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O93-09ORDINANCE O93-.~ AN ORDINANCE OF THE CITY COMMISSION OF THE CiTY OF BOYNTON BEACH, FLORIDA, AMENDING ORDINANCE 092-51 WHICH ESTABLISHED THE CITY'S DRUG FREE WORKPLACE POLICY (CODIFIED AS SECTION 2- 19 OF THE CITY CODE); PROVIDING FOR POLICY AMENDMENTS BY RESOLUTION; PROVIDING FOR CONFLICTS, SEVERABILITY, CODIFICATION, AND AN EFFECTIVE DATE. WHEREAS, the City Commission of the City of Boynton Beach, Florida, deems it to be in the best interests of the citizens of the City of Boynton Beach and its employees to amend Ordinance No. 092-51, enacted on October 20, 1992; and WHEREAS, the City Commission of the City of Boynton Beach, Florida acknowledges that policy may require amendments from time to time; NOW, THEREFORE, BE IT ORDAINED BY THE CITY COMMISSION OF THE CITY OF BOYNTON BEACH, FLORIDA THAT: Section i. The foregoing "Whereas" clauses are hereby ratified and confirmed as being true and correct and are hereby made a specific part of this Ordinance. Section 2. Ordinance No. O92-51, is hereby amended by adding the words and figures in underlined type and deleting the words and figures in struck-through type in Composite Exhibit "A~' attached hereto and by this reference made a part hereof. Section 3. That policy can be amended from time to time by Resolution. Section 4. Ail ordinances or parts of ordinances in conflict herewith are hereby repealed. Section 5. Should any section or provision of this Ordinance or any portion thereof be declared by a court of competent jurisdiction to be invalid, such decision shall not affect the remainder of this ordinance. Section 6. Specific authority' is hereby given to codify this ordinance. Section 7. This ordinance shall become effective immediately upon passage° FIRST READING this ~ day of mAY, 1993. SECOND READING AND FINAL PASSAGE this 1993. day of May, CITY OF BOYNTg~ BEACH, FLORIDA .? ATTEST: Commissioner Commi s s i~ ~ (Corporate Seal) DRUG.WKP-Rev. 1/28/93 COMPOSITE EXHIBIT "A" (REVISED MAY 1993) POLICY STATEMENT THE CITY OF BOYNTON BEACH IS COMMITTED TO PROVIDE A SAFE WORK ENVIRONMENT FOR ITS EMPLOYEES, OUR COMMUNITY AND SOCIETY. SUBSTANCE ABUSE IS A NATIONAL PROBLEM WHICH IMPAIRS THE HEALTH AND SAFETY OF EMPLOYEES, PROMOTES CRIME AND HARMS OUR COMMUNITY. THE CITY IS ADDRESSING THIS PROBLEM BY INSTITUTING A DRUG FREE WORKPLACE PROGRAM. SUBSTANCE ABUSE IS A COMPLEX, YET TREATABLE DISEASE. THE ULTIMATE GOAL OF THIS POLICY IS TO BALANCE OUR RESPECT FOR INDIVIDUAL PRIVACY WITH OUR NEED TO KEEP A SAFE, PRODUCTIVE DRUG FREE ENVIRONMENT. OUR INTENTION IS TO PREVENT AND TREAT SUBSTANCE ABUSE. WE WOULD LIKE TO ENCOURAGE THOSE WHO USE DRUGS OR ABUSE ALCOHOL TO SEEK HELP IN OVERCOMING THEIR PROBLEM. THE CITY WILL ATTEMPT TO ASSIST AN EMPLOYEE IN OBTAINING TREATMENT PRIOR TO TAKING DISCIPLINARY ACTION WHEN SUCH TREATMENT IS ASSOCIATED WITH A FIRST OCCURRENCE OF SUBSTANCE ABUSE. THE CITY CONSIDERS SUBSTANCE ABUSE TO BE AN UNSAFE AND COUNTER PRODUCTIVE WORK PRACTICE. THE CITY'S POLICY IS IN ACCORDANCE WITH THE FLORIDA DRUG FREE WORKPLACE PROGRAM AS PROVIDED IN SECTION 440.102, FLORIDA STATUTES AND CHAPTER 38F-9, FLORIDA ADMINISTRATIVE CODE. IT IS THE INTENT OF THE CITY TO ADOPT THE POLICIES AND STANDARDS SET FORTH IN CHAPTER 38F-9. TO THE EXTENT OF ANY CONFLICT BETWEEN THE STANDARDS ESTABLISHED BY THIS POLICY AND THE STANDARDS SET FORTH IN CHAPTER 38F-9 F.A.C., AS AMENDED FROM TIME TO TIME, THE STANDARDS SET FORTH IN CHAPTER 38F-9 SHALL PREVAIL. POLICIES AND STANDARDS CONTAINED HEREIN AND NOT ADDRESSED IN CHAPTER 38F-9 F.A.C. SHALL CONTROL. TO ENSURE A WORK PLACE FREE FROM THE INFLUENCE OF ILLEGAL DRUGS AND ALCOHOL ABUSE THE FOLLOWING POLICY HAS BEEN ESTABLISHED. IT IS THE POLICY OF THE CITY THAT AN EMPLOYEE FOUND WITH THE PRESENCE OF ALCOHOL OR ILLEGAL DRUGS IN HIS/HER SYSTEM, IN POSSESSION OF, USING, SELLING TRADING OR OFFERING FOR