iii. drug-free workplace programs - fhmic.com fileiii. drug-free workplace programs ... y drug-free...

I I I . DRUG-FREE WORKPLACE PROGRAMS

A POLICY TO DO MORE®

III. DR

UG

-FREE W

OR

KPLACE PRO

GR

AMS

© FHM Insurance Company, Inc. 2007


888-346-3461 www.fhmic.comINSURANCE COMPANYFHM

1

DRUG-FREE WORKPLACE PROGRAMS

FHM believes a drug-free workplace is an important component of an effective Loss Control Program.

This section contains information about the two programs available to FHM policyholders and also provides information necessary to qualify for a workers’ compensation premium credit.

For more information about FHM’s Drug-Free Workplace programs, visit us online at www.fhmic.com or call Policy Services at 888-346-3461, Ext. 401 or 424.

FL Rev. 05/07 © FHM Insurance Company, Inc. 2007



2

DRUG-FREE WORKPLACE PROGRAM CHARACTERISTICS

A workplace that is drug-free can be an effective tool for maintaining workplace safety. The Drug-Free Workplace Program has several advantages including:

Drug-free determination is a major factor in hiring qualified applicants.

There is a required drug test any time an accident or injury occurs. Positive test results can lead to denial of workers’ compensation benefits to employees.

A drug-free workplace will deter the use of alcohol and drugs in the workplace, leading to a safer, more productive environment.

Employers can select from two Drug-Free Workplace Programs:

The State Certified Drug-Free Workplace Program

Post-Injury Drug Testing Program

Once a drug-free workplace is established, all elements of the program must be followed as written, or liability may result.

State Certified Drug-Free Workplace Program

Requires pre-employment drug screens on all new employees – the cost of the pre-employment drug test is paid for by the employer.

Requires annual re-certification.

Usually requires the employer to pay for the drug test done at the time of accident or injury.

Provides a 5% workers’ compensation premium credit.

Post-Injury Drug Testing Program

Is set up one time and continues indefinitely – no annual re-certification required.

Does not require pre-employment drug screens.

Includes any drug testing as part of the reported claim cost.




3

To Initiate a Drug-Free Workplace Program

For more information about FHM’s Drug-Free Workplace Program, contact Policy Services at 888-346-3461, Ext. 401 or 424, or visit the FHM web site at www.fhmic.com.

For information on the State Certified Drug-Free Workplace Program, contact Total Compliance Network (TCN) at 800-881-4826, Ext. 22 or Ext. 26.

To initiate the Post-Injury Drug Testing Program, complete the Application for Post-Injury Drug and/or Alcohol Testing Program form and fax to FHM’s Policy Services at 407-926-9419.




4

SHOULD YOUR COMPANY BE A DRUG-FREE WORKPLACE

The answer is not easy. The main concern of many clients is that a drug-free program will turn away prospective new hires. Other concerns are the cost of testing and the inevitable administrative hassles. But the following statistics should be considered when deciding whether to be a drug-free workplace.

An employee who uses drugs versus an employee who is drug-free:

80% of internal embezzlement, fraud and pilferage in the workplace is drug related.

73% of all drug users are employed.

300% more sick benefits used by substance abusers.

250% more absences of 8 days or more.

220% more requests for early dismissal or time off.

300% more often late for work.

300% more often involved in job-related accidents.

500% more likely to file a Workers’ Compensation claim.

Uses 2.5 times more medical benefits.

A positive post-accident drug and/or alcohol test results in a denial of most Workers’ Compensation claims. A claim was recently denied after a positive post-accident drug test where the insurer had established a preliminary loss reserve of $150,000.00. A $150,000.00 claim will have a serious impact on most businesses.

More and more businesses are realizing the long-term benefits of being a drug-free workplace - K mart, Wal-Mart, Burger King, McDonald’s, Disney World, etc., have drug-free policies. In fact, most major companies now require employees to be drug-free as a condition of employment. Drug users who are not candidates at these businesses will seek out those employers that do not have such a program.

Those employers without a drug-free program will be accepting those job applicants for employment who are rejected by the drug-free employer, and assuming the associated costs and liability involved with such employees.




5

POST-INJURY DRUG TESTING PROGRAM

Keeping your workplace accident-free is challenging enough without adding drug use to the mix. The Substance Abuse and Mental Health Services Administration (SAMHSA) found that most drug users age 18-49 are employed full-time. That means 6.3 million illegal drug users and 6.2 million heavy alcohol users are in today’s full-time work force.

Post-Injury Drug Testing is an effective way to send a strong, zero-tolerance message to employees, reduce an employer’s liability for drug-related workplace accidents and reduce an employer’s claims experience and exposure.

The Post-Injury Drug Testing Program provides professional drug and alcohol testing as an automatic part of the regimen for work-related injuries. Employees must be treated through an FHM Total Care Management Provider in the WECARxE Network. Should an employee test positive for drug or alcohol use, an investigation is begun by FHM.

Program features include:

All employees are tested for drugs/alcohol after every workplace injury.

The initial cost of drug testing is charged as a medical expense to the workers' compensation claim — not as a separate employer expense.

Claims by employees testing positive are investigated and accepted or denied on a case-by-case basis.

The program requires a completed consent form from each current and future employee (to be retained in the employee's file) and a completed Post-Injury Drug Testing Kit .

If your company is a State Certified Drug-Free Workplace, a positive post-injury test is grounds for an automatic denial of future workers' compensation benefits for the employee.

To register for FHM's Post-Injury Drug Testing program, complete and fax or mail the Application for Post-Injury Drug and/or Alcohol Testing Program to Policy Services:

FHM Insurance Company Policy Services Department P.O. Box 616648 Orlando, FL 32861-6648 Fax: 407-926-9419

If you are a Certified Drug-Free Workplace, you do not have to sign up for the Post-Injury Drug Testing Program as long as you are satisfied with your current program provider.




6

FORMS LIST

Application for Post-Injury Drug and/or Alcohol Testing Program

Application for Drug-Free Workplace Premium Credit Program

Consent to Employee Drug and/or Alcohol Testing

Employer’ Guide For a Drug-Free Workplace




APPLICATION FOR POST-INJURYDRUG AND/OR ALCOHOL TESTING PROGRAM

TO: FHM Policy Services Department Fax No. 1-407-926-9419 Date:

INFORMATION NEEDED TO REGISTER YOUR COMPANY(Please complete all information on this page and fax to FHM Policy Services Department)

GENERAL INFORMATIONPolicy No. 306-Company Name :

D/B/A:Street:City: State: FL Zip:Phone: Fax:Contact: Email:

YES, I am interested in registering my Company for this program:

MANAGED CARE PROVIDER INFORMATION(Where you send your injured employee for treatment)

Provider Name:Street:City: State: FL Zip:Phone: Fax:Contact: Email:

Provider Name:Street:City: State: FL Zip:Phone: Fax:Contact: Email:

NO, I am not interested in registering my Company for this program:Reason please:

PLEASE NOTE: Your co mpany willbe responsible for the costs of drug tests conducted at a designatedmedical cente r or collection site for tests that are NOT part of the FHM“Post-Accident Drug Testing Program” (examples are: (1) Post-accident testing in which a claim is not reported; (2) Pre-Employment;(3) Random & reasonable suspicion). Also, you are NOT set-up to do post-accident testing until youreceive “chain of custody” forms and further instructions for Total Compliance Network (TCN) – (800)881-4826.

Com pany Official’s Signature:Print Name : Title:


APPLICATION FOR DRUG-FREE WORKPLACE PREMIUM CREDIT PROGRAMFHMIC POLICY NO. 306-

Name of Employer:

Date Program Implemented:

TESTINGDRUG TESTING HAS BEEN CONDUCTED IN THE FOLLOWING AREAS

Job applications Routine fitness for duty

Reasonable suspicion Follow-up to Employee Assistance Programs

NOTICE OF EMPLOYER'S DRUG TESTING POLICY

Copy to all employees prior to testing Show notice of drug testing on vacancy announcements

Posted on employer's premises Copies available in personnel office or other suitablelocations

Copy to job applicants prior to testing No notice required because the employer had a drugtesting program in place prior to this rule's effectivedate (12/16/91)

General notice given 60 days prior to testing

EDUCATION

Resource file on providers Annual education course

Employee Assistance Programs

Name of Medical Review Officer:

A. Name of approved Department of Health and Rehabilitative Service Lab or NIDA approved lab:

B. Telephone #: ( )

C. Address:

I (we) understand the premium credit will be revoked from inception if physical verification or other evidence reveals programnot in compliance with Florida Statutes 440.101 and 440.102.

