3.7 Northland Occupation Health Screening Agreement
Request for
City Council Action
DEPARTMENT INFORMATION
ORIGINATING DEPARTMENT REQUESTOR: MEETING DATE:
Human Resources Assistant City Administrator/Human Resources Hille June 27, 2022
PRESENTER(s) REVIEWED BY: ITEM #:
Consent City Administrator/Finance Director Flaherty 3.7 – Northland Drug
Screening Agreement
STRATEGIC VISION
MEETS: THE CITY OF OTSEGO:
Is a strong organization that is committed to leading the community through innovative
communication.
Has proactively expanded infrastructure to responsibly provide core services.
Is committed to delivery of quality emergency service responsive to community needs and
expectations in a cost-effective manner.
X Is a social community with diverse housing, service options, and employment opportunities.
Is a distinctive, connected community known for its beauty and natural surroundings.
AGENDA ITEM DETAILS
RECOMMENDATION:
City staff recommends the City Council approve the contract with Northland Occupational Health and DOT
Compliance, for the City’s designated TPA for FMCSA compliance.
ARE YOU SEEKING APPROVAL OF A CONTRACT? IS A PUBLIC HEARING REQUIRED?
Yes No
BACKGROUND/JUSTIFICATION:
Previously, Human Resources was looking to switch the Third Party Administrator (TPA) for Random Drug
Screening for compliance with Department of Transportation (DOT), back in November of 2021. Due to
some issues locating the history on the agreement with the current TPA, the City was unable to move
forward. After finding the correct agreement information and history, the City now has the ability to end
the agreement with Vault Health. Vault Health has evolved, and the City started using the original company
as they were automatically transitioned to them when Otsego was on the Minnesota County Insurance
program.
This change will not affect any current employees who are subject to Random Screening, the testing
location will remain the same. The difference will be City of Otsego will join a general random pool, and all
administration will be tracked electronically instead of paper forms. This change will reduce costs, and the
annual price for administration is lower than the current costs.
Staff is in support of this change and anticipates the switch will allow the process to be more efficient.
SUPPORTING DOCUMENTS ATTACHED:
• Random Drug & Alcohol Consortium Service Agreement
POSSIBLE MOTION
PLEASE WORD MOTION AS YOU WOULD LIKE IT TO APPEAR IN THE MINUTES:
Motion to approve service agreement for Random Drug & Alcohol Consortium Service Agreement with
Northland Occupational Health & DOT Compliance.
BUDGET INFORMATION
FUNDING: BUDGETED:
General Fund – Human Resources
101-41800-355
Yes
Northland Occupational Health & DOT Compliance
7533 Sunwood Drive NW, Suite 212
Ramsey, MN 55303
Phone: 763-600-6664 | Fax 866-726-3973
Random Drug & Alcohol Consortium Service Agreement
This Agreement is made on June 14, 2022 by and between Northland Occupational Health & DOT Compliance
(“Northland”) located at 7533 Sunwood Dr. NW Suite 212, Ramsey, MN 55303, a FMCSA Certified Medical Examina-
tion site (Registry #: 9397605920) and; City of Otsego
with a business address of ______________________________________hereby referred to as “Member.”
Services
Northland will provide federally mandated random drug and alcohol testing following all federal DOT regulations.
Laboratory Analysis
Samples will be couriered daily and tested by a SAMHSA approved and regulated laboratory. Negative test results will
be available within 24 hours and positive results will be returned following Medical Review Officer (MRO) review per
DOT protocol. The laboratory will store all positive samples for one year.
Positive Result
All positive results will be reviewed by the MRO and all follow-up contact will be made with the Employee. The purpose
of this follow-up is to determine the presence of legal medications. Confirmation will be made with the prescribing
physician prior to clearing a positive result.
Result Reporting
Negative results will be communicated to the Member by secure fax, email or USPS within 24 hours. Positive results
will require review by the MRO which may take up to five days. Positive results will be communicated by telephone to
the Member representative as soon as confirmed with written confirmation by fax, email or USPS.
Collection Protocol
All collections, other than the exceptions listed below for observed collections, will afford the Employee full privacy and
dignity. Collections may take place at Northland or the Member’s business. Standard urine collections meet all DOT
requirements and follows DOT regulations.
Observed collections are permitted under the following conditions:
1. Written protocol with the Member that includes written disclosure to the employee that is acknowledged by
the Employee’s signature.
