Last Updated: SEP 24, 2012
Drug Testing Policy/Process for Spokane Training Sites
Policy
The School of Medicine does not require “routine” drug testing of medical students. However, starting
in September 2012, specific Spokane clinical training sites (Deaconess Hospital, Valley Hospital, Shriners
Hospitals for Children-Spokane, Rockwood Clinic, Community Health Association of Spokane, and
Community Health Systems) have started to require drug testing before they will accept a student for a
rotation. The following drug testing policy/procedure will serve as an interim solution for drug testing
requirements until a long-term agreement can be finalized.
The School has contracted with Pathology Associates Laboratories (PAML) in Spokane to have a 10-panel
urine drug screen test performed on all students scheduled at rotations at these impacted Spokane
training sites. The testing must be completed within 30 days of the scheduled rotation. PAML will bill
the University of Washington $15 for each drug screen and all expenses will be paid directly through
Academic Affairs. The test results should be good for one year and can be used as needed for other
rotations at Spokane-area clinical training sites. The urine drug screen will test for the following drugs:
•
Amphetamines
•
Benzoylecgonine (Cocaine)
•
Opiates
•
Morphine
•
THC (Cannabinoids)
•
Barbiturates
•
Benzodiazepines
•
Methadone
•
Methaqualone
•
Propoxyphene
•
Phencyclidine
Students are required to complete a drug screening consent form for the School to release the results to
the clinical training site. Only negative drug test results will be shared with the appropriate Spokane
clerkship facility.
If the initial test results are positive, PAML will conduct a second confirmation test (on the same sample)
at the School’s expense. If the confirmation test is positive, the medical student will be referred to the
Vice Dean for Academic Affairs. The Vice Dean will refer the student to the Washington Physician’s
Health Program (WPHP) for further evaluation and testing as indicated. The additional referral process
will likely affect student clinical clerkship rotations to any facility requiring drug testing. Students who
are confirmed with positive drug test results will receive further information and guidance working with
the Vice Dean for Academic Affairs.
Process
1. One month before a scheduled elective or required clerkship rotation at Deaconess Hospital,
Valley Hospital, or Rockwood Clinic in Spokane, Janie Ford, from the WWAMI Medical Education
Office in Spokane, will email each scheduled student information on drug testing urinalysis lab
order instructions and a drug testing consent form.
2. The student and witness need to provide an original signature on the drug testing consent form
(see Appendix A). The witness doesn’t have to be a School of Medicine staff member; rather, it
can be any adult who is able to witness the student signing the form. It is important that the
student completing the consent form check the box providing “consent” to release the drug
testing results. The drug testing consent form should be scanned and emailed to
somcompl@uw.edu or faxed to 206-543-9052.
3. If the student is in Spokane, they should schedule a drug testing appointment as soon as
possible. If outside of Spokane, the student should expect to complete their drug testing on the
first day of the clerkship (all three institutions have approved the late testing for out-of-town
students). The drug test results will be good for one year. Results may be used for other
Spokane-area clinical training sites if the student is scheduled for multiple rotations.
4. It will normally take 1-2 days after providing a specimen for PAML to process the results.
Results will be made available online through the PAML website:
https://extranet.paclab.com/ards/Login.aspx
5. The Compliance Officer (Laura Ellis) will log in to the PAML website to check for student drug
testing results.
a. Negative result reports will be downloaded from the PAML website and uploaded into
E*Value.
b. Positive test results will be referred to the Vice Dean for Academic Affairs for action.
Positive results will not be uploaded into E*Value
6. The Compliance Officer will notify Registration and Scheduling (Trudy Furberry) when drug
testing results are available. Trudy will contact the clinical training site facility to provide them a
copy of the negative report findings.
Appendix A – Drug Testing Consent Form
STUDENT SUBSTANCE POLICY AND CONSENT FORM
Name of School:
University of Washington School of Medicine
Name of Facility:
Deaconess Hospital, Valley Hospital, Shriners Hospitals for ChildrenSpokane, Rockwood Clinic, Community Health Association of Spokane, and Community Health
Systems
Facility policy prohibits Students (as well as applicants, employees and contractors) from using
“Substances” including, but not limited to, illegal drugs and legal prescription drugs without a
current, legal and valid prescription. Alcohol may not be used in a manner that will cause
Student to be impaired while at the Facility. Students shall be tested for Substances as
described herein.
The Substance Policy
The Students are seeking Facility experience that is not granted to the general public.
It is Facility policy to maintain a drug and alcohol free environment.
By choosing to access the Facility through the program, the Student must agree to follow the
Facility’s substance abuse policy, including Substance testing.
Any Student who chooses not to agree to this policy has chosen not to be in the program.
No Student shall be in the program who:



Has chosen not to comply with the Facility’s or School’s directives;
Is unfit for duty; and/or
Has not passed a Substance test within the twelve (12) months preceding Student’s first
day of a rotation that involves provision of Patent Care Services.
The School shall:




Inform each Student that Facility requires him/her to complete a Student Substance
Policy Consent Form;
Provide the Facility with a copy of each Student’s completed Consent Form or request
Student to provide the completed Consent Form to the Facility;
Conduct testing of Students through a licensed laboratory, including when a Student has
been absent from the School or program for more than thirty (30) days (except for
regularly calendared breaks) and there is reasonable cause to believe that Substanceinduced impairment is involved; and
Provide Facility with documentation of Students’ laboratory test results.
Drug Testing may also be required by the Facility:




When a Student is injured at the Facility and Facility has reasonable cause to believe
that such Substance-induced impairment is involved;
When a drug is not accounted for per Facility policy and Facility has reasonable cause to
believe that the Student may have diverted the drug;
For oversight of a Student who has previously completed a drug rehabilitation program;
When a Student appears to be unfit for duty and Facility has reasonable cause to
believe that Substance-induced impairment is involved.
Student Consent, Disclosure and Release
I choose to:



Agree with and follow the Substance Policy.
Provide any specimen(s) and authorize the School and/or Facility and any associated
persons and/or entities to conduct screening tests for alcohol and drugs as provided in
the Substance Policy in the instances described and allow them to access and utilize
specimen and test information as needed as provided in the Substance Policy.
Release the School and the Facility and any associated persons and/or entities from
any and all claims, causes of action, damages, or liabilities whatsoever arising out of or
related to the Substance Policy and process.
Student Choice to Consent or Not Consent
I have read the above and I choose to (check one)
□ Consent
or
□ Not consent (not remain or be in the program)
Student and Witness Signatures
Student:
Witness:
Signature
Signature
Printed Name
Printed Name
Date
Date
Additional Consent for Students under the Age of 18
As the parent and/or guardian of the Student named above, I hereby consent to and authorize
the School and Facility and affiliated persons and/or entities to proceed as outlined above.
Parent and/or Guardian’s Signature
Student’s Printed Name
Date
Appendix B – Spokane Clerkships Contact List for Sites Requiring UA Drug Screen
Dept Contact
Clerkship
Kim Mabee
Anesth #674
Teresa Jewell
Chronic Care
- Pain Track
#668
Clerkship Training Site
Deaconess Medical Center
Melanie Roberts
robertsm@empirehealth.org
Phone 509-473-3660
Fax (509) 473-7662
Deaconess Medical Center
Melanie Roberts
robertsm@empirehealth.org
Phone 509-473-3660
Fax (509) 473-7662



Criminal Background Check report
10-panel urine drug screen report
Student sends immunization



Criminal Background Check report
10-panel urine drug screen report
Student sends immunization
Valley Hospital
Sue Kent, RN


kents@empirehealth.org



Criminal Background Check report
10-panel urine drug screen report
CPR certification
Letter of Good Standing
Student sends immunization
Deaconess Medical Center
Melanie Roberts
robertsm@empirehealth.org
Phone 509-473-3660
Fax (509) 473-7662



Criminal Background Check report
10-panel urine drug screen report
Student sends immunization
Valley Hospital
Sue Kent, RN


kents@empirehealth.org



Criminal Background Check report
10-panel urine drug screen report
CPR certification
Letter of Good Standing
Student sends immunization



Criminal Background Check report
10-panel urine drug screen report
Student sends immunization



Criminal Background Check report
10-panel urine drug screen report
Student sends immunization
Phone (509) 473-5744
Fax 509.473.5886
AND
Anna Salviejo
salviea@empirehealth.org
Phone (509) 473-5379
Fax (509) 473-5760
Teresa Jewell
Chronic Care
– Rehab Track
#692
Phone (509) 473-5744
Fax 509.473.5886
AND
Anna Salviejo
salviea@empirehealth.org
Phone (509) 473-5379
Fax (509) 473-5760
Brian Brown
Fammed Sub-I
#688
Brian Brown
Fammed #641
Requirements
Deaconess Medical Center
Melanie Roberts
robertsm@empirehealth.org
Phone 509-473-3660
Fax (509) 473-7662
Deaconess Medical Center
Melanie Roberts
robertsm@empirehealth.org
Phone 509-473-3660
Fax (509) 473-7662
Carmelita
MasonRichardson
Medicine
#621
Yolanda Virgil
Medicine –
Card #633
Yolanda Virgil
Medicine – GI
#636
Yolanda Virgil
Medicine –
ICU #640
Yolanda Virgil
Medicine-ID
#638
Yolanda Virgil
MedicineNephrology
#639
Whitney Hiatt
OB/GYN #668
Amanda
Schwanz
Ortho-Peds
#668
Deaconess Medical Center
Melanie Roberts
robertsm@empirehealth.org
Phone 509-473-3660
Fax (509) 473-7662
Deaconess Medical Center
Melanie Roberts
robertsm@empirehealth.org
Phone 509-473-3660
Fax (509) 473-7662
Deaconess Medical Center
Melanie Roberts
robertsm@empirehealth.org
Phone 