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Service Agents Series: Your Required Medical Review Officer or “MRO”
Your Required Medical Review Officer or “MRO”
This is the third installment in a series about the roles of DOT Service Agents (SAs) the people who help you implement your drug free workplace program.
After an employee participates in a DOT urine drug screen the specimen is sent by the urine collector to and processed by a DOT approved laboratory.
That process generates an initial result that is electronically sent to and reviewed by an Medical Doctors acting in the DOT Service Agent role of Medical Review Officer or “MRO”.
The urine collector also is required to send or electronically transmit the Medical Review Officer copy of the DOT urine collection Control and Custody Form of “CCF” to the MRO.
The MRO’s job is to review the initial result of a drug screen and determine several things:
- Is the result properly documented?
- Have they (the MRO’s office) received their copy (physical or electronic) of the drug screen form yet?
- Does the (the MRO) require additional information to determine the final result of a drug screen and report it.
- Is the test a positive drug screen result requiring an interview with the urine donor (employee that got tested)?
- Make contact with the donor (employee that got tested) when required and contact the employer when required.
- Make the final determination of the result
- Report the result of the drug screen to the donor’s employer either directly or through their (the donor’s employer) service agent authorized to do so.
- Determining and reporting negative DOT drug screen results
Most of the time results are negative and don't require any further action on the part of the MRO’s office so they report them out usually within 24 of receiving the initial results. Most MRO’s offer multiple options for getting a result including secure fax, email, and secure web portal access.
Determining and reporting positive DOT drug screen results
In the event of a positive result depending on how long it takes the MRO to get in touch with a donor (if the MRO needs to speak to them) before determining and reporting a result. Sometimes positive results can take a day or two longer to report.
The DOT requires results be processed and reported in a timely way so generally results are available between 24 to 48 hours after the lab receives the urine sample.
Delays in reporting results
MROs aren't allowed to report a DOT urine drug screen result until they have their copy and are able to determine it was filled out properly.
In some cases when the collection site does not send the MRO copy of the testing form to the MRO, results can end up being delayed until they receive it.
Mydrugtestingprogram.com sets all our clients up with an MRO that offers 24/7 online access to results and records through a secured system as well as 24/7 toll free live customer service.
What a DOT Urine Drug Screen Collector does
What the DOT Urine Collector does
This is the first in a series of blog posts at mydrugtestingprogram.com where we’ll be discussing the roles of each of the Service Agents (SAs) that help you adminsiter your required DOT drug and alcohol testing program.
Today we’ll be covering the role of the person working at a collection site that takes your employee through the steps to conduct a urine collection for a DOT drug screen.
The DOT requires that urine drug screen collectors “...must receive qualification training...” The collectors must be trained by a “trainer” who meets the qualifications also outlined by the FMCSA regulations.
The collector training includes:
- The steps required to properly conduct a DOT urine collection.
- How to direct an employee in the process.
- How to fill out and transmit the special collection forms called control and custody forms (CCFs).
- How to handle various problems that come up during collection such as when the employee can’t go (or not enough) called a “shy bladder.”
- What to do if an employee attempts to tamper with a urine specimen.
- What “Flaws” or errors in the process are correctable and which aren't.
- How to correct flaws in the collection process.
- What their responsibility is for the privacy of employees being tested.
- The “chain of custody” process to ensuring the security of the specimen
There are also requirements about the physical setting for a DOT urine drug screen collection beginning with cutting off employee access to water in the collection area to make it harder for an employee who might try to tamper with a specimen. They are also trained to not allow employees to wear jackets or outer clothing that could be used to conceal equipment used to substitute urine to cheat on on a drug test.
In the past the DOT regulations were far less demanding in regards to collector training which led to a lot of errors and problems in testing. In 2005 the DOT got much more demanding about requiring collectors to be properly trained and documented as such.
This is one of the reasons mydrugtestingprogram.com generally doesnt recommend motor carriers trying to do any in-house self collections as it requires a lot of training and dramatically increases their liability by taking on the collector role.
