R523-15. Drug Testing Requirements, R523. Human Services, Substance Abuse and Mental Health, Utah Administrative Code

Utah Administrative Code (Current through November 1, 2019)

R523. Human Services, Substance Abuse and Mental Health

R523-15-1. Authority

Latest version.

This rule is authorized by 62A-15-105 and establishes procedures and standards for drug testing services provided by substance use disorder and mental health service providers receiving public funds or certified by the Division of Substance Abuse and Mental Health (DSAMH).

R523-15-2. Purpose

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This rule is designed to ensure that drug testing practices of agencies contracted with the DSAMH are consistent with science and best practice.

R523-15-3. Definitions

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(1) Drug screen means a method for identifying the presence of one or more drugs of abuse that typically involves the use of immunoassay technology, a laboratory technique that makes use of the binding between an antigen and its homologous antibody to identify and quantify the specific antigen or antibody in a sample.

(2) Drug Test means any test administered to detect the presence of alcohol and other drugs from a blood, saliva, urine sample or other accepted scientific methodology.

(3) Confirmation test means a quantitative test used by laboratories to distinguish the presence of a specific drug and/or metabolite and determine the drug's concentration. This is typically accomplished through the use of gas chromatography/mass spectrometry (GC/MS) technology.

(4) Participants means the individuals receiving substance use disorder treatment and who are required to receive drug screenings and tests.

R523-15-4. Required Written Policy and Procedures

Latest version.

(1) All DSAMH programs, contractors, subcontractors and providers who perform drug testing shall have written policies and procedures that address:

(a) Selection of participants to be tested,

(b) Frequency of testing,

(d) Collection and handling of specimens,

(e) Procedure for verifying integrity of sample that includes checks for tampering, adulteration and dilution,

(f) Chain of custody procedures,

(g) Documentation standards,

(h) Training requirements for all direct service staff that includes training on principles of trauma informed care,

(i) Disclosure of results or other information related to drug screen participation,

(j) Potential consequences for testing positive,

(k) The participant's right to request confirmation testing, and

(l) Procedures to ensure the physical and emotional safety of staff and participants.

(m) All policies and procedures are subject to review and approval by the Department of Human Services (DHS).

R523-15-5. Drug Testing Program Requirements

Latest version.

(1) Prior to administration participants shall be informed of:

(a) The purpose of a drug screen,

(b) Who will have access to the results,

(d) Their right to request confirmation testing of a sample using accepted methodologies such as GC/MS technology.

(2) Testing methodologies with scientific standards developed by SAMHSA shall be used for all drug screens. For this reason, urine and saliva are the preferred testing specimens. If other methodologies such as testing of hair, sweat, or meconium are used, additional information regarding the specific detection window of the methodology and any other limitations shall be communicated along with the results.

(3) DSAMH does not recommend random drug testing more frequently than an average of three times a week; however, testing to confirm suspicion of use is always permissible.

(4) Cut-off levels for drug screens shall conform to the Substance Abuse and Mental Health Services Administration (SAMHSA) recommended levels. If the screen is for a substance that SAMSHA has not identified a cutoff level, the industry standard shall be applied.

(5) A drug screen shall not be considered positive unless:

(a) A participant admits to use, or

(b) The sample screen has been confirmed by a SAMSHA certified laboratory using scientifically accepted methodologies such as GC/MS technology.

(6) Drug testing procedures shall not be used as a rationale to:

(a) Bar participants from participation in a program or service; or

(b) To discontinue the use of a lawfully prescribed or court ordered medication.

(7) Sanctions may be imposed based on the results of a drug screen if applied in a manner consistent with the participant's due process rights.

(8) Confirmation testing is required for any contested drug screen if:

(a) Sanctions outside of treatment will be imposed, or

(b) The result is being used for evidentiary purposes.

(9) Participants receiving treatment from a publicly funded agency shall not be responsible to pay for a confirmation test if the result is negative. Agencies providing treatment to persons who are justice involved shall not practice balance billing to offset cost associated with a conformation test if the test is negative.

(10) Testing frequency should be based on the participant's circumstances and the purpose of the test. Factors to consider include:

(a) The participant's history of drug use,

(b) Drug of choice,

(d) Treatment progress,

(e) Personal observations,

(f) Special circumstances/transitions, and

(g) Other factors as needed.

(11) Duplicate drug testing among DHS divisions should be avoided. With signed participant consent consistent with 42 CFR, DHS agencies may share results. The following information shall also be shared with results:

(a) The cut-off level(s) used with the drug screen,

(b) A description of how sample was collected,

(d) The specific panel of drugs included in the screen,

(e) Whether the sample was checked for adulteration, tampering and dilution,

(f) Whether the participant admitted to use or not, and

(g) Whether the result(s) is from a drug screen or a confirmation test.

(12) Drug testing should not be the only means to detect substance use or monitor treatment compliance. DSAMH encourages all divisions, agencies, providers, and contractors to evaluate a participant's progress using:

(a) Validated assessments,

(b) Clinical evaluations,

(e) Personal observation through regular contact.

(13) DSAMH recommends the use of medication-assisted drug treatments such as the use of Methadone, Bupinorphine, and Naltrexone for individuals who meet clinical criteria for their use.