Any person who, knowingly and with intent to injure, defraud or deceive any insurer, files a statement of claim or anapplication containing any false, incomplete, or misleading information is guilty of a felony of the third degree.

Employer Name Date Officer/Owner Signature

Application must be signed by an officer or owner.

THE ABOVE SIGNED CERTIFIES THAT THIS INFORMATION IS A TRUE AND FACTUAL DEPICTION OF THEIRCURRENT PROGRAM.

Notary Public's Signature Date Expiration of Commission

PLEASE NOTE: Only notarized applications will be processed for the premium discount. Rev. 10/96)


CONSENT TO EMPLOYEE DRUG AND/OR ALCOHOL TESTING

I understand that submission to a Post-Injury Drug And/Or Alcohol Screen is a condition of employment with thisemployer. I understand that, should my testing results be confirmed positive or I refuse to test, I will be subject to thecompany’s disciplinary action, including possible discharge. I understand that a tampered with or an adulteratedspecimen will be considered a refusal to test, resulting in possible discharge.

I hereby give my consent to release the results of my blood and/or urinalysis to the person(s) or department(s) or thespecified agent of my employer, including my employer’s Workers’ Compensation Insurance Company, for the purposeof determining the presence of alcohol and/or other drugs in my body for the duration of my employment.

I understand that if I am injured during the course and scope of my employment and I test positive for the presence ofalcohol and/or drugs, I may forfeit my eligibility for medical and indemnity benefits under Florida’s Workers’Compensation Law (Florida Statutes 440.101, 440.102). I also understand that a refusal to test, a tampered with or anadulterated specimen under this circumstance may also result in forfeiture of my eligibility for medical and indemnitybenefits and immediate action, including possible discharge.

By signing this form, I hereby release to the Company and/or Company’s Medical Review Officer the results of thetest(s) to which I have consented. I further authorize the Company to discuss the results with medical personnel /physician collecting the specimen, the testing facility, its directors, officers, agents, and employees responsible foradministering the aforementioned test(s) or evaluating the results thereof and any of them herein. I also authorize theCompany to discuss the results with its legal advisors and to use the test results as a defense to any legal action towhich I am a party.

I further release any testing facility or any physicians who have tested me from any liability arising from a release ofany and all results, written reports, medical records, and data concerning my test(s) to the appropriate Employerofficials. I agree to have the results released to the Company and/or the Company’s Medical Review officer.

Employee or Applicant Signature:_____________________ Print Name:___________________ Date:___________(Parent or Guardian Signature if Employee is a Minor)

Employee or Applicant S/ S.#:________________________ Witness:______________________ Date:__________

OR

I hereby refuse to consent to submit testing for the presence of drugs and/or alcohol.

Employee or Applicant Signature:_____________________ Print Name:___________________ Date:___________(Parent or Guardian Signature if Employee is a Minor)

Employee or Applicant S/ S#:_________________________ Witness:_____________________ Date:___________


EMPLOYER’S GUIDE FOR A DRUG-FREE WORKPLACE

(FLORIDA)


Dear Policyholder: Establishing a drug-free workplace should be a primary goal for employers who wish to continue to remain competitive. The National Institute of Drug Abuse (NIDA) recently revealed that at least seventy percent (70%) of all current users of illicit drugs are employed and this fact poses a major threat to the continued health of your business. Additionally, an employed substance abuser is five (5) times as likely to file a Workers’ Compensation claim and three (3) times as likely to file group health medical claims. These costs, combined with the productivity and performance issues associated with substance abuse, can have a significant impact on the continued survival of any business. In response to the drug problem in the workplace, the state Legislature recently passed the “Drug-Free Workplace Law.” The “Employer’s Guide For A Drug-Free Workplace” is provided to assist members in implementing and recognizing the benefits of a “Drug-Free Workplace Program.” FHM Insurance Company disclaims any responsibility for the implementation of suggested procedures, exhibits and examples and cautions employers to seek the advice of legal counsel prior to implementation. Sincerely, John Bledsoe Vice President of Field Services


DRUG-FREE WORKPLACE PROGRAM

On January 1, 1992, the Department of Insurance approved a 5% Workers’ Compensation premium discount for those employers who implement a Drug-Free Workplace Program pursuant to Florida Statutes 440.101 and 440.102.

The enclosed “Employer’s Guide for a Drug-Free Workplace” provides detailed instructions on establishing a Drug-Free Workplace Program.

If you have or are planning to institute a drug-free workplace program and wish to take advantage of the 5% discount, please complete and return the notarized application on the reverse side to:

FHM INSURANCE SERVICES P.O. Box 616648

Orlando, FL 32861-6648

PLEASE NOTE: Only notarized applications will be processed for the premium discount.


APPLICATION FOR DRUG-FREE WORKPLACE PREMIUM CREDIT PROGRAM FHMIC POLICY NO. 306-______

Name of Employer: Date Program Implemented:

TESTINGDRUG TESTING HAS BEEN CONDUCTED IN THE FOLLOWING AREAS

Job applicants Routine fitness for duty Reasonable suspicion Follow-up to Employee Assistance Programs

NOTICE OF EMPLOYER’S DRUG TESTING POLICY Copy to all employees prior to testing Show notice of drug testing on vacancy announcements Posted on employer’s premises Copies available in personnel office or other suitable

locations Copy to job applicants prior to testing No notice required because the employer had a drug

testing program in place prior to this rule’s effective date (12/16/91)

General notice given 60 days prior to testing EDUCATION

Resource file on providers Annual education course Employee Assistance Programs Name of Medical Review Officer: A. Name of approved Department of Health and Rehabilitative Service Lab or NIDA approved Lab:

B. Telephone #: ( ) C. Address: I (we) understand the premium credit will be revoked from inception if physical verification or other evidence reveals program not in compliance with Florida Statutes 440.101 and 440.102. Any person who knowingly and with intent to injure, defraud or deceive any insurer, files a statement of claim or an application containing any false, incomplete or misleading information is guilty of a felony of the third degree. Employer Name Date Office/Owner Signature

Application must be signed by an officer or owner. THE ABOVE SIGNED CERTIFIES THAT THIS INFORMATION IS A TRUE AND FACTUAL DEPICTION OF THE CURRENT PROGRAM. Notary Public’s Signature Date Exp. Of Commission

PLEASE NOTE: Only notarized applications will be processed for the premium discount. (Rev. 4/99)


SECTION 1

DRUG-FREE WORKPLACE LAW

The 1990 session of the Florida Legislature made significant changes in Workers’ Compensation law, including establishing rules for employers to qualify their places of business as drug-free workplaces. The 1990 law was overturned but passed again in a special session in January, 1991. By early 1992, businesses that qualified were entitled to premium-reduction benefits.

The legislative intent of the law is this:

To promote drug-free workplaces in order that employers in the State be afforded the opportunity to maximize their levels of productivity, enhance their competitive positions in the marketplace, and reach their desired levels of success without experiencing the costs, delays and tragedies associated with work-related accidents resulting from drug abuse by employees. It is further the intent of the Legislature that drug abuse be discouraged and that employees who choose to engage in drug abuse face the risk of unemployment and the forfeiture of Workers’ Compensation benefits.

Florida Statute 440.101

Drug-Free Workplace Act

The presumption that an accident was caused by the use of drugs/alcohol when the employee tests positive post-injury for drugs or alcohol can be rebutted only if there is no “reasonable hypothesis” that substance abuse contributed to the injury. The 1998 Legislative change was in response to a Supreme Court decision that declared unconstitutional a portion of the Florida Drug-Free Workplace Act that had created a conclusive presumption that an accident was caused by drugs/alcohol (automatically denying Workers’ Compensation benefits) if the employee tested positive after an accident.


Specific Authority: Florida Statutes 440.09(7)(c), 440.101, 440.102(10), Florida Statutes Law Implemented 440.09(3), 440.101, 440.102(7), Florida Statutes History—New 01/30/91.