SALE ILLEGAL DRUGS OR ALCOHOL DURING WORKING HOURS, MAY BE SUBJECT TO DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION. (CITY SPONSORED ACTIVITIES WHICH MAY INCLUDE THE SERVICE OF ALCOHOLIC BEVERAGES ARE NOT INCLUDED IN THIS PROVISION). AN EMPLOYEE REPORTING FOR WORK VISIBLY IMPAIRED SHALL BE CONSIDERED UNABLE TO PROPERLY PERFORM REQUIRED DUTIES AND WILL NOT BE ALLOWED TO WORK. IF POSSIBLE, THE SUPERVISOR SHOULD Rev. May, 1993 FIRST SEEK ANOTHER SUPERVISOR'S OPINION OF THE EMPLOYEES CONDITION. THEN THE SUPERVISOR, TOGETHER WITH A REPRESENTATIVE FROM THE PERSONNEL DEPARTMENT SHOULD CONSULT PRIVATELY WITH THE EMPLOYEE TO RULE OUT ANY PROBLEM(S) THAT MAY HAVE BEEN CAUSED BY PRESCRIPTION DRUGS. WHEN AN OFF-DUTY EMPLOYEE IS CALLED BACK TO WORK AND THAT EMPLOYEE HAS CONSUMED ALCOHOLIC BEVERAGES, THAT EMPLOYEE SHALL DISCLOSE SUCH USE AND DECLINE CALL BACK. AN EMPLOYEE SHALL NOT BE DISCIPLINED FOR REFUSING TO RESPOND TO CALL BACK WHEN SUCH EMPLOYEE HAS REASONABLE BELIEF THAT HE OR SHE COULD NOT PASS AN ALCOHOL BLOOD LEVEL TEST. EMPLOYEES WHO ARE ON STAND- BY THAT THEY F~AY BE SUBJECT TO CALL BACK SHOULD NOT ENGAGE IN SOCIAL DRINKING AND MAY NOT DECLINE CALL BACK WITHOUT BEING SUBJECT TO DISCIPLINE. IF, IN THE OPINION OF THE SUPERVISOR AND A REPRESENTATIVE OF THE CITY MANAGER'S OFFICE OR THE PERSONNEL DIRECTOR OR HIS/HER DEPARTMENT REPRESENTATIVE THE EMPLOYEE IS CONSIDERED IMPAIRED, THE EMPLOYEE SHOULD BE SENT HOME, AFTER DRUG TESTING BY A MEDICAL FACILITY, BY TAXI OR OTHER SAFE TRANSPORTATION ALTERNATIVE, DEPENDING ON THE DETERMINATION OF THE OBSERVED IMPAIRMENT, ACCOMPANIED BY THE SUPERVISOR OR ANOTHER EMPLOYEE, IF NECESSARY. AN IMPAIRED EMPLOYEE SHOULD NOT BE ALLOWED TO DRIVE. THE PRESCRIBED TEST DIRECTION FORM SHALL BE COMPLETED BY THE SUPERVISOR. PRESCRIPTION DRUGS PRESCRIBED BY THE EMPLOYEE'S PHYSICIAN MAY BE TAKEN DURING WORKING HOURS. THE EMPLOYEE SHALL NOTIFY THE SUPERVISOR IF THE USE OF PROPERLY PRESCRIBED DRUGS WILL AFFECT THE EMPLOYEE'S WORK PERFORMANCE. ABUSE OF PRESCRIPTION DRUGS WILL NOT BE TOLERATED. IT IS THE RESPONSIBILITY OF THE CITY'S SUPERVISORS TO COUNSEL WITH AN EMPLOYEE WHENEVER THEY SEE CHANGES IN PERFORMANCE THAT SUGGEST AN EMPLOYEE PROBLEM. THE SUPERVISOR MAY SUGGEST THAT THE EMPLOYEE VOLUNTARILY SEEK HELP FROM THE EMPLOYEE ASSISTANCE PROGRAM OR DECIDE THAT THE SEVERITY OF THE OBSERVED PROBLEM IS SUCH THAT A FORMAL REFERRAL TO THE EAP SHOULD BE MADE o DEFINITIONS A. ALCOHOL MEANS ETHYL ALCOHOL (ETHANOL) AND INCLUDES DISTILLED SPIRITS, WINE, MALT BEVERAGES AND INTOXICATING LIQUORS. B. ALCOHOL ABUSE - AN EMPLOYEE SHALL BE DETERMINED TO BE UNDER THE INFLUENCE OF ALCOHOL IF THE EMPLOYEE'S NORMAL FACULTIES ARE IMPAIRED DUE TO THE CONSUMPTION OF ALCOHOL OR THE EMPLOYEE BLOOD ALCOHOL LEVEL IS 0.05g/dl% OR HIGHER. C. ILLEGAL DRUGS MEANS ANY DRUG(S) WHICH IS NOT LEGALLY OBTAINABLE, WHICH MAY BE LEGALLY OBTAINABLE BUT HAS NOT BEEN LEGALLY OBTAINED OR WHICH IS BEING USED IN A MANNER OR FOR A Rev. May, 1993 2 PURPOSE OTHER THAN AS PRESCRIBED. D. DRUGS MEANS ALCOHOL, AMPHETAMINES, CANNABINOIDS, COCAINE, PHENCYCLIDINE (PCP), HALLUCINOGENS, SYNTHETIC NARCOTICS, DESIGNER DRUGS, OR A METABOLITE OF ANY OF THE SUBSTANCES LISTED ABOVE. E. LEGAL DRUG MEANS PRESCRIBED DRUGS AND OVER THE COUNTER DRUGS WHICH HAVE BEEN LEGALLY OBTAINED AND ARE BEING USED SOLELY FOR THE PURPOSE FOR WHICH THEY WERE PRESCRIBED OR MANUFACTURED. F. JOB APPLICANT MEANS A PERSON WHO HAS APPLIED FOR A POSITION WITH THE CITY AND HAS BEEN OFFERED EMPLOYMENT CONDITIONED UPON SUCCESSFULLY PASSING A DRUG TEST. G. EMPLOYEE MEANS AN INDIVIDUAL WHO WORKS FOR THE CITY FOR COMPENSATION AND IS COVERED BY THE WORKERS COMPENSATION ACT. H. DRUG TESTING MEANS ANY CHEMICAL, BIOLOGICAL OR PHYSICAL INSTRUMENTAL ANALYSIS FOR THE PURPOSE OF DETERMINING THE PRESENCE OF A ILLEGAL DRUG OR ITS METABOLITES, INCLUDING ALCOHOL. (1). DRUG TESTING MAY REQUIRE THE COLLECTION OF