ALCOHOL AND DRUG POLICY AND TESTING
PROCEDURES FOR THE OMNIBUS TRANSPORTATION EMPLOYEE
TESTING ACT OF 1991
POLICY STATEMENT AND AUTHORIZATION
The Town of Sebago has a strong commitment to the health, safety and welfare of its employees, their families, its customers, and the public at large. Accordingly, the Town seeks to hire and employ workers requiring a Commercial Drivers License (CDL) who are free from the illegal use and abuse of drugs and alcohol and to protect employees, their families and the public from the adverse effects of alcohol and drug abuse. The Town requires that final applicants selected for the positions requiring a CDL undergo an Alcohol and Drug Test to detect the presence of alcohol and drug abuse substances in the body.
Any applicant with a positive pre-employment test may be denied employment with the Town by reason of the positive test.
The use and misuse of alcohol or drugs, whether prescribed or illegal, impairs the ability of an employee to perform assigned duties, particularly those requiring a CDL, and may endanger the employee, co-workers, the public, the Town and the public and private property. The Town seeks to prevent employees from using alcohol and drugs when the use of such is illegal, or in any way endangers the Town of the public. The Town also wants to provide appropriate and reasonable assistance to employees whose use or misuse impairs their ability to perform their duties.
This policy is designed to comply with the Omnibus Transportation Employee Testing Act of 1991 and with the Rules and Regulations under CFR 49 Part 653, Prevention of Prohibited Drug Use in Transit Operations and CFR 49 Part 382, Substances and Alcohol Use and Testing (both published February 15, 1994) and related parts, and to provide guidance to Town officials on the implementation of the requirements of the Act.
PROGRAM ADMINISTRATION
It is the responsibility of the Town Manager to administer and enforce this policy and the procedures as outlined. Employment by the Town shall not be deemed to have been offered, nor shall a perspective employee have the right to accept any offer or suggestion of an offer of employment until such time as a drug test evaluation has been received and cleared by the Town Manager.
The Town will contract for specimen collection, medical review, testing, and training for supervisors and employees. It is the responsibility of each department director or manager to administer applicable sections of this policy. It is the responsibility of the Town Manager and each department head to see that supervisors are properly trained and that employees have notice of and are familiar with these drugs and alcohol policies and procedures.
SCOPE OF PROGRAM
This policy will apply to all regular full-time, part-time, temporary and seasonal employees who are required to hold a Commercial Driver’s License (CDL) for their position. Compliance with this policy will also be required of successful job applicants who will be hired contingent on passing a drug test.
PARTICIPATION AS A CONDITION OF EMPLOYMENT
All employees in, or applicants for, positions defined as CDL safety-sensitive, must participate in the drug and alcohol testing program prescribed by the FHWA rules as a condition of employment. Failure to participate and comply with program requirements may result in disciplinary action up to and including termination of employment.
COMPLIANCE WITH REGULATIONS
All CDL employees subject to alcohol and drug testing must be in compliance with this policy at all times while working for the Town. This will include all time spent operating commercial vehicles, as well as time spent maintaining or repairing these vehicles.
DEFINITIONS
Alcohol and Drug Test. A generally accepted and proven test methodology or methodologies as recommended by the Rules and Regulations under CFR 49 Part 653, Prevention of Prohibited Drug Use in Transit Operations and CFR Part 382, Substances and Alcohol Use and Testing. This test method determines whether an individual has ingested or otherwise used the substance in question within a period of time before the test.
Applicant. A person who has applied for a position with the Town of Sebago, including past employees eligible for rehire, and present employees voluntarily seeking another position.
Medical Review Officer (MRO). Physician responsible for reviewing all test results for confirmation prior to communicating same to the employer. The MRO is required to protect the confidentiality of the individual involved.
NIDA. The National Institute on Drug Abuse.
Positive Test. Alcohol and Drug tests results that meet or exceed the standards outlined under CFR 49.
Random Testing. A scientific method used to select employees for testing at random. This method will occur throughout the year, and involve a minimum of fifty percent (50%) employees/positions requiring a CDL selected for drug testing and minimum of ten percent (10%) for alcohol testing. The minimum percent to be tested may decrease in subsequent years based on the number of confirmed positive test results.
