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Federal Register / Vol. 82, No. 13 / Monday, January 23, 2017 / Notices
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Substance Abuse and Mental Health
Services Administration
Mandatory Guidelines for Federal
Workplace Drug Testing Programs
Substance Abuse and Mental
Health Services Administration
(SAMHSA), HHS.
ACTION: Revised Mandatory Guidelines
by the Secretary of Health and Human
Services.
AGENCY:
The Department of Health and
Human Services (‘‘HHS’’ or
‘‘Department’’) has revised the
Mandatory Guidelines for Federal
Workplace Drug Testing Programs
(Guidelines), 73 FR 71858 (November
25, 2008) for urine testing.
DATES: Effective Date: October 1, 2017.
FOR FURTHER INFORMATION CONTACT:
Charles LoDico, M.S., F–ABFT, Division
of Workplace Programs, Center for
Substance Abuse Prevention (CSAP),
SAMHSA mail to: 5600 Fishers Lane,
Room 16N03A, Rockville, MD 20857,
telephone (240) 276–2600 or email at
charles.lodico@samhsa.hhs.gov.
SUPPLEMENTARY INFORMATION: In
particular, these revised Mandatory
Guidelines for Federal Workplace Drug
Testing Programs using Urine (UrMG)
allow federal executive branch agencies
to test for additional Schedule II drugs
of the Controlled Substances Act (i.e.,
oxycodone, oxymorphone, hydrocodone
and hydromorphone) in federal drugfree workplace programs, remove
methylenedioxyethylamphetamine
(MDEA) from the authorized drugs in
Section 3.4, add
methylenedioxyamphetamine (MDA) as
an initial test analyte, raise the lower pH
cutoff from 3 to 4 for identifying
specimens as adulterated, require MRO
requalification training and reexamination at least every five years
after initial MRO certification, and
allow federal agencies to authorize
collection of an alternate specimen (e.g.,
oral fluid) when a donor in their
program is unable to provide a sufficient
amount of urine specimen at the
collection site. Many of the wording
changes and reorganization of the UrMG
were made for clarity, to use current
scientific terminology or preferred
grammar, and for consistency with the
OFMG.
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SUMMARY:
Background
The Department of Health and Human
Services (HHS), by the authority of
Section 503 of Public Law 100–71, 5
U.S.C. Section 7301, and Executive
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Order No. 12564, has established the
scientific and technical guidelines for
federal workplace drug testing programs
and established standards for
certification of laboratories engaged in
urine drug testing for federal agencies.
As required, HHS originally published
the Mandatory Guidelines for Federal
Workplace Drug Testing Programs
(Guidelines) in the Federal Register
[FR] on April 11, 1988 [53 FR 11979].
The Substance Abuse and Mental
Health Services Administration
(SAMHSA) subsequently revised the
Guidelines on June 9, 1994 [59 FR
29908], September 30, 1997 [62 FR
51118], November 13, 1998 [63 FR
63483], April 13, 2004 [69 FR 19644],
and November 25, 2008 [73 FR 71858]
with an effective date of May 1, 2010
(correct effective date published on
December 10, 2008; [73 FR 75122]). The
effective date of the Guidelines was
further changed to October 1, 2010 on
April 30, 2010 [75 FR 22809].
The proposed Mandatory Guidelines
for Federal Workplace Drug Testing
Programs using Urine (UrMG) published
in the Federal Register on May 15, 2015
(80 FR 28101) include revisions to the
initial and confirmatory drug test
analytes and methods for urine testing,
the cutoff for reporting a urine specimen
as adulterated based on low pH, and the
requalification requirements for
individuals serving as Medical Review
Officers (MROs) and, where appropriate,
include references to the use of an
alternate specimen in federal workplace
drug testing programs. References to an
alternate specimen are not applicable
until final Guidelines are implemented
for the use of the alternative specimen
matrix. The Department published a
separate Notice in the May 15, 2015
Federal Register (80 FR 28054)
proposing Mandatory Guidelines for
Federal Workplace Drug Testing
Programs using Oral Fluid (OFMG) to
allow federal agencies to collect and test
oral fluid specimens in their workplace
drug testing programs. There was a 60day public comment period for both
Federal Register Notices, during which
125 commenters submitted comments
on the proposed changes to the
Guidelines. These commenters were
comprised of individuals, organizations,
and private sector companies. The
comments are available for public view
at http://www.regulations.gov/. All
comments were reviewed and taken into
consideration in the preparation of the
revised Guidelines. The issues and
concerns raised in the public comments
for the UrMG are set out below. Similar
comments are considered together in the
discussion.
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Summary of Public Comments and
HHS’s Response
The following comments were
directed to the information and
questions in the preamble.
Costs and Benefits
The Department requested comments
on costs and benefits. One commenter
disagreed that the cost increase for
laboratories to add analytes to regulated
testing will be minimal, stating that
significant costs would be incurred for
information technology (IT)
development, as well as incremental
costs for additional immunoassays (if
required); for additional calibrators,
controls, and internal standards; and for
increased confirmatory testing costs
(including data review and result
certification) based on an expected
increased positivity rate for opioids.
One commenter disagreed with the
Department’s estimated 3% cost
increase for Medical Review Officers
(MROs) and estimated that the increase
will be 10%. The commenters did not
provide any substantive evidence or
data to support these comments. The
Department recognizes that there will be
start-up costs to laboratories to
implement testing for the additional
analytes for regulated specimens
including administrative costs, and
agrees that the estimated increased costs
for some MROs may exceed the 3%
estimate. The Department’s cost analysis
was based on information provided by
multiple HHS-certified laboratories and
MROs, as well as the estimated number
of additional positives resulting from
the inclusion of the new opioid
analytes. Costs are expected to vary
among individual laboratories and
MROs, depending on their processes
and testing populations. Additional
information on the estimated costs
associated with these Guidelines is
included under Regulatory Impact and
Notices below.
Proposed New Analytes: Oxycodone,
Oxymorphone, Hydrocodone, and
Hydromorphone
Seven commenters specifically agreed
with the addition of these drugs to the
Guidelines. Two commenters expressed
concerns over the added drugs,
indicating that individuals who follow
their physician’s treatment plan of
taking legally prescribed medication
would produce positive tests, leading to
greater reliance on MROs to determine
whether tests are truly positive (as a
result of illegal use) or are positive due
to prescribed usage of the drugs, and a
greater number of workers will be
subject to scrutiny and their medical
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records examined at length. One of the
commenters maintained that such
testing would exceed the legal mandate
under Executive Order No. 12564 and
the promulgation of scientific
Guidelines by HHS pursuant to it. The
Guidelines include requirements to
protect individuals’ privacy while
maintaining public safety, including
procedures for MRO review to verify
legitimate drug use and maintain the
confidentiality of donor drug testing
records. The Department provides
additional guidance in the Medical
Review Officer Manual for Federal
Workplace Drug Testing Programs. The
inclusion of these additional drugs in
the Guidelines is within the scope of the
Department’s regulatory authority to test
for illegal drug use under Section
503(a)(1)(A)(ii)(II) of Public Law 100–71
and Executive Order No. 12564.
New Analytes—Cutoff Concentrations
Eight commenters addressed the
proposed cutoffs for the added drugs:
Three commenters agreed with the
proposed cutoffs; four disagreed with
the cutoffs for one or more of the added
drugs. Of these, three commenters stated
that the cutoffs are too low: Two of
these commenters believe that these
cutoffs will unnecessarily identify
workers using prescription drugs and
one commenter noted that these cutoffs
will affect accurate quantitation in
routine specimens. The Department
recognizes that the added analytes will
result in an increased number of
positive opioid results requiring MRO
review, and has incorporated
requirements for MRO requalification
and retraining at least every five years.
Additional guidance and information on
the added drugs will be provided in the
Medical Review Officer Guidance
Manual for Federal Workplace Drug
Testing Programs. The Department
disagrees that the cutoffs will affect
accurate quantitation in routine
specimens. Information from HHScertified laboratories indicates that
testing at these cutoffs can be
accomplished with current
instrumentation. However, the
Department has raised the confirmatory
test cutoffs for oxycodone and
oxymorphone from 50 ng/mL to 100 ng/
mL. These higher cutoffs are supported
by a single dose study which showed
similar detection rates for oxycodone
and oxymorphone using either a 50 ng/
mL or 100 ng/mL cutoff.1 Use of the 100
ng/mL confirmatory test cutoffs is
expected to be less analytically
challenging for laboratories.
One commenter suggested changing
the oxycodone and oxymorphone initial
test cutoff to 300 ng/mL and changing
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the hydrocodone and hydromorphone
initial test cutoff to 100 ng/mL, to
equate the detection times for these
drugs. One commenter requested that
the Department provide the justification
and data used to determine the cutoff
levels for the added opioids. The
Department raised the oxycodone and
oxymorphone confirmatory test cutoffs
to 100 ng/mL as described above. The
Department has evaluated the comments
and has concluded that no further
change is needed. The selection of
cutoff concentration is not based solely
on the factor of detection times and
must take into consideration a variety of
factors, both pharmacological and
chemical. Drug potency, disposition in
urine, impact and prevalence must be
considered. For example, oxycodone is
approximately twice as potent as
hydrocodone and may be prescribed in
lower doses, thus a cutoff lower than
that for hydrocodone is warranted.
Therefore, in selecting the cutoffs, the
Department considered the detection
times of equipotent doses as well as
dispositional patterns of each drug in
urine. Data on the disposition of
hydrocodone and oxycodone in urine
following administration of a single
dose can be found in two recently
published scientific articles.1 2
Medical Review Officer (MRO)
Requalification—Continuing Education
Units (CEUs)
The Department requested comments
on requiring MRO requalification
continuing education units (CEUs) and
on the optimum number of credits and
the appropriate CEU accreditation
bodies should CEUs be required as part
of MRO requalification. Three
commenters agreed with requiring MRO
recertification, but disagreed with the
addition of CEU requirements to the
Guidelines. Two commenters disagreed
with specifying the number of CEUs
required. Two commenters indicated
that certification entities already enforce
training requirements and
recommended that acceptance of CEUs
be handled by MRO certification boards,
not the Department. Two commenters
recommended a requirement of annual
CEUs: One suggested 16 CEUs and the
other recommended three CEUs. One
commenter recommended 12 CEUs
prior to initial certification, eight CEUs
every five years, and also recommended
two CEUs related to the new
requirements/topics within two years of
implementation of the revised
Guidelines. The Department has
evaluated the comments and has
concluded that requirements for
continuing education units will remain
with the MRO certification entities and
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will not be included in the Guidelines.
The Department has removed references
to MRO training entities in Sections
13.2 and 13.3, because training
documentation is maintained by MRO
certification entities. The Department
agrees with the comment that MROs
should receive training on revisions to
the Guidelines, and has added item
Section 13.3(b) to require such training
prior to the effective date of revised
Guidelines.
Discussion of Sections
The Department has not included a
discussion in the preamble of any
sections for which public comments
were not submitted or where minor
typographical or grammatical changes
were made.
Subpart A—Applicability
1.5 What do the terms used in these
Guidelines mean?
One commenter disagreed with the
definition for ‘‘dilute specimen’’
because it does not include numerical
values for creatinine and specific
gravity. The Department has concluded
that no change is needed; the analytical
(numerical) criteria for a dilute
specimen are provided in Section 3.8.
One commenter requested that
‘‘external service provider’’ be defined,
because this is a new term included in
the proposed Guidelines. The
Department agrees and has added the
definition.
The Department has added the
definition for ‘‘gender identity’’ to
Section 1.5. This term is now used in
Guidelines sections addressing observed
and monitored collections as described
in this preamble under Sections 4.4, 8.1,
8.10, and 8.12. Gender identity means
an individual’s internal sense of being
male or female, which may be different
from an individual’s sex assigned at
birth.
Two commenters disagreed with the
proposed definition for ‘‘invalid result’’
which indicated that an invalid result
was reported only when an HHScertified laboratory could not complete
testing or obtain a valid drug test result.
The Department agrees with the
commenters and has reinstituted the
definition from the Guidelines effective
October 1, 2010 (73 FR 71858).
To address comments described in
this preamble under Section 13.1, the
Department deleted the definition for
‘‘non-medical use of a drug.’’
Two commenters found the definition
of ‘‘specimen’’ confusing, because the
term ‘‘sample’’ used in the definition
was also defined as a representative
portion of a donor’s specimen. The
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Department agrees, and has reinstituted
some wording for the definition of
‘‘specimen’’ from the Guidelines
effective October 1, 2010 (73 FR 71858)
for clarity.
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1.6 What is an agency required to do
to protect employee records?
One commenter suggested that the
non-applicability of the Health
Insurance Portability and
Accountability Act (HIPAA) and the
Health Information Technology for
Economic and Clinical Health Act
(HITECH) should be clearly stated in the
Guidelines. The Department has
evaluated the comment and has
concluded that the applicability of
HIPAA and other relevant privacy laws
is clearly stated in Section 1.6.
Accordingly, except for minor
rewording for clarity, no further
revisions are necessary.
1.7 What is a refusal to take a federally
regulated drug test?
One commenter noted that, per
Sections 8.4(c) and 8.9(b), when a
collector finds an adulterant or
substitution product or observes an
attempt to substitute a urine specimen,
this prompts a direct observed
collection, not a refusal to test. The
commenter suggested bringing an
adulterant or a substitution product to
the collection should be a refusal to test.
The Department has evaluated the
comment, and agrees that the collector
must report a refusal to test when a
donor brings materials for adulterating,
substituting, or diluting the specimen to
the collection site, or when the collector
observes a donor’s clear attempt to
tamper with a specimen. The
Department has revised Sections 1.7,
8.3(h), 8.4(c), and 8.9(b) accordingly.
One commenter noted that the
collector does not report a refusal to test
when a donor leaves the collection site
before the collection process begins for
a pre-employment test. The commenter
recommended defining the beginning of
the pre-employment test collection
process as the point at which the donor
is asked to present photo identification.
The Department agrees with the
suggestion to define the beginning of the
collection process specifically for this
situation. However, the Department has
designated the beginning as the step
described in Section 8.4(a), when the
collector provides or the donor selects a
specimen collection container. The
Department has revised Sections
1.7(a)(2) and (3) to include a reference
to this section. All subsequent items in
Section 1.7(a) (i.e., items 4–13) apply
once the donor has arrived for the preemployment test collection.
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1.8 What are the potential
consequences for refusing to take a
federally regulated drug test?
The Department reworded Section
1.8(b) to clarify that the requirements in
this section apply to donors who fail to
appear at the collection site in a
reasonable time for any test (except a
pre-employment test), as described in
Section 1.7(a)(1).
Subpart B—Urine Specimens
2.1 What type of specimen may be
collected?
Two commenters requested
clarification on the collection/testing
scenario where the federal agency
authorizes collection of an oral fluid
specimen, but the contracted laboratory
does not perform oral fluid testing. The
Department has evaluated the comments
and has concluded that no change is
needed. This will be addressed in the
federal agency plan.
2.2 Under what circumstances may a
urine specimen be collected?
One commenter suggested that the
cost of mandatory random drug and
alcohol testing among airline pilots
outweighs the benefit. The Department
has evaluated the comment and has
concluded that no change is needed.
Airline pilots are subject to drug and
alcohol testing under DOT regulations.
Therefore, this public comment is not
relevant to the Guidelines. In regard to
drug testing of federal agency employees
and applicants, each federal agency
establishes its agency plan based on its
mission, its employees’ duties, and the
potential consequences to the public
health and safety or national security
that could result from the failure of an
employee to adequately perform their
duties and responsibilities.
Subpart C—Urine Specimen Tests
3.1 Which tests are conducted on a
urine specimen?
One commenter suggested changing
the term ‘‘opiates’’ to ‘‘opioids’’ in the
Guidelines. The Department agrees with
the commenter and has changed the
term ‘‘opiates’’ to ‘‘opioids’’ where
appropriate to refer to oxycodone,
oxymorphone, hydrocodone, and
hydromorphone in addition to codeine,
morphine, and 6-acetylmorphine (6AM).
3.2 May a specimen be tested for
additional drugs?
The Department reworded Section
3.2(a) to clarify the additional drug tests
that may be performed on federal
employee specimens.
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3.3 May any of the specimens be used
for other purposes?
Section 3.3 states that specimens
collected pursuant to Executive Order
12564, Public Law 100–71, and these
Guidelines may not be used for
purposes other than drug and validity
testing in accordance with Subpart C of
the Guidelines. One commenter
disagreed with prohibiting employees
from using their drug test specimens for
other purposes (e.g., deoxyribonucleic
acid, DNA, testing). The Department has
evaluated this comment and has
concluded that no change is needed.
While the Guidelines do not authorize
the release of urine specimens, or
portions thereof, to federal employees,
the Guidelines afford employees a
variety of protections that ensure the
identity, security and integrity of their
specimens. For example, see Sections
8.5(b), 8.8, and 15.1(a).
In addition, under Public Law 100–
71, Section 503(a)(1)(A)(ii)(I), HHS is
mandated to establish ‘‘strict procedures
governing the chain of custody of
specimens collected for drug testing
. . . .’’ Sections 11.7(a) and 11.20(a)
also provide that an ‘‘HHS-certified
laboratory must control access to the
drug testing facility, specimens,
aliquots, and records,’’ and must retain
specimens that, among other things,
have been reported ‘‘drug positive’’ for
a minimum of one year. Therefore, the
release of specimens to employees, or to
an employee’s designee, is inconsistent
with the mandates of the federal drug
testing process, and could significantly
compromise a specimen’s integrity,
security, and an HHS-certified
laboratory’s ability to fulfill its
regulatory duties under the Guidelines.
One commenter requested further
clarification of the phrase ‘‘unless
authorized in accordance with
[applicable] federal law’’ in Section 3.3.
The phrase ‘‘unless otherwise
authorized in accordance with
applicable law in Section 3.3(a) does not
represent a significant change from the
intent of the prior Guidelines language.
Section 3.3, among others, is intended
to prohibit the use of specimens for
purposes other than those specifically
authorized by the Guidelines. However,
there may be circumstances in which
federal law authorizes an HHS-certified
laboratory to handle a specimen in a
manner that differs from the Guidelines.
Therefore, the phrase ‘‘unless
authorized in accordance with
applicable federal law’’ in Section 3.3 of
the Guidelines is intended to avoid
conflict with other applicable federal
law.
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It should be noted that Section 3.3
specifically prohibits conducting
deoxyribonucleic acid (DNA) testing on
urine specimens, unless authorized in
accordance with applicable federal law.
3.4 What are the drug test cutoff
concentrations for urine?
The Department proposed
methylenedioxyamphetamine (MDA)
and methylenedioxyethylamphetamine
(MDEA) as initial test analytes. Three
commenters disagreed with the addition
of MDA and MDEA as target analytes,
stating this change would require
modification of current immunoassay
reagents, laboratory processes, or both.
The commenters noted that this imposes
an unnecessary burden for compounds
with such low incidence in workplace
testing. The Department has evaluated
the comments and has removed MDEA
from the Guidelines (i.e., MDEA is no
longer included as an authorized drug
in Section 3.4). The number of positive
MDEA specimens reported by HHScertified laboratories (i.e., information
provided to the Department through the
NLCP) does not support testing all
specimens for MDEA in federal
workplace drug testing programs.
Because MDEA is a Schedule I drug, a
federal agency may test specimens for
MDEA in accordance with Section 3.2
(i.e., on a case-by-case basis for
reasonable suspicion or post accident
testing, routinely with a waiver from the
Secretary). The Department understands
that MDA and some other analytes also
have a low incidence, but believes that
continued testing for these analytes is
warranted in a deterrent program. In
particular, inclusion of MDA as an
initial and confirmatory test analyte is
warranted because, in addition to being
a drug of abuse, it is a metabolite of
MDEA and MDMA.
An HHS-certified laboratory or
Instrumented Initial Test Facility (IITF)
may group analytes for initial testing.
For clarity, the Department has defined
the term ‘‘grouped analytes’’ where used
in footnote 1 of the table in Section 3.4:
‘‘(i.e., two or more analytes that are in
the same drug class and have the same
initial test cutoff).’’
The Department proposed criteria for
immunoassays for grouped analytes
such as opioids and amphetamines,
specifying the minimum cross-reactivity
to the other analyte(s) within the group.
Two commenters disagreed with the
added cross-reactivity requirements,
noting this section should not attempt to
provide equivalence between
immunoassay and other initial testing
technologies. One of these commenters
suggested the Department develop
separate requirements for initial test
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methods using an alternate technology
or, alternatively, require the combined
cross-reactivity of low-reacting
compounds (e.g., hydrocodone and
hydromorphone for an opiate assay;
MDA and MDEA for an amphetamines
assay) to be equal to or greater than the
cutoff. The other commenter
recommended not allowing methods
other than immunoassay for urine initial
testing. One commenter stated that
cross-reactivity specifications for
hydromorphone are not necessary,
based on their non-regulated testing
results (i.e., confirmatory test
concentrations detected after using an
immunoassay with 60% cross-reactivity
for hydromorphone). The Department
has evaluated the comments and has
concluded that no change is needed for
immunoassay cross-reactivity
requirements. The requirements in
Section 3.4 are necessary to ensure
consistency in testing among
laboratories using different
immunoassay kits, as well as those
using different test methods for initial
drug testing. Cross-reactivity must be
demonstrated and documented by the
manufacturer (e.g., package insert) and
by the HHS-certified laboratory or IITF
(i.e., assay validation studies, reagent lot
verification, and batch quality control
for any analyte that exhibits less than
100% cross-reactivity). The Department
will continue to allow the use of
methods other than immunoassay for
initial testing.
However, the Department has revised
Section 3.4 regarding the use of
alternate technology initial tests for
THCA and benzoylecgonine. Depending
on the technology, the confirmatory test
cutoff (i.e., 15 ng/mL for THCA, 100 ng/
mL for benzoylecgonine) must be used
as the cutoff for an initial test using an
alternate technology to ensure
consistent treatment of specimens. For
these analytes, the immunoassay test is
not specific for the target analyte for the
confirmatory test. For example,
immunoassays for cannabinoids react
with multiple compounds that are
excreted as a result of marijuana use.
Therefore, it is necessary to use an
immunoassay cutoff higher than that of
the confirmatory test in order to detect
the target analyte (THCA) at or above
the confirmatory test cutoff. An initial
test using an alternate technology with
specificity comparable to the
confirmatory test requires use of the
confirmatory test cutoff.
Also in Section 3.4, the Department
did not specify the target analyte to be
used to calibrate an initial test for
grouped analytes such as amphetamines
or opioids. Three commenters noted
that when an immunoassay is calibrated
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with a low-reacting drug, other analytes
may exhibit high cross-reactivity,
leading to false initial test positives.
Two of these commenters also noted
that this may result in possibly different
cross-reactivity profiles for some
structurally unrelated and
concomitantly used prescription and/or
over the counter drugs. One commenter
noted that the option to ‘‘include a
control containing the lowest reacting
analyte at its cutoff concentration in
each batch’’ was described in the
preamble to the proposed Guidelines,
but was not specified in Section 3.4 of
the Guidelines. It was not the
Department’s intent for the laboratory or
IITF to calibrate an immunoassay test
using an analyte other than that
specified by the manufacturer. In the
preamble to the proposed UrMG, the
Department described using a control
containing the lowest reacting analyte at
its cutoff concentration to establish the
decision point (i.e., when an
immunoassay for grouped analytes did
not demonstrate at least 80% crossreactivity to each analyte). The
Department has determined that this
approach is not necessary, and will not
be permitted. There are current
immunoassays that meet the
requirements of this section for two or
more analytes in a group (i.e., analytes
in the same drug class that have the
same initial test cutoff). As indicated in
Section 3.4, the laboratory or IITF may
use multiple test kits or a single kit to
meet the requirements.
3.5 May an HHS-certified laboratory
perform additional drug and/or
specimen validity tests on a specimen at
the request of the Medical Review
Officer (MRO)?
One commenter recommended that
HHS maintain a list of allowable
additional tests and reporting criteria
(e.g., threshold for reporting as positive,
adulterated, substituted, and/or invalid,
and a limit of detection as appropriate),
to ensure consistency among
laboratories and within the testing
program. The Department has evaluated
the comment and has concluded that no
change is needed. The Department does
not want to limit the analytes that may
be tested, and will provide guidance to
laboratories as needed. It is also noted
that the section requires all tests to meet
appropriate validation and quality
control requirements. The procedures
and specimen records for such tests will
be reviewed at NLCP inspections. The
Department will continue to maintain a
list of HHS-certified laboratories that
choose to perform additional tests for
regulated specimens.
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One commenter asked whether an
MRO could submit a blanket request to
perform additional testing (e.g.,
additional opioid metabolites) for all
confirmatory specimens (i.e., would
laboratories be permitted to monitor the
additional compounds in all
confirmatory test assays?). The
Department believes that testing all
specimens for additional analytes may
not be appropriate for some tests,
especially hydrocodone,
hydromorphone, oxycodone and
oxymorphone. Recent studies show that
testing for norhydrocodone and or
noroxycodone is not necessary for the
interpretation of all results.1 2
Norhydrocodone and noroxycodone
metabolites may be helpful for the MRO
to interpret test results only when a
donor’s prescription does not support
the test results. For example, a
hydrocodone dose may result in urine
concentrations of only hydromorphone
metabolite above the cutoff. The
presence of norhydrocodone metabolite
would support the use of hydrocodone
and validate the donor’s prescription.
The same could be said for interpreting
test results following an oxycodone
dose. The presence of noroxycodone
metabolite would support the use of
oxycodone when only oxymorphone
was reported as positive. The
Department will provide guidance on
these and other additional tests that may
provide useful information for the MRO
in the Medical Review Officer Guidance
Manual for Federal Workplace Drug
Testing Programs. The Department has
revised Section 3.5 to clarify that HHScertified laboratories are authorized to
perform additional tests upon MRO
request on a case-by-case basis, but are
not authorized to routinely perform
such tests without prior authorization
from the Secretary or designated HHS
representative, with the exception of the
determination of D,L stereoisomers of
amphetamine and methamphetamine.
The Department will continue to allow
HHS-certified laboratories to test for D,L
amphetamine and methamphetamine
routinely or upon MRO request. The
Department will provide guidance on
these and other additional tests that may
provide useful information for the MRO
(e.g., tetrahydrocannabivarin) in the
Medical Review Officer Guidance
Manual for Federal Workplace Drug
Testing Programs.
Additional drug and specimen
validity testing under Section 3.5 does
not include DNA testing.
3.6 What criteria are used to report a
urine specimen as adulterated?
Two commenters agreed and one
disagreed with raising the lower pH
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cutoff from 3.0 to 4.0 for identifying
specimens as adulterated. One
commenter advised caution in changing
specimen validity test cutoffs, and
indicated that the proposed change will
require updates to computer systems for
reporting, calibrators, and controls. One
commenter indicated that previous
review of data (more than 10 years ago)
indicated this change would have more
than doubled the number of low pH/
adulterated results reported. The
commenter that disagreed with
changing the pH cutoff believes HHS
does not have enough scientific
evidence supporting the change. The
Department has evaluated the comments
and has concluded that no change is
needed to the proposed cutoff (i.e., 4.0).
As stated in the preamble to the
proposed Guidelines (80 FR 28101), this
decision is based on the fact that the
physiologically minimum achievable
urine pH that can be produced by the
kidneys is about pH 4.5. Furthermore,
the Department is not aware of any
medical conditions or medications that
would cause urine pH to be less than
4.5.
3.8 What criteria are used to report a
urine specimen as dilute?
One commenter suggested removing
the three-decimal place criteria for
reporting a specimen as dilute. One
commenter indicated that the criteria for
reporting a specimen as dilute in
Section 3.8 and 11.19(f) were not
consistent, and that Section 3.8 does not
address the situation when creatinine is
between 5 and 20 mg/dL and the
specific gravity is less than 1.0020. This
section was intended to clarify that only
HHS-certified laboratories (and not
HHS-certified IITFs) may report a
specimen as dilute when the creatinine
concentration is greater than or equal to
2.0 mg/dL and less than or equal to 5
mg/dL, and the laboratory must use a
four-decimal place refractometer for the
specific gravity test. The Department
will retain the three-decimal place
criteria in Section 3.8(a) because both
HHS-certified IITFs and laboratories
may use a three-decimal place
refractometer for a specific gravity
screening test when the creatinine
concentration is greater than 5 mg/dL
and less than 20 mg/dL. However, the
Department agrees that this section did
not address all situations, so has revised
the wording in Section 3.8(b) to be
consistent with the wording in 11.19(f).
3.9 What criteria are used to report an
invalid result for a urine specimen?
One commenter suggested increasing
the acceptable pH range upper end from
9.0 to 9.5 due to heat during summer
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months. One commenter recommended
that the Department define requirements
to be met before a new validity marker
is implemented. One commenter
suggested that additional biomarkers
used to support a result of invalid
should be standardized across all HHScertified laboratories and one solution to
donor subversion might be random
assignment of collection of alternative
specimens. The Department has
evaluated the comments and has
concluded that no change is needed. A
2006 study on the stability of regulated
drug analytes in urine slightly below
and within the high pH invalid range
supports the pH 9.0 decision point due
to the loss of drug analytes at a pH
between 9.0 and 9.5.3
Subpart D—Collectors
4.4 What are the requirements to be an
observer for a direct observed
collection?
One commenter disagreed with the
requirement for an observer to be the
same gender as the donor, and suggested
that a physician or health care
professional (regardless of gender)
should be allowed to function as an
observer. The commenter indicated that
gender determination can be
challenging (i.e., transgender
employees). The Department has
evaluated these comments and agrees
that all observed collections must be
conducted in a professional manner that
minimizes discomfort to the donor. The
Department has revised Sections 4.4(b),
8.1(b), and 8.10 to allow the donor to be
observed by a person whose gender
matches the donor’s gender, which is
determined by the donor’s gender
identity (defined in Section 1.5). The
donor’s gender identity may be the same
as or different from the donor’s sex
assigned at birth. The Department also
revised Sections 8.1(b) and 8.12 for
monitored collections, to allow the
donor to be monitored by a person
whose gender matches the donor’s
gender, unless the monitor is a medical
professional (as described in Section
8.12).
The Department disagrees with the
commenter’s suggestion to allow an
individual to serve as an observer based
solely on their credentials as a
physician or health care professional.
Such credentials alone would not
guarantee that these individuals could
appropriately perform the functions of
an observer (i.e., as specified in Section
4.4).
The same commenter expressed
concerns over the requirement for an
observer to have received training,
indicating that this would require
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documentation and may make finding
short notice observers more difficult.
The Department disagrees with this
comment. These are the same
requirements as in the Guidelines
effective October 1, 2010 (73 FR 71858).
As stated in the preamble to those
Guidelines, the training elements are
included to ensure that the observer
interacts with the donor in a
professional manner, respecting the
donor’s modesty and privacy, and that
the collector maintains the
confidentiality and integrity of
collection information.
Subpart F—Federal Drug Testing
Custody and Control Form (CCF)
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6.1 What federal form is used to
document custody and control?
Two commenters recommended that
the Department provide instructions on
recording results for the added drugs on
the CCF until the Federal CCF is
revised. Three commenters
recommended that the CCF be revised to
address the addition of the oral fluid
specimen matrix. One commenter
encouraged SAMHSA to modify the
CCF to account for collections where
multiple specimens are collected during
a single collection event. The
Department will publish a Federal
Register Notice with the revised Federal
CCF, including changes for the added
analytes, with the same effective date as
these Guidelines. Guidance on the use
of the revised Federal CCF will be
posted on the SAMHSA Web site http://
www.samhsa.gov/workplace. In regard
to when the collector submits multiple
urine specimens (i.e., different voids)
collected during the same testing event,
the Department has concluded that no
change is needed; the collector must use
a separate Federal CCF for each
specimen.
6.2 What happens if the correct OMB
approved Federal CCF is not available
or is not used?
One commenter questioned the
purpose of a Memorandum for the
Record (MFR) obtained from the
collector when an incorrect CCF was
used for the collection. The commenter
suggested that if certain information is
required to be in the MFR, these
requirements should be specified in the
Guidelines. The commenter suggested
that if the purpose of the MFR is to
correct the collector’s behavior (i.e.,
using an incorrect form), then it would
be more effective to reject the specimen
upon receipt and indicate that it was
rejected due to the use of an incorrect
form. The Department has evaluated the
comments and has concluded that no
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change is needed. Section 6.2 describes
the information required in the MFR
from the collector. However, the
Department reworded items 6.2(b) and
(c) for clarity.
Department has revised Section 8.4
accordingly.
Subpart H—Urine Specimen Collection
Procedure
8.6 What procedure is used when the
donor states that they are unable to
provide a urine specimen?
8.1 What privacy must the donor be
given when providing a urine
specimen?
As described in this preamble under
Section 4.4, the Department has revised
Section 8.1(b) to require that the gender
of the observer matches the donor’s
gender, and that the gender of the
monitor matches the donor’s gender
unless the monitor is a medical
professional as described in Section
8.12.
8.3 What are the preliminary steps in
the urine specimen collection
procedure?
One commenter was concerned that
the Guidelines do not mention alcohol
testing, which was added to the
Department of Transportation (DOT)
program in 1991. Alcohol testing is
outside of the scope of the Department’s
regulatory authority granted by
Executive Order 12564 and Public Law
100–71.
In response to comments described
under Sections 1.7 and 8.4 in this
preamble, the Department revised
Section 8.3(h) to require the collector to
report a refusal to test when a donor
brings materials for adulterating,
substituting, or diluting a specimen to
the collection site.
8.4 What steps does the collector take
in the collection procedure before the
donor provides a urine specimen?
The proposed section included the
same requirement as the Guidelines
effective October 1, 2010 (73 FR 71858)
for the collector to perform an observed
collection when the donor exhibits
conduct that clearly indicates an
attempt to tamper with a specimen (e.g.,
substitute urine in plain view or an
attempt to bring into the collection site
an adulterant or urine substitute). One
commenter stated that if the collector
finds an adulterant or substitution
product or observes the donor attempt
to substitute a urine specimen, this
should be a refusal to test. As noted
under Section 1.7 in this preamble, the
Department agrees that the collector
must report a refusal to test when a
donor brings materials for adulterating,
substituting, or diluting a specimen to
the collection site, or when the collector
observes a donor’s clear attempt to
tamper with a specimen. The
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8.5 What steps does the collector take
during and after the urine specimen
collection procedure?
Comments on these two sections are
addressed here. Numerous commenters
expressed concern with the
Department’s urine collection policy,
stating that 7 to 10% of Americans have
a condition (‘‘paruresis’’), described as a
social anxiety disorder which prevents
a person from producing urine on
demand or in the presence of other
people. These commenters stated that if
the government wants to seek the largest
group of qualified applicants, the
Guidelines should specify that a
diagnosis of paruresis means non-urine
(i.e., oral fluid) testing will
automatically be provided, and that
donors should not have to attempt to
provide a urine specimen first. The
Department has evaluated the comments
and has concluded that no change is
needed. The Guidelines will allow a
federal agency to use any authorized
specimen types (e.g., urine, oral fluid, or
both) in their drug testing programs. The
Guidelines will continue to require that
the donor be allowed reasonable
attempts to provide a urine specimen as
described in Sections 8.5 and 8.6, and
allow collection of an authorized
alternate specimen (i.e., oral fluid).
Three commenters disagreed with the
requirement for the collector to contact
the agency representative for
authorization to collect an alternate
specimen each time a donor is unable to
provide a sufficient volume. These
commenters suggested that the
Guidelines allow this to be addressed in
established standard protocols for the
agency. The Department agrees with the
commenters. Each federal agency may
decide whether to require notification in
each case or whether to provide a
standard protocol for collectors to
follow. Sections 8.5 and 8.6 have been
revised accordingly.
Also in regard to Section 8.6, one
commenter indicated that some
employers may wish to retain urine
testing as the primary test due to a
longer detection window. This
commenter raised concern that some
donors may claim they are unable to
provide a urine specimen so that an
alternative specimen (i.e., OF) with a
shorter detection window will be
collected. The commenter suggested
that the Guidelines be changed to
indicate that an alternative specimen
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may be collected when a donor is
physiologically unable to provide a
urine specimen, and not just when the
donor states that they are unable to
provide a urine specimen. The
Department disagrees; collectors are not
qualified to conduct a medical
evaluation to verify or refute the donor’s
claim. It will be the agency’s decision to
collect urine or an authorized alternate
specimen, and Sections 13.6 and 13.7
include procedures for medical
evaluation as needed during the MRO
review process.
The Department reworded Section
8.5(d) to clarify that the collector must
record comments on both CCFs when
two specimens from the same collection
event are forwarded to a laboratory.
8.7 If the donor is unable to provide a
urine specimen, may another specimen
type be collected for testing?
