect
the legibility of information printed on the labels/seals. We are also
proposing to change the designation ``Copy 1--Laboratory'' printed on
the bottom of Copy 1 to ``Copy 1--Test Facility Copy''.
Copy 2
Steps 1 through 4 of Copy 2 (Medical Review Officer Copy) will be
the same as Steps 1 through 4 of Copy 1 (Test Facility Copy) through
the collector chain of custody section. The changes to the proposed
Federal CCF begin in Step 4 of Copy 2. We propose to delete the
``Received at Lab'' section in Step 4 of Copy 2 of the current Federal
CCF. The collector separates the copies of the Federal CCF and sends
Copy 1 to the test facility with the specimen. At that time, the test
facility resumes chain of custody documentation. Therefore, chain of
custody sections beyond the collector section are not completed on
Copies 2 through 5.
The collector instructs the donor to read the donor certification
statement in Step 5 of Copy 2 and to complete the entries (signature,
printed name, date, daytime telephone number, evening telephone number,
and date of birth) in this section. The MRO uses this information to
contact the donor as necessary during the verification process. We
propose to revise the instructions to the donor at the bottom of the
section to be consistent with current Guidelines requirements. The
current statement ``Should the results of the laboratory tests for the
specimen identified by this form be confirmed positive, the Medical
Review Officer will contact you * * *'' will be changed to ``After the
Medical Review Officer receives the test results for the specimen
identified by this form, he/she may contact you * * *.'' Also, for
clarity and ease of viewing, we propose to bold the lines on the
proposed Federal CCF above and below Step 5 to provide visual
separation of the section completed by the donor and the rest of the
form.
Step 6 on Copy 2 is used by the MRO to report the primary specimen
test results to the employer after completing the verification. The
proposed changes to this section are intended to facilitate form
completion in accordance with MRO reporting requirements in the
Guidelines and in DOT Regulations. The proposed changes include:
changing the term ``determination/verification'' to ``verification'',
repositioning results and checkboxes, adding a line after ``Positive''
for the MRO to specify the positive drug analyte(s), adding a line
after ``Adulterated'' for the MRO to specify the adulterant/reason,
adding ``Other'' under the ``Refusal to Test'' grouping to allow
additional reasons for this result, and adding another ``Remarks'' line
for the MRO's explanatory comments.
Step 7 is used by the MRO to report the split specimen test results
to the employer after completing the verification. The proposed changes
to this section are intended to facilitate form completion in
accordance with MRO reporting requirements in the Guidelines and in DOT
Regulations. The proposed changes include: changing the term
``determination/verification'' to ``verification'', adding a line after
``Reconfirmed'' for the MRO to specify the reconfirmed test results
(i.e., drug analytes, substitution, adulteration), adding the result
and checkbox to report ``Test Cancelled'', adding a line after ``Failed
to Reconfirm'' for the MRO to specify the test results that were not
reconfirmed (i.e., drug analytes, substitution, adulteration), and
adding another ``Remarks'' line for the MRO's explanatory comments.
Copy 3, Copy 4, Copy 5
Copy 3 (Collector Copy), Copy 4 (Employer Copy), and Copy 5 (Donor
Copy) will be the same as Copy 2 (Medical Review Officer Copy).
Instructions for Completing the Federal Custody and Control Form
As on the current Federal CCF, instructions for completing the form
are included on the back of Copy 5 (Donor Copy). The purpose of these
instructions is to provide the donor with an overview of the specimen
collection process. We propose to revise and update the instructions
for clarity and for consistency with the revised Guidelines.
Public Burden Statement
The Public Burden Statement in Appendix A must appear on all
Federal Government forms that place a reporting burden on gathering
information. This statement must be included on the back of each copy
of the Federal CCF (i.e., Copies 1 through 5). The reporting address in
this notice has been updated on the proposed revised Federal CCF and
the word ``laboratory'' has been changed to ``test facility''.
Otherwise, the statement is the same as the
[[Page 59199]]
``Paperwork Reduction Act Notice'' on the current OMB-approved Federal
CCF. However, SAMHSA is interested in receiving public comments
concerning the estimated average times for the collector, the donor,
the test facility, and the MRO to complete the form. Individuals
commenting on these topics should include in their estimates the time
to review, print information, and/or read certification statements on
the form.
