Mandatory Guidelines for Federal Workplace Drug Testing Programs, 7920-7970 [2017-00979]
Download as PDF
7920
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Substance Abuse and Mental Health
Services Administration
Mandatory Guidelines for Federal
Workplace Drug Testing Programs
Substance Abuse and Mental
Health Services Administration
(SAMHSA), HHS.
ACTION: Revised Mandatory Guidelines
by the Secretary of Health and Human
Services.
AGENCY:
The Department of Health and
Human Services (‘‘HHS’’ or
‘‘Department’’) has revised the
Mandatory Guidelines for Federal
Workplace Drug Testing Programs
(Guidelines), 73 FR 71858 (November
25, 2008) for urine testing.
DATES: Effective Date: October 1, 2017.
FOR FURTHER INFORMATION CONTACT:
Charles LoDico, M.S., F–ABFT, Division
of Workplace Programs, Center for
Substance Abuse Prevention (CSAP),
SAMHSA mail to: 5600 Fishers Lane,
Room 16N03A, Rockville, MD 20857,
telephone (240) 276–2600 or email at
charles.lodico@samhsa.hhs.gov.
SUPPLEMENTARY INFORMATION: 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 drugs
of the Controlled Substances Act (i.e.,
oxycodone, oxymorphone, hydrocodone
and hydromorphone) in federal drugfree workplace programs, remove
methylenedioxyethylamphetamine
(MDEA) from the authorized drugs in
Section 3.4, add
methylenedioxyamphetamine (MDA) as
an initial test analyte, raise the lower pH
cutoff from 3 to 4 for identifying
specimens as adulterated, require MRO
requalification training and reexamination 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 wording
changes and reorganization of the UrMG
were made for clarity, to use current
scientific terminology or preferred
grammar, and for consistency with the
OFMG.
mstockstill on DSK3G9T082PROD with NOTICES2
SUMMARY:
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
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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],
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].
The proposed Mandatory Guidelines
for Federal Workplace Drug Testing
Programs using Urine (UrMG) published
in the Federal Register on May 15, 2015
(80 FR 28101) include revisions to the
initial and confirmatory drug test
analytes and methods for urine testing,
the cutoff for reporting a urine specimen
as adulterated based on low pH, and 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 published a
separate Notice in the May 15, 2015
Federal Register (80 FR 28054)
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. There was a 60day public comment period for both
Federal Register Notices, during which
125 commenters submitted comments
on the proposed changes to the
Guidelines. These commenters were
comprised of individuals, organizations,
and private sector companies. The
comments are available for public view
at https://www.regulations.gov/. All
comments were reviewed and taken into
consideration in the preparation of the
revised Guidelines. The issues and
concerns raised in the public comments
for the UrMG are set out below. Similar
comments are considered together in the
discussion.
PO 00000
Frm 00002
Fmt 4701
Sfmt 4703
Summary of Public Comments and
HHS’s Response
The following comments were
directed to the information and
questions in the preamble.
Costs and Benefits
The Department requested comments
on costs and benefits. One commenter
disagreed that the cost increase for
laboratories to add analytes to regulated
testing will be minimal, stating that
significant costs would be incurred for
information technology (IT)
development, as well as incremental
costs for additional immunoassays (if
required); for additional calibrators,
controls, and internal standards; and for
increased confirmatory testing costs
(including data review and result
certification) based on an expected
increased positivity rate for opioids.
One commenter disagreed with the
Department’s estimated 3% cost
increase for Medical Review Officers
(MROs) and estimated that the increase
will be 10%. The commenters did not
provide any substantive evidence or
data to support these comments. The
Department recognizes that there will be
start-up costs to laboratories to
implement testing for the additional
analytes for regulated specimens
including administrative costs, and
agrees that the estimated increased costs
for some MROs may exceed the 3%
estimate. The Department’s cost analysis
was based on information provided by
multiple HHS-certified laboratories and
MROs, as well as the estimated number
of additional positives resulting from
the inclusion of the new opioid
analytes. Costs are expected to vary
among individual laboratories and
MROs, depending on their processes
and testing populations. Additional
information on the estimated costs
associated with these Guidelines is
included under Regulatory Impact and
Notices below.
Proposed New Analytes: Oxycodone,
Oxymorphone, Hydrocodone, and
Hydromorphone
Seven commenters specifically agreed
with the addition of these drugs to the
Guidelines. Two commenters expressed
concerns over the added drugs,
indicating that individuals who follow
their physician’s treatment plan of
taking legally prescribed medication
would produce positive tests, leading to
greater reliance on MROs to determine
whether tests are truly positive (as a
result of illegal use) or are positive due
to prescribed usage of the drugs, and a
greater number of workers will be
subject to scrutiny and their medical
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
mstockstill on DSK3G9T082PROD with NOTICES2
records examined at length. One of the
commenters maintained that such
testing would exceed the legal mandate
under Executive Order No. 12564 and
the promulgation of scientific
Guidelines by HHS pursuant to it. The
Guidelines include requirements to
protect individuals’ privacy while
maintaining public safety, including
procedures for MRO review to verify
legitimate drug use and maintain the
confidentiality of donor drug testing
records. The Department provides
additional guidance in the Medical
Review Officer Manual for Federal
Workplace Drug Testing Programs. The
inclusion of these additional drugs in
the Guidelines is within the scope of the
Department’s regulatory authority to test
for illegal drug use under Section
503(a)(1)(A)(ii)(II) of Public Law 100–71
and Executive Order No. 12564.
New Analytes—Cutoff Concentrations
Eight commenters addressed the
proposed cutoffs for the added drugs:
Three commenters agreed with the
proposed cutoffs; four disagreed with
the cutoffs for one or more of the added
drugs. Of these, three commenters stated
that the cutoffs are too low: Two of
these commenters believe that these
cutoffs will unnecessarily identify
workers using prescription drugs and
one commenter noted that these cutoffs
will affect accurate quantitation in
routine specimens. The Department
recognizes that the added analytes will
result in an increased number of
positive opioid results requiring MRO
review, and has incorporated
requirements for MRO requalification
and retraining at least every five years.
Additional guidance and information on
the added drugs will be provided in the
Medical Review Officer Guidance
Manual for Federal Workplace Drug
Testing Programs. The Department
disagrees that the cutoffs will affect
accurate quantitation in routine
specimens. Information from HHScertified laboratories indicates that
testing at these cutoffs can be
accomplished with current
instrumentation. However, the
Department has raised the confirmatory
test cutoffs for oxycodone and
oxymorphone from 50 ng/mL to 100 ng/
mL. These higher cutoffs are supported
by a single dose study which showed
similar detection rates for oxycodone
and oxymorphone using either a 50 ng/
mL or 100 ng/mL cutoff.1 Use of the 100
ng/mL confirmatory test cutoffs is
expected to be less analytically
challenging for laboratories.
One commenter suggested changing
the oxycodone and oxymorphone initial
test cutoff to 300 ng/mL and changing
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
the hydrocodone and hydromorphone
initial test cutoff to 100 ng/mL, to
equate the detection times for these
drugs. One commenter requested that
the Department provide the justification
and data used to determine the cutoff
levels for the added opioids. The
Department raised the oxycodone and
oxymorphone confirmatory test cutoffs
to 100 ng/mL as described above. The
Department has evaluated the comments
and has concluded that no further
change is needed. The selection of
cutoff concentration is not based solely
on the factor of detection times and
must take into consideration a variety of
factors, both pharmacological and
chemical. Drug potency, disposition in
urine, impact and prevalence must be
considered. For example, oxycodone is
approximately twice as potent as
hydrocodone and may be prescribed in
lower doses, thus a cutoff lower than
that for hydrocodone is warranted.
Therefore, in selecting the cutoffs, the
Department considered the detection
times of equipotent doses as well as
dispositional patterns of each drug in
urine. Data on the disposition of
hydrocodone and oxycodone in urine
following administration of a single
dose can be found in two recently
published scientific articles.1 2
Medical Review Officer (MRO)
Requalification—Continuing Education
Units (CEUs)
The Department requested comments
on requiring MRO requalification
continuing education units (CEUs) and
on the optimum number of credits and
the appropriate CEU accreditation
bodies should CEUs be required as part
of MRO requalification. Three
commenters agreed with requiring MRO
recertification, but disagreed with the
addition of CEU requirements to the
Guidelines. Two commenters disagreed
with specifying the number of CEUs
required. Two commenters indicated
that certification entities already enforce
training requirements and
recommended that acceptance of CEUs
be handled by MRO certification boards,
not the Department. Two commenters
recommended a requirement of annual
CEUs: One suggested 16 CEUs and the
other recommended three CEUs. One
commenter recommended 12 CEUs
prior to initial certification, eight CEUs
every five years, and also recommended
two CEUs related to the new
requirements/topics within two years of
implementation of the revised
Guidelines. The Department has
evaluated the comments and has
concluded that requirements for
continuing education units will remain
with the MRO certification entities and
PO 00000
Frm 00003
Fmt 4701
Sfmt 4703
7921
will not be included in the Guidelines.
The Department has removed references
to MRO training entities in Sections
13.2 and 13.3, because training
documentation is maintained by MRO
certification entities. The Department
agrees with the comment that MROs
should receive training on revisions to
the Guidelines, and has added item
Section 13.3(b) to require such training
prior to the effective date of revised
Guidelines.
Discussion of Sections
The Department has not included a
discussion in the preamble of any
sections for which public comments
were not submitted or where minor
typographical or grammatical changes
were made.
Subpart A—Applicability
1.5 What do the terms used in these
Guidelines mean?
One commenter disagreed with the
definition for ‘‘dilute specimen’’
because it does not include numerical
values for creatinine and specific
gravity. The Department has concluded
that no change is needed; the analytical
(numerical) criteria for a dilute
specimen are provided in Section 3.8.
One commenter requested that
‘‘external service provider’’ be defined,
because this is a new term included in
the proposed Guidelines. The
Department agrees and has added the
definition.
The Department has added the
definition for ‘‘gender identity’’ to
Section 1.5. This term is now used in
Guidelines sections addressing observed
and monitored collections as described
in this preamble under Sections 4.4, 8.1,
8.10, and 8.12. Gender identity means
an individual’s internal sense of being
male or female, which may be different
from an individual’s sex assigned at
birth.
Two commenters disagreed with the
proposed definition for ‘‘invalid result’’
which indicated that an invalid result
was reported only when an HHScertified laboratory could not complete
testing or obtain a valid drug test result.
The Department agrees with the
commenters and has reinstituted the
definition from the Guidelines effective
October 1, 2010 (73 FR 71858).
To address comments described in
this preamble under Section 13.1, the
Department deleted the definition for
‘‘non-medical use of a drug.’’
Two commenters found the definition
of ‘‘specimen’’ confusing, because the
term ‘‘sample’’ used in the definition
was also defined as a representative
portion of a donor’s specimen. The
E:\FR\FM\23JAN2.SGM
23JAN2
7922
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
Department agrees, and has reinstituted
some wording for the definition of
‘‘specimen’’ from the Guidelines
effective October 1, 2010 (73 FR 71858)
for clarity.
mstockstill on DSK3G9T082PROD with NOTICES2
1.6 What is an agency required to do
to protect employee records?
One commenter suggested that the
non-applicability of the Health
Insurance Portability and
Accountability Act (HIPAA) and the
Health Information Technology for
Economic and Clinical Health Act
(HITECH) should be clearly stated in the
Guidelines. The Department has
evaluated the comment and has
concluded that the applicability of
HIPAA and other relevant privacy laws
is clearly stated in Section 1.6.
Accordingly, except for minor
rewording for clarity, no further
revisions are necessary.
1.7 What is a refusal to take a federally
regulated drug test?
One commenter noted that, per
Sections 8.4(c) and 8.9(b), when a
collector finds an adulterant or
substitution product or observes an
attempt to substitute a urine specimen,
this prompts a direct observed
collection, not a refusal to test. The
commenter suggested bringing an
adulterant or a substitution product to
the collection should be a refusal to test.
The Department has evaluated the
comment, and agrees that the collector
must report a refusal to test when a
donor brings materials for adulterating,
substituting, or diluting the specimen to
the collection site, or when the collector
observes a donor’s clear attempt to
tamper with a specimen. The
Department has revised Sections 1.7,
8.3(h), 8.4(c), and 8.9(b) accordingly.
One commenter noted that the
collector does not report a refusal to test
when a donor leaves the collection site
before the collection process begins for
a pre-employment test. The commenter
recommended defining the beginning of
the pre-employment test collection
process as the point at which the donor
is asked to present photo identification.
The Department agrees with the
suggestion to define the beginning of the
collection process specifically for this
situation. However, the Department has
designated the beginning as the step
described in Section 8.4(a), when the
collector provides or the donor selects a
specimen collection container. The
Department has revised Sections
1.7(a)(2) and (3) to include a reference
to this section. All subsequent items in
Section 1.7(a) (i.e., items 4–13) apply
once the donor has arrived for the preemployment test collection.
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
1.8 What are the potential
consequences for refusing to take a
federally regulated drug test?
The Department reworded Section
1.8(b) to clarify that the requirements in
this section apply to donors who fail to
appear at the collection site in a
reasonable time for any test (except a
pre-employment test), as described in
Section 1.7(a)(1).
Subpart B—Urine Specimens
2.1 What type of specimen may be
collected?
Two commenters requested
clarification on the collection/testing
scenario where the federal agency
authorizes collection of an oral fluid
specimen, but the contracted laboratory
does not perform oral fluid testing. The
Department has evaluated the comments
and has concluded that no change is
needed. This will be addressed in the
federal agency plan.
2.2 Under what circumstances may a
urine specimen be collected?
One commenter suggested that the
cost of mandatory random drug and
alcohol testing among airline pilots
outweighs the benefit. The Department
has evaluated the comment and has
concluded that no change is needed.
Airline pilots are subject to drug and
alcohol testing under DOT regulations.
Therefore, this public comment is not
relevant to the Guidelines. In regard to
drug testing of federal agency employees
and applicants, each federal agency
establishes its agency plan based on its
mission, its employees’ duties, and the
potential consequences to the public
health and safety or national security
that could result from the failure of an
employee to adequately perform their
duties and responsibilities.
Subpart C—Urine Specimen Tests
3.1 Which tests are conducted on a
urine specimen?
One commenter suggested changing
the term ‘‘opiates’’ to ‘‘opioids’’ in the
Guidelines. The Department agrees with
the commenter and has changed the
term ‘‘opiates’’ to ‘‘opioids’’ where
appropriate to refer to oxycodone,
oxymorphone, hydrocodone, and
hydromorphone in addition to codeine,
morphine, and 6-acetylmorphine (6AM).
3.2 May a specimen be tested for
additional drugs?
The Department reworded Section
3.2(a) to clarify the additional drug tests
that may be performed on federal
employee specimens.
PO 00000
Frm 00004
Fmt 4701
Sfmt 4703
3.3 May any of the specimens be used
for other purposes?
Section 3.3 states that specimens
collected pursuant to Executive Order
12564, Public Law 100–71, and these
Guidelines may not be used for
purposes other than drug and validity
testing in accordance with Subpart C of
the Guidelines. One commenter
disagreed with prohibiting employees
from using their drug test specimens for
other purposes (e.g., deoxyribonucleic
acid, DNA, testing). The Department has
evaluated this comment and has
concluded that no change is needed.
While the Guidelines do not authorize
the release of urine 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. For example, see Sections
8.5(b), 8.8, and 15.1(a).
In addition, under Public Law 100–
71, Section 503(a)(1)(A)(ii)(I), HHS is
mandated to establish ‘‘strict procedures
governing the chain of custody of
specimens collected for drug testing
. . . .’’ Sections 11.7(a) and 11.20(a)
also provide that an ‘‘HHS-certified
laboratory must control access to the
drug testing facility, specimens,
aliquots, and records,’’ and must retain
specimens that, among other things,
have been reported ‘‘drug positive’’ for
a minimum of one year. Therefore, the
release of specimens to employees, or to
an employee’s designee, is inconsistent
with the mandates of the federal drug
testing process, and could significantly
compromise a specimen’s integrity,
security, and an HHS-certified
laboratory’s ability to fulfill its
regulatory duties under the Guidelines.
One commenter requested further
clarification of the phrase ‘‘unless
authorized in accordance with
[applicable] federal law’’ in Section 3.3.
The phrase ‘‘unless otherwise
authorized in accordance with
applicable law in Section 3.3(a) does not
represent a significant change from the
intent of the prior Guidelines language.
Section 3.3, among others, is intended
to prohibit the use of specimens for
purposes other than those specifically
authorized by the Guidelines. However,
there may be circumstances in which
federal law authorizes an HHS-certified
laboratory to handle a specimen in a
manner that differs from the Guidelines.
Therefore, the phrase ‘‘unless
authorized in accordance with
applicable federal law’’ in Section 3.3 of
the Guidelines is intended to avoid
conflict with other applicable federal
law.
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
mstockstill on DSK3G9T082PROD with NOTICES2
It should be noted that Section 3.3
specifically prohibits conducting
deoxyribonucleic acid (DNA) testing on
urine specimens, unless authorized in
accordance with applicable federal law.
3.4 What are the drug test cutoff
concentrations for urine?
The Department proposed
methylenedioxyamphetamine (MDA)
and methylenedioxyethylamphetamine
(MDEA) as initial test analytes. Three
commenters disagreed with the addition
of MDA and MDEA as target analytes,
stating this change would require
modification of current immunoassay
reagents, laboratory processes, or both.
The commenters noted that this imposes
an unnecessary burden for compounds
with such low incidence in workplace
testing. The Department has evaluated
the comments and has removed MDEA
from the Guidelines (i.e., MDEA is no
longer included as an authorized drug
in Section 3.4). The number of positive
MDEA specimens reported by HHScertified laboratories (i.e., information
provided to the Department through the
NLCP) does not support testing all
specimens for MDEA in federal
workplace drug testing programs.
Because MDEA is a Schedule I drug, a
federal agency may test specimens for
MDEA in accordance with Section 3.2
(i.e., on a case-by-case basis for
reasonable suspicion or post accident
testing, routinely with a waiver from the
Secretary). The Department understands
that MDA and some other analytes also
have a low incidence, but believes that
continued testing for these analytes is
warranted in a deterrent program. In
particular, inclusion of MDA as an
initial and confirmatory test analyte is
warranted because, in addition to being
a drug of abuse, it is a metabolite of
MDEA and MDMA.
An HHS-certified laboratory or
Instrumented Initial Test Facility (IITF)
may group analytes for initial testing.
For clarity, the Department has defined
the term ‘‘grouped analytes’’ where used
in footnote 1 of the table in Section 3.4:
‘‘(i.e., two or more analytes that are in
the same drug class and have the same
initial test cutoff).’’
The Department proposed criteria for
immunoassays for grouped analytes
such as opioids and amphetamines,
specifying the minimum cross-reactivity
to the other analyte(s) within the group.
Two commenters disagreed with the
added cross-reactivity requirements,
noting this section should not attempt to
provide equivalence between
immunoassay and other initial testing
technologies. One of these commenters
suggested the Department develop
separate requirements for initial test
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
methods using an alternate technology
or, alternatively, require the combined
cross-reactivity of low-reacting
compounds (e.g., hydrocodone and
hydromorphone for an opiate assay;
MDA and MDEA for an amphetamines
assay) to be equal to or greater than the
cutoff. The other commenter
recommended not allowing methods
other than immunoassay for urine initial
testing. One commenter stated that
cross-reactivity specifications for
hydromorphone are not necessary,
based on their non-regulated testing
results (i.e., confirmatory test
concentrations detected after using an
immunoassay with 60% cross-reactivity
for hydromorphone). The Department
has evaluated the comments and has
concluded that no change is needed for
immunoassay cross-reactivity
requirements. The requirements in
Section 3.4 are necessary to ensure
consistency in testing among
laboratories using different
immunoassay kits, as well as those
using different test methods for initial
drug testing. Cross-reactivity must be
demonstrated and documented by the
manufacturer (e.g., package insert) and
by the HHS-certified laboratory or IITF
(i.e., assay validation studies, reagent lot
verification, and batch quality control
for any analyte that exhibits less than
100% cross-reactivity). The Department
will continue to allow the use of
methods other than immunoassay for
initial testing.
However, the Department has revised
Section 3.4 regarding the use of
alternate technology initial tests for
THCA and benzoylecgonine. Depending
on the technology, the confirmatory test
cutoff (i.e., 15 ng/mL for THCA, 100 ng/
mL for benzoylecgonine) must be used
as the cutoff for an initial test using an
alternate technology to ensure
consistent treatment of specimens. For
these analytes, the immunoassay test is
not specific for the target analyte for the
confirmatory test. For example,
immunoassays for cannabinoids react
with multiple compounds that are
excreted as a result of marijuana use.
Therefore, it is necessary to use an
immunoassay cutoff higher than that of
the confirmatory test in order to detect
the target analyte (THCA) at or above
the confirmatory test cutoff. An initial
test using an alternate technology with
specificity comparable to the
confirmatory test requires use of the
confirmatory test cutoff.
Also in Section 3.4, the Department
did not specify the target analyte to be
used to calibrate an initial test for
grouped analytes such as amphetamines
or opioids. Three commenters noted
that when an immunoassay is calibrated
PO 00000
Frm 00005
Fmt 4701
Sfmt 4703
7923
with a low-reacting drug, other analytes
may exhibit high cross-reactivity,
leading to false initial test positives.
Two of these commenters also noted
that this may result in possibly different
cross-reactivity profiles for some
structurally unrelated and
concomitantly used prescription and/or
over the counter drugs. One commenter
noted that the option to ‘‘include a
control containing the lowest reacting
analyte at its cutoff concentration in
each batch’’ was described in the
preamble to the proposed Guidelines,
but was not specified in Section 3.4 of
the Guidelines. It was not the
Department’s intent for the laboratory or
IITF to calibrate an immunoassay test
using an analyte other than that
specified by the manufacturer. In the
preamble to the proposed UrMG, the
Department described using a control
containing the lowest reacting analyte at
its cutoff concentration to establish the
decision point (i.e., when an
immunoassay for grouped analytes did
not demonstrate at least 80% crossreactivity to each analyte). The
Department has determined that this
approach is not necessary, and will not
be permitted. There are current
immunoassays that meet the
requirements of this section for two or
more analytes in a group (i.e., analytes
in the same drug class that have the
same initial test cutoff). As indicated in
Section 3.4, the laboratory or IITF may
use multiple test kits or a single kit to
meet the requirements.
