.... Specimen Collection Audits for Workplace Drug Testing
By Joe Reilly, Past Chairman DATIA
Reprinted from DATIA Focus, Cover Story, Summer 2014 Issue
Collection sites are often audited by FAA and FTA auditors and recently I have been retained by several regional and national collection site operators to provide audits of their company owned collection sites and mobile collections. Audits are a good thing because if you find out what your collectors are doing wrong, you can make the appropriate corrections and get the appropriate training completed so that your collectors eliminate mistakes that cause non-compliance and fatal flaws.
GOVERNMENT ACCOUNTABILITY OFFICE (GAO) 2007 UNDERCOVER INVESTIGATION FINDINGS
You might remember back in 2007 media exposure that exposed procedural errors in direct violation of the testing procedures defined in 49 CFR Part 40. An NBC Nightly News news story, aired on November 1, 2007, and reported the findings of a Government Accountability Office (GAO) undercover investigation that found it was surprisingly easy to cheat on random drug tests. The story was picked up by many other media outlets including FOX news. The news reports were aimed specifically at truck drivers. The box to the right lists a summary of those findings and in addition investigators used bogus identification to initiate the testing process in all (100%) of the 24 sites that were investigated demonstrating the ease at which safety-sensitive employees can send other (presumably drug-free) individuals to take the tests for them. Only two of the twenty-four sites followed all of the remainder of the testing procedures tested by the Investigators. The remaining twenty-two (91.7%) had two or more serious protocol violations.
Reviewing over 100 audits performed over the past 12 months, I am proud to say that collection sites are doing better but there are still issues that can certainly be corrected if collection site operators would pay more attention to DOT training requirements. Qualification training as a DOT specimen collector is not difficult to obtain, but it is also not a quick easy process for a new collector. When I train new collectors, there is a minimum 6 hour training process and mock collections always take at least two hours.
So what are we finding on current audits? You might be surprised at some of these findings.
- Very common in my audit finding is that prior to the collection, the collector failed to explain collection procedures or show the instructions on the back of the CCF. It is important to review with your collectors 49 CFR Part 40 Section 40.61 - (e) Explain the basic collection procedure to the employee, including showing the employee the instructions on the back of the CCF.
- A collector becomes familiar with the donor after 12 follow up tests and neglects to check the donors ID. In addition the procedures for direct observation are not followed properly. Familiarly does not grant the collector a pass to not follow strict collection procedures, always perform the collection the same way every time with every donor.
- Collector has a temperature out of range situation which goes into a Shy Bladder process for the second collection. The donor gets frustrated after 1 hour and leaves the collection site stating “I don’t have time for this”. Collector then throws away the first specimen collected and all of the paperwork. This of course is a major issue because now there is no documentation of anything that occurred.
- In another temperature out of range situation, the collector starts the second collection process immediately after receiving the first specimen. Upon receiving the second specimen, the collector is pouring off the specimen into the four specimen vials and filling out the Custody and Control forms (CCF) simultaneously. Of course what happens is that the specimen seals are put on the incorrect bottles and at the lab the specimen ID numbers on the bottles do not match the specimen ID numbers on the CCF forms.
- The practice of altering a form when the correct form is not available seems to come up often in our audits. Some collectors are stating that altering a form is not allowed by DOT. Other collectors when altering forms, do not alter the forms properly. DOT is clear that when the collector has no “blank” CCFs and the CCFs on-hand contain inaccurate pre-printed employer, MRO, collection site, and/or laboratory information, the collector is permitted to “line through” the inaccurate information and insert legibly the proper information. I always advise collectors to be as neat as possible when altering a form and provide the correct account number for the test. The collector should also “line through” barcodes on the form so that at the laboratory the new printed information is utilized.
- Pre-filling out the CCF is a very common audit item discovered. Collectors like to pre-date the specimen security seals, pre-print the collector name, date and time on Step 4; and in some cases pre-sign on Step 4. In one large mobile collection event I audited, the two collectors handed out the CCF forms to 35 donors and asked them to initial the specimen security seals and complete Step 5 in its entirety. I cannot tell you how messed up this collection became with 4 fatal flaws and 12 correctable errors.
