Mandatory Guidelines for Federal Workplace Drug Testing Programs, 28101-28151 [2015-11524]

Agencies

• DEPARTMENT OF HEALTH AND HUMAN SERVICES
• Substance Abuse and Mental Health Services Administration

[Federal Register Volume 80, Number 94 (Friday, May 15, 2015)]
[Notices]
[Pages 28101-28151]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-11524]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration


Mandatory Guidelines for Federal Workplace Drug Testing Programs

AGENCY: Substance Abuse and Mental Health Services Administration 
(SAMHSA), HHS.

ACTION: Notice of proposed revisions to the mandatory guidelines by the 
Secretary of Health and Human Services.

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SUMMARY: The Department of Health and Human Services (``HHS'' or 
``Department'') is proposing to revise the Mandatory Guidelines for 
Federal Workplace Drug Testing Programs (Guidelines), 73 FR 71858 
(November 25, 2008) for urine testing.

DATES: Submit comments on or before July 14, 2015.

ADDRESSES: In commenting, please refer to file code SAMHSA-2015-0002. 
Because of staff and resource limitations, SAMHSA cannot accept 
comments by facsimile (FAX) transmission.
    You may submit comments in one of four ways (please choose only one 
of the ways listed):
     Electronically. You may submit electronic comments on this 
regulation to https://www.regulations.gov. Follow ``Submit a comment'' 
instructions.
     By regular mail. You may mail written comments to the 
following address ONLY: SAMHSA, Attention Division of Workplace 
Programs (DWP), 1 Choke Cherry RD., Rm. #7-1045, Rockville, MD 20857. 
Please allow sufficient time for mailed comments to be received before 
the close of the comment period.
     By express or overnight mail. You may send written 
comments to the following address ONLY: SAMHSA, Attention DWP, 1 Choke 
Cherry RD., Rm. #7-1045, Rockville, MD 20850.
     By hand or courier. Alternatively, you may deliver (by 
hand or courier) your written comments ONLY to the following address 
prior to the close of the comment period: SAMHSA, Attention DWP, 1 
Choke Cherry RD., Rm. #7-1045, Rockville, MD 20850. If you intend to 
deliver your comments to the Rockville address, call telephone number 
(240) 276-2600 in advance to schedule your arrival with one of our 
staff members. Because access to the interior of the SAMHSA Building is 
not readily available to persons without federal government 
identification, commenters are encouraged to schedule their delivery or 
to leave comments with the security guard front desk located in the 
main lobby of the building. Comments erroneously mailed to the address 
indicated as appropriate for hand or courier delivery may be delayed 
and received after the comment period.

FOR FURTHER INFORMATION CONTACT: Charles LoDico, M.S., DABFT, Division 
of Workplace Programs, Center for Substance Abuse Prevention (CSAP), 
SAMHSA mail to: 1 Choke Cherry Road, Room 7-1045, Rockville, MD 20857, 
telephone (240) 276-2600, fax (240) 276-2610, or email at 
charles.lodico@samhsa.hhs.gov.

SUPPLEMENTARY INFORMATION: 

Executive Summary

    This notice of proposed revisions to the Mandatory Guidelines for 
Federal Workplace Drug Testing Programs (Guidelines) will revise the 
initial and confirmatory drug test analytes and methods for urine 
testing, revise the cutoff for reporting a specimen as adulterated 
based on low pH, revise the requalification requirements for 
individuals serving as Medical Review Officers (MROs) and, where 
appropriate, include references to the use of an alternate specimen in 
federal workplace drug testing programs. References to an alternate 
specimen are not applicable until final Guidelines are implemented for 
the use of the alternative specimen matrix. The Department is issuing a 
separate Notice in the Federal Register proposing Mandatory Guidelines 
for Federal Workplace Drug Testing Programs using Oral Fluid (OFMG) to 
allow federal agencies to collect and test oral fluid specimens in 
their workplace drug testing programs.
    In particular, these revised Mandatory Guidelines for Federal 
Workplace Drug Testing Programs using Urine (UrMG) allow federal 
executive branch agencies to test for additional Schedule II of the 
Controlled Substances Act prescription medications (i.e., oxycodone, 
oxymorphone, hydrocodone and hydromorphone) in federal drug-free 
workplace programs, add methylenedioxyamphetamine (MDA) and 
methylenedioxyethylamphetamine (MDEA) as initial test analytes, raise 
the lower pH cutoff from 3 to 4 for identifying specimens as 
adulterated, require MRO requalification training and re-examination at 
least every five years after initial MRO certification, and allow 
federal agencies to authorize collection of an alternate specimen 
(e.g., oral fluid) when a donor in their program is unable to provide a 
sufficient amount of urine specimen at the collection site. Many of the 
proposed wording changes and reorganization of the UrMG were made for 
clarity, to use current scientific terminology or preferred grammar, 
and for consistency with the proposed OFMG.

Costs and Benefits

    Using data obtained from the Federal Workplace Drug Testing 
Programs and HHS certified laboratories, the Department estimates the 
number of specimens tested annually for federal agencies to be 150,000. 
HHS projects that approximately 7% (or 10,500) of the 150,000 specimens 
tested per year will be oral fluid specimens and 93% (or 139,500) will 
be urine specimens once the proposed OFMG have been

[[Page 28102]]

implemented. The approximate annual numbers of regulated specimens for 
the Department of Transportation (DOT) and Nuclear Regulatory 
Commission (NRC) are 6 million and 200,000, respectively. Should DOT 
and NRC allow oral fluid testing in regulated industries' workplace 
programs, the estimated annual numbers of specimens for DOT would be 
180,000 oral fluid and 5,820,000 urine, and number of specimens for NRC 
would be 14,000 oral fluid and 186,000 urine.
    In Section 3.4, the Department is proposing criteria for 
calibrating initial tests for grouped analytes such as opiates and 
amphetamines, and specifying the cross-reactivity of the immunoassay to 
the other analyte(s) within the group. These proposed Guidelines allow 
the use of methods other than immunoassay for initial testing. In 
addition, these proposed Guidelines include an alternative for 
laboratories to continue to use existing FDA-cleared immunoassays which 
do not have the specified cross-reactivity, by establishing a decision 
point with the lowest-reacting analyte. An immunoassay manufacturer may 
incur costs if they choose to alter their existing product and resubmit 
the immunoassay for FDA clearance.
    For the added opiate analytes, the two immunoassays currently used 
for oxycodone and oxymorphone meet the requirements, and two of the 
three existing opiate immunoassays used in certified laboratories meet 
the requirements for hydrocodone and hydromorphone analysis. The opiate 
immunoassay that does not have sufficient cross-reactivity would be 
acceptable as an initial test under these Guidelines when the lowest-
reacting analyte, hydromorphone, is used to establish a decision point.
    For amphetamines, one of the three existing methylenedioxymeth 
amphetamine (MDMA) immunoassays used in certified laboratories meets 
the requirements. The remaining two exhibit insufficient cross-
reactivity for MDA. These two immunoassays would be acceptable as an 
initial test under these Guidelines when the lowest-reacting analyte, 
MDA, is used to establish a decision point. An immunoassay manufacturer 
may incur costs if they choose to alter their existing product and 
resubmit the immunoassay for FDA clearance.
    Costs associated with the addition of oxycodone, oxymorphone, 
hydrocodone and hydromorphone will be minimal because the Department 
has determined that all HHS certified laboratories testing specimens 
from federal agencies are currently conducting tests for one or more of 
these analytes on non-regulated urine specimens. Likewise, there will 
be minimal costs associated with changing initial testing to include 
MDA and MDEA since the current immunoassays can be adapted to test for 
these analytes. Laboratory personnel are currently trained and test 
methods have been implemented. However, there will be some 
administrative costs associated with adding these analytes. Prior to 
being allowed to test regulated specimens for these compounds, HHS 
certified laboratories will be required to demonstrate that their 
performance meets Guideline requirements by testing three (3) groups of 
PT samples. The Department will provide the PT samples through the 
National Laboratory Certification Program (NLCP) at no cost to the 
certified laboratories. Based on costs charged for specimen testing, 
laboratory costs to conduct the PT testing would range from $900 to 
$1,800 for each of the certified laboratories.
    Once the testing has been implemented, the cost per specimen for 
initial testing for the added analytes will range from $.06 to $0.20 
due to reagent costs. Current costs for each confirmatory test range 
from $5.00 to $10.00 for each specimen reported as positive due to 
costs of sample preparation and analysis. Based on information from 
non-regulated workplace drug testing for these analytes in 2012 and 
testing performed by the Department on de-identified federally 
regulated specimens in 2011, approximately 1% of the submitted 
specimens is expected to be confirmed as positive for the added 
analytes. Therefore, the added cost for confirmatory testing will be 
$0.05 to $0.10 per submitted specimen. This would indicate that the 
total cost per specimen submitted for testing will increase by $0.11-
$0.30.
    The addition of the Schedule II prescription medications will 
require MRO review to verify legitimate drug use. Based on the 
positivity rates from non-regulated workplace drug testing for these 
analytes and this additional review of specimens confirmed positive for 
prescription medications, MRO costs are estimated to increase by 
approximately 3%.
    The additional costs for testing and MRO review will be 
incorporated into the overall cost for the federal agency submitting 
the specimen to the laboratory. The estimation of costs incurred is 
based upon overall cost to the federal agency because cost is usually 
based on all specimens submitted from an agency, rather than individual 
specimen testing costs or MRO review of positive specimens. Agencies 
may also incur some costs for training of federal employees such as 
drug program coordinators due to implementation of the revised 
Guidelines. However, costs are expected to be minimal in the training 
process to understand the required changes in these Guidelines.
    Based on the current figures, the cost for urine testing in the 
first year is estimated on 139,500 urine specimens for HHS, 5,820,000 
urine specimens for DOT, and 186,000 urine specimens for NRC. Estimated 
costs are $99,045-$230,175 for HHS, $4,132,200-$9,603,000 for DOT, and 
$132,060-$306,900 for NRC.
    Inspection of Public Comments: All comments received before the 
close of the comment period are available for viewing by the public. 
Please note that all comments are posted in their entirety, including 
personal or confidential business information that is included in a 
comment. SAMHSA posts all comments before the close of the comment 
period on the following Web site as soon as possible after they have 
been received: https://www.regulations.gov. Follow the search 
instructions on the Web site to view public comments. Comments received 
before the close of the comment period will also be available for 
public inspection as they are received, generally beginning 
approximately three weeks after publication of a document, at the 
Substance Abuse and Mental Health Services Administration, Division of 
Workplace Programs, 1 Choke Cherry RD., Rockville, MD, 20850, Monday 
through Friday of each week from 8:30 a.m. to 4:00 p.m. To schedule an 
appointment to view public comments, call (240) 276-2600.

Background

    The Department of Health and Human Services (HHS), by the authority 
of Section 503 of Public Law 100-71, 5 U.S.C. Section 7301, and 
Executive Order No. 12564, has established the scientific and technical 
guidelines for federal workplace drug testing programs and established 
standards for certification of laboratories engaged in urine drug 
testing for federal agencies. As required, HHS originally published the 
Mandatory Guidelines for Federal Workplace Drug Testing Programs 
(Guidelines) in the Federal Register [FR] 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], September 30, 1997 [62 FR 51118], November 13, 1998 [63 FR 
63483], April 13, 2004 [69 FR 19644],

[[Page 28103]]

and 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 effective date of the Guidelines was further changed to 
October 1, 2010 on April 30, 2010 [75 FR 22809].

History and Proposed Changes to the HHS Mandatory Guidelines for 
Federal Workplace Drug Testing Programs

    At the July 2011 meeting of SAMHSA's Drug Testing Advisory Board 
(DTAB), Board members voted unanimously for the following:

    (1) Based on review of the science, DTAB recommends that SAMHSA 
include oral fluid as an alternative specimen in the Mandatory 
Guidelines for Federal Workplace Drug Testing Programs; and (2) DTAB 
recommends the inclusion of additional Schedule II prescription 
medications (e.g., oxycodone, oxymorphone, hydrocodone and 
hydromorphone) in the Mandatory Guidelines for Federal Workplace 
Drug Testing Programs.

    At the January 2012 DTAB meeting, the SAMHSA Administrator received 
the DTAB recommendations from the July 2011 meeting.
    The responses to the April 13, 2004 notice proposing alternative 
specimen matrices (69 FR 19673) had made it clear that if the 
Department were to subsequently authorize alternative specimens for the 
Mandatory Guidelines for Federal Workplace Drug Testing Programs, 
separate Guidelines would be needed to provide clear and comprehensive 
information on the scientific and technical requirements for each 
specimen matrix. Therefore, HHS is proposing Mandatory Guidelines for 
Federal Workplace Drug Testing Programs Using Urine (UrMG) and 
Mandatory Guidelines for Federal Workplace Drug Testing Programs Using 
Oral Fluid (OFMG). The proposed UrMG and OFMG have been organized into 
analogous sections and use the same language where possible. The only 
differences are due to requirements that are specific for each specimen 
matrix.
    Since the original Guidelines were published in 1988, a number of 
recommendations have been made for additional drugs to be included in 
federal workplace drug testing programs. Further, the Department 
monitors drug abuse trends and reviews information on new drugs of 
abuse from sources such as federal regulators, researchers, the drug 
testing industry, and public and private sector employers. The 
Department revised the Guidelines to include 6-acetylmorphine in 1998 
(63 FR 63483) and three amphetamine analogues 
[methylenedioxymethamphetamine (MDMA), methylenedioxyamphetamine (MDA), 
and methylenedioxyethylamphetamine (MDEA)] in 2008 (73 FR 71858). The 
July 21, 2011 DTAB recommendations for the added drugs were based on 
the Board members' review of scientific information on the methods 
necessary to detect the analytes of these drugs and on drug abuse 
trends.
    The DTAB recommendations, current drug abuse trends and other 
relevant information, and the private sector experience have led the 
Department to conclude that the additional opiates oxycodone, 
oxymorphone, hydrocodone, and hydromorphone should be added in the 
federal program.

Provisions for the Administration of the National Laboratory 
Certification Program (NLCP)

    In accordance with the current practice, an HHS contractor will 
perform certain functions on behalf of the Department. These functions 
include maintaining laboratory inspection and performance testing (PT) 
programs that satisfy the requirements described in the Guidelines. 
These activities include, but are not limited to, reviewing inspection 
reports submitted by inspectors, reviewing PT results submitted by 
laboratories, preparing inspection and PT result reports, and making 
recommendations to the Department regarding certification or 
suspension/revocation of laboratories' certification. It is important 
to note that, although a contractor gathers and evaluates information 
provided by the inspectors or laboratories, all final decisions 
regarding laboratory certification, suspension, or revocation of 
certification are made by the Secretary.
    The Department contributes funds to this contract for purposes not 
directly related to laboratory certification activities, such as 
evaluating technologies and instruments and providing assessments of 
their potential applicability to workplace drug testing programs.

Organization of Proposed Guidelines

    This preamble describes the differences between the current 
Mandatory Guidelines for Federal Workplace Drug Testing Programs 
(Guidelines) and the proposed Mandatory Guidelines for Federal 
Workplace Drug Testing Programs using Urine Specimens (UrMG), and the 
rationale for the differences. In addition, the Preamble presents two 
topics of special interest to be addressed for the revised Guidelines. 
These topics are presented first in summary as they appear in the text 
of the proposed UrMG and later as topics of special interest for which 
the Department is seeking public comments.

Subpart A--Applicability

    Section 1.5 defines terms used in the UrMG. Where possible, the 
Department proposes to revise the definitions in the current Guidelines 
to apply to any specimen matrix allowed in federal workplace drug 
testing programs, so the terms and their definitions will be identical 
in both the UrMG and the proposed Mandatory Guidelines for Federal 
Workplace Drug Testing Programs using Oral Fluid Specimens (OFMG). In 
addition, the Department proposes to add new definitions or revise the 
definitions in the current Guidelines as needed for terms that apply 
only to urine (e.g., collection container). The Department also 
proposes to revise and update terms and definitions in the current 
Guidelines for clarity and consistency with current scientific 
terminology (e.g., changing the term limit of quantitation to limit of 
quantification; no longer using the term quality control samples for 
both calibrators and controls).
    Sections 1.6, 1.7, and 1.8 contain the same policies as described 
in the current Guidelines with regard to what an agency is required to 
do to protect employee records, the conditions that constitute refusal 
to take a federally regulated drug test, and the consequences of a 
refusal to take a federally regulated drug test. In the proposed UrMG, 
Section 1.7 of the current Guidelines was divided into two sections for 
clarity: Section 1.7 describes what constitutes a refusal to test and 
Section 1.8 describes the subsequent actions and consequences. Section 
1.7 also has been reworded as needed to address other authorized 
specimen types.

Subpart B--Urine Specimen

    The Department proposes to revise Section 2.1 of the current 
Guidelines to reflect the Department's proposed expansion of the drug-
testing program for federal agencies to permit the use of oral fluid 
specimens. There is no requirement for federal agencies to use oral 
fluid as part of their program. When the OFMG become effective and HHS 
has certified laboratories under the OFMG, a federal agency may choose 
to use urine, oral fluid, or both specimen types in their drug testing 
program. Any agency choosing to use urine is required to follow the 
UrMG and any agency choosing to use oral fluid is required to follow 
the OFMG. For example, an agency program can randomly assign

[[Page 28104]]

individuals to either urine or OF testing, for random or pre-employment 
testing. This would not only help reduce subversion, but would allow 
comparison of urine and OF testing outcomes for planning purposes.
    Section 2.6 was added to clarify that all entities and individuals 
identified in Section 1.1 of these Guidelines are prohibited from 
releasing specimens collected under the federal workplace drug testing 
program to any individual or entity unless expressly authorized by 
these Guidelines or in accordance with applicable federal law.
    While these Guidelines do not authorize the release of specimens, 
or portions thereof, to federal employees, the Guidelines afford 
employees a variety of protections that ensure the identity, security 
and integrity of their specimens from the time of collection through 
final disposition of the specimen. There are also procedures that allow 
federal employees to request the retesting of their specimen (for 
drugs, adulteration, or substitution) at a different certified 
laboratory. Furthermore, the Guidelines grant federal employees access 
to a wide variety of information and records related to the testing of 
their specimens, including a documentation package that includes, among 
other items, a copy of the Federal CCF with any attachments, internal 
chain of custody records for the specimen, and any memoranda generated 
by the laboratory or Instrumented Initial Test Facility (IITF).
    Therefore, the Guidelines offer federal employees and federal 
agencies transparent and definitive evidence of a specimen's identity, 
security, control and chain of custody. However, the Guidelines do not 
entitle employees access to the specimen itself or to a portion 
thereof. The reason for this prohibition is that specimens collected 
under the Guidelines are uniquely designed for the purpose of drug and 
validity testing only. They are not designed for other purposes such as 
deoxyribonucleic acid (DNA) testing. Furthermore, conducting additional 
testing outside the parameters of the Guidelines would not guarantee 
incorporation of the safeguards, quality control protocols, and the 
exacting scientific standards developed under the Guidelines to ensure 
the security, reliability and accuracy of the drug testing process.

Subpart C--Urine Specimen Tests

    Section 3.3(a) includes the same requirement as the current 
Guidelines for urine specimens collected for federal agency workplace 
drug testing programs to be tested only for drugs and to determine 
their validity. While satisfied that the policy as stated in the 
current Guidelines prohibits other testing (e.g., DNA testing) on a 
specimen, the Department has removed the phrase ``unless otherwise 
authorized by law'' and reworded for clarity. The revised section 
states that specimens must only be tested for drugs and to determine 
their validity in accordance with Subpart C of these Guidelines. The 
reasons for this prohibition are described above, in comments for 
Section 2.6.
    Section 3.4 lists the drug test analytes and cutoff concentrations 
for urine. The table in Section 3.4 is the same in the current 
Guidelines with three notable exceptions. First, the proposed UrMG 
include the added opiates oxycodone, oxymorphone, hydrocodone, and 
hydromorphone as initial and confirmatory test analytes. Second, the 
proposed UrMG include methylenedioxyamphetamine (MDA) and 
methylenedioxyethylamphetamine (MDEA) as initial test and confirmatory 
test analytes. The current Guidelines include these two drugs as 
confirmatory test analytes only. Third, the requirement for initial 
testing using immunoassay-based technology has been changed to allow 
initial testing by ``alternate'' technologies (see footnote 2 of the 
table). This is also the reason for specifying the target analyte for 
each initial test. Considerable discussion was conducted in DTAB 
meetings regarding these proposed revisions. The DTAB received input 
from laboratories, reagent manufacturers, subject matter experts, and 
the FDA.
    For initial tests for opiates and amphetamines using immunoassay, 
the Department is proposing that the immunoassay be calibrated with one 
analyte from the group that is identified as the target analyte. 
Footnote 2 of the table in Section 3.4 includes the proposed criteria 
for calibrating initial tests for these grouped analytes. The cross-
reactivity of the immunoassay to the other analyte(s) within the group 
must be 80% or greater. The Department is aware that an FDA-cleared 
immunoassay meeting these criteria may not exist at the time of the 
UrMG effective date. If an FDA-cleared immunoassay does not demonstrate 
at least 80 percent cross-reactivity to each analyte, the laboratory or 
IITF may use the lowest-reacting analyte to establish a decision point 
to identify specimens as negative or requiring confirmatory testing. 
This is accomplished by calibrating the FDA-cleared immunoassay using 
the manufacturer's target analyte, including a control containing the 
lowest-reacting analyte at its cutoff concentration in each initial 
test batch, and comparing the immunoassay responses of specimens in the 
batch to that of the lowest-reacting analyte control. Alternatively, 
the laboratory or IITF must use separate immunoassays. The proposed 
analytes and cutoffs are addressed separately and in detail below. The 
Department is proposing to permit the use of technologies other than 
immunoassay techniques for initial drug testing. In recent years, 
technological advances have been made to techniques (e.g., methods 
using spectrometry or spectroscopy) that enable their use as efficient 
and cost-effective alternatives to the immunoassay techniques for 
initial drug testing while maintaining the required degree of 
sensitivity, specificity, and accuracy. The proposed Guidelines allow 
the use of alternate technologies provided that the laboratory or IITF 
validates the method in accordance with Section 11 for laboratories or 
Section 12 for IITFs and demonstrates acceptable performance in the PT 
program.
    The proposed analytes and cutoffs follow.

Inclusion of Oxycodone, Oxymorphone, Hydrocodone, Hydromorphone

    Misuse and abuse of psychotherapeutic prescription drugs, including 
opioid pain relievers, are issues of concern for all populations 
regardless of age, gender, ethnicity, race, or community. Recent data 
show that opioid-related overdose deaths in the U.S. now outnumber 
overdose deaths involving all illicit drugs such as heroin and cocaine 
combined. In addition to overdose deaths, emergency department visits, 
substance treatment admissions and economic costs associated with 
opioid abuse have all increased in recent years. The Department is 
continuing to work with partners at the federal, state, and local 
levels to implement policies and programs to reduce prescription drug 
abuse and improve public health.\1\
    The Department proposes the inclusion of additional Schedule II 
prescription medications (i.e., oxycodone, oxymorphone, hydrocodone and 
hydromorphone) in the list of authorized drug tests and cutoff 
concentrations. This action was recommended by the DTAB, reviewed by 
the Department's Prescription Drug Subcommittee of the Behavioral 
Health Coordinating Committee, and received by the SAMHSA Administrator 
in January 2012. The inclusion of oxycodone, oxymorphone, hydrocodone 
and hydromorphone is supported by various data. According to the 2012

[[Page 28105]]

National Survey on Drug Use and Health, which provides data on illicit 
drug use in the United Sates, current (past month) nonmedical users 
aged 12 years and older of prescription psychotherapeutic drugs 
increased from 2003 (6.5 million) to 2012 (6.8 million).\2\ 
Psychotherapeutic drugs are defined as opioid pain relievers, 
tranquilizers, sedatives, and stimulants. The abuse of 
psychotherapeutic drugs non-medically is ranked second behind 
marijuana, where pain relievers represent the majority of the group. 
The Drug Abuse Warning Network (DAWN), which provides national 
estimates of drug-related visits to hospital emergency departments 
(ED), showed that, of the 1.2 million ED visits involving nonmedical 
use of pharmaceuticals in 2011, 46.0 percent involved nonmedical use of 
pain relievers, with 29 percent being narcotic pain relievers.\3\ The 
most frequently involved narcotic pain relievers were oxycodone and 
hydrocodone. From 2004 to 2011, ED visits involving nonmedical use of 
narcotic pain relievers increased by 153 percent. ED visits involving 
opiates/opioids increased by 183 percent during this period, with 
increases of 438 percent for hydromorphone, 263 percent for oxycodone, 
and over 100 percent for hydrocodone, as well as fentanyl and morphine. 
In addition, the National Forensic Laboratory Information System 
(NFLIS) found that oxycodone and hydrocodone were among the top ten 
drugs seized in law enforcement operations and sent to federal, state, 
and municipal forensic laboratories.\4\ Among prescription drugs, 
oxycodone and hydrocodone ranked first and second. Information on over 
5 million drug tests in general workplace drug testing shows that the 
positivity rate for oxycodone and hydrocodone (0.96%) was second only 
to marijuana in 2012.\5\
    The addition of these Schedule II prescription medications will 
require MRO review to verify legitimate drug use. Consistent with the 
current Guidelines, the MRO must contact the donor to determine if 
there is a legitimate medical explanation for a positive result. If the 
donor provides a legitimate medical explanation (e.g., a valid 
prescription) for the positive result, the MRO reports the test result 
as negative to the agency.
    The use of medications, specifically Schedule II drugs, without a 
prescription is a growing concern for the Department in workplace drug 
testing, and the proposal for their inclusion offers the opportunity to 
deter nonmedical use of these drugs among federal workers. The 
Department does note that in recognition of the prescription drug abuse 
issue, the Department of Defense issued a memorandum on January 30, 
2012, announcing the expansion of their drug testing panel to include 
hydrocodone and benzodiazepines starting on May 1, 2012. Similarly, the 
Department proposes that federal agencies include the testing of 
oxycodone, oxymorphone, hydrocodone, and hydromorphone in urine 
specimens as described below.

Oxycodone/Oxymorphone

    The Department is proposing to test for oxycodone/oxymorphone using 
a 100 ng/mL cutoff concentration for the initial test and 50 ng/mL for 
the confirmatory test cutoff concentration. Both oxycodone and 
oxymorphone are potent analgesics that are available by prescription 
for pain relief. Oxycodone is partially metabolized by O-demethylation 
to oxymorphone and both parent drug and metabolite are excreted in 
urine following oxycodone administration.6-10 Following 
oxymorphone administration, oxymorphone is metabolized and excreted in 
urine primarily as a glucuronide conjugate of the parent 
drug.6 10
    An immunoassay initial test for oxycodone/oxymorphone should be 
calibrated with one of the two analytes and demonstrate sufficient 
cross-reactivity with the other analyte. The Department proposes that 
the minimum cross-reactivity with either analyte be 80 percent or 
greater. If an alternate technology initial test is performed instead 
of immunoassay, either one or both analytes in the group should be used 
to calibrate, depending on the technology. The quantitative sum of the 
two analytes must be equal to or greater than 100 ng/mL. The 
quantitative sum of the two analytes must be based on quantitative 
values for each analyte that are equal to or above the laboratory's 
validated limit of quantification.
    The 50 ng/mL confirmatory test cutoff concentration applies equally 
to oxycodone and oxymorphone. A positive test would be comprised of 
either or both analytes with a confirmed concentration equal to or 
greater than 50 ng/mL.

Hydrocodone/Hydromorphone

    The Department is proposing to test for hydrocodone/hydromorphone 
using a 300 ng/mL cutoff concentration for the initial test and 100 ng/
mL for the confirmatory test cutoff concentration. Both hydrocodone and 
hydromorphone are potent analgesics that are available by prescription 
for pain relief. Hydrocodone is partially metabolized by O-
demethylation to hydromorphone and both parent drug and metabolite are 
excreted in urine following hydrocodone 
administration.6 9 12-14 Following hydromorphone 
administration, hydromorphone is metabolized and excreted in urine 
primarily as a glucuronide conjugate of the parent drug.\15\ 
Hydrocodone has been reported to be a minor metabolite of codeine \16\ 
and hydromorphone has been reported to be a minor metabolite of 
morphine.17 18
    An immunoassay initial test for hydrocodone/hydromorphone should be 
calibrated with one of the two analytes and demonstrate sufficient 
cross-reactivity with the other analyte. The Department proposes that 
the minimum cross-reactivity with either analyte be 80 percent or 
greater. If an alternate technology initial test is performed instead 
of immunoassay, either one or both analytes in the group should be used 
to calibrate, depending on the technology. The quantitative sum of the 
two analytes must be equal to or greater than 300 ng/mL. The 
quantitative sum of the two analytes must be based on quantitative 
values for each analyte that are equal to or above the laboratory's 
validated limit of quantification.
    The confirmatory test cutoff concentration applies equally to 
hydrocodone and hydromorphone. A positive test would be comprised of 
either or both analytes with a confirmed concentration equal to or 
greater than 100 ng/mL.
    In 2009, the U.S. Drug Enforcement Administration (DEA) asked the 
U.S. Department of Health and Human Services (HHS) for a recommendation 
regarding whether to change the schedule for hydrocodone combination 
drug products, such as Vicodin. The proposed change was from Schedule 
III to Schedule II, which would increase the controls on these 
products. Due to the unique history of this issue and the tremendous 
amount of public interest, in October 2013, the FDA Center for Drug 
Evaluation and Research announced the agency's intent to recommend to 
HHS that hydrocodone combination drug products should be reclassified 
to Schedule II. FDA stated that this determination came after a 
thorough and careful analysis of extensive scientific literature, 
review of hundreds of public comments on the issue, and several public 
meetings, during which FDA received input from a wide range of 
stakeholders, including patients, health care providers, outside 
experts, and other government entities.
    In December 2013, FDA, with the concurrence of the National 
Institute on Drug Abuse (NIDA), submitted a formal recommendation 
package to HHS to

[[Page 28106]]

reclassify hydrocodone combination drug products into Schedule II. Also 
in December 2013, the Secretary of HHS submitted the scientific and 
medical evaluation and scheduling recommendation to the DEA for its 
consideration. On August 22, 2014, DEA published the Final Rule that 
moves hydrocodone combination drug products from Schedule III to 
Schedule II.

Inclusion of Methylenedioxyamphetamine (MDA) and 
Methylenedioxyethylamphetamine (MDEA) as Initial Test Analytes

    The Department proposes adding MDA and MDEA as initial test 
analytes in the list of authorized drug tests and cutoff 
concentrations. The current Guidelines include these two drugs as 
confirmatory test analytes only, in conjunction with an initial test 
for MDMA. Specifying these compounds as initial test analytes (in 
addition to MDMA) improves their detection by initial tests using 
immunoassay, and enables detection by initial tests using an alternate 
technology, as allowed under these proposed Guidelines. All three 
analytes are Schedule I drugs. The Department is proposing to test for 
MDMA/MDA/MDEA using a 500 ng/mL cutoff concentration for the initial 
test and 250 ng/mL for the confirmatory test cutoff concentration.
    An immunoassay initial test for MDMA/MDA/MDEA should be calibrated 
with one of the three analytes and demonstrate sufficient cross-
reactivity with the other analytes. The Department proposes that the 
minimum cross-reactivity with each analyte be 80 percent or greater. If 
an alternate technology initial test is performed instead of 
immunoassay, either one or all analytes in the group should be used to 
calibrate, depending on the technology. The quantitative sum of the 
three analytes must be equal to or greater than 500 ng/mL. The 
quantitative sum of the three analytes must be based on quantitative 
values for each analyte that are equal to or above the laboratory's 
validated limit of quantification.
    The confirmatory test cutoff concentration applies equally to MDMA, 
MDA, and MDEA. A positive test would be comprised of one or more 
analytes with a confirmed concentration equal to or greater than 250 
ng/mL.
    Section 3.5 authorizes HHS-certified laboratories to perform 
additional tests to assist the Medical Review Officer (MRO) in making a 
determination of positive or negative results. The Department believes 
that additional tests requested by the MRO can provide useful 
information to determine the veracity of a donor's medical explanation. 
This is a revision to the current Guidelines, but is consistent with 
current practices. An example of an additional test currently requested 
by an MRO is when the laboratory reports a positive methamphetamine 
result. The MRO may request a d,l-stereoisomer determination for 
methamphetamine, to determine whether the result could be attributed to 
use of an over-the-counter nasal inhaler. Another example of current 
practice is when the laboratory reports a positive THCA result, and the 
MRO requests testing for cannabivarin, to distinguish marijuana use 
from dronabinol (e.g., Marinol[supreg]).
    In Section 3.6, the Department proposes to revise the criteria to 
report a urine specimen as adulterated based on pH. Specifically, in 
paragraph 3.6(a), the Department is proposing to raise the low pH 
cutoff for adulteration from less than 3 to less than 4. This decision 
is based on the fact that the physiologically minimum achievable urine 
pH that can be produced by the kidneys is about pH 4.5.\19\ 
Furthermore, there are no known medical conditions or medications that 
would cause urine pH to be less than 4.5. Any free hydrogen ions 
present in the renal tubular fluid are either buffered and secreted 
into urine in the form of ammonium, phosphate, sulfate, and weak 
organic acid ions with minimal change to the urine pH or they back leak 
into the extracellular fluid and are not excreted into the urine, which 
explains the physiological lower limit of 4.5 for urine pH. A proposed 
pH cutoff for adulteration of less than 4 creates an invalid pH range 
of ``equal to or greater than 4 and less than 4.5,'' which protects the 
donor from a pH test result less than 4.5 that could be due to 
analytical imprecision.
    Section 3.8 contains the same criteria as the current Guidelines 
for reporting a urine specimen as dilute in conjunction with positive 
or negative drug test results. The section has been revised to clarify 
the criteria for specific gravity results measured to four-decimal 
places (i.e., as required when creatinine is less than or equal to 5 
mg/dL).
    Section 3.9 contains the criteria for reporting an invalid result 
for a urine specimen. This section contains the same criteria for 
reporting an invalid result for a urine specimen as in the current 
Guidelines with four revisions. Paragraph 3.9(b) contains the criteria 
for reporting a specimen as invalid based on pH. The lower pH range has 
been changed to ``equal to or greater than 4 and less than 4.5,'' 
consistent with the proposed change to the low pH cutoff for 
adulteration [i.e., raising the pH 3 cutoff to 4; Section 3.6(a)]. 
Paragraph 3.9(i) addresses interference using an alternate initial drug 
test method (i.e., other than immunoassay) as proposed in the UrMG. 
This section includes an additional criterion in Paragraph 3.9(m) that 
allows reporting an invalid result when the specimen is not consistent 
with human urine as evidenced by additional specimen validity test 
results. This is consistent with the proposed Section 3.5 that allows 
the MRO to request additional tests. For example, at least one HHS-
certified laboratory currently tests their non-regulated workplace 
urine specimens for a urine biomarker (i.e., uric acid) to distinguish 
urine of human origin from synthetic urine. The Department believes 
that such tests can be useful, especially in light of the proliferation 
of urine substitution products that have been formulated to meet the 
criteria for routine specimen validity tests (i.e., creatinine and pH). 
The tests must be forensically acceptable and scientifically sound.

Subpart D--Collectors

    Sections 4.1 through 4.6 contain the same policies as the current 
Guidelines in regard to who may or may not collect a specimen, the 
requirements to be a collector, the requirements to be an observer for 
a direct observed collection, the requirements to be a trainer for 
collectors, and what a federal agency must do before a collector is 
permitted to collect a specimen. The only changes from the current 
Guidelines are some rewording for clarity and a minor change in the 
type of mock collections required for collector training in Section 
4.3(a)(4).

Subpart E--Collection Sites

    Sections 5.1 through 5.6 address requirements for collection sites, 
collection site records, how a collector ensures the security and 
integrity of a specimen at the collection site, and the privacy 
requirements when collecting a specimen. Most requirements are the same 
as in the current Guidelines, but some items have been reworded for 
clarity. The Department added a new Section 5.3 clarifying that 
collection site records must be stored at a secure site designated by 
the collector or the collector's employer. The Department also revised 
Section 5.4 to allow hardcopy records to be discarded 6 months after 
conversion to electronic records. This change ensures the availability 
of the records while reducing the recordkeeping burden, and is 
consistent with the Paperwork Reduction Act.

[[Page 28107]]

Subpart F--Federal Drug Testing Custody and Control Form

    Sections 6.1 and 6.2 are the same as in the current Guidelines, 
requiring an OMB-approved Federal CCF be used to document custody and 
control of each specimen at the collection site, and specifying what 
should occur if the correct OMB-approved CCF is not used.