The Department proposed within
Section 8.7 that when the donor is
unable to provide a urine specimen,
another specimen type may be collected
only if specifically authorized by the
agency. One commenter disagreed with
the Guidelines as written and suggested
that when a donor cannot provide the
primary specimen type, an alternate
specimen should be collected
immediately. The commenter cited the
additional time and cost (evaluation of
donor for ‘‘shy bladder’’) as well as the
fact that the collector may not know the
agency’s policy on alternate specimen
types. The Department has concluded
that no change is needed for Section 8.7
in response to this comment. The
Guidelines will continue to require that
the donor be allowed reasonable
attempts to provide a urine specimen as
described in Sections 8.5 and 8.6. The
Department has revised those sections
to allow a federal agency to either
require notification in each case or
provide a standard protocol for
collectors to follow when the donor is
unable to provide a urine specimen. The
Department has reworded this section to
state ‘‘Yes, if . . .’’ rather than ‘‘No,
unless . . . .’’ in response to a federal
agency’s comment and to enhance
clarity. The meaning of this section
remains the same.
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8.8 How does the collector prepare the
urine specimens?
In response to a federal agency
comment, the Department deleted a
sentence in item 8.8(h) that required the
collector to send a copy of the Federal
CCF to the HHS-certified laboratory or
IITF. The Department agreed with the
federal agency that this instruction is
redundant because item 8.8(g) instructs
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the collector to distribute copies of the
Federal CCF as required.
8.9 When is a direct observed
collection conducted?
The proposed section included
requirements for the collector to
perform an observed collection when
the donor exhibits conduct that clearly
indicates an attempt to tamper with a
specimen or the collector observed
materials brought by the donor to the
collection site for the purpose of
adulterating, substituting, or diluting
the specimen. One commenter stated
that if the collector finds an adulterant
or substitution product or observes the
donor attempt to substitute a urine
specimen, this should be a refusal to
test. As noted in this preamble under
Sections 1.7 and 8.4, the Department
agrees that the collector must report a
refusal to test when a donor brings
materials for adulterating, substituting,
or diluting the specimen to the
collection site, or when the collector
observes a donor’s clear attempt to
tamper with a specimen. The
Department has revised Section 8.9
accordingly.
8.10 How is a direct observed
collection conducted?
To address a comment described in
this preamble under Section 4.4, the
Department has revised Section 8.10 to
allow the donor to be observed by an
observer whose gender matches the
donor’s gender. At the beginning of the
observed collection, the collector
requests that the donor document the
donor’s gender on the Federal CCF and
initial the annotation. An observer of
the same gender is provided, and the
collector records the name and gender
of the observer on the Federal CCF.
8.12 How is a monitored collection
conducted?
To address a comment described in
this preamble under Section 4.4, the
Department has revised Section 8.12 to
allow the donor to be monitored by a
monitor whose gender matches the
donor’s gender, unless the monitor is a
medical professional (e.g., nurse, doctor,
physician’s assistant, technologist, or
technician licensed or certified to
practice in the jurisdiction in which the
collection takes place). As described in
Section 8.10, at the beginning of the
monitored collection, the collector
follows the same procedure as for
observer selection in Section 8.10(b).
That is, the collector requests that the
donor document the donor’s gender on
the Federal CCF and initial the
annotation. A monitor of the same
gender is provided, and the collector
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records the name and gender of the
monitor on the Federal CCF. A medical
professional may serve as the monitor,
regardless of gender.
Subpart I—HHS Certification of
Laboratories and IITFs
9.5 What are the qualitative and
quantitative specifications of
performance testing (PT) samples?
One commenter noted that, because
proposed initial test requirements allow
calibration with a low-reacting analyte,
PT schemes would likely need to be
designed based on the specific
implementation at each laboratory. The
commenter provided an example: When
an immunoassay is calibrated with a
drug/metabolite that exhibits 50% crossreactivity, the intended target analyte
(‘‘calibrant’’) at the cutoff concentration
would elicit a response well in excess
of the cutoff. This could result in
inaccurate initial test results (i.e., a
positive initial test result for a specimen
containing the calibrant at a
concentration below the cutoff). The
commenter stated that this result could
be scored as a ‘‘false positive’’ PT result.
The Department has evaluated the
comment and has concluded that no
change is needed. As noted above
regarding Section 3.4, it was not the
Department’s intent for the laboratory or
IITF to calibrate an immunoassay test
using an analyte other than that
specified by the manufacturer. NLCP PT
schemes are designed based on known
cross-reactivity profiles of the initial
tests used by HHS-certified laboratories.
Also in regard to proposed Section
9.5, one commenter suggested that the
Guidelines use the same wording as in
the Guidelines effective October 1, 2010
(73 FR 71858) for retest PT sample
specifications (i.e., ‘‘. . . may be as low
as . . .’’ rather than the proposed
wording ‘‘. . . may be less than. . .’’).
The Department agrees and has
reinstituted wording from Section 9.3 of
the Guidelines effective October 1, 2010
(73 FR 71858) into Section 9.5(a)(1)(ii).
Subpart J—Blind Samples Submitted by
an Agency
10.1 What are the requirements for
federal agencies to submit blind samples
to HHS-certified laboratories or IITFs?
Two commenters disagreed with the
proposed limit to the number of blind
samples required (i.e., a maximum of
400 blind samples per year) in Section
10.1(b). The commenters indicated that
for a large agency, there is a very large
difference between 3% and 400 samples
and suggested keeping only the 3%
requirement. Another commenter
disagreed with the 3% requirement for
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blind samples and requested that the
amount to be lowered to 1% to lessen
the burden on employers. One
commenter suggested that the wording
be modified to clarify that employers are
responsible for ensuring blind samples
are sent to the laboratories, but that
collectors are tasked with submitting the
blind samples. The Department has
evaluated the comments and has
concluded that no change is needed.
The 400 sample limit was added to
reduce the burden on large agencies
based on the Department’s review of
agencies’ blind testing programs. The
wording in Section 10.1(a) clearly
describes the responsibilities of the
federal agency and the role of the
collector in blind sample submission;
however, the Department reworded
Section 10.3(a) for clarity as described
below.
10.3 How is a blind sample submitted
to an HHS-certified laboratory?
The Department has reworded Section
10.3(a) to clarify that the collector sends
a blind sample to a laboratory or IITF as
a split specimen (i.e., Bottle A and
Bottle B).
Subpart K—Laboratory
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11.10 What are the requirements for an
initial drug test?
One commenter noted that HHS
previously required initial and
confirmatory testing using different
techniques, and asked whether this
requirement had been removed with
allowance of technologies other than
immunoassay for initial testing. The
commenter expressed concern that an
error in the initial drug test could be
repeated in the confirmatory drug test
using the same method. The Department
has evaluated the comments and has
concluded that no change is needed.
The Guidelines maintain the
requirement for initial and confirmatory
tests on two separate aliquots to report
a result other than negative. The NLCP
will review validation and quality
control records, as well as specimen
records, to ensure that the initial and
confirmatory testing methods meet
Guidelines requirements and provide
scientifically and forensically
supportable results.
Also in regard to the proposed Section
11.10, one commenter asked whether
non-FDA cleared immunoassays were
included in the category of alternate
initial drug test technology. The
Department has evaluated the comment
and has concluded that no change is
needed. This section clearly
distinguishes initial tests using
immunoassay from those using an
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alternate technology. Furthermore,
Section 1.5 includes the definition for
‘‘alternate technology initial drug test.’’
11.11 What must an HHS-certified
laboratory do to validate an initial drug
test?
One commenter noted that an
immunoassay initial test calibrated with
a low-reacting analyte may not be able
to meet Guidelines requirements for
performance of the test around the
cutoff concentration. The Department
has evaluated the comments and has
concluded that no change is needed. All
tests must be validated by the HHScertified laboratory to meet the
requirements prior to use for regulated
drug testing.
One commenter noted that the
requirement in section 11.11(b) for
reagent verification prior to use is an
operational, not a validation,
requirement. The Departments agrees
with the commenter but has concluded
that no change is needed. While this
section addresses initial drug test
validation requirements, the verification
of each new reagent lot is essential to
verify that lot-to-lot differences have not
significantly affected assay performance
as demonstrated and documented
during validation. Therefore, this is the
most appropriate section of the
Guidelines to include the requirement.
11.12 What are the batch quality
control requirements when conducting
an initial drug test?
One commenter noted that this and
other sections use inconsistent
terminology when describing quality
controls samples relative to the cutoff
concentration (i.e., ‘‘25 percent above
the cutoff,’’ ‘‘75 percent of the cutoff’’).
The commenter suggested that the
Department use one version
consistently. The Department has
considered the comment and has
concluded that no change is needed.
These terms have been used in the
Guidelines, in NLCP documents, and in
other guidance to HHS-certified
laboratories without issue.
One commenter asked whether the
added analytes affect quality control
content requirements. The Department
has evaluated the comment and has
concluded that no change is needed.
The initial drug test quality control
requirements in the Guidelines apply to
each analyte used to calibrate the test
(i.e., immunoassay or alternate
technology initial drug test). When a
single immunoassay test is used for two
or more analytes in a drug class, the
HHS-certified laboratory or IITF must
include a control in accordance with
item 11.12(a)(2) for each analyte that has
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less than 100% cross-reactivity with the
assay, to demonstrate that the
requirement for at least 80% crossreactivity has been met.
11.12 What are the batch quality
control requirements when conducting
an initial drug test?
11.15 What are the batch quality
control requirements when conducting a
confirmatory drug test?
Comments on these two sections are
addressed here. One commenter
requested clarification for the
requirement for a drug-free control in
initial and confirmatory drug test
batches (i.e., whether the control should
contain no drug or whether the control
should not contain the specific analyte
for that test). The Department has
evaluated the comment and has
concluded that no change is needed.
These Guidelines sections list the
requirement for ‘‘at least one control
certified to contain no drug or drug
metabolite,’’ meaning that the control
must contain no regulated drug
analytes.
11.16 What are the analytical and
quality control requirements for
conducting specimen validity tests?
One commenter found the wording of
Section 11.16(a) to be confusing, noting
that a specimen would not be subjected
to a second specimen validity test when
the first test was in the acceptable range.
The Department agrees with the
comment and has revised Section
11.16(a) to correctly reflect
requirements.
11.18 What are the requirements for
conducting each specimen validity test?
One commenter noted that the
proposed changes in the lower pH cutoff
for identifying adulterated specimens
and lower pH decision point for
identifying invalid specimens may
cause additional costs for manufacturers
and laboratories. The Department has
evaluated the comment and has
concluded that no change is needed.
The Department recognizes that the
revised cutoff will necessitate changes
by HHS-certified laboratories as well as
by manufacturers of commercial quality
control samples; however, the 4.0 pH
cutoff is supported by scientific studies
and workplace drug testing data, and is
expected to reduce the incidence of
undetected attempts to subvert the drug
test.
11.19 What are the requirements for an
HHS-certified laboratory to report a test
result?
One commenter suggested that the
Department remove the requirement for
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an executed CCF as the official report
for ‘‘non-negative’’ specimens and
permit the use of an electronic report
with the required information. The
Department has evaluated the comment
and has concluded that no change is
needed. The Federal CCF serves as the
chain of custody for the specimen from
the time of collection until receipt by
the laboratory and also contains the
certification statement signed by the
certifying scientist. The Federal CCF
may be paper or electronic.
11.21 How long must an HHS-certified
laboratory retain records?
In Section 11.21, the Department
proposed that laboratories be allowed to
convert hardcopy records to electronic
records for storage and then discard the
hardcopy records after six months. One
commenter stated their assumption that
this section did not require laboratories
to convert electronic records to
hardcopy records and maintain them for
six months. This assumption is correct;
the intent is to allow laboratories to
maintain records in electronic format for
the required storage period. The
Department has concluded that no
change is needed.
11.22 What statistical summary reports
must an HHS-certified laboratory
provide for urine testing?
One commenter asked why the
proposed Guidelines include a
requirement for a copy of the
semiannual statistical summary report
to be sent to the Secretary or designated
HHS representative. The Department
included the requirement in Section
11.22 (and in Section 12.19 for IITFs) to
facilitate compilation of statistical
information for the federal drug-free
workplace program. This will not place
an additional burden on the test
facilities other than transmission of the
report. The Department will continue to
evaluate the effectiveness of this
requirement.
Subpart M—Medical Review Officer
(MRO)
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13.1
Who may serve as an MRO?
Three commenters disagreed with the
term ‘‘nonmedical use of a drug’’ used
in Section 13.1 (and defined in Section
1.5) and indicated that the term changes
the role of an MRO from review, verify
and ‘‘report a non-negative result’’ to
review, verify and ‘‘interpret before
reporting a result as negative or
nonmedical use of a drug.’’ Two
commenters disagreed with use of
‘‘interpretation of results’’ to supplant
‘‘alternative medical explanation.’’ One
commenter noted that this perceived
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change in the MRO’s role represents an
unjustified shifting of risk to the MRO.
One commenter believes the term
presents a possible legal flaw to the
Guidelines, stating that this term is
legally different from ‘‘safety concern’’
and places MROs in the position of
being in conflict with the prescribing
physician and subject to lawsuits. This
commenter stated that even a lack of a
finding of nonmedical use could be an
issue if the donor subsequently had an
accident after using the drug. The same
commenter submitted five
recommendations related to inclusion of
prescription drugs in federal workplace
drug testing programs, to address the
commenter’s concerns with the
proposed Guidelines. These five specific
recommendations pertain to matters that
are outside the scope of these
Guidelines, and therefore are not
addressed in the Department’s response
below.
The responsibilities of an MRO to
interpret results have largely remained
the same between the Guidelines
effective October 1, 2010 (73 FR 71858)
and these Guidelines. As stated in
Section 13.5(c) of these Guidelines, ‘‘if
the donor provides a legitimate medical
explanation (e.g., a valid prescription)
for the positive result, the MRO reports
the test result as negative to the
agency.’’ Accordingly, the intent of the
Guidelines, in this context, is to confirm
whether a positive drug test is the result
of drug use under a valid prescription.
Furthermore, the term ‘‘alternate
medical explanation’’ has never been
used in the Guidelines, but has been
used in the HHS Medical Review Officer
Manual for Federal Workplace Drug
Testing Programs.
For the reasons above, the Department
believes that the definition of
‘‘nonmedical use of a drug’’ and the
requirement for a physician serving as
an MRO to have knowledge of this topic
do not fundamentally change the MRO’s
responsibilities. However, to address the
commenters’ concerns, the Department
has removed this term from the
Guidelines (i.e., revised Sections 1.5
and 13.1).
The Department proposed within
Section 13.1 who may serve as an MRO.
One commenter requested clarification
that it is the federal agency’s burden to
ensure that the MRO is certified. One
commenter asked how the laboratory
will be informed that an MRO has met
requirements for re-qualification. The
Department evaluated the comments
and concluded that no change is
needed. The MRO is an employee or a
contractor of the agency. Therefore, it is
the agency’s responsibility to ensure
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that the MRO meets the Guidelines
qualification requirements.
Two commenters disagreed with the
requirement for MRO recertification
every five years, and recommended that
MROs complete training every three
years. Five commenters stated support
for five year requalification and
examination requirements. The
Department has evaluated the comments
and has concluded that no change is
needed. The Department will keep the
five-year recertification requirement as
proposed.
13.2 How are nationally recognized
entities or subspecialty boards that
certify MROs approved?
One commenter agreed with MRO
certification/training entities submitting
the delivery method and content of the
MRO examination as applicable along
with other required documents. One
commenter agreed with extending time
from one to two years for approved
MRO certification/training entities’
resubmission of qualifications for HHS
approval. The commenter noted that
they would support further extension to
3 years. One commenter recommended
that approval of MRO educational
courses and content be at the discretion
of the MRO certification entities, not
HHS. Since the certification entities and
their examinations are subject to HHS
oversight and approval, the commenter
noted that it may be burdensome for
HHS to review and approve the courses
and content, and be a disincentive to
development of new courses. One
commenter recommended that
examinations be allowed to be in-person
or online with appropriate security
precautions for each delivery method.
The Department has evaluated the
comments and agrees that the
submission of training materials to HHS
would possibly discourage the
development of new training courses.
Therefore, the review of MRO
educational courses and content will
not be part of the approval process for
MRO certification entities. As described
under Medical Review Officer (MRO)
requalification—continuing education
units (CEUs) in this preamble, the
Department has removed references to
MRO training entities in Section 13.2,
because training documentation is
maintained by MRO certification
entities. The Department will only
require the MRO certification entities to
submit their examination and any other
necessary supporting examination
materials (e.g., answers, examination
statistics or background information on
questions) that will help in the
Department’s evaluation of the
examination. The Department will
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review and evaluate the examination
delivery method (e.g., in-person or
online) when reviewing submitted
training materials to ensure that the
delivery method employs appropriate
security and identification procedures.
13.3 What training is required before a
physician may serve as an MRO?
Five commenters disagreed and one
commenter agreed with the added
requirement for MRO training to include
information about how to discuss
substance misuse and abuse and how to
access those services. The Department
has evaluated the comments and has
revised Section 13.3 to remove this
requirement. Federal agencies may
provide this information to employees
and applicants to facilitate their access
to effective treatment and support
recovery. The Department provides
information to the public on help and
treatment for substance misuse and
abuse, and how to access those services,
on the SAMHSA Web site http://
www.samhsa.gov/.
One commenter stated that the
Department should add a requirement
for MRO training on what constitutes a
refusal to test. One commenter
suggested that the Department should
add a requirement for MRO training on
when and how to report safety concerns
to employers when prescription and/or
over-the-counter medications may affect
performance. The Department has
evaluated the comments and has
concluded that no change is needed.
Criteria for reporting a refusal to test are
covered under the topics listed in
Section 13.3 such as items (a)(4) training
on the Guidelines and (a)(5) procedures
for interpretation, review, and reporting
of results. When a donor provides a
legitimate medical explanation for a
positive drug test result (e.g., a valid
prescription), the Guidelines do not
require MROs to contact federal agency
employers for the purpose of reporting
a safety concern. Accordingly, MRO
training related to reporting ‘‘safety
concerns’’ does not relate to a
mandatory function under the
Guidelines and, therefore, is not an
essential component of required MRO
training. The Department will provide
additional guidance in the HHS Medical
Review Officer Guidance Manual for
Federal Workplace Drug Testing
Programs.
In addition, the Department revised
Section 13.3 as described under Medical
Review Officer (MRO) requalification—
continuing education units (CEUs) in
this preamble. The Department removed
references to MRO training entities,
because training documentation is
maintained by MRO certification
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entities, and added item 13.3(b) to
require MRO training on revised
Guidelines prior to their effective date.
13.4 What are the responsibilities of an
MRO?
One commenter suggested creating a
subset of medical professionals trained
specifically to determine fitness for duty
since an MRO cannot determine fitness
for duty over the telephone. The
Department has evaluated the comment
and has concluded that no change is
needed. Fitness for duty evaluations fall
outside the purview of the Guidelines.
13.5 What must an MRO do when
reviewing a urine specimen’s test
results?
The Department has revised Section
13.5(d)(1) to include an example of
documentation to support a medical
explanation for a positive drug test
result.
Three commenters disagreed with
MRO procedures for ‘‘a positive result
for opiates’’ (i.e., requirement for
clinical evidence of illegal use in
addition to positive result) and noted
that the proposed Guidelines wording
was not changed to clarify that the
described procedures do not apply to
the added opioids. The Department
agrees with the commenters and has
revised Section 13.5(d) to clarify that
the procedures do not apply to the
added opioid analytes. Wording in
Section 13.5(d)(2)(i) regarding ‘‘clinical
evidence of illegal use’’ was also edited
for clarity and for consistency with the
wording in the OFMG.
One commenter disagreed with
requirements concerning two separate
specimens collected at a single test
event and sent to the laboratory for
testing (e.g., a urine specimen outside
the acceptable temperature range and
the subsequently collected specimen).
The proposed Guidelines require that,
when one of the two specimens is
negative and other is not, the MRO
reports only the verified result other
than negative. This commenter
suggested that the MRO cancel the
negative result. The Department has
evaluated the comments and has
concluded no change is needed.
Cancellation of the test may be
confusing in the situation referenced by
the commenter and lead to
inappropriate specimen recollection.
Both the MRO and the federal agency
employer will receive their Federal CCF
copies with explanatory collector
remarks in Step 2 including the
specimen identification number of the
associated specimen, and the MRO may
provide additional comment in the
MRO’s report.
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The Department also revised Section
13.5(d) to reflect the policy of the
Department that passive exposure to
marijuana smoke and ingestion of food
products containing marijuana are not
acceptable medical explanations for a
positive drug test result. Individuals
who are passively exposed to marijuana
smoke or who consume food products
containing marijuana can pose public
safety and/or security risks.4 5 Marijuana
is listed as a Schedule I drug under the
Controlled Substances Act.
13.6 What action does the MRO take
when the collector reports that the
donor did not provide a sufficient
amount of urine for a drug test?
One commenter suggested the
Guidelines define ‘‘appropriate
expertise’’ of a physician with a list of
conditions and an appropriate type of
physician in an appendix. The same
commenter requested medical referral
information on the employer’s actions
when a donor could not provide a urine
specimen and then could not provide an
oral fluid specimen. The Department
has evaluated the comments and has
concluded that no change is needed. A
physician who is a trained MRO will
have the knowledge necessary to
identify another physician with
appropriate expertise for the medical
evaluation. The Department will
provide additional guidance in the HHS
Medical Review Officer Guidance
Manual for Federal Workplace Drug
Testing Programs as appropriate when
alternate specimen types (e.g., oral
fluid) are allowed in federal workplace
drug testing programs.
The Department clarified the
definition of ‘‘permanent or long-term
medical conditions’’ in Section
13.6(b)(1) based on a federal agency
comment.
Subpart O—Criteria for Rejecting a
Specimen for Testing
15.1 What discrepancies require an
HHS-certified laboratory or an HHScertified IITF to report a specimen as
rejected for testing?
The Department revised wording in
items a and b of this section, and
included three additional fatal flaws as
items f–h, to reflect fatal flaws for
regulated donor specimens that have
been identified by HHS-certified
laboratories. These fatal flaws were
addressed in NLCP guidance sent to all
HHS-certified and applicant laboratories
and IITFs on August 9, 2016. In
addition, the Department revised this
section to include an additional item i
to allow a laboratory or IITF to reject a
specimen when they identify a flaw that
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prevents testing or affects the forensic
defensibility of the drug test, and cannot
be corrected. This general item enables
laboratories and IITFs to reject
specimens with fatal flaws that may be
rare, but do occur. It is not possible to
list all such flaws in the Guidelines.
15.3 What discrepancies are not
sufficient to require an HHS-certified
laboratory or an HHS-certified IITF to
reject a urine specimen for testing or an
MRO to cancel a test?
Two commenters indicated that
inclusion of some items as insignificant
discrepancies contradicts guidance
provided to HHS-certified laboratories
and IITFs in NLCP Notices, which
required laboratories to attempt to
recover missing information. One of
these commenters suggested that if these
items are important, they should be
removed from the ‘‘insignificant’’ list.
Two commenters disagreed with the
Guidelines designating the listed
omissions and discrepancies as
‘‘insignificant only when they occur no
more than once per month.’’ The
Department has evaluated the
comments. The listed discrepancies
would not result in rejection or
cancellation. NLCP Notices requiring
laboratory action are consistent with
this section. However, the Department
has reworded section 15.3 to not classify
these errors as insignificant. While these
types of errors do not warrant laboratory
rejection of a specimen or MRO
cancellation of a test, as noted in section
15.3(c), corrective action must be
initiated when they occur more than
once a month.
The commenters indicated that this
section implies that the MRO must keep
a log of insignificant errors by laboratory
and by collection site in order to track
frequency. The commenters noted that
this is an unenforceable policy, that this
should be a duty of inspectors of
laboratories and collection sites, and
that requiring MROs to keep these types
of logs would create significant extra
costs. One commenter suggested that
item 15.3(c) be modified for the MRO to
advise the collector or laboratory to
retrain staff on relevant procedures to
ensure that collections are completed
correctly (rather than directing them to
immediately take corrective action). The
Department has evaluated the comments
and has concluded that no change is
needed. This section is the same as in
the Guidelines effective October 1, 2010
(73 FR 71858).
One commenter suggested modifying
15.3(a)(5) to read ‘‘donor identification
number’’ which would include a social
security number or an employee
identification number since many
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employers no longer use social security
numbers for employee identification.
The Department agrees and has revised
Section 15.3(a)(5) to include ‘‘employee
identification number’’ in addition to
‘‘Social Security Number.’’.
15.4 What discrepancies may require
an MRO to cancel a test?
One commenter suggested adding the
scenario where the donor did not sign
the CCF because the collector forgot to
ask the donor to sign, rather than the
donor’s refusal to sign. The Department
has evaluated the comment and has
concluded that no change is needed. As
stated in Section 15.4, the MRO contacts
the collector ‘‘to obtain a statement to
verify that the donor refused to sign the
MRO copy.’’
Regulatory Impact and Notices
Executive Orders 13563 and 12866
Executive Order 13563 of January 18,
2011 (Improving Regulation and
Regulatory Review) states ‘‘Our
regulatory system must protect public
health, welfare, safety, and our
environment while promoting economic
growth, innovation, competitiveness,
and job creation.’’ Consistent with this
mandate, Executive Order 13563
requires agencies to tailor ‘‘regulations
to impose the least burden on society,
consistent with obtaining regulatory
objectives.’’ Executive Order 13563 also
requires agencies to ‘‘identify and
consider regulatory approaches that
reduce burdens and maintain flexibility
and freedom of choice’’ while selecting
‘‘those approaches that maximize net
benefits.’’ This notice presents a
regulatory approach that will reduce
burdens to providers and to consumers
while continuing to provide adequate
protections for public health and
welfare.
The Secretary has examined the
impact of the Guidelines under
Executive Order 12866, which directs
federal agencies to assess all costs and
benefits of available regulatory
alternatives and, when regulation is
necessary, to select regulatory
approaches that maximize net benefits
(including potential economic,
environmental, public health and safety,
and other advantages; distributive
impacts; and equity).
According to Executive Order 12866,
a regulatory action is ‘‘significant’’ if it
meets any one of a number of specified
conditions, including having an annual
effect on the economy of $100 million;
adversely affecting in a material way a
sector of the economy, competition, or
jobs; or if it raises novel legal or policy
issues. The Guidelines do establish
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additional regulatory requirements and
allow an activity that was otherwise
prohibited. The Administrative
Procedure Act (APA) delineates an
exception to its rulemaking procedures
for ‘‘a matter relating to agency
management or personnel’’ 5 U.S.C.
553(a)(2). Because the Guidelines issued
by the Secretary govern federal
workplace drug testing programs, HHS
has taken the position that the
Guidelines are a ‘‘matter relating to
agency management or personnel’’ and,
thus, are not subject to the APA’s
requirements for notice and comment
rulemaking. This position is consistent
with Executive Order 12564 regarding
Drug-Free Workplaces, which directs
the Secretary to promulgate scientific
and technical guidelines for executive
agency drug testing programs. However,
the statute under which the mandatory
guidelines were created (Pub. L. 100–71,
section 503(a)(3)) required notice and
comment apart from the APA. This
provision provides the following:
(3) Notwithstanding any provision of
chapter 5 of title 5, United States Code, the
mandatory guidelines to be published
pursuant to subsection (a)(l)(A)(ii) shall be
published and made effective exclusively
according to the provisions of this paragraph.
Notice of the mandatory guidelines proposed
by the Secretary of Health and Human
Services shall be published in the Federal
Register, and interested persons shall be
given not less than 60 days to submit written
comments on the proposed mandatory
guidelines. Following review and
consideration of written comments, final
mandatory guidelines shall be published in
the Federal Register and shall become
effective upon publication.
The Department included a
Regulatory Impact and Notices section
with cost and benefits analysis and
burden estimates in the May 15, 2015
Federal Register Notice for the
proposed UrMG (80 FR 28101), and
requested public comment on all figures
and assumptions. The Department’s
projections were developed using
information from current HHS-certified
urine testing laboratories, with input
from DOT and the Nuclear Regulatory
Commission (NRC), and cost analysis
was based on information provided by
multiple HHS-certified laboratories and
MROs. The Department received no
substantive data or evidence through
public comments in favor of changing
the estimated costs and benefits
provided in the Department’s May 2015
Federal Register Notice for the UrMG,
and therefore, has retained the analysis
and estimates provided in that notice
below. Comments that related to the
costs and benefits of this rule are
summarized and discussed above in the
Summary of Public Comments and
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HHS’s Response under the heading
Costs and Benefits.
Need for Revisions to the Guidelines
The inclusion of oxycodone,
oxymorphone, hydrocodone and
hydromorphone in the URMG was
recommended by the DTAB, reviewed
by the Department’s Prescription Drug
Subcommittee of the Behavioral Health
Coordinating Committee, and approved
by the SAMHSA Administrator in
January 2012. This action is supported
by various data, described in this
preamble.1–4 In addition, in 2008, 12
percent of military personnel admitted
to the illicit use of prescription
medications. Prevalence testing by the
Department of Defense (DoD) in 2009
indicated that prescription drug abuse
exceeded illegal drug abuse. Because of
this, hydrocodone and hydromorphone
testing was added to the regular DoD
drug testing panel in 2011.
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Costs
Costs associated with the
implementation of testing for
oxycodone, oxymorphone, hydrocodone
and hydromorphone will be minimal
because the Department has determined
that all HHS certified laboratories
testing specimens from federal agencies
are currently conducting tests for one or
more of these analytes on non-regulated
urine specimens. Likewise, there will be
minimal costs associated with changing
initial testing to include MDA since the
current immunoassays can be adapted
to test for this analyte. Laboratory
personnel are currently trained and test
methods have been implemented.
However, there will be some
administrative costs associated with
adding these analytes. Prior to being
allowed to test regulated specimens for
these compounds, HHS certified
laboratories will be required to
demonstrate that their performance
meets Guideline requirements by testing
three (3) groups of PT samples. The
Department will provide the PT samples
through the National Laboratory
Certification Program (NLCP) at no cost
to the certified laboratories. Based on
costs charged for specimen testing,
laboratory costs to conduct the PT
testing would range from $900 to $1,800
for each certified laboratory.
In Section 3.4, the Department
included criteria for calibrating initial
tests for grouped analytes such as
opiates and amphetamines, and
specified the cross-reactivity of the
immunoassay to the other analytes(s)
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within the group. These Guidelines
allow the use of methods other than
immunoassay for initial testing. An
immunoassay manufacturer may incur
costs if they choose to alter their
existing product and resubmit the
immunoassay for FDA clearance.
For the added opiate analytes, the two
immunoassays currently used for
oxycodone and oxymorphone meet the
requirements, and two of the three
existing opiate immunoassays used in
certified laboratories meet the
requirements for hydrocodone and
hydromorphone analysis. The opiate
immunoassay that does not have
sufficient cross-reactivity would be
acceptable as an initial test under these
Guidelines when the lowest-reacting
analyte, hydromorphone, is used to
establish a decision point. Therefore,
the Department assumes that all
certified laboratories will elect to use
existing immunoassays. Thus, the costs
associated with implementing the initial
tests for these analytes is expected to be
de minimis.
For amphetamines, one of the three
existing
methylenedioxymethamphetamine
(MDMA) immunoassays used in
certified laboratories meets the
requirements. The remaining two
exhibit insufficient cross-reactivity for
MDA. These two immunoassays would
be acceptable as an initial test under
these Guidelines when the lowestreacting analyte, MDA, is used to
establish a decision point. An
immunoassay manufacturer may incur
costs if they choose to alter their
existing product and resubmit the
immunoassay for FDA clearance. Again,
the Department assumes that certified
laboratories will use the existing
immunoassays and incur de minimis
costs.
Once the testing has been
implemented, the cost per specimen for
initial testing for the added analytes will
range from $.06 to $0.20 due to reagent
costs. Current costs for each
confirmatory test range from $5.00 to
$10.00 for each specimen reported
positive, due to sample preparation and
analysis costs. Based on information
from non-regulated workplace drug
testing for these analytes and testing
performed by the Department on deidentified federally regulated specimens
in 2011, approximately 1% of the
submitted specimens is expected to be
confirmed as positive for the added
analytes. Therefore, the added cost for
confirmatory testing will be $0.05 to
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7931
$0.10 per submitted specimen. This
would indicate that the cost per
specimen submitted for testing will
increase by $0.11–$0.30. Annual
recurring testing costs in the table below
are based on an estimated number of
6,145,500 specimens.
The addition of the Schedule II
prescription medications will require
MRO review to verify legitimate drug
use. Based on the positivity rates from
non-regulated workplace drug testing
for these analytes and the additional
review of specimens confirmed positive
for prescription medications, MRO costs
are estimated to increase by
approximately 3%. The burden of this
3% cost increase is expected to shift
gradually from MROs to agencies as
agencies’ existing contracts expire and
they renegotiate the terms of new
contracts, with an increase to the total
cost of a federal drug test over time to
between $0.60–$1.35. This cost would
indicate a total cost of $3,687,300 to
$8,296,425 in the urine testing program.
A federal agency may also incur
additional costs (e.g., additional
managerial effort to arrange substitute
workers) when an employee tests
positive for a prescription medication
and is removed from duties during the
MRO verification process.
The additional costs for testing and
MRO review will be incorporated into
the overall cost for the federal agency
submitting the specimen to the
laboratory. The estimation of costs
incurred is based upon overall cost to
the federal agency because the review of
positive specimens is usually based on
all specimens submitted from an
agency, rather than individual specimen
testing costs or MRO review of positive
specimens. Agencies may also incur
some costs for training of federal
employees such as drug program
coordinators due to implementation of
the revised Guidelines. Based on current
training modules offered to drug
program coordinators, and other
associated costs including travel for
90% of drug program coordinators, the
estimated total training cost for a oneday training session would be between
$108,000 and $138,000 (i.e., assuming 8
hours of time multiplied by a GS 12/13
wage including benefits and overhead
adjustments). The Department will offer
the choice of online or in-person
training. This will eliminate travel costs
for those federal agencies who choose to
use online training.
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RECURRING ANNUAL COSTS SUMMARY TABLE
Lower bound
Upper bound
Reagent Costs .............................................................................................................................................
Additional Confirmatory tests .......................................................................................................................
MRO Costs ..................................................................................................................................................
$368,730.00
307,275.00
3,687,300.00
$1,229,100.00
614,550.00
8,296,425.00
Total annual costs ................................................................................................................................
4,363,305.00
10,140,075.00
UPFRONT (ONE-TIME) COSTS SUMMARY TABLE
Lower bound
Performance Testing ...................................................................................................................................
Training ........................................................................................................................................................
$27,900.00
108,000
$55,800.00
138,000
Total ......................................................................................................................................................
135,900.00
193,800.00
Benefits
The potential benefits of deterring use
of oxycodone, oxymorphone,
hydrocodone and hydromorphone are
the prevention of their side effects (e.g.,
anxiety, dizziness, drowsiness, fatigue,
and other neurological effects), which
will result in a healthier and more alert
workforce as well as avoid the issues
associated with addiction and
rehabilitation. Since the personnel
tested under this program are in
positions that are safety sensitive,
potential benefits include decreased risk
of transportation accidents, decreased
risk of low-probability high
consequence events, more responsible
workforce in positions of public trust,
and potentially reducing individuals’
dependence or addiction and the
personal benefits associated with those
conditions.
Considering the potential health and
performance costs of narcotic abuse, the
benefits to the federal workplace and
the individuals within that workplace
justify the inclusion of oxycodone,
oxymorphone, hydrocodone and
hydromorphone in Federal Workplace
Drug Testing programs.
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Upper bound
Regulatory Flexibility Analysis
For the reasons outlined above, the
Secretary has determined that the
Guidelines will not have a significant
impact upon a substantial number of
small entities within the meaning of the
Regulatory Flexibility Act [5 U.S.C.
605(b)]. The flexibility added by the
UrMG will not require addition
expenditures. Therefore, a final
regulatory flexibility analysis is not
required for this notice.
The Secretary has determined that the
Guidelines are not a major rule for the
purpose of congressional review. For the
purpose of congressional review, a
major rule is one which is likely to
cause an annual effect on the economy
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of $100 million; a major increase in
costs or prices; significant effects on
competition, employment, productivity,
or innovation; or significant effects on
the ability of U.S.-based enterprises to
compete with foreign-based enterprises
in domestic or export markets. This is
not a major rule under the Small
Business Regulatory Enforcement
Fairness Act (SBREFA) of 1996.
Unfunded Mandates
The Secretary has examined the
impact of the Guidelines under the
Unfunded Mandates Reform Act
(UMRA) of 1995 (Pub. L. 104–4). This
notice does not trigger the requirement
for a written statement under section
202(a) of the UMRA because the
Guidelines do not impose a mandate
that results in an expenditure of $100
million (adjusted annually for inflation)
or more by either state, local, and tribal
governments in the aggregate or by the
private sector in any one year.
Environmental Impact
The Secretary has considered the
environmental effects of the UrMG. No
information or comments have been
received that would affect the agency’s
determination there would be a
significant impact on the human
environment and that neither an
environmental assessment nor an
environmental impact statement is
required.
Executive Order 13132: Federalism
The Secretary has analyzed the
Guidelines in accordance with
Executive Order 13132: Federalism.
