Comm. 626 (09/21)
Drug Testing,
Practice, Policy,
and Protocols
Effective August 2021
Drug Testing, Practice, Policy, and Protocols Page i
Comm. 626 (09/21)
Table of Contents
DHS Drug Testing Policy and Practice .............................................................. 1
Purpose of Drug Testing ............................................................................... 1
Limitations of Drug Testing ........................................................................... 1
Appropriate Use of Drug Testing .................................................................... 1
DHS Approach to Drug Testing ...................................................................... 2
Drug Testing Based on Behavioral Indicators ................................................... 3
Drug Testing Services for the Parent/Caretaker .............................................. 4
Effective Use of Drug Testing ........................................................................ 4
Sharing Drug Testing Results With the Parent/Caretaker ................................... 5
A Relapse or Return to Use ........................................................................... 5
Drug Testing Training, Resources, and Supports .............................................. 6
Service Area Drug Testing Coordinators .......................................................... 6
DHS Laboratory and Collection Services Contracts ........................................... 7
Drug Testing Laboratory and Collection Services Contractors ............................. 7
Types of Drug Testing .................................................................................. 8
Modes of Collection ...................................................................................... 8
Costs of Laboratory and Collection Drug Testing Services .................................. 8
Drug Testing Laboratory Costs ............................................................... 8
Drug Testing Collection Costs ................................................................. 9
Court Testimony........................................................................................ 10
DHS Drug Testing Protocols ........................................................................... 11
Authorizing Drug Tests ............................................................................... 11
Types of Drug Tests ................................................................................... 11
Drug Tests and Detection Times .................................................................. 12
Modes of Collection .................................................................................... 13
Fixed Site Testing ............................................................................... 13
In-Home Testing ................................................................................ 13
Emergency Testing ............................................................................. 14
Frequency and Duration of Drug Testing ....................................................... 15
DHS Drug Testing Authorization System ....................................................... 15
DHS Statewide Drug Testing Guidelines ......................................................... 17
Child Abuse Assessments and Drug Testing ................................................... 17
Court Ordered Drug Testing ........................................................................ 17
Drug Testing Services for Children ............................................................... 18
DHS Statewide Drug Testing Procedures ....................................................... 18
Drug Testing, Practice, Policy, and Protocols Page 1
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DHS Drug Testing Policy and Practice
Purpose of Drug Testing
Drug testing is the process by which a sample of hair, sweat, or urine is obtained from a
donor’s body and through laboratory analysis; the sample is chemically analyzed to
determine the presence of certain legal or illegal substances. In child welfare, drug testing
is conducted to better protect children. Drug testing results often assist in the effort to
identify or eliminate substance abuse as a possible contributing factor or risk in a child
abuse assessment or child welfare service case. Drug testing may indicate a
parent/caretaker’s past substance use or the absence of an illegal substance. Drug testing
may also be used as a check against a parent/caretaker’s verbal assertions in regards to
usage or to confirm or contradict what has been learned through direct observation and
information gathered from other sources and assessments. With regard to children, drug
testing may indicate possible ingestion or exposure to drugs.
Limitations of Drug Testing
Drug testing results do not reveal the existence nor the absence of a substance abuse
disorder. Results cannot detect low levels of substance use or substance use that occurred
outside of the detection period. Drug testing results can only determine if a drug or its
metabolite is present at or above the established concentration cutoff level. With regard to
child welfare, drug testing is limited in terms of its ability to provide sufficient information
in determining or predicting a parent/caretaker’s behavioral patterns or their ability to
parent effectively. As such, drug testing does not indicate how substance use is impacting
parenting or child safety. Due to these limitations, drug testing results should not be relied
on as the sole measure in determining issues of danger and risk. Drug testing results
should be viewed as one component of the accumulated information that needs to be
considered during a child abuse assessment and an ongoing child welfare service case.
Appropriate Use of Drug Testing
Drug testing is considered appropriate:
When used to identify and/or eliminate substance abuse as a possible contributing
factor or risk in a child abuse case
When used as part of a comprehensive assessment to identify and address or to
monitor danger and risks to a child
As a check against a parent/caretaker’s verbal assertions in regards to usage
To confirm or contradict what has been learned through direct observation and
information gathered from other sources and assessments.
