Using a SAMHSA Certified Laboratory ensures that every test you perform on an employee or applicant will stand up in a court proceeding; it is a defensible test.

What to Look for in a C/TPA or Program Manager

The wrong choice in a service agent for your drug testing services may or may not cause ongoing problems, but it only takes one test to go bad for devastating consequences to occur.

Drug and alcohol testing is serious business; it is not like buying office supplies where you get the lowest price for 100 staplers. You need a drug testing program with many moving parts and you need service, compliance, accuracy and someone who will answer the phone. There will always be questions and you need a service agent that will answer your questions. This article will focus on what end users should look for when contracting with a C/TPA or Program Manager.

Let's start with some basic concepts. The term Consortia/Third Party Administrator (C/TPA) was coined by the Department of Transportation (DOT) with the rewrite of 49 CFR Part 40 (the federal drug testing regulations that apply to DOT-mandated employers) back in 2001. For the purpose of this article the terms C/TPA and TPA shall have the same meaning and are interchangeable and shall refer to both DOT and non-DOT drug and alcohol testing programs.

The program manager is typically an in-house employee of a large employer that intimately manages the drug and alcohol testing program and often acts in place of a C/TPA. Typically this is a hybrid program where some functions of the program are outsourced to service agents.

The C/TPA provides or coordinates the provision of a variety of drug and alcohol testing services to employers. These may be for DOT and/or non-DOT programs. Many times the C/TPA provides some of these services directly as the service agent, and often some or all of these services are outsourced. Listed below are the service agents involved in the business of providing drug and alcohol testing and drug-free workplace programs:

  • Specimen Collectors (the collector)
  • Collection Site
  • Breath Alcohol Technician (BAT) and/or Screening Test Technician (STT)
  • Laboratory
  • Instant Testing Distributors
  • Medical Review Officer (MRO)
  • Employee Assistance Program (EAP)
  • Substance Abuse Professional (SAP)
  • Policy Consultant or Writer

So what do you look for in a C/TPA? My good friend Dr. Carol Law out of Pensacola, Fla., talks about the C/TPA employer relationship like a marriage. She emphasizes that the contract or agreement between the employer and C/TPA can be like a "pre-nup" agreement and this benefits both sides in the event of a breakup. So in looking for a C/TPA, I suggest that you first clearly list what services you need. This will depend greatly on your operation and several questions:

  • Do you have DOT-regulated employees?
  • Do you have both DOT and non-DOT regulated employees?
  • Are you in a state with Drug-Free Workplace program requirements?
  • Do you operate in one state or multiple states?

As you answer these questions and clearly list what services you need, you can then start matching up qualified C/TPAs that can provide these services. The local doctors' office that handles your employment physicals may also be qualified to collect urine specimens, but are they qualified to manage DOT and non-DOT programs in their entirety?

Some of the basics in evaluating a prospective C/TPA to work with you help to ensure your employer drug testing program includes insurance coverage, qualification, certification, experience, and the ability to handle your specific needs as an employer. A C/TPA that specializes and has knowledge of Federal Motor Carrier Safety Administration (FMCSA) drug testing programs may not have the same knowledge and experience in managing Federal Aviation Administration (FAA) programs. Depending on the state(s) in which you are located for your non-DOT drug testing program, the C/TPA must have knowledge of the state law and expertise in any state Drug-Free Workplace program requirements. Many states offer discounts on workers' compensation insurance when the employer implements a comprehensive drug-free workplace program; if you are taking advantage of these programs and receiving the discount, you will want a C/TPA who has knowledge and experience with that particular state program.

Insurance
Check with your C/TPA and get copies of insurance certificates to verify insurance coverage for professional liability (errors and omissions). Make sure this coverage is for drug and alcohol testing.

Qualification and Experience
What makes your C/TPA qualified to do the job you need done for your specific needs? Ask the C/TPA to tell you what makes them qualified. What is the C/TPA's experience, and how long have they been in business? Do they service similar employers? Can the C/TPA provide you with references? Is the C/TPA an active member of drug testing industry associations?

