Category: USDOT Drug Testing

FMCSA Clearinghouse OPEN for Registration!

Posted by on in Regulatory Update, USDOT Drug Testing

Registration is open for the Drug and Alcohol Clearinghouse. To access the Clearinghouse once it is operational, authorized users will be required to request access from FMCSA by registering for the Clearinghouse. Registering is the first step to ensuring you will be ready when the Clearinghouse is operational on January 6, 2020.

Authorized users include:

  • CDL drivers
  • Employers – this includes motor carriers and other employers of drivers operating commercial motor vehicles (CMVs) that require a commercial driver’s license (CDL) or commercial learner’s permit (CLP)
  • Consortia/third-party administrators (C/TPAs)
  • Medical review officers (MROs)
  • Substance abuse professionals (SAPs)
  • Enforcement personnel

To register, go to: https://clearinghouse.fmcsa.dot.gov

The Clearinghouse is a secure online database that will give employers, the Federal Motor Carrier Safety Administration (FMCSA), State Driver Licensing Agencies (SDLAs), and State law enforcement personnel real-time information about commercial driver’s license (CDL) and commercial learner’s permit (CLP) holders’ drug and alcohol program violations.

The Clearinghouse will contain records of violations of drug and alcohol prohibitions in 49 CFR Part 382, Subpart B, including positive drug or alcohol test results and test refusals. When a driver completes the return-to-duty (RTD) process and follow-up testing plan, this information will also be recorded in the Clearinghouse.

In addition, employers may designate a C/TPA who can report violations and/or conduct queries on their behalf. An owner-operator—an employer that employs himself or herself as a CDL driver, typically a single-driver operation—must designate the C/TPA in the Clearinghouse. If you choose to designate Nationwide Testing Assocation, Inc., to report violations and conduct queries on your behalf then contact us!

For more information, contact us!

Medical Review Officer (MRO) Services

Posted by on in Medical Review Office, USDOT Drug Testing, Workplace Drug Testing

A Medical Review Officer (MRO) is a licensed physician responsible for receiving and reviewing laboratory results generated by an employer’s drug testing program. Regulations require that Medical Review Officers have knowledge about the pharmacology and toxicology of prescriptions as well as illicit drugs. An MRO should also have knowledge of the federal agency drug testing regulations and guidelines from the Department Of Transportation.

As a Medical Review Officer (MRO), we must act as an independent and impartial “gatekeeper” and advocate for the accuracy and integrity of the drug testing process. Nationwide Testing Association, Inc., is required to review the documents for possible errors, interview donors who have non-negative results to determine if there is a legitimate medical explanation for their results, and provide feedback to employers regarding performance problems, if necessary.

At Nationwide Testing Association, Inc., our Medical Review Officers (MRO) are certified by a nationally recognized MRO certification board. We ensure that our MROs maintain their certifications by retaking and passing the exam every five years.

Medical Review Officer (MRO) Process

The first part of the process is the collection; the employee/donor/applicant will go into the collection site to provide the required specimen. The collection site will follow applicable protocols and will ship the specimen, along with the lab copy of the Custody and Control Form (CCF), to the laboratory to begin testing. The collection site should also transmit the Medical Review Officer and the DER copy of the CCF to the correct parties.

Once the laboratory receives the specimen, they will begin conducting the required testing. Once completed, the laboratory will transmit the results to the MRO to review and report.

After the Custody and Control Form (CCF) is received, the donor’s name and id number are entered into the system. The Custody and Control Form is then processed so that it will link to the result.

When the lab results are received through an electronic interface, they are immediately downloaded into our system. During this process, the result links to the client, the donor record, and the Custody and Control Form. The system will also determine an applicable status for the result based on pre-set identifiers and criteria

If the lab result is non-negative the system will automatically assign that result to our Medical Review Office, they are then reviewed by our Medical Review Officers. Each donor with a non-negative result will have the opportunity to speak with an MRO regarding their results.

If the lab result is negative, they will report to the company automatically through the system. If the laboratory results appear positive, the MRO will interview the donor to discuss the results and then the final report will be distributed to the company. The medical review process offers an opportunity for the donor to provide a valid medical explanation for any questionable results. Our process is designed to protect individuals and employers from wrongful accusations. We exceed all federal and state regulations and help you maintain a safer workplace!

Contact us today to learn about the Nationwide Difference!