Self Insurers in Workers’ Compensation Law, Dept. of Labor & Employment Security, Florida Division of Workers’ Compensation

Basically, part (a) of the above rule says that if the employer has a drug-free workplace program, an employee tested to have a drug presence at a prescribed level will not be eligible for medical or indemnity benefits and may lose his or her job.

Part (b) reverts to the old law which says that there will be argument as to whether the impairment was due to the influence of drugs.


SECTION 2

PROCEDURES FOR ESTABLISHING A DRUG-FREE WORKPLACE PROGRAM PURSUANT TO SECTIONS 440.101 & 440.102, F.S.

The following is a step-by-step process for setting up a drug-free workplace program as provided for under established law and rules adopted by the Division of Workers’ Compensation. Where appropriate, sample forms are suggested. You are strongly urged to consult your attorney or legal adviser and to develop forms and procedures that apply to your particular business.

1. Include a notice of drug testing in vacancy announcements for those positions where drug testing is required and post in an appropriate location (Exhibit 1).

2. Notice of the employer’s drug testing policy must be posted in an appropriate and conspicuous location on the employer’s premises and copies of the policy must be available for inspection by the employees or job applicants during regular business hours in the employer’s personnel office or other suitable location (Exhibit 2). An employer initiating a drug testing program must ensure that at least 60 days elapse between a general one-time notice to all employees that a drug testing program is being implemented and the beginning of actual drug testing. An employer already having a drug testing program in place is not required to provide the 60-day notice period.

3. Maintain a current resource file of employee assistance programs for alcohol and drug abuse. The local telephone directory is an excellent source for identifying local providers of employee assistance programs.

4. Provide at least an annual education course to assist employees and/or supervisors in identifying personal and emotional problems which may result from the misuse of alcohol or drugs. This course must include a presentation on the legal, social, physical and emotional consequences of the misuse of alcohol or drugs.

5. Inform all job applicants and employees of the drug program and testing procedures on a form similar to Exhibit 3. This notice should be posted in a conspicuous place and copies should be made available for inspection during regular business hours by the general public in the employer’s personnel office or other suitable location. An applicant is defined as a person who has applied for a position and who has been offered a job contingent upon successfully passing a drug test. Allow the applicant or employee to complete a “History of Recent


Medication” form (Attachment “B” to Exhibit “3” – Notice to Employees and Applicants) before being tested. If the employee/applicant requests, allow the individual to complete the bottom half of the same form, or a similar form, after being tested. Also, require that all applicants and employees complete a drug testing consent form similar to Exhibit 4.

6. Employ or contract with a licensed physician who is responsible for receiving and reviewing all confirmation results from a laboratory on your behalf. This medical review officer or MRO is responsible for contacting all positively tested individuals to inquire about possible prescriptive or over-the-counter medications which could have caused a positive result. The MRO must have knowledge of substance abuse disorders and must have appropriate training to interpret and evaluate a positive test result with prescriptive or other relevant medical information. The MRO shall:

a) Receive from the employer a form completed by the employee/applicant showing any information that may be relevant to the drug testing including medication being taken and medical information, (i.e., History of Recent Medication Form – Exhibit 3, Attachment B). Such information shall be reviewed in interpreting any positive confirmed results.

b) Report to employer all quantitative alcohol results above 0.05%.

c) Ensure the security of data transmission and restrict access to any data transmission, storage and retrieval system.

d) Report to the employer all confirmed drug tests, taking into account all relevant information received.

e) Comply fully with requirements of applicable regulations.

7. Designate a collection site that will collect all specimens for drug testing (Exhibit5). (The proposed contract is one in which the licensed laboratory also acts as the collection site. If a medical facility or entity other than the laboratory collects the sample, another contract will be needed.)

8. Enter into a contractual relationship with a licensed testing laboratory for the testing of the sample specimen (Exhibit 5).

9. Direct the applicant or employee to a drug collection site/testing laboratory. The testing laboratory must be licensed by H.R.S. The laboratory must report the test results to the MRO within seven (7) working days after receipt of the specimen. If


reported positive, the specific drug will be named. The MRO may request quantitation of the test results after the test has been determined to be positive. Results must be confidentially reported to the employer.

10. If testing is to be performed following an injury at the workplace, the employee should be taken to a medical facility for immediate treatment. No specimen shall be obtained prior to the administration of emergency care. Once the test has been taken, an injured employee must release to the employer the result of any test conducted for the presence of drugs. If the employee is not at a designated collection site, the employee should be transported to such a site as soon as it is medically feasible. If it is not medically feasible to move the employee, specimens should be obtained at the treating facility and transported to the laboratory by the treating facility. Confirm that the treating facility knows to comply with the applicable regulations on specimen collection.

11. If testing is conducted based on reasonable suspicion, the employer should document within seven (7) days of testing the circumstances leading to that conclusion. A copy of this documentation should be given to the employee upon request. The documentation must be kept confidential and retained by the employer for at least one year. An appropriate form for this purpose is shown as Exhibit 6.

12. If the applicant/employee refuses to take the drug test, advise him/her that employment is being denied or the employee is being terminated or otherwise disciplined, or Workers’ Compensation benefits are being denied.

13. If the initial test is negative, the employer may request a confirmation test, at its expense. If the initial test is positive a confirmation test with the laboratory must be obtained at the employer’s cost. The employer cannot discharge, discipline, refuse to hire, discriminate against or request or require rehabilitation of a job applicant/employee on the basis of a positive drug test unless such test has been confirmed.

14. Within five (5) working days after receipt of a positive confirmed test result, the employer must notify the applicant/employee in writing of the test result (Exhibit 7)and allow the applicant/employee to explain the test results. The applicant/ employee should also be advised fully of his/her rights. The employee must be notified of the consequences of such results and of the options available including the right to file an administrative or legal challenge. The employee shall have five (5) working days after receiving notice to explain the test results.

15. Provide the applicant or employee, upon request, a copy of the test results.


16. If the explanation of the applicant/employee is unsatisfactory, advise the applicant/employee in writing and provide him/her with a copy of the positive results (Exhibit 8). Prior to this time, the test results will be provided to the employee upon request. The response to the employee’s explanation must be made within fifteen (15) days of receipt of the explanation.

17. Within 180 days after written notification of a positive test result, the applicant/employee shall be permitted by the employer to have a portion of the specimen retested, at the expense of the applicant/employee. This should be explained in detail in the initial letter of notification to the applicant/employee (Exhibit 7).

18. If the applicant/employee desires to have the specimen tested at another laboratory, the MRO should ask the first laboratory to transfer the specimen to the second laboratory. The employer should not make the transfer.

19. The applicant/employee can administratively challenge the results of a drug test by filing a claim within 30 days after receipt of the employer’s response to his explanation. A union applicant/employee must file a claim with the ombudsman; and the non-union applicant/employee must file a claim with a judge of Workers’ Compensation claims.

20. Confidentiality of drug testing is extremely important. The employer must follow the procedures below:

a) Do not ask the testing laboratory for information concerning the health or mental condition of the tested employee.

b) Do not ask the testing laboratory for information concerning the personal health, habit or condition of employees including but not limited to the presence or absence of HIV antibodies in the employee’s body fluids.

c) All information, interviews, reports, statements, memoranda and drug test results, written or otherwise, received by the employer through a drug testing program are confidential communications and may not be used or received in evidence; obtained in discovery; or disclosed in any public or private proceeding except in determining compensability of injuries under the Workers’ Compensation Act.

d) Employers, laboratories, employee assistance programs, drug and alcohol rehabilitation programs, and their agents who receive or have access to


information concerning drug test results shall keep all information confidential. Release of such information under any other circumstances shall be solely pursuant to a written consent form signed voluntarily by the person tested, unless such release is compelled by a hearing officer or a court of competent jurisdiction pursuant to an appeal, or unless deemed appropriate by a professional or occupational licensing board in a related disciplinary proceeding. The consent form shall be similar to Exhibit 9.

e) Information on drug test results shall not be released or used in any criminal proceeding against the employee or job applicant. Information released contrary to this shall be inadmissible as evidence in any such criminal proceeding.

f) The employer, agent of the employer, or laboratory conducting a drug test can have access to employee drug test information when consulting with legal counsel in connection with actions brought under or related to the employer’s drug testing program or when the information is relevant to its defense in a civil or administrative matter.

