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Item Q3
Q3 BOARD OF COUNTY COMMISSIONERS COUNTY of MONROE �� i Mayor Holly Merrill Raschein,District 5 The Florida Keys Mayor Pro Tern James K.Scholl,District 3 Craig Cates,District 1 Michelle Lincoln,District 2 ' David Rice,District 4 Board of County Commissioners Meeting October 16, 2024 Agenda Item Number: Q3 2023-3055 BULK ITEM: No DEPARTMENT: Administration TIME APPROXIMATE: STAFF CONTACT: Bob Shillinger Yes AGENDA ITEM WORDING: Discussion of the Grand Jury's report into the Investigation into the 2022 Trauma Star Diversion of Controlled Substances and direction to staff on the recommendations contained therein. TIME APPROXIMATE 10:30 A.M. ITEM BACKGROUND: On August 29, 2024, the Grand Jury's report regarding the Investigation into the 2022 Trauma Star Diversion of Controlled Substances was made public. The report summarizes the Grand Jury's findings and conclusions as well as makes 14 recommendations to the County Commission and staff. County staff has attached a chart summarizing the recommendations and outlining the steps the County has taken and will be taken to respond to each recommendation. PREVIOUS RELEVANT BOCC ACTION: The Board held a preliminary discussion prior to the public release of the Grand Jury Report on August 21, 2024 and a more detailed discussion on September 11, 2024, after the Grand Jury report was published. INSURANCE REQUIRED: No CONTRACT/AGREEMENT CHANGES: n/a STAFF RECOMMENDATION: Discussion and direction. 5101 DOCUMENTATION: GJReport and comments on 10-16-24 as of 10-1-24 FINAL.pdf Final Report of the Monroe County Grand Jury Spring term 2024-Trama Star published on Clerk-pdf FINANCIAL IMPACT: n/a 5102 M O T— LO O = v N � Z_ � � z Z z © Cj 'j Z ° 1 1 z 4-1 zzw m � v ° wQ � o , 3 0Co ° > � cv Q cN L ca 0 ° N ON WU � Z (£) o 7 = LL N ~ LL O � w a) LLB SU O) a , 0, 0— o . �- U) ZQ m L 70 0 0 o ° J U N cB ZJw U QOOw N oU N, N �- ZO0 om H 0 75; LL It - GN Z U U U CD 000LU � \ wpz � cn U � � O ZwQ c� , - 0— wN c� - LL � o a) U a) m cn O ff_ CO c - r a� ca w � c� ° © -c3 c c m m0 o m � QZ cu U cuO � © cs a - om 0- (n "- � ,�LLcn � ° ° °i ° cn .4_ -.- 0- 0� 0� "cis ' ~ .+ p © 7+ 0 m .� N E w � w " 4 © � � o — LU Q o tt3 M3 © t°- E ,© -0 ° 0 © N N c--a 5 M „— � o cn LL 0 co 0 Q ._ 1 cl , 0, a) -0 C: C: d' 0 LO O � w 0 zp OQ cy � LLJU) U) > � _I O W > > (0 Cal z J W N 0 Q (n ram-+ C3 Q � � N z 'i ."U U 04 LL J LL o ° _ w �ON U m . � WU6i p 0 ,C � zzmU) u u U) U)Z) z zo 0- c� z Q < 'cn cz " a � 0 O p 0 0 — ? zLU O -iwU U �-- > OZzo � .c z zO � O U- p _ � U OOOJ O U N LO Uzz C Om � w w 0 U) a E � U � `� � `� U° U°z O > Q U) Oo Lu 0 � = Qz © % C: N NZ3 N 3 ( © 2 LL (n O �R ,,_ u5 OQU o 2 -� �° 0 ' a 0 � cu U co 0 -0 © = O � � 0 O 0 co co � N Lcuo ,, � 0 is Q © U , 0 � s� � � � �°zCa � , ° � � � cameo' LO 0 LO O m cv U = j � cn n L c cu cu O i / cu U ; / / r U L O c CU om � � N N O ; U) O (n C'4 OUP cn .� � 70 � � — moo a� � ,� � U ' U O O O O � L =70 a) L7 O a) o ,cu E (n a) O �U/ 4- a) L LL L 0 7o E U 6- cr V70 ` _Q a) O ; / M / (D 0 LO 0 0 0 0 m U U w c c 4-- cu cu cu U) m m i i 0) m L i - U cu 7 1 Q O i / 0 X U w o m / LLU 0) o w 70 cu c U w a) 0- cu 0) L ;� O / �i L.L I U L a) O ;� � CY, o 0 / 70 .O o a) z ~ i vOi vi � > N O O 0)70 LL W W L cu O a) O O C Q to to (CS LO > U U O O O cu i ~ U U O 0 _ Q w w O L L � � - U l N N N Q w w 0 cu 70" cu , cu c 'E � � � MMMd Mc) c) mm6O a) LL U (Cf OOO000N L- I cu O X � I� titititititi U Lu d d It It It Itrg U o � U CU om7 (n d d- C = N N cu j O cu U) O a) (ncu cu >+ cn 70 cv cCf m to U U U- cu O / E 0- O O O L cu O O U cu— �� � w E � �, 0- L � `� a, � 0 0Q m m m cu 70 o O ai � ° O 0 7 O a) L / �i �U 0 C 70 CD j 'j , / o � 7 L a) Q —o D o m m i 0 7 U cn U w U- a) a) (n 0 0 ccs °� � U L_ L_ / co U) T 0U t� � � I- � QQ W I- C) _ p c cu o = U 3 f m 4- D@ @ 0 0 70 � o@@ @ � 70 2 0 2 c D E > - 0 0 c % 0 cu ® � k j � _ _ % 0 § @ k � m % § .§ 2 2 D § 0 k 0 2 0 � S \ 70 22 (n - @ � .- / �70@ u @ k 7 (n CU - .§ o @ k 2 0 } \ \ k k .7 . � � -a E } � cu 0 7 @ @ 0 -0 o c 2 E @ 0) 7 \ 0) > 0 a) _ @ E 'Q .g > w @ 0 2 0- _ - -0 '- 70 M 0 M ? / § k 3 7 § _ 2 An - u .§ % 0) cu % > % k ® 2 7 2 c / E 'E R % 3 ® n § E % 2 2 U . 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(A) Drug�Free Workplace Act--F.S.440.102 Enclosure: (1) Drug Free Workplace Policy and Summary (2)Employee Acknowledgement Effective Date: Upon Receipt (1) Back round: Reference(A)requires most federal government contractors,as well as recipients of federal grants,to take specific steps to ensure a drug-free workplace for all employees. Provision requires employers to prepare and distribute an anti-drug policy. (2) u ose: The purpose of this instruction is to maintain a program for a drug-free workplace for Monroe County employees. (3) Cancellation: This instruction is to remain in effect until specifically revised or canceled. (4) Instruction/Action: A. Enclosure(2)is signed by all new hires and made part of their personnel file. ,e/ Roman Gastesi County Administrator Distribution: List III Originator: DHR Review: August 23,2025 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) MONROE COUNTY DRUG-FREE WORKPLACE POLICY AND WORK RULES 5117 M.C.A. Inst 4703 . 12 August 23, 2022 Enclosure (1) INDEX SECTION PAGE A. Policy Statement...................................................................................................... 2 B. Definitions ............................................................................................................... 3 C. Rules on Drugs and Alcohol.................................................................................... 5 D. Testing Pursuant to the Drug-Free Workplace Policy................................................................................... 12 E. Drug and Alcohol Testing of Drivers and Owner-Operators ................................................................................................... 17 APPENDIX 1 Over-the-Counter and Prescription Drugs Which Could Alter or Affect the Outcome of a Drug Test................................................. 17 APPENDIX 2 Form for Reporting Use of Medication ..................................................19 APPENDIX 3 List of Drugs by Trade or Common Name.............................................................. 20 APPENDIX 4 Form for Reasonable Suspicion Testing ................................................................ 22 APPENDIX 5 Notice (form)to Insurer of Denial of Worker's Compensation Benefits................ 23 APPENDIX 6 Form for Ordering a Drug Test .............................................................. 24 APPENDIX 7 Summary of Drug Free Workplace Policy.............................................................. 25 1 08/23/22 5118 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) A. POLICY STATEMENT Monroe County (the "County") is committed to providing a safe work environment for our employees, our guests, our community and the public. The abuse of alcohol and drugs is a national problem which impairs the safety and health of employees,promotes crime and harms our community. In order to maintain the highest standards of morale,productivity and safety in our operations, we have a drug and alcohol-free workplace policy. The program is designed to provide a safe workplace environment free from drugs and alcohol use and/or abuse. We recognize that alcohol and drug dependency require medical supervision and treatment if there is to be successful rehabilitation. Our desire and intent is to encourage any employee with alcohol or drug dependency to voluntarily enter a drug or alcohol rehabilitation program. It is the responsibility of each employee to initiate and obtain assistance before any difficulties with drugs or alcohol affect his or her work. Accordingly: EMPLOYEES OF MONROE COUNTY ARE HEREBY NOTIFIED THAT IT IS A CONDITION OF EMPLOYMENT FOR EACH EMPLOYEE TO REFRAIN FROM REPORTING TO WORK OR WORKING WITH THE PRESENCE OF DRUGS OR ALCOHOL IN HIS OR HER BODY. IF AN INJURED EMPLOYEE REFUSES TO SUBMIT TO A TEST FOR DRUGS OR ALCOHOL, PURSUANT TO STATE LAW THE EMPLOYEE MAY FORFEIT ELIGIBILITY FOR MEDICAL AND INDEMNITY BENEFITS. Our Policy complies with the Florida Drug-Free Workplace Program, as provided in Section 440.101, et seq, Florida Statutes. This Drug Free Workplace Policy and Work Rules requires all employees to be free from the influence of drugs and alcohol while working or while on County property. The use, possession, sale, distribution, or manufacture of any drugs, and/or the unauthorized possession and/or use of alcohol, while working or while on County property is prohibited. All employees will be subject to drug and alcohol testing upon reasonable suspicion, after an accident or injury, and as part of a routine fitness for duty (physical) examination. All employees are encouraged to be aware of the effects of and to advise their supervisor when taking prescription medication which may affect their performance at work. 08/23/22 Page2 5119 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) To ensure a workplace free from the influence of illegal drugs and alcohol abuse, the following Policy has been established. The Policy applies to all employees, supervisors and managers. Any violation of the Policy will result in discipline, up to and including termination of employment. B. DEFINITIONS 1.0 Alcohol: "Alcohol" means ethyl alcohol (ethanol) and includes distilled spirits,wine,malt beverages and intoxicating liquors. For purposes of this policy, alcohol is considered to be a drug. Thus, any reference to drugs and/or drug testing includes alcohol and/or alcohol testing. 2.0 Drugs: "Drugs" means alcohol, an amphetamine; a cannabinoid; cocaine, phencyclidine (PCP); a hallucinogen; methaqualone; an opiate; a barbiturate; benzodiazepines; a synthetic narcotic; a designer drug; or a metabolite of any of the substances listed in this policy. 3.0 Employee: "Employee" means an individual who works for the County on a full-time or part-time basis and receives salary, wages, or compensation. 4.0 Drug Test: 4.1 "Drug test" means any chemical, biological or physical instrumental analysis administered by a laboratory certified by the United States Department of Health and Human Services (HHS)or licensed by the Agency for Health Care Administration(AHCA)for the purpose of determining the presence of a drug or its metabolites, including alcohol. 4.2 Drug testing may require the collection of blood, urine, breath, saliva, or hair (if approved by the FDA) of an employee. The County has the right to use more accurate, scientifically accepted methods which may be approved in the future by the United States Food and Drug Administration (FDA) or the AHCA as such technology becomes available in a cost effective form. 4.3 "Initial Drug Test" means a sensitive,rapid, and reliable screening procedure of the blood or urine of employees for the presence of alcohol and drugs in accordance with the Florida Drug-Free Workplace Program and appropriate Florida Administrative Rules. 4.4 "Confirmation Test" means a second test of all specimens identified as positive on an initial test in accordance with the Florida Drug-Free Workplace Program and appropriate Florida Administrative Rules. 08/23/22 Page3 5120 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) 4.5 Drug Testing Methodology: Specimens for drug testing will be collected, handled, maintained and tested in accordance with the Florida Drug-Free Workplace Program. Urine will be used for the initial and confirmation tests for all drugs except alcohol. Blood will be used for the initial and confirmation tests for alcohol. 5.0 Positive Confirmed Test or Confirmation Test: "Positive confirmed test" or "confirmation test" means a second analytical procedure which confirms a positive result from an initial drug test in accordance with the Florida Drug-Free Workplace Program. 6.0 Medical Review Officer: "Medical Review Officer" (MRO) means a licensed physician who has knowledge of substance abuse disorders, laboratory testing procedures and chain of custody collection procedures,who is responsible for receiving and reviewing all positive confirmed test results, and who is responsible for contacting all individuals who tested positive in a confirmation test to inquire about possible medications which could have caused apositive result. 7.0 Prescription Or Non-Prescription Medication: "Prescription or non-prescription medication" means a drug or medication obtained pursuant to a prescription as defined by Section 893.02, Florida Statutes, or a medication that is authorized pursuant to federal or state law for general distribution and use without a prescription in the treatment of human diseases, ailments, or injuries. 8.0 Reasonable Suspicion Drug Testing: "Reasonable suspicion drug testing" means drug testing based on a belief that an employee is using or has used drugs or alcohol in violation of this Policy drawn from specific objective and articulable facts and reasonable inferences drawn from those facts in light of experience. Reasonable suspicion drug testing shall not be required except upon the recommendation of a supervisor who is at least one level of supervision higher than the immediate supervisor of the employee in question. Among other things, such facts and inferences may be based upon: (a) Observable phenomena while at work, such as direct observation of drug use or of the physical symptoms or manifestations or being under the influence of a drug or alcohol; (b) Abnormal conduct or erratic behavior while at work or a significant deterioration of work performance; (c) A report of drug or alcohol use,provided by a reliable and credible source; (d) Evidence that an individual has tampered with a drug test during his employment with the County; 08/23/22 Page4 5121 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) (e) Information that an employee has caused, contributed to, or been involved in an accident while at work; report of reckless driving or (f) Evidence that an employee has used,possessed, sold, solicited, or transferred drugs or alcohol while working or while on the County's premises or while operating a vehicle, machinery, or equipment of the County. 9.0 Safety-Sensitive Position: "Safety-sensitive position" means a position in which a drug or alcohol impairment constitutes an immediate and direct threat to public health or safety, such as a position that requires the employee to carry a firearm, perform life-threatening procedures,work with confidential information or documents pertaining to criminal investigations, or work with controlled substances; a position subject to Section 110.1127, Florida Statutes; or a position in which a momentary lapse in attention could result in injury or death to another person. 10.0 Special-Risk Position: "Special-risk position" means a position that is required to be filled by a person who is certified under Sections 633 or 943, Florida Statutes, as amended. 11.0 Specimen: "Specimen" means a tissue or product of the human body including blood, urine, saliva, and hair that is capable of revealing the presence of alcohol and/or drugs or their metabolites as approved the FDA or the AHCA. C. RULES ON DRUGS AND ALCOHOL EMPLOYEES OF MONROE COUNTY ARE HEREBY NOTIFIED THAT IT IS A CONDITION OF EMPLOYMENT FOR EACH EMPLOYEE TO REFRAIN FROM REPORTING TO WORK OR WORKING WITH THE PRESENCE OF DRUGS OR ALCOHOL IN HIS OR HER BODY. IF AN INJURED EMPLOYEE REFUSES TO SUBMIT TO A TEST FOR DRUGS OR ALCOHOL, PURSUANT TO STATE LAW THE EMPLOYEE MAY FORFEIT ELIGIBILITY FOR MEDICAL AND INDEMNITY BENEFITS. It is not the intent of the County to intrude into the private lives of its employees. However, the effect of drug and alcohol use, abuse and/or dependency on safety, work quality, increased medical expenses and lost productivity requires that this Policy be implemented. Any employee 08/23/22 PageS 5122 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) who violates any of these rules will be subject to termination of employment. The following rules apply under the County's Policy. 1_0 Pre-Employment Conditions 1.1 The County will not discriminate against an applicant for employment because of the applicant's past addiction to drugs or alcohol. It is the current use/abuse of drugs or alcohol that will not be tolerated. 2.0 Conditions of Continuing _Employ Employment 2.1 The County will provide each employee with a summary of the County's Drug Free Workplace Policy and Work Rules. The entire policy is available in Microsoft Exchange. It is a condition of continuing employment for each employee to abide by the Policy and Work Rules. The rules contained in the Policy are to be considered conditions of continuing employment and are to be consistently followed. Any violation of these conditions of continuing employment will result in termination. 3.0 Prohibition of Possession, etc. 3.1 The unlawful manufacture,distribution, dispensation,possession,sale or use of any drug or unprescribed, controlled substances and/or the unauthorized possession or usage of alcohol by employees while working or when on any County property are strictly prohibited. 4.0 Prohibition of Drug or Alcohol Use 4.1 All employees are prohibited from being at work or on County property with the presence of any drug or its metabolite, as set forth herein, in the employee's body. Any employee who has a confirmed positive test of a drug or its metabolite at the levels defined herein will be presumed to be under the influence of the drug and in violation of County Policy. 4.2 All employees are prohibited from being at work or on County property with the presence of alcohol, as set forth herein, in the employee's body. Any employee who has a confirmed positive test of alcohol at the levels defined herein will be presumed to be under the influence of alcohol and in violation of County Policy and Rules. 5.0 Requirement to Report Medication Use 5.1 The County does not prohibit the use of a drug (prescribed medication) provided: 08/23/22 Page6 5123 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) (a) The drug is prescribed or authorized for an employee by a medical doctor; and (b) The use of the drug at the prescribed or authorized level is consistent with the safe performance of the employee's duties; and (c) The drug is used at the dosage prescribed or authorized. 5.2 Employees are encouraged to notify their immediate supervisor when reporting for work or during the course of a work shift if the use of any prescription or non- prescription medication may adversely affect his or her ability to satisfactorily and safely perform his normal job duties (�.& including but not limited to drowsiness). A form for reporting the use of prescription or non-prescription medication is attached. Additional forms are available from the Human Resources Office. Employees in safety sensitive or special risk positions (see page 5) are required to provide their supervisor with such information. 6.0 Employee Drug and Alcohol Testing 6.1 Employees will be required to submit to drug and/or alcohol testing upon reasonable suspicion as defined in this policy, during a routine fitness for duty (physical) examination, and after an on-the-job accident, or injury or any off-the-job accident and/or injury which involves or occurs on County property. This would exclude employees who are on County property such as parks and beaches during non-working hours for purely recreational purposes. 6.2 An employee who tests positive on a confirmation test will be subject to termination. 6.3 Confidentiality will be maintained at all times except to the extent necessary to comply with these policies and to the extent permitted by law. 7.0 Employee Drug or Alcohol Related Criminal Charges or Arrests 7.1 Employees are required to notify the Human Resources Office of any criminal drug statute related criminal charge or arrest no later than five days after such charge has been bled. Employees in positions which require driving a County vehicle on County business must notify the Human Resources Office of any alcohol or drug related (ems including but not limited to Driving while Under the Influence) arrest on the next workday. 7.2 The County will take appropriate action with respect to an employee who is so charged, which action may include transfer to a non-safety sensitive or special risk position in alcohol related cases or discipline in cases related to illegal drugs. 08/23/22 Pagel 5124 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) 7.3 Employees are required to notify the Human Resources Office of any final action regarding all criminal drug statute or alcohol related criminal charges no later than five days after said final action. Final action includes but is not necessarily limited to, notification of a conviction, a plea of guilty, and adjudication of guilty, a plea of nolo contendere, and adjudication withheld, and acquittal or a dismissal of the charges. 7.4 The County will take appropriate disciplinary action against such employee within thirty days of receiving notice of the outcome or any change in the status of such criminal drug statute or alcohol related charges. 8.0 Rehabilitation Procedures 8.1 An employee who is experiencing problems as a result of drug and/or alcohol abuse should contact the Administrator of Human Resources for referral for treatment and/or counseling. This discussion will be kept confidential. Such employee will be subject to testing to verify recovery from substance abuse pursuant to the Policy requirements and failure to take or pass a drug and/or alcohol test will result in termination of employment. Where an employee voluntarily enters a treatment program before disciplinary action is initiated,the County, in its sole discretion, may elect to waive follow-up drug testing. If follow-up drug testing is required it must be conducted at least once a year for a two-year period after completion of the program. Advance notice of a follow-up testing date to the employee to be tested is strictly prohibited. 8.2 An employee in a safety-sensitive position who enters a substance abuse rehabilitation program will be assigned to a position other than a safety-sensitive position, or, if such a position is not available, will be placed on leave while the employee is participating in the program. The employee shall be permitted to use any accumulated leave credits before leave will be ordered without pay. 8.3 An employee in a special-risk position is subject to discharge for the first positive confirmed test result if the drug confirmed is an illicit drug under section 893.03, Florida Statutes (1993). A special-risk employee who is participating in a substance abuse program will not be allowed to continue to work in a safety-sensitive or special-risk position, but will be assigned to a position other than a safety-sensitive position or placed on leave while the employee is participating in the program. The employee shall be permitted to use any accumulated annual leave credits before leave will be ordered without pay. 8.4 This section applies to employees referenced in Sections 8.2 and 8.3 (above) and who are permitted to enter into a substance abuse rehabilitation program. The County will attempt to hold the employee's job open for so long as is possible. When the employee sucessfully completes said program, the County will attempt to return them to their former position. It is recognized that it may not be feasible to return the employee to their former position (e.g., if the job involves driving). If the employee is not returned to their former job, the County will utilize its best efforts to place the employee in another similar available position. 9.0 Employee Education and Referral Program 08/23/22 Page8 5125 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) 9.1 It is the responsibility of each employee to seek assistance before drugs and alcohol use or abuse leads to disciplinary problems. Employees who may require assistance for substance dependency and related programs are encouraged to seek assistance and information from the Human Resources Office. 9.2 Once a violation of this Policy occurs, subsequent use of a counseling or rehabilitation program on a voluntary basis will not affect the imposition of appropriate discipli- nary action. 9.3 An employee's decision to seek assistance or referral from the Human Resources Administrator prior to any incident warranting disciplinary action will not be used as the basis for disciplinary action or in any disciplinary proceeding. 9.4 The County has no interest in restricting social drinking outside of working hours (working hours does include an employee's lunch and break periods) and no intent to intrude upon private or personal lives of employees. The County is concerned only when the employee's health,job performance and safety conditions are adversely affected. 9.5 Upon successful completion of a drug treatment program an employee may be released to resume work but, except as provided in section 8.0 above, will be subject to drug testing on a random,periodic basis, at least quarterly,for at least two years thereafter as a condition of continued employment. 9.6 An individual's participation in an alcohol or drug treatment program will not be made part of any personnel records and will remain confidential except to the extent necessary to comply with this Policy and to the extent permitted by law. Medical and insurance records, if any, will be preserved in the same confidential manner as all other medical records. Program participation records will be maintained by the Administrator of Human Resources. 