BLOOD, URINE, BREATH, SALIVA OR HAIR OF AN EMPLOYEE OR JOB APPLICANT. I. INITIAL DRUG TEST MEANS A SCREENING PROCEDURE OF THE BLOOD AND URINE OF EMPLOYEES AND JOB APPLICANTS FOR THE PRESENCE OF ALCOHOL AND ILLEGAL DRUGS IN ACCORDANCE WITH THE FLORIDA DRUG FREE WORKPLACE PROGRAM AND APPROPRIATE FLORIDA ADMINISTRATIVE RULES. ALL LEVELS EQUAL TO OR EXCEEDING THE FOLLOWING SHALL BE REPORTED AS POSITIVE: ALCOHOL .05g/dl% AMPHETAMINES 1,000 NG/ML CANNABINOIDS 100 NG/ML COCAINE 300 NG/ML PHENCYCLIDINE 25 NG/ML METHAQUALONE 300 NG/ML OPIATES 300 NG/ML BARBITURATES 300 NG/ML BENZODIAZEPINES 300 NG/ML SYNTHETIC NARCOTICS: METHADONE PROPOXYPHENE 300 NG/ML 300 NG/ML J. CONFIRMATION TEST MEANS A SECOND TEST OF ALL SPECIMENS IDENTIFIED AS POSITIVE ON AN INITIAL TEST IN ACCORDANCE WITH THE FLORIDA DRUG FREE WORKPLACE PROGRAM AND APPROPRIATE FLORIDA ADMINISTRATIVE RULES. ALL LEVELS EQUAL TO OR EXCEEDING THE FOLLOWING SHALL BE REPORTED AS POSITIVE: Rev. May, 1993 3 ALCOHOL AMPHETAMINES CANNABINOIDS COCAINE PHENCYCLIDINE METHAQUALONE OPIATES BARBITURATES BENZODIAZEPINES SYNTHETIC NARCOTICS: METHADONE PROPOXYPHENE .05g/dl% 500 NG/ML 15 NG/ML 150 NG/ML 25 NG/ML 150 NG/ML 300 NG/ML 150 NG/ML 150 NG/ML 150 NG/ML 150 NG/ML K. DRUG TESTING METHODOLOGY SPECIMENS FOR DRUG TESTING WILL BE COLLECTED, HANDLED, MAINTAINED AND TESTED IN ACCORDANCE WITH THE FLORIDA DRUG FREE WORKPLACE PROGRAM AND THE PROCEDURES SET FORTH IN FLORIDA ADMINISTRATIVE CODE SECTION 38F-9. L. POSITIVE CONFIRMED TEST OR CONFIRMATION TEST MEANS A SECOND PROCEDURE WHICH CONFIRMS A POSITIVE RESULT FROM AN INITIAL DRUG TEST. M. MEDICAL REVIEW OFFICER (MRO) MEANS A LICENSED PHYSICIAN WITH KNOWLEDGE OF PRESCRIPTION DRUGS, PHARMACOLOGY AND TOXICOLOGY OF DRUGS, WHO MAY BE RESPONSIBLE FOR RECEIVING AND REVIEWING ALL POSITIVE CONFIRMED TEST RESULTS AND WHO MAY BE RESPONSIBLE FOR CONTACTING ALL INDIVIDUALS WHO TEST POSITIVE IN A CONFIRMATION TEST TO INQUIRE ABOUT POSSIBLE MEDICATIONS WHICH COULD HAVE CAUSED A POSITIVE RESULT. THE MRO NEED NOT BE AN EMPLOYEE OF THE CITY. N. PRESCRIPTION OR NON PRESCRIPTION MEDICATION MEANS A DRUG OR MEDICATION OBTAINED PURSUANT TO A PRESCRIPTION AS DEFINED BY SECTION 893.02, FLORIDA STATUTES, OR A MEDICATION THAT IS AUTHORIZED PURSUANT TO A FEDERAL OR STATE LAW FOR GENERAL DISTRIBUTION AND USE WITHOUT A PRESCRIPTION IN THE TREATMENT OF HUMAN DISEASES, AILMENTS OR INJURIES. O. REASONABLE SUSPICION DRUG TESTING MEANS DRUG TESTING BASED ON A BELIEF THAT AN EMPLOYEE IS USING OR HAS USED DRUGS IN VIOLATION OF THIS POLICY DRAWN FROM SPECIFIC OBJECTIVE AND DOCUMENTED FACTS AND REASONABLE INFERENCES DRAWN FROM THOSE FACTS IN LIGHT OF EXPERIENCE. AMONG OTHER THINGS, SUCH FACTS AND INFERENCES MAY BE BASED UPON: (1). OBSERVABLE PHENOMENA WHILE AT WORK, SUCH AS DIRECT OBSERVATION OF DRUG USE OR OF THE PHYSICAL SYMPTOMS OR MANIFESTATIONS OF BEING UNDER THE INFLUENCE OF A DRUG. (2). ABNORMAL CONDUCT OR ERRATIC BEHAVIOR WHILE AT WORK OR A SIGNIFICANT DETERIORATION OF WORK PERFORMANCE, EITHER OR BOTH OF WHICH ARE RECOGNIZED SYMPTOMS OF ALCOHOL OR Rev. May, 1993 4 DRUG ABUSE AND WHICH ARE NOT EMPLOYEE OR ARE NOT RELATED CONDITIONS. ADEQUATELY EXPLAINED BY THE TO THE EMPLOYEE'S WORKING (3). A REPORT AND CREDIBLE SOURCE, CORROBORATED. OF DRUG USE, PROVIDED BY A RELIABLE WHICH HAS BEEN INDEPENDENTLY (4). EVIDENCE THAT AN EMPLOYEE HAS TAMPERED WITH A DRUG TEST DURING HIS EMPLOYMENT WITH THE CURRENT EMPLOYER. (5). INFORMATION THAT AN EMPLOYEE HAS CAUSED, OR CONTRIBUTED TO, AN ACCIDENT WHILE AT WORK. (6). EVIDENCE THAT AN EMPLOYEE HAS USED, POSSESSED, SOLD, SOLICITED, OR TRANSFERRED DRUGS, WHILE WORKING OR WHILE ON THE CITY'S PREMISES OR WHILE OPERATING A VEHICLE, MACHINERY, OR EQUIPMENT OF THE CITY. P. SPECIMEN MEANS A TISSUE OR PRODUCT OF THE HUMAN BODY INCLUDING BLOOD, URINE, SALIVA, HAIR, CAPABLE OF REVEALING THE PRESENCE OF ALCOHOL AND/OR ILLEGAL DRUGS OR THEIR METABOLITES. GENERAL