Executive Order 13132 requires federal
agencies to carefully examine actions to
determine if they contain policies that
have federalism implications or that
preempt state law. As defined in the
Order, ‘‘policies that have federalism
implications’’ refer to regulations,
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legislative comments or proposed
legislation, and other policy statements
or actions that have substantial direct
effects on the states, on the relationship
between the national government and
the states, or on the distribution of
power and responsibilities among the
various levels of government.
In this notice, the Secretary revised
the standards for certification of
laboratories engaged in urine fluid drug
testing for federal agencies and the use
of urine testing in federal drug-free
workplace programs. The Department of
Health and Human Services, by
authority of Section 503 of Public Law
100–71, 5 U.S.C. Section 7301, and
Executive Order No. 12564, establishes
the scientific and technical guidelines
for federal workplace drug testing
programs and establishes standards for
certification of laboratories engaged in
urine drug testing for federal agencies.
Because the Mandatory Guidelines
govern standards applicable to the
management of federal agency
personnel, there should be little, if any,
direct effect on the states, on the
relationship between the national
government and the states, or on the
distribution of power and
responsibilities among the various
levels of government. Accordingly, the
Secretary has determined that the
Guidelines do not contain policies that
have federalism implications.
Paperwork Reduction Act of 1995
The Guidelines contain information
collection requirements which are
subject to review by the Office of
Management and Budget (OMB) under
the Paperwork Reduction Act of 1995
[the PRA 44 U.S.C. 3507(d)].
Information collection and
recordkeeping requirements which
would be imposed on laboratories
engaged in drug testing for federal
agencies concern quality assurance and
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quality control documentation, reports,
performance testing, and inspections as
set out in subparts H, I, K, L, M and N.
Information collection and
recordkeeping requirements which
would be imposed on MROs engaged in
drug testing services for federal agencies
concern drug testing result review and
reports as set out in subparts M and N.
To facilitate ease of use and uniform
reporting, a Federal CCF for each type
of specimen collected will be developed
as referenced in section 6.1. The
Department will submit the information
collection and recordkeeping
requirements contained in the
Guidelines to OMB for review and
approval prior to the effective date of
the final Guidelines. Information
collections changed by these Guidelines
are not effective until approved by
OMB.
Privacy Act
The Secretary has determined that the
Guidelines do not contain information
collection requirements constituting a
system of records under the Privacy Act.
The Federal Register notice announcing
the Mandatory Guidelines for Federal
Workplace Drug Testing Programs using
Urine is not a system of records as noted
in the information collection/
recordkeeping requirements below. As
required, HHS originally published the
Mandatory Guidelines for Federal
Workplace Drug Testing Programs
(Guidelines) in the Federal Register on
April 11, 1988 [53 FR 11979]. SAMHSA
subsequently revised the Guidelines on
June 9, 1994 [59 FR 29908], September
30, 1997 [62 FR 51118], November 13,
1998 [63 FR 63483], April 13, 2004 [69
FR 19644], and November 25, 2008 [73
FR 71858] with an effective date of May
1, 2010 (correct effective date published
on December 10, 2008 [73 FR 75122]).
The effective date of the Guidelines was
further changed to October 1, 2010 on
April 30, 2010 [75 FR 22809].
Executive Order 13175: Consultation
and Coordination With Indian Tribal
Governments
Executive Order 13175 (65 FR 67249,
November 6, 2000) requires SAMHSA to
develop an accountable process to
ensure ‘‘meaningful and timely input by
tribal officials in the development of
regulatory policies that have tribal
implications.’’ ‘‘Policies that have tribal
implications’’ as defined in the
Executive Order, include regulations
that have ‘‘substantial direct effects on
one or more Indian tribes, on the
relationship between the federal
government and the Indian tribes, or on
the distribution of power and
responsibilities between the federal
government and Indian tribes.’’ The
Guidelines do not have tribal
implications. The Guidelines will not
have substantial direct effects on tribal
governments, on the relationship
between the federal government and
Indian tribes, or on the distribution of
power and responsibilities between the
federal government and Indian tribes, as
specified in Executive Order 13175.
Information Collection/Record Keeping
Requirements
The information collection
requirements (i.e., reporting and
recordkeeping) in the current
Guidelines (73 FR 71858) are approved
by the Office of Management and
Budget (OMB) under control number
0930–0158. The Federal Drug Testing
Custody and Control Form used to
document the collection and chain of
custody of urine specimens at the
collection site, for laboratories to report
results, and for Medical Review Officers
to make a determination, the National
Laboratory Certification Program (NLCP)
application, the NLCP Laboratory
7933
Information Checklist, and
recordkeeping requirements in the
current Guidelines, as approved under
control number 0930–0158, will remain
in effect until these final Guidelines are
effective and OMB approves the revised
information collection. OMB will assign
a new control number to account for
changes associated with the final
Guidelines.
The title, description and respondent
description of the information
collections are shown in the following
paragraphs with an estimate of the
annual reporting, disclosure and
recordkeeping burden. Included in the
estimate is the time for reviewing
instructions, searching existing data
sources, gathering and maintaining the
data needed, and completing and
reviewing the collection of information.
Title: The Mandatory Guidelines for
Federal Workplace Drug Testing
Programs using Urine Specimens
Description: The Mandatory
Guidelines establish the scientific and
technical guidelines for federal drug
testing programs and establish standards
for certification of laboratories engaged
in drug testing for federal agencies
under authority of Public Law 100–71,
5 U.S.C. 7301 note, and Executive Order
No. 12564. Federal drug testing
programs test applicants to sensitive
positions, individuals involved in
accidents, individuals for cause, and
random testing of persons in sensitive
positions.
Description of Respondents:
Individuals or households; businesses;
or other-for-profit; not-for-profit
institutions.
The burden estimates in the tables
below are based on the following
number of respondents: 38,000 donors
who apply for employment in testing
designated positions, 100 collectors, 30
urine specimen testing laboratories, 1
IITF, and 100 MROs.
ESTIMATE OF ANNUAL REPORTING BURDEN
Purpose
9.2(a)(1) ..........................
Laboratory or IITF 1 required to submit application
for certification.
Materials to submit to become an HHS inspector
Laboratory submits qualifications of RP to HHS ..
Laboratory submits information to HHS on new
RP or alternate RP.
Specifications for laboratory semi-annual statistical report of test results to each federal agency.
IITF1 submits qualifications of RT to HHS ............
IITF1 submits information to HHS on new RT or
alternate RT.
Specifications for IITF 1 semi-annual statistical report of test results to each federal agency.
9.12(a)(3) ........................
11.3(a) ............................
11.4(c) ............................
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Number of
respondents
Section
11.22 ..............................
12.3(a) ............................
12.4(c) ............................
12.19 ..............................
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Responses/
respondent
Hours/
response
Total hours
10
1
3 ..................
30
10
10
10
1
1
1
2 ..................
2 ..................
2 ..................
20
20
20
10
5
0.5 ...............
25
1
1
1
1
1 ..................
1 ..................
1
1
1
1
1 ..................
1
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ESTIMATE OF ANNUAL REPORTING BURDEN—Continued
Number of
respondents
Responses/
respondent
Hours/
response
Section
Purpose
13.9 and 14.7 .................
100
14
1
1
3 ..................
3
1
1
0.5 ...............
0.5
1
1
0.5 ...............
0.5
1
1
50 ................
50
1
1
3 ..................
3
16.9(c) ............................
Specifies that MRO must report all verified primary and split specimen test results to the federal agency.
Specifies content of request for informal review of
suspension/proposed revocation of certification.
Specifies information appellant provides in first
written submission when laboratory suspension/revocation is proposed.
Requires appellant to notify reviewing official of
resolution status at end of abeyance period.
Specifies contents of appellant submission for review.
Specifies content of appellant request for expedited review of suspension or proposed revocation.
Specifies contents of review file and briefs ..........
1
1
50 ................
50
Total ........................
................................................................................
159
........................
.....................
295
16.1(b) & 16.5(a) ............
16.4 ................................
16.6 ................................
16.7(a) ............................
16.9(a) ............................
0.05 (3 min)
Total hours
70
1 Although
IITFs are allowed under the Guidelines effective October 1, 2010 (73 FR 71858), SAMHSA has not received any IITF applications
for certification to test federally regulated specimens. IITF numbers are provided in this analysis as placeholders for administrative purposes.
[Section 10.3(a)]; MRO notifies the
federal agency and HHS when an error
occurs on a blind sample [Section
10.4(c)]; Section 13.5 describes the
actions an MRO takes to report a
primary specimen result; Section 14.6
describes the actions an MRO takes to
report a split specimen result; and
Sections 13.6 and 13.7 describe the
The following reporting requirements
are also in the Guidelines, but have not
been addressed in the above reporting
burden table: Collector must report any
unusual donor behavior or refusal to
participate in the collection process on
the Federal CCF [Sections 1.8, 8.9];
collector annotates the Federal CCF
when a sample is a blind sample
actions an MRO takes for the medical
evaluation of a donor who cannot
provide a urine specimen. SAMHSA has
not calculated a separate reporting
burden for these requirements because
they are included in the burden hours
estimated for collectors to complete
Federal CCFs and for MROs to report
results to federal agencies.
ESTIMATE OF ANNUAL DISCLOSURE BURDEN
Number of
respondents
Responses/
respondent
Hours/
response
Section
Purpose
8.3(a), 8.5(f)(2) (iii),
8.6(b)(2).
11.23, 11.24 ...................
Collector must contact federal agency point of
contact.
Information on drug test that laboratory must provide to federal agency upon request or to
donor through MRO.
Information on drug test that IITF1 must provide
to federal agency upon request or to donor
through MRO.
MRO must inform donor of right to request split
specimen test when a positive, adulterated, or
substituted result is reported.
100
1
50
10
3 ..................
1,500
1
1
1 ..................
1
100
14
3 ..................
4,200
................................................................................
211
........................
.....................
5,706
12.20, 12.21 ...................
13.8(b) ............................
Total ........................
Total hours
0.05 (3 min)
5
1 Although
IITFs are allowed under the Guidelines effective October 1, 2010 (73 FR 71858), SAMHSA has not certified any IITFs to test federally regulated specimens. IITF numbers are provided in this analysis as placeholders for administrative purposes.
mstockstill on DSK3G9T082PROD with NOTICES2
The following disclosure
requirements are also included in the
Guidelines, but have not been addressed
in the above disclosure burden table:
The collector must explain the basic
collection procedure to the donor and
answer any questions [Section 8.3(e)
and (g)]. SAMHSA believes having the
collector explain the collection
procedure to the donor and answer any
questions is a standard business practice
and not a disclosure burden.
ESTIMATE OF ANNUAL RECORDKEEPING BURDEN
Number of
respondents
Section
Purpose
8.3, 8.5, 8.8 ....................
Collector completes Federal CCF for specimen
collected.
Donor initials specimen labels/seals and signs
statement on the Federal CCF.
8.8(d) & (f) ......................
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Responses/
respondent
Hours/
response
Total hours
100
380
0.07 (4 min)
2,534
38,000
1
0.08 (5 min)
3,167
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7935
ESTIMATE OF ANNUAL RECORDKEEPING BURDEN—Continued
Number of
respondents
Section
Purpose
11.8(a) & 11.19 ..............
Laboratory completes Federal CCF upon receipt
of specimen and before reporting result.
IITF1 completes Federal CCF upon receipt of
specimen and before reporting result.
MRO completes Federal CCF before reporting
the primary or split specimen result.
MRO documents donor’s request to have split
specimen tested.
12.8(a) & 12.15 ..............
13.4(d)(4),13.9(c),14.7(c)
14.1(b) ............................
Total ...............................
................................................................................
Responses/
respondent
Hours/
response
Total hours
10
3,800
0.05 (3 min)
1,900
1
1
100
380
0.05 (3 min)
1,900
300
1
0.05 (3 min)
15
38,511
........................
1 ..................
.....................
1
9,517
1 Although
mstockstill on DSK3G9T082PROD with NOTICES2
IITFs are allowed under the Guidelines effective October 1, 2010 (73 FR 71858), SAMHSA has not certified any IITFs to test federally regulated specimens. IITF numbers are provided in this analysis as placeholders for administrative purposes.
The Guidelines contain a number of
recordkeeping requirements that
SAMHSA considers not to be an
additional recordkeeping burden. In
subpart D, a trainer is required to
document the training of an individual
to be a collector [Section 4.3(a)(3)] and
the documentation must be maintained
in the collector’s training file [Section
4.3(c)]. Because this is required by the
current Guidelines and is consistent
with general forensic requirements,
SAMHSA believes this training
documentation is common practice and
is not considered an additional burden.
In subpart F, if a collector uses an
incorrect form to collect a federal
agency specimen, the collector is
required to provide a statement [Section
6.2(b)] explaining why an incorrect form
was used to document collecting the
specimen. SAMHSA believes this is an
extremely infrequent occurrence and
does not create a significant additional
recordkeeping burden. Subpart H
[Sections 8.4(c), 8.5(d)(2), 8.5(e)(1) and
(2)] requires collectors to enter any
information on the Federal CCF of any
unusual findings during the urine
specimen collection procedure. These
recordkeeping requirements are an
integral part of the collection procedure
and are essential to documenting the
chain of custody for the specimens
collected. The burden for these entries
are included in the recordkeeping
burden estimated to complete the
Federal CCF and is, therefore, not
considered an additional recordkeeping
burden. Subpart K describes a number
of recordkeeping requirements for
laboratories associated with their testing
procedures, maintaining chain of
custody, and keeping records [i.e.,
Sections 11.1(a) and (d); 11.2(b), (c), and
(d); 11.6(b); 11.7(c); 11.8; 11.11(a);
11.14(a); 11.17; 11.21(a), (b), and (c);
11.22; 11.23(a) and 11.24. These
recordkeeping requirements are
necessary for any laboratory to conduct
forensic drug testing and to ensure the
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19:03 Jan 19, 2017
Jkt 241001
scientific supportability of the test
results. Therefore, they are considered
to be standard business practice and are
not considered a burden for this
analysis.
Thus the total annual response
burden associated with the testing of
urine specimens by the laboratories and
IITFs is estimated to be 15,518 hours
(that is, the sum of the total hours from
the above tables). This is in addition to
the 1,788,809 hours currently approved
by OMB under control number 0930–
0158 for urine testing under the current
Guidelines.
As required by section 3507(d) of the
PRA, the Secretary submitted a copy of
these proposed Guidelines to OMB for
its review. Comments on the
information collection requirements
were specifically solicited in order to:
(1) Evaluate whether the proposed
collection of information is necessary
for the proper performance of HHS’s
functions, including whether the
information will have practical utility;
(2) evaluate the accuracy of HHS’s
estimate of the burden of the proposed
collection of information, including the
validity of the methodology and
assumptions used; (3) enhance the
quality, utility, and clarity of the
information to be collected; and (4)
minimize the burden of the collection of
information on those who are to
respond, including through the use of
appropriate automated, electronic,
mechanical, or other technological
collection techniques or other forms of
information technology.
metabolism and excretion patterns of
hydrocodone in urine following
controlled single dose administration. J.
Anal. Toxicol, 37, 486–494.
3. Esposito, F.M., Mitchell, J.M., Baylor,
M.R., Bush, D.M, 2006. Influence of basic
pH on federal regulated drugs in urine at
room temperature. Poster presented at
the Society of Forensic Toxicologists
(SOFT) Annual Meeting, Austin, TX.
October 2006.
4. Cone, E.J., Bigelow, G.E., Herrmann, E.S.,
Mitchell, J.M., LoDico, C., Flegel, R.,
Vandrey, R, 2015. Nonsmoker exposure
to secondhand cannabis smoke. III. oral
fluid and blood concentrations and
corresponding subjective effects. J. Anal.
Toxicol, 39, 497–509.
5. Hermann, E.S, Cone, E.J., Mitchell, J.M.,
Bigelow, G.E., LoDico, C., Flegel, R.,
Vandrey, R., 2016. Non-smoker exposure
to secondhand cannabis smoke II: Effect
of room ventilation on the physiological,
subjective, and behavioral/cognitive
effects. Drug alcohol depend, 151, 194–
202.
References
Subpart A—Applicability
1.1 To whom do these Guidelines apply?
1.2 Who is responsible for developing and
implementing these Guidelines?
1.3 How does a federal agency request a
change from these Guidelines?
1.4 How are these Guidelines revised?
1.5 What do the terms used in these
Guidelines mean?
1.6 What is an agency required to do to
protect employee records?
1. Cone, E.J., Heltsley, R., Black, D.L.,
Mitchell, J.M., LoDico, C.P., Flegel, R.R,
2013. Prescription opioids. I. metabolism
and excretion patterns of oxycodone in
urine following controlled single dose
administration. J. Anal. Toxicol, 37, 255–
264.
2. Cone, E.J., Heltsley. R., Black, D.L.,
Mitchell, J.M., LoDico, C.P., Flegel, R.R,
2013. Prescription opioids. II.
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Dated: January 11, 2017.
Kana Enomoto,
Acting Deputy Assistant Secretary for Mental
Health and Substance Use, SAMHSA.
Dated: January 11, 2017.
Sylvia M. Burwell
Secretary.
The Mandatory Guidelines using
Urine Specimens as revised are hereby
adopted in accordance with section 503
of Public Law 100–71 and Executive
Order 12564.
Mandatory Guidelines for Federal
Workplace Drug Testing Programs
Using Urine Specimens
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1.7
What is a refusal to take a federally
regulated drug test?
1.8 What are the potential consequences for
refusing to take a federally regulated
drug test?
Subpart B—Urine Specimens
2.1
2.2
2.3
2.4
2.5
2.6
What type of specimen may be
collected?
Under what circumstances may a urine
specimen be collected?
How is each urine specimen collected?
What volume of urine is collected?
How does the collector split the urine
specimen?
When may an entity or individual
release a urine specimen?
Subpart C—Urine Specimen Tests
3.1
3.2
3.3
3.4
3.5
3.6
3.7
3.8
3.9
Which tests are conducted on a urine
specimen?
May a specimen be tested for additional
drugs?
May any of the specimens be used for
other purposes?
What are the drug test cutoff
concentrations for urine?
May an HHS-certified laboratory
perform additional drug and/or
specimen validity tests on a specimen at
the request of the Medical Review
Officer (MRO)?
What criteria are used to report a urine
specimen as adulterated?
What criteria are used to report a urine
specimen as substituted?
What criteria are used to report a urine
specimen as dilute?
What criteria are used to report an
invalid result for a urine specimen?
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Subpart D—Collectors
4.1 Who may collect a specimen?
4.2 Who may not collect a specimen?
4.3 What are the requirements to be a
collector?
4.4 What are the requirements to be an
observer for a direct observed collection?
4.5 What are the requirements to be a
trainer for collectors?
4.6 What must a federal agency do before a
collector is permitted to collect a
specimen?
Subpart E—Collection Sites
5.1 Where can a collection for a drug test
take place?
5.2 What are the requirements for a
collection site?
5.3 Where must collection site records be
stored?
5.4 How long must collection site records
be stored?
5.5 How does the collector ensure the
security and integrity of a specimen at
the collection site?
5.6 What are the privacy requirements
when collecting a urine specimen?
Subpart F—Federal Drug Testing Custody
and Control Form
6.1 What federal form is used to document
custody and control?
6.2 What happens if the correct OMBapproved Federal CCF is not available or
is not used?
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Subpart G—Urine Specimen Collection
Containers and Bottles
7.1 What is used to collect a urine
specimen?
7.2 What are the requirements for a urine
collection container and specimen
bottles?
7.3 What are the minimum performance
requirements for a urine collection
container and specimen bottles?
Subpart H—Urine Specimen Collection
Procedure
8.1 What privacy must the donor be given
when providing a urine specimen?
8.2 What must the collector ensure at the
collection site before starting a urine
specimen collection?
8.3 What are the preliminary steps in the
urine specimen collection procedure?
8.4 What steps does the collector take in the
collection procedure before the donor
provides a urine specimen?
8.5 What steps does the collector take
during and after the urine specimen
collection procedure?
8.6 What procedure is used when the donor
states that they are unable to provide a
urine specimen?
8.7 If the donor is unable to provide a urine
specimen, may another specimen type be
collected for testing?
8.8 How does the collector prepare the
urine specimens?
8.9 When is a direct observed collection
conducted?
8.10 How is a direct observed collection
conducted?
8.11 When is a monitored collection
conducted?
8.12 How is a monitored collection
conducted?
8.13 How does the collector report a
donor’s refusal to test?
8.14 What are a federal agency’s
responsibilities for a collection site?
Subpart I—HHS Certification of Laboratories
and IITFs
9.1 Who has the authority to certify
laboratories and IITFs to test urine
specimens for federal agencies?
9.2 What is the process for a laboratory or
IITF to become HHS-certified?
9.3 What is the process for a laboratory or
IITF to maintain HHS certification?
9.4 What is the process when a laboratory
or IITF does not maintain its HHS
certification?
9.5 What are the qualitative and
quantitative specifications of
performance testing (PT) samples?
9.6 What are the PT requirements for an
applicant laboratory?
9.7 What are the PT requirements for an
HHS-certified urine laboratory?
9.8 What are the PT requirements for an
applicant IITF?
9.9 What are the PT requirements for an
HHS-certified IITF?
9.10 What are the inspection requirements
for an applicant laboratory or IITF?
9.11 What are the maintenance inspection
requirements for an HHS-certified
laboratory or IITF?
9.12 Who can inspect an HHS-certified
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laboratory or IITF and when may the
inspection be conducted?
9.13 What happens if an applicant
laboratory or IITF does not satisfy the
minimum requirements for either the PT
program or the inspection program?
9.14 What happens if an HHS-certified
laboratory or IITF does not satisfy the
minimum requirements for either the PT
program or the inspection program?
9.15 What factors are considered in
determining whether revocation of a
laboratory’s or IITF’s HHS certification is
necessary?
9.16 What factors are considered in
determining whether to suspend a
laboratory’s or an IITF’s HHS
certification?
9.17 How does the Secretary notify an HHScertified laboratory or IITF that action is
being taken against the laboratory or
IITF?
9.18 May a laboratory or IITF that had its
HHS certification revoked be recertified
to test federal agency specimens?
9.19 Where is the list of HHS-certified
laboratories and IITFs published?
Subpart J—Blind Samples Submitted by an
Agency
10.1 What are the requirements for federal
agencies to submit blind samples to
HHS-certified laboratories or IITFs?
10.2 What are the requirements for blind
samples?
10.3 How is a blind sample submitted to an
HHS-certified laboratory or IITF?
10.4 What happens if an inconsistent result
is reported for a blind sample?
Subpart K—Laboratory
11.1 What must be included in the HHScertified laboratory’s standard operating
procedure manual?
11.2 What are the responsibilities of the
responsible person (RP)?
11.3 What scientific qualifications must the
RP have?
11.4 What happens when the RP is absent
or leaves an HHS-certified laboratory?
11.5 What qualifications must an individual
have to certify a result reported by an
HHS-certified laboratory?
11.6 What qualifications and training must
other personnel of an HHS-certified
laboratory have?
11.7 What security measures must an HHScertified laboratory maintain?
11.8 What are the laboratory chain of
custody requirements for specimens and
aliquots?
11.9 What test(s) does an HHS-certified
laboratory conduct on a urine specimen
received from an IITF?
11.10 What are the requirements for an
initial drug test?
11.11 What must an HHS-certified
laboratory do to validate an initial drug
test?
11.12 What are the batch quality control
requirements when conducting an initial
drug test?
11.13 What are the requirements for a
confirmatory drug test?
11.14 What must an HHS-certified
laboratory do to validate a confirmatory
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drug test?
11.15 What are the batch quality control
requirements when conducting a
confirmatory drug test?
11.16 What are the analytical and quality
control requirements for conducting
specimen validity tests?
11.17 What must an HHS-certified
laboratory do to validate a specimen
validity test?
11.18 What are the requirements for
conducting each specimen validity test?
11.19 What are the requirements for an
HHS-certified laboratory to report a test
result?
11.20 How long must an HHS-certified
laboratory retain specimens?
11.21 How long must an HHS-certified
laboratory retain records?
11.22 What statistical summary reports
must an HHS-certified laboratory
provide for urine testing?
11.23 What HHS-certified laboratory
information is available to a federal
agency?
11.24 What HHS-certified laboratory
information is available to a federal
employee?
11.25 What types of relationships are
prohibited between an HHS-certified
laboratory and an MRO?
11.26 What type of relationship can exist
between an HHS-certified laboratory and
an HHS-certified IITF?
Subpart L—Instrumented Initial Test
Facility (IITF)
12.1 What must be included in the HHScertified IITF’s standard operating
procedure manual?
12.2 What are the responsibilities of the
responsible technician (RT)?
12.3 What qualifications must the RT have?
12.4 What happens when the RT is absent
or leaves an HHS-certified IITF?
12.5 What qualifications must an individual
have to certify a result reported by an
HHS-certified IITF?
12.6 What qualifications and training must
other personnel of an HHS-certified IITF
have?
12.7 What security measures must an HHScertified IITF maintain?
12.8 What are the IITF chain of custody
requirements for specimens and
aliquots?
12.9 What are the requirements for an
initial drug test?
12.10 What must an HHS-certified IITF do
to validate an initial drug test?
12.11 What are the batch quality control
requirements when conducting an initial
drug test?
12.12 What are the analytical and quality
control requirements for conducting
specimen validity tests?
12.13 What must an HHS-certified IITF do
to validate a specimen validity test?
12.14 What are the requirements for
conducting each specimen validity test?
12.15 What are the requirements for an
HHS-certified IITF to report a test result?
12.16 How does an HHS-certified IITF
handle a specimen that tested positive,
adulterated, substituted, or invalid at the
IITF?
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12.17 How long must an HHS-certified IITF
retain a specimen?
12.18 How long must an HHS-certified IITF
retain records?
12.19 What statistical summary report must
an HHS-certified IITF provide?
12.20 What HHS-certified IITF information
is available to a federal employee?
12.21 What types of relationships are
prohibited between an HHS-certified
IITF and an MRO?
12.22 What type of relationship can exist
between an HHS-certified IITF and an
HHS-certified laboratory?
IITF to report a specimen as rejected for
testing?
15.2 What discrepancies require an HHScertified laboratory or an HHS-certified
IITF to report a specimen as rejected for
testing unless the discrepancy is
corrected?
15.3 What discrepancies are not sufficient
to require an HHS-certified laboratory or
an HHS-certified IITF to reject a urine
specimen for testing or an MRO to cancel
a test?
15.4 What discrepancies may require an
MRO to cancel a test?
Subpart M—Medical Review Officer (MRO)
13.1 Who may serve as an MRO?
13.2 How are nationally recognized entities
or subspecialty boards that certify MROs
approved?
13.3 What training is required before a
physician may serve as an MRO?
13.4 What are the responsibilities of an
MRO?
13.5 What must an MRO do when
reviewing a urine specimen’s test
results?
13.6 What action does the MRO take when
the collector reports that the donor did
not provide a sufficient amount of urine
for a drug test?
13.7 What happens when an individual is
unable to provide a sufficient amount of
urine for a federal agency applicant/preemployment test, a follow-up test, or a
return-to-duty test because of a
permanent or long-term medical
condition?
13.8 Who may request a test of a split (B)
specimen?
13.9 How does an MRO report a primary
(A) specimen test result to an agency?
13.10 What types of relationships are
prohibited between an MRO and an
HHS-certified laboratory or an HHScertified IITF?
Subpart P—Laboratory or IITF Suspension/
Revocation Procedures
16.1 When may the HHS certification of a
laboratory or IITF be suspended?
16.2 What definitions are used for this
subpart?
16.3 Are there any limitations on issues
subject to review?
16.4 Who represents the parties?
16.5 When must a request for informal
review be submitted?
16.6 What is an abeyance agreement?
16.7 What procedures are used to prepare
the review file and written argument?
16.8 When is there an opportunity for oral
presentation?
16.9 Are there expedited procedures for
review of immediate suspension?
16.10 Are any types of communications
prohibited?
16.11 How are communications transmitted
by the reviewing official?
16.12 What are the authority and
responsibilities of the reviewing official?
16.13 What administrative records are
maintained?
16.14 What are the requirements for a
written decision?
16.15 Is there a review of the final
administrative action?
Subpart N—Split Specimen Tests
14.1 When may a split (B) specimen be
tested?
14.2 How does an HHS-certified laboratory
test a split (B) specimen when the
primary (A) specimen was reported
positive?
14.3 How does an HHS-certified laboratory
test a split (B) urine specimen when the
primary (A) specimen was reported
adulterated?
14.4 How does an HHS-certified laboratory
test a split (B) urine specimen when the
primary (A) specimen was reported
substituted?
14.5 Who receives the split (B) specimen
result?
14.6 What action(s) does an MRO take after
receiving the split (B) urine specimen
result from the second HHS-certified
laboratory?
14.7 How does an MRO report a split (B)
specimen test result to an agency?
14.8 How long must an HHS-certified
laboratory retain a split (B) specimen?
Section 1.1 To whom do these
Guidelines apply?
(a) These Guidelines apply to:
(1) Executive Agencies as defined in
5 U.S.C. 105;
(2) The Uniformed Services, as
defined in 5 U.S.C. 2101(3) (but
excluding the Armed Forces as defined
in 5 U.S.C. 2101(2));
(3) Any other employing unit or
authority of the federal government
except the United States Postal Service,
the Postal Rate Commission, and
employing units or authorities in the
Judicial and Legislative Branches; and
(4) The Intelligence Community, as
defined by Executive Order 12333, is
subject to these Guidelines only to the
extent agreed to by the head of the
affected agency;
(5) Laboratories and instrumented
initial test facilities (IITFs) that provide
drug testing services to the federal
agencies;
(6) Collectors who provide specimen
collection services to the federal
agencies; and
Subpart O—Criteria for Rejecting a
Specimen for Testing
15.1 What discrepancies require an HHScertified laboratory or an HHS-certified
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Subpart A—Applicability
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(7) Medical Review Officers (MROs)
who provide drug testing review and
interpretation of results services to the
federal agencies.
(b) These Guidelines do not apply to
drug testing under authority other than
Executive Order 12564, including
testing of persons in the criminal justice
system, such as arrestees, detainees,
probationers, incarcerated persons, or
parolees.1
Section 1.2 Who is responsible for
developing and implementing these
Guidelines?
(a) Executive Order 12564 and Public
Law 100–71 require the Department of
Health and Human Services (HHS) to
establish scientific and technical
guidelines for federal workplace drug
testing programs.
(b) The Secretary has the
responsibility to implement these
Guidelines.
Section 1.3 How does a federal agency
request a change from these Guidelines?
(a) Each federal agency must ensure
that its workplace drug testing program
complies with the provisions of these
Guidelines unless a waiver has been
obtained from the Secretary.
(b) To obtain a waiver, a federal
agency must submit a written request to
the Secretary that describes the specific
change for which a waiver is sought and
a detailed justification for the change.
Section 1.4
revised?
How are these Guidelines
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(a) To ensure the full reliability and
accuracy of specimen tests, the accurate
reporting of test results, and the
integrity and efficacy of federal drug
testing programs, the Secretary may
make changes to these Guidelines to
reflect improvements in the available
science and technology.
(b) The changes will be published in
final as a notice in the Federal Register.
1 The NRC-related information in this notice
pertains to individuals subject to drug testing
conducted pursuant to 10 CFR part 26, ‘‘Fitness for
Duty Programs’’ (i.e., employees of certain NRCregulated entities).
Although HHS has no authority to regulate the
transportation industry, the Department of
Transportation (DOT) does have such authority.
DOT is required by law to develop requirements for
its regulated industry that ‘‘incorporate the
Department of Health and Human Services
scientific and technical guidelines dated April 11,
1988, and any amendments to those guidelines
. . .’’ See 49 U.S.C. 20140(c)(2). In carrying out its
mandate, DOT requires by regulation at 49 CFR part
40 that its federally-regulated employers use only
HHS-certified laboratories in the testing of
employees, 49 CFR 40.81, and incorporates the
scientific and technical aspects of the HHS
Mandatory Guidelines.
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Section 1.5 What do the terms used in
these Guidelines mean?
The following definitions are adopted:
Accessioner. The individual who
signs the Federal Drug Testing Custody
and Control Form at the time of
specimen receipt at the HHS-certified
laboratory or (for urine) the HHScertified IITF.
Adulterated Specimen. A specimen
that has been altered, as evidenced by
test results showing either a substance
that is not a normal constituent for that
type of specimen or showing an
abnormal concentration of an
endogenous substance.
Aliquot. A portion of a specimen used
for testing.
Alternate Responsible Person. The
person who assumes professional,
organizational, educational, and
administrative responsibility for the
day-to-day management of the HHScertified laboratory when the
responsible person is unable to fulfill
these obligations.
Alternate Responsible Technician.
The person who assumes professional,
organizational, educational, and
administrative responsibility for the
day-to-day management of the HHScertified IITF when the responsible
technician is unable to fulfill these
obligations.
Alternate Technology Initial Drug
Test. An initial drug test using
technology other than immunoassay to
differentiate negative specimens from
those requiring further testing.
Batch. A number of specimens or
aliquots handled concurrently as a
group.
Biomarker. An endogenous substance
used to validate a biological specimen.
Blind Sample. A sample submitted to
an HHS-certified test facility for quality
assurance purposes, with a fictitious
identifier, so that the test facility cannot
distinguish it from a donor specimen.
Calibrator. A sample of known
content and analyte concentration
prepared in the appropriate matrix used
to define expected outcomes of a testing
procedure. The test result of the
calibrator is verified to be within
established limits prior to use.
Cancelled Test. The result reported by
the MRO to the federal agency when a
specimen has been reported to the MRO
as an invalid result (and the donor has
no legitimate explanation) or rejected
for testing, when a split specimen fails
to reconfirm, or when the MRO
determines that a fatal flaw or
unrecovered correctable flaw exists in
the forensic records (as described in
Sections 15.1 and 15.2).
Carryover. The effect that occurs
when a sample result (e.g., drug
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concentration) is affected by a preceding
sample during the preparation or
analysis of a sample.
Certifying Scientist (CS). The
individual responsible for verifying the
chain of custody and scientific
reliability of a test result reported by an
HHS-certified laboratory.
Certifying Technician (CT). The
individual responsible for verifying the
chain of custody and scientific
reliability of negative, rejected for
testing, and (for urine) negative/dilute
results reported by an HHS-certified
laboratory or (for urine) an HHScertified IITF.
Chain of Custody (COC) Procedures.
Procedures that document the integrity
of each specimen or aliquot from the
point of collection to final disposition.
Chain of Custody Documents. Forms
used to document the control and
security of the specimen and all
aliquots. The document may account for
an individual specimen, aliquot, or
batch of specimens/aliquots and must
include the name and signature of each
individual who handled the specimen(s)
or aliquot(s) and the date and purpose
of the handling.
Collection Container. A receptacle
used to collect a urine specimen.
Collection Site. The location where
specimens are collected.
Collector. A person trained to instruct
and assist a donor in providing a
specimen.
Confirmatory Drug Test. A second
analytical procedure performed on a
separate aliquot of a specimen to
identify and quantify a specific drug or
drug metabolite.
Confirmatory Specimen Validity Test.
A second test performed on a separate
aliquot of a specimen to further support
a specimen validity test result.
Control. A sample used to evaluate
whether an analytical procedure or test
is operating within predefined tolerance
limits.
Cutoff. The analytical value (e.g., drug
or drug metabolite concentration) used
as the decision point to determine a
result (e.g., negative, positive,
adulterated, invalid, or, for urine,
substituted) or the need for further
testing.
Dilute Specimen. A urine specimen
with creatinine and specific gravity
values that are lower than expected but
are still within the physiologically
producible ranges of human urine.
Donor. The individual from whom a
specimen is collected.
External Service Provider. An
independent entity that performs
services related to federal workplace
drug testing on behalf of a federal
agency, a collector/collection site, an
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HHS-certified laboratory, a Medical
Review Officer (MRO), or, for urine, an
HHS-certified Instrumented Initial Test
Facility (IITF).
Failed to Reconfirm. The result
reported for a split (B) specimen when
a second HHS-certified laboratory is
unable to corroborate the result reported
for the primary (A) specimen.
Federal Drug Testing Custody and
Control Form (Federal CCF). The Office
of Management and Budget (OMB)
approved form that is used to document
the collection and chain of custody of a
specimen from the time the specimen is
collected until it is received by the test
facility (i.e., HHS-certified laboratory or,
for urine, HHS-certified IITF). It may be
a paper (hardcopy), electronic, or
combination electronic and paper
format (hybrid). The form may also be
used to report the test result to the
Medical Review Officer.
Gender Identity. Gender identity
means an individual’s internal sense of
being male or female, which may be
different from an individual’s sex
assigned at birth.
HHS. The Department of Health and
Human Services.
Initial Drug Test. An analysis used to
differentiate negative specimens from
those requiring further testing.
Initial Specimen Validity Test. The
first analysis used to determine if a
specimen is invalid, adulterated, or (for
urine) diluted or substituted.