10.0 Employee Education Information 10.1 The following "crisis information centers" will provide information regarding employee assistance programs and local alcohol and drug rehabilitation programs available to employees: Monroe County Guidance/Care Center Telephone: 305-434-7660 Employee Assistance Program Telephone: 1-877-747-1200 08/23/22 Page9 5126 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) Lower Keys Medical Center(Chemical Dependency Unit). 1200 Kennedy Drive Key West, FL 33040 Telephone: (305) 292-5531 Dade County Switchboard of Miami Telephone: (305) 358-4357 Broward County Crisis Information Line Telephone: (305) 467-6333 Collier County Project Help Naples, Florida Telephone: (239) 262-7227 10.2 Other available resources include: 1-800-356-9996 Al-Anon 1-800-527-5344 American Council of Alcoholism Helpline 1-800-COCAINE COCAINE HOTLINE 1-800-NCA-CALL National Council on Alcoholism 1-800-662-HELP National Institute on Drug Abuse Hotline 1-800-843-4971 National Institute on Drug Abuse Hotline 10.3 Employees may obtain further information regarding available drug and alcohol assistance and rehabilitation programs by contacting the Human Resources Office 11.0 Management's Responsibilities 11.1 County Officers,Managers, and Supervisors (hereafter collectively referred to as "supervisors") are responsible for implementing the drug and alcohol-free workplace Policy. It is the responsibility of supervisors to observe the behavior of employees on the job as a precaution against unstable or unreliable behavior which could threaten the safety and well-being of employees or the public. 11.2 Supervisors are responsible for maintaining a safe work environment by determining each employee's fitness for duty. 11.3 In the event a supervisor has a reasonable suspicion (as defined in this policy)that an employee may be affected by drugs or alcohol or has otherwise violated this Policy, the employee will be sent for drug testing. A form for reporting the reason(s) for drug testing is 08/23/22 Page10 5127 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) attached and should be completed as soon as practicable following the incident or observations giving rise to such reasonable suspicion. 11.4 In all cases when an employee is being removed from duty for drug testing, the supervisor should notify his superior at the earliest possible time. 12.0 Employees' Responsibilities 12.1 It is each employee's responsibility to be fit for duty when reporting for work and to inform his or her supervisor if he or she is under the influence of prescription medication which may affect job performance or safety. 12.2 In the event an employee observes behavior which raises a doubt as to the ability of a co-worker to work in a safe and reliable manner, the employee should report this behavior to his/her supervisor. 12.3 Employees who voluntarily, enter a drug or alcohol treatment and/or rehabilitation program must participate and complete recommended treatment. Any employee who enters a drug or alcohol treatment and/or rehabilitation program will be responsible for payment for the treatment and/or program to the extent not covered by medical insurance provided by the County. If the employee fails to comply with the treatment and/or the program, the employee will be subject to termination. 12.4 An employee in a safety-sensitive position shall be placed by the employer in a non-safety sensitive position, or if such position is unavailable, on leave status while participating in an employee assistance program or an alcohol and drug rehabilitation program. If placed on leave status without pay, the employee shall be permitted to use any accumulated leave credits prior to being placed on leave without pay. 13.0 Employee Education 13.1 Employees and Supervisors will be required to participate in a drug-free awareness program on an annual basis. The program will inform employees about the following: (a) The legal, social,physical and emotional consequences of the use, misuse and/or abuse of alcohol or drugs; (b) The County's commitment to maintain a drug-free workplace; (c) Available drug counselling,rehabilitation and employee assistance programs; (d) Assistance in identifying personal and emotional problems which may result in the misuse of alcohol or drugs. 08/23/22 Page11 5128 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) (e) The penalties which may be imposed by the County on employees for drug abuse violations occurring in the workplace. 14.0 Rights Under Collective Bargaining Agreements: Employees who are covered under any collective bargaining agreement between the County and any certified labor organization will have the right to file a grievance regarding discipline imposed by the County as a result of a violation of this policy if said grievance is permitted to be filed pursuant to the collective bargaining agreement. D. TESTING PURSUANT TO THE DRUG-FREE WORKPLACE POLICY 1.0 Types of Testing: In order to maintain a drug and alcohol free work environment and in accordance with Florida's Drug-Free Workplace Program, Section 440.101, et seq, as amended, and applicable administrative regulations,the County will test for the presence of drugs and/or alcohol in the following circumstances: 1.1 Reasonable Suspicion: Employees who are determined to be under reasonable suspicion of drug or alcohol use (as defined in this policy), will be required to submit to a drug and/or alcohol test. 1.2 Fitness-For-Duty: All employees who are subject to a routine fitness for duty medical examinations must take a drug and/or alcohol test as part of their medical examina- tion. 1.3 Follow-up: All employees who have entered an employee assistance program or rehabilitation program for drug and/or alcohol abuse must take drug and/or alcohol tests on a quarterly, semi-annual or annual basis for two years after return to work. This requirement may be waived in the sole discretion of the County in cases where an employee voluntarily enters a drug treatment program before disciplinary action has been taken. 1.4 Post Accident or Injury: All employees who are involved in an accident or injury to an employee occurring while at work which was caused, contributed to or involved an employee must take a drug and/or alcohol test after administration of emergency medical treatment. If it cannot be determined who was driving the County vehicle at the time of the accident, then anyone who was driving the vehicle during the applicable time period will be required to submit to testing. 1.5 Random Testing for Safety-Sensitive or Special-Risk Employees: Safety- sensitive and special-risk employees are subject to random testing as determined by the County. Random testing shall be conducted via an unbiased selection procedure, and in accordance with drug-testing rules adopted by the Agency for Health Care Administration and the Department of 08/23/22 Page12 5129 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) Labor and Employment Security. Random testing shall be subject to collective bargaining, and shall not be conducted for employees covered by such agreements unless expressly included in the agreement. 2.0 Consequences of Refusing _a Drug g Test 2.1 An employee who refuses to submit to a drug test will be subject to termination. An employee who refuses to submit to a drug test following an occupational injury which requires medical treatment forfeits his eligibility for all workers' compensation medical and indemnity benefits in accordance with Florida law. 3.0 Actions Following Positive Confirmed Test: The County will terminate any employee who has a positive, confirmed drug test. 4.0 Reporting of Use of Medication: Employees may confidentially report the use of prescription or non-prescription medication both before and after having a drug test. A form for reporting medication use is attached. 5.0 Notice of Common Medications: A list of the most common medications by brand name or common name, as applicable, as well as by chemical name, which may alter or affect a drug test, is attached. Employees should review this list prior to submitting to a drug test. 6.0 Medication Information: An employee may consult with the County's MRO or the testing laboratory for technical information regarding prescription and non-prescription medication. 7.0 Drugs To Be Tested 7.1 Our Policy complies with the Florida Drug-Free Workplace Program as provided in Section 440.101, et seq, Florida Statutes. Drug testing will be required for any or all of the drugs listed in the Florida State Statute, Section 440.102. These drugs may be subject to change as per federal regulations. 7.2 Drug Cut-Off Levels will be followed as indicated by the Florida State Statutes 8.0 Reasonable Suspicion Drug Testing esting 08/23/22 Page13 5130 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) 8.1 Employees will be required to submit to drug and/or alcohol testing when a supervisor has "reasonable suspicion," as defined in this policy, to believe that an employee is using or has used drugs or alcohol in violation of this Policy. The supervisor will document the circumstances which formed his or her determination of"reasonable suspicion" in writing as soon as is practicable. While this should be done on the same day or the next working day, it must be done within three working days from the date of the determination. A form for the use of a supervisor to specify the reason(s) for the test is attached. A copy of this documentation will be given to the employee upon request within seven days from the date of the supervisor's de- termination of"reasonable suspicion." 9.0 Confidentiality and Records Maintenance 9.1 Confidentiality of records concerning drug testing pursuant to the Drug- Free Workplace Policy will be maintained in accordance with Florida law. All information, records, drug test results in the possession of the County, laboratories, employee assistance programs and drug and alcohol rehabilitation programs will be kept confidential. No such information or records will be released unless written consent, signed by an employee, is provided or unless disclosure of such information or records is compelled by court order. The County may also disclose such information when relevant in any civil, disciplinary or administrative hearing. The County will maintain records concerning drug testing separate and apart from an employee's personnel file. 9.2 Information on drug testing results will not be released in any criminal proceeding. 10.0 Challenge of Test Results of Drug Test Under Florida Law 10.1 An employee who receives a positive confirmed test result may submit information to the MRO contesting or explaining the results in writing within five (5) working days of receipt of notification of a positive confirmed test result. 10.2 If the explanation or challenge of the employee is unsatisfactory to the MRO, the MRO shall report a positive result back to the County. 10.3 Within five (5)working days after receiving notice of a positive confirmed test result from the MRO, the County shall inform the employee in writing of the positive test result, the consequences of such results, and the options available to the employee. Upon request, the County shall provide a copy of the test result to the employee. 10.4 Within five (5)working days after receiving notice of a positive confirmed test result from the County, the employee may submit information to the County explaining or contesting the test result, and explaining why the result does not constitute a violation of the County's policy. 10.5 If the explanation or challenge of the employee is unsatisfactory to the County, the County shall provide a written explanation (within fifteen (15) days of receipt) as to 08/23/22 Page14 5131 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) why the employee explanation is unsatisfactory, along with a copy of the report of positive confirmed test results. All such documentation will be kept confidential except as provided in Section 9, above and will be retained by the County for at least one (1)year. 10.6 An employee may further challenge the results of the test in a court of competent jurisdiction or, if the drug test was administered due to a workplace injury, by filing a claim for benefits with a Judge of Compensation Claims,pursuant to Chapter 440,Florida Statutes. 10.7 If an employee contests the drug test results, he or she will be solely responsible for notifying the laboratory and the County in writing by certified mail and provide a copy of the written notice, by certified mail, to the County. The notice must include reference to the chain of custody specimen identification number. 10.8 An employee who receives a positive, confirmed test result may, at the employee's expense, obtain a retest of a portion of the original specimen at another licensed and approved laboratory selected by the employee,within one hundred eighty (180) days of the notice of the positive test result. 11.0 Medical Review Officer's Responsibilities for Testing Under Florida Law 11.1 The Medical Review Officer (MRO) shall fully comply with all of the requirements set forth in Section 440.102, Florida Statutes, as it may from time to time be amended. The MRO shall be a licensed physician, under contract with the County, who has knowledge of substance abuse disorders, laboratory testing procedures, chain of custody collection procedures, and medical use of prescription drugs and pharmacology and toxicology of illicit drugs. 11.2 The MRO shall review and verify drug test results prior to the transmittal of the test results, either positive or negative,to the County. The MRO shall evaluate the drug test result(s), verify the chain of custody forms and ensure that the donor's identification number on the laboratory report and the chain of custody form accurately identifies the individual. 11.3 If the test results reported are negative, the MRO shall notify the County of the negative test result and submit the appropriate documentation to the ACHA. 11.4 If the test results reported are positive, the MRO shall notify the employee of a confirmed positive test result within three (3) days of receipt of the test result from the laboratory and inquire as to whether prescriptive or over-the-counter medications could have caused the positive test result. Within five (5) days after receiving written notification of the positive test result, the employee may contest or explain the result to the MRO. If the employee's explanation or challenge is unsatisfactory to the MRO, the MRO will report a positive test result back to the County. 08/23/22 Page15 5132 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) 11.5 Upon contacting an employee who has received a positive test result, the MRO shall properly identify the donor, inform the donor that the MRO is an agent of the County whose responsibility is to make a determination on test results and report them to the County, and inform the donor that medical information revealed during the MRO's inquiry will be kept confidential, unless the donor is in a safety sensitive position and the MRO believes that such information is related to the safety of the donor or to the other employees. 11.6 Additionally, the MRO shall outline the rights and procedures for a retest of the original specimen for the donor and process any employee's request for retest of the original specimen within one hundred eighty (180) days of notice of the positive test result in another licensed laboratory selected by the employee. The employee who requests the additional test shall be required to pay for the cost of the retest, including handling and shipping expenses. The MRO shall contact the original testing laboratory to initiate the retest. 11.7 Upon receipt of information and/or documentation from the employee, the MRO shall review any medical records provided, authorized and/or released by the individual's physician, to determine if the positive test result was caused by a legally prescribed medication. If the donor does not have prescribed medication, the MRO shall inquire about over-the-counter medications which could have caused the positive test result. The donor shall be responsible for providing all necessary documentation (i.e., a doctor's report, signed prescription, etc.) within the five (5) day period after notification of the positive test result. 11.8 If the MRO determines that there is a legitimate medical explanation for the positive test result,the MRO shall report a negative test result to the County. However, should the MRO feel that the legal use of the drug would endanger the individual or others, then the MRO shall report that the test is negative due to a validated prescription and shall request that the indi- vidual be placed in a position which would not threaten the safety of the individual or others. 11.9 If the MRO has any question as to the accuracy or validity of a test result or has a concern regarding the scientific reliability of the sample,the MRO may request the individual to provide another sample. As a safeguard to employees, once an MRO verifies a positive test result, the MRO may change the verification of the result if the donor presents information which documents that a serious illness, injury, or other circumstances that unavoidably prevented the donor from contacting the MRO within the specified time frame and if the donor presents information concerning a legitimate explanation for the positive test result. 11.10 Laboratories can now report if a specimen has been tampered with. They can identify the substance used to alter the specimen and can report such substance, in addition to reporting a positive or negative result. An adulterated or tampered with specimen is considered a refusal to test. 11.11 If the MRO is unable to contact a positive-tested donor within three(3)days of receipt of the test results from the laboratory, the MRO shall contact the County and request that the County direct the donor to contact the MRO as soon as possible. If the MRO has not been 08/23/22 Page16 5133 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) contacted by the donor within two (2) days from the request of the County, the MRO shall verify the report as positive. 11.12 If the donor refuses to talk with the MRO regarding a positive test result, the MRO shall validate the result as a positive and annotate such refusal in the remarks section. If the donor voluntarily admits to the use of the drug in question without a proper prescription, the MRO shall advise the donor that a verified positive test result will be sent to the County. 11.13 The MRO shall notify the County in writing of the verified test result, either negative, positive, or unsatisfactory and appropriately file chain of custody forms to the County and submit the proper forms to the ACHA. 12.0 Collective Bargaining 12.1 In the event of any conflict between this policy and the terms of a collective bargaining agreement, the terms of the Agreement will prevail. 12.2 In the event that mandatory changes to the policy need to be made based on state law or regulation, said changes may be made as required. Permissive changes will be made subject to impact bargaining. E. DRUG AND ALCOHOL TESTING OF DRIVERS AND OWNER-OPERATORS In addition to the policies and procedures set forth above, some employees who are connected with the operation of commercial motor vehicles are subject to drug and alcohol testing as required by the Omnibus Transportation Employee Testing Act of 1991 and all applicable procedures and regulations promulgated by the Department of Transportation and the Federal Highway Administration, particularly the regulations promulgated by the Department of Transportation contained in 49 C.F.R. part 40, as well as any additional policy adopted by the County pursuant to those federal laws and regulations. In cases where the requirements of both federal and state drug and alcohol laws and regulations and/or the County's Drug-Free Workplace Policy may be applicable, the requirements of federal drug and alcohol laws and regulations will control if a conflict arises between federal law and regulations and the requirements of state law or the County's Drug-Free Workplace Policy. OVER-THE-COUNTER AND PRESCRIPTION DRUGS WHICH COULD ALTER OR AFFECT THE OUTCOME OF A DRUG TEST ALCOHOL All liquid medications containing ethyl alcohol (ethanol). Please read the label for alcohol content. As an example, Vick's Nyquil is 25% (50 proof) ethyl alcohol, Comtrex is 20% (40 proof), Contac Severe Cold Formula Night Strength is 25% (50 proof) and Listerine is 26.9% (54 proof). 08/23/22 Page17 5134 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) OPIATES Paregoric, Parepectolin, Donnagel PG, Morphine, Tylenol with Codeine, Empirin with Codeine, APAP with Codeine, Aspirin with Codeine, Robitussin AC: Guiatuss AC, Novahistine DH, Novahistine Expectorant, Dilaudid (Hydromorphone), M-S Contin and Roxanol (morphine sulfate), Percodan, Vicodin, etc. BARBITURATES Phenobarbital, Tuinal, Amytal, Nembutal, Seconal, Lotusate, Fiorinal, Fioricet, Esgic, Butisol, Mebaral, Butabarbital, Butabital, Phrenilin, Triad, etc. BENZODIAZEPINES Ativan, Azene, Clonopin, Dalmane, Diazepam, Librium, Xanax, Serax, Tranxene, Valium, Verstran, Halcion, Paxipam, Restoril, Centrax. METHADONE Dolophine, Methadose PROPDXYPHENE Darvocet, Darvon N, Dolene, etc. 08/23/22 Page18 5135 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) MONROE COUNTY FORM FOR REPORTING THE USE OF PRESCRIPTION OR NON-PRESCRIPTION MEDICATION. NAME: SIGNATURE: DATE: PRESCRIPTION MEDICATION(S): NON-PRESCRIPTION MEDICATION(S): DO ANY OF THE ABOVE MENTIONED MEDICATIONS IMPAIR YOUR ABILITY TO DRIVE? YES NO OR PERFORM ANY OTHER REQUIRED DUTIES? YES NO ------------------------------------------------------------------------------------------------------------------------------- IF THE ABOVE IS "YES" ON EITHER QUESTION, SUPERVISOR IS TO CONTACT HUMAN RESOURCES FOR FUTHER INSTRUCTIONS. ------------------------------------------------------------------------------------------------------------------------------- RECEIVED BY: NAME: POSITION: DATE: CC: Human Resources 08/23/22 Page19 5136 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) LIST OF DRUGS BY TRADE OR COMMON NAMES Please note this is not a list indicative of the drugs that may be tested for DRUGS TRADE OR COMMON NAMES Narcotics Opium Dover's Powder, Paregoric, Parepectolin Morphine Morphine, Pectoral Syrup Codeine Tylenol with Codeine, Empirin Compound with Codeine, Robitussin A-C Heroin Diacetylmorphine, Horse, Smack Hydromorphone Dilaudid Meperidine (Pethidine) Demerol, Mepergan Methadone Dolophine, Methadone, Methadose Other Narcotics LAAM, Leritine, Numorphan, Percodan, Tussionex, Fentanyl, Darvon, Talwin, Lomotil Depressants Chloral Hydrate Noctec, Somnos Barbiturates Phenobarbital, Tuinal, Amytal,Nembutal, Seconal, Lotusate Benzodiazepines Ativan, Azene, Clonopin, Dalmane, Diazepam, Librium, Xanax, Serax, Tranxene, Valium, Verstran, Halcion, Paxipam, Restoril Methaqualone Quaalude Glutethimide Doriden Other Depressants Equanil, Miltown, Noludar, Placidyl, Valmid Stimulants Cocaine Coke, Flake, Snow, Crack Amphetamines Biphetamine, Delcobese, Desoxyn, Dexedrine, Mediatric Phenmetrazine Preludin Methylphenidate Ritalin Other Stimulants Adipex, Bacarate, Cylert, Didrex, Ionamin, Plegine, Pre-Sate, Sanorex, Tenuate, Tepanil, Voranil 08/23/22 Page20 5137 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) Hallucinogens LSD Acid, Microdot Mescaline and Peyote Mesc, Buttons, Cactus Amphetamine Variants 2,5-DMA, PMA, STP, MDA, MDMA, TMA, DOM, DOB Phencyclidine PDP, Angel Dust, Hog Phencyclidine Analogs PCE, PCPy, TCP Other Hallucinogens Bufotenine, lbogaine, DMT, DET, Psilocyin Cannabis Marijuana Pot, Acapulco Gold, Grass, Reefer, Sinsemilla, Thai Sticks Tetrahydrocannabinol THC Hashish Hash Hashish Oil Hash Oil 08/23/22 Page21 5138 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) MEMORANDUM TO: Human Resources Office FROM: DATE: SUBJECT: Reasonable Suspicion Report +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ As per the Monroe County Drug Free Workplace Policy Section 8.0(a), I am hereby requesting that be tested for: (employee name) drugs and/or alcohol, as per the Reasonable Suspicion provisions outlined below. 1. Observable phenomena while at work, such as direct observation of drug use or of the physical symptoms or manifestations of being under the influence of drugs or alcohol. (List signs of drug or alcohol use.) 2. Behavioral symptoms associated with drug use or intoxication from either drugs or alcohol such as abnormal conduct, erratic behavior,reckless driving, or a significant deterioration in work performance. (List behavioral symptoms.) 3. Report of drug or alcohol use provided by a credible source. (List evidence such as letters,reports, etc.) 4. Any evidence that an individual has tampered with a drug test during his/her current employment. (List evidence.) 5. Any evidence that an employee has used,possessed, sold, solicited, or transferred drugs while working or on County property whether the employee is working or not, or while operating County vehicles, machinery,or other equipment. (List evidence.) 