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Internal Drug Free Workplace Memo and Acknowledgement FormPurposeIn compliance with the Drug-Free Workplace Act of 1988, Power Component SystemsInc. (PCS) has a longstanding commitment to provide a safe, quality-oriented andproductive work environment consistent with the standards of the community in whichthe company operates. Alcohol and drug abuse poses a threat to the health and safetyof Power Component Systems Inc. employees and to the security of the company'sequipment and facilities. For these reasons, PCS is committed to the elimination of drugand alcohol use and abuse in the workplace
ScopeThis policy outlines the practice and procedure designed to correct instances ofidentified alcohol and drug use in the workplace
This policy applies to all employees and all applicants for employment of PowerComponent Systems. The human resource (HR) department is responsible for policyadministration
Substance Abuse AwarenessIllegal drug use and alcohol misuse have many serious adverse health and safetyconsequences. Information about those consequences and sources of help for drug oralcohol problems is available from the HR department, which has been trained to makereferrals and to assist employees with drug or alcohol problems
Employee AssistancePCS will assist and support employees who voluntarily seek help for such problemsbefore becoming subject to discipline or termination under this or other companypolicies. Such employees will be allowed to use accrued paid time off, placed on leavesof absence, referred to treatment providers and otherwise accommodated as requiredby law. Such employees may be required to document that they are successfullyfollowing prescribed treatment and to take and pass follow-up tests if they hold jobs thatare safety-sensitive or require driving, or if they have violated this policy previously
Once a drug test has been scheduled, unless otherwise required by the Family andMedical Leave Act or the Americans with Disabilities Act, the employee will have forfeited the opportunity to be granted a leave of absence for treatment, and possiblediscipline, up to and including discharge, will be enforced
Employees should report to work fit for duty and free of any adverse effects of illegaldrugs or alcohol. This policy does not prohibit employees from the lawful use andpossession of prescribed medications. Employees must, however, consult with theirdoctors about the medications' effect on their fitness for duty and ability to work safely,and they must promptly disclose any work restrictions to their supervisor. Employeesshould not, however, disclose to Power Component Systems Inc. underlying medicalconditions unless directed to do so
Work Rules 1. Whenever employees are working, are operating any Power Component Systems Inc. vehicle, are present on Power Component Systems Inc. premises or are conducting company-related work offsite, they are prohibited from: a. Using, possessing, buying, selling, manufacturing or dispensing an illegal drug (to include possession of drug paraphernalia)
b. Being under the influence of alcohol or an illegal drug as defined in this policy
c. Possessing or consuming alcohol
2. The presence of any detectable amount of any illegal drug or illegal controlled substance in an employee's body system, while performing company business or while in a company facility, is prohibited
3. Power Component Systems Inc. will also not allow employees to perform their duties while taking prescribed drugs that are adversely affecting their ability to safely and effectively perform their job duties. Employees taking a prescribed medication must carry it in the container labeled by a licensed pharmacist or be prepared to produce it if asked
4. Any illegal drugs or drug paraphernalia will be turned over to an appropriate law enforcement agency and may result in criminal prosecution
Required TestingPre-employmentAll applicants must pass a drug test before beginning work after receiving an offer ofemployment. Refusal to submit to testing will result in disqualification of furtheremployment consideration
Reasonable suspicionEmployees are subject to testing based on (but not limited to) observations by thesupervision of apparent workplace use, possession or impairment. HR, the departmentmanager or the director of operations should be consulted before sending an employee for testing. All levels of supervision making this decision must use the ObservationChecklist to document specific observations and behaviors that create a reasonablesuspicion that the person is under the influence of illegal drugs or alcohol. If the resultsof the Observation Checklist indicate further action is justified, the manager orsupervisor should confront the employee with the documentation and another memberof management. Under no circumstances will the employee be allowed to drive himselfor herself to the testing facility. A member of supervision/management must escort theemployee; the supervisor/manager will make arrangements for the employee to betransported home