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)?
One commenter recommended that
HHS maintain a list of allowable
additional tests and reporting criteria
(e.g., threshold for reporting as positive,
adulterated, substituted, and/or invalid,
and a limit of detection as appropriate),
to ensure consistency among
laboratories and within the testing
program. The Department has evaluated
the comment and has concluded that no
change is needed. The Department does
not want to limit the analytes that may
be tested, and will provide guidance to
laboratories as needed. It is also noted
that the section requires all tests to meet
appropriate validation and quality
control requirements. The procedures
and specimen records for such tests will
be reviewed at NLCP inspections. The
Department will continue to maintain a
list of HHS-certified laboratories that
choose to perform additional tests for
regulated specimens.
E:\FR\FM\23JAN2.SGM
23JAN2
mstockstill on DSK3G9T082PROD with NOTICES2
7924
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
One commenter asked whether an
MRO could submit a blanket request to
perform additional testing (e.g.,
additional opioid metabolites) for all
confirmatory specimens (i.e., would
laboratories be permitted to monitor the
additional compounds in all
confirmatory test assays?). The
Department believes that testing all
specimens for additional analytes may
not be appropriate for some tests,
especially hydrocodone,
hydromorphone, oxycodone and
oxymorphone. Recent studies show that
testing for norhydrocodone and or
noroxycodone is not necessary for the
interpretation of all results.1 2
Norhydrocodone and noroxycodone
metabolites may be helpful for the MRO
to interpret test results only when a
donor’s prescription does not support
the test results. For example, a
hydrocodone dose may result in urine
concentrations of only hydromorphone
metabolite above the cutoff. The
presence of norhydrocodone metabolite
would support the use of hydrocodone
and validate the donor’s prescription.
The same could be said for interpreting
test results following an oxycodone
dose. The presence of noroxycodone
metabolite would support the use of
oxycodone when only oxymorphone
was reported as positive. The
Department will provide guidance on
these and other additional tests that may
provide useful information for the MRO
in the Medical Review Officer Guidance
Manual for Federal Workplace Drug
Testing Programs. The Department has
revised Section 3.5 to clarify that HHScertified laboratories are authorized to
perform additional tests upon MRO
request on a case-by-case basis, but are
not authorized to routinely perform
such tests without prior authorization
from the Secretary or designated HHS
representative, with the exception of the
determination of D,L stereoisomers of
amphetamine and methamphetamine.
The Department will continue to allow
HHS-certified laboratories to test for D,L
amphetamine and methamphetamine
routinely or upon MRO request. The
Department will provide guidance on
these and other additional tests that may
provide useful information for the MRO
(e.g., tetrahydrocannabivarin) in the
Medical Review Officer Guidance
Manual for Federal Workplace Drug
Testing Programs.
Additional drug and specimen
validity testing under Section 3.5 does
not include DNA testing.
3.6 What criteria are used to report a
urine specimen as adulterated?
Two commenters agreed and one
disagreed with raising the lower pH
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
cutoff from 3.0 to 4.0 for identifying
specimens as adulterated. One
commenter advised caution in changing
specimen validity test cutoffs, and
indicated that the proposed change will
require updates to computer systems for
reporting, calibrators, and controls. One
commenter indicated that previous
review of data (more than 10 years ago)
indicated this change would have more
than doubled the number of low pH/
adulterated results reported. The
commenter that disagreed with
changing the pH cutoff believes HHS
does not have enough scientific
evidence supporting the change. The
Department has evaluated the comments
and has concluded that no change is
needed to the proposed cutoff (i.e., 4.0).
As stated in the preamble to the
proposed Guidelines (80 FR 28101), 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. Furthermore,
the Department is not aware of any
medical conditions or medications that
would cause urine pH to be less than
4.5.
3.8 What criteria are used to report a
urine specimen as dilute?
One commenter suggested removing
the three-decimal place criteria for
reporting a specimen as dilute. One
commenter indicated that the criteria for
reporting a specimen as dilute in
Section 3.8 and 11.19(f) were not
consistent, and that Section 3.8 does not
address the situation when creatinine is
between 5 and 20 mg/dL and the
specific gravity is less than 1.0020. This
section was intended to clarify that only
HHS-certified laboratories (and not
HHS-certified IITFs) may report a
specimen as dilute when the creatinine
concentration is greater than or equal to
2.0 mg/dL and less than or equal to 5
mg/dL, and the laboratory must use a
four-decimal place refractometer for the
specific gravity test. The Department
will retain the three-decimal place
criteria in Section 3.8(a) because both
HHS-certified IITFs and laboratories
may use a three-decimal place
refractometer for a specific gravity
screening test when the creatinine
concentration is greater than 5 mg/dL
and less than 20 mg/dL. However, the
Department agrees that this section did
not address all situations, so has revised
the wording in Section 3.8(b) to be
consistent with the wording in 11.19(f).
3.9 What criteria are used to report an
invalid result for a urine specimen?
One commenter suggested increasing
the acceptable pH range upper end from
9.0 to 9.5 due to heat during summer
PO 00000
Frm 00006
Fmt 4701
Sfmt 4703
months. One commenter recommended
that the Department define requirements
to be met before a new validity marker
is implemented. One commenter
suggested that additional biomarkers
used to support a result of invalid
should be standardized across all HHScertified laboratories and one solution to
donor subversion might be random
assignment of collection of alternative
specimens. The Department has
evaluated the comments and has
concluded that no change is needed. A
2006 study on the stability of regulated
drug analytes in urine slightly below
and within the high pH invalid range
supports the pH 9.0 decision point due
to the loss of drug analytes at a pH
between 9.0 and 9.5.3
Subpart D—Collectors
4.4 What are the requirements to be an
observer for a direct observed
collection?
One commenter disagreed with the
requirement for an observer to be the
same gender as the donor, and suggested
that a physician or health care
professional (regardless of gender)
should be allowed to function as an
observer. The commenter indicated that
gender determination can be
challenging (i.e., transgender
employees). The Department has
evaluated these comments and agrees
that all observed collections must be
conducted in a professional manner that
minimizes discomfort to the donor. The
Department has revised Sections 4.4(b),
8.1(b), and 8.10 to allow the donor to be
observed by a person whose gender
matches the donor’s gender, which is
determined by the donor’s gender
identity (defined in Section 1.5). The
donor’s gender identity may be the same
as or different from the donor’s sex
assigned at birth. The Department also
revised Sections 8.1(b) and 8.12 for
monitored collections, to allow the
donor to be monitored by a person
whose gender matches the donor’s
gender, unless the monitor is a medical
professional (as described in Section
8.12).
The Department disagrees with the
commenter’s suggestion to allow an
individual to serve as an observer based
solely on their credentials as a
physician or health care professional.
Such credentials alone would not
guarantee that these individuals could
appropriately perform the functions of
an observer (i.e., as specified in Section
4.4).
The same commenter expressed
concerns over the requirement for an
observer to have received training,
indicating that this would require
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
documentation and may make finding
short notice observers more difficult.
The Department disagrees with this
comment. These are the same
requirements as in the Guidelines
effective October 1, 2010 (73 FR 71858).
As stated in the preamble to those
Guidelines, the training elements are
included to ensure that the observer
interacts with the donor in a
professional manner, respecting the
donor’s modesty and privacy, and that
the collector maintains the
confidentiality and integrity of
collection information.
Subpart F—Federal Drug Testing
Custody and Control Form (CCF)
mstockstill on DSK3G9T082PROD with NOTICES2
6.1 What federal form is used to
document custody and control?
Two commenters recommended that
the Department provide instructions on
recording results for the added drugs on
the CCF until the Federal CCF is
revised. Three commenters
recommended that the CCF be revised to
address the addition of the oral fluid
specimen matrix. One commenter
encouraged SAMHSA to modify the
CCF to account for collections where
multiple specimens are collected during
a single collection event. The
Department will publish a Federal
Register Notice with the revised Federal
CCF, including changes for the added
analytes, with the same effective date as
these Guidelines. Guidance on the use
of the revised Federal CCF will be
posted on the SAMHSA Web site https://
www.samhsa.gov/workplace. In regard
to when the collector submits multiple
urine specimens (i.e., different voids)
collected during the same testing event,
the Department has concluded that no
change is needed; the collector must use
a separate Federal CCF for each
specimen.
6.2 What happens if the correct OMB
approved Federal CCF is not available
or is not used?
One commenter questioned the
purpose of a Memorandum for the
Record (MFR) obtained from the
collector when an incorrect CCF was
used for the collection. The commenter
suggested that if certain information is
required to be in the MFR, these
requirements should be specified in the
Guidelines. The commenter suggested
that if the purpose of the MFR is to
correct the collector’s behavior (i.e.,
using an incorrect form), then it would
be more effective to reject the specimen
upon receipt and indicate that it was
rejected due to the use of an incorrect
form. The Department has evaluated the
comments and has concluded that no
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
7925
change is needed. Section 6.2 describes
the information required in the MFR
from the collector. However, the
Department reworded items 6.2(b) and
(c) for clarity.
Department has revised Section 8.4
accordingly.
Subpart H—Urine Specimen Collection
Procedure
8.6 What procedure is used when the
donor states that they are unable to
provide a urine specimen?
8.1 What privacy must the donor be
given when providing a urine
specimen?
As described in this preamble under
Section 4.4, the Department has revised
Section 8.1(b) to require that the gender
of the observer matches the donor’s
gender, and that the gender of the
monitor matches the donor’s gender
unless the monitor is a medical
professional as described in Section
8.12.
8.3 What are the preliminary steps in
the urine specimen collection
procedure?
One commenter was concerned that
the Guidelines do not mention alcohol
testing, which was added to the
Department of Transportation (DOT)
program in 1991. Alcohol testing is
outside of the scope of the Department’s
regulatory authority granted by
Executive Order 12564 and Public Law
100–71.
In response to comments described
under Sections 1.7 and 8.4 in this
preamble, the Department revised
Section 8.3(h) to require the collector to
report a refusal to test when a donor
brings materials for adulterating,
substituting, or diluting a specimen to
the collection site.
8.4 What steps does the collector take
in the collection procedure before the
donor provides a urine specimen?
The proposed section included the
same requirement as the Guidelines
effective October 1, 2010 (73 FR 71858)
for the collector to perform an observed
collection when the donor exhibits
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). One
commenter stated that if the collector
finds an adulterant or substitution
product or observes the donor attempt
to substitute a urine specimen, this
should be a refusal to test. As noted
under Section 1.7 in this preamble, the
Department agrees that the collector
must report a refusal to test when a
donor brings materials for adulterating,
substituting, or diluting a specimen to
the collection site, or when the collector
observes a donor’s clear attempt to
tamper with a specimen. The
PO 00000
Frm 00007
Fmt 4701
Sfmt 4703
8.5 What steps does the collector take
during and after the urine specimen
collection procedure?
Comments on these two sections are
addressed here. Numerous commenters
expressed concern with the
Department’s urine collection policy,
stating that 7 to 10% of Americans have
a condition (‘‘paruresis’’), described as a
social anxiety disorder which prevents
a person from producing urine on
demand or in the presence of other
people. These commenters stated that if
the government wants to seek the largest
group of qualified applicants, the
Guidelines should specify that a
diagnosis of paruresis means non-urine
(i.e., oral fluid) testing will
automatically be provided, and that
donors should not have to attempt to
provide a urine specimen first. The
Department has evaluated the comments
and has concluded that no change is
needed. The Guidelines will allow a
federal agency to use any authorized
specimen types (e.g., urine, oral fluid, or
both) in their drug testing programs. The
Guidelines will continue to require that
the donor be allowed reasonable
attempts to provide a urine specimen as
described in Sections 8.5 and 8.6, and
allow collection of an authorized
alternate specimen (i.e., oral fluid).
Three commenters disagreed with the
requirement for the collector to contact
the agency representative for
authorization to collect an alternate
specimen each time a donor is unable to
provide a sufficient volume. These
commenters suggested that the
Guidelines allow this to be addressed in
established standard protocols for the
agency. The Department agrees with the
commenters. Each federal agency may
decide whether to require notification in
each case or whether to provide a
standard protocol for collectors to
follow. Sections 8.5 and 8.6 have been
revised accordingly.
Also in regard to Section 8.6, one
commenter indicated that some
employers may wish to retain urine
testing as the primary test due to a
longer detection window. This
commenter raised concern that some
donors may claim they are unable to
provide a urine specimen so that an
alternative specimen (i.e., OF) with a
shorter detection window will be
collected. The commenter suggested
that the Guidelines be changed to
indicate that an alternative specimen
E:\FR\FM\23JAN2.SGM
23JAN2
7926
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
may be collected when a donor is
physiologically unable to provide a
urine specimen, and not just when the
donor states that they are unable to
provide a urine specimen. The
Department disagrees; collectors are not
qualified to conduct a medical
evaluation to verify or refute the donor’s
claim. It will be the agency’s decision to
collect urine or an authorized alternate
specimen, and Sections 13.6 and 13.7
include procedures for medical
evaluation as needed during the MRO
review process.
The Department reworded Section
8.5(d) to clarify that the collector must
record comments on both CCFs when
two specimens from the same collection
event are forwarded to a laboratory.
8.7 If the donor is unable to provide a
urine specimen, may another specimen
type be collected for testing?
The Department proposed within
Section 8.7 that when the donor is
unable to provide a urine specimen,
another specimen type may be collected
only if specifically authorized by the
agency. One commenter disagreed with
the Guidelines as written and suggested
that when a donor cannot provide the
primary specimen type, an alternate
specimen should be collected
immediately. The commenter cited the
additional time and cost (evaluation of
donor for ‘‘shy bladder’’) as well as the
fact that the collector may not know the
agency’s policy on alternate specimen
types. The Department has concluded
that no change is needed for Section 8.7
in response to this comment. The
Guidelines will continue to require that
the donor be allowed reasonable
attempts to provide a urine specimen as
described in Sections 8.5 and 8.6. The
Department has revised those sections
to allow a federal agency to either
require notification in each case or
provide a standard protocol for
collectors to follow when the donor is
unable to provide a urine specimen. The
Department has reworded this section to
state ‘‘Yes, if . . .’’ rather than ‘‘No,
unless . . . .’’ in response to a federal
agency’s comment and to enhance
clarity. The meaning of this section
remains the same.
mstockstill on DSK3G9T082PROD with NOTICES2
8.8 How does the collector prepare the
urine specimens?
In response to a federal agency
comment, the Department deleted a
sentence in item 8.8(h) that required the
collector to send a copy of the Federal
CCF to the HHS-certified laboratory or
IITF. The Department agreed with the
federal agency that this instruction is
redundant because item 8.8(g) instructs
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
the collector to distribute copies of the
Federal CCF as required.
8.9 When is a direct observed
collection conducted?
The proposed section included
requirements for the collector to
perform an observed collection when
the donor exhibits conduct that clearly
indicates an attempt to tamper with a
specimen or the collector observed
materials brought by the donor to the
collection site for the purpose of
adulterating, substituting, or diluting
the specimen. One commenter stated
that if the collector finds an adulterant
or substitution product or observes the
donor attempt to substitute a urine
specimen, this should be a refusal to
test. As noted in this preamble under
Sections 1.7 and 8.4, the Department
agrees that the collector must report a
refusal to test when a donor brings
materials for adulterating, substituting,
or diluting the specimen to the
collection site, or when the collector
observes a donor’s clear attempt to
tamper with a specimen. The
Department has revised Section 8.9
accordingly.
8.10 How is a direct observed
collection conducted?
To address a comment described in
this preamble under Section 4.4, the
Department has revised Section 8.10 to
allow the donor to be observed by an
observer whose gender matches the
donor’s gender. At the beginning of the
observed collection, the collector
requests that the donor document the
donor’s gender on the Federal CCF and
initial the annotation. An observer of
the same gender is provided, and the
collector records the name and gender
of the observer on the Federal CCF.
8.12 How is a monitored collection
conducted?
To address a comment described in
this preamble under Section 4.4, the
Department has revised Section 8.12 to
allow the donor to be monitored by a
monitor whose gender matches the
donor’s gender, 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). As described in
Section 8.10, at the beginning of the
monitored collection, the collector
follows the same procedure as for
observer selection in Section 8.10(b).
That is, the collector requests that the
donor document the donor’s gender on
the Federal CCF and initial the
annotation. A monitor of the same
gender is provided, and the collector
PO 00000
Frm 00008
Fmt 4701
Sfmt 4703
records the name and gender of the
monitor on the Federal CCF. A medical
professional may serve as the monitor,
regardless of gender.
Subpart I—HHS Certification of
Laboratories and IITFs
9.5 What are the qualitative and
quantitative specifications of
performance testing (PT) samples?
One commenter noted that, because
proposed initial test requirements allow
calibration with a low-reacting analyte,
PT schemes would likely need to be
designed based on the specific
implementation at each laboratory. The
commenter provided an example: When
an immunoassay is calibrated with a
drug/metabolite that exhibits 50% crossreactivity, the intended target analyte
(‘‘calibrant’’) at the cutoff concentration
would elicit a response well in excess
of the cutoff. This could result in
inaccurate initial test results (i.e., a
positive initial test result for a specimen
containing the calibrant at a
concentration below the cutoff). The
commenter stated that this result could
be scored as a ‘‘false positive’’ PT result.
The Department has evaluated the
comment and has concluded that no
change is needed. As noted above
regarding Section 3.4, it was not the
Department’s intent for the laboratory or
IITF to calibrate an immunoassay test
using an analyte other than that
specified by the manufacturer. NLCP PT
schemes are designed based on known
cross-reactivity profiles of the initial
tests used by HHS-certified laboratories.
Also in regard to proposed Section
9.5, one commenter suggested that the
Guidelines use the same wording as in
the Guidelines effective October 1, 2010
(73 FR 71858) for retest PT sample
specifications (i.e., ‘‘. . . may be as low
as . . .’’ rather than the proposed
wording ‘‘. . . may be less than. . .’’).
The Department agrees and has
reinstituted wording from Section 9.3 of
the Guidelines effective October 1, 2010
(73 FR 71858) into Section 9.5(a)(1)(ii).
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?
Two commenters disagreed with the
proposed limit to the number of blind
samples required (i.e., a maximum of
400 blind samples per year) in Section
10.1(b). The commenters indicated that
for a large agency, there is a very large
difference between 3% and 400 samples
and suggested keeping only the 3%
requirement. Another commenter
disagreed with the 3% requirement for
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
blind samples and requested that the
amount to be lowered to 1% to lessen
the burden on employers. One
commenter suggested that the wording
be modified to clarify that employers are
responsible for ensuring blind samples
are sent to the laboratories, but that
collectors are tasked with submitting the
blind samples. The Department has
evaluated the comments and has
concluded that no change is needed.
The 400 sample limit was added to
reduce the burden on large agencies
based on the Department’s review of
agencies’ blind testing programs. The
wording in Section 10.1(a) clearly
describes the responsibilities of the
federal agency and the role of the
collector in blind sample submission;
however, the Department reworded
Section 10.3(a) for clarity as described
below.
10.3 How is a blind sample submitted
to an HHS-certified laboratory?
The Department has reworded Section
10.3(a) to clarify that the collector sends
a blind sample to a laboratory or IITF as
a split specimen (i.e., Bottle A and
Bottle B).
Subpart K—Laboratory
mstockstill on DSK3G9T082PROD with NOTICES2
11.10 What are the requirements for an
initial drug test?
One commenter noted that HHS
previously required initial and
confirmatory testing using different
techniques, and asked whether this
requirement had been removed with
allowance of technologies other than
immunoassay for initial testing. The
commenter expressed concern that an
error in the initial drug test could be
repeated in the confirmatory drug test
using the same method. The Department
has evaluated the comments and has
concluded that no change is needed.
The Guidelines maintain the
requirement for initial and confirmatory
tests on two separate aliquots to report
a result other than negative. The NLCP
will review validation and quality
control records, as well as specimen
records, to ensure that the initial and
confirmatory testing methods meet
Guidelines requirements and provide
scientifically and forensically
supportable results.
Also in regard to the proposed Section
11.10, one commenter asked whether
non-FDA cleared immunoassays were
included in the category of alternate
initial drug test technology. The
Department has evaluated the comment
and has concluded that no change is
needed. This section clearly
distinguishes initial tests using
immunoassay from those using an
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
alternate technology. Furthermore,
Section 1.5 includes the definition for
‘‘alternate technology initial drug test.’’
11.11 What must an HHS-certified
laboratory do to validate an initial drug
test?
One commenter noted that an
immunoassay initial test calibrated with
a low-reacting analyte may not be able
to meet Guidelines requirements for
performance of the test around the
cutoff concentration. The Department
has evaluated the comments and has
concluded that no change is needed. All
tests must be validated by the HHScertified laboratory to meet the
requirements prior to use for regulated
drug testing.
One commenter noted that the
requirement in section 11.11(b) for
reagent verification prior to use is an
operational, not a validation,
requirement. The Departments agrees
with the commenter but has concluded
that no change is needed. While this
section addresses initial drug test
validation requirements, the verification
of each new reagent lot is essential to
verify that lot-to-lot differences have not
significantly affected assay performance
as demonstrated and documented
during validation. Therefore, this is the
most appropriate section of the
Guidelines to include the requirement.
11.12 What are the batch quality
control requirements when conducting
an initial drug test?
One commenter noted that this and
other sections use inconsistent
terminology when describing quality
controls samples relative to the cutoff
concentration (i.e., ‘‘25 percent above
the cutoff,’’ ‘‘75 percent of the cutoff’’).
The commenter suggested that the
Department use one version
consistently. The Department has
considered the comment and has
concluded that no change is needed.
These terms have been used in the
Guidelines, in NLCP documents, and in
other guidance to HHS-certified
laboratories without issue.
One commenter asked whether the
added analytes affect quality control
content requirements. The Department
has evaluated the comment and has
concluded that no change is needed.