6. Information that an employee has caused, contributed to, or been involved in an accident while at work. (Explain:) Supervisor Date 2nd Supervisor in concurrence Date "Reasonable suspicion drug testing shall not be required except upon the recommendation of a supervisor who is at least one level of supervision higher than the immediate supervisor of the employee in question. 08/23/22 Page22 5139 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) COUNTY'S NOTIFICATION TO WORKERS' COMPENSATION CARRIER OR SELF-INSURER, RE: NOTICE OF DENIAL OF MEDICAL INDEMNITY BENEFITS BECAUSE OF AN INJURED EMPLOYEE'S POSITIVE DRUG TEST. A notification similar to this one should be sent to the County's workers' compensation carrier as soon as you receive written positive drug test results and decide to deny medical and indemnity benefits. Date: Dear Worker's Compensation Carrier: The employee listed below and who may have suffered an on-the-job injury on [date of accident] has tested positive for drugs pursuant to our County's Drug- Free Workplace Policy. [Employee's name] [Employee's social security no.] The specimen/sample collected from the employee at the time of the accident was tested twice by the laboratory. In addition,the test results were verified by the County's Medical Review Officer in order to ensure the accuracy of the test. Pursuant to Florida Statutes §440.102(5)(p),carriers [or self insurers] are required to give "reasonable notice" to all affected health care providers that payment for treatment, care and attendance provided to the above-named employee after a future date certain will be denied. We hereby request that you immediately provide reasonable notice to all affected health care providers that the payment for treatment, care and attendance provided to the above-employee will be denied. We also request that you deny payment for any other medical or indemnity benefits to the above named employee, after you have provided the above described reasonable notice. Please call if you need more information. Thank you for your cooperation in this matter. Respectfully submitted, [County's Official] 08/23/22 Page23 5140 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) FORMS FOR ORDERING DRUG TESTS The form for ordering a drug test is in Microsoft Exchange under/Public Folders/County Forms/Personnel Forms. This form is to be completed by Human Resources only, but it is available in the exchange for your review. 08/23/22 Page24 5141 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) SUMMARY OF DRUG-FREE WORKPLACE POLICY EMPLOYEES OF MONROE COUNTY ARE HEREBY NOTIFIED THAT IT IS A CONDITION OF EMPLOYMENT FOR EACH EMPLOYEE TO REFRAIN FROM REPORTING TO WORK OR WORKING WITH THE PRESENCE OF DRUGS OR ALCOHOL IN HIS OR HER BODY. IF AN INJURED EMPLOYEE REFUSES TO SUBMIT TO A TEST FOR DRUGS OR ALCOHOL, PURSUANT TO STATE LAW THE EMPLOYEE MAY FORFEIT ELIGIBILITY FOR MEDICAL AND INDEMNITY BENEFITS. L WHAT IS THE DRUG-FREE WORKPLACE PLACE POLICY? A. In accordance with Florida's Drug Free Workplace law, Section 440.101 et seq., Monroe County ("the County") prohibits the illegal use, possession, sale, manufacture, or distribution, of drugs, alcohol, or other controlled substances on its property. For purposes of this policy alcohol is considered to be a drug. B. It is also against County policy for employees to report to work or to work under the influence of drugs or alcohol. This includes prescription drugs which induce an unsafe mental or physical state. Any employee who is taking any prescription drug which might impair safety, performance, or any motor functions should advise his or her supervisor before commencing work under such medication. C. For the purpose of this policy, an individual is presumed to be under the influence of drugs or alcohol if a confirmed drug or alcohol test is positive. D. The use, sale,purchase,possession, distribution, or dispensing of drugs or alcohol on duty or on County property is cause for immediate discharge. E. The County may suspend employees without pay under this policy pending the results of a drug test or investigation. If placed on leave status without pay, the employee shall be permitted to use any accumulated leave credits prior to being placed on leave without pay. F. This County has contracted with a Medical Review Officer (MRO) who is a licensed physician with knowledge of substance abuse disorders, laboratory testing procedures, chain of custody collection procedures, the medical use of prescription drugs and the pharmacology and toxicology of illicit drugs. The purpose of the MRO is to ensure to the maximum extent possible that all test 08/23/22 Page25 5142 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) results are accurate. Applicants or employees can discuss any technical questions regarding testing with the MRO prior to or after the test. It WHO IS TESTED BY THE COUNTY? The County tests all employees as described below: A. Employees: 1. Reasonable-suspicion Testing: Employees will be tested when there is a reasonable suspicion that an employee is using or has used drugs or alcohol. 2. Post On-the-Job Accident or Injury Testing: Employees who sustain an on-the-job injury, or who have caused, contributed to or have been involved in an accident while at work will be tested at the time medical treatment is administered, or as soon as possible. 3. Routine Fitness-for-Duty Testing: Employees will be drug tested as part of any routinely scheduled employee fitness-for-duty medical examination. 4. Additional Testing: Additional testing may also be conducted as required by applicable state or federal laws, rules, or regulations or as deemed necessary by the County. III. WHAT IF AN EMPLOYEE REFUSES TO BE TESTED? A. Any employee who refuses to submit to a drug test will be terminated from employment. An injured employee who refuses to submit to a drug or alcohol test, or has a positive confirmation test, in addition to the above, forfeits his or her eligibility for all workers' compensation medical and indemnity benefits. IV. WHAT IF SOMEONE TESTS POSITIVE? A. Tests will be conducted only by laboratories licensed and approved by the proper state and/or federal agencies. Test specimens will be collected,tested, and stored pursuant to the requirements of Florida law. No physician-patient relationship is created between an employee and the County or any person performing or evaluating a drug test. 08/23/22 Page26 5143 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) B. Laboratories can now report if a specimen has been tampered with. They can identify the substance used to alter the specimen and can report such substance, in addition to reporting a positive or negative result. An adulterated or tampered with specimen is considered a refusal to test. C. The County's Medical Review Officer(MRO)will initially receive and verify that test results were properly analyzed and handled by the laboratory testing. The MRO will then contact the employee to give the person an opportunity to explain or challenge a positive test result to determine whether prescription or other legitimately taken drugs could have caused the positive test result. If the MRO decides that the applicant or employee's explanation is unsatisfactory, the MRO will report a positive test to the County. The County will notify the employee of confirmed positive test results within five (5) working days after receipt of the result from the MRO. D. A employee who receives a positive confirmed drug test result may contest or explain the result to the MRO or the County within five (5) days after written notification of the positive test result. If the explanation or challenge is unsatisfactory, a written explanation will be given to the applicant or employee. If the applicant's or employee's challenge is unsatisfactory to the MRO or the County,the applicant or employee has the right to contest the test results pursuant to rules adopted by the Florida Division of Workers' Compensation. E. The testing laboratory will preserve specimens of confirmed positive test results for at least 210 days after the result was mailed to the MRO. A employee has the responsibility of notifying the drug testing laboratory of any administrative or civil action brought pursuant to Chapter 440, Florida Statutes. If timely notified, the testing laboratory will maintain the sample until the case or administrative appeal is settled. F. Any applicant or employee who elects to have a portion of his or her specimen retested must notify the testing laboratory and make a request to the County within 180 days after written notification of a positive test result. G. A list of names, addresses, and telephone numbers of employee assistance programs and local drug rehabilitation programs are on file with the County. This information will be provided to any person upon request. V. WHAT IF AN EMPLOYEE HAS QUESTIONS ABOUT LEGITIMATE PRESCRIPTION DRUG OR OTHER TECHNICAL INFORMATION ABOUT THE TESTS? 08/23/22 Page27 5144 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) A. Employees have the right to confidentially consult the Medical Review Officer (MRO) for technical information regarding prescription and non-prescription medication and may contest or explain the test result to the MRO both before and after being tested. B. Prior to testing,the employee will be given a list of the most common medications by brand name or common name and chemical name which may alter or affect a drug test. This information is on the Drug Testing/Chain-of-Custody/HRS Form 1806. C. A Drug Use Information form,which is a confidential report,may be filled out by employees before or after being drug tested. This form permits individuals to provide to the MRO a list of all prescription and non-prescription drugs they are currently using or have used in the last month, as well as any other information they consider relevant to the test. D. All information, interviews,reports, statements,memoranda and drug test results, written or otherwise, received by the County as part of this drug testing program are confidential communications. Unless authorized by state laws, rules or regulations, the County will not release such information without a written consent form signed voluntarily by the person tested. The County or its legal counsel may disclose such information in the event that a challenge or other form of civil, disciplinary or administrative litigation is commenced by a employee. VL WHAT TYPE OF DRUGS ARE TESTED? Our policy complies with the Florida Drug-Free Workplace Program, as provided in Section 440.101, et seq, Florida Statutes. Monroe County tests for drugs listed in the Florida State Statutes, Section 440.102. This list could be subject to change according to federal regulations. VII. WHAT ELSE SHOULD I KNOW ABOUT THE POLICY? A. Details of this policy may be obtained from the Human Resources Office. B. The contents of this policy constitute statements of the County's current policy and may be changed and updated by the County at any time. Nothing in this policy is intended to create a contract between the County and any employee. Nothing in these guidelines binds the County to a specific or definite period of employment or to any specific policies,procedures,actions, rules, or terms and conditions of employment. C. As a condition of employment and continued employment, all employees are required to abide by this policy. 08/23/22 Page28 5145 M.C.A. Inst 4703.12 August 23,2022 Enclosure(1) D. All information, interviews, reports, statements, memoranda, and drug test results, written or otherwise, received or produced as a result of a drug testing program are confidential and exempt from the provisions of s. 119.07(1) and s. 24(a), Art 1 of the State Constitution, and may not be used or received in evidence, obtained in discovery, or disclosed in any public or private proceedings, except in accordance with this section. E. An employee in a safety-sensitive position shall be placed by the employer in a non- safety sensitive position, or if such position is unavailable, on leave status while participating in an employee assistance program or an alcohol and drug rehabilitation program. If placed on leave status without pay, the employee shall be permitted to use any accumulated leave credits prior to being placed on leave without pay. 08/23/22 Page29 5146 M.C.A.Inst.4703.12 August 23,2022 Enclosure(2) EMPLOYEE ACKNOWLEDGMENT OF RECEIPT OF SUMMARY OF DRUG-FREE WORKPLACE POLICY I, , hereby acknowledge that I received a (Employee's Name) copy of the Monroe County Summary of Drug-Free Workplace Policy, consisting of this page and the five (5)preceding typewritten pages on the date indicated below. I understand that on the effective date of the policy, it will be a condition of my employment to refrain from reporting to work or working with the presence of drugs or alcohol in my body. (Employee's Signature) DATE: 08/23/22 Page30 5147 eD d C S Y Mayor David Rice,District 4 Mayor Pro Tern Craig Cates,District 1 OUNTY C acheNe ( iron,District 2 KEY WESTjo '�MONROE LORIDA 33040 James K.Scholl,District 3 t305y s4a Holly Merrill Raschein,District,5 race of the Employee Services Director The Historic Cato Cigar Factory 110 Simonton Street,Suite 268 Ivey West,FL 3 010 (305)292408—Phone ;f' (305)292-M-1-Fax OFF ICE of the COUP ADMINISTRATOR Key West,Florida MONROE COUNTY ADMINISTRATIVE INSTRUCTION 4709.3 Date: August 23, 2022 Subject: Department of Transportation(DOT) rug,,Free Workplace Policy Reference: Omnibus Transportation Employee Testing Act of 1991,49 U.S.C. Section 31306,et seq. and related regulations,49 C.F.R.parts 40 and 382,as amended from time to time, Enclosure: (1)DOT Policy and Summary (2)Employee Acknowledgement Effective Date: Upon Receipt (1) Background: In 1994,as required by the Omnibus Transportation Employee Testing Act of 1991,the Federal Highway Administration (an operating agency of the United States Department of Transportation)enacted federal regulations,which are published at 49 C.F.R.part 382. These federal regulations mandate that all employers of certain drivers of commercial motor vehicles implement a program to monitor and test for alcohol misuse and controlled substances use by those drivers. (2) Purpose: e purpose of this instruction is to comply with regulations and to provide information about the regulations and the County's policies and procedures to all County employees whose fob duties place them under the mandate. (3) Cancellation: This instruction is to remain in effect until specifically revised or canceled. (4) Instruction/Action: A. Enclosure(2) is signed by all new hires r 'de part of their personnel file. oma astesi County Administrator Distribution: List III Originator- DHR Review: /23/25 M.C.A.Inst.4709.3 August 23,2022 Page 1 Enclosure(1) DEPARTMENT OF TRANSPORTATION (DOT) DRUG FREE WORKPLACE POLICY TABLE OF CONTENTS SECTION PAGE POLICY STATEMENT 2 ADDITIONAL INFORMATION&INTERPRETATIONS 2 DEFINITIONS 2 PROHIBITED CONDUCT 6 TYPES OF TESTING 7 PRE-EMPLOYMENT 7 POST ACCIDENT 8 RANDOM 9 REASONABLE SUSPICION 9 RETURN-TO-DUTY 10 FOLLOW-UP 11 ALCOHOL TESTING PROGRAM&PROCEDURES 11 THE BREATH ALCOHOL TECHNICIAN(BAT) 11 DEVICES TO BE USED FOR ALCOHOL TESTING 12 QUALITY ASSURANCE PLANS FOR EBT'S 12 LOCATIONS FOR BREATH ALCOHOL TESTING 13 THE BREATH ALCOHOL TESTING FORM&LOG BOOK 14 PREPARATIONS FOR THE BREATH ALCOHOL TESTING 14 PROCEDURES FOR BREATH ALCOHOL SCREENING TESTS 14 PROCEDURES FOR BREATH ALCOHOL CONFIRMATION TESTS 15 REFUSALS TO TEST&UNCOMPLETED TESTS 17 INABILITY TO PROVIDE ADEQUATE AMOUNT OF BREATH 17 DISCLOSURE OF ALCOHOL TESTING INFORMATION 18 MAINTENANCE&DISCLOSURE OF RECORDS 19 CONTROLLED SUBSTANCES TESTING PROGRAM AND PROCEDURES 20 SCOPE OF CONTROLLED SUBSTANCE TESTING PROGRAM 20 REPORTING AND REVIEW OF RESULTS 20 PROTECTION OF EMPLOYEE RECORDS 22 INDIVIDUAL ACCESS TO TEST&LAB CERTIFICATION RESULT 22 USE OF DHHS-CERTIFIED LABORATORIES 22 NOTICE REQUIREMENTS 23 NOTIFICATION BY THE COUNTY 23 NOTIFICATION BY THE MRO 23 RECORD KEEPING,PRE-EMPLOYMENT INQUIRY&REPORTING 24 LOCATION OF RECORDS 25 PERIOD OF RETENTION OF RECORDS BY THE COUNTY 25 RETENTION OF CONTROLLED SUBSTANCES RECORDS BY MRO 25 PRE-EMPLOYMENT INQUIRY,RELEASE OF ALCOHOL& CONTROLLED SUBSTANCES TEST INFORMATION BY PREVIOUS EMPLOYERS 25 REPORTING OF RESULTS IN A MANAGEMENT INFO SYSTEM 26 CONFIDENTIALITY&ACCESS TO FACILITIES&RECORDS 28 CONFIDENTIALITY OF RECORDS KEPT BY THE COUNTY 28 ACCESS TO FACILITIES 28 CONFIDENTIALITY OF RECORDS KEPT BY MRO 29 REFERRAL,EVALUATION&TREATMENT 29 EDUCATIONAL INFORMATION&TRAINING OF SUPERVISORS 30 EDUCATIONAL INFORMATION TO EMPLOYEES 30 ACKNOWLEDGMENT OF RECEIPT 31 TRAINING FOR SUPERVISOR 31 DISCIPLINE 32 5149 M.C.A.Inst.4709.3 August 23,2022 Page 2 Enclosure(1) I. POLICY STATEMENT Monroe County ("County") is committed to providing a safe work environment for all of its employees and the public. The abuse of alcohol and drugs is a national problem which impairs the safety and health of employees and the public, promotes crime and harms the entire community. In order to maintain the highest standards of morale,productivity and safety in our operations, the County has instituted a drug and alcohol free workplace program. In 1994, as required by the Omnibus Transportation Employee Testing Act of 1991, the Federal Highway Administration (an operating agency of the United States Department of Transportation) enacted federal regulations, which are published at 49 C.F.R. part 382. These federal regulations mandate that all employers of certain drivers of commercial motor vehicles implement a program to monitor and test for alcohol misuse and controlled substances use by those drivers. Accordingly, the County has established the following policies which will be applicable to those County employees who fall within the requirements of this federal law and related regulations. All County employees whose job duties place them under the mandate of the federal regulations will be provided information about the regulations, and the County's policies and procedures that have been established to comply with the regulations. IN ADDITION TO THE REQUIREMENTS OF 49 C.F.R. PART 382, EMPLOYEES WHO ENGAGE IN CONDUCT PROHIBITED BY THIS POLICY ARE SUBJECT TO DISCIPLINARY ACTION BY THE COUNTY, UP TO AND INCLUDING TERMINATION. II. ADDITIONAL INFORMATION AND INTERPRETATION Employees who have any questions about this policy are encouraged to speak with their supervisor and/or to call the Human Resources Office. This Policy is intended to conform to the requirements of the Omnibus Transportation Employee Testing Act of 1991, 49 U.S.C. Section 31301, et seq. and related regulations, 49 C.F.R. part 40 and 382, as amended from time-to-time. Accordingly, that federal law and related regulations should be referenced to assist in the interpretation of questions arising from the requirements of this Policy. III. DEFINITIONS 3.1 AIR BLANK means a reading by an Evidential Breath Testing device (EBT) of ambient air containing no alcohol (in EBT's using gas chromatography technology, a reading of the device's internal standard). 3.2 ALCOHOL means the intoxicating agent in beverage alcohol, ethyl alcohol, or other low molecular weight alcohols, including methyl and isopropyl alcohol. 3.3 ALCOHOL CONCENTRATION (CONTENT) means the alcohol in a volume of breath expressed in terms of grams of alcohol per 210 liters of breath, as indicated by an Evidential Breath Testing device ("EBT"). 3.4 ALCOHOL USE means the consumption of any beverage, mixture, or preparation including medication, containing alcohol. 5150 M.C.A.Inst.4709.3 August 23,2022 Page 3 Enclosure(1) 3.5 CANCELLED OR INVALID TEST 3.5.A In drug testing, a cancelled test is a drug test that has been declared invalid by an MRO. A cancelled test is neither a positive nor a negative test. For purposes of this Policy, a specimen that has been rejected for testing by a laboratory is treated the same as a cancelled test. 3.5.13 In alcohol testing, a cancelled test is a test deemed to be invalid under Section 6.12 of this Policy. A cancelled alcohol test is neither a positive nor a negative test. 3.6 BLIND SAMPLE OR BLIND PERFORMANCE TEST SPECIMEN. A urine specimen submitted to a laboratory for quality control testing purposes, with a fictitious identifier, so that the laboratory cannot distinguish it from employee specimens, and which is spiked with known quantities of specific drugs or which is blank, containing no drugs. 3.7 BREATH ALCOHOL TECHNICIAN (BAT) is an individual who instructs and assists individuals in the alcohol testing process and who operates an Evidential Breath Testing device (EBT). 3.8 CHAIN OF CUSTODY refers to the procedures to account for the integrity of each urine or blood specimen by tracking its handling and storage from point of specimen collection to final disposition of the specimen. 3.9 COLLECTION CONTAINER means a container into which the employee urinates to provide the urine sample for a drug test. 3.10 COLLECTION SITE means a place designated by the County where individuals present themselves for the purpose of providing a specimen of their urine to be analyzed for the presence of drugs. 3.11 COLLECTION SITE PERSON means a person who instructs and assists individuals at a collection site and who receives and makes a screening examination of the urine specimen provided by those individuals. 3.12 COMMERCIAL MOTOR VEHICLE means a motor vehicle or combination of motor vehicles used in commerce to transport passengers or property if the motor vehicle: 3.12.A. Has a gross weight rating of 26,001 or more pounds, inclusive of a towed unit with a gross vehicle weight rating of more than 10,000 pounds; or 3.12.13 Has a gross vehicle weight rating of 26,001 or more pounds; or 3.12.0 Is designed to transport sixteen (16) or more passengers, including the driver; or 3.12.1) Is of any size and is used in the transportation of materials found to be hazardous for the purposes of the Hazardous Materials Transportation Act and which require the motor vehicle to be placarded under the Hazardous Materials Regulations (49 C.F.R. part 172, subpart F) 3.13 CONFIRMATION TEST FOR ALCOHOL TESTING means a second test, following a screening test with a result of 0.02 or greater that provides quantitative data of alcohol concentration. 3.14 CONFIRMATION TEST FOR SUBSTANCE ABUSE TESTING means a second analytical procedure to identify the presence of a specific drug or metabolite which is independent of the screening test and which uses a different technique and chemical principal from that of the screening test in order to ensure reliability and accuracy (gas chromatography/mass spectrometry [GC/MS] is the only authorized confirmation for cocaine, marijuana, opiates, amphetamines, and phencyclidine.) 5151 M.C.A.Inst.4709.3 August 23,2022 Page 4 Enclosure(1) 3.15 DHHS means the United States Department of Health and Human Services or any designee of the Secretary, Department of Health and Human Services. 3.16 DOT means the United States Department of Transportation 3.17 DOT AGENCY means an agency (or"operating administrator") of the DOT administering regulations requiring alcohol and/or drug testing, in accordance with 49 C.F.R. part 40, including the Federal Aviation Administration (FAA), the Federal Railroad Administration (FRA), the Federal Highway Administration (FHWA), the Federal Transit Administration (FTA), the Research and Special Programs Administration (RSPA), and the Office of the Secretary. 3.18 DRIVER means any person who operates a commercial motor vehicle. This includes, but is not limited to: full time, regularly employed drivers; casual, intermittent or occasional drivers; leased drivers and independent, owner-operator contractors who are either directly employed by or under lease to the County or who operate a commercial motor vehicle at the direction of with the consent of the County. For purposes of pre-employment/pre-duty testing only, the term driver includes a person applying for a position with the County to drive a commercial motor vehicle. 3.19 EMPLOYER as defined in the regulations means any person (including the United States, a State, District of Columbia or a political subdivision of a State)who owns or leases a commercial motor vehicle or assigns persons to operate such a vehicle. The term employer as used in this Policy refers to the County, and includes the County's agents, officers and representatives. 3.20 EVIDENTIAL BREATH TESTING DEVICE (EBT)means an evidential breath testing device approved by the National Highway Traffic Safety Administration (NHTSA) for the evidential testing of breath and which is placed on NHTSA's "Conforming Products List of Evidential Breath Measurement Devices" (CPL). 3.21 FHWA means the Federal Highway Administration. 3.22 MEDICAL REVIEW OFFICER (MRO)means a licensed physician (medical doctor or doctor of osteopathy) responsible for receiving laboratory results generated by the County's drug testing program, who has knowledge of substance abuse disorders and has appropriate medical training to interpret and evaluate an individual's confirmed positive test result, together with that individual's medical history and any other relevant biomedical information. 3.23 NHTSA means the National Highway Traffic Safety Administration. 3.24 PERFORMING A SAFETY-SENSITIVE FUNCTION. A driver is considered to be `performing a safety-sensitive function' during any period in which he or she is actually performing, ready to perform or immediately available to perform any `Safety-Sensitive' functions, which are defined in Section 3.26 of this Policy. 