21. The employer cannot discharge, discipline or discriminate against an employee solely upon the employee voluntarily entering into an employee assistance program for drug related problems or entering an alcohol and drug rehabilitation program if the employee has not previously tested positive for drug or alcohol use.

22. The employer should retain all documentation related to these matters for at least one (1) year. Longer retention periods pertain to retention of specimens and documentation prepared by the laboratory or MRO.

For clarification or additional information, contact:

Agency for Health Care Administration Bureau of Managed Care 2727 Mahan Drive Tallahassee, FL 32308

850-414-8972


EXHIBIT “1”

(Employer)

NOTICE

ALL PROSPECTIVE EMPLOYEES WILL BE REQUIRED TO TEST FOR DRUGS AND

ALCOHOL.

THE COMPANY WILL ALSO REQUIRE ANY CURRENT EMPLOYEE WHO IS

BELIEVED TO BE IMPAIRED BY DRUGS OR ALCOHOL TO SUBMIT TO BLOOD

ALCOHOL AND/OR URINALYSIS TESTING.


EXHIBIT “2”

DRUG-FREE WORKPLACE

COMPANY POLICY

It is the position of (Employer) that the use of drugs, which by

definition includes alcohol, is strongly discouraged. As a condition of employment with

this employer, you must refrain from reporting to work or working with the presence of

drugs or alcohol in your body.

This employer performs drug testing. If there is a positive confirmed drug test, you will

be denied employment with this company or, if presently employed, you will be

immediately terminated or otherwise disciplined. If there is a positive confirmed drug

test and you are injured on the job, Workers’ Compensation benefits can be denied.

_____________________________________

President


EXHIBIT “3”

NOTICE TO EMPLOYEES AND JOB APPLICANTS

1. COMPANY POLICY. It is the position of (Employer) that the use of drugs, which by definition includes alcohol, is strongly discouraged. As a condition of employment with this employer, you must refrain from reporting to work or working with the presence of drugs or alcohol in your body. This employer performs drug testing. If there is a positive confirmed drug test, you will be denied employment with this company or if presently employed, you will be immediately terminated or otherwise disciplined. If there is a positive confirmed drug test and you are injured on the job, Workers’ Compensation benefits can be denied. Section 440.102, Florida Statutes, and Florida Administrative Rules 38F-9.001 through 38F-9.014 provide for Drug-Free Workplace Program requirements.

2. REQUIRED TESTING. You are advised that (Employer) will conduct the following types of drug tests for those drugs identified by brand names or common names as well as chemical names in “Attachment “A” attached to this policy statement.

a) JOB APPLICANT TESTING. Job applicants will be tested for the presence of drugs.

b) REASONABLE SUSPICION TESTING. If there is reasonable suspicion that any employee is using or has used drugs in violation of this company’s policies, drug testing is required. Testing under this provision may be conducted if you are observed using drugs, exhibiting symptoms or manifestations of being under the influence of drugs; exhibiting abnormal conduct or erratic behavior while at work; a significant deterioration occurs in your work performance; reported using drugs by a reliable and credible source which has been independently corroborated; tampering with any drug test during your employment with this company; cause/contribute to/are involved in an accident while at work; evidence that you have used, possessed, sold, solicited or transferred drugs while working for this company, or while on our premises or while operating our vehicles, machinery or equipment.

c) ROUTINE FITNESS-FOR-DUTY TESTING. Drug testing shall be part of a routinely scheduled employee fitness-for duty medical examination. This examination may be held routinely for all persons employed with the company or by employment classification or group.

d) FOLLOW-UP TESTING. If during your employment with this company, you enter into an employee assistance program for drug-related problems or an alcohol or drug rehabilitation program, you will be required to submit to drug testing as a follow-up to such program. This testing will be performed on a quarterly basis for up to two (2) years thereafter.


e) REANALYSIS TESTING. A Medical Review Officer (MRO), after reviewing an original drug test, may request that you submit to another test. This will be done if the MRO determines that the original test result was scientifically unsatisfactory.

3. REFUSAL TO SUBMIT TO TESTING. Refusal to submit to a drug test may be the basis for refusing to hire you. If already hired, such refusal will preclude further employment with this company or result in disciplinary action. If injured on the job, refusal to test will be the basis for your forfeiture of being eligible for medical and indemnity benefits under the Workers’ Compensation Act.

4. REPORTING OF PRESCRIPTION OR NON-PRESCRIPTION MEDICATIONS. Attachment “B” contains a form which allows applicants and employees, both before and after being tested, to provide confidential information regarding their use of prescription and non-prescription medications. If you wish to provide this information before being tested, please complete and sign Attachment “B” before providing a urine or blood specimen. If you wish to provide new or additional information after being tested, please ask the Company and the original form or a substitute form will be provided to you. You may also provide this information, after being tested, to the Company’s Medical Review Officer whose address and telephone number is:

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Attachment “C” contains a list, developed by the Department of Health and Rehabilitative Services, of the most common drugs or medication (by brand name or common name, as well as by chemical name) which may alter or affect a drug test. The laboratory may also be consulted for technical information concerning prescription or non-prescription medication.

5. EMPLOYEE ASSISTANCE, ALCOHOL AND DRUG REHABILITATION PROGRAMS.You are advised that, within this community, there are employee assistance programs and alcohol and drug rehabilitation programs. The names, addresses and telephone numbers of these agencies are as follows:

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________


6. CONTESTING DRUG TESTING RESULTS. If you receive a positive confirmed drug test result, you have the right to legally or administratively contest the result or explain the result to the person in charge of the employees’ drug test program for the company whose name and telephone number is as follows:

________________________________________________________________________

________________________________________________________________________

This must be done within five (5) working days after you are given written notification of a positive confirmed drug test result. [If employer is covered by union contract, add the following: You also may have the right to file a grievance under the applicable contract and may have the right to appeal the results of any such grievance to an appropriate court.] If you are refused employment or terminated from employment even after your explanation, you may still contest the drug test result pursuant to rules adopted by the Florida Department of Labor and Employment Security. In order to challenge a drug test, union individuals must file a claim with the ombudsman; and non-union individuals must file a claim with a judge of Workers’ Compensation claims within 30 days of being advised that this employer rejects your explanation of the positive drug test if in fact there is such a rejection. You must notify the testing laboratory of any administrative or civil action brought pursuant to this policy statement and Florida laws and advise the laboratory of the need to retain any sample taken until the case or administrative appeal is settled. The name, address and telephone number of the testing laboratory is as follows:

________________________________________________________________________

________________________________________________________________________

You have the right to consult this testing laboratory for technical information regarding prescription and non-prescription medication or in regards to any other information you desire.

7. CONFIDENTIALITY. Information about drug screening, including all records, forms, or test results are confidential communications. Unless otherwise authorized by law, the Company will not release such information without appropriate written consent from the applicant or employee.

I acknowledge that I have received a copy of this Notice to Employees and Job Applicants concerning the Company’s Drug-Free Workplace Program and that I have had an opportunity to ask any questions which I may have regarding this policy.

_____________________________ _________________________________________ DATE APPLICANT OR EMPLOYEE

_____________________________ _________________________________________ DATE WITNESS


ATTACHMENT “A”

The company may test for any or all of the following drugs:

ALCOHOL Booze, Drink

AMPHETAMINES Binhetamine, Desoxyn, Dexedrine

CANNABINOIDS Marijuana, Hashish, Hash, Hash Oil, Pot, Joint, Roach, Spleaf, Grass, Weed, Reefer

COCAINE Coke, Blow, Nose Candy, Snow, Flake, Crack

PHENCYCLIDINE PCP, Angel Dust, Hog

METHAQUALONE

OPIATES Opium, Dover’s Powder, Paregoric, Parepectolin

BARBITURATES Phenobarbital, Tuinal, Amytail

BENZODIAZAPHINES Ativan, Azene, Clonopin, Dalmone, Diozepam, Halcion, Librium, Poxipam, Restoril, Serax, Transene, Valium, Vertron, Xanax

METHADONE Dolophine, Mathadose

PROPOXYPHENE Darvocet, Darvon N, Dolene


ATTACHMENT “B”

HISTORY OF RECENT MEDICATION (ALLOW APPLICANT/EMPLOYEE TO COMPLETE BEFORE AND AFTER TESTING)

If you have taken ANY medication and/or drugs of any kind in the past thirty (30) days, indicate by checking the appropriate spaces.