The initial drug test quality control
requirements in the Guidelines apply to
each analyte used to calibrate the test
(i.e., immunoassay or alternate
technology initial drug test). When a
single immunoassay test is used for two
or more analytes in a drug class, the
HHS-certified laboratory or IITF must
include a control in accordance with
item 11.12(a)(2) for each analyte that has
PO 00000
Frm 00009
Fmt 4701
Sfmt 4703
7927
less than 100% cross-reactivity with the
assay, to demonstrate that the
requirement for at least 80% crossreactivity has been met.
11.12 What are the batch quality
control requirements when conducting
an initial drug test?
11.15 What are the batch quality
control requirements when conducting a
confirmatory drug test?
Comments on these two sections are
addressed here. One commenter
requested clarification for the
requirement for a drug-free control in
initial and confirmatory drug test
batches (i.e., whether the control should
contain no drug or whether the control
should not contain the specific analyte
for that test). The Department has
evaluated the comment and has
concluded that no change is needed.
These Guidelines sections list the
requirement for ‘‘at least one control
certified to contain no drug or drug
metabolite,’’ meaning that the control
must contain no regulated drug
analytes.
11.16 What are the analytical and
quality control requirements for
conducting specimen validity tests?
One commenter found the wording of
Section 11.16(a) to be confusing, noting
that a specimen would not be subjected
to a second specimen validity test when
the first test was in the acceptable range.
The Department agrees with the
comment and has revised Section
11.16(a) to correctly reflect
requirements.
11.18 What are the requirements for
conducting each specimen validity test?
One commenter noted that the
proposed changes in the lower pH cutoff
for identifying adulterated specimens
and lower pH decision point for
identifying invalid specimens may
cause additional costs for manufacturers
and laboratories. The Department has
evaluated the comment and has
concluded that no change is needed.
The Department recognizes that the
revised cutoff will necessitate changes
by HHS-certified laboratories as well as
by manufacturers of commercial quality
control samples; however, the 4.0 pH
cutoff is supported by scientific studies
and workplace drug testing data, and is
expected to reduce the incidence of
undetected attempts to subvert the drug
test.
11.19 What are the requirements for an
HHS-certified laboratory to report a test
result?
One commenter suggested that the
Department remove the requirement for
E:\FR\FM\23JAN2.SGM
23JAN2
7928
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
an executed CCF as the official report
for ‘‘non-negative’’ specimens and
permit the use of an electronic report
with the required information. The
Department has evaluated the comment
and has concluded that no change is
needed. The Federal CCF serves as the
chain of custody for the specimen from
the time of collection until receipt by
the laboratory and also contains the
certification statement signed by the
certifying scientist. The Federal CCF
may be paper or electronic.
11.21 How long must an HHS-certified
laboratory retain records?
In Section 11.21, the Department
proposed that laboratories be allowed to
convert hardcopy records to electronic
records for storage and then discard the
hardcopy records after six months. One
commenter stated their assumption that
this section did not require laboratories
to convert electronic records to
hardcopy records and maintain them for
six months. This assumption is correct;
the intent is to allow laboratories to
maintain records in electronic format for
the required storage period. The
Department has concluded that no
change is needed.
11.22 What statistical summary reports
must an HHS-certified laboratory
provide for urine testing?
One commenter asked why the
proposed Guidelines include a
requirement for a copy of the
semiannual statistical summary report
to be sent to the Secretary or designated
HHS representative. The Department
included the requirement in Section
11.22 (and in Section 12.19 for IITFs) to
facilitate compilation of statistical
information for the federal drug-free
workplace program. This will not place
an additional burden on the test
facilities other than transmission of the
report. The Department will continue to
evaluate the effectiveness of this
requirement.
Subpart M—Medical Review Officer
(MRO)
mstockstill on DSK3G9T082PROD with NOTICES2
13.1
Who may serve as an MRO?
Three commenters disagreed with the
term ‘‘nonmedical use of a drug’’ used
in Section 13.1 (and defined in Section
1.5) and indicated that the term changes
the role of an MRO from review, verify
and ‘‘report a non-negative result’’ to
review, verify and ‘‘interpret before
reporting a result as negative or
nonmedical use of a drug.’’ Two
commenters disagreed with use of
‘‘interpretation of results’’ to supplant
‘‘alternative medical explanation.’’ One
commenter noted that this perceived
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
change in the MRO’s role represents an
unjustified shifting of risk to the MRO.
One commenter believes the term
presents a possible legal flaw to the
Guidelines, stating that this term is
legally different from ‘‘safety concern’’
and places MROs in the position of
being in conflict with the prescribing
physician and subject to lawsuits. This
commenter stated that even a lack of a
finding of nonmedical use could be an
issue if the donor subsequently had an
accident after using the drug. The same
commenter submitted five
recommendations related to inclusion of
prescription drugs in federal workplace
drug testing programs, to address the
commenter’s concerns with the
proposed Guidelines. These five specific
recommendations pertain to matters that
are outside the scope of these
Guidelines, and therefore are not
addressed in the Department’s response
below.
The responsibilities of an MRO to
interpret results have largely remained
the same between the Guidelines
effective October 1, 2010 (73 FR 71858)
and these Guidelines. As stated in
Section 13.5(c) of these Guidelines, ‘‘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.’’ Accordingly, the intent of the
Guidelines, in this context, is to confirm
whether a positive drug test is the result
of drug use under a valid prescription.
Furthermore, the term ‘‘alternate
medical explanation’’ has never been
used in the Guidelines, but has been
used in the HHS Medical Review Officer
Manual for Federal Workplace Drug
Testing Programs.
For the reasons above, the Department
believes that the definition of
‘‘nonmedical use of a drug’’ and the
requirement for a physician serving as
an MRO to have knowledge of this topic
do not fundamentally change the MRO’s
responsibilities. However, to address the
commenters’ concerns, the Department
has removed this term from the
Guidelines (i.e., revised Sections 1.5
and 13.1).
The Department proposed within
Section 13.1 who may serve as an MRO.
One commenter requested clarification
that it is the federal agency’s burden to
ensure that the MRO is certified. One
commenter asked how the laboratory
will be informed that an MRO has met
requirements for re-qualification. The
Department evaluated the comments
and concluded that no change is
needed. The MRO is an employee or a
contractor of the agency. Therefore, it is
the agency’s responsibility to ensure
PO 00000
Frm 00010
Fmt 4701
Sfmt 4703
that the MRO meets the Guidelines
qualification requirements.
Two commenters disagreed with the
requirement for MRO recertification
every five years, and recommended that
MROs complete training every three
years. Five commenters stated support
for five year requalification and
examination requirements. The
Department has evaluated the comments
and has concluded that no change is
needed. The Department will keep the
five-year recertification requirement as
proposed.
13.2 How are nationally recognized
entities or subspecialty boards that
certify MROs approved?
One commenter agreed with MRO
certification/training entities submitting
the delivery method and content of the
MRO examination as applicable along
with other required documents. One
commenter agreed with extending time
from one to two years for approved
MRO certification/training entities’
resubmission of qualifications for HHS
approval. The commenter noted that
they would support further extension to
3 years. One commenter recommended
that approval of MRO educational
courses and content be at the discretion
of the MRO certification entities, not
HHS. Since the certification entities and
their examinations are subject to HHS
oversight and approval, the commenter
noted that it may be burdensome for
HHS to review and approve the courses
and content, and be a disincentive to
development of new courses. One
commenter recommended that
examinations be allowed to be in-person
or online with appropriate security
precautions for each delivery method.
The Department has evaluated the
comments and agrees that the
submission of training materials to HHS
would possibly discourage the
development of new training courses.
Therefore, the review of MRO
educational courses and content will
not be part of the approval process for
MRO certification entities. As described
under Medical Review Officer (MRO)
requalification—continuing education
units (CEUs) in this preamble, the
Department has removed references to
MRO training entities in Section 13.2,
because training documentation is
maintained by MRO certification
entities. The Department will only
require the MRO certification entities to
submit their examination and any other
necessary supporting examination
materials (e.g., answers, examination
statistics or background information on
questions) that will help in the
Department’s evaluation of the
examination. The Department will
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
mstockstill on DSK3G9T082PROD with NOTICES2
review and evaluate the examination
delivery method (e.g., in-person or
online) when reviewing submitted
training materials to ensure that the
delivery method employs appropriate
security and identification procedures.
13.3 What training is required before a
physician may serve as an MRO?
Five commenters disagreed and one
commenter agreed with the added
requirement for MRO training to include
information about how to discuss
substance misuse and abuse and how to
access those services. The Department
has evaluated the comments and has
revised Section 13.3 to remove this
requirement. Federal agencies may
provide this information to employees
and applicants to facilitate their access
to effective treatment and support
recovery. The Department provides
information to the public on help and
treatment for substance misuse and
abuse, and how to access those services,
on the SAMHSA Web site https://
www.samhsa.gov/.
One commenter stated that the
Department should add a requirement
for MRO training on what constitutes a
refusal to test. One commenter
suggested that the Department should
add a requirement for MRO training on
when and how to report safety concerns
to employers when prescription and/or
over-the-counter medications may affect
performance. The Department has
evaluated the comments and has
concluded that no change is needed.
Criteria for reporting a refusal to test are
covered under the topics listed in
Section 13.3 such as items (a)(4) training
on the Guidelines and (a)(5) procedures
for interpretation, review, and reporting
of results. When a donor provides a
legitimate medical explanation for a
positive drug test result (e.g., a valid
prescription), the Guidelines do not
require MROs to contact federal agency
employers for the purpose of reporting
a safety concern. Accordingly, MRO
training related to reporting ‘‘safety
concerns’’ does not relate to a
mandatory function under the
Guidelines and, therefore, is not an
essential component of required MRO
training. The Department will provide
additional guidance in the HHS Medical
Review Officer Guidance Manual for
Federal Workplace Drug Testing
Programs.
In addition, the Department revised
Section 13.3 as described under Medical
Review Officer (MRO) requalification—
continuing education units (CEUs) in
this preamble. The Department removed
references to MRO training entities,
because training documentation is
maintained by MRO certification
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
entities, and added item 13.3(b) to
require MRO training on revised
Guidelines prior to their effective date.
13.4 What are the responsibilities of an
MRO?
One commenter suggested creating a
subset of medical professionals trained
specifically to determine fitness for duty
since an MRO cannot determine fitness
for duty over the telephone. The
Department has evaluated the comment
and has concluded that no change is
needed. Fitness for duty evaluations fall
outside the purview of the Guidelines.
13.5 What must an MRO do when
reviewing a urine specimen’s test
results?
The Department has revised Section
13.5(d)(1) to include an example of
documentation to support a medical
explanation for a positive drug test
result.
Three commenters disagreed with
MRO procedures for ‘‘a positive result
for opiates’’ (i.e., requirement for
clinical evidence of illegal use in
addition to positive result) and noted
that the proposed Guidelines wording
was not changed to clarify that the
described procedures do not apply to
the added opioids. The Department
agrees with the commenters and has
revised Section 13.5(d) to clarify that
the procedures do not apply to the
added opioid analytes. Wording in
Section 13.5(d)(2)(i) regarding ‘‘clinical
evidence of illegal use’’ was also edited
for clarity and for consistency with the
wording in the OFMG.
One commenter disagreed with
requirements concerning two separate
specimens collected at a single test
event and sent to the laboratory for
testing (e.g., a urine specimen outside
the acceptable temperature range and
the subsequently collected specimen).
The proposed Guidelines require that,
when one of the two specimens is
negative and other is not, the MRO
reports only the verified result other
than negative. This commenter
suggested that the MRO cancel the
negative result. The Department has
evaluated the comments and has
concluded no change is needed.
Cancellation of the test may be
confusing in the situation referenced by
the commenter and lead to
inappropriate specimen recollection.
Both the MRO and the federal agency
employer will receive their Federal CCF
copies with explanatory collector
remarks in Step 2 including the
specimen identification number of the
associated specimen, and the MRO may
provide additional comment in the
MRO’s report.
PO 00000
Frm 00011
Fmt 4701
Sfmt 4703
7929
The Department also revised Section
13.5(d) to reflect the policy of the
Department that passive exposure to
marijuana smoke and ingestion of food
products containing marijuana are not
acceptable medical explanations for a
positive drug test result. Individuals
who are passively exposed to marijuana
smoke or who consume food products
containing marijuana can pose public
safety and/or security risks.4 5 Marijuana
is listed as a Schedule I drug under the
Controlled Substances Act.
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?
One commenter suggested the
Guidelines define ‘‘appropriate
expertise’’ of a physician with a list of
conditions and an appropriate type of
physician in an appendix. The same
commenter requested medical referral
information on the employer’s actions
when a donor could not provide a urine
specimen and then could not provide an
oral fluid specimen. The Department
has evaluated the comments and has
concluded that no change is needed. A
physician who is a trained MRO will
have the knowledge necessary to
identify another physician with
appropriate expertise for the medical
evaluation. The Department will
provide additional guidance in the HHS
Medical Review Officer Guidance
Manual for Federal Workplace Drug
Testing Programs as appropriate when
alternate specimen types (e.g., oral
fluid) are allowed in federal workplace
drug testing programs.
The Department clarified the
definition of ‘‘permanent or long-term
medical conditions’’ in Section
13.6(b)(1) based on a federal agency
comment.
Subpart O—Criteria for Rejecting a
Specimen for Testing
15.1 What discrepancies require an
HHS-certified laboratory or an HHScertified IITF to report a specimen as
rejected for testing?
The Department revised wording in
items a and b of this section, and
included three additional fatal flaws as
items f–h, to reflect fatal flaws for
regulated donor specimens that have
been identified by HHS-certified
laboratories. These fatal flaws were
addressed in NLCP guidance sent to all
HHS-certified and applicant laboratories
and IITFs on August 9, 2016. In
addition, the Department revised this
section to include an additional item i
to allow a laboratory or IITF to reject a
specimen when they identify a flaw that
E:\FR\FM\23JAN2.SGM
23JAN2
7930
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
mstockstill on DSK3G9T082PROD with NOTICES2
prevents testing or affects the forensic
defensibility of the drug test, and cannot
be corrected. This general item enables
laboratories and IITFs to reject
specimens with fatal flaws that may be
rare, but do occur. It is not possible to
list all such flaws in the Guidelines.
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?
Two commenters indicated that
inclusion of some items as insignificant
discrepancies contradicts guidance
provided to HHS-certified laboratories
and IITFs in NLCP Notices, which
required laboratories to attempt to
recover missing information. One of
these commenters suggested that if these
items are important, they should be
removed from the ‘‘insignificant’’ list.
Two commenters disagreed with the
Guidelines designating the listed
omissions and discrepancies as
‘‘insignificant only when they occur no
more than once per month.’’ The
Department has evaluated the
comments. The listed discrepancies
would not result in rejection or
cancellation. NLCP Notices requiring
laboratory action are consistent with
this section. However, the Department
has reworded section 15.3 to not classify
these errors as insignificant. While these
types of errors do not warrant laboratory
rejection of a specimen or MRO
cancellation of a test, as noted in section
15.3(c), corrective action must be
initiated when they occur more than
once a month.
The commenters indicated that this
section implies that the MRO must keep
a log of insignificant errors by laboratory
and by collection site in order to track
frequency. The commenters noted that
this is an unenforceable policy, that this
should be a duty of inspectors of
laboratories and collection sites, and
that requiring MROs to keep these types
of logs would create significant extra
costs. One commenter suggested that
item 15.3(c) be modified for the MRO to
advise the collector or laboratory to
retrain staff on relevant procedures to
ensure that collections are completed
correctly (rather than directing them to
immediately take corrective action). The
Department has evaluated the comments
and has concluded that no change is
needed. This section is the same as in
the Guidelines effective October 1, 2010
(73 FR 71858).
One commenter suggested modifying
15.3(a)(5) to read ‘‘donor identification
number’’ which would include a social
security number or an employee
identification number since many
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
employers no longer use social security
numbers for employee identification.
The Department agrees and has revised
Section 15.3(a)(5) to include ‘‘employee
identification number’’ in addition to
‘‘Social Security Number.’’.
15.4 What discrepancies may require
an MRO to cancel a test?
One commenter suggested adding the
scenario where the donor did not sign
the CCF because the collector forgot to
ask the donor to sign, rather than the
donor’s refusal to sign. The Department
has evaluated the comment and has
concluded that no change is needed. As
stated in Section 15.4, the MRO contacts
the collector ‘‘to obtain a statement to
verify that the donor refused to sign the
MRO copy.’’
Regulatory Impact and Notices
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 presents a
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 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 Guidelines do establish
PO 00000
Frm 00012
Fmt 4701
Sfmt 4703
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:
(3) 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.
The Department included a
Regulatory Impact and Notices section
with cost and benefits analysis and
burden estimates in the May 15, 2015
Federal Register Notice for the
proposed UrMG (80 FR 28101), and
requested public comment on all figures
and assumptions. The Department’s
projections were developed using
information from current HHS-certified
urine testing laboratories, with input
from DOT and the Nuclear Regulatory
Commission (NRC), and cost analysis
was based on information provided by
multiple HHS-certified laboratories and
MROs. The Department received no
substantive data or evidence through
public comments in favor of changing
the estimated costs and benefits
provided in the Department’s May 2015
Federal Register Notice for the UrMG,
and therefore, has retained the analysis
and estimates provided in that notice
below. Comments that related to the
costs and benefits of this rule are
summarized and discussed above in the
Summary of Public Comments and
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
HHS’s Response under the heading
Costs and Benefits.
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.
mstockstill on DSK3G9T082PROD with NOTICES2
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 since the
current immunoassays can be adapted
to test for this analyte. 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
included criteria for calibrating initial
tests for grouped analytes such as
opiates and amphetamines, and
specified the cross-reactivity of the
immunoassay to the other analytes(s)
VerDate Sep<11>2014
19:32 Jan 19, 2017
Jkt 241001
within the group. These Guidelines
allow the use of methods other than
immunoassay for initial testing. 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 is 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 lowestreacting 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 deidentified 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
PO 00000
Frm 00013
Fmt 4701
Sfmt 4703
7931
$0.10 per submitted specimen. This
would indicate that the cost per
specimen submitted for testing will
increase by $0.11–$0.30. Annual
recurring testing costs in the table below
are based on an estimated number of
6,145,500 specimens.
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%. The burden of this
3% cost increase is expected to shift
gradually from MROs to agencies 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 of $3,687,300 to
$8,296,425 in the urine testing program.
A federal agency may also incur
additional costs (e.g., additional
managerial effort to arrange substitute
workers) when an employee tests
positive for a prescription medication
and is removed from duties during the
MRO verification process.
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 oneday training session would be between
$108,000 and $138,000 (i.e., assuming 8
hours of time multiplied by a GS 12/13
wage including benefits and overhead
adjustments). The Department will offer
the choice of online or in-person
training. This will eliminate travel costs
for those federal agencies who choose to
use online training.
E:\FR\FM\23JAN2.SGM
23JAN2
7932
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
RECURRING ANNUAL COSTS SUMMARY TABLE
Lower bound
Upper bound
Reagent Costs .............................................................................................................................................
Additional Confirmatory tests .......................................................................................................................
MRO Costs ..................................................................................................................................................
$368,730.00
307,275.00
3,687,300.00
$1,229,100.00
614,550.00
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 ...................................................................................................................................
Training ........................................................................................................................................................
$27,900.00
108,000
$55,800.00
138,000
Total ......................................................................................................................................................
135,900.00
193,800.00
mstockstill on DSK3G9T082PROD with NOTICES2
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
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, a final
regulatory flexibility analysis is not
required for this notice.
The Secretary has determined that the
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
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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 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
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
Guidelines in accordance with
Executive Order 13132: Federalism.
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,
PO 00000
Frm 00014
Fmt 4701
Sfmt 4703
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 revised
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 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
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
quality control documentation, reports,
performance testing, and inspections as
set out in subparts H, I, K, L, M and N.
Information collection and
recordkeeping requirements which
would be imposed on MROs engaged in
drug testing services for federal agencies
concern drug testing result review and
reports as set out in subparts 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 will submit the information
collection and recordkeeping
requirements contained in the
Guidelines to OMB for review and
approval prior to the effective date of
the final Guidelines. Information
collections changed by these Guidelines
are not effective until approved by
OMB.
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 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
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 (73 FR 71858) 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
7933
Information Checklist, and
recordkeeping requirements in the
current Guidelines, as approved under
control number 0930–0158, will remain
in effect until these final Guidelines are
effective and OMB approves the revised
information collection. OMB will assign
a new control number to account for
changes associated with the final
Guidelines.
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, 1
IITF, and 100 MROs.
ESTIMATE OF ANNUAL REPORTING BURDEN
Number of
respondents
Section
Purpose
9.2(a)(1) ..........................
Laboratory or IITF 1 required to submit application
for certification.
Materials to submit to become an HHS inspector
Laboratory submits qualifications of RP to HHS ..
Laboratory submits information to HHS on new
RP or alternate RP.
Specifications for laboratory semi-annual statistical report of test results to each federal agency.
IITF1 submits qualifications of RT to HHS ............
IITF1 submits information to HHS on new RT or
alternate RT.
Specifications for IITF 1 semi-annual statistical report of test results to each federal agency.
mstockstill on DSK3G9T082PROD with NOTICES2
9.12(a)(3) ........................
11.3(a) ............................
11.4(c) ............................
11.22 ..............................
12.3(a) ............................
12.4(c) ............................
12.19 ..............................
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
PO 00000
Frm 00015
Fmt 4701
Sfmt 4703
Responses/
respondent
Hours/
response
Total hours
10
1
3 ..................
30
10
10
10
1
1
1
2 ..................
2 ..................
2 ..................
20
20
20
10
5
0.5 ...............
25
1
1
1
1
1 ..................
1 ..................
1
1
1
1
1 ..................
1
E:\FR\FM\23JAN2.SGM
23JAN2
7934
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
ESTIMATE OF ANNUAL REPORTING BURDEN—Continued
Number of
respondents
Responses/
respondent
Hours/
response
Section
Purpose
13.9 and 14.7 .................
100
14
1
1
3 ..................
3
1
1
0.5 ...............
0.5
1
1
0.5 ...............
0.5
1
1
50 ................
50
1
1
3 ..................
3
16.9(c) ............................
Specifies that MRO must report all verified primary and split specimen test results to the federal agency.
Specifies content of request for informal review of
suspension/proposed revocation of certification.
Specifies information appellant provides in first
written submission when laboratory suspension/revocation is proposed.