3.25 REFUSE TO SUBMIT TO AN ALCOHOL OR CONTROLLED SUBSTANCES TEST means that an employee/driver has: 3.25.A failed to provide adequate breath for testing without a valid medical explanation after the employee/driver has received notice of the requirement for breath testing in accordance with the provisions of this Policy (i.e., 49 C.F.R. part 382 and part 40); or, 3.25.13 failed to provide adequate urine for controlled substances testing without a valid medical explanation after the employee/driver has received notice of the 5152 M.C.A.Inst.4709.3 August 23,2022 Page 5 Enclosure(1) requirement for urine testing in accordance with the provisions of this Policy (i.e., 49 C.F.R. part 382 and part 40); or, 3.25.0 engaged in conduct that clearly obstructs the testing process; and/or 3.25.D failed to sign the alcohol testing form (if the employee did not take the test). 3.26 SAFETY SENSITIVE FUNCTION means on-duty time during which the DRIVER is engaged in any of the following: 3.26.A All time at a carrier or shipper plant, terminal, facility, or other property, or on any public property, waiting to be dispatched, unless the driver has been relieved from duty by the County; 3.26.13 All time inspecting equipment(as required by 49 C.F.R. § 392.7 and 392.8) or otherwise inspecting, servicing, or conditioning any commercial motor vehicle at any time; 3.26.0 All driving time; 3.26.D All time, other than driving time, in or upon any commercial motor vehicle, except time spent resting in a sleeper berth; 3.26.E All time loading or unloading a vehicle, supervising, or assisting in the loading or unloading, attending a vehicle being loaded or unloaded, remaining in readiness to operate the vehicle, or in giving or receiving receipts for shipments loaded or unloaded; 3.26.17 All time repairing, obtaining assistance, or remaining in attendance upon a disabled vehicle. 3.27 SCREENING TEST (also known as INITIAL TEST): 3.27.A In alcohol testing, a `screening test' means an analytical procedure to determine whether a driver may have a prohibited concentration of alcohol in his or her system. 3.27.13 In controlled substance testing, a `screening test' means an immunoassay screen to eliminate `negative' urine specimens from further consideration. 3.28 SHIPPING CONTAINER means a container, capable of being secured with a tamper-proof seal, that is used for transfer of one (1) or more specimen bottle(s) and associated documentation from the collection site to the laboratory. 3.29 SPECIMEN BOTTLE means the bottle which, after being labeled and sealed according to the procedures in Section VII of this Policy (i.e., 49 C.F.R. part 40), is used to transmit a urine sample to the laboratory. 3.30 SUBSTANCE ABUSE PROFESSIONAL means a licensed physician (Medical Doctor or Doctor or Osteopathy), or a licensed or certified psychologist, social worker, employee assistance professional, or addiction counselor(certified by the National Association of Alcoholism and Drug Abuse Counselors Certification Commission)with knowledge of and clinical experience in the diagnosis and treatment of alcohol and controlled substances- related disorders. 5153 M.C.A.Inst.4709.3 August 23,2022 Page 6 Enclosure(1) IV PROHIBITED CONDUCT 4.1 ALCOHOL CONCENTRATION: No driver shall report for duty or remain on duty requiring the performance of safety-sensitive functions while having an alcohol concentration of 0.04 or greater. 4.2 ALCOHOL POSESSION: No driver shall be on duty or operate a commercial motor vehicle while the driver possesses alcohol, unless the alcohol is manifested and transported as part of a shipment. 4.3 ON DUTY USE OF ALCOHOL: No driver shall use alcohol while performing safety- sensitive functions. 4.4 PRE DUTY USE OF ALCOHOL: No driver shall perform safety-sensitive functions within four(4) hours after using alcohol. 4.5 USE OF ALCOHOL FOLLOWING AN ACCIDENT: No driver required to take a post- accident alcohol test shall use alcohol for eight(8) hours following the accident, or until the driver undergoes a post-accident alcohol test, whichever occurs first. 4.6 REFUSAL TO SUBMIT TO A REQUIRED ALCOHOL OR CONTROLLED SUBSTANCE TEST: No driver shall `refuse to submit' to a post-accident alcohol or controlled substances test, a random alcohol or controlled substances test, a reasonable suspicion alcohol or controlled substance test, a return-to-duty or a follow-up alcohol or controlled substances test. 4.7 CONTROLLED SUBSTANCES USE: 4.7.A No driver shall report for duty or remain on duty requiring the performance of safety-sensitive functions when the driver uses any controlled substance, except when the use is for therapeutic purposes pursuant to the instructions of a physician who has advised the driver that the substance does not adversely affect the driver's ability to safely operate a commercial motor vehicle. 4.7.13 Drivers must inform their supervisor(or the Human Resources Office) of any therapeutic drug use prior to the performance of any `safety-sensitive' function. 4.8 CONTROLLED SUBSTANCE TESTING: No driver shall report for duty, remain on duty or perform a safety-sensitive function, if the driver tests positive for controlled substances. 4.9 All drivers who engage in any conduct prohibited by this Policy (i.e., 49 C.F.R. part 382) must comply with all applicable requirements of Section XI of this Policy (i.e., 49 C.F.R. § 382.605)before returning to work to perform safety-sensitive functions for the County or any other employer. 4.9.A No driver tested under the provisions of this Policy (i.e., 49 C.F.R. part 382)who is found to have an alcohol concentration of 0.04 or greater, shall perform or continue to perform safety-sensitive functions for the County, including driving a commercial motor vehicle, nor shall the County permit the driver to perform or continue to perform safety-sensitive functions, until the start of the driver's next regularly scheduled duty period, but not less than twenty-four(24) hours following administration of the test. 4.9.13 Except as provided in paragraph 4.9.A of this Section, the County shall not take any action pursuant to this Section against a driver based solely on test results showing an alcohol concentration less than 0.04. This does not prohibit the County from taking any action otherwise consistent with law and the County's policies, rules and regulations. 5154 M.C.A.Inst.4709.3 August 23,2022 Page 7 Enclosure(1) 4.10 IN ADDITION TO THE REQUIREMENTS OF 49 C.F.R. PART 382, EMPLOYEES WHO ENGAGE IN CONDUCT PROHIBITED BY THIS POLICY ARE SUBJECT TO DISCIPLINARY ACTION BY THE COUNTY, UP TO AND INCLUDING TERMINATION. 4.11 THE COUNTY: If the County has actual knowledge that a driver has violated any of the above-noted prohibitions, it will not permit the driver to drive or continue to drive a commercial motor vehicle, or to perform or continue to perform safety sensitive functions until the driver has met all applicable requirements of Section XI of this Policy (i.e., 49 C.F.R. § 382.605) V. TYPES OF TESTING 5.1 PRE-EMPLOYMENT TESTING 5.1.A Prior to the first time a driver performs safety-sensitive functions for the County, the driver shall undergo testing for alcohol and controlled substances. The County shall not allow a driver to perform safety-sensitive functions unless the driver has been administered an alcohol test with a result indicating an alcohol concentration less than 0.04, and has received a controlled substances test result from MRO indicating a verified negative test result. If a pre-employment alcohol test result under this Section indicates an alcohol content of 0.02 or greater, but less than 0.04, the provisions of Sections 4.9.A and 4.9.13 of this Policy (i.e., 49 C.F.R. § 382.505) shall apply. 5.1.13 Exception for Pre-Employment Alcohol Testing: The County may choose not to administer a pre-employment alcohol test required by this Section if: 1. The driver has undergone an alcohol test required by this Policy or by 49 C.F.R. part 382, or by the alcohol misuse rule of another DOT agency under 49 C.F.R. part 40 within the previous six (6) months, with a result indicating an alcohol concentration of less than 0.04; and 2. The County is able to ensure that none of the driver's prior employer(s) (of whom the County has knowledge) has record(s) of a violation of 49 C.F.R.,part 382 or the alcohol misuse rule of another DOT agency within the previous six (6) months. 5.LC Exception for Pre-Employment Controlled Substances Testing: The County may choose not to administer a pre-employment controlled substances test required by this Section if: 1. The driver has participated in a drug testing program that meets the requirements of 49 C.F.R. part 382 within the previous thirty (30) days; and 2. While participating in that program, the driver either: a. was tested for controlled substances within the past six (6) months (from the date of application for the job or transfer with the County); or b. participated in a random controlled substances testing program for the previous twelve (12) months (from the date of application with the County for the job or transfer); and 3. The County is able to ensure that none of the driver's prior employers (of whom the County has knowledge) has record(s) of a violation of 49 C.F.R. part 382 or 5155 M.C.A.Inst.4709.3 August 23,2022 Page 8 Enclosure(1) the controlled substance use rule of another DOT agency within the pervious six (6) months. 5.1.D If the County exercises either of the above-noted exceptions to pre-employment testing, it shall contact the alcohol and/or controlled substances testing program(s) in which the driver participates or participated and shall obtain from the testing program(s)the following information: 1. Name(s) and address(es) of the program(s). 2. Verification that the driver participates or participated in the program(s). 3. Verification that the program(s) conformed to 49 C.F.R. part 40. 4. Verification that the driver is qualified under 49 C.F.R. part 382, including that the driver has not refused to be tested for alcohol or controlled substances. 5. The date the driver was last tested for alcohol and controlled substances. 6. The results of any tests taken within the previous six (6) months and any other violations of 49 C.F.R. part 382. 5.2 POST ACCIDENT TESTING: 5.2.A As soon as practicable following an accident involving a commercial motor vehicle, the County shall test for alcohol and controlled substances, each of its surviving driver(s): 1. Who were performing safety-sensitive functions with respect to the vehicle if the accident involved the loss of human life; or 2. Who receives a citation under State or local law for a moving traffic violation arising from the accident. 5.2.13 Timing of Post-Accident Tests 1. Alcohol Tests: a. If an alcohol test required by this Policy is not administered, within the (2) two hours following the accident, the County shall prepare and maintain on file a record stating the reasons that the test was not promptly administered. b. If an alcohol test required by the Policy is not administered within eight (8) hours following the accident, the County shall cease attempts to administer an alcohol test and shall prepare and maintain the same record. C. Records shall be submitted to the FHWA upon request of the FHWA Administrator. 2. Controlled Substances Tests. If a controlled substances test required by this Policy is not administered within thirty-two (32) hours following the accident, the County shall cease attempts to administer a controlled substances test, and prepare and maintain on file a record stating the reasons that the test was not promptly administered. Records shall be submitted to the FHWA upon request of the FHWA Administrator. 5.2.0 A driver who is subject to post-accident testing shall remain readily available for such testing or may be deemed by the County to have refused to submit to testing. Nothing in this Policy shall be construed to require the delay of necessary medical attention for injured people following an accident, or to prohibit a driver from leaving the scene of an accident for the period necessary to obtain assistance in responding to the accident, or to obtain necessary emergency medical care. 5156 M.C.A.Inst.4709.3 August 23,2022 Page 9 Enclosure(1) 5.2.D The County shall provide drivers with necessary post-accident information, procedures and instructions,prior to the driver operating a commercial motor vehicle, so that drivers will be able to comply with the requirements of this Section. 5.2.E The results of a breath or blood test for the use of alcohol or a urine test for the use of controlled substances, conducted by Federal, State, or local officials having independent authority for the test, shall be considered to meet the requirements of this Policy,provided such tests conform to applicable Federal, State or local requirements, and that the results of the tests are obtained by the County. 5.3 RANDOM TESTING: 5.3.A The minimum annual percentage rate for random alcohol testing shall be ten (10%)percent of the average number of driver positions. 5.3.13 The minimum annual percentage rate for random controlled substances testing shall be fifty (50%)percent of the average number of driver positions. 5.3.0 The selection of drivers for random alcohol and controlled substances testing shall be made by a scientifically valid method, such as a random number table of a computer- based random number generator that is matched with driver's social security numbers,payroll identification numbers, or other comparable identifying numbers. Under the selection process used, each driver shall have an equal chance of being tested each time selections are made. 5.3.D The County shall randomly select a sufficient number of drivers for alcohol testing during each calendar year to equal the annual rate not less than the minimum annual percentage rate for random alcohol testing determined by the FHWA Administrator. For controlled substance testing, the County shall randomly select a sufficient number of drivers for controlled substance testing during each calendar year to equal an annual rate not less than the minimum annual percentage rate of fifty (50%) percent of drivers. 5.3.E The County shall ensure that random alcohol and controlled substances tests conducted under this Policy are unannounced and that the dates for administering random alcohol and controlled substances tests are spread reasonably throughout the calendar year. 5.3.17 The County shall require that each driver who is notified of selection of random alcohol and/or controlled substances testing proceeds to the test site immediately; provided, however, that if the driver is performing a safety-sensitive function at the time of notification, the County shall instead ensure that the driver ceases to perform the safety-sensitive function and proceeds to the testing site as soon as possible. 5.3.G A driver shall only be tested for alcohol while the driver is to perform safety- sensitive functions,just before the driver is to perform safety-sensitive functions, or just after the driver has ceased performing such functions. 5.4 REASONABLE SUSPICION TESTING: 5.4.A The County shall require a driver to submit to an alcohol and/or controlled substances test when the County has reasonable suspicion to believe that the driver has violated the prohibitions of this Policy concerning alcohol and/or controlled substances. The County's determination that reasonable suspicion exists to require the driver to undergo a test must be based on specific, contemporaneous, articulable observations concerning the appearance, behavior, speech or body odors of the 5157 M.C.A.Inst.4709.3 August 23,2022 Page 10 Enclosure(1) driver. The observations may include indications of the chronic and withdrawal effects of controlled substances. 5.4.13 The required observations for alcohol and/or controlled substances reasonable suspicion testing shall me made by a supervisor or County official who is trained in accordance with the supervisory training requirements set forth in Section XII of this Policy (i.e., 49 C.F.R. part 382). The person who makes the determination that reasonable suspicion exists to conduct an alcohol test shall not conduct the alcohol test of the driver. 5.4.0 Reasonable suspicion alcohol testing is authorized by this Policy only if the observations required by Section 5.4.A of this Policy are made during,just proceeding, or just after the period of the workday that the driver is required to be in compliance with this Policy (i.e., 49 C.F.R. part 382). A driver may be directed by the County to undergo reasonable suspicion testing only while the driver is performing safety-sensitive functions,just before the driver is to perform safety- sensitive functions, or just after the driver has ceased performing such functions. 5.4.1) If an alcohol test required by this Section is not administered within two (2) hours following the determination under Section 5.4.A of this Policy, the County shall prepare and maintain on file a record stating the reasons the alcohol test was not promptly administered. If an alcohol test required by this Section is not administered within eight(8) hours following the determination under Section 5A.A. of this Policy, the County shall cease attempts to administer an alcohol test and shall state in the record the reasons for not administering the tests. 5.4.E Notwithstanding the absence of a reasonable suspicion alcohol test under this Section, no driver shall report for duty or remain on duty requiring the performance of safety-sensitive functions while the driver is under the influence of or impaired by alcohol, as shown by the behavioral, speech, and performance indicators of alcohol misuse, nor shall the County permit the driver to perform or continue to perform safety-sensitive functions, until: l. An alcohol test is administered and the driver's alcohol concentration measures less than 0.02; or 2. Twenty-four (24) hours have elapsed following the determination under Section 5A.A. of this Policy that there is reasonable suspicion to believe that the driver has violated the prohibitions and this Policy concerning the use of alcohol. 5.4.17 Except as provided in Section 5.4.E of this Policy, the County shall not take any action under this Policy against a driver based solely on the driver's behavior and appearance, with respect to alcohol use, in the absence of an alcohol test. This Policy does not prohibit the County from exercising its independent authority to take any action otherwise consistent with law. 5.4.G A written record shall be made of the observations leading to a controlled substance reasonable suspicion test, and signed by the supervisor or County official who made the observations, within twenty-four (24) hours of the observed behavior or before the results of the controlled substances tests are released, whichever is earlier. 5.5 RETURN-TO-DUTY TESTING: 5.5.A Return to duty testing shall be conducted in accordance with 49 C.F.R. subpart O. 5158 M.C.A.Inst.4709.3 August 23,2022 Page 11 Enclosure(1) 5.53 The County shall ensure that before a driver returns to duty requiring the performance of a safety-sensitive function after engaging in conduct concerning alcohol that is prohibited by this Policy, the driver shall undergo a return-to-duty alcohol test with a result indicating an alcohol concentration of less than 0.02. 5.5.0 The County shall ensure that before a driver returns to duty requiring the performance of a safety-sensitive function after engaging in conduct concerning controlled substances that is prohibited by this Policy, the driver shall undergo a return-to-duty controlled substances test with a result indicating a verified negative result for controlled substances use. 5.6 FOLLOW-UP TESTING 5.6.A Follow up testing shall be conducted in accordance with 49 C.F.R. subpart O. 5.63 Following a determination that a driver(who remains employed with the County to perform safety-sensitive functions) is in need of assistance in resolving problems associated with alcohol misuse and/or use of controlled substances, the County shall ensure that the driver is subject to unannounced follow-up alcohol and/or controlled substance testing as directed by a Substance Abuse Professional. 5.6.0 Follow-up alcohol testing shall be conducted only when the driver is performing safety-sensitive functions,just before the driver is to perform safety-sensitive functions, or just after the driver has ceased performing safety-sensitive functions. VI. ALCOHOL TESTING PROGRAM AND PROCEDURES 6.1 Alcohol testing for purposes of this Policy shall be conducted pursuant to the requirements of 49 C.F.R. part 40 and part 382. Under normal circumstances, testing for alcohol will be done by a Breath Alcohol Technician ("BAT") via an Evidential Breath Testing device ("EBT"). 6.2 THE BREATH ALCOHOL TECHNICIAN ("BAT" 6.2.A The BAT shall be trained to proficiency in the operation of the EBT that he or she is using and in the alcohol testing procedures of this Section (i.e., 49 CFR part 40). 6.23 Proficiency shall be demonstrated by successful completion of a course of instruction which, at a minimum, provides training in the principles of EBT methodology, operation, and calibration checks; the fundamentals of breath analysis for alcohol content; and the procedures required in this Policy for obtaining a breath sample, and interpreting and recording EBT results. 6.2.0 Only courses of instruction for operation of EBT's that are equivalent to the Department of Transportation Model Course, as determined by the NHTSA, may be used to train BAT's to proficiency. On request, NHTSA will review a BAT instruction course for equivalency. 6.2.D The course of instruction shall provide documentation that the BAT has demonstrated competence in the operation of the specifics EBT(s) he or she will use. 6.2.E Any BAT who will perform an external calibration check of an EBT shall be trained to proficiency in conducting the check on the particular model of EBT, to include practical experience and demonstrated competence in preparing the breath alcohol simulator or alcohol standard, and in maintenance and calibration of the EBT. 5159 M.C.A.Inst.4709.3 August 23,2022 Page 12 Enclosure(1) 6.2.17 The BAT shall receive additional training, as needed, to ensure proficiency, concerning new or additional devices or changes in technology that he or she will use. 6.2.G The County or its agent shall establish documentation of the training and proficiency test of each BAT it uses to test employees, and maintain the documentation for two (2)years as provided in Section 6.14 of this Policy (i.e., 49 C.F.R. § 40.83) 6.2.H A BAT-qualified supervisor of an employee may conduct the alcohol test for that employee only if another BAT is unavailable to perform the test in a timely manner. However, the supervisor who made a reasonable cause determination for testing cannot act as the BAT for that employee. 6.2.I Law enforcement officers who have been certified by state or local governments to conduct breath alcohol testing are deemed to be qualified as BATS. In order for a test conducted by such an officer to be accepted under DOT alcohol testing requirements, the officer must have been certified by a state or local government to use the EBT that was used for the test. 6.3 DEVICES TO BE USED FOR BREATH ALCOHOL TESTING ("EBT" 6.3.A For screening tests, the County shall use only EBT's. When the County uses, for a screening test, an EBT that does not meet the requirements of Section 6.3.13 of this Policy (i.e., 49 CFR § 40.229), the County shall use a log book in conjunction with the EBT as set forth in Section 6.6 of this Policy. 6.3.13 For confirmation tests, the County shall use EBTs that meet the following requirements: 1. EBTs shall have the capability of providing, independently or by direct link to a separate printer, a printed result in triplicate (or three (3) consecutive identical copies) of each breath test and of the operations specified in paragraphs (2) and (3) of this Section. 2. EBT's shall be capable of assigning a unique and sequential number to each completed test, with the number capable of being read by the BAT and the employee before each test and being printed out on each copy of the result. 3. EBTs shall be capable of printing out, on each copy of the result, the manufacturer's name for the device, the device's serial number, and the time of the test. 4. EBTs shall be able to distinguish alcohol from acetone at the 0.02 alcohol concentration level. 5. EBT's shall be capable of the following operations: a. Testing an air black prior to each collection of breaths; and b. Performing an external calibration check. 6.4 QUALITY ASSURANCE PLANS FOR EBT'S: 6.4.A In order to be used in either screening or confirmation alcohol testing under this Policy (i.e., 49 CFR part 40), an EBT shall have a Quality Assurance Plan (QAP) developed by the manufacturer. 6.4.13 The plan shall designate the method or methods to be used to perform external calibration checks on the device, using only calibration devices on the NHTSA "confronting Products List of Calibrating Units for Breath Alcohol Test". 6.4.0 The plan shall specify the minimum intervals for performing external calibration checks of the device. Intervals shall be specified for different frequencies of use, 5160 M.C.A.Inst.4709.3 August 23,2022 Page 13 Enclosure(1) environmental conditions (e.g., temperature, altitude, humidity), and context of operation (e.g., stationary or mobile use). 