Instrumented Initial Test Facility
(IITF). A permanent location where (for
urine) initial testing, reporting of
results, and recordkeeping are
performed under the supervision of a
responsible technician.
Invalid Result. The result reported by
an HHS-certified laboratory in
accordance with the criteria established
in Section 3.9 when a positive, negative,
adulterated, or substituted result cannot
be established for a specific drug or
specimen validity test.
Laboratory. A permanent location
where initial and confirmatory drug
testing, reporting of results, and
recordkeeping are performed under the
supervision of a responsible person.
Limit of Detection. The lowest
concentration at which the analyte (e.g.,
drug or drug metabolite) can be
identified.
Limit of Quantification. For
quantitative assays, the lowest
concentration at which the identity and
concentration of the analyte (e.g., drug
or drug metabolite) can be accurately
established.
Lot. A number of units of an item
(e.g., reagents, quality control material)
manufactured from the same starting
materials within a specified period of
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time for which the manufacturer
ensures that the items have essentially
the same performance characteristics
and expiration date.
Medical Review Officer (MRO). A
licensed physician who reviews,
verifies, and reports a specimen test
result to the federal agency.
Negative Result. The result reported
by an HHS-certified laboratory or (for
urine) an HHS-certified IITF to an MRO
when a specimen contains no drug and/
or drug metabolite; or the concentration
of the drug or drug metabolite is less
than the cutoff for that drug or drug
class.
Oral Fluid Specimen. An oral fluid
specimen is collected from the donor’s
oral cavity and is a combination of
physiological fluids produced primarily
by the salivary glands.
Oxidizing Adulterant. A substance
that acts alone or in combination with
other substances to oxidize drug or drug
metabolites to prevent the detection of
the drugs or drug metabolites, or affects
the reagents in either the initial or
confirmatory drug test.
Performance Testing (PT) Sample. A
program-generated sample sent to a
laboratory or (for urine) to an IITF to
evaluate performance.
Positive Result. The result reported by
an HHS-certified laboratory when a
specimen contains a drug or drug
metabolite equal to or greater than the
confirmation cutoff concentration.
Reconfirmed. The result reported for
a split (B) specimen when the second
HHS-certified laboratory corroborates
the original result reported for the
primary (A) specimen.
Rejected for Testing. The result
reported by an HHS-certified laboratory
or (for urine) HHS-certified IITF when
no tests are performed on a specimen
because of a fatal flaw or an
unrecovered correctable error (see
Sections 15.1 and 15.2).
Responsible Person (RP). The person
who assumes professional,
organizational, educational, and
administrative responsibility for the
day-to-day management of an HHScertified laboratory.
Responsible Technician (RT). The
person who assumes professional,
organizational, educational, and
administrative responsibility for the
day-to-day management of an HHScertified IITF.
Sample. A performance testing
sample, calibrator or control used
during testing, or a representative
portion of a donor’s specimen.
Secretary. The Secretary of the U.S.
Department of Health and Human
Services.
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Specimen. Fluid or material collected
from a donor at the collection site for
the purpose of a drug test.
Split Specimen Collection (for Urine).
A collection in which the specimen
collected is divided into a primary (A)
specimen and a split (B) specimen,
which are independently sealed in the
presence of the donor.
Standard. Reference material of
known purity or a solution containing a
reference material at a known
concentration.
Substituted Specimen. A specimen
that has been submitted in place of the
donor’s urine, as evidenced by
creatinine and specific gravity values
that are outside the physiologically
producible ranges of human urine.
Section 1.6 What is an agency required
to do to protect employee records?
Consistent with 5 U.S.C. 552a and 48
CFR 24.101–24.104, all agency contracts
with laboratories, IITFs, collectors, and
MROs must require that they comply
with the Privacy Act, 5 U.S.C. 552a. In
addition, the contracts must require
compliance with employee access and
confidentiality provisions of Section
503 of Public Law 100–71. Each federal
agency must establish a Privacy Act
System of Records or modify an existing
system or use any applicable
Government-wide system of records to
cover the records of employee drug test
results. All contracts and the Privacy
Act System of Records must specifically
require that employee records be
maintained and used with the highest
regard for employee privacy.
The Health Insurance Portability and
Accountability Act of 1996 (HIPAA)
Privacy Rule (Rule), 45 CFR parts 160
and 164, Subparts A and E, may be
applicable to certain health care
providers with whom a federal agency
may contract. If a health care provider
is a HIPAA covered entity, the provider
must protect the individually
identifiable health information it
maintains in accordance with the
requirements of the Rule, which
includes not using or disclosing the
information except as permitted by the
Rule and ensuring there are reasonable
safeguards in place to protect the
privacy of the information. For more
information regarding the HIPAA
Privacy Rule, please visit http://
www.hhs.gov/ocr/hipaa.
Section 1.7 What is a refusal to take a
federally regulated drug test?
(a) As a donor for a federally regulated
drug test, you have refused to take a
federally regulated drug test if you:
(1) Fail to appear for any test (except
a pre-employment test) within a
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reasonable time, as determined by the
federal agency, consistent with
applicable agency regulations, after
being directed to do so by the federal
agency;
(2) Fail to remain at the collection site
until the collection process is complete
with the exception of a donor who
leaves the collection site before the
collection process begins for a preemployment test as described in section
8.4(a);
(3) Fail to provide a specimen (e.g.,
urine or another authorized specimen
type) for any drug test required by these
Guidelines or federal agency regulations
with the exception of a donor who
leaves the collection site before the
collection process begins for a preemployment test as described in section
8.4(a);
(4) In the case of a direct observed or
monitored collection, fail to permit the
observation or monitoring of your
provision of a specimen when required
as described in Sections 8.9 and 8.10;
(5) Fail to provide a sufficient amount
of urine when directed, and it has been
determined, through a required medical
evaluation, that there was no legitimate
medical explanation for the failure as
determined by the process described in
Section 13.6;
(6) Fail or decline to participate in an
alternate specimen collection (e.g., oral
fluid) as directed by the federal agency
or collector (i.e., as described in Section
8.6);
(7) Fail to undergo a medical
examination or evaluation, as directed
by the MRO as part of the verification
process (i.e., Section 13.6) or as directed
by the federal agency. In the case of a
federal agency applicant/preemployment drug test, the donor is
deemed to have refused to test on this
basis only if the federal agency
applicant/pre-employment test is
conducted following a contingent offer
of employment. If there was no
contingent offer of employment, the
MRO will cancel the test;
(8) Fail to cooperate with any part of
the testing process (e.g., refuse to empty
pockets when directed by the collector,
disrupt the collection process, fail to
wash hands after being directed to do so
by the collector);
(9) For an observed collection, fail to
follow the observer’s instructions
related to the collection process;
(10) Bring materials to the collection
site for the purpose of adulterating,
substituting, or diluting the specimen;
(11) Attempt to adulterate, substitute,
or dilute the specimen;
(12) Possess or wear a prosthetic or
other device that could be used to
interfere with the collection process; or
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(13) Admit to the collector or MRO
that you have adulterated or substituted
the specimen.
Section 1.8 What are the potential
consequences for refusing to take a
federally regulated drug test?
(a) As a federal agency employee or
applicant, a refusal to take a test may
result in the initiation of disciplinary or
adverse action, up to and including
removal from, or non-selection for,
federal employment.
(b) When a donor has refused to
participate in a part of the collection
process, including failing to appear in a
reasonable time for any test except a
pre-employment test as described in
Section 1.7(a)(1), the collector must
terminate the collection process and
take action as described in Section 8.13.
Required action includes immediately
notifying the federal agency’s
designated representative by any means
(e.g., telephone or secure fax machine)
that ensures that the refusal notification
is immediately received and, if a
Federal CCF has been initiated,
documenting the refusal on the Federal
CCF, signing and dating the Federal
CCF, and sending all copies of the
Federal CCF to the federal agency’s
designated representative.
(c) When documenting a refusal to
test during the verification process as
described in Sections 13.4, 13.5, and
13.6, the MRO must complete the MRO
copy of the Federal CCF to include:
(1) Checking the refusal to test box;
(2) Providing a reason for the refusal
in the remarks line; and
(3) Signing and dating the MRO copy
of the Federal CCF.
Subpart B—Urine Specimens
Section 2.1 What type of specimen
may be collected?
A federal agency may collect urine
and/or an alternate specimen type for its
workplace drug testing program. Only
specimen types authorized by
Mandatory Guidelines for Federal
Workplace Drug Testing Programs may
be collected. An agency using urine
must follow these Guidelines.
Section 2.2 Under what circumstances
may a urine specimen be collected?
A federal agency may collect a urine
specimen for the following reasons:
(a) Federal agency applicant/Preemployment test;
(b) Random test;
(c) Reasonable suspicion/cause test;
(d) Post accident test;
(e) Return to duty test; or
(f) Follow-up test.
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Section 2.3 How is each urine
specimen collected?
Each urine specimen is collected as a
split specimen as described in Section
2.5.
Section 2.4
collected?
What volume of urine is
A donor is expected to provide at
least 45 mL of urine for a specimen.
Section 2.5 How does the collector
split the urine specimen?
The collector pours at least 30 mL
into a specimen bottle that is designated
as A (primary) and then pours at least
15 mL into a specimen bottle that is
designated as B (split).
Section 2.6 When may an entity or
individual release a urine specimen?
Entities and individuals subject to
these Guidelines under Section 1.1 may
not release specimens collected
pursuant to Executive Order 12564,
Public Law 100–71, and these
Guidelines to donors or their designees.
Specimens also may not be released to
any other entity or individual unless
expressly authorized by these
Guidelines or by applicable federal law.
This section does not prohibit a donor’s
request to have a split (B) specimen
tested in accordance with Section 13.8.
Subpart C—Urine Drug and Specimen
Validity Tests
Section 3.1 Which tests are conducted
on a urine specimen?
A federal agency:
(a) Must ensure that each specimen is
tested for marijuana and cocaine
metabolites as provided under Section
3.4;
(b) Is authorized to test each specimen
for opioids, amphetamines, and
phencyclidine, as provided under
Section 3.4; and
(c) Must ensure that the following
specimen validity tests are conducted
on each urine specimen:
(1) Determine the creatinine
concentration on every specimen;
(2) Determine the specific gravity on
every specimen for which the creatinine
concentration is less than 20 mg/dL;
(3) Determine the pH on every
specimen; and
(4) Perform one or more specimen
validity tests for oxidizing adulterants
on every specimen.
(d) If a specimen exhibits abnormal
characteristics (e.g., unusual odor or
color, semi-solid characteristics), causes
reactions or responses characteristic of
an adulterant during initial or
confirmatory drug tests (e.g., nonrecovery of internal standard, unusual
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validated initial and confirmatory
analytical methods. If an initial test
procedure is not available upon request
for a suspected Schedule I or Schedule
II drug, the federal agency can request
an HHS-certified laboratory to test for
the drug by analyzing two separate
aliquots of the specimen in two separate
testing batches using the confirmatory
analytical method. Additionally, the
split (B) specimen will be available for
testing if the donor requests a retest at
another HHS-certified laboratory.
(b) A federal agency covered by these
Guidelines must petition the Secretary
in writing for approval to routinely test
for any drug class not listed in Section
3.1. Such approval must be limited to
the use of the appropriate science and
technology and must not otherwise limit
agency discretion to test for any drug
tested under paragraph (a) of this
section.
response), or contains an unidentified
substance that interferes with the
confirmatory analysis, then additional
testing may be performed.
Section 3.2 May a specimen be tested
for additional drugs?
(a) On a case-by-case basis, a
specimen may be tested for additional
drugs, if a federal agency is conducting
the collection for reasonable suspicion
or post accident testing. A specimen
collected from a federal agency
employee may be tested by the federal
agency for any drugs listed in Schedule
I or II of the Controlled Substances Act.
The federal agency must request the
HHS-certified laboratory to test for the
additional drug, include a justification
to test a specific specimen for the drug,
and ensure that the HHS-certified
laboratory has the capability to test for
the drug and has established properly
7941
Section 3.3 May any of the specimens
be used for other purposes?
(a) Specimens collected pursuant to
Executive Order 12564, Public Law
100–71, and these Guidelines must only
be tested for drugs and to determine
their validity in accordance with
Subpart C of these Guidelines. Use of
specimens by donors, their designees, or
any other entity, for other purposes (e.g.,
deoxyribonucleic acid, DNA, testing) is
prohibited unless authorized in
accordance with applicable federal law.
(b) These Guidelines are not intended
to prohibit federal agencies specifically
authorized by law to test a specimen for
additional classes of drugs in its
workplace drug testing program.
Section 3.4 What are the drug test
cutoff concentrations for urine?
Confirmatory test
cutoff concentration
Initial test analyte
Initial test cutoff 1
Confirmatory test analyte
Marijuana metabolites (THCA) 2 ....
Cocaine
metabolite
(Benzoylecgonine).
Codeine/Morphine ..........................
50 ng/mL 3 ....................................
150 ng/mL 3 ..................................
THCA ............................................
Benzoylecgonine ..........................
15 ng/mL.
100 ng/mL.
2,000 ng/mL ..................................
Hydrocodone/Hydromorphone .......
300 ng/mL .....................................
Oxycodone/Oxymorphone .............
100 ng/mL .....................................
6-Acetylmorphine ...........................
Phencyclidine .................................
Amphetamine/Methamphetamine ..
10 ng/mL .......................................
25 ng/mL .......................................
500 ng/mL .....................................
MDMA 4/MDA 5 ...............................
500 ng/mL .....................................
Codeine ........................................
Morphine .......................................
Hydrocodone ................................
Hydromorphone ............................
Oxycodone ....................................
Oxymorphone ...............................
6-Acetylmorphine ..........................
Phencyclidine ................................
Amphetamine ................................
Methamphetamine ........................
MDMA ...........................................
MDA ..............................................
2,000 ng/mL.
2,000 ng/mL.
100 ng/mL.
100 ng/mL.
100 ng/mL.
100 ng/mL.
10 ng/mL.
25 ng/mL.
250 ng/mL.
250 ng/mL.
250 ng/mL.
250 ng/mL.
1 For
grouped analytes (i.e., two or more analytes that are in the same drug class and have the same initial test cutoff):
Immunoassay: The test must be calibrated with one analyte from the group identified as the target analyte. The cross-reactivity of the
immunoassay to the other analyte(s) within the group must be 80 percent or greater; if not, separate immunoassays must be used for the
analytes within the group.
Alternate technology: Either one analyte or all analytes from the group must be used for calibration, depending on the technology. At least one
analyte within the group must have a concentration equal to or greater than the initial test cutoff or, alternatively, the sum of the analytes present
(i.e., equal to or greater than the laboratory’s validated limit of quantification) must be equal to or greater than the initial test cutoff.
2 An immunoassay must be calibrated with the target analyte, D-9-tetrahydrocannabinol-9-carboxylic acid (THCA).
3 Alternate technology (THCA and benzoylecgonine): The confirmatory test cutoff must be used for an alternate technology initial test that is
specific for the target analyte (i.e., 15 ng/mL for THCA, 100 ng/mL for benzoylecgonine).
4 Methylenedioxymethamphetamine (MDMA).
5 Methylenedioxyamphetamine (MDA).
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Section 3.5 May an HHS-certified
laboratory perform additional drug and/
or specimen validity tests on a specimen
at the request of the Medical Review
Officer (MRO)?
An HHS-certified laboratory is
authorized to perform additional drug
and/or specimen validity tests on a caseby-case basis as necessary to provide
information that the MRO would use to
report a verified drug test result (e.g.,
tetrahydrocannabivarin, specimen
validity tests using biomarkers). An
HHS-certified laboratory is not
authorized to routinely perform
additional drug and/or specimen
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validity tests at the request of an MRO
without prior authorization from the
Secretary or designated HHS
representative, with the exception of the
determination of D,L stereoisomers of
amphetamine and methamphetamine.
All tests must meet appropriate
validation and quality control
requirements in accordance with these
Guidelines.
Section 3.6 What criteria are used to
report a urine specimen as adulterated?
An HHS-certified laboratory reports a
primary (A) specimen as adulterated
when:
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(a) The pH is less than 4 or equal to
or greater than 11 using either a pH
meter or a colorimetric pH test for the
initial test on the first aliquot and a pH
meter for the confirmatory test on the
second aliquot;
(b) The nitrite concentration is equal
to or greater than 500 mcg/mL using
either a nitrite colorimetric test or a
general oxidant colorimetric test for the
initial test on the first aliquot and a
different confirmatory test (e.g., multiwavelength spectrophotometry, ion
chromatography, capillary
electrophoresis) on the second aliquot;
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(c) The presence of chromium (VI) is
verified using either a general oxidant
colorimetric test (with an equal to or
greater than 50 mcg/mL chromium (VI)equivalent cutoff) or a chromium (VI)
colorimetric test (chromium (VI)
concentration equal to or greater than 50
mcg/mL) for the initial test on the first
aliquot and a different confirmatory test
(e.g., multi-wavelength
spectrophotometry, ion
chromatography, atomic absorption
spectrophotometry, capillary
electrophoresis, inductively coupled
plasma-mass spectrometry) with the
chromium (VI) concentration equal to or
greater than the limit of quantitation
(LOQ) of the confirmatory test on the
second aliquot;
(d) The presence of halogen (e.g.,
bleach, iodine, fluoride) is verified
using either a general oxidant
colorimetric test (with an equal to or
great than 200 mcg/mL nitriteequivalent cutoff or an equal to or great
than 50 mcg/mL chromium (VI)equivalent cutoff) or halogen
colorimetric test (halogen concentration
equal to or greater than the LOQ) for the
initial test on the first aliquot and a
different confirmatory test (e.g., multiwavelength spectrophotometry, ion
chromatography, inductively coupled
plasma-mass spectrometry) with a
specific halogen concentration equal to
or greater than the LOQ of the
confirmatory test on the second aliquot;
(e) The presence of glutaraldehyde is
verified using either an aldehyde test
(aldehyde present) or the characteristic
immunoassay response on one or more
drug immunoassay tests for the initial
test on the first aliquot and a different
confirmatory test (e.g., GC/MS) for the
confirmatory test with the
glutaraldehyde concentration equal to or
greater than the LOQ of the analysis on
the second aliquot;
(f) The presence of pyridine
(pyridinium chlorochromate) is verified
using either a general oxidant
colorimetric test (with an equal to or
greater than 200 mcg/mL nitriteequivalent cutoff or an equal to or
greater than 50 mcg/mL chromium (VI)equivalent cutoff) or a chromium (VI)
colorimetric test (chromium (VI)
concentration equal to or greater than 50
mcg/mL) for the initial test on the first
aliquot and a different confirmatory test
(e.g., GC/MS) for the confirmatory test
with the pyridine concentration equal to
or greater than the LOQ of the analysis
on the second aliquot;
(g) The presence of a surfactant is
verified by using a surfactant
colorimetric test with an equal to or
greater than 100 mcg/mL
dodecylbenzene sulfonate-equivalent
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cutoff for the initial test on the first
aliquot and a different confirmatory test
(e.g., multi-wavelength
spectrophotometry) with an equal to or
greater than 100 mcg/mL
dodecylbenzene sulfonate-equivalent
cutoff on the second aliquot; or
(h) The presence of any other
adulterant not specified in paragraphs
(b) through (g) of this section is verified
using an initial test on the first aliquot
and a different confirmatory test on the
second aliquot.
Section 3.7 What criteria are used to
report a urine specimen as substituted?
An HHS-certified laboratory reports a
primary (A) specimen as substituted
when the creatinine concentration is
less than 2 mg/dL on both the initial
and confirmatory creatinine tests on two
separate aliquots (i.e., the same
colorimetric test may be used to test
both aliquots) and the specific gravity is
less than or equal to 1.0010 or equal to
or greater than 1.0200 on both the initial
and confirmatory specific gravity tests
on two separate aliquots (i.e., a
refractometer is used to test both
aliquots).
Section 3.8 What criteria are used to
report a urine specimen as dilute?
A dilute result may be reported only
in conjunction with the positive or
negative drug test results for a
specimen.
(a) An HHS-certified laboratory or an
HHS-certified IITF reports a primary (A)
specimen as dilute when the creatinine
concentration is greater than 5 mg/dL
but less than 20 mg/dL and the specific
gravity is equal to or greater than 1.002
but less than 1.003 on a single aliquot.
(b) In addition, an HHS-certified
laboratory reports a primary (A)
specimen as dilute when the creatinine
concentration is equal to or greater than
2 mg/dL but less than 20 mg/dL and the
specific gravity is greater than 1.0010
but less than 1.0030.
Section 3.9 What criteria are used to
report an invalid result for a urine
specimen?
An HHS-certified laboratory reports a
primary (A) specimen as an invalid
result when:
(a) Inconsistent creatinine
concentration and specific gravity
results are obtained (i.e., the creatinine
concentration is less than 2 mg/dL on
both the initial and confirmatory
creatinine tests and the specific gravity
is greater than 1.0010 but less than
1.0200 on the initial and/or
confirmatory specific gravity test, the
specific gravity is less than or equal to
1.0010 on both the initial and
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confirmatory specific gravity tests and
the creatinine concentration is equal to
or greater than 2 mg/dL on either or
both the initial or confirmatory
creatinine tests);
(b) The pH is equal to or greater than
4 and less than 4.5 or equal to or greater
than 9 and less than 11 using either a
colorimetric pH test or pH meter for the
initial test and a pH meter for the
confirmatory test on two separate
aliquots;
(c) The nitrite concentration is equal
to or greater than 200 mcg/mL using a
nitrite colorimetric test or equal to or
greater than the equivalent of 200 mcg/
mL nitrite using a general oxidant
colorimetric test for both the initial
(first) test and the second test or using
either initial test and the nitrite
concentration is equal to or greater than
200 mcg/mL but less than 500 mcg/mL
for a different confirmatory test (e.g.,
multi-wavelength spectrophotometry,
ion chromatography, capillary
electrophoresis) on two separate
aliquots;
(d) The possible presence of
chromium (VI) is determined using the
same chromium (VI) colorimetric test
with a cutoff equal to or greater than 50
mcg/mL chromium (VI) for both the
initial (first) test and the second test on
two separate aliquots;
(e) The possible presence of a halogen
(e.g., bleach, iodine, fluoride) is
determined using the same halogen
colorimetric test with a cutoff equal to
or greater than the LOQ for both the
initial (first) test and the second test on
two separate aliquots or relying on the
odor of the specimen as the initial test;
(f) The possible presence of
glutaraldehyde is determined by using
the same aldehyde test (aldehyde
present) or characteristic immunoassay
response on one or more drug
immunoassay tests for both the initial
(first) test and the second test on two
separate aliquots;
(g) The possible presence of an
oxidizing adulterant is determined by
using the same general oxidant
colorimetric test (with an equal to or
greater than 200 mcg/mL nitriteequivalent cutoff, an equal to or greater
than 50 mcg/mL chromium (VI)equivalent cutoff, or a halogen
concentration is equal to or greater than
the LOQ) for both the initial (first) test
and the second test on two separate
aliquots;
(h) The possible presence of a
surfactant is determined by using the
same surfactant colorimetric test with
an equal to greater than 100 mcg/mL
dodecylbenzene sulfonate-equivalent
cutoff for both the initial (first) test and
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the second test on two separate aliquots
or a foam/shake test for the initial test;
(i) Interference occurs on the initial
drug tests on two separate aliquots (i.e.,
valid immunoassay or alternate
technology initial drug test results
cannot be obtained);
(j) Interference with the drug
confirmatory assay occurs on two
separate aliquots of the specimen and
the laboratory is unable to identify the
interfering substance;
(k) The physical appearance of the
specimen (e.g., viscosity) is such that
testing the specimen may damage the
laboratory’s instruments; or
(l) The specimen has been tested and
the appearances of the primary (A) and
the split (B) specimens (e.g., color) are
clearly different; or
(m) The concentration of a biomarker
is not consistent with that established
for human urine for both the initial
(first) test and the second test on two
separate aliquots.
Subpart D—Collectors
Section 4.1
specimen?
Who may collect a
(a) A collector who has been trained
to collect urine specimens in
accordance with these Guidelines.
(b) The immediate supervisor of a
federal employee donor may only
collect that donor’s specimen when no
other collector is available. The
supervisor must be a trained collector.
(c) The hiring official of a federal
agency applicant may only collect that
federal agency applicant’s specimen
when no other collector is available.
The hiring official must be a trained
collector.
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Section 4.2
specimen?
Who may not collect a
(a) A federal agency employee who is
in a testing designated position and
subject to the federal agency drug
testing rules must not be a collector for
co-workers in the same testing pool or
who work together with that employee
on a daily basis.
(b) A federal agency applicant or
employee must not collect their own
drug testing specimen.
(c) An employee working for an HHScertified laboratory or IITF must not act
as a collector if the employee could link
the identity of the donor to the donor’s
drug test result.
(d) To avoid a potential conflict of
interest, a collector must not be related
to the employee (e.g., spouse, ex-spouse,
relative) or a close personal friend (e.g.,
fiance´e).
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Section 4.3 What are the requirements
to be a collector?
(a) An individual may serve as a
collector if they fulfill the following
conditions:
(1) Is knowledgeable about the
collection procedure described in these
Guidelines;
(2) Is knowledgeable about any
guidance provided by the federal
agency’s Drug-Free Workplace Program
and additional information provided by
the Secretary relating to these
Guidelines;
(3) Is trained and qualified to collect
a urine specimen. Training must
include the following:
(i) All steps necessary to complete a
urine collection;
(ii) Completion and distribution of the
Federal CCF;
(iii) Problem collections;
(iv) Fatal flaws, correctable flaws, and
how to correct problems in collections;
and
(v) The collector’s responsibility for
maintaining the integrity of the
collection process, ensuring the privacy
of the donor, ensuring the security of
the specimen, and avoiding conduct or
statements that could be viewed as
offensive or inappropriate.
(4) Has demonstrated proficiency in
collections by completing five
consecutive error-free mock collections.
(i) The five mock collections must
include one uneventful collection
scenario, one insufficient specimen
quantity scenario, one temperature out
of range scenario, one scenario in which
the donor refuses to sign the Federal
CCF, and one scenario in which the
donor refuses to initial the specimen
bottle tamper-evident seal.
(ii) A qualified trainer for collectors
must monitor and evaluate the
individual being trained, in person or by
a means that provides real-time
observation and interaction between the
trainer and the trainee, and the trainer
must attest in writing that the mock
collections are error-free.
(b) A trained collector must complete
refresher training at least every five
years that includes the requirements in
paragraph (a) of this section.
(c) The collector must maintain the
documentation of their training and
provide that documentation to a federal
agency when requested.
(d) An individual may not collect
specimens for a federal agency until the
individual’s training as a collector has
been properly documented.
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Section 4.4 What are the requirements
to be an observer for a direct observed
collection?
(a) An individual may serve as an
observer for a direct observed collection
when the individual has satisfied the
requirements:
(1) Is knowledgeable about the direct
observed collection procedure described
in Section 8.9 of these Guidelines;
(2) Is knowledgeable about any
guidance provided by the federal
agency’s Drug-Free Workplace Program
or additional information provided by
the Secretary relating to the direct
observed collection procedure described
in these Guidelines;
(3) Has received training on the
following subjects:
(i) All steps necessary to perform a
direct observed collection; and
(ii) The observer’s responsibility for
maintaining the integrity of the
collection process, ensuring the privacy
of individuals being tested, ensuring
that the observation is done in a
professional manner that minimizes the
discomfort to the employee so observed,
ensuring the security of the specimen by
maintaining visual contact with the
collection container until it is delivered
to the collector, and avoiding conduct or
statements that could be viewed as
offensive or inappropriate.
(b) The gender of the observer must be
the same as the donor’s gender, which
is determined by the donor’s gender
identity. The observer selection process
is described in Section 8.10(b).
(c) The observer is not required to be
a trained collector.
Section 4.5 What are the requirements
to be a trainer for collectors?
(a) Individuals are considered
qualified trainers for collectors and may
train others to collect urine specimens
when they have completed the
following:
(1) Qualified as a trained collector and
regularly conducted urine drug test
collections for a period of at least one
year or
(2) Completed a ‘‘train the trainer’’
course given by an organization (e.g.,
manufacturer, private entity, contractor,
federal agency).
(b) A qualified trainer for collectors
must complete refresher training at least
every five years in accordance with the
collector requirements in Section 4.3(a).
(c) A qualified trainer for collectors
must maintain the documentation of the
trainer’s training and provide that
documentation to a federal agency when
requested.
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Section 4.6 What must a federal
agency do before a collector is permitted
to collect a specimen?
A federal agency must ensure the
following:
(a) The collector has satisfied the
requirements described in Section 4.3;
(b) The collector, who may be selfemployed, or an organization (e.g., third
party administrator that provides a
collection service, collector training
company, federal agency that employs
its own collectors) maintains a copy of
the training record(s); and
(c) The collector has been provided
the name and telephone number of the
federal agency representative.
Subpart E—Collection Sites
Section 5.1 Where can a collection for
a drug test take place?
(a) A collection site may be a
permanent or temporary facility located
either at the work site or at a remote
site.
(b) In the event that an agencydesignated collection site is not
accessible and there is an immediate
requirement to collect a urine specimen
(e.g., an accident investigation), a public
restroom may be used for the collection,
using the procedures for a monitored
collection described in Section 8.12.
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Section 5.2 What are the requirements
for a collection site?
The facility used as a collection site
must have the following:
(a) Provisions to ensure donor privacy
during the collection (as described in
Section 8.1);
(b) A suitable and clean surface area
that is not accessible to the donor for
handling the specimens and completing
the required paperwork;
(c) A secure temporary storage area to
maintain specimens until the specimen
is transferred to an HHS-certified
laboratory or IITF;
(d) A restricted access area where
only authorized personnel may be
present during the collection;
(e) A restricted access area for the
storage of collection supplies;
(f) The ability to store records
securely; and
(g) The ability to restrict the donor
access to potential diluents in
accordance with Section 8.2.
Section 5.3 Where must collection site
records be stored?
Collection site records must be stored
at a secure site designated by the
collector or the collector’s employer.
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Section 5.4 How long must collection
site records be stored?
Collection site records (e.g., collector
copies of the OMB-approved Federal
CCF) must be stored securely for a
minimum of 2 years. The collection site
may convert hardcopy records to
electronic records for storage and
discard the hardcopy records after 6
months.
Section 5.5 How does the collector
ensure the security and integrity of a
specimen at the collection site?
(a) A collector must do the following
to maintain the security and integrity of
a specimen:
(1) Not allow unauthorized personnel
to enter the collection area during the
collection procedure;
(2) Perform only one donor collection
at a time;
(3) Restrict access to collection
supplies before, during and after
collection;
(4) Ensure that only the collector and
the donor are allowed to handle the
unsealed specimen;
(5) Ensure the chain of custody
process is maintained and documented
throughout the entire collection, storage,
and transport procedures;
(6) Ensure that the Federal CCF is
completed and distributed as required;
and
(7) Ensure that specimens transported
to an HHS-certified laboratory or IITF
are sealed and placed in transport
containers designed to minimize the
possibility of damage during shipment
(e.g., specimen boxes, padded mailers,
or other suitable shipping container),
and those containers are securely sealed
to eliminate the possibility of
undetected tampering;
(b) Couriers, express carriers, and
postal service personnel are not
required to document chain of custody
since specimens are sealed in packages
that would indicate tampering during
transit to the HHS-certified laboratory or
IITF.
Section 5.6 What are the privacy
requirements when collecting a urine
specimen?
Collections must be performed at a
site that provides reasonable privacy (as
described in Section 8.1).
Subpart F—Federal Drug Testing
Custody and Control Form
Section 6.1 What federal form is used
to document custody and control?
The OMB-approved Federal CCF must
be used to document custody and
control of each specimen at the
collection site.
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Section 6.2 What happens if the
correct OMB-approved Federal CCF is
not available or is not used?
(a) The use of a non-federal CCF or an
expired Federal CCF is not, by itself, a
reason for the HHS-certified laboratory
or IITF to automatically reject the
specimen for testing or for the MRO to
cancel the test.
(b) If the collector does not use the
correct OMB-approved Federal CCF, the
collector must document that it is a
federal agency specimen collection and
provide the reason that the incorrect
form was used. Based on the
information provided by the collector,
the HHS-certified laboratory or IITF
must handle and test the specimen as a
federal agency specimen.
(c) If the HHS-certified laboratory,
HHS-certified IITF, or MRO discovers
that the collector used an incorrect
form, the laboratory, IITF, or MRO must
obtain a memorandum for the record
from the collector describing the reason
the incorrect form was used. If a
memorandum for the record cannot be
obtained, the laboratory or IITF reports
a rejected for testing result to the MRO
and the MRO cancels the test. The HHScertified laboratory or IITF must wait at
least 5 business days while attempting
to obtain the memorandum before
reporting a rejected for testing result to
the MRO.
Subpart G—Urine Specimen Collection
Containers and Bottles
Section 7.1 What is used to collect a
urine specimen?
A single-use collection container with
a means (i.e., thermometer) to measure
urine temperature and two specimen
bottles must be used.
Section 7.2 What are the requirements
for a urine collection container and
specimen bottles?
(a) The collection container, the
thermometer, and the specimen bottles
must not substantially affect the
composition of drugs and/or metabolites
in the urine specimen.
(b) The two specimen bottles must be
sealable and non-leaking, and must
maintain the integrity of the specimen
during storage and transport so that the
specimen contained therein can be
tested in an HHS-certified laboratory or
IITF for the presence of drugs or their
metabolites.
(c) The two specimen bottles must be
sufficiently transparent to enable an
objective assessment of specimen
appearance and identification of
abnormal physical characteristics
without opening the bottle.
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Section 7.3 What are the minimum
performance requirements for a urine
collection container and specimen
bottles?
(a) The collection container must be
capable of holding at least 55 mL and
have a volume marking clearly noting a
level of 45 mL.
(b) One of the two specimen bottles
must be capable of holding at least 35
mL and the other at least 20 mL, and
each must have a volume marking
clearly noting the appropriate level (30
mL for the primary specimen and 15 mL
for the split specimen).
(c) The thermometer may be affixed to
or built into the collection container and
must provide graduated temperature
readings from 32–38 °C/90–100 °F.
Alternatively, the collector may use
another technology to measure
specimen temperature (e.g., thermal
radiation scanning), providing the
thermometer does not come into contact
with the specimen.
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Subpart H—Urine Specimen Collection
Procedure
Section 8.1 What privacy must the
donor be given when providing a urine
specimen?
The following privacy requirements
apply when a donor is providing a urine
specimen:
(a) Only authorized personnel and the
donor may be present in the restricted
access area where the collection takes
place.
(b) The collector is not required to be
the same gender as the donor. The
gender of the observer for purposes of a
direct observed collection (i.e., as
described in Section 8.10) must be the
same as the donor’s gender, which is
determined by the donor’s gender
identity. The gender of the monitor for
a monitored collection (i.e., as described
in Section 8.12) must be the same as the
donor’s gender, unless the monitor is a
medical professional (e.g., nurse, doctor,
physician’s assistant, technologist, or
technician licensed or certified to
practice in the jurisdiction in which the
collection takes place).
(c) The collector must give the donor
visual privacy while providing the
specimen. The donor is allowed to
provide a urine specimen in an enclosed
stall within a multi-stall restroom or in
a single person restroom during a
monitored collection.
Section 8.2 What must the collector
ensure at the collection site before
starting a urine specimen collection?
The collector must deter the dilution
or substitution of a specimen at the
collection site by:
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(a) Placing a toilet bluing agent in a
toilet bowl or toilet tank, so the
reservoir of water in the toilet bowl
always remains blue. If no bluing agent
is available or if the toilet has an
automatic flushing system, the collector
shall turn the water supply off to the
toilet and flush the toilet to remove the
water in the toilet when possible.
(b) Secure other sources of water (e.g.,
shower or sink) in the enclosure where
urination occurs. If the enclosure has a
source of water that cannot be disabled
or secured, a monitored collection must
be conducted in accordance with
Section 8.11.
Section 8.3 What are the preliminary
steps in the urine specimen collection
procedure?
The collector must take the following
steps before beginning a urine specimen
collection:
(a) If a donor fails to arrive at the
collection site at the assigned time, the
collector must follow the federal agency
policy or contact the federal agency
representative to obtain guidance on
action to be taken.
(b) When the donor arrives at the
collection site, the collector should
begin the collection procedure without
undue delay. For example, the
collection should not be delayed
because the donor states that they are
unable to urinate or an authorized
employer or employer representative is
late in arriving.
(c) The collector requests the donor to
present photo identification (e.g.,
driver’s license; employee badge issued
by the employer; an alternative photo
identification issued by a federal, state,
or local government agency). If the
donor does not have proper photo
identification, the collector shall contact
the supervisor of the donor or the
federal agency representative who can
positively identify the donor. If the
donor’s identity cannot be established,
the collector must not proceed with the
collection.
(d) The collector must provide
identification (e.g., employee badge,
employee list) if requested by the donor.
(e) The collector explains the basic
collection procedure to the donor.