Requires appellant to notify reviewing official of
resolution status at end of abeyance period.
Specifies contents of appellant submission for review.
Specifies content of appellant request for expedited review of suspension or proposed revocation.
Specifies contents of review file and briefs ..........
1
1
50 ................
50
Total ........................
................................................................................
159
........................
.....................
295
16.1(b) & 16.5(a) ............
16.4 ................................
16.6 ................................
16.7(a) ............................
16.9(a) ............................
0.05 (3 min)
Total hours
70
1 Although
IITFs are allowed under the Guidelines effective October 1, 2010 (73 FR 71858), SAMHSA has not received any IITF applications
for certification to test federally regulated specimens. IITF numbers are provided in this analysis as placeholders for administrative purposes.
[Section 10.3(a)]; MRO notifies the
federal agency and HHS when an error
occurs on a blind sample [Section
10.4(c)]; Section 13.5 describes the
actions an MRO takes to report a
primary specimen result; Section 14.6
describes the actions an MRO takes to
report a split specimen result; and
Sections 13.6 and 13.7 describe the
The following reporting requirements
are also in the 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
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.
ESTIMATE OF ANNUAL DISCLOSURE BURDEN
Number of
respondents
Responses/
respondent
Hours/
response
Section
Purpose
8.3(a), 8.5(f)(2) (iii),
8.6(b)(2).
11.23, 11.24 ...................
Collector must contact federal agency point of
contact.
Information on drug test that laboratory must provide to federal agency upon request or to
donor through MRO.
Information on drug test that IITF1 must provide
to federal agency upon request or to donor
through MRO.
MRO must inform donor of right to request split
specimen test when a positive, adulterated, or
substituted result is reported.
100
1
50
10
3 ..................
1,500
1
1
1 ..................
1
100
14
3 ..................
4,200
................................................................................
211
........................
.....................
5,706
12.20, 12.21 ...................
13.8(b) ............................
Total ........................
Total hours
0.05 (3 min)
5
1 Although
IITFs are allowed under the Guidelines effective October 1, 2010 (73 FR 71858), SAMHSA has not certified any IITFs to test federally regulated specimens. IITF numbers are provided in this analysis as placeholders for administrative purposes.
mstockstill on DSK3G9T082PROD with NOTICES2
The following disclosure
requirements are also included in the
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
respondents
Section
Purpose
8.3, 8.5, 8.8 ....................
Collector completes Federal CCF for specimen
collected.
Donor initials specimen labels/seals and signs
statement on the Federal CCF.
8.8(d) & (f) ......................
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
PO 00000
Frm 00016
Fmt 4701
Sfmt 4703
Responses/
respondent
Hours/
response
Total hours
100
380
0.07 (4 min)
2,534
38,000
1
0.08 (5 min)
3,167
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
7935
ESTIMATE OF ANNUAL RECORDKEEPING BURDEN—Continued
Number of
respondents
Section
Purpose
11.8(a) & 11.19 ..............
Laboratory completes Federal CCF upon receipt
of specimen and before reporting result.
IITF1 completes Federal CCF upon receipt of
specimen and before reporting result.
MRO completes Federal CCF before reporting
the primary or split specimen result.
MRO documents donor’s request to have split
specimen tested.
12.8(a) & 12.15 ..............
13.4(d)(4),13.9(c),14.7(c)
14.1(b) ............................
Total ...............................
................................................................................
Responses/
respondent
Hours/
response
Total hours
10
3,800
0.05 (3 min)
1,900
1
1
100
380
0.05 (3 min)
1,900
300
1
0.05 (3 min)
15
38,511
........................
1 ..................
.....................
1
9,517
1 Although
mstockstill on DSK3G9T082PROD with NOTICES2
IITFs are allowed under the Guidelines effective October 1, 2010 (73 FR 71858), SAMHSA has not certified any IITFs to test federally regulated specimens. IITF numbers are provided in this analysis as placeholders for administrative purposes.
The 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)]. Because this is required by the
current Guidelines and is consistent
with general forensic requirements,
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
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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 15,518 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
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 submitted a copy of
these proposed Guidelines to OMB for
its review. Comments on the
information collection requirements
were 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.
metabolism and excretion patterns of
hydrocodone in urine following
controlled single dose administration. J.
Anal. Toxicol, 37, 486–494.
3. Esposito, F.M., Mitchell, J.M., Baylor,
M.R., Bush, D.M, 2006. Influence of basic
pH on federal regulated drugs in urine at
room temperature. Poster presented at
the Society of Forensic Toxicologists
(SOFT) Annual Meeting, Austin, TX.
October 2006.
4. Cone, E.J., Bigelow, G.E., Herrmann, E.S.,
Mitchell, J.M., LoDico, C., Flegel, R.,
Vandrey, R, 2015. Nonsmoker exposure
to secondhand cannabis smoke. III. oral
fluid and blood concentrations and
corresponding subjective effects. J. Anal.
Toxicol, 39, 497–509.
5. Hermann, E.S, Cone, E.J., Mitchell, J.M.,
Bigelow, G.E., LoDico, C., Flegel, R.,
Vandrey, R., 2016. Non-smoker exposure
to secondhand cannabis smoke II: Effect
of room ventilation on the physiological,
subjective, and behavioral/cognitive
effects. Drug alcohol depend, 151, 194–
202.
References
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. Cone, E.J., Heltsley, R., Black, D.L.,
Mitchell, J.M., LoDico, C.P., Flegel, R.R,
2013. Prescription opioids. I. metabolism
and excretion patterns of oxycodone in
urine following controlled single dose
administration. J. Anal. Toxicol, 37, 255–
264.
2. Cone, E.J., Heltsley. R., Black, D.L.,
Mitchell, J.M., LoDico, C.P., Flegel, R.R,
2013. Prescription opioids. II.
PO 00000
Frm 00017
Fmt 4701
Sfmt 4703
Dated: January 11, 2017.
Kana Enomoto,
Acting Deputy Assistant Secretary for Mental
Health and Substance Use, SAMHSA.
Dated: January 11, 2017.
Sylvia M. Burwell
Secretary.
The Mandatory Guidelines using
Urine Specimens as revised are hereby
adopted in accordance with section 503
of Public Law 100–71 and Executive
Order 12564.
Mandatory Guidelines for Federal
Workplace Drug Testing Programs
Using Urine Specimens
E:\FR\FM\23JAN2.SGM
23JAN2
7936
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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
2.1
2.2
2.3
2.4
2.5
2.6
What type of specimen may be
collected?
Under what circumstances may a urine
specimen be collected?
How is each urine specimen collected?
What volume of urine is collected?
How does the collector split the urine
specimen?
When may an entity or individual
release a urine specimen?
Subpart C—Urine Specimen Tests
3.1
3.2
3.3
3.4
3.5
3.6
3.7
3.8
3.9
Which tests are conducted on a urine
specimen?
May a specimen be tested for additional
drugs?
May any of the specimens be used for
other purposes?
What are the drug test cutoff
concentrations for urine?
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)?
What criteria are used to report a urine
specimen as adulterated?
What criteria are used to report a urine
specimen as substituted?
What criteria are used to report a urine
specimen as dilute?
What criteria are used to report an
invalid result for a urine specimen?
mstockstill on DSK3G9T082PROD with NOTICES2
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 OMBapproved Federal CCF is not available or
is not used?
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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 they are 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
PO 00000
Frm 00018
Fmt 4701
Sfmt 4703
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 HHScertified 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 HHScertified 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 HHScertified 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
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
mstockstill on DSK3G9T082PROD with NOTICES2
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
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 HHScertified 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 HHScertified 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?
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
7937
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?
IITF to report a specimen as rejected for
testing?
15.2 What discrepancies require an HHScertified 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 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/preemployment 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 HHScertified IITF?
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 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?
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
Subpart O—Criteria for Rejecting a
Specimen for Testing
15.1 What discrepancies require an HHScertified laboratory or an HHS-certified
PO 00000
Frm 00019
Fmt 4701
Sfmt 4703
Subpart A—Applicability
E:\FR\FM\23JAN2.SGM
23JAN2
7938
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
(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
system, such as arrestees, detainees,
probationers, incarcerated persons, or
parolees.1
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
revised?
How are these Guidelines
mstockstill on DSK3G9T082PROD with NOTICES2
(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.
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 NRCregulated 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.
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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 HHScertified 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 HHScertified 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 HHScertified 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
PO 00000
Frm 00020
Fmt 4701
Sfmt 4703
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 HHScertified 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.
External Service Provider. An
independent entity that performs
services related to federal workplace
drug testing on behalf of a federal
agency, a collector/collection site, an
E:\FR\FM\23JAN2.SGM
23JAN2
mstockstill on DSK3G9T082PROD with NOTICES2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
HHS-certified laboratory, a Medical
Review Officer (MRO), or, for urine, an
HHS-certified Instrumented Initial Test
Facility (IITF).
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,
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.
Gender Identity. Gender identity
means an individual’s internal sense of
being male or female, which may be
different from an individual’s sex
assigned at birth.
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 in
accordance with the criteria established
in Section 3.9 when a positive, negative,
adulterated, or substituted result cannot
be established for a specific drug or
specimen validity test.
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
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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.
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 HHScertified laboratory.
Responsible Technician (RT). The
person who assumes professional,
organizational, educational, and
administrative responsibility for the
day-to-day management of an HHScertified 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.
PO 00000
Frm 00021
Fmt 4701
Sfmt 4703
7939
Specimen. Fluid or material 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.
The Health Insurance Portability and
Accountability Act of 1996 (HIPAA)
Privacy Rule (Rule), 45 CFR parts 160
and 164, Subparts A and E, may be
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
E:\FR\FM\23JAN2.SGM
23JAN2
mstockstill on DSK3G9T082PROD with NOTICES2
7940
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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 preemployment test as described in section
8.4(a);
(3) Fail to provide a specimen (e.g.,
urine or another authorized specimen
type) for any drug test required by these
Guidelines or federal agency regulations
with the exception of a donor who
leaves the collection site before the
collection process begins for a preemployment test as described in section
8.4(a);
(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 13.6;
(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/preemployment 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) Bring materials to the collection
site for the purpose of adulterating,
substituting, or diluting the specimen;
(11) Attempt to adulterate, substitute,
or dilute the specimen;
(12) Possess or wear a prosthetic or
other device that could be used to
interfere with the collection process; or
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
(13) Admit to the collector or MRO
that you have adulterated or 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, including failing to appear in a
reasonable time for any test except a
pre-employment test as described in
Section 1.7(a)(1), the collector must
terminate the collection process and
take action as described in Section 8.13.
Required action includes immediately
notifying 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 and, if a
Federal CCF has been initiated,
documenting the refusal on the Federal
CCF, signing and dating the Federal
CCF, and sending 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/Preemployment test;
(b) Random test;
(c) Reasonable suspicion/cause test;
(d) Post accident test;
(e) Return to duty test; or
(f) Follow-up test.
PO 00000
Frm 00022
Fmt 4701
Sfmt 4703
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
collected?
What volume of urine is
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 opioids, 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., nonrecovery of internal standard, unusual
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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 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.
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.
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
7941
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
cutoff concentration
Initial test analyte
Initial test cutoff 1
Confirmatory test analyte
Marijuana metabolites (THCA) 2 ....
Cocaine
metabolite
(Benzoylecgonine).
Codeine/Morphine ..........................
50 ng/mL 3 ....................................
150 ng/mL 3 ..................................
THCA ............................................
Benzoylecgonine ..........................
15 ng/mL.
100 ng/mL.
2,000 ng/mL ..................................
Hydrocodone/Hydromorphone .......
300 ng/mL .....................................
Oxycodone/Oxymorphone .............
100 ng/mL .....................................
6-Acetylmorphine ...........................
Phencyclidine .................................
Amphetamine/Methamphetamine ..
10 ng/mL .......................................
25 ng/mL .......................................
500 ng/mL .....................................
MDMA 4/MDA 5 ...............................
500 ng/mL .....................................
Codeine ........................................
Morphine .......................................
Hydrocodone ................................
Hydromorphone ............................
Oxycodone ....................................
Oxymorphone ...............................
6-Acetylmorphine ..........................
Phencyclidine ................................
Amphetamine ................................
Methamphetamine ........................
MDMA ...........................................
MDA ..............................................
2,000 ng/mL.
2,000 ng/mL.
100 ng/mL.
100 ng/mL.
100 ng/mL.
100 ng/mL.
10 ng/mL.
25 ng/mL.
250 ng/mL.
250 ng/mL.
250 ng/mL.
250 ng/mL.
1 For
grouped analytes (i.e., two or more analytes that are in the same drug class and have the same initial test cutoff):
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.
2 An immunoassay must be calibrated with the target analyte, D-9-tetrahydrocannabinol-9-carboxylic acid (THCA).
3 Alternate technology (THCA and benzoylecgonine): The confirmatory test cutoff must be used for an alternate technology initial test that is
specific for the target analyte (i.e., 15 ng/mL for THCA, 100 ng/mL for benzoylecgonine).
4 Methylenedioxymethamphetamine (MDMA).
5 Methylenedioxyamphetamine (MDA).
mstockstill on DSK3G9T082PROD with NOTICES2
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 on a caseby-case basis as necessary to provide
information that the MRO would use to
report a verified drug test result (e.g.,
tetrahydrocannabivarin, specimen
validity tests using biomarkers). An
HHS-certified laboratory is not
authorized to routinely perform
additional drug and/or specimen
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
validity tests at the request of an MRO
without prior authorization from the
Secretary or designated HHS
representative, with the exception of the
determination of D,L stereoisomers of
amphetamine and methamphetamine.
All tests must meet appropriate
validation and quality control
requirements in accordance with these
Guidelines.
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:
PO 00000
Frm 00023
Fmt 4701
Sfmt 4703
(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., multiwavelength spectrophotometry, ion
chromatography, capillary
electrophoresis) on the second aliquot;
E:\FR\FM\23JAN2.SGM
23JAN2
mstockstill on DSK3G9T082PROD with NOTICES2
7942
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
(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 nitriteequivalent 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., multiwavelength 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
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 nitriteequivalent 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
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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 20 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
PO 00000
Frm 00024
Fmt 4701
Sfmt 4703
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 nitriteequivalent 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
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
the second test on two separate aliquots
or a foam/shake test for the initial test;
(i) Interference occurs on the 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 for both the initial
(first) test and the second test on two
separate aliquots.
Subpart D—Collectors
Section 4.1
specimen?
Who may collect a
(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.
The hiring official must be a trained
collector.
mstockstill on DSK3G9T082PROD with NOTICES2
Section 4.2
specimen?
Who may not collect a
(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 their own
drug testing specimen.
(c) An employee working for an HHScertified 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).
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
Section 4.3 What are the requirements
to be a collector?
(a) An individual may serve as a
collector if they fulfill 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 scenario, 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 their training and
provide that documentation to a federal
agency when requested.
(d) An individual may not collect
specimens for a federal agency until the
individual’s training as a collector has
been properly documented.
PO 00000
Frm 00025
Fmt 4701
Sfmt 4703
7943
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 gender of the observer must be
the same as the donor’s gender, which
is determined by the donor’s gender
identity. The observer selection process
is described in Section 8.10(b).
(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 the
trainer’s training and provide that
documentation to a federal agency when
requested.
E:\FR\FM\23JAN2.SGM
23JAN2
7944
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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 selfemployed, 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 agencydesignated 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 8.12.
mstockstill on DSK3G9T082PROD with NOTICES2
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;
(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.
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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 6
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.
PO 00000
Frm 00026
Fmt 4701
Sfmt 4703
Section 6.2 What happens if the
correct OMB-approved Federal CCF is
not available or is not used?
(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 does not use the
correct OMB-approved Federal CCF, 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 the collector used an incorrect
form, 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 laboratory or IITF reports
a rejected for testing result to the MRO
and the MRO cancels the test. The HHScertified laboratory or IITF must wait at
least 5 business days while attempting
to obtain the memorandum before
reporting a rejected for testing result to
the MRO.
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.
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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 °C/90–100 °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.
mstockstill on DSK3G9T082PROD with NOTICES2
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
gender of the observer for purposes of a
direct observed collection (i.e., as
described in Section 8.10) must be the
same as the donor’s gender, which is
determined by the donor’s gender
identity. The gender of the monitor for
a monitored collection (i.e., as described
in Section 8.12) must be the same as the
donor’s gender, 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
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:
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
(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 they are
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
PO 00000
Frm 00027
Fmt 4701
Sfmt 4703
7945
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 the
donor’s wallet.
(2) The collector asks the donor to
empty the donor’s pockets and display
the contents to ensure no items are
present 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 the donor’s 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,
substitute, or dilute the specimen, 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. 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 the donor’s
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 the donor’s
hands prior to urination. After washing
the donor’s 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 the
donor’s 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 the specimen in the privacy
of a stall or otherwise partitioned area
that allows for individual privacy. The
collector directs the donor to provide a
E:\FR\FM\23JAN2.SGM
23JAN2
7946
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
mstockstill on DSK3G9T082PROD with NOTICES2
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 8.12),
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 report a refusal to test in
accordance with Section 8.13.
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 the donor’s 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
temperature is in the acceptable range of
32 °–38 °C/90 °–100 °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 °–38 °C/90 °–
100 °F, that is a reason to believe that
the donor may have adulterated or
substituted the specimen. Another
specimen must be collected under direct
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
observation in accordance with Section
8.9. The collector must 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 for each
specimen.
(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 HHScertified 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 must 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 for each
specimen.
(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
PO 00000
Frm 00028
Fmt 4701
Sfmt 4703
Federal CCF to the MRO and to the
federal agency’s designated
representative. The federal agency may
choose to provide the collection site
with a standard protocol to follow in
lieu of requiring the collector to notify
the agency’s designated representative
for authorization in each case. 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 they are
unable to provide a urine specimen?
(a) If the donor states that they are
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 their
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 they 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 they are
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. The federal
agency may choose to provide the
collection site with a standard protocol
to follow in lieu of requiring the
collector to notify the agency’s
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
designated representative for
authorization in each case. 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.
mstockstill on DSK3G9T082PROD with NOTICES2
Section 8.7 If the donor is unable to
provide a urine specimen, may another
specimen type be collected for testing?
Yes, if 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 the
donor. 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 their
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 HHScertified laboratory or IITF that will be
testing the Bottle A urine specimen.
(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
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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; or
(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).
(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) 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’s
gender must be the same as the donor’s
PO 00000
Frm 00029
Fmt 4701
Sfmt 4703
7947
gender, which is determined by the
donor’s gender identity, with no
exception to this requirement.
(b) Before an observer is selected, the
collector informs the donor that the
gender of the observer will match the
donor’s gender, which is determined by
the donor’s gender identity (as defined
in Section 1.5). The collector then
selects the observer to conduct the
observation:
(i) The collector asks the donor to
identify the donor’s gender on the
Federal CCF and initial it.
(ii) The donor will then be provided
an observer whose gender matches the
donor’s gender.
(iii) The collector documents the
observer’s name and gender on the
Federal CCF.
(c) If there is no collector available of
the same gender as the donor’s gender,
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.
(d) 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:
(1) The observer enters the restroom
with the donor;
(2) 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);
(3) The observer must not touch or
handle the collection container unless
the observer is also serving as the
collector;
(4) After the donor has completed
urinating into the collection container:
(i) If the same person serves as the
observer and collector, that person may
receive the collection container from the
donor while they are both in the
restroom;
(ii) 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.
(5) 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
(6) The collector then continues with
the routine collection procedure in
Section 8.3.
E:\FR\FM\23JAN2.SGM
23JAN2
7948
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
mstockstill on DSK3G9T082PROD with NOTICES2
Section 8.11 When is a monitored
collection conducted?
(a) In the event that an agencydesignated 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
same procedures used for selecting an
observer of the appropriate gender in
Section 8.10(b) must be used to select
the monitor for the purposes of Section
8.12, unless the monitor is a medical
professional as described above. 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, that person may
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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.
(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 selfassessment (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.
PO 00000
Frm 00030
Fmt 4701
Sfmt 4703
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 HHScertified 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 HHScertified 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 HHScertified?
(a) A laboratory or IITF seeking HHS
certification must:
(1) Submit a completed OMBapproved 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.
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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.
mstockstill on DSK3G9T082PROD with NOTICES2
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 HHScertification.
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 as low as 40 percent
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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
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
PO 00000
Frm 00031
Fmt 4701
Sfmt 4703
7949
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.
E:\FR\FM\23JAN2.SGM
23JAN2
mstockstill on DSK3G9T082PROD with NOTICES2
7950
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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;
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
(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
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
PO 00000
Frm 00032
Fmt 4701
Sfmt 4703
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.
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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 HHScertified laboratory or IITF must
continue to satisfy the minimum
requirements as stated in these
Guidelines.
Section 9.12 Who can inspect an HHScertified laboratory or IITF and when
may the inspection be conducted?
mstockstill on DSK3G9T082PROD with NOTICES2
(a) An individual may be selected as
an inspector for the Secretary if they
satisfy the following criteria:
(1) Has experience and an educational
background similar to that required for
either a responsible person or a
certifying scientist for an HHS-certified
laboratory as described in Subpart K or
as a responsible technician for an HHScertified IITF 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 HHScertified 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.
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
Section 9.14 What happens if an HHScertified 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.
(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 HHScertified 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
PO 00000
Frm 00033
Fmt 4701
Sfmt 4703
7951
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
E:\FR\FM\23JAN2.SGM
23JAN2
7952
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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 HHScertified 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 HHScertified 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
mstockstill on DSK3G9T082PROD with NOTICES2
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
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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.
(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
as a split specimen (specimens A and B)
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/
PO 00000
Frm 00034
Fmt 4701
Sfmt 4703
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:
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
(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.
mstockstill on DSK3G9T082PROD with NOTICES2
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
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
7953
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;
(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.
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 11.4 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
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
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.
PO 00000
Frm 00035
Fmt 4701
Sfmt 4703
E:\FR\FM\23JAN2.SGM
23JAN2
7954
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
(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 they are permitted to
work independently with federally
regulated specimens. All training must
be documented.
mstockstill on DSK3G9T082PROD with NOTICES2
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
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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.