Privacy Act Statement
The Privacy Act Statement in Appendix A must appear on the back of
Copy 5 (Donor Copy). It applies to all donors who are Federal
employees. The statement is the same as that on the current Federal
CCF.
Tamper-Evident Labels/Seals
The size of the two tamper-evident labels/seals may vary, but they
must be placed within the space provided at the bottom of Copy 1. It is
the responsibility of the supplier of the specimen bottle labels/seals
to ensure that they are tamper-evident. Tamper-evident tape is a tape
that is placed on a specimen bottle which cannot be removed and be
replaced without visible evidence that tampering has occurred. SAMHSA
believes this single requirement is sufficient to ensure that the
labels/seals provided with the Federal CCF are tamper-evident; however,
comments are welcome on recommending other specifications/requirements
that should be considered.
Availability of the Federal CCF
The proposed Federal CCF, once approved by OMB, will be available
on the SAMHSA Web site at https://www.drugfreeworkplace.gov/as an
electronic file (using several different formats) that can be
downloaded. Photocopies will also be available from the Division of
Workplace Programs (DWP). SAMHSA believes making the Federal CCF
available using this approach will ensure that the form is readily
available from different sources.
Elaine Parry,
Director, Office of Program Services, SAMHSA.
APPENDIX A--Federal Drug Testing Custody and Control Forms
BILLING CODE 4162-20-P
[[Page 59200]]
[GRAPHIC] [TIFF OMITTED] TN17NO09.005
Public Burden Statement
Public Burden Statement: An agency may not conduct or sponsor, and
a person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number. The OMB
control number for this project is 0930-0158. Public reporting burden
for this collection of information is estimated to average 5 minutes/
donor, 4 minutes/collector, 3 minutes/test facility and 3 minutes/
Medical Review Officer. Send comments regarding this burden estimate or
any other aspect of this
[[Page 59201]]
collection information, including suggestions for reducing this burden,
to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 7-1044,
Rockville, Maryland 20857.
[GRAPHIC] [TIFF OMITTED] TN17NO09.006
Public Burden Statement
Public Burden Statement: An agency may not conduct or sponsor, and
a person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number. The OMB
control number for this project is 0930-0158. Public reporting burden
for this collection of information is estimated to average 5 minutes/
donor, 4 minutes/collector, 3 minutes/test facility and 3 minutes/
[[Page 59202]]
Medical Review Officer. Send comments regarding this burden estimate or
any other aspect of this collection information, including suggestions
for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke
Cherry Road, Room 7-1044, Rockville, Maryland 20857.
[GRAPHIC] [TIFF OMITTED] TN17NO09.007
Public Burden Statement
Public Burden Statement: An agency may not conduct or sponsor, and
a person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number. The OMB
control number for this project is 0930-0158. Public reporting burden
for this collection of information is estimated to average 5 minutes/
donor, 4 minutes/collector, 3 minutes/test facility and 3 minutes/
[[Page 59203]]
Medical Review Officer. Send comments regarding this burden estimate or
any other aspect of this collection information, including suggestions
for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke
Cherry Road, Room 7-1044, Rockville, Maryland 20857.
[GRAPHIC] [TIFF OMITTED] TN17NO09.008
Public Burden Statement
Public Burden Statement: An agency may not conduct or sponsor, and
a person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number. The OMB
control number for this project is 0930-0158. Public reporting burden
for this collection of information is estimated to average 5 minutes/
donor, 4 minutes/collector, 3 minutes/test facility and 3 minutes/
[[Page 59204]]
Medical Review Officer. Send comments regarding this burden estimate or
any other aspect of this collection information, including suggestions
for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke
Cherry Road, Room 7-1044, Rockville, Maryland 20857.
[GRAPHIC] [TIFF OMITTED] TN17NO09.009
[[Page 59205]]
BILLING CODE 4162-20-C
Instructions for Completing the Federal Drug Testing Custody and
Control Form
When Making Entries Use Black or Blue Ink Pen and Press Firmly
Collector ensures that the name and address of the HHS-certified
Instrumented Initial Test Facility (IITF) or HHS-certified laboratory
are on the top of the Federal CCF and the Specimen identification
(I.D.). Number on the top of the Federal CCF matches the Specimen I.D.
number on the label(s)/seal(s).
STEP 1:
Collector ensures that the required information is in STEP
1. Collector enters a remark in STEP 2 if donor refuses to provide his/
her SSN or Employee I.D. number.