Over-the-counter medications (cough medicine, cold tablets, etc.) Identify those taken.

__________________________________________________________________________________________

Prescription or other drugs*: Identify those taken.

__________________________________________________________________________________________

Other (please specify) __________________________________________________________________________________________

Additional information that may affect drug testing results:

I CERTIFY THAT THE ABOVE INFORMATION IS COMPLETE AND ACCURATE.NAME (Please Print) SIGNATURE DATE

After being tested I wish to add the following information, which may include identification of any drugs I have taken which may affect my test results.

NAME (Please Print) SIGNATURE DATE

* Be prepared to furnish valid prescription information if requested. A list of medications and prescription drugs that may affect drug test results is attached.


ATTACHMENT “C”

OVER-THE-COUNTER AND PRESCRIPTION DRUGS WHICH COULD ALTER OR AFFECT THE OUTCOME OF A DRUG TEST

ALCOHOL All liquid medications containing ethyl alcohol (ethanol). Please read the label for alcohol content. As an example, Vicks Nyquil is 25% (50 proof) ethyl alcohol, Comtrex is 20% (40 proof), Contact Severe Cold Formula Night Strength is 25% (50 proof) and Listerine is 26.9% (54 proof).

AMPHETAMINES Obetrol, Biphetamine, Desoxyn, Dexedine, Didrex

CANNABINOIDS Marinol (Dronabinol, THC)

COCAINE Cocaine HCI topical solution (Roxanne)

PHENCYCLIDINE Not legal by prescription.

METHAQUALONE Not legal by prescription.

OPIATES Paregoric, Parepectolin, Donnagel PG, Morphine, Tylenol with Codeine, Empirin with Codeine, APAP with Codeine, Aspirin with Codeine, Robitussin AC, Guiatuss AC, Novahistine DH, Novahistine Expectorant, Dilaudid (Hydromorphone), M-S Contin and Roxanol (morphine sulfate), Perdocan, Vicodin, etc.

BARBITURATES Phenobarbital, Tuinal, Amytal, Nembutal, Seconal, Lotusate, Fiorinal, Fioricet, Exgic, Butisol, Mebaral, Butabarbital, Butabital, Phrenilin, Triad, etc.

BENZODIAZAPHINES Ativan, Azene, Clonopin, Dalmane, Diazepam, Librium, Xanax, Serax, Tranxene, Valium, Verstran, Halcion, Paxipam, Restoril, Centrex

METHADONE Dolophone, Methose

PROPOXYPHENE Darvocet, Darvon N, Dolene, etc.


EXHIBIT “4”

DRUG TESTING CONSENT FORM

I, ____________________________, consent to submit a urine, blood or breath sample under the direction of medical or laboratory personnel designated by [the Company] and understand that this sample will be used for the purpose of conducting a chemical analysis to determine if I have engaged in the use of alcohol or illegal drugs. I give my permission to the physician, medical or laboratory personnel collecting the specimen, the testing facility, and any employees or agents responsible for administering or evaluating the test, to the release of the test results to [the Company] and to any government agencies in connection with the investigation of [the Company’s]employment policies. I further authorize the Company and/or the Laboratory to use the drug test results as evidence in any action brought on my behalf. This release shall be valid for the duration of my employment, or for the duration of any legal or administrative action which may concern my test results or resulting employment action. I agree to the release and discussion by the Company of my test results with all laboratory and medical personnel with responsibility for collecting, administering or evaluating the test.

This examination is being conducted pursuant to the Company’s published Drug-Free Workplace Policy. I understand and voluntarily agree that any hiring by [the Company]is conditional upon successful completion of all pre-employment screening, and if my drug test is confirmed positive, or if I refuse to consent to the drug test, such conditional employment will be terminated and remove me from further consideration for employment. If a current employee, I will be subject to discipline up to and including discharge. I also understand that, should I be injured in an on-the-job accident, if I test positive or refuse to be tested following the accident, I will forfeit all Workers’ Compensation medical and indemnity benefits.

I hereby release and agree to hold [the Company] harmless against all claims, charges or causes of action whatsoever I now have or may have in the future against the Company, as well as the laboratory personnel conducting the tests, which may arise from the operation of the laboratory testing equipment, the taking of testing samples, the laboratory’s interpretation of the test data, or the publishing and reporting of the examination results to the company, or any investigation relating to or arising out of, such testing.

I CERTIFY THAT I HAVE READ, UNDERSTAND AND AGREE TO THE ABOVE PROVISIONS.

______________________________________________________________________ Name Date


EXHIBIT “5”

SERVICE CONTRACT FOR SPECIMEN COLLECTION ANDTESTING FOR DRUGS

[NOTE: This contract is to be used where the LABORATORY collects and tests for drugs. If two separate entities are used for collection and testing, contracts should be divided with applicable provisions used for each entity.]

This agreement is made and entered into this _____day of _____________, 20___, by and between ______________________ (“COMPANY”) and _____________________ (“LABORATORY”).

ACKNOWLEDGEMENTS

WHEREAS, COMPANY is an employer doing business in the State of Florida and desires to establish a Drug-Free Workplace Program pursuant to the terms of Sections 440.101 and 440.102 of the Florida Workers’ Compensation Act (“the Act”); and

WHEREAS, COMPANY desires to contract with a qualified facility for the collection of specimens and testing of these specimens to determine the presence of the drugs identified in Attachment “A” of this Agreement; and

WHEREAS, LABORATORY has represented itself as and, in fact, is a licensed laboratory approved by the Department of Health and Rehabilitative Services (“HRS”) using the criteria established by the National Institute on Drug Abuse (“NIDA”) as guidelines; and

WHEREAS LABORATORY is licensed and approved to perform drug testing in accordance with Section 112.0455, Florida Statutes, in its accompanying rules as established by HRS in Chapter 10E-18, Florida Administrative Code; and

WHEREAS, LABORATORY has designated_________________________(“collectionsite”) as a designated collection site for LABORATORY which has all collection, security and chain of custody procedures necessary for the temporary storage and the shipping or transportation of urine or blood specimens to LABORATORY or is a medical facility with such capabilities; and

WHEREAS, COMPANY has determined that LABORATORY, its principals, and employees have the experience and qualifications to meet the needs of COMPANY for sample collection and drug testing; and

WHEREAS, COMPANY has selected LABORATORY to provide services as an independent contractor in connection with sample specimen collection and drug testing, and


WHEREAS, it is the desire of the Parties to this Agreement that the functions, duties and responsibilities of the LABORATORY and the compensation to be paid to the LABORATORY by the COMPANY be set forth in a written agreement,

NOW, THEREFORE, in consideration of the mutual covenants, conditions and agreements set forth in this Agreement, and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties hereby agree as follows:

I. OBLIGATIONS OF LABORATORY

1. LABORATORY, through its designated collection site, shall collect urine or blood specimens, as appropriate, from job applicants or employees referred by COMPANY and conduct initial and confirmation testing of such specimens for the presence of alcohol and those drugs identified in Attachment “A” to this agreement and report the results of such drug tests to the COMPANY through a designated Medical Review Officer.

2. LABORATORY certifies that it is familiar with the provisions set forth in Sections 112.0455, 440.101 and 440.102 of the Florida Statutes, as well as the rules and regulations promulgated by the Division of Workers’ Compensation (Chapter 38F-9, Florida Administrative Code), and HRS (Chapter 10E-18, Florida Administrative Code) which pertain to laboratory certification, specimen collection, drug testing, reporting of drug test results, medical review officer procedures, confidentiality of documents and information pertaining to drug testing, retention of drug testing records and specimens and other provisions which pertain to laboratories and collection sites engaged in the collection and/or testing of specimens pursuant to the Drug-Free Workplace Provisions set forth in this paragraph are hereby incorporated by reference as part of this Agreement.

3. In performing its obligations under this Agreement, LABORATORY shall fully comply with the statutory and regulatory provisions set forth in paragraph two (2), of this Agreement as such provisions currently exist and as they may be amended during the course of this Agreement.