Reasonable Suspicion. A determination made by a trained supervisor that an employee is in violation of the Omnibus Transportation Employee Testing Act of 1991 concerning alcohol or controlled substances. This determination must be based upon specific, contemporaneous, articulate observations concerning the appearance, behavior, speech and body odors of the driver. Circumstances which may constitute a basis for determining “reasonable suspicion” may include, but are not limited to:
A pattern of abnormal or erratic behavior; Direct observation of drug or alcohol use; Presence of
the physical symptoms of drug or alcohol use (i.e., glassy or bloodshot eyes, alcohol odor on
breath, slurred speech, poor coordination and/or reflexes); Any trained supervisor who has
reasonable suspicion to believe that a violation has occurred must complete an “Observed
Behavior-Reasonable Cause Record” form within twenty-four (24) hours of the observed
behavior or before the results of the tests are released, whichever is earlier.
Substance Abuse. The use of alcohol, prescription or over-the-counter drugs, any of which impairs the ability of an employee to perform the job safely and effectively, or the use of illegal drugs or other controlled substances without a valid prescription.
Work-Related Vehicular Accident. Any reportable vehicular accident that damages property or involves injury to self or others for which a moving traffic violation citation is issued (does not include minor personal injury not requiring transport to a medical facility or care beyond first aid.), and all vehicular accidents involving a fatality.
DRUG AND ALCOHOL TESTING
The following circumstances shall require Drug and Alcohol Testing:
Pre-employment. Pre-employment Drug Testing shall be conducted before applicants are hired or after an offer to hire, but before actually performing safety-sensitive functions for the first time. Testing is also required when employees transfer to a safety-sensitive (driver) position. Pre-employment alcohol testing shall be required when or if the federal government requires it.
Post-Accident. Post-accident testing shall be conducted after accidents on drivers whose performance could have contributed to the accident (as determined by a citation for a moving traffic violation) and all fatal accidents even if the driver is not cited for a moving traffic violation.
Reasonable Suspicion. Reasonable Suspicion testing shall be conducted when a trained supervisor has reasonable suspicions, based upon specific, contemporaneous, articulate observations concerning the appearance, behavior, speech or body odors that the employee has:
Unlawfully used illicit drugs and/or abused controlled substances; or
Reported to work under the influence of or has illicitly ingested controlled substances or alcohol during work hours.
Random Testing. Random testing shall be conducted on a random, unannounced basis just before, during, or just after performance of a safety sensitive function. Fifty percent (50%) of
employees in safety sensitive positions must be tested for controlled substances and ten percent (10%) of employees in safety sensitive positions must be tested for alcohol on an annual basis.
Return to Duty and Follow-Up. Return to duty and follow-up testing shall be conducted when an individual who has violated the prohibited alcohol or drug conduct standards returns to performing safety-sensitive duties. Follow-up tests are unannounced and at least 6 tests must be conducted in the first 12 months after a driver returns to duty.
Failure to report to the designated collection site within thirty (30) minutes of being notified to submit to a required test.
Failure to remain readily available for post-accident testing for eight (8) hours or until the employee undergoes testing, whichever occurs first.
TESTING FOR JOB APPLICANTS AND EMPLOYEES
Drugs to Be Tested for:
When chemical drug and alcohol screening is required under the provisions of this policy and CFR Title 49, a breath test and/or urinalysis test will be given to detect the presence of the following drug groups:
Alcohol (ethyl); Amphetamines; Cocaine; Opiates; Phencyclidine (PCP); Marijuana
Applicant Testing General Standard
Applicants for all classes of employment requiring a CDL will be required to undergo a chemical drug and alcohol test upon an offer of employment and prior to their final appointment to that position.
Current Employee Testing General Standard
The Town may require a current Town employee whose position requires a CDL to undergo drug and alcohol testing if there is reasonable suspicion by the immediate supervisor or other trained management personnel within the department that the employee is under the influence of drugs or alcohol during work hours.
Supervisors are required to document the specific facts, symptoms, or observations which formed the basis that reasonable suspicion existed to warrant the testing of an employee. This documentation shall be forwarded to the appropriate department head and the Town Manager. (See attached “Observed Behavior – Reasonable Cause Record”.)
This documentation shall be forwarded to the appropriate department director, and Town Manager. The “Observed Behavior-Reasonable Cause Record” form must be completed.
