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-Sample-Post Accident Substance Abuse PolicyPrepared by:Midwest Builders’ CasualtyThis is a sample policy. There is no guarantee, warranty or assurance, express or implied, that the language found within this policy will insure compliance with the requirements of any Federal or State regulation, or any OSHA regulations or other laws or regulations dealing with safety and health as it pertains to employees, or the safety and health regulations as it pertains to hazardous substances and/or the work environment. For example, federal contractors or grantees would be subject to federal Drug-Free Workplace Act of 1988 applies which may contain different requirements than state law. Substance abuse policies are most effective when they are designed as part of a comprehensive program. The intent of this sample policy is to encourage the development of an individual, Company specific, policy by providing a sample format and suggested wording for program components. For a substance abuse program to be completely effective it must include not only the policy, but also employee education, supervisor training, drug and alcohol testing, and an employee assistance program. It is strongly recommended that this or any other policy be reviewed by a legal consultant, such as a labor/employment attorney, for compliance with applicable law specific to your Company prior to adoption, distribution, and/or implementationSubstance Abuse PolicyPurpose and Goal[Company Name] is committed to providing a safe, healthy, productive and efficient work environment for our employees as well as our customers and the public in general. We recognize that alcohol abuse and drug use pose a significant threat to our goals. It is the policy of the Company to maintain a drug-free workplace, and as such we have established a Substance Abuse Policy that balances our respect for individuals with the need to maintain an alcohol and drug-free environment.Accordingly, it is the policy of the Company to maintain its property and to provide a drug-free work environment that is both safe for our employee, including others having business with the Company or on Company property, and conducive to efficient and productive work standards. It is also the policy of the Company to comply with state and federal laws. This Policy restricts certain items and substances from being brought on or being present on Company property, including its parking areas and its vehicles; prohibits Company employees and all others from reporting to work, working, or being present on Company property, independent of whether on duty, form having detectable levels or identifiable trace quantities of certain drugs and other substances; and prohibits the unauthorized possession, by employees or others, of certain materials and substances. Covered EmployeesThis Policy applies to all employees, including employees in managerial and supervisory positions, part-time and full-time employees, and to all applicants who are conditionally hired pending the results of a pre-employment drug test and other background checks. ApplicabilityThis Policy is intended to apply whenever anyone is representing or conducting business for the Company. Therefore, this Policy applies whenever conducting business or representing the Company during all working hours, and/or while on call, paid standby, while on Company property, while in Company vehicles, and at Company-sponsored events. Prohibited Behavior & ItemsEmployees are prohibited from reporting to work while under the influence of alcohol, illegal drugs, and other intoxicants. Prescription medication is only allowed when prescribed for the person in possession of the drugs and under written orders. Post-Accident Testing – Following an on-the-job accident all person involved and within the immediate vicinity of the incident may be subject to having their blood, saliva, hair and/or urine tested. The substances that will be tested for include, but are not limited to, amphetamines, cannabinoids, cocaine, opiates, phencyclidine (PCP) and alcohol. Testing for the presence of alcohol will be conducted by analysis of breath, saliva urine and/or blood. Testing for the presence of the metabolites of drugs will be conducted by the analysis of urine, blood, saliva and/or hair.Consequences & PenaltiesAny employee found in violation of this Policy, or any employee failing after a one-hour period to submit to testing will be informed that his refusal constitutes failure to obey this Policy and may be grounds for termination. Any employee who, as a result of drug testing and screening, is found to have detectable levels or identifiable trace quantities of a prohibited drug or substance in his or her system, regardless of when or where the drug or substance entered that person’s system, without an explanation satisfactory to Company [or as provided for under this Policy], will be considered in violation of this Policy and will be subject to disciplinary action, up to and including termination of employment. ConfidentialityAll information received by the organization through the drug and alcohol program is confidential communication. Access to this information is limited to those who have a legitimate need to know in compliance with relevant laws and management policies.AcknowledgementI _______________________________, have read, understand, and received a copy of the Company’s policy on drugs, alcohol, and other prohibited articles, and agree to abide by this policy as a condition of employment. ____________________________________DateSignature__________________Employee NamePLEASE DO NOT ATTACH THIS FORM TO THE SAMPLE POLICY. INSTEAD, USE AS A SEPARATE DOCUMENT WHEN AN EMPLOYEE REFUSES TO SUBMIT TO TESTINGEMPLOYEE REFUSAL TO SUBMIT TO SUBSTANCE ABUSE TESTINGI have been informed and understand that the Company Substance Abuse Policy requires me to submit to a substance abuse testing of my blood, hair, saliva and/or urine. I have been informed by my supervisor/manager that it has been requested that I submit to substance abuse testing of my blood, saliva, hair and/or urine pursuant to the Company’s Substance Abuse Policy. I understand that my refusal to submit to substance abuse testing may in and of itself be grounds for corrective action, up to and including termination of my employment. I hereby refuse to authorize or submit to any substance abuse testing of my blood, saliva, hair and/or urine for alcohol and/or drugs.______________________________________________Employee – Print Name_____________________________________________________________Employee – SignatureDate______________________________________________Supervisor/Manager – Print Name_____________________________________________________________Supervisor/Manager – SignatureDateNote to Supervisor: If employee refuses to sign either the Consent to Drug and/or Alcohol Testing Form or this refusal to test form, please complete the following Statement of Refusal.I, _________________the supervisor whose signature appears below, affirm that I explained to the information that appears above and informed the employee that refusal to submit to substance abuse testing based upon reasonable suspicion was grounds for termination of employment. The employee refused to sign either the consent or the refusal.______________________________________________Supervisor/Manager – Print Name & Title_____________________________________________________________Supervisor/Manager – SignatureDate ................
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