OTETA UPDATE Regina Doural, C-SAPA General Manager, Compliance Services April 7, 2016

Agenda Electronic CCF Changes at FirstLab Drug Testing Trends FMCSA Updates Commercial Driver Medical Exam

Electronic Chain of Custody Forms ODAPC approved the use of an eCCF for DOT drug testing programs on April 13, 2015. Laboratory must have their eCCF approved by HHS prior to use Alere Toxicology, Gretna LA

FirstLab Changes Online Invoices Limited Access Users Dashboard

Drug Testing Trends The 2014 positivity rate for the U.S. general workforce increased overall by 9.3%. Illicit drug use may be increasing. Marijuana positivity rate increased for the second consecutive year. Positivity rate for 6-acetylmorphine or 6-AM doubled between 2011 and 2014 for the general U.S. workforce.

Emerging Drugs Synthetic Cannabinoids Synthetic Cathinones K2/Spice Mr. Smiley, Black Mamba, Aztec Fire, Eclipse Users tend to be Males in 20’s, working or attending school Synthetic Cathinones Bath Salts, Ivory Wave, Cloud 9, White Lightning, Flakka, Gravel Highest rate of recent increase seen in Florida Easy Overdoses Mexxy (Methoxetamine) Special K Opiods Oxy, Percocet, Vicodin Almost 100% of world hydrocodone is consumed in US Decrease Opiod, increase Heroin Krokodil (Desomorphine) Marijuana Concentrates

25% FMCSA Updates FMCSA lowered their random drug testing rates Commercial Driver's License Drug and Alcohol Clearinghouse Final Rule expected late summer or early fall 2016 Only applies to FMCSA covered employers May still need to use current method on some. The motor carrier must have been using hair testing for last 24 months Some sources indicate the possibility of passing is less than 1%

Commercial Driver Medical Exam April 2016 New Medical Examination Reports Extensions on Short cards are no longer allowed Determination pending replaces Temporary DQ May 2015 NPRM Comments on allowing Drivers treating Diabetes with insulin to operate in interstate commerce. October 2015 Recommendations were made to revise medical questionnaire No action yet March 2016 NPRM Seeking comments on issues regarding Sleep Apnea

Q & A Questions? Regina Doural, C-SAPA General Manager, Compliance Services Mary Ann Malarkey WP Team Supervisor & FL Account Manager