Drug Testing
Drug Screening identifies applicants and/or employees who are current users of illegal drugs through analysis of a body fluid or specimen. ScreeningONE provides comprehensive implementation and management of a drug screening program for applicants from its service centers. ScreeningONE identifies and coordinates specimen collection services, laboratory analysis, and physician review and reporting of test results, and many other program administration services.

Introducing the eScreen^TM Instrumented Rapid 5-Panel Non-DOT Urine Testing
An automated, web-based drug testing solution that eliminates manual processes and provides negative test results in 15 minutes of test completion.

• Save Time - Schedule drug testing online
• Paperless Process - Applicant is electronically notified and given a map to collection site
• Secure - Electronic Chain of Custody accompanies the specimen throughout process.
• Real-Time Tracking - Monitor status throughout entire process.
• Fast Turnaround Time - Receive results electronically.

How the process works:

Specimen Collection
ScreeningONE has a network of over 11,000 qualified specimen collection sites. The network includes laboratory patient service centers (eScreen, Quest Diagnostic, LabCorp and Concentra facilities), occupational health clinics, independent outpatient medical facilities and hospital-based collections services. Many of these facilities also provide evidential breath alcohol testing services, blood alcohol testing and other related occupational health services. All facilities in the ScreeningONE network have signed service agreements attesting that their collection/testing personnel met US Department of Health and Human Services (DHHS) or US Department of Transportation (DOT) qualifications, and that they use applicable procedures for urine specimen collection, saliva, hair and breath or blood alcohol testing.

Laboratory Analysis
The analysis of samples is performed by a laboratory that is certified by the Substance Abuse and Mental Health Services Administration (SAMHSA). The laboratories used by ScreeningONE have written procedures concerning sample accession, chain of custody quality control and result certification, and they follow the guidelines prescribed by DHHS and/or DOT.

Medical Review
ScreeningONE’s fees include all Medical Review Officer (MRO) functions performed in receiving test results from the laboratory, review of custody and control forms and laboratory documentation, interpretation of test results, donor interviews, and reporting of test. All medical review services described below apply to negative and non-negative test results with the exception of the donor interview, which is conducted only for non-negative results (positive, adulterated, substituted, and invalid results).

All MROs are certified by the American Association of Medical Review Officers and/or the Medical Review Officer Certification Council of the American College of Occupational and Environmental Medicine, and are board certified in a medical specialty. They meet the qualification training standards specified in the DOT regulations. The MRO communicates directly with the designated employer contact person each time a test result is verified as a positive or when the specimen has been adulterated or substituted. The MRO handles the entire donor interview process as prescribed by Federal regulations. Each laboratory result is reviewed to ensure that the custody and control form is adequate and attests to the validity of the test result, and the proper identification of the test result with the applicant or employee.

Medical Review Process
Test results are reported to the MRO in an electronic download from the laboratory. The results are reported by social security number and specimen ID number. As required by Federal regulations, the MRO reviews a copy of the custody and control form signed by the laboratory’s certifying scientist for every test result that is a non-negative report (positive, adulterated, substituted, invalid) prior to initiating the interview with the donor.

Donor Contact
Following the custody and control form review, the MRO will attempt the initial telephone contact with the specimen donor. At least 3 attempts are made in a 24-hour period to contact the donor. If the MRO cannot contact the donor after these attempts, the MRO requests assistance from the client. If the donor does not respond to the employer’s instruction to contact the MRO within 72 hours, the result is reported to the client without a donor interview.

Donor Interview
When the donor is reached, the MRO will identify himself/herself and ensure he/she is speaking with the correct donor. The MRO will explain the laboratory findings and ask the donor about illicit drug use, medications, and medical procedures within the recent past. If the donor admits to illicit drug use or cannot provide documentation of authorized medical use of the drug, the MRO verifies the test as positive. For opiate positive results, the MRO must establish collaborative evidence of illegal opiate use unless the laboratory finding is specific for a heroin metabolite (6 MAM) or the quantitative levels for morphine or codeine exceed 15, 000 ng/mL. The MRO may require the individual to undergo a medical examination by a qualified physician. If the laboratory reported that the specimen was adulterated or substituted, or the test was invalid, the MRO will interview the donor to offer the individual the opportunity to present any medical documentation that may explain the laboratory findings.