(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 HHScertified 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:
PO 00000
Frm 00036
Fmt 4701
Sfmt 4703
(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 HHScertified 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 reverify 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;
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
(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 invalid, adulterated, or
substituted specimen validity test result
must be based on an initial specimen
validity test on one aliquot and a
confirmatory specimen validity 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 HHScertified 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.
mstockstill on DSK3G9T082PROD with NOTICES2
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.
(3) 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.
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
(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;
(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;
PO 00000
Frm 00037
Fmt 4701
Sfmt 4703
7955
(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
E:\FR\FM\23JAN2.SGM
23JAN2
7956
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
mstockstill on DSK3G9T082PROD with NOTICES2
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., multiwavelength 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)
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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 nitriteequivalent 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., multiwavelength 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;
(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 nitriteequivalent 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
PO 00000
Frm 00038
Fmt 4701
Sfmt 4703
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 HHScertified 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
E:\FR\FM\23JAN2.SGM
23JAN2
mstockstill on DSK3G9T082PROD with NOTICES2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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 nitriteequivalent 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).
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
(i) An HHS-certified laboratory shall
reject a primary (A) 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
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
PO 00000
Frm 00039
Fmt 4701
Sfmt 4703
7957
a legible image or copy of the completed
Federal CCF.
Section 11.20 How long must an HHScertified 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 1
year.
(b) Retained specimens must be kept
in secured frozen storage (¥20 °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 1-year period.
Section 11.21 How long must an HHScertified laboratory retain records?
(a) An HHS-certified laboratory must
retain all records generated to support
test results for at least 2 years. The
laboratory may convert hardcopy
records to electronic records for storage
and then discard the hardcopy records
after 6 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 2-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;
E:\FR\FM\23JAN2.SGM
23JAN2
7958
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
(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.
mstockstill on DSK3G9T082PROD with NOTICES2
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 HHScertified laboratory’s initial drug and
specimen validity testing procedures,
instrumentation, and batch quality
control requirements;
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
(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 HHScertified 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 resume 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 the employee’s
drug 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 HHScertified 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.
PO 00000
Frm 00040
Fmt 4701
Sfmt 4703
Section 11.26 What type of
relationship can exist between an HHScertified laboratory and an HHScertified IITF?
An HHS-certified laboratory can enter
into any relationship with an HHScertified 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
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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.
mstockstill on DSK3G9T082PROD with NOTICES2
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.
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
(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
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.
PO 00000
Frm 00041
Fmt 4701
Sfmt 4703
7959
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 they are 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.
E:\FR\FM\23JAN2.SGM
23JAN2
7960
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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.
mstockstill on DSK3G9T082PROD with NOTICES2
Section 12.10 What must an HHScertified 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.
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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 HHScertified 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:
(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
than1.003) or dilute (equal to or greater
than1.002 and less than1.003).
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:
PO 00000
Frm 00042
Fmt 4701
Sfmt 4703
(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
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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 computergenerated 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 HHScertified 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.
mstockstill on DSK3G9T082PROD with NOTICES2
Section 12.17 How long must an HHScertified IITF retain a specimen?
A specimen that is negative, negative/
dilute, or rejected for testing is
discarded.
Section 12.18 How long must an HHScertified 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
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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;
(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 drugtesting 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
PO 00000
Frm 00043
Fmt 4701
Sfmt 4703
7961
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 HHScertified 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 resume 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 the employee’s 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 HHScertified 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 HHScertified IITF that may be construed as
a potential conflict of interest.
E:\FR\FM\23JAN2.SGM
23JAN2
7962
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
Section 12.23 What type of
relationship can exist between an HHScertified 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
MRO?
Who may serve as an
(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;
(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 from
initial certification, 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.
mstockstill on DSK3G9T082PROD with NOTICES2
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
physicians as MROs for federal
workplace drug testing programs must
submit their qualifications, a sample
examination, and other necessary
supporting examination materials (e.g.,
answers, previous examination statistics
or other background examination
information, if requested). Approval
will be based on an objective review of
qualifications that include a copy of the
MRO applicant application form,
documentation that the continuing
education courses are accredited by a
professional organization, and the
delivery method and content of the
examination. Each approved MRO
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://
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
www.samhsa.gov/workplace/drugtesting.
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; and
(5) Procedures for interpretation,
review (e.g., donor interview for
legitimate medical explanations, review
of documentation provided by the donor
to support a legitimate medical
explanation), and reporting of results
specified by any federal agency for
which the individual may serve as an
MRO;
(b) Certified MROs must complete
training on any revisions to these
Guidelines prior to their effective date,
to continue serving as an MRO for
federal agency specimens.
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
PO 00000
Frm 00044
Fmt 4701
Sfmt 4703
(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 (f) 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 (f) 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
documentation (e.g., a valid
E:\FR\FM\23JAN2.SGM
23JAN2
mstockstill on DSK3G9T082PROD with NOTICES2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
prescription) to support 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
13.5(b)(1) or (2) for the recollected
specimen.
(i) Passive exposure to marijuana
smoke is not a legitimate medical
explanation for a positive THCA result.
(ii) Ingestion of food products
containing marijuana is not a legitimate
medical explanation for a positive
THCA result.
(2) If the donor is unable to provide
a legitimate medical explanation, the
MRO reports a positive result to the
agency for all drugs except codeine and/
or morphine (see below). If the
laboratory also reports that the urine
specimen is dilute, the MRO may
choose not to report the dilute result.
(i) For codeine and/or morphine less
than 15,000 ng/mL and no legitimate
medical explanation: the MRO must
determine if there is clinical evidence of
illegal use (in addition to the test result)
to report a positive result to the agency.
If there is no clinical evidence of illegal
use, the MRO reports a negative result
to the agency. However, this
requirement does not apply if the
laboratory confirms the presence of 6acetylmorphine (i.e., the presence of
this metabolite is proof of heroin use).
(ii) For codeine and/or morphine
equal to or greater than 15,000 ng/mL
and no legitimate medical explanation:
the MRO reports a positive result to the
agency. Consumption of food products
must not be considered a legitimate
medical explanation for the donor
having morphine or codeine at or above
this concentration.
(e) When the 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.
(f) 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
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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
result, the MRO follows the procedures
in 13.5(a) through (e).
(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).
(g) 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
PO 00000
Frm 00045
Fmt 4701
Sfmt 4703
7963
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.
(h) 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
E:\FR\FM\23JAN2.SGM
23JAN2
mstockstill on DSK3G9T082PROD with NOTICES2
7964
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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. 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
genitourinary 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
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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.
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 the donor from
providing a sufficient specimen for a
federal agency applicant/preemployment 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
PO 00000
Frm 00046
Fmt 4701
Sfmt 4703
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 HHScertified 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
the donor’s 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 the donor 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.
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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.
mstockstill on DSK3G9T082PROD with NOTICES2
Subpart N—Split Specimen Tests
Section 14.1 When may a split (B)
specimen be tested?
(a) The donor may request, verbally or
in writing, 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 request after being informed of the
result by the MRO. The MRO must
document in the MRO’s 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,
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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 HHScertified 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
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 HHScertified 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
PO 00000
Frm 00047
Fmt 4701
Sfmt 4703
7965
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 HHScertified 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
E:\FR\FM\23JAN2.SGM
23JAN2
mstockstill on DSK3G9T082PROD with NOTICES2
7966
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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 drugfree 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
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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 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,
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
PO 00000
Frm 00048
Fmt 4701
Sfmt 4703
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 drugfree 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 drugfree 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.
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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 HHScertified 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 HHScertified 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.
mstockstill on DSK3G9T082PROD with NOTICES2
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 HHScertified 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
primary (A) or split (B) 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 missing, misapplied, broken, or
shows evidence of tampering and the
split (B) specimen cannot be redesignated as the primary (A) specimen;
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
(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;
(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;
(f) The specimen was received at the
HHS-certified laboratory or IITF without
a CCF;
(g) The CCF was received at the HHScertified laboratory or IITF without a
specimen;
(h) The collector performed two
separate collections using one CCF; or
(i) The HHS-certified laboratory or
IITF identifies a flaw (other than those
specified above) that prevents testing or
affects the forensic defensibility of the
drug test and cannot be corrected.
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 HHScertified 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
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.
PO 00000
Frm 00049
Fmt 4701
Sfmt 4703
7967
Section 15.3 What discrepancies are
not sufficient to require an HHScertified 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 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 Social Security Number or
employee identification number;
(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 the collector did measure the
specimen temperature, the HHScertified 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.
E:\FR\FM\23JAN2.SGM
23JAN2
7968
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
mstockstill on DSK3G9T082PROD with NOTICES2
(b) The following omissions and
discrepancies on the Federal CCF that
are made at the HHS-certified laboratory
or IITF 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 their
name;
(3) The certifying scientist or
certifying technician fails to print their
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 should occur no more
than once a month. The expectation is
that each trained collector and HHScertified 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, HHScertified 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 HHScertified 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 they
inadvertently forgot to sign the Federal
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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 HHScertified 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
official may be assisted by one or more
of the official’s 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
PO 00000
Frm 00050
Fmt 4701
Sfmt 4703
not be subject to review under these
procedures.
Section 16.4
parties?
Who represents the
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
agreement?
What is an abeyance
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.
E:\FR\FM\23JAN2.SGM
23JAN2
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
mstockstill on DSK3G9T082PROD with NOTICES2
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.
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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 their
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 the
official’s employees or consultants in
conducting 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,
PO 00000
Frm 00051
Fmt 4701
Sfmt 4703
7969
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 crossexaminations.
(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 their
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
E:\FR\FM\23JAN2.SGM
23JAN2
mstockstill on DSK3G9T082PROD with NOTICES2
7970
Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
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
VerDate Sep<11>2014
19:03 Jan 19, 2017
Jkt 241001
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
necessary to resolve disputes in
accordance with the objectives of these
procedures.
PO 00000
Frm 00052
Fmt 4701
Sfmt 9990
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 their
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. 2017–00979 Filed 1–19–17; 8:45 am]
BILLING CODE 4162–20–P
E:\FR\FM\23JAN2.SGM
23JAN2
Agencies
[Federal Register Volume 82, Number 13 (Monday, January 23, 2017)]
[Notices]
[Pages 7920-7970]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-00979]
[[Page 7919]]
Vol. 82
Monday,
No. 13
January 23, 2017
Part II
Department of Health and Human Services
-----------------------------------------------------------------------
Substance Abuse and Mental Health Services Administration
-----------------------------------------------------------------------
Mandatory Guidelines for Federal Workplace Drug Testing Programs;
Notice
Federal Register / Vol. 82 , No. 13 / Monday, January 23, 2017 /
Notices
[[Page 7920]]
-----------------------------------------------------------------------
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: Revised Mandatory Guidelines by the Secretary of Health and
Human Services.
-----------------------------------------------------------------------
SUMMARY: The Department of Health and Human Services (``HHS'' or
``Department'') has revised the Mandatory Guidelines for Federal
Workplace Drug Testing Programs (Guidelines), 73 FR 71858 (November 25,
2008) for urine testing.
DATES: Effective Date: October 1, 2017.
FOR FURTHER INFORMATION CONTACT: Charles LoDico, M.S., F-ABFT, Division
of Workplace Programs, Center for Substance Abuse Prevention (CSAP),
SAMHSA mail to: 5600 Fishers Lane, Room 16N03A, Rockville, MD 20857,
telephone (240) 276-2600 or email at charles.lodico@samhsa.hhs.gov.
SUPPLEMENTARY INFORMATION: 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 drugs of the Controlled Substances Act (i.e., oxycodone,
oxymorphone, hydrocodone and hydromorphone) in federal drug-free
workplace programs, remove methylenedioxyethylamphetamine (MDEA) from
the authorized drugs in Section 3.4, add methylenedioxyamphetamine
(MDA) as an initial test analyte, 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 wording changes and reorganization of the
UrMG were made for clarity, to use current scientific terminology or
preferred grammar, and for consistency with the OFMG.
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], 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].
The proposed Mandatory Guidelines for Federal Workplace Drug
Testing Programs using Urine (UrMG) published in the Federal Register
on May 15, 2015 (80 FR 28101) include revisions to the initial and
confirmatory drug test analytes and methods for urine testing, the
cutoff for reporting a urine specimen as adulterated based on low pH,
and 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 published a separate Notice in the May
15, 2015 Federal Register (80 FR 28054) 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. There was a 60-day public
comment period for both Federal Register Notices, during which 125
commenters submitted comments on the proposed changes to the
Guidelines. These commenters were comprised of individuals,
organizations, and private sector companies. The comments are available
for public view at https://www.regulations.gov/. All comments were
reviewed and taken into consideration in the preparation of the revised
Guidelines. The issues and concerns raised in the public comments for
the UrMG are set out below. Similar comments are considered together in
the discussion.
Summary of Public Comments and HHS's Response
The following comments were directed to the information and
questions in the preamble.
Costs and Benefits
The Department requested comments on costs and benefits. One
commenter disagreed that the cost increase for laboratories to add
analytes to regulated testing will be minimal, stating that significant
costs would be incurred for information technology (IT) development, as
well as incremental costs for additional immunoassays (if required);
for additional calibrators, controls, and internal standards; and for
increased confirmatory testing costs (including data review and result
certification) based on an expected increased positivity rate for
opioids. One commenter disagreed with the Department's estimated 3%
cost increase for Medical Review Officers (MROs) and estimated that the
increase will be 10%. The commenters did not provide any substantive
evidence or data to support these comments. The Department recognizes
that there will be start-up costs to laboratories to implement testing
for the additional analytes for regulated specimens including
administrative costs, and agrees that the estimated increased costs for
some MROs may exceed the 3% estimate. The Department's cost analysis
was based on information provided by multiple HHS-certified
laboratories and MROs, as well as the estimated number of additional
positives resulting from the inclusion of the new opioid analytes.
Costs are expected to vary among individual laboratories and MROs,
depending on their processes and testing populations. Additional
information on the estimated costs associated with these Guidelines is
included under Regulatory Impact and Notices below.
Proposed New Analytes: Oxycodone, Oxymorphone, Hydrocodone, and
Hydromorphone
Seven commenters specifically agreed with the addition of these
drugs to the Guidelines. Two commenters expressed concerns over the
added drugs, indicating that individuals who follow their physician's
treatment plan of taking legally prescribed medication would produce
positive tests, leading to greater reliance on MROs to determine
whether tests are truly positive (as a result of illegal use) or are
positive due to prescribed usage of the drugs, and a greater number of
workers will be subject to scrutiny and their medical
[[Page 7921]]
records examined at length. One of the commenters maintained that such
testing would exceed the legal mandate under Executive Order No. 12564
and the promulgation of scientific Guidelines by HHS pursuant to it.
The Guidelines include requirements to protect individuals' privacy
while maintaining public safety, including procedures for MRO review to
verify legitimate drug use and maintain the confidentiality of donor
drug testing records. The Department provides additional guidance in
the Medical Review Officer Manual for Federal Workplace Drug Testing
Programs. The inclusion of these additional drugs in the Guidelines is
within the scope of the Department's regulatory authority to test for
illegal drug use under Section 503(a)(1)(A)(ii)(II) of Public Law 100-
71 and Executive Order No. 12564.
New Analytes--Cutoff Concentrations
Eight commenters addressed the proposed cutoffs for the added
drugs: Three commenters agreed with the proposed cutoffs; four
disagreed with the cutoffs for one or more of the added drugs. Of
these, three commenters stated that the cutoffs are too low: Two of
these commenters believe that these cutoffs will unnecessarily identify
workers using prescription drugs and one commenter noted that these
cutoffs will affect accurate quantitation in routine specimens. The
Department recognizes that the added analytes will result in an
increased number of positive opioid results requiring MRO review, and
has incorporated requirements for MRO requalification and retraining at
least every five years. Additional guidance and information on the
added drugs will be provided in the Medical Review Officer Guidance
Manual for Federal Workplace Drug Testing Programs. The Department
disagrees that the cutoffs will affect accurate quantitation in routine
specimens. Information from HHS-certified laboratories indicates that
testing at these cutoffs can be accomplished with current
instrumentation. However, the Department has raised the confirmatory
test cutoffs for oxycodone and oxymorphone from 50 ng/mL to 100 ng/mL.
These higher cutoffs are supported by a single dose study which showed
similar detection rates for oxycodone and oxymorphone using either a 50
ng/mL or 100 ng/mL cutoff.\1\ Use of the 100 ng/mL confirmatory test
cutoffs is expected to be less analytically challenging for
laboratories.
One commenter suggested changing the oxycodone and oxymorphone
initial test cutoff to 300 ng/mL and changing the hydrocodone and
hydromorphone initial test cutoff to 100 ng/mL, to equate the detection
times for these drugs. One commenter requested that the Department
provide the justification and data used to determine the cutoff levels
for the added opioids. The Department raised the oxycodone and
oxymorphone confirmatory test cutoffs to 100 ng/mL as described above.
The Department has evaluated the comments and has concluded that no
further change is needed. The selection of cutoff concentration is not
based solely on the factor of detection times and must take into
consideration a variety of factors, both pharmacological and chemical.
Drug potency, disposition in urine, impact and prevalence must be
considered. For example, oxycodone is approximately twice as potent as
hydrocodone and may be prescribed in lower doses, thus a cutoff lower
than that for hydrocodone is warranted. Therefore, in selecting the
cutoffs, the Department considered the detection times of equipotent
doses as well as dispositional patterns of each drug in urine. Data on
the disposition of hydrocodone and oxycodone in urine following
administration of a single dose can be found in two recently published
scientific articles.1 2
Medical Review Officer (MRO) Requalification--Continuing Education
Units (CEUs)
The Department requested comments on requiring MRO requalification
continuing education units (CEUs) and on the optimum number of credits
and the appropriate CEU accreditation bodies should CEUs be required as
part of MRO requalification. Three commenters agreed with requiring MRO
recertification, but disagreed with the addition of CEU requirements to
the Guidelines. Two commenters disagreed with specifying the number of
CEUs required. Two commenters indicated that certification entities
already enforce training requirements and recommended that acceptance
of CEUs be handled by MRO certification boards, not the Department. Two
commenters recommended a requirement of annual CEUs: One suggested 16
CEUs and the other recommended three CEUs. One commenter recommended 12
CEUs prior to initial certification, eight CEUs every five years, and
also recommended two CEUs related to the new requirements/topics within
two years of implementation of the revised Guidelines. The Department
has evaluated the comments and has concluded that requirements for
continuing education units will remain with the MRO certification
entities and will not be included in the Guidelines. The Department has
removed references to MRO training entities in Sections 13.2 and 13.3,
because training documentation is maintained by MRO certification
entities. The Department agrees with the comment that MROs should
receive training on revisions to the Guidelines, and has added item
Section 13.3(b) to require such training prior to the effective date of
revised Guidelines.
Discussion of Sections
The Department has not included a discussion in the preamble of any
sections for which public comments were not submitted or where minor
typographical or grammatical changes were made.
Subpart A--Applicability
1.5 What do the terms used in these Guidelines mean?
One commenter disagreed with the definition for ``dilute specimen''
because it does not include numerical values for creatinine and
specific gravity. The Department has concluded that no change is
needed; the analytical (numerical) criteria for a dilute specimen are
provided in Section 3.8.
One commenter requested that ``external service provider'' be
defined, because this is a new term included in the proposed
Guidelines. The Department agrees and has added the definition.
The Department has added the definition for ``gender identity'' to
Section 1.5. This term is now used in Guidelines sections addressing
observed and monitored collections as described in this preamble under
Sections 4.4, 8.1, 8.10, and 8.12. Gender identity means an
individual's internal sense of being male or female, which may be
different from an individual's sex assigned at birth.
Two commenters disagreed with the proposed definition for ``invalid
result'' which indicated that an invalid result was reported only when
an HHS-certified laboratory could not complete testing or obtain a
valid drug test result. The Department agrees with the commenters and
has reinstituted the definition from the Guidelines effective October
1, 2010 (73 FR 71858).
To address comments described in this preamble under Section 13.1,
the Department deleted the definition for ``non-medical use of a
drug.''
Two commenters found the definition of ``specimen'' confusing,
because the term ``sample'' used in the definition was also defined as
a representative portion of a donor's specimen. The
[[Page 7922]]
Department agrees, and has reinstituted some wording for the definition
of ``specimen'' from the Guidelines effective October 1, 2010 (73 FR
71858) for clarity.
1.6 What is an agency required to do to protect employee records?
One commenter suggested that the non-applicability of the Health
Insurance Portability and Accountability Act (HIPAA) and the Health
Information Technology for Economic and Clinical Health Act (HITECH)
should be clearly stated in the Guidelines. The Department has
evaluated the comment and has concluded that the applicability of HIPAA
and other relevant privacy laws is clearly stated in Section 1.6.
Accordingly, except for minor rewording for clarity, no further
revisions are necessary.
1.7 What is a refusal to take a federally regulated drug test?
One commenter noted that, per Sections 8.4(c) and 8.9(b), when a
collector finds an adulterant or substitution product or observes an
attempt to substitute a urine specimen, this prompts a direct observed
collection, not a refusal to test. The commenter suggested bringing an
adulterant or a substitution product to the collection should be a
refusal to test. The Department has evaluated the comment, and agrees
that the collector must report a refusal to test when a donor brings
materials for adulterating, substituting, or diluting the specimen to
the collection site, or when the collector observes a donor's clear
attempt to tamper with a specimen. The Department has revised Sections
1.7, 8.3(h), 8.4(c), and 8.9(b) accordingly.
One commenter noted that the collector does not report a refusal to
test when a donor leaves the collection site before the collection
process begins for a pre-employment test. The commenter recommended
defining the beginning of the pre-employment test collection process as
the point at which the donor is asked to present photo identification.
The Department agrees with the suggestion to define the beginning of
the collection process specifically for this situation. However, the
Department has designated the beginning as the step described in
Section 8.4(a), when the collector provides or the donor selects a
specimen collection container. The Department has revised Sections
1.7(a)(2) and (3) to include a reference to this section. All
subsequent items in Section 1.7(a) (i.e., items 4-13) apply once the
donor has arrived for the pre-employment test collection.
1.8 What are the potential consequences for refusing to take a
federally regulated drug test?
The Department reworded Section 1.8(b) to clarify that the
requirements in this section apply to donors who fail to appear at the
collection site in a reasonable time for any test (except a pre-
employment test), as described in Section 1.7(a)(1).