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DHS Approach to Drug Testing
It is important that Department of Human Services (DHS) child welfare workers have a
working knowledge of substance abuse and the potential risk it poses to child safety.
Substance abuse can lead to drug addiction and chemical dependency. Addiction is a
chronic illness that has a powerful and adverse impact on brain functions to the point that
an individual can experience a compulsive need for drugs regardless of any consequences.
Recovery can be a long-term process which often requires months of substance abuse
treatment and aftercare services for a person to sufficiently stabilize his or her life.
Equally important is that DHS child welfare workers understand their role when working
with a parent/caretaker who is dealing with a substance abuse disorder. That role is to
support the client’s treatment and recovery and to reduce barriers to services whenever
possible. This is in contrast to a more punitive approach in which the emphasis is on
“catching clients” through drug testing and punishing the parent/caregiver in some way if
caught. DHS child welfare workers who are working with client’s who are suffering from a
substance abuse disorder or addiction should also be mindful of the language they use. In
practice, this includes refraining from such things as labeling the parent/caretaker as
“cheaters” of drug testing. Such language indicates a lack of understanding that relapse is
often a part of substance abuse treatment and recovery. The role of the DHS child welfare
worker should include the use of strength-based language and strategies that assist the
parent/caretaker in moving to a more functional level of behavior through abstinence as
well as, adherence to the appropriate treatment plan goals regarding substance abuse
recovery.
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Drug Testing Based on Behavioral Indicators
Whenever possible drug testing should be limited to situations where behavioral indicators
have been observed and/or reported that could potentially impact a child’s safety.
Behavioral Indicators that have been observed and/or reported should be documented in
the Child Abuse Assessment, Case Plan, and/or Case Notes.
The National Center on Substance Abuse and Child Welfare offers a listing of some of
physiological signs and symptoms that drug use may cause and what signs to watch for in
the home environment. By observing the person and the home environment important
indicators of drug use may become apparent.
National Center on Substance Abuse and Child Welfare:
Behavioral Indicators
Personal Appearance
Physical Environment
Agitated behavior or mood
Excessive talking
Paranoia
Depression
Manic behavior
Lack of motivation
Criminal activity
Financial challenges
Missed appointments
Slurred speech
Nodding off
Disorientation
Tremors
Cold or sweaty palms
Dilated or constricted
pupils
Bloodshot or glazed-
over eyes
Needle marks
Bruises
Poor personal
hygiene
Signs of drug
paraphernalia (such as
straws, rolling papers,
razorblades, small
mirrors, glass pipes,
aluminum foil, lighters,
needles, syringes,
tourniquets, belts,
shoelaces, spoons)
Unusual smells
Reluctance to allow
home visits
Unexplained visitors in
and out of home
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Drug Testing Services for the Parent/Caretaker
It is essential that the parent/caretaker who is receiving drug testing services understand the
purpose of drug testing and the procedures involved within the context of child welfare services.
In an effort to engage the parent/caretaker in drug testing services the following information
should be shared with the parent/caretaker in a non-shaming open-ended way:
The purpose of drug testing (to assist in case planning and to monitor progress if substance
abuse treatment services are warranted).
The process and procedures involved in taking a drug sample.
What random drug testing means and how to access the CIJDC collection site information
online including hour of operation for the day: https://www.cijdc.com/today.pdf
The current collection methods (urine, sweat patch and hair test) that DHS uses in drug
testing.
What a positive or negative test result means (A positive test indicates a substance was
detected. A negative test indicates that no drugs or metabolites were detected above the
cutoff level in the sample tested).
The need for complete disclosure of any medical conditions, prescriptions, and/or over-the-
counter drugs and medication taken by the parent/caretaker. (With the increase in
prescription drug abuse it is important to get an accurate history of current and recent
prescriptions and over-the-counter medication).
How and when the parent/caretaker will receive their drug testing results.
How DHS will use the drug testing results in assessing their child’s safety.
The services and supports available to parents/caretakers who may have a positive test
result.
How DHS may interpret a refusal to undergo a drug test.
Effective Use of Drug Testing
Drug testing may be an incentive for the parent/caretaker to stop using drugs.
