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Xit. Appendix E
<br />PHMSA Anti -Drug and Alcohol Misuse.Program Inspection Protocol Form; form No.: 4.1, Revision 3 (dated March 1 j 2021)
<br />Protocol Area A — General Drug & Alcohol (D&A) Program Requirements
<br />A-1: Designated Employer Representative (DER)
<br />Has the operator appointed a Designated Employer Representative (DER)? §40.3, §40.15(d), §40.355(k), Verify that a service agent
<br />is not used to fulfill the function of a DER. §40.3, §40.15(d), §40.355(k)
<br />Plan: IX: Appendix B — Designated Personnel and Service Agents, /it. Policy and Responsibilities — 2. Responsibilities of
<br />Key Personnel, Designated Employer Representative (DER), 4. Use of Service Agents, Compliance, Consortium/Third Party
<br />Administrator.
<br />A-2: Employer Responsibilities for Officials Representatives, and Service A ents
<br />Does the operator's D&A program have a process to ensure the operator remains responsible for all actions of its officials,
<br />representatives, and service agents, including a Consodium/Third Party Administrator (C/TPA), to ensure compliance when these
<br />officials, representatives, and service agents carry out the requirements of Parts 199 and 40? §40.11(b), §40.15(c), §40,341
<br />Plan: Ill. Policy and Responsibilities — 4. Use of Service Agents, Compliance.
<br />A-3: Qualification Requirements
<br />Verify the operator's D&A program positions and/or service agents meet the applicable qualification requirements of Part 40 and Part
<br />199: Medical Review Officer (MRO) §40.121 and §199.109(b), Urine Specimen Collector §40.33, Substance Abuse Professional SAP)
<br />§40.281, Laboratories certified by the Department of Health and Human Services (HHS) National Laboratory Certification program
<br />(NLCP) §40.81(a) and §199.107(a), Screening Test Technician (STT) §40.213, Breath Alcohol Technician (BAT) §40,213
<br />Plan: V. AntiDrug Program — 3. Specimen Collection Procedures, 4. PHMSA Inspection Protocol for Specimen Collection
<br />Sites, 5, Drug Testing Laboratory, 8. MRO Review of Drug Test Results, Ill. Alcohol Misuse Prevention Program — 2. Alcohol
<br />Test, Vll. Program Elements Common to Drug and Alcohol — 1.. Substance Abuse Professional
<br />A-4: Service Agent Limitations
<br />Verify the operator's D&A program ensures its service agents: Do not require an employee to sign a consent, release, waiver of
<br />liability, or indemnification agreement with respect to any part of the DOT D&A testing process (including, but not limited to, collections,
<br />laboratory testing, MRO and SAP services). §40.355(a), Do not act as an intermediary in the transmission of laboratory drug test
<br />results direct from the laboratory to the MRO, operator, or to another service agent, or in the transmission of alcohol test results of
<br />0.02 or higher direct from the STT or BAT to the DER, §40.355(b-d), Do not make decisions to test an employee based upon
<br />reasonable suspicion/cause; post -accident, return -to -duty, and follow-up determination criteria. While a service agent may provide
<br />advice and information, these are duties the operator cannot delegate to a C/TPA. §40.355(g) - see §40.355(h) for exceptions, Do not
<br />make determinations that an employee has refused a drug or alcohol test. While a service agent may provide advice and information,
<br />these are duties the operator cannot delegate to a C/TPA. §40.355(i) - see §40.355Q) for exceptions, Do not impose conditions or
<br />requirements on the operator, such as the DOT D&A testing of non -covered employees, that DOT regulations do not authorize.
<br />§40.355(m), Do not intentionally delay the transmission of drug or alcohol testing -related documents concerning actions the service
<br />agent performed because of a payment dispute or other reasons. §40.355(n)
<br />Plan: M. Policy and Responsibilities — 4. Use of Service Agents, Service Agent Limitations.
<br />A 5: Supervisory Personnel Training
<br />Does the operator require a 60-minute period of training on the specifc, contemporaneous physical, behavioral, and performance
<br />indicators of probable drug use under the EAP for supervisory personnel who will determine whether an employee must be drug tested
<br />based on reasonable cause? §199.113(c), Does the operator require a 60-minute period of training on the physical, behavioral,
<br />speech, and performance indicators of probable alcohol misuse for supervisors designated to determine whether reasonable suspicion
<br />exists to require a covered employee to undergo alcohol testing? §199.241.
<br />Plan: VII. Program Elements Common to Drug and Alcohol— 3, Supervisor Training
<br />A-6: Covered Employees
<br />Does the operator have a process to ensure the operator properly identifies the covered employees who are required to be DOT
<br />tested for the presence of prohibited drugs and alcohol? §199.3, Verify the operator does not conduct DOT tests for the presence of
<br />prohibited drugs and/or alcohol on any individual who is not a covered employee. §199.1, §199.3 and §40.347(b)(2)
<br />Plan: X. Appendix C— Covered Positions, Ill. Policy and Responsibilities— 6. "NON -DOT" Testing Program, IV. DOT Program
<br />Requirements — 1. Employees Subject to Testing, Compliance
<br />A 7: Employee DOT D&A Testing Record Checks
<br />For an employee seeking to perform covered functions for the first time (i.e., new hire or an employee transferring into a safety -
<br />Premium Concrete Services, Inc.- PHMSA DRUG/ALCOHOL PLAN
<br />rj NATIONA1 COMPIJAAICE MANAGEMENT SERVICE, IIJC. (NCMS) 2011 (update'2021). The NCMS plan is
<br />the subject of registered copyright and Is proleciatl by copyrfghl laws in the If S. and elsewhere. All rights
<br />reserved
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