Subpart G--Urine Specimen Collection Containers and Bottles

    Sections 7.1 through 7.3 describe requirements for the collection 
container, temperature strip, and bottles that must be used to for 
urine specimen collections. The Department has added detailed 
requirements for these items, to enable proper collection and 
maintenance of the urine specimen.
    Section 7.1 requires a single use container that has a means to 
measure urine temperature and two specimen bottles for urine 
collection.
    Section 7.2 requires that the urine collection container, including 
the temperature strip and the bottles, not substantially affect the 
composition of drug and/or drug metabolites in the specimen. In 
addition, the two bottles must be sealable and non-leaking and maintain 
the integrity of the specimen during storage and transport, and must be 
sufficiently transparent to enable an objective assessment of the A and 
B specimens' appearance and identification of abnormal physical 
characteristics upon receipt at the HHS-certified laboratory or IITF.
    Section 7.3 details the minimum performance requirements for a 
collection container and bottles (i.e., required volume capacity and 
volume markings) and for the thermometer used to measure specimen 
temperature. The thermometer may be affixed to or built into the 
collection container and must provide graduated temperature readings. 
Alternatively, the collector may use another technology to measure 
specimen temperature (e.g., thermal radiation scanning), providing the 
thermometer does not come into contact with the specimen.

Subpart H--Urine Specimen Collection Procedure

    This subpart addresses the same topics, in the same order, as the 
OFMG procedures for oral fluid specimen collection. While the procedure 
is essentially the same as described in the current Guidelines, the 
Department has reordered and/or reworded steps for clarity and for 
consistency with the proposed OFMG. Differences exist due to the 
differences in urine and oral fluid collection procedures. In addition, 
the Department is proposing to allow federal agencies to authorize 
collection of oral fluid as an alternate specimen when a donor does not 
provide an adequate urine specimen. References to agency authorization 
and collection procedures for oral fluid are applicable only when the 
OFMG become effective and HHS has certified laboratories to perform 
oral fluid testing under the Guidelines.
    Section 8.5 describes the responsibilities and procedures the 
collector must follow during and after a urine collection. The 
Department has revised Section 8.5 to enable a federal agency to 
authorize collection of oral fluid as an alternate specimen when a 
donor is unable to provide a sufficient volume of urine within the 
allowed wait period (i.e., up to three hours). As noted above, this 
revision will be applicable when the OFMG become effective and HHS has 
certified laboratories to perform oral fluid testing under the 
Guidelines. Specifically, Paragraph 8.5(f)(2)(iii) instructs the 
collector to request authorization for the alternate specimen 
collection when he/she notifies the federal agency representative of 
the insufficient urine specimen.
    Section 8.6 describes the procedures the collector must follow when 
a donor is unable to provide a urine specimen. The Department has 
revised Section 8.5 to enable a federal agency to authorize collection 
of oral fluid as an alternate specimen when a donor is unable to 
provide a urine specimen. As noted above, this revision will be 
applicable when the OFMG become effective and HHS has certified 
laboratories to perform oral fluid testing under the Guidelines. 
Specifically, Paragraph 8.6(b)(2) instructs the collector to request 
authorization for the alternate specimen collection when he/she 
notifies the federal agency representative of the donor's inability to 
provide a urine specimen.
    Section 8.7 prohibits collection of an alternate specimen when a 
donor is unable to provide an adequate urine specimen, unless 
specifically authorized by the Mandatory Guidelines for Federal 
Workplace Drug Testing Programs and by the federal agency. As noted 
above, Paragraphs 8.5(f)(2)(iii) and 8.6(b)(2) describe the 
circumstances in which the federal agency representative can authorize 
the collector to collect an alternate specimen (e.g., oral fluid).
    Section 8.14 describes a federal agency's responsibilities for a 
collection site. The Department has included an additional example of 
appropriate action that may be taken in response to a reported 
collection site deficiency: Self-assessment using the Collection Site 
Checklist for the Collection of Urine Specimens for Federal Agency 
Workplace Drug Testing Programs. This document is available on the 
SAMHSA Web site https://www.samhsa.gov/workplace.

Subpart I--HHS Certification of Laboratories and IITFs

    This subpart contains the same requirements for HHS certification 
of laboratories and instrumented initial test facilities (IITFs) as the 
current Guidelines.
    Section 9.5 includes the same qualitative and quantitative 
specifications for PT samples as the current Guidelines. Section 9.19 
describes where the monthly list of laboratories and IITFs certified by 
HHS to conduct forensic drug testing for federal agencies is published. 
The list will indicate the type of specimen (e.g., urine or oral fluid) 
that each laboratory is certified to test.

Subpart J--Blind Samples Submitted by an Agency

    This subpart describes the policies for federal agency blind 
samples. In Section 10.1, the Department is keeping the annual 3 
percent requirement for federal agency blind samples (i.e., as a 
percentage of the agency's donor specimens) but is proposing to limit 
the annual number of blind samples to a maximum of 400.
    Section 10.2 includes the same requirements for a blind sample as 
the current Guidelines. The Department has reworded the section for 
clarity. Also, in Paragraph 10.2(e), the Department added information 
that blind sample suppliers must provide and specified that the 
information is to be provided to the collection site/collector sending 
the sample and, upon request, to the MRO, federal agency, or the 
Secretary.
    In Section 10.4, the Department added that the MRO must contact the 
laboratory or IITF as the first step after receiving a report for a 
blind sample with a result that is inconsistent with the expected 
result.

Subpart K--Laboratory

    Section 11.10 addresses initial drug test requirements. These are 
the same as the current Guidelines requirements, except that the 
Department is proposing to allow the use of technologies other than 
immunoassay (i.e., alternate initial test technologies). In recent 
years, technological advances have been made to techniques (e.g., 
methods using spectrometry or spectroscopy) that enable their use as 
efficient and cost-effective alternatives to the

[[Page 28108]]

immunoassay techniques for initial drug testing while maintaining the 
required degree of sensitivity, specificity, and accuracy.
    Section 11.11 describes validation requirements for initial drug 
tests. The Department has included a requirement in Paragraph 
11.11(a)(5) for laboratories to assess potential interferences during 
assay validation. The revision is consistent with current requirements 
for HHS-certified laboratories. In Paragraphs 11.11(a)(6) and 11.11(c), 
the Department is proposing additional requirements for alternate 
technology initial drug tests based on the characteristics of these 
technologies.
    Section 11.13 addresses confirmatory drug test requirements. The 
Department is proposing to allow analytical procedures using mass 
spectrometry or other equivalent technologies. Based on ongoing reviews 
of the scientific and forensic literature, and the assessment of a DTAB 
working group that has studied newer instruments and technologies, the 
Department believes that scientifically valid confirmatory methods 
other than combined chromatographic and mass spectrometric methods can 
be used to successfully detect and report the drug analytes in Subpart 
C--Urine Specimen Drug Tests.
    Section 11.14 describes validation requirements for confirmatory 
tests. The Department has included a requirement for laboratories to 
assess matrix effects when validating a confirmatory drug test using 
liquid chromatography coupled with mass spectrometry and has added the 
requirement for laboratories to verify each new lot of reagent prior to 
placement into service. These revisions are consistent with current 
requirements for HHS-certified laboratories.
    In Section 11.17, the Department added the requirement for 
laboratories to verify each new lot of reagent for specimen validity 
testing prior to placement into service, consistent with current 
requirements for HHS-certified laboratories.
    The requirements for conducting each specimen validity test are the 
same as the current Guidelines, with the exception of pH testing and 
quality control requirements in Section 11.18(c) which have been 
revised in accordance with the proposed change to the low pH cutoff for 
adulteration [i.e., raising the pH 3 cutoff to 4; Section 3.6(a)].
    Section 11.19 addresses laboratory requirements for reporting test 
results. The Department made a change to wording in Section 11.19(a), 
deleting the requirement for laboratories to report results directly to 
the MRO, to allow the use of external service providers. Providing test 
results electronically to MROs can be timely and cost-effective, and is 
expected to increase following implementation of the Federal Custody 
and Control Form (CCF) as an electronic document. Section 11.19(n) was 
revised to require HHS-certified laboratories and external service 
providers to maintain the confidentiality, integrity, and availability 
of the data, which includes test results and donor personal identifying 
information (PII), and to limit access to any data transmission, 
storage, and retrieval system. Changes have been made to the criteria 
for reporting a specimen as adulterated or as invalid based on low pH 
[i.e., Sections 11.19(d) and 11.19(h)(2)] to reflect the proposed 
change to the low pH cutoff for adulteration [i.e., raising the pH 3 
cutoff to 4; Section 3.6(a)]. In Section 11.19(p), the Department has 
added the requirement for the laboratory to send a legible image or 
copy of the Federal CCF for rejected specimens to the MRO, as is 
current practice.
    The Department revised Section 11.21(a) to allow hardcopy records 
to be discarded 6 months after conversion to electronic records. This 
change ensures the availability of the records while reducing the 
recordkeeping burden, and is consistent with the Paperwork Reduction 
Act.
    Section 11.22 describes the semiannual statistical summary report 
that a laboratory must provide to a federal agency for urine testing. 
The Department is proposing to require the laboratory to submit a copy 
(paper or electronic) of each statistical summary report to the 
Secretary or designated HHS representative.
    Section 11.23 is a new section addressing the laboratory 
information to be made available to a federal agency and describes the 
contents of a standard laboratory documentation package, which are the 
same as in the current Guidelines. The Department is proposing that a 
federal agency may obtain laboratory information related to a positive, 
adulterated, or substituted drug test reported for a federal employee 
tested in its workplace program, as well as any relevant certification, 
review, or revocation of certification records for the laboratory.
    Section 11.24 was modified to clarify that specimens are not a part 
of the information package that donors can receive from HHS-certified 
laboratories.

Subpart L--Instrumented Initial Test Facility (IITF)

    This subpart addresses requirements for IITFs. Most requirements 
remain the same as the current Guidelines. The proposed revisions, 
detailed below, are consistent with the proposed revisions for 
laboratories in Section 11.
    Section 12.9 addresses initial drug test requirements for IITFs. 
The Department is proposing to allow IITFs to use technologies other 
than immunoassay (i.e., alternate initial test technologies). In recent 
years, technological advances have been made to techniques (e.g., 
methods using spectrometry or spectroscopy) that enable their use as 
efficient and cost-effective alternatives to the immunoassay techniques 
for initial drug testing while maintaining the required degree of 
sensitivity, specificity, and accuracy.
    Section 12.10 describes validation requirements for initial drug 
tests. The Department has included a requirement in Paragraph 
12.10(a)(5) for IITFs to assess potential interferences during assay 
validation. The revision is consistent with current requirements for 
HHS-certified IITFs. In Paragraphs 12.10(a)(6) and 12.10(c), the 
Department is proposing additional requirements for alternate 
technology initial drug tests based on the characteristics of these 
technologies.
    In Section 12.13, the Department added the requirement for IITFs to 
verify each new lot of reagent for specimen validity testing prior to 
placement into service, consistent with current requirements for HHS-
certified IITFs.
    Section 12.15 addresses IITF requirements for reporting test 
results. The Department made a change to wording in Section 12.15(a), 
deleting the requirement for IITFs to report results directly to the 
MRO, to allow the use of external service providers. Providing test 
results electronically to MROs can be timely and cost-effective, and is 
expected to increase following implementation of the Federal Custody 
and Control Form (CCF) as an electronic document. Section 12.15(e) was 
revised to require HHS-certified IITFs and external service providers 
to maintain the confidentiality, integrity, and availability of the 
data, which includes test results and donor PII, and to limit access to 
any data transmission, storage, and retrieval system. In Section 
12.15(g), the Department has added the requirement for the IITF to send 
a legible image or copy of the Federal CCF for rejected specimens to 
the MRO.
    The Department revised Section 12.18(a) to allow hardcopy records 
to be discarded 6 months after conversion to electronic records. This 
change ensures the availability of the records while reducing the 
recordkeeping burden, and

[[Page 28109]]

is consistent with the Paperwork Reduction Act.
    Section 12.19 describes the semiannual statistical summary report 
that an IITF must provide to a federal agency for urine testing. The 
Department is proposing to require the IITF to submit a copy of each 
semiannual statistical summary report (paper or electronic) to the 
Secretary or designated HHS representative.
    Section 12.20 is a new section addressing the IITF information to 
be made available to a federal agency and describes the contents of a 
standard IITF documentation package, which are the same as in the 
current Guidelines. The Department is proposing that a federal agency 
may obtain IITF information related to a positive, adulterated, or 
substituted drug test reported by a laboratory for a federal employee 
tested in its workplace program, as well as any relevant certification, 
review, or revocation of certification records for the IITF.

Subpart M--Medical Review Officer (MRO)

    Section 13.1 describes who may serve as an MRO. With the inclusion 
of additional Schedule II prescription medications in the Guidelines 
and the ever-changing field of drug testing, medical review of drug 
test results is more complex today than before. Therefore, the 
Department proposes to incorporate MRO requalification training and 
reexamination on a regular basis (at least every five years). The UrMG 
and OFMG do not include a requirement for MROs to obtain continuing 
education units (CEUs). The Department understands that it would be 
difficult to determine whether CEUs obtained are related to federal 
agency drug testing. The requalification requirement every five years 
will assure agency auditors and inspectors and regulated employers that 
MROs are appropriately qualified. This requirement is not expected to 
increase costs to MROs. Current practices for MRO requirements have 
equivalent standards but vary among MRO training entities. These 
requirements will standardize the length of time each MRO is required 
to take a requalification examination. Currently, some MRO 
requalification periods are longer than five years, while others are 
less than five years. The Department assumes that the costs to those 
MROs that have requalification periods over five years will be offset 
by the cost savings to MROs that have periods shorter than five years. 
Thus, the Department has not estimated any costs associated with this 
provision, but it welcomes comment on this assumption.
    The Department anticipates that MROs will continue to obtain CEUs 
by virtue of maintaining their medical licensure requirements. In 
addition, the MRO certification/training entities provide MRO manuals 
and periodic newsletters with updates on federal drug testing program 
requirements. However, the Department is seeking comments on requiring 
MRO requalification CEUs and on the optimum number of credits and the 
appropriate CEU accreditation bodies should CEUs be required as part of 
MRO requalification.
    MROs play a key role in the federal safety program and maintain the 
balance between the safety and privacy objectives of the program. The 
MRO's role in gathering and evaluating the medical evidence and 
providing due process is imperative. These are duties that must be 
carried out by the MRO, and cannot be delegated to other personnel who 
are not certified by an MRO entity.
    The MRO is charged with certain important medical and 
administrative duties. The MRO must have detailed knowledge of the 
effects of medications and other potential alternative medical 
explanations for laboratory reported drug test results. He or she is 
responsible for determining whether legitimate medical explanations are 
available to explain an employee's drug test result. This medical 
review process has become far more complex as a result of specimen 
validity testing and the myriad of donor explanations for adulterated, 
substituted, and invalid laboratory test results.
    In addition, MROs confer with prescribing physicians in making 
decisions about prescription changes so that alternative medications 
can be used that will not impact public safety. Similarly, the MRO is 
required to report to employers the employees' prescription and over-
the-counter medication use (or dangerous combinations of use) that the 
MRO believes will negatively affect duty performance. In addition, the 
MRO is required to medically assess referral physician examinations and 
evaluations in certain positive and refusal-to-test situations. These, 
too, have become more complex over time.
    Section 13.2 describes how nationally recognized entities or 
subspecialty boards that certify MROs are approved. The Department is 
proposing to extend the due date for resubmission of qualifications for 
HHS approval from each year to every two years and to publish the list 
of approved entities at least every two years, rather than annually. 
The revised time periods appear sufficient to ensure that educational 
material is updated at least every two years and the Department 
requiring the nationally recognized entities that approves MROs ensures 
the qualifications are being met. The Department has also revised this 
section to require submission of the certification examination delivery 
method along with other documentation for review.
    Section 13.3 describes the training that is required before a 
physician may serve as an MRO. With the issue of prescription drug 
abuse and the inclusion of additional opiates to the federal drug-
testing panel, MROs have the difficult task of interpreting positive 
drug test results from prescription drugs. Further guidance on these 
drug test results will be included in the MRO manual. The Department 
has added a requirement for MRO training to include information about 
how to discuss substance misuse and abuse and how to access those 
services. MROs performing the review of federal employee drug test 
results should be aware of prevention and treatment opportunities for 
individuals and can provide information to the donor.
    The Department also revised Section 13.4 to allow the MRO to 
discard hardcopy records 6 months after conversion to electronic 
records. This change ensures the availability of the records while 
reducing the recordkeeping burden, and is consistent with the Paperwork 
Reduction Act.
    Section 13.5 describes MRO actions when reviewing a urine 
specimen's test results. Section 13.5(d) contains the same procedure as 
the current Guidelines: When the HHS-certified laboratory reports a 
positive result for the primary (A) specimen, the MRO must contact the 
donor to determine if there is any legitimate medical explanation for 
the positive result. If the donor provides a legitimate medical 
explanation for the positive result, the MRO reports the test result as 
negative to the agency. The Department added a new Section 13.5(c) to 
address multiple test results for one specimen and added Section 
13.5(h) to address MRO procedures for multiple specimens from the same 
testing event (e.g., when the collector forwarded to the laboratory a 
urine specimen with temperature out of range and the subsequently 
collected specimen--urine or another authorized specimen type). In 
Paragraphs 13.5(b) and 13.5(g), the Department added instructions for 
handling recollected negative/dilute or invalid specimens that provide 
the same results as the first specimen (i.e., when another specimen

[[Page 28110]]

was collected from a donor because of a negative/dilute or invalid 
result, and the recollected specimen provides the same result as the 
first specimen). The proposed revisions provide a final resolution to 
report such drug tests, which were not adequately addressed in the 
current Guidelines. The Department revised Section 13.5(i) to specify 
the type of specimen (i.e., urine) to be collected from the donor 
following a cancelled test for a rejected specimen.
    Section 13.6 describes what an MRO must do when the collector 
reports that a donor did not provide a sufficient amount of urine for a 
drug test. For those instances in which the donor did not provide an 
adequate urine specimen and the federal agency authorized collection of 
another specimen type (e.g., oral fluid), the Department is proposing 
that the MRO review and report those results. If the federal agency did 
not authorize collection of another specimen type, the current 
Guidelines procedures remain in effect (i.e., medical evaluation). The 
Department revised this section to address collection of an alternative 
specimen for any subsequent tests when the donor has a permanent or 
long-term medical condition that prevents provision of a sufficient 
volume of urine for the drug test. As noted previously, a federal 
agency may authorize collection of oral fluid only when the OFMG are 
effective and HHS has certified laboratories to perform oral fluid 
testing under the Guidelines.
    Section 13.7 describes what an MRO must do when a donor has a 
permanent or long-term medical condition that prevents him or her from 
providing a sufficient amount of urine, a negative test is required 
(i.e., for a federal agency applicant/pre-employment, follow-up, or 
return-to-duty test), and the federal agency did not authorize 
collection of another specimen type (e.g., oral fluid). As noted 
previously, a federal agency may authorize collection of oral fluid 
only when the OFMG are effective and HHS has certified laboratories to 
perform oral fluid testing under the Guidelines.
    Section 13.9 describes how an MRO reports a primary (A) specimen 
result to an agency. The Department revised Section 13.9(a) to address 
MRO use of external service providers. The revised section requires 
MROs and external service providers to maintain the confidentiality, 
integrity, and availability of the data, which includes donor PII, and 
to limit access to any data transmission, storage, and retrieval 
system. The Department is also proposing to delete the requirement in 
Paragraph 13.9(c) for the MRO to send a paper copy of the Federal CCF 
or separate letter/memorandum. The MRO may report results 
electronically.

Subpart N--Split Specimen Tests

    The Department is proposing to revise Section 14.1(c) to clarify 
that, in a case where a B specimen is not available for testing, the 
MRO reports only to the federal agency and not to the donor. This is 
consistent with the requirement in the next sentence that no notice be 
given to the donor until immediately before the observed recollection.
    Section 14.3(a) addresses criteria for reconfirming an adulterated 
result. The low pH cutoff in Section 14.3(a)(1) has been changed to 
reflect the proposed change to the low pH cutoff for adulteration 
[i.e., raising the pH 3 cutoff to 4; Section 3.6(a)].
    Section 14.5 describes who receives the split specimen report from 
the laboratory. The Department reworded this section to address MRO use 
of external service providers, similar to the change made to Section 
11.19(a) for primary specimen reports.
    Section 14.7 describes how an MRO reports a split (B) specimen 
result to an agency. The Department revised Section 14.7(a) to address 
MRO use of external service providers. The revised section requires 
MROs and external service providers to maintain the confidentiality, 
integrity, and availability of the data, which includes donor PII, and 
to limit access to any data transmission, storage, and retrieval 
system. The Department revised Section 14.7(c) to clarify that MRO must 
use the Federal CCF or separate letter/memorandum to report all split 
specimens (i.e., not just positive, adulterated, or substituted 
specimens), and deleted the requirement for the MRO to send paper 
copies of these documents. The MRO may report results electronically.

Subpart O--Criteria for Rejecting a Specimen for Testing

    In Section 15.1, the Department is proposing a new Paragraph 
15.1(e) requiring specimen rejection if the accessioner has not 
documented the primary (A) seal condition at the time of accessioning 
and the split (B) specimen cannot be redesignated as the primary (A) 
specimen. This is consistent with current practice. The Department 
maintains that relying on the accessioner's recall of a particular 
specimen's bottle seal condition is not a forensically acceptable 
practice.

Subpart P--Laboratory or IITF Suspension/Revocation Procedures

    This subpart includes procedures to revoke or suspend the HHS-
certification of laboratories and IITFs. These are the same as in the 
current Guidelines.

Impact of These Guidelines on Government Regulated Industries

    The Department is aware that these proposed new Guidelines may 
impact the Department of Transportation (DOT) and Nuclear Regulatory 
Commission (NRC) regulated industries depending on these agencies' 
decisions to incorporate the final UrMG revisions into their programs 
under their own authority.

Topics of Special Interest

    The Department requests public comment on all aspects of this 
notice. However, the Department is providing the following list of 
areas for which specific comments are requested.
    Section 3.4 lists the proposed new analytes oxycodone, oxymorphone, 
hydrocodone, and hydromorphone and their cutoff concentrations. The 
Department is specifically requesting comments on these revisions.
    Section 13.1 describes proposed requirements for MRO 
requalification training and reexamination on a regular basis (i.e., 
every five years) but does not require MROs to obtain continuing 
education units (CEUs). The Department is seeking comments on requiring 
MRO CEUs and on the optimum number of credits and the appropriate CEU 
accreditation bodies should CEUs be required.

Regulatory Impact and Notices

    The Department welcomes public comment on all figures and 
assumptions used for the regulatory impact assessment described in this 
section.

Executive Orders 13563 and 12866

    Executive Order 13563 of January 18, 2011 (Improving Regulation and 
Regulatory Review) states ``Our regulatory system must protect public 
health, welfare, safety, and our environment while promoting economic 
growth, innovation, competitiveness, and job creation.'' Consistent 
with this mandate, Executive Order 13563 requires agencies to tailor 
``regulations to impose the least burden on society, consistent with 
obtaining regulatory objectives.'' Executive Order 13563 also requires 
agencies to ``identify and consider regulatory approaches that reduce 
burdens and maintain flexibility and freedom of choice'' while 
selecting ``those approaches that maximize net benefits.'' This notice 
proposes a

[[Page 28111]]

regulatory approach that will reduce burdens to providers and to 
consumers while continuing to provide adequate protections for public 
health and welfare.
    The Secretary has examined the impact of the proposed Guidelines 
under Executive Order 12866, which directs federal agencies to assess 
all costs and benefits of available regulatory alternatives and, when 
regulation is necessary, to select regulatory approaches that maximize 
net benefits (including potential economic, environmental, public 
health and safety, and other advantages; distributive impacts; and 
equity).
    According to Executive Order 12866, a regulatory action is 
``significant'' if it meets any one of a number of specified 
conditions, including having an annual effect on the economy of $100 
million; adversely affecting in a material way a sector of the economy, 
competition, or jobs; or if it raises novel legal or policy issues. The 
proposed Guidelines do establish additional regulatory requirements and 
allow an activity that was otherwise prohibited. The Administrative 
Procedure Act (APA) delineates an exception to its rulemaking 
procedures for ``a matter relating to agency management or personnel'' 
5 U.S.C. 553(a)(2). Because the Guidelines issued by the Secretary 
govern federal workplace drug testing programs, HHS has taken the 
position that the Guidelines are a ``matter relating to agency 
management or personnel'' and, thus, are not subject to the APA's 
requirements for notice and comment rulemaking. This position is 
consistent with Executive Order 12564 regarding Drug-Free Workplaces, 
which directs the Secretary to promulgate scientific and technical 
guidelines for executive agency drug testing programs. However, the 
statute under which the mandatory guidelines were created (Pub. L. 100-
71, section 503(a)(3)) required notice and comment apart from the APA. 
This provision provides the following: Notwithstanding any provision of 
chapter 5 of title 5, United States Code, the mandatory guidelines to 
be published pursuant to subsection (a)(l)(A)(ii) shall be published 
and made effective exclusively according to the provisions of this 
paragraph. Notice of the mandatory guidelines proposed by the Secretary 
of Health and Human Services shall be published in the Federal 
Register, and interested persons shall be given not less than 60 days 
to submit written comments on the proposed mandatory guidelines. 
Following review and consideration of written comments, final mandatory 
guidelines shall be published in the Federal Register and shall become 
effective upon publication.

Need for Revisions to the Guidelines

    The inclusion of oxycodone, oxymorphone, hydrocodone and 
hydromorphone in the URMG was recommended by the DTAB, reviewed by the 
Department's Prescription Drug Subcommittee of the Behavioral Health 
Coordinating Committee, and approved by the SAMHSA Administrator in 
January 2012. This action is supported by various data, described in 
this preamble.1-4 In addition, in 2008, 12 percent of 
military personnel admitted to the illicit use of prescription 
medications. Prevalence testing by the Department of Defense (DoD) in 
2009 indicated that prescription drug abuse exceeded illegal drug 
abuse. Because of this, hydrocodone and hydromorphone testing was added 
to the regular DoD drug testing panel in 2011.

Costs

    Costs associated with the implementation of testing for oxycodone, 
oxymorphone, hydrocodone and hydromorphone will be minimal because the 
Department has determined that all HHS certified laboratories testing 
specimens from federal agencies are currently conducting tests for one 
or more of these analytes on non-regulated urine specimens. Likewise, 
there will be minimal costs associated with changing initial testing to 
include MDA and MDEA since the current immunoassays can be adapted to 
test for these analytes. Laboratory personnel are currently trained and 
test methods have been implemented. However, there will be some 
administrative costs associated with adding these analytes. Prior to 
being allowed to test regulated specimens for these compounds, HHS 
certified laboratories will be required to demonstrate that their 
performance meets Guideline requirements by testing three (3) groups of 
PT samples. The Department will provide the PT samples through the 
National Laboratory Certification Program (NLCP) at no cost to the 
certified laboratories. Based on costs charged for specimen testing, 
laboratory costs to conduct the PT testing would range from $900 to 
$1,800 for each certified laboratory.
    In Section 3.4, the Department is proposing criteria for 
calibrating initial tests for grouped analytes such as opiates and 
amphetamines, and specifying the cross-reactivity of the immunoassay to 
the other analytes(s) within the group. These proposed Guidelines allow 
the use of methods other than immunoassay for initial testing. In 
addition, these proposed Guidelines include an alternative for 
laboratories to continue to use existing FDA-cleared immunoassays which 
do not have the specified cross-reactivity, by establishing a decision 
point with the lowest-reacting analyte. An immunoassay manufacturer may 
incur costs if they choose to alter their existing product and resubmit 
the immunoassay for FDA clearance.
    For the added opiate analytes, the two immunoassays currently used 
for oxycodone and oxymorphone meet the requirements, and two of the 
three existing opiate immunoassays used in certified laboratories meet 
the requirements for hydrocodone and hydromorphone analysis. The opiate 
immunoassay that does not have sufficient cross-reactivity would be 
acceptable as an initial test under these Guidelines when the lowest-
reacting analyte, hydromorphone, is used to establish a decision point. 
Therefore, the Department assumes that all certified laboratories will 
elect to use existing immunoassays. Thus, the costs associated with 
implementing the initial tests for these analytes are expected to be de 
minimis.
    For amphetamines, one of the three existing 
methylenedioxymethamphetamine (MDMA) immunoassays used in certified 
laboratories meets the requirements. The remaining two exhibit 
insufficient cross-reactivity for MDA. These two immunoassays would be 
acceptable as an initial test under these Guidelines when the lowest-
reacting analyte, MDA, is used to establish a decision point. An 
immunoassay manufacturer may incur costs if they choose to alter their 
existing product and resubmit the immunoassay for FDA clearance. Again, 
the Department assumes that certified laboratories will use the 
existing immunoassays and incur de minimis costs.
    Once the testing has been implemented, the cost per specimen for 
initial testing for the added analytes will range from $.06 to $0.20 
due to reagent costs. Current costs for each confirmatory test range 
from $5.00 to $10.00 for each specimen reported positive, due to sample 
preparation and analysis costs. Based on information from non-regulated 
workplace drug testing for these analytes and testing performed by the 
Department on de-identified federally regulated specimens in 2011, 
approximately 1% of the submitted specimens is expected to be confirmed 
as positive for the added analytes. Therefore, the added cost for 
confirmatory testing will be $0.05 to $0.10 per submitted specimen. 
This

[[Page 28112]]

would indicate that the cost per specimen submitted for testing will 
increase by $0.11-$0.30.
    The addition of the Schedule II prescription medications will 
require MRO review to verify legitimate drug use. Based on the 
positivity rates from non-regulated workplace drug testing for these 
analytes and the additional review of specimens confirmed positive for 
prescription medications, MRO costs are estimated to increase by 
approximately 3%. This 3% cost increase is expected to occur gradually 
as agencies' existing contracts expire and they renegotiate the terms 
of new contracts, with an increase to the total cost of a federal drug 
test over time to between $0.60-$1.35. This cost would indicate a total 
cost for federal agencies of $83,700 to $188,325 in the urine testing 
program.
    The additional costs for testing and MRO review will be 
incorporated into the overall cost for the federal agency submitting 
the specimen to the laboratory. The estimation of costs incurred is 
based upon overall cost to the federal agency because the review of 
positive specimens is usually based on all specimens submitted from an 
agency, rather than individual specimen testing costs or MRO review of 
positive specimens. Agencies may also incur some costs for training of 
federal employees such as drug program coordinators due to 
implementation of the revised Guidelines. Based on current training 
modules offered to drug program coordinators, and other associated 
costs including travel for 90% of drug program coordinators, the 
estimated total training cost for a one-day training session would be 
between $54,000 and $69,000 (i.e., assuming 8 hours of time multiplied 
by a GS 12/13 wage).

                  Recurring Annual Costs Summary Table
------------------------------------------------------------------------
                                         Lower bound       Upper bound
------------------------------------------------------------------------
Reagent Costs.......................       $368,730.00     $1,229,100.00
Additional Confirmatory tests.......        307,275.00        614,550.00
MRO Costs...........................      3,687,300.00      8,296,425.00
                                     -----------------------------------
    Total annual costs..............      4,363,305.00     10,140,075.00
------------------------------------------------------------------------


                 Upfront (One-Time) Costs Summary Table
------------------------------------------------------------------------
                                         Lower bound       Upper bound
------------------------------------------------------------------------
Performance Testing.................        $27,900.00        $55,800.00
Training............................            54,000            69,000
                                     -----------------------------------
    Total...........................         81,900.00        124,800.00
------------------------------------------------------------------------

Benefits

    The potential benefits of deterring use of oxycodone, oxymorphone, 
hydrocodone and hydromorphone are the prevention of their side effects 
(e.g., anxiety, dizziness, drowsiness, fatigue, and other neurological 
effects), which will result in a healthier and more alert workforce as 
well as avoid the issues associated with addiction and rehabilitation. 
Since the personnel tested under this program are in positions that are 
safety sensitive, potential benefits include decreased risk of 
transportation accidents, decreased risk of low-probability high 
consequence events, more responsible workforce in positions of public 
trust, and potentially reducing individuals' dependence or addiction 
and the personal benefits associated with those conditions.
    Considering the potential health and performance costs of narcotic 
abuse, the benefits to the federal workplace and the individuals within 
that workplace justify the inclusion of oxycodone, oxymorphone, 
hydrocodone and hydromorphone in Federal Workplace Drug Testing 
programs.

Regulatory Flexibility Analysis

    For the reasons outlined above, the Secretary has determined that 
the proposed Guidelines will not have a significant impact upon a 
substantial number of small entities within the meaning of the 
Regulatory Flexibility Act [5 U.S.C. 605(b)]. The flexibility added by 
the UrMG will not require addition expenditures. Therefore, an initial 
regulatory flexibility analysis is not required for this notice.
    The Secretary has determined that the proposed Guidelines are not a 
major rule for the purpose of congressional review. For the purpose of 
congressional review, a major rule is one which is likely to cause an 
annual effect on the economy of $100 million; a major increase in costs 
or prices; significant effects on competition, employment, 
productivity, or innovation; or significant effects on the ability of 
U.S.-based enterprises to compete with foreign-based enterprises in 
domestic or export markets. This is not a major rule under the Small 
Business Regulatory Enforcement Fairness Act (SBREFA) of 1996.

Unfunded Mandates

    The Secretary has examined the impact of the proposed Guidelines 
under the Unfunded Mandates Reform Act (UMRA) of 1995 (Pub. L. 104-4). 
This notice does not trigger the requirement for a written statement 
under section 202(a) of the UMRA because the proposed Guidelines do not 
impose a mandate that results in an expenditure of $100 million 
(adjusted annually for inflation) or more by either state, local, and 
tribal governments in the aggregate or by the private sector in any one 
year.

Environmental Impact

    The Secretary has considered the environmental effects of the UrMG. 
No information or comments have been received that would affect the 
agency's determination there would be a significant impact on the human 
environment and that neither an environmental assessment nor an 
environmental impact statement is required.

Executive Order 13132: Federalism

    The Secretary has analyzed the proposed Guidelines in accordance 
with Executive Order 13132: Federalism.

[[Page 28113]]

Executive Order 13132 requires federal agencies to carefully examine 
actions to determine if they contain policies that have federalism 
implications or that preempt state law. As defined in the Order, 
``policies that have federalism implications'' refer to regulations, 
legislative comments or proposed legislation, and other policy 
statements or actions that have substantial direct effects on the 
states, on the relationship between the national government and the 
states, or on the distribution of power and responsibilities among the 
various levels of government.
    In this notice, the Secretary is proposing to revise the standards 
for certification of laboratories engaged in urine fluid drug testing 
for federal agencies and the use of urine testing in federal drug-free 
workplace programs. The Department of Health and Human Services, by 
authority of Section 503 of Public Law 100-71, 5 U.S.C. Section 7301, 
and Executive Order No. 12564, establishes the scientific and technical 
guidelines for federal workplace drug testing programs and establishes 
standards for certification of laboratories engaged in urine drug 
testing for federal agencies. Because the Mandatory Guidelines govern 
standards applicable to the management of federal agency personnel, 
there should be little, if any, direct effect on the states, on the 
relationship between the national government and the states, or on the 
distribution of power and responsibilities among the various levels of 
government. Accordingly, the Secretary has determined that the 
Guidelines do not contain policies that have federalism implications.

Paperwork Reduction Act of 1995

    The proposed Guidelines contain information collection requirements 
which are subject to review by the Office of Management and Budget 
(OMB) under the Paperwork Reduction Act of 1995 [the PRA 44 U.S.C. 
3507(d)]. Information collection and recordkeeping requirements which 
would be imposed on laboratories engaged in drug testing for federal 
agencies concern quality assurance and quality control documentation, 
reports, performance testing, and inspections as set out in subparts H, 
I, K, L, M and N. To facilitate ease of use and uniform reporting, a 
Federal CCF for each type of specimen collected will be developed as 
referenced in section 6.1. The Department has submitted the information 
collection and recordkeeping requirements contained in the proposed 
Guidelines to OMB for review and approval.

Privacy Act

    The Secretary has determined that the Guidelines do not contain 
information collection requirements constituting a system of records 
under the Privacy Act. The Federal Register notice announcing the 
proposed Mandatory Guidelines for Federal Workplace Drug Testing 
Programs using Urine is not a system of records as noted in the 
information collection/recordkeeping requirements below. As required, 
HHS originally published the Mandatory Guidelines for Federal Workplace 
Drug Testing Programs (Guidelines) in the Federal Register on April 11, 
1988 [53 FR 11979]. SAMHSA subsequently revised the Guidelines on June 
9, 1994 [59 FR 29908], September 30, 1997 [62 FR 51118], November 13, 
1998 [63 FR 63483], April 13, 2004 [69 FR 19644], and 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 effective date 
of the Guidelines was further changed to October 1, 2010 on April 30, 
2010 [75 FR 22809].

Executive Order 13175: Consultation and Coordination With Indian Tribal 
Governments

    Executive Order 13175 (65 FR 67249, November 6, 2000) requires 
SAMHSA to develop an accountable process to ensure ``meaningful and 
timely input by tribal officials in the development of regulatory 
policies that have tribal implications.'' ``Policies that have tribal 
implications'' as defined in the Executive Order, include regulations 
that have ``substantial direct effects on one or more Indian tribes, on 
the relationship between the federal government and the Indian tribes, 
or on the distribution of power and responsibilities between the 
federal government and Indian tribes.'' The proposed Guidelines do not 
have tribal implications. The Guidelines will not have substantial 
direct effects on tribal governments, on the relationship between the 
federal government and Indian tribes, or on the distribution of power 
and responsibilities between the federal government and Indian tribes, 
as specified in Executive Order 13175.