Drug & Alcohol Clearinghouse: An Update

Posted by on in Regulatory Update, USDOT Drug Testing

Beginning January 6, 2020

To ensure you are prepared on January 6, 2020, when the Federal Motor Carrier Safety Administration (FMCSA) Drug and Alcohol Clearinghouse (Clearinghouse) becomes operational, we want to remind you about an upcoming change related to recording information on the Federal Drug Testing Custody and Control Form (CCF) and Alcohol Testing Form (ATF).

What Changed?

The current versions of the CCF and ATF specifically permit the use of either the driver’s social security number (SSN) or employee identification number (EIN) when completing the CCF or ATF.  However, effective January 6, 2020, FMCSA is requiring that the commercial driver’s license number (CDL) must be used instead of the SSN or EIN when FMCSA-covered drivers’ positive drug or alcohol test results are reported to the Clearinghouse.

Therefore, Employers, Consortia/Third Party Administrators (C/TPAs), Collection Sites, Laboratories, and Medical Review Officers (MROs) may want to ensure that their respective data systems can accommodate a donor identification number of up to 25 alphanumeric characters.

What does this mean for Employers, C/TPAs, Collectors and Alcohol Technicians?

  • In accordance with 49 CFR 382.123(b), the person completing the CCF or the ATF must annotate the driver’s CDL number and State of Issuance in Step 1, Section C of the CCF or Step 1B of the ATF for each FMCSA-regulated test.
  • If the employer or C/TPA does not provide the CDL and the State of Issuance, then the collector or alcohol technician should ask the driver for this information at the collection site.
  • Even if the CDL number and State of Issuance is not listed on the CCF, the collector must send the controlled substance test specimen to the laboratory for testing.

What does this mean for Laboratories?

Laboratories who receive a CCF that indicates this is a FMCSA-regulated urine specimen but does not have the driver’s CDL number listed in Step 1 C should process the urine specimen without delay, and send the results to the MRO.

What does this mean for the MRO?

When the MRO receives a laboratory-confirmed positive drug test result for a FMCSA-regulated employee, and the CCF is without the driver’s CDL number and State of Issuance listed, the MRO should contact the driver, driver’s employer or designated employer representative to obtain it.  The MRO will report the verified positive test result in the Clearinghouse.

For additional information, please visit https://clearinghouse.fmcsa.dot.gov.

What Happens to a Specimen after Collection?

Posted by on in Drug-Free Workplace, Medical Review Office, Non-DOT Drug Testing, USDOT Drug Testing, Workplace Drug Testing

What happens to a specimen immediately after it is collected?

1. From the point of collection, the specimen is packaged & sent to the laboratory via carrier or FedEx.

2. Specimens are processed in a strategic fashion by the certified laboratory. Once the specimen arrives at the lab, the specimen and the accompanying COC are unpackaged. The COC and the specimen vials are scanned at multiple points in each process for record keeping & also to guarantee accuracy.

3.The specimen is divided into equal parts for the testing process & the first immunoassay test is conducted. If the preliminary finding suggests that the specimen is positive, it is sent to another part of the lab for GC/MS confirmation testing. Another primary reason for dividing the specimen is to also reserve a portion in the event that a split specimen test is requested by the donor.

4. The specimen is then tested via the GCMS or Gas Chromatography/Mass Spectrometry. Gas chromatography-mass spectrometry (GC-MS) combines the features or gas-liquid chromatography (GC) and mass spectrometry (MS) & makes it possible to identify different substances within the sample. Initial (immunoassay) and confirmatory (gas chromatography-mass spectrometry [GS-MS]) tests are the methods most frequently utilized for drug tests. Implementing these tests allows a high level of sensitivity and specificity. The approach also reduces the chance for false positives or false negatives greatly.

5. The exact findings of the screening test are confirmed and the laboratory generates an official report to record their findings. The report will include the specific test performed, the panels or drugs that the specimen was tested for, and the final verdict for each panel (positive, negative, or a cancelled specimen as a whole). Positive results will also feature the appropriate quantitative level for the verified substances and corresponding panels listed.

6. Normal negative results are reported immediately by the applicable reporting arrangements determined by the lab account profile.