(f) The collector informs the donor
that the instructions for completing the
Federal Custody and Control Form are
located on the back of the Federal CCF
or available upon request.
(g) The collector answers any
reasonable and appropriate questions
the donor may have regarding the
collection procedure.
(h) The collector asks the donor to
remove any unnecessary outer garments
(e.g., coat, jacket) that might conceal
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items or substances that could be used
to adulterate or substitute the urine
specimen:
(1) The collector must ensure that all
personal belongings (e.g., purse or
briefcase) remain with the outer
garments; the donor may retain the
donor’s wallet.
(2) The collector asks the donor to
empty the donor’s pockets and display
the contents to ensure no items are
present that could be used to adulterate
or substitute the specimen.
(3) If no items are present that can be
used to adulterate or substitute the
specimen, the donor can place the items
back into the donor’s pockets and
continue the collection procedure.
(4) If an item is present that appears
to have been brought to the collection
site with the intent to adulterate,
substitute, or dilute the specimen, this
is considered a refusal to test. The
collector must stop the collection and
report the refusal to test as described in
Section 8.13. If the item appears to be
inadvertently brought to the collection
site, the collector must secure the item
and continue the normal collection
procedure.
(5) If the donor refuses to show the
collector the items in the donor’s
pockets, this is considered a refusal to
test. The collector must stop the
collection and report the refusal to test
as described in Section 8.13.
(i) The collector shall instruct the
donor to wash and dry the donor’s
hands prior to urination. After washing
the donor’s hands, the donor must
remain in the presence of the collector
and must not have access to any water
fountain, faucet, soap dispenser,
cleaning agent, or any other materials
which could be used to adulterate or
substitute the specimen.
(1) If the donor refuses to wash the
donor’s hands when instructed by the
collector, this is considered a ‘‘refusal to
test.’’ The collector must stop the
collection and report the refusal to test
as described in Section 8.13.
Section 8.4 What steps does the
collector take in the collection
procedure before the donor provides a
urine specimen?
(a) The collector will provide or the
donor may select a specimen collection
container that is clean, unused,
wrapped/sealed in original packaging
and compliant with Subpart G. The
specimen collection container will be
opened in view of the donor.
(b) The collector instructs the donor
to provide the specimen in the privacy
of a stall or otherwise partitioned area
that allows for individual privacy. The
collector directs the donor to provide a
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specimen of at least 45 mL, to not flush
the toilet, and to return with the
specimen as soon as the donor has
completed the void.
(1) Except in the case of a direct
observed collection (i.e., as described in
Section 8.10) or a monitored collection
(i.e., as described in Section 8.12),
neither the collector nor anyone else
may go into the room with the donor.
(2) The collector may set a reasonable
time limit for specimen collection.
(c) The collector notes any unusual
behavior or appearance of the donor on
the Federal CCF. If the collector detects
any conduct that clearly indicates an
attempt to tamper with a specimen (e.g.,
substitute urine in plain view or an
attempt to bring into the collection site
an adulterant or urine substitute), the
collector must report a refusal to test in
accordance with Section 8.13.
Section 8.5 What steps does the
collector take during and after the urine
specimen collection procedure?
Integrity and Identity of the
Specimen. The collector must take the
following steps during and after the
donor provides the urine specimen:
(a) The collector must inform the
donor that, once the collection
procedure has begun, the donor must
remain at the collection site (i.e., in an
area designated by the collector) until
the collection is complete. This includes
the wait period (i.e., up to 3 hours) if
needed to provide a sufficient specimen
as described in step (f)(2) below and in
Section 8.6.
(b) After providing the specimen, the
donor gives the specimen collection
container to the collector. Both the
donor and the collector must keep the
specimen container in view at all times
until the collector seals the specimen
bottles as described in Section 8.8.
(c) After the donor has given the
specimen to the collector, whenever
practical, the donor shall be allowed to
wash the donor’s hands and the donor
may flush the toilet.
(d) The collector must measure the
temperature of the specimen within 4
minutes of receiving the specimen from
the donor. The collector records on the
Federal CCF whether or not the
temperature is in the acceptable range of
32 °–38 °C/90 °–100 °F.
(1) The temperature measuring device
must accurately reflect the temperature
of the specimen and not contaminate
the specimen.
(2) If the temperature of the specimen
is outside the range of 32 °–38 °C/90 °–
100 °F, that is a reason to believe that
the donor may have adulterated or
substituted the specimen. Another
specimen must be collected under direct
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observation in accordance with Section
8.9. The collector must forward both
specimens (i.e., from the first and
second collections) to an HHS-certified
laboratory for testing and record a
comment on the Federal CCF for each
specimen.
(e) The collector must inspect the
specimen to determine if there is any
sign indicating that the specimen may
not be a valid urine specimen (e.g.,
unusual color, presence of foreign
objects or material, unusual odor).
(1) The collector notes any unusual
finding on the Federal CCF. A specimen
suspected of not being a valid urine
specimen must be forwarded to an HHScertified laboratory for testing.
(2) When there is any reason to
believe that a donor may have
adulterated or substituted the specimen,
another specimen must be obtained as
soon as possible under direct
observation in accordance with Section
8.10. The collector must forward both
specimens (i.e., from the first and
second collections) to an HHS-certified
laboratory for testing and record a
comment on the Federal CCF for each
specimen.
(f) The collector must determine the
volume of urine in the specimen
container. The collector must never
combine urine collected from separate
voids to create a specimen.
(1) If the volume is at least 45 mL, the
collector will proceed with steps
described in Section 8.8.
(2) If the volume is less than 45 mL,
the collector discards the specimen and
immediately collects a second specimen
using the same procedures as for the
first specimen (including steps in
paragraphs c and d of this section).
(i) The collector may give the donor
a reasonable amount of liquid to drink
for this purpose (e.g., an 8 ounce glass
of water every 30 minutes, but not to
exceed a maximum of 40 ounces over a
period of 3 hours or until the donor has
provided a sufficient urine specimen).
However, the donor is not required to
drink any fluids during this waiting
time.
(ii) If the donor provides a sufficient
urine specimen (i.e., at least 45 mL), the
collector proceeds with steps described
in Section 8.8.
(iii) If the employee has not provided
a sufficient specimen (i.e., at least 45
mL) within three hours of the first
unsuccessful attempt to provide the
specimen, the collector records the
reason for not collecting a urine
specimen on the Federal CCF, notifies
the federal agency’s designated
representative for authorization of an
alternate specimen to be collected, and
sends the appropriate copies of the
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Federal CCF to the MRO and to the
federal agency’s designated
representative. The federal agency may
choose to provide the collection site
with a standard protocol to follow in
lieu of requiring the collector to notify
the agency’s designated representative
for authorization in each case. If an
alternate specimen is authorized, the
collector may begin the collection
procedure for the alternate specimen
(see Section 8.7) in accordance with the
Mandatory Guidelines for Federal
Workplace Drug Testing Programs using
the alternative specimen.
(g) If the donor fails to remain present
through the completion of the
collection, declines to have a direct
observed collection as required in steps
(d)(2) or (e)(2) above, refuses to provide
a second specimen as required in step
(f)(2) above, or refuses to provide an
alternate specimen as authorized in step
(f)(2)(iii) above, the collector stops the
collection and reports the refusal to test
in accordance with Section 8.13.
Section 8.6 What procedure is used
when the donor states that they are
unable to provide a urine specimen?
(a) If the donor states that they are
unable to provide a urine specimen
during the collection process, the
collector requests that the donor enter
the restroom (stall) and attempt to
provide a urine specimen.
(b) The donor demonstrates their
inability to provide a specimen when he
or she comes out of the stall with an
empty collection container.
(1) If the donor states that they could
provide a specimen after drinking some
fluids, the collector gives the donor a
reasonable amount of liquid to drink for
this purpose (e.g., an 8 ounce glass of
water every 30 minutes, but not to
exceed a maximum of 40 ounces over a
period of 3 hours or until the donor has
provided a sufficient urine specimen). If
the donor simply needs more time
before attempting to provide a urine
specimen, the donor is not required to
drink any fluids during the 3 hour wait
time.
(2) If the donor states that they are
unable to provide a urine specimen, the
collector records the reason for not
collecting a urine specimen on the
Federal CCF, notifies the federal
agency’s designated representative for
authorization of an alternate specimen
to be collected, and sends the
appropriate copies of the Federal CCF to
the MRO and to the federal agency’s
designated representative. The federal
agency may choose to provide the
collection site with a standard protocol
to follow in lieu of requiring the
collector to notify the agency’s
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designated representative for
authorization in each case. If an
alternate specimen is authorized, the
collector may begin the collection
procedure for the alternate specimen
(see Section 8.7) in accordance with the
Mandatory Guidelines for Federal
Workplace Drug Testing Programs using
the alternative specimen.
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Section 8.7 If the donor is unable to
provide a urine specimen, may another
specimen type be collected for testing?
Yes, if the alternate specimen type is
authorized by Mandatory Guidelines for
Federal Workplace Drug Testing
Programs and specifically authorized by
the federal agency.
Section 8.8 How does the collector
prepare the urine specimens?
(a) All federal agency collections are
to be split specimen collections.
(b) The collector, in the presence of
the donor, pours the urine from the
collection container into two specimen
bottles to be labeled ‘‘A’’ and ‘‘B’’. The
collector pours at least 30 mL of urine
into Bottle A and at least 15 mL into
Bottle B, and caps each bottle.
(c) In the presence of the donor, the
collector places a tamper-evident label/
seal from the Federal CCF over each
specimen bottle cap. The collector
records the date of the collection on the
tamper-evident labels/seals.
(d) The collector instructs the donor
to initial the tamper-evident labels/seals
on each specimen bottle. If the donor
refuses to initial the labels/seals, the
collector notes the refusal on the
Federal CCF and continues with the
collection process.
(e) The collector must ensure that all
the information required on the Federal
CCF is provided.
(f) The collector asks the donor to
read and sign a statement on the Federal
CCF certifying that the specimens
identified were collected from the
donor. If the donor refuses to sign the
certification statement, the collector
notes the refusal on the Federal CCF and
continues with the collection process.
(g) The collector signs and prints their
name on the Federal CCF, completes the
Federal CCF, and distributes the copies
of the Federal CCF as required.
(h) The collector seals the specimens
(Bottle A and Bottle B) in a package and,
within 24 hours or during the next
business day, sends them to the HHScertified laboratory or IITF that will be
testing the Bottle A urine specimen.
(i) If the specimen and Federal CCF
are not immediately transported to an
HHS-certified laboratory or IITF, they
must remain under direct control of the
collector or be appropriately secured
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under proper specimen storage
conditions until transported.
(j) The collector must discard any
urine left over in the collection
container after both specimen bottles
have been appropriately filled and
sealed. There is one exception to this
requirement: The collector may use
excess urine to conduct clinical tests
(e.g., protein, glucose) if the collection
was conducted in conjunction with a
physical examination required by
federal agency regulation. Neither the
collector nor anyone else may conduct
further testing (such as specimen
validity testing) on the excess urine.
Section 8.9 When is a direct observed
collection conducted?
A direct observed collection
procedure must be conducted when:
(a) The agency has authorized a direct
observed collection because:
(1) The donor’s previous drug test
result was reported by an MRO as
positive, adulterated, or substituted; or
(2) The HHS-certified laboratory
reports to the MRO that a specimen is
invalid, and the MRO reported to the
agency that there was not a legitimate
medical explanation for the result; or
(3) The MRO reported to the agency
that the primary bottle (A) specimen
was positive, adulterated, or substituted
result had to be cancelled because the
test of the split specimen could not be
tested and/or the split specimen bottle
(B) failed to reconfirm; or
(b) At the collection site, an
immediate collection of a second urine
specimen is required because:
(1) The temperature of the specimen
collected during a routine collection is
outside the acceptable temperature
range; or
(2) The collector suspects that the
donor has tampered with the specimen
during a routine collection (e.g.,
abnormal physical characteristic such as
unusual color and/or odor, and/or
excessive foaming when shaken).
(c) The collector must contact a
collection site supervisor to review and
concur in advance with any decision by
the collector to obtain a specimen under
direct observation.
(d) If the donor declines to have a
direct observed collection, the collector
reports a refusal to test (i.e., as described
in Section 8.13).
Section 8.10 How is a direct observed
collection conducted?
(a) A direct observed collection
procedure is the same as that for a
routine collection, except an observer
watches the donor urinate into the
collection container. The observer’s
gender must be the same as the donor’s
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gender, which is determined by the
donor’s gender identity, with no
exception to this requirement.
(b) Before an observer is selected, the
collector informs the donor that the
gender of the observer will match the
donor’s gender, which is determined by
the donor’s gender identity (as defined
in Section 1.5). The collector then
selects the observer to conduct the
observation:
(i) The collector asks the donor to
identify the donor’s gender on the
Federal CCF and initial it.
(ii) The donor will then be provided
an observer whose gender matches the
donor’s gender.
(iii) The collector documents the
observer’s name and gender on the
Federal CCF.
(c) If there is no collector available of
the same gender as the donor’s gender,
the collector or collection site
supervisor shall select an observer
trained in direct observed specimen
collection as described in Section 4.4.
The observer may be an individual that
is not a trained collector.
(d) At the point in a routine collection
where the donor enters the restroom
with the collection container, a direct
observed collection includes the
following additional steps:
(1) The observer enters the restroom
with the donor;
(2) The observer must directly watch
the urine go from the donor’s body into
the collection container (the use of
mirrors or video cameras is not
permitted);
(3) The observer must not touch or
handle the collection container unless
the observer is also serving as the
collector;
(4) After the donor has completed
urinating into the collection container:
(i) If the same person serves as the
observer and collector, that person may
receive the collection container from the
donor while they are both in the
restroom;
(ii) If the observer is not serving as the
collector, the donor and observer leave
the restroom and the donor hands the
collection container directly to the
collector. The observer must maintain
visual contact of the collection
container until the donor hands the
container to the collector.
(5) The collector checks the box for an
observed collection on the Federal CCF
and writes the name of the observer and
the reason for an observed collection on
the Federal CCF; and
(6) The collector then continues with
the routine collection procedure in
Section 8.3.
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Section 8.11 When is a monitored
collection conducted?
(a) In the event that an agencydesignated collection site is not
available and there is an immediate
requirement to collect a specimen (e.g.,
an accident investigation), a public
restroom may be used for the collection,
using the procedures for a monitored
collection described in Section 8.12.
(b) If the enclosure used by the donor
to provide a specimen has a source of
water that cannot be disabled or
secured, a monitored collection must be
conducted.
(c) If the donor declines to permit a
collection to be monitored when
required, the collector reports a refusal
to test (i.e., as described in Section
8.13).
Section 8.12 How is a monitored
collection conducted?
A monitored collection is the same as
that for a routine collection, except that
a monitor accompanies the donor into
the restroom to check for signs that the
donor may be tampering with the
specimen. The monitor remains in the
restroom, but outside the stall, while the
donor is providing the specimen. A
person of the same gender as the donor
shall serve as the monitor, unless the
monitor is a medical professional (e.g.,
nurse, doctor, physician’s assistant,
technologist, or technician licensed or
certified to practice in the jurisdiction
in which the collection takes place). The
same procedures used for selecting an
observer of the appropriate gender in
Section 8.10(b) must be used to select
the monitor for the purposes of Section
8.12, unless the monitor is a medical
professional as described above. The
monitor may be an individual other
than the collector and need not be a
qualified collector.
(a) The collector secures the restroom
being used for the monitored collection
so that no one except the employee and
the monitor can enter the restroom until
after the collection has been completed.
(b) The monitor enters the restroom
with the donor.
(c) The monitor must not watch the
employee urinate into the collection
container. If the monitor hears sounds
or makes other observations indicating
an attempt by the donor to tamper with
a specimen, there must be an additional
collection under direct observation in
accordance with Section 8.9.
(d) The monitor must not touch or
handle the collection container unless
the monitor is also the collector.
(e) After the donor has completed
urinating into the collection container:
(1) If the same person serves as the
monitor and collector, that person may
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receive the collection container from the
donor while they are both in the
restroom;
(2) If the monitor is not serving as the
collector, the donor and monitor leave
the restroom and the donor hands the
collection container directly to the
collector. The monitor must ensure that
the employee takes the collection
container directly to the collector as
soon as the employee has exited the
enclosure.
(f) If the monitor is not serving as the
collector, the collector writes the name
of the monitor on the Federal CCF.
(g) The collector then continues with
the routine collection procedure in
Section 8.3.
Section 8.13 How does the collector
report a donor’s refusal to test?
If there is a refusal to test as defined
in Section 1.7, the collector stops the
collection, discards any urine collected
and reports the refusal to test by:
(a) Notifying the federal agency by
means (e.g., telephone, email, or secure
fax) that ensures that the notification is
immediately received,
(b) Documenting the refusal to test on
the Federal CCF, and
(c) Sending all copies of the Federal
CCF to the federal agency’s designated
representative.
Section 8.14 What are a federal
agency’s responsibilities for a collection
site?
(a) A federal agency must ensure that
collectors and collection sites satisfy all
requirements in subparts D, E, F, G, and
H.
(b) A federal agency (or only one
federal agency when several agencies
are using the same collection site) must
inspect 5 percent or up to a maximum
of 50 collection sites each year, selected
randomly from those sites used to
collect agency specimens (e.g., virtual,
onsite, or self-evaluation).
(c) A federal agency must investigate
reported collection site deficiencies
(e.g., specimens reported ‘‘rejected for
testing’’ by an HHS-certified laboratory
or IITF) and take appropriate action
which may include a collection site selfassessment (i.e., using the Collection
Site Checklist for the Collection of Urine
Specimens for Federal Agency
Workplace Drug Testing Programs) or an
inspection of the collection site. The
inspections of these additional
collection sites may be included in the
5 percent or maximum of 50 collection
sites inspected annually.
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Subpart I—HHS Certification of
Laboratories and IITFs
Section 9.1 Who has the authority to
certify laboratories and IITFs to test
urine specimens for federal agencies?
(a) The Secretary has broad discretion
to take appropriate action to ensure the
full reliability and accuracy of drug
testing and reporting, to resolve
problems related to drug testing, and to
enforce all standards set forth in these
Guidelines. The Secretary has the
authority to issue directives to any HHScertified laboratory or IITF including
suspending the use of certain analytical
procedures when necessary to protect
the integrity of the testing process;
ordering any HHS-certified laboratory or
IITF to undertake corrective actions to
respond to material deficiencies
identified by an inspection or through
performance testing; ordering any HHScertified laboratory or IITF to send
specimens or specimen aliquots to
another HHS-certified laboratory for
retesting when necessary to ensure the
accuracy of testing under these
Guidelines; ordering the review of
results for specimens tested under the
Guidelines for private sector clients to
the extent necessary to ensure the full
reliability of drug testing for federal
agencies; and ordering any other action
necessary to address deficiencies in
drug testing, analysis, specimen
collection, chain of custody, reporting of
results, or any other aspect of the
certification program.
(b) A laboratory or IITF is prohibited
from stating or implying that it is
certified by HHS under these Guidelines
to test urine specimens for federal
agencies unless it holds such
certification.
Section 9.2 What is the process for a
laboratory or IITF to become HHScertified?
(a) A laboratory or IITF seeking HHS
certification must:
(1) Submit a completed OMBapproved application form (i.e., the
applicant laboratory or IITF provides
detailed information on both the
administrative and analytical
procedures to be used for federally
regulated specimens);
(2) Have its application reviewed as
complete and accepted by HHS;
(3) Successfully complete the PT
challenges in 3 consecutive sets of
initial PT samples;
(4) Satisfy all the requirements for an
initial inspection; and
(5) Receive notification of certification
from the Secretary before testing
specimens for federal agencies.
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Section 9.3 What is the process for a
laboratory or IITF to maintain HHS
certification?
(a) To maintain HHS certification, a
laboratory or IITF must:
(1) Successfully participate in both
the maintenance PT and inspection
programs (i.e., successfully test the
required quarterly sets of maintenance
PT samples, undergo an inspection 3
months after being certified, and
undergo maintenance inspections at a
minimum of every 6 months thereafter);
(2) Respond in an appropriate, timely,
and complete manner to required
corrective action requests if deficiencies
are identified in the maintenance PT
performance, during the inspections,
operations, or reporting; and
(3) Satisfactorily complete corrective
remedial actions, and undergo special
inspection and special PT sets to
maintain or restore certification when
material deficiencies occur in either the
PT program, inspection program, or in
operations and reporting.
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Section 9.4 What is the process when
a laboratory or IITF does not maintain
its HHS certification?
(a) A laboratory or IITF that does not
maintain its HHS certification must:
(1) Stop testing federally regulated
specimens;
(2) Ensure the security of federally
regulated specimens and records
throughout the required storage period
described in Sections 11.20, 11.21,
12.18, and 14.8;
(3) Ensure access to federally
regulated specimens and records in
accordance with Sections 11.23, 11.24,
12.20, 12.21, and Subpart P; and
(4) Follow the HHS suspension and
revocation procedures when imposed by
the Secretary, follow the HHS
procedures in Subpart P that will be
used for all actions associated with the
suspension and/or revocation of HHScertification.
Section 9.5 What are the qualitative
and quantitative specifications of
performance testing (PT) samples?
(a) PT samples used to evaluate drug
tests will be prepared using the
following specifications:
(1) PT samples may contain one or
more of the drugs and drug metabolites
in the drug classes listed in Section 3.4
and must satisfy one of the following
parameters:
(i) The concentration of a drug or
metabolite will be at least 20 percent
above the initial test cutoff
concentration for the drug or drug
metabolite;
(ii) The concentration of a drug or
metabolite may be as low as 40 percent
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of the confirmatory test cutoff
concentration when the PT sample is
designated as a retest sample; or
(iii) The concentration of drug or
metabolite may differ from 9.5(a)(1)(i)
and 9.5(a)(1)(ii) for a special purpose.
(2) A PT sample may contain an
interfering substance, an adulterant, or
satisfy the criteria for a substituted
specimen, dilute specimen, or invalid
result.
(3) A negative PT sample will not
contain a measurable amount of a target
analyte.
(b) PT samples used to evaluate
specimen validity tests shall satisfy, but
are not limited to, one of the following
criteria:
(1) The nitrite concentration will be at
least 20 percent above the cutoff;
(2) The pH will be between 1.5 and
5.0 or between 8.5 and 12.5;
(3) The concentration of an oxidant
will be at a level sufficient to challenge
a laboratory’s ability to identify and
confirm the oxidant;
(4) The creatinine concentration will
be between 0 and 20 mg/dL; or
(5) The specific gravity will be less
than or equal to 1.0050 or between
1.0170 and 1.0230.
(c) For each PT cycle, the set of PT
samples going to each HHS-certified
laboratory or IITF will vary but, within
each calendar year, each HHS-certified
laboratory or IITF will analyze
essentially the same total set of samples.
(d) The laboratory or IITF must (to the
greatest extent possible) handle, test,
and report a PT sample in a manner
identical to that used for a donor
specimen, unless otherwise specified.
Section 9.6 What are the PT
requirements for an applicant
laboratory?
(a) An applicant laboratory that seeks
certification under these Guidelines
must satisfy the following criteria on
three consecutive sets of PT samples:
(1) Have no false positive results;
(2) Correctly identify, confirm, and
report at least 90 percent of the total
drug challenges over the three sets of PT
samples;
(3) Correctly identify at least 80
percent of the drug challenges for each
initial drug test over the three sets of PT
samples;
(4) For the confirmatory drug tests,
correctly determine the concentrations
[i.e., no more than ±20 percent or ±2
standard deviations (whichever is
larger) from the appropriate reference or
peer group means] for at least 80 percent
of the total drug challenges over the
three sets of PT samples;
(5) For the confirmatory drug tests,
must not obtain any drug concentration
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that differs by more than ±50 percent
from the appropriate reference or peer
group mean;
(6) For each confirmatory drug test,
correctly identify and determine the
concentrations [i.e., no more than ±20
percent or ±2 standard deviations
(whichever is larger) from the
appropriate reference or peer group
means] for at least 50 percent of the
drug challenges for an individual drug
over the three sets of PT samples;
(7) Correctly identify at least 80
percent of the total specimen validity
testing challenges over the three sets of
PT samples;
(8) Correctly identify at least 80
percent of the challenges for each
individual specimen validity test over
the three sets of PT samples;
(9) For quantitative specimen validity
tests, obtain quantitative values for at
least 80 percent of the total challenges
over the three sets of PT samples that
satisfy the following criteria:
(i) Nitrite and creatinine
concentrations are no more than ±20
percent or ±2 standard deviations from
the appropriate reference or peer group
mean; and
(ii) pH values are no more than ±0.3
pH units from the appropriate reference
or peer group mean using a pH meter;
and
(iii) Specific gravity values are no
more than ±0.0003 specific gravity units
from the appropriate reference or peer
group mean when the mean is less than
1.0100 and specific gravity values are no
more than ±0.0004 specific gravity units
from the appropriate reference or peer
group mean when the mean is equal to
or greater than 1.0100;
(10) Must not obtain any quantitative
value on a specimen validity test PT
sample that differs from the appropriate
reference or peer group mean by more
than ±50 percent for nitrite and
creatinine concentrations, ±0.8 pH units
using a pH meter, ±0.0006 specific
gravity units when the mean is less than
1.0100, or ±0.0007 specific gravity units
when the mean is equal to or greater
than 1.0100; and
(11) Must not report any sample as
adulterated with a compound that is not
present in the sample, adulterated based
on pH when the appropriate reference
or peer group mean is within the
acceptable pH range, or substituted
when the appropriate reference or peer
group means for both creatinine and
specific gravity are within the
acceptable range.
(b) Failure to satisfy these
requirements will result in
disqualification.
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Section 9.7 What are the PT
requirements for an HHS-certified urine
laboratory?
(a) A laboratory certified under these
Guidelines must satisfy the following
criteria on the maintenance PT samples:
(1) Have no false positive results;
(2) Correctly identify, confirm, and
report at least 90 percent of the total
drug challenges over two consecutive
PT cycles;
(3) Correctly identify at least 80
percent of the drug challenges for each
initial drug test over two consecutive PT
cycles;
(4) For the confirmatory drug tests,
correctly determine that the
concentrations for at least 80 percent of
the total drug challenges are no more
than ±20 percent or ±2 standard
deviations (whichever is larger) from the
appropriate reference or peer group
means over two consecutive PT cycles;
(5) For the confirmatory drug tests,
obtain no more than one drug
concentration on a PT sample that
differs by more than ±50 percent from
the appropriate reference or peer group
mean over two consecutive PT cycles;
(6) For each confirmatory drug test,
correctly identify and determine that the
concentrations for at least 50 percent of
the drug challenges for an individual
drug are no more than ±20 percent or ±2
standard deviations (whichever is
larger) from the appropriate reference or
peer group means over two consecutive
PT cycles;
(7) Correctly identify at least 80
percent of the total specimen validity
testing challenges over two consecutive
PT cycles;
(8) Correctly identify at least 80
percent of the challenges for each
individual specimen validity test over
two consecutive PT cycles;
(9) For quantitative specimen validity
tests, obtain quantitative values for at
least 80 percent of the total challenges
over two consecutive PT cycles that
satisfy the following criteria:
(i) Nitrite and creatinine
concentrations are no more than ±20
percent or ±2 standard deviations from
the appropriate reference or peer group
mean;
(ii) pH values are no more than ±0.3
pH units from the appropriate reference
or peer group mean using a pH meter;
and
(iii) Specific gravity values are no
more than ±0.0003 specific gravity units
from the appropriate reference or peer
group mean when the mean is less than
1.0100 and specific gravity values are no
more than ±0.0004 specific gravity units
from the appropriate reference or peer
group mean when the mean is equal to
or greater than 1.0100;
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(10) Obtain no more than one
quantitative value over 2 consecutive PT
cycles on a specimen validity test PT
sample that differs from the appropriate
reference or peer group mean by more
than ±50 percent for nitrite and
creatinine concentrations, ±0.8 pH units
using a pH meter, ±0.0006 specific
gravity units when the mean is less than
1.0100, or ±0.0007 specific gravity units
when the mean is equal to or greater
than 1.0100; and
(11) Do not report any PT sample as
adulterated with a compound that is not
present in the sample, adulterated based
on pH when the appropriate reference
or peer group mean is within the
acceptable pH range, or substituted
when the appropriate reference or peer
group means for both creatinine and
specific gravity are within the
acceptable range.
(b) Failure to participate in all PT
cycles or to satisfy these requirements
may result in suspension or revocation
of an HHS-certified laboratory’s
certification.
Section 9.8 What are the PT
requirements for an applicant IITF?
(a) An applicant IITF that seeks
certification under these Guidelines
must satisfy the following criteria on
three consecutive sets of PT samples:
(1) Correctly identify at least 90
percent of the total drug challenges over
the three sets of PT samples;
(2) Correctly identify at least 80
percent of the drug challenges for each
individual drug test over the three sets
of PT samples;
(3) Correctly identify at least 80
percent of the total specimen validity
test challenges over the three sets of PT
samples;
(4) Correctly identify at least 80
percent of the challenges for each
individual specimen validity test over
the three sets of PT samples;
(5) For quantitative specimen validity
tests, obtain quantitative values for at
least 80 percent of the total specimen
validity test challenges over the three
sets of PT samples that satisfy the
following criteria:
(i) Creatinine concentrations are no
more than ±20 percent or ±2 standard
deviations (whichever is larger) from the
appropriate reference or peer group
mean; and
(ii) Specific gravity values are no
more than ±0.001 specific gravity units
from the appropriate reference or peer
group mean; and
(6) Must not obtain any quantitative
value on a specimen validity test PT
sample that differs from the appropriate
reference or peer group mean by more
than ±50 percent for creatinine
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concentration, or ±0.002 specific gravity
units for specific gravity.
(b) Failure to satisfy these
requirements will result in
disqualification.
Section 9.9 What are the PT
requirements for an HHS-certified IITF?
(a) An IITF certified under these
Guidelines must satisfy the following
criteria on the maintenance PT samples
to maintain its certification:
(1) Correctly identify at least 90
percent of the total drug challenges over
two consecutive PT cycles;
(2) Correctly identify at least 80
percent of the drug challenges for each
individual drug test over two
consecutive PT cycles;
(3) Correctly identify at least 80
percent of the total specimen validity
test challenges over two consecutive PT
cycles;
(4) Correctly identify at least 80
percent of the challenges for each
individual specimen validity test over
two consecutive PT cycles;
(5) For quantitative specimen validity
tests, obtain quantitative values for at
least 80 percent of the total specimen
validity test challenges over two
consecutive PT cycles that satisfy the
following criteria:
(i) Creatinine concentrations are no
more than ±20 percent or ±2 standard
deviations (whichever is larger) from the
appropriate reference or peer group
mean; and
(ii) Specific gravity values are no
more than ±0.001 specific gravity units
from the appropriate reference or peer
group mean; and
(6) Obtain no more than one
quantitative value over 2 consecutive PT
cycles on a specimen validity test PT
sample that differs from the appropriate
reference or peer group mean by more
than ±50 percent for creatinine
concentration, or ±0.002 specific gravity
units for specific gravity.
(b) Failure to participate in all PT
cycles or to satisfy these requirements
may result in suspension or revocation
of an HHS-certified IITF’s certification.
Section 9.10 What are the inspection
requirements for an applicant
laboratory or IITF?
(a) An applicant laboratory or IITF is
inspected by a team of two inspectors.
(b) Each inspector conducts an
independent review and evaluation of
all aspects of the laboratory’s or IITF’s
testing procedures and facilities using
an inspection checklist.
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Section 9.11 What are the
maintenance inspection requirements
for an HHS-certified laboratory or IITF?
(a) An HHS-certified laboratory or
IITF must undergo an inspection 3
months after becoming certified and at
least every 6 months thereafter.
(b) An HHS-certified laboratory or
IITF is inspected by one or more
inspectors. The number of inspectors is
determined according to the number of
specimens reviewed. Additional
information regarding inspections is
available from SAMHSA.
(c) Each inspector conducts an
independent evaluation and review of
the HHS-certified laboratory’s or IITF’s
procedures, records, and facilities using
guidance provided by the Secretary.
(d) To remain certified, an HHScertified laboratory or IITF must
continue to satisfy the minimum
requirements as stated in these
Guidelines.
Section 9.12 Who can inspect an HHScertified laboratory or IITF and when
may the inspection be conducted?
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(a) An individual may be selected as
an inspector for the Secretary if they
satisfy the following criteria:
(1) Has experience and an educational
background similar to that required for
either a responsible person or a
certifying scientist for an HHS-certified
laboratory as described in Subpart K or
as a responsible technician for an HHScertified IITF as described in Subpart L;
(2) Has read and thoroughly
understands the policies and
requirements contained in these
Guidelines and in other guidance
consistent with these Guidelines
provided by the Secretary;
(3) Submits a resume and
documentation of qualifications to HHS;
(4) Attends approved training; and
(5) Performs acceptably as an
inspector on an inspection of an HHScertified laboratory or IITF.
(b) The Secretary or a federal agency
may conduct an inspection at any time.
Section 9.13 What happens if an
applicant laboratory or IITF does not
satisfy the minimum requirements for
either the PT program or the inspection
program?
If an applicant laboratory or IITF fails
to satisfy the requirements established
for the initial certification process, the
laboratory or IITF must start the
certification process from the beginning.
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Section 9.14 What happens if an HHScertified laboratory or IITF does not
satisfy the minimum requirements for
either the PT program or the inspection
program?
(a) If an HHS-certified laboratory or
IITF fails to satisfy the minimum
requirements for certification, the
laboratory or IITF is given a period of
time (e.g., 5 or 30 working days
depending on the nature of the
deficiency) to provide any explanation
for its performance and evidence that all
deficiencies have been corrected.
(b) A laboratory’s or IITF’s HHS
certification may be revoked,
suspended, or no further action taken
depending on the seriousness of the
deficiencies and whether there is
evidence that the deficiencies have been
corrected and that current performance
meets the requirements for certification.
(c) An HHS-certified laboratory or
IITF may be required to undergo a
special inspection or to test additional
PT samples to address deficiencies.
(d) If an HHS-certified laboratory’s or
IITF’s certification is revoked or
suspended in accordance with the
process described in Subpart P, the
laboratory or IITF is not permitted to
test federally regulated specimens until
the suspension is lifted or the laboratory
or IITF has successfully completed the
certification requirements as a new
applicant laboratory or IITF.
Section 9.15 What factors are
considered in determining whether
revocation of a laboratory’s or IITF’s
HHS certification is necessary?
(a) The Secretary shall revoke
certification of an HHS-certified
laboratory or IITF in accordance with
these Guidelines if the Secretary
determines that revocation is necessary
to ensure fully reliable and accurate
drug and specimen validity test results
and reports.
(b) The Secretary shall consider the
following factors in determining
whether revocation is necessary:
(1) Unsatisfactory performance in
analyzing and reporting the results of
drug and specimen validity tests (e.g.,
an HHS-certified laboratory reporting a
false positive result for an employee’s
drug test);
(2) Unsatisfactory participation in
performance testing or inspections;
(3) A material violation of a
certification standard, contract term, or
other condition imposed on the HHScertified laboratory or IITF by a federal
agency using the laboratory’s or IITF’s
services;
(4) Conviction for any criminal
offense committed as an incident to
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operation of the HHS-certified
laboratory or IITF; or
(5) Any other cause that materially
affects the ability of the HHS-certified
laboratory or IITF to ensure fully
reliable and accurate drug test results
and reports.
(c) The period and terms of revocation
shall be determined by the Secretary
and shall depend upon the facts and
circumstances of the revocation and the
need to ensure accurate and reliable
drug testing.
Section 9.16 What factors are
considered in determining whether to
suspend a laboratory’s or IITF’s HHS
certification?
(a) The Secretary may immediately
suspend (either partially or fully) a
laboratory’s or IITF’s HHS certification
to conduct drug testing for federal
agencies if the Secretary has reason to
believe that revocation may be required
and that immediate action is necessary
to protect the interests of the United
States and its employees.
(b) The Secretary shall determine the
period and terms of suspension based
upon the facts and circumstances of the
suspension and the need to ensure
accurate and reliable drug testing.
Section 9.17 How does the Secretary
notify an HHS-certified laboratory or
IITF that action is being taken against
the laboratory or IITF?
(a) When laboratory’s or IITF’s HHS
certification is suspended or the
Secretary seeks to revoke HHS
certification, the Secretary shall
immediately serve the HHS-certified
laboratory or IITF with written notice of
the suspension or proposed revocation
by facsimile, mail, personal service, or
registered or certified mail, return
receipt requested. This notice shall state
the following:
(1) The reasons for the suspension or
proposed revocation;
(2) The terms of the suspension or
proposed revocation; and
(3) The period of suspension or
proposed revocation.
(b) The written notice shall state that
the laboratory or IITF will be afforded
an opportunity for an informal review of
the suspension or proposed revocation
if it so requests in writing within 30
days of the date the laboratory or IITF
received the notice, or if expedited
review is requested, within 3 days of the
date the laboratory or IITF received the
notice. Subpart P contains detailed
procedures to be followed for an
informal review of the suspension or
proposed revocation.