How the process works:

Negative Results
With eScreen Rapid Response Testing, negative results are confirmed at the collection site and are available within 15 minutes of completion of the test.

With traditional lab-based testing, negative test results are reviewed by the MRO. The results and chain of custody are transmitted electronically to ScreeningONE. Each result is reviewed for completeness and matched by applicant ID number, specimen ID number and client account number before recording in the ScreeningONE system.

Positive, Adulterated, Substituted and Other Non-Negative Results
All non-negative test results handled by the MRO for resolution. If the donor claims to be prescribed a medication that explains the positive result, the MRO will require written documentation of the prescription. The MRO reviews the documentation and may contact the prescribing physician and/or dispensing pharmacist to verify that the prescription is legitimate. If acceptable validation of authorized medical use is obtained, the result is reported as negative. If there is no acceptable medical explanation for the positive result, the MRO will verify the test as positive. The MRO will call the client immediately following the result determination. A written, signed test result will be transmitted to the client following the verbal report.

Other non-negative results include specimens identified as adulterated, substituted, invalid, or rejected for testing. For most of these atypical results, the MRO will conduct an interview with the donor to ensure that there is no medical explanation for the laboratory findings. For adulterated and substituted specimen results for which there is no acceptable medical explanation, the MRO will report the result as a “Refusal to Test.” If the MRO accepts an applicant’s explanation and supporting medical documentation as the cause of the adulterated or substituted specimen result, the MRO will report the test as “Canceled.” Atypical specimens are handled in accordance with HHS/DOT guidance on regulated specimens, or according to the client protocol for non-regulated specimens.

Split Specimen or Reanalysis Request
If a test result is verified as positive or Refusal to Test (adulterated, substituted), the MRO will offer the applicant/employee the opportunity to have the split specimen tested at a second DHHS certified laboratory. The individual will ordinarily have 72 hours to make this decision. The expense of such additional testing is generally the responsibility of the donor, as required in the client's policy. If a split specimen collection is not used in the client's drug testing program, the donor is usually provided the opportunity to have a residual portion of the specimen tested for reconfirmation of the original findings. This reconfirmation may be done at the same, or a second, DHHS certified laboratory.

Turnaround Time
ScreeningONE receives results 24 hours a day 7 days a week, via direct computer linkage from our major laboratory providers. We have the ability to transmit pure negative results within two hours of receipt from the laboratories. Because of this direct computer link and constant downloads, we believe this to be the most competitive time frame available in the industry today. On the same day the results are received, the Medical Review Officer initiates the verification process for non-negative results. The results from a non-negative test are generally submitted to the customer in 48-72 hours after receipt of the laboratory findings.

Confidentiality and Limitations on Disclosure of Medical Information
All MRO interviews with donors are conducted in accordance with DOT requirements for confidentiality and disclosure of medical information. Applicants are informed of the confidentiality protections and limitations on disclosure at the start of the interview. Medical information disclosed to the MRO by the donor during the test result verification process is not provided to any third party (including the client) without the donor’s expressed written consent, unless required by Federal law or regulation. MROs are generally required to inform clients of medications or medical conditions that may make an individual medically unqualified to perform his/her duties or conditions that may create a safety risk. Quantitative levels of drug or drug metabolites detected in the specimen are not ordinarily disclosed to clients; however the name of the drug or drugs detected is included in the test result.

Turnaround Time
ScreeningONE receives drug screening results 24 hours a day 7 days a week via direct linkage from its major laboratory providers. Lab-based pure negative results are reported in 24 to 34 hours. eScreen Rapid Response negative results are available in 15 minutes of completion of the testing. The results from a non-negative test (lab-based or eScreen) are reported in 48 to 72 hours of receipt of the laboratory findings. Because of our direct links and constant downloads, we believe this to be the most competitive time frame available in the industry today.

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