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XII. <br />PHMSA Anti -Drug and Alcohol Misuse Program Inspection Protocol Form, -Form Na`. 4.1; Revision 3 (dated March 1; 2021) <br />Protocol Area A General Drug & Alcohol (D&A) Program Requirements <br />A 1 Designated Employer Representative D( ERl <br />Has the operator appointed a Designated Employer Representative (DER)? §40.3, §40.15(d), §40.355(k), Verify that a service agent <br />fs not used to fulfill the function of a DER. §40.31 §40.15(d), §40.355(k) <br />Plan: IX: Appendix B — Designated Personnel and Service Agents, 1/1. Policy and Responsibilities — 2. Responsibilities of <br />l<ey Personnel, Designated Employer Representative (DER), 4. Use of Service Agents, Compliance, Consortium/Third Party <br />Administrator. <br />A 2 Cmolover Responsibilities for Officials Representatives and Service Agents <br />Does the operators D&A program have 2 rop Tess to ensure the operator remains responsible for all actions of its officials, <br />representalives, and service agents, including a Consortium/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 Regulremenls ' <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 §199A09(1s), 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.(S'FT) §40.213, Breath Alcohol Technician (BAT) §40.213 <br />Pla Jn• V Anfi-Drug Program — 3. Specimen Collection Procedures, 4. PHMSAYn§pecfion Protocol for Specimen Collection <br />Sites, 5. Drug Testing Laboratory, 8. MR0 Review of Drug Test 12osults, VI, Alconvi Misuse Preventtmr Program — 2. Alcohol <br />Test, VII, 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 90 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 net 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-m-duly, 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 infonnatlon, <br />these are duties the operator cannot delegate to a C/TPA. §40.355(b - see §40,3560) 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. §40.366(n) <br />Rlan: Ill. Policy and Responsibilities — 4, Use of Service Agents, Service Agent Limitations, <br />A-'' Supervisory Personnel Training <br />Does the operator require a 60-minute ported of training on the specific, 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: Vll, 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 tlrugs and alcohol? §799.3, Verily 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, UL Policy and Responsibilities— 6. "NON -DOT" Testing Program, IV, DOT Program <br />Requirements — 1. Employees Sublect 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 asafely- <br />Premium Concrete Services, Inc: PHMSA DRUG/ALCOFIOL PLAN <br />(C) NATIONAL COMPLIANCE MANAGEMENT SERVICE, INC. INGMS) eat t (updale 2021) The NCMS plan is <br />ilia si bJecl of registered copyright and is protected by copyright Taws In the 11.5. and elsel,here- All rights <br />reserved. 43 <br />