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 Drug Screen Testing

 POLICY

The purpose of random drug screen testing is to provide a record that the individual’s required abstinence of alcohol and unauthorized and illegal controlled substances is occurring and is being monitored on a routine basis. 

PROCEDURE

  1. Individuals being monitored by a Board Order that are required to have random drug screens will be assigned a color level depending on the appropriate monitoring level.  There are various color levels, which will require various numbers of collections, discards and analysis.
  2. Initially, an identified number of screens required on a random basis will be established during the development of the Board Order and are subject to change throughout the drug testing process.  Ethylgucuronide (EtG) and Ethylsufate (EtS) testing for the detection of alcohol may be utilized throughout the random drug testing process.  The frequency and type of screens depends on the diagnosis, substance abused, and practice issues.  Progression through the assigned color levels is dependent on the issues stated above and the individual’s drug screen testing results.
Color Level # Collections # Tested # Discarded Cost/Lab Analysis• Collector Fee••
Blue 12/quarter 6/quarter 6/quarter Varies
Brown 9/quarter 6/quarter 3/quarter Varies
Green 6/quarter 3/quarter 3/quarter Varies
Pink 6/quarter 6/quarter 0 Varies
Purple 6/year 6/year 0 Varies
Orange 4/year 4/year 0 Varies


 Note: 
• The cost of lab analysis is currently $35 per test and is subject to change.

••There is an additional fee paid directly to the collector to collect the samples.  This is not included in the price for lab analysis.  Collection fees are established by the various collection sites and will vary in price. 

  1. The monitored individual will make initial contact with the drug testing company within 10 days of the date of the Board Order to obtain the designated collector and the collection site location. 
  2. All screens are done on a random basis.
  3. Specimen testing will be done through the program designated drug-testing laboratory.  All specimens are to be provided consistent with the protocols and collection procedures established by the designated laboratory.
  4. All drug screens are completed using an observed and/or secured dry room technique and following proper chain of custody.
  5. Dilute urine may be considered positive and must be repeated as soon as possible.  Drinking excess fluids prior to a drug screen may lower the specific gravity and creatinine level.  A low specific gravity/creatinine may invalidate the analysis.  The following criteria will be implemented for individuals who present with a specific gravity of less than 1.003 and a creatinine level of less than 20 mg/dL:

 1st Dilute -      Warning Letter sent to individual 

2nd Dilute -     Individual must pay for an additional drug test collection and analysis to replace the invalidated analysis.

3rd Dilute -      Individual must pay for two (2) additional drug test collections and analysis (1 to replace the invalidated analysis and 1 as a consequence).

4th Dilute -      The individual’s color level will be increased to the next highest level for a minimum of 3 months, with re-evaluation at the end of the 3 month period. 

  1. The individual is responsible for any and all fees and costs associated with the drug screens.  All drug screen payments are prepaid and must be postmarked by the 23rd of each month.  For example, all drug testing fees for July must be in the mail by June 23rd.
  2. Checks/money orders for drug screens are to be made payable and sent to:

Rocky Mountain Monitoring (RMM)
PO Box 8115
Missoula MT 59807

  1. Drug screen results are reported directly to the Board’s designee at the Board of Nursing office.
  2. The individual must provide prior notification, in writing, to the Board’s designee if unable to test.
  3. The individual may voluntarily submit to drug screen testing at any time.
  4. The Board’s designee or the employer may request a drug screen test if there is suspicion of use/diversion of alcohol or drugs by the individual.  Refusal to immediately submit a specimen for a drug screen may be considered a positive and a violation of the Board Order.
  5. The individual is responsible for informing any employer and/or supervisor of the need to leave work to give a drug screen test.  In case of an emergency, if the individual is unable to leave the work site, the supervisor must contact the Board’s designee for an excused absence.
  6. Positive results obtained by initial screening are verified by additional testing.  Positive results will be evaluated in light of information provided in consent form (i.e. medication or drugs taken) and all other information available to the laboratory and the Board. The drug testing company and the Board’s designee shall examine alternate medical explanations for any positive drug test results.
  7. Noncompliance issues:
    1. A missed drug screen test or refusal to submit a specimen for a drug screen is considered a positive.
    2. The drug testing company will send a written notice of noncompliance to the individual for any late payments or NSF checks, with the information also submitted to the Board’s designee for possible disciplinary action.
    3. Any NSF payment will require all future payments in the form of a money order.
    4. Any collections not paid for in advance will not be analyzed and may be considered a positive.
    5. A confirmed positive drug screen will be considered a relapse if the Board has not received the proper documentation from the prescribing practitioner.
    6. A positive screen will result in referral to the Disciplinary Review Panel for review and may result in additional disciplinary action.
  8. Individuals must have no dual conflicting relationship with the specimen collectors.  If a conflicting relationship develops, the individual may be referred to the Disciplinary Review Panel for additional disciplinary action.
  9. Individuals must call the drug testing toll free number, shown below, by 11:00 am local time, Monday through Friday to obtain the color of the day and to determine if drug testing is required that day.  Individuals must report to the appropriate collection site and submit a specimen within 2-6 hours and prior to 5:00 p.m. local time or collection site closing time, on the day of the requested drug screen.  Provisions for testing after 5:00 p.m. local time must be approved by the drug testing company representative or the Board’s designee.  There are no collections on state holidays.
  10. If the individual is unable to connect with the toll free number to obtain the color of the day, the individual must then contact the designated collector to check for the color of the day.
  11. Prior to drug testing, the individual will disclose to the designated collector the use of any substance which could alter a drug screen, including, but not limited to:
    1. Prescribed medications/samples
    2. Over-the-counter aids
    3. Dietary intake
      NOTE:  It is important to know what products you are ingesting.  You will need to abstain from all substances known to interfere with the toxicology screening process, including but not limited to foods, beverages, over the counter medications, and products containing poppy seeds, hempseeds, and ethyl alcohol.  Examples include nonalcoholic beer or wine, some desserts, salad dressings, soups and herbal remedies, as well as some hand sanitizing and mouthwash products.  The ingestion or use of such products will not be accepted as an acceptable reason for a positive drug screen result.
  12. The individual must report the use of any PRN controlled substance medications or mood/mind altering substances to the Board’s designee within 24 hours.  Written verification from the designated healthcare practitioner must also be submitted to the Board’s designee within 3 working days.
  13. Specific medications (both prescription and non-prescription AND any medications obtained out of the country, i.e. Canada and Mexico) that must be reported to the Board’s designee are:
    1. Any and all mood altering substances and controlled substance medications, including, but not limited to:
      1. antidepressants
      2. antipsychotics
      3. antianxiety agents
      4. hypnotics
      5. narcotic analgesics
      6. sedatives
      7. stimulants
    2. Over-the-counter products and herbal preparations containing mind/mood altering substances matching the categories listed , including, but not limited to:
      1. diet aids/diuretics
      2. digestive aids
      3. energy aids
      4. laxatives
      5. painkillers
      6. sleep aids
    3. Any other substances having similar effects.

 

Drug Testing Company
Toll free number: 1-888-663-2991 


 

 

Approved: May 1998
Reviewed/Revised: 07/15