Drug Testing may serve as a positive reinforcement for continued abstinence during the
early recovery stage.
Drug Testing may motivate the parent/caretaker to enter or continue with treatment
services.
Drug Testing may encourage a parent/caretaker to self-disclose.
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Sharing Drug Testing Results With the Parent/Caretaker
A discussion of the drug testing results with the parent/caretaker should be done in a
timely manner when warranted. A negative result can provide positive reinforcement and
encouragement for a parent/caretaker to participate in treatment interventions and case
planning.
A positive drug test result may mean a one-time lapse or it may signal a return to
chronic use. The DHS child welfare worker should communicate the test results directly to
the parent/caregiver. Positive and non-stigmatizing language should be used when
discussing drug test results such as, using the terms positive or negative result verses
clean or dirty results. When a positive test result is received, discuss with the
parent/caretaker the possible need for alternative interventions and/or adjustments in the
current treatment services. Where applicable, discussions should also include the
substance abuse treatment provider. If behavioral, relational, psychological, and/or
physical indicators of substance abuse are present and the parent/caretaker‘s ability to
provide safe care for the child is in question, the danger and risk to the child should be
reassessed to ascertain if any safety factors have risen to the level of a safety threat. If
so, safety planning is needed.
A Relapse or Return to Use
A relapse or a return to use can be part of the recovery process. A positive test may signal
that the current treatment plan and/or services need to be modified or added to. Following
a positive test result, discuss with the parent/caregiver what happened before, during, and
after the use. If a safety plan is part of the case, ask if it was enacted. Ask the
parent/caregiver what they will do next time to avoid use and/or to ensure child safety.
Consult with the supervisor and the treatment provider to determine if adjustments to the
treatment plan and/or to the drug testing schedule are needed.
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Drug Testing Training, Resources, and Supports
Drug testing training and other additional resources and supports are available to all DHS child
welfare workers.
Substance abuse training is available to all workers and can be found on the DHS Learning
Management System (LMS).
Drug testing information can also be found on the DHS Drug Testing SharePoint:
http://dhssp/fo/Service/Drug%20Testing/Forms/AllItems.aspx . A variety of different
resources are available at this site including documents and reports on laboratory analysis of
drug testing, Iowa court rulings in drug testing cases, expert opinions on toxicology reports,
and a Q & A document regarding the different types of drug tests that are available under
the DHS contracts.
DHS child welfare workers are encouraged to consult with any treatment providers who may
be involved in the case. Input from substance abuse and mental health providers as well as,
medical personnel can provide additional insight into the parent/caretaker’s substance abuse
disorder and their treatment needs. Such information may help to improve child safety.
An excellent resource for DHS child welfare workers is the website for the National Center on
Substance Abuse and Child Welfare: http://ncsacw.samhsa.gov . This website offers
technical assistance and a large number of resources including publications, webinars, and
tools that child welfare workers can use to better serve children and families that are
involved in the child welfare system due to substance abuse issues.
Service Area Drug Testing Coordinators
Each of the five DHS Service Areas has designated a Service Area Drug Testing
Coordinator to perform duties related to the Drug Testing Laboratory and Collections
contracts. These persons are responsible for the day-to-day implementation of drug
testing services within their respective Service Area and for providing ongoing consultation
and technical assistance to staff. Additional tasks assigned to the Drug Testing
Coordinators include: arranging for and approving the purchase of supplies from the
laboratory contractor, reviewing and submitting invoices to payments and receipts for final
processing, calculating the collection error data, and working with the contractors to
resolve any Service Area issues that may arise in the provision of services. Service Area
Drug Testing Coordinators also receive and review all Service Area requests regarding the
internal drug testing authorization process.
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DHS Laboratory and Collection Services Contracts
DHS has two statewide contracts for the purpose of securing drug testing services. This includes
a contract for Drug Testing Laboratory Services and a contract for Drug Testing Collection
Services. The move to statewide drug testing contracts was related to the need for cost
containment in this area and statewide consistency in collection services and laboratory
analysis. Benefits gained from having instituted statewide Collection and Laboratory contracts
include the following:
Certification Requirements for Laboratory Contractor. Certifications requirements
include the College of American Pathologists, the federal Substance Abuse and Mental Health
Services Administration (SAMHSA) and the Clinical Laboratory Improvement Amendments
Program.