PROCEDURES A. TYPES OF TESTING IN ORDER TO MAINTAIN A DRUG AND ALCOHOL FREE WORK ENVIRONMENT, THE CITY WILL TEST FOR THE PRESENCE OF ALCOHOL AND DRUGS IN THE FOLLOWING CIRCUMSTANCES: (1). JOB APPLICANTS: ALL JOB APPLICANTS WHO HAVE BEEN OFFERED A POSITION OF EMPLOYMENT ARE REQUIRED TO TAKE A DRUG AND ALCOHOL TEST. (2). REASONABLE SUSPICION: ALL EMPLOYEES WHO ARE DETERMINED TO BE UNDER REASONABLE SUSPICION OF DRUG OR ALCOHOL USE (AS DEFINED HEREIN), ARE REQUIRED TO TAKE A DRUG AND ALCOHOL TEST. (3). FITNESS FOR DUTY: ALL EMPLOYEES WHO ARE SUBJECT TO A ROUTINE FITNESS FOR DUTY MEDICAL EXAMINATIONS ARE REQUIRED TO TAKE A DRUG AND ALCOHOL TEST AS PART OF THEIR MEDICAL EXAMINATION. (4). FOLLOW-UP: ALL EMPLOYEES WHO HAVE BEEN REFERRED TO AN EMPLOYEE ASSISTANCE PROGRAM OR REHABILITATION PROGRAM BY THE CITY FOR DRUG AND/OR ALCOHOL ABUSE ARE REQUIRED TO TAKE DRUG AND ALCOHOL TESTS ON A QUARTERLY, SEMI ANNUAL OR ANNUAL BASIS FOR TWO YEARS AFTER RETURN TO WORK. (5). POST ACCIDENT OR INJURY: EMPLOYEES WHO ARE INVOLVED IN A JOB RELATED ACCIDENT OR INCIDENT, AND WHOSE IMPAIRMENT APPEARS TO BE CONTRIBUTORY, WHICH RESULTS OR MIGHT HAVE Rev. May, 1993 5 RESULTED IN BODILY INJURY OR PROPERTY LOSS OR DAMAGE. (6). THE PERSONNEL DEPARTMENT SHALL ESTABLISH FORMS TO FACILITATE RECORD KEEPING AND REPORTING. THE FORMS ATTACHED AS ATTACHMENT 1 THRU § SHALL BE USED INITIALLY BDT MAY BE AMENDED FROM TIME TO TIME BY THE PERSONNEL DEPARTMENT WITHOUT FURTHER COMMISSION ACTION. B. CONSEQUENCES OF REFUSING A DRUG TEST (1) . AN EMPLOYEE WHO REFUSES TO SUBMIT TO A DRUG TEST WILL BE SUBJECT TO DISCIPLINE, UP TO AND INCLUDING TERMINATION. AN EMPLOYEE WHO REFUSES TO SUBMIT TO A DRUG TEST ALSO WILL FORFEIT HIS ELIGIBILITY FOR ALL WORKER'S COMPENSATION MEDICAL AND INDEMNITY BENEFITS. (2). A JOB APPLICANT WHO REFUSES TO SUBMIT TO A DRUG TEST WILL NOT BE HIRED. C. ACTIONS FOLLOWING A POSITIVE CONFIRMED TEST THE CITY MAY INSTITUTE DISCIPLINARY ACTION, UP TO AND INCLUDING TERMINATION, FOR ANY EMPLOYEE WHO HAS A POSITIVE, CONFIRMED DRUG TEST. D. CONFIDENTIALITY CONFIDENTIALITY OF RECORDS CONCERNING DRUG TESTING WILL BE MAINTAINED EXCEPT TO THE EXTENT NECESSARY TO COMPLY WITH THIS POLICY AND APPLICABLE PUBLIC RECORDS LAW. ALL INFORMATION, REPORTS, MEMOS AND DRUG TEST REPORTS, WRITTEN OR OTHERWISE, RECEIVED BY THE CITY THROUGH THE DRUG TESTING PROGRAM WILL BE KEPT CONFIDENTIAL TO THE EXTENT PROVIDED BY LAW. THE CITY, EMPLOYEE ASSISTANCE PROGRAM, LABORATORIES, DRUG AND ALCOHOL REHABILITATION PROGRAMS WHO RECEIVE OR HAVE ACCESS TO INFORMATION CONCERNING DRUG TEST RESULTS SHALL KEEP ALL INFORMATION CONFIDENTIAL. NO SUCH INFORMATION WILL BE RELEASED UNLESS THERE IS A VOLUNTARY WRITTEN CONSENT, SIGNED BY AN EMPLOYEE OR JOB APPLICANT, EXCEPT WHERE SUCH RELEASE IS COMPELLED BY A COURT PURSUANT TO AN APPEAL TAKEN UNDER THIS SECTION, OR WHERE DEEMED APPROPRIATE BY A PROFESSIONAL OR OCCUPATIONAL LICENSING BOARD IN A RELATED DISCIPLINARY PROCEEDING. THE CITY WILL MAINTAIN RECORDS CONCERNING DRUG TESTING SEPARATE AND APART FROM AN EMPLOYEE'S OR JOB APPLICANT'S PERSONNEL FILE. INFORMATION ON DRUG TESTING RESULTS SHALL NOT BE RELEASED IN ANY CRIMINAL HEARING. E. REPORTING OF USE OF MEDICATION EMPLOYEES AND JOB APPLICANTS MAY CONFIDENTIALLY REPORT Rev. May, 1993 6 THE USE OF PRESCRIPTION OR NON PRESCRIPTION MEDICATION BOTH BEFORE AND AFTER HAVING A DRUG TEST. A FORM FOR REPORTING MEDICATION USE IS ATTACHED. F. NOTICE OF COMMON MEDICATIONS A LIST OF THE MOST COMMON MEDICATIONS, BY BRAND NAME OR COMMON NAME, AS APPLICABLE, AS WELL AS BY CHEMICAL NAME, WHICH MAY ALTER OR AFFECT A DRUG TEST IS ATTACHED. EMPLOYEES AND JOB APPLICANTS SHOULD REVIEW THIS LIST PRIOR TO SUBMITTING TO A DRUG TEST. G. MEDICATION INFORMATION AN EMPLOYEE OR JOB APPLICANT MAY CONSULT WITH THE TESTING LABORATORY FOR TECHNICAL INFORmaTION REGARDING PRESCRIPTION AND NON PRESCRIPTION MEDICATION. H. EMPLOYEE ASSISTANCE