Hawaii Administrative Rules › Title 11 - DEPARTMENT OF HEALTH › Subtitle 1 - GENERAL DEPARTMENTAL PROVISIONS › Chapter 113 - SUBSTANCE ABUSE TESTING BY LABORATORIES › Section 11-113-6 - Urine specimen

Current through June, 2024
(a) In addition to
				section
				11-113-5,
				the collection of urine specimens shall include the following:
(1) Procedures for collecting urine specimens
				shall allow for individual privacy unless there is reason to believe that a
				particular individual may alter or substitute the specimen to be
				provided.
(2) The collection site
				person shall ask the individual to remove any unnecessary outer garments such
				as a coat or jacket that might conceal items or substances that could be used
				to tamper with or adulterate the individual's urine specimen. The collection
				site person shall ensure that all personal belongings such as a purse or
				briefcase remain with the outer garments. The individual may retain his or her
				wallet.
(3) The individual shall be
				instructed to wash and dry his or her hands prior to urination.
(4) After washing hands, the individual shall
				remain in the presence of the collection site person and shall not use any
				water fountain, faucet, soap dispenser, cleaning agent or any other material
				which could be used to adulterate the specimen.
(5) Toilet bluing agents shall be placed in
				toilet tanks wherever possible, so the water in the toilet bowl remains blue.
				There shall be no other source of water in the enclosure where urination
				occurs.
(6) The collection site
				person shall instruct the individual not to flush the toilet.
(7) The individual may provide his or her
				specimen in the privacy of a stall or otherwise partitioned area that allows
				for individual privacy.
(8) The
				collection site person shall note in writing in the chain of custody form any
				unusual behavior or appearance of the individual.
(9) In the event that a third
				party-designated collection site is not accessible and there is an immediate
				requirement for specimen collection, a public rest room may be used according
				to the following procedures:
(A) A collection
				site person of the same gender as the individual shall accompany the individual
				into the public rest room which shall be made secure during the collection
				procedure.
(B) If possible, a
				toilet bluing agent shall be placed in the bowl and any accessible toilet
				tank.
(C) The collection site
				person shall remain in the rest room, but outside the stall, until the specimen
				is collected.
(D) If no bluing
				agent is available, the collection site person shall instruct the individual
				not to flush the toilet until the specimen is delivered to the collection site
				person.
(E) After the collection
				site person has possession of the specimen, the individual will be instructed
				to flush the toilet and to participate with the collection site person in
				completing the chain of custody procedures.
(10) Upon receiving the specimen from the
				individual, the collection site person shall determine that it contains at
				least thirty milliliters of urine. If there is less than thirty milliliters of
				urine in the bottle, the bottle and contents shall be discarded and another
				urine specimen shall be collected in a separate container. The individual may
				be allowed to drink a reasonable amount of water for this purpose (but not to
				exceed a maximum of 24 ounces in 8 ounce increments every 30 minutes). If the
				individual fails for any reason to provide at least thirty milliliters of
				urine, the collection site person shall contact the third party.
(11) After the specimen has been provided and
				submitted to the collection site person, the individual shall be allowed to
				wash his or her hands.
(12)
				Immediately after the specimen is collected, the collection site person shall
				measure the temperature of the specimen. The temperature measuring device used
				shall not contaminate the specimen with alcohol, drugs, or the metabolites of
				drugs. The time from urination to temperature measurement shall not exceed four
				minutes.
(13) The collection site
				person shall inspect the specimen for color and any other signs of
				contaminants. Any unusual findings shall be noted in the chain of custody
				form.
(14) The collection site
				person shall inspect the toilet, urinal, or stall where the individual provided
				the urine specimen for any indication of specimen adulteration.
(15) The collect site person shall check the
				temperature of the specimen with a temperature strip capable of indicating
				temperature readings between 90-100 degrees F (or 32-38 degrees C). If the
				temperature of a specimen is outside the range, there is reason to believe that
				the individual may have altered or substituted the specimen, and another
				specimen may be collected under direct observation as an option of the third
				party, as described in paragraph (16). Both specimens shall be forwarded to the
				laboratory for testing. An individual shall be given the option to have his or
				her oral temperature taken to provide evidence to counter the reason to believe
				the individual may have altered or substituted the specimen caused by the
				specimen's temperature falling outside the prescribed range.
(16) If there is reason to believe that the
				individual may have altered or substituted the specimen, based on paragraphs
				(13) to (15), another specimen may be collected with or without direct
				observation by a same gender collection site person, as an option of the third
				party. Both specimens shall be forwarded to the laboratory for
				testing.
(17) All specimens
				suspected of being adulterated shall be forwarded to the laboratory for
				testing.
(18) The collection site
				person and the individual shall be present at the same time during procedures
				outlined in paragraphs (19) to (22).
(19) The specimen shall be kept in view of
				both the individual being tested and the collection site person at all times
				prior to and while it is being sealed with the placement of a tamper-evident
				tape over the bottle cap and down the sides of the bottle.
(20) The collection site person shall place
				securely on the bottle an identification label which contains the date, the
				individual's specimen number, and any other identifying information provided or
				required by the third party.
(21)
				The individual shall initial the identification label on the specimen bottle
				for the purpose of certifying that it is the specimen collected from him or
				her.
(22) The collection site
				person shall enter in the chain of custody form all information identifying the
				specimen. The collection site person shall sign the chain of custody
				form.
(23) The individual shall be
				asked to read and sign a statement in the chain of custody form certifying that
				the specimen identified as having been collected from him or her is in fact
				that specimen he or she provided.
(24) The third party shall review and concur
				in advance with any decision that a specimen be collected under the direct
				observation of a same gender collection site person based on a reason to
				believe that the individual may alter or substitute the specimen to be
				provided.
(25) The collection site
				person and the same gender observer, if applicable, shall complete the chain of
				custody form.
(26) If the specimen
				is not immediately prepared for shipment, it shall be placed in a tamperproof
				specimen bag or shall be secured by another method, and placed in an
				appropriately safeguarded location during temporary storage.
(27) While any part of the above chain of
				custody procedures is being performed, it is essential that the urine specimen
				and custody documents be under the control of the involved collection site
				person. If the involved collection site person leaves his or her work station
				momentarily, the specimen and custody form shall be secured. After the
				collection site person returns to the work station, the custody process will
				continue. If the collection site person is leaving for an extended period of
				time, the specimen and documents shall either be packaged for mailing before he
				or she leaves the site, or be signed over to the custody of another collection
				site person prior to leaving the area.