Standardized cutoff levels. Industry standard cut off levels established through the
Federal Government Substance Abuse and Mental Health Services Administration are
required when applicable for drug testing analysis under these contracts to ensure that all
testing of all DHS clients is handled in the same manner.
Uniformity in confirming tests. All laboratory testing incorporates immunoassay
technology. Positive results are verified by Gas Chromatography/Mass Spectrometry
(GC/MS), Liquid Chromatography/Mass Spectrometry (LC/MS) or Liquid Chromatography –
Mass Spectrometry/Mass Spectrometry (LC-MS/MS).
Statewide Drug Testing Protocol. The Laboratory and Collections contracts reflect the
drug testing protocol that is aligned with the federal Substance Abuse and Mental Health
Services Administration (SAMHSA) requirements.
Drug Testing Laboratory and Collection Services Contractors
The Contractors for drug testing services are listed below followed by a description of the
key provisions within the contracts including; the types of drug testing that are available,
the modes of collections, the current costs of Laboratory and Collection services, and the
availability of court testimony.
Laboratory Contractor
CSS, LLC (Comprehensive Screening Solutions)
20 E Clementon Road
Suite 201-S
Gibbsboro, NJ 08026
Collection Contractor
Central Iowa Juvenile Detention Center (CIJDC)
2317 Rick Collins Way
Eldora, IA 50627
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Types of Drug Testing
The following types of tests are available under the current Laboratory and Collection Drug
Testing contracts:
Lab-Based Urine
Hair
Sweat Patch
Point of Collection “Instant” Tests for urine screening
Modes of Collection
Under the Drug Testing Collection Services Contract there are three modes of collection.
These include Fixed Site, In-Home and Emergency testing. The modes of collection
services are discussed in detail later in this report
Costs of Laboratory and Collection Drug Testing Services
Following are the costs for drug testing laboratory services and the costs for collection
services. It is important to note that these are two separate services with costs associated
with each.
Drug Testing Laboratory Costs
Laboratory service costs are per person and type of test conducted.
Laboratory Drug Testing Costs
07/01/2021 – 06/30/2022
Type of Drug
Cost Per Test
Hair - 5 Panel
$70.38
UA - 9 Panel
$15.50
UA - 9 Panel + Alcohol
$17.54
UA - 14 Panel
$30.86
Canceled or Rejected Specimen for Analysis
$15.00
Purchased Items
Sweat Patch - 5 Panel - Sweat Patch includes cost of Laboratory
Analysis. (Minimum order quantity - 50 per box)
$39.27
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Drug Testing Collection Costs
Collection Service Costs are per person and by the collection mode used. As
such, the cost for a drug test per person may differ depending on the type of drug
test that is conducted and the collection mode that is used.
Drug Testing Collection Costs
07/01/2021 – 06/30/2022
Basic Collection Type (Fixed Site Collection)
Cost Per
Collection
Hair
$72.10
UA
$72.10
Sweat Patch
$72.10
Instant Urine
$72.10
Additional Charge (In-Home & Emergency Collections)
In-Home Trip Fee
$200.58
Emergency Collection
$296.64
Charges per collection are adjusted up or down depending on volume, so the actual
cost may vary depending on the volume. If multiple persons are tested at same
household address, the Collector is able to charge a collection fee of $72.10 for each
sample collected.
EXAMPLE:
DHS authorizes the Collection Contractor to conduct an In-Home collection at a family’s
home. The Collection Contractor is to collect a UA 9 panel sample from the mother, the
father, and the 16 year old son. The charges for this collection are as follows:
First attempt, the collections were made:
Attempt/ charge for In-Home Testing = $ 200.58
Collection fee for the mother’s sample = $ 72.10
Collection fee for the father’s sample = $ 72.10
Collection fee for the son’s sample = $ 72.10
Total cost for In-Home Collection= $ 416.88
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Court Testimony
Requests for expert court testimony shall be made through the Service Area Drug Testing
Coordinator. The Drug Testing Coordinator will contact and work with the Laboratory
Contractor on the request and will work the Drug Testing Collection Contractor when
required. All requests for expert court testimony must be approved by the Service Area
Manager (SAM), Social Work Administrators (SWA), and/or Designee.