6.4.D The plan shall specify the tolerances on an external calibration check within which the EBT is regarded to be in proper calibration. 6.4.E The plan shall specify inspection, maintenance, and calibration requirements and intervals for the device. 6.4.17 For a plan to be regarded as valid, the manufacturer shall have submitted the plan to NHTSA for review and have received the NHTSA approval of the plan. 6.4.G The County shall comply with the NHTSA-approved QAP for each EBT it uses for alcohol screening or confirmation testing subject to this Policy. 6.4.H The County shall ensure that external calibration of checks of each EBT are performed as provided in the QAP. 6.4.I The County shall take an EBT out of service if any external calibration check results in a reading outside the tolerances for the EBT set forth in the QAP. The EBT shall not again be used for alcohol testing under this Policy until it has been serviced and has had an external calibration check resulting in a reading within the tolerances for the EBT. 6.4.J The County shall ensure that inspection, maintenance, and calibration of each EBT are performed by the manufacturer or a maintenance representative certified by the device's manufacturer or a state health agency of other appropriate state agency. 6.4.K The County shall also ensure that each BAT or other individual who performs an external calibration check of an EBT used for alcohol testing subject to this Policy has demonstrated proficiency in conducting such a check of the model of EBT in question. 6.4.L The County shall maintain records of the external calibration checks of EBT's for two (2)years, as provided in Section 6.14 of this Policy. 6.4.M When the EBT is not being used at an alcohol testing site, it shall be stored in a secured space. 6.5 LOCATIONS FOR BREATH ALCOHOL TESTING: 6.5.A The County shall conduct alcohol testing in a location that affords visual and aural privacy to the individual being tested, sufficient to prevent unauthorized persons from seeing or hearing test results. All necessary equipment, personnel, and materials for breath testing shall be provided at the location where testing is conducted. 6.53 The County may use a mobile collection facility (e.g. a van equipped for alcohol testing)that meets the requirements of Section 6.3 of this Policy. 6.5.0 No unauthorized persons shall be permitted access to the testing location when the EBT remains unsecured or, in order to prevent such persons from seeing or hearing a test result, any time when testing is being conducted. 6.5.D In unusual circumstances (e.g. when it is essential to conduct a test outdoors at the scene of an accident), a test may be conducted at a location that does not fully meet the requirements of Section 6.5.A of this Policy. In such a case, the County or BAT shall provide visual and aural privacy to the employee to the greatest extent practicable. 5161 M.C.A.Inst.4709.3 August 23,2022 Page 14 Enclosure(1) 6.5.E The BAT shall supervise only one (1) employee's use of the EBT at a time. The BAT shall not leave the alcohol testing location while the testing procedure for a given employee is in progress (see Sections 6.7, 6.8, and 6.9 of this Policy). 6.6 THE BREATH ALCOHOL TESTING FORM AND LOG BOOK: 6.6.A The County shall use the Breath Alcohol Testing Form prescribed under 49 C.F.R. part 40. The prescribed form may not be modified or revised, except that a form directly generated by an EBT shall omit the space for affixing a separate printed result to the form. 6.6.13 The Form shall provide triplicate (3) consecutive identical copies. Copy one (white) shall be retained by the BAT. Copy two (green) shall be provided to the employee. Copy three (blue) shall be transmitted to the County. Except for a form generated by an EBT, the Form shall be 8.5x11 inches in size. 6.6.0 A log book shall be used in conjunction with any EBT used for screening tests that does not meet the requirements of Section 6.3.13 of this Policy. 1. There shall be a log book for each such EBT. The log book shall not be used in conjunction with any other EBT. Every test conducted on the EBT shall be recorded in the applicable log book. 2. The log book shall include columns for the test number, date of the test, name of the BAT, location of the test, quantified test result, and initials of the employee taking each test. 6.7 PREPARATION FOR THE BREATH ALCOHOL TESTING: 6.7.A When the employee enters the alcohol testing location, the BAT will require him or her to provide positive identification (e.g., through use of a photo identification card or identification by a County representative). On request by the employee, the BAT shall provide positive identification to the employee. 6.7.13 The BAT shall explain the testing procedures to the employee. 6.8 PROCEDURES FOR BREATH ALCOHOL SCREENING TESTS: 6.8.A. The BAT shall complete Step 1 on the Breath Alcohol Testing Form. The employee shall then complete Step 2 on the Form, signing the certification. 6.8.13 Refusal by the employee to sign this certification shall be regarded as a refusal to take the test. 6.8.0 An individually-sealed mouthpiece shall be opened in view of the employee and BAT and attached to the EBT in accordance with the manufacturer's instructions. 6.8.1) The BAT shall instruct the employee to blow forcefully into the mouthpiece for at least six (6) seconds or until the EBT indicates that an adequate amount of breath has been obtained. 6.8.E If the EBT does not meet the requirements of Section 6.3.2. of this Policy, the BAT and the employee shall take the following steps: 1. The BAT shall show the employee the test result displayed on the EBT. The BAT shall record the displayed result, test number, testing device, serial number of the testing device, time, and quantified result in Step 3 of the Form. 5162 M.C.A.Inst.4709.3 August 23,2022 Page 15 Enclosure(1) 2. The BAT shall record the test number, date of the test, name of the BAT, location, and quantified test result in the log book. The employee shall initial the log book entry. 6.8.17 If the EBT provides printed result, but does not print the results directly onto the Form, the BAT shall show the employee the result displayed on the EBT. The BAT shall affix the test result printout to the Breath Alcohol Test Form in the designated space, using a method that will provide clear evidence of removal (e.g., tamper evident tape). 6.8.G If the EBT prints the test results directly onto the Form, the BAT shall show the employee the result displayed on the BET. 6.8.1-1 In any case in which the result of the screening test is a breath alcohol concentration of less than 0.02, the BAT shall date the Form and sign the certification in Step 3 of the Form. The employee shall sign the certification and fill in the date in Step 4 of the Form. 1. If the employee does not sign the certification in Step 4 of the Form or does not initial the log book entry for a test, it shall not be considered a refusal to be tested. In this event, the BAT shall note the employee's failure to sign or initial in the "Remarks" section of the Form. 2. If a test result printed by the EBT (see Sections 6.8.17 and 6.8.G) does not match the displayed result, the BAT shall note the disparity in the `remarks' section of the Form. Both the employee and the BAT shall initial or sign the notation. In accordance with Section 6.12 of this Policy, the test is invalid and the County and employee shall be so advised by the BAT. 3. No further testing is authorized. The BAT shall transmit the result of less than 0.02 to the County in a confidential manner, and the County shall receive and store the information so as to ensure that confidentiality is maintained and required by Section 6.13 of this Policy. 6.8.I If the result of the screening test is an alcohol concentration of 0.02 or greater, a confirmation test shall be performed as provided in Section 6.9 of this Policy (i.e., 49 CFR § 40.25). 6.8.J If the confirmation test will be conducted by a different BAT, the BAT who conducts the screening test shall complete and sign the Form and log book entry. The BAT will provide the employee with Copy two of the Form. 6.9 PROCEDURES FOR BREATH ALCOHOL CONFIRMATION TESTS: 6.9.A If a BAT other than the one who conducted the screening test is conducting the confirmation test, the new BAT shall follow the procedures of Section 6.7 of this Policy (i.e., 49 CFR § 40.251). 6.9.13 The BAT shall instruct the employee not to eat, drink,put any object or substance in his or her mouth, and, to the extent possible, not belch during a waiting period before the confirmation test. 1. This time period begins with the completion of the screening test, and shall not be less than fifteen (15) minutes. The confirmation test shall be conducted within thirty (30) minutes of the completion of the screening test. 5163 M.C.A.Inst.4709.3 August 23,2022 Page 16 Enclosure(1) 2. The BAT shall explain to the employee the reason for this requirement (i.e., to prevent any accumulation of mouth alcohol leading to an artificially higher reading) and the fact that it is for the employee's benefit. The BAT shall also explain that the test will be conducted at the end of the waiting period, even if the employee has disregarded the instruction. 3. If the BAT becomes aware that the employee has not complied with this instruction, the BAT shall so note in the `remarks' section of the Form. 6.9.0 If a BAT other than the one who conducted the screening test is conducting the confirmation test, the new BAT shall complete Step 1 on the Form. The employee shall then complete Step 2 on the Form, signing the certification. Refusal by the employee to sign this certification shall be regarded as a refusal to take the test. The BAT shall note in the `Remarks' section of the Form that a different BAT conducted the screening test. 6.9.1) In all cases, the procedures of Sections 6.8.A through 6.8.P (i.e., 49 CFR§ 40.253) shall be followed. A new mouthpiece shall be used for the confirmation test. 6.9.E Before the confirmation test is administered for each employee, the BAT shall ensure that the EBT registers 0.00 on an air blank. If the reading is greater than 0.00, the BAT shall conduct one (1) more air blank. If the reading is greater than 0.00, testing shall not proceed using that instrument. However, testing may proceed on another instrument. 6.9.17 Any EBT taken out of service because of failure to perform an air blank accurately shall not be used for testing until a check of external calibration is conducted and the BET is found to be within tolerance limits. 6.9.G In the event that the screening and confirmation test results are not identical, the confirmation test results are not identical, the confirmation test result is deemed to be the final result upon which any action under operating administration rules shall be based. 6.9.1-1 If the EBT provides a printed result, but does not print the results directly onto the Form, the BAT shall show the employee the result displayed on the EBT. The BAT shall then affix the test result printout to the Breath Alcohol Test Form in the designated space, using a method that will provide clear evidence of remove (e.g., tampered-evident tape) 6.9.I If the EBT prints the test results directly onto the Form,the BAT shall show the employee the result displayed on the EBT. 6.9.K Following the completion of the test, the BAT shall date the Form and sign the certification in Step 3 of the Form. The employee shall sign the certification and fill in the date in Step 4 of the Form. 6.9.L If the employee does not sign the certification in Step 4 of the Form or does not initial the log book entry for a test, it shall not be considered a refusal to be tested. In this event, the BAT shall note the employee's failure to sign or initial in the Remarks section of the Form. 6.9.M If a test result printed by the EBT (see Sections 6.9 H and 6.9.I) does not match the displayed result, the BAT shall note the disparity in the Remarks section. 5164 M.C.A.Inst.4709.3 August 23,2022 Page 17 Enclosure(1) Both the employee and the BAT shall initial or sign the notation. In accordance with Section 6.12 of this Policy (i.e. 49 CFR § 40.255), the test is invalid and the County and employee shall be so advised by the BAT. 6.9.N The BAT shall conduct an air blank. If the reading is greater than 0.00, the test is invalid. 6.9.0 The BAT shall transmit all results to the County in a confidential manner. 6.9.P The County shall designate one (1) or more representatives for the purpose of receiving and handling alcohol testing results in a confidential manner. All communications by BATS to the County concerning the alcohol testing results of employees shall be to a designated County representative. 6.9.Q Such transmission may be in writing, in person, or by telephone or electronic means, but the BAT shall ensure immediate transmission to the County of results that require the County to prevent the employee from performing a safety-sensitive function. 6.9.R If the initial transmission is not in writing (e.g., by telephone), the County shall establish a mechanism to verify the identity of the BAT providing the information. 6.9.5 If the initial transmission is not in writing,the BAT shall follow the initial transmission by providing to the County, the County's copy of the Breath Alcohol Testing Form. The County shall store the information so as to ensure the confidentiality is maintained as required by Section 6.13 of this Policy (i.e., 49 CFR § 40.255). 6.10 REFUSALS TO TEST AND UNCOMPLETED TESTS: 6.10.A Refusal by an employee to complete and sign the Breath Alcohol Testing Form (Step 2), to provide breath, to provide an adequate amount of breath, or otherwise to cooperate with the testing process in any way that prevents the completion of the test, shall be noted by the BAT in the `remarks' section of the Form. The testing process shall be terminated and the BAT shall immediately notify the County. 6.10.13 If a screening or confirmation test cannot be completed, or if an event occurs that would invalidate the test, the BAT shall, if practicable, begin a new screening or confirmation test, as applicable using a new Breath Alcohol Testing Form with a new sequential test number(in the case of a screening test conducted on an EBT that meets the requirements of Section 6.3 B of this Policy, or in the case of a confirmation test. 6.11 INABILITY TO PROVIDE AN ADEQUATE AMOUNT OF BREATH: 6.1 LA This Section sets forth procedures to be followed in any case in which an employee is unable, or alleges that he or she is unable, to provide an amount of breath sufficient to permit a valid breath test because of a medical condition. 6.11.13 The BAT shall again instruct the employee to attempt to provide an adequate amount of breath. If the employee refuses to make the attempt, the BAT shall immediately inform the County. 6.1 LC If the employee attempts and fails to provide an adequate amount of breath, the BAT shall so note in the `Remarks' section of the Breath Alcohol Testing Form and immediately inform the County. 5165 M.C.A.Inst.4709.3 August 23,2022 Page 18 Enclosure(1) 6.1 LD If the employee attempts and fails to provide an adequate amount of breath, the County shall proceed as follows: 1. The County shall direct the employee to obtain, as soon as practical after the attempted provision of breath, an evaluation form a licensed physician who is acceptable to the County concerning the employee's medical ability to provide an adequate amount of breath. 2. If the physician determines, in his or her reasonable medical judgement, that a medical condition has, or with a high degree of probability, could have,precluded the employee from providing an adequate amount of breath, the employee's failure to provide an adequate amount of breath shall not be deemed a refusal to take a test. The physician shall provide to the County a written statement of the basis for his or her conclusion. 3. If the licensed physician, in his or her reasonable medical judgement, is unable to make the determination set forth in Section 6.11.D.2 of this Policy, the employee's failure to provide an adequate amount of breath shall be regarded as a refusal to take a test. The licensed physician shall provide a written statement of the basis for his or her conclusion to the County. 6.12 A Breath Alcohol Test shall be invalid under the following circumstances: 6.12.A The external calibration check of an EBT produces a result that differs by more than the tolerance stated in QAP from the known value of the test standard. In this event, every test result of 0.02 or above obtained on the device since the last valid external calibration check shall be invalid; 6.12.13 The BAT does not observe the minimum fifteen (15) minute waiting period prior to the confirmation test, as provided in Section 6.9.13 of this Policy; 6.12.0 The BAT does not perform an air blank of the EBT before a confirmation test, or an air blank does not result in a reading of 0.00 prior to or after the administration of the test, as provided in Section 6.9 of this Policy; 6.12.1) The BAT does not sign the Form as required by Sections 6.8 and 6.9 of this Policy; 6.12.E The BAT has failed to note on the Remarks section of the Form that the employee has failed or refused to sign the Form following the recording or printing on or attachment to the Form of the test result; 6.12.17 An EBT fails to print a confirmation test result; or 6.12.G On a confirmation test and, where applicable, on a screening test, the sequential test number or alcohol concentration displayed on the EBT is not the same as the sequential test number or alcohol concentration on the printed result. 6.13 AVAILABILITY AND DISCLOSURE OF ALCOHOL TESTING INFORMATION ABOUT INDIVIDUAL EMPLOYEES: 6.13.A The County shall maintain records in a secure manner, so that disclosure of information to unauthorized persons does not occur. 6.13.13 Except as required by law or expressly authorized or required in this Section, the County shall not release covered employee information that is contained in the records required to be maintained by this Policy or by DOT agency alcohol misuse rules. 5166 M.C.A.Inst.4709.3 August 23,2022 Page 19 Enclosure(1) 6.13.0 An employee subject to testing is entitled, upon written request, to obtain copies of any records pertaining to the employee's use of alcohol, including any records pertaining to his or her alcohol tests. The County shall promptly provide the records requested by the employee. Access to an employee's records shall not be contingent upon payment for records other than those specifically requested. 6.13.D The County shall permit access to all facilities utilized in complying with the requirements of 49 CFR part 40 and DOT agency alcohol misuse rules to the Secretary of Transportation, any DOT agency with regulatory authority over the County, or a state agency with regulatory authority over the County (as authorized by DOT agency regulations.) 6.13.E When requested by the Secretary of Transportation, any DOT agency with regulatory authority over the County, or a state agency with regulatory authority over the County (as authorized by DOT agency regulations), the County shall make available copies of all results for County alcohol testing conducted under the requirements of this Policy and any information pertaining to the County's alcohol misuse prevention program. The information shall include name-specific alcohol test results, records and reports. 6.13.17 When requested by the National Transportation Safety Board as part of an accident investigation, the County shall disclose information related to the County's administration of any post-accident alcohol test administered following the accident under investigation. 6.13.G The County shall make records available to a subsequent employer upon receipt of a written request from a covered employee. 6.13.H The County may disclose information required to be maintained under this Policy pertaining to a covered employee to that employee or to the decision maker in a lawsuit, grievance, or other proceeding initiated by or on behalf of the individual, and arising from the results of an alcohol test administered under the requirements of this Policy, or from the County's determination that the employee engaged in conduct prohibited by a DOT agency alcohol misuse regulation (including but not limited to, a worker's compensation, unemployment compensation, or other proceeding relating to a benefit sought by the employee.) 6.13.I The County shall release information regarding a covered employee's records as directed by the specific, written consent of the employee authorizing release of the information to an identified person. Release of such information is permitted only in accordance with the terms of the employee's consent. 6.14 MAINTENANCE AND DISCLOSURE OF RECORDS CONCERNING EVIDENTIAL BREATH TESTING DEVICES (EBT'S) AND BREATH ALCOHOL TECHNICIANS BAT'S 6.14.A The County or its agent shall maintain the following records for two (2)years: 1. Records of the inspection and maintenance of each EBT used in employee testing: 5167 M.C.A.Inst.4709.3 August 23,2022 Page 20 Enclosure(1) a. Documentation of the County's compliance with the QAP for each EBT that is used for alcohol testing under this policy; b. Records of the training and proficiency testing of each BAT used in employee testing; c. The log books required by Section 6.6 of this Policy. 6.14.B The County or its agent shall maintain for five (5)years records pertaining to the calibration of each EBT used in alcohol testing under this Policy, including records of the results of external calibration checks. 6.14.0 Records required to be maintained by this Section shall be disclosed on the same basis as provided in Section 6.13 of this Policy. VIL CONTROLLED SUBSTANCES TESTING PROGRAM AND PROCEDURES 7.1 SCOPE OF CONTROLLED SUBSTANCES TESTING PROGRAM: 7.1.A ALL LABORATORIES, LABORATORY PERSONNEL, MEDICAL REVIEW OFFICERS AND ANALYSIS PROCEDURES FOR CONTROLLED SUBSTANCES TESTING MUST CONFORM TO THE REQUIREMENTS OF 49 CFR PART 40. 7.2 REPORTING AND REVIEW OF RESULTS: 7.2.A MRO Shall Review Confirmed Positive Results: An essential part of the drug testing program is the final review of confirmed positive results from the laboratory. A positive test result does not automatically identify an employee/applicant as having used drugs in violation of a DOT agency regulation. An individual with a detailed knowledge of possible alternate medical explanations is essential to the review of results. This review shall be performed by the MRO prior to the transmission of the results to the County's administrative officials. The MRO review shall include review of the chain of custody to ensure that it is complete and sufficient on its face. 7.2.B The duties of the MRO with respect to negative results are purely administrative. 7.2.0 MRO-Qualifications and Responsibilities. The MRO shall be a licensed physician with knowledge of substance abuse disorders and may be an employee of the County or a private physician retained for this purpose. 1. The MRO shall not be an employee of the laboratory conducting the drug test unless the laboratory establishes a clear separation of functions to prevent any appearance of a conflict of interest, including assuring that the MRO has no responsibility for, and is not supervised by or the supervisor of, any person who has responsibility for the drug testing or quality control operations of the laboratory. 2. The role of the MRO is to review and interpret confirmed positive test results obtained through the County's testing program. In carrying out this responsibility, the MRO shall examine alternate medical explanations for any positive test result. This MRO review may include conducting a medical interview, review of the individual's medical history, and a review of any other relevant biomedical factors. 5168 M.C.A.Inst.4709.3 August 23,2022 Page 21 Enclosure(1) 3. The MRO shall review all medical records made available by the tested individual when a confirmed positive test could have resulted from legally prescribed medication. The MRO shall not, however, consider the results or urine samples that are not obtained or processed in accordance with this Policy. 7.2.1) Positive Test Result: 1. Prior to making a final decision to verify a positive test result for an individual, the MRO shall give the employee an opportunity to discuss the test result with him or her. 2. The MRO shall contact the employee directly, on a confidential basis, to determine whether the employee wishes to discuss the test result. A staff person under the MRO's supervision may make the initial contact, and a medically licensed or certified staff person may gather information from the individual. Except as provided in Section 7.2.1)(5) of this Policy, the MRO shall speak directly with the employee before verifying a test as positive. (49 C.F.R. § 49.133.) 3. If, after making all reasonable efforts and documenting them, the MRO is unable to reach the employee directly, the MRO shall contact a designated County official who shall direct the employee to contact the MRO as soon as possible. If it becomes necessary to reach the employee through the designated County official, the designated management official shall employee procedures that ensure, to the maximum extent practicable, the requirement that the employee contact with the MRO is held in confidence. 