2. Obstacles, Challenges & Resistance Niagara Frontier Transportation Authority Concerns  Understaffing resulting in “work’ being cut.  Employee compensation Unions Concerns- 13 separate unions  Union will comply only with polices and procedures that are mandated by state / federal regulation or contractually negotiated.  Employee compensation

3. Incremental Progression Utilized New York State 19-A Vehicle & Traffic Law medical regulations to create several forms and postings relating to the use of RX & OTC medication(s). 2003

4. Article 19A of the New York State Vehicle and Traffic Law §509-l: No person shall: a) consume a drug, controlled substance or an intoxicating liquor, regardless of its alcoholic content, or be under the influence of an intoxicating liquor or drug, within six hours before going on duty or operating, or having physical control of a bus, or

5. Commissioner’s Regulations §6.10(b)(11): A person is physically qualified to drive a bus If he or she: does not use an amphetamine, narcotic, or any habit- forming drug

7. Prescribing Physician Certification

11. Notice Posted in all NFTA Facilities

13. Incremental Progression Added questions on health history form requiring the disclosure of the use of RX & OTC medication(s). 2006

16. Incremental Progression Introduced Rx & OTC education during “new hire” orientation. Which includes PowerPoint and hand-outs. 2009

21. Monitoring Street Supervisors Medical Department Passenger Concerns

22. Street Supervisors Assess for evidence of driver impairment during accident investigation Review bus video for evidence of impairment Refer to Medical Department for evaluation if any concerns

23. Monitoring - Medical Drivers fill out questionnaire listing all medications at annual or biennial 19A physical exam – same as pre-placement Drivers are questioned about medications by nurse on return to work following sick leave Medical evaluation on referral from supervisor Medical referral following customer complaint or concern