II. COMPENSATION

4. In consideration for the covenants, conditions and agreements contained in this Agreement, which the LABORATORY agrees to perform, COMPANY agrees to pay LABORATORY a fee equal to the following amount:

(INSERT AGREED UPON FEE ARRANGEMENTS)


5. If any applicant or employee tested requests a re-testing procedure after the initial and confirmation test, the employee or applicant shall be responsible for paying any charges for such re-test. LABORATORY shall be responsible for collecting any such charges from the applicant or employee.

III. INDEPENDENT CONTRACTOR RELATIONSHIP

6. In the LABORATORY’s performance of its work, duties, and obligations under this Agreement, LABORATORY is at all times acting and performing as an independent contractor. COMPANY shall neither have nor exercise any control or direction over the methods by which LABORATORY or its employees shall perform their obligations under this agreement.

IV. INDEMNIFICATION

7. LABORATORY shall indemnify and hold COMPANY harmless from and against all costs, damages, judgments, attorneys’ fees, (including fees on appeal), expenses, obligations and liabilities of any kind or nature that may occur, arise or result from LABORATORY’s acts or omissions in LABORATORY’s performance of its obligations under this Agreement or from LABORATORY’s breach of this Agreement.

V. ENTIRE AGREEMENT

8. This Agreement contains entire understanding and agreement between the Parties and shall not be modified or superseded except upon the express written consent of all Parties to this Agreement. This Agreement supersedes and renders null and void any previous Agreements or Contracts whether oral or written between LABORATORY and COMPANY.

VI. SEVERABILITY

9. If any provision of this Agreement is invalidated by a Court of Competent Jurisdiction, then all of the remaining provisions of this Agreement shall continue unabated and in full force and effect.

VII. GOVERNING LAW

10. This Agreement should be governed by and construed in accordance with the laws of the State of Florida.


VIII. TERM OF AGREEMENT

11. This Agreement shall become effective on _______________________ and remain in full force and effect until _____________________. Either Party, however, may cancel this Agreement by giving _____ days’ written notice. Notwithstanding any right of either Party to cancel this Agreement, both Parties shall be responsible for and shall adhere to the requirements set forth in Part I, paragraphs two (2) and three (3) of this Agreement including, but not limited to, those pertaining to retention of records, tests, data, information and specimens as required by Florida Statutes Sections 112.0455, 440.101, and 440.102 and regulations promulgated by the Division of Workers’ Compensation (Chapter 38F-9, Florida Administrative Code) and HRS (Chapter 10E-18, Florida Administrative Code).

IN WITNESS WHEREOF, and intending to be legally bound, LABORATORY and COMPANY by their authorized representatives execute this Agreement consisting of four (4) pages and eleven (11) enumerated paragraphs by signing their names below.

EXECUTED THIS _____ DAY OF _____________________, 20_____.

______________________________________ COMPANY

_____________________________ ______________________________________DATE WITNESS

EXECUTED THIS _____ DAY OF ______________________, 20_____.

______________________________________ LABORATORY

_____________________________ ______________________________________DATE WITNESS


EXHIBIT “6”

INVESTIGATION REPORT SUSPECTED USE OF DRUGS OR ALCOHOL

[Must be completed within seven (7) days of test and retained for one (1) year]

______________________________ is being tested based on reasonable suspicion of use of alcohol or drugs. The following is a description of the objective facts which created the suspicion of drug or alcohol use:

Direct observation of drug use. Date, location and witnesses:________ __________________________________________________________________________________________________________________

Physical symptoms of being under the influence. Describe in detail, including smell of alcohol on breath or of marijuana on clothes, possession of drug paraphernalia (describe), stumbling or lurching or unable to walk a straight line, or other specific symptoms: ___________ __________________________________________________________________________________________________________________

Abnormal conduct or erratic behavior while at work or a significant deterioration in work performance. Describe specific actions and how they differ from previous behavior: _____________________________ __________________________________________________________________________________________________________________

Report of drug use, provided by a reliable and credible source, which has been independently corroborated. Identify source and independent corroboration (such as second witness or other consistent information): ___________________________________________________________________________________________________________________________________________________________________________

Evidence of tampering with a drug test while a current employee. Specify evidence: ____________________________________________________________________________________________________________________________________________________________


Accident while at work which was caused or contributed to by employee, or which involved employee. Describe accident and suspected employee’s involvement: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Evidence of use, possession, selling, soliciting or transferring drugs while working or on Company premises, including company vehicles. [NOTE: if you have proof of these activities, no drug test is needed, as such actions independently violate Company policy.] If evidence is not conclusive, drug or alcohol tests may be conducted based upon reasonable suspicion, as follows: ______________________________ ___________________________________________________________________________________________________________________________________________________________________________

Other evidence of reasonable suspicion of employee use of illegal drugs or alcohol. Details: _________________________________________ ___________________________________________________________________________________________________________________________________________________________________________

________________________________ _________________________________Supervisor Making Observation Second Manager (if available)

________________________________ _________________________________Date of Described Activity Date Report Completed

________________________________Date of Drug Test


EXHIBIT “7”

EMPLOYER’S FIRST LETTER TO APPLICANT/EMPLOYEE UPON RECEIPT OF CONFIRMED POSITIVE TEST RESULT

(must be completed within five (5) working days of receipt of apositive confirmed test)

Dear (Employee) (Job Applicant):

Pursuant to the Drug-Free Workplace procedures of (Employer) and its drug testing procedures, it has been determined that you have a positive confirmed drug test result. As a consequence of this positive drug test, you are (being denied employment) (being terminated from employment) (being denied Workers’ Compensation benefits) (being disciplined as follows).

Enclosed is a copy of the statement that you originally signed which explained your rights in detail. However, we would like to reiterate your rights, duties, and obligations under this company’s drug-free workplace program. You have the right to contest or explain the result of the test within five (5) working days after you receive this letter notifying you of the test results. The explanation should state why the test results do not constitute a violation of this company’s drug-free workplace policy.

[Insert next paragraph only if union contract applies]

You also have the right to appeal, file a grievance under the applicable collective bargaining agreement or contract and possibly, to appeal the results of any such grievance to an appropriate court.

If you intend to contest or explain the results of the drug test, you must notify the testing laboratory of any administrative or civil action and advise the laboratory of the need to retain any sample taken. The name, address and telephone number of the testing laboratory is as follows:

______________________________________________________________________

______________________________________________________________________

You have the right to consult this testing laboratory for technical information regarding prescription and non-prescription medications or other relevant information. You have the right to a copy of the drug test results, upon request, and to have a portion of any sample or specimen retested, at your expense, at a laboratory of your choice.


The retesting must be done at an HRS licensed or NIDA approved laboratory. This testing must be performed within 180 days after receipt of this letter. The second laboratory test must test at equal or greater sensitivity for the drug in question as the first laboratory. The first laboratory which performed the test shall be responsible for the transfer of the portion of the specimen to be retested, and for the integrity of the chain of custody during such transfer. If you intend to have the specimen sample retested, please advise so that the sample can be forwarded to the laboratory of your choice.

If your explanation is not accepted, you have the right to administratively challenge this position by filing a claim within thirty (30) days after receipt of this employer’s response to your explanation. Union individuals must file a claim with the ombudsman; and non-union individuals must file a claim with a judge of Workers’ Compensation claims. If you intend to challenge the drug test, it is your responsibility to notify the above stated laboratory at the address and telephone number shown to ensure that the specimen sample is retained.

_________________________________COMPANY OFFICIAL SIGNATURE AND TITLE


EXHIBIT “8”

EMPLOYER’S SECOND LETTER TO APPLICANT/EMPLOYEE IF APPLICANT/EMPLOYEE EXPLANATION OF POSITIVE TEST RESULTS IS UNACCEPTABLE

Date: [Must be provided to applicant/employee within fifteen (15) days of employer’s receipt of applicant/employee explanation.]

Dear (Applicant) (Employee) :

This company has reviewed your explanation and/or challenge of the positive drug test results. Following company standards and policies, your explanation or challenge is unacceptable and unsatisfactory because:

[Give Explanation]

Attached is the report of the positive test results. This is to advise you that (your application for employment is herewith rejected) (you are hereby terminated from your employment with this company) (you are disciplined as follows).