4. If, after making all reasonable efforts, the designated County official is unable to contact the employee, the County may place the individual on temporary medical unqualified status or medical leave. 5. The MRO may verify a test as positive without having communicated directly with the employee about the test in three (3) circumstances: a. The employee expressly declines the opportunity to discuss the test; b. The employer has contacted the employee, instructed the employee to contact the MRO within seventy-two (72) hours, and the employee has failed to do so; or C. Neither the MRO nor the employer after making and documenting all reasonable efforts, is able to contact the employee within ten (10) days from the date on which the MRO received the confirmed positive test result from the laboratory. 6. If a test is verified positive under the circumstances specified in Section 7.2.1)(5)(b) of this Policy, the employee may present to the MRO information documenting that serious illness, injury, or other circumstances unavoidably prevented the employee from timely contacting the MRO. The MRO, on the basis of such information, may reopen the verification, allowing the employee to present information concerning a legitimate explanation for the confirmed positive test. If the MRO concludes that there is a legitimate explanation, the MRO declares the test to be negative. 7. Following verification of a positive test result, the MRO shall, as provided in this Policy, refer the case to the County's employee assistance program, if applicable, to the County official empowered to recommend or take administrative action (or the official's designated agent), or both. 5169 M.C.A.Inst.4709.3 August 23,2022 Page 22 Enclosure(1) 7.2.E Verification for Opiates: Review for Prescription Medication. Before the MRO verifies a confirmed positive result for opiates, he or she shall determine that there is clinical evidence—in addition to the urine test—of unauthorized use of any opium, opiate, or opium derivative (e.g., morphine/codeine). This requirement does not apply if the County GC/MS confirmation testing for opiates confirms the presence of 6-monoacetylmorphine. 7.2.17 Request for Test of Split Specimen. The MRO shall notify each individual who has a confirmed positive test that the employee has seventy-two (72) hours in which to request a test of the `split-specimen', if the test is verified as positive. If the employee requests an analysis of the `split specimen' within seventy-two (72) hours of having been informed of a verified positive test, the MRO shall direct, in writing, the laboratory to provide the `split specimen' to another DHHS-certified laboratory for analysis. If the analysis of the `split specimen' fails to reconfirm the presence of the drug(s) or drug metabolite(s) found in the primary specimen, or if the `split specimen' is unavailable , inadequate for testing or untestable, the MRO shall cancel the test and report cancellation and the reasons for it to the FHWA , the County, and the employee. 7.2.G If an employee has not contacted the MRO within seventy-two (72) hours, as provided in Section 7.2.D of this Policy, the employee may present to the MRO information documenting that serious illness, injury, and ability to contact the MRO, lack of actual notice of the verified positive test, or other circumstances unavoidably prevented the employee from timely contacting the MRO. If the MRO concludes that there is a legitimate explanation for the employee's failure to contact the MRO within seventy-two (72) hours, the MRO shall direct that the reanalysis of the primary specimen or analysis of the `split specimen', as applicable, be performed. 7.2.H The employee is not authorized to request a re-analysis of the primary specimen. 7.2.1 . Disclosure of Information by MRO. Except as provided in this Policy, the MRO shall not disclose to any third party medical information provided by the employee to the MRO as part of the testing verification process. 7.2.J The MRO may disclose such information to the County, a DOT agency or other Federal safety agency, or a physician responsible for determining the medical qualification of the employee under an applicable DOT agency regulation, only if: 1. An applicable DOT regulation permits or requires such disclosure; 2. In the MRO's reasonable medical judgment, the information could result in employee being determined to be medically unqualified under an applicable DOT agency rule; or 3. In the MRO's reasonable medical judgment, in a situation in which there is no DOT agency rule establishing physical qualification standards applicable to the employee, the information indicates that continued performance by the employee of his or her safety-sensitive function could pose a significant safety risk. 7.2.K Before obtaining medical information from the employee as part of the verification process, the MRO shall inform the employee that information may be disclosed to third parties to whom information may be disclosed. 7.3 PROTECTION OF EMPLOYEE RECORDS: The County's contracts with testing laboratories shall require that the laboratory maintain employee test records in confidence, as provided in DOT agency regulations. The contracts shall provide that the laboratory shall disclose information related to a positive drug test of an employee to the employee, the County, or the decision maker in a lawsuit, grievance, or other proceeding initiated by or on behalf of the employee and arising from a certified positive drug test. 5170 M.C.A.Inst.4709.3 August 23,2022 Page 23 Enclosure(1) 7.4 INDIVIDUAL ACCESS TO TEST AND LABORATORY CERTIFICATION RESULT Any employee who is subject of a drug test conducted under this policy shall, upon written request, have access to any records relating to his or her drug test and any records relating to the results of any relevant certification, review, or revocation-of-certification-proceedings. 7.5 USE OF DHHS —CERTIFIED LABORATORIES The County shall use only laboratories certified under the DHHS "mandatory guidelines for federal workplace drug testing programs," 50 FR 1170, April 11, 1988, and subsequent amendments thereto. VIIL NOTICE REQUIREMENTS 8.1 NOTIFICATION BY THE COUNTY: 8.1.A. The County will notify a driver when the alcohol or controlled substances test to be administered is required by this Policy (i.e., 49 CFR,part 382), before performing an alcohol or controlled substances test under this Policy. 8.1.13 The County shall notify a driver of the results of a pre-employment controlled substances test conducted under this Policy, if the driver requests such results within sixty (60) calendar days of being notified of the disposition of the employment application. 8.LC The County shall notify a driver of the results of random, reasonable suspicion and post-accident tests for controlled substances conducted under this Policy if the test results are verified positive. This notice will include identification of which controlled substance or substances were verified as positive. 8.LD A County official shall make reasonable efforts to contact and request each driver who submitted a specimen for testing under this Policy, regardless of the driver's employment status, to contact and discuss the results of the controlled substances test with an MRO who has been unable to contact the driver. 8.LE A County official shall immediately notify the MRO that the driver has been notified to contact the MRO within twenty-four(24) hours. 8.2 NOTIFICATION BY THE MRO: 8.2.A The MRO may report test results to the County using any communications device, but in all instances a signed, written notification must be forwarded within three (3) business days of completion of the MRO's review. The MRO's report to the County will clearly note: 1. That the controlled substances test being reported was in accordance with 49 CFR part 40. 2. The name of the individual for whom the test results are being reported; 3. The type of test indicated on the custody and control form (i.e., random,post- accident, etc.) 4. The date and location of the test collection; 5. The identities of the persons or entities performing the collection, analysis of the specimens, and the individual serving as the MRO for the specific test; 6. The verified results of a controlled substances test, either positive or negative, and if positive, the identity of the controlled substance(s) for which the test was verified positive. 5171 M.C.A.Inst.4709.3 August 23,2022 Page 24 Enclosure(1) 8.23 The MRO shall report to the County that the MRO has made all reasonable efforts to contact the driver as provided in Section 7.2.D. of this Policy (i.e., 49 CFR § 40.133(c)). The County shall, as soon as practicable, request that the driver contact the MRO prior to dispatching the driver or within twenty-four(24) hours, whichever is earlier. IX. RECORDKEEPING, PRE-EMPLOYMENT INQUIRY,AND REPORTING 9.l.A Records related to the collection process: 1. Collection log books, if used; 2. Documents relating to the random selection process; 3. Calibration documentation for EBT devices; 4. Documentation of BAT training; 5. Documents generated in connection with decisions to administer reasonable suspicion alcohol or controlled substances testing. 6. Documents generated in connection with decisions on post accident tests 7. Documents verifying existence of a medical explanation of the inability of a driver to provide adequate breath or to provide a urine sample for testing; and 8. Consolidated annual calendar year summaries as required by Section 9.6 of this Policy. 9.1.B. Records related to an employee/driver's test result: 1. The County's copy of the alcohol test form, including the results of the test; 2. The County's copy of the controlled substances test chain of custody and control form; 3. Documents sent by the MRO to the County, including those required by Section 8.2.A. of this Policy. 4. Documents related to the refusal of any employee/driver to submit to an alcohol or controlled substances test required by this Policy and 49 CFR part 382; and 5. Documents presented by an employee/driver to dispute the result of an alcohol or controlled substances test administered under this policy. 9.1.C. Records related to other violations of this Policy. 9.1.D. Records related to evaluations: 1. Records pertaining to a determination by a Substance Abuse Professional concerning an employee/driver's need for assistance; and 2. Records concerning an employee/driver's compliance with recommendations of the Substance Abuse Professional. 9.1.E. Records related to education and training: 1. Materials on alcohol misuse and controlled substance use awareness, including a copy of this Policy on alcohol misuse and controlled substance use; 2. Documentation of compliance with the educational information requirements of 49 CFR § 382.601 (see section XII of this Policy), including the employee/driver's signed receipt of education materials. 3. Documentation of training provided to supervisors for the purpose of qualifying the supervisors to make a determination concerning the need for alcohol and/or controlled substances testing based on reasonable suspicion, and 4. Certification that any training conducted under this Policy complies with the requirements for such training as set forth in 49 CFR,part 382. 9.1.17 Records related to controlled substances testing: 5172 M.C.A.Inst.4709.3 August 23,2022 Page 25 Enclosure(1) 1. Agreements with collection site facilities, laboratories and MRO's. 2. Names and positions of officials and their role in the County's alcohol and controlled substances testing program(s). 3. The County's drug testing policy and procedures. 9.2 LOCATION OF RECORDS: All records required by this Policy shall be maintained as required by 49 CFR § 390.31 and 49 C.F.R. § 382.401 and shall be made available for inspection at the County's principal place of business within two (2)business days after a request has been made by an authorized representative of the FHWA or Federal Motor Carrier Safety Administration. 9.3 PERIOD OF RETENTION OF RECORDS BY THE COUNTY (49 C.F.R. §382.401): The County shall maintain records of its alcohol misuse and controlled substances use prevention programs in a secure location with controlled access in accordance with the following schedule: 9.3.A Five (5) Years. The following records shall be maintained for a minimum of five (5) years: 1. Records of employee/driver alcohol tests with results indicating an alcohol concentration of.02 or greater. 2. Records of employee/driver verified positive controlled substances test results, 3. Documentation of refusals to take required alcohol and/or controlled substances test, 4. Calibration documentation 5. Employee/driver evaluation and referrals, and 6. A copy of each annual calendar year summary required by Section 9.6 of this Policy (i.e. 49 CFR § 382.403) 7. Records related to the administration of the alcohol and controlled substances testing program, including records of all driver violations. 9.3.13 Two (2) Years. Records related to the alcohol and controlled substances collection process (except calibration of EBT devices) and training shall be maintained for a minimum of two (2)years. 9.3.C. One (1) Year: Records of negative and cancelled controlled substances test results (as defined herein and/or in 49 CFR part 40) and alcohol test results with a concentration of less than .02 shall be maintained for a minimum of one (1)year. 9.3.D Indefinite: Records related to education and training of breath alcohol technicians, screening test technicians, supervisors and drivers shall be maintained by the employer while the individual performs the functions which requite the training, and for two years after ceasing to perform those functions. 9.4. RETENTION OF CONTROLLED SUBSTANCES RECORDS BY THE MRO: 9A.A. An MRO shall maintain all dated records and notifications, identified by individual, for a minimum of five (5)years after verified positive controlled substances test results. 9.4.13. An MRO shall maintain all dated records and notifications, identified by individual, for a minimum of one (1) year for negative and cancelled controlled substances test results. 9.5 PRE-EMPLOYMENT INQUIRY, AND RELEASE OF ALCOHOL AND CONTROLLED SUBSTANCES TEST INFORMATION BY PREVIOUS EMPLOYERS: 5173 M.C.A.Inst.4709.3 August 23,2022 Page 26 Enclosure(1) 9.5.A The County (or a prospective employer of a former County driver) must(with the driver's consent)request alcohol and controlled substances information from all DOT regulated employers within the previous 3 years and the scope of information requested must go back 3 years. Beginning 1/6/2023, employers must use the Drug and Alcohol Clearinghouse in accordance with 49 C.F.R. § 382.701(a). 9.5.13 The County must obtain,pursuant to a driver's consent, information on the driver's alcohol tests with a concentration result of.04 or greater,positive controlled substances test results, and refusals to be tested, within the preceding two (2)years which are maintained by the driver's previous employers under 49 CFR § 382.401 (b)(1)(i)through(iii) and 49 C.F.R. § 40.25 (see Section 9.3.A. (1)-(3) of this Policy). 9.5.0 The information in Section 9.5.13. of this Policy must be obtained and reviewed by the County no later than fourteen (14) calendar days after the first time a driver performs safety-sensitive functions for the County, if it is not feasible to obtain the information prior to the driver performing safety-sensitive functions. The County may not permit a driver to perform safety-sensitive functions after fourteen (14) days w/o obtaining the information. 9.5.1) If the driver stops performing safety-sensitive functions for the County before expiration of the fourteen (14) day period or before the County has obtained the information required by Section 9.5.13. of this Policy, the County must still obtain the information. 9.5.E The County must provide each driver's employers within the two (2)preceding years, the driver's specific, written authorization for release of the information required by Section 9.5.13. of this Policy. 9.5.17 The release of any information under this Section may take the form of personal interviews, telephone interviews, letters, or any other method of obtaining information that ensures confidentiality. The County must maintain a written, confidential record with respect to each past employer contacted. 9.5.G The County may not use a driver to perform safety-sensitive functions if the County obtains information on the driver's alcohol test with a concentration of.04 or greater, verified positive controlled substances test result, or refusal to be tested, by the driver, w/o obtaining information on a subsequent Substance Abuse Professional evaluation and/or determination under 49 C.F.R. § 382.401 (c)(4) (e.g., records pertaining to the evaluation and recommendations regarding the driver from a Substance Abuse Professional and the driver's compliance with those recommendations) and compliance with 49 CFR § 382.309 (i.e. Return-to-Duty testing as required by Section 5.5 of this Policy). 9.6 REPORTING OF RESULTS IN A MANAGEMENT INFORMATION SYSTEM: 9.6.A The County shall prepare and maintain an annual calendar summary of the results of its alcohol and controlled substances testing programs performed under this Policy (i.e. 49 CFR,part 382). By March 15 of each year, the County shall complete the annual summary covering the previous calendar year. 9.6.13 If the County is notified, during the month of January, of a request by the FHWA to report the County's annual calendar year summary information, the County shall prepare and submit the report to the FHWA by March 15 of the year. The County shall ensure that the annual summary report is accurate and received by March 15 at 5174 M.C.A.Inst.4709.3 August 23,2022 Page 27 Enclosure(1) the location that the FHWA specifies in its request. The report shall be in the form and manner prescribed by the FHWA by mail or electronic transmission, the information requested shall be typed, except for the signature of the certifying official. The County shall ensure the accuracy and timeliness of each report submitted. 9.6.0 Each annual calendar year summary that contains information on a verified positive controlled substances test result, an alcohol screening test result of.02 or greater, or any other violation of the alcohol misuse provisions of this Policy (i.e. 49 CFR,part 382), shall include the following information; 1. Number of drivers subject to this Policy under 49 CFR part 382. 2. Number of drivers subject to testing under the alcohol misuse or controlled substances use rules of more than one (1) DOT agency, identified by each agency; 3. Number or urine specimens collected by type of test(e.g.,pre-employment, random, reasonable suspicion,post-accident); 4. Number of positive tests verified by an MRO by type of test, and type of controlled substance; 5. Number of negative controlled substance tests verified by an MRO by type of test; 6. Number of person denied a position as a driver following a pre-employment verified positive controlled substances test and/or a pre-employment alcohol test that indicates an alcohol concentration of.04 or greater; 7. Number of drivers with tests verified positive by an MRO for multiple controlled substances; 8. Number of drivers who refused to submit to an alcohol or controlled substances test required under this Policy (i.e. 49 CFR part 382); 9. Number of supervisors who have received alcohol training during the reporting period; 10. Number of supervisors who have received required controlled substances training during the reporting period; 11. Number of screening alcohol tests, by type of test. 12. Number of confirmation alcohol tests, by type of test; 13. Number of confirmation alcohol tests indicating an alcohol concentration of.02 or greater, but less then .04, by type of test. 14. Number of confirmation alcohol tests indicating an alcohol concentration of.04 or greater, by type of test; 15. Number of drivers who were returned to duty, having complied with the recommendations of a Substance Abuse Professional as described in Section XI of this Policy (and 49 CFR § 382.503 and 382.605) during this reporting period, who previously: a. had a verified positive controlled substance test result; or b. engaged in prohibited alcohol misuse under the provisions of 49 CFR part 382 16. Number of drivers who were administered alcohol and drug tests at the same time, with both a verified positive drug test result and an alcohol test result indicating an alcohol concentration of.04 or greater, and; 17. Number of drivers who were found to have violated any non-testing prohibitions of subpart B of 49 CFR part 382, and this Policy, and any action taken in response to the violation; 5175 M.C.A.Inst.4709.3 August 23,2022 Page 28 Enclosure(1) 9.6.D In the event that the County's annual calendar year summary contains only negative controlled substance test results, alcohol screening test result of less than .02, and does not contain any other violations of this Policy and/or subpart B of 49 CFR,part 382, then the County may prepare and submit, as required by Section 9.6.13 of this Policy, either a standard report form containing all the information elements specified in Section 9.6.0 of this Policy, or an `EZ' report form. The `EZ' report shall include the following information elements. 1. Number of drivers subject to 49. CFR,part 382. 2. Number of drivers subject to testing under the alcohol misuse or controlled substance use rules of more than one (1) DOT agency, identified by each agency; 3. Number of urine specimens collected by type of test(e.g. pre-employment, random, reasonable suspicion,post accident) 4. Number of negative tests verified by an MRO, by type of test; 5. Number of drivers who refused to submit to an alcohol or controlled substances test required by 49 CFR part 382. 6. Number of supervisors who have received required alcohol training during the reporting period; and number of supervisors who have received required controlled substances training during the reporting period; 7. Number of alcohol screening tests, by type of test; and 8. Number of drivers who returned to duty (having complied with the recommendations of a Substance Abuse Professional as described in 49 CFR § 382.503 and 382.605 and Section XI of this Policy) in this reporting period, who previously: a. had a verified positive controlled substance test result, or b. engaged in prohibited alcohol misuse under the provisions of 49 CFR part 382. X. CONFIDENTIALITY,AND ACCESS TO FACILITIES AND RECORDS 10.1 CONFIDENTIALITY OF RECORDS KEPT BY THE COUNTY. Except as required by law or expressly authorized or required in this Policy or pursuant to 49 CFR part 382, the County shall not release employee/driver information that is contained in records required to be maintained under this Policy. 10.2 An employee/driver is entitled, upon written request, to obtain copies of any records pertaining to the driver's use of alcohol or controlled substances, including any records pertaining to his or her alcohol or controlled substances test. The County shall promptly provide the records requested by the employee/driver. Access to a driver's records shall not be contingent upon payment for records other than those specifically requested. 10.3 ACCESS TO FACILITIES: The County shall permit access to all facilities utilized in complying with the recordkeeping requirement of 49 CFR § 382.405 to the Secretary of Transportation, any DOT agency, or any State or local officials with regulatory authority over the County of any of its drivers. 10.4 The County shall make available copies of all results for the alcohol and/or controlled substances testing conducted under this Policy and 49 CFR part 382, and any other information pertaining to the County's alcohol misuse and/or controlled substances use 5176 M.C.A.Inst.4709.3 August 23,2022 Page 29 Enclosure(1) prevention program, when requested by the Secretary of Transportation, any DOT agency, or any state or local officials with regulatory authority over the County or any of its drivers. 10.5 The County shall disclose, to the National Transportation Safety Board, as part of an accident investigation, information related to the County's administration of a post- accident alcohol and/or controlled substances test administered following the accident under investigation. 10.6 Records shall be made available to a subsequent employer of a driver(who was formerly employed by the County)upon receipt of a written request from that driver. Disclosure of information to the subsequent employer is permitted only as expressly authorized by the terms of the driver's request. 10.7 The County may disclose information required to be maintained under 49 CFR part 382 pertaining to an employee/driver, the decision maker in a lawsuit, grievance, or other proceeding initiated by or on behalf of the employee/driver, and arising from the results of an alcohol and/or controlled substances test administered under this Policy, or from the County's determination that the driver engaged in conduct prohibited by this Policy (including, but not limited to, a worker's compensation, unemployment compensation, or other proceeding relating to a benefit sought by the employee/driver) 10.8 The County shall release information regarding an employee/driver's records as directed by the specific, written request of the employee/driver authorizing release of the information to an identified person. Release of such information by the person receiving the information is permitted only in accordance with the terms of the driver's consent. 