Random Drug Testing

 

I.          Service Description

 

Random screens are designed for individuals who may or may not meet the criteria for substance abuse and may or may not actively participate in drug treatment services. Each random screen referral shall consist of no more then twenty-four (24) screens to be completed over a period not to exceed six (6) months, with a maximum of three (3) screens per week as indicated by the referral form. It is expected that the referring worker and provider agency will work together to develop a plan to determine the appropriate duration (up to 6 months) of each referral. A second referral will be required if an excess of twenty-four (24) screens per referral are necessary.

 

The service provider must identify a plan to engage the client in the process, a plan to work with non-cooperative clients including those who believe they have no problems to address as well as working with special needs clients such as those who are mentally ill or developmentally delayed.

 

Services include providing any requested testimony and/or court appearances (to include hearing or appeals).

 

All sample collections drug screens will be observed. Minimum of substances tested should include Alcohol, Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Cannabis, Opiates, Phencyclidine, Methadone, Creatinine (urine only), Propoxyphene, Oxycodone, and Methamphetamines. The agency will be expected to provide reports that state the minimum level necessary to detect the presence of each substance, the level of substance detected, and the chain of custody documentation.

 

All sample collections drug screens will be observed sample collections screens. Minimum of substances tested should include Alcohol, Amphetamines, Barbiturates, Benzodiazepines, Cocaine, Cannabis, Opiates, Methadone, Oxycodone, Propoxyphene, and Methamphetamine. The agency will be expected to provide reports that state the minimum level necessary to detect the presence of each substance, the level of substance detected, and the chain of custody documentation.

For urine screens, testing for creatinine levels shall be conducted on all samples. The vendor shall also insure testing for total Cannabinoids per mg of creatinine using spectrophotometer technology. The Vendor shall insure testing for specific gravity on all samples with a creatinine level below 20 mg per deciliter. The Vendor shall also insure the administration of a nitrite test on any specimen that contains no creatinine and has a specific gravity test of 1.000.

 

Initial screening shall be conducted utilizing an enzyme immunoassay method. Testing should occur for the following substances utilizing the cut-off levels listed below:

* For all other substances tested use recommended laboratory cutoff levels

Confirmation Testing

Confirmation Testing shall be conducted utilizing GC/MS Technology on all samples initially testing POSITIVE. The following cut-off levels shall be utilized:

 

*Hair uses = PG/MG = weight

* For all other substances tested use recommended laboratory cutoff levels

 

In situations where the source of the Amphetamine present in any specimen may come into question, the vendor must insure the performance of a d-1-isomer differentiation. This service is to be offered at no additional cost to the Department of Child Services and performed when requested by DCS.

 

The Vendor shall ensure proper legal chain-of-custody procedures are maintained and comply with departmental procedure, state and federal law. The vendor shall also ensure complete integrity of each specimen tested and the respective test results. Receiving, transfer and handling of all specimens by personnel shall be fully documented using the proper chain-of-custody.

 

The vendor shall insure that all laboratories used for drug testing purposes must comply with all applicable Federal Department of Health and Human Service, and, under these federal requirements, are subsumed Substance Abuse and Mental Health Services Administration (SAMSHA) or The College of American Pathology (CAP), or Clinical Laboratory Improvement Act (CLIA) requirements.

 

A letter to all referred clients will be required within three (3) calendar days of referral with instructions for contacting the agency immediately to begin screens. It is expected that the first screen will be collected within seven (7) calendar days of referral and each subsequent screen will be random. One or more toll free phone lines for clients to call daily to determine the day their screen is to be required. Agency must have a plan in place to modify the phone messages every day by 5 a.m., instructing clients whether to report that day for a screen or call again the next day

 

 

The agency shall update the referring worker, by phone or email, within ten (10) calendar days of the date the referral was sent regarding the status of the referral. Agencies should inform the referring worker of the date the client completed their first screen or, if the client has not contacted the agency to complete their first screen, a consultation with the referring worker should be held to determine the next steps of services.

