Current through Register Vol. 43, No. 52, December 26, 2024
(a) Definitions.
(1) "Department" means the department of
health and environment.
(2)
"Division" means the division of Kansas health and environmental laboratory.
(3) "Laboratory director" means
the person responsible for the professional, administrative, organizational,
and educational duties of a laboratory.
(4) "Laboratory supervisor" means the
individual responsible for providing day-to-day supervision of testing
personnel, including the proper performance of all laboratory procedures and
reporting of test results.
(5)
"Testing personnel" means individuals responsible for specimen processing, test
performance, and reporting test results.
(6) "Test for controlled substance" means a
procedure to evaluate a specimen for compounds identified in schedule I or II
of the Kansas controlled substance act, K.S.A. 1996 Supp.
65-4105 and
65-4107.
(7) "Threshold" means a defined drug or
metabolite concentration that is established at a level resulting in the
following:
(A) a concentration at or above
this level defines a positive result; and
(B) a concentration below this level defines
a negative result.
(8)
"Screening test" means a test designed to eliminate true negative specimens
from further consideration. Threshold limits used for screening tests shall
conform to the mandatory guidelines for federal workplace drug testing programs
established by the substance abuse and mental health services administration of
the department of health and human services in the federal register, volume 59,
number 110, page 29921, published June 9, 1994.
(9) "Confirmatory test" means a mass
spectrometry analytical procedure used to specifically identify the presence of
a drug or drug metabolite. Threshold limits used for confirmatory testing shall
conform to the mandatory guidelines for federal workplace drug testing programs
established by the substance abuse and mental health services administration of
the department of health and human services in the federal register, volume 59,
number 110, pages 29921-29922, published June 9, 1994.
(10) "Unsatisfactory performance" means a
score for any analyte of less than 80% as determined by the proficiency testing
provider.
(11) "Unsuccessful
participation" means unsatisfactory performance for the same analyte in two
consecutive or two out of three consecutive proficiency testing events.
(12) "CLIA" means the clinical
laboratory improvement amendments of 1988, Public Law 100-578, as implemented
by 42 CFR part 493, issued February 28, 1992, as amended and in effect on April
24, 1995.
(b) Approval
procedure.
(1) Except as provided in
subsection (k), each laboratory located in Kansas seeking approval of the
department to perform tests on biological specimens for controlled substances,
as defined in schedule I and II of the Kansas controlled substance act, K.S.A.
1996 Supp.
65-4105 and
65-4107, shall be a laboratory
that the division director or director's designee determines meets the
requirements for certification under CLIA for the type and complexity of the
tests being performed.
(2)
(A) Except as set out in paragraph (C), each
laboratory seeking approval to test biological specimens for the following
drugs or their metabolites shall meet the requirements set out in paragraph
(B):
(ii) cannabinoids or tetrahyrocannabinoids
(THC);
(B) In addition to meeting requirements for
certification under CLIA, each laboratory seeking approval under paragraph (A)
shall submit the following:
(i) a completed
application on standard forms furnished by the division; and
(ii) documents demonstrating successful
performance in one testing event using a proficiency testing program approved
by the division.
(C)
Any laboratory facility testing specimens for emergency diagnosis and treatment
may test for drugs listed on schedule I or II of the Kansas controlled
substance act, K.S.A. 1996 Supp.
65-4105 and
65-4107, without meeting the
requirements of paragraph (B), if test results are used only for diagnosis and
treatment.
(c) Upon receipt of a laboratory's
application for approval, the laboratory shall be inspected by a representative
of the division. The laboratory shall be evaluated to determine compliance
using the following criteria.
(1) Screening
test methods shall screen for the following five classes of drugs:
(B) cannabinoid or THC metabolites;
(2) Each test procedure shall be performed in
accordance with a written protocol. The protocol shall be approved by the
laboratory director. The protocol shall require that a blank control containing
no drug and a control fortified with a known analyte concentration greater than
the threshold limit for each analyte be included with each batch of specimens
tested. At least one fortified control shall be at or near the threshold
cutoff. The protocol shall insure that carryover between specimens does not
occur.
(3) A laboratory quality
assurance program shall be developed and implemented. The program shall contain
the following components:
(A) requirements
for sample collection that adhere to the criteria of the division director or
the director's designee, or a signed statement that the specimen was properly
collected according to these criteria, if collection is at a location other
than the laboratory performing the test;
(B) identification and chain of custody
procedures for specimens;
(C)
procedures for assuring the security of the testing area, test records, and
test reports;
(D) confirmation
procedures for all positive screening tests unless evidenced by documentation
that the testing is performed for one of the following:
(i) medical purposes on a hospital inpatient
or patient currently undergoing treatment in a hospital emergency room;
(ii) a specimen from an individual
currently under treatment for substance abuse; or
(iii) a correctional facility solely for the
purpose of internal management of persons as defined in regulations promulgated
by the secretary of corrections;
(E) a policy stating that only confirmed
positive results shall be reported as positive;
(F) procedures for an internal quality
control program that monitors the accuracy and precision of laboratory
performance;
(G) procedures for an
instrument maintenance program that, at a minimum, conforms to the
manufacturer's specifications;
(H)
provision for retention of all confirmed positive specimens for at least one
year;
(I) policies requiring
disposal of all medical wastes in accordance with K.A.R. 28-29-27; and
(J) documentation of adherence to
the foregoing policies and procedures.