_______________________________COMPANY OFFICIAL SIGNATURE AND TITLE


EXHIBIT “9”

CONSENT TO RELEASE DRUG TEST INFORMATION

I, ____________________________, whose date of birth is ________________

and whose Social Security Number is ______________________________, do hereby

authorize the Records Custodian for ___________________________________whose

address is _____________________________________, to release all information and

records relating to drug tests performed on any specimens provided by me, including

any and all records, charts, reports, notes, test results, documents and correspondence

to______________________ whose address is _______________________________.

The above referenced information is being requested for the purpose of : ______

______________________________________________________________________

The duration of this consent shall be for______________________________________.

________________________ _____________________________________ Date Name

_____________________________________ Address

_____________________________________ Telephone Number

(The person signing this consent form must be identified as the person tested and his/her signature must be verified.)


SECTION 3

DRUG TESTING LABORATORIES LICENSED BYDEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES

TO PERFORM DRUG-FREE WORKPLACE TESTING UNDER CHAPTER 112, FLORIDA STATUTE

An approved laboratory has the capability to assist employers in complying with the medical requirements for a drug-free workplace, i.e., Medical Review Office (MRO), collection site, chain of custody, etc.

NAME, ADDRESS & CONTACT TELEPHONE #

ALABAMA REFERENCE LABORATORY, INC.543 S. Hull Street P.O. Box 4600 Montgomery, AL 36103-4600 Charles Thomas Huber, Ph.D., Director

(205) 263-5745

AMERICAN MEDICAL LABORATORIES, INC. 14225 Newbrook Drive P.O. Box 10841 Chantilly, VA 22021 Anthony G. Costantino, Ph.D., Director

(703) 802-6900

AMERICAN MEDICAL LABORATORIES, INC. 8549 Parkline Boulevard Orlando, FL 34809 Evan Holzgerg, Ph.D., Co-Director

(407) 857-8188

CEDARS MEDICAL CENTER, TOXICOLOGY DEPARTMENT 1400 N.W. 12th Avenue Miami, FL 33136 Daniel Seckinger, M.D., Director

(305) 325-5190

COMPUCHEM LABORATORIES, INC. 1904 Alexander Drive Research Triangle Park, NC 27709 Paula S. Childs, Ph.D., Director

(919) 549-8263

CORNING CLINICAL LABORATORY Toxicology Dept. One Malcolm Avenue Teterboro, NJ 07608 Joseph E. O’Brien, M.D., Director

(201) 393-5600


NAME, ADDRESS & CONTACT TELEPHONE # CORNING CLINICAL LABORATORY Toxicology Dept. 5850 W. Cypress Tampa, FL 33607 Jack Perman, Ph.D., Director

(813) 289-5400

CORNING NICHOLS INSTITUTE 7470 Mission Valley Road San Diego, CA 92108 Robert K. Latven, PH.D., Director

(619) 686-3200

DIAGNOSTIC REFERRAL LABORATORY University of Florida, Pathology Dept. P.O. Box 100275, Room D-617 Gainesville, FL 32610 Bruce Goldberger, Ph.D.

(904) 392-2699

DIAGNOSTIC SERVICES, INC. 4048 Evans Avenue, Suite 302 Fort Myers, FL 33901 Robert White, Sr., PhD., Director

(813) 936-5446

DOCTORS LABORATORY, INC. 2906 Julia Drive P.O. Box 2658 Valdosta, GA 31604-2658 Byron Davis, M.D., Ph.D., Director

(912) 244-4468

LAB ONE, INC. 8915 Lenexa Drive Overland Park, KS 66214 Michael A. Peat, Ph.D., Director

(913) 888-1770

LABORATORY CORPORATION OF AMERICA 5610 Lasalle Street Tampa, FL 33607 W. Allen Taylor, Ph.D., Director

(813) 289-5227

MEDTOX LABORATORIES, INC. 402 W. County Road D St. Paul, MN 55112 D. Gary Hemphill, Ph.D., Director

(612) 636-7466

NATIONAL LABORATORY CENTER, INC. D/B/A/ MedExpress 4022 Willow Lake Boulevard Memphis, TN 38118 Robert F. Foery, Ph.D., Director

(800) 526-6339


NAME, ADDRESS & CONTACT TELEPHONE #

PHARMCHEM LABORATORIES 1505-A O’Brien Drive Menlo Park, CA 94025 Maxine Warren, Ph.D., Director

(415) 328-6200

SMITHKLINE BEECHAM CLINICAL LABS 3175 Presidential Drive Atlanta, GA 30340 R.H. Barry Sample, Ph.D., Director

(404) 452-1590

SMITHKLINE BEECHAM CLINICAL LABS 801 E. Dixie Avenue Leesburg, FL 34749 Michael Schaffer, Ph.D., Director

(352) 787-9006

TOXICOLOGY TESTING SERVICES, INC. 5426 N.W. 79th Avenue Miami, FL 33166 Terry D. Hall, Ph.D., Director

(305) 593-2260


SECTION 4

EMPLOYEE EDUCATION

Education and training are the keys to building employee support for a drug-free workplace policy and program. The education must stress the dangers to fellow employees of drug and alcohol abuse in the workplace, as well as the hazards of substance abuse on and off the job. It should also emphasize how to take responsible action.

Supervisors and managers need special training to do an effective job of managing a drug-free workplace. They need to understand the physiological and psychological aspects of substance abuse:

How to confront employees suspected of drug or alcohol abuse.

How to document unsatisfactory job performance due to drug or alcohol abuse.

How to discipline employees within the limits of company policy and the law.

How and when to interact with company specialists (such as security or human relations personnel) or with outside specialists (such as Employee-Assistance Program counselors or law enforcement officers).


SECTION 5

SUBSTANCE ABUSE RECOGNITION

Managers and supervisors must be trained to recognize the subtle signs of abuse. Individually these signs seem harmless, but together they can give the clues necessary to recognize a problem.

Do not ignore these indications, but record them as they are evident. Documentation of specific performance problems helps when confronting a drug user.

Abrupt changes in work attendance, quality and/or quantity of work.

Unusual flare-ups or outbursts of temper.

Significant changes in overall attitude.

Deterioration of physical appearance and grooming.

Wearing sunglasses at inappropriate times (to hide dilated or constricted pupils).

Wearing long-sleeved garments (to hide injection marks), particularly in hot weather, or reluctance to wear short-sleeved attire when appropriate.

Association with known substance abusers.

Excessive borrowing of money from friends, coworkers.

Theft.

Secretive behavior regarding actions and possessions; poorly concealed attempts to avoid attention and suspicion, i.e., frequent trips to storage room closets, restrooms, basements (to use drugs).

Tardiness, lengthy lunches and/or frequent breaks; leaving work early.

A series of accidents causing minor injuries to self and others and/or causing damage to equipment.

Increase in physical complaints and medical ailments resulting in lost time.

Complaints from co-workers, customers and/or the public about work output, quality, timeliness or attitude.

Promises to improve behavior (which may happen for a while) that eventually deteriorates.


SIGNS CHARACTERISTIC OF USE OF SPECIFIC SUBSTANCES

Substances are listed in order of popularity of abuse

ALCOHOL (“Booze,” “Juice,” “Sauce,” “Brew,” “Vino”)

Odor on the breath. Strong excitement or elation, indicating intoxication. Difficulty focusing; glazed eyes. Uncharacteristically passive behavior or combative and argumentative behavior. Gradual deterioration (or sudden deterioration in adolescents) in personal

appearance and hygiene. Gradual development of dysfunction, especially in job performance or schoolwork. Absenteeism (particularly at the beginning of the week). Unexplained bruises and accidents. Unusual irritability. Flushed skin. Loss of memory (blackouts). Availability and consumption of alcohol becomes the focus of social or professional

activities. Changes in peer-group associations and friendships. Impaired interpersonal relationships (troubled marriage, unexplainable termination of

deep relationships, alienation from close family members).

NOTE: Behavioral and physiological signs of alcohol abuse may emerge in as little as six months for adolescents and the aged or as long as 15 years for some adults.

MARIJUANA (“Dope,” “Weed,” “Herb,” “Grass,” “Pot,” “Hashish,” “Hash”)

Rapid, loud talking and bursts of laughter in early stages of intoxication. Sleepiness or stupor in the later stages. Forgetfulness in conversation (May ask, “What was I saying?” or voice may simply

trail off). Inflammation in whites of eyes; pupils unlikely to be dilated. Odor similar to burnt rope on clothing or breath. Tendency to drive unusually slowly (below speed limit). Distorted sense of time passage, tendency to overestimate time intervals. Use or possession of paraphernalia, including “roach clips” for holding the cigarette,

packs of cigarette papers, pipes or “bongs.”