Certifications/Accreditations
What certifications/accreditations does the C/TPA have to demonstrate their commitment to their industry, education, and standards? Look for a C/TPA that has received status as Nationally Accredited for Administration of Drug and Alcohol Testing Programs (NAADATP). This is an accreditation from the Drug & Alcohol Testing Industry Association for C/TPAs. C/TPAs receiving NAADATP accreditation adhere to a national standards program for companies that provide drug-free workplace program management services, to ensure they have company-specific standard operating procedures, safeguards, knowledge, and professional practices that keep their clients in compliance with federal and state drug and alcohol testing regulations. By utilizing a NAADATP provider, employers can rest assured that the provider of services is in full compliance with regulations. Through the required contract process, employers are made aware of what services they are being provided. In cases where the client does not have all services provided by the NAADATP provider, the contract spells out what additional services need to be performed for the employer to be in full compliance with any applicable federal regulations, state laws, and best practices.

All companies needing drug testing will need specimen collection services. Most specimen collections are contracted out. It is extremely important that collectors are well trained and qualified to perform the specimen collections within applicable federal regulations, state laws, and best practices. Ask the C/TPA about the specimen collection process and how the C/TPA ensures the collectors are properly trained and qualified. A drug test event can go bad really quickly at the point of collection if the collector does not follow the correct procedures. Many collectors have received status as Certified Professional Collectors® (CPC). This collector certification from DATIA aims to ensure that the collection is performed in a professional and consistent manner, maintaining confidentiality for the donor and security, integrity, and control of the specimen. Always seek to use collectors that are Certified Professional Collectors® and collection sites that have received status as an Accredited Collection Facility (ACF). Collection sites that have received the DATIA ACF status uphold the highest professional standards in the following two main areas: 1) the collection facility and its operation and 2) the collection facility’s personnel. To obtain accredited status, collection facilities are required to adhere to strict standards in areas such as regulatory compliance, company services standards, specimen handling, operational practices, business ethics, and facility equipment. All accredited collection facilities are also required to maintain a staff of Certified Professional Collectors®.

For workplace drug testing, your laboratory should be certified by the Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA). This is the gold standard for labs performing workplace drug testing and is required for DOT drug testing and under many state laws. These labs are subject to multiple rigorous inspections each year, ensuring quality control. Using a SAMHSA Certified Laboratory ensures that every test you perform on an employee or applicant will stand up in a court proceeding; it is a defensible test.

The Medical Review Officer (MRO) closes out the drug test result with review and verification. Any prescription drug use is taken into account. MROs are required to have extensive training and certification, typically by the Medical Review Officer Certification Council (MROCC) or the American Association of Medical Review Officers (AAMRO). Other organizations that certify MROs include the American College of Occupational and Environmental Medicine (ACOEM) and the American Society of Addiction Medicine (ASAM). Ask to see your MRO’s certification and also ask whether the MRO is a full-time MRO. Some practicing physicians are also MROs. You really want to use an MRO service that employs full-time MROs.

Contracts and Service Agreements
Once you find the C/TPA that will work well for your business, the final scrutiny is in the contract or agreement. Contracts or service agreements should set forth in detail the respective roles and responsibilities of both the C/TPA and the client or vendor. An addendum to the service agreement can outline the detailed specific responsibilities of the C/TPA and the detailed specific responsibilities of the employer client. Be diligent in reviewing your C/TPA agreement regarding non-compliant or negligent services. For DOT-regulated drug and alcohol testing programs, the employer is ultimately responsible for compliance.

The bottom line is to ask a lot of questions and get the details in writing. Employers need to protect themselves from non-compliance issues with regulatory authorities and also from exposure to liability. The wrong choice in a service agent for your drug testing services may or may not cause ongoing problems, but it only takes one test to go bad for devastating consequences to occur. Always look to hire the professional specializing in your specific needs. Remember: You don't hire a plumber to do your electrical work, so why hire an urgent care clinic to do your drug testing?

This article originally appeared in the September 2015 issue of Occupational Health & Safety.

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