7. If a result is positive, it is sent to the MRO or Medical Review Office for a final review. Multiple attempts are made to contact the donor in an effort to obtain a valid medical explanation. Quality and accuracy are of utmost importance to NTA, Inc. as the valid medical explanation is determined. Since drug tests are based on the detection of drug metabolites, it is of primary importance that the correct medication causing the positive is identified. In short, the goal of the Medical Review process and steps is to verify that the prescription serving as the contributing factor was legally prescribed to the donor prior to the drug test collection date. The Medical Review Officer or Medical Review Assistants attempt to contact the donor adhering to a high-level of procedural standards and practices based on the type of test being processed, for example;

7a. DOT Results are processed in accordance of DOT Regulations and federal guidelines and with respect to the Medical Review Officer’s responsibility.
7b. NON-DOT Results are processed according to NON-DOT procedures and are generally processed by our highly-qualified Medical Review Office Assistant Staff.

8. If the laboratory determines that a result is cancelled, the MRO Office will review the result and attempt to make contact with the donor as outlined above. A cancelled result can be attributed to a multitude of scenarios and findings. Examples of Cancelled Result causes or contributing factors include fatal flaw detection or rejection, abnormal PH, immunoassay interference, or abnormal creatinine level.

9. Once the full medical review process has concluded, the result is reported to the client as a verified result, negative result, or cancelled result.

  •          Normal Negative tests are usually reported within 24-48 hours from the time they enter the laboratory for analysis.
  •          Positive or Cancelled tests are usually reported from the laboratory within 5-7 business days from the time they are received for processing.

NTA, Inc. has one of the best Medical Review Offices in the country and we guarantee that diligent care is taken for each result that we review and process!

Post Accident Drug Testing Positivity

Posted by on in USDOT Drug Testing, Workplace Drug Testing

After a workplace accident, an employer may be required or may choose to drug test individuals involved in the accident to determine if drugs played a role. Post-accident drug testing is the third most common reason for drug testing. New findings from the Quest Diagnostics Drug Testing Index show the following facts about post-accident urine drug testing.

  • Post-accident drug positivity for urine testing has been increasing annually since 2011 across the combined US workforce.
  • For the general US workforce tested, post-accident positivity in 2018 was 8.4%, up 9% from 2017.
  • One in twelve US workforce employees tested was positive for drugs following an accident.
  • For the federally mandated safety-sensitive workforce tested, post-accident positivity in 2018 was 4.7% up 51% from 2017.
  • General US workforce positivity has increased by 29% over five years.
  • Safety-sensitive workforce positivity has increased by 81% over five years.

According to the Centers for Disease Control and Prevention, opioid prescribing rates are still very high in certain areas across the country. Having a valid prescription does not mean the medication is risk-free or is being used properly.

In 2018, marijuana was more than twice as likely to be detected by a post-accident drug test than in 2009. Marijuana can impair body movement, cause difficulty with thinking, and may even cause hallucinations and delusions when taken in high doses. All of these impacts can pose a risk and lower a user’s productivity regardless of the workplace setting.

Are you doing post-accident testing? Should you be? Contact our office today to learn about the risks! (800) 452-0030

Drug and Alcohol Clearinghouse

Posted by on in Regulatory Update, USDOT Drug Testing

The Federal Motor Carrier Safety Administration (FMCSA) is establishing the Commercial Driver’s License (CDL) Drug and Alcohol Clearinghouse. The Clearinghouse will hold information on violations of the Department of Transportation (DOT) controlled substance and alcohol testing program for CDL holders. The purpose of this database is to prevent CDL holders with violations from moving from job to job and avoiding the repercussions of violations. The Clearinghouse closes current gaps, allowing prospective employers to obtain information on violations.

When will the Clearinghouse be available?

In the fall of 2019, you can begin registering for the Clearinghouse by establishing an account. The Clearinghouse will not become fully operational until January 6, 2020. Once operational, employers will be required to query both the Clearinghouse and request the drug and alcohol testing history from previous employers. When seeking violations, you must search three years of history. On January 6, 2023, the clearinghouse will replace the need for the previous employer requests. The information available in the Clearinghouse will be accessible for a minimum of five years. Each employer will be required to query the database as part of the pre-hire process, and again annually.
According to the Federal Motor Carrier Safety Administration, Employers, Medical Review Officers (MRO), and Substance Abuse Professionals will be required to report to the database. The reports will include any verified positive, adulterated, or substituted tests; any refusals to test; positive breath alcohol tests above 0.04; DUI citation and conviction records; actual knowledge of abusive substance use; and all return to duty and follow up results.

If you have any questions on the Clearinghouse, contact us at 1.800.452.0030!