The Town will require a current Town employee in a position requiring a CDL to undergo post-accident drug and alcohol testing if he/she is involved in a reportable vehicular accident or if there is a fatality and/or receives a citation under state law for a moving traffic violation relating to the accident.
All current employees in safety sensitive positions requiring the use of a CDL will be subject to Random Testing.
Drug abuse counseling and referral services are available.
Testing of Supervisors
All supervisors requiring a CDL are subject to the testing rules and procedures outlined in this policy.
If an employee suspects a supervisor of substance abuse, the employee will notify the department head or Town Manager of the employee’s suspicions. The contacted official will act as specified above and in accordance with the reasonable suspicion section below. All employee reports are kept strictly confidential. Anonymous complains will not be investigated.
The MRO will notify the applicant of the test results, and if positive, will give the applicant an opportunity to discuss the same prior to release of the information to the Town.
After the Town Manager has received the test results from the MRO or medical facility, she/he will not inform the hiring authority or department head of the test results. This disclosure from
the MRO will state whether the test is positive or negative, and if positive, which substances were detected, and shall be kept confidential by the Town Manager.
The Town Manager will inform the department head whether or not the applicant is eligible for employment. All test results shall be kept confidential within the Personnel Department.
Record Keeping
Records shall be maintained by the department where supervisory training is given, and copies shall be forwarded to the Town Manager.
Records shall be maintained by the department documenting that employees have been provided with information required under this policy, and copies shall be forwarded to the Town Manager.
TESTING PROCEDURES
Notice and Consent
Before a drug and alcohol test is administered, employees and job applicants will be asked to sign a consent form authorizing the test and permitting the release of test results to those Town officials with a need to know. The chemical screen consent form shall provide space to indicate current or recent use of prescription and over-the-counter medication.
All recruitment announcements for any position requiring a CDL including in-house recruitment and promotion will disclose that a chemical, alcohol, and drug screening test will be required for the applicant.
Pre-employment Testing
Before any department head or other Town hiring authority makes a conditional offer of employment to an applicant, he/she will notify the Town Manager of the final or top applicant for the position. The Town Manager will schedule a chemical, alcohol, and drug screening test for the applicant.
The applicant shall be given a copy of this policy, a consent form to complete and sign, and will be informed of the test appointment.
The MRO will notify the applicant of the test results, and if positive, will give the applicant an opportunity to discuss same prior to release of the information to the Town.
After the Town Manager has received the test results from the MRO or medical facility, they will not inform the hiring department or division of the test results. This disclosure from the MRO will state whether the test is positive or negative, and if positive, which substances were detected, and shall be kept confidential by the Town Manager.
After the Town Manager has received the test results from the MRO or medical facility, she/he will inform the department head whether or not the applicant is eligible for employment. All results shall be kept confidential.
Reasonable Suspicion Testing
A supervisor may upon reasonable suspicion and after at least attempting to consult with the department head, if available, ask any on-duty employee to submit to an immediate alcohol and drug test. The department head or designee should be notified as soon as possible.
The employee’s department head or designee shall immediately advise the Town Manager or designee of the determination of reasonable suspicion.
The employee shall immediately be given a “Test Consent Form” to complete and sign.
The employee will be immediately taken by the supervisor or another supervisor or management employee to the appropriate medical facility/clinic for testing.
If the employee is not able to be taken to the appropriate medical facility/clinic for testing, the supervisor shall immediately telephone the agency and primary medical facility (any time day or night) and/or call medical personnel from the primary medical facility and request that they go to where the employee has been taken to acquire the drug and alcohol test samples.
The employee shall be immediately removed from duty and assisted in getting home after the drug and alcohol test.
When “reasonable suspicion” is the grounds for requiring a drug/alcohol test, the employee shall be placed on paid administrative leave until the test results are available and a preliminary administrative review has been conducted.
An alcohol and drug test for reasonable suspicion will include the urinalysis test.
Results from the alcohol and drug screen test will be given by the laboratory to the MRO who, after confirmation, will forward to the Town Manager.
Random Testing
This procedure will occur throughout the year and will initially involve a minimum of fifty percent (50%) of the employees/positions requiring a CDL for drug testing and twenty-five percent (25%) for alcohol testing selected at random and unannounced throughout the year.
If the test yields a positive result and the positive result is confirmed by the MRO, then the employee will be subject to disciplinary action.