Page 2 of 6
2. The DER will be contacted for concurrence prior to the collection.
3. The Employee will not be permitted to leave the collection site until the collection is complete. If the Employee
chooses to leave before the collection is complete, it is considered a Refusal to Test and is reportable to the
Department of Transportation.]
4. An observer of the same sex will be used at all times.
Cause for observed collections are: adulterated sample, out of range temperature, Member request due to suspected
adulterations of previous samples or the Member suspects an attempt will be made to adulterate the current sample.
All Northland collectors are DOT Certified Breath Alcohol Technicians and ensure conformance to all regulatory stat-
utes and ethical standards.
Member Responsibilities
1. Provide a current list of safety sensitive employees on or before the first Monday of each January, April, July
and October;
2. Provide a secure and confidential means for Member to receive test results from Northland;
3. Provide the required training pursuant to DOT regulations;
4. Serve as the primary custodian of testing and personnel records per DOT regulations;
5. Maintain a copy of each test result for existing employees for review and/or in the event of an audit;
6. Require testing of new safety sensitive employees and clear result prior to starting any safety sensitive work;
7. Provide a primary and alternate DER with 24-hour access to these individuals;
8. Provide all test results not generated by Northland to Northland.
It is the Member’s responsibility to provide Northland with employee additions or terminations from the group to comply
with all applicable DOT regulations related to drug testing and to provide ongoing employee education to the drug
testing program. The Member is to apply the drug testing policy in a non-discriminatory manner and participate in
ongoing supervisory training to assure compliance with applicable laws and standards.
It is the Member’s responsibility to comply with regulations set forth in 49 CFR Part 40. Northland reserves the right to
place Member into a non-conforming random selection pool for a probationary period of up to 180 days due to the
Member’s failure to comply with 49 CFR Part 40 regulations. Should the Member continue to fail to comply, Northland
may remove the Member from random selection pools. Removal from random selection pools for any reason may
result in immediate notification to the DOT.
Payment Terms
Member agrees to submit payment in full within thirty (30) days of receipt of the billing statement. Unpaid balances
over thirty-one (31) days overdue will incur a late payment fee of $10 along with an APR of 18% on the outstanding
balance. If you are charged an annual fee, this must be paid to stay in compliance with the 49 CFR Part 40. Member
agrees to pay a NSF fee of $36 for any dishonored, rejected or returned checks.
Page 3 of 6
Agreement Terms
This agreement will be effective for a full calendar year (January 1 – December 31) and will automatically renew at the
beginning of each calendar year. Either party can terminate this agreement in writing with a sixty (60) day notice.
Attorney Fees
Northland shall be entitled to reasonable attorney fees, costs and disbursements in any litigation and appeal brought
to enforce, modify, interpret or void the provisions of this agreement.
Substance Abuse Provider Referrals
Northland will provide access to a network of Substance Abuse Providers (SAP) in the Member’s area. Member is
responsible for making the final determination of whether to refer an employee to a SAP or terminate the employee for
a positive test result. If Member refers an employee to a SAP, Member will ensure that the employee will immediately
cease any safety sensitive duties, tasks and/or responsibilities prior to SAP approval.
Confidentiality
Northland acknowledges that its employees may, in the course of performing services identified in this agreement, be
exposed to or acquire information that is proprietary or confidential to the Member, its affiliates, subsidiaries, investors
or to a third party to whom the Member has contractual or other obligations of confidentiality. Any and all non-public
information of any form obtained by Northland employees shall be deemed confidential and proprietary information.
Northland agrees to hold all data and information in strict confidence.
Page 4 of 6
Member Contact Information
Business Name:
USDOT #:
Driver Name(if o/o):
DL#(if o/o):
Address:
Phone:
Secure Fax:
Email:
Primary DER Name:
DER Phone:
DER Fax:
DER Email:
Alternate DER Name:
Page 5 of 6
The undersigned understands and agrees to the terms in services as outlined in this service agreement:
Member Signature Date
Northland Occupational Health & DOT Compliance
7533 Sunwood Drive, Suite 212
Ramsey, MN 55303
Date
Page 6 of 6
Northland Occupational Health & DOT Compliance
7533 Sunwood Drive NW, Suite 212
Ramsey, MN 55303
Phone: 763-600-6664 | Fax 866-726-3973