Subpart B--Urine Specimens
2.1 What type of specimen may be collected?
Two commenters requested clarification on the collection/testing
scenario where the federal agency authorizes collection of an oral
fluid specimen, but the contracted laboratory does not perform oral
fluid testing. The Department has evaluated the comments and has
concluded that no change is needed. This will be addressed in the
federal agency plan.
2.2 Under what circumstances may a urine specimen be collected?
One commenter suggested that the cost of mandatory random drug and
alcohol testing among airline pilots outweighs the benefit. The
Department has evaluated the comment and has concluded that no change
is needed. Airline pilots are subject to drug and alcohol testing under
DOT regulations. Therefore, this public comment is not relevant to the
Guidelines. In regard to drug testing of federal agency employees and
applicants, each federal agency establishes its agency plan based on
its mission, its employees' duties, and the potential consequences to
the public health and safety or national security that could result
from the failure of an employee to adequately perform their duties and
responsibilities.
Subpart C--Urine Specimen Tests
3.1 Which tests are conducted on a urine specimen?
One commenter suggested changing the term ``opiates'' to
``opioids'' in the Guidelines. The Department agrees with the commenter
and has changed the term ``opiates'' to ``opioids'' where appropriate
to refer to oxycodone, oxymorphone, hydrocodone, and hydromorphone in
addition to codeine, morphine, and 6-acetylmorphine (6-AM).
3.2 May a specimen be tested for additional drugs?
The Department reworded Section 3.2(a) to clarify the additional
drug tests that may be performed on federal employee specimens.
3.3 May any of the specimens be used for other purposes?
Section 3.3 states that specimens collected pursuant to Executive
Order 12564, Public Law 100-71, and these Guidelines may not be used
for purposes other than drug and validity testing in accordance with
Subpart C of the Guidelines. One commenter disagreed with prohibiting
employees from using their drug test specimens for other purposes
(e.g., deoxyribonucleic acid, DNA, testing). The Department has
evaluated this comment and has concluded that no change is needed.
While the Guidelines do not authorize the release of urine 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. For example, see Sections 8.5(b),
8.8, and 15.1(a).
In addition, under Public Law 100-71, Section 503(a)(1)(A)(ii)(I),
HHS is mandated to establish ``strict procedures governing the chain of
custody of specimens collected for drug testing . . . .'' Sections
11.7(a) and 11.20(a) also provide that an ``HHS-certified laboratory
must control access to the drug testing facility, specimens, aliquots,
and records,'' and must retain specimens that, among other things, have
been reported ``drug positive'' for a minimum of one year. Therefore,
the release of specimens to employees, or to an employee's designee, is
inconsistent with the mandates of the federal drug testing process, and
could significantly compromise a specimen's integrity, security, and an
HHS-certified laboratory's ability to fulfill its regulatory duties
under the Guidelines.
One commenter requested further clarification of the phrase
``unless authorized in accordance with [applicable] federal law'' in
Section 3.3. The phrase ``unless otherwise authorized in accordance
with applicable law in Section 3.3(a) does not represent a significant
change from the intent of the prior Guidelines language. Section 3.3,
among others, is intended to prohibit the use of specimens for purposes
other than those specifically authorized by the Guidelines. However,
there may be circumstances in which federal law authorizes an HHS-
certified laboratory to handle a specimen in a manner that differs from
the Guidelines. Therefore, the phrase ``unless authorized in accordance
with applicable federal law'' in Section 3.3 of the Guidelines is
intended to avoid conflict with other applicable federal law.
[[Page 7923]]
It should be noted that Section 3.3 specifically prohibits
conducting deoxyribonucleic acid (DNA) testing on urine specimens,
unless authorized in accordance with applicable federal law.
3.4 What are the drug test cutoff concentrations for urine?
The Department proposed methylenedioxyamphetamine (MDA) and
methylenedioxyethylamphetamine (MDEA) as initial test analytes. Three
commenters disagreed with the addition of MDA and MDEA as target
analytes, stating this change would require modification of current
immunoassay reagents, laboratory processes, or both. The commenters
noted that this imposes an unnecessary burden for compounds with such
low incidence in workplace testing. The Department has evaluated the
comments and has removed MDEA from the Guidelines (i.e., MDEA is no
longer included as an authorized drug in Section 3.4). The number of
positive MDEA specimens reported by HHS-certified laboratories (i.e.,
information provided to the Department through the NLCP) does not
support testing all specimens for MDEA in federal workplace drug
testing programs. Because MDEA is a Schedule I drug, a federal agency
may test specimens for MDEA in accordance with Section 3.2 (i.e., on a
case-by-case basis for reasonable suspicion or post accident testing,
routinely with a waiver from the Secretary). The Department understands
that MDA and some other analytes also have a low incidence, but
believes that continued testing for these analytes is warranted in a
deterrent program. In particular, inclusion of MDA as an initial and
confirmatory test analyte is warranted because, in addition to being a
drug of abuse, it is a metabolite of MDEA and MDMA.
An HHS-certified laboratory or Instrumented Initial Test Facility
(IITF) may group analytes for initial testing. For clarity, the
Department has defined the term ``grouped analytes'' where used in
footnote 1 of the table in Section 3.4: ``(i.e., two or more analytes
that are in the same drug class and have the same initial test
cutoff).''
The Department proposed criteria for immunoassays for grouped
analytes such as opioids and amphetamines, specifying the minimum
cross-reactivity to the other analyte(s) within the group. Two
commenters disagreed with the added cross-reactivity requirements,
noting this section should not attempt to provide equivalence between
immunoassay and other initial testing technologies. One of these
commenters suggested the Department develop separate requirements for
initial test methods using an alternate technology or, alternatively,
require the combined cross-reactivity of low-reacting compounds (e.g.,
hydrocodone and hydromorphone for an opiate assay; MDA and MDEA for an
amphetamines assay) to be equal to or greater than the cutoff. The
other commenter recommended not allowing methods other than immunoassay
for urine initial testing. One commenter stated that cross-reactivity
specifications for hydromorphone are not necessary, based on their non-
regulated testing results (i.e., confirmatory test concentrations
detected after using an immunoassay with 60% cross-reactivity for
hydromorphone). The Department has evaluated the comments and has
concluded that no change is needed for immunoassay cross-reactivity
requirements. The requirements in Section 3.4 are necessary to ensure
consistency in testing among laboratories using different immunoassay
kits, as well as those using different test methods for initial drug
testing. Cross-reactivity must be demonstrated and documented by the
manufacturer (e.g., package insert) and by the HHS-certified laboratory
or IITF (i.e., assay validation studies, reagent lot verification, and
batch quality control for any analyte that exhibits less than 100%
cross-reactivity). The Department will continue to allow the use of
methods other than immunoassay for initial testing.
However, the Department has revised Section 3.4 regarding the use
of alternate technology initial tests for THCA and benzoylecgonine.
Depending on the technology, the confirmatory test cutoff (i.e., 15 ng/
mL for THCA, 100 ng/mL for benzoylecgonine) must be used as the cutoff
for an initial test using an alternate technology to ensure consistent
treatment of specimens. For these analytes, the immunoassay test is not
specific for the target analyte for the confirmatory test. For example,
immunoassays for cannabinoids react with multiple compounds that are
excreted as a result of marijuana use. Therefore, it is necessary to
use an immunoassay cutoff higher than that of the confirmatory test in
order to detect the target analyte (THCA) at or above the confirmatory
test cutoff. An initial test using an alternate technology with
specificity comparable to the confirmatory test requires use of the
confirmatory test cutoff.
Also in Section 3.4, the Department did not specify the target
analyte to be used to calibrate an initial test for grouped analytes
such as amphetamines or opioids. Three commenters noted that when an
immunoassay is calibrated with a low-reacting drug, other analytes may
exhibit high cross-reactivity, leading to false initial test positives.
Two of these commenters also noted that this may result in possibly
different cross-reactivity profiles for some structurally unrelated and
concomitantly used prescription and/or over the counter drugs. One
commenter noted that the option to ``include a control containing the
lowest reacting analyte at its cutoff concentration in each batch'' was
described in the preamble to the proposed Guidelines, but was not
specified in Section 3.4 of the Guidelines. It was not the Department's
intent for the laboratory or IITF to calibrate an immunoassay test
using an analyte other than that specified by the manufacturer. In the
preamble to the proposed UrMG, the Department described using a control
containing the lowest reacting analyte at its cutoff concentration to
establish the decision point (i.e., when an immunoassay for grouped
analytes did not demonstrate at least 80% cross-reactivity to each
analyte). The Department has determined that this approach is not
necessary, and will not be permitted. There are current immunoassays
that meet the requirements of this section for two or more analytes in
a group (i.e., analytes in the same drug class that have the same
initial test cutoff). As indicated in Section 3.4, the laboratory or
IITF may use multiple test kits or a single kit to meet the
requirements.
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)?
One commenter recommended that HHS maintain a list of allowable
additional tests and reporting criteria (e.g., threshold for reporting
as positive, adulterated, substituted, and/or invalid, and a limit of
detection as appropriate), to ensure consistency among laboratories and
within the testing program. The Department has evaluated the comment
and has concluded that no change is needed. The Department does not
want to limit the analytes that may be tested, and will provide
guidance to laboratories as needed. It is also noted that the section
requires all tests to meet appropriate validation and quality control
requirements. The procedures and specimen records for such tests will
be reviewed at NLCP inspections. The Department will continue to
maintain a list of HHS-certified laboratories that choose to perform
additional tests for regulated specimens.
[[Page 7924]]
One commenter asked whether an MRO could submit a blanket request
to perform additional testing (e.g., additional opioid metabolites) for
all confirmatory specimens (i.e., would laboratories be permitted to
monitor the additional compounds in all confirmatory test assays?). The
Department believes that testing all specimens for additional analytes
may not be appropriate for some tests, especially hydrocodone,
hydromorphone, oxycodone and oxymorphone. Recent studies show that
testing for norhydrocodone and or noroxycodone is not necessary for the
interpretation of all results.1 2 Norhydrocodone and
noroxycodone metabolites may be helpful for the MRO to interpret test
results only when a donor's prescription does not support the test
results. For example, a hydrocodone dose may result in urine
concentrations of only hydromorphone metabolite above the cutoff. The
presence of norhydrocodone metabolite would support the use of
hydrocodone and validate the donor's prescription. The same could be
said for interpreting test results following an oxycodone dose. The
presence of noroxycodone metabolite would support the use of oxycodone
when only oxymorphone was reported as positive. The Department will
provide guidance on these and other additional tests that may provide
useful information for the MRO in the Medical Review Officer Guidance
Manual for Federal Workplace Drug Testing Programs. The Department has
revised Section 3.5 to clarify that HHS-certified laboratories are
authorized to perform additional tests upon MRO request on a case-by-
case basis, but are not authorized to routinely perform such tests
without prior authorization from the Secretary or designated HHS
representative, with the exception of the determination of D,L
stereoisomers of amphetamine and methamphetamine. The Department will
continue to allow HHS-certified laboratories to test for D,L
amphetamine and methamphetamine routinely or upon MRO request. The
Department will provide guidance on these and other additional tests
that may provide useful information for the MRO (e.g.,
tetrahydrocannabivarin) in the Medical Review Officer Guidance Manual
for Federal Workplace Drug Testing Programs.
Additional drug and specimen validity testing under Section 3.5
does not include DNA testing.
3.6 What criteria are used to report a urine specimen as adulterated?
Two commenters agreed and one disagreed with raising the lower pH
cutoff from 3.0 to 4.0 for identifying specimens as adulterated. One
commenter advised caution in changing specimen validity test cutoffs,
and indicated that the proposed change will require updates to computer
systems for reporting, calibrators, and controls. One commenter
indicated that previous review of data (more than 10 years ago)
indicated this change would have more than doubled the number of low
pH/adulterated results reported. The commenter that disagreed with
changing the pH cutoff believes HHS does not have enough scientific
evidence supporting the change. The Department has evaluated the
comments and has concluded that no change is needed to the proposed
cutoff (i.e., 4.0). As stated in the preamble to the proposed
Guidelines (80 FR 28101), 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. Furthermore, the Department is not aware of
any medical conditions or medications that would cause urine pH to be
less than 4.5.
3.8 What criteria are used to report a urine specimen as dilute?
One commenter suggested removing the three-decimal place criteria
for reporting a specimen as dilute. One commenter indicated that the
criteria for reporting a specimen as dilute in Section 3.8 and 11.19(f)
were not consistent, and that Section 3.8 does not address the
situation when creatinine is between 5 and 20 mg/dL and the specific
gravity is less than 1.0020. This section was intended to clarify that
only HHS-certified laboratories (and not HHS-certified IITFs) may
report a specimen as dilute when the creatinine concentration is
greater than or equal to 2.0 mg/dL and less than or equal to 5 mg/dL,
and the laboratory must use a four-decimal place refractometer for the
specific gravity test. The Department will retain the three-decimal
place criteria in Section 3.8(a) because both HHS-certified IITFs and
laboratories may use a three-decimal place refractometer for a specific
gravity screening test when the creatinine concentration is greater
than 5 mg/dL and less than 20 mg/dL. However, the Department agrees
that this section did not address all situations, so has revised the
wording in Section 3.8(b) to be consistent with the wording in
11.19(f).
3.9 What criteria are used to report an invalid result for a urine
specimen?
One commenter suggested increasing the acceptable pH range upper
end from 9.0 to 9.5 due to heat during summer months. One commenter
recommended that the Department define requirements to be met before a
new validity marker is implemented. One commenter suggested that
additional biomarkers used to support a result of invalid should be
standardized across all HHS-certified laboratories and one solution to
donor subversion might be random assignment of collection of
alternative specimens. The Department has evaluated the comments and
has concluded that no change is needed. A 2006 study on the stability
of regulated drug analytes in urine slightly below and within the high
pH invalid range supports the pH 9.0 decision point due to the loss of
drug analytes at a pH between 9.0 and 9.5.\3\
Subpart D--Collectors
4.4 What are the requirements to be an observer for a direct observed
collection?
One commenter disagreed with the requirement for an observer to be
the same gender as the donor, and suggested that a physician or health
care professional (regardless of gender) should be allowed to function
as an observer. The commenter indicated that gender determination can
be challenging (i.e., transgender employees). The Department has
evaluated these comments and agrees that all observed collections must
be conducted in a professional manner that minimizes discomfort to the
donor. The Department has revised Sections 4.4(b), 8.1(b), and 8.10 to
allow the donor to be observed by a person whose gender matches the
donor's gender, which is determined by the donor's gender identity
(defined in Section 1.5). The donor's gender identity may be the same
as or different from the donor's sex assigned at birth. The Department
also revised Sections 8.1(b) and 8.12 for monitored collections, to
allow the donor to be monitored by a person whose gender matches the
donor's gender, unless the monitor is a medical professional (as
described in Section 8.12).
The Department disagrees with the commenter's suggestion to allow
an individual to serve as an observer based solely on their credentials
as a physician or health care professional. Such credentials alone
would not guarantee that these individuals could appropriately perform
the functions of an observer (i.e., as specified in Section 4.4).
The same commenter expressed concerns over the requirement for an
observer to have received training, indicating that this would require
[[Page 7925]]
documentation and may make finding short notice observers more
difficult. The Department disagrees with this comment. These are the
same requirements as in the Guidelines effective October 1, 2010 (73 FR
71858). As stated in the preamble to those Guidelines, the training
elements are included to ensure that the observer interacts with the
donor in a professional manner, respecting the donor's modesty and
privacy, and that the collector maintains the confidentiality and
integrity of collection information.
Subpart F--Federal Drug Testing Custody and Control Form (CCF)
6.1 What federal form is used to document custody and control?
Two commenters recommended that the Department provide instructions
on recording results for the added drugs on the CCF until the Federal
CCF is revised. Three commenters recommended that the CCF be revised to
address the addition of the oral fluid specimen matrix. One commenter
encouraged SAMHSA to modify the CCF to account for collections where
multiple specimens are collected during a single collection event. The
Department will publish a Federal Register Notice with the revised
Federal CCF, including changes for the added analytes, with the same
effective date as these Guidelines. Guidance on the use of the revised
Federal CCF will be posted on the SAMHSA Web site https://www.samhsa.gov/workplace. In regard to when the collector submits
multiple urine specimens (i.e., different voids) collected during the
same testing event, the Department has concluded that no change is
needed; the collector must use a separate Federal CCF for each
specimen.
6.2 What happens if the correct OMB approved Federal CCF is not
available or is not used?
One commenter questioned the purpose of a Memorandum for the Record
(MFR) obtained from the collector when an incorrect CCF was used for
the collection. The commenter suggested that if certain information is
required to be in the MFR, these requirements should be specified in
the Guidelines. The commenter suggested that if the purpose of the MFR
is to correct the collector's behavior (i.e., using an incorrect form),
then it would be more effective to reject the specimen upon receipt and
indicate that it was rejected due to the use of an incorrect form. The
Department has evaluated the comments and has concluded that no change
is needed. Section 6.2 describes the information required in the MFR
from the collector. However, the Department reworded items 6.2(b) and
(c) for clarity.
Subpart H--Urine Specimen Collection Procedure
8.1 What privacy must the donor be given when providing a urine
specimen?
As described in this preamble under Section 4.4, the Department has
revised Section 8.1(b) to require that the gender of the observer
matches the donor's gender, and that the gender of the monitor matches
the donor's gender unless the monitor is a medical professional as
described in Section 8.12.
8.3 What are the preliminary steps in the urine specimen collection
procedure?
One commenter was concerned that the Guidelines do not mention
alcohol testing, which was added to the Department of Transportation
(DOT) program in 1991. Alcohol testing is outside of the scope of the
Department's regulatory authority granted by Executive Order 12564 and
Public Law 100-71.
In response to comments described under Sections 1.7 and 8.4 in
this preamble, the Department revised Section 8.3(h) to require the
collector to report a refusal to test when a donor brings materials for
adulterating, substituting, or diluting a specimen to the collection
site.
8.4 What steps does the collector take in the collection procedure
before the donor provides a urine specimen?
The proposed section included the same requirement as the
Guidelines effective October 1, 2010 (73 FR 71858) for the collector to
perform an observed collection when the donor exhibits 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). One commenter
stated that if the collector finds an adulterant or substitution
product or observes the donor attempt to substitute a urine specimen,
this should be a refusal to test. As noted under Section 1.7 in this
preamble, the Department agrees that the collector must report a
refusal to test when a donor brings materials for adulterating,
substituting, or diluting a specimen to the collection site, or when
the collector observes a donor's clear attempt to tamper with a
specimen. The Department has revised Section 8.4 accordingly.
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 they are unable
to provide a urine specimen?
Comments on these two sections are addressed here. Numerous
commenters expressed concern with the Department's urine collection
policy, stating that 7 to 10% of Americans have a condition
(``paruresis''), described as a social anxiety disorder which prevents
a person from producing urine on demand or in the presence of other
people. These commenters stated that if the government wants to seek
the largest group of qualified applicants, the Guidelines should
specify that a diagnosis of paruresis means non-urine (i.e., oral
fluid) testing will automatically be provided, and that donors should
not have to attempt to provide a urine specimen first. The Department
has evaluated the comments and has concluded that no change is needed.
The Guidelines will allow a federal agency to use any authorized
specimen types (e.g., urine, oral fluid, or both) in their drug testing
programs. The Guidelines will continue to require that the donor be
allowed reasonable attempts to provide a urine specimen as described in
Sections 8.5 and 8.6, and allow collection of an authorized alternate
specimen (i.e., oral fluid).
Three commenters disagreed with the requirement for the collector
to contact the agency representative for authorization to collect an
alternate specimen each time a donor is unable to provide a sufficient
volume. These commenters suggested that the Guidelines allow this to be
addressed in established standard protocols for the agency. The
Department agrees with the commenters. Each federal agency may decide
whether to require notification in each case or whether to provide a
standard protocol for collectors to follow. Sections 8.5 and 8.6 have
been revised accordingly.
Also in regard to Section 8.6, one commenter indicated that some
employers may wish to retain urine testing as the primary test due to a
longer detection window. This commenter raised concern that some donors
may claim they are unable to provide a urine specimen so that an
alternative specimen (i.e., OF) with a shorter detection window will be
collected. The commenter suggested that the Guidelines be changed to
indicate that an alternative specimen
[[Page 7926]]
may be collected when a donor is physiologically unable to provide a
urine specimen, and not just when the donor states that they are unable
to provide a urine specimen. The Department disagrees; collectors are
not qualified to conduct a medical evaluation to verify or refute the
donor's claim. It will be the agency's decision to collect urine or an
authorized alternate specimen, and Sections 13.6 and 13.7 include
procedures for medical evaluation as needed during the MRO review
process.
The Department reworded Section 8.5(d) to clarify that the
collector must record comments on both CCFs when two specimens from the
same collection event are forwarded to a laboratory.
8.7 If the donor is unable to provide a urine specimen, may another
specimen type be collected for testing?
The Department proposed within Section 8.7 that when the donor is
unable to provide a urine specimen, another specimen type may be
collected only if specifically authorized by the agency. One commenter
disagreed with the Guidelines as written and suggested that when a
donor cannot provide the primary specimen type, an alternate specimen
should be collected immediately. The commenter cited the additional
time and cost (evaluation of donor for ``shy bladder'') as well as the
fact that the collector may not know the agency's policy on alternate
specimen types. The Department has concluded that no change is needed
for Section 8.7 in response to this comment. The Guidelines will
continue to require that the donor be allowed reasonable attempts to
provide a urine specimen as described in Sections 8.5 and 8.6. The
Department has revised those sections to allow a federal agency to
either require notification in each case or provide a standard protocol
for collectors to follow when the donor is unable to provide a urine
specimen. The Department has reworded this section to state ``Yes, if .
. .'' rather than ``No, unless . . . .'' in response to a federal
agency's comment and to enhance clarity. The meaning of this section
remains the same.
8.8 How does the collector prepare the urine specimens?
In response to a federal agency comment, the Department deleted a
sentence in item 8.8(h) that required the collector to send a copy of
the Federal CCF to the HHS-certified laboratory or IITF. The Department
agreed with the federal agency that this instruction is redundant
because item 8.8(g) instructs the collector to distribute copies of the
Federal CCF as required.