Expert Court Testimony Costs
07/01/2021 – 06/30/2022
Collections Services
By phone per hour (Services available only by phone)
$72.10
Laboratory Services
By phone per hour (Services available only by phone)
Varies based on level of expertise
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DHS Drug Testing Protocols
The following DHS Drug Testing Protocols reflect the parameters and procedures contained
within the current Drug Testing Laboratory and Collection Services contracts and the most
recent changes (August 2021) to the DHS Drug Testing Authorization System.
Authorizing Drug Tests
The Collection Contractor is responsible for providing drug testing collection services at the
request of the DHS child welfare worker. To initiate drug testing services, the DHS child
welfare worker must authorize the testing through the DHS Drug Testing Authorization
System that is located in JARVIS. When authorizing a drug test the worker must enter the
following information into the system prior to the Collector collecting a sample:
Type of drug testing to be conducted (Urine, Hair, Sweat Patch)
Mode of collection (Fixed-Site, In-Home, or Emergency)
Frequency of the drug testing (Number of tests)
Duration of the testing (Over what time period the testing will be conducted)
Types of Drug Tests
Under the statewide DHS Drug Testing Laboratory Services Contract, the number and
types of illegal drugs that can be tested in the same panel has been standardized. This
allows for the bundling of compatible kinds of illegal drugs that can be analyzed in the
same laboratory procedure which ultimately results in cost savings.
Below are the test panels that are available under the Drug Testing Laboratory Services
Contract followed by a listing of the drugs that each panel can detect:
Urine 9 Panel Test - detects THC/marijuana, cocaine, opiates, PCP, benzodiazepines,
barbiturates, methadone, propoxyphene, and amphetamines.
Urine 9 Panel Test +Alcohol – detects all of the 9 drugs listed above plus alcohol.
Instant Tests 10 panel – this test corresponds to the 9 panel Urine. The 10
th
panel is
for measuring urine Temperature. If an instant test produces a presumptive positive,
then the sample will be submitted to the laboratory for analysis.
Patch 5 Panel - detects THC, opiates, amphetamines, cocaine, and PCP.
Hair Test 5 Panel - detects Amphetamines (Amphetamine, Methamphetamine,
Ecstasy (MDMA), MDA-Methylenedioxy, and MDEA (Eve); Cocaine/Metabolites
(Benzoylecgonine, Cocaine, Cocaethylene, and Norocaine); Marijuana Metabolite
(THCA), Opiates (Morphine, Codeine, 6-Monoacetylmorphone (6-MAM) Heroin,
Hydromorphone, Hydrocodone, Oxycodone, Oxymorphone) and Phencyclidine.
Urine 14 Panel based detects THC/marijuana, cocaine, opiates, barbiturates,
methadone, propoxyphene, amphetamine, fentanyl, meperidine, nalbuphine,
oxycodone, oxymorphone, and pentazocine.
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Drug Tests and Detection Times
Timing is a critical factor in drug testing. How long a drug remains in the body is
dependent upon the specific drug used, the amount of drug that has been introduced into
the person’s body, the frequency of the drug use, and the person’s metabolism. The
window of detection for each drug type should be considered in determining
which test panel should be used in collecting the specimen.
Strengths and Limitations of the Drug Tests
In selecting the appropriate test panel to use, it is important that the DHS child welfare
worker be familiar with the strengths and limitations of the drug tests that are available
under the current DHS Laboratory and Collection contracts.
Urine Testing. Most illicit drugs are excreted into urine within 48 hours after use.
Urine testing is widely used based on its well-researched results for detecting drug
usage in adults and for its cost effectiveness. A disadvantage of urine testing is that the
specimen may be adulterated, substituted or diluted without careful observation during
the collection process. As such, a urine test can be considered invasive and
uncomfortable.
A Hair specimen test can detect drug use over several months depending on the
length and type of the hair specimen. Additional advantages of hair testing include: the
ability to pinpoint long-term changes in drug use patterns, difficulty of substituting
specimens or invalidating the test results, and the non-invasive collection method.