Post-Accident Testing
A post-accident test will be conducted on any CDL employee involved in a work-related motor vehicle accident if:
The accident results in a loss of life.
The operator receives a citation under local or state law for a moving traffic violation arising from the accident.
Return-to-Duty Testing
Any employee returning to duty following a confirmed positive test must be subjected to a return-to-duty test following the same guidelines described in the Pre-employment section. The test must show a verified negative result prior to the employee returning to duty.
Follow-Up Testing
An employee returning to work following a confirmed positive test and period of assistance/discipline will be subject to announcing testing for a period of not more than 60 months. There will be a mandatory minimum of 6 tests within the first 12 months. Follow-up tests may be used to determine whether or not any controlled substance is still being used.
BEHAVIOR THAT CONSTITUTES A REFUSAL TO SUBMIT TO A TEST
Failure to submit to testing will automatically be considered a verified positive test and he/she will have to follow the procedures outlined in this policy. Specifically, the following circumstances will be considered a refusal to test:
Refusal to take the test. This will automatically be considered a verified positive test and he/she will have to follow the procedures outlined in this policy.
Inability to provide sufficient quantities of breath or urine to be tested without a valid medical explanation.
Tampering with or attempting to adulterate the specimen or collection procedure.
Refusal to Consent
Applicants. A job applicant who refused to consent to a drug and alcohol screening test will be denied employment with the Town. If the applicant is a current Town employee, the applicant will be denied employment in the position for which application was made. No denial shall be made without first attempting to discuss the impact of the refusal with the applicant.
Employees. An employee who refuses to consent to a drug and alcohol screening test when selected for random testing, post accident, or when reasonable suspicion of drug or alcohol use has been identified, is subject to disciplinary action up to and including termination. The reasons for the refusal shall be considered in determining the appropriate disciplinary action. No disciplinary action shall be taken without first discussing the matter with the employee, department head, and the Town Manager.
CONSEQUENCES of CONFIRMED POSITIVE TEST RESULTS – Drugs & Alcohol
Applicants. Job Applicants will be denied employment with the Town if their initial positive test results have been confirmed. Applicants who are current Town employees shall be denied employment in the position for which application was made. Applicants shall be informed in writing if they are rejected on the basis of a confirmed positive test result. Employee applicants shall be handled in accordance with Section 2 below.
The applicant will be provided an opportunity to discuss with the MRO the results of any positive test and seek a second confirmation test.
Employees. If an employee’s positive test result has been confirmed for Drug or Alcohol use, the employee is subject to action as follows:
Positive Drug Test. The employee shall be referred to a Substance Abuse Professional through the Town Employee Assistance Program (EAP). The Substance Abuse Professional shall determine what assistance, if any, is needed to resolve problems associated with controlled substance abuse. In accordance with MRSA 26, Section 685, the Town is obligated to offer treatment assistance and limited financial assistance. Failure to comply with the recommended treatment, if any, however, shall be cause for disciplinary action up to and including termination. Factors to be considered in determining the appropriate disciplinary response include, but are not limited to: employee’s work history, length of employment, current job performance and existence of past disciplinary actions. No
disciplinary action shall be taken against any employee who voluntarily identified himself/herself as a substance abuser prior to the time that it is apparent that the use has been detected. A second positive test, should the employee continue to be employed following an initial positive test or further violation of this policy following an initial positive test shall be cause for discharge. Prior to any disciplinary action being imposed by the Town, the employee is entitled to a disciplinary hearing.
Positive Alcohol Test. The employee shall be referred to a Substance Abuse Professional through the Town Employee Assistance Program (EAP). The Substance Abuse Professional shall determine what assistance, if any, is needed to resolve problems associated with alcohol abuse and shall make those recommendations to the employee. Notwithstanding any recommendations made by the Substance Abuse Professional, the Town may take disciplinary action up to and including termination. Factors to be considered in determining the appropriate disciplinary response include, but are not limited to: employee’s work history, length of employment, current job performance and existence of past disciplinary actions. No disciplinary action shall be taken against any employee who voluntarily identified
himself/herself as an alcohol abuser prior to the time that it is apparent that the use has been detected. A second positive test, should the employee continue to be employed following an initial positive test, shall be cause for discharge. Prior to any disciplinary action being imposed by the Town, the employee is entitled to a disciplinary hearing.