8.9 When is a direct observed collection conducted?
The proposed section included requirements for the collector to
perform an observed collection when the donor exhibits conduct that
clearly indicates an attempt to tamper with a specimen or the collector
observed materials brought by the donor to the collection site for the
purpose of adulterating, substituting, or diluting the specimen. One
commenter stated that if the collector finds an adulterant or
substitution product or observes the donor attempt to substitute a
urine specimen, this should be a refusal to test. As noted in this
preamble under Sections 1.7 and 8.4, the Department agrees that the
collector must report a refusal to test when a donor brings materials
for adulterating, substituting, or diluting the specimen to the
collection site, or when the collector observes a donor's clear attempt
to tamper with a specimen. The Department has revised Section 8.9
accordingly.
8.10 How is a direct observed collection conducted?
To address a comment described in this preamble under Section 4.4,
the Department has revised Section 8.10 to allow the donor to be
observed by an observer whose gender matches the donor's gender. At the
beginning of the observed collection, the collector requests that the
donor document the donor's gender on the Federal CCF and initial the
annotation. An observer of the same gender is provided, and the
collector records the name and gender of the observer on the Federal
CCF.
8.12 How is a monitored collection conducted?
To address a comment described in this preamble under Section 4.4,
the Department has revised Section 8.12 to allow the donor to be
monitored by a monitor whose gender matches the donor's gender, 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). As
described in Section 8.10, at the beginning of the monitored
collection, the collector follows the same procedure as for observer
selection in Section 8.10(b). That is, the collector requests that the
donor document the donor's gender on the Federal CCF and initial the
annotation. A monitor of the same gender is provided, and the collector
records the name and gender of the monitor on the Federal CCF. A
medical professional may serve as the monitor, regardless of gender.
Subpart I--HHS Certification of Laboratories and IITFs
9.5 What are the qualitative and quantitative specifications of
performance testing (PT) samples?
One commenter noted that, because proposed initial test
requirements allow calibration with a low-reacting analyte, PT schemes
would likely need to be designed based on the specific implementation
at each laboratory. The commenter provided an example: When an
immunoassay is calibrated with a drug/metabolite that exhibits 50%
cross-reactivity, the intended target analyte (``calibrant'') at the
cutoff concentration would elicit a response well in excess of the
cutoff. This could result in inaccurate initial test results (i.e., a
positive initial test result for a specimen containing the calibrant at
a concentration below the cutoff). The commenter stated that this
result could be scored as a ``false positive'' PT result. The
Department has evaluated the comment and has concluded that no change
is needed. As noted above regarding Section 3.4, it was not the
Department's intent for the laboratory or IITF to calibrate an
immunoassay test using an analyte other than that specified by the
manufacturer. NLCP PT schemes are designed based on known cross-
reactivity profiles of the initial tests used by HHS-certified
laboratories.
Also in regard to proposed Section 9.5, one commenter suggested
that the Guidelines use the same wording as in the Guidelines effective
October 1, 2010 (73 FR 71858) for retest PT sample specifications
(i.e., ``. . . may be as low as . . .'' rather than the proposed
wording ``. . . may be less than. . .''). The Department agrees and has
reinstituted wording from Section 9.3 of the Guidelines effective
October 1, 2010 (73 FR 71858) into Section 9.5(a)(1)(ii).
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?
Two commenters disagreed with the proposed limit to the number of
blind samples required (i.e., a maximum of 400 blind samples per year)
in Section 10.1(b). The commenters indicated that for a large agency,
there is a very large difference between 3% and 400 samples and
suggested keeping only the 3% requirement. Another commenter disagreed
with the 3% requirement for
[[Page 7927]]
blind samples and requested that the amount to be lowered to 1% to
lessen the burden on employers. One commenter suggested that the
wording be modified to clarify that employers are responsible for
ensuring blind samples are sent to the laboratories, but that
collectors are tasked with submitting the blind samples. The Department
has evaluated the comments and has concluded that no change is needed.
The 400 sample limit was added to reduce the burden on large agencies
based on the Department's review of agencies' blind testing programs.
The wording in Section 10.1(a) clearly describes the responsibilities
of the federal agency and the role of the collector in blind sample
submission; however, the Department reworded Section 10.3(a) for
clarity as described below.
10.3 How is a blind sample submitted to an HHS-certified laboratory?
The Department has reworded Section 10.3(a) to clarify that the
collector sends a blind sample to a laboratory or IITF as a split
specimen (i.e., Bottle A and Bottle B).
Subpart K--Laboratory
11.10 What are the requirements for an initial drug test?
One commenter noted that HHS previously required initial and
confirmatory testing using different techniques, and asked whether this
requirement had been removed with allowance of technologies other than
immunoassay for initial testing. The commenter expressed concern that
an error in the initial drug test could be repeated in the confirmatory
drug test using the same method. The Department has evaluated the
comments and has concluded that no change is needed. The Guidelines
maintain the requirement for initial and confirmatory tests on two
separate aliquots to report a result other than negative. The NLCP will
review validation and quality control records, as well as specimen
records, to ensure that the initial and confirmatory testing methods
meet Guidelines requirements and provide scientifically and
forensically supportable results.
Also in regard to the proposed Section 11.10, one commenter asked
whether non-FDA cleared immunoassays were included in the category of
alternate initial drug test technology. The Department has evaluated
the comment and has concluded that no change is needed. This section
clearly distinguishes initial tests using immunoassay from those using
an alternate technology. Furthermore, Section 1.5 includes the
definition for ``alternate technology initial drug test.''
11.11 What must an HHS-certified laboratory do to validate an initial
drug test?
One commenter noted that an immunoassay initial test calibrated
with a low-reacting analyte may not be able to meet Guidelines
requirements for performance of the test around the cutoff
concentration. The Department has evaluated the comments and has
concluded that no change is needed. All tests must be validated by the
HHS-certified laboratory to meet the requirements prior to use for
regulated drug testing.
One commenter noted that the requirement in section 11.11(b) for
reagent verification prior to use is an operational, not a validation,
requirement. The Departments agrees with the commenter but has
concluded that no change is needed. While this section addresses
initial drug test validation requirements, the verification of each new
reagent lot is essential to verify that lot-to-lot differences have not
significantly affected assay performance as demonstrated and documented
during validation. Therefore, this is the most appropriate section of
the Guidelines to include the requirement.
11.12 What are the batch quality control requirements when conducting
an initial drug test?
One commenter noted that this and other sections use inconsistent
terminology when describing quality controls samples relative to the
cutoff concentration (i.e., ``25 percent above the cutoff,'' ``75
percent of the cutoff''). The commenter suggested that the Department
use one version consistently. The Department has considered the comment
and has concluded that no change is needed. These terms have been used
in the Guidelines, in NLCP documents, and in other guidance to HHS-
certified laboratories without issue.
One commenter asked whether the added analytes affect quality
control content requirements. The Department has evaluated the comment
and has concluded that no change is needed. The initial drug test
quality control requirements in the Guidelines apply to each analyte
used to calibrate the test (i.e., immunoassay or alternate technology
initial drug test). When a single immunoassay test is used for two or
more analytes in a drug class, the HHS-certified laboratory or IITF
must include a control in accordance with item 11.12(a)(2) for each
analyte that has less than 100% cross-reactivity with the assay, to
demonstrate that the requirement for at least 80% cross-reactivity has
been met.
11.12 What are the batch quality control requirements when conducting
an initial drug test?
11.15 What are the batch quality control requirements when conducting a
confirmatory drug test?
Comments on these two sections are addressed here. One commenter
requested clarification for the requirement for a drug-free control in
initial and confirmatory drug test batches (i.e., whether the control
should contain no drug or whether the control should not contain the
specific analyte for that test). The Department has evaluated the
comment and has concluded that no change is needed. These Guidelines
sections list the requirement for ``at least one control certified to
contain no drug or drug metabolite,'' meaning that the control must
contain no regulated drug analytes.
11.16 What are the analytical and quality control requirements for
conducting specimen validity tests?
One commenter found the wording of Section 11.16(a) to be
confusing, noting that a specimen would not be subjected to a second
specimen validity test when the first test was in the acceptable range.
The Department agrees with the comment and has revised Section 11.16(a)
to correctly reflect requirements.
11.18 What are the requirements for conducting each specimen validity
test?
One commenter noted that the proposed changes in the lower pH
cutoff for identifying adulterated specimens and lower pH decision
point for identifying invalid specimens may cause additional costs for
manufacturers and laboratories. The Department has evaluated the
comment and has concluded that no change is needed. The Department
recognizes that the revised cutoff will necessitate changes by HHS-
certified laboratories as well as by manufacturers of commercial
quality control samples; however, the 4.0 pH cutoff is supported by
scientific studies and workplace drug testing data, and is expected to
reduce the incidence of undetected attempts to subvert the drug test.
11.19 What are the requirements for an HHS-certified laboratory to
report a test result?
One commenter suggested that the Department remove the requirement
for
[[Page 7928]]
an executed CCF as the official report for ``non-negative'' specimens
and permit the use of an electronic report with the required
information. The Department has evaluated the comment and has concluded
that no change is needed. The Federal CCF serves as the chain of
custody for the specimen from the time of collection until receipt by
the laboratory and also contains the certification statement signed by
the certifying scientist. The Federal CCF may be paper or electronic.
11.21 How long must an HHS-certified laboratory retain records?
In Section 11.21, the Department proposed that laboratories be
allowed to convert hardcopy records to electronic records for storage
and then discard the hardcopy records after six months. One commenter
stated their assumption that this section did not require laboratories
to convert electronic records to hardcopy records and maintain them for
six months. This assumption is correct; the intent is to allow
laboratories to maintain records in electronic format for the required
storage period. The Department has concluded that no change is needed.
11.22 What statistical summary reports must an HHS-certified laboratory
provide for urine testing?
One commenter asked why the proposed Guidelines include a
requirement for a copy of the semiannual statistical summary report to
be sent to the Secretary or designated HHS representative. The
Department included the requirement in Section 11.22 (and in Section
12.19 for IITFs) to facilitate compilation of statistical information
for the federal drug-free workplace program. This will not place an
additional burden on the test facilities other than transmission of the
report. The Department will continue to evaluate the effectiveness of
this requirement.
Subpart M--Medical Review Officer (MRO)
13.1 Who may serve as an MRO?
Three commenters disagreed with the term ``nonmedical use of a
drug'' used in Section 13.1 (and defined in Section 1.5) and indicated
that the term changes the role of an MRO from review, verify and
``report a non-negative result'' to review, verify and ``interpret
before reporting a result as negative or nonmedical use of a drug.''
Two commenters disagreed with use of ``interpretation of results'' to
supplant ``alternative medical explanation.'' One commenter noted that
this perceived change in the MRO's role represents an unjustified
shifting of risk to the MRO. One commenter believes the term presents a
possible legal flaw to the Guidelines, stating that this term is
legally different from ``safety concern'' and places MROs in the
position of being in conflict with the prescribing physician and
subject to lawsuits. This commenter stated that even a lack of a
finding of nonmedical use could be an issue if the donor subsequently
had an accident after using the drug. The same commenter submitted five
recommendations related to inclusion of prescription drugs in federal
workplace drug testing programs, to address the commenter's concerns
with the proposed Guidelines. These five specific recommendations
pertain to matters that are outside the scope of these Guidelines, and
therefore are not addressed in the Department's response below.
The responsibilities of an MRO to interpret results have largely
remained the same between the Guidelines effective October 1, 2010 (73
FR 71858) and these Guidelines. As stated in Section 13.5(c) of these
Guidelines, ``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.'' Accordingly, the intent of
the Guidelines, in this context, is to confirm whether a positive drug
test is the result of drug use under a valid prescription. Furthermore,
the term ``alternate medical explanation'' has never been used in the
Guidelines, but has been used in the HHS Medical Review Officer Manual
for Federal Workplace Drug Testing Programs.
For the reasons above, the Department believes that the definition
of ``nonmedical use of a drug'' and the requirement for a physician
serving as an MRO to have knowledge of this topic do not fundamentally
change the MRO's responsibilities. However, to address the commenters'
concerns, the Department has removed this term from the Guidelines
(i.e., revised Sections 1.5 and 13.1).
The Department proposed within Section 13.1 who may serve as an
MRO. One commenter requested clarification that it is the federal
agency's burden to ensure that the MRO is certified. One commenter
asked how the laboratory will be informed that an MRO has met
requirements for re-qualification. The Department evaluated the
comments and concluded that no change is needed. The MRO is an employee
or a contractor of the agency. Therefore, it is the agency's
responsibility to ensure that the MRO meets the Guidelines
qualification requirements.
Two commenters disagreed with the requirement for MRO
recertification every five years, and recommended that MROs complete
training every three years. Five commenters stated support for five
year requalification and examination requirements. The Department has
evaluated the comments and has concluded that no change is needed. The
Department will keep the five-year recertification requirement as
proposed.
13.2 How are nationally recognized entities or subspecialty boards that
certify MROs approved?
One commenter agreed with MRO certification/training entities
submitting the delivery method and content of the MRO examination as
applicable along with other required documents. One commenter agreed
with extending time from one to two years for approved MRO
certification/training entities' resubmission of qualifications for HHS
approval. The commenter noted that they would support further extension
to 3 years. One commenter recommended that approval of MRO educational
courses and content be at the discretion of the MRO certification
entities, not HHS. Since the certification entities and their
examinations are subject to HHS oversight and approval, the commenter
noted that it may be burdensome for HHS to review and approve the
courses and content, and be a disincentive to development of new
courses. One commenter recommended that examinations be allowed to be
in-person or online with appropriate security precautions for each
delivery method. The Department has evaluated the comments and agrees
that the submission of training materials to HHS would possibly
discourage the development of new training courses. Therefore, the
review of MRO educational courses and content will not be part of the
approval process for MRO certification entities. As described under
Medical Review Officer (MRO) requalification--continuing education
units (CEUs) in this preamble, the Department has removed references to
MRO training entities in Section 13.2, because training documentation
is maintained by MRO certification entities. The Department will only
require the MRO certification entities to submit their examination and
any other necessary supporting examination materials (e.g., answers,
examination statistics or background information on questions) that
will help in the Department's evaluation of the examination. The
Department will
[[Page 7929]]
review and evaluate the examination delivery method (e.g., in-person or
online) when reviewing submitted training materials to ensure that the
delivery method employs appropriate security and identification
procedures.
13.3 What training is required before a physician may serve as an MRO?
Five commenters disagreed and one commenter agreed with the added
requirement for MRO training to include information about how to
discuss substance misuse and abuse and how to access those services.
The Department has evaluated the comments and has revised Section 13.3
to remove this requirement. Federal agencies may provide this
information to employees and applicants to facilitate their access to
effective treatment and support recovery. The Department provides
information to the public on help and treatment for substance misuse
and abuse, and how to access those services, on the SAMHSA Web site
https://www.samhsa.gov/.
One commenter stated that the Department should add a requirement
for MRO training on what constitutes a refusal to test. One commenter
suggested that the Department should add a requirement for MRO training
on when and how to report safety concerns to employers when
prescription and/or over-the-counter medications may affect
performance. The Department has evaluated the comments and has
concluded that no change is needed. Criteria for reporting a refusal to
test are covered under the topics listed in Section 13.3 such as items
(a)(4) training on the Guidelines and (a)(5) procedures for
interpretation, review, and reporting of results. When a donor provides
a legitimate medical explanation for a positive drug test result (e.g.,
a valid prescription), the Guidelines do not require MROs to contact
federal agency employers for the purpose of reporting a safety concern.
Accordingly, MRO training related to reporting ``safety concerns'' does
not relate to a mandatory function under the Guidelines and, therefore,
is not an essential component of required MRO training. The Department
will provide additional guidance in the HHS Medical Review Officer
Guidance Manual for Federal Workplace Drug Testing Programs.
In addition, the Department revised Section 13.3 as described under
Medical Review Officer (MRO) requalification--continuing education
units (CEUs) in this preamble. The Department removed references to MRO
training entities, because training documentation is maintained by MRO
certification entities, and added item 13.3(b) to require MRO training
on revised Guidelines prior to their effective date.
13.4 What are the responsibilities of an MRO?
One commenter suggested creating a subset of medical professionals
trained specifically to determine fitness for duty since an MRO cannot
determine fitness for duty over the telephone. The Department has
evaluated the comment and has concluded that no change is needed.
Fitness for duty evaluations fall outside the purview of the
Guidelines.
13.5 What must an MRO do when reviewing a urine specimen's test
results?
The Department has revised Section 13.5(d)(1) to include an example
of documentation to support a medical explanation for a positive drug
test result.
Three commenters disagreed with MRO procedures for ``a positive
result for opiates'' (i.e., requirement for clinical evidence of
illegal use in addition to positive result) and noted that the proposed
Guidelines wording was not changed to clarify that the described
procedures do not apply to the added opioids. The Department agrees
with the commenters and has revised Section 13.5(d) to clarify that the
procedures do not apply to the added opioid analytes. Wording in
Section 13.5(d)(2)(i) regarding ``clinical evidence of illegal use''
was also edited for clarity and for consistency with the wording in the
OFMG.
One commenter disagreed with requirements concerning two separate
specimens collected at a single test event and sent to the laboratory
for testing (e.g., a urine specimen outside the acceptable temperature
range and the subsequently collected specimen). The proposed Guidelines
require that, when one of the two specimens is negative and other is
not, the MRO reports only the verified result other than negative. This
commenter suggested that the MRO cancel the negative result. The
Department has evaluated the comments and has concluded no change is
needed. Cancellation of the test may be confusing in the situation
referenced by the commenter and lead to inappropriate specimen
recollection. Both the MRO and the federal agency employer will receive
their Federal CCF copies with explanatory collector remarks in Step 2
including the specimen identification number of the associated
specimen, and the MRO may provide additional comment in the MRO's
report.
The Department also revised Section 13.5(d) to reflect the policy
of the Department that passive exposure to marijuana smoke and
ingestion of food products containing marijuana are not acceptable
medical explanations for a positive drug test result. Individuals who
are passively exposed to marijuana smoke or who consume food products
containing marijuana can pose public safety and/or security
risks.4 5 Marijuana is listed as a Schedule I drug under the
Controlled Substances Act.
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?
One commenter suggested the Guidelines define ``appropriate
expertise'' of a physician with a list of conditions and an appropriate
type of physician in an appendix. The same commenter requested medical
referral information on the employer's actions when a donor could not
provide a urine specimen and then could not provide an oral fluid
specimen. The Department has evaluated the comments and has concluded
that no change is needed. A physician who is a trained MRO will have
the knowledge necessary to identify another physician with appropriate
expertise for the medical evaluation. The Department will provide
additional guidance in the HHS Medical Review Officer Guidance Manual
for Federal Workplace Drug Testing Programs as appropriate when
alternate specimen types (e.g., oral fluid) are allowed in federal
workplace drug testing programs.
The Department clarified the definition of ``permanent or long-term
medical conditions'' in Section 13.6(b)(1) based on a federal agency
comment.
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?
The Department revised wording in items a and b of this section,
and included three additional fatal flaws as items f-h, to reflect
fatal flaws for regulated donor specimens that have been identified by
HHS-certified laboratories. These fatal flaws were addressed in NLCP
guidance sent to all HHS-certified and applicant laboratories and IITFs
on August 9, 2016. In addition, the Department revised this section to
include an additional item i to allow a laboratory or IITF to reject a
specimen when they identify a flaw that
[[Page 7930]]
prevents testing or affects the forensic defensibility of the drug
test, and cannot be corrected. This general item enables laboratories
and IITFs to reject specimens with fatal flaws that may be rare, but do
occur. It is not possible to list all such flaws in the Guidelines.
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?
Two commenters indicated that inclusion of some items as
insignificant discrepancies contradicts guidance provided to HHS-
certified laboratories and IITFs in NLCP Notices, which required
laboratories to attempt to recover missing information. One of these
commenters suggested that if these items are important, they should be
removed from the ``insignificant'' list. Two commenters disagreed with
the Guidelines designating the listed omissions and discrepancies as
``insignificant only when they occur no more than once per month.'' The
Department has evaluated the comments. The listed discrepancies would
not result in rejection or cancellation. NLCP Notices requiring
laboratory action are consistent with this section. However, the
Department has reworded section 15.3 to not classify these errors as
insignificant. While these types of errors do not warrant laboratory
rejection of a specimen or MRO cancellation of a test, as noted in
section 15.3(c), corrective action must be initiated when they occur
more than once a month.
The commenters indicated that this section implies that the MRO
must keep a log of insignificant errors by laboratory and by collection
site in order to track frequency. The commenters noted that this is an
unenforceable policy, that this should be a duty of inspectors of
laboratories and collection sites, and that requiring MROs to keep
these types of logs would create significant extra costs. One commenter
suggested that item 15.3(c) be modified for the MRO to advise the
collector or laboratory to retrain staff on relevant procedures to
ensure that collections are completed correctly (rather than directing
them to immediately take corrective action). The Department has
evaluated the comments and has concluded that no change is needed. This
section is the same as in the Guidelines effective October 1, 2010 (73
FR 71858).
One commenter suggested modifying 15.3(a)(5) to read ``donor
identification number'' which would include a social security number or
an employee identification number since many employers no longer use
social security numbers for employee identification. The Department
agrees and has revised Section 15.3(a)(5) to include ``employee
identification number'' in addition to ``Social Security Number.''.
15.4 What discrepancies may require an MRO to cancel a test?
One commenter suggested adding the scenario where the donor did not
sign the CCF because the collector forgot to ask the donor to sign,
rather than the donor's refusal to sign. The Department has evaluated
the comment and has concluded that no change is needed. As stated in
Section 15.4, the MRO contacts the collector ``to obtain a statement to
verify that the donor refused to sign the MRO copy.''
Regulatory Impact and Notices
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
presents a 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 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
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:
(3) 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.
The Department included a Regulatory Impact and Notices section
with cost and benefits analysis and burden estimates in the May 15,
2015 Federal Register Notice for the proposed UrMG (80 FR 28101), and
requested public comment on all figures and assumptions. The
Department's projections were developed using information from current
HHS-certified urine testing laboratories, with input from DOT and the
Nuclear Regulatory Commission (NRC), and cost analysis was based on
information provided by multiple HHS-certified laboratories and MROs.