Disadvantages of hair testing are the test’s inability to detect drug use within the past
3 – 5 days and the fact that the test does not discriminate between recent drug use
and drug use that possibly occurred months earlier. Due to these limitations hair
testing is not consider an effective way to monitor compliance on a regular basis.
Sweat patch specimens are collected by applying a gauze patch with a tamper-
evident adhesive seal directly to the skin for typically a 7-day period. The patch is
usually applied to the upper arm or upper back. A sweat patch is relatively non-
invasive and is difficult to tamper with. The window of detection for a sweat patch is 1-
2 days prior to the application and up to seven days after or whenever the patch is
removed. Limitations for a sweat patch includes the limited number of drugs it detects
and the possibility of contamination during the application and removal process.
Point of Collection “Instant” Tests for urine may be used if there is need for an
immediate, preliminary result determination. An understanding of a presumptive
positive test is essential when using an Instant test. When considering this type of
testing it is always advised to obtain lab-based GC/MS or equivalent confirmation
before making significant case-related decisions or seeking court action based on a
positive result. Without obtaining a lab-based GC/MS or equivalent confirmation, an
instant test result is not always legally defendable in court. The DHS child welfare
worker should make sure the court accepts instant test results before authorizing this
method of collection.
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Modes of Collection
Under the Drug Testing Collection Services Contract there are three modes of collection.
These include Fixed Site, In-Home and Emergency testing. All collected samples,
regardless of the mode of collection that is used, are to be submitted to the laboratory
facility for analysis within two (2) business days of collection.
Fixed Site Testing
Fixed-Site Testing means that the client physically goes to a specific site or location
to complete a drug test. The number and locations of the Fixed –Sites were
determined by each Service Areas. A listing of the locations of Fixed-Sties can be
found at: https://www.cijdc.com/today.pdf
The days and operational hours at Fixed-Sites are randomized with those
areas doing a lower volume of drug testing having less hours of operation
compared to a high-volume area.
The Collection Contractor sends out a Drug and Alcohol Testing Calendar with
the hours of operation for each of the Fixed-Site locations 10 days prior to the
beginning of the month. The monthly schedule is sent by email to the Service
Area Manager (SAM), Social Work Administrators (SWA), and/or Designee.
If changes need to be made to the monthly Drug and Alcohol Testing Calendar,
the Collection Contractor will send out a revised Drug and Alcohol Testing
Calendar with the changes highlighted to the Service Area Manager (SAM),
Social Work Administrators (SWA), and/or Designee affected.
All Fixed-Site attempts and/or collections are documented and reported to
the designated Service Area.
In-Home Testing
To address drug testing needs in areas where Fixed-Sites are not located or easily
accessible, In-Home testing is available. “In-Home Testing” means that the
Collector physically goes out to the client’s home or an address as arranged to collect
a sample. An “In-Home Collection Attempt” means the physical arrival of the
Collector at the client’s home or address as arranged and includes the related
collection efforts performed at the home or address to obtain a sample for laboratory
drug testing analysis.
In-Home Testing must be approved by the Service Area Manager (SAM), Social
Work Administrators (SWA), and/or Designee.
In-Home Testing should be limited to those circumstances in which distance
and/or transportation are an issue and DHS cannot demonstrate reasonable
efforts without bringing the test to the parent/caretaker. To minimize the need for
In-Home Testing, workers should attempt to problem solve with the client
regarding the use of informal supports to assist the client in accessing a Fixed-Site
location for drug testing.
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The Collector will make an In-Home collection attempt or collect the specimen
within 3 calendar days of the referral
A maximum of two attempts to collect an In-Home specimen is allowed.
DHS will not reimburse the Collection Contractor beyond one attempt per day,
up to a maximum of two attempts. A phone call does not constitute an attempt
and cannot be billed.
As only two In-Home collection attempts, it is essential that the authorization
include the correct address, any unique or case specific information
regarding the location and/or barriers to accessing the place of
collection, and the time that the client will be available.
All In-Home attempts and/or collections will be documented in a
collection log and reported/sent to the designated Service Area Manager
(SAM), Social Work Administrators (SWA), and/or Designee.