10.9 CONFIDENTIALITY OF RECORDS KEPT BY MRO: No person may obtain the individual controlled substances test results retained by an MRO, and no MRO shall release the individual controlled substances test results of any driver to any person, w/o first obtaining a specific, written authorization from the tested driver. 10.9.A. Nothing in this paragraph shall prohibit an MRO from releasing, to the County or to officials of the Secretary of Transportation, any DOT agency or any State or local officials with regulatory authority over the controlled substances testing program under 49 CFR part 382, the information delineated in Section 8.2 of this Policy (i.e. 49 CFR § 382.407 (a)). XI REFERRAL, EVALUATION,AND TREATMENT. 11.1 No driver has engaged in conduct prohibited by Section IV of this Policy (i.e., subpart B of 49 CFR part 382) shall perform safety-sensitive functions, including driving a commercial motor vehicle, unless the driver has met the requirements of Section 11.1-11.9 of this Policy (i.e. 49 CFR § 382.605). 11.2 The County shall not permit a driver who has engaged in conduct prohibited by Section IV of this Policy (i.e. subpart B of 49 CFR part 382)to perform safety-sensitive functions, including driving a commercial motor vehicle, unless the driver has met the requirements of Sections 11.3.-11.9 of this Policy (i.e., 49 CFR § 382.605). 11.3 Each driver who has engaged in conduct prohibited by this Policy shall be advised by the County of the resources available to the driver in evaluating and resolving problems associated with the misuse of alcohol and use of controlled substances, including the 5177 M.C.A.Inst.4709.3 August 23,2022 Page 30 Enclosure(1) names, addresses, and telephone numbers of Substance Abuse Professionals and counseling and treatment programs. 11.4 Each employee/driver who engages in conduct prohibited by this Policy shall be evaluated by a Substance Abuse Professional who shall determine what assistance, if any, the employee/driver's needs in resolving problems associated with alcohol misuse and controlled substances use. 11.5 Before a driver returns to duty requiring the performance of a safety-sensitive function after engaging in conduct prohibited by this Policy, the driver shall undergo a Return-to-Duty alcohol test with a result indicating an alcohol concentration of less than .02 if the driver's conduct involved alcohol, or a controlled substances test with a verified negative result if the driver's conduct involved a controlled substance. 11.6 In addition, each driver identified as needing assistance in resolving problems associated with alcohol misuse or controlled substances use: 1. Shall be evaluated by a Substance Abuse Professional to determine that the driver has properly followed any rehabilitation program prescribed under this Section, and 2. Shall be subject to unannounced follow-up alcohol and controlled substances tests administered by the County following the driver's return to duty. a. The number and frequency of such follow-up testing shall be as directed by the Substance Abuse Professional, and shall consist of at least six (6)tests in the first twelve (12) months following the driver's return to duty. b. The County may direct the driver to undergo Return-to-Duty and Follow-up testing for both alcohol and controlled substances, if the Substance Abuse Professional determines that Return-to-Duty and Follow-Up testing for both alcohol and controlled substances is necessary for that particular driver. Any such testing shall be performed in accordance with the requirements of 49 CFR part 40. c. Follow-up testing shall not exceed sixty (6)months from the date of the driver's return to duty. The Substance Abuse Professional may terminate the requirement for Follow-Up testing at any time after the first six (6) tests have been administrated, if the Substance Abuse Professional determines that such testing is no longer necessary. 11.7 Evaluation and rehabilitation may be provided by the County, by a Substance Abuse Professional under contract with the County, or by a Substance Abuse Professional not affiliated with the County. The choice of Substance Abuse Professional and assignment of costs shall be made in accordance with County/driver agreements and County policies. 11.8 The County shall ensure that a Substance Abuse Professional who determines that a driver requires assistance in resolving problems with alcohol misuse of controlled substances does not refer to the driver to the Substance Abuse Professional's private practice or to a person or organization from which the Substance Abuse Professional receives remuneration or in which the Substance Abuse Professional has a financial interest. This paragraph does not prohibit a Substance Abuse Professional from referring a driver for assistance provided through: 1. A public agency, such as a state, the County or municipality; 2. The County or a person under contract to provide treatment for alcohol or controlled substance problems on behalf of the County; 3. The sole source of therapeutically appropriate treatment under the driver's health insurance program; 5178 M.C.A.Inst.4709.3 August 23,2022 Page 31 Enclosure(1) 4. The sole source of therapeutically appropriate treatment reasonably accessible to the driver. 11.9 The requirements of this Section with respect to referral, evaluation and rehabilitation do not apply to applicants who refuse to submit to a pre-employment alcohol or controlled substances test or who have a pre-employment alcohol test with result indicating an alcohol concentration of 0.04 or greater of a controlled substances test with a verified positive test results. XIL EDUCATIONAL INFORMATION,AND TRAINING OF SUPERVISORS 12.1 EDUCATIONAL INFORMATION TO EMPLOYEES. The County shall provide educational information that explains the requirements of 49 CFR part 382 and the County's policies and procedures with respect to meeting these requirements. 1. The County shall ensure that a copy of these materials is distributed to each driver prior to the start of alcohol and controlled substances testing under this Policy and to each driver subsequently hired or transferred into a position requiring driving a commercial motor vehicle. 2. The County shall provide written notice to representatives of employee organizations of the availability of this information. 12.2 The materials to be made available to drivers shall include detailed discussion of at least the following: 1. The identity of the person designated by the County to answer driver's questions about the materials; 2. The categories of drivers who are subject to the provisions of this Policy (i.e.49 CFR, part 382) 3. Sufficient information about the safety-sensitive functions performed by those drivers to make clear what period of the workday the driver is required to be in compliance with this Policy (i.e. 49 CFR,part 382) 4. Specific information concerning driver conduct that is prohibited by this Policy (i.e.49 CFR part 382) 5. The circumstance under which driver will be tested for alcohol and/or controlled substances under this policy (i.e. 49 CFR part 382) 6. The procedures that will be used to test for the presence of alcohol and controlled substances,protect the driver and the integrity of the testing processes, safeguard the validity of the test results, and ensure that those results are attributed to the correct driver; 7. The requirement that a driver submit to alcohol and controlled substances tests administered in accordance with this Policy (i.e. 49 CFR,part 382) 8. An explanation of what constitutes a refusal to submit to an alcohol or controlled substances test and the attendant consequences; 9. The consequences for drivers found to have violated this Policy and subpart B of 49 CFR part 382, including the requirement that the driver be removed immediately from safety-sensitive functions, and the procedures for referral and evaluation under 49 CFR § 382-605 (as set forth in Section XI of this Policy) 10. The consequences for drivers found to have alcohol concentration of.02 or greater, but less than .04; 5179 M.C.A.Inst.4709.3 August 23,2022 Page 32 Enclosure(1) 11. Information concerning the effects of alcohol and controlled substances use on an individual's health, work, and personal life; 12. Signs and symptoms of an alcohol or controlled substances problem (the driver's or a co-worker's); and available methods of intervening when an alcohol or a controlled substances problem is suspected, including confrontation, referral to any employee assistance program and/or referral to management. 12.3 ACKNOWLEDGMENT OF RECEIPT: The County shall ensure that each driver is required to sign a statement certifying that he or she has received a copy of those materials described in Section 12.2. The County shall maintain the original of the signed acknowledgment and may provide a copy of the acknowledgment to the driver. 12.4 TRAINING FOR SUPERVISOR: The County shall ensure that persons designated to determine whether reasonable suspicion exists to require an employee/driver to undergo Reasonable Suspicion testing under Section 5.4 of this Policy (i.e. 49 CFR § 382.307) receive at least sixty (60) minutes of training on alcohol misuse and receive at least an additional sixty (60) minutes of training on controlled substances use. The training shall cover the physical, behavioral, speech and performance indicators or probable alcohol misuse and use of controlled substances. XIII DISCIPLINE 13. 1 IN ADDITION TO THE REQUIREMENTS OF 49 CFR PART 382, EMPLOYEES WHO ENGAGE IN CONDUCT PROHIBITED BY THIS POLICY ARE SUBJECT TO DISCIPLINARY ACTION BY THE COUNTY, UP TO AND INCLUDING TERMINATION. 5180 M.C.A.Inst.4709.3 August 23,2022 Enclosure(2) ACKNOWLEDGEMENT OF RECEIPT OF A SUMMARY OF THE COUNTY'S DOT DRUG AND ALCOHOL TESTING POLICY I, , hereby acknowledge that I received a copy of the Summary of the County's DOT Drug and Alcohol Testing Policy, and related materials. I understand that it is a condition of my continued employment to abide by the terms of the Policy and to refrain from reporting to work or working with the presence of drugs or alcohol in my body. (Employee's Signature) DATE: The County shall maintain the original of the signed acknowledgement and may provide a copy of the acknowledgment to the driver/applicant/employee. 5181 N 00 V_ to BOARD OF COUNTY COMMISSIONERS County �� Mayor David Rice„District l Monroe Mayor Pro'Tem,Craig Cates,Distrir t 3 The Florida Keys Michelle Coldiron„District ) James K,Scholl,District 4 Holly Merrill Raschein,District 5 Office of the Employee Services Director Use Historic Gato Cigar Factory 1100 Simonton Street,Suite 268 Key West,FL 330-10 (305)2924158—Phone (305)292-1564-Fax Office of the County Administrator Key West, Florida MONROE COUNTY ADMINISTRATIVE INSTRUCTION 4720.4 Date: September 11, 2022 Subject: On the job Drug and Alcohol Testing Reference: Drug Free Workplace Policy 4703 DOT Drug and Alcohol Policy 4709 How to Report and Document Injuries/11 Ines s/Property Damage 8605 Effective Date: Immediately (1) Background: In 2010, Monroe County was in need of a procedure for after-hours drug/alcohol testing involving on-the-job post accident and reasonable suspicion. After hours is defined as weekdays after 5:00 p.m. and weekends. In 2013, this Administrative Instruction was revised to also include the past and current practice of testing during normal business hours (8am—5pm). (2) Purpose: The purpose of this instruction is to comply with the Monroe County Drug Free Workplace Policy at all times. (3) Cancellation: Instruction is to remain continuously in effect unless specifically revised or canceled. (4) Instruction: This procedure is to be followed in the event of on the job accidents and reasonable suspicion drug/alcohol testing before, during or after normal business hours. M.C.A. s ci 20.4 September , 2022 Page 2 ( ) Action: All employees and Supervisors must comply with the Monroe County Drug Free Workplace Policy and the DOT Policy which state that all employees shall be tested for the presence of drugs/alcohol if they sustain an on-the-job injury,, or they have caused, contributed to, or have been involved in an accident while at work. If it cannot be determined at the time of the accident who contributed to or caused the accident, all employees involved in the accident will be drug tested. These accidents must be reported AS THEY OCCUR. Keep in mind that the employee's safety comes first. Seek medical attention first if necessary. n the event of .in injury, accident oir reasonable suspicion drug/alcohol testing during normal business s, contact Human Resources at 5- 9 557„ In the event of an after-hours injury, accident or reasonable suspicion drug/alcohol testing, supervisors are instructed to contact Bryan Cook, Employee Services Director at 305-587-8311 for instructions regarding testing., The Director will coordinate drug and/or alcohol testing with the ont "s physician. Individuals shall be tested for any on the job accident that results i (a) any injury (whether medical attention is requested or not), or (b) property damage in excess of $1,000.00. Additionally, for employees falling under the DOT DrugFree Workplace Policy, individuals will be tested if they receive a moving violation while on County business, or if involved in a accident that results in a fatality. Supervisors and employees must complete and submit all necessary accident forms with the Workers Compensation and/or Risk Management office (Administrative Instruction 8605). , rvrvrvrvrvrvrvrvrvM.,,,, n M„ „ tBSIrv,��>�,,., u. ,.,..... Roman County Administrator Distribution: VI Originator: DHR Review: September 11, 2025 v, eo w EXHIBIT B : IAFF Random Drug Testing Policy Drug Free Workplace Policy Section 1: 1.1 The parties agree that the County's Drug Free Workplace Policy as set forth in Monroe County Administrative Instruction 4703.12, which is attached to the Agreement as Attachment , will apply to all members of the bargaining unit effective upon the ratification of the Board of County Commissioners, and subject to the additions/ modifications set forth in this Article.The additions/modifications set forth in this article are a supplement to the full policies and procedures set forth in the County Drug Free Work Place Policy. Section 2: Confidentiality- 2.1 All drug testing shall be done in accordance with confidentiality procedures outlines in section 440.102(8), Florida Statutes. All urine and blood test results performed hereunder will be considered medical records and held confidential. Confidentiality will be maintained at all times except to the extent necessary to comply with the Drug Free Work Policy and to the extent permitted by law. 2.2All individuals and entities involved in or associated with the drugtesting and their agents may not release any information concerning drug test results obtained pursuant to the drug testing without a written consent form signed voluntarily by the person tested, unless such release is compelled by a hearing officer or a court of competent jurisdiction pursuant to an appeal taken from job action by the employer or denial of benefits under the workers compensation agreement and statute.The consent form willfully advise the employee of the information to be disclosed, the name of the person who is authorized to obtain the information, the purpose of the disclosure, and the duration of the consent. 2.3 Any results of positive testing, which the Employer later determines have been refuted, shall have affixed thereto the subsequent refutation 2.4 Every specimen that produces a positive, confirmed test result shall be preserved by the licensed or certified laboratory that conducted the confirmation test for a period of at least 210 days after the result of the test was mailed or otherwise delivered to the MRO, or until any legal case or administrative appeal is settled. During the 180 day period after written notification of the positive • test result, the employee who has provided the specimen shall be permitted by the employer to have a portion of the specimen retested, at the employee's expense, at another laboratory, licensed and approved by the State of Florida. 5185 SECTION 3: 3.1 Titles-Where appropriate throughout the Policy,the"Department Head" shall mean "Fire Chief" or"Acting Fire Chief". SECTION 4: 4.1 Reasonable Suspicion Report Procedure - If an employee has information upon which there may be a reasonable suspicion of another employee's drug and/or alcohol use in violation of County policy, he or she must immediately report the information to the suspect employee's higher ranking officer on duty, the Director of that Department, or that Director designee; and provide notice to the County Administrator not later than 48 hours (excluding weekends and holidays)following the initial report. 4.2 The officer on duty receiving such a report must report the same to the Shift Commander. When a Shift Commander, or higher ranking officer, has a reasonable suspicion based upon objective factors which is supported by at least one other member above the rank of a firefighter that the employee has possession, is under the influence of, or is using, dispensing or selling any illegal drug or controlled substance which is not prescribed by a licensed physician while on duty, or that the employee is abusing illegal drugs and the abuse either adversely affects his job performance or represents a threat to the safety of the employee, his co-workers, or the public, that officer will report the same to the Fire Chief or his designee. The Fire Chief shall report the same to the County Administrator by written report confirming or dismissing same. 4.3 If the Fire Chief or his acting designee, concludes that a reasonable suspicion testing is justified, he or she must consult with the Director of Human Resources, a County attorney or both, prior to his or her final reasonable suspicion determination. Reasonable suspicion testing may only be authorized by the Fire Chief, his or her designee or by the Assistant County Administrator or County Administrator. The order for an employee to submit to reasonable suspicion testing will be made by the Fire Chief or his or her designee. 4.4 The County must document, in writing, the circumstances which formed the basis of its reasonable suspicion testing prior to issuing an order for testing. 4.5 One copy of the document shall be given to the bargaining unit employee before he is tested. The affected bargaining unit employee shall be allowed enough time to be able to read and understand the entire document. 4.6 Employees shall be transported to the specimen collection site by a Captain or Watch Commander. When requested by the Employee, a Union Representative shall be allowed to 5186 accompany the employee to the test and observe the collecting, bottling and sealing of the specimen. Section 5: Random Drug Testing Procedure- 5.1 Random testing shall be conducted via an unbiased selection procedure, and in accordance with drug-testing rules adopted by the Agency for Health Care Administration and the Department of Labor and Employment Security. 5.2 On a monthly basis ten percent (10%) of the members of the bargaining unit will be subject to random drug testing. The member shall be notified of their selection in writing by the Battalion Chief. Upon being notified that they have been selected, the member shall report immediately for testing. The testing will either be conducted onsite or at a testing facility at the discretion of the County. If the member is off duty or on vacation when they are notified that they have been selected for random testing,they shall report for testing on their next scheduled shift. 5.3 Consequences of Refusing a DrugTest:An employee who refuses to submitto a drugtest will be subject to termination.An employee who refuses to submit to a drug test following an occupational injury which requires medical treatment forfeits his eligibility for all workers' compensation medical and indemnity benefits in accordance with Florida law. 5.4 Actions Following Positive Confirmed Test:The County will terminate any employee who has a positive, confirmed drug test. 5.5 Reporting of Use of Medication: Employees may confidentially report the use of prescription or non-prescription medication both before and after having a drug test.A form for reporting medication use is attached. 5.6 Notice of Common Medications:A list of the most common medications by brand name or common name, as applicable, as well as by chemical name, which may alter or affect a drug test, is attached. Employees should review this list prior to submitting to a drug test. 5.7 Medication Information: An employee may consult with the County's MRO or the testing laboratory for technical information regarding prescription and non-prescription medication. Section 6: Drugs to be Tested- 6.1 Our Policy complies with the Florida Drug-Free Workplace Program as provided in Section 440.101, et seq, Florida Statutes. Drug testing will be required for any or all of the 5187 drugs listed in the Florida State Statute,Section 440.102 and Florida Statute,Section 893.03. These drugs may be subject to change as per federal regulations. 6.2 Drug Cut-Off Levels will be followed as indicated by the Florida State Statutes. Section 7: Reasonable Suspicion DrugTesting- 7.1 Employees will be required to submit to drug and/or alcohol testing when a supervisor has "reasonable suspicion;' as defined in this policy, to believe that an employee is using or has used drugs or alcohol in violation of this Policy. The supervisor will document the circumstances which formed his or her determination of "reasonable suspicion" in writing as soon as is practicable.While this should be done on the same day orthe next working day, it must be done within three working days from the date of the determination.A form for the use of a supervisor to specify the reason(s) for the test is attached. A copy of this documentation will be given to the employee upon request within seven days from the date of the supervisor's determination of"reasonable suspicion:' Section 8: Post Accident Testing 8.1 An order to submit to post accident testing can be made by a Battalion Chief or any chief officerwithin the division.Any bargaining unit member ordered for a post-accident drug test may, at the member's option, be accompanied to the testing by an available Union Representative. The Union Representative shall act as a quiet observer to the testing procedure and shall not interfere with the testing procedures. 8.2 Refusal to submit to an order for post-accident drug testing, or intentionally delaying a post-accident drug test can result in termination; however, nothing herein shall abrogate a bargaining unit member's right to challenge the results of the drug test. Section 9: Challenge of Test Results if Drug Test Under Florida Law 9.1 An employee who receives a positive confirmed test result may submit information to the MRO contesting or explaining the results in writing within five (5) working days of receipt of notification of a positive confirmed test result. 9.2 If the explanation or challenge of the employee is unsatisfactory to the MRO, the MRO shall report a positive result back to the County. 9.3 Within five (5)working days after receiving notice of a positive confirmed test result from the MRO, the County shall inform the employee in writing of the positive test result, the consequences of such results, and the options available to the employee. Upon request,the County shall provide a copy of the test result to the employee. 5188 9.4 Within five (5)working days after receiving notice of a positive confirmed test result from the County,the employee may submit information to the County explaining or contestingthe test result, and explaining why the result does not constitute a violation of the County's policy. 9.5 If the explanation or challenge of the employee is unsatisfactory to the County, the County shall provide a written explanation (within fifteen (15) days of receipt) as to why the employee explanation is unsatisfactory, alongwith a copy of the report of positive confirmed test results. All such documentation will be kept confidential except as provided, in accordance with the County Drug Free Work Place Policy, above and will be retained by the County for at least one (1)year. 9.6 An employee may further challenge the results of the test in a court of competent jurisdiction or, if the drug test was administered due to a workplace injury, by filing a claim for benefits with a Judge of Compensation Claims, pursuant to Chapter 440, Florida Statutes. 9.7 If an employee contests the drug test results, he or she will be solely responsible for notifying the laboratory and the County in writing by certified mail and provide a copy of the written notice, by certified mail, to the County. The notice must include reference to the chain of custody specimen identification number. 9.8 An employee who receives a positive, confirmed test result may, at the employee's expense, obtain a retest of a portion of the original specimen at another licensed and approved laboratory selected by the employee, within one hundred eighty (180) days of the notice of the positive test result. Section 10: The County Drug Free Workplace Policy is applicable to members in its entirety. 