Information Collection/Record Keeping Requirements

    The information collection requirements (i.e., reporting and 
recordkeeping) in the current Guidelines, which establish the 
scientific and technical guidelines for federal workplace drug testing 
programs and establish standards for certification of laboratories 
engaged in urine drug testing for federal agencies under authority of 5 
U.S.C. 7301 and Executive Order 12564, are approved by the Office of 
Management and Budget (OMB) under control number 0930-0158. The Federal 
Drug Testing Custody and Control Form used to document the collection 
and chain of custody of urine specimens at the collection site, for 
laboratories to report results, and for Medical Review Officers to make 
a determination, the National Laboratory Certification Program (NLCP) 
application, the NLCP Laboratory Information Checklist, and 
recordkeeping requirements in the current Guidelines, as approved under 
control number 0930-0158, will remain in effect until final Guidelines 
including the use of another specimen matrix are issued.
    The title, description and respondent description of the 
information collections are shown in the following paragraphs with an 
estimate of the annual reporting, disclosure and recordkeeping burden. 
Included in the estimate is the time for reviewing instructions, 
searching existing data sources, gathering and maintaining the data 
needed, and completing and reviewing the collection of information.
    Title: The Mandatory Guidelines for Federal Workplace Drug Testing 
Programs Using Urine Specimens.
    Description: The Mandatory Guidelines establish the scientific and 
technical guidelines for federal drug testing programs and establish 
standards for certification of laboratories engaged in drug testing for 
federal agencies under authority of Public Law 100-71, 5 U.S.C. 7301 
note, and Executive Order No. 12564. Federal drug testing programs test 
applicants to sensitive positions, individuals involved in accidents, 
individuals for cause, and random testing of persons in sensitive 
positions.
    Description of Respondents: Individuals or households; businesses; 
or other-for-profit; not-for-profit institutions.
    The burden estimates in the tables below are based on the following 
number of respondents: 38,000 donors who apply for employment in 
testing designated positions, 100 collectors, 30 urine specimen testing 
laboratories, 5 IITFs, and 100 MROs.

[[Page 28114]]



                                                           Estimate of Annual Reporting Burden
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                              Number of      Responses/        Hours/
                          Section                                       Purpose              respondents     respondent       response      Total hours
--------------------------------------------------------------------------------------------------------------------------------------------------------
9.2(a)(1)..................................................  Laboratory or IITF required               10               1            3              30
                                                              to submit application for
                                                              certification.
9.12(a)(3).................................................  Materials to submit to                    10               1            2              20
                                                              become an HHS inspector.
11.3(a)....................................................  Laboratory submits                        10               1            2              20
                                                              qualifications of RP to HHS.
11.4(c)....................................................  Laboratory submits                        10               1            2              20
                                                              information to HHS on new
                                                              RP or alternate RP.
11.22......................................................  Specifications for                        10               5            0.5            25
                                                              laboratory semi-annual
                                                              statistical report of test
                                                              results to each federal
                                                              agency.
12.3(a)....................................................  IITF submits qualifications   ..............  ..............  ..............  .............
                                                              of RT to HHS.
12.4(c)....................................................  IITF submits information to   ..............  ..............  ..............  .............
                                                              HHS on new RT or alternate
                                                              RT.
12.19......................................................  Specifications for IITF semi- ..............  ..............  ..............  .............
                                                              annual statistical report
                                                              of test results to each
                                                              federal agency.
13.9 and 14.7..............................................  Specifies that MRO must                  100               5          * 0.05           25
                                                              report all verified primary
                                                              and split specimen test
                                                              results to the federal
                                                              agency.
16.1(b) & 16.5(a)..........................................  Specifies content of request               1               1            3               3
                                                              for informal review of
                                                              suspension/proposed
                                                              revocation of certification.
16.4.......................................................  Specifies information                      1               1            0.5             0.5
                                                              appellant provides in first
                                                              written submission when
                                                              laboratory suspension/
                                                              revocation is proposed.
16.6.......................................................  Requires appellant to notify               1               1            0.5             0.5
                                                              reviewing official of
                                                              resolution status at end of
                                                              abeyance period.
16.7(a)....................................................  Specifies contents of                      1               1           50              50
                                                              appellant submission for
                                                              review.
16.9(a)....................................................  Specifies content of                       1               1            3               3
                                                              appellant request for
                                                              expedited review of
                                                              suspension or proposed
                                                              revocation.
16.9(c)....................................................  Specifies contents of review               1               1           50              50
                                                              file and briefs.
                                                                                          --------------------------------------------------------------
    Total..................................................  ............................             156  ..............  ..............          247
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 3 min.

    The following reporting requirements are also in the proposed 
Guidelines, but have not been addressed in the above reporting burden 
table: Collector must report any unusual donor behavior or refusal to 
participate in the collection process on the Federal CCF [Sections 1.8, 
8.9]; collector annotates the Federal CCF when a sample is a blind 
sample [Section 10.3(a)]; MRO notifies the federal agency and HHS when 
an error occurs on a blind sample [Section 10.4(c)]; and Sections 13.6 
and 13.7 describe the actions an MRO takes for the medical evaluation 
of a donor who cannot provide a urine specimen. SAMHSA has not 
calculated a separate reporting burden for these requirements because 
they are included in the burden hours estimated for collectors to 
complete Federal CCFs and for MROs to report results to federal 
agencies.

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                             Number of      Responses/        Hours/
                          Section                                      Purpose              respondents     respondent       response       Total hours
--------------------------------------------------------------------------------------------------------------------------------------------------------
8.3(a), 8.5(f)(2)(iii), 8.6(b)(2).........................  Collector must contact                   100               1          * 0.05               5
                                                             federal agency point of
                                                             contact.
11.23, 11.24..............................................  Information on drug test                  10              10            3              1,500
                                                             that laboratory must
                                                             provide to federal agency
                                                             upon request or to donor
                                                             through MRO.

[[Page 28115]]

 
12.20, 12.21..............................................  Information on drug test      ..............  ..............  ..............  ..............
                                                             that IITF must provide to
                                                             federal agency upon request
                                                             or to donor through MRO.
13.8(b)...................................................  MRO must inform donor of                 100               5            3              1,500
                                                             right to request split
                                                             specimen test when a
                                                             positive, adulterated, or
                                                             substituted result is
                                                             reported.
                                                                                         ---------------------------------------------------------------
    Total.................................................  ............................             210  ..............  ..............           3,505
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 3 min.

    The following disclosure requirements are also included in the 
proposed Guidelines, but have not been addressed in the above 
disclosure burden table: The collector must explain the basic 
collection procedure to the donor and answer any questions [Section 
8.3(e) and (g)]. SAMHSA believes having the collector explain the 
collection procedure to the donor and answer any questions is a 
standard business practice and not a disclosure burden.

                                                         Estimate of Annual Recordkeeping Burden
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                          Number of      Responses/
                         Section                                     Purpose             respondents     respondent     Hours/ response     Total hours
--------------------------------------------------------------------------------------------------------------------------------------------------------
8.3, 8.5, 8.8............................................  Collector completes                    100             380          * 0.07              2,534
                                                            Federal CCF for specimen
                                                            collected.
8.8(d) & (f).............................................  Donor initials specimen             38,000               1         ** 0.08              3,167
                                                            labels/seals and signs
                                                            statement on the Federal
                                                            CCF.
11.8(a) & 11.19..........................................  Laboratory completes                    10           3,800        *** 0.05              1,900
                                                            Federal CCF upon receipt
                                                            of specimen and before
                                                            reporting result.
12.8(a) & 12.15..........................................  IITF completes Federal CCF  ..............  ..............  .................  ..............
                                                            upon receipt of specimen
                                                            and before reporting
                                                            result.
13.4(d)(4), 13.9(c), 14.7(c).............................  MRO completes Federal CCF              100             380        *** 0.05              1,900
                                                            before reporting the
                                                            primary or split specimen
                                                            result.
14.1(b)..................................................  MRO documents donor's                  300               1        *** 0.05                 15
                                                            request to have split
                                                            specimen tested.
                                                                                      ------------------------------------------------------------------
    Total................................................  ..........................          38,510  ..............  .................           9,516
--------------------------------------------------------------------------------------------------------------------------------------------------------
* 4 min.
** 5 min.
*** 3 min.

    The proposed Guidelines contain a number of recordkeeping 
requirements that SAMHSA considers not to be an additional 
recordkeeping burden. In subpart D, a trainer is required to document 
the training of an individual to be a collector [Section 4.3(a)(3)] and 
the documentation must be maintained in the collector's training file 
[Section 4.3(c)]. SAMHSA believes this training documentation is common 
practice and is not considered an additional burden. In subpart F, if a 
collector uses an incorrect form to collect a federal agency specimen, 
the collector is required to provide a statement [Section 6.2(b)] 
explaining why an incorrect form was used to document collecting the 
specimen. SAMHSA believes this is an extremely infrequent occurrence 
and does not create a significant additional recordkeeping burden. 
Subpart H [Sections 8.4(c), 8.5(d)(2), 8.5(e)(1) and (2)] requires 
collectors to enter any information on the Federal CCF of any unusual 
findings during the urine specimen collection procedure. These 
recordkeeping requirements are an integral part of the collection 
procedure and are essential to documenting the chain of custody for the 
specimens collected. The burden for these entries are included in the 
recordkeeping burden estimated to complete the Federal CCF and is, 
therefore, not considered an additional recordkeeping burden. Subpart K 
describes a number of recordkeeping requirements for laboratories 
associated with their testing procedures, maintaining chain of custody, 
and keeping records [i.e., Sections 11.1(a) and (d); 11.2(b), (c), and 
(d); 11.6(b); 11.7(c); 11.8; 11.11(a); 11.14(a); 11.17; 11.21(a), (b), 
and (c); 11.22; 11.23(a) and 11.24. These recordkeeping requirements 
are necessary for any laboratory to conduct forensic drug testing and 
to ensure the scientific supportability of the test results. Therefore, 
they are considered to be standard business practice and are not 
considered a burden for this analysis.
    Thus the total annual response burden associated with the testing 
of urine specimens by the laboratories and IITFs is estimated to be 
13,268 hours (that is, the sum of the total hours from the above 
tables). This is in addition to the 1,788,809 hours currently approved

[[Page 28116]]

by OMB under control number 0930-0158 for urine testing under the 
current Guidelines.
    As required by section 3507(d) of the PRA, the Secretary has 
submitted a copy of these proposed Guidelines to OMB for its review. 
Comments on the information collection requirements are specifically 
solicited in order to: (1) Evaluate whether the proposed collection of 
information is necessary for the proper performance of HHS's functions, 
including whether the information will have practical utility; (2) 
evaluate the accuracy of HHS's estimate of the burden of the proposed 
collection of information, including the validity of the methodology 
and assumptions used; (3) enhance the quality, utility, and clarity of 
the information to be collected; and (4) minimize the burden of the 
collection of information on those who are to respond, including 
through the use of appropriate automated, electronic, mechanical, or 
other technological collection techniques or other forms of information 
technology.
    OMB is required to make a decision concerning the collection of 
information contained in these proposed Guidelines between 30 and 60 
days after publication of this document in the Federal Register. 
Therefore, a comment to OMB is best assured of having its full effect 
if OMB receives it within 30 days of publication. This does not affect 
the deadline for the public to comment to HHS on the proposed 
Guidelines.
    Organizations and individuals desiring to submit comments on the 
information collection requirements should direct them to the Office of 
Information and Regulatory Affairs, OMB, New Executive Office Building, 
725 17th Street NW., Washington, DC 20502, Attn: Desk Officer for 
SAMHSA. Because of delays in receipt of mail, comments may also be sent 
to 202-395-6974 (fax).

References

1. U.S. Department of Health and Human Services, Behavioral Health 
Coordinating Committee, Prescription Drug Abuse Subcommittee, 
Addressing Prescription Drug Abuse in the United States: Current 
Activities and Future Opportunities. Department of Health and Human 
Services, 2013. https://www.cdc.gov/HomeandRecreationalSafety/pdf/HHS_Prescription_Drug_Abuse_Report_09.2013.pdf (accessed 15 
September 2014).
2. Substance Abuse and Mental Health Services Administration, 
Results from the 2012 National Survey on Drug Use and Health: 
Summary of National Findings, NSDUH Series H-46, HHS Publication No. 
(SMA) 13-4795. Rockville, MD: Substance Abuse and Mental Health 
Services Administration, 2013.
3. Substance Abuse and Mental Health Services Administration, Drug 
Abuse Warning Network, 2011: National Estimates of Drug-Related 
Emergency Department Visits. HHS Publication No. (SMA) 13-4760, DAWN 
Series D-39. Rockville, MD: Substance Abuse and Mental Health 
Services Administration, 2013.
4. U.S. Drug Enforcement Administration, Office of Diversion 
Control, 2013. National Forensic Laboratory Information System: Year 
2012 Annual Report. Springfield, VA: U.S. Drug Enforcement 
Administration.
5. Quest Diagnostics Incorporated, Drug Use Among American Workers 
Declined 74% Over the Past 25 Years, Finds Unprecedented Analysis of 
More Than 125 Million Workplace Urine Tests, https://blog.employersolutions.com/wp-content/uploads/2013/11/dti25-press-release-11-18-2013.pdf, 18 November 2013 (accessed 19 August 2014).
6. Smith, M.L., Hughes, R.O., Levine, B., Dickerson, S., Darwin, 
W.D., and Cone, E.J. (1995), Forensic drug testing for opiates. VI. 
Urine testing for hydromorphone, hydrocodone, oxymorphone, and 
oxycodone with commercial opiate immunoassays and gas 
chromatography-mass spectrometry. J. Anal. Toxicol., 19, 18-26.
7. Cone, E.J., Zichterman, A., Heltsley, R., Black, D.L., Cawthon, 
B., Robert, T., Moser, F., and Caplan, Y.H. (2010), Urine testing 
for norcodeine, norhydrocodone, and noroxycodone facilitates 
interpretation and reduces false negatives. Forensic Sci. Int., 198, 
58-61.
8. Lalovic, B., Kharasch, E., Hoffer, C., Risler, L., Liu-Chen, 
L.Y., and Shen, D.D. (2006), Pharmacokinetics and pharmacodynamics 
of oral oxycodone in healthy human subjects: role of circulating 
active metabolites. Clin. Pharmacol. Ther., 79, 461-479.
9. Heltsley, R., Zichterman, A., Black, D.L., Cawthon, B., Robert, 
T., Moser, F., Caplan, Y.H., and Cone, E.J. (2010), Urine drug 
testing of chronic pain patients. II. Prevalence patterns of 
prescription opiates and metabolites. J. Anal. Toxicol., 34, 32-38.
10. Poyhia, R., Seppala, T., Olkkola, K.T., and Kalso, E. (1992), 
The pharmacokinetics and metabolism of oxycodone after intramuscular 
and oral administration to healthy subjects. Br. J. Clin. 
Pharmacol., 33, 617-621.
11. Yee, D.A., Best, B.M., Atayee, R.S., and Pesce, A.J. (2012), 
Observations on the urine metabolic ratio of oxymorphone to 
oxycodone in pain patients. J. Anal. Toxicol., 36, 232-238.
12. Cone, E.J., Darwin, W.D., Gorodetzky, C.W., and Tan, T. (1978), 
Comparative metabolism of hydrocodone in man, rat, guinea pig, 
rabbit, and dog. Drug Metab. Dispos., 6, 488-493.
13. Cone, E.J. and Darwin, W.D. (1978), Simultaneous determination 
of hydromorphone, hydrocodone and their 6a-and 6B hydroxy 
metabolites in urine using selected ion recording with methane 
chemical ionization. Biochem. Mass Spectrom., 5, 291-295.
14. Valtier, S. and Bebarta, V.S. (2012), Excretion profile of 
hydrocodone, hydromorphone and norhydrocodone in urine following 
single dose administration of hydrocodone to healthy volunteers. J. 
Anal. Toxicol., 36, 507-514.
15. Cone, E.J., Phelps, B.A., and Gorodetzky, C.W. (1977), Urinary 
excretion of hydromorphone and metabolites in humans, rats, dogs, 
guinea pigs, and rabbits. J.Pharm.Sci., 66, 1709-1713.
16. Oyler, J.M., Cone, E.J., Joseph, R.E., Jr., and Huestis, M.A. 
(2000), Identification of hydrocodone in human urine following 
controlled codeine administration. J. Anal. Toxicol., 24, 530-535.
17. Cone, E.J., Heit, H.A., Caplan, Y.H., and Gourlay, D. (2006), 
Evidence of morphine metabolism to hydromorphone in pain patients 
chronically treated with morphine. J. Anal. Toxicol., 30, 1-5.
18. Cone, E.J., Caplan, Y.H., Moser, F., Robert, T., and Black, D. 
(2008), Evidence that morphine is metabolized to hydromorphone but 
not to oxymorphone. J. Anal. Toxicol., 32, 319-323.
19. Cook, J.D., Strauss, K.A., Caplan, Y.H., LoDico, C.P., Bush, 
D.M. (2007), Urine pH: the effects of time and temperature after 
collection. J. Anal. Toxicol., 31, 486-496.

    Dated: May 4, 2015.
Pamela S. Hyde,
Administrator, SAMHSA.
    Dated: May 7, 2015.
Sylvia M. Burwell,
Secretary.
    For reasons set forth in the preamble, the Department proposes to 
revise the Mandatory Guidelines for Federal Workplace Drug Testing 
Programs to include Mandatory Guidelines using Urine Specimens to read 
as follows:

MANDATORY GUIDELINES FOR FEDERAL WORKPLACE DRUG TESTING PROGRAMS USING 
URINE SPECIMENS

Subpart A--Applicability

1.1 To whom do these Guidelines apply?
1.2 Who is responsible for developing and implementing these 
Guidelines?
1.3 How does a federal agency request a change from these 
Guidelines?
1.4 How are these Guidelines revised?
1.5 What do the terms used in these Guidelines mean?
1.6 What is an agency required to do to protect employee records?
1.7 What is a refusal to take a federally regulated drug test?
1.8 What are the potential consequences for refusing to take a 
federally regulated drug test?

Subpart B--Urine Specimens

2.2 Under what circumstances may a urine

[[Page 28117]]

specimen be collected?
2.3 How is each urine specimen collected?
2.4 What volume of urine is collected?
2.5 How does the collector split the urine specimen?
2.6 When may an entity or individual release a urine specimen?

Subpart C--Urine Specimen Tests

3.1 Which tests are conducted on a urine specimen?
3.2 May a specimen be tested for additional drugs?
3.3 May any of the specimens be used for other purposes?
3.4 What are the drug test cutoff concentrations for urine?
3.5 May an HHS-certified laboratory perform additional drug and/or 
specimen validity tests on a specimen at the request of the Medical 
Review Officer (MRO)?
3.6 What criteria are used to report a urine specimen as 
adulterated?
3.7 What criteria are used to report a urine specimen as 
substituted?
3.8 What criteria are used to report a urine specimen as dilute?
3.9 What criteria are used to report an invalid result for a urine 
specimen?

Subpart D--Collectors

4.1 Who may collect a specimen?
4.2 Who may not collect a specimen?
4.3 What are the requirements to be a collector?
4.4 What are the requirements to be an observer for a direct 
observed collection?
4.5 What are the requirements to be a trainer for collectors?
4.6 What must a federal agency do before a collector is permitted to 
collect a specimen?

Subpart E--Collection Sites

5.1 Where can a collection for a drug test take place?
5.2 What are the requirements for a collection site?
5.3 Where must collection site records be stored?
5.4 How long must collection site records be stored?
5.5 How does the collector ensure the security and integrity of a 
specimen at the collection site?
5.6 What are the privacy requirements when collecting a urine 
specimen?

Subpart F--Federal Drug Testing Custody and Control Form

6.1 What federal form is used to document custody and control?
6.2 What happens if the correct OMB-approved Federal CCF is not 
available or is not used?

Subpart G--Urine Specimen Collection Containers and Bottles

7.1 What is used to collect a urine specimen?
7.2 What are the requirements for a urine collection container and 
specimen bottles?
7.3 What are the minimum performance requirements for a urine 
collection container and specimen bottles?

Subpart H--Urine Specimen Collection Procedure

8.1 What privacy must the donor be given when providing a urine 
specimen?
8.2 What must the collector ensure at the collection site before 
starting a urine specimen collection?
8.3 What are the preliminary steps in the urine specimen collection 
procedure?
8.4 What steps does the collector take in the collection procedure 
before the donor provides a urine specimen?
8.5 What steps does the collector take during and after the urine 
specimen collection procedure?
8.6 What procedure is used when the donor states that he or she is 
unable to provide a urine specimen?
8.7 If the donor is unable to provide a urine specimen, may another 
specimen type be collected for testing?
8.8 How does the collector prepare the urine specimens?
8.9 When is a direct observed collection conducted?
8.10 How is a direct observed collection conducted?
8.11 When is a monitored collection conducted?
8.12 How is a monitored collection conducted?
8.13 How does the collector report a donor's refusal to test?
8.14 What are a federal agency's responsibilities for a collection 
site?

Subpart I--HHS Certification of Laboratories and IITFs

9.1 Who has the authority to certify laboratories and IITFs to test 
urine specimens for federal agencies?
9.2 What is the process for a laboratory or IITF to become HHS-
certified?
9.3 What is the process for a laboratory or IITF to maintain HHS 
certification?
9.4 What is the process when a laboratory or IITF does not maintain 
its HHS certification?
9.5 What are the qualitative and quantitative specifications of 
performance testing (PT) samples?
9.6 What are the PT requirements for an applicant laboratory?
9.7 What are the PT requirements for an HHS-certified urine 
laboratory?
9.8 What are the PT requirements for an applicant IITF?
9.9 What are the PT requirements for an HHS-certified IITF?
9.10 What are the inspection requirements for an applicant 
laboratory or IITF?
9.11 What are the maintenance inspection requirements for an HHS-
certified laboratory or IITF?
9.12 Who can inspect an HHS-certified laboratory or IITF and when 
may the inspection be conducted?
9.13 What happens if an applicant laboratory or IITF does not 
satisfy the minimum requirements for either the PT program or the 
inspection program?
9.14 What happens if an HHS-certified laboratory or IITF does not 
satisfy the minimum requirements for either the PT program or the 
inspection program?
9.15 What factors are considered in determining whether revocation 
of a laboratory's or IITF's HHS certification is necessary?
9.16 What factors are considered in determining whether to suspend a 
laboratory's or an IITF's HHS certification?
9.17 How does the Secretary notify an HHS-certified laboratory or 
IITF that action is being taken against the laboratory or IITF?
9.18 May a laboratory or IITF that had its HHS certification revoked 
be recertified to test federal agency specimens?
9.19 Where is the list of HHS-certified laboratories and IITFs 
published?

Subpart J--Blind Samples Submitted by an Agency

10.1 What are the requirements for federal agencies to submit blind 
samples to HHS-certified laboratories or IITFs?
10.2 What are the requirements for blind samples?
10.3 How is a blind sample submitted to an HHS-certified laboratory 
or IITF?
10.4 What happens if an inconsistent result is reported for a blind 
sample?

Subpart K--Laboratory

11.1 What must be included in the HHS-certified laboratory's 
standard operating procedure manual?
11.2 What are the responsibilities of the responsible person (RP)?
11.3 What scientific qualifications must the RP have?
11.4 What happens when the RP is absent or leaves an HHS-certified 
laboratory?
11.5 What qualifications must an individual have to certify a result 
reported by an HHS-certified laboratory?
11.6 What qualifications and training must other personnel of an 
HHS-certified laboratory have?
11.7 What security measures must an HHS-certified laboratory 
maintain?
11.8 What are the laboratory chain of custody requirements for 
specimens and aliquots?
11.9 What test(s) does an HHS-certified laboratory conduct on a 
urine specimen received from an IITF?
11.10 What are the requirements for an initial drug test?
11.11 What must an HHS-certified laboratory do to validate an 
initial drug test?
11.12 What are the batch quality control requirements when 
conducting an initial drug test?
11.13 What are the requirements for a confirmatory drug test?
11.14 What must an HHS-certified laboratory do to validate a 
confirmatory drug test?
11.15 What are the batch quality control requirements when 
conducting a confirmatory drug test?
11.16 What are the analytical and quality control requirements for 
conducting specimen validity tests?
11.17 What must an HHS-certified laboratory do to validate a 
specimen validity test?
11.18 What are the requirements for

[[Page 28118]]

conducting each specimen validity test?
11.19 What are the requirements for an HHS-certified laboratory to 
report a test result?
11.20 How long must an HHS-certified laboratory retain specimens?
11.21 How long must an HHS-certified laboratory retain records?
11.22 What statistical summary reports must an HHS-certified 
laboratory provide for urine testing?
11.23 What HHS-certified laboratory information is available to a 
federal agency?
11.24 What HHS-certified laboratory information is available to a 
federal employee?
11.25 What types of relationships are prohibited between an HHS-
certified laboratory and an MRO?
11.26 What type of relationship can exist between an HHS-certified 
laboratory and an HHS-certified IITF?

Subpart L--Instrumented Initial Test Facility (IITF)

12.1 What must be included in the HHS-certified IITF's standard 
operating procedure manual?
12.2 What are the responsibilities of the responsible technician 
(RT)?
12.3 What qualifications must the RT have?
12.4 What happens when the RT is absent or leaves an HHS-certified 
IITF?
12.5 What qualifications must an individual have to certify a result 
reported by an HHS-certified IITF?
12.6 What qualifications and training must other personnel of an 
HHS-certified IITF have?
12.7 What security measures must an HHS-certified IITF maintain?
12.8 What are the IITF chain of custody requirements for specimens 
and aliquots?
12.9 What are the requirements for an initial drug test?
12.10 What must an HHS-certified IITF do to validate an initial drug 
test?
12.11 What are the batch quality control requirements when 
conducting an initial drug test?
12.12 What are the analytical and quality control requirements for 
conducting specimen validity tests?
12.13 What must an HHS-certified IITF do to validate a specimen 
validity test?
12.14 What are the requirements for conducting each specimen 
validity test?
12.15 What are the requirements for an HHS-certified IITF to report 
a test result?
12.16 How does an HHS-certified IITF handle a specimen that tested 
positive, adulterated, substituted, or invalid at the IITF?
12.17 How long must an HHS-certified IITF retain a specimen?
12.18 How long must an HHS-certified IITF retain records?
12.19 What statistical summary report must an HHS-certified IITF 
provide?
12.20 What HHS-certified IITF information is available to a federal 
employee?
12.21 What types of relationships are prohibited between an HHS-
certified IITF and an MRO?
12.22 What type of relationship can exist between an HHS-certified 
IITF and an HHS-certified laboratory?

Subpart M--Medical Review Officer (MRO)

13.1 Who may serve as an MRO?
13.2 How are nationally recognized entities or subspecialty boards 
that certify MROs approved?
13.3 What training is required before a physician may serve as an 
MRO?
13.4 What are the responsibilities of an MRO?
13.5 What must an MRO do when reviewing a urine specimen's test 
results?
13.6 What action does the MRO take when the collector reports that 
the donor did not provide a sufficient amount of urine for a drug 
test?
13.7 What happens when an individual is unable to provide a 
sufficient amount of urine for a federal agency applicant/pre-
employment test, a follow-up test, or a return-to-duty test because 
of a permanent or long-term medical condition?
13.8 Who may request a test of a split (B) specimen?
13.9 How does an MRO report a primary (A) specimen test result to an 
agency?
13.10 What types of relationships are prohibited between an MRO and 
an HHS-certified laboratory or an HHS-certified IITF?

Subpart N--Split Specimen Tests

14.1 When may a split (B) specimen be tested?
14.2 How does an HHS-certified laboratory test a split (B) specimen 
when the primary (A) specimen was reported positive?
14.3 How does an HHS-certified laboratory test a split (B) urine 
specimen when the primary (A) specimen was reported adulterated?
14.4 How does an HHS-certified laboratory test a split (B) urine 
specimen when the primary (A) specimen was reported substituted?
14.5 Who receives the split (B) specimen result?
14.6 What action(s) does an MRO take after receiving the split (B) 
urine specimen result from the second HHS-certified laboratory?
14.7 How does an MRO report a split (B) specimen test result to an 
agency?
14.8 How long must an HHS-certified laboratory retain a split (B) 
specimen?

Subpart O--Criteria for Rejecting a Specimen for Testing

15.1 What discrepancies require an HHS-certified laboratory or an 
HHS-certified IITF to report a specimen as rejected for testing?
15.2 What discrepancies require an HHS-certified laboratory or an 
HHS-certified IITF to report a specimen as rejected for testing 
unless the discrepancy is corrected?
15.3 What discrepancies are not sufficient to require an HHS-
certified laboratory or an HHS-certified IITF to reject a urine 
specimen for testing or an MRO to cancel a test?
15.4 What discrepancies may require an MRO to cancel a test?

Subpart P--Laboratory or IITF Suspension/Revocation Procedures

16.1 When may the HHS certification of a laboratory or IITF be 
suspended?
16.2 What definitions are used for this subpart?
16.3 Are there any limitations on issues subject to review?
16.4 Who represents the parties?
16.5 When must a request for informal review be submitted?
16.6 What is an abeyance agreement?
16.7 What procedures are used to prepare the review file and written 
argument?
16.8 When is there an opportunity for oral presentation?
16.9 Are there expedited procedures for review of immediate 
suspension?
16.10 Are any types of communications prohibited?
16.11 How are communications transmitted by the reviewing official?
16.12 What are the authority and responsibilities of the reviewing 
official?
16.13 What administrative records are maintained?
16.14 What are the requirements for a written decision?
16.15 Is there a review of the final administrative action?

Subpart A--Applicability

Section 1.1 To whom do these Guidelines apply?

    (a) These Guidelines apply to:
    (1) Executive Agencies as defined in 5 U.S.C. 105;
    (2) The Uniformed Services, as defined in 5 U.S.C. 2101(3) (but 
excluding the Armed Forces as defined in 5 U.S.C. 2101(2));
    (3) Any other employing unit or authority of the federal government 
except the United States Postal Service, the Postal Rate Commission, 
and employing units or authorities in the Judicial and Legislative 
Branches; and
    (4) The Intelligence Community, as defined by Executive Order 
12333, is subject to these Guidelines only to the extent agreed to by 
the head of the affected agency;
    (5) Laboratories and instrumented initial test facilities (IITFs) 
that provide drug testing services to the federal agencies;
    (6) Collectors who provide specimen collection services to the 
federal agencies; and
    (7) Medical Review Officers (MROs) who provide drug testing review 
and interpretation of results services to the federal agencies.
    (b) These Guidelines do not apply to drug testing under authority 
other than Executive Order 12564, including testing of persons in the 
criminal justice

[[Page 28119]]

system, such as arrestees, detainees, probationers, incarcerated 
persons, or parolees.\1\
---------------------------------------------------------------------------

    \1\ The NRC-related information in this notice pertains to 
individuals subject to drug testing conducted pursuant to 10 CFR 
part 26, ``Fitness for Duty Programs'' (i.e., employees of certain 
NRC-regulated entities).
    Although HHS has no authority to regulate the transportation 
industry, the Department of Transportation (DOT) does have such 
authority. DOT is required by law to develop requirements for its 
regulated industry that ``incorporate the Department of Health and 
Human Services scientific and technical guidelines dated April 11, 
1988, and any amendments to those guidelines . . .'' See 49 U.S.C. 
20140(c)(2). In carrying out its mandate, DOT requires by regulation 
at 49 CFR part 40 that its federally-regulated employers use only 
HHS-certified laboratories in the testing of employees, 49 CFR 
40.81, and incorporates the scientific and technical aspects of the 
HHS Mandatory Guidelines.
---------------------------------------------------------------------------

Section 1.2 Who is responsible for developing and implementing these 
Guidelines?

    (a) Executive Order 12564 and Public Law 100-71 require the 
Department of Health and Human Services (HHS) to establish scientific 
and technical guidelines for federal workplace drug testing programs.
    (b) The Secretary has the responsibility to implement these 
Guidelines.

Section 1.3 How does a federal agency request a change from these 
Guidelines?

    (a) Each federal agency must ensure that its workplace drug testing 
program complies with the provisions of these Guidelines unless a 
waiver has been obtained from the Secretary.
    (b) To obtain a waiver, a federal agency must submit a written 
request to the Secretary that describes the specific change for which a 
waiver is sought and a detailed justification for the change.

Section 1.4 How are these Guidelines revised?

    (a) To ensure the full reliability and accuracy of specimen tests, 
the accurate reporting of test results, and the integrity and efficacy 
of federal drug testing programs, the Secretary may make changes to 
these Guidelines to reflect improvements in the available science and 
technology.
    (b) The changes will be published in final as a notice in the 
Federal Register.

Section 1.5 What do the terms used in these Guidelines mean?

    The following definitions are adopted:
    Accessioner. The individual who signs the Federal Drug Testing 
Custody and Control Form at the time of specimen receipt at the HHS-
certified laboratory or (for urine) the HHS-certified IITF.
    Adulterated Specimen. A specimen that has been altered, as 
evidenced by test results showing either a substance that is not a 
normal constituent for that type of specimen or showing an abnormal 
concentration of an endogenous substance.
    Aliquot. A portion of a specimen used for testing.
    Alternate Responsible Person. The person who assumes professional, 
organizational, educational, and administrative responsibility for the 
day-to-day management of the HHS-certified laboratory when the 
responsible person is unable to fulfill these obligations.
    Alternate Responsible Technician. The person who assumes 
professional, organizational, educational, and administrative 
responsibility for the day-to-day management of the HHS-certified IITF 
when the responsible technician is unable to fulfill these obligations.
    Alternate Technology Initial Drug Test. An initial drug test using 
technology other than immunoassay to differentiate negative specimens 
from those requiring further testing.
    Batch. A number of specimens or aliquots handled concurrently as a 
group.
    Biomarker. An endogenous substance used to validate a biological 
specimen.
    Blind Sample. A sample submitted to an HHS-certified test facility 
for quality assurance purposes, with a fictitious identifier, so that 
the test facility cannot distinguish it from a donor specimen.
    Calibrator. A sample of known content and analyte concentration 
prepared in the appropriate matrix used to define expected outcomes of 
a testing procedure. The test result of the calibrator is verified to 
be within established limits prior to use.
    Cancelled Test. The result reported by the MRO to the federal 
agency when a specimen has been reported to the MRO as an invalid 
result (and the donor has no legitimate explanation) or rejected for 
testing, when a split specimen fails to reconfirm, or when the MRO 
determines that a fatal flaw or unrecovered correctable flaw exists in 
the forensic records (as described in Sections 15.1 and 15.2).
    Carryover. The effect that occurs when a sample result (e.g., drug 
concentration) is affected by a preceding sample during the preparation 
or analysis of a sample.
    Certifying Scientist (CS). The individual responsible for verifying 
the chain of custody and scientific reliability of a test result 
reported by an HHS-certified laboratory.
    Certifying Technician (CT). The individual responsible for 
verifying the chain of custody and scientific reliability of negative, 
rejected for testing, and (for urine) negative/dilute results reported 
by an HHS-certified laboratory or (for urine) an HHS-certified IITF.
    Chain of Custody (COC) Procedures. Procedures that document the 
integrity of each specimen or aliquot from the point of collection to 
final disposition.
    Chain of Custody Documents. Forms used to document the control and 
security of the specimen and all aliquots. The document may account for 
an individual specimen, aliquot, or batch of specimens/aliquots and 
must include the name and signature of each individual who handled the 
specimen(s) or aliquot(s) and the date and purpose of the handling.
    Collection Container. A receptacle used to collect a urine 
specimen.
    Collection Site. The location where specimens are collected.
    Collector. A person trained to instruct and assist a donor in 
providing a specimen.
    Confirmatory Drug Test. A second analytical procedure performed on 
a separate aliquot of a specimen to identify and quantify a specific 
drug or drug metabolite.
    Confirmatory Specimen Validity Test. A second test performed on a 
separate aliquot of a specimen to further support a specimen validity 
test result.
    Control. A sample used to evaluate whether an analytical procedure 
or test is operating within predefined tolerance limits.
    Cutoff. The analytical value (e.g., drug or drug metabolite 
concentration) used as the decision point to determine a result (e.g., 
negative, positive, adulterated, invalid, or, for urine, substituted) 
or the need for further testing.
    Dilute Specimen. A urine specimen with creatinine and specific 
gravity values that are lower than expected but are still within the 
physiologically producible ranges of human urine.
    Donor. The individual from whom a specimen is collected.
    Failed to Reconfirm. The result reported for a split (B) specimen 
when a second HHS-certified laboratory is unable to corroborate the 
result reported for the primary (A) specimen.
    Federal Drug Testing Custody and Control Form (Federal CCF). The 
Office of Management and Budget (OMB) approved form that is used to 
document the collection and chain of custody of a specimen from the 
time the specimen is collected until it is received by the test 
facility (i.e., HHS-certified laboratory or,

[[Page 28120]]

for urine, HHS-certified IITF). It may be a paper (hardcopy), 
electronic, or combination electronic and paper format (hybrid). The 
form may also be used to report the test result to the Medical Review 
Officer.
    HHS. The Department of Health and Human Services.
    Initial Drug Test. An analysis used to differentiate negative 
specimens from those requiring further testing.
    Initial Specimen Validity Test. The first analysis used to 
determine if a specimen is invalid, adulterated, or (for urine) diluted 
or substituted.
    Instrumented Initial Test Facility (IITF). A permanent location 
where (for urine) initial testing, reporting of results, and 
recordkeeping are performed under the supervision of a responsible 
technician.
    Invalid Result. The result reported by an HHS-certified laboratory 
when the laboratory determines that it cannot complete testing or 
obtain a valid drug test result.
    Laboratory. A permanent location where initial and confirmatory 
drug testing, reporting of results, and recordkeeping are performed 
under the supervision of a responsible person.
    Limit of Detection. The lowest concentration at which the analyte 
(e.g., drug or drug metabolite) can be identified.
    Limit of Quantification. For quantitative assays, the lowest 
concentration at which the identity and concentration of the analyte 
(e.g., drug or drug metabolite) can be accurately established.
    Lot. A number of units of an item (e.g., reagents, quality control 
material) manufactured from the same starting materials within a 
specified period of time for which the manufacturer ensures that the 
items have essentially the same performance characteristics and 
expiration date.
    Medical Review Officer (MRO). A licensed physician who reviews, 
verifies, and reports a specimen test result to the federal agency.
    Negative Result. The result reported by an HHS-certified laboratory 
or (for urine) an HHS-certified IITF to an MRO when a specimen contains 
no drug and/or drug metabolite; or the concentration of the drug or 
drug metabolite is less than the cutoff for that drug or drug class.
    Non-Medical Use of a Drug: The use of a prescription drug, whether 
obtained by prescription or otherwise, other than in the manner or for 
the time period prescribed, or by a person for whom the drug was not 
prescribed.
    Oral Fluid Specimen. An oral fluid specimen is collected from the 
donor's oral cavity and is a combination of physiological fluids 
produced primarily by the salivary glands.
    Oxidizing Adulterant. A substance that acts alone or in combination 
with other substances to oxidize drug or drug metabolites to prevent 
the detection of the drugs or drug metabolites, or affects the reagents 
in either the initial or confirmatory drug test.
    Performance Testing (PT) Sample. A program-generated sample sent to 
a laboratory or (for urine) to an IITF to evaluate performance.
    Positive Result. The result reported by an HHS-certified laboratory 
when a specimen contains a drug or drug metabolite equal to or greater 
than the confirmation cutoff concentration.
    Reconfirmed. The result reported for a split (B) specimen when the 
second HHS-certified laboratory corroborates the original result 
reported for the primary (A) specimen.
    Rejected for Testing. The result reported by an HHS-certified 
laboratory or (for urine) HHS-certified IITF when no tests are 
performed on a specimen because of a fatal flaw or an unrecovered 
correctable error (see Sections 15.1 and 15.2).
    Responsible Person (RP). The person who assumes professional, 
organizational, educational, and administrative responsibility for the 
day-to-day management of an HHS-certified laboratory.
    Responsible Technician (RT). The person who assumes professional, 
organizational, educational, and administrative responsibility for the 
day-to-day management of an HHS-certified IITF.
    Sample. A performance testing sample, calibrator or control used 
during testing, or a representative portion of a donor's specimen.
    Secretary. The Secretary of the U.S. Department of Health and Human 
Services.
    Specimen. A sample collected from a donor at the collection site 
for the purpose of a drug test.
    Split Specimen Collection (for Urine). A collection in which the 
specimen collected is divided into a primary (A) specimen and a split 
(B) specimen, which are independently sealed in the presence of the 
donor.
    Standard. Reference material of known purity or a solution 
containing a reference material at a known concentration.
    Substituted Specimen. A specimen that has been submitted in place 
of the donor's urine, as evidenced by creatinine and specific gravity 
values that are outside the physiologically producible ranges of human 
urine.