PROGRAM REFER TO THE EMPLOYEE ASSISTANCE PROGRAM POLICY FOR THE NAME, ADDRESS AND TELEPHONE NUMBER OF THE CURRENT PROVIDER. OTHER RESOURCES AVAILABLE ARE: 1 800 - 356-9996 1 800 - 527-5344 1 800 - COCAINE 1 800 - NCA-CALL 1 800 - 662-HELP 1 800 843-4971 AL-ANON AMERICAN COUNCIL OF ALCOHOLICS HELPLINE COCAINE HOTLINE NATIONAL COUNCIL ON ALCOHOLISM NATIONAL INSTITUTE ON DRUG ABUSE HOTLINE NATIONAL INSTITUTE ON DRUG ABUSE HOTLINE I. DRUGS TO BE TESTED DRUGS THAT WILL BE TESTED ARE AS FOLLOWS: C. D. E. F. H. I. J. K. ALCOHOL, INCLUDING DISTILLED SPIRITS, WINE, MALT BEVERAGES AND INTOXICATING LIQUORS AMPHETAMINES CANNABINOIDS COCAINE PHENCYCLIDINE (PCP) HALLUCINOGENS, PROVIDED THE ONLY HALLUCINOGEN TO BE TESTED FOR IS PHENCYCLIDINE (PCP) METHAQUALONE OPIATES BARBITURATES BENZODIAZEPINES SYNTHETIC NARCOTIC, BUT LIMITED TO METHADONE AND PROPOXYPHENE Rev. May, 1993 7 L. A METABOLITE OF ANY SUBSTANCE LISTED HEREIN. (A LIST OF DRUGS BY BRAND NAMES OR COMMON NAMES IS ATTACHED.) J. CHALLENGE OF TEST RESULTS (1). AN EMPLOYEE OR A JOB APPLICANT WHO RECEIVES A POSITIVE CONFIRMED TEST RESULT MAY CONTEST OR EXPLAIN THE RESULT IN WRITING WITHIN FIVE (5) DAYS OF RECEIPT OF NOTIFICATION OF A POSITIVE CONFIRMED TEST RESULT. (2). IF THE EXPLANATION OR CHALLENGE OF THE EMPLOYEE OR JOB APPLICANT IS UNSATISFACTORY TO THE CITY, THE CITY WITHIN FIFTEEN (15) DAYS OF RECEIPT WILL PROVIDE A WRITTEN EXPLANATION AS TO WHY THE EMPLOYEE OR JOB APPLICANT'S EXPLANATION IS UNSATISFACTORY, AND A COPY OF THE REPORT OF POSITIVE CONFIRMED TEST RESULTS. (3). AN EMPLOYEE MAY FURTHER CHALLENGE THE RESULTS OF THE TEST IN A COURT OF COMPETENT JURISDICTION OR, IF THE DRUG TEST WAS ADMINISTERED DUE TO A WORKPLACE INJURY, BY FILING A CLAIM FOR BENEFITS WITH A JUDGE OF COMPENSATION CLAIMS, PURSUANT TO CHAPTER 440, FLORIDA STATUTE. (4). IF AN EMPLOYEE OR JOB APPLICANT CONTESTS THE DRUG TEST RESULTS HE MUST NOTIFY THE LABORATORY. K. RIGHTS UNDER COLLECTIVE BARGAINING AGREEMENTS EMPLOYEES WHO ARE COVERED UNDER A COLLECTIVE BARGAINING AGREEMENT BETWEEN THE CITY AND ANY COLLECTIVE BARGAINING UNIT MAY HAVE A RIGHT TO FILE A GRIEVANCE REGARDING DISCIPLINE IMPOSED BY THE CITY AS A RESULT OF A VIOLATION OF THIS POLICY. A GRIEVANCE OF THIS NATURE SHALL NOT BE LIMITED TO THE DISCIPLINE IMPOSED BUT DISCIPLINE BASED ON A POSITIVE RESULT SHALL NOT BE SET ASIDE SOLELY ON THE BASIS OF ERROR IN ORDERING THE TEST. POLICY REQUIREMENTS A. CONDITIONS OF PRE-EMPLOYMENT THE CITY WILL CONDUCT PRE-EMPLOYMENT SCREENING EXAMINATIONS DESIGNED TO PREVENT HIRING INDIVIDUALS WHO USE DRUGS. (1). TO DETERMINE THE SUITABILITY OF EMPLOYEES TO WORK FOR THE CITY THE FOLLOWING PRE-EMPLOYMENT CONDITIONS ARE ESTABLISHED: ALL JOB APPLICANTS WILL BE TESTED PRIOR TO EMPLOYMENT FOR DRUG USE AND ALCOHOL USE. ANY JOB OFFER WHICH A JOB APPLICANT MAY RECEIVE FROM THE CITY IS CONTINGENT UPON Rev. May, 1993 8 SUCCESSFULLY COMPLETING PHYSICAL EXAMINATION. A REQUIRED (2). ANY JOB APPLICANT WHO REFUSES TO SUBMIT TO DRUG AND ALCOHOL TESTING AS PART OF THE PRE-EMPLOYMENT TESTING PROCESS WILL BE REFUSED EMPLOYMENT. (3). ANY JOB APPLICANT WHO TESTS POSITIVE FOR DRUGS OR ALCOHOL USE WILL BE REFUSED EMPLOYMENT AT THAT TIME. (4). CONFIDENTIALITY WILL BE MAINTAINED PURSUANT TO THIS POLICY. (5). THE CITY WILL NOT DISCRIMINATE AGAINST APPLICANTS FOR EMPLOYMENT BECAUSE OF THE PAST ABUSE OF DRUGS OR ALCOHOL. IT IS THE CURRENT ABUSE OF DRUGS OR ALCOHOL THAT THE CITY WILL NOT TOLERATE. B. CURRENT EMPLOYEE DRUG AND ALCOHOL ABUSE SCREENING THE CITY WILL MAINTAIN SCREENING PRACTICES TO IDENTIFY EMPLOYEES WHO USE ILLEGAL DRUG OR ABUSE ALCOHOL. IT SHALL BE A CONDITION OF CONTINUED EMPLOYMENT FOR ALL EMPLOYEES TO SUBMIT TO DRUG SCREENING UNDER THE FOLLOWING CONDITIONS: (1). REASONABLE SUSPICION: ALL EMPLOYEES WHO ARE DETERMINED TO BE UNDER REASONABLE SUSPICION OF DRUG OR ALCOHOL USE (AS DEFINED HEREIN), ARE REQUIRED TO TAKE A DRUG AND ALCOHOL