(c) A suspension must be effective
immediately. A proposed revocation
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must be effective 30 days after written
notice is given or, if review is requested,
upon the reviewing official’s decision to
uphold the proposed revocation. If the
reviewing official decides not to uphold
the suspension or proposed revocation,
the suspension must terminate
immediately and any proposed
revocation shall not take effect.
(d) The Secretary will publish in the
Federal Register the name, address, and
telephone number of any HHS-certified
laboratory or IITF that has its
certification revoked or suspended
under Section 9.13 or Section 9.14,
respectively, and the name of any HHScertified laboratory or IITF that has its
suspension lifted. The Secretary shall
provide to any member of the public
upon request the written notice
provided to a laboratory or IITF that has
its HHS certification suspended or
revoked, as well as the reviewing
official’s written decision which
upholds or denies the suspension or
proposed revocation under the
procedures of Subpart P.
Section 9.18 May a laboratory or IITF
that had its HHS certification revoked
be recertified to test federal agency
specimens?
Following revocation, a laboratory or
IITF may apply for recertification.
Unless otherwise provided by the
Secretary in the notice of revocation
under Section 9.17 or the reviewing
official’s decision under Section 16.9(e)
or 16.14(a), a laboratory or IITF which
has had its certification revoked may
reapply for HHS certification as an
applicant laboratory or IITF.
Section 9.19 Where is the list of HHScertified laboratories and IITFs
published?
(a) The list of HHS-certified
laboratories and IITFs is published
monthly in the Federal Register. This
notice is also available on the Internet
at http://www.samhsa.gov/workplace.
(b) An applicant laboratory or IITF is
not included on the list.
Subpart J—Blind Samples Submitted by
an Agency
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Section 10.1 What are the requirements
for federal agencies to submit blind
samples to HHS-certified laboratories or
IITFs?
(a) Each federal agency is required to
submit blind samples for its workplace
drug testing program. The collector
must send the blind samples to the
HHS-certified laboratory or IITF that the
collector sends employee specimens.
(b) Each federal agency must submit
at least 3 percent blind samples along
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with its donor specimens based on the
projected total number of donor
specimens collected per year (up to a
maximum of 400 blind samples). Every
effort should be made to ensure that
blind samples are submitted quarterly.
(c) Approximately 75 percent of the
blind samples submitted each year by
an agency must be negative, 15 percent
must be positive for one or more drugs,
and 10 percent must either be
adulterated or substituted.
Section 10.2 What are the
requirements for blind samples?
(a) Drug positive blind samples must
be validated by the supplier as to their
content using appropriate initial and
confirmatory tests.
(1) Drug positive blind samples must
be fortified with one or more of the
drugs or metabolites listed in Section
3.4.
(2) Drug positive blind samples must
contain concentrations of drugs between
1.5 and 2 times the initial drug test
cutoff concentration.
(b) Drug negative blind samples (i.e.,
certified to contain no drugs) must be
validated by the supplier as negative
using appropriate initial and
confirmatory tests.
(c) A blind sample that is adulterated
must be validated using appropriate
initial and confirmatory specimen
validity tests, and have the
characteristics to clearly show that it is
an adulterated sample at the time of
validation.
(d) A blind sample that is substituted
must be validated using appropriate
initial and confirmatory specimen
validity tests, and have the
characteristics to clearly show that it is
a substituted sample at the time of
validation.
(e) The supplier must provide
information on the blind samples’
content, validation, expected results,
and stability to the collection site/
collector sending the blind samples to
the laboratory or IITF, and must provide
the information upon request to the
MRO, the federal agency for which the
blind sample was submitted, or the
Secretary.
Section 10.3 How is a blind sample
submitted to an HHS-certified
laboratory or IITF?
(a) A blind sample must be submitted
as a split specimen (specimens A and B)
with the current Federal CCF that the
HHS-certified laboratory or IITF uses for
donor specimens. The collector
provides the required information to
ensure that the Federal CCF has been
properly completed and provides
fictitious initials on the specimen label/
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seal. The collector must indicate that
the specimen is a blind sample on the
MRO copy where a donor would
normally provide a signature.
(b) A collector should attempt to
distribute the required number of blind
samples randomly with donor
specimens rather than submitting the
full complement of blind samples as a
single group.
Section 10.4 What happens if an
inconsistent result is reported for a
blind sample?
If an HHS-certified laboratory or IITF
reports a result for a blind sample that
is inconsistent with the expected result
(e.g., a laboratory or IITF reports a
negative result for a blind sample that
was supposed to be positive, a
laboratory reports a positive result for a
blind sample that was supposed to be
negative):
(a) The MRO must contact the
laboratory or IITF and attempt to
determine if the laboratory or IITF made
an error during the testing or reporting
of the sample;
(b) The MRO must contact the blind
sample supplier and attempt to
determine if the supplier made an error
during the preparation or transfer of the
sample;
(c) The MRO must contact the
collector and determine if the collector
made an error when preparing the blind
sample for transfer to the HHS-certified
laboratory or IITF;
(d) If there is no obvious reason for
the inconsistent result, the MRO must
notify both the federal agency for which
the blind sample was submitted and the
Secretary; and
(e) The Secretary shall investigate the
blind sample error. A report of the
Secretary’s investigative findings and
the corrective action taken in response
to identified deficiencies must be sent to
the federal agency. The Secretary shall
ensure notification of the finding as
appropriate to other federal agencies
and coordinate any necessary actions to
prevent the recurrence of the error.
Subpart K—Laboratory
Section 11.1 What must be included in
the HHS-certified laboratory’s standard
operating procedure manual?
(a) An HHS-certified laboratory must
have a standard operating procedure
(SOP) manual that describes, in detail,
all HHS-certified laboratory operations.
When followed, the SOP manual
ensures that all specimens are tested
using the same procedures.
(b) The SOP manual must include at
a minimum, but is not limited to, a
detailed description of the following:
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(1) Chain of custody procedures;
(2) Accessioning;
(3) Security;
(4) Quality control/quality assurance
programs;
(5) Analytical methods and
procedures;
(6) Equipment and maintenance
programs;
(7) Personnel training;
(8) Reporting procedures; and
(9) Computers, software, and
laboratory information management
systems.
(c) All procedures in the SOP manual
must be compliant with these
Guidelines and all guidance provided
by the Secretary.
(d) A copy of all procedures that have
been replaced or revised and the dates
on which the procedures were in effect
must be maintained for at least 2 years.
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Section 11.2 What are the
responsibilities of the responsible
person (RP)?
(a) Manage the day-to-day operations
of the HHS-certified laboratory even if
another individual has overall
responsibility for alternate areas of a
multi-specialty laboratory.
(b) Ensure that there are sufficient
personnel with adequate training and
experience to supervise and conduct the
work of the HHS-certified laboratory.
The RP must ensure the continued
competency of laboratory staff by
documenting their in-service training,
reviewing their work performance, and
verifying their skills.
(c) Maintain a complete and current
SOP manual that is available to all
personnel of the HHS-certified
laboratory and ensure that it is followed.
The SOP manual must be reviewed,
signed, and dated by the RP(s) when
procedures are first placed into use and
when changed or when a new
individual assumes responsibility for
the management of the HHS-certified
laboratory. The SOP must be reviewed
and documented by the RP annually.
(d) Maintain a quality assurance
program that ensures the proper
performance and reporting of all test
results; verify and monitor acceptable
analytical performance for all controls
and calibrators; monitor quality control
testing; and document the validity,
reliability, accuracy, precision, and
performance characteristics of each test
and test system.
(e) Initiate and implement all
remedial actions necessary to maintain
satisfactory operation and performance
of the HHS-certified laboratory in
response to the following: Quality
control systems not within performance
specifications; errors in result reporting
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Section 11.3 What scientific
qualifications must the RP have?
The RP must have documented
scientific qualifications in analytical
toxicology.
Minimum qualifications are:
(a) Certification or licensure as a
laboratory director by the state in
forensic or clinical laboratory
toxicology, a Ph.D. in one of the natural
sciences, or training and experience
comparable to a Ph.D. in one of the
natural sciences with training and
laboratory/research experience in
biology, chemistry, and pharmacology
or toxicology;
(b) Experience in forensic toxicology
with emphasis on the collection and
analysis of biological specimens for
drugs of abuse;
(c) Experience in forensic applications
of analytical toxicology (e.g.,
publications, court testimony,
conducting research on the
pharmacology and toxicology of drugs
of abuse) or qualify as an expert witness
in forensic toxicology;
(d) Fulfillment of the RP
responsibilities and qualifications, as
demonstrated by the HHS-certified
laboratory’s performance and verified
upon interview by HHS-trained
inspectors during each on-site
inspection; and
(e) Qualify as a certifying scientist.
Secretary’s approval of a new
permanent RP or alternate RP.
(b) If the RP leaves an HHS-certified
laboratory:
(1) The HHS-certified laboratory may
maintain certification and continue
testing federally regulated specimens
under the direction of an alternate RP
for a period of up to 180 days while
seeking to hire and receive the
Secretary’s approval of the RP’s
replacement.
(2) The Secretary, in accordance with
these Guidelines, will suspend a
laboratory’s HHS certification for all
federally regulated specimens if the
laboratory does not have a permanent
RP within 180 days. The suspension
will be lifted upon the Secretary’s
approval of the new permanent RP.
(c) To nominate an individual as an
RP or alternate RP, the HHS-certified
laboratory must submit the following
documents to the Secretary: The
candidate’s current resume or
curriculum vitae, copies of diplomas
and licensures, a training plan (not to
exceed 90 days) to transition the
candidate into the position, an itemized
comparison of the candidate’s
qualifications to the minimum RP
qualifications described in the
Guidelines, and have official academic
transcript(s) submitted from the
candidate’s institution(s) of higher
learning. The candidate must be found
qualified during an on-site inspection of
the HHS-certified laboratory.
(d) The HHS-certified laboratory must
fulfill additional inspection and PT
criteria as required prior to conducting
federally regulated testing under a new
RP.
Section 11.4 What happens when the
RP is absent or leaves an HHS-certified
laboratory?
(a) HHS-certified laboratories must
have multiple RPs or one RP and an
alternate RP. If the RP(s) are
concurrently absent, an alternate RP
must be present and qualified to fulfill
the responsibilities of the RP.
(1) If an HHS-certified laboratory is
without the RP and alternate RP for 14
calendar days or less (e.g., temporary
absence due to vacation, illness, or
business trip), the HHS-certified
laboratory may continue operations and
testing of federal agency specimens
under the direction of a certifying
scientist.
(2) The Secretary, in accordance with
these Guidelines, will suspend a
laboratory’s HHS certification for all
specimens if the laboratory does not
have an RP or alternate RP for a period
of more than 14 calendar days. The
suspension will be lifted upon the
Section 11.5 What qualifications must
an individual have to certify a result
reported by an HHS-certified
laboratory?
(a) A certifying scientist must have:
(1) At least a bachelor’s degree in the
chemical or biological sciences or
medical technology, or equivalent;
(2) Training and experience in the
analytical methods and forensic
procedures used by the HHS-certified
laboratory relevant to the results that the
individual certifies; and
(3) Training and experience in
reviewing and reporting forensic test
results and maintaining chain of
custody, and an understanding of
appropriate remedial actions in
response to problems that may arise.
(b) A certifying technician must have:
(1) Training and experience in the
analytical methods and forensic
procedures used by the HHS-certified
laboratory relevant to the results that the
individual certifies; and
or in analysis of performance testing
samples; and inspection deficiencies.
The RP must ensure that specimen
results are not reported until all
corrective actions have been taken and
that the results provided are accurate
and reliable.
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(2) Training and experience in
reviewing and reporting forensic test
results and maintaining chain of
custody, and an understanding of
appropriate remedial actions in
response to problems that may arise.
Section 11.6 What qualifications and
training must other personnel of an
HHS-certified laboratory have?
(a) All HHS-certified laboratory staff
(e.g., technicians, administrative staff)
must have the appropriate training and
skills for the tasks they perform.
(b) Each individual working in an
HHS-certified laboratory must be
properly trained (i.e., receive training in
each area of work that the individual
will be performing, including training in
forensic procedures related to their job
duties) before they are permitted to
work independently with federally
regulated specimens. All training must
be documented.
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Section 11.7 What security measures
must an HHS-certified laboratory
maintain?
(a) An HHS-certified laboratory must
control access to the drug testing
facility, specimens, aliquots, and
records.
(b) Authorized visitors must be
escorted at all times, except for
individuals conducting inspections (i.e.,
for the Department, a federal agency, a
state, or other accrediting agency) or
emergency personnel (e.g., firefighters
and medical rescue teams).
(c) An HHS-certified laboratory must
maintain records documenting the
identity of the visitor and escort, date,
time of entry and exit, and purpose for
access to the secured area.
Section 11.8 What are the laboratory
chain of custody requirements for
specimens and aliquots?
(a) HHS-certified laboratories must
use chain of custody procedures
(internal and external) to maintain
control and accountability of specimens
from the time of receipt at the laboratory
through completion of testing, reporting
of results, during storage, and
continuing until final disposition of the
specimens.
(b) HHS-certified laboratories must
use chain of custody procedures to
document the handling and transfer of
aliquots throughout the testing process
until final disposal.
(c) The chain of custody must be
documented using either paper copy or
electronic procedures.
(d) Each individual who handles a
specimen or aliquot must sign and
complete the appropriate entries on the
chain of custody form when the
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specimen or aliquot is handled or
transferred, and every individual in the
chain must be identified.
(e) The date and purpose must be
recorded on an appropriate chain of
custody form each time a specimen or
aliquot is handled or transferred.
Section 11.9 What test(s) does an
HHS-certified laboratory conduct on a
urine specimen received from an IITF?
An HHS-certified laboratory must test
the specimen in the same manner as a
specimen that had not been previously
tested.
Section 11.10 What are the
requirements for an initial drug test?
(a) An initial drug test may be:
(1) An immunoassay or
(2) An alternate technology (e.g.,
spectrometry, spectroscopy).
(b) An HHS-certified laboratory must
validate an initial drug test before
testing specimens.
(c) Initial drug tests must be accurate
and reliable for the testing of specimens
when identifying drugs or their
metabolites.
(d) An HHS-certified laboratory may
conduct a second initial drug test using
a method with different specificity, to
rule out cross-reacting compounds. This
second initial drug test must satisfy the
batch quality control requirements
specified in Section 11.12.
Section 11.11 What must an HHScertified laboratory do to validate an
initial drug test?
(a) An HHS-certified laboratory must
demonstrate and document the
following for each initial drug test:
(1) The ability to differentiate negative
specimens from those requiring further
testing;
(2) The performance of the test around
the cutoff concentration, using samples
at several concentrations between 0 and
150 percent of the cutoff concentration;
(3) The effective concentration range
of the test (linearity);
(4) The potential for carryover;
(5) The potential for interfering
substances; and
(6) The potential matrix effects if
using an alternate technology.
(b) Each new lot of reagent must be
verified prior to being placed into
service.
(c) Each initial drug test using an
alternate technology must be re-verified
periodically or at least annually.
Section 11.12 What are the batch
quality control requirements when
conducting an initial drug test?
(a) Each batch of specimens must
contain the following controls:
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(1) At least one control certified to
contain no drug or drug metabolite;
(2) At least one positive control with
the drug or drug metabolite targeted at
a concentration 25 percent above the
cutoff;
(3) At least one control with the drug
or drug metabolite targeted at a
concentration 75 percent of the cutoff;
and
(4) At least one control that appears
as a donor specimen to the analysts.
(b) Calibrators and controls must total
at least 10 percent of the aliquots
analyzed in each batch.
Section 11.13 What are the
requirements for a confirmatory drug
test?
(a) The analytical method must use
mass spectrometric identification [e.g.,
gas chromatography/mass spectrometry
(GC/MS), liquid chromatography/mass
spectrometry (LC/MS), GC/MS/MS, LC/
MS/MS] or equivalent.
(b) A confirmatory drug test must be
validated before it can be used to test
federally regulated specimens.
(c) Confirmatory drug tests must be
accurate and reliable for the testing of a
urine specimen when identifying and
quantifying drugs or their metabolites.
Section 11.14 What must an HHScertified laboratory do to validate a
confirmatory drug test?
(a) An HHS-certified laboratory must
demonstrate and document the
following for each confirmatory drug
test:
(1) The linear range of the analysis;
(2) The limit of detection;
(3) The limit of quantification;
(4) The accuracy and precision at the
cutoff concentration;
(5) The accuracy (bias) and precision
at 40 percent of the cutoff concentration;
(6) The potential for interfering
substances;
(7) The potential for carryover; and
(8) The potential matrix effects if
using liquid chromatography coupled
with mass spectrometry.
(b) Each new lot of reagent must be
verified prior to being placed into
service.
(c) HHS-certified laboratories must reverify each confirmatory drug test
method periodically or at least annually.
Section 11.15 What are the batch
quality control requirements when
conducting a confirmatory drug test?
(a) At a minimum, each batch of
specimens must contain the following
calibrators and controls:
(1) A calibrator at the cutoff
concentration;
(2) At least one control certified to
contain no drug or drug metabolite;
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(3) At least one positive control with
the drug or drug metabolite targeted at
25 percent above the cutoff; and
(4) At least one control targeted at or
less than 40 percent of the cutoff.
(b) Calibrators and controls must total
at least 10 percent of the aliquots
analyzed in each batch.
Section 11.16 What are the analytical
and quality control requirements for
conducting specimen validity tests?
(a) Each invalid, adulterated, or
substituted specimen validity test result
must be based on an initial specimen
validity test on one aliquot and a
confirmatory specimen validity test on a
second aliquot;
(b) The HHS-certified laboratory must
establish acceptance criteria and
analyze calibrators and controls as
appropriate to verify and document the
validity of the test results (required
specimen validity tests are addressed in
Section 11.18); and
(c) Controls must be analyzed
concurrently with specimens.
Section 11.17 What must an HHScertified laboratory do to validate a
specimen validity test?
An HHS-certified laboratory must
demonstrate and document for each
specimen validity test the appropriate
performance characteristics of the test,
and must re-verify the test periodically,
or at least annually. Each new lot of
reagent must be verified prior to being
placed into service.
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Section 11.18 What are the
requirements for conducting each
specimen validity test?
(a) The requirements for measuring
creatinine concentration are as follows:
(1) The creatinine concentration must
be measured to one decimal place on
both the initial creatinine test and the
confirmatory creatinine test;
(2) The initial creatinine test must
have the following calibrators and
controls:
(i) A calibrator at 2 mg/dL;
(ii) A control in the range of 1.0 mg/
dL to 1.5 mg/dL;
(iii) A control in the range of 3 mg/
dL to 20 mg/dL; and
(iv) A control in the range of 21 mg/
dL to 25 mg/dL.
(3) The confirmatory creatinine test
(performed on those specimens with a
creatinine concentration less than 2 mg/
dL on the initial test) must have the
following calibrators and controls:
(i) A calibrator at 2 mg/dL;
(ii) A control in the range of 1.0 mg/
dL to 1.5 mg/dL; and
(iii) A control in the range of 3 mg/
dL to 4 mg/dL.
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(b) The requirements for measuring
specific gravity are as follows:
(1) For specimens with initial
creatinine test results greater than 5 mg/
dL and less than 20 mg/dL, laboratories
may perform a screening test using a
refractometer that measures urine
specific gravity to at least three decimal
places to identify specific gravity values
that are acceptable (equal to or greater
than 1.003) or dilute (equal to or greater
than 1.002 and less than 1.003).
Specimens must be subjected to an
initial specific gravity test using a four
decimal place refractometer when the
initial creatinine test result is less than
or equal to 5 mg/dL or when the
screening specific gravity test result
using a three decimal place
refractometer is less than 1.002.
(2) The screening specific gravity test
must have the following calibrators and
controls:
(i) A calibrator or control at 1.000;
(ii) One control targeted at 1.002;
(iii) One control in the range of 1.004
to 1.018.
(3) For the initial and confirmatory
specific gravity tests, the refractometer
must report and display specific gravity
to four decimal places. The
refractometer must be interfaced with a
laboratory information management
system (LIMS), computer, and/or
generate a paper copy of the digital
electronic display to document the
numerical values of the specific gravity
test results;
(4) The initial and confirmatory
specific gravity tests must have the
following calibrators and controls:
(i) A calibrator or control at 1.0000;
(ii) One control targeted at 1.0020;
(iii) One control in the range of 1.0040
to 1.0180; and
(iv) One control equal to or greater
than 1.0200 but not greater than 1.0250.
(c) Requirements for measuring pH
are as follows:
(1) Colorimetric pH tests that have the
dynamic range of 3 to 12 to support the
4 and 11 pH cutoffs and pH meters must
be capable of measuring pH to one
decimal place. Colorimetric pH tests,
dipsticks, and pH paper (i.e., screening
tests) that have a narrow dynamic range
and do not support the cutoffs may be
used only to determine if an initial pH
specimen validity test must be
performed;
(2) For the initial and confirmatory
pH tests, the pH meter must report and
display pH to at least one decimal place.
The pH meter must be interfaced with
a LIMS, computer, and/or generate a
paper copy of the digital electronic
display to document the numerical
values of the pH test results;
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(3) pH screening tests must have, at a
minimum, the following controls:
(i) One control below the lower
decision point in use;
(ii) One control between the decision
points in use; and
(iii) One control above the upper
decision point in use;
(4) An initial colorimetric pH test
must have the following calibrators and
controls:
(i) One calibrator at 4;
(ii) One calibrator at 11;
(iii) One control in the range of 3 to
3.8;
(iv) One control in the range 4.2 to 5;
(v) One control in the range of 5 to 9;
(vi) One control in the range of 10 to
10.8; and
(vii) One control in the range of 11.2
to 12;
(5) An initial pH meter test, if a pH
screening test is not used, must have the
following calibrators and controls:
(i) One calibrator at 3;
(ii) One calibrator at 7;
(iii) One calibrator at 10;
(iv) One control in the range of 3 to
3.8;
(v) One control in the range 4.2 to 5;
(vi) One control in the range of 10 to
10.8; and
(vii) One control in the range of 11.2
to 12;
(6) An initial pH meter test (if a pH
screening test is used) or confirmatory
pH meter test must have the following
calibrators and controls when the result
of the preceding pH test indicates that
the pH is below the lower decision
point in use:
(i) One calibrator at 4;
(ii) One calibrator at 7;
(iii) One control in the range of 3 to
3.8; and
(iv) One control in the range 4.2 to 5;
and
(7) An initial pH meter test (if a pH
screening test is used) or confirmatory
pH meter test must have the following
calibrators and controls when the result
of the preceding pH test indicates that
the pH is above the upper decision
point in use:
(i) One calibrator at 7;
(ii) One calibrator at 10;
(iii) One control in the range of 10 to
10.8; and
(iv) One control in the range of 11.2
to 12.
(d) Requirements for performing
oxidizing adulterant tests are as follows:
(1) The initial test must include an
appropriate calibrator at the cutoff
specified in Sections 11.19(d)(2), (3), or
(4) for the compound of interest, a
control without the compound of
interest (i.e., a certified negative
control), and at least one control with
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one of the compounds of interest at a
measurable concentration; and
(2) A confirmatory test for a specific
oxidizing adulterant must use a
different analytical method than that
used for the initial test. Each
confirmatory test batch must include an
appropriate calibrator, a control without
the compound of interest (i.e., a
certified negative control), and a control
with the compound of interest at a
measurable concentration.
(e) The requirements for measuring
the nitrite concentration are that the
initial and confirmatory nitrite tests
must have a calibrator at the cutoff
concentration, a control without nitrite
(i.e., certified negative urine), one
control in the range of 200 mcg/mL to
250 mcg/mL, and one control in the
range of 500 mcg/mL to 625 mcg/mL.
Section 11.19 What are the
requirements for an HHS-certified
laboratory to report a test result?
(a) Laboratories must report a test
result to the agency’s MRO within an
average of 5 working days after receipt
of the specimen. Reports must use the
Federal CCF and/or an electronic report.
Before any test result can be reported, it
must be certified by a certifying scientist
or a certifying technician (as
appropriate).
(b) A primary (A) specimen is
reported negative when each initial drug
test is negative or if the specimen is
negative upon confirmatory drug
testing, and the specimen does not meet
invalid criteria as described in items
(h)(1) through (h)(12) below.
(c) A primary (A) specimen is
reported positive for a specific drug or
drug metabolite when both the initial
drug test is positive and the
confirmatory drug test is positive in
accordance with Section 3.4.
(d) A primary (A) urine specimen is
reported adulterated when:
(1) The pH is less than 4 or equal to
or greater than 11 using either a pH
meter or a colorimetric pH test for the
initial test on the first aliquot and a pH
meter for the confirmatory test on the
second aliquot;
(2) The nitrite concentration is equal
to or greater than 500 mcg/mL using
either a nitrite colorimetric test or a
general oxidant colorimetric test for the
initial test on the first aliquot and a
different confirmatory test (e.g., multiwavelength spectrophotometry, ion
chromatography, capillary
electrophoresis) on the second aliquot;
(3) The presence of chromium (VI) is
verified using either a general oxidant
colorimetric test (with an equal to or
greater than 50 mcg/mL chromium (VI)equivalent cutoff) or a chromium (VI)
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colorimetric test (chromium (VI)
concentration equal to or greater than 50
mcg/mL) for the initial test on the first
aliquot and a different confirmatory test
(e.g., multi-wavelength
spectrophotometry, ion
chromatography, atomic absorption
spectrophotometry, capillary
electrophoresis, inductively coupled
plasma-mass spectrometry) with the
chromium (VI) concentration equal to or
greater than the LOQ of the
confirmatory test on the second aliquot;
(4) The presence of halogen (e.g.,
bleach, iodine, fluoride) is verified
using either a general oxidant
colorimetric test (with an equal to or
greater than 200 mcg/mL nitriteequivalent cutoff or an equal to or
greater than 50 mcg/mL chromium (VI)equivalent cutoff) or halogen
colorimetric test (halogen concentration
equal to or greater than the LOQ) for the
initial test on the first aliquot and a
different confirmatory test (e.g., multiwavelength spectrophotometry, ion
chromatography, inductively coupled
plasma-mass spectrometry) with a
specific halogen concentration equal to
or greater than the LOQ of the
confirmatory test on the second aliquot;
(5) The presence of glutaraldehyde is
verified using either an aldehyde test
(aldehyde present) or the characteristic
immunoassay response on one or more
drug immunoassay tests for the initial
test on the first aliquot and a different
confirmatory method (e.g., GC/MS) for
the confirmatory test with the
glutaraldehyde concentration equal to or
greater than the LOQ of the analysis on
the second aliquot;
(6) The presence of pyridine
(pyridinium chlorochromate) is verified
using either a general oxidant
colorimetric test (with an equal to or
greater than 200 mcg/mL nitriteequivalent cutoff or an equal to or
greater than 50 mcg/mL chromium (VI)equivalent cutoff) or a chromium (VI)
colorimetric test (chromium (VI)
concentration equal to or greater than 50
mcg/mL) for the initial test on the first
aliquot and a different confirmatory
method (e.g., GC/MS) for the
confirmatory test with the pyridine
concentration equal to or greater than
the LOQ of the analysis on the second
aliquot;
(7) The presence of a surfactant is
verified by using a surfactant
colorimetric test with an equal to or
greater than 100 mcg/mL
dodecylbenzene sulfonate-equivalent
cutoff for the initial test on the first
aliquot and a different confirmatory test
(e.g., multi-wavelength
spectrophotometry) with an equal to or
greater than 100 mcg/mL
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dodecylbenzene sulfonate-equivalent
cutoff on the second aliquot; or
(8) The presence of any other
adulterant not specified in paragraphs
d(2) through d(7) of this section is
verified using an initial test on the first
aliquot and a different confirmatory test
on the second aliquot.
(e) A primary (A) urine specimen is
reported substituted when the
creatinine concentration is less than 2
mg/dL and the specific gravity is less
than or equal to 1.0010 or equal to or
greater than 1.0200 on both the initial
and confirmatory creatinine tests (i.e.,
the same colorimetric test may be used
to test both aliquots) and on both the
initial and confirmatory specific gravity
tests (i.e., a refractometer is used to test
both aliquots) on two separate aliquots.
(f) A primary (A) urine specimen is
reported dilute when the creatinine
concentration is equal to or greater than
2 mg/dL but less than 20 mg/dL and the
specific gravity is greater than 1.0010
but less than 1.0030 on a single aliquot.
(g) For a specimen that has an invalid
result for one of the reasons stated in
items (h)(4) through (h)(12) below, the
HHS-certified laboratory shall contact
the MRO and both will decide if testing
by another HHS-certified laboratory
would be useful in being able to report
a positive or adulterated result. If no
further testing is necessary, the HHScertified laboratory then reports the
invalid result to the MRO.
(h) A primary (A) urine specimen is
reported as an invalid result when:
(1) Inconsistent creatinine
concentration and specific gravity
results are obtained (i.e., the creatinine
concentration is less than 2 mg/dL on
both the initial and confirmatory
creatinine tests and the specific gravity
is greater than 1.0010 but less than
1.0200 on the initial and/or
confirmatory specific gravity test, the
specific gravity is less than or equal to
1.0010 on both the initial and
confirmatory specific gravity tests and
the creatinine concentration is equal to
or greater than 2 mg/dL on either or
both the initial or confirmatory
creatinine tests);
(2) The pH is equal to or greater than
4 and less than 4.5 or equal to or greater
than 9 and less than 11 using either a
colorimetric pH test or pH meter for the
initial test and a pH meter for the
confirmatory test on two separate
aliquots;
(3) The nitrite concentration is equal
to or greater than 200 mcg/mL using a
nitrite colorimetric test or equal to or
greater than the equivalent of 200 mcg/
mL nitrite using a general oxidant
colorimetric test for both the initial
(first) test and the second test or using
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either initial test and the nitrite
concentration is equal to or greater than
200 mcg/mL but less than 500 mcg/mL
for a different confirmatory test (e.g.,
multi-wavelength spectrophotometry,
ion chromatography, capillary
electrophoresis) on two separate
aliquots;
(4) The possible presence of
chromium (VI) is determined using the
same chromium (VI) colorimetric test
with a cutoff equal to or greater than 50
mcg/mL chromium (VI) for both the
initial (first) test and the second test on
two separate aliquots;
(5) The possible presence of a halogen
(e.g., bleach, iodine, fluoride) is
determined using the same halogen
colorimetric test with a cutoff equal to
or greater than the LOQ for both the
initial (first) test and the second test on
two separate aliquots or relying on the
odor of the specimen as the initial test;
(6) The possible presence of
glutaraldehyde is determined by using
the same aldehyde test (aldehyde
present) or characteristic immunoassay
response on one or more drug
immunoassay tests for both the initial
(first) test and the second test on two
separate aliquots;
(7) The possible presence of an
oxidizing adulterant is determined by
using the same general oxidant
colorimetric test (with an equal to or
greater than 200 mcg/mL nitriteequivalent cutoff, an equal to or greater
than 50 mcg/mL chromium (VI)equivalent cutoff, or a halogen
concentration is equal to or greater than
the LOQ) for both the initial (first) test
and the second test on two separate
aliquots;
(8) The possible presence of a
surfactant is determined by using the
same surfactant colorimetric test with
an equal to or greater than 100 mcg/mL
dodecylbenzene sulfonate-equivalent
cutoff for both the initial (first) test and
the second test on two separate aliquots
or a foam/shake test for the initial test;
(9) Interference occurs on the initial
drug tests on two separate aliquots (i.e.,
valid initial drug test results cannot be
obtained);
(10) Interference with the
confirmatory drug test occurs on at least
two separate aliquots of the specimen
and the HHS-certified laboratory is
unable to identify the interfering
substance;
(11) The physical appearance of the
specimen is such that testing the
specimen may damage the laboratory’s
instruments; or
(12) The physical appearances of the
A and B specimens are clearly different
(note: A is tested).
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(i) An HHS-certified laboratory shall
reject a primary (A) specimen for testing
when a fatal flaw occurs as described in
Section 15.1 or when a correctable flaw
as described in Section 15.2 is not
recovered. The HHS-certified laboratory
will indicate on the Federal CCF that
the specimen was rejected for testing
and provide the reason for reporting the
rejected for testing result.
(j) An HHS-certified laboratory must
report all positive, adulterated,
substituted, and invalid test results for
a urine specimen. For example, a
specimen can be positive for a specific
drug and adulterated.
(k) An HHS-certified laboratory must
report the confirmatory concentration of
each drug or drug metabolite reported
for a positive result.
(l) An HHS-certified laboratory must
report numerical values of the specimen
validity test results that support a
specimen that is reported adulterated,
substituted, or invalid (as appropriate).
(m) When the concentration of a drug
or drug metabolite exceeds the validated
linear range of the confirmatory test,
HHS-certified laboratories may report to
the MRO that the quantitative value
exceeds the linear range of the test or
that the quantitative value is greater
than ‘‘insert the actual value for the
upper limit of the linear range,’’ or
laboratories may report a quantitative
value above the upper limit of the linear
range that was obtained by diluting an
aliquot of the specimen to achieve a
result within the method’s linear range
and multiplying the result by the
appropriate dilution factor.
(n) HHS-certified laboratories may
transmit test results to the MRO by
various electronic means (e.g.,
teleprinter, facsimile, or computer).
Transmissions of the reports must
ensure confidentiality and the results
may not be reported verbally by
telephone. Laboratories and external
service providers must ensure the
confidentiality, integrity, and
availability of the data and limit access
to any data transmission, storage, and
retrieval system.
(o) HHS-certified laboratories must
facsimile, courier, mail, or electronically
transmit a legible image or copy of the
completed Federal CCF and/or forward
a computer-generated electronic report.
The computer-generated report must
contain sufficient information to ensure
that the test results can accurately
represent the content of the custody and
control form that the MRO received
from the collector.
(p) For positive, adulterated,
substituted, invalid, and rejected
specimens, laboratories must facsimile,
courier, mail, or electronically transmit
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a legible image or copy of the completed
Federal CCF.
Section 11.20 How long must an HHScertified laboratory retain specimens?
(a) An HHS-certified laboratory must
retain specimens that were reported as
positive, adulterated, substituted, or as
an invalid result for a minimum of 1
year.
(b) Retained specimens must be kept
in secured frozen storage (¥20 °C or
less) to ensure their availability for
retesting during an administrative or
judicial proceeding.
(c) Federal agencies may request that
the HHS-certified laboratory retain a
specimen for an additional specified
period of time and must make that
request within the 1-year period.
Section 11.21 How long must an HHScertified laboratory retain records?
(a) An HHS-certified laboratory must
retain all records generated to support
test results for at least 2 years. The
laboratory may convert hardcopy
records to electronic records for storage
and then discard the hardcopy records
after 6 months.
(b) A federal agency may request the
HHS-certified laboratory to maintain a
documentation package (as described in
Section 11.23) that supports the chain of
custody, testing, and reporting of a
donor’s specimen that is under legal
challenge by a donor. The federal
agency’s request to the laboratory must
be in writing and must specify the
period of time to maintain the
documentation package.
(c) An HHS-certified laboratory may
retain records other than those included
in the documentation package beyond
the normal 2-year period of time.
Section 11.22 What statistical
summary reports must an HHS-certified
laboratory provide for urine testing?
(a) HHS-certified laboratories must
provide to each federal agency for
which they perform testing a
semiannual statistical summary report
that must be submitted by mail,
facsimile, or email within 14 working
days after the end of the semiannual
period. The summary report must not
include any personal identifying
information. A copy of the semiannual
statistical summary report will also be
sent to the Secretary or designated HHS
representative. The semiannual
statistical report contains the following
information:
(1) Reporting period (inclusive dates);
(2) HHS-certified laboratory name and
address;
(3) Federal agency name;
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(4) Number of specimen results
reported;
(5) Number of specimens collected by
reason for test;
(6) Number of specimens reported
negative and the number reported
negative/dilute;
(7) Number of specimens rejected for
testing because of a fatal flaw;
(8) Number of specimens rejected for
testing because of an uncorrected flaw;
(9) Number of specimens tested
positive by each initial drug test;
(10) Number of specimens reported
positive;
(11) Number of specimens reported
positive for each drug and drug
metabolite;
(12) Number of specimens reported
adulterated;
(13) Number of specimens reported
substituted; and
(14) Number of specimens reported as
invalid result.
(b) An HHS-certified laboratory must
make copies of an agency’s test results
available when requested to do so by the
Secretary or by the federal agency for
which the laboratory is performing
drug-testing services.
(c) An HHS-certified laboratory must
ensure that a qualified individual is
available to testify in a proceeding
against a federal employee when the
proceeding is based on a test result
reported by the laboratory.
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Section 11.23 What HHS-certified
laboratory information is available to a
federal agency?
(a) Following a federal agency’s
receipt of a positive, adulterated, or
substituted drug test report, the federal
agency may submit a written request for
copies of the records relating to the drug
test results or a documentation package
or any relevant certification, review, or
revocation of certification records.