Section 1.6 What is an agency required to do to protect employee 
records?

    Consistent with 5 U.S.C. 552a and 48 CFR 24.101-24.104, all agency 
contracts with laboratories, IITFs, collectors, and MROs must require 
that they comply with the Privacy Act, 5 U.S.C. 552a. In addition, the 
contracts must require compliance with employee access and 
confidentiality provisions of Section 503 of Public Law 100-71. Each 
federal agency must establish a Privacy Act System of Records or modify 
an existing system or use any applicable Government-wide system of 
records to cover the records of employee drug test results. All 
contracts and the Privacy Act System of Records must specifically 
require that employee records be maintained and used with the highest 
regard for employee privacy.
    In addition, the Health Insurance Portability and Accountability 
Act of 1996 (HIPAA) Privacy Rule (Rule), 45 CFR parts 160 and 164, 
Subparts A and E, is applicable to certain health care providers with 
whom a federal agency may contract. If a health care provider is a 
HIPAA covered entity, the provider must protect the individually 
identifiable health information it maintains in accordance with the 
requirements of the Rule, which includes not using or disclosing the 
information except as permitted by the Rule and ensuring there are 
reasonable safeguards in place to protect the privacy of the 
information. For more information regarding the HIPAA Privacy Rule, 
please visit https://www.hhs.gov/ocr/hipaa.

Section 1.7 What is a refusal to take a federally regulated drug test?

    (a) As a donor for a federally regulated drug test, you have 
refused to take a federally regulated drug test if you:
    (1) Fail to appear for any test (except a pre-employment test) 
within a reasonable time, as determined by the federal agency, 
consistent with applicable agency regulations, after being directed to 
do so by the federal agency;
    (2) Fail to remain at the collection site until the collection 
process is complete (with the exception of a donor who leaves the 
collection site before the collection process begins for a pre-
employment test);
    (3) Fail to provide a specimen (e.g., urine or another authorized 
specimen type) for any drug test required by these Guidelines and 
authorized by federal agency regulations (with the exception of a donor 
who leaves the collection site before the collection process begins for 
a pre-employment test);

[[Page 28121]]

    (4) In the case of a direct observed or monitored collection, fail 
to permit the observation or monitoring of your provision of a specimen 
when required as described in Sections 8.9 and 8.10;
    (5) Fail to provide a sufficient amount of urine when directed, and 
it has been determined, through a required medical evaluation, that 
there was no legitimate medical explanation for the failure as 
determined by the process described in Section 13.5;
    (6) Fail or decline to participate in an alternate specimen 
collection (e.g., oral fluid) as directed by the federal agency or 
collector (i.e., as described in Section 8.6);
    (7) Fail to undergo a medical examination or evaluation, as 
directed by the MRO as part of the verification process (i.e., Section 
13.6) or as directed by the federal agency. In the case of a federal 
agency applicant/pre-employment drug test, the donor is deemed to have 
refused to test on this basis only if the federal agency applicant/pre-
employment test is conducted following a contingent offer of 
employment. If there was no contingent offer of employment, the MRO 
will cancel the test;
    (8) Fail to cooperate with any part of the testing process (e.g., 
refuse to empty pockets when directed by the collector, disrupt the 
collection process, fail to wash hands after being directed to do so by 
the collector);
    (9) For an observed collection, fail to follow the observer's 
instructions related to the collection process;
    (10) Possess or wear a prosthetic or other device that could be 
used to interfere with the collection process; or
    (11) Admit to the collector or MRO that you have adulterated or 
(for urine) substituted the specimen.

Section 1.8 What are the potential consequences for refusing to take a 
federally regulated drug test?

    (a) As a federal agency employee or applicant, a refusal to take a 
test may result in the initiation of disciplinary or adverse action, up 
to and including removal from, or non-selection for, federal 
employment.
    (b) When a donor has refused to participate in a part of the 
collection process, the collector must terminate that portion of the 
collection process and take action as described in Section 8.9; 
immediately notify the federal agency's designated representative by 
any means (e.g., telephone or secure fax machine) that ensures that the 
refusal notification is immediately received, document the refusal on 
the Federal CCF, sign and date the Federal CCF, and send all copies of 
the Federal CCF to the federal agency's designated representative.
    (c) When documenting a refusal to test during the verification 
process as described in Sections 13.4, 13.5, and 13.6, the MRO must 
complete the MRO copy of the Federal CCF to include:
    (1) Checking the refusal to test box;
    (2) Providing a reason for the refusal in the remarks line; and
    (3) Signing and dating the MRO copy of the Federal CCF.

Subpart B--Urine Specimens

Section 2.1 What type of specimen may be collected?

    A federal agency may collect urine and/or an alternate specimen 
type for its workplace drug testing program. Only specimen types 
authorized by Mandatory Guidelines for Federal Workplace Drug Testing 
Programs may be collected. An agency using urine must follow these 
Guidelines.

Section 2.2 Under what circumstances may a urine specimen be collected?

    A federal agency may collect a urine specimen for the following 
reasons:
    (a) Federal agency applicant/Pre-employment test;
    (b) Random test;
    (c) Reasonable suspicion/cause test;
    (d) Post-accident test;
    (e) Return to duty test; or
    (f) Follow-up test.

Section 2.3 How is each urine specimen collected?

    Each urine specimen is collected as a split specimen as described 
in Section 2.5.

Section 2.4 What volume of urine is collected?

    A donor is expected to provide at least 45 mL of urine for a 
specimen.

Section 2.5 How does the collector split the urine specimen?

    The collector pours at least 30 mL into a specimen bottle that is 
designated as A (primary) and then pours at least 15 mL into a specimen 
bottle that is designated as B (split).

Section 2.6 When may an entity or individual release a urine specimen?

    Entities and individuals subject to these Guidelines under Section 
1.1 may not release specimens collected pursuant to Executive Order 
12564, Public Law 100-71, and these Guidelines to donors or their 
designees. Specimens also may not be released to any other entity or 
individual unless expressly authorized by these Guidelines or by 
applicable federal law. This section does not prohibit a donor's 
request to have a split (B) specimen tested in accordance with Section 
13.8.

Subpart C--Urine Drug and Specimen Validity Tests

Section 3.1 Which tests are conducted on a urine specimen?

    A federal agency:
    (a) Must ensure that each specimen is tested for marijuana and 
cocaine metabolites as provided under Section 3.4;
    (b) Is authorized to test each specimen for opiates, amphetamines, 
and phencyclidine, as provided under Section 3.4; and
    (c) Must ensure that the following specimen validity tests are 
conducted on each urine specimen:
    (1) Determine the creatinine concentration on every specimen;
    (2) Determine the specific gravity on every specimen for which the 
creatinine concentration is less than 20 mg/dL;
    (3) Determine the pH on every specimen; and
    (4) Perform one or more specimen validity tests for oxidizing 
adulterants on every specimen.
    (d) If a specimen exhibits abnormal characteristics (e.g., unusual 
odor or color, semi-solid characteristics), causes reactions or 
responses characteristic of an adulterant during initial or 
confirmatory drug tests (e.g., non-recovery of internal standard, 
unusual response), or contains an unidentified substance that 
interferes with the confirmatory analysis, then additional testing may 
be performed.

Section 3.2 May a specimen be tested for additional drugs?

    (a) On a case-by-case basis, a specimen may be tested for 
additional drugs, if a federal agency is conducting the collection for 
reasonable suspicion or post accident testing. A specimen collected 
from a federal agency employee may be tested by the federal agency for 
any drugs listed in Schedule I or II of the Controlled Substances Act 
(other than the drugs listed in Section 3.1, or when used pursuant to a 
valid prescription or when used as otherwise authorized by law). The 
federal agency must request the HHS-certified laboratory to test for 
the additional drug, include a justification to test a specific 
specimen for the drug, and ensure that the HHS-certified laboratory has 
the capability to test for the drug and has established properly 
validated initial and confirmatory analytical methods. If an initial 
test procedure is not available upon request for a suspected Schedule I 
or Schedule II drug, the federal agency can request an HHS-certified 
laboratory

[[Page 28122]]

to test for the drug by analyzing two separate aliquots of the specimen 
in two separate testing batches using the confirmatory analytical 
method. Additionally, the split (B) specimen will be available for 
testing if the donor requests a retest at another HHS-certified 
laboratory.
    (b) A federal agency covered by these Guidelines must petition the 
Secretary in writing for approval to routinely test for any drug class 
not listed in Section 3.1. Such approval must be limited to the use of 
the appropriate science and technology and must not otherwise limit 
agency discretion to test for any drug tested under paragraph (a) of 
this section.

Section 3.3 May any of the specimens be used for other purposes?

    (a) Specimens collected pursuant to Executive Order 12564, Public 
Law 100-71, and these Guidelines must only be tested for drugs and to 
determine their validity in accordance with Subpart C of these 
Guidelines. Use of specimens by donors, their designees, or any other 
entity, for other purposes (e.g., deoxyribonucleic acid, DNA, testing) 
is prohibited unless authorized in accordance with applicable federal 
law.
    (b) These Guidelines are not intended to prohibit federal agencies, 
specifically authorized by law to test a specimen for additional 
classes of drugs in its workplace drug testing program.

Section 3.4 What are the drug test cutoff concentrations for urine?

----------------------------------------------------------------------------------------------------------------
                                                                                               Confirmatory test
                                               Initial test                                         cutoff
           Initial test analyte               cutoff (ng/mL)      Confirmatory test analyte   concentration (ng/
                                                                                                      mL)
----------------------------------------------------------------------------------------------------------------
Marijuana (THCA) \1\......................                  50  THCA........................                  15
Benzoylecgonine...........................                 150  Benzoylecgonine.............                 100
Codeine/Morphine..........................            \2\ 2000  Codeine.....................                2000
                                                                Morphine....................                2000
Hydrocodone/Hydromorphone.................             \2\ 300  Hydrocodone.................                 100
                                                                Hydromorphone...............                 100
Oxycodone/Oxymorphone.....................             \2\ 100  Oxycodone...................                  50
                                                                Oxymorphone.................                  50
6-Acetylmorphine..........................                  10  6-Acetylmorphine............                  10
Phencyclidine.............................                  25  Phencyclidine...............                  25
Amphetamine/Methamphetamine...............             \2\ 500  Amphetamine.................                 250
                                                                Methamphetamine.............                 250
MDMA \3\/MDA \4\/MDEA \5\.................             \2\ 500  MDMA \3\....................                 250
                                                                MDA \4\.....................                 250
                                                                MDEA \5\....................                 250
----------------------------------------------------------------------------------------------------------------
\1\ [Delta]-9-Tetrahydrocannabinol-9-carboxylic acid (THCA)
\2\ Immunoassay: The test must be calibrated with one analyte from the group identified as the target analyte.
  The cross-reactivity of the immunoassay to the other analyte(s) within the group must be 80 percent or
  greater; if not, separate immunoassays must be used for the analytes within the group.
Alternate technology: Either one analyte or all analytes from the group must be used for calibration, depending
  on the technology. At least one analyte within the group must have a concentration equal to or greater than
  the initial test cutoff or, alternatively, the sum of the analytes present (i.e., equal to or greater than the
  laboratory's validated limit of quantification) must be equal to or greater than the initial test cutoff.
\3\ Methylenedioxymethamphetamine (MDMA).
\4\ Methylenedioxyamphetamine (MDA).
\5\ Methylenedioxyethylamphetamine (MDEA).

Section 3.5 May an HHS-certified laboratory perform additional drug 
and/or specimen validity tests on a specimen at the request of the 
Medical Review Officer (MRO)?

    An HHS-certified laboratory is authorized to perform additional 
drug and/or specimen validity tests as necessary to provide information 
that the MRO would use to report a verified drug test result (e.g., 
d,l-stereoisomers determination for methamphetamine, 
tetrahydrocannabivarin, and other specimen validity tests using 
biomarkers). All tests must meet appropriate validation and quality 
control requirements.

Section 3.6 What criteria are used to report a urine specimen as 
adulterated?

    An HHS-certified laboratory reports a primary (A) specimen as 
adulterated when:
    (a) The pH is less than 4 or equal to or greater than 11 using 
either a pH meter or a colorimetric pH test for the initial test on the 
first aliquot and a pH meter for the confirmatory test on the second 
aliquot;
    (b) The nitrite concentration is equal to or greater than 500 mcg/
mL using either a nitrite colorimetric test or a general oxidant 
colorimetric test for the initial test on the first aliquot and a 
different confirmatory test (e.g., multi-wavelength spectrophotometry, 
ion chromatography, capillary electrophoresis) on the second aliquot;
    (c) The presence of chromium (VI) is verified using either a 
general oxidant colorimetric test (with an equal to or greater than 50 
mcg/mL chromium (VI)-equivalent cutoff) or a chromium (VI) colorimetric 
test (chromium (VI) concentration equal to or greater than 50 mcg/mL) 
for the initial test on the first aliquot and a different confirmatory 
test (e.g., multi-wavelength spectrophotometry, ion chromatography, 
atomic absorption spectrophotometry, capillary electrophoresis, 
inductively coupled plasma-mass spectrometry) with the chromium (VI) 
concentration equal to or greater than the limit of quantitation (LOQ) 
of the confirmatory test on the second aliquot;
    (d) The presence of halogen (e.g., bleach, iodine, fluoride) is 
verified using either a general oxidant colorimetric test (with an 
equal to or great than 200 mcg/mL nitrite-equivalent cutoff or an equal 
to or great than 50 mcg/mL chromium (VI)-equivalent cutoff) or halogen 
colorimetric test (halogen concentration equal to or greater than the 
LOQ) for the initial test on the first aliquot and a different 
confirmatory test (e.g., multi-wavelength spectrophotometry, ion 
chromatography, inductively coupled plasma-mass spectrometry) with a 
specific halogen concentration equal to or greater than the LOQ of the 
confirmatory test on the second aliquot;
    (e) The presence of glutaraldehyde is verified using either an 
aldehyde test (aldehyde present) or the characteristic

[[Page 28123]]

immunoassay response on one or more drug immunoassay tests for the 
initial test on the first aliquot and a different confirmatory test 
(e.g., GC/MS) for the confirmatory test with the glutaraldehyde 
concentration equal to or greater than the LOQ of the analysis on the 
second aliquot;
    (f) The presence of pyridine (pyridinium chlorochromate) is 
verified using either a general oxidant colorimetric test (with an 
equal to or greater than 200 mcg/mL nitrite-equivalent cutoff or an 
equal to or greater than 50 mcg/mL chromium (VI)-equivalent cutoff) or 
a chromium (VI) colorimetric test (chromium (VI) concentration equal to 
or greater than 50 mcg/mL) for the initial test on the first aliquot 
and a different confirmatory test (e.g., GC/MS) for the confirmatory 
test with the pyridine concentration equal to or greater than the LOQ 
of the analysis on the second aliquot;
    (g) The presence of a surfactant is verified by using a surfactant 
colorimetric test with an equal to or greater than 100 mcg/mL 
dodecylbenzene sulfonate-equivalent cutoff for the initial test on the 
first aliquot and a different confirmatory test (e.g., multi-wavelength 
spectrophotometry) with an equal to or greater than 100 mcg/mL 
dodecylbenzene sulfonate-equivalent cutoff on the second aliquot; or
    (h) The presence of any other adulterant not specified in 
paragraphs (b) through (g) of this section is verified using an initial 
test on the first aliquot and a different confirmatory test on the 
second aliquot.

Section 3.7 What criteria are used to report a urine specimen as 
substituted?

    An HHS-certified laboratory reports a primary (A) specimen as 
substituted when the creatinine concentration is less than 2 mg/dL on 
both the initial and confirmatory creatinine tests on two separate 
aliquots (i.e., the same colorimetric test may be used to test both 
aliquots) and the specific gravity is less than or equal to 1.0010 or 
equal to or greater than 1.0200 on both the initial and confirmatory 
specific gravity tests on two separate aliquots (i.e., a refractometer 
is used to test both aliquots).

Section 3.8 What criteria are used to report a urine specimen as 
dilute?

    A dilute result may be reported only in conjunction with the 
positive or negative drug test results for a specimen.
    (a) An HHS-certified laboratory or an HHS-certified IITF reports a 
primary (A) specimen as dilute when the creatinine concentration is 
greater than 5 mg/dL but less than 20 mg/dL and the specific gravity is 
equal to or greater than 1.002 but less than 1.003 on a single aliquot.
    (b) In addition, an HHS-certified laboratory reports a primary (A) 
specimen as dilute when the creatinine concentration is equal to or 
greater than 2 mg/dL but less than or equal to 5 mg/dL and the specific 
gravity is greater than 1.0010 but less than 1.0030.

Section 3.9 What criteria are used to report an invalid result for a 
urine specimen?

    An HHS-certified laboratory reports a primary (A) specimen as an 
invalid result when:
    (a) Inconsistent creatinine concentration and specific gravity 
results are obtained (i.e., the creatinine concentration is less than 2 
mg/dL on both the initial and confirmatory creatinine tests and the 
specific gravity is greater than 1.0010 but less than 1.0200 on the 
initial and/or confirmatory specific gravity test, the specific gravity 
is less than or equal to 1.0010 on both the initial and confirmatory 
specific gravity tests and the creatinine concentration is equal to or 
greater than 2 mg/dL on either or both the initial or confirmatory 
creatinine tests);
    (b) The pH is equal to or greater than 4 and less than 4.5 or equal 
to or greater than 9 and less than 11 using either a colorimetric pH 
test or pH meter for the initial test and a pH meter for the 
confirmatory test on two separate aliquots;
    (c) The nitrite concentration is equal to or greater than 200 mcg/
mL using a nitrite colorimetric test or equal to or greater than the 
equivalent of 200 mcg/mL nitrite using a general oxidant colorimetric 
test for both the initial (first) test and the second test or using 
either initial test and the nitrite concentration is equal to or 
greater than 200 mcg/mL but less than 500 mcg/mL for a different 
confirmatory test (e.g., multi-wavelength spectrophotometry, ion 
chromatography, capillary electrophoresis) on two separate aliquots;
    (d) The possible presence of chromium (VI) is determined using the 
same chromium (VI) colorimetric test with a cutoff equal to or greater 
than 50 mcg/mL chromium (VI) for both the initial (first) test and the 
second test on two separate aliquots;
    (e) The possible presence of a halogen (e.g., bleach, iodine, 
fluoride) is determined using the same halogen colorimetric test with a 
cutoff equal to or greater than the LOQ for both the initial (first) 
test and the second test on two separate aliquots or relying on the 
odor of the specimen as the initial test;
    (f) The possible presence of glutaraldehyde is determined by using 
the same aldehyde test (aldehyde present) or characteristic immunoassay 
response on one or more drug immunoassay tests for both the initial 
(first) test and the second test on two separate aliquots;
    (g) The possible presence of an oxidizing adulterant is determined 
by using the same general oxidant colorimetric test (with an equal to 
or greater than 200 mcg/mL nitrite-equivalent cutoff, an equal to or 
greater than 50 mcg/mL chromium (VI)-equivalent cutoff, or a halogen 
concentration is equal to or greater than the LOQ) for both the initial 
(first) test and the second test on two separate aliquots;
    (h) The possible presence of a surfactant is determined by using 
the same surfactant colorimetric test with an equal to greater than 100 
mcg/mL dodecylbenzene sulfonate-equivalent cutoff for both the initial 
(first) test and the second test on two separate aliquots or a foam/
shake test for the initial test;
    (i) Interference occurs on the immunoassay or alternate technology 
initial drug tests on two separate aliquots (i.e., valid immunoassay or 
alternate technology initial drug test results cannot be obtained);
    (j) Interference with the drug confirmatory assay occurs on two 
separate aliquots of the specimen and the laboratory is unable to 
identify the interfering substance;
    (k) The physical appearance of the specimen (e.g., viscosity) is 
such that testing the specimen may damage the laboratory's instruments; 
or
    (l) The specimen has been tested and the appearances of the primary 
(A) and the split (B) specimens (e.g., color) are clearly different; or
    (m) The concentration of a biomarker is not consistent with that 
established for human urine.

Subpart D--Collectors

Section 4.1 Who may collect a specimen?

    (a) A collector who has been trained to collect urine specimens in 
accordance with these Guidelines.
    (b) The immediate supervisor of a federal employee donor may only 
collect that donor's specimen when no other collector is available. The 
supervisor must be a trained collector.
    (c) The hiring official of a federal agency applicant may only 
collect that federal agency applicant's specimen when no other 
collector is available.

[[Page 28124]]

The hiring official must be a trained collector.

Section 4.2 Who may not collect a specimen?

    (a) A federal agency employee who is in a testing designated 
position and subject to the federal agency drug testing rules must not 
be a collector for co-workers in the same testing pool or who work 
together with that employee on a daily basis.
    (b) A federal agency applicant or employee must not collect his or 
her own drug testing specimen.
    (c) An employee working for an HHS-certified laboratory or IITF 
must not act as a collector if the employee could link the identity of 
the donor to the donor's drug test result.
    (d) To avoid a potential conflict of interest, a collector must not 
be related to the employee (e.g., spouse, ex-spouse, relative) or a 
close personal friend (e.g., fiancée).

Section 4.3 What are the requirements to be a collector?

    (a) An individual may serve as a collector if he or she fulfills 
the following conditions:
    (1) Is knowledgeable about the collection procedure described in 
these Guidelines;
    (2) Is knowledgeable about any guidance provided by the federal 
agency's Drug-Free Workplace Program and additional information 
provided by the Secretary relating to these Guidelines;
    (3) Is trained and qualified to collect a urine specimen. Training 
must include the following:
    (i) All steps necessary to complete a urine collection;
    (ii) Completion and distribution of the Federal CCF;
    (iii) Problem collections;
    (iv) Fatal flaws, correctable flaws, and how to correct problems in 
collections; and
    (v) The collector's responsibility for maintaining the integrity of 
the collection process, ensuring the privacy of the donor, ensuring the 
security of the specimen, and avoiding conduct or statements that could 
be viewed as offensive or inappropriate.
    (4) Has demonstrated proficiency in collections by completing five 
consecutive error-free mock collections.
    (i) The five mock collections must include one uneventful 
collection scenario, one insufficient specimen quantity, one 
temperature out of range scenario, one scenario in which the donor 
refuses to sign the Federal CCF, and one scenario in which the donor 
refuses to initial the specimen bottle tamper-evident seal.
    (ii) A qualified trainer for collectors must monitor and evaluate 
the individual being trained, in person or by a means that provides 
real-time observation and interaction between the trainer and the 
trainee, and the trainer must attest in writing that the mock 
collections are ``error-free.''
    (b) A trained collector must complete refresher training at least 
every five years that includes the requirements in paragraph (a) of 
this section.
    (c) The collector must maintain the documentation of his or her 
training and provide that documentation to a federal agency when 
requested.
    (d) An individual may not collect specimens for a federal agency 
until his or her training as a collector has been properly documented.

Section 4.4 What are the requirements to be an observer for a direct 
observed collection?

    (a) An individual may serve as an observer for a direct observed 
collection when the individual has satisfied the requirements:
    (1) Is knowledgeable about the direct observed collection procedure 
described in Section 8.9 of these Guidelines;
    (2) Is knowledgeable about any guidance provided by the federal 
agency's Drug-Free Workplace Program or additional information provided 
by the Secretary relating to the direct observed collection procedure 
described in these Guidelines;
    (3) Has received training on the following subjects:
    (i) All steps necessary to perform a direct observed collection; 
and
    (ii) The observer's responsibility for maintaining the integrity of 
the collection process, ensuring the privacy of individuals being 
tested, ensuring that the observation is done in a professional manner 
that minimizes the discomfort to the employee so observed, ensuring the 
security of the specimen by maintaining visual contact with the 
collection container until it is delivered to the collector, and 
avoiding conduct or statements that could be viewed as offensive or 
inappropriate.
    (b) The observer must be the same gender as the donor.
    (c) The observer is not required to be a trained collector.

Section 4.5 What are the requirements to be a trainer for collectors?

    (a) Individuals are considered qualified trainers for collectors 
and may train others to collect urine specimens when they have 
completed the following:
    (1) Qualified as a trained collector and regularly conducted urine 
drug test collections for a period of at least one year or
    (2) Completed a ``train the trainer'' course given by an 
organization (e.g., manufacturer, private entity, contractor, federal 
agency).
    (b) A qualified trainer for collectors must complete refresher 
training at least every five years in accordance with the collector 
requirements in Section 4.3(a).
    (c) A qualified trainer for collectors must maintain the 
documentation of his or her training and provide that documentation to 
a federal agency when requested.

Section 4.6 What must a federal agency do before a collector is 
permitted to collect a specimen?

    A federal agency must ensure the following:
    (a) The collector has satisfied the requirements described in 
Section 4.3;
    (b) The collector, who may be self-employed, or an organization 
(e.g., third party administrator that provides a collection service, 
collector training company, federal agency that employs its own 
collectors) maintains a copy of the training record(s); and
    (c) The collector has been provided the name and telephone number 
of the federal agency representative.

Subpart E--Collection Sites

Section 5.1 Where can a collection for a drug test take place?

    (a) A collection site may be a permanent or temporary facility 
located either at the work site or at a remote site.
    (b) In the event that an agency-designated collection site is not 
accessible and there is an immediate requirement to collect a urine 
specimen (e.g., an accident investigation), a public restroom may be 
used for the collection, using the procedures for a monitored 
collection described in Section 8.11.

Section 5.2 What are the requirements for a collection site?

    The facility used as a collection site must have the following:
    (a) Provisions to ensure donor privacy during the collection (as 
described in Section 8.1);
    (b) A suitable and clean surface area that is not accessible to the 
donor for handling the specimens and completing the required paperwork;
    (c) A secure temporary storage area to maintain specimens until the 
specimen is transferred to an HHS-certified laboratory or IITF;
    (d) A restricted access area where only authorized personnel may be 
present during the collection;

[[Page 28125]]

    (e) A restricted access area for the storage of collection 
supplies;
    (f) The ability to store records securely; and
    (g) The ability to restrict the donor access to potential diluents 
in accordance with Section 8.2.

Section 5.3 Where must collection site records be stored?

    Collection site records must be stored at a secure site designated 
by the collector or the collector's employer.

Section 5.4 How long must collection site records be stored?

    Collection site records (e.g., collector copies of the OMB-approved 
Federal CCF) must be stored securely for a minimum of 2 years. The 
collection site may convert hardcopy records to electronic records for 
storage and discard the hardcopy records after six months.

Section 5.5 How does the collector ensure the security and integrity of 
a specimen at the collection site?

    (a) A collector must do the following to maintain the security and 
integrity of a specimen:
    (1) Not allow unauthorized personnel to enter the collection area 
during the collection procedure;
    (2) Perform only one donor collection at a time;
    (3) Restrict access to collection supplies before, during and after 
collection;
    (4) Ensure that only the collector and the donor are allowed to 
handle the unsealed specimen;
    (5) Ensure the chain of custody process is maintained and 
documented throughout the entire collection, storage, and transport 
procedures;
    (6) Ensure that the Federal CCF is completed and distributed as 
required; and
    (7) Ensure that specimens transported to an HHS-certified 
laboratory or IITF are sealed and placed in transport containers 
designed to minimize the possibility of damage during shipment (e.g., 
specimen boxes, padded mailers, or other suitable shipping container), 
and those containers are securely sealed to eliminate the possibility 
of undetected tampering;
    (b) Couriers, express carriers, and postal service personnel are 
not required to document chain of custody since specimens are sealed in 
packages that would indicate tampering during transit to the HHS-
certified laboratory or IITF.

Section 5.6 What are the privacy requirements when collecting a urine 
specimen?

    Collections must be performed at a site that provides reasonable 
privacy (as described in Section 8.1).

Subpart F--Federal Drug Testing Custody and Control Form

Section 6.1 What federal form is used to document custody and control?

    The OMB-approved Federal CCF must be used to document custody and 
control of each specimen at the collection site.

Section 6.2 What happens if the correct OMB-approved Federal CCF is not 
available or is not used for a urine specimen?

    (a) The use of a non-federal CCF or an expired Federal CCF is not, 
by itself, a reason for the HHS-certified laboratory or IITF to 
automatically reject the specimen for testing or for the MRO to cancel 
the test.
    (b) If the collector uses an incorrect form, the collector must 
document that it is a federal agency specimen collection and provide 
the reason that the incorrect form was used. Based on the information 
provided by the collector, the HHS-certified laboratory or IITF must 
handle and test the specimen as a federal agency specimen.
    (c) If the HHS-certified laboratory, HHS-certified IITF, or MRO 
discovers that an incorrect form was used by the collector, the 
laboratory, IITF, or MRO must obtain a memorandum for the record from 
the collector describing the reason the incorrect form was used. If a 
memorandum for the record cannot be obtained, the HHS-certified 
laboratory or IITF must wait at least 5 business days before the 
laboratory or IITF reports a rejected for testing result to the MRO and 
the MRO cancels the test.

Subpart G--Urine Specimen Collection Containers and Bottles

Section 7.1 What is used to collect a urine specimen?

    A single-use collection container with a means (i.e., thermometer) 
to measure urine temperature and two specimen bottles must be used.

Section 7.2 What are the requirements for a urine collection container 
and specimen bottles?

    (a) The collection container, the thermometer, and the specimen 
bottles must not substantially affect the composition of drugs and/or 
metabolites in the urine specimen.
    (b) The two specimen bottles must be sealable and non-leaking, and 
must maintain the integrity of the specimen during storage and 
transport so that the specimen contained therein can be tested in an 
HHS-certified laboratory or IITF for the presence of drugs or their 
metabolites.
    (c) The two specimen bottles must be sufficiently transparent to 
enable an objective assessment of specimen appearance and 
identification of abnormal physical characteristics without opening the 
bottle.

Section 7.3 What are the minimum performance requirements for a urine 
collection container and specimen bottles?

    (a) The collection container must be capable of holding at least 55 
mL and have a volume marking clearly noting a level of 45 mL.
    (b) One of the two specimen bottles must be capable of holding at 
least 35 mL and the other at least 20 mL, and each must have a volume 
marking clearly noting the appropriate level (30 mL for the primary 
specimen and 15 mL for the split specimen).
    (c) The thermometer may be affixed to or built into the collection 
container and must provide graduated temperature readings from 32-38 
[deg]C/90-100[emsp14][deg]F. Alternatively, the collector may use 
another technology to measure specimen temperature (e.g., thermal 
radiation scanning), providing the thermometer does not come into 
contact with the specimen.

Subpart H--Urine Specimen Collection Procedure

Section 8.1 What privacy must the donor be given when providing a urine 
specimen?

    The following privacy requirements apply when a donor is providing 
a urine specimen:
    (a) Only authorized personnel and the donor may be present in the 
restricted access area where the collection takes place.
    (b) The collector is not required to be the same gender as the 
donor. The observer for a direct observed collection (i.e., as 
described in Section 8.10) must be the same gender as the donor. The 
monitor for a monitored collection (i.e., as described in Section 8.11) 
must be the same gender as the donor, unless the monitor is a medical 
professional (e.g., nurse, doctor, physician's assistant, technologist, 
or technician licensed or certified to practice in the jurisdiction in 
which the collection takes place).
    (c) The collector must give the donor visual privacy while 
providing the specimen. The donor is allowed to provide a urine 
specimen in an enclosed

[[Page 28126]]

stall within a multi-stall restroom or in a single person restroom 
during a monitored collection.

Section 8.2 What must the collector ensure at the collection site 
before starting a urine specimen collection?

    The collector must deter the dilution or substitution of a specimen 
at the collection site by:
    (a) Placing a toilet bluing agent in a toilet bowl or toilet tank, 
so the reservoir of water in the toilet bowl always remains blue. If no 
bluing agent is available or if the toilet has an automatic flushing 
system, the collector shall turn the water supply off to the toilet and 
flush the toilet to remove the water in the toilet when possible.
    (b) Secure other sources of water (e.g., shower or sink) in the 
enclosure where urination occurs. If the enclosure has a source of 
water that cannot be disabled or secured, a monitored collection must 
be conducted in accordance with Section 8.11.

Section 8.3 What are the preliminary steps in the urine specimen 
collection procedure?