Post-accidentEmployees are subject to testing when they cause or contribute to accidents thatseriously damage a Power Component Systems Inc. vehicle, machinery, equipment orproperty or result in an injury to themselves or another employee requiring offsitemedical attention in which there is a reasonable basis for concluding that drug use couldhave contributed to the incident. A circumstance that constitutes probable belief will bepresumed to arise in any instance involving a work-related accident or injury in which anemployee who was operating a motorized vehicle (including a forklift, pickup truck,overhead cranes and aerial/man-lifts) is found to be responsible for causing theaccident. In any of these instances, the investigation and subsequent testing must takeplace within two hours following the accident, if not sooner. Under no circumstances willthe employee be allowed to drive himself or herself to the testing facility
Random TestingPCS reserves the right to conduct random drug tests in compliance with its drug-freeworkplace policy. As used in this policy, “random testing” refers to a method of selectingemployees for testing. The selection will result in an equal probability that any employeefrom a group of employees will be tested without bias to age, race, gender, position etc
PCS will conduct oral drug tests in a private and confidential manner to whereemployees’ privacy rights are not violated. Once the drug test is complete, the HRrepresentative will disclose the employees’ results to the employee. Should theemployee refute the results of the drug screen, the employee will then be directed toretest at an outside designated testing facility. All expenses related to the offsite testingfacility will be incurred by the company in accordance with State and Federalregulations. The employee must report to the outside testing facility no more than 1 ½hours from the time of the initial drug screen result or the secondary test will not beconsidered
Follow-upEmployees who have tested positive, or otherwise violated this policy, are subject todiscipline, up to and including discharge. Depending on the circumstances and theemployee's work history/record, Power Component Systems Inc. may offer anemployee who violates this policy or tests positive the opportunity to return to work on alast-chance basis pursuant to mutually agreeable terms, which could include follow-updrug testing at times and frequencies determined by Power Component Systems for aminimum of one year but not more than two years as well as a waiver of the right tocontest any termination resulting from a subsequent positive test. If the employee eitherdoes not complete the rehabilitation program or tests positive after completing therehabilitation program, the employee will be subject to immediate discharge fromemployment
ConsequencesApplicants who refuse to cooperate in a drug test or who test positive will not be hiredand will not be allowed to reapply/retest in the future
Employees who refuse to cooperate in required tests or who use, possess, buy, sell,manufacture or dispense an illegal drug in violation of this policy will be terminated. Ifthe employee refuses to be tested, yet the company believes he or she is impaired,under no circumstances will the employee be allowed to drive himself or herself home
The first time an employee tests positive for alcohol or illegal drug use under this policy,the result will be discipline up to and including discharge
Employees will be paid for time spent in alcohol or drug testing and then suspendedpending the results of the drug or alcohol test. After the results of the test are received,a date and time will be scheduled to discuss the results of the test; this meeting willinclude a member of management/supervision, and HR. Should the results prove to benegative, the employee will receive back pay for the times/days of suspension
ConfidentialityInformation and records relating to positive test results, drug and alcohol dependencies,and legitimate medical explanations provided to the MRO should be kept confidential tothe extent required by law and maintained in secure files separate from normalpersonnel files. Such records and information may be disclosed among managers andsupervisors on a need-to-know basis and may also be disclosed when relevant to a grievance, charge, claim or other legal proceeding initiated by or on behalf of anemployee or applicant
InspectionsPCS reserves the right to inspect all portions of its premises for drugs, alcohol or othercontraband All employees, contract employees and visitors may be asked to cooperatein inspections of their persons, work areas and property that might conceal a drug,alcohol or other contraband. Employees who possess such contraband or refuse tocooperate in such inspections are subject to appropriate discipline, up to and includingdischarge
Crimes Involving DrugsPCS prohibits all employees, including employees performing work under governmentcontracts, from manufacturing, distributing, dispensing, possessing or using an illegaldrug in or on company premises or while conducting company business. PCSemployees are also prohibited from misusing legally prescribed or over-the-counter(OTC) drugs. Law enforcement personnel should be notified, as appropriate, whencriminal activity is suspected
PCS does not desire to intrude into the private lives of its employees, but recognizesthat employees' off-the-job involvement with drugs and alcohol may have an impact onthe workplace. Therefore, PCS reserves the right to take appropriate disciplinary actionfor drug use, sale or distribution while off company premises. All employees who areconvicted of, plead guilty to or are sentenced for a crime involving an illegal drug arerequired to report the conviction, plea or sentence to HR within five days. Failure tocomply will result in automatic discharge. Cooperation in complying may result insuspension without pay to allow management to review the nature of the charges andthe employee's past record with PCS