- Several audits have revealed collections sites that do not properly secure the bathroom to be used for the collection. Some have made a half-hearted attempt at this with partial security and integrity measures, and some just plain do not make any proper attempt at all. One collector used bleach as the bluing agent for the toilet. I always highly recommend DOT’s 10 Steps to Collection Site Security and Integrity Video and DOT’s 10 Steps to Collection Site Security and Integrity poster. Both are available from DOT at www.dot.gov/odapc and both are excellent tools to help a facility learn how to properly secure a restroom for a DOT urine specimen collection.
- Lastly I have performed audits on collection sites for alcohol testing where the facility did not have an evidential breath alcohol testing device on hand. An instant alcohol test device was used and when I tested positive (with mouthwash); there was no mechanism for the collection site to perform the required confirmation testing. This was really a disaster as the collection site sent me on my way in my car after their knowledge that I was at a .09 alcohol level. They were lost in space as to how to properly arrange for the required confirmation testing.
As mentioned, still common in the specimen collection industry is the incorrect practice of filling out Step 4 of the CCF prior to starting the collection and pre dating the security seals. There are no shortcuts in the collection process, shortcuts lead to errors. The steps of the collection should be followed in order, and remember the DOT specimen collection order is 1, 2, 3, 5, and 4. If the steps are filled out properly and in order, the percentage of mistakes that occur declines significantly. I cannot over emphasize the importance of taking your time with a collection and not taking short cuts; taking your leads to perfect collections.
The Federal Transit Administration (FTA) is particularly aggressive on collection audits. FTA maintains a full-fledged clandestine collection site inspection program. Reports from April 2014 from the FTA indicate that 10% of collection sites audited showed critical failures. Most common findings included not checking identity of donor, not checking pockets and not requiring hand washing. These are easily correctable errors, review these items with your collectors today.
Audits are occurring more and more. Several large collection services have begun doing internal audits. Of course the bottom line is proper training of collectors; and of course don’t forget the DOT required refresher training and proficiency demonstration every five years.
Why is all of this so important? There are several reasons. We hear often that the collector or collection site is the weakest link in the drug testing process – lets change this. Errors in the collection process can lead to issues with DOT regulators and the employer might be out of compliance facing fines and other sanctions. What about the donor, the employee who might have an erroneous test result reported due to an error? On the legal front, you certainly want all collections done properly and consistently – if not, you might face issues from a plaintiff’s attorney on any challenge or law suit from a donor who tested positive and lost his or her job.
Without proper security and integrity in the collection process, donors have an opportunity to cheat on the test. This is a real safety issue as these same donors are driving on our public roads and may be under the influence of drugs or alcohol and undetected.
Employers should be monitoring the collection facilities or collectors that they hire to make sure collections are being performed correctly and collectors are not making the errors noted above. It is an employer’s responsibility to make sure that the process is in compliance. I urge employers to not use collection facilities that are not up to speed and not doing collections properly. Ask your collectors about their training and about their procedures. Many collectors have not received the five year refresher training required by DOT and many have done collections that resulted in fatal flaws and not completed the required error correction training and proficiency demonstration. Employers and their Designated Employer Representatives (DER’s) need to be proactive in monitoring the work performed by the service agents in the DOT drug testing program.
Collectors and collection site companies need to step up and make sure that the required training and refresher trainings are conducted by qualified trainers. There is no way this process can be learned by merely reading a pamphlet or watching a short video. It is time to be proactive and eliminate and change the common phrase mentioned previously – collectors should not be the weakest link in the drug testing process. Qualified trainers should go through a train the trainer process like the DATIA Certified Professional Collector Trainer Program (CPCT). Don’t have your existing collectors with bad habits train your new collectors.
When errors occur, many times the donor will more than likely have to go back for another specimen collection; this will annoy both the donor and the employer – and the employer will not want to pay for the first collection which resulted in the fatal flaw. As collectors, we need to avoid all of these issues and do it right the first time – the key is training and refresher training and keeping up to date with the regulations. Look to DATIA for a great resource for regulatory updates, training and promotion of the highest possible standards for the industry.
Joe Reilly entered the world of drug testing in 1993, he is well known throughout the industry and considered a leading expert on workplace drug testing issues. Joe served for nine years on the DATIA Board of Directors and served as Chairman of the Board from 2004–2008. Joe is currently a DATIA Board member and a Regional Certified Professional Collector Trainer (RCPCT) for DATIA and is available for DATIA CPC training in all areas of Florida.