    The collector must take the following steps before beginning a 
urine specimen collection:
    (a) If a donor fails to arrive at the collection site at the 
assigned time, the collector must follow the federal agency policy or 
contact the federal agency representative to obtain guidance on action 
to be taken.
    (b) When the donor arrives at the collection site, the collector 
should begin the collection procedure without undue delay. For example, 
the collection should not be delayed because the donor states that he 
or she is unable to urinate or an authorized employer or employer 
representative is late in arriving.
    (c) The collector requests the donor to present photo 
identification (e.g., driver's license; employee badge issued by the 
employer; an alternative photo identification issued by a federal, 
state, or local government agency). If the donor does not have proper 
photo identification, the collector shall contact the supervisor of the 
donor or the federal agency representative who can positively identify 
the donor. If the donor's identity cannot be established, the collector 
must not proceed with the collection.
    (d) The collector must provide identification (e.g., employee 
badge, employee list) if requested by the donor.
    (e) The collector explains the basic collection procedure to the 
donor.
    (f) The collector informs the donor that the instructions for 
completing the Federal Custody and Control Form are located on the back 
of the Federal CCF or available upon request.
    (g) The collector answers any reasonable and appropriate questions 
the donor may have regarding the collection procedure.
    (h) The collector asks the donor to remove any unnecessary outer 
garments (e.g., coat, jacket) that might conceal items or substances 
that could be used to adulterate or substitute the urine specimen:
    (1) The collector must ensure that all personal belongings (e.g., 
purse or briefcase) remain with the outer garments; the donor may 
retain his or her wallet.
    (2) The collector asks the donor to empty his or her pockets and 
display any items that could be used to adulterate or substitute the 
specimen.
    (3) If no items are present that can be used to adulterate or 
substitute the specimen, the donor can place the items back into his or 
her pockets and continue the collection procedure.
    (4) If an item is present that appears to have been brought to the 
collection site with the intent to adulterate or substitute the 
specimen, a direct observed collection procedure is used in accordance 
with Section 8.9. If the item appears to be inadvertently brought to 
the collection site, the collector must secure the item and continue 
the normal collection procedure.
    (5) If the donor refuses to show the collector the items in his or 
her pockets, this is considered a ``refusal to test.'' The collector 
must stop the collection and report the refusal to test as described in 
Section 8.13.
    (i) The collector shall instruct the donor to wash and dry his or 
her hands prior to urination. After washing his or her hands, the donor 
must remain in the presence of the collector and must not have access 
to any water fountain, faucet, soap dispenser, cleaning agent, or any 
other materials which could be used to adulterate or substitute the 
specimen.
    (1) If the donor refuses to wash his or her hands when instructed 
by the collector, this is considered a ``refusal to test.'' The 
collector must stop the collection and report the refusal to test as 
described in Section 8.13.

Section 8.4 What steps does the collector take in the collection 
procedure before the donor provides a urine specimen?

    (a) The collector will provide or the donor may select a specimen 
collection container that is clean, unused, wrapped/sealed in original 
packaging and compliant with Subpart G. The specimen collection 
container will be opened in view of the donor.
    (b) The collector instructs the donor to provide his or her 
specimen in the privacy of a stall or otherwise partitioned area that 
allows for individual privacy. The collector directs the donor to 
provide a specimen of at least 45 mL, to not flush the toilet, and to 
return with the specimen as soon as the donor has completed the void.
    (1) Except in the case of a direct observed collection (i.e., as 
described in Section 8.10) or a monitored collection (i.e., as 
described in Section 8.11), neither the collector nor anyone else may 
go into the room with the donor.
    (2) The collector may set a reasonable time limit for specimen 
collection.
    (c) The collector notes any unusual behavior or appearance of the 
donor on the Federal CCF. If the collector detects any conduct that 
clearly indicates an attempt to tamper with a specimen (e.g., 
substitute urine in plain view or an attempt to bring into the 
collection site an adulterant or urine substitute), the collector must 
conduct an immediate collection under direct observation in accordance 
with Section 8.10. The collector must note the conduct and the fact 
that the collection was observed on the Federal CCF.

Section 8.5 What steps does the collector take during and after the 
urine specimen collection procedure?

    Integrity and Identity of the Specimen. The collector must take the 
following steps during and after the donor provides the urine specimen:
    (a) The collector must inform the donor that, once the collection 
procedure has begun, the donor must remain at the collection site 
(i.e., in an area designated by the collector) until the collection is 
complete. This includes the wait period (i.e., up to 3 hours) if needed 
to provide a sufficient specimen as described in step (f)(2) below and 
in Section 8.6.
    (b) After providing the specimen, the donor gives the specimen 
collection container to the collector. Both the donor and the collector 
must keep the specimen container in view at all times until the 
collector seals the specimen bottles as described in Section 8.8.
    (c) After the donor has given the specimen to the collector, 
whenever practical, the donor shall be allowed to wash his or her hands 
and the donor may flush the toilet.
    (d) The collector must measure the temperature of the specimen 
within 4 minutes of receiving the specimen from the donor. The 
collector records on the Federal CCF whether or not the

[[Page 28127]]

temperature is in the acceptable range of 32[deg]-38 [deg]C/90[deg]-
100[emsp14][deg]F.
    (1) The temperature measuring device must accurately reflect the 
temperature of the specimen and not contaminate the specimen.
    (2) If the temperature of the specimen is outside the range of 
32[deg]-38[deg]C/90[deg]-100[emsp14][deg]F, that is a reason to believe 
that the donor may have adulterated or substituted the specimen. 
Another specimen must be collected under direct observation in 
accordance with Section 8.9. The collector will forward both specimens 
(i.e., from the first and second collections) to an HHS-certified 
laboratory for testing and record a comment on the Federal CCF.
    (e) The collector must inspect the specimen to determine if there 
is any sign indicating that the specimen may not be a valid urine 
specimen (e.g., unusual color, presence of foreign objects or material, 
unusual odor).
    (1) The collector notes any unusual finding on the Federal CCF. A 
specimen suspected of not being a valid urine specimen must be 
forwarded to an HHS-certified laboratory for testing.
    (2) When there is any reason to believe that a donor may have 
adulterated or substituted the specimen, another specimen must be 
obtained as soon as possible under direct observation in accordance 
with Section 8.10. The collector will forward both specimens (i.e., 
from the first and second collections) to an HHS-certified laboratory 
for testing and records a comment on the Federal CCF.
    (f) The collector must determine the volume of urine in the 
specimen container. The collector must never combine urine collected 
from separate voids to create a specimen.
    (1) If the volume is at least 45 mL, the collector will proceed 
with steps described in Section 8.8.
    (2) If the volume is less than 45 mL, the collector discards the 
specimen and immediately collects a second specimen using the same 
procedures as for the first specimen (including steps in paragraphs c 
and d of this section).
    (i) The collector may give the donor a reasonable amount of liquid 
to drink for this purpose (e.g., an 8 ounce glass of water every 30 
minutes, but not to exceed a maximum of 40 ounces over a period of 3 
hours or until the donor has provided a sufficient urine specimen). 
However, the donor is not required to drink any fluids during this 
waiting time.
    (ii) If the donor provides a sufficient urine specimen (i.e., at 
least 45 mL), the collector proceeds with steps described in Section 
8.8.
    (iii) If the employee has not provided a sufficient specimen (i.e., 
at least 45 mL) within three hours of the first unsuccessful attempt to 
provide the specimen, the collector records the reason for not 
collecting a urine specimen on the Federal CCF, notifies the federal 
agency's designated representative for authorization of an alternate 
specimen to be collected, and sends the appropriate copies of the 
Federal CCF to the MRO and to the federal agency's designated 
representative. If an alternate specimen is authorized, the collector 
may begin the collection procedure for the alternate specimen (see 
Section 8.7) in accordance with the Mandatory Guidelines for Federal 
Workplace Drug Testing Programs using the alternative specimen.
    (g) If the donor fails to remain present through the completion of 
the collection, declines to have a direct observed collection as 
required in steps (d)(2) or (e)(2) above, refuses to provide a second 
specimen as required in step (f)(2) above, or refuses to provide an 
alternate specimen as authorized in step (f)(2)(iii) above, the 
collector stops the collection and reports the refusal to test in 
accordance with Section 8.13.

Section 8.6 What procedure is used when the donor states that he or she 
is unable to provide a urine specimen?

    (a) If the donor states that he or she is unable to provide a urine 
specimen during the collection process, the collector requests that the 
donor enter the restroom (stall) and attempt to provide a urine 
specimen.
    (b) The donor demonstrates his or her inability to provide a 
specimen when he or she comes out of the stall with an empty collection 
container.
    (1) If the donor states that he or she could provide a specimen 
after drinking some fluids, the collector gives the donor a reasonable 
amount of liquid to drink for this purpose (e.g., an 8 ounce glass of 
water every 30 minutes, but not to exceed a maximum of 40 ounces over a 
period of 3 hours or until the donor has provided a sufficient urine 
specimen). If the donor simply needs more time before attempting to 
provide a urine specimen, the donor is not required to drink any fluids 
during the 3 hour wait time.
    (2) If the donor states that he or she is unable to provide a urine 
specimen, the collector records the reason for not collecting a urine 
specimen on the Federal CCF, notifies the federal agency's designated 
representative for authorization of an alternate specimen to be 
collected, and sends the appropriate copies of the Federal CCF to the 
MRO and to the federal agency's designated representative. If an 
alternate specimen is authorized, the collector may begin the 
collection procedure for the alternate specimen (see Section 8.7) in 
accordance with the Mandatory Guidelines for Federal Workplace Drug 
Testing Programs using the alternative specimen.

Section 8.7 If the donor is unable to provide a urine specimen, may 
another specimen type be collected for testing?

    No, unless the alternate specimen type is authorized by Mandatory 
Guidelines for Federal Workplace Drug Testing Programs and specifically 
authorized by the federal agency.

Section 8.8 How does the collector prepare the urine specimens?

    (a) All federal agency collections are to be split specimen 
collections.
    (b) The collector, in the presence of the donor, pours the urine 
from the collection container into two specimen bottles to be labeled 
``A'' and ``B''. The collector pours at least 30 mL of urine into 
Bottle A and at least 15 mL into Bottle B, and caps each bottle.
    (c) In the presence of the donor, the collector places a tamper-
evident label/seal from the Federal CCF over each specimen bottle cap. 
The collector records the date of the collection on the tamper-evident 
labels/seals.
    (d) The collector instructs the donor to initial the tamper-evident 
labels/seals on each specimen bottle. If the donor refuses to initial 
the labels/seals, the collector notes the refusal on the Federal CCF 
and continues with the collection process.
    (e) The collector must ensure that all the information required on 
the Federal CCF is provided.
    (f) The collector asks the donor to read and sign a statement on 
the Federal CCF certifying that the specimens identified were collected 
from him or her. If the donor refuses to sign the certification 
statement, the collector notes the refusal on the Federal CCF and 
continues with the collection process.
    (g) The collector signs and prints his or her name on the Federal 
CCF, completes the Federal CCF, and distributes the copies of the 
Federal CCF as required.
    (h) The collector seals the specimens (Bottle A and Bottle B) in a 
package and, within 24 hours or during the next business day, sends 
them to the HHS-certified laboratory or IITF that will be testing the 
Bottle A urine specimen. The collector must also send a copy of the 
Federal CCF to the HHS-certified laboratory or IITF.

[[Page 28128]]

    (i) If the specimen and Federal CCF are not immediately transported 
to an HHS-certified laboratory or IITF, they must remain under direct 
control of the collector or be appropriately secured under proper 
specimen storage conditions until transported.
    (j) The collector must discard any urine left over in the 
collection container after both specimen bottles have been 
appropriately filled and sealed. There is one exception to this 
requirement: The collector may use excess urine to conduct clinical 
tests (e.g., protein, glucose) if the collection was conducted in 
conjunction with a physical examination required by federal agency 
regulation. Neither the collector nor anyone else may conduct further 
testing (such as specimen validity testing) on the excess urine.

Section 8.9 When is a direct observed collection conducted?

    A direct observed collection procedure must be conducted when:
    (a) The agency has authorized a direct observed collection because:
    (1) The donor's previous drug test result was reported by an MRO as 
positive, adulterated, or substituted; or
    (2) The HHS-certified laboratory reports to the MRO that a specimen 
is invalid, and the MRO reported to the agency that there was not a 
legitimate medical explanation for the result; or
    (3) The MRO reported to the agency that the primary bottle (A) 
specimen was positive, adulterated, or substituted result had to be 
cancelled because the test of the split specimen could not be tested 
and/or the split specimen bottle (B) failed to reconfirm; or
    (b) At the collection site, an immediate collection of a second 
urine specimen is required because:
    (1) The temperature of the specimen collected during a routine 
collection is outside the acceptable temperature range;
    (2) The collector suspects that the donor has tampered with the 
specimen during a routine collection (e.g., abnormal physical 
characteristic such as unusual color and/or odor, and/or excessive 
foaming when shaken);
    (3) The collector observes conduct by the donor that indicates a 
possible attempt to adulterate or substitute the specimen; or
    (4) The collector observed materials brought by the donor to the 
collection site for the purpose of adulterating, substituting, or 
diluting the specimen.
    (c) The collector must contact a collection site supervisor to 
review and concur in advance with any decision by the collector to 
obtain a specimen under direct observation.
    (d) If the donor declines to have a direct observed collection, the 
collector reports a refusal to test (i.e., as described in Section 
8.13).

Section 8.10 How is a direct observed collection conducted?

    A direct observed collection procedure is the same as that for a 
routine collection, except an observer watches the donor urinate into 
the collection container. The observer must be the same gender as the 
donor with no exception to this requirement. If there is no collector 
available of the same gender as the donor, the collector or collection 
site supervisor shall select an observer trained in direct observed 
specimen collection as described in Section 4.4. The observer may be an 
individual that is not a trained collector.
    At the point in a routine collection where the donor enters the 
restroom with the collection container, a direct observed collection 
includes the following additional steps:
    (a) The observer enters the restroom with the donor;
    (b) The observer must directly watch the urine go from the donor's 
body into the collection container (the use of mirrors or video cameras 
is not permitted);
    (c) The observer must not touch or handle the collection container 
unless the observer is also serving as the collector;
    (d) After the donor has completed urinating into the collection 
container:
    (1) If the same person serves as the observer and collector, he or 
she may receive the collection container from the donor while they are 
both in the restroom;
    (2) If the observer is not serving as the collector, the donor and 
observer leave the restroom and the donor hands the collection 
container directly to the collector. The observer must maintain visual 
contact of the collection container until the donor hands the container 
to the collector.
    (e) The collector checks the box for an observed collection on the 
Federal CCF and writes the name of the observer and the reason for an 
observed collection on the Federal CCF; and
    (f) The collector then continues with the routine collection 
procedure in Section 8.3.

Section 8.11 When is a monitored collection conducted?

    (a) In the event that an agency-designated collection site is not 
available and there is an immediate requirement to collect a specimen 
(e.g., an accident investigation), a public restroom may be used for 
the collection, using the procedures for a monitored collection 
described in Section 8.12.
    (b) If the enclosure used by the donor to provide a specimen has a 
source of water that cannot be disabled or secured, a monitored 
collection must be conducted.
    (c) If the donor declines to permit a collection to be monitored 
when required, the collector reports a refusal to test (i.e., as 
described in Section 8.13).

Section 8.12 How is a monitored collection conducted?

    A monitored collection is the same as that for a routine 
collection, except that a monitor accompanies the donor into the 
restroom to check for signs that the donor may be tampering with the 
specimen. The monitor remains in the restroom, but outside the stall, 
while the donor is providing the specimen. A person of the same gender 
as the donor shall serve as the monitor, unless the monitor is a 
medical professional (e.g., nurse, doctor, physician's assistant, 
technologist, or technician licensed or certified to practice in the 
jurisdiction in which the collection takes place). The monitor may be 
an individual other than the collector and need not be a qualified 
collector.
    (a) The collector secures the restroom being used for the monitored 
collection so that no one except the employee and the monitor can enter 
the restroom until after the collection has been completed.
    (b) The monitor enters the restroom with the donor.
    (c) The monitor must not watch the employee urinate into the 
collection container. If the monitor hears sounds or makes other 
observations indicating an attempt by the donor to tamper with a 
specimen, there must be an additional collection under direct 
observation in accordance with Section 8.9.
    (d) The monitor must not touch or handle the collection container 
unless the monitor is also the collector.
    (e) After the donor has completed urinating into the collection 
container:
    (1) If the same person serves as the monitor and collector, he or 
she may receive the collection container from the donor while they are 
both in the restroom;
    (2) If the monitor is not serving as the collector, the donor and 
monitor leave the restroom and the donor hands the collection container 
directly to the collector. The monitor must ensure that the employee 
takes the collection container directly to the collector as soon as the 
employee has exited the enclosure.

[[Page 28129]]

    (f) If the monitor is not serving as the collector, the collector 
writes the name of the monitor on the Federal CCF.
    (g) The collector then continues with the routine collection 
procedure in Section 8.3.

Section 8.13 How does the collector report a donor's refusal to test?

    If there is a refusal to test as defined in Section 1.7, the 
collector stops the collection, discards any urine collected and 
reports the refusal to test by:
    (a) Notifying the federal agency by means (e.g., telephone, email, 
or secure fax) that ensures that the notification is immediately 
received,
    (b) Documenting the refusal to test on the Federal CCF, and
    (c) Sending all copies of the Federal CCF to the federal agency's 
designated representative.

Section 8.14 What are a federal agency's responsibilities for a 
collection site?

    (a) A federal agency must ensure that collectors and collection 
sites satisfy all requirements in subparts D, E, F, G, and H.
    (b) A federal agency (or only one federal agency when several 
agencies are using the same collection site) must inspect 5 percent or 
up to a maximum of 50 collection sites each year, selected randomly 
from those sites used to collect agency specimens (e.g., virtual, 
onsite, or self-evaluation).
    (c) A federal agency must investigate reported collection site 
deficiencies (e.g., specimens reported ``rejected for testing'' by an 
HHS-certified laboratory or IITF) and take appropriate action which may 
include a collection site self-assessment (i.e., using the Collection 
Site Checklist for the Collection of Urine Specimens for Federal Agency 
Workplace Drug Testing Programs) or an inspection of the collection 
site. The inspections of these additional collection sites may be 
included in the 5 percent or maximum of 50 collection sites inspected 
annually.

Subpart I--HHS Certification of Laboratories and IITFs

Section 9.1 Who has the authority to certify laboratories and IITFs to 
test urine specimens for federal agencies?

    (a) The Secretary has broad discretion to take appropriate action 
to ensure the full reliability and accuracy of drug testing and 
reporting, to resolve problems related to drug testing, and to enforce 
all standards set forth in these Guidelines. The Secretary has the 
authority to issue directives to any HHS-certified laboratory or IITF 
including suspending the use of certain analytical procedures when 
necessary to protect the integrity of the testing process; ordering any 
HHS-certified laboratory or IITF to undertake corrective actions to 
respond to material deficiencies identified by an inspection or through 
performance testing; ordering any HHS-certified laboratory or IITF to 
send specimens or specimen aliquots to another HHS-certified laboratory 
for retesting when necessary to ensure the accuracy of testing under 
these Guidelines; ordering the review of results for specimens tested 
under the Guidelines for private sector clients to the extent necessary 
to ensure the full reliability of drug testing for federal agencies; 
and ordering any other action necessary to address deficiencies in drug 
testing, analysis, specimen collection, chain of custody, reporting of 
results, or any other aspect of the certification program.
    (b) A laboratory or IITF is prohibited from stating or implying 
that it is certified by HHS under these Guidelines to test urine 
specimens for federal agencies unless it holds such certification.

Section 9.2 What is the process for a laboratory or IITF to become HHS-
certified?

    (a) A laboratory or IITF seeking HHS certification must:
    (1) Submit a completed OMB-approved application form (i.e., the 
applicant laboratory or IITF provides detailed information on both the 
administrative and analytical procedures to be used for federally 
regulated specimens);
    (2) Have its application reviewed as complete and accepted by HHS;
    (3) Successfully complete the PT challenges in 3 consecutive sets 
of initial PT samples;
    (4) Satisfy all the requirements for an initial inspection; and
    (5) Receive notification of certification from the Secretary before 
testing specimens for federal agencies.

Section 9.3 What is the process for a laboratory or IITF to maintain 
HHS certification?

    (a) To maintain HHS certification, a laboratory or IITF must:
    (1) Successfully participate in both the maintenance PT and 
inspection programs (i.e., successfully test the required quarterly 
sets of maintenance PT samples, undergo an inspection 3 months after 
being certified, and undergo maintenance inspections at a minimum of 
every 6 months thereafter);
    (2) Respond in an appropriate, timely, and complete manner to 
required corrective action requests if deficiencies are identified in 
the maintenance PT performance, during the inspections, operations, or 
reporting; and
    (3) Satisfactorily complete corrective remedial actions, and 
undergo special inspection and special PT sets to maintain or restore 
certification when material deficiencies occur in either the PT 
program, inspection program, or in operations and reporting.

Section 9.4 What is the process when a laboratory or IITF does not 
maintain its HHS certification?

    (a) A laboratory or IITF that does not maintain its HHS 
certification must:
    (1) Stop testing federally regulated specimens;
    (2) Ensure the security of federally regulated specimens and 
records throughout the required storage period described in Sections 
11.20, 11.21, 12.18, and 14.8;
    (3) Ensure access to federally regulated specimens and records in 
accordance with Sections 11.23, 11.24, 12.20, 12.21, and Subpart P; and
    (4) Follow the HHS suspension and revocation procedures when 
imposed by the Secretary, follow the HHS procedures in Subpart P that 
will be used for all actions associated with the suspension and/or 
revocation of HHS-certification.

Section 9.5 What are the qualitative and quantitative specifications of 
performance testing (PT) samples?

    (a) PT samples used to evaluate drug tests will be prepared using 
the following specifications:
    (1) PT samples may contain one or more of the drugs and drug 
metabolites in the drug classes listed in Section 3.4 and must satisfy 
one of the following parameters:
    (i) The concentration of a drug or metabolite will be at least 20 
percent above the initial test cutoff concentration for the drug or 
drug metabolite;
    (ii) The concentration of a drug or metabolite may be less than 40 
percent of the confirmatory test cutoff concentration when the PT 
sample is designated as a retest sample; or
    (iii) The concentration of drug or metabolite may differ from 
9.5(a)(1)(i) and 9.5(a)(1)(ii) for a special purpose.
    (2) A PT sample may contain an interfering substance, an 
adulterant, or satisfy the criteria for a substituted specimen, dilute 
specimen, or invalid result.
    (3) A negative PT sample will not contain a measurable amount of a 
target analyte.
    (b) PT samples used to evaluate specimen validity tests shall 
satisfy, but

[[Page 28130]]

are not limited to, one of the following criteria:
    (1) The nitrite concentration will be at least 20 percent above the 
cutoff;
    (2) The pH will be between 1.5 and 5.0 or between 8.5 and 12.5;
    (3) The concentration of an oxidant will be at a level sufficient 
to challenge a laboratory's ability to identify and confirm the 
oxidant;
    (4) The creatinine concentration will be between 0 and 20 mg/dL; or
    (5) The specific gravity will be less than or equal to 1.0050 or 
between 1.0170 and 1.0230.
    (c) For each PT cycle, the set of PT samples going to each HHS-
certified laboratory or IITF will vary but, within each calendar year, 
each HHS-certified laboratory or IITF will analyze essentially the same 
total set of samples.
    (d) The laboratory or IITF must (to the greatest extent possible) 
handle, test, and report a PT sample in a manner identical to that used 
for a donor specimen, unless otherwise specified.

Section 9.6 What are the PT requirements for an applicant laboratory?

    (a) An applicant laboratory that seeks certification under these 
Guidelines must satisfy the following criteria on three consecutive 
sets of PT samples:
    (1) Have no false positive results;
    (2) Correctly identify, confirm, and report at least 90 percent of 
the total drug challenges over the three sets of PT samples;
    (3) Correctly identify at least 80 percent of the drug challenges 
for each initial drug test over the three sets of PT samples;
    (4) For the confirmatory drug tests, correctly determine the 
concentrations [i.e., no more than 20 percent or 2 standard deviations (whichever is larger) from the appropriate 
reference or peer group means] for at least 80 percent of the total 
drug challenges over the three sets of PT samples;
    (5) For the confirmatory drug tests, must not obtain any drug 
concentration that differs by more than 50 percent from the 
appropriate reference or peer group mean;
    (6) For each confirmatory drug test, correctly identify and 
determine the concentrations [i.e., no more than 20 percent 
or 2 standard deviations (whichever is larger) from the 
appropriate reference or peer group means] for at least 50 percent of 
the drug challenges for an individual drug over the three sets of PT 
samples;
    (7) Correctly identify at least 80 percent of the total specimen 
validity testing challenges over the three sets of PT samples;
    (8) Correctly identify at least 80 percent of the challenges for 
each individual specimen validity test over the three sets of PT 
samples;
    (9) For quantitative specimen validity tests, obtain quantitative 
values for at least 80 percent of the total challenges over the three 
sets of PT samples that satisfy the following criteria:
    (i) Nitrite and creatinine concentrations are no more than 20 percent or 2 standard deviations from the 
appropriate reference or peer group mean; and
    (ii) pH values are no more than 0.3 pH units from the 
appropriate reference or peer group mean using a pH meter; and
    (iii) Specific gravity values are no more than 0.0003 
specific gravity units from the appropriate reference or peer group 
mean when the mean is less than 1.0100 and specific gravity values are 
no more than 0.0004 specific gravity units from the 
appropriate reference or peer group mean when the mean is equal to or 
greater than 1.0100;
    (10) Must not obtain any quantitative value on a specimen validity 
test PT sample that differs from the appropriate reference or peer 
group mean by more than 50 percent for nitrite and 
creatinine concentrations, 0.8 pH units using a pH meter, 
0.0006 specific gravity units when the mean is less than 
1.0100, or 0.0007 specific gravity units when the mean is 
equal to or greater than 1.0100; and
    (11) Must not report any sample as adulterated with a compound that 
is not present in the sample, adulterated based on pH when the 
appropriate reference or peer group mean is within the acceptable pH 
range, or substituted when the appropriate reference or peer group 
means for both creatinine and specific gravity are within the 
acceptable range.
    (b) Failure to satisfy these requirements will result in 
disqualification.

Section 9.7 What are the PT requirements for an HHS-certified urine 
laboratory?

    (a) A laboratory certified under these Guidelines must satisfy the 
following criteria on the maintenance PT samples:
    (1) Have no false positive results;
    (2) Correctly identify, confirm, and report at least 90 percent of 
the total drug challenges over two consecutive PT cycles;
    (3) Correctly identify at least 80 percent of the drug challenges 
for each initial drug test over two consecutive PT cycles;
    (4) For the confirmatory drug tests, correctly determine that the 
concentrations for at least 80 percent of the total drug challenges are 
no more than 20 percent or 2 standard 
deviations (whichever is larger) from the appropriate reference or peer 
group means over two consecutive PT cycles;
    (5) For the confirmatory drug tests, obtain no more than one drug 
concentration on a PT sample that differs by more than 50 
percent from the appropriate reference or peer group mean over two 
consecutive PT cycles;
    (6) For each confirmatory drug test, correctly identify and 
determine that the concentrations for at least 50 percent of the drug 
challenges for an individual drug are no more than 20 
percent or 2 standard deviations (whichever is larger) from 
the appropriate reference or peer group means over two consecutive PT 
cycles;
    (7) Correctly identify at least 80 percent of the total specimen 
validity testing challenges over two consecutive PT cycles;
    (8) Correctly identify at least 80 percent of the challenges for 
each individual specimen validity test over two consecutive PT cycles;
    (9) For quantitative specimen validity tests, obtain quantitative 
values for at least 80 percent of the total challenges over two 
consecutive PT cycles that satisfy the following criteria:
    (i) Nitrite and creatinine concentrations are no more than 20 percent or 2 standard deviations from the 
appropriate reference or peer group mean;
    (ii) pH values are no more than 0.3 pH units from the 
appropriate reference or peer group mean using a pH meter; and
    (iii) Specific gravity values are no more than 0.0003 
specific gravity units from the appropriate reference or peer group 
mean when the mean is less than 1.0100 and specific gravity values are 
no more than 0.0004 specific gravity units from the 
appropriate reference or peer group mean when the mean is equal to or 
greater than 1.0100;
    (10) Obtain no more than one quantitative value over 2 consecutive 
PT cycles on a specimen validity test PT sample that differs from the 
appropriate reference or peer group mean by more than 50 
percent for nitrite and creatinine concentrations, 0.8 pH 
units using a pH meter, 0.0006 specific gravity units when 
the mean is less than 1.0100, or 0.0007 specific gravity 
units when the mean is equal to or greater than 1.0100; and
    (11) Do not report any PT sample as adulterated with a compound 
that is not present in the sample, adulterated based on pH when the 
appropriate reference or peer group mean is within the

[[Page 28131]]

acceptable pH range, or substituted when the appropriate reference or 
peer group means for both creatinine and specific gravity are within 
the acceptable range.
    (b) Failure to participate in all PT cycles or to satisfy these 
requirements may result in suspension or revocation of an HHS-certified 
laboratory's certification.

Section 9.8 What are the PT requirements for an applicant IITF?

    (a) An applicant IITF that seeks certification under these 
Guidelines must satisfy the following criteria on three consecutive 
sets of PT samples:
    (1) Correctly identify at least 90 percent of the total drug 
challenges over the three sets of PT samples;
    (2) Correctly identify at least 80 percent of the drug challenges 
for each individual drug test over the three sets of PT samples;
    (3) Correctly identify at least 80 percent of the total specimen 
validity test challenges over the three sets of PT samples;
    (4) Correctly identify at least 80 percent of the challenges for 
each individual specimen validity test over the three sets of PT 
samples;
    (5) For quantitative specimen validity tests, obtain quantitative 
values for at least 80 percent of the total specimen validity test 
challenges over the three sets of PT samples that satisfy the following 
criteria:
    (i) Creatinine concentrations are no more than 20 
percent or 2 standard deviations (whichever is larger) from 
the appropriate reference or peer group mean; and
    (ii) Specific gravity values are no more than 0.001 
specific gravity units from the appropriate reference or peer group 
mean; and
    (6) Must not obtain any quantitative value on a specimen validity 
test PT sample that differs from the appropriate reference or peer 
group mean by more than 50 percent for creatinine 
concentration, or 0.002 specific gravity units for specific 
gravity.
    (b) Failure to satisfy these requirements will result in 
disqualification.

Section 9.9 What are the PT requirements for an HHS-certified IITF?

    (a) An IITF certified under these Guidelines must satisfy the 
following criteria on the maintenance PT samples to maintain its 
certification:
    (1) Correctly identify at least 90 percent of the total drug 
challenges over two consecutive PT cycles;
    (2) Correctly identify at least 80 percent of the drug challenges 
for each individual drug test over two consecutive PT cycles;
    (3) Correctly identify at least 80 percent of the total specimen 
validity test challenges over two consecutive PT cycles;
    (4) Correctly identify at least 80 percent of the challenges for 
each individual specimen validity test over two consecutive PT cycles;
    (5) For quantitative specimen validity tests, obtain quantitative 
values for at least 80 percent of the total specimen validity test 
challenges over two consecutive PT cycles that satisfy the following 
criteria:
    (i) Creatinine concentrations are no more than 20 
percent or 2 standard deviations (whichever is larger) from 
the appropriate reference or peer group mean; and
    (ii) Specific gravity values are no more than 0.001 
specific gravity units from the appropriate reference or peer group 
mean; and
    (6) Obtain no more than one quantitative value over 2 consecutive 
PT cycles on a specimen validity test PT sample that differs from the 
appropriate reference or peer group mean by more than 50 
percent for creatinine concentration, or 0.002 specific 
gravity units for specific gravity.
    (b) Failure to participate in all PT cycles or to satisfy these 
requirements may result in suspension or revocation of an HHS-certified 
IITF's certification.

Section 9.10 What are the inspection requirements for an applicant 
laboratory or IITF?

    (a) An applicant laboratory or IITF is inspected by a team of two 
inspectors.
    (b) Each inspector conducts an independent review and evaluation of 
all aspects of the laboratory's or IITF's testing procedures and 
facilities using an inspection checklist.

Section 9.11 What are the maintenance inspection requirements for an 
HHS-certified laboratory or IITF?

    (a) An HHS-certified laboratory or IITF must undergo an inspection 
3 months after becoming certified and at least every 6 months 
thereafter.
    (b) An HHS-certified laboratory or IITF is inspected by one or more 
inspectors. The number of inspectors is determined according to the 
number of specimens reviewed. Additional information regarding 
inspections is available from SAMHSA.
    (c) Each inspector conducts an independent evaluation and review of 
the HHS-certified laboratory's or IITF's procedures, records, and 
facilities using guidance provided by the Secretary.
    (d) To remain certified, an HHS-certified laboratory or IITF must 
continue to satisfy the minimum requirements as stated in these 
Guidelines.

Section 9.12 Who can inspect an HHS-certified laboratory or IITF and 
when may the inspection be conducted?

    (a) An individual may be selected as an inspector for the Secretary 
if he or she satisfies the following criteria:
    (1) Has experience and an educational background similar to that 
required for either the responsible person or the certifying scientist 
as described in Subpart K for an HHS-certified laboratory or as a 
responsible technician as described in Subpart L;
    (2) Has read and thoroughly understands the policies and 
requirements contained in these Guidelines and in other guidance 
consistent with these Guidelines provided by the Secretary;
    (3) Submits a resume and documentation of qualifications to HHS;
    (4) Attends approved training; and
    (5) Performs acceptably as an inspector on an inspection of an HHS-
certified laboratory or IITF.
    (b) The Secretary or a federal agency may conduct an inspection at 
any time.

Section 9.13 What happens if an applicant laboratory or IITF does not 
satisfy the minimum requirements for either the PT program or the 
inspection program?

    If an applicant laboratory or IITF fails to satisfy the 
requirements established for the initial certification process, the 
laboratory or IITF must start the certification process from the 
beginning.

Section 9.14 What happens if an HHS-certified laboratory or IITF does 
not satisfy the minimum requirements for either the PT program or the 
inspection program?

    (a) If an HHS-certified laboratory or IITF fails to satisfy the 
minimum requirements for certification, the laboratory or IITF is given 
a period of time (e.g., 5 or 30 working days depending on the nature of 
the deficiency) to provide any explanation for its performance and 
evidence that all deficiencies have been corrected.
    (b) A laboratory's or IITF's HHS certification may be revoked, 
suspended, or no further action taken depending on the seriousness of 
the deficiencies and whether there is evidence that the deficiencies 
have been corrected and that current performance meets the requirements 
for certification.
    (c) An HHS-certified laboratory or IITF may be required to undergo 
a special inspection or to test additional PT samples to address 
deficiencies.

[[Page 28132]]

    (d) If an HHS-certified laboratory's or IITF's certification is 
revoked or suspended in accordance with the process described in 
Subpart P, the laboratory or IITF is not permitted to test federally 
regulated specimens until the suspension is lifted or the laboratory or 
IITF has successfully completed the certification requirements as a new 
applicant laboratory or IITF.

Section 9.15 What factors are considered in determining whether 
revocation of a laboratory's or IITF's HHS certification is necessary?

    (a) The Secretary shall revoke certification of an HHS-certified 
laboratory or IITF in accordance with these Guidelines if the Secretary 
determines that revocation is necessary to ensure fully reliable and 
accurate drug and specimen validity test results and reports.
    (b) The Secretary shall consider the following factors in 
determining whether revocation is necessary:
    (1) Unsatisfactory performance in analyzing and reporting the 
results of drug and specimen validity tests (e.g., an HHS-certified 
laboratory reporting a false positive result for an employee's drug 
test);
    (2) Unsatisfactory participation in performance testing or 
inspections;
    (3) A material violation of a certification standard, contract 
term, or other condition imposed on the HHS-certified laboratory or 
IITF by a federal agency using the laboratory's or IITF's services;
    (4) Conviction for any criminal offense committed as an incident to 
operation of the HHS-certified laboratory or IITF; or
    (5) Any other cause that materially affects the ability of the HHS-
certified laboratory or IITF to ensure fully reliable and accurate drug 
test results and reports.
    (c) The period and terms of revocation shall be determined by the 
Secretary and shall depend upon the facts and circumstances of the 
revocation and the need to ensure accurate and reliable drug testing.

Section 9.16 What factors are considered in determining whether to 
suspend a laboratory's or IITF's HHS certification?

    (a) The Secretary may immediately suspend (either partially or 
fully) a laboratory's or IITF's HHS certification to conduct drug 
testing for federal agencies if the Secretary has reason to believe 
that revocation may be required and that immediate action is necessary 
to protect the interests of the United States and its employees.
    (b) The Secretary shall determine the period and terms of 
suspension based upon the facts and circumstances of the suspension and 
the need to ensure accurate and reliable drug testing.

Section 9.17 How does the Secretary notify an HHS-certified laboratory 
or IITF that action is being taken against the laboratory or IITF?

    (a) When laboratory's or IITF's HHS certification is suspended or 
the Secretary seeks to revoke HHS certification, the Secretary shall 
immediately serve the HHS-certified laboratory or IITF with written 
notice of the suspension or proposed revocation by facsimile, mail, 
personal service, or registered or certified mail, return receipt 
requested. This notice shall state the following:
    (1) The reasons for the suspension or proposed revocation;
    (2) The terms of the suspension or proposed revocation; and
    (3) The period of suspension or proposed revocation.
    (b) The written notice shall state that the laboratory or IITF will 
be afforded an opportunity for an informal review of the suspension or 
proposed revocation if it so requests in writing within 30 days of the 
date the laboratory or IITF received the notice, or if expedited review 
is requested, within 3 days of the date the laboratory or IITF received 
the notice. Subpart P contains detailed procedures to be followed for 
an informal review of the suspension or proposed revocation.
    (c) A suspension must be effective immediately. A proposed 
revocation must be effective 30 days after written notice is given or, 
if review is requested, upon the reviewing official's decision to 
uphold the proposed revocation. If the reviewing official decides not 
to uphold the suspension or proposed revocation, the suspension must 
terminate immediately and any proposed revocation shall not take 
effect.
    (d) The Secretary will publish in the Federal Register the name, 
address, and telephone number of any HHS-certified laboratory or IITF 
that has its certification revoked or suspended under Section 9.13 or 
Section 9.14, respectively, and the name of any HHS-certified 
laboratory or IITF that has its suspension lifted. The Secretary shall 
provide to any member of the public upon request the written notice 
provided to a laboratory or IITF that has its HHS certification 
suspended or revoked, as well as the reviewing official's written 
decision which upholds or denies the suspension or proposed revocation 
under the procedures of Subpart P.