TEST. (2) . FITNESS FOR DUTY: ALL EMPLOYEES WHO ARE SUBJECT TO A ROUTINE FITNESS FOR DUTY MEDICAL EXAMINATIONS ARE REQUIRED TO TAKE A DRUG AND ALCOHOL TEST AS PART OF THEIR MEDICAL EXAMINATION. (3) . FOLLOW-UP: ALL EMPLOYEES WHO HAVE BEEN REFERRED TO AN EMPLOYEE ASSISTANCE PROGRb24 OR REHABILITATION PROGRAM BY THE CITY FOR DRUG AND/OR ALCOHOL ABUSE ARE REQUIRED TO TAKE DRUG AND ALCOHOL TESTS ON A QUARTERLY, SEMI ANNUAL OR ANNUAL BASIS FOR TWO YEARS AFTER RETURN TO WORK. (4) . POST ACCIDENT OR INJURY: EMPLOYEES WHO ARE INVOLVED IN A JOB RELATED ACCIDENT OR INCIDENT, AND WHOSE IMPAIRMENT APPEARS TO BE CONTRIBUTORY, AND WHICH RESULTS OR MIGHT HAVE RESULTED IN BODILY INJURY OR PROPERTY LOSS OR DAMAGE. C. EMPLOYEE ASSISTANCE PROGRAM THE CITY MAINTAINS AN EMPLOYEE ASSISTANCE PROGRAM (EAP) WHICH PROVIDES HELP TO EMPLOYEES AND THEIR FAMILIES WHO SUFFER FROM ALCOHOL OR DRUG ABUSE. (REFER TO EAP POLICY) IT IS THE RESPONSIBILITY OF EACH EMPLOYEE TO SEEK ASSISTANCE Rev. May, 1993 9 BEFORE DRUGS AND ALCOHOL LEAD TO DISCIPLINARY PROBLEMS. TO ENSURE THE EFFECTIVENESS OF THE DRUG FREE WORKPLACE POLICY IT IS THE RESPONSIBILITY OF ALL EMPLOYEES TO INFORM SUPERVISORY PERSONNEL OF ANY ACTIVITY THAT WOULD LEAD A REASONABLE PERSON TO BELIEVE THAT DRUGS OR ALCOHOL ARE BEING ABUSED IN THE WORKPLACE. AN EMPLOYEE'S DECISION TO SEEK ASSISTANCE FROM THE EMPLOYEE ASSISTANCE PROGRAM ON A VOLUNTARY BASIS PRIOR TO ANY INCIDENT WARRANTING DISCIPLINARY ACTION WILL NOT BE USED AS THE BASIS FOR DISCIPLINARY ACTION OR IN ANY DISCIPLINARY PROCEEDING. ON THE OTHER HAND, USING THE EAP WILL NOT BE A DEFENSE TO THE IMPOSITION OF DISCIPLINARY ACTION WHERE FACTS PROVIDING VIOLATION OF THIS POLICY ARE OBTAINED OUTSIDE OF THE EAP. ACCORDINGLY, THE PURPOSE AND PRACTICES OF THIS POLICY AND THE EAP ARE NOT IN CONFLICT BUT ARE DISTINCTLY SEPARATE IN THEIR APPLICATIONS. (2) . THROUGH THE EAP, THE CITY WILL PROVIDE APPROPRIATE ASSESSMENT, REFERRAL TO TREATMENT AND TREATMENT OF DRUG AND ALCOHOL ABUSE (SUBJECT TO THE PROVISIONS OF THE CITY'S HEALTH INSURANCE PLAN). SUCH EMPLOYEES MAY BE GRANTED LEAVE WITH A CONDITIONAL RETURN TO WORK DEPENDING ON SUCCESSFUL COMPLETION OF THE AGREED UPON APPROPRIATE TREATMENT REGIMEN AND IN ACCORDANCE WITH THE CAREER SERVICES RULES AND REGULATIONS AND ANY DEPARTMENTAL RULES AND REGULATIONS. AN EMPLOYEE'S BANK OF SICK OR VACATION TIME SHALL BE USED (IN THAT ORDER) FOR SUCH LEAVE. (3.) (4.) (5.) UPON SUCCESSFUL COMPLETION OF A DRUG AND/OR ALCOHOL TREATMENT PROGRAM AN EMPLOYEE MAY BE RELEASED TO RESUME WORK BUT WILL BE SUBJECT TO DRUG TESTING ON A PERIODIC BASIS, AT LEAST QUARTERLY FOR UP TO TWO YEARS THEREAFTER AS A CONDITION OF CONTINUED EMPLOYMENT. ONCE A VIOLATION OF THIS POLICY OCCURS, SUBSEQUENT USE OF THE EMPLOYEE ASSISTANCE PROGRAm, ON A VOLUNTARY BASIS, WILL NOT AFFECT THE DETERMINATION OF APPROPRIATE DISCIPLINARY ACTION. AN INDIVIDUAL'S PARTICIPATION IN THE PROGRAM WILL NOT BE MADE PART OF ANY PERSONNEL RECORDS, AND WILL REMAIN CONFIDENTIAL EXCEPT TO THE EXTENT NECESSARY TO COMPLY WITH THIS POLICY. MEDICAL AND INSURANCE RECORDS, IF ANY, WILL BE PRESERVED IN THE SAME CONFIDENTIAL MANNER AS ALL OTHER MEDICAL RECORDS AND BE RETAINED IN A SEPARATE FILE AS PROVIDED BY LAW. Rev. May, 1993 10 D. MANAGEMENT'S RESPONSIBILITY SUPERVISORS ARE RESPONSIBLE FOR IMPLEMENTING THE DRUG AND ALCOHOL FREE WORK PLACE POLICY. IT IS THE RESPONSIBILITY OF THE SUPERVISORS TO OBSERVE THE BEHAVIOR OF EMPLOYEES ON THE JOB AS A PRECAUTION AGAINST UNSTABLE OR UNRELIABLE BEHAVIOR WHICH COULD THREATEN THE SAFETY AND WELL BEING OF EMPLOYEES AND THE COMMUNITY. (i). SUPERVISORS ARE RESPONSIBLE FOR MAINTAINING A SAFE WORK ENVIRONMENT BY DETERMINING EMPLOYEES FITNESS FOR DUTY. (2) . IN THE EVENT A SUPERVISOR WITH THE CONCURRENCE OF A REPRESENTATIVE OF THE CITY MANAGER'S OFFICE OR THE PERSONNEL DIRECTOR OR HIS/HER DEPARTMENT REPRESENTATIVE , HAS A REASONABLE SUSPICION THAT AN