Emergency Testing
In addition to Fixed-Site and In-Home collection services, the Drug Testing Collection
Services Contract allows for Emergency Testing. “Emergency Testing” means an
expedited test is required. Emergency Testing is to be limited to rare occasions
such as during a child abuse assessment when an immediate drug test may
be required.
Emergency Testing must be approved by the Service Area Manager (SAM),
Social Work Administrators (SWA), and/or Designee.
Emergency Testing is available at all hours and includes weekends.
Emergency Testing may be conducted in the home of the client or at an
agreed upon location.
After an Emergency Testing authorization is approved, the DHS referral worker
and/or supervisor must contact the Collection Contractor by email or phone
to notify them of the request for an emergency test. The number and email for
CIJDC is:
Phone: 641-858-3852
Email address: drugtes[email protected]m
Within one hour of receiving an approved authorization for Emergency Testing,
the Collection Collector will respond to the referring DHS worker and/or supervisor
by email or phone verifying receipt of the authorization.
The Collection Collector shall collect the specimen or make an attempt to collect
a sample within two days of the referral.
The Collector shall make only two Emergency attempts to collect a specimen.
DHS will not reimburse beyond one attempt per day, up to a maximum of two
total attempts.
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All Emergency Testing attempts and/or collections will be documented and
reported to the designated Service Area Manager, Social Work Administrators
and/or Designee.
Frequency and Duration of Drug Testing
When determining the frequency and duration of drug testing, or the modification of either
or both of these, input may be sought from the supervisor and the Service Area Drug
Testing Coordinator. To determine the frequency and duration of drug testing, a number of
factors should be taken into account including:
If behavioral, relational, psychological, and/or physical indicators have been observed
and/or reported.
Type of drug being used.
The detection time for each type of drug.
Any current clinical diagnosis.
Severity of the parent/caretaker’s substance use disorder.
Parent/caretaker’s historical patterns of use.
Any input from the substance abuse treatment provider and/or other professionals
working with the family.
DHS Drug Testing Authorization System
The DHS Drug Testing Authorization System was redesigned to promote the use of
behavioral indicators in determining the need for testing and to support best practice
decisions in terms of the type of test that should be authorized and the frequency and
duration of testing. To this end, guidance features that highlight best practice and help
workers determine the appropriate type of test to authorize are available within the
authorization system. Workers can now access information within the system on each type
of test and what drugs a particular test can detect. In addition to the guidance features,
the DHS Drug Testing Authorization System includes a checks and balance aspect whereby
Supervisors are required to approve test(s) in certain circumstances with an effort to
prevent unnecessary testing.
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The redesigned Drug testing Authorization System also allows for data collection. Drug
testing information and data are being collected to better understand child welfare
practices and needs. The information will be used to help identify what changes and/or
adjustments may be needed to DHS policy and procedures regarding drug testing. The
information and data that is being collected includes the following:
Information regarding Court Orders
Documentation of Behavioral Indicators
Length of time the case has been opened
Substance Abuse Treatment Services
Supervisory Approvals
If DHS workers have problems accessing and/or entering an authorization in the DHS Drug
Testing Authorization System they should contact the DHS, CWIS Help Desk at:
cwishelp@dhs.state.ia.us.
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DHS Statewide Drug Testing Guidelines
Following are the DHS Statewide Drug Testing Guidelines that reflect best practices in the area
of drug testing. Any DHS drug testing beyond these guidelines is not recommended but they do
not preclude the use of a lesser frequency and/or stopping drug testing altogether if the
situation or results warrant it. As drug usage increases and as new drugs emerge on the scene,
DHS policies and procedures will be added and/or amended to these guidelines to reflect the
changing trends and practices.
Child Abuse Assessments and Drug Testing
One test per client is allowed during a child abuse assessment. Any type of test (urine,
sweat patch, hair) may be authorized.
At the request of DHS, a health practitioner may perform drug testing of a child before
or during a child abuse assessment when the practitioner has determined that it is
medically indicated.
Drug testing should not be authorized during a Family Assessment.