It is expected that the referring worker and provider agency will work together to develop a plan to determine the appropriate duration (up to 6 months) of each referral. All random screen referrals shall include no more than twenty-four (24) screens and are to be completed over a period of no more than six (6) months. A second referral will be required if an excess of twenty-four (24) screens per client are necessary.

The vendor shall notify the local Department of Child Services Office/ Probation Officer of testing results via email on vendor letterhead. The results will also be sent by U.S. mail to the referring county as well. The vendor shall gain approval from DCS for any changes in the results notification system.

 

The referring worker and DCS (if not the referral source) will be notified of positive test results within 24 hours of receiving test results from the testing laboratory. Negative test results will be provided within 72 hours of receiving test results from the testing laboratory.

 

No-show alert forms will be provided by the contracted agency to the referring worker within 24 hours of the client’s failure to show. Failure to show may result in an administrative discharge. Any client who is administratively discharged must request a new referral from the referring worker to begin receiving services again.

 

The referring location shall be notified in writing if the specimen has been rejected due to an invalid chain-of-custody or any other integrity problem.

 

For those employing urine tests diluted results must be reported on the result form.

 

Testing shall not be conducted on any specimen that does not have a legal chain-of-custody. All specimens found to be “Adulterated” shall be treated as an Invalid Specimen. Any specimen without a valid chain-of-custody is to be destroyed. The referring location shall be notified in writing when a specimen has been rejected due to an invalid chain-of-custody or any other integrity problem. Monthly reports shall document how many random samples were attempted and completed minus how many "Adulterate" specimens there were for the month.

 

 

Services must be restricted to the following eligibility categories:

 

1.         Parent(s) for whom a CPS assessment has been initiated

 

2.         Children and parent(s) who have substantiated cases of abuse and/or neglect

 

3.         Children with a status of CHINS, and/or JD/JS

 

4.         Minor children suspected of drug use prior to adjudication

 

 

Drug screen results will be provided to the referring worker in a timely fashion.

Outcome Measures

 

1) 100% of positive reports will be reported verbally by phone, voice mail or email within 24 hours of receiving results of the drug screen from the lab.

 

2) 100 % of written sample reports will be mailed or faxed to the referring worker within 24 hours of receipt of laboratory results.

 

Goal #2

 

100% of “No Shows” alerts will be provided to referring worker within 24 hours of failed attempts.

 

 

Sample collection does not require the services of a certified drug abuse counselor. The person providing this service must be trained in sample collection and the chain of custody procedures to document the integrity and security of the specimen from time of collection until receipt by the laboratory.

 

 

 

Actual cost of the screens. The provider is to present a list of the drug screens available with the total cost of each drug screen or set of drug screens. The DCS will specify which drug screen or screens they are authorizing for each client on the authorizing referral form.

 

Grantees will bill monthly based on these payment points:

 

Services include the collection of sample collections specimens and ensuring that the chain of custody procedure is followed to maintain the integrity and security of the specimen from time of collection until receipt by the laboratory. This will be billed for all tests that are negative.

 

Services include the collection of the specimen. This confirmation testing charge shall include confirmation of positive results for one or more substances in the same sample. Ensuring the testing of specimens and that the chain of custody procedure delivery to the testing laboratory to the results notification.

 

Services include translation for families who are non-English language speakers or hearing impaired and must be provided by a non-family member of the client. Dollar for dollar amount

 

 

Grantees will bill monthly based on these payment points:

 

Initial Test: Actual Cost

Confirmation Testing: Actual Cost

Translation or sign language: Actual Cost

 

 

Necessary case record documentation for service eligibility must include:

 

1.      A completed, dated, signed DCS/Probation referral form authorizing service

2.      Documentation of regular contact with the referred families/children

3.      Written reports as stated in this service standard.

 

 

 

Services must be accessed through a DCS Family Case Manager or DCS Service Consultant referral. Referrals are valid for a maximum of twelve (12) months unless otherwise specified by the DCS. Providers must initiate a reauthorization for services to continue beyond the approved period.