10.1 In the event that mandatory changes to the policy need to be made based on state law or regulation, said changes may be made as required. Permissive changes will be made subject to impact bargaining. 5189 IN THE CIRCUIT COURT OF THE SIXTEENTH JUDICIAL CIRCUIT IN AND FOR MONROE COUNTY, FLORIDA FINAL REPORT OF THE MONROE COUNTY GRAND JURY SPRING TERM 2024 THE INVESTIGATION INTO 2022 TRAUMA STAR DIVERSION OF CONTROLLED SUBSTANCES, THE INDIVIDUALS INVOLVED AND THE ACTIONS/INACTIONS OF MONROE COUNTY PUBLIC OFFICIALS AND SERVANTS MEMBERS OF THE SPRING TERM 2024 GRAND JURY RANDALL PETERS, Foreperson DENNIS W. WARD w ac = ► State Attorney � s, COLLEEN M. DUNNE Assistant State Attorney 5190 I. INTRODUCTION It is the province and the duty of the Grand Jury to investigate possible unlawful actions by all the persons, private citizens and public officials alike, and to return indictments when warranted; it is also the Grand Jury's lawful and proper function to consider the actions of public bodies and officials in the use of public funds, and to report or present findings and recommendations as to practices, procedures, incompetency, inefficiency, mistakes, and misconduct involving public offices and public monies. On July 26, 2022, the Monroe County Sheriffs Office (MCSO) was notified by Monroe Country Fire Rescue (MCFR) that it was discovered from their controlled substance logs that numerous vials of narcotics were unaccounted for and Trauma Star Chief Flight Nurse, Lynda Rusinowski had admitted to being responsible. At the time MCFR reported the crime to MCSO, it was still undetermined how many total controlled substance vials had been diverted and how far back the diversions had started. The Monroe County Sheriffs Office commenced a criminal investigation into the facts surrounding not only the actual thefts of the controlled substances but also how it was discovered, how the thefts occurred, what information members of MCFR had of the thefts or any suspicions they may have had, whether any other individuals may have been involved in the thefts directly or indirectly as well as whether there had been any prior similar incidents. Simultaneous to the investigation being conducted by MCSO, the then Fire Chief, Steven Hudson, requested the Monroe County Clerk of Courts conduct an audit of MCFR's Emergency Medical Services system performance and controlled substance inventory records for the period of June 2021 through July 2022. The Clerk's Office was requested to evaluate MCFR's methods of ordering controlled substances, the internal controls and processes over storage and security of the controlled substances, the efficiency and effectiveness of the receipt and storage of the controlled substances, review MCFR's compliance with the controlled substance z 5191 policy and procedures as well as applicable laws and regulations, review and evaluate the inspection and reporting requirements of controlled substance containers tampered or degraded, the disposal activities of unused and expired controlled substances and the documentation, records, reviews and management for storage policies. On May 11, 2023, the Monroe County Clerk's Office issued a 79-page Internal Audit Report and provided copies to the Board of County Commissioners, Roman Gastesi the County Administrator, Bob Schillinger the County Attorney, Fire Chief James Callahan and Deputy Fire Chief R. L. Colina. The Internal Audit was also made public by the Clerk of Court. The report contained numerous findings of inefficiencies and inadequacies in the management of controlled substances by MCFR, lack of and deficient performance on the part of Dr. Sandra Schwemmer, the Medical Director contracted by the Board of County Commissioners and also reported a total of over 600 missing controlled substances likely to have been diverted in just a 13-month review. Along with the findings, the audit report made many detailed recommendations to MCFR management for the purpose of correcting the inadequacies and safety issues identified. Although MCFR did provide written responses to the clerk's recommendations, it is unclear to what extent any of the recommendations or alternative processes were put into place by MCFR management. The State Attorneys Office initiated an investigation into MCFR's response to the 2022 criminal investigation by MCSO and thereafter the Clerk of Court's internal audit report. On August 2, S, and 15th, 2024, the Grand Jury heard testimony from 20 witnesses involved in or having knowledge of the 2022 Trauma Star investigation and actions by MCFR and other public servants. It should be noted that Roman Gastesi was afforded an invitation on two separate dates to appear in person or via ZOOM but did not appear. 3 5192 On August 2, 2024, the Grand Jury returned a thirty-six-count indictment charging Lynda Rusinowski with Official Misconduct and Grand Theft of Controlled Substances. On August 8, 2024, the Grand Jury returned a nine-count indictment against Division Chief of Trauma Star/EMS Andrea Thompson charging Official Misconduct, Tampering with a Witness, Tampering with Evidence, False Statement to Law Enforcement and Alteration of Patient Records. On the same day a third indictment was also returned against Dr. Sandra Schwemmer charging Official Misconduct, False Statement to Law Enforcement and Alteration of Patient Records. Thereafter on August 15, 2024, the Grand Jury returned a one-count indictment against the former County Administrator Roman Gastesti charging Official misconduct and a superseding indictment against Andrea Thomson adding two additional charges of False Statement to Law Enforcement. This report is the culmination of the Grand Jury's inquiry and contains not only findings but recommendations based upon the testimony and evidence presented over three full days. II. THE FACTS AND OUR ASSESSMENT Integrity and accountability are important in public service to ensure that the public's best interests are served. What we the Grand Jury have discovered is that those two core principles are seriously lacking in current (and former) MCFR high ranking administrators and county employees and allowed for a caustic and cronyistic environment and culture to exist for many years within the agency. This culture seriously affects the morale of its employees and the delivery of services affecting the life and safety of Monroe County citizens and visitors and must come to a stop. This culture has been one of long duration where certain employees have received preferential treatment to the detriment of other employees, often leading to the termination or resignation of such employees who have refused to allow such dysfunctional behavior to exist. Sadly, such threats of retaliation and harassment have resulted in various employees caving into the demands or turning a blind eye 4 5193 because of fear of being terminated or retaliation otherwise being imposed. Unfortunately, this environment has existed for many years and can be documented back to 2010. Over the years, many recommendations have been made to the Board of County Commissioners (BOCC). Grand Jury Reports, Clerk of Court Audits, Sheriff Reports, and other official documents have been issued seeking to address various problems, criminal conduct, and other misdeeds that have occurred in Monroe County Government and its Departments. While some processes and procedures have been taken and/or implemented, many have not. Individuals identified as being responsible for various misdeeds have been allowed to remain in their governmental positions, often being promoted to newly created positions. The Board of County Commissioners (BOCC) is ultimately responsible for the effective and efficient operation of Monroe County Government. This responsibility is accomplished through the County Administrator, who serves at the pleasure of the BOCC, and directly answers to the BOCC. The County Administrator oversees the daily operation of County government through various Department heads, who report directly to the County Administrator. Each Department then has its own hierarchy of supervision or chain of command. When the hierarchy of supervision/chain of command is compromised through favoritism, special treatment, misappropriation, intimidation, harassment, criminal activity, or otherwise turning a blind eye to the professional responsibilities that enure to and are expected of Public Officials, a toxic work environment is created and allowed to exist. All Public Officials are expected to uphold a standard of professionalism that is beyond reproach. Thomas Jefferson once said that the basic principle of public service is when a person assumes a public trust, that person should consider themselves as public property. Public service is a public trust. To ensure public confidence in the integrity of Monroe County Government and its employees, ethical behavior is required and expected of all County officials and employees, both exempt and non-exempt. County employees are expected to place loyalty to Federal and State laws, and ethical principles above their own personal and/or private 5 5194 gains. Unfortunately, this has not occurred in Monroe County and MCFR. Roman Gastesi has served as Monroe County Administrator since May 2008. He retired on February 23, 2024, but has continued to serve as a "volunteer" to the BOCC during the six-month period of time he cannot be employed by Monroe County under the terms of Florida's Deferred Retirement Option Program (DROP). Based upon public information in various news articles, the BOCC is planning to rehire Roman Gastesi as County Administrator. This is unacceptable to the Grand Jury. Based on the witness testimony, Mr. Gastesi has been directly involved in many of the events that transpired involving certain employees of the MCFR and are part of this investigation. The Grand Jury returned its indictment against Roman Gastesi on August 15, 2024, charging him with official misconduct as a public official.. This is not the first time Mr. Gastesi has been a part of a Grand Jury investigation. In 2012, the Grand Jury issued its Official Report calling for the termination of Roman Gastesi as County Administrator for his participation in the theft of County owned cell phones and 1-pads by another county employee. Obviously the BOCC chose to ignore the recommendations of that Grand Jury. The question is posed as to whether Mr. Gastesi actually serves at the pleasure of the BOCC, or does Mr. Gastesi control the actions of the BOCC? The proverbial "tail wagging the dog." What is certain, through the testimony of the various witnesses, is that Mr. Gastesti has used what appears to be boundless power and authority in manners not consistent with the best interests of Monroe County as a whole, but rather for select individuals that align themselves with him, or otherwise not against his agenda. From the investigation undertaken by the State Attorney's office and presented to this Grand Jury through witness testimony and documentation, it is clear that the incident in July 2022, in which Lynda Rusinowski was initially charged with theft of morphine and alteration of drug logs, was merely the tip of the iceberg. Multiple incidents involving controlled substances and drugs utilized by 6 5195 the Trauma Star/EMS program have occurred since at least 2010. Many of these incidents (2010, 2013, 2019, and 2022) have involved the same employees of Monroe County, Roman Gasesti, James Callahan, Andrea Thompson, and Sandra Schwemmer. Mrs. Thompson has been directly involved in several of the incidents and instead of being terminated or disciplined as recommended by MCFR officials, she has consistently been promoted throughout the years until she was most recently serving as MCFR Division Chief of the EMS and Trauma Star Division at the time of her arrest on August 9, 2024. Information provided to the Grand Jury has shown that both Roman Gastesi and Fire Chief James Callahan have consistently intervened on behalf of Mrs. Thompson throughout her career with MCFR to prevent disciplinary action being taken. Of concern to the Grand Jury is the personal relationship between Andrea Thompson, James Callahan, and Roman Gastesi, together with the involvement of Sandra Schwemmer. These relationships have resulted in minimal, if any, discipline imposed on Mrs. Thompson since the first misconduct we heard about back in 2010 wherein, Andrea Thompson, while off-duty removed medical supplies from the supply room to allegedly treat a volunteer firefighter at their residence. For a reason still unclear to the Grand Jury, Andrea Thompson was not disciplined, and more disturbing was learning that the only mention of this behavior in her personnel file is in an unrelated complaint she fled against another employee. The Grand Jury learned of various accounts where Andrea Thompson exhibited very poor leadership and judgment while acting in a position of authority at MCFR. She placed her personal friendship with the Chief Flight Nurse Rusinowski ahead of public safety, improperly inserted herself in the investigation into the narcotics theft by Rusinowski and thwarted law enforcernents attempts to discover all the facts and evidence surrounding the crime committed by her friend. Andrea Thompson failed miserably in her commitment to serving the citizens of Monroe County with honor and integrity. 5196 Aside from the above, Andrea Thompson was a main architect of the toxic workplace that existed at MCFR, actively participating in intimidation, threats and coercion to keep those she managed under her control. Yet, Thompson was rewarded for her "loyalty and service" by being promoted multiple times even after she was suspended with pay in connection with her acts as reported by MCSQ's investigation into the theft of the controlled substances by Rusinowski. Fire Chief Callahan and Mr. Gastesi have been able to directly influence many of the incidents and outcomes to this day. Most recently, Roman Gasesti intervened and stopped HR and Employee Services from conducting an internal investigation by an outside third-party independent firm of the July 2022 incident and more specifically Andrea Thompson. The popular adage, "it's who you know, not what you know," could not be more fitting to describe Andrea Thompson and the obvious cronyism. Fire Chief James Callahan served as Fire Chief of MCFR for 15 years before retiring in May 2021. Thereafter, Deputy Chief Steven Hudson served as Fire Chief of MCFR until his retirement December 17, 2022. Information presented to the Grand Jury indicates that Chief Hudson was harassed and received multiple threats of retaliation resulting in his decision to retire instead of being terminated when Chief Hudson attempted to implement changes and impose discipline for the July 2022 Rusinowski incident. To Chief Hudson's credit, he requested that the Monroe County CIerk of Court conduct a full and complete audit of the EMS and Trauma Star program. Not surprisingly, Chief Hudson received much pushback from the County Administrator Gastesi and certain BQCC commissioners. Despite the pushback, the Monroe County Clerk of Court completed the Audit releasing its findings in May 2023. With Fire Chief Hudson's December 2022 retirement, County Administrator Gastesi rehired former Fire Chief Callahan to serve as interim Fire Chief beginning January 3, 2023 until the present day. Fire Chief Callahan was to serve temporarily as fire chief during which time the MCFR was to seek a new fire chief. Deputy Chief R. L. Colina served as interim Fire Chief from December 2022 until January 2023 8 5197 when Fire Chief Callahan came onboard. At this time Fire Chief Callahan has been retained as fire chief for MCFR. Information presented to the Grand Jury indicates that former Fire Chief Hudson was not afforded the tradition of selecting his successor. Information also presented to the Grand Jury indicates that County Administrator Gastesi authorized Fire Chief Callahan to work remotely resulting in his being out of Monroe County more often than he is in Monroe County, typically only appearing for the monthly BGCC meetings. While Fire Chief Callahan is out of county, Deputy Chief R. L. Colina continues to serve as acting Fire Chief. Sandra Schwemmer has served as the Medical Director for Monroe County since 1987. Her contract with the BGCC has continually been renewed since then and she was currently serving as the Monroe County Medical Director at the time of her arrest. The Grand Jury received a significant amount of information indicating that Dr. Schwemmer was not complying with the terms of her contract with the BGCC. She was not readily available to MCFR EMS/Trauma Star personnel when needed. She rarely appeared in County and would delegate her various responsibilities to other EMS/Trauma Star personnel including but not limited to Andrea Thompson, Linda Rusinowski, and others. Actions required to be taken by Dr. Schwemmer under the terms of her contract were not completed, such as required monthly meetings. Reference is made to the Clerk of Court's May 2023 Audit for additional examples of contractual noncompliance. Testimony and information presented to the Grand Jury indicated that inventory controls for controlled substances such as morphine, fentanyl, dilaudid, ketamine, and versed regularly went missing without remedial action being taken. However, she did not institute any real changes to the inventory process during her tenure that would ensure such drugs did not go missing or unaccounted for. In fact, Dr. Schwemmer did not enforce at least one of her directives that incorrect entries in the drug logs must be struck through and reentered. The Clerk's Audit and MCFR internal review of the paper drug logs showed that this procedure was not being followed and the logs were being altered. 9 5198 The Grand Jury is extremely concerned about the BOCC's willingness to continually renew contracts, such as the Medical Director contract, without ensuring that the terms of the contract have been complied with. Given the multiple incidents involving controlled substances during Dr. Schwernmer's tenure, the Grand Jury is deeply concerned about the willingness of the BOCC to continually renew Dr. Schwemmer's contracts that regularly increased the amount of compensation she received without any oversight that the terms of the contracts were being complied with. We believe that MCFR EMS services and the Trauma Star program are exceptional services which are vital for Monroe County. There are many highly trained, dedicated, ethical and committed individuals within those programs who take pride in serving Monroe County. The long standing, underlying problem has been the various individuals placed in leadership roles who have abused the power given to them and created an unhealthy almost tyrannical environment. We acknowledge and support the steps thus taken since the Clerk's Internal Audit Report to ensure best practices are followed. It is evident additional actions are critically necessary. We encourage the BOCC to provide the necessary resources needed to bring about more accountability, integrity and transparency. We must highly commend the fire-fighter/paramedics, the auditors for the Clerk of Court, and former MCFR employees who provided critical and impactful testimony and enlightened the Grand Jury to the existing work environment and culture. The currently employed fire-fighter/paramedics who testified exposed themselves to potential retribution and ostracism, were especially courageous despite being at risk of severe personal and professional consequences. Without their courage to speak out, many issues might have remained hidden, allowing harmful practices to persist unchecked. The Grand Jury was in full consensus that MCFR EMS and the Trauma Star program provides outstanding critical patient care and services. Many lives depend 10 5199 on these services on a daily basis. We commend their efforts and encourage public trust and confidence in these services. John Stuart Mill stated, "A person may cause evil to others not only by his actions but by his inaction, and in either case he is justly accountable to them for the injury." Although the Grand Jury has only indicted four (4) individuals whose actions and inactions were criminal and affected the public's trust and safety, there may be others whose actions are questionable. III. RECOMMENDATIONS We make the following recommendations and strongly encourage they be immediately adopted and implemented. if such recommendations are not adopted, the BOCC and MCFR should provide a written explanation to the Grand Jury and provide an explanation at a public BOCC meeting before the end of 2024. 1. Roman Gastesi be immediately terminated from any and all Monroe County positions, including volunteer positions. This recommendation was previously made by the 2012 Grand Jury in its Official Report and ignored. Mr. Gastesti must never hold any position with Monroe County. 2. Andrea Thompson be immediately terminated from her position with MCFR and not be allowed to return or hold any position with MCFR or hold any position of trust with Monroe County. 3. Chief Callahan be asked to resign as Fire Chief before the end of 2024 and the BOCC begin immediately the necessary steps to appoint a new Fire Chief who possesses the requisite education, technological knowledge and professional skills to perform the Fire Chiefs job responsibilities and oversees the daily operations in county and be on site. 4. We strongly recommend that MCSO allow Firefighter/Paramedics Damian Suarez and Harold Perez to return to Trauma Star as flight medics if they so 11 5200 choose. Additionally, Monroe County should reinstate with backpay Damian Suarez and Harold Perez Trauma Star flight pay from the day they were allowed to return to work, but denied flight status pay. 5. An internal affairs division should be created to handle MCFR personnel discipline, similar to what is afforded for law enforcement officers under Chapter 112, Florida Statute. 6. Monroe County Employee Services to implement random drug testing for all county employees in special-risk positions as was previously recommended in the Clerk's Internal Audit Report. 7. Employee Services and MCFR request the Medical Director to issue a Medical Directive requiring all MCFR EMS and Trauma Star employees to be subject to random drug testing. 8. All MCFR employees to receive diversion training to identify signs of substance abuse, and steps to prevent the theft of narcotics. 9. Monroe County's Human Resources/Employee Services department to develop a new and uniform policy and procedures for the handling of any complaint received from a Monroe County employee. More specifically, the policy and procedures to require in every complaint that a written finding, resolution or conclusion be provided to the complainant or the subject of the complaint no later than 45 days from receipt of the complaint. That the subject of the complaint be allowed to review the complaint and all statements, names of witnesses and evidence before any investigative interview is conducted of the subject of the complaint. The complainant to also be allowed to review any evidence, statements or names of witnesses by the subject of the complaint and allowed to respond prior to any investigative interview of the complainant. 10. Monroe County's Human Resources/Employee Services departments should review and update its whistleblower/anonymous reporting process to require a response be sent confirming receipt of the report. There also needs to be a written report or response documented internally indicating what was done 12 5201 to investigate the report as well as a response being provided to the individual who made the report. 11. All Monroe County elected officials, BOCC, department heads, executives and any person in a management/supervisory level be required to complete an ethics and compliance in the workplace training with a focus on intimidation, bullying, harassment, retaliation, discrimination and working in a regulated environment. The training should be required on an annual basis. 12. All Monroe County elected officials, BOCC, department heads, executives and any person in a management/supervisory level be required to complete a Leadership training course with continuing education on an annual basis. 13. The BOCC immediately hire an independent third-party firm to conduct a review of all contracts of services and determine compliance with the required contract terms before any contact is renewed. 14. The BOCC implement more checks and balances as it pertains to the County Administrator position. There should be written monthly reports detailing a thorough review by the County Administrator of the County's departments' work environment, work product and efficiency along with any pending complaints or incidents related to public trust or accountability A reminder from Thomas Paine, "A body of men holding themselves accountable to nobody ought not to be trusted by anybody." We ought not trust those who are unwilling to be accountable. SO SAY WE ALL, RANDALL PE �- —,........__. w TERS Foreperson 13 5202 w Z Z � OQ � c� � jU) Cf) J ~ U) 0Q Z z w CL ca — Q H Z — Q c I Q � p:3 NzJV O — Q O . NLLJ a c � HLLo w � ON � � a) L L wU6i ,O cU Z Z J H � CO Q � c� 0)to LL L .> CO C� m O . 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