Section 9.18 May a laboratory or IITF that had its HHS certification 
revoked be recertified to test federal agency specimens?

    Following revocation, a laboratory or IITF may apply for 
recertification. Unless otherwise provided by the Secretary in the 
notice of revocation under Section 9.17 or the reviewing official's 
decision under Section 16.9(e) or 16.14(a), a laboratory or IITF which 
has had its certification revoked may reapply for HHS certification as 
an applicant laboratory or IITF.

Section 9.19 Where is the list of HHS-certified laboratories and IITFs 
published?

    (a) The list of HHS-certified laboratories and IITFs is published 
monthly in the Federal Register. This notice is also available on the 
Internet at https://www.samhsa.gov/workplace.
    (b) An applicant laboratory or IITF is not included on the list.

Subpart J--Blind Samples Submitted by an Agency

Section 10.1 What are the requirements for federal agencies to submit 
blind samples to HHS-certified laboratories or IITFs?

    (a) Each federal agency is required to submit blind samples for its 
workplace drug testing program. The collector must send the blind 
samples to the HHS-certified laboratory or IITF that the collector 
sends employee specimens.
    (b) Each federal agency must submit at least 3 percent blind 
samples along with its donor specimens based on the projected total 
number of donor specimens collected per year (up to a maximum of 400 
blind samples). Every effort should be made to ensure that blind 
samples are submitted quarterly.
    (c) Approximately 75 percent of the blind samples submitted each 
year by an agency must be negative, 15 percent must be positive for one 
or more drugs, and 10 percent must either be adulterated or 
substituted.

Section 10.2 What are the requirements for blind samples?

    (a) Drug positive blind samples must be validated by the supplier 
as to their content using appropriate initial and confirmatory tests.
    (1) Drug positive blind samples must be fortified with one or more 
of the drugs or metabolites listed in Section 3.4.
    (2) Drug positive blind samples must contain concentrations of 
drugs between 1.5 and 2 times the initial drug test cutoff 
concentration.

[[Page 28133]]

    (b) Drug negative blind samples (i.e., certified to contain no 
drugs) must be validated by the supplier as negative using appropriate 
initial and confirmatory tests.
    (c) A blind sample that is adulterated must be validated using 
appropriate initial and confirmatory specimen validity tests, and have 
the characteristics to clearly show that it is an adulterated sample at 
the time of validation.
    (d) A blind sample that is substituted must be validated using 
appropriate initial and confirmatory specimen validity tests, and have 
the characteristics to clearly show that it is a substituted sample at 
the time of validation.
    (e) The supplier must provide information on the blind samples' 
content, validation, expected results, and stability to the collection 
site/collector sending the blind samples to the laboratory or IITF, and 
must provide the information upon request to the MRO, the federal 
agency for which the blind sample was submitted, or the Secretary.

Section 10.3 How is a blind sample submitted to an HHS-certified 
laboratory or IITF?

    (a) A blind sample must be submitted with the current Federal CCF 
that the HHS-certified laboratory or IITF uses for donor specimens. The 
collector provides the required information to ensure that the Federal 
CCF has been properly completed and provides fictitious initials on the 
specimen label/seal. The collector must indicate that the specimen is a 
blind sample on the MRO copy where a donor would normally provide a 
signature.
    (b) A collector should attempt to distribute the required number of 
blind samples randomly with donor specimens rather than submitting the 
full complement of blind samples as a single group.

Section 10.4 What happens if an inconsistent result is reported for a 
blind sample?

    If an HHS-certified laboratory or IITF reports a result for a blind 
sample that is inconsistent with the expected result (e.g., a 
laboratory or IITF reports a negative result for a blind sample that 
was supposed to be positive, a laboratory reports a positive result for 
a blind sample that was supposed to be negative):
    (a) The MRO must contact the laboratory or IITF and attempt to 
determine if the laboratory or IITF made an error during the testing or 
reporting of the sample;
    (b) The MRO must contact the blind sample supplier and attempt to 
determine if the supplier made an error during the preparation or 
transfer of the sample;
    (c) The MRO must contact the collector and determine if the 
collector made an error when preparing the blind sample for transfer to 
the HHS-certified laboratory or IITF;
    (d) If there is no obvious reason for the inconsistent result, the 
MRO must notify both the federal agency for which the blind sample was 
submitted and the Secretary; and
    (e) The Secretary shall investigate the blind sample error. A 
report of the Secretary's investigative findings and the corrective 
action taken in response to identified deficiencies must be sent to the 
federal agency. The Secretary shall ensure notification of the finding 
as appropriate to other federal agencies and coordinate any necessary 
actions to prevent the recurrence of the error.

Subpart K--Laboratory

Section 11.1 What must be included in the HHS-certified laboratory's 
standard operating procedure manual?

    (a) An HHS-certified laboratory must have a standard operating 
procedure (SOP) manual that describes, in detail, all HHS-certified 
laboratory operations. When followed, the SOP manual ensures that all 
specimens are tested using the same procedures.
    (b) The SOP manual must include at a minimum, but is not limited 
to, a detailed description of the following:
    (1) Chain of custody procedures;
    (2) Accessioning;
    (3) Security;
    (4) Quality control/quality assurance programs;
    (5) Analytical methods and procedures;
    (6) Equipment and maintenance programs;
    (7) Personnel training;
    (8) Reporting procedures; and
    (9) Computers, software, and laboratory information management 
systems.
    (c) All procedures in the SOP manual must be compliant with these 
Guidelines and all guidance provided by the Secretary.
    (d) A copy of all procedures that have been replaced or revised and 
the dates on which the procedures were in effect must be maintained for 
at least 2 years.

Section 11.2 What are the responsibilities of the responsible person 
(RP)?

    (a) Manage the day-to-day operations of the HHS-certified 
laboratory even if another individual has overall responsibility for 
alternate areas of a multi-specialty laboratory.
    (b) Ensure that there are sufficient personnel with adequate 
training and experience to supervise and conduct the work of the HHS-
certified laboratory. The RP must ensure the continued competency of 
laboratory staff by documenting their in-service training, reviewing 
their work performance, and verifying their skills.
    (c) Maintain a complete and current SOP manual that is available to 
all personnel of the HHS-certified laboratory and ensure that it is 
followed. The SOP manual must be reviewed, signed, and dated by the 
RP(s) when procedures are first placed into use and when changed or 
when a new individual assumes responsibility for the management of the 
HHS-certified laboratory. The SOP must be reviewed and documented by 
the RP annually.
    (d) Maintain a quality assurance program that ensures the proper 
performance and reporting of all test results; verify and monitor 
acceptable analytical performance for all controls and calibrators; 
monitor quality control testing; and document the validity, 
reliability, accuracy, precision, and performance characteristics of 
each test and test system.
    (e) Initiate and implement all remedial actions necessary to 
maintain satisfactory operation and performance of the HHS-certified 
laboratory in response to the following: quality control systems not 
within performance specifications; errors in result reporting or in 
analysis of performance testing samples; and inspection deficiencies. 
The RP must ensure that specimen results are not reported until all 
corrective actions have been taken and that the results provided are 
accurate and reliable.

Section 11.3 What scientific qualifications must the RP have?

    The RP must have documented scientific qualifications in analytical 
toxicology. Minimum qualifications are:
    (a) Certification or licensure as a laboratory director by the 
state in forensic or clinical laboratory toxicology, a Ph.D. in one of 
the natural sciences, or training and experience comparable to a Ph.D. 
in one of the natural sciences with training and laboratory/research 
experience in biology, chemistry, and pharmacology or toxicology;
    (b) Experience in forensic toxicology with emphasis on the 
collection and analysis of biological specimens for drugs of abuse;

[[Page 28134]]

    (c) Experience in forensic applications of analytical toxicology 
(e.g., publications, court testimony, conducting research on the 
pharmacology and toxicology of drugs of abuse) or qualify as an expert 
witness in forensic toxicology;
    (d) Fulfillment of the RP responsibilities and qualifications, as 
demonstrated by the HHS-certified laboratory's performance and verified 
upon interview by HHS-trained inspectors during each on-site 
inspection; and
    (e) Qualify as a certifying scientist.

Section 11.4 What happens when the RP is absent or leaves an HHS-
certified laboratory?

    (a) HHS-certified laboratories must have multiple RPs or one RP and 
an alternate RP. If the RP(s) are concurrently absent, an alternate RP 
must be present and qualified to fulfill the responsibilities of the 
RP.
    (1) If an HHS-certified laboratory is without the RP and alternate 
RP for 14 calendar days or less (e.g., temporary absence due to 
vacation, illness, or business trip), the HHS-certified laboratory may 
continue operations and testing of federal agency specimens under the 
direction of a certifying scientist.
    (2) The Secretary, in accordance with these Guidelines, will 
suspend a laboratory's HHS certification for all specimens if the 
laboratory does not have an RP or alternate RP for a period of more 
than 14 calendar days. The suspension will be lifted upon the 
Secretary's approval of a new permanent RP or alternate RP.
    (b) If the RP leaves an HHS-certified laboratory:
    (1) The HHS-certified laboratory may maintain certification and 
continue testing federally regulated specimens under the direction of 
an alternate RP for a period of up to 180 days while seeking to hire 
and receive the Secretary's approval of the RP's replacement.
    (2) The Secretary, in accordance with these Guidelines, will 
suspend a laboratory's HHS certification for all federally regulated 
specimens if the laboratory does not have a permanent RP within 180 
days. The suspension will be lifted upon the Secretary's approval of 
the new permanent RP.
    (c) To nominate an individual as an RP or alternate RP, the HHS-
certified laboratory must submit the following documents to the 
Secretary: The candidate's current resume or curriculum vitae, copies 
of diplomas and licensures, a training plan (not to exceed 90 days) to 
transition the candidate into the position, an itemized comparison of 
the candidate's qualifications to the minimum RP qualifications 
described in the Guidelines, and have official academic transcript(s) 
submitted from the candidate's institution(s) of higher learning. The 
candidate must be found qualified during an on-site inspection of the 
HHS-certified laboratory.
    (d) The HHS-certified laboratory must fulfill additional inspection 
and PT criteria as required prior to conducting federally regulated 
testing under a new RP.

Section 11.5 What qualifications must an individual have to certify a 
result reported by an HHS-certified laboratory?

    (a) A certifying scientist must have:
    (1) At least a bachelor's degree in the chemical or biological 
sciences or medical technology, or equivalent;
    (2) Training and experience in the analytical methods and forensic 
procedures used by the HHS-certified laboratory relevant to the results 
that the individual certifies; and
    (3) Training and experience in reviewing and reporting forensic 
test results and maintaining chain of custody, and an understanding of 
appropriate remedial actions in response to problems that may arise.
    (b) A certifying technician must have:
    (1) Training and experience in the analytical methods and forensic 
procedures used by the HHS-certified laboratory relevant to the results 
that the individual certifies; and
    (2) Training and experience in reviewing and reporting forensic 
test results and maintaining chain of custody, and an understanding of 
appropriate remedial actions in response to problems that may arise.

Section 11.6 What qualifications and training must other personnel of 
an HHS-certified laboratory have?

    (a) All HHS-certified laboratory staff (e.g., technicians, 
administrative staff) must have the appropriate training and skills for 
the tasks they perform.
    (b) Each individual working in an HHS-certified laboratory must be 
properly trained (i.e., receive training in each area of work that the 
individual will be performing, including training in forensic 
procedures related to their job duties) before he or she is permitted 
to work independently with federally regulated specimens. All training 
must be documented.

Section 11.7 What security measures must an HHS-certified laboratory 
maintain?

    (a) An HHS-certified laboratory must control access to the drug 
testing facility, specimens, aliquots, and records.
    (b) Authorized visitors must be escorted at all times, except for 
individuals conducting inspections (i.e., for the Department, a federal 
agency, a state, or other accrediting agency) or emergency personnel 
(e.g., firefighters and medical rescue teams).
    (c) An HHS-certified laboratory must maintain records documenting 
the identity of the visitor and escort, date, time of entry and exit, 
and purpose for access to the secured area.

Section 11.8 What are the laboratory chain of custody requirements for 
specimens and aliquots?

    (a) HHS-certified laboratories must use chain of custody procedures 
(internal and external) to maintain control and accountability of 
specimens from the time of receipt at the laboratory through completion 
of testing, reporting of results, during storage, and continuing until 
final disposition of the specimens.
    (b) HHS-certified laboratories must use chain of custody procedures 
to document the handling and transfer of aliquots throughout the 
testing process until final disposal.
    (c) The chain of custody must be documented using either paper copy 
or electronic procedures.
    (d) Each individual who handles a specimen or aliquot must sign and 
complete the appropriate entries on the chain of custody form when the 
specimen or aliquot is handled or transferred, and every individual in 
the chain must be identified.
    (e) The date and purpose must be recorded on an appropriate chain 
of custody form each time a specimen or aliquot is handled or 
transferred.

Section 11.9 What test(s) does an HHS-certified laboratory conduct on a 
urine specimen received from an IITF?

    An HHS-certified laboratory must test the specimen in the same 
manner as a specimen that had not been previously tested.

Section 11.10 What are the requirements for an initial drug test?

    (a) An initial drug test may be:
    (1) An immunoassay or
    (2) An alternate technology (e.g., spectrometry, spectroscopy).
    (b) An HHS-certified laboratory must validate an initial drug test 
before testing specimens.

[[Page 28135]]

    (c) Initial drug tests must be accurate and reliable for the 
testing of specimens when identifying drugs or their metabolites.
    (d) An HHS-certified laboratory may conduct a second initial drug 
test using a method with different specificity, to rule out cross-
reacting compounds. This second initial drug test must satisfy the 
batch quality control requirements specified in Section 11.12.

Section 11.11 What must an HHS-certified laboratory do to validate an 
initial drug test?

    (a) An HHS-certified laboratory must demonstrate and document the 
following for each initial drug test:
    (1) The ability to differentiate negative specimens from those 
requiring further testing;
    (2) The performance of the test around the cutoff concentration, 
using samples at several concentrations between 0 and 150 percent of 
the cutoff concentration;
    (3) The effective concentration range of the test (linearity);
    (4) The potential for carryover;
    (5) The potential for interfering substances; and
    (6) The potential matrix effects if using an alternate technology.
    (b) Each new lot of reagent must be verified prior to being placed 
into service.
    (c) Each initial drug test using an alternate technology must be 
re-verified periodically or at least annually.

Section 11.12 What are the batch quality control requirements when 
conducting an initial drug test?

    (a) Each batch of specimens must contain the following controls:
    (1) At least one control certified to contain no drug or drug 
metabolite;
    (2) At least one positive control with the drug or drug metabolite 
targeted at a concentration 25 percent above the cutoff;
    (3) At least one control with the drug or drug metabolite targeted 
at a concentration 75 percent of the cutoff; and
    (4) At least one control that appears as a donor specimen to the 
analysts.
    (b) Calibrators and controls must total at least 10 percent of the 
aliquots analyzed in each batch.

Section 11.13 What are the requirements for a confirmatory drug test?

    (a) The analytical method must use mass spectrometric 
identification [e.g., gas chromatography/mass spectrometry (GC/MS), 
liquid chromatography/mass spectrometry (LC/MS), GC/MS/MS, LC/MS/MS] or 
equivalent.
    (b) A confirmatory drug test must be validated before it can be 
used to test federally regulated specimens.
    (c) Confirmatory drug tests must be accurate and reliable for the 
testing of a urine specimen when identifying and quantifying drugs or 
their metabolites.

Section 11.14 What must an HHS-certified laboratory do to validate a 
confirmatory drug test?

    (a) An HHS-certified laboratory must demonstrate and document the 
following for each confirmatory drug test:
    (1) The linear range of the analysis;
    (2) The limit of detection;
    (3) The limit of quantification;
    (4) The accuracy and precision at the cutoff concentration;
    (5) The accuracy (bias) and precision at 40 percent of the cutoff 
concentration;
    (6) The potential for interfering substances;
    (7) The potential for carryover; and
    (8) The potential matrix effects if using liquid chromatography 
coupled with mass spectrometry.
    (b) Each new lot of reagent must be verified prior to being placed 
into service.
    (c) HHS-certified laboratories must re-verify each confirmatory 
drug test method periodically or at least annually.

Section 11.15 What are the batch quality control requirements when 
conducting a confirmatory drug test?

    (a) At a minimum, each batch of specimens must contain the 
following calibrators and controls:
    (1) A calibrator at the cutoff concentration;
    (2) At least one control certified to contain no drug or drug 
metabolite;
    (3) At least one positive control with the drug or drug metabolite 
targeted at 25 percent above the cutoff; and
    (4) At least one control targeted at or less than 40 percent of the 
cutoff.
    (b) Calibrators and controls must total at least 10 percent of the 
aliquots analyzed in each batch.

Section 11.16 What are the analytical and quality control requirements 
for conducting specimen validity tests?

    (a) Each specimen validity test result must be based on performing 
an initial specimen validity test on one aliquot and a second or 
confirmatory test on a second aliquot;
    (b) The HHS-certified laboratory must establish acceptance criteria 
and analyze calibrators and controls as appropriate to verify and 
document the validity of the test results (required specimen validity 
tests are addressed in Section 11.18); and
    (c) Controls must be analyzed concurrently with specimens.

Section 11.17 What must an HHS-certified laboratory do to validate a 
specimen validity test?

    An HHS-certified laboratory must demonstrate and document for each 
specimen validity test the appropriate performance characteristics of 
the test, and must re-verify the test periodically, or at least 
annually. Each new lot of reagent must be verified prior to being 
placed into service.

Section 11.18 What are the requirements for conducting each specimen 
validity test?

    (a) The requirements for measuring creatinine concentration are as 
follows:
    (1) The creatinine concentration must be measured to one decimal 
place on both the initial creatinine test and the confirmatory 
creatinine test;
    (2) The initial creatinine test must have the following calibrators 
and controls:
    (i) A calibrator at 2 mg/dL;
    (ii) A control in the range of 1.0 mg/dL to 1.5 mg/dL;
    (iii) A control in the range of 3 mg/dL to 20 mg/dL; and
    (iv) A control in the range of 21 mg/dL to 25 mg/dL.
    (4) The confirmatory creatinine test (performed on those specimens 
with a creatinine concentration less than 2 mg/dL on the initial test) 
must have the following calibrators and controls:
    (i) A calibrator at 2 mg/dL;
    (ii) A control in the range of 1.0 mg/dL to 1.5 mg/dL; and
    (iii) A control in the range of 3 mg/dL to 4 mg/dL.
    (b) The requirements for measuring specific gravity are as follows:
    (1) For specimens with initial creatinine test results greater than 
5 mg/dL and less than 20 mg/dL, laboratories may perform a screening 
test using a refractometer that measures urine specific gravity to at 
least three decimal places to identify specific gravity values that are 
acceptable (equal to or greater than 1.003) or dilute (equal to or 
greater than 1.002 and less than 1.003). Specimens must be subjected to 
an initial specific gravity test using a four decimal place 
refractometer when the initial creatinine test result is less than or 
equal to 5 mg/dL or when the screening specific gravity test result 
using a three decimal place refractometer is less than 1.002.
    (2) The screening specific gravity test must have the following 
calibrators and controls:
    (i) A calibrator or control at 1.000;
    (ii) One control targeted at 1.002;

[[Page 28136]]

    (iii) One control in the range of 1.004 to 1.018.
    (3) For the initial and confirmatory specific gravity tests, the 
refractometer must report and display specific gravity to four decimal 
places. The refractometer must be interfaced with a laboratory 
information management system (LIMS), computer, and/or generate a paper 
copy of the digital electronic display to document the numerical values 
of the specific gravity test results;
    (4) The initial and confirmatory specific gravity tests must have 
the following calibrators and controls:
    (i) A calibrator or control at 1.0000;
    (ii) One control targeted at 1.0020;
    (iii) One control in the range of 1.0040 to 1.0180; and
    (iv) One control equal to or greater than 1.0200 but not greater 
than 1.0250.
    (c) Requirements for measuring pH are as follows:
    (1) Colorimetric pH tests that have the dynamic range of 3 to 12 to 
support the 4 and 11 pH cutoffs and pH meters must be capable of 
measuring pH to one decimal place. Colorimetric pH tests, dipsticks, 
and pH paper (i.e., screening tests) that have a narrow dynamic range 
and do not support the cutoffs may be used only to determine if an 
initial pH specimen validity test must be performed;
    (2) For the initial and confirmatory pH tests, the pH meter must 
report and display pH to at least one decimal place. The pH meter must 
be interfaced with a LIMS, computer, and/or generate a paper copy of 
the digital electronic display to document the numerical values of the 
pH test results;
    (3) pH screening tests must have, at a minimum, the following 
controls:
    (i) One control below the lower decision point in use;
    (ii) One control between the decision points in use; and
    (iii) One control above the upper decision point in use;
    (4) An initial colorimetric pH test must have the following 
calibrators and controls:
    (i) One calibrator at 4;
    (ii) One calibrator at 11;
    (iii) One control in the range of 3 to 3.8;
    (iv) One control in the range 4.2 to 5;
    (v) One control in the range of 5 to 9;
    (vi) One control in the range of 10 to 10.8; and
    (vii) One control in the range of 11.2 to 12;
    (5) An initial pH meter test, if a pH screening test is not used, 
must have the following calibrators and controls:
    (i) One calibrator at 3;
    (ii) One calibrator at 7;
    (iii) One calibrator at 10;
    (iv) One control in the range of 3 to 3.8;
    (v) One control in the range 4.2 to 5;
    (vi) One control in the range of 10 to 10.8; and
    (vii) One control in the range of 11.2 to 12;
    (6) An initial pH meter test (if a pH screening test is used) or 
confirmatory pH meter test must have the following calibrators and 
controls when the result of the preceding pH test indicates that the pH 
is below the lower decision point in use:
    (i) One calibrator at 4;
    (ii) One calibrator at 7;
    (iii) One control in the range of 3 to 3.8; and
    (iv) One control in the range 4.2 to 5; and
    (7) An initial pH meter test (if a pH screening test is used) or 
confirmatory pH meter test must have the following calibrators and 
controls when the result of the preceding pH test indicates that the pH 
is above the upper decision point in use:
    (i) One calibrator at 7;
    (ii) One calibrator at 10;
    (iii) One control in the range of 10 to 10.8; and
    (iv) One control in the range of 11.2 to 12.
    (d) Requirements for performing oxidizing adulterant tests are as 
follows:
    (1) The initial test must include an appropriate calibrator at the 
cutoff specified in Sections 11.19(d)(2), (3), or (4) for the compound 
of interest, a control without the compound of interest (i.e., a 
certified negative control), and at least one control with one of the 
compounds of interest at a measurable concentration; and
    (2) A confirmatory test for a specific oxidizing adulterant must 
use a different analytical method than that used for the initial test. 
Each confirmatory test batch must include an appropriate calibrator, a 
control without the compound of interest (i.e., a certified negative 
control), and a control with the compound of interest at a measurable 
concentration.
    (e) The requirements for measuring the nitrite concentration are 
that the initial and confirmatory nitrite tests must have a calibrator 
at the cutoff concentration, a control without nitrite (i.e., certified 
negative urine), one control in the range of 200 mcg/mL to 250 mcg/mL, 
and one control in the range of 500 mcg/mL to 625 mcg/mL.

Section 11.19 What are the requirements for an HHS-certified laboratory 
to report a test result?

    (a) Laboratories must report a test result to the agency's MRO 
within an average of 5 working days after receipt of the specimen. 
Reports must use the Federal CCF and/or an electronic report. Before 
any test result can be reported, it must be certified by a certifying 
scientist or a certifying technician (as appropriate).
    (b) A primary (A) specimen is reported negative when each initial 
drug test is negative or if the specimen is negative upon confirmatory 
drug testing, and the specimen does not meet invalid criteria as 
described in items (h)(1) through (h)(12) below.
    (c) A primary (A) specimen is reported positive for a specific drug 
or drug metabolite when both the initial drug test is positive and the 
confirmatory drug test is positive in accordance with Section 3.4.
    (d) A primary (A) urine specimen is reported adulterated when:
    (1) The pH is less than 4 or equal to or greater than 11 using 
either a pH meter or a colorimetric pH test for the initial test on the 
first aliquot and a pH meter for the confirmatory test on the second 
aliquot;
    (2) The nitrite concentration is equal to or greater than 500 mcg/
mL using either a nitrite colorimetric test or a general oxidant 
colorimetric test for the initial test on the first aliquot and a 
different confirmatory test (e.g., multi-wavelength spectrophotometry, 
ion chromatography, capillary electrophoresis) on the second aliquot;
    (3) The presence of chromium (VI) is verified using either a 
general oxidant colorimetric test (with an equal to or greater than 50 
mcg/mL chromium (VI)-equivalent cutoff) or a chromium (VI) colorimetric 
test (chromium (VI) concentration equal to or greater than 50 mcg/mL) 
for the initial test on the first aliquot and a different confirmatory 
test (e.g., multi-wavelength spectrophotometry, ion chromatography, 
atomic absorption spectrophotometry, capillary electrophoresis, 
inductively coupled plasma-mass spectrometry) with the chromium (VI) 
concentration equal to or greater than the LOQ of the confirmatory test 
on the second aliquot;
    (4) The presence of halogen (e.g., bleach, iodine, fluoride) is 
verified using either a general oxidant colorimetric test (with an 
equal to or greater than 200 mcg/mL nitrite-equivalent cutoff or an 
equal to or greater than 50 mcg/mL chromium (VI)-equivalent cutoff) or 
halogen colorimetric test (halogen concentration equal to or greater 
than the LOQ) for the initial test on the first aliquot and a different 
confirmatory test (e.g., multi-wavelength spectrophotometry, ion 
chromatography, inductively coupled

[[Page 28137]]

plasma-mass spectrometry) with a specific halogen concentration equal 
to or greater than the LOQ of the confirmatory test on the second 
aliquot;
    (5) The presence of glutaraldehyde is verified using either an 
aldehyde test (aldehyde present) or the characteristic immunoassay 
response on one or more drug immunoassay tests for the initial test on 
the first aliquot and a different confirmatory method (e.g., GC/MS) for 
the confirmatory test with the glutaraldehyde concentration equal to or 
greater than the LOQ of the analysis on the second aliquot;
    (6) The presence of pyridine (pyridinium chlorochromate) is 
verified using either a general oxidant colorimetric test (with an 
equal to or greater than 200 mcg/mL nitrite-equivalent cutoff or an 
equal to or greater than 50 mcg/mL chromium (VI)-equivalent cutoff) or 
a chromium (VI) colorimetric test (chromium (VI) concentration equal to 
or greater than 50 mcg/mL) for the initial test on the first aliquot 
and a different confirmatory method (e.g., GC/MS) for the confirmatory 
test with the pyridine concentration equal to or greater than the LOQ 
of the analysis on the second aliquot;
    (7) The presence of a surfactant is verified by using a surfactant 
colorimetric test with an equal to or greater than 100 mcg/mL 
dodecylbenzene sulfonate-equivalent cutoff for the initial test on the 
first aliquot and a different confirmatory test (e.g., multi-wavelength 
spectrophotometry) with an equal to or greater than 100 mcg/mL 
dodecylbenzene sulfonate-equivalent cutoff on the second aliquot; or
    (8) The presence of any other adulterant not specified in 
paragraphs d(2) through d(7) of this section is verified using an 
initial test on the first aliquot and a different confirmatory test on 
the second aliquot.
    (e) A primary (A) urine specimen is reported substituted when the 
creatinine concentration is less than 2 mg/dL and the specific gravity 
is less than or equal to 1.0010 or equal to or greater than 1.0200 on 
both the initial and confirmatory creatinine tests (i.e., the same 
colorimetric test may be used to test both aliquots) and on both the 
initial and confirmatory specific gravity tests (i.e., a refractometer 
is used to test both aliquots) on two separate aliquots.
    (f) A primary (A) urine specimen is reported dilute when the 
creatinine concentration is equal to or greater than 2 mg/dL but less 
than 20 mg/dL and the specific gravity is greater than 1.0010 but less 
than 1.0030 on a single aliquot.
    (g) For a specimen that has an invalid result for one of the 
reasons stated in items (h)(4) through (h)(12) below, the HHS-certified 
laboratory shall contact the MRO and both will decide if testing by 
another HHS-certified laboratory would be useful in being able to 
report a positive or adulterated result. If no further testing is 
necessary, the HHS-certified laboratory then reports the invalid result 
to the MRO.
    (h) A primary (A) urine specimen is reported as an invalid result 
when:
    (1) Inconsistent creatinine concentration and specific gravity 
results are obtained (i.e., the creatinine concentration is less than 2 
mg/dL on both the initial and confirmatory creatinine tests and the 
specific gravity is greater than 1.0010 but less than 1.0200 on the 
initial and/or confirmatory specific gravity test, the specific gravity 
is less than or equal to 1.0010 on both the initial and confirmatory 
specific gravity tests and the creatinine concentration is equal to or 
greater than 2 mg/dL on either or both the initial or confirmatory 
creatinine tests);
    (2) The pH is equal to or greater than 4 and less than 4.5 or equal 
to or greater than 9 and less than 11 using either a colorimetric pH 
test or pH meter for the initial test and a pH meter for the 
confirmatory test on two separate aliquots;
    (3) The nitrite concentration is equal to or greater than 200 mcg/
mL using a nitrite colorimetric test or equal to or greater than the 
equivalent of 200 mcg/mL nitrite using a general oxidant colorimetric 
test for both the initial (first) test and the second test or using 
either initial test and the nitrite concentration is equal to or 
greater than 200 mcg/mL but less than 500 mcg/mL for a different 
confirmatory test (e.g., multi-wavelength spectrophotometry, ion 
chromatography, capillary electrophoresis) on two separate aliquots;
    (4) The possible presence of chromium (VI) is determined using the 
same chromium (VI) colorimetric test with a cutoff equal to or greater 
than 50 mcg/mL chromium (VI) for both the initial (first) test and the 
second test on two separate aliquots;
    (5) The possible presence of a halogen (e.g., bleach, iodine, 
fluoride) is determined using the same halogen colorimetric test with a 
cutoff equal to or greater than the LOQ for both the initial (first) 
test and the second test on two separate aliquots or relying on the 
odor of the specimen as the initial test;
    (6) The possible presence of glutaraldehyde is determined by using 
the same aldehyde test (aldehyde present) or characteristic immunoassay 
response on one or more drug immunoassay tests for both the initial 
(first) test and the second test on two separate aliquots;
    (7) The possible presence of an oxidizing adulterant is determined 
by using the same general oxidant colorimetric test (with an equal to 
or greater than 200 mcg/mL nitrite-equivalent cutoff, an equal to or 
greater than 50 mcg/mL chromium (VI)-equivalent cutoff, or a halogen 
concentration is equal to or greater than the LOQ) for both the initial 
(first) test and the second test on two separate aliquots;
    (8) The possible presence of a surfactant is determined by using 
the same surfactant colorimetric test with an equal to or greater than 
100 mcg/mL dodecylbenzene sulfonate-equivalent cutoff for both the 
initial (first) test and the second test on two separate aliquots or a 
foam/shake test for the initial test;
    (9) Interference occurs on the initial drug tests on two separate 
aliquots (i.e., valid initial drug test results cannot be obtained);
    (10) Interference with the confirmatory drug test occurs on at 
least two separate aliquots of the specimen and the HHS-certified 
laboratory is unable to identify the interfering substance;
    (11) The physical appearance of the specimen is such that testing 
the specimen may damage the laboratory's instruments; or
    (12) The physical appearances of the A and B specimens are clearly 
different (note: A is tested).
    (i) An HHS-certified laboratory shall reject a primary (A) urine 
specimen for testing when a fatal flaw occurs as described in Section 
15.1 or when a correctable flaw as described in Section 15.2 is not 
recovered. The HHS-certified laboratory will indicate on the Federal 
CCF that the specimen was rejected for testing and provide the reason 
for reporting the rejected for testing result.
    (j) An HHS-certified laboratory must report all positive, 
adulterated, substituted, and invalid test results for a urine 
specimen. For example, a specimen can be positive for a specific drug 
and adulterated.
    (k) An HHS-certified laboratory must report the confirmatory 
concentration of each drug or drug metabolite reported for a positive 
result.
    (l) An HHS-certified laboratory must report numerical values of the 
specimen validity test results that support a specimen that is reported 
adulterated, substituted, or invalid (as appropriate).
    (m) When the concentration of a drug or drug metabolite exceeds the 
validated

[[Page 28138]]

linear range of the confirmatory test, HHS-certified laboratories may 
report to the MRO that the quantitative value exceeds the linear range 
of the test or that the quantitative value is greater than ``insert the 
actual value for the upper limit of the linear range,'' or laboratories 
may report a quantitative value above the upper limit of the linear 
range that was obtained by diluting an aliquot of the specimen to 
achieve a result within the method's linear range and multiplying the 
result by the appropriate dilution factor.
    (n) HHS-certified laboratories may transmit test results to the MRO 
by various electronic means (e.g., teleprinter, facsimile, or 
computer). Transmissions of the reports must ensure confidentiality and 
the results may not be reported verbally by telephone. Laboratories and 
external service providers must ensure the confidentiality, integrity, 
and availability of the data and limit access to any data transmission, 
storage, and retrieval system.
    (o) HHS-certified laboratories must facsimile, courier, mail, or 
electronically transmit a legible image or copy of the completed 
Federal CCF and/or forward a computer-generated electronic report. The 
computer-generated report must contain sufficient information to ensure 
that the test results can accurately represent the content of the 
custody and control form that the MRO received from the collector.
    (p) For positive, adulterated, substituted, invalid, and rejected 
specimens, laboratories must facsimile, courier, mail, or 
electronically transmit a legible image or copy of the completed 
Federal CCF.

Section 11.20 How long must an HHS-certified laboratory retain 
specimens?

    (a) An HHS-certified laboratory must retain specimens that were 
reported as positive, adulterated, substituted, or as an invalid result 
for a minimum of one year.
    (b) Retained specimens must be kept in secured frozen storage (-20 
[deg]C or less) to ensure their availability for retesting during an 
administrative or judicial proceeding.
    (c) Federal agencies may request that the HHS-certified laboratory 
retain a specimen for an additional specified period of time and must 
make that request within the one-year period.

Section 11.21 How long must an HHS-certified laboratory retain records?

    (a) An HHS-certified laboratory must retain all records generated 
to support test results for at least two years. The laboratory may 
convert hardcopy records to electronic records for storage and then 
discard the hardcopy records after six months.
    (b) A federal agency may request the HHS-certified laboratory to 
maintain a documentation package (as described in Section 11.23) that 
supports the chain of custody, testing, and reporting of a donor's 
specimen that is under legal challenge by a donor. The federal agency's 
request to the laboratory must be in writing and must specify the 
period of time to maintain the documentation package.
    (c) An HHS-certified laboratory may retain records other than those 
included in the documentation package beyond the normal two-year period 
of time.

Section 11.22 What statistical summary reports must an HHS-certified 
laboratory provide for urine testing?

    (a) HHS-certified laboratories must provide to each federal agency 
for which they perform testing a semiannual statistical summary report 
that must be submitted by mail, facsimile, or email within 14 working 
days after the end of the semiannual period. The summary report must 
not include any personal identifying information. A copy of the 
semiannual statistical summary report will also be sent to the 
Secretary or designated HHS representative. The semiannual statistical 
report contains the following information:
    (1) Reporting period (inclusive dates);
    (2) HHS-certified laboratory name and address;
    (3) Federal agency name;
    (4) Number of specimen results reported;
    (5) Number of specimens collected by reason for test;
    (6) Number of specimens reported negative and the number reported 
negative/dilute;
    (7) Number of specimens rejected for testing because of a fatal 
flaw;
    (8) Number of specimens rejected for testing because of an 
uncorrected flaw;
    (9) Number of specimens tested positive by each initial drug test;
    (10) Number of specimens reported positive;
    (11) Number of specimens reported positive for each drug and drug 
metabolite;
    (12) Number of specimens reported adulterated;
    (13) Number of specimens reported substituted; and
    (14) Number of specimens reported as invalid result.
    (b) An HHS-certified laboratory must make copies of an agency's 
test results available when requested to do so by the Secretary or by 
the federal agency for which the laboratory is performing drug-testing 
services.
    (c) An HHS-certified laboratory must ensure that a qualified 
individual is available to testify in a proceeding against a federal 
employee when the proceeding is based on a test result reported by the 
laboratory.

Section 11.23 What HHS-certified laboratory information is available to 
a federal agency?