EMPLOYEE MAY BE AFFECTED BY DRUGS OR ALCOHOL, THE EMPLOYEE MUST BE SENT FOR DRUG TESTING. A FORM FOR REPORTING THE REASON(S) FOR DRUG TESTING IS ATTACHED. (3) . IN ALL CASES WHEN AN EMPLOYEE IS BEING REMOVED FROM DUTY FOR DRUG TESTING, THE SUPERVISOR SHOULD NOTIFY HIS SUPERIOR AT THE EARLIEST POSSIBLE TIME. E. EMPLOYEES RESPONSIBILITY (1) . IT IS EACH EMPLOYEE'S RESPONSIBILITY TO BE FIT FOR DUTY WHEN REPORTING FOR WORK AND TO INFORM HIS SUPERVISOR IF HE IS UNDER PRESCRIPTION OR NON PRESCRIPTION MEDICATION WHICH MAY AFFECT JOB PERFORMANCE. (2) . IN THE EVENT AN EMPLOYEE OBSERVES BEHAVIOR WHICH RAISES A DOUBT AS TO THE ABILITY OF A CO-WORKER TO WORK IN A SAFE, RELIABLE AND TRUSTWORTHY MANNER, THE EMPLOYEE SHOULD REPORT THIS BEHAVIOR TO HIS SUPERVISOR. (3). EMPLOYEES WHO VOLUNTARILY ENTER A DRUG OR ALCOHOL TREATMENT AND/OR REHABILITATION PROGRAM AT THE REQUEST OR INSISTENCE OF THE CITY OR, AS A CONDITION OF CONTINUED EMPLOYMENT, ENTER A DRUG OR ALCOHOL TREATMENT AND/OR REHABILITATION PROGRAM ARE REQUIRED TO PARTICIPATE AND COMPLETE RECOMMENDED TREATMENT. ANY EMPLOYEE WHO ENTERS A DRUG OR ALCOHOL TREATMENT AND/OR REHABILITATION PROGRAM WILL BE RESPONSIBLE FOR PAYMENT OF THE TREATMENT AND/OR PROGRAM. IF THE EMPLOYEE FAILS TO COMPLY WITH THE TREATMENT AND/OR THE PROGRAM, THE EMPLOYEE WILL BE SUBJECT TO DISCIPLINE , UP TO AND INCLUDING TERMINATION. Rev. May, 1993 11 F. MEDICAL REVIEW OFFICER'S RESPONSIBILITIES (1) . THE MRO WILL REVIEW ALL INFORMATION FROM THE TESTING LABORATORY IN THE EVENT OF A POSITIVE, CONFIRMED TEST. THE MRO WILL REVIEW ANY INFORMATION FROM THE EMPLOYEE OR JOB APPLICANT REGARDING THE USE OF MEDICATION OR OTHER RELEVANT MEDICAL INFORMATION SET FORTH IN THE FORM SUBMITTED PRIOR TO DRUG TESTING. (2). THE MRO MAY REQUEST THAT THE TESTING LABORATORY PROVIDE QUANTIFICATION OF TEST RESULTS. (3). THE MRO WILL PROVIDE HIS INTERPRETATION OF POSITIVE, CONFIRMED TEST RESULTS TO THE PERSONNEL DIRECTOR OR HIS/HER DEPARTMENT REPRESENTATIVE. (4) . THE MRO WILL ASSIST EMPLOYEE'S IN AN EMPLOYEE ASSISTANCE PROGRAM, MONITOR SUCH EMPLOYEES PROGRESS AND CONFIRM COMPLETION OF THE TREATMENT PROGRAM. LIST OF DRUGS BY TRADE OR COMMON NAMES DRUGS OPIUM MORPHINE CODEINE ROBITUSSAN HEROIN HYDROMORPHIME MEPERIDINE (PETHIDINE) METHADONE OTHER NARCOTICS DEPRESSANTS CHLORAL HYDRATE BARBITURATES Rev. May, 1993 TRADE OR COMMON NAME DOVER'S POWDER, PAREGORIC, PARE- PECTOLIN MORPHINE, PECTORAL SYRUP TYLENOL WITH CODEINE, EMPIRIN COMPOUND WITH CODEINE, A-C DIACETYLMORPHINE, HORSE, SMACK DILAUDID DEMEROL, MEPERGAN DOLOPHINE, METHADONE, METHADOSE LAAM, LERITINE, NUMORPHAN, PERCODAN, TUSSIONEX, FENTANYL, DARVON, TALWIN, LOMOTIL NOCTEC, SOMNOS PHENOBARBITAL, TUINAL, AMVTAL NEMBUTAL, SECONAL, LOTUSATE, 12 Rev. BENZODIAZEPINES METHAQUALONE GLUTETHIMIDE OTHER DEPRESSANTS STIMULANTS COCAINE AMPHETAMINES PHENMETRAZINE METHYLPHENIDATE OTHER STIMULANTS DIDREX, HALLUCINOGENS LSD MESCALINE AND PEYOTE AMPHETAMINE VARIANTS PHENCYCLIDINE PHENCYCLIDINE ANALOGS OTHER HALLUCINOGENS CANNABIS MARIJUANA TETRAHYDROCANNABINOL HASHISH HASHISH OIL May, 1993 ATAVAN, AZENE, CLONOPIN, DALMANE DIAZEPAM, LIBRIUM, XANAX, SERAX, TRANXENE, VALIUM, VERSTRAN, HALCION, PAXIPAM, RESTORIL QUAALUDE DORIDEN EQUANIL, MILTOWN, PLACIDYL, VALMID NOLUDAR, COKE, FLAKE, SNOW, CRACK BIPHETAMINE, DELCOBESE, DESOXYN DEXEDRENE, METIATRIC PRELUDIN RITALIN ADIPEX, BACARATE, CYLERT, IONAMIN, PLEGINE, PRE-SATE, SANOREX, TEN-dATE, TEPANIL, VORANIL ACID, MICRODOT MESC, BUTTONS, CACTUS 2,5-DMA, PM_A, STP, MDA, MDMA TMA, DOM, DOB PCP, ANGEL DUST, HOG PCE, PCPy, TCP BUFOTENINE, IBOGAINE, DMT, DET, PSILOCYN POT, ACAPULCO GOLD, GRASS, REEFER, SINSEMOLLA, THAI STICKS THC HASH HASH OIL 13 OVER THE COUNTER AND PRESCRIPTION DRUGS WHICH COULD ALTER OR AFFECT THE OUTCOME OF A DRUG TEST ALCOHOL ALL LIQUID MEDICATIONS CONTAINING ETHYL ALCOHOL (ETHANOL). PLEASE READ THE LABEL FOR ALCOHOL CONTENT. AS AN EXAMPLE, VICK'S NYQUIL