NOTE: Marijuana users are difficult to recognize unless they are under the influence of the drug at the time of observation. Casual users may show none of the general symptoms.

Marijuana has a distinct smell and may be the same color as, or greener than, tobacco. Marijuana cigarettes are usually hand-rolled, but paper may be white or colored. They are smaller than a regular cigarette, with the paper twisted or tucked in at both ends. The butts (“roaches”) usually are not discarded, but saved for later smoking. Marijuana may also be smoked in pipes (various and unusual shapes) or cooked in food, such as brownies or cookies.

STIMULANTS (Amphetamines, Cocaine, “Speed,” “Bennies,” “Uppers”)

Dilated pupils (when large amounts are taken). Dry mouth and nose, bad breath, frequent lip licking. Excessive activity, difficulty sitting still, lack of interest in food or sleep. Irritability, argumentativeness, nervousness. Talkativeness (Bus conversation often lacks continuity and person changes subjects

rapidly). Runny nose, cold or chronic sinus/nasal problems, nosebleeds (for cocaine users). Use or possession of paraphernalia (by cocaine users), i.e., small spoons, razor

blades, mirror, little bottles of white powder, and plastic, glass or metal straws.

DEPRESSANTS (Barbiturates, “Ludes,” “Tranquilizers,” “Downs”)

Symptoms of alcohol intoxication, with no alcohol on breath (Remember, however, that depressants are frequently used along with alcohol).

Slurred speech. Lack of facial expression or animation; flaccid appearance.

NOTE: Although there are few readily apparent symptoms, abuse of depressants may be indicated by activities such as frequent visits to different physicians for prescriptions to treat so-called nervousness, stress, or tension – or by having prescriptions filled at numerous pharmacies widely separated in distance or even outside local community.


NARCOTICS (Heroin, Morphine)

Lethargy, drowsiness. Constricted pupils which fail to respond to light. Red and raw nostrils from inhaling heroin in powder form; possible traces of white

powder on nostrils. Scars (tracks”) on inner arms or other parts of body from needle injections. Use or possession of paraphernalia, including syringes, bent spoons, bottle caps,

eye droppers, rubber tubing, cotton and needles.

NARCOTIC ANALGESICS

No readily apparent symptoms. However, abuse may be indicated by frequent visits to different physicians or dentists for prescriptions to treat pain of nonspecific origin or by filling prescriptions at numerous widely separated pharmacies.

INHALANTS (Glue, Vapor-Producing Solvents, Propellants)

Substance odor on breath and clothes. Runny nose, watering eyes. Poor muscle control. Drowsiness or unconsciousness. Preference for group, rather than solitary, activity. Presence of bags or rags containing dry plastic cement or other solvent. Discarded whipped cream cans or similar aerosol containers (users of nitrous oxide). Small bottles labeled “incense” (users of butyl nitrite).

HALLUCINOGENS (LSD, Mescaline, MDA, MDM, Psilocybin, DMT, STP)

Extremely dilated pupils. Warm skin, excessive perspiration and body odor. Distorted senses of sight, hearing, touch; distorted image of self and time

perception. Mood and behavior changes, the extent depending on emotional state of user and

environmental conditions. Unpredictable flashback episodes, even long after withdrawal from LSD.

NOTE: It is unlikely persons using hallucinogens will do so at work where they might be observed. At least in the early stages of usage, these drugs are generally taken in a group under special conditions designed to enhance their effect.


LSD is odorless, tasteless and colorless. It can be taken orally in tablets or capsules, or it can be impregnated in liquids. It is commonly sold on pieces of paper resembling postage stamps and is often named after the picture on the paper, i.e., lightning bolt, alien, rainbow, Snoopy. It may also be placed on clear cellophane and called “windowpane.”

Users may become fearful and terrified, particularly if confronted or if dealt with in a threatening manner at the time of LSD use or while under its influence. A calm, reassuring attitude is essential in dealing with the user to avoid a psychological crisis with possible lasting effects. Avoid confrontation.

Flashbacks are extremely rare and are probably caused by the user’s failure to resolve emotional-psychological conflicts that arise during a “trip.”

DISSOCIATIVE ANESTHETICS (PCP, “Angel Dust,” Phencyclidine Hydrochloride)

Unpredictable behavior, mood may swing from passive to violent for no apparent reason.

Symptoms of intoxication. Disorientation; agitation and violence if exposed to excessive sensory stimulation. Fear, terror. Rigid muscles, strange gait. Deadened sensory perception (may exercise severe injuries while appearing not to

notice). Pupils may appear dilated. Mask-like facial appearance. Floating pupils appear to follow a moving object (nystagmus). Comatose (unresponsive) if large amount consumed; eyes may be open or closed.

NOTE: PCP (phencyclidine hydrochloride) has stimulant, depressant, hallucinogenic and analgesic effects. Which of these actions will be most pronounced is unpredictable and will depend upon the user’s personality, psychological state, and the setting at the time of use.

PCP is most frequently found in tablets or powder or is mixed with marijuana or leafy herbs for smoking.

Many illicit drugs may contain PCP.


FL Rev. 12/06

CHARLIE CRIST, GOVERNOR ANDREW AGWUNOBI, SECRETARY

Toxicology Testing Service, Inc. 5426 N.W. 79th Avenue Miami, FL 33166 (305) 593-2260 Terry D. Hall, Ph.D., Director License Number T003

Labcorp Occupational Testing Services 1904 Alexander Drive Research Triangle Park, NC 27709 (919) 572-6900 William R. Lynn, Director License Number T005

Diagnostic Services, Inc. 12700 Westlinks Dr. Fort Myers, FL 33913 (941) 561-8200 Robert M. White, Sr., Ph.D., Director License Number T011

Quest Diagnostics Clinical Laboratories 3175 Presidential Drive Atlanta, GA 30340 (770) 452-1590 Edward A’Zary, Ph.d., Director License Number T017

Medtox Laboratories, Inc. 402 W. County Road D St. Paul, MN 55112 (651) 636-7466 Jennifer Collins, Ph.D., Director License Number T019

Doctor’s Laboratory, Inc. 2906 Julia Drive P.O. Box 2658 Valdosta, GA 31602 (912) 244-4468 David C. Williams, Ph.D., Director License Number T026

Quest Diagnostics, Inc. 10101 Renner Blvd. Lenexa, KS 66219 (913) 577-1517 Lance C. Presley, Ph.D., Director License Number T029

Clinical Reference Laboratory, Inc. 8433 Quivira Road Lenexa, KS 66215 (913) 492-3652 Stan Kammerer, Ph.D., Director License Number T035

Mercy Hospital Forensic Toxicology Lab 3663 South Miami Avenue Miami, FL 33133 (305) 285-2731 R. Spencer Howell, M.D., Director License Number T038

Kroll Laboratory Specialists, Inc. 1111 Newton Street Gretna, LA 70053 (504) 361-8989 David A. Green, Ph.D., Director License Number T039

Advanced Toxicology Network 3560 Air Center Cove #101 Memphis, TN 38118 (888) 290-1150 Stuart C. Bogema, Ph.D., Director License Number T041

(continued on page 2)

Psychemidics Corporation 5832 Uplander Way Culver City, CA 90230 (800) 522-7424 Michael I. Schaffer, Ph.D., Director License Number T042

2727 Mahan Drive, MS# 32 Tallahassee, Florida 32308

Visit AHCA online at http://ahca.myflorida.com

FL Rev. 05/07 Health Care in the Sunshine www.FloridaCompareCare.gov

© FHM Insurance Company, Inc. 2007

Licensed DFW Laboratories

Quest Diagnostics, Inc. 4230 South Burnham Avenue #212 Las Vegas, NV 89119 (702) 733-7866 James A. Bourland, Ph.D., Director License Number T043

Laboratory Corp of America 1120 Main Street Southhaven, MS 38671 (662) 342-1286 Edwin K. Armitage Ph.D., Director License Number T050


iii. drug-free workplace programs - fhmic.com fileiii. drug-free workplace programs ... y drug-free...

Documents