(4) Equipment required by the test system
shall meet the specifications of the test system's manufacturer.
(5) Reagents, controls, and any other
required materials for the procedure being performed shall be available and
shall be stored according to the manufacturer's specifications.
(d) During the inspection by the
division, one or more testing personnel may be required to demonstrate
performance of the procedure under consideration.
(e) Except as provided in subsection (k),
each approved laboratory located in Kansas shall be inspected by the division
biennially. A follow-up inspection of any approved laboratory may be conducted
by the division at any time.
(f)
Each laboratory performing tests for controlled substances shall have an
individual serving as laboratory director who holds one of the following
credentials:
(1) current licensure as a
physician in the state where the laboratory is located, with additional
training in pharmacology, toxicology, clinical pathology or forensic pathology;
or
(2) an earned doctoral degree
from an accredited institution in a chemical or biological science and at least
two years of laboratory experience in chemistry or analytical toxicology.
(g) Each laboratory
performing tests for controlled substances shall have an individual or
individuals serving as a laboratory supervisor. Each laboratory supervisor
shall hold one of the following credentials:
(1) an earned doctoral degree from an
accredited institution in a chemical or biological science and at least two
years of laboratory experience in chemistry or analytical toxicology; or
(2) an earned baccalaureate degree
from an accredited institution in a chemical or biological science or medical
technology and at least four years of experience in chemistry or analytical
toxicology.
(h) Each
laboratory performing tests for controlled substances shall have one or more
individuals serving as testing personnel. Each individual serving as testing
personnel shall hold one of the following credentials:
(1) an earned baccalaureate degree from an
accredited institution in a chemical or biological science or medical
technology;
(2) an earned
associate degree from an accredited institution in a chemical or biological
science or medical technology; or
(3) have achieved a satisfactory grade in the
health and human services written clinical laboratory technologist examinations
offered between March 7, 1975 and August 28, 1987 by the professional
examination service.
(A) The laboratory
director shall document that testing personnel performing tests have been
adequately trained in each test procedure being performed.
(B) Records of educational credentials and
training shall be maintained for each individual qualified under subsections
(f), (g), or (h) of this regulation.
(i) One copy of each test requisition, test
record, and test report shall be maintained in a readily retrievable manner by
the laboratory for a period of two years.
(j) Proficiency program. Each laboratory
shall enroll and participate in an approved external proficiency testing
program for opiates, cocaine, connabinoids or THC, amphetamines, and
phencyclidine. A list of approved proficiency testing programs shall be
available from the division.
(1) The results
of each laboratory's performance in the proficiency testing program shall be
sent directly from the approved program provider to the division.
(2) The approval for any laboratory may be
revoked by the director of the division or the director's designee when the
laboratory meets the criteria for unsuccessful participation in an approved
external proficiency testing program.
(3) Each laboratory shall undertake an
investigation and institute corrective action for all incorrect responses
identified in the proficiency testing program. The laboratory shall maintain
documentation of the investigation and corrective action for a period of two
years.
(k)
(1) Any laboratory that is not located in the
state of Kansas may apply for approval. Such a laboratory shall be added to the
list of approved laboratories if it meets the following conditions.
(A) The laboratory shall be certified or
approved by a federal, state, or independent agency having standards that are
determined by the director of the division, or the director's designee, to be
generally equivalent or more stringent than the standards set out in
subsections (b) through (j) of this regulation.
(B) The laboratory seeking approval shall
submit the following documentation for inspection by the department:
(i) a completed application on standard forms
furnished by the division;
(ii) a
report of the most recently completed on-site inspection by the approving
agency addressing subsections (c) through (e);
(iii) proficiency testing results from the
most recently completed proficiency challenge;
(iv) documents demonstrating that the
laboratory personnel meet the qualifications set forth in subsections (f), (g),
and (h); and
(v) any other
documentation deemed necessary by the division.
(2) Any laboratory located in
Kansas may seek approval under this subsection in lieu of following approval
procedures in subsection (b) and meeting the on-site inspection requirements in
subsections (c) through (e).
(l) List of approved laboratories. A current
list of approved laboratories shall be maintained by the division. Each
laboratory shall be approved biennially.
(m) Removal from approved list.
(1) A laboratory shall be removed from the
approved list after voluntarily terminating or after notice and an opportunity
for a hearing. All orders of revocation shall become final 15 days after
service unless an appeal is filed in writing. All appeals shall be conducted
according to the Kansas administrative procedure act,
K.S.A.
77-501 et seq. and any amendments.
(2) Notification of removal of a laboratory
from the approved list shall be made by certified mail.