There’s a lot to know about the DOT drug screen urine collection process to get it right and a lot of liability risk if it’s not done right so it best left in the hands of those who’ve been properly trained and are paid to take on those responsibilities.
If you would like to know more about it you can check out the DOT web site covering it here: https://www.transportation.gov/odapc/part40/40_33
Mydrugtestingprogram.com helps our clients find and use a local collection site with properly trained urine collectors from their chopice of over 10,000 sites nationwide.
DOT Cuts Random Drug Testing Amount in Half
DOT Cuts Random Drug Testing Amount in Half
In case you didn't know it, the DOT and the FMSCA has cut the required amount of random drug testing in half.
The required amount of random drug testing was cut in half to only 25%. The change is applicable whether the random pool your company’s employees are in is made up of only your own employees or a consortium pool made up of employees from multiple companies.
This is not the first big cut in DOT random testing requirements
When the DOT Drug Free Workplace regulations came out in 1996 the required random drug testing percentage was 50% of the average number of drivers in the pool and 25% for random alcohol testing. Also drug and alcohol screening were required for pre employment at that time.
But the DOT keeps track of how the testing regulations are working out industry wide and makes adjustments to the requirements based on that research. In one case they eliminated pre-employment alcohol testing and a few years after the regulations came into effect they reduced the amount of random alcohol testing from 25% to 10%.
Why it's great news
This is all great news in many ways as the DOT has seen a reliably low rate of positive results on random drug tests and felt it safe to reduce the amount of random drug testing needed. That also means less money spent on testing for employers and less employee time lost in testing related activities.
If you want to know more about the required testing rates and how much drug and alcohol testing your company is required to do you should check out the blog post for that right here.
What types of testing are you required to do?
What types of testing are you required to do?
If you are required to have a DOT drug testing under the regulations for motor carriers found in the Code of Federal Regulations (CFR) Title 49 part 382 and 40 , then there are 5 types of drug and 4 types of alcohol testing you must do when required.
DOT approved drug testing for all drug screening is a NIDA 5 panel drug screen, collected at a complying collection site, packaged and shipped in a complying chain of custody processed, tested at a Federally approved clinical laboratory, and reported by a Medical Review Officer (MRO) following DOT guidelines for handling results.
DOT approved alcohol testing comes in two types and two approved methods. The initial screening can be done by any Federally approved breath or saliva screening method. However if an initial alcohol screening test is above the allowed limit, then a second confirmation test must be done using a federally approved Evidential Breath Testing device (EBT). Blood testing is not allowed for either the initial screening or confirmation testing.
Pre-employment drug testing (no alcohol)
The first type of testing is pre-employment drug screening of new employees who are required to be a in a drug-free workplace program. Typically those are employee required to hold a CDL license. There are exceptions to the rule for pre-employment testing (click here to see the post covering it detail).There is no required pre-employment alcohol testing.
Random drug and alcohol testing
Random drug and alcohol testing is to be submitted to by covered employees (generally CDL holders) who have been selected by a scientifically random method at the rate required by the regulations. An employee who has been notified of a required test must proceed immediately for testing. They may not refuse, interfere with, or tamper with the testing in any way or it will be considered a refusal which carries the same consequences as a positive result.
Post-accident drug and alcohol testing
Whenever a covered driver has an accident that either results in an injury to any party, requires any vehicle involved to be towed, or results in a citation to the CDL driver, they are required to submit to post-accident drug and alcohol testing. They are to have the testing done as soon as possible which can sometimes present some challenges depending on the location of the accident and the hour of the day. There are some cases where if the testing is delayed too long it can be skipped but there is some extra documentation required to explain the delay/omission of testing.
The last two types of testing are both for employees that are returning to work after a positive (or violation with the same consequences).
The first is Return to Duty drug or alcohol testing (depending on the circumstance). It/they must be administered and return negative before an employee is allowed to return to safety sensitive duties.
The second is Follow Up testing. This type of testing can vary in frequency which is determined by a Substance Abuse Professional (SAP) who makes the determination (following the DOT guidelines) when/if an employee is allowed to return to safety sensitive duty and how often they are to have follow up testing.
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