Collector gives collection container to Donor and
instructs Donor to provide a specimen. Collector notes any unusual
behavior or appearance of Donor in the remarks line STEP 2. If the
Donor's conduct at any time during the collection process clearly
indicates an attempt to tamper with the specimen, Collector notes the
conduct in the remarks line in STEP 2 and takes action as required.
STEP 2:
Collector checks specimen temperature within 4 minutes
after receiving the specimen from Donor, and marks the appropriate
temperature box in STEP 2. If the temperature is outside the acceptable
range, Collector enters a remark in STEP 2 and takes action as
required.
Collector inspects the specimen and notes any unusual
findings in the remarks line in STEP 2 and takes action as required.
Any specimen with unusual physical characteristics (e.g., unusual
color, presence of foreign objects or material, unusual odor) cannot be
sent to an IITF and must be sent to an HHS-certified laboratory for
testing, as required.
Collector determines the volume of specimen in the
collection container. If the volume is acceptable, Collector proceeds
with the collection. If the volume is less than required by the Federal
Agency, Collector takes action as required, and enters remarks in STEP
2. If no specimen is collected by the end of the collection process,
Collector checks the None Provided box, enters a remark in STEP 2,
discards Copy 1, and distributes remaining copies as required.
Collector checks the Split or Single specimen collection
box. If the collection is observed, Collector checks the Observed box
and enters a remark in STEP 2.
STEP 3:
Donor watches Collector pour the specimen from the
collection container into the specimen bottle(s), place the cap(s) on
the specimen bottle(s), and affix the label(s)/seal(s) on the specimen
bottle(s).
Collector dates the specimen bottle label(s) after
placement on the specimen bottle(s).
Donor initials the specimen bottle label(s) after
placement on the specimen bottle(s).
Collector turns to Copy 2 (Medical Review Officer Copy)
and instructs the Donor to read and complete the certification
statement in STEP 5 (signature, printed name, date, phone numbers, and
date of birth). If Donor refuses to sign the certification statement,
Collector enters a remark in STEP 2 on Copy 1.
STEP 4:
Collector completes STEP 4 on Copy 1 (signature, printed
name, date, time of collection, and name of delivery service), places
the sealed specimen bottle(s) and Copy 1 in a leak-proof plastic bag,
seals the bag, prepares the specimen package for shipment, and
distributes the remaining CCF copies as required.
Privacy Act Statement: (For Federal Employees Only)
Submission of the requested information on the attached form is
voluntary. However, incomplete submission of the requested information,
refusal to provide a urine specimen, or substitution or adulteration of
a specimen may result in delay or denial of your application for
employment/appointment or may result in removal from the Federal
service or other disciplinary action.
The authority for obtaining the urine specimen and identifying
information contained herein is Executive Order 12564 (``Drug-Free
Federal Workplace''), 5 U.S.C. Sec. 3301 (2), 5 U.S.C. Sec. 7301, and
Section 503 of Public Law 100-71, 5 U.S.C. Sec. 7301 note. Under
provisions of Executive Order 12564 and 5 U.S.C. 7301, test results may
only be disclosed to agency officials on a need-to-know basis. This may
include the agency Medical Review Officer, the administrator of the
Employee Assistance Program, and a supervisor with authority to take
adverse personnel action. This information may also be disclosed to a
court where necessary to defend against a challenge to an adverse
personnel action.
Submission of your SSN is not required by law and is voluntary.
Your refusal to furnish your number will not result in the denial of
any right, benefit, or privilege provided by law. Your SSN is
solicited, pursuant to Executive Order 9397, for purposes of
associating information in agency files relating to you and for
purposes of identifying the urine specimen provided for testing for the
presence of illegal drugs. If you refuse to indicate your SSN, a
substitute number or other identifier will be assigned, as required, to
process the specimen.
Public Burden Statement
Public Burden Statement: An agency may not conduct or sponsor, and
a person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number. The OMB
control number for this project is 0930-0158. Public reporting burden
for this collection of information is estimated to average 5 minutes/
donor, 4 minutes/collector, 3 minutes/test facility and 3 minutes/
Medical Review Officer. Send comments regarding this burden estimate or
any other aspect of this collection information, including suggestions
for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke
Cherry Road, Room 7-1044, Rockville, Maryland 20857.
[FR Doc. E9-27371 Filed 11-16-09; 8:45 am]
BILLING CODE 4162-20-P