    (a) Following a federal agency's receipt of a positive, 
adulterated, or substituted drug test report, the federal agency may 
submit a written request for copies of the records relating to the drug 
test results or a documentation package or any relevant certification, 
review, or revocation of certification records.
    (b) Standard documentation packages provided by an HHS-certified 
laboratory must contain the following items:
    (1) A cover sheet providing a brief description of the procedures 
and tests performed on the donor's specimen;
    (2) A table of contents that lists all documents and materials in 
the package by page number;
    (3) A copy of the Federal CCF with any attachments, internal chain 
of custody records for the specimen, memoranda (if any) generated by 
the HHS-certified laboratory, and a copy of the electronic report (if 
any) generated by the HHS-certified laboratory;
    (4) A brief description of the HHS-certified laboratory's initial 
drug and specimen validity testing procedures, instrumentation, and 
batch quality control requirements;
    (5) Copies of the initial test data for the donor's specimen with 
all calibrators and controls and copies of all internal chain of 
custody documents related to the initial tests;
    (6) A brief description of the HHS-certified laboratory's 
confirmatory drug (and specimen validity, if applicable) testing 
procedures, instrumentation, and batch quality control requirements;
    (7) Copies of the confirmatory test data for the donor's specimen 
with all calibrators and controls and copies of all internal chain of 
custody documents related to the confirmatory tests; and
    (8) Copies of the r[eacute]sum[eacute] or curriculum vitae for the 
RP(s) and the certifying technician or certifying scientist of record.

Section 11.24 What HHS-certified laboratory information is available to 
a federal employee?

    A federal employee who is the subject of a workplace drug test may 
submit a written request through the MRO and/or the federal agency 
requesting copies of any records relating to his or her drug

[[Page 28139]]

test results or a documentation package as described in Section 
11.23(b) and any relevant certification, review, or revocation of 
certification records. Federal employees, or their designees, are not 
permitted access to their specimens collected pursuant to Executive 
Order 12564, Public Law 100-71, and these Guidelines.

Section 11.25 What types of relationships are prohibited between an 
HHS-certified laboratory and an MRO?

    An HHS-certified laboratory must not enter into any relationship 
with a federal agency's MRO that may be construed as a potential 
conflict of interest or derive any financial benefit by having a 
federal agency use a specific MRO.
    This means an MRO may be an employee of the agency or a contractor 
for the agency; however, an MRO shall not be an employee or agent of or 
have any financial interest in the HHS-certified laboratory for which 
the MRO is reviewing drug testing results. Additionally, an MRO shall 
not derive any financial benefit by having an agency use a specific 
HHS-certified laboratory or have any agreement with an HHS-certified 
laboratory that may be construed as a potential conflict of interest.

Section 11.26 What type of relationship can exist between an HHS-
certified laboratory and an HHS-certified IITF?

    An HHS-certified laboratory can enter into any relationship with an 
HHS-certified IITF.

Subpart L--Instrumented Initial Test Facility (IITF)

Section 12.1 What must be included in the HHS-certified IITF's standard 
operating procedure manual?

    (a) An HHS-certified IITF must have a standard operating procedure 
(SOP) manual that describes, in detail, all HHS-certified IITF 
operations. When followed, the SOP manual ensures that all specimens 
are tested consistently using the same procedures.
    (b) The SOP manual must include at a minimum, but is not limited 
to, a detailed description of the following:
    (1) Chain of custody procedures;
    (2) Accessioning;
    (3) Security;
    (4) Quality control/quality assurance programs;
    (5) Analytical methods and procedures;
    (6) Equipment and maintenance programs;
    (7) Personnel training;
    (8) Reporting procedures; and
    (9) Computers, software, and laboratory information management 
systems.
    (c) All procedures in the SOP manual must be compliant with these 
Guidelines and all guidance provided by the Secretary.
    (d) A copy of all procedures that have been replaced or revised and 
the dates on which the procedures were in effect must be maintained for 
two years.

Section 12.2 What are the responsibilities of the responsible 
technician (RT)?

    (a) Manage the day-to-day operations of the HHS-certified IITF even 
if another individual has overall responsibility for alternate areas of 
a multi-specialty facility.
    (b) Ensure that there are sufficient personnel with adequate 
training and experience to supervise and conduct the work of the HHS-
certified IITF. The RT must ensure the continued competency of IITF 
personnel by documenting their in-service training, reviewing their 
work performance, and verifying their skills.
    (c) Maintain a complete and current SOP manual that is available to 
all personnel of the HHS-certified IITF, and ensure that it is 
followed. The SOP manual must be reviewed, signed, and dated by the RT 
when procedures are first placed into use or changed or when a new 
individual assumes responsibility for the management of the HHS-
certified IITF. The SOP must be reviewed and documented by the RT 
annually.
    (d) Maintain a quality assurance program that ensures the proper 
performance and reporting of all test results; verify and monitor 
acceptable analytical performance for all controls and calibrators; 
monitor quality control testing; and document the validity, 
reliability, accuracy, precision, and performance characteristics of 
each test and test system.
    (e) Initiate and implement all remedial actions necessary to 
maintain satisfactory operation and performance of the HHS-certified 
IITF in response to the following: Quality control systems not within 
performance specifications, errors in result reporting or in analysis 
of performance testing samples, and inspection deficiencies. The RT 
must ensure that specimen results are not reported until all corrective 
actions have been taken and that the results provided are accurate and 
reliable.

Section 12.3 What qualifications must the RT have?

    An RT must:
    (a) Have at least a bachelor's degree in the chemical or biological 
sciences or medical technology, or equivalent;
    (b) Have training and experience in the analytical methods and 
forensic procedures used by the HHS-certified IITF;
    (c) Have training and experience in reviewing and reporting 
forensic test results and maintaining chain of custody, and an 
understanding of appropriate remedial actions in response to problems 
that may arise;
    (d) Be found to fulfill RT responsibilities and qualifications, as 
demonstrated by the HHS-certified IITF's performance and verified upon 
interview by HHS-trained inspectors during each on-site inspection; and
    (e) Qualify as a certifying technician.

Section 12.4 What happens when the RT is absent or leaves an HHS-
certified IITF?

    (a) HHS-certified IITFs must have an RT and an alternate RT. When 
an RT is absent, an alternate RT must be present and qualified to 
fulfill the responsibilities of the RT.
    (1) If an HHS-certified IITF is without the RT and alternate RT for 
14 calendar days or less (e.g., temporary absence due to vacation, 
illness, business trip), the HHS-certified IITF may continue operations 
and testing of federal agency specimens under the direction of a 
certifying technician.
    (2) The Secretary, in accordance with these Guidelines, will 
suspend an IITF's HHS certification for all specimens if the IITF does 
not have an RT or alternate RT for a period of more than 14 calendar 
days. The suspension will be lifted upon the Secretary's approval of a 
new permanent RT or alternate RT.
    (b) If the RT leaves an HHS-certified IITF:
    (1) The HHS-certified IITF may maintain certification and continue 
testing federally regulated specimens under the direction of an 
alternate RT for a period of up to 180 days while seeking to hire and 
receive the Secretary's approval of the RT's replacement.
    (2) The Secretary, in accordance with these Guidelines, will 
suspend an IITF's HHS certification for all federally regulated 
specimens if the IITF does not have a permanent RT within 180 days. The 
suspension will be lifted upon the Secretary's approval of the new 
permanent RT.
    (c) To nominate an individual as the RT or alternate RT, the HHS-
certified IITF must submit the following documents to the Secretary: 
The candidate's current resume or curriculum vitae, copies of diplomas

[[Page 28140]]

and licensures, a training plan (not to exceed 90 days) to transition 
the candidate into the position, an itemized comparison of the 
candidate's qualifications to the minimum RT qualifications described 
in the Guidelines, and have official academic transcript(s) submitted 
from the candidate's institution(s) of higher learning. The candidate 
must be found qualified during an on-site inspection of the HHS-
certified IITF.
    (d) The HHS-certified IITF must fulfill additional inspection and 
PT criteria as required prior to conducting federally regulated testing 
under a new RT.

Section 12.5 What qualifications must an individual have to certify a 
result reported by an HHS-certified IITF?

    A certifying technician must have:
    (a) Training and experience in the analytical methods and forensic 
procedures used by the HHS-certified IITF relevant to the results that 
the individual certifies; and
    (b) Training and experience in reviewing and reporting forensic 
test results and maintaining chain of custody, and an understanding of 
appropriate remedial actions in response to problems that may arise.

Section 12.6 What qualifications and training must other personnel of 
an HHS-certified IITF have?

    (a) All HHS-certified IITF staff (e.g., technicians, administrative 
staff) must have the appropriate training and skills for the tasks they 
perform.
    (b) Each individual working in an HHS-certified IITF must be 
properly trained (i.e., receive training in each area of work that the 
individual will be performing, including training in forensic 
procedures related to their job duties) before he or she is permitted 
to work independently with federally regulated specimens. All training 
must be documented.

Section 12.7 What security measures must an HHS-certified IITF 
maintain?

    (a) An HHS-certified IITF must control access to the drug testing 
facility, specimens, aliquots, and records.
    (b) Authorized visitors must be escorted at all times except for 
individuals conducting inspections (i.e., for the Department, a federal 
agency, a state, or other accrediting agency) or emergency personnel 
(e.g., firefighters and medical rescue teams).
    (c) An HHS-certified IITF must maintain records documenting the 
identity of the visitor and escort, date, time of entry and exit, and 
purpose for the access to the secured area.

Section 12.8 What are the IITF chain of custody requirements for 
specimens and aliquots?

    (a) HHS-certified IITFs must use chain of custody procedures 
(internal and external) to maintain control and accountability of 
specimens from the time of receipt at the IITF through completion of 
testing, reporting of results, during storage, and continuing until 
final disposition of the specimens.
    (b) HHS-certified IITFs must use chain of custody procedures to 
document the handling and transfer of aliquots throughout the testing 
process until final disposal.
    (c) The chain of custody must be documented using either paper copy 
or electronic procedures.
    (d) Each individual who handles a specimen or aliquot must sign and 
complete the appropriate entries on the chain of custody form when the 
specimen or aliquot is handled or transferred, and every individual in 
the chain must be identified.
    (e) The date and purpose must be recorded on an appropriate chain 
of custody form each time a specimen or aliquot is handled or 
transferred.

Section 12.9 What are the requirements for an initial drug test?

    (a) An initial drug test may be:
    (1) An immunoassay or
    (2) An alternate technology (e.g., spectrometry, spectroscopy).
    (b) An HHS-certified IITF must validate an initial drug test before 
testing specimens;
    (c) Initial drug tests must be accurate and reliable for the 
testing of urine specimens when identifying drugs or their metabolites.
    (d) An HHS-certified IITF may conduct a second initial drug test 
using a method with different specificity, to rule out cross-reacting 
compounds. This second initial drug test must satisfy the batch quality 
control requirements specified in Section 12.11.

Section 12.10 What must an HHS-certified IITF do to validate an initial 
drug test?

    (a) An HHS-certified IITF must demonstrate and document the 
following for each initial drug test:
    (1) The ability to differentiate negative specimens from those 
requiring further testing;
    (2) The performance of the test around the cutoff concentration, 
using samples at several concentrations between 0 and 150 percent of 
the cutoff concentration;
    (3) The effective concentration range of the test (linearity);
    (4) The potential for carryover;
    (5) The potential for interfering substances; and
    (6) The potential matrix effects if using an alternate technology.
    (b) Each new lot of reagent must be verified prior to being placed 
into service.
    (c) Each initial drug test using an alternate technology must be 
re-verified periodically or at least annually.

Section 12.11 What are the batch quality control requirements when 
conducting an initial drug test?

    (a) Each batch of specimens must contain the following calibrators 
and controls:
    (1) At least one control certified to contain no drug or drug 
metabolite;
    (2) At least one positive control with the drug or drug metabolite 
targeted at a concentration 25 percent above the cutoff;
    (3) At least one control with the drug or drug metabolite targeted 
at a concentration 75 percent of the cutoff; and
    (4) At least one control that appears as a donor specimen to the 
analysts.
    (b) Calibrators and controls must total at least 10 percent of the 
aliquots analyzed in each batch.

Section 12.12 What are the analytical and quality control requirements 
for conducting specimen validity tests?

    (a) Each specimen validity test result must be based on performing 
a single test on one aliquot;
    (b) The HHS-certified IITF must establish acceptance criteria and 
analyze calibrators and controls as appropriate to verify and document 
the validity of the test results in accordance with Section 12.14; and
    (c) Controls must be analyzed concurrently with specimens.

Section 12.13 What must an HHS-certified IITF do to validate a specimen 
validity test?

    An HHS-certified IITF must demonstrate and document for each 
specimen validity test the appropriate performance characteristics of 
the test, and must re-verify the test periodically, or at least 
annually. Each new lot of reagent must be verified prior to being 
placed into service.

Section 12.14 What are the requirements for conducting each specimen 
validity test?

    (a) The requirements for measuring creatinine concentration are as 
follows:
    (1) The creatinine concentration must be measured to one decimal 
place on the test;
    (2) The creatinine test must have the following calibrators and 
controls:

[[Page 28141]]

    (i) A calibrator at 2 mg/dL;
    (ii) A control in the range of 1.0 mg/dL to 1.5 mg/dL;
    (iii) A control in the range of 3 mg/dL to 20 mg/dL; and
    (iv) A control in the range of 21 mg/dL to 25 mg/dL.
    (b) The requirements for measuring specific gravity are as follows:
    (1) For specimens with creatinine test results greater than 5 mg/dL 
and less than 20 mg/dL, an IITF must perform a screening test using a 
refractometer to identify specific gravity values that are acceptable 
(equal to or greater than 1.003) or dilute (equal to or greater than 
1.002 and less than 1.003). Specimens must be forwarded to an HHS-
certified laboratory when the creatinine test result is less than or 
equal to 5 mg/dL or when the screening specific gravity test result is 
less than 1.002.
    (2) The screening specific gravity test must have the following 
calibrators and controls:
    (i) A calibrator or control at 1.000;
    (ii) One control targeted at 1.002; and
    (iii) One control in the range of 1.004 to 1.018.
    (c) The requirements for measuring pH are as follows:
    (1) The IITF may perform the pH test using a pH meter, colorimetric 
pH test, dipsticks, or pH paper. Specimens must be forwarded to an HHS-
certified laboratory when the pH is less than 4.5 or equal to or 
greater than 9.0.
    (2) The pH test must have, at a minimum, the following calibrators 
and controls:
    (i) One control below 4.5;
    (ii) One control between 4.5 and 9.0;
    (iii) One control above 9.0; and
    (iv) One or more calibrators as appropriate for the test. For a pH 
meter: Calibrators at 4, 7, and 10.
    (d) The requirements for measuring the nitrite concentration are 
that the nitrite test must have a calibrator at 200 mcg/mL nitrite, a 
control without nitrite (i.e., certified negative urine), one control 
in the range of 200 mcg/mL to 250 mcg/mL, and one control in the range 
of 500 mcg/mL to 625 mcg/mL. Specimens with a nitrite concentration 
equal to or greater than 200 mcg/mL must be forwarded to an HHS-
certified laboratory; and,
    (e) Requirements for performing oxidizing adulterant tests are that 
the test must include an appropriate calibrator at the cutoff specified 
in Sections 11.19(d)(3), (4), or (6) for the compound of interest, a 
control without the compound of interest (i.e., a certified negative 
control), and at least one control with one of the compounds of 
interest at a measurable concentration. Specimens with an oxidizing 
adulterant result equal to or greater than the cutoff must be forwarded 
to an HHS-certified laboratory.

Section 12.15 What are the requirements for an HHS-certified IITF to 
report a test result?

    (a) An HHS-certified IITF must report a test result to the agency's 
MRO within an average of 3 working days after receipt of the specimen. 
Reports must use the Federal CCF and/or an electronic report. Before 
any test result can be reported, it must be certified by a certifying 
technician.
    (b) A primary (A) specimen is reported negative when each drug test 
is negative and each specimen validity test result indicates that the 
specimen is a valid urine specimen.
    (c) A primary (A) urine specimen is reported dilute when the 
creatinine concentration is greater than 5 mg/dL but less than 20 mg/dL 
and the specific gravity is equal to or greater than 1.002 but less 
than 1.003.
    (d) An HHS-certified IITF shall reject a urine specimen for testing 
when a fatal flaw occurs as described in Section 15.1 or when a 
correctable flaw as described in Section 15.2 is not recovered. The 
HHS-certified IITF will indicate on the Federal CCF that the specimen 
was rejected for testing and provide the reason for reporting the 
rejected for testing result.
    (e) HHS-certified IITFs may transmit test results to the MRO by 
various electronic means (e.g., teleprinter, facsimile, or computer). 
Transmissions of the reports must ensure confidentiality and the 
results may not be reported verbally by telephone. IITFs and external 
service providers must ensure the confidentiality, integrity, and 
availability of the data and limit access to any data transmission, 
storage, and retrieval system.
    (f) HHS-certified IITFs must facsimile, courier, mail, or 
electronically transmit a legible image or copy of the completed 
Federal CCF and/or forward a computer-generated electronic report. The 
computer-generated report must contain sufficient information to ensure 
that the test results can accurately represent the content of the 
custody and control form that the MRO received from the collector.
    (g) For rejected specimens, IITFs must facsimile, courier, mail, or 
electronically transmit a legible image or copy of the completed 
Federal CCF.

Section 12.16 How does an HHS-certified IITF handle a specimen that 
tested positive, adulterated, substituted, or invalid at the IITF?

    (a) The remaining specimen is resealed using a tamper-evident 
label/seal;
    (b) The individual resealing the remaining specimen initials and 
dates the tamper-evident label/seal; and
    (c) The resealed specimen and split specimen and the Federal CCF 
are sealed in a leak-proof plastic bag, and are sent to an HHS-
certified laboratory under chain of custody within one day after 
completing the drug and specimen validity tests.

Section 12.17 How long must an HHS-certified IITF retain a specimen?

    A specimen that is negative, negative/dilute, or rejected for 
testing is discarded.

Section 12.18 How long must an HHS-certified IITF retain records?

    (a) An HHS-certified IITF must retain all records generated to 
support test results for at least 2 years. The IITF may convert 
hardcopy records to electronic records for storage and then discard the 
hardcopy records after six months.
    (b) A federal agency may request the HHS-certified IITF to maintain 
a documentation package (as described in Section 12.20) that supports 
the chain of custody, testing, and reporting of a donor's specimen that 
is under legal challenge by a donor. The federal agency's request to 
the IITF must be in writing and must specify the period of time to 
maintain the documentation package.
    (c) An HHS-certified IITF may retain records other than those 
included in the documentation package beyond the normal two-year period 
of time.

Section 12.19 What statistical summary reports must an HHS-certified 
IITF provide?

    (a) HHS-certified IITFs must provide to each federal agency for 
which they perform testing a semiannual statistical summary report that 
must be submitted by mail, facsimile, or email within 14 working days 
after the end of the semiannual period. The summary report must not 
include any personal identifying information. A copy of the semiannual 
statistical summary report will also be sent to the Secretary or 
designated HHS representative. The semiannual statistical report 
contains the following information:
    (1) Reporting period (inclusive dates);
    (2) HHS-certified IITF name and address;
    (3) Federal agency name;

[[Page 28142]]

    (4) Total number of specimens tested;
    (5) Number of specimens collected by reason for test;
    (6) Number of specimens reported negative and the number reported 
negative/dilute;
    (7) Number of specimens rejected for testing because of a fatal 
flaw;
    (8) Number of specimens rejected for testing because of an 
uncorrected flaw;
    (9) Number of specimens tested positive by each initial drug test; 
and
    (10) Number of specimens forwarded to an HHS-certified laboratory 
for testing.
    (b) An HHS-certified IITF must make copies of an agency's test 
results available when requested to do so by the Secretary or by the 
federal agency for which the IITF is performing drug-testing services.
    (c) An HHS-certified IITF must ensure that a qualified individual 
is available to testify in a proceeding against a federal employee when 
the proceeding is based on a test result reported by the IITF.

Section 12.20 What HHS-certified IITF information is available to a 
federal agency?

    (a) Following a federal agency's receipt of a positive, 
adulterated, or substituted drug test report from a laboratory, the 
federal agency may submit a written request for copies of the IITF 
records relating to the drug test results or a documentation package or 
any relevant certification, review, or revocation of certification 
records.
    (b) Standard documentation packages provided by an HHS-certified 
IITF must contain the following items:
    (1) A cover sheet providing a brief description of the procedures 
and tests performed on the donor's specimen;
    (2) A table of contents that lists all documents and materials in 
the package by page number;
    (3) A copy of the Federal CCF with any attachments, internal chain 
of custody records for the specimen, memoranda (if any) generated by 
the HHS-certified IITF, and a copy of the electronic report (if any) 
generated by the HHS-certified IITF;
    (4) A brief description of the HHS-certified IITF's drug and 
specimen validity testing procedures, instrumentation, and batch 
quality control requirements;
    (5) Copies of all test data for the donor's specimen with all 
calibrators and controls and copies of all internal chain of custody 
documents related to the tests; and
    (6) Copies of the r[eacute]sum[eacute] or curriculum vitae for the 
RT and for the certifying technician of record.

Section 12.21 What HHS-certified IITF information is available to a 
federal employee?

    A federal employee who is the subject of a drug test may provide a 
written request through the MRO and/or the federal agency requesting 
access to any records relating to his or her drug test results or a 
documentation package (as described in Section 12.20) and any relevant 
certification, review, or revocation of certification records.

Section 12.22 What types of relationships are prohibited between an 
HHS-certified IITF and an MRO?

    An HHS-certified IITF must not enter into any relationship with a 
federal agency's MRO that may be construed as a potential conflict of 
interest or derive any financial benefit by having a federal agency use 
a specific MRO.
    This means an MRO may be an employee of the agency or a contractor 
for the agency; however, an MRO shall not be an employee or agent of or 
have any financial interest in the HHS-certified IITF for which the MRO 
is reviewing drug testing results. Additionally, an MRO shall not 
derive any financial benefit by having an agency use a specific HHS-
certified IITF or have any agreement with an HHS-certified IITF that 
may be construed as a potential conflict of interest.

Section 12.23 What type of relationship can exist between an HHS-
certified IITF and an HHS-certified laboratory?

    An HHS-certified IITF can enter into any relationship with an HHS-
certified laboratory.

Subpart M--Medical Review Officer (MRO)

Section 13.1 Who may serve as an MRO?

    (a) A currently licensed physician who has:
    (1) A Doctor of Medicine (M.D.) or Doctor of Osteopathy (D.O.) 
degree;
    (2) Knowledge regarding the pharmacology and toxicology of illicit 
drugs and nonmedical use of prescription drugs;
    (3) The training necessary to serve as an MRO as set out in Section 
13.3;
    (4) Satisfactorily passed an initial examination, administered by a 
nationally recognized entity or a subspecialty board that has been 
approved by the Secretary to certify MROs; and
    (5) At least every five years, completed requalification training 
on the topics in Section 13.3 and satisfactorily passed a 
requalification examination administered by a nationally recognized 
entity or a subspecialty board that has been approved by the Secretary 
to certify MROs.

Section 13.2 How are nationally recognized entities or subspecialty 
boards that certify MROs approved?

    All nationally recognized entities or subspecialty boards which 
seek approval by the Secretary to certify and/or train physicians as 
MROs for federal workplace drug testing programs must submit their 
qualifications and, if applicable, a sample examination. Approval will 
be based on an objective review of qualifications that include a copy 
of the MRO applicant application form, the course syllabus and 
materials, documentation that the continuing education courses are 
accredited by a professional organization, and, if applicable, the 
delivery method and content of the examination. Each approved MRO 
training/certification entity must resubmit their qualifications for 
approval every two years. The Secretary shall publish at least every 
two years a notice in the Federal Register listing those entities and 
subspecialty boards that have been approved. This notice is also 
available on the Internet at https://www.samhsa.gov/workplace/drug-testing.

Section 13.3 What training is required before a physician may serve as 
an MRO?

    (a) A physician must receive training that includes a thorough 
review of the following:
    (1) The collection procedures used to collect federal agency 
specimens;
    (2) How to interpret test results reported by HHS-certified IITFs 
and laboratories (e.g., negative, negative/dilute, positive, 
adulterated, substituted, rejected for testing, and invalid);
    (3) Chain of custody, reporting, and recordkeeping requirements for 
federal agency specimens;
    (4) The HHS Mandatory Guidelines for Federal Workplace Drug Testing 
Programs for all authorized specimen types;
    (5) Procedures for interpretation, review (e.g., donor interview 
for legitimate medical explanations), and reporting of results 
specified by any federal agency for which the individual may serve as 
an MRO; and
    (6) Training in Substance Abuse including information about how to 
discuss substance misuse and abuse, and how individuals that test 
positive can access services.

[[Page 28143]]

    (b) Nationally recognized entities or subspecialty boards that 
train or certify physicians as MROs should make the MROs aware of 
prevention and treatment opportunities for individuals after testing 
positive.

Section 13.4 What are the responsibilities of an MRO?

    (a) The MRO must review all positive, adulterated, rejected for 
testing, invalid, and (for urine) substituted test results.
    (b) Staff under the direct, personal supervision of the MRO may 
review and report negative and (for urine) negative/dilute test results 
to the agency's designated representative. The MRO must review at least 
5 percent of all negative results reported by the MRO staff to ensure 
that the MRO staff are properly performing the review process.
    (c) The MRO must discuss potential invalid results with the HHS-
certified laboratory, as addressed in Section 11.19(g) to determine 
whether testing at another HHS-certified laboratory may be warranted.
    (d) After receiving a report from an HHS-certified laboratory or 
(for urine) HHS-certified IITF, the MRO must:
    (1) Review the information on the MRO copy of the Federal CCF that 
was received from the collector and the report received from the HHS-
certified laboratory or HHS-certified IITF;
    (2) Interview the donor when required;
    (3) Make a determination regarding the test result; and
    (4) Report the verified result to the federal agency.
    (e) The MRO must maintain records for a minimum of two years while 
maintaining the confidentiality of the information. The MRO may convert 
hardcopy records to electronic records for storage and discard the 
hardcopy records after six months.
    (f) The MRO must conduct a medical examination or a review of the 
examining physician's findings and make a determination of refusal to 
test or cancelled test when a collector reports that the donor was 
unable to provide a specimen, as addressed in Section 8.6.

Section 13.5 What must an MRO do when reviewing a urine specimen's test 
results?

    (a) When the HHS-certified laboratory or HHS-certified IITF reports 
a negative result for the primary (A) specimen, the MRO reports a 
negative result to the agency.
    (b) When the HHS-certified laboratory or HHS-certified IITF reports 
a negative/dilute result for the primary (A) urine specimen, the MRO 
reports a negative/dilute result to the agency and directs the agency 
to immediately collect another specimen from the donor.
    (1) If the recollected specimen provides a negative or negative/
dilute result, the MRO reports a negative result to the agency, with no 
further action required.
    (2) If the recollected specimen provides a result other than 
negative or negative/dilute, the MRO follows the procedures in 13.5(c) 
through (g) for the recollected specimen.
    (c) When the HHS-certified laboratory reports multiple results for 
the primary (A) urine specimen, as the MRO, you must follow the 
verification procedures described in 13.5(c) through (g) and:
    (1) Report all verified positive and/or refusal to test results to 
the federal agency.
    (2) If an invalid result was reported in conjunction with a 
positive, adulterated, or substituted result, do not report the 
verified invalid result to the federal agency at this time. The MRO 
reports the verified invalid result(s) for the primary (A) urine 
specimen only if the split specimen is tested and reported as a failure 
to reconfirm as described in Section 14.6(l).
    (d) When the HHS-certified laboratory reports a positive result for 
the primary (A) specimen, the MRO must contact the donor to determine 
if there is any legitimate medical explanation for the positive result.
    (1) If the donor provides a legitimate medical explanation for the 
positive result, the MRO reports the test result as negative to the 
agency. If the laboratory also reports that the urine specimen is 
dilute, the MRO reports a negative/dilute result to the agency and 
directs the agency to immediately collect another specimen from the 
donor. The MRO follows the procedures in Section 13.5(b)(1) or (2) for 
the recollected specimen.
    (2) If the donor is unable to provide a legitimate medical 
explanation, the MRO reports a positive result to the agency. If the 
laboratory also reports that the urine specimen is dilute, the MRO may 
choose not to report the dilute result.
    (e) When the HHS-certified laboratory reports a positive result for 
opiates for the primary (A) urine specimen, the MRO must determine if 
there is clinical evidence (in addition to the test result) of illegal 
use of any opium, or opiates, listed in Schedule I or II of the 
Controlled Substances Act. However, this requirement does not apply if 
the laboratory confirms the presence of 6-acetylmorphine (i.e., the 
presence of this metabolite is proof of heroin use) or the morphine or 
codeine concentration is equal to or greater than 15,000 ng/mL and the 
donor does not present a legitimate medical explanation for the 
presence of morphine or codeine at or above this concentration. 
Consumption of food products must not be considered a legitimate 
medical explanation for the donor having morphine or codeine at or 
above this concentration.
    (f) When an HHS-certified laboratory reports an adulterated or 
substituted result for the primary (A) urine specimen, the MRO contacts 
the donor to determine if the donor has a legitimate medical 
explanation for the adulterated or substituted result.
    (1) If the donor provides a legitimate medical explanation, the MRO 
reports a negative result to the federal agency.
    (2) If the donor is unable to provide a legitimate explanation, the 
MRO reports a refusal to test to the federal agency because the urine 
specimen was adulterated or substituted.
    (g) When the HHS-certified laboratory reports an invalid result for 
the primary (A) urine specimen, the MRO must contact the donor to 
determine if there is a legitimate explanation for the invalid result. 
In the case of an invalid result based on pH of 9.0 to 9.5, when an 
employee has no other medical explanation for the pH in this range, the 
MRO must consider whether there is evidence of elapsed time and high 
temperature that could account for the pH value. The MRO may contact 
the collection site, HHS-certified IITF, and/or HHS-certified 
laboratory to discuss time and temperature issues (e.g., time elapsed 
from collection to receipt at the testing facility, likely temperature 
conditions between the time of the collection and transportation to the 
testing facility, specimen storage conditions).
    (1) If the donor provides a legitimate explanation (e.g., a 
prescription medication) or if the MRO determines that time and 
temperature account for the pH in the 9.0 to 9.5 range, the MRO reports 
a test cancelled result with the reason for the invalid result and 
informs the federal agency that a recollection is not required because 
there is a legitimate explanation for the invalid result.
    (2) If the donor is unable to provide a legitimate explanation or 
if the MRO determines that time and temperature fail to account for the 
pH in the 9.0-9.5 range, the MRO reports a test cancelled result with 
the reason for the invalid result and directs the federal agency to 
immediately collect another urine specimen from the donor using a 
direct observed collection.
    (i) If the specimen collected under direct observation provides a 
valid

[[Page 28144]]

result, the MRO follows the procedures in Section 13.5(a) through (f).
    (ii) If the specimen collected under direct observation provides an 
invalid result, the MRO reports this specimen as test cancelled and 
recommends that the agency collect another authorized specimen type 
(e.g., oral fluid).
    (h) When two separate specimens collected during the same testing 
event were sent to the HHS-certified laboratory for testing (e.g., the 
collector sent a urine specimen out of temperature range and the 
subsequently collected specimen--urine or another authorized specimen 
type), as the MRO, you must follow the verification procedures 
described in Sections 13.4, 13.5, and 13.6, and:
    (1) If both specimens were verified negative, report the result as 
negative.
    (2) If one specimen was verified negative and the other was not 
(i.e., the specimen was verified as negative/dilute or as positive, 
adulterated, substituted, and/or invalid), report only the verified 
result(s) other than negative. For example, if you verified one 
specimen as negative and the other as a refusal to test because the 
specimen was substituted, report only the refusal to the federal 
agency.
    (3) If both specimens were verified as positive, adulterated, and/
or substituted, report all results. For example, if you verified one 
specimen as positive and the other as a refusal to test because the 
specimen was adulterated, report the positive and the refusal results 
to the federal agency.
    (4) If one specimen has been verified and the HHS-certified 
laboratory has not reported the result(s) of the other specimen,
    (i) Report verified result(s) of positive, adulterated, or 
substituted immediately and do not wait to receive the result(s) of the 
other specimen.
    (ii) Do not report a verified result of negative, negative/dilute, 
or invalid for the first specimen to the federal agency. Hold the 
report until results of both specimens have been received and verified.
    (5) When the HHS-certified laboratory reports an invalid result for 
one or both specimens, follow the procedures in paragraph c above.
    (i) When the HHS-certified laboratory or HHS-certified IITF reports 
a rejected for testing result for the primary (A) specimen, the MRO 
reports a test cancelled result to the agency and recommends that the 
agency collect another specimen from the donor. The recollected 
specimen must be the same type (i.e., urine).

Section 13.6 What action does the MRO take when the collector reports 
that the donor did not provide a sufficient amount of urine for a drug 
test?

    (a) When another specimen type (e.g., oral fluid) was collected as 
authorized by the federal agency, the MRO reviews and reports the test 
result in accordance with the Mandatory Guidelines for Federal 
Workplace Drug Testing Programs using the alternative specimen.
    (b) When the federal agency did not authorize the collection of an 
alternative specimen, the MRO consults with the federal agency. The 
federal agency immediately directs the donor to obtain, within five 
days, an evaluation from a licensed physician, acceptable to the MRO, 
who has expertise in the medical issues raised by the donor's failure 
to provide a specimen. The MRO may perform this evaluation if the MRO 
has appropriate expertise.
    (1) For purposes of this section, a medical condition includes an 
ascertainable physiological condition (e.g., a urinary system 
dysfunction) or a medically documented pre-existing psychological 
disorder, but does not include unsupported assertions of ``situational 
anxiety'' or dehydration. Permanent or long-term medical conditions are 
those physiological, anatomic, or psychological abnormalities 
documented as being present prior to the attempted collection, and 
considered not amenable to correction or cure for an extended period of 
time, if ever. Examples would include destruction (any cause) of the 
glomerular filtration system leading to renal failure; unrepaired 
traumatic disruption of the urinary tract; or a severe psychiatric 
disorder focused on genitor-urinary matters. Acute or temporary medical 
conditions, such as cystitis, urethritis or prostatitis, though they 
might interfere with collection for a limited period of time, cannot 
receive the same exceptional consideration as the permanent or long-
term conditions discussed in the previous sentence.
    (2) As the MRO, if another physician will perform the evaluation, 
you must provide the other physician with the following information and 
instructions:
    (i) That the donor was required to take a federally regulated drug 
test, but was unable to provide a sufficient amount of urine to 
complete the test;
    (ii) The consequences of the appropriate federal agency regulation 
for refusing to take the required drug test;
    (iii) That, after completing the evaluation, the referral physician 
must agree to provide a written statement to the MRO with a 
recommendation for one of the determinations described in paragraph 
(b)(3) of this section and the basis for the recommendation. The 
statement must not include detailed information on the employee's 
medical condition beyond what is necessary to explain the referral 
physician's conclusion.
    (3) As the MRO, if another physician performed the evaluation, you 
must consider and assess the referral physician's recommendations in 
making your determination. You must make one of the following 
determinations and report it to the federal agency in writing:
    (i) A medical condition as defined in paragraph (b)(1) of this 
section has, or with a high degree of probability could have, precluded 
the employee from providing a sufficient amount of urine, but is not a 
permanent or long-term disability. As the MRO, you must report a test 
cancelled result to the federal agency.
    (ii) A permanent or long-term medical condition as defined in 
paragraph (b)(1) of this section has, or with a high degree of 
probability could have, precluded the employee from providing a 
sufficient amount of urine and is highly likely to prevent the employee 
from providing a sufficient amount of urine for a very long or 
indefinite period of time. As the MRO, you must follow the requirements 
of Section 13.7, as appropriate. If Section 13.7 is not applicable, you 
report a test cancelled result to the federal agency and recommend that 
the agency authorize collection of an alternative specimen type (e.g., 
oral fluid) for any subsequent drug tests for the donor.
    (iii) There is not an adequate basis for determining that a medical 
condition has, or with a high degree of probability could have, 
precluded the employee from providing a sufficient amount of urine. As 
the MRO, you must report a refusal to test to the federal agency.
    (4) When a federal agency receives a report from the MRO indicating 
that a test is cancelled as provided in paragraph (b)(3)(i) of this 
section, the agency takes no further action with respect to the donor. 
When a test is canceled as provided in paragraph (b)(3)(ii) of this 
section, the agency takes no further action with respect to the donor 
other than designating collection of an alternate specimen type (i.e., 
authorized by the Mandatory Guidelines for Federal Workplace Drug 
Testing Programs) for any subsequent collections, in accordance with 
the federal agency plan. The donor remains in the random testing pool.

[[Page 28145]]

Section 13.7 What happens when an individual is unable to provide a 
sufficient amount of urine for a federal agency applicant/pre-
employment test, a follow-up test, or a return-to-duty test because of 
a permanent or long-term medical condition?