(b) Standard documentation packages
provided by an HHS-certified laboratory
must contain the following items:
(1) A cover sheet providing a brief
description of the procedures and tests
performed on the donor’s specimen;
(2) A table of contents that lists all
documents and materials in the package
by page number;
(3) A copy of the Federal CCF with
any attachments, internal chain of
custody records for the specimen,
memoranda (if any) generated by the
HHS-certified laboratory, and a copy of
the electronic report (if any) generated
by the HHS-certified laboratory;
(4) A brief description of the HHScertified laboratory’s initial drug and
specimen validity testing procedures,
instrumentation, and batch quality
control requirements;
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(5) Copies of the initial test data for
the donor’s specimen with all
calibrators and controls and copies of all
internal chain of custody documents
related to the initial tests;
(6) A brief description of the HHScertified laboratory’s confirmatory drug
(and specimen validity, if applicable)
testing procedures, instrumentation, and
batch quality control requirements;
(7) Copies of the confirmatory test
data for the donor’s specimen with all
calibrators and controls and copies of all
internal chain of custody documents
related to the confirmatory tests; and
(8) Copies of the re´sume´ or
curriculum vitae for the RP(s) and the
certifying technician or certifying
scientist of record.
Section 11.24 What HHS-certified
laboratory information is available to a
federal employee?
A federal employee who is the subject
of a workplace drug test may submit a
written request through the MRO and/
or the federal agency requesting copies
of any records relating to the employee’s
drug test results or a documentation
package as described in Section 11.23(b)
and any relevant certification, review, or
revocation of certification records.
Federal employees, or their designees,
are not permitted access to their
specimens collected pursuant to
Executive Order 12564, Public Law
100–71, and these Guidelines.
Section 11.25 What types of
relationships are prohibited between an
HHS-certified laboratory and an MRO?
An HHS-certified laboratory must not
enter into any relationship with a
federal agency’s MRO that may be
construed as a potential conflict of
interest or derive any financial benefit
by having a federal agency use a specific
MRO.
This means an MRO may be an
employee of the agency or a contractor
for the agency; however, an MRO shall
not be an employee or agent of or have
any financial interest in the HHScertified laboratory for which the MRO
is reviewing drug testing results.
Additionally, an MRO shall not derive
any financial benefit by having an
agency use a specific HHS-certified
laboratory or have any agreement with
an HHS-certified laboratory that may be
construed as a potential conflict of
interest.
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Section 11.26 What type of
relationship can exist between an HHScertified laboratory and an HHScertified IITF?
An HHS-certified laboratory can enter
into any relationship with an HHScertified IITF.
Subpart L—Instrumented Initial Test
Facility (IITF)
Section 12.1 What must be included in
the HHS-certified IITF’s standard
operating procedure manual?
(a) An HHS-certified IITF must have
a standard operating procedure (SOP)
manual that describes, in detail, all
HHS-certified IITF operations. When
followed, the SOP manual ensures that
all specimens are tested consistently
using the same procedures.
(b) The SOP manual must include at
a minimum, but is not limited to, a
detailed description of the following:
(1) Chain of custody procedures;
(2) Accessioning;
(3) Security;
(4) Quality control/quality assurance
programs;
(5) Analytical methods and
procedures;
(6) Equipment and maintenance
programs;
(7) Personnel training;
(8) Reporting procedures; and
(9) Computers, software, and
laboratory information management
systems.
(c) All procedures in the SOP manual
must be compliant with these
Guidelines and all guidance provided
by the Secretary.
(d) A copy of all procedures that have
been replaced or revised and the dates
on which the procedures were in effect
must be maintained for two years.
Section 12.2 What are the
responsibilities of the responsible
technician (RT)?
(a) Manage the day-to-day operations
of the HHS-certified IITF even if another
individual has overall responsibility for
alternate areas of a multi-specialty
facility.
(b) Ensure that there are sufficient
personnel with adequate training and
experience to supervise and conduct the
work of the HHS-certified IITF. The RT
must ensure the continued competency
of IITF personnel by documenting their
in-service training, reviewing their work
performance, and verifying their skills.
(c) Maintain a complete and current
SOP manual that is available to all
personnel of the HHS-certified IITF, and
ensure that it is followed. The SOP
manual must be reviewed, signed, and
dated by the RT when procedures are
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first placed into use or changed or when
a new individual assumes responsibility
for the management of the HHS-certified
IITF. The SOP must be reviewed and
documented by the RT annually.
(d) Maintain a quality assurance
program that ensures the proper
performance and reporting of all test
results; verify and monitor acceptable
analytical performance for all controls
and calibrators; monitor quality control
testing; and document the validity,
reliability, accuracy, precision, and
performance characteristics of each test
and test system.
(e) Initiate and implement all
remedial actions necessary to maintain
satisfactory operation and performance
of the HHS-certified IITF in response to
the following: Quality control systems
not within performance specifications,
errors in result reporting or in analysis
of performance testing samples, and
inspection deficiencies. The RT must
ensure that specimen results are not
reported until all corrective actions have
been taken and that the results provided
are accurate and reliable.
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Section 12.3 What qualifications must
the RT have?
An RT must:
(a) Have at least a bachelor’s degree in
the chemical or biological sciences or
medical technology, or equivalent;
(b) Have training and experience in
the analytical methods and forensic
procedures used by the HHS-certified
IITF;
(c) Have training and experience in
reviewing and reporting forensic test
results and maintaining chain of
custody, and an understanding of
appropriate remedial actions in
response to problems that may arise;
(d) Be found to fulfill RT
responsibilities and qualifications, as
demonstrated by the HHS-certified
IITF’s performance and verified upon
interview by HHS-trained inspectors
during each on-site inspection; and
(e) Qualify as a certifying technician.
Section 12.4 What happens when the
RT is absent or leaves an HHS-certified
IITF?
(a) HHS-certified IITFs must have an
RT and an alternate RT. When an RT is
absent, an alternate RT must be present
and qualified to fulfill the
responsibilities of the RT.
(1) If an HHS-certified IITF is without
the RT and alternate RT for 14 calendar
days or less (e.g., temporary absence due
to vacation, illness, business trip), the
HHS-certified IITF may continue
operations and testing of federal agency
specimens under the direction of a
certifying technician.
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(2) The Secretary, in accordance with
these Guidelines, will suspend an IITF’s
HHS certification for all specimens if
the IITF does not have an RT or
alternate RT for a period of more than
14 calendar days. The suspension will
be lifted upon the Secretary’s approval
of a new permanent RT or alternate RT.
(b) If the RT leaves an HHS-certified
IITF:
(1) The HHS-certified IITF may
maintain certification and continue
testing federally regulated specimens
under the direction of an alternate RT
for a period of up to 180 days while
seeking to hire and receive the
Secretary’s approval of the RT’s
replacement.
(2) The Secretary, in accordance with
these Guidelines, will suspend an IITF’s
HHS certification for all federally
regulated specimens if the IITF does not
have a permanent RT within 180 days.
The suspension will be lifted upon the
Secretary’s approval of the new
permanent RT.
(c) To nominate an individual as the
RT or alternate RT, the HHS-certified
IITF must submit the following
documents to the Secretary: The
candidate’s current re´sume´ or
curriculum vitae, copies of diplomas
and licensures, a training plan (not to
exceed 90 days) to transition the
candidate into the position, an itemized
comparison of the candidate’s
qualifications to the minimum RT
qualifications described in the
Guidelines, and have official academic
transcript(s) submitted from the
candidate’s institution(s) of higher
learning. The candidate must be found
qualified during an on-site inspection of
the HHS-certified IITF.
(d) The HHS-certified IITF must fulfill
additional inspection and PT criteria as
required prior to conducting federally
regulated testing under a new RT.
Section 12.5 What qualifications must
an individual have to certify a result
reported by an HHS-certified IITF?
A certifying technician must have:
(a) Training and experience in the
analytical methods and forensic
procedures used by the HHS-certified
IITF relevant to the results that the
individual certifies; and
(b) Training and experience in
reviewing and reporting forensic test
results and maintaining chain of
custody, and an understanding of
appropriate remedial actions in
response to problems that may arise.
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Section 12.6 What qualifications and
training must other personnel of an
HHS-certified IITF have?
(a) All HHS-certified IITF staff (e.g.,
technicians, administrative staff) must
have the appropriate training and skills
for the tasks they perform.
(b) Each individual working in an
HHS-certified IITF must be properly
trained (i.e., receive training in each
area of work that the individual will be
performing, including training in
forensic procedures related to their job
duties) before they are permitted to
work independently with federally
regulated specimens. All training must
be documented.
Section 12.7 What security measures
must an HHS-certified IITF maintain?
(a) An HHS-certified IITF must
control access to the drug testing
facility, specimens, aliquots, and
records.
(b) Authorized visitors must be
escorted at all times except for
individuals conducting inspections (i.e.,
for the Department, a federal agency, a
state, or other accrediting agency) or
emergency personnel (e.g., firefighters
and medical rescue teams).
(c) An HHS-certified IITF must
maintain records documenting the
identity of the visitor and escort, date,
time of entry and exit, and purpose for
the access to the secured area.
Section 12.8 What are the IITF chain
of custody requirements for specimens
and aliquots?
(a) HHS-certified IITFs must use chain
of custody procedures (internal and
external) to maintain control and
accountability of specimens from the
time of receipt at the IITF through
completion of testing, reporting of
results, during storage, and continuing
until final disposition of the specimens.
(b) HHS-certified IITFs must use
chain of custody procedures to
document the handling and transfer of
aliquots throughout the testing process
until final disposal.
(c) The chain of custody must be
documented using either paper copy or
electronic procedures.
(d) Each individual who handles a
specimen or aliquot must sign and
complete the appropriate entries on the
chain of custody form when the
specimen or aliquot is handled or
transferred, and every individual in the
chain must be identified.
(e) The date and purpose must be
recorded on an appropriate chain of
custody form each time a specimen or
aliquot is handled or transferred.
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Section 12.9 What are the
requirements for an initial drug test?
(a) An initial drug test may be:
(1) An immunoassay or
(2) An alternate technology (e.g.,
spectrometry, spectroscopy).
(b) An HHS-certified IITF must
validate an initial drug test before
testing specimens;
(c) Initial drug tests must be accurate
and reliable for the testing of urine
specimens when identifying drugs or
their metabolites.
(d) An HHS-certified IITF may
conduct a second initial drug test using
a method with different specificity, to
rule out cross-reacting compounds. This
second initial drug test must satisfy the
batch quality control requirements
specified in Section 12.11.
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Section 12.10 What must an HHScertified IITF do to validate an initial
drug test?
(a) An HHS-certified IITF must
demonstrate and document the
following for each initial drug test:
(1) The ability to differentiate negative
specimens from those requiring further
testing;
(2) The performance of the test around
the cutoff concentration, using samples
at several concentrations between 0 and
150 percent of the cutoff concentration;
(3) The effective concentration range
of the test (linearity);
(4) The potential for carryover;
(5) The potential for interfering
substances; and
(6) The potential matrix effects if
using an alternate technology.
(b) Each new lot of reagent must be
verified prior to being placed into
service.
(c) Each initial drug test using an
alternate technology must be re-verified
periodically or at least annually.
Section 12.11 What are the batch
quality control requirements when
conducting an initial drug test?
(a) Each batch of specimens must
contain the following calibrators and
controls:
(1) At least one control certified to
contain no drug or drug metabolite;
(2) At least one positive control with
the drug or drug metabolite targeted at
a concentration 25 percent above the
cutoff;
(3) At least one control with the drug
or drug metabolite targeted at a
concentration 75 percent of the cutoff;
and
(4) At least one control that appears
as a donor specimen to the analysts.
(b) Calibrators and controls must total
at least 10 percent of the aliquots
analyzed in each batch.
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Section 12.12 What are the analytical
and quality control requirements for
conducting specimen validity tests?
(a) Each specimen validity test result
must be based on performing a single
test on one aliquot;
(b) The HHS-certified IITF must
establish acceptance criteria and
analyze calibrators and controls as
appropriate to verify and document the
validity of the test results in accordance
with Section 12.14; and
(c) Controls must be analyzed
concurrently with specimens.
Section 12.13 What must an HHScertified IITF do to validate a specimen
validity test?
An HHS-certified IITF must
demonstrate and document for each
specimen validity test the appropriate
performance characteristics of the test,
and must re-verify the test periodically,
or at least annually. Each new lot of
reagent must be verified prior to being
placed into service.
Section 12.14 What are the
requirements for conducting each
specimen validity test?
(a) The requirements for measuring
creatinine concentration are as follows:
(1) The creatinine concentration must
be measured to one decimal place on
the test;
(2) The creatinine test must have the
following calibrators and controls:
(i) A calibrator at 2 mg/dL;
(ii) A control in the range of 1.0 mg/
dL to 1.5 mg/dL;
(iii) A control in the range of 3 mg/
dL to 20 mg/dL; and
(iv) A control in the range of 21 mg/
dL to 25 mg/dL.
(b) The requirements for measuring
specific gravity are as follows:
(1) For specimens with creatinine test
results greater than 5 mg/dL and less
than 20 mg/dL, an IITF must perform a
screening test using a refractometer to
identify specific gravity values that are
acceptable (equal to or greater
than1.003) or dilute (equal to or greater
than1.002 and less than1.003).
Specimens must be forwarded to an
HHS-certified laboratory when the
creatinine test result is less than or
equal to 5 mg/dL or when the screening
specific gravity test result is less than
1.002.
(2) The screening specific gravity test
must have the following calibrators and
controls:
(i) A calibrator or control at 1.000;
(ii) One control targeted at 1.002; and
(iii) One control in the range of 1.004
to 1.018.
(c) The requirements for measuring
pH are as follows:
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(1) The IITF may perform the pH test
using a pH meter, colorimetric pH test,
dipsticks, or pH paper. Specimens must
be forwarded to an HHS-certified
laboratory when the pH is less than 4.5
or equal to or greater than 9.0.
(2) The pH test must have, at a
minimum, the following calibrators and
controls:
(i) One control below 4.5;
(ii) One control between 4.5 and 9.0;
(iii) One control above 9.0; and
(iv) One or more calibrators as
appropriate for the test. For a pH meter:
calibrators at 4, 7, and 10.
(d) The requirements for measuring
the nitrite concentration are that the
nitrite test must have a calibrator at 200
mcg/mL nitrite, a control without nitrite
(i.e., certified negative urine), one
control in the range of 200 mcg/mL to
250 mcg/mL, and one control in the
range of 500 mcg/mL to 625 mcg/mL.
Specimens with a nitrite concentration
equal to or greater than 200 mcg/mL
must be forwarded to an HHS-certified
laboratory; and,
(e) Requirements for performing
oxidizing adulterant tests are that the
test must include an appropriate
calibrator at the cutoff specified in
Sections 11.19(d)(3), (4), or (6) for the
compound of interest, a control without
the compound of interest (i.e., a
certified negative control), and at least
one control with one of the compounds
of interest at a measurable
concentration. Specimens with an
oxidizing adulterant result equal to or
greater than the cutoff must be
forwarded to an HHS-certified
laboratory.
Section 12.15 What are the
requirements for an HHS-certified IITF
to report a test result?
(a) An HHS-certified IITF must report
a test result to the agency’s MRO within
an average of 3 working days after
receipt of the specimen. Reports must
use the Federal CCF and/or an
electronic report. Before any test result
can be reported, it must be certified by
a certifying technician.
(b) A primary (A) specimen is
reported negative when each drug test is
negative and each specimen validity test
result indicates that the specimen is a
valid urine specimen.
(c) A primary (A) urine specimen is
reported dilute when the creatinine
concentration is greater than 5 mg/dL
but less than 20 mg/dL and the specific
gravity is equal to or greater than 1.002
but less than 1.003.
(d) An HHS-certified IITF shall reject
a urine specimen for testing when a fatal
flaw occurs as described in Section 15.1
or when a correctable flaw as described
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in Section 15.2 is not recovered. The
HHS-certified IITF will indicate on the
Federal CCF that the specimen was
rejected for testing and provide the
reason for reporting the rejected for
testing result.
(e) HHS-certified IITFs may transmit
test results to the MRO by various
electronic means (e.g., teleprinter,
facsimile, or computer). Transmissions
of the reports must ensure
confidentiality and the results may not
be reported verbally by telephone. IITFs
and external service providers must
ensure the confidentiality, integrity, and
availability of the data and limit access
to any data transmission, storage, and
retrieval system.
(f) HHS-certified IITFs must facsimile,
courier, mail, or electronically transmit
a legible image or copy of the completed
Federal CCF and/or forward a computergenerated electronic report. The
computer-generated report must contain
sufficient information to ensure that the
test results can accurately represent the
content of the custody and control form
that the MRO received from the
collector.
(g) For rejected specimens, IITFs must
facsimile, courier, mail, or electronically
transmit a legible image or copy of the
completed Federal CCF.
Section 12.16 How does an HHScertified IITF handle a specimen that
tested positive, adulterated, substituted,
or invalid at the IITF?
(a) The remaining specimen is
resealed using a tamper-evident label/
seal;
(b) The individual resealing the
remaining specimen initials and dates
the tamper-evident label/seal; and
(c) The resealed specimen and split
specimen and the Federal CCF are
sealed in a leak-proof plastic bag, and
are sent to an HHS-certified laboratory
under chain of custody within one day
after completing the drug and specimen
validity tests.
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Section 12.17 How long must an HHScertified IITF retain a specimen?
A specimen that is negative, negative/
dilute, or rejected for testing is
discarded.
Section 12.18 How long must an HHScertified IITF retain records?
(a) An HHS-certified IITF must retain
all records generated to support test
results for at least 2 years. The IITF may
convert hardcopy records to electronic
records for storage and then discard the
hardcopy records after six months.
(b) A federal agency may request the
HHS-certified IITF to maintain a
documentation package (as described in
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Section 12.20) that supports the chain of
custody, testing, and reporting of a
donor’s specimen that is under legal
challenge by a donor. The federal
agency’s request to the IITF must be in
writing and must specify the period of
time to maintain the documentation
package.
(c) An HHS-certified IITF may retain
records other than those included in the
documentation package beyond the
normal two-year period of time.
Section 12.19 What statistical
summary reports must an HHS-certified
IITF provide?
(a) HHS-certified IITFs must provide
to each federal agency for which they
perform testing a semiannual statistical
summary report that must be submitted
by mail, facsimile, or email within 14
working days after the end of the
semiannual period. The summary report
must not include any personal
identifying information. A copy of the
semiannual statistical summary report
will also be sent to the Secretary or
designated HHS representative. The
semiannual statistical report contains
the following information:
(1) Reporting period (inclusive dates);
(2) HHS-certified IITF name and
address;
(3) Federal agency name;
(4) Total number of specimens tested;
(5) Number of specimens collected by
reason for test;
(6) Number of specimens reported
negative and the number reported
negative/dilute;
(7) Number of specimens rejected for
testing because of a fatal flaw;
(8) Number of specimens rejected for
testing because of an uncorrected flaw;
(9) Number of specimens tested
positive by each initial drug test; and
(10) Number of specimens forwarded
to an HHS-certified laboratory for
testing.
(b) An HHS-certified IITF must make
copies of an agency’s test results
available when requested to do so by the
Secretary or by the federal agency for
which the IITF is performing drugtesting services.
(c) An HHS-certified IITF must ensure
that a qualified individual is available to
testify in a proceeding against a federal
employee when the proceeding is based
on a test result reported by the IITF.
Section 12.20 What HHS-certified IITF
information is available to a federal
agency?
(a) Following a federal agency’s
receipt of a positive, adulterated, or
substituted drug test report from a
laboratory, the federal agency may
submit a written request for copies of
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the IITF records relating to the drug test
results or a documentation package or
any relevant certification, review, or
revocation of certification records.
(b) Standard documentation packages
provided by an HHS-certified IITF must
contain the following items:
(1) A cover sheet providing a brief
description of the procedures and tests
performed on the donor’s specimen;
(2) A table of contents that lists all
documents and materials in the package
by page number;
(3) A copy of the Federal CCF with
any attachments, internal chain of
custody records for the specimen,
memoranda (if any) generated by the
HHS-certified IITF, and a copy of the
electronic report (if any) generated by
the HHS-certified IITF;
(4) A brief description of the HHScertified IITF’s drug and specimen
validity testing procedures,
instrumentation, and batch quality
control requirements;
(5) Copies of all test data for the
donor’s specimen with all calibrators
and controls and copies of all internal
chain of custody documents related to
the tests; and
(6) Copies of the re´sume´ or
curriculum vitae for the RT and for the
certifying technician of record.
Section 12.21 What HHS-certified IITF
information is available to a federal
employee?
A federal employee who is the subject
of a drug test may provide a written
request through the MRO and/or the
federal agency requesting access to any
records relating to the employee’s drug
test results or a documentation package
(as described in Section 12.20) and any
relevant certification, review, or
revocation of certification records.
Section 12.22 What types of
relationships are prohibited between an
HHS-certified IITF and an MRO?
An HHS-certified IITF must not enter
into any relationship with a federal
agency’s MRO that may be construed as
a potential conflict of interest or derive
any financial benefit by having a federal
agency use a specific MRO.
This means an MRO may be an
employee of the agency or a contractor
for the agency; however, an MRO shall
not be an employee or agent of or have
any financial interest in the HHScertified IITF for which the MRO is
reviewing drug testing results.
Additionally, an MRO shall not derive
any financial benefit by having an
agency use a specific HHS-certified IITF
or have any agreement with an HHScertified IITF that may be construed as
a potential conflict of interest.
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Section 12.23 What type of
relationship can exist between an HHScertified IITF and an HHS-certified
laboratory?
An HHS-certified IITF can enter into
any relationship with an HHS-certified
laboratory.
Subpart M—Medical Review Officer
(MRO)
Section 13.1
MRO?
Who may serve as an
(a) A currently licensed physician
who has:
(1) A Doctor of Medicine (M.D.) or
Doctor of Osteopathy (D.O.) degree;
(2) Knowledge regarding the
pharmacology and toxicology of illicit
drugs;
(3) The training necessary to serve as
an MRO as set out in Section 13.3;
(4) Satisfactorily passed an initial
examination administered by a
nationally recognized entity or a
subspecialty board that has been
approved by the Secretary to certify
MROs; and
(5) At least every five years from
initial certification, completed
requalification training on the topics in
Section 13.3 and satisfactorily passed a
requalification examination
administered by a nationally recognized
entity or a subspecialty board that has
been approved by the Secretary to
certify MROs.
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Section 13.2 How are nationally
recognized entities or subspecialty
boards that certify MROs approved?
All nationally recognized entities or
subspecialty boards which seek
approval by the Secretary to certify
physicians as MROs for federal
workplace drug testing programs must
submit their qualifications, a sample
examination, and other necessary
supporting examination materials (e.g.,
answers, previous examination statistics
or other background examination
information, if requested). Approval
will be based on an objective review of
qualifications that include a copy of the
MRO applicant application form,
documentation that the continuing
education courses are accredited by a
professional organization, and the
delivery method and content of the
examination. Each approved MRO
certification entity must resubmit their
qualifications for approval every two
years. The Secretary shall publish at
least every two years a notice in the
Federal Register listing those entities
and subspecialty boards that have been
approved. This notice is also available
on the Internet at http://
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www.samhsa.gov/workplace/drugtesting.
Section 13.3 What training is required
before a physician may serve as an
MRO?
(a) A physician must receive training
that includes a thorough review of the
following:
(1) The collection procedures used to
collect federal agency specimens;
(2) How to interpret test results
reported by HHS-certified IITFs and
laboratories (e.g., negative, negative/
dilute, positive, adulterated, substituted,
rejected for testing, and invalid);
(3) Chain of custody, reporting, and
recordkeeping requirements for federal
agency specimens;
(4) The HHS Mandatory Guidelines
for Federal Workplace Drug Testing
Programs for all authorized specimen
types; and
(5) Procedures for interpretation,
review (e.g., donor interview for
legitimate medical explanations, review
of documentation provided by the donor
to support a legitimate medical
explanation), and reporting of results
specified by any federal agency for
which the individual may serve as an
MRO;
(b) Certified MROs must complete
training on any revisions to these
Guidelines prior to their effective date,
to continue serving as an MRO for
federal agency specimens.
Section 13.4 What are the
responsibilities of an MRO?
(a) The MRO must review all positive,
adulterated, rejected for testing, invalid,
and (for urine) substituted test results.
(b) Staff under the direct, personal
supervision of the MRO may review and
report negative and (for urine) negative/
dilute test results to the agency’s
designated representative. The MRO
must review at least 5 percent of all
negative results reported by the MRO
staff to ensure that the MRO staff are
properly performing the review process.
(c) The MRO must discuss potential
invalid results with the HHS-certified
laboratory, as addressed in Section
11.19(g) to determine whether testing at
another HHS-certified laboratory may be
warranted.
(d) After receiving a report from an
HHS-certified laboratory or (for urine)
HHS-certified IITF, the MRO must:
(1) Review the information on the
MRO copy of the Federal CCF that was
received from the collector and the
report received from the HHS-certified
laboratory or HHS-certified IITF;
(2) Interview the donor when
required;
(3) Make a determination regarding
the test result; and
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(4) Report the verified result to the
federal agency.
(e) The MRO must maintain records
for a minimum of two years while
maintaining the confidentiality of the
information. The MRO may convert
hardcopy records to electronic records
for storage and discard the hardcopy
records after six months.
(f) The MRO must conduct a medical
examination or a review of the
examining physician’s findings and
make a determination of refusal to test
or cancelled test when a collector
reports that the donor was unable to
provide a specimen, as addressed in
Section 8.6.
Section 13.5 What must an MRO do
when reviewing a urine specimen’s test
results?
(a) When the HHS-certified laboratory
or HHS-certified IITF reports a negative
result for the primary (A) specimen, the
MRO reports a negative result to the
agency.
(b) When the HHS-certified laboratory
or HHS-certified IITF reports a negative/
dilute result for the primary (A) urine
specimen, the MRO reports a negative/
dilute result to the agency and directs
the agency to immediately collect
another specimen from the donor.
(1) If the recollected specimen
provides a negative or negative/dilute
result, the MRO reports a negative result
to the agency, with no further action
required.
(2) If the recollected specimen
provides a result other than negative or
negative/dilute, the MRO follows the
procedures in 13.5(c) through (f) for the
recollected specimen.
(c) When the HHS-certified laboratory
reports multiple results for the primary
(A) urine specimen, as the MRO, you
must follow the verification procedures
described in 13.5(c) through (f) and:
(1) Report all verified positive and/or
refusal to test results to the federal
agency.
(2) If an invalid result was reported in
conjunction with a positive, adulterated,
or substituted result, do not report the
verified invalid result to the federal
agency at this time. The MRO reports
the verified invalid result(s) for the
primary (A) urine specimen only if the
split specimen is tested and reported as
a failure to reconfirm as described in
Section 14.6(l).
(d) When the HHS-certified laboratory
reports a positive result for the primary
(A) specimen, the MRO must contact the
donor to determine if there is any
legitimate medical explanation for the
positive result.
(1) If the donor provides
documentation (e.g., a valid
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prescription) to support a legitimate
medical explanation for the positive
result, the MRO reports the test result as
negative to the agency. If the laboratory
also reports that the urine specimen is
dilute, the MRO reports a negative/
dilute result to the agency and directs
the agency to immediately collect
another specimen from the donor. The
MRO follows the procedures in
13.5(b)(1) or (2) for the recollected
specimen.
(i) Passive exposure to marijuana
smoke is not a legitimate medical
explanation for a positive THCA result.
(ii) Ingestion of food products
containing marijuana is not a legitimate
medical explanation for a positive
THCA result.
(2) If the donor is unable to provide
a legitimate medical explanation, the
MRO reports a positive result to the
agency for all drugs except codeine and/
or morphine (see below). If the
laboratory also reports that the urine
specimen is dilute, the MRO may
choose not to report the dilute result.
(i) For codeine and/or morphine less
than 15,000 ng/mL and no legitimate
medical explanation: the MRO must
determine if there is clinical evidence of
illegal use (in addition to the test result)
to report a positive result to the agency.
If there is no clinical evidence of illegal
use, the MRO reports a negative result
to the agency. However, this
requirement does not apply if the
laboratory confirms the presence of 6acetylmorphine (i.e., the presence of
this metabolite is proof of heroin use).
(ii) For codeine and/or morphine
equal to or greater than 15,000 ng/mL
and no legitimate medical explanation:
the MRO reports a positive result to the
agency. Consumption of food products
must not be considered a legitimate
medical explanation for the donor
having morphine or codeine at or above
this concentration.
(e) When the HHS-certified laboratory
reports an adulterated or substituted
result for the primary (A) urine
specimen, the MRO contacts the donor
to determine if the donor has a
legitimate medical explanation for the
adulterated or substituted result.
(1) If the donor provides a legitimate
medical explanation, the MRO reports a
negative result to the federal agency.
(2) If the donor is unable to provide
a legitimate explanation, the MRO
reports a refusal to test to the federal
agency because the urine specimen was
adulterated or substituted.
(f) When the HHS-certified laboratory
reports an invalid result for the primary
(A) urine specimen, the MRO must
contact the donor to determine if there
is a legitimate explanation for the
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invalid result. In the case of an invalid
result based on pH of 9.0 to 9.5, when
an employee has no other medical
explanation for the pH in this range, the
MRO must consider whether there is
evidence of elapsed time and high
temperature that could account for the
pH value. The MRO may contact the
collection site, HHS-certified IITF, and/
or HHS-certified laboratory to discuss
time and temperature issues (e.g., time
elapsed from collection to receipt at the
testing facility, likely temperature
conditions between the time of the
collection and transportation to the
testing facility, specimen storage
conditions).
(1) If the donor provides a legitimate
explanation (e.g., a prescription
medication) or if the MRO determines
that time and temperature account for
the pH in the 9.0 to 9.5 range, the MRO
reports a test cancelled result with the
reason for the invalid result and informs
the federal agency that a recollection is
not required because there is a
legitimate explanation for the invalid
result.
(2) If the donor is unable to provide
a legitimate explanation or if the MRO
determines that time and temperature
fail to account for the pH in the 9.0—
9.5 range, the MRO reports a test
cancelled result with the reason for the
invalid result and directs the federal
agency to immediately collect another
urine specimen from the donor using a
direct observed collection.
(i) If the specimen collected under
direct observation provides a valid
result, the MRO follows the procedures
in 13.5(a) through (e).
(ii) If the specimen collected under
direct observation provides an invalid
result, the MRO reports this specimen as
test cancelled and recommends that the
agency collect another authorized
specimen type (e.g., oral fluid).
(g) When two separate specimens
collected during the same testing event
were sent to the HHS-certified
laboratory for testing (e.g., the collector
sent a urine specimen out of
temperature range and the subsequently
collected specimen—urine or another
authorized specimen type), as the MRO,
you must follow the verification
procedures described in Sections 13.4,
13.5, and 13.6, and:
(1) If both specimens were verified
negative, report the result as negative.
(2) If one specimen was verified
negative and the other was not (i.e., the
specimen was verified as negative/
dilute or as positive, adulterated,
substituted, and/or invalid), report only
the verified result(s) other than negative.
For example, if you verified one
specimen as negative and the other as a
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refusal to test because the specimen was
substituted, report only the refusal to
the federal agency.
(3) If both specimens were verified as
positive, adulterated, and/or
substituted, report all results. For
example, if you verified one specimen
as positive and the other as a refusal to
test because the specimen was
adulterated, report the positive and the
refusal results to the federal agency.
(4) If one specimen has been verified
and the HHS-certified laboratory has not
reported the result(s) of the other
specimen,
(i) Report verified result(s) of positive,
adulterated, or substituted immediately
and do not wait to receive the result(s)
of the other specimen.
(ii) Do not report a verified result of
negative, negative/dilute, or invalid for
the first specimen to the federal agency.
Hold the report until results of both
specimens have been received and
verified.
(5) When the HHS-certified laboratory
reports an invalid result for one or both
specimens, follow the procedures in
paragraph c above.
(h) When the HHS-certified laboratory
or HHS-certified IITF reports a rejected
for testing result for the primary (A)
specimen, the MRO reports a test
cancelled result to the agency and
recommends that the agency collect
another specimen from the donor. The
recollected specimen must be the same
type (i.e., urine).
Section 13.6 What action does the
MRO take when the collector reports
that the donor did not provide a
sufficient amount of urine for a drug
test?
(a) When another specimen type (e.g.,
oral fluid) was collected as authorized
by the federal agency, the MRO reviews
and reports the test result in accordance
with the Mandatory Guidelines for
Federal Workplace Drug Testing
Programs using the alternative
specimen.
(b) When the federal agency did not
authorize the collection of an alternative
specimen, the MRO consults with the
federal agency. The federal agency
immediately directs the donor to obtain,
within five days, an evaluation from a
licensed physician, acceptable to the
MRO, who has expertise in the medical
issues raised by the donor’s failure to
provide a specimen. The MRO may
perform this evaluation if the MRO has
appropriate expertise.
(1) For purposes of this section, a
medical condition includes an
ascertainable physiological condition
(e.g., a urinary system dysfunction) or a
medically documented pre-existing
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psychological disorder, but does not
include unsupported assertions of
‘‘situational anxiety’’ or dehydration.
Permanent or long-term medical
conditions are those physiological,
anatomic, or psychological
abnormalities documented as being
present prior to the attempted
collection, and considered not amenable
to correction or cure for an extended
period of time. Examples would include
destruction (any cause) of the
glomerular filtration system leading to
renal failure; unrepaired traumatic
disruption of the urinary tract; or a
severe psychiatric disorder focused on
genitourinary matters. Acute or
temporary medical conditions, such as
cystitis, urethritis or prostatitis, though
they might interfere with collection for
a limited period of time, cannot receive
the same exceptional consideration as
the permanent or long-term conditions
discussed in the previous sentence.
(2) As the MRO, if another physician
will perform the evaluation, you must
provide the other physician with the
following information and instructions:
(i) That the donor was required to take
a federally regulated drug test, but was
unable to provide a sufficient amount of
urine to complete the test;
(ii) The consequences of the
appropriate federal agency regulation
for refusing to take the required drug
test;
(iii) That, after completing the
evaluation, the referral physician must
agree to provide a written statement to
the MRO with a recommendation for
one of the determinations described in
paragraph (b)(3) of this section and the
basis for the recommendation. The
statement must not include detailed
information on the employee’s medical
condition beyond what is necessary to
explain the referral physician’s
conclusion.
(3) As the MRO, if another physician
performed the evaluation, you must
consider and assess the referral
physician’s recommendations in making
your determination. You must make one
of the following determinations and
report it to the federal agency in writing:
(i) A medical condition as defined in
paragraph (b)(1) of this section has, or
with a high degree of probability could
have, precluded the employee from
providing a sufficient amount of urine,
but is not a permanent or long-term
disability. As the MRO, you must report
a test cancelled result to the federal
agency.
(ii) A permanent or long-term medical
condition as defined in paragraph (b)(1)
of this section has, or with a high degree
of probability could have, precluded the
employee from providing a sufficient
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amount of urine and is highly likely to
prevent the employee from providing a
sufficient amount of urine for a very
long or indefinite period of time. As the
MRO, you must follow the requirements
of Section 13.7, as appropriate. If
Section 13.7 is not applicable, you
report a test cancelled result to the
federal agency and recommend that the
agency authorize collection of an
alternative specimen type (e.g., oral
fluid) for any subsequent drug tests for
the donor.
(iii) There is not an adequate basis for
determining that a medical condition
has, or with a high degree of probability
could have, precluded the employee
from providing a sufficient amount of
urine. As the MRO, you must report a
refusal to test to the federal agency.
(4) When a federal agency receives a
report from the MRO indicating that a
test is cancelled as provided in
paragraph (b)(3)(i) of this section, the
agency takes no further action with
respect to the donor. When a test is
canceled as provided in paragraph
(b)(3)(ii) of this section, the agency takes
no further action with respect to the
donor other than designating collection
of an alternate specimen type (i.e.,
authorized by the Mandatory Guidelines
for Federal Workplace Drug Testing
Programs) for any subsequent
collections, in accordance with the
federal agency plan. The donor remains
in the random testing pool.
13.7 What happens when an
individual is unable to provide a
sufficient amount of urine for a federal
agency applicant/pre-employment test,
a follow-up test, or a return-to-duty test
because of a permanent or long-term
medical condition?
(a) This section concerns a situation
in which the donor has a medical
condition that precludes the donor from
providing a sufficient specimen for a
federal agency applicant/preemployment test, a follow-up test, or a
return-to-duty test and the condition
involves a permanent or long-term
disability and the federal agency does
not authorize collection of an alternative
specimen. As the MRO in this situation,
you must do the following:
(1) You must determine if there is
clinical evidence that the individual is
an illicit drug user. You must make this
determination by personally
conducting, or causing to be conducted,
a medical evaluation and through
consultation with the donor’s physician
and/or the physician who conducted the
evaluation under Section 13.6.
(2) If you do not personally conduct
the medical evaluation, you must ensure
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that one is conducted by a licensed
physician acceptable to you.