IS 25% (50 PROOF) ETHYL ALCOHOL, COMTREX IS 20% (40 PROOF), CONTAC SEVERE COLD FORMULA NIGHT STRENGTH IS 25% (50 PROOF) AND LISTRINE IS 26.9% (55 PROOF). AMPHETAMINES OBETROL, BIPHETAMINE, DESOXYN, DEXEDRINE, DIDREX CANNABINOIDS MARINOL (DRONABINOL, THC) COCAINE COCAINE HCI TOPICAL SOLUTION PHENCYCLIDINE NOT LEGAL BY PRESCRIPTION METHAQUALONE NOT LEGAL BY PRESCRIPTION OPIATES PAREGORIC, PAREPECTOLIN, DONNAGEL, PG, MORPHINE, TYLENOL WITH CODEINE, EMPIRIN WITH CODEINE, APAP WITH CODEINE, ASPIRIN WITH CODEINE, ROBITUSSIN A-C, GUIATUSS AC, NOVAHISTINE DH, NOVAHISTINE EXPECTORANT, DILAUDID (HYDROMORPHINE), M-S CONTIN AND ROXANOL (MORPHINE SULFATE), PERCODAN, VICIDIN BARBITURATES PHENOBARBITAL, TUINAL, AMYTAL, NEMBUTAL, SECONAL, LOTUSATE, FIORINAL, FIORICET, ESGIC, BUTISOL, MEBARIL, BUTABARBITAL, BUTABITAL, PHRENILIN, TRIAD BENZODIAZEPHINES ATAVAN, AZENE, CLONOPIN, DALMANE, DIAZEPAM, LIBRIUM, XANAX, SERAX, TRANXENE, VALID-M, VERSTRAN, HALCION, PAXIPAM, RESTORIAL, CENTRAX METHADONE DOLOPHINE, METHADOSE PROPOXYPHENE DARVOCET, DARVON N, DOLENE Rev. May, 1993 14 ATTACHMENT 1 LIST PRESCRIPTION DRUGS TAKEN WITHIN THE PAST DAYS. THIS IS FOR YOUR USE ONLY AT THIS TIME. THIRTY (30) Rev. May, 1993 15 ATTACHMENT 2 THE CITY OF BOYNTON BEACH TEST DIRECTION FORM I DIRECT NAME OF EMPLOYEE TO TAKE A DRUG AND/OR ALCOHOL TEST PURSUANT TO THE CITY OF BOYNTON BEACH DRUG FREE WORKPLACE POLICY AND WORK RULES. THIS DRUG TEST IS REQUIRED BECAUSE OF THE FOLLOWING REASON(S). (EXAMPLE: REASONABLE SUSPICION, ACCIDENT): THE ABOVE STATED REASON(S) WAS (WERE) WITNESSED BY: NAME OF OBSERVER/WITNESS NAME: POSITION: DATE: SIGNATURE ADDITIONAL WITNESS NAME: POSITION: DATE: SIGNATURE: Rev. May, 1993 16 NAME: DATE: ATTACHMENT 3 THE CITY OF EOYNTON BEACH FORM FOR REPORTING THE USE OF PRESCRIPTION OR NON-PRESCRIPTION MEDICATION PRESCRIPTION MEDICATION: NON-PRESCRIPTION MEDICATION: SIGNATURE: PRINT NAME: SOCIAL SECURITY NUMBER: Rev. May, 1993 17 ATTACHMENT 4 THE CITY OF BOYNTON BEACH PRE-EMPLOYMENT AGREEMENT PLEASE READ CAREFULLY I FREELY AND VOLUNTARILY CONSENT TO A DRUG AND ALCOHOL TEST OF MY URINE AND BLOOD AS PART OF MY APPLICATION FOR EMPLOYMENT. I UNDERSTAND THAT MY REFUSAL TO SUBMIT TO THE DRUG AND ALCOHOL TEST OR MY FAILURE TO QUALIFY ACCORDING TO THE MINIMUM STANDARDS ESTABLISHED BY THE CITY OF BOYNTON BEACH FOR THIS DRUG AND ALCOHOL TEST MAY DISQUALIFY ME FROM FURTHER CONSIDERATION FOE EMPLOYMENT. I FURTHER UNDERSTAND THAT UPON COMMENCEMENT OF EMPLOYMENT WITH THE CITY OF BOYNTON BEACH, I MAY AGAIN BE REQUIRED TO SUBMIT TO A DRUG AND ALCOHOL TEST. I UNDERSTAND THAT REFUSAL TO TAKE A REQUESTED TEST OR FAILURE TO MEET THE MINIMUM STANDARDS SET FOR THE TEST, MAY RESULT IN DISCIPLINE, UP TO AND INCLUDING TERMINATION. I HAVE READ IN FULL AND UNDERSTAND THE ABOVE STATEMENTS AND CONDITIONS OF EMPLOYMENT. THIS CONSENT DOES NOT INDICATE CONSENT BY THE APPLICANT TO RANDOM DRUG TESTING NOR DOES THIS CONSTITUTE A WAIVER OF AN APPLICANT'S RIGHT TO CHALLENGE TEST RESULTS. APPLICANTS SIGNATURE PRINT NAME WITNESSED BY (SIGNATURE) PRINT NAME DATE DATE Rev. May, 1993 18 ATTACHMENT 5 THE CITY OF BOYNTON BEACH CERTIFICATE OF AGREEMENT I HEREBY CERTIFY THAT I HAVE RECEIVED AND READ THE CITY OF BOYNTON BEACH, "DRUG FREE WORKPLACE POLICY AND WORK RULES" REGARDING SUBSTANCE ABUSE AND HAVE HAD THE POLICY EXPLAINED TO ME. I HEREBY CONSENT TO SUBMIT TO DRUG AND ALCOHOL TESTING OF MY BLOOD AND URINE AT ANY TIME REQUESTED BY THE CITY OF BOYNTON BEACH PURSUANT TO THE CITY'S POLICY. I ALSO UNDERSTAND THAT FAILURE TO COMPLY WITH A REQUEST TO SUBMIT TO A DRUG TEST OR A POSITIVE CONFIRMED RESULT FROM A DRUG TEST MAY LEAD TO TERMINATION OF MY EMPLOYMENT. THIS CONSENT DOES NOT INDICATE CONSENT BY THE EMPLOYEE TO RANDOM DRUG TESTING NOR DOES THIS CONSTITUTE A WAIVER OF AN EMPLOYEE'S RIGHT TO CHALLENGE TEST RESULTS. NAME (PLEASE PRINT) SIGNATURE WITNESSED BY PRINT NAME DATE DATE Rev. May, 1993 19