    (a) This section concerns a situation in which the donor has a 
medical condition that precludes him or her from providing a sufficient 
specimen for a federal agency applicant/pre-employment test, a follow-
up test, or a return-to-duty test and the condition involves a 
permanent or long-term disability and the federal agency does not 
authorize collection of an alternative specimen. As the MRO in this 
situation, you must do the following:
    (1) You must determine if there is clinical evidence that the 
individual is an illicit drug user. You must make this determination by 
personally conducting, or causing to be conducted, a medical evaluation 
and through consultation with the donor's physician and/or the 
physician who conducted the evaluation under Section 13.6.
    (2) If you do not personally conduct the medical evaluation, you 
must ensure that one is conducted by a licensed physician acceptable to 
you.
    (b) If the medical evaluation reveals no clinical evidence of drug 
use, as the MRO, you must report the result to the federal agency as a 
negative test with written notations regarding results of both the 
evaluation conducted under Section 13.6 and any further medical 
examination. This report must state the basis for the determination 
that a permanent or long-term medical condition exists, making 
provision of a sufficient urine specimen impossible, and for the 
determination that no signs and symptoms of drug use exist. The MRO 
recommends that the agency authorize collection of an alternate 
specimen type (e.g., oral fluid) for any subsequent collections.
    (c) If the medical evaluation reveals clinical evidence of drug 
use, as the MRO, you must report the result to the federal agency as a 
cancelled test with written notations regarding results of both the 
evaluation conducted under Section 13.6 and any further medical 
examination. This report must state that a permanent or long-term 
medical condition [as defined in Section 13.6(b)(1)] exists, making 
provision of a sufficient urine specimen impossible, and state the 
reason for the determination that signs and symptoms of drug use exist. 
Because this is a cancelled test, it does not serve the purposes of a 
negative test (e.g., the federal agency is not authorized to allow the 
donor to begin or resume performing official functions, because a 
negative test is needed for that purpose).

Section 13.8 Who may request a test of a split (B) specimen?

    (a) For a positive, adulterated, or substituted result reported on 
a primary (A) specimen, a donor may request through the MRO that the 
split (B) specimen be tested by a second HHS-certified laboratory to 
verify the result reported by the first HHS-certified laboratory.
    (b) The donor has 72 hours (from the time the MRO notified the 
donor that his or her specimen was reported positive, adulterated, or 
(for urine) substituted to request a test of the split (B) specimen. 
The MRO must inform the donor that he or she has the opportunity to 
request a test of the split (B) specimen when the MRO informs the donor 
that a positive, adulterated, or (for urine) substituted result is 
being reported to the federal agency on the primary (A) specimen.

Section 13.9 How does an MRO report a primary (A) specimen test result 
to an agency?

    (a) The MRO must report all verified results to an agency using the 
completed MRO copy of the Federal CCF or a separate report using a 
letter/memorandum format. The MRO may use various electronic means for 
reporting (e.g., teleprinter, facsimile, or computer). Transmissions of 
the reports must ensure confidentiality. The MRO and external service 
providers must ensure the confidentiality, integrity, and availability 
of the data and limit access to any data transmission, storage, and 
retrieval system.
    (b) A verified result may not be reported to the agency until the 
MRO has completed the review process.
    (c) The MRO must send a copy of either the completed MRO copy of 
the Federal CCF or the separate letter/memorandum report for all 
positive, adulterated, and (for urine) substituted results.
    (d) The MRO must not disclose numerical values of drug test results 
to the agency.

Section 13.10 What types of relationships are prohibited between an MRO 
and an HHS-certified laboratory or an HHS-certified IITF?

    An MRO must not be an employee, agent of, or have any financial 
interest in an HHS-certified laboratory or an HHS-certified IITF for 
which the MRO is reviewing drug test results.
    This means an MRO must not derive any financial benefit by having 
an agency use a specific HHS-certified laboratory or HHS-certified 
IITF, or have any agreement with the HHS-certified laboratory or the 
HHS-certified IITF that may be construed as a potential conflict of 
interest.

Subpart N--Split Specimen Tests

Section 14.1 When may a split (B) specimen be tested?

    (a) The donor may verbally request through the MRO that the split 
(B) specimen be tested at a different (i.e., second) HHS-certified 
laboratory when the primary (A) specimen was determined by the MRO to 
be positive, adulterated, or (for urine) substituted.
    (b) A donor has 72 hours to initiate the verbal request after being 
informed of the result by the MRO. The MRO must document in his or her 
records the verbal request from the donor to have the split (B) 
specimen tested.
    (c) If a split (B) urine specimen cannot be tested by a second HHS-
certified laboratory (e.g., insufficient specimen, lost in transit, 
split not available, no second HHS-certified laboratory available to 
perform the test), the MRO reports to the federal agency that the test 
must be cancelled and the reason for the cancellation. The MRO directs 
the federal agency to ensure the immediate recollection of another 
urine specimen from the donor under direct observation, with no notice 
given to the donor of this collection requirement until immediately 
before the collection.
    (d) If a donor chooses not to have the split (B) specimen tested by 
a second HHS-certified laboratory, a federal agency may have a split 
(B) specimen retested as part of a legal or administrative proceeding 
to defend an original positive, adulterated, or (for urine) substituted 
result.

Section 14.2 How does an HHS-certified laboratory test a split (B) 
specimen when the primary (A) specimen was reported positive?

    (a) The testing of a split (B) specimen for a drug or metabolite is 
not subject to the testing cutoff concentrations established.
    (b) The HHS-certified laboratory is only required to confirm the 
presence of the drug or metabolite that was reported positive in the 
primary (A) specimen.
    (c) For a split (B) urine specimen, if the second HHS-certified 
laboratory fails to reconfirm the presence of the drug or drug 
metabolite that was reported by the first HHS-certified laboratory, the 
second laboratory must conduct specimen validity tests in an attempt to 
determine the reason for being unable to reconfirm the presence

[[Page 28146]]

of the drug or drug metabolite. The second laboratory should conduct 
the same specimen validity tests as it would conduct on a primary (A) 
urine specimen and reports those results to the MRO.

Section 14.3 How does an HHS-certified laboratory test a split (B) 
urine specimen when the primary (A) specimen was reported adulterated?

    (a) An HHS-certified laboratory must use one of the following 
criteria to reconfirm an adulterated result when testing a split (B) 
urine specimen:
    (1) pH must be measured using the laboratory's confirmatory pH test 
with the appropriate cutoff (i.e., either less than 4 or equal to or 
greater than 11);
    (2) Nitrite must be measured using the laboratory's confirmatory 
nitrite test with a cutoff concentration of equal to or greater than 
500 mcg/mL;
    (3) Surfactant must be measured using the laboratory's confirmatory 
surfactant test with a cutoff concentration of equal to or greater than 
100 mcg/mL dodecylbenzene sulfonate-equivalent cutoff; or
    (4) For adulterants without a specified cutoff (e.g., 
glutaraldehyde, chromium (VI), pyridine, halogens (such as, bleach, 
iodine), peroxidase, peroxide, other oxidizing agents), the laboratory 
must use its confirmatory specimen validity test at an established 
limit of quantification (LOQ) to reconfirm the presence of the 
adulterant.
    (b) The second HHS-certified laboratory may only conduct the 
confirmatory specimen validity test(s) needed to reconfirm the 
adulterated result reported by the first HHS-certified laboratory.

Section 14.4 How does an HHS-certified laboratory test a split (B) 
urine specimen when the primary (A) specimen was reported substituted?

    (a) An HHS-certified laboratory must use the following criteria to 
reconfirm a substituted result when testing a split (B) urine specimen:
    (1) The creatinine must be measured using the laboratory's 
confirmatory creatinine test with a cutoff concentration of less than 2 
mg/dL; and
    (2) The specific gravity must be measured using the laboratory's 
confirmatory specific gravity test with the specified cutoffs of less 
than or equal to 1.0010 or equal to or greater than 1.0200.
    (b) The second HHS-certified laboratory may only conduct the 
confirmatory specimen validity test(s) needed to reconfirm the 
substituted result reported by the first HHS-certified laboratory.

Section 14.5 Who receives the split (B) specimen result?

    The second HHS-certified laboratory must report the result to the 
MRO.

Section 14.6 What action(s) does an MRO take after receiving the split 
(B) urine specimen result from the second HHS-certified laboratory?

    The MRO takes the following actions when the second HHS-certified 
laboratory reports the result for the split (B) urine specimen as:
    (a) Reconfirmed the drug(s), adulteration, and/or substitution 
result. The MRO reports reconfirmed to the agency.
    (b) Failed to reconfirm a single or all drug positive results and 
adulterated. If the donor provides a legitimate medical explanation for 
the adulteration result, the MRO reports a failed to reconfirm [specify 
drug(s)] and cancels both tests. If there is no legitimate medical 
explanation, the MRO reports a failed to reconfirm [specify drug(s)] 
and a refusal to test to the agency and indicates the adulterant that 
is present in the specimen. The MRO gives the donor 72 hours to request 
that Laboratory A retest the primary (A) specimen for the adulterant. 
If Laboratory A reconfirms the adulterant, the MRO reports refusal to 
test and indicates the adulterant present. If Laboratory A fails to 
reconfirm the adulterant, the MRO cancels both tests and directs the 
agency to immediately collect another specimen using a direct observed 
collection procedure. The MRO shall notify the appropriate regulatory 
office about the failed to reconfirm and cancelled test.
    (c) Failed to reconfirm a single or all drug positive results and 
substituted. If the donor provides a legitimate medical explanation for 
the substituted result, the MRO reports a failed to reconfirm [specify 
drug(s)] and cancels both tests. If there is no legitimate medical 
explanation, the MRO reports a failed to reconfirm [specify drug(s)] 
and a refusal to test (substituted) to the agency. The MRO gives the 
donor 72 hours to request Laboratory A to review the creatinine and 
specific gravity results for the primary (A) specimen. If the original 
creatinine and specific gravity results confirm that the specimen was 
substituted, the MRO reports a refusal to test (substituted) to the 
agency. If the original creatinine and specific gravity results from 
Laboratory A fail to confirm that the specimen was substituted, the MRO 
cancels both tests and directs the agency to immediately collect 
another specimen using a direct observed collection procedure. The MRO 
shall notify the HHS office responsible for coordination of the drug-
free workplace program about the failed to reconfirm and cancelled 
test.
    (d) Failed to reconfirm a single or all drug positive results and 
not adulterated or substituted. The MRO reports to the agency a failed 
to reconfirm result [specify drug(s)], cancels both tests, and notifies 
the HHS office responsible for coordination of the drug-free workplace 
program.
    (e) Failed to reconfirm a single or all drug positive results and 
invalid result. The MRO reports to the agency a failed to reconfirm 
result [specify drug(s) and give the reason for the invalid result], 
cancels both tests, directs the agency to immediately collect another 
specimen using a direct observed collection procedure, and notifies the 
HHS office responsible for coordination of the drug-free workplace 
program.
    (f) Failed to reconfirm one or more drugs, reconfirmed one or more 
drugs, and adulterated. The MRO reports to the agency a reconfirmed 
result [(specify drug(s)]) and a failed to reconfirm result [specify 
drug(s)]. The MRO tells the agency that it may take action based on the 
reconfirmed drug(s) although Laboratory B failed to reconfirm one or 
more drugs and found that the specimen was adulterated. The MRO shall 
notify the HHS office official responsible for coordination of the 
drug-free workplace program regarding the test results for the 
specimen.
    (g) Failed to reconfirm one or more drugs, reconfirmed one or more 
drugs, and substituted. The MRO reports to the agency a reconfirmed 
result [specify drug(s)] and a failed to reconfirm result [(specify 
drug(s)]). The MRO tells the agency that it may take action based on 
the reconfirmed drug(s) although Laboratory B failed to reconfirm one 
or more drugs and found that the specimen was substituted. The MRO 
shall notify the HHS office responsible for coordination of the drug-
free workplace program regarding the test results for the specimen.
    (h) Failed to reconfirm one or more drugs, reconfirmed one or more 
drugs, and not adulterated or substituted. The MRO reports a 
reconfirmed result [specify drug(s)] and a failed to reconfirm result 
[specify drug(s)]. The MRO tells the agency that it may take action 
based on the reconfirmed drug(s) although Laboratory B failed to 
reconfirm one or more drugs. The MRO shall notify the HHS office 
responsible for coordination of the drug-free workplace program 
regarding the test results for the specimen.
    (i) Failed to reconfirm one or more drugs, reconfirmed one or more 
drugs,

[[Page 28147]]

and invalid result. The MRO reports to the agency a reconfirmed result 
[specify drug(s)] and a failed to reconfirm result [specify drug(s)]. 
The MRO tells the agency that it may take action based on the 
reconfirmed drug(s) although Laboratory B failed to reconfirm one or 
more drugs and reported an invalid result. The MRO shall notify the HHS 
office responsible for coordination of the drug-free workplace program 
regarding the test results for the specimen.
    (j) Failed to reconfirm substitution or adulteration. The MRO 
reports to the agency a failed to reconfirm result (specify adulterant 
or not substituted) and cancels both tests. The MRO shall notify the 
HHS office responsible for coordination of the drug-free workplace 
program regarding the test results for the specimen.
    (k) Failed to reconfirm a single or all drug positive results and 
reconfirmed an adulterated or substituted result. The MRO reports to 
the agency a reconfirmed result (adulterated or substituted) and a 
failed to reconfirm result [specify drug(s)]. The MRO tells the agency 
that it may take action based on the reconfirmed result (adulterated or 
substituted) although Laboratory B failed to reconfirm the drug(s) 
result.
    (l) Failed to reconfirm a single or all drug positive results and 
failed to reconfirm the adulterated or substituted result. The MRO 
reports to the agency a failed to reconfirm result [specify drug(s) and 
specify adulterant or substituted] and cancels both tests. The MRO 
shall notify the HHS office responsible for coordination of the drug-
free workplace program regarding the test results for the specimen.
    (m) Failed to reconfirm at least one drug and reconfirmed the 
adulterated result. The MRO reports to the agency a reconfirmed result 
[(specify drug(s) and adulterated] and a failed to reconfirm result 
[specify drug(s)]. The MRO tells the agency that it may take action 
based on the reconfirmed drug(s) and the adulterated result although 
Laboratory B failed to reconfirm one or more drugs.
    (n) Failed to reconfirm at least one drug and failed to reconfirm 
the adulterated result. The MRO reports to the agency a reconfirmed 
result [specify drug(s)] and a failed to reconfirm result [specify 
drug(s) and specify adulterant]. The MRO tells the agency that it may 
take action based on the reconfirmed drug(s) although Laboratory B 
failed to reconfirm one or more drugs and failed to reconfirm the 
adulterated result.
    (o) Failed to reconfirm an adulterated result and failed to 
reconfirm a substituted result. The MRO reports to the agency a failed 
to reconfirm result [(specify adulterant) and not substituted] and 
cancels both tests. The MRO shall notify the HHS office responsible for 
coordination of the drug-free workplace program regarding the test 
results for the specimen.
    (p) Failed to reconfirm an adulterated result and reconfirmed a 
substituted result. The MRO reports to the agency a reconfirmed result 
(substituted) and a failed to reconfirm result (specify adulterant). 
The MRO tells the agency that it may take action based on the 
substituted result although Laboratory B failed to reconfirm the 
adulterated result.
    (q) Failed to reconfirm a substituted result and reconfirmed an 
adulterated result. The MRO reports to the agency a reconfirmed result 
(adulterated) and a failed to reconfirm result (not substituted). The 
MRO tells the agency that it may take action based on the adulterated 
result although Laboratory B failed to reconfirm the substituted 
result.

Section 14.7 How does an MRO report a split (B) specimen test result to 
an agency?

    (a) The MRO must report all verified results to an agency using the 
completed MRO copy of the Federal CCF or a separate report using a 
letter/memorandum format. The MRO may use various electronic means for 
reporting (e.g., teleprinter, facsimile, or computer). Transmissions of 
the reports must ensure confidentiality. The MRO and external service 
providers must ensure the confidentiality, integrity, and availability 
of the data and limit access to any data transmission, storage, and 
retrieval system.
    (b) A verified result may not be reported to the agency until the 
MRO has completed the review process.
    (c) The MRO must send a copy of either the completed MRO copy of 
the Federal CCF or the separate letter/memorandum report for all split 
specimen results.
    (d) The MRO must not disclose the numerical values of the drug test 
results to the agency.

Section 14.8 How long must an HHS-certified laboratory retain a split 
(B) specimen?

    A split (B) specimen is retained for the same period of time that a 
primary (A) specimen is retained and under the same storage conditions. 
This applies even for those cases when the split (B) specimen is tested 
by a second HHS-certified laboratory and the second HHS-certified 
laboratory does not confirm the original result reported by the first 
HHS-certified laboratory for the primary (A) specimen.

Subpart O--Criteria for Rejecting a Specimen for Testing

Section 15.1 What discrepancies require an HHS-certified laboratory or 
an HHS-certified IITF to report a specimen as rejected for testing?

    The following discrepancies are considered to be fatal flaws. The 
HHS-certified laboratory or IITF must stop the testing process, reject 
the specimen for testing, and indicate the reason for rejecting the 
specimen on the Federal CCF when:
    (a) The specimen ID number on the specimen label/seal does not 
match the ID number on the Federal CCF, or the ID number is missing 
either on the Federal CCF or on either specimen label/seal;
    (b) The primary (A) specimen label/seal is broken or shows evidence 
of tampering and the split (B) specimen cannot be re-designated as the 
primary (A) specimen;
    (c) The collector's printed name and signature are omitted on the 
Federal CCF;
    (d) There is an insufficient amount of specimen for analysis in the 
primary (A) specimen unless the split (B) specimen can be re-designated 
as the primary (A) specimen; or
    (e) The accessioner failed to document the primary (A) specimen 
seal condition on the Federal CCF at the time of accessioning, and the 
split (B) specimen cannot be re-designated as the primary (A) specimen.

Section 15.2 What discrepancies require an HHS-certified laboratory or 
an HHS-certified IITF to report a specimen as rejected for testing 
unless the discrepancy is corrected?

    The following discrepancies are considered to be correctable:
    (a) If a collector failed to sign the Federal CCF, the HHS-
certified laboratory or IITF must attempt to recover the collector's 
signature before reporting the test result. If the collector can 
provide a memorandum for record recovering the signature, the HHS-
certified laboratory or IITF may report the test result for the 
specimen. If, after holding the specimen for at least 5 business days, 
the HHS-certified laboratory or IITF cannot recover the collector's 
signature, the laboratory or IITF must report a rejected for testing 
result and indicate the reason for the rejected for testing result on 
the Federal CCF.
    (b) If a specimen is submitted using a non-federal form or an 
expired Federal

[[Page 28148]]

CCF, the HHS-certified laboratory or IITF must test the specimen and 
also attempt to obtain a memorandum for record explaining why a non-
federal form or an expired Federal CCF was used and ensure that the 
form used contains all the required information. If, after holding the 
specimen for at least 5 business days, the HHS-certified laboratory or 
IITF cannot obtain a memorandum for record from the collector, the 
laboratory or IITF must report a rejected for testing result and 
indicate the reason for the rejected for testing result on the report 
to the MRO.

Section 15.3 What discrepancies are not sufficient to require an HHS-
certified laboratory or an HHS-certified IITF to reject a urine 
specimen for testing or an MRO to cancel a test?

    (a) The following omissions and discrepancies on the Federal CCF 
that are received by the HHS-certified laboratory or IITF are 
considered insignificant and should not cause an HHS-certified 
laboratory or IITF to reject a urine specimen or cause an MRO to cancel 
a test:
    (1) An incorrect laboratory name and address appearing at the top 
of the form;
    (2) Incomplete/incorrect/unreadable employer name or address;
    (3) MRO name is missing;
    (4) Incomplete/incorrect MRO address;
    (5) A transposition of numbers in the donor's SSN;
    (6) A telephone number is missing/incorrect;
    (7) A fax number is missing/incorrect;
    (8) A ``reason for test'' box is not marked;
    (9) A ``drug tests to be performed'' box is not marked;
    (10) A ``specimen collection'' box is not marked;
    (11) The ``observed'' box is not marked (if applicable);
    (12) The collection site address is missing;
    (13) The collector's printed name is missing but the collector's 
signature is properly recorded;
    (14) The time of collection is not indicated;
    (15) The date of collection is not indicated;
    (16) Incorrect name of delivery service;
    (17) The collector has changed or corrected information by crossing 
out the original information on either the Federal CCF or specimen 
label/seal without dating and initialing the change; or
    (18) The donor's name inadvertently appears on the HHS-certified 
laboratory or IITF copy of the Federal CCF or on the tamper-evident 
labels used to seal the specimens.
    (19) The collector failed to check the specimen temperature box and 
the ``Remarks'' line did not have a comment regarding the temperature 
being out of range. If, after at least 5 business days, the collector 
cannot provide a memorandum for record to attest to the fact that he or 
she did measure the specimen temperature, the HHS-certified laboratory 
or IITF may report the test result for the specimen but indicates that 
the collector could not provide a memorandum to recover the omission.
    (b) The following omissions and discrepancies on the Federal CCF 
that are made at the HHS-certified laboratory or IITF are considered 
insignificant and should not cause an MRO to cancel a test:
    (1) The testing laboratory or IITF fails to indicate the correct 
name and address in the results section when a different laboratory or 
IITF name and address is printed at the top of the Federal CCF;
    (2) The accessioner fails to print his or her name;
    (3) The certifying scientist or certifying technician fails to 
print his or her name;
    (4) The certifying scientist or certifying technician accidentally 
initials the Federal CCF rather than signing for a specimen reported as 
rejected for testing;
    (c) The above omissions and discrepancies are considered 
insignificant only when they occur no more than once a month. The 
expectation is that each trained collector and HHS-certified laboratory 
or IITF will make every effort to ensure that the Federal CCF is 
properly completed and that all the information is correct. When an 
error occurs more than once a month, the MRO must direct the collector, 
HHS-certified laboratory, or HHS-certified IITF (whichever is 
responsible for the error) to immediately take corrective action to 
prevent the recurrence of the error.

Section 15.4 What discrepancies may require an MRO to cancel a test?

    (a) An MRO must attempt to correct the following errors:
    (1) The donor's signature is missing on the MRO copy of the Federal 
CCF and the collector failed to provide a comment that the donor 
refused to sign the form;
    (2) The certifying scientist failed to sign the Federal CCF for a 
specimen being reported drug positive, adulterated, invalid, or (for 
urine) substituted; or
    (3) The electronic report provided by the HHS-certified laboratory 
or HHS-certified IITF does not contain all the data elements required 
for the HHS standard laboratory or IITF electronic report for a 
specimen being reported drug positive, adulterated, invalid result, or 
(for urine) substituted.
    (b) If error (a)(1) occurs, the MRO must contact the collector to 
obtain a statement to verify that the donor refused to sign the MRO 
copy. If, after at least 5 business days, the collector cannot provide 
such a statement, the MRO must cancel the test.
    (c) If error (a)(2) occurs, the MRO must obtain a statement from 
the certifying scientist that he or she inadvertently forgot to sign 
the Federal CCF, but did, in fact, properly conduct the certification 
review. If, after at least 5 business days, the MRO cannot get a 
statement from the certifying scientist, the MRO must cancel the test.
    (d) If error (a)(3) occurs, the MRO must contact the HHS-certified 
laboratory or HHS-certified IITF. If, after at least 5 business days, 
the laboratory or IITF does not retransmit a corrected electronic 
report, the MRO must cancel the test.

Subpart P--Laboratory or IITF Suspension/Revocation Procedures

Section 16.1 When may the HHS certification of a laboratory or IITF be 
suspended?

    These procedures apply when:
    (a) The Secretary has notified an HHS-certified laboratory or IITF 
in writing that its certification to perform drug testing under these 
Guidelines has been suspended or that the Secretary proposes to revoke 
such certification.
    (b) The HHS-certified laboratory or IITF has, within 30 days of the 
date of such notification or within 3 days of the date of such 
notification when seeking an expedited review of a suspension, 
requested in writing an opportunity for an informal review of the 
suspension or proposed revocation.

Section 16.2 What definitions are used for this subpart?

    Appellant. Means the HHS-certified laboratory or IITF which has 
been notified of its suspension or proposed revocation of its 
certification to perform testing and has requested an informal review 
thereof.
    Respondent. Means the person or persons designated by the Secretary 
in implementing these Guidelines.
    Reviewing Official. Means the person or persons designated by the 
Secretary who will review the suspension or proposed revocation. The 
reviewing

[[Page 28149]]

official may be assisted by one or more of his or her employees or 
consultants in assessing and weighing the scientific and technical 
evidence and other information submitted by the appellant and 
respondent on the reasons for the suspension and proposed revocation.

Section 16.3 Are there any limitations on issues subject to review?

    The scope of review shall be limited to the facts relevant to any 
suspension or proposed revocation, the necessary interpretations of 
those facts, the relevant Mandatory Guidelines for Federal Workplace 
Drug Testing Programs, and other relevant law. The legal validity of 
these Guidelines shall not be subject to review under these procedures.

Section 16.4 Who represents the parties?

    The appellant's request for review shall specify the name, address, 
and telephone number of the appellant's representative. In its first 
written submission to the reviewing official, the respondent shall 
specify the name, address, and telephone number of the respondent's 
representative.

Section 16.5 When must a request for informal review be submitted?

    (a) Within 30 days of the date of the notice of the suspension or 
proposed revocation, the appellant must submit a written request to the 
reviewing official seeking review, unless some other time period is 
agreed to by the parties. A copy must also be sent to the respondent. 
The request for review must include a copy of the notice of suspension 
or proposed revocation, a brief statement of why the decision to 
suspend or propose revocation is wrong, and the appellant's request for 
an oral presentation, if desired.
    (b) Within 5 days after receiving the request for review, the 
reviewing official will send an acknowledgment and advise the appellant 
of the next steps. The reviewing official will also send a copy of the 
acknowledgment to the respondent.

Section 16.6 What is an abeyance agreement?

    Upon mutual agreement of the parties to hold these procedures in 
abeyance, the reviewing official will stay these procedures for a 
reasonable time while the laboratory or IITF attempts to regain 
compliance with the Guidelines or the parties otherwise attempt to 
settle the dispute. As part of an abeyance agreement, the parties can 
agree to extend the time period for requesting review of the suspension 
or proposed revocation. If abeyance begins after a request for review 
has been filed, the appellant shall notify the reviewing official at 
the end of the abeyance period advising whether the dispute has been 
resolved. If the dispute has been resolved, the request for review will 
be dismissed. If the dispute has not been resolved, the review 
procedures will begin at the point at which they were interrupted by 
the abeyance agreement with such modifications to the procedures as the 
reviewing official deems appropriate.

Section 16.7 What procedures are used to prepare the review file and 
written argument?

    The appellant and the respondent each participate in developing the 
file for the reviewing official and in submitting written arguments. 
The procedures for development of the review file and submission of 
written argument are:
    (a) Appellant's Documents and Brief. Within 15 days after receiving 
the acknowledgment of the request for review, the appellant shall 
submit to the reviewing official the following (with a copy to the 
respondent):
    (1) A review file containing the documents supporting appellant's 
argument, tabbed and organized chronologically, and accompanied by an 
index identifying each document. Only essential documents should be 
submitted to the reviewing official.
    (2) A written statement, not to exceed 20 double-spaced pages, 
explaining why respondent's decision to suspend or propose revocation 
of appellant's certification is wrong (appellant's brief).
    (b) Respondent's Documents and Brief. Within 15 days after 
receiving a copy of the acknowledgment of the request for review, the 
respondent shall submit to the reviewing official the following (with a 
copy to the appellant):
    (1) A review file containing documents supporting respondent's 
decision to suspend or revoke appellant's certification to perform drug 
testing, which is tabbed and organized chronologically, and accompanied 
by an index identifying each document. Only essential documents should 
be submitted to the reviewing official.
    (2) A written statement, not exceeding 20 double-spaced pages in 
length, explaining the basis for suspension or proposed revocation 
(respondent's brief).
    (c) Reply Briefs. Within 5 days after receiving the opposing 
party's submission, or 20 days after receiving acknowledgment of the 
request for review, whichever is later, each party may submit a short 
reply not to exceed 10 double-spaced pages.
    (d) Cooperative Efforts. Whenever feasible, the parties should 
attempt to develop a joint review file.
    (e) Excessive Documentation. The reviewing official may take any 
appropriate step to reduce excessive documentation, including the 
return of or refusal to consider documentation found to be irrelevant, 
redundant, or unnecessary.

Section 16.8 When is there an opportunity for oral presentation?

    (a) Electing Oral Presentation. If an opportunity for an oral 
presentation is desired, the appellant shall request it at the time it 
submits its written request for review to the reviewing official. The 
reviewing official will grant the request if the official determines 
that the decision-making process will be substantially aided by oral 
presentations and arguments. The reviewing official may also provide 
for an oral presentation at the official's own initiative or at the 
request of the respondent.
    (b) Presiding Official. The reviewing official or designee will be 
the presiding official responsible for conducting the oral 
presentation.
    (c) Preliminary Conference. The presiding official may hold a 
prehearing conference (usually a telephone conference call) to consider 
any of the following: Simplifying and clarifying issues, stipulations 
and admissions, limitations on evidence and witnesses that will be 
presented at the hearing, time allotted for each witness and the 
hearing altogether, scheduling the hearing, and any other matter that 
will assist in the review process. Normally, this conference will be 
conducted informally and off the record; however, the presiding 
official may, at his or her discretion, produce a written document 
summarizing the conference or transcribe the conference, either of 
which will be made a part of the record.
    (d) Time and Place of the Oral Presentation. The presiding official 
will attempt to schedule the oral presentation within 30 days of the 
date the appellant's request for review is received or within 10 days 
of submission of the last reply brief, whichever is later. The oral 
presentation will be held at a time and place determined by the 
presiding official following consultation with the parties.
    (e) Conduct of the Oral Presentation.
    (1) General. The presiding official is responsible for conducting 
the oral presentation. The presiding official may be assisted by one or 
more of his or her employees or consultants in conducting

[[Page 28150]]

the oral presentation and reviewing the evidence. While the oral 
presentation will be kept as informal as possible, the presiding 
official may take all necessary steps to ensure an orderly proceeding.
    (2) Burden of Proof/Standard of Proof. In all cases, the respondent 
bears the burden of proving by a preponderance of the evidence that its 
decision to suspend or propose revocation is appropriate. The 
appellant, however, has a responsibility to respond to the respondent's 
allegations with evidence and argument to show that the respondent is 
wrong.
    (3) Admission of Evidence. The Federal Rules of Evidence do not 
apply and the presiding official will generally admit all testimonial 
evidence unless it is clearly irrelevant, immaterial, or unduly 
repetitious. Each party may make an opening and closing statement, may 
present witnesses as agreed upon in the prehearing conference or 
otherwise, and may question the opposing party's witnesses. Since the 
parties have ample opportunity to prepare the review file, a party may 
introduce additional documentation during the oral presentation only 
with the permission of the presiding official. The presiding official 
may question witnesses directly and take such other steps necessary to 
ensure an effective and efficient consideration of the evidence, 
including setting time limitations on direct and cross-examinations.
    (4) Motions. The presiding official may rule on motions including, 
for example, motions to exclude or strike redundant or immaterial 
evidence, motions to dismiss the case for insufficient evidence, or 
motions for summary judgment. Except for those made during the hearing, 
all motions and opposition to motions, including argument, must be in 
writing and be no more than 10 double-spaced pages in length. The 
presiding official will set a reasonable time for the party opposing 
the motion to reply.
    (5) Transcripts. The presiding official shall have the oral 
presentation transcribed and the transcript shall be made a part of the 
record. Either party may request a copy of the transcript and the 
requesting party shall be responsible for paying for its copy of the 
transcript.
    (f) Obstruction of Justice or Making of False Statements. 
Obstruction of justice or the making of false statements by a witness 
or any other person may be the basis for a criminal prosecution under 
18 U.S.C. 1505 or 1001.
    (g) Post-hearing Procedures. At his or her discretion, the 
presiding official may require or permit the parties to submit post-
hearing briefs or proposed findings and conclusions. Each party may 
submit comments on any major prejudicial errors in the transcript.

Section 16.9 Are there expedited procedures for review of immediate 
suspension?

    (a) Applicability. When the Secretary notifies an HHS-certified 
laboratory or IITF in writing that its certification to perform drug 
testing has been immediately suspended, the appellant may request an 
expedited review of the suspension and any proposed revocation. The 
appellant must submit this request in writing to the reviewing official 
within 3 days of the date the HHS-certified laboratory or IITF received 
notice of the suspension. The request for review must include a copy of 
the suspension and any proposed revocation, a brief statement of why 
the decision to suspend and propose revocation is wrong, and the 
appellant's request for an oral presentation, if desired. A copy of the 
request for review must also be sent to the respondent.
    (b) Reviewing Official's Response. As soon as practicable after the 
request for review is received, the reviewing official will send an 
acknowledgment with a copy to the respondent.
    (c) Review File and Briefs. Within 7 days of the date the request 
for review is received, but no later than 2 days before an oral 
presentation, each party shall submit to the reviewing official the 
following:
    (1) A review file containing essential documents relevant to the 
review, which is tabbed, indexed, and organized chronologically; and
    (2) A written statement, not to exceed 20 double-spaced pages, 
explaining the party's position concerning the suspension and any 
proposed revocation. No reply brief is permitted.
    (d) Oral Presentation. If an oral presentation is requested by the 
appellant or otherwise granted by the reviewing official, the presiding 
official will attempt to schedule the oral presentation within 7-10 
days of the date of appellant's request for review at a time and place 
determined by the presiding official following consultation with the 
parties. The presiding official may hold a prehearing conference in 
accordance with Section 16.8(c) and will conduct the oral presentation 
in accordance with the procedures of Sections 16.8(e), (f), and (g).
    (e) Written Decision. The reviewing official shall issue a written 
decision upholding or denying the suspension or proposed revocation and 
will attempt to issue the decision within 7-10 days of the date of the 
oral presentation or within 3 days of the date on which the transcript 
is received or the date of the last submission by either party, 
whichever is later. All other provisions set forth in Section 16.14 
will apply.
    (f) Transmission of Written Communications. Because of the 
importance of timeliness for these expedited procedures, all written 
communications between the parties and between either party and the 
reviewing official shall be by facsimile, secured electronic 
transmissions, or overnight mail.

Section 16.10 Are any types of communications prohibited?

    Except for routine administrative and procedural matters, a party 
shall not communicate with the reviewing or presiding official without 
notice to the other party.

Section 16.11 How are communications transmitted by the reviewing 
official?

    (a) Because of the importance of a timely review, the reviewing 
official should normally transmit written communications to either 
party by facsimile, secured electronic transmissions, or overnight mail 
in which case the date of transmission or day following mailing will be 
considered the date of receipt. In the case of communications sent by 
regular mail, the date of receipt will be considered 3 days after the 
date of mailing.
    (b) In counting days, include Saturdays, Sundays, and federal 
holidays. However, if a due date falls on a Saturday, Sunday, or 
federal holiday, then the due date is the next federal working day.

Section 16.12 What are the authority and responsibilities of the 
reviewing official?

    In addition to any other authority specified in these procedures, 
the reviewing official and the presiding official, with respect to 
those authorities involving the oral presentation, shall have the 
authority to issue orders; examine witnesses; take all steps necessary 
for the conduct of an orderly hearing; rule on requests and motions; 
grant extensions of time for good reasons; dismiss for failure to meet 
deadlines or other requirements; order the parties to submit relevant 
information or witnesses; remand a case for further action by the 
respondent; waive or modify these procedures in a specific case, 
usually with notice to the parties; reconsider a decision of the 
reviewing official where a party promptly alleges a clear error of fact 
or law; and to take any other action

[[Page 28151]]

necessary to resolve disputes in accordance with the objectives of 
these procedures.

Section 16.13 What administrative records are maintained?

    The administrative record of review consists of the review file; 
other submissions by the parties; transcripts or other records of any 
meetings, conference calls, or oral presentation; evidence submitted at 
the oral presentation; and orders and other documents issued by the 
reviewing and presiding officials.

Section 16.14 What are the requirements for a written decision?

    (a) Issuance of Decision. The reviewing official shall issue a 
written decision upholding or denying the suspension or proposed 
revocation. The decision will set forth the reasons for the decision 
and describe the basis therefore in the record. Furthermore, the 
reviewing official may remand the matter to the respondent for such 
further action as the reviewing official deems appropriate.
    (b) Date of Decision. The reviewing official will attempt to issue 
his or her decision within 15 days of the date of the oral 
presentation, the date on which the transcript is received, or the date 
of the last submission by either party, whichever is later. If there is 
no oral presentation, the decision will normally be issued within 15 
days of the date of receipt of the last reply brief. Once issued, the 
reviewing official will immediately communicate the decision to each 
party.
    (c) Public Notice. If the suspension and proposed revocation are 
upheld, the revocation will become effective immediately and the public 
will be notified by publication of a notice in the Federal Register. If 
the suspension and proposed revocation are denied, the revocation will 
not take effect and the suspension will be lifted immediately. Public 
notice will be given by publication in the Federal Register.

Section 16.15 Is there a review of the final administrative action?

    Before any legal action is filed in court challenging the 
suspension or proposed revocation, respondent shall exhaust 
administrative remedies provided under this subpart, unless otherwise 
provided by Federal Law. The reviewing official's decision, under 
Section 16.9(e) or 16.14(a) constitutes final agency action and is ripe 
for judicial review as of the date of the decision.

[FR Doc. 2015-11524 Filed 5-13-15; 4:15 pm]
 BILLING CODE 4162-20-P