(b) If the medical evaluation reveals
no clinical evidence of drug use, as the
MRO, you must report the result to the
federal agency as a negative test with
written notations regarding results of
both the evaluation conducted under
Section 13.6 and any further medical
examination. This report must state the
basis for the determination that a
permanent or long-term medical
condition exists, making provision of a
sufficient urine specimen impossible,
and for the determination that no signs
and symptoms of drug use exist. The
MRO recommends that the agency
authorize collection of an alternate
specimen type (e.g., oral fluid) for any
subsequent collections.
(c) If the medical evaluation reveals
clinical evidence of drug use, as the
MRO, you must report the result to the
federal agency as a cancelled test with
written notations regarding results of
both the evaluation conducted under
Section 13.6 and any further medical
examination. This report must state that
a permanent or long-term medical
condition [as defined in Section
13.6(b)(1)] exists, making provision of a
sufficient urine specimen impossible,
and state the reason for the
determination that signs and symptoms
of drug use exist. Because this is a
cancelled test, it does not serve the
purposes of a negative test (e.g., the
federal agency is not authorized to allow
the donor to begin or resume performing
official functions, because a negative
test is needed for that purpose).
Section 13.8 Who may request a test of
a split (B) specimen?
(a) For a positive, adulterated, or
substituted result reported on a primary
(A) specimen, a donor may request
through the MRO that the split (B)
specimen be tested by a second HHScertified laboratory to verify the result
reported by the first HHS-certified
laboratory.
(b) The donor has 72 hours (from the
time the MRO notified the donor that
the donor’s specimen was reported
positive, adulterated, or (for urine)
substituted to request a test of the split
(B) specimen. The MRO must inform the
donor that the donor has the
opportunity to request a test of the split
(B) specimen when the MRO informs
the donor that a positive, adulterated, or
(for urine) substituted result is being
reported to the federal agency on the
primary (A) specimen.
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Section 13.9 How does an MRO report
a primary (A) specimen test result to an
agency?
(a) The MRO must report all verified
results to an agency using the completed
MRO copy of the Federal CCF or a
separate report using a letter/
memorandum format. The MRO may
use various electronic means for
reporting (e.g., teleprinter, facsimile, or
computer). Transmissions of the reports
must ensure confidentiality. The MRO
and external service providers must
ensure the confidentiality, integrity, and
availability of the data and limit access
to any data transmission, storage, and
retrieval system.
(b) A verified result may not be
reported to the agency until the MRO
has completed the review process.
(c) The MRO must send a copy of
either the completed MRO copy of the
Federal CCF or the separate letter/
memorandum report for all positive,
adulterated, and (for urine) substituted
results.
(d) The MRO must not disclose
numerical values of drug test results to
the agency.
Section 13.10 What types of
relationships are prohibited between an
MRO and an HHS-certified laboratory or
an HHS-certified IITF?
An MRO must not be an employee,
agent of, or have any financial interest
in an HHS-certified laboratory or an
HHS-certified IITF for which the MRO
is reviewing drug test results.
This means an MRO must not derive
any financial benefit by having an
agency use a specific HHS-certified
laboratory or HHS-certified IITF, or have
any agreement with the HHS-certified
laboratory or the HHS-certified IITF that
may be construed as a potential conflict
of interest.
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Subpart N—Split Specimen Tests
Section 14.1 When may a split (B)
specimen be tested?
(a) The donor may request, verbally or
in writing, through the MRO that the
split (B) specimen be tested at a
different (i.e., second) HHS-certified
laboratory when the primary (A)
specimen was determined by the MRO
to be positive, adulterated, or (for urine)
substituted.
(b) A donor has 72 hours to initiate
the request after being informed of the
result by the MRO. The MRO must
document in the MRO’s records the
verbal request from the donor to have
the split (B) specimen tested.
(c) If a split (B) urine specimen cannot
be tested by a second HHS-certified
laboratory (e.g., insufficient specimen,
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lost in transit, split not available, no
second HHS-certified laboratory
available to perform the test), the MRO
reports to the federal agency that the test
must be cancelled and the reason for the
cancellation. The MRO directs the
federal agency to ensure the immediate
recollection of another urine specimen
from the donor under direct
observation, with no notice given to the
donor of this collection requirement
until immediately before the collection.
(d) If a donor chooses not to have the
split (B) specimen tested by a second
HHS-certified laboratory, a federal
agency may have a split (B) specimen
retested as part of a legal or
administrative proceeding to defend an
original positive, adulterated, or (for
urine) substituted result.
Section 14.2 How does an HHScertified laboratory test a split (B)
specimen when the primary (A)
specimen was reported positive?
(a) The testing of a split (B) specimen
for a drug or metabolite is not subject to
the testing cutoff concentrations
established.
(b) The HHS-certified laboratory is
only required to confirm the presence of
the drug or metabolite that was reported
positive in the primary (A) specimen.
(c) For a split (B) urine specimen, if
the second HHS-certified laboratory
fails to reconfirm the presence of the
drug or drug metabolite that was
reported by the first HHS-certified
laboratory, the second laboratory must
conduct specimen validity tests in an
attempt to determine the reason for
being unable to reconfirm the presence
of the drug or drug metabolite. The
second laboratory should conduct the
same specimen validity tests as it would
conduct on a primary (A) urine
specimen and reports those results to
the MRO.
Section 14.3 How does an HHScertified laboratory test a split (B) urine
specimen when the primary (A)
specimen was reported adulterated?
(a) An HHS-certified laboratory must
use one of the following criteria to
reconfirm an adulterated result when
testing a split (B) urine specimen:
(1) pH must be measured using the
laboratory’s confirmatory pH test with
the appropriate cutoff (i.e., either less
than 4 or equal to or greater than 11);
(2) Nitrite must be measured using the
laboratory’s confirmatory nitrite test
with a cutoff concentration of equal to
or greater than 500 mcg/mL;
(3) Surfactant must be measured using
the laboratory’s confirmatory surfactant
test with a cutoff concentration of equal
to or greater than 100 mcg/mL
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dodecylbenzene sulfonate-equivalent
cutoff; or
(4) For adulterants without a specified
cutoff (e.g., glutaraldehyde, chromium
(VI), pyridine, halogens (such as, bleach,
iodine), peroxidase, peroxide, other
oxidizing agents), the laboratory must
use its confirmatory specimen validity
test at an established limit of
quantification (LOQ) to reconfirm the
presence of the adulterant.
(b) The second HHS-certified
laboratory may only conduct the
confirmatory specimen validity test(s)
needed to reconfirm the adulterated
result reported by the first HHS-certified
laboratory.
Section 14.4 How does an HHScertified laboratory test a split (B) urine
specimen when the primary (A)
specimen was reported substituted?
(a) An HHS-certified laboratory must
use the following criteria to reconfirm a
substituted result when testing a split
(B) urine specimen:
(1) The creatinine must be measured
using the laboratory’s confirmatory
creatinine test with a cutoff
concentration of less than 2 mg/dL; and
(2) The specific gravity must be
measured using the laboratory’s
confirmatory specific gravity test with
the specified cutoffs of less than or
equal to 1.0010 or equal to or greater
than 1.0200.
(b) The second HHS-certified
laboratory may only conduct the
confirmatory specimen validity test(s)
needed to reconfirm the substituted
result reported by the first HHS-certified
laboratory.
Section 14.5 Who receives the split (B)
specimen result?
The second HHS-certified laboratory
must report the result to the MRO.
Section 14.6 What action(s) does an
MRO take after receiving the split (B)
urine specimen result from the second
HHS-certified laboratory?
The MRO takes the following actions
when the second HHS-certified
laboratory reports the result for the split
(B) urine specimen as:
(a) Reconfirmed the drug(s),
adulteration, and/or substitution result.
The MRO reports reconfirmed to the
agency.
(b) Failed to reconfirm a single or all
drug positive results and adulterated. If
the donor provides a legitimate medical
explanation for the adulteration result,
the MRO reports a failed to reconfirm
[specify drug(s)] and cancels both tests.
If there is no legitimate medical
explanation, the MRO reports a failed to
reconfirm [specify drug(s)] and a refusal
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to test to the agency and indicates the
adulterant that is present in the
specimen. The MRO gives the donor 72
hours to request that Laboratory A retest
the primary (A) specimen for the
adulterant. If Laboratory A reconfirms
the adulterant, the MRO reports refusal
to test and indicates the adulterant
present. If Laboratory A fails to
reconfirm the adulterant, the MRO
cancels both tests and directs the agency
to immediately collect another
specimen using a direct observed
collection procedure. The MRO shall
notify the appropriate regulatory office
about the failed to reconfirm and
cancelled test.
(c) Failed to reconfirm a single or all
drug positive results and substituted. If
the donor provides a legitimate medical
explanation for the substituted result,
the MRO reports a failed to reconfirm
[specify drug(s)] and cancels both tests.
If there is no legitimate medical
explanation, the MRO reports a failed to
reconfirm [specify drug(s)] and a refusal
to test (substituted) to the agency. The
MRO gives the donor 72 hours to
request Laboratory A to review the
creatinine and specific gravity results
for the primary (A) specimen. If the
original creatinine and specific gravity
results confirm that the specimen was
substituted, the MRO reports a refusal to
test (substituted) to the agency. If the
original creatinine and specific gravity
results from Laboratory A fail to confirm
that the specimen was substituted, the
MRO cancels both tests and directs the
agency to immediately collect another
specimen using a direct observed
collection procedure. The MRO shall
notify the HHS office responsible for
coordination of the drug-free workplace
program about the failed to reconfirm
and cancelled test.
(d) Failed to reconfirm a single or all
drug positive results and not
adulterated or substituted. The MRO
reports to the agency a failed to
reconfirm result [specify drug(s)],
cancels both tests, and notifies the HHS
office responsible for coordination of
the drug-free workplace program.
(e) Failed to reconfirm a single or all
drug positive results and invalid result.
The MRO reports to the agency a failed
to reconfirm result [specify drug(s) and
give the reason for the invalid result],
cancels both tests, directs the agency to
immediately collect another specimen
using a direct observed collection
procedure, and notifies the HHS office
responsible for coordination of the drugfree workplace program.
(f) Failed to reconfirm one or more
drugs, reconfirmed one or more drugs,
and adulterated. The MRO reports to
the agency a reconfirmed result [(specify
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drug(s)] and a failed to reconfirm result
[specify drug(s)]. The MRO tells the
agency that it may take action based on
the reconfirmed drug(s) although
Laboratory B failed to reconfirm one or
more drugs and found that the specimen
was adulterated. The MRO shall notify
the HHS office responsible for
coordination of the drug-free workplace
program regarding the test results for the
specimen.
(g) Failed to reconfirm one or more
drugs, reconfirmed one or more drugs,
and substituted. The MRO reports to the
agency a reconfirmed result [specify
drug(s)] and a failed to reconfirm result
[(specify drug(s)]). The MRO tells the
agency that it may take action based on
the reconfirmed drug(s) although
Laboratory B failed to reconfirm one or
more drugs and found that the specimen
was substituted. The MRO shall notify
the HHS office responsible for
coordination of the drug-free workplace
program regarding the test results for the
specimen.
(h) Failed to reconfirm one or more
drugs, reconfirmed one or more drugs,
and not adulterated or substituted. The
MRO reports a reconfirmed result
[specify drug(s)] and a failed to
reconfirm result [specify drug(s)]. The
MRO tells the agency that it may take
action based on the reconfirmed drug(s)
although Laboratory B failed to
reconfirm one or more drugs. The MRO
shall notify the HHS office responsible
for coordination of the drug-free
workplace program regarding the test
results for the specimen.
(i) Failed to reconfirm one or more
drugs, reconfirmed one or more drugs,
and invalid result. The MRO reports to
the agency a reconfirmed result [specify
drug(s)] and a failed to reconfirm result
[specify drug(s)]. The MRO tells the
agency that it may take action based on
the reconfirmed drug(s) although
Laboratory B failed to reconfirm one or
more drugs and reported an invalid
result. The MRO shall notify the HHS
office responsible for coordination of
the drug-free workplace program
regarding the test results for the
specimen.
(j) Failed to reconfirm substitution or
adulteration. The MRO reports to the
agency a failed to reconfirm result
(specify adulterant or not substituted)
and cancels both tests. The MRO shall
notify the HHS office responsible for
coordination of the drug-free workplace
program regarding the test results for the
specimen.
(k) Failed to reconfirm a single or all
drug positive results and reconfirmed an
adulterated or substituted result. The
MRO reports to the agency a
reconfirmed result (adulterated or
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substituted) and a failed to reconfirm
result [specify drug(s)]. The MRO tells
the agency that it may take action based
on the reconfirmed result (adulterated
or substituted) although Laboratory B
failed to reconfirm the drug(s) result.
(l) Failed to reconfirm a single or all
drug positive results and failed to
reconfirm the adulterated or substituted
result. The MRO reports to the agency
a failed to reconfirm result [specify
drug(s) and specify adulterant or
substituted] and cancels both tests. The
MRO shall notify the HHS office
responsible for coordination of the drugfree workplace program regarding the
test results for the specimen.
(m) Failed to reconfirm at least one
drug and reconfirmed the adulterated
result. The MRO reports to the agency
a reconfirmed result [(specify drug(s)
and adulterated] and a failed to
reconfirm result [specify drug(s)]. The
MRO tells the agency that it may take
action based on the reconfirmed drug(s)
and the adulterated result although
Laboratory B failed to reconfirm one or
more drugs.
(n) Failed to reconfirm at least one
drug and failed to reconfirm the
adulterated result. The MRO reports to
the agency a reconfirmed result [specify
drug(s)] and a failed to reconfirm result
[specify drug(s) and specify adulterant].
The MRO tells the agency that it may
take action based on the reconfirmed
drug(s) although Laboratory B failed to
reconfirm one or more drugs and failed
to reconfirm the adulterated result.
(o) Failed to reconfirm an adulterated
result and failed to reconfirm a
substituted result. The MRO reports to
the agency a failed to reconfirm result
[(specify adulterant) and not
substituted] and cancels both tests. The
MRO shall notify the HHS office
responsible for coordination of the drugfree workplace program regarding the
test results for the specimen.
(p) Failed to reconfirm an adulterated
result and reconfirmed a substituted
result. The MRO reports to the agency
a reconfirmed result (substituted) and a
failed to reconfirm result (specify
adulterant). The MRO tells the agency
that it may take action based on the
substituted result although Laboratory B
failed to reconfirm the adulterated
result.
(q) Failed to reconfirm a substituted
result and reconfirmed an adulterated
result. The MRO reports to the agency
a reconfirmed result (adulterated) and a
failed to reconfirm result (not
substituted). The MRO tells the agency
that it may take action based on the
adulterated result although Laboratory B
failed to reconfirm the substituted
result.
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Section 14.7 How does an MRO report
a split (B) specimen test result to an
agency?
(a) The MRO must report all verified
results to an agency using the completed
MRO copy of the Federal CCF or a
separate report using a letter/
memorandum format. The MRO may
use various electronic means for
reporting (e.g., teleprinter, facsimile, or
computer). Transmissions of the reports
must ensure confidentiality. The MRO
and external service providers must
ensure the confidentiality, integrity, and
availability of the data and limit access
to any data transmission, storage, and
retrieval system.
(b) A verified result may not be
reported to the agency until the MRO
has completed the review process.
(c) The MRO must send a copy of
either the completed MRO copy of the
Federal CCF or the separate letter/
memorandum report for all split
specimen results.
(d) The MRO must not disclose the
numerical values of the drug test results
to the agency.
Section 14.8 How long must an HHScertified laboratory retain a split (B)
specimen?
A split (B) specimen is retained for
the same period of time that a primary
(A) specimen is retained and under the
same storage conditions. This applies
even for those cases when the split (B)
specimen is tested by a second HHScertified laboratory and the second
HHS-certified laboratory does not
confirm the original result reported by
the first HHS-certified laboratory for the
primary (A) specimen.
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Subpart O—Criteria for Rejecting a
Specimen for Testing
Section 15.1 What discrepancies
require an HHS-certified laboratory or
an HHS-certified IITF to report a
specimen as rejected for testing?
The following discrepancies are
considered to be fatal flaws. The HHScertified laboratory or IITF must stop
the testing process, reject the specimen
for testing, and indicate the reason for
rejecting the specimen on the Federal
CCF when:
(a) The specimen ID number on the
primary (A) or split (B) specimen label/
seal does not match the ID number on
the Federal CCF, or the ID number is
missing either on the Federal CCF or on
either specimen label/seal;
(b) The primary (A) specimen label/
seal is missing, misapplied, broken, or
shows evidence of tampering and the
split (B) specimen cannot be redesignated as the primary (A) specimen;
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(c) The collector’s printed name and
signature are omitted on the Federal
CCF;
(d) There is an insufficient amount of
specimen for analysis in the primary (A)
specimen unless the split (B) specimen
can be re-designated as the primary (A)
specimen;
(e) The accessioner failed to
document the primary (A) specimen
seal condition on the Federal CCF at the
time of accessioning, and the split (B)
specimen cannot be re-designated as the
primary (A) specimen;
(f) The specimen was received at the
HHS-certified laboratory or IITF without
a CCF;
(g) The CCF was received at the HHScertified laboratory or IITF without a
specimen;
(h) The collector performed two
separate collections using one CCF; or
(i) The HHS-certified laboratory or
IITF identifies a flaw (other than those
specified above) that prevents testing or
affects the forensic defensibility of the
drug test and cannot be corrected.
Section 15.2 What discrepancies
require an HHS-certified laboratory or
an HHS-certified IITF to report a
specimen as rejected for testing unless
the discrepancy is corrected?
The following discrepancies are
considered to be correctable:
(a) If a collector failed to sign the
Federal CCF, the HHS-certified
laboratory or IITF must attempt to
recover the collector’s signature before
reporting the test result. If the collector
can provide a memorandum for record
recovering the signature, the HHScertified laboratory or IITF may report
the test result for the specimen. If, after
holding the specimen for at least 5
business days, the HHS-certified
laboratory or IITF cannot recover the
collector’s signature, the laboratory or
IITF must report a rejected for testing
result and indicate the reason for the
rejected for testing result on the Federal
CCF.
(b) If a specimen is submitted using a
non-federal form or an expired Federal
CCF, the HHS-certified laboratory or
IITF must test the specimen and also
attempt to obtain a memorandum for
record explaining why a non-federal
form or an expired Federal CCF was
used and ensure that the form used
contains all the required information. If,
after holding the specimen for at least 5
business days, the HHS-certified
laboratory or IITF cannot obtain a
memorandum for record from the
collector, the laboratory or IITF must
report a rejected for testing result and
indicate the reason for the rejected for
testing result on the report to the MRO.
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Section 15.3 What discrepancies are
not sufficient to require an HHScertified laboratory or an HHS-certified
IITF to reject a urine specimen for
testing or an MRO to cancel a test?
(a) The following omissions and
discrepancies on the Federal CCF that
are received by the HHS-certified
laboratory or IITF should not cause an
HHS-certified laboratory or IITF to reject
a urine specimen or cause an MRO to
cancel a test:
(1) An incorrect laboratory name and
address appearing at the top of the form;
(2) Incomplete/incorrect/unreadable
employer name or address;
(3) MRO name is missing;
(4) Incomplete/incorrect MRO
address;
(5) A transposition of numbers in the
donor’s Social Security Number or
employee identification number;
(6) A telephone number is missing/
incorrect;
(7) A fax number is missing/incorrect;
(8) A ‘‘reason for test’’ box is not
marked;
(9) A ‘‘drug tests to be performed’’ box
is not marked;
(10) A ‘‘specimen collection’’ box is
not marked;
(11) The ‘‘observed’’ box is not
marked (if applicable);
(12) The collection site address is
missing;
(13) The collector’s printed name is
missing but the collector’s signature is
properly recorded;
(14) The time of collection is not
indicated;
(15) The date of collection is not
indicated;
(16) Incorrect name of delivery
service;
(17) The collector has changed or
corrected information by crossing out
the original information on either the
Federal CCF or specimen label/seal
without dating and initialing the
change; or
(18) The donor’s name inadvertently
appears on the HHS-certified laboratory
or IITF copy of the Federal CCF or on
the tamper-evident labels used to seal
the specimens.
(19) The collector failed to check the
specimen temperature box and the
‘‘Remarks’’ line did not have a comment
regarding the temperature being out of
range. If, after at least 5 business days,
the collector cannot provide a
memorandum for record to attest to the
fact that the collector did measure the
specimen temperature, the HHScertified laboratory or IITF may report
the test result for the specimen but
indicates that the collector could not
provide a memorandum to recover the
omission.
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(b) The following omissions and
discrepancies on the Federal CCF that
are made at the HHS-certified laboratory
or IITF should not cause an MRO to
cancel a test:
(1) The testing laboratory or IITF fails
to indicate the correct name and address
in the results section when a different
laboratory or IITF name and address is
printed at the top of the Federal CCF;
(2) The accessioner fails to print their
name;
(3) The certifying scientist or
certifying technician fails to print their
name;
(4) The certifying scientist or
certifying technician accidentally
initials the Federal CCF rather than
signing for a specimen reported as
rejected for testing;
(c) The above omissions and
discrepancies should occur no more
than once a month. The expectation is
that each trained collector and HHScertified laboratory or IITF will make
every effort to ensure that the Federal
CCF is properly completed and that all
the information is correct. When an
error occurs more than once a month,
the MRO must direct the collector, HHScertified laboratory, or HHS-certified
IITF (whichever is responsible for the
error) to immediately take corrective
action to prevent the recurrence of the
error.
Section 15.4 What discrepancies may
require an MRO to cancel a test?
(a) An MRO must attempt to correct
the following errors:
(1) The donor’s signature is missing
on the MRO copy of the Federal CCF
and the collector failed to provide a
comment that the donor refused to sign
the form;
(2) The certifying scientist failed to
sign the Federal CCF for a specimen
being reported drug positive,
adulterated, invalid, or (for urine)
substituted; or
(3) The electronic report provided by
the HHS-certified laboratory or HHScertified IITF does not contain all the
data elements required for the HHS
standard laboratory or IITF electronic
report for a specimen being reported
drug positive, adulterated, invalid
result, or (for urine) substituted.
(b) If error (a)(1) occurs, the MRO
must contact the collector to obtain a
statement to verify that the donor
refused to sign the MRO copy. If, after
at least 5 business days, the collector
cannot provide such a statement, the
MRO must cancel the test.
(c) If error (a)(2) occurs, the MRO
must obtain a statement from the
certifying scientist that they
inadvertently forgot to sign the Federal
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CCF, but did, in fact, properly conduct
the certification review. If, after at least
5 business days, the MRO cannot get a
statement from the certifying scientist,
the MRO must cancel the test.
(d) If error (a)(3) occurs, the MRO
must contact the HHS-certified
laboratory or HHS-certified IITF. If, after
at least 5 business days, the laboratory
or IITF does not retransmit a corrected
electronic report, the MRO must cancel
the test.
Subpart P—Laboratory or IITF
Suspension/Revocation Procedures
Section 16.1 When may the HHS
certification of a laboratory or IITF be
suspended?
These procedures apply when:
(a) The Secretary has notified an HHScertified laboratory or IITF in writing
that its certification to perform drug
testing under these Guidelines has been
suspended or that the Secretary
proposes to revoke such certification.
(b) The HHS-certified laboratory or
IITF has, within 30 days of the date of
such notification or within 3 days of the
date of such notification when seeking
an expedited review of a suspension,
requested in writing an opportunity for
an informal review of the suspension or
proposed revocation.
Section 16.2 What definitions are used
for this subpart?
Appellant. Means the HHS-certified
laboratory or IITF which has been
notified of its suspension or proposed
revocation of its certification to perform
testing and has requested an informal
review thereof.
Respondent. Means the person or
persons designated by the Secretary in
implementing these Guidelines.
Reviewing Official. Means the person
or persons designated by the Secretary
who will review the suspension or
proposed revocation. The reviewing
official may be assisted by one or more
of the official’s employees or
consultants in assessing and weighing
the scientific and technical evidence
and other information submitted by the
appellant and respondent on the reasons
for the suspension and proposed
revocation.
Section 16.3 Are there any limitations
on issues subject to review?
The scope of review shall be limited
to the facts relevant to any suspension
or proposed revocation, the necessary
interpretations of those facts, the
relevant Mandatory Guidelines for
Federal Workplace Drug Testing
Programs, and other relevant law. The
legal validity of these Guidelines shall
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not be subject to review under these
procedures.
Section 16.4
parties?
Who represents the
The appellant’s request for review
shall specify the name, address, and
telephone number of the appellant’s
representative. In its first written
submission to the reviewing official, the
respondent shall specify the name,
address, and telephone number of the
respondent’s representative.
Section 16.5 When must a request for
informal review be submitted?
(a) Within 30 days of the date of the
notice of the suspension or proposed
revocation, the appellant must submit a
written request to the reviewing official
seeking review, unless some other time
period is agreed to by the parties. A
copy must also be sent to the
respondent. The request for review must
include a copy of the notice of
suspension or proposed revocation, a
brief statement of why the decision to
suspend or propose revocation is wrong,
and the appellant’s request for an oral
presentation, if desired.
(b) Within 5 days after receiving the
request for review, the reviewing official
will send an acknowledgment and
advise the appellant of the next steps.
The reviewing official will also send a
copy of the acknowledgment to the
respondent.
Section 16.6
agreement?
What is an abeyance
Upon mutual agreement of the parties
to hold these procedures in abeyance,
the reviewing official will stay these
procedures for a reasonable time while
the laboratory or IITF attempts to regain
compliance with the Guidelines or the
parties otherwise attempt to settle the
dispute. As part of an abeyance
agreement, the parties can agree to
extend the time period for requesting
review of the suspension or proposed
revocation. If abeyance begins after a
request for review has been filed, the
appellant shall notify the reviewing
official at the end of the abeyance
period advising whether the dispute has
been resolved. If the dispute has been
resolved, the request for review will be
dismissed. If the dispute has not been
resolved, the review procedures will
begin at the point at which they were
interrupted by the abeyance agreement
with such modifications to the
procedures as the reviewing official
deems appropriate.
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Section 16.7 What procedures are used
to prepare the review file and written
argument?
The appellant and the respondent
each participate in developing the file
for the reviewing official and in
submitting written arguments. The
procedures for development of the
review file and submission of written
argument are:
(a) Appellant’s Documents and Brief.
Within 15 days after receiving the
acknowledgment of the request for
review, the appellant shall submit to the
reviewing official the following (with a
copy to the respondent):
(1) A review file containing the
documents supporting appellant’s
argument, tabbed and organized
chronologically, and accompanied by an
index identifying each document. Only
essential documents should be
submitted to the reviewing official.
(2) A written statement, not to exceed
20 double-spaced pages, explaining why
respondent’s decision to suspend or
propose revocation of appellant’s
certification is wrong (appellant’s brief).
(b) Respondent’s Documents and
Brief. Within 15 days after receiving a
copy of the acknowledgment of the
request for review, the respondent shall
submit to the reviewing official the
following (with a copy to the appellant):
(1) A review file containing
documents supporting respondent’s
decision to suspend or revoke
appellant’s certification to perform drug
testing, which is tabbed and organized
chronologically, and accompanied by an
index identifying each document. Only
essential documents should be
submitted to the reviewing official.
(2) A written statement, not exceeding
20 double-spaced pages in length,
explaining the basis for suspension or
proposed revocation (respondent’s
brief).
(c) Reply Briefs. Within 5 days after
receiving the opposing party’s
submission, or 20 days after receiving
acknowledgment of the request for
review, whichever is later, each party
may submit a short reply not to exceed
10 double-spaced pages.
(d) Cooperative Efforts. Whenever
feasible, the parties should attempt to
develop a joint review file.
(e) Excessive Documentation. The
reviewing official may take any
appropriate step to reduce excessive
documentation, including the return of
or refusal to consider documentation
found to be irrelevant, redundant, or
unnecessary.
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Section 16.8 When is there an
opportunity for oral presentation?
(a) Electing Oral Presentation. If an
opportunity for an oral presentation is
desired, the appellant shall request it at
the time it submits its written request
for review to the reviewing official. The
reviewing official will grant the request
if the official determines that the
decision-making process will be
substantially aided by oral presentations
and arguments. The reviewing official
may also provide for an oral
presentation at the official’s own
initiative or at the request of the
respondent.
(b) Presiding Official. The reviewing
official or designee will be the presiding
official responsible for conducting the
oral presentation.
(c) Preliminary Conference. The
presiding official may hold a prehearing
conference (usually a telephone
conference call) to consider any of the
following: Simplifying and clarifying
issues, stipulations and admissions,
limitations on evidence and witnesses
that will be presented at the hearing,
time allotted for each witness and the
hearing altogether, scheduling the
hearing, and any other matter that will
assist in the review process. Normally,
this conference will be conducted
informally and off the record; however,
the presiding official may, at their
discretion, produce a written document
summarizing the conference or
transcribe the conference, either of
which will be made a part of the record.
(d) Time and Place of the Oral
Presentation. The presiding official will
attempt to schedule the oral
presentation within 30 days of the date
the appellant’s request for review is
received or within 10 days of
submission of the last reply brief,
whichever is later. The oral presentation
will be held at a time and place
determined by the presiding official
following consultation with the parties.
(e) Conduct of the Oral Presentation.
(1) General. The presiding official is
responsible for conducting the oral
presentation. The presiding official may
be assisted by one or more of the
official’s employees or consultants in
conducting the oral presentation and
reviewing the evidence. While the oral
presentation will be kept as informal as
possible, the presiding official may take
all necessary steps to ensure an orderly
proceeding.
(2) Burden of Proof/Standard of Proof.
In all cases, the respondent bears the
burden of proving by a preponderance
of the evidence that its decision to
suspend or propose revocation is
appropriate. The appellant, however,
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has a responsibility to respond to the
respondent’s allegations with evidence
and argument to show that the
respondent is wrong.
(3) Admission of Evidence. The
Federal Rules of Evidence do not apply
and the presiding official will generally
admit all testimonial evidence unless it
is clearly irrelevant, immaterial, or
unduly repetitious. Each party may
make an opening and closing statement,
may present witnesses as agreed upon
in the prehearing conference or
otherwise, and may question the
opposing party’s witnesses. Since the
parties have ample opportunity to
prepare the review file, a party may
introduce additional documentation
during the oral presentation only with
the permission of the presiding official.
The presiding official may question
witnesses directly and take such other
steps necessary to ensure an effective
and efficient consideration of the
evidence, including setting time
limitations on direct and crossexaminations.
(4) Motions. The presiding official
may rule on motions including, for
example, motions to exclude or strike
redundant or immaterial evidence,
motions to dismiss the case for
insufficient evidence, or motions for
summary judgment. Except for those
made during the hearing, all motions
and opposition to motions, including
argument, must be in writing and be no
more than 10 double-spaced pages in
length. The presiding official will set a
reasonable time for the party opposing
the motion to reply.
(5) Transcripts. The presiding official
shall have the oral presentation
transcribed and the transcript shall be
made a part of the record. Either party
may request a copy of the transcript and
the requesting party shall be responsible
for paying for its copy of the transcript.
(f) Obstruction of Justice or Making of
False Statements. Obstruction of justice
or the making of false statements by a
witness or any other person may be the
basis for a criminal prosecution under
18 U.S.C. 1505 or 1001.
(g) Post-hearing Procedures. At their
discretion, the presiding official may
require or permit the parties to submit
post-hearing briefs or proposed findings
and conclusions. Each party may submit
comments on any major prejudicial
errors in the transcript.
Section 16.9 Are there expedited
procedures for review of immediate
suspension?
(a) Applicability. When the Secretary
notifies an HHS-certified laboratory or
IITF in writing that its certification to
perform drug testing has been
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immediately suspended, the appellant
may request an expedited review of the
suspension and any proposed
revocation. The appellant must submit
this request in writing to the reviewing
official within 3 days of the date the
HHS-certified laboratory or IITF
received notice of the suspension. The
request for review must include a copy
of the suspension and any proposed
revocation, a brief statement of why the
decision to suspend and propose
revocation is wrong, and the appellant’s
request for an oral presentation, if
desired. A copy of the request for review
must also be sent to the respondent.
(b) Reviewing Official’s Response. As
soon as practicable after the request for
review is received, the reviewing official
will send an acknowledgment with a
copy to the respondent.
(c) Review File and Briefs. Within 7
days of the date the request for review
is received, but no later than 2 days
before an oral presentation, each party
shall submit to the reviewing official the
following:
(1) A review file containing essential
documents relevant to the review,
which is tabbed, indexed, and organized
chronologically; and
(2) A written statement, not to exceed
20 double-spaced pages, explaining the
party’s position concerning the
suspension and any proposed
revocation. No reply brief is permitted.
(d) Oral Presentation. If an oral
presentation is requested by the
appellant or otherwise granted by the
reviewing official, the presiding official
will attempt to schedule the oral
presentation within 7–10 days of the
date of appellant’s request for review at
a time and place determined by the
presiding official following consultation
with the parties. The presiding official
may hold a prehearing conference in
accordance with Section 16.8(c) and
will conduct the oral presentation in
accordance with the procedures of
Sections 16.8(e), (f), and (g).
(e) Written Decision. The reviewing
official shall issue a written decision
upholding or denying the suspension or
proposed revocation and will attempt to
issue the decision within 7–10 days of
the date of the oral presentation or
within 3 days of the date on which the
transcript is received or the date of the
last submission by either party,
whichever is later. All other provisions
set forth in Section 16.14 will apply.
(f) Transmission of Written
Communications. Because of the
importance of timeliness for these
expedited procedures, all written
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communications between the parties
and between either party and the
reviewing official shall be by facsimile,
secured electronic transmissions, or
overnight mail.
Section 16.10 Are any types of
communications prohibited?
Except for routine administrative and
procedural matters, a party shall not
communicate with the reviewing or
presiding official without notice to the
other party.
Section 16.11 How are
communications transmitted by the
reviewing official?
(a) Because of the importance of a
timely review, the reviewing official
should normally transmit written
communications to either party by
facsimile, secured electronic
transmissions, or overnight mail in
which case the date of transmission or
day following mailing will be
considered the date of receipt. In the
case of communications sent by regular
mail, the date of receipt will be
considered 3 days after the date of
mailing.
(b) In counting days, include
Saturdays, Sundays, and federal
holidays. However, if a due date falls on
a Saturday, Sunday, or federal holiday,
then the due date is the next federal
working day.
Section 16.12 What are the authority
and responsibilities of the reviewing
official?
In addition to any other authority
specified in these procedures, the
reviewing official and the presiding
official, with respect to those authorities
involving the oral presentation, shall
have the authority to issue orders;
examine witnesses; take all steps
necessary for the conduct of an orderly
hearing; rule on requests and motions;
grant extensions of time for good
reasons; dismiss for failure to meet
deadlines or other requirements; order
the parties to submit relevant
information or witnesses; remand a case
for further action by the respondent;
waive or modify these procedures in a
specific case, usually with notice to the
parties; reconsider a decision of the
reviewing official where a party
promptly alleges a clear error of fact or
law; and to take any other action
necessary to resolve disputes in
accordance with the objectives of these
procedures.
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Section 16.13 What administrative
records are maintained?
The administrative record of review
consists of the review file; other
submissions by the parties; transcripts
or other records of any meetings,
conference calls, or oral presentation;
evidence submitted at the oral
presentation; and orders and other
documents issued by the reviewing and
presiding officials.
Section 16.14 What are the
requirements for a written decision?
(a) Issuance of Decision. The
reviewing official shall issue a written
decision upholding or denying the
suspension or proposed revocation. The
decision will set forth the reasons for
the decision and describe the basis
therefore in the record. Furthermore, the
reviewing official may remand the
matter to the respondent for such
further action as the reviewing official
deems appropriate.
(b) Date of Decision. The reviewing
official will attempt to issue their
decision within 15 days of the date of
the oral presentation, the date on which
the transcript is received, or the date of
the last submission by either party,
whichever is later. If there is no oral
presentation, the decision will normally
be issued within 15 days of the date of
receipt of the last reply brief. Once
issued, the reviewing official will
immediately communicate the decision
to each party.
(c) Public Notice. If the suspension
and proposed revocation are upheld, the
revocation will become effective
immediately and the public will be
notified by publication of a notice in the
Federal Register. If the suspension and
proposed revocation are denied, the
revocation will not take effect and the
suspension will be lifted immediately.
Public notice will be given by
publication in the Federal Register.
Section 16.15 Is there a review of the
final administrative action?
Before any legal action is filed in
court challenging the suspension or
proposed revocation, respondent shall
exhaust administrative remedies
provided under this subpart, unless
otherwise provided by Federal Law. The
reviewing official’s decision, under
Section 16.9(e) or 16.14(a) constitutes
final agency action and is ripe for
judicial review as of the date of the
decision.
[FR Doc. 2017–00979 Filed 1–19–17; 8:45 am]
BILLING CODE 4162–20–P
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| File Type | application/pdf |
| File Modified | 2017-01-20 |
| File Created | 2017-01-20 |