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POLICY AND PROCEDURE MANUALSUBJECT:Pre-Employment Drug Testing PolicyPOLICY NUMBER: II-Street Address
APPROVED: PAGES: 1 of 4DATE ISSUED: 10/31/2008DAVID BRODSKY DATE REVIEWED/REVISED: 04/06/21GENERAL POLICY:Montefiore Medical Center is committed to ensuring a safe, healthy, productive and efficient work environment for its Associates, patients and visitors. Accordingly, the Medical Center has established a pre-employment drug-testing program for job applicants and other individuals seeking to work, train or volunteer at the Medical Center.POLICY APPLICABLE TO:All applicants for temporary or regular employment, and all other individuals seeking to work, train, or volunteer at Montefiore Medical Center, including interns, residents, independent contractors who will work on site and individuals referred through employment agencies (hereinafter referred to collectively as applicants). Applicants must undergo and pass a drug test before they may actually commence employment, work, training or volunteer activity at Montefiore Medical Center. The pre-employment drug testing policy does not apply to persons under 18 years of age. PROCEDURE:Montefiore Medical Centers pre-employment drug testing procedure complies with applicable federal, state and local law.All applications (as defined above) must undergo a pre-employment drug test and must receive a negative test result as a condition of employment, work, training or volunteer activity (unless an exception applies under federal, state or local law). The pre-employment drug test is administered after the applicant receives from Montefiore Medical Center a conditional offer of employment, work, training or volunteer opportunity. At the time Montefiore Medical Center extends to the applicant a conditional offer of employment, work, training or volunteer opportunity, the applicant will promptly be provided with the documents and/or information they will need to comply with the pre-employment drug testing procedure. These documents include:A drug testing authorization form.A list of drug testing collection sites approved by the certified laboratory from which applicant will select the most convenient site.An acknowledgement and consent form which the applicant must return to the Recruitment Department at the time they receive a copy of this policy. Candidate's Name
POLICY AND PROCEDURE MANUALSUBJECT:Pre-Employment Drug Testing PolicyPOLICY NUMBER: II-15APPROVED: PAGES: 2 of 4DATE ISSUED: 10/31/2008DAVID BRODSKY DATE REVIEWED/REVISED: 04/06/21An applicant is required to provide a urine specimen at an approved collection site within forty-eight(48) hours of receiving from Montefiore Medical Center an offer of employment, work, training, or volunteer opportunity. If the day after the applicant receives such an offer is not a business day in which a collection site is open, the applicant will be allowed seventy-two (72) hours to provide the urine specimen.Negative Test ResultsThe HR Recruiter will be informed by the certified laboratory of negative test results within two (2) days from the collection date.Positive Test ResultsWhen an applicant tests positive for drugs, the certified laboratory will automatically retest the original specimen before concluding that the test result is positive. The Medical Officer (MRO) will then contact the applicant directly to review positive test results. If the MRO determines that there is no valid reason for the positive tests results, the applicant will be ineligible to work, train, or volunteer at Montefiore Medical Center.Negative Dilute ResultsWhen a test result comes back as a negative dilute, the applicant will be given an opportunity to re- test once within a 24 hour timeframe. If the second test result comes back as a negative dilute again, the applicant will be ineligible to work, train, or volunteer at Montefiore Medical Center. Refusal to Submit to a Drug TestAlthough an applicant has the right to refuse to submit to a pre-employment drug test, Montefiore Medical Center will not consider the applicant who so refuses. Moreover, Montefiore Medical Center will consider the following conduct by an applicant as a refusal to submit to a drug test:Refusing or failing to appear to a substance abuse test within a specified time, as determined by Montefiore Medical Center, after being directed to do so;Failing to remain at the testing site until the testing process is complete;Falling to provide a urine specimen for collection; failure to provide a sufficient amount of urine when directed, without an adequate medical explanation;Failing or declining to take a second drug test that Montefiore Medical Center or collector has directed to be taken;Failing to undergo a medical examination or evaluation, as directed by the MRO as part of the verification process, or as directed by Montefiore Medical Center as part of the shy bladder procedures;Adulterating or substituting a urine sample, or attempting to adulterate or substitute a urine sample; orCandidate's Name
POLICY AND PROCEDURE MANUALSUBJECT:Pre-Employment Drug Testing PolicyPOLICY NUMBER: II-15APPROVED: PAGES: 3 of 4DATE ISSUED: 10/31/2008DAVID BRODSKY DATE REVIEWED/REVISED: 04/06/21Failing to cooperate with any part of the testing process such as delaying the collection, testing or verification process or otherwise engaging in conduct that obstructs or manipulates, or attempts to obstruct or manipulate, the testing process. Questions regarding the meaning or application of this policy should be directed to the Montefiore Medical Center Recruitment Department.This policy is not a contract of employment. If an applicant fails to comply with this policy, the applicant will be ineligible for employment.All Medical Center Candidate's Name
POLICY AND PROCEDURE MANUALSUBJECT:Pre-Employment Drug Testing PolicyPOLICY NUMBER: II-15APPROVED: PAGES: 4 of 4DATE ISSUED: 10/31/2008DAVID BRODSKY DATE REVIEWED/REVISED: 04/06/21Pre-Employment Drug TestingAcknowledgement and Consent FormI have received a copy of Montefiore Medical Center's policy regarding pre-employment drug testing and the documents/information referred to in the policy. I have reviewed the policy, information, and the documents and I have been given the opportunity to ask questions. I understand the terms of the policy and I understand that I will not be eligible to work, train or volunteer at the Medical Center if I receive a positive drug test result (unless an exception applies under federal, state or local law) or two negative dilute results. I voluntarily consent to the pre-employment drug testing described in the policy and related documents.I hereby authorize the certified laboratory and Medical Review Officer referred to in the policy to provide the results of such testing to Montefiore Medical Center.Applicant Name (Print) Applicant Signature Date

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