Definitions"Company premises" includes all buildings, offices, facilities, grounds, parking lots,lockers, places and vehicles owned, leased or managed by PCS or on any site on whichthe company is conducting business
"Illegal drug" means a substance whose use or possession is controlled by federal lawbut that is not being used or possessed under the supervision of a licensed health careprofessional. (Controlled substances are listed in Schedules I-V of 21 C.F.R. Part 1308.)"Refuse to cooperate" means to obstruct the collection or testing process; to submit analtered, adulterated or substitute sample; to fail to show up for a scheduled test; torefuse to complete the requested drug testing forms; or to fail to promptly provide specimen(s) for testing when directed to do so, without a valid medical basis for thefailure. Employees who leave the scene of an accident without justifiable explanationprior to submission to drug and alcohol testing will also be considered to have refusedto cooperate and will automatically be subject to discharge
"Under the influence of alcohol" means an alcohol concentration equal to or greaterthan .04, or actions, appearance, speech or bodily odors that reasonably cause asupervisor to conclude that an employee is impaired because of alcohol use
"Under the influence of drugs" means a confirmed positive test result for illegal drug useper this policy. In addition, it means the misuse of legal drugs (prescription and possiblyOTC) when there is not a valid prescription from a physician for the lawful use of a drugin the course of medical treatment (containers must include the patient's name, thename of the substance, quantity/amount to be taken and the period of authorization)
Reasonable Suspicion and Post-Accident Testing Protocol 1. The employee will be advised that PCS believes that there is reasonable suspicion to believe that he or she is affected by illegal drugs or alcohol (or due to the nature of the accident the policy mandates this) and that this test is being offered to confirm or deny this suspicion
2. The employee will be transported to any one of the company's contracted testing facilities (e.g., health services, prompt care or the emergency department). One member of management or a designated attendant will accompany the employee. Under no circumstances will the employee be allowed to drive himself or herself to the testing facility
3. Prior to leaving for the testing facility, supervision/management will contact the testing facility to inform it that a staff member from [Company Name] will be arriving and will need a drug or alcohol test completed
4. The employee should be provided water to drink prior to leaving the company premises
5. The employee should be given reasonable time—not to exceed 15 minutes—to secure photo ID in the company of a PCS representative
6. The employee to be tested must present a photo ID (i.e., a driver's license or state ID card) to the testing facility staff before the specimen can be obtained
Ensure that the employee brings the photo ID with him or her when leaving PCS premises
7. The employee to be tested must sign a consent form provided by the testing facility. Refusal to sign is addressed under the "Consequences" section of this document
8. A PCS representative must sign as a witness to the collection procedure, along with the tested employee
9. After returning to the company or when leaving the testing facility, the supervisor/manager must make arrangements to transport the person home (unless testing results are immediate). Under no circumstances will the tested employee be allowed to drive himself or herself home
EnforcementThe HR department is responsible for policy interpretation, administration andenforcement
Drug and Alcohol Policy Certificate of ReceiptI hereby certify that I have received a copy of this latest version of the PCS Drug andAlcohol Policy
Internal Drug Free Workplace Memo and Acknowledgement Form Purpose. In compliance with the Drug-Free Workplace Act of 1988, Power Component Systems Inc. (PCS) has a …
Give a copy of the Drug Free Policy to all employees as well as those offered a position with the company, along with these forms: a. Consent, Release and Acknowledgement of Understanding b. Worker’s Compensation Policy Acknowledgement 4. Make sure all forms are signed and are witnessed where necessary. 5.
A written letter attached to the form saying that the applicant has 24 or 48 hours (Or whatever you choose) to complete the test. 1. To receive work comp insurance drug free workplace credit, send DFWP Credit Application with policy and forms to your Workers’ Compensation Insurance Company. 2.
Please note it may be important to have your company drug screening policy in your employee’s handbooks. You should also address the time limit for taking the drug test at the time you provide the chain of custody forms to the applicant.
Please also note that many drug screening, driving record and state release authorization forms are available in a PDF file to our Automated Employment Screening Clients. All of these FCRA compliant release documents may be e-mailed to the applicants and easily completed online.