Drug testing requested by a DHS child protection worker should be performed
whenever possible during the child abuse assessment. If the drug test is authorized
and scheduled before the conclusion of the assessment, but cannot be administered
before the completion of the assessment or the results have not yet been received,
document in the written report that an Addendum will be submitted.
Court Ordered Drug Testing
If drug testing is court-ordered and the court order is prescriptive as to the type,
frequency and duration of testing, the drug testing should follow the court order.
Document this in the Child Abuse Assessment, Case Plan, and/or Case Notes.
If the court order states drug testing at the discretion of DHS or drug testing with
no other specifics, the DHS Statewide Drug Testing Guidelines in this Protocol
are to be followed.
If drug testing is court-ordered and DHS believes the testing level could be decreased,
a recommendation as such, should be made to the court.
Inform the court when the parent/caretaker is participating in drug testing with
other agencies as the court may accept drug testing results from other agencies.
Within the DHS Authorization System, any type of test is allowed with a court
order. The type of test authorized may vary for a person throughout the duration of
testing or as specifically stated in the court order.
When authorizing court ordered testing, workers will be asked to enter the Court
Order docket number, the effective date of the court order, and the name of
issuing Judge.
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Drug Testing Services for Children
Service Areas should continue to follow their current practice for screening infants and
children through the Child Protection/Advocacy Centers. While under the current Drug
Testing Collections Contract CIJDC is able to provide drug testing for children, it is in very
limited circumstances and is dependent upon the developmental level of the child. For
example, CIJDC cannot do drug testing on infants. CIJDC could do a hair collection on a
five year old with sufficient hair but attempting to capture a UA for this same child would
not be an option.
DHS Statewide Drug Testing Procedures
Whenever possible drug testing should be limited to situations where behavioral
indicators have been observed and/or reported. Behavioral indicators are to be
documented in the Child Abuse Assessment, Case Plan and/or in Case Notes.
One test per client is allowed without a court order when behavioral indicators
have been observed and/or reported and have been documented. Any type of test
(urine, sweat patch, hair) may be ordered. The authorization will be active for 30 days.
The DHS Drug Testing Authorization System will indicate if there is already a
current/active test and the expiration date of that test.
A retest is warranted under the following conditions: if the sample provided (hair
or urine) was insufficient for the lab analysis and as result, the lab had to cancel the
analysis; if the lab analysis had to reject analysis because of a chain of custody flaw or
seal was broken; or a sweat patch had been tampered with.
After two consecutive negative tests and the parent/caretaker no longer
exhibits substance use behavior, routine drug testing should be discontinued.
Following supervisory consultation and approval, additional testing in these cases may
be authorized at any time when behavioral indicators have been observed and/or
reported.
When the parent/caregiver admits or acknowledges drug use testing may not be
necessary as in a case where prior testing has continuously yielded positive results.
Exceptions to this may be:
• If the behavioral indicators do not fit the admission such as; the parent/caretaker
admits to marijuana use but behaviors are indicative of methamphetamine use.
• The parent/caretaker admits to recent methamphetamine use but denies current
use.
In these situations the danger and risk to the child’s safety should be reassessed to
ascertain if any safety factors have risen to the level of a safety threat and if so, safety
planning is needed.
Drug testing may not be needed if the parent/caregiver is an active participant in a
substance abuse treatment program that requires frequent, random drug testing
and the testing results are available to DHS.
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Drug testing may not be required when the parent/caretaker is being randomly
tested by a probation/parole officer and the testing results are being shared with
DHS.
Following a positive test result the parent/caretaker should be referred for a
substance abuse evaluation if deemed appropriate. A substance abuse evaluation can
provide a clinical diagnosis and recommendations for the treatment services and
supports.
Repeated positive test results do not always indicate a need to increase testing, but
rather a need for increased interventions and/or a change in the level of services.
At each reauthorization for testing, the worker and supervisor should review the
current level of drug testing to see if it can be decreased and/or otherwise modified
as needed.
With appropriate releases of information, whenever possible share drug testing
results across systems with other providers involved in the case such as substance
abuse and mental health providers and medical personnel. Sharing drug testing results
avoids duplication of services while promoting a more integrated and effective
approach to rehabilitation and recovery services for the parent/caretaker.