The Department received no substantive data or evidence through public
comments in favor of changing the estimated costs and benefits provided
in the Department's May 2015 Federal Register Notice for the UrMG, and
therefore, has retained the analysis and estimates provided in that
notice below. Comments that related to the costs and benefits of this
rule are summarized and discussed above in the Summary of Public
Comments and
[[Page 7931]]
HHS's Response under the heading Costs and Benefits.
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 since the current immunoassays can be adapted to test for
this analyte. 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 included criteria for calibrating
initial tests for grouped analytes such as opiates and amphetamines,
and specified the cross-reactivity of the immunoassay to the other
analytes(s) within the group. These Guidelines allow the use of methods
other than immunoassay for initial testing. 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 is 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 would indicate that the cost per specimen submitted for testing
will increase by $0.11-$0.30. Annual recurring testing costs in the
table below are based on an estimated number of 6,145,500 specimens.
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%. The burden of this 3% cost increase is expected to
shift gradually from MROs to agencies 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 of $3,687,300 to
$8,296,425 in the urine testing program. A federal agency may also
incur additional costs (e.g., additional managerial effort to arrange
substitute workers) when an employee tests positive for a prescription
medication and is removed from duties during the MRO verification
process.
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 $108,000 and $138,000 (i.e., assuming 8 hours of time
multiplied by a GS 12/13 wage including benefits and overhead
adjustments). The Department will offer the choice of online or in-
person training. This will eliminate travel costs for those federal
agencies who choose to use online training.
[[Page 7932]]
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.......................... 108,000 138,000
-------------------------------------
Total......................... 135,900.00 193,800.00
------------------------------------------------------------------------
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 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, a final regulatory
flexibility analysis is not required for this notice.
The Secretary has determined that the 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 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 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 Guidelines in accordance with
Executive Order 13132: Federalism. 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 revised 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 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
[[Page 7933]]
quality control documentation, reports, performance testing, and
inspections as set out in subparts H, I, K, L, M and N. Information
collection and recordkeeping requirements which would be imposed on
MROs engaged in drug testing services for federal agencies concern drug
testing result review and reports as set out in subparts 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 will submit the information collection and
recordkeeping requirements contained in the Guidelines to OMB for
review and approval prior to the effective date of the final
Guidelines. Information collections changed by these Guidelines are not
effective until approved by OMB.
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
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 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 (73 FR 71858) 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 these final Guidelines are effective and OMB approves the
revised information collection. OMB will assign a new control number to
account for changes associated with the final Guidelines.
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, 1 IITF, and 100 MROs.
Estimate of Annual Reporting Burden
--------------------------------------------------------------------------------------------------------------------------------------------------------
Number of Responses/
Section Purpose respondents respondent Hours/ response Total hours
--------------------------------------------------------------------------------------------------------------------------------------------------------
9.2(a)(1)............................... Laboratory or IITF \1\ required 10 1 3........................... 30
to submit application for
certification.
9.12(a)(3).............................. Materials to submit to become an 10 1 2........................... 20
HHS inspector.
11.3(a)................................. Laboratory submits 10 1 2........................... 20
qualifications of RP to HHS.
11.4(c)................................. Laboratory submits information 10 1 2........................... 20
to HHS on new RP or alternate
RP.
11.22................................... Specifications for laboratory 10 5 0.5......................... 25
semi-annual statistical report
of test results to each federal
agency.
12.3(a)................................. IITF\1\ submits qualifications 1 1 1........................... 1
of RT to HHS.
12.4(c)................................. IITF\1\ submits information to 1 1 1........................... 1
HHS on new RT or alternate RT.
12.19................................... Specifications for IITF \1\ semi- 1 1 1........................... 1
annual statistical report of
test results to each federal
agency.
[[Page 7934]]
13.9 and 14.7........................... Specifies that MRO must report 100 14 0.05 (3 min)................ 70
all verified primary and split
specimen test results to the
federal agency.
16.1(b) & 16.5(a)....................... Specifies content of request for 1 1 3........................... 3
informal review of suspension/
proposed revocation of
certification.
16.4.................................... Specifies information appellant 1 1 0.5......................... 0.5
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 appellant 1 1 50.......................... 50
submission for review.
16.9(a)................................. Specifies content of appellant 1 1 3........................... 3
request for expedited review of
suspension or proposed
revocation.
16.9(c)................................. Specifies contents of review 1 1 50.......................... 50
file and briefs.
-----------------------------------------------------------------------------
Total............................... ................................ 159 .............. ............................ 295
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Although IITFs are allowed under the Guidelines effective October 1, 2010 (73 FR 71858), SAMHSA has not received any IITF applications for
certification to test federally regulated specimens. IITF numbers are provided in this analysis as placeholders for administrative purposes.
The following reporting requirements are also in the 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)]; Section 13.5
describes the actions an MRO takes to report a primary specimen result;
Section 14.6 describes the actions an MRO takes to report a split
specimen result; 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.
Estimate of Annual Disclosure Burden
--------------------------------------------------------------------------------------------------------------------------------------------------------
Number of Responses/
Section Purpose respondents respondent Hours/ response Total hours
--------------------------------------------------------------------------------------------------------------------------------------------------------
8.3(a), 8.5(f)(2) (iii), 8.6(b)(2)...... Collector must contact federal 100 1 0.05 (3 min)................ 5
agency point of contact.
11.23, 11.24............................ Information on drug test that 50 10 3........................... 1,500
laboratory must provide to
federal agency upon request or
to donor through MRO.
12.20, 12.21............................ Information on drug test that 1 1 1........................... 1
IITF\1\ must provide to federal
agency upon request or to donor
through MRO.
13.8(b)................................. MRO must inform donor of right 100 14 3........................... 4,200
to request split specimen test
when a positive, adulterated,
or substituted result is
reported.
-----------------------------------------------------------------------------
Total............................... ................................ 211 .............. ............................ 5,706
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Although IITFs are allowed under the Guidelines effective October 1, 2010 (73 FR 71858), SAMHSA has not certified any IITFs to test federally
regulated specimens. IITF numbers are provided in this analysis as placeholders for administrative purposes.
The following disclosure requirements are also included in the
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 Federal CCF 100 380 0.07 (4 min)................ 2,534
for specimen collected.
8.8(d) & (f)............................ Donor initials specimen labels/ 38,000 1 0.08 (5 min)................ 3,167
seals and signs statement on
the Federal CCF.
[[Page 7935]]
11.8(a) & 11.19......................... Laboratory completes Federal CCF 10 3,800 0.05 (3 min)................ 1,900
upon receipt of specimen and
before reporting result.
12.8(a) & 12.15......................... IITF\1\ completes Federal CCF 1 1 1........................... 1
upon receipt of specimen and
before reporting result.
13.4(d)(4),13.9(c),14.7(c).............. MRO completes Federal CCF before 100 380 0.05 (3 min)................ 1,900
reporting the primary or split
specimen result.
14.1(b)................................. MRO documents donor's request to 300 1 0.05 (3 min)................ 15
have split specimen tested.
-----------------------------------------------------------------------------
Total................................... ................................ 38,511 .............. ............................ 9,517
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ Although IITFs are allowed under the Guidelines effective October 1, 2010 (73 FR 71858), SAMHSA has not certified any IITFs to test federally
regulated specimens. IITF numbers are provided in this analysis as placeholders for administrative purposes.
The 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)].
Because this is required by the current Guidelines and is consistent
with general forensic requirements, 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
15,518 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
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 submitted
a copy of these proposed Guidelines to OMB for its review. Comments on
the information collection requirements were 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.
References
1. Cone, E.J., Heltsley, R., Black, D.L., Mitchell, J.M., LoDico,
C.P., Flegel, R.R, 2013. Prescription opioids. I. metabolism and
excretion patterns of oxycodone in urine following controlled single
dose administration. J. Anal. Toxicol, 37, 255-264.
2. Cone, E.J., Heltsley. R., Black, D.L., Mitchell, J.M., LoDico,
C.P., Flegel, R.R, 2013. Prescription opioids. II. metabolism and
excretion patterns of hydrocodone in urine following controlled
single dose administration. J. Anal. Toxicol, 37, 486-494.
3. Esposito, F.M., Mitchell, J.M., Baylor, M.R., Bush, D.M, 2006.
Influence of basic pH on federal regulated drugs in urine at room
temperature. Poster presented at the Society of Forensic
Toxicologists (SOFT) Annual Meeting, Austin, TX. October 2006.
4. Cone, E.J., Bigelow, G.E., Herrmann, E.S., Mitchell, J.M.,
LoDico, C., Flegel, R., Vandrey, R, 2015. Nonsmoker exposure to
secondhand cannabis smoke. III. oral fluid and blood concentrations
and corresponding subjective effects. J. Anal. Toxicol, 39, 497-509.
5. Hermann, E.S, Cone, E.J., Mitchell, J.M., Bigelow, G.E., LoDico,
C., Flegel, R., Vandrey, R., 2016. Non-smoker exposure to secondhand
cannabis smoke II: Effect of room ventilation on the physiological,
subjective, and behavioral/cognitive effects. Drug alcohol depend,
151, 194-202.
Dated: January 11, 2017.
Kana Enomoto,
Acting Deputy Assistant Secretary for Mental Health and Substance Use,
SAMHSA.
Dated: January 11, 2017.
Sylvia M. Burwell
Secretary.
The Mandatory Guidelines using Urine Specimens as revised are
hereby adopted in accordance with section 503 of Public Law 100-71 and
Executive Order 12564.
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?
[[Page 7936]]
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
2.1 What type of specimen may be collected?
2.2 Under what circumstances may a urine 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 they are
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
[[Page 7937]]
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 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
[[Page 7938]]
(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 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.
External Service Provider. An independent entity that performs
services related to federal workplace drug testing on behalf of a
federal agency, a collector/collection site, an
[[Page 7939]]
HHS[hyphen]certified laboratory, a Medical Review Officer (MRO), or,
for urine, an HHS[hyphen]certified Instrumented Initial Test Facility
(IITF).
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, 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.
Gender Identity. Gender identity means an individual's internal
sense of being male or female, which may be different from an
individual's sex assigned at birth.
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
in accordance with the criteria established in Section 3.9 when a
positive, negative, adulterated, or substituted result cannot be
established for a specific drug or specimen validity test.
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.
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. Fluid or material 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.
The Health Insurance Portability and Accountability Act of 1996
(HIPAA) Privacy Rule (Rule), 45 CFR parts 160 and 164, Subparts A and
E, may be 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
[[Page 7940]]
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 as described in section 8.4(a);
(3) Fail to provide a specimen (e.g., urine or another authorized
specimen type) for any drug test required by these Guidelines or
federal agency regulations with the exception of a donor who leaves the
collection site before the collection process begins for a pre-
employment test as described in section 8.4(a);
(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 13.6;
(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) Bring materials to the collection site for the purpose of
adulterating, substituting, or diluting the specimen;
(11) Attempt to adulterate, substitute, or dilute the specimen;
(12) Possess or wear a prosthetic or other device that could be
used to interfere with the collection process; or
(13) Admit to the collector or MRO that you have adulterated or
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, including failing to appear in a reasonable time
for any test except a pre-employment test as described in Section
1.7(a)(1), the collector must terminate the collection process and take
action as described in Section 8.13. Required action includes
immediately notifying 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 and, if a Federal CCF has
been initiated, documenting the refusal on the Federal CCF, signing and
dating the Federal CCF, and sending 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 opioids, 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
[[Page 7941]]
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.
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 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 Confirmatory test
Initial test analyte Initial test cutoff \1\ analyte cutoff concentration
----------------------------------------------------------------------------------------------------------------
Marijuana metabolites (THCA) \2\..... 50 ng/mL \3\........... THCA................... 15 ng/mL.
Cocaine metabolite (Benzoylecgonine). 150 ng/mL \3\.......... Benzoylecgonine........ 100 ng/mL.
Codeine/Morphine..................... 2,000 ng/mL............ Codeine................ 2,000 ng/mL.
Morphine............... 2,000 ng/mL.
Hydrocodone/Hydromorphone............ 300 ng/mL.............. Hydrocodone............ 100 ng/mL.
Hydromorphone.......... 100 ng/mL.
Oxycodone/Oxymorphone................ 100 ng/mL.............. Oxycodone.............. 100 ng/mL.
Oxymorphone............ 100 ng/mL.
6-Acetylmorphine..................... 10 ng/mL............... 6-Acetylmorphine....... 10 ng/mL.
Phencyclidine........................ 25 ng/mL............... Phencyclidine.......... 25 ng/mL.
Amphetamine/Methamphetamine.......... 500 ng/mL.............. Amphetamine............ 250 ng/mL.
Methamphetamine........ 250 ng/mL.
MDMA \4\/MDA \5\..................... 500 ng/mL.............. MDMA................... 250 ng/mL.
MDA.................... 250 ng/mL.
----------------------------------------------------------------------------------------------------------------
\1\ For grouped analytes (i.e., two or more analytes that are in the same drug class and have the same initial
test cutoff):
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.
\2\ An immunoassay must be calibrated with the target analyte, [Delta]-9-tetrahydrocannabinol-9-carboxylic acid
(THCA).
\3\ Alternate technology (THCA and benzoylecgonine): The confirmatory test cutoff must be used for an alternate
technology initial test that is specific for the target analyte (i.e., 15 ng/mL for THCA, 100 ng/mL for
benzoylecgonine).
\4\ Methylenedioxymethamphetamine (MDMA).
\5\ Methylenedioxyamphetamine (MDA).
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 on a case-by-case basis as
necessary to provide information that the MRO would use to report a
verified drug test result (e.g., tetrahydrocannabivarin, specimen
validity tests using biomarkers). An HHS-certified laboratory is not
authorized to routinely perform additional drug and/or specimen
validity tests at the request of an MRO without prior authorization
from the Secretary or designated HHS representative, with the exception
of the determination of D,L stereoisomers of amphetamine and
methamphetamine. All tests must meet appropriate validation and quality
control requirements in accordance with these Guidelines.
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;
[[Page 7942]]
(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 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 20 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
[[Page 7943]]
the second test on two separate aliquots or a foam/shake test for the
initial test;
(i) Interference occurs on the 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 for both the initial (first) test and the
second test on two separate aliquots.
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. 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 their
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 they fulfill 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 scenario, 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 their training
and provide that documentation to a federal agency when requested.
(d) An individual may not collect specimens for a federal agency
until the individual's 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 gender of the observer must be the same as the donor's
gender, which is determined by the donor's gender identity. The
observer selection process is described in Section 8.10(b).
(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 the trainer's training and provide that documentation
to a federal agency when requested.
[[Page 7944]]
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 8.12.
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;
(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 6 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?
(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 does not use the correct OMB-approved Federal
CCF, 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 the collector used an incorrect form, 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 laboratory or IITF reports a
rejected for testing result to the MRO and the MRO cancels the test.
The HHS-certified laboratory or IITF must wait at least 5 business days
while attempting to obtain the memorandum before reporting a rejected
for testing result to the MRO.
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.
[[Page 7945]]
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 [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 gender of the observer for purposes of a direct observed
collection (i.e., as described in Section 8.10) must be the same as the
donor's gender, which is determined by the donor's gender identity. The
gender of the monitor for a monitored collection (i.e., as described in
Section 8.12) must be the same as the donor's gender, 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 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 they
are 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 the donor's wallet.
(2) The collector asks the donor to empty the donor's pockets and
display the contents to ensure no items are present 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 the
donor's 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, substitute, or dilute
the specimen, 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. 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 the
donor's 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 the
donor's hands prior to urination. After washing the donor's 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 the donor's 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 the specimen in
the privacy of a stall or otherwise partitioned area that allows for
individual privacy. The collector directs the donor to provide a
[[Page 7946]]
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 8.12), 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
report a refusal to test in accordance with Section 8.13.
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 the donor's
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 temperature is
in the acceptable range of 32 [deg]-38 [deg]C/90 [deg]-100 [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 [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 must 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 for each specimen.
(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 must 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 for each specimen.
(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. The federal agency may choose to provide the collection
site with a standard protocol to follow in lieu of requiring the
collector to notify the agency's designated representative for
authorization in each case. 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 they are
unable to provide a urine specimen?
(a) If the donor states that they are 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 their 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 they 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 they are 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. The federal
agency may choose to provide the collection site with a standard
protocol to follow in lieu of requiring the collector to notify the
agency's
[[Page 7947]]
designated representative for authorization in each case. 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?
Yes, if 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 the donor. 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 their 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.
(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; or
(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).
(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) 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's gender must be the same as the
donor's gender, which is determined by the donor's gender identity,
with no exception to this requirement.
(b) Before an observer is selected, the collector informs the donor
that the gender of the observer will match the donor's gender, which is
determined by the donor's gender identity (as defined in Section 1.5).
The collector then selects the observer to conduct the observation:
(i) The collector asks the donor to identify the donor's gender on
the Federal CCF and initial it.
(ii) The donor will then be provided an observer whose gender
matches the donor's gender.
(iii) The collector documents the observer's name and gender on the
Federal CCF.
(c) If there is no collector available of the same gender as the
donor's gender, 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.
(d) 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:
(1) The observer enters the restroom with the donor;
(2) 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);
(3) The observer must not touch or handle the collection container
unless the observer is also serving as the collector;
(4) After the donor has completed urinating into the collection
container:
(i) If the same person serves as the observer and collector, that
person may receive the collection container from the donor while they
are both in the restroom;
(ii) 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.
(5) 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
(6) The collector then continues with the routine collection
procedure in Section 8.3.
[[Page 7948]]
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 same procedures
used for selecting an observer of the appropriate gender in Section
8.10(b) must be used to select the monitor for the purposes of Section
8.12, unless the monitor is a medical professional as described above.
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, that
person 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.
(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.
[[Page 7949]]
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 as low as 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 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.
[[Page 7950]]
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 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.
[[Page 7951]]
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 they satisfy the following criteria:
(1) Has experience and an educational background similar to that
required for either a responsible person or a certifying scientist for
an HHS-certified laboratory as described in Subpart K or as a
responsible technician for an HHS-certified IITF 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.
(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
[[Page 7952]]
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.
(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 as a split specimen (specimens
A and B) 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:
[[Page 7953]]
(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;
(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
[[Page 7954]]
(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 they are 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.
(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;
[[Page 7955]]
(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 invalid, adulterated, or substituted specimen validity
test result must be based on an initial specimen validity test on one
aliquot and a confirmatory specimen validity 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.
(3) 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;
(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
[[Page 7956]]
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 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
[[Page 7957]]
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) 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 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 1 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 1-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 2 years. The laboratory may
convert hardcopy records to electronic records for storage and then
discard the hardcopy records after 6 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 2-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;
[[Page 7958]]
(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 the employee's drug 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
[[Page 7959]]
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 r[eacute]sum[eacute] 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 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 they are 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.
[[Page 7960]]
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:
(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 than1.003) or dilute (equal to or greater
than1.002 and less than1.003). 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
[[Page 7961]]
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;
(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 the employee's 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.
[[Page 7962]]
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;
(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 from initial certification, 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 physicians as MROs for
federal workplace drug testing programs must submit their
qualifications, a sample examination, and other necessary supporting
examination materials (e.g., answers, previous examination statistics
or other background examination information, if requested). Approval
will be based on an objective review of qualifications that include a
copy of the MRO applicant application form, documentation that the
continuing education courses are accredited by a professional
organization, and the delivery method and content of the examination.
Each approved MRO 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; and
(5) Procedures for interpretation, review (e.g., donor interview
for legitimate medical explanations, review of documentation provided
by the donor to support a legitimate medical explanation), and
reporting of results specified by any federal agency for which the
individual may serve as an MRO;
(b) Certified MROs must complete training on any revisions to these
Guidelines prior to their effective date, to continue serving as an MRO
for federal agency specimens.
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 (f) 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 (f) 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 documentation (e.g., a valid
[[Page 7963]]
prescription) to support 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 13.5(b)(1) or (2) for the
recollected specimen.
(i) Passive exposure to marijuana smoke is not a legitimate medical
explanation for a positive THCA result.
(ii) Ingestion of food products containing marijuana is not a
legitimate medical explanation for a positive THCA result.
(2) If the donor is unable to provide a legitimate medical
explanation, the MRO reports a positive result to the agency for all
drugs except codeine and/or morphine (see below). If the laboratory
also reports that the urine specimen is dilute, the MRO may choose not
to report the dilute result.
(i) For codeine and/or morphine less than 15,000 ng/mL and no
legitimate medical explanation: the MRO must determine if there is
clinical evidence of illegal use (in addition to the test result) to
report a positive result to the agency. If there is no clinical
evidence of illegal use, the MRO reports a negative result to the
agency. 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).
(ii) For codeine and/or morphine equal to or greater than 15,000
ng/mL and no legitimate medical explanation: the MRO reports a positive
result to the agency. Consumption of food products must not be
considered a legitimate medical explanation for the donor having
morphine or codeine at or above this concentration.
(e) When the 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.
(f) 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 result, the MRO follows the procedures in 13.5(a) through (e).
(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).
(g) 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.
(h) 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
[[Page 7964]]
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. 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 genitourinary 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.
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 the donor 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 the donor's 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 the donor 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.
[[Page 7965]]
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 request, verbally or in writing, 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 request after being
informed of the result by the MRO. The MRO must document in the MRO's
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 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
[[Page 7966]]
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 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, 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.
[[Page 7967]]
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 primary (A) or split (B) 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 missing, misapplied,
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;
(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;
(f) The specimen was received at the HHS-certified laboratory or
IITF without a CCF;
(g) The CCF was received at the HHS-certified laboratory or IITF
without a specimen;
(h) The collector performed two separate collections using one CCF;
or
(i) The HHS-certified laboratory or IITF identifies a flaw (other
than those specified above) that prevents testing or affects the
forensic defensibility of the drug test and cannot be corrected.
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 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 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 Social Security
Number or employee identification number;
(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 the
collector 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.
[[Page 7968]]
(b) The following omissions and discrepancies on the Federal CCF
that are made at the HHS-certified laboratory or IITF 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 their name;
(3) The certifying scientist or certifying technician fails to
print their 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 should 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 they 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 official may be assisted by one or more of the official's
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.
[[Page 7969]]
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 their 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 the official's employees or consultants in conducting 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 their 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
[[Page 7970]]
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 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
their 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. 2017-00979 Filed 1-19-17; 8:45 am]
BILLING CODE 4162-20-P