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If the driver attempts and fails to provide an adequate amount of breath, they will be referred to a <br />physician to determine if the driver's inability to provide a specimen is genuine or constitutes a <br />refusal to test. Alcohol test results are reported directly to the City by the collection site staff. <br />Controlled Substance Testing <br />The City will use a "split urine specimen" collection procedure for controlled substance testing. <br />Collection of urine specimens for controlled substance testing will be conducted by an approved <br />collector and will be conducted in a setting and manner to ensure the driver's privacy. <br />Controlled substance testing generally takes about 15 minutes. At the collection site, the driver <br />will be given a sealed container and must provide at least 45 ml of urine or oral liquid for testing. <br />Once the sample is provided the collection personnel will check the temperature and color and <br />look for signs of contamination. The urine is then split into two separate specimen containers (A, <br />or "primary," and B, or "split") with identifying labels and security seals affixed to both. The <br />collection facility will be responsible for maintaining a proper chain of custody for delivery of <br />the sample to a DHHS-certified laboratory for analysis. The laboratory will retain a sufficient <br />portion of any positive sample for testing and store that portion in a scientifically acceptable <br />manner for a minimum 365-day period. <br />If an employee fails to provide a sufficient amount of urine/oral liquid to permit a controlled <br />substance test (45 milliliters of urine), the collector will discard the insufficient specimen, unless <br />there is evidence of tampering with that specimen. The collector will urge the driver to drink up <br />to 40 ounces of fluid, distributed reasonably over a period of up to three hours, or until the driver <br />has provided a sufficient urine/oral liquid specimen, whichever occurs first. If the driver has not <br />provided a sufficient specimen within three hours of the first unsuccessful attempt, the collector <br />will cease efforts to attempt to obtain a specimen. The driver must then obtain, within five <br />calendar days, an evaluation from a licensed physician, acceptable to the MRO, who has <br />expertise in the medical issues raised by the employee's failure to provide a sufficient specimen. <br />If the licensed physician concludes the driver has a medical condition, or with a high degree of <br />probability could have, precluded the driver from providing a sufficient amount of urine/oral <br />liquid, the City will consider the test to have been canceled. If a licensed physician cannot make <br />such a determination, the City will consider the driver to have engaged in a refusal to test and <br />will take appropriate disciplinary action under this policy. <br />The primary specimen is used for the first test. If the test is negative, it is reported to the MRO <br />who then reports the result, following a review of the CCF Form for compliance, to the City. If <br />the initial result is positive or non -negative, a "confirmatory retest" will be conducted on the <br />primary specimen. If the confirmatory re -test is also positive, the result will be sent to the MRO. <br />The MRO will contact the driver to verify the positive result. If the MRO is unable to reach the <br />driver directly, the MRO must contact the City who will direct the driver to contact the MRO. <br />REVIEW OF TEST RESULTS <br />The MRO is a licensed physician with knowledge and clinical experience in substance abuse <br />disorders and is responsible for receiving and reviewing laboratory results of the controlled <br />substances test as well as evaluating medical explanations for certain drug test results. Prior to <br />106 <br />