Consequences of a Controlled Substance Test Result (Drug Test)
An employee or job applicant whose drug test yields a positive result, confirmed by the MRO, shall be given a second test. The second test shall use a portion of the same test sample withdrawn from the employee or applicant for use in the first test.
If the second test confirms the positive test yields a positive result, confirmed by the MRO, shall be given a second test. The second test shall use a portion of the same test sample withdrawn from the employee or applicant for use in the first test.
CONFIDENTIALITY OF TEST RESULTS
All information from an employee’s or applicant’s drug and alcohol test is confidential and only those with a need to know are to be informed of test results. Disclosure of test results to any other person, agency, or organization is prohibited unless written authorization is obtained from
the employee or applicant or upon subpoena. The results of a positive drug test shall not be released by the MRO until confirmed. The records of unconfirmed positive test results and negative test results shall be destroyed by the testing laboratory. All positive test results will be maintained by the MRO, and reported to the Town Manager, where they will be kept on file.
PRIVACY IN CHEMICAL DRUG TESTING
Urine samples shall be provided in a private restroom stall or similar enclosure so that employees and applicants may not be viewed while providing the sample. Employees and applicants may be required to disrobe and will be given hospital gowns to wear while they are providing test samples in order to ensure that there is no tampering. Street clothes, bags, briefcases, purses, and other containers may not be carried into the test area. The water in the commode, if any, shall be colored with dye to protect against dilution of test samples. Testing procedures which ensure privacy to employees and applicants consistent with the prevention of tampering;
Methods of analysis which ensure reliable test results, including the use of gas chromatography/mass spectrometry to confirm positive test results; Chain-of-custody procedures which ensure proper identification, labeling and handling of test samples; and Retention and storage procedures which ensure reliable results on confirmatory tests of original samples.
SECOND CONFIRMATION TEST
The applicant or employee may request form the MRO a second confirmation test of the same sample within 72 hours of notice that the first test was positive. The cost of the second confirmation test must be paid in advance by the applicant or employee. If the test is negative, the Town shall reimburse the applicant or employee for the cost of the test. The second confirmation test will be performed by a NIDA certified laboratory selected by the MRO.
PROHIBITED CONDUCT
The following conduct or behavior is determined to be unacceptable and therefore is prohibited under this policy. Violation shall be cause for disciplinary action, up to and including dismissal.
Reporting to or remaining on duty with a blood/alcohol concentration of 0.02 or greater. Any employee found to have a blood/alcohol concentration of at least 0.02 but less than 0.04 shall be immediately removed from the safety sensitive position and shall not be permitted to perform that function until the start of the driver’s next regularly scheduled duty period, but not less than 24 hours following administration of the test. Any employee found to have blood/alcohol concentrations of greater than 0.04 may be subject to further disciplinary action.
Possessing alcohol on duty that is not manifested or part of a shipment.
Use of alcohol while on duty.
Use of alcohol for eight (8) hours after an accident that will require a post-accident test or until the test is performed, whichever occurs first.
Any use of alcohol within 4 hours of reporting to duty.
Refusal to submit and properly participate in a required alcohol and/or controlled substances test. A refusal is defined as:
Failing to report immediately to the identified testing site, once notified.
Failing to follow proper instructions or participate in the required testing procedures.
Reporting to or remaining on duty while using any controlled substance, except when used under the direct orders of a physician and the physician has informed the employee that the use will not affect the safety use and operation of the commercial vehicle.
Reporting to or remaining on duty after testing positive for any controlled substance under this
policy.
DISCIPLINARY ACTION
Any employee who violates this policy may be subject to disciplinary action up to and including dismissal. Factors to be considered in determining the appropriate disciplinary response include, but are not limited to the following: employee’s work history, length of employment, current job performance and existence of past disciplinary actions.
Specific actions which may be subject to dismissal include, but are not limited to the following:
Refusal to submit to a rehabilitation program after testing positive.
Failure to successfully complete a rehabilitation program after receiving a positive test.
The employee has twice substituted, adulterated, diluted or otherwise tampered with his/her urine
sample.
While on Town premises, the employee was caught drinking alcohol or using, manufacturing, distributing, dispensing, selling or possessing any illegal or unlawfully obtained substances or drugs.
The use of alcohol while on Town premises. This includes a conviction for driving while intoxicated (OUI) during work hours.
Failure to contact the Town’s approved substance abuse clinician (EAP provider) within five (5) regular working days after being notified of a confirmed (MRO certified) positive test for the use of an unauthorized substance.
Any permanent employee who tests positive the first time for either alcohol or substance misuse will be offered an opportunity for rehabilitation. The employee will be responsible for any outstanding payments after the insurance payments have been applied. The offer of rehabilitation does not apply to job applicants, temporary or probationary employees.
Employees who test positive a second time will be suspended immediately without pay and terminated after being notified of the second confirmed (MRO certified) positive test for the use of an unauthorized substance.
Employees who are found to have an alcohol concentration of .02 or greater, but less than 0.04, will be placed on unpaid leave for a minimum of twenty-four (24) hours.
During the period the Town is awaiting an employee’s test result due to a post-accident or reasonable suspicion circumstance, the Town may transfer the employee to another position with no reduction in pay or benefits. The Town also reserves the right to place an employee on paid or unpaid suspension. A determination whether an employee is placed in another position or placed on paid or unpaid suspension may be based, but not limited to, who is responsible for and/or the severity of the accident, if applicable; the observed condition of the employee, if applicable, the employee’s work history, length of employment, current job performance, the existence of past disciplinary actions and the availability of another position.
EMPLOYEE/APPLICANT RIGHTS AND RESPONSIBILITIES
It is the responsibility of each employee to seek help before alcohol and drug problems lead to disciplinary action.
In the event of a positive test result, employees and job applicants shall have the opportunity to present an alternative explanation for the test result by contacting the Medical Review Officer (MRO). This shall be done no later than five (5) days after notification of the result. No further
action will be taken if there is a justified explanation or there is a reasonable doubt as to the accuracy of the result or chain of custody of the sample.
Any employee or job applicant with a positive test result may also upon written request within five (5) working days have the right to any information relating to the test result and procedure.
Any permanent employee who tests positive for a first offense and cannot provide a satisfactory explanation will be offered EAP referral to a certified rehabilitation program.
CONFIDENTIALITY OF INFORMATION
Unless the employee or applicant consents, all information acquired by the Town in the testing process is confidential and may not be released to any person other than the employee or applicant who is tested, the Program Administrator, respective department heads or designees, as well as the EAP or Rehabilitation Provider. The foregoing shall not prevent the release of information that is required or permitted by state or federal law, or the use of information in any grievance procedure, administrative hearing or civil action relating to the imposition of the test or the use of test results.
TRAINING
Training for Supervisors
The Town of Sebago shall ensure that all supervisors and other persons designated to determine whether reasonable suspicion exists to require an employee to undergo testing must receive training on alcohol misuse and controlled substances use. The training shall include the physical, behavioral, speech, and performance indicators of probably alcohol misuse and use of controlled substances. The training shall include an overview of the program requirements, disciplinary procedures, confrontation and documentation of procedures, and rehabilitation and treatment options which are available.
Training for Safety-Sensitive Employees
The Town of Sebago shall ensure that all employees performing job functions deemed safety-sensitive shall be trained on the effects and consequences of prohibited drug use on personal health, safety, and the work environment as well as the manifestations and behavioral signs that may indicated prohibited use.
SUPERVISORY RESPONSIBILITIES
Supervisors are responsible for determining through direct observation whether an employee is capable of performing his or her assigned duties. Determinations shall be based on specific, contemporaneous, reliable observations concerning the appearance, behavior, speech, or body odor of the employee.
Employees who are suspected of being unfit for duty as a result of alcohol or drug use should be required to undergo reasonable suspicion drug and/or alcohol testing in accordance with FHWA
rules and this policy. Supervisors should immediately bring their observations to the attention of their managers in order that arrangements for testing can be implemented as soon as practicable.
Employees who are suspected of being impaired and unfit for duty may not remain at the work place. Incidents and behavior described in #1 above should be witnessed and documented immediately by completing the Reasonable Cause Record form. The Program Administrator should be consulted and advised of the incident. An employee who is impaired should not be allowed to drive home from the work place.
ACKNOWLEDGMENT
I certify that I have received a copy of the Town of Sebago Alcohol and Drug Policy and Testing Procedures and other printed material explaining the effects of alcohol and/or controlled substances.
_________________________ ________________________________________________
Date Employee’s Signature
_________________________ ________________________________________________
Date Supervisor’s Signature
Town of Sebago
Alcohol and Drug Policy
Employee Breath Test & Urinalysis Consent Form
The Town of Sebago (Town) has a strong commitment to the health, safety and welfare of its employees, their families, its customers, and the public at large. Use and misuse of alcohol or drugs, whether prescribed or illegal, impairs the ability of an employee to perform assigned duties, particularly those requiring a Commercial Drivers License (CDL), and may endanger the employee, co-workers, the public, the Town, and public and private property. The Town seeks to prevent employees from using alcohol and drugs when the use of such is illegal, or in any way endangers the Town or public. The Town also wants to provide appropriate and reasonable assistance to employees whose use or misuse impairs their ability to perform their duties.
Under Title 49, CFR, the Town may require a current Town employee whose position requires a CDL to undergo drug and alcohol testing consisting of the following: random testing, post-accident testing, reasonable suspicion testing, and follow-up testing. Refusal to be tested may subject an employee to disciplinary action and possible termination.
I understand that as required by title 49, Code of Federal Regulations, the Town of Sebago is required to ensure that employees in safety sensitive positions are tested for the use of alcohol and controlled substances such tests include: Random Testing, Post Accident Testing, Reasonable Suspicion Testing, and Return to Duty/Follow-up Testing.
I consent to breath tests, and urine sample collection and testing for controlled substances.
I understand that a positive test result for controlled substances will render me unqualified to operate a commercial motor vehicle and may result in disciplinary action up to and including discharge of employment.
The Medical Review Officer contracted by the Town will maintain the results of my test. Negative and positive results will be reported to the Town. If the results are positive, the controlled substance will be identified. The results will not be released to other parties without my written consent.
I understand that disputed test results or the resulting disciplinary action will be settled by a qualified arbitrator, and that all parties of the dispute agree to abide with the decision of such arbitrator.
I UNDERSTAND THE ABOVE CONDITIONS AND HEREBY AGREE TO COMPLY WITH THEM.
_________________________________________________________ __________________________
Employee’s Name (Please print.) Date
_________________________________________________________ __________________________
Employee’s Signature Social Security Number
PLEASE NOTE ANY CURRENT OR RECENT USE OF PRESCRIPTION OR OVER-THE-COUNTER MEDICATION IN THE SPACE BELOW.
______________________________________________________________________________________
Town of Sebago
Alcohol and Drug Policy
Pre-Employment and Urinalysis Consent Form
The Town of Sebago (Town) has a strong commitment to the health, safety and welfare of its employees, their families, its customers, and the public at large. Therefore, the City seeks to hire and employ workers requiring a Commercial Drivers License (CDL) who are free of illegal and abused drugs and alcohol, and protect employees, their families and the public from the adverse effects of alcohol and drug abuse. The Town requires the final applicant selected for a position requiring a CDL to undergo and Alcohol and Drug Test to detect the presence of alcohol and drug abuse substances in the body.
Any applicant with a positive pre-employee test may be denied employment with the Town by reason for the positive test. Also, any applicant refusing to be tested will be denied employment.
I understand that as required by Title 49, Code of Federal Regulations, all applicants for positions requiring a commercial driver’s license must be tested for the use of controlled substances as a precondition for employment.
I consent to a urine sample collection and testing for controlled substances.
I understand that a positive test result for controlled substances will render me unqualified to operate a commercial motor vehicle and result in my being denied employment with the Town of Sebago.
The Medical Review Officer contracted by the Town will maintain the results of my test. Negative and positive results will be reported to the Town. If the results are positive, the controlled substance will be identified. The results will not be released to other parties without my consent.
I understand that disputed test results or the resulting disciplinary action will be settled by a qualified arbitrator, and that all parties of the dispute agree to abide with the decision of such arbitrator.
I UNDERSTAND THE ABOVE CONDITIONS AND HEREBY AGREE TO COMPLY WITH THEM.
___________________________________________________ ___________________________
Applicant’s Name (Please print.) Date
___________________________________________________ ___________________________
Applicant’s Signature Social Security Number
PLEASE NOTE ANY CURRENT OR RECENT USE OF PRESCRIPTION OR OVER-THE-COUNTER MEDICATION IN THE SPACE BELOW:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
ALCOHOL AND DRUG POLICY AND TESTING PROCEDURES
GUIDELINES FOR SUPERVISORS
All employees in CDL positions covered by this policy must be given a copy of the policy. A certification form will be provided to the covered employees indicating that they have received a copy of the policy. The signed form must be returned to the Town Manager and maintained on file.
Any time spent by the employee going to, while at, and returning from the test site shall be considered as time worked.
The procedure for Random Alcohol and Drug Testing shall be as follows:
The Town Manager will receive the random listing of employees selected to be tested from Affiliated Healthcare on a monthly basis. This information will remain confidential until the test date.
The Town Manager or designee will contact the employee’s supervisor. The supervisor will assure that the employee is working on the testing date to schedule the appropriate test. The employee will not be notified until the supervisor is ready to send the employee directly to the testing facility. If the employee is absent from work, the supervisor will notify the Town Manager who may select the next employee on the list or hold the employee’s name on file until the employee returns to work. The employee must not be notified until immediately prior to proceeding to the testing facility.
The employee will proceed immediately to the testing facility following notification of their selection.
Drug test results will not be available for at least 24 hours. The employee should return to duty following random drug testing.
Alcohol test results are immediate. The following action should be taken based on the results.
0.0 but less than 0.02 NEGATIVE TEST RESULT; employee returns to work.
0.02 but less than 0.04 POSITIVE TEST RESULT; not a violation of the policy. Employee must be removed from any safety sensitive position until the start of the next regular duty period, but not less than 24 hours following administration of the test. (They may continue to work in a non-safety sensitive position, take vacation time, or time off without pay.) Sick leave may not be used.
0.04 or greater POSITIVE TEST RESULT; and a violation of the policy. The employee must be referred to the Employee Assistance Program for further referral to a Substance Abuse Professional, and into an appropriate rehabilitation program.
Any employee who is selected or required to undergo drug or alcohol testing must participate in the testing and cooperate during all phases of the process, including rehabilitation when recommended. Refusal to cooperate or participate in any phase as instructed will result disciplinary action up to and including termination.
No “reasonable suspicion” testing will take place until supervisors have received training in alcohol and controlled substance abuse.
Employees who will be tested must present the following at the testing facility: Picture Identification (driver’s license, passport, etc.
Consent Form. A consent form will be provided when the employee is notified to report for a test. Additional forms will be located at the testing facility. It is the supervisors’ responsibility to note the time that the employee departs for the testing facility on the consent form.
This process is confidential. Supervisors are not to share or provide any information concerning the testing process, employees being tested, or any action taken as a result of the testing process.
After required training, if a supervisor has “reasonable suspicion” that an employee is impaired and potentially under the influence of drugs and/or alcohol, the “Observed Behavior-Reasonable Cause Record” form must be completed and signed prior to referral for testing. The supervisor should then complete the following:
Contact the test facility Ann Gosselin, Health Care Today, at phone number (207) 883-8100 during regular business hours, and Ann Gosselin, Health Care Today, at (207) 883-8100 after business hours and advise them that you will be transporting an employee for testing. The supervisor should transport the employee to the testing facility, wait until testing is complete, and transport the employee home following the test.
Notify the Town Manager that the employee has undergone reasonable suspicion testing.
If a “post accident” test is required due to a fatality or issuance of a citation for a moving vehicle violation, the supervisor should complete the following:
Immediately contact the testing facility Ann Gosselin, Health Care Today, by calling (207) 883-8100 during regular business hours, and Ann Gosselin, Health Care Today, at (207) 883-8100 after business hours and request that a Breath Alcohol Technician respond to the scene.
Following the breath test at the scene, the supervisor should transport the employee to the testing facility for drug testing. Once the drug testing is completed, the supervisor will accompany the employee home or back to work as appropriate.
At no time should this process interfere with the investigations of law enforcement officers at the scene or delay any necessary medical attention for injured people or prohibit a safety-sensitive employee from leaving the scene of an accident to obtain assistance in responding to the accident or to obtain necessary emergency medical care.
RESPONSIBLE TOWN OFFICIAL
The Public Works Department Head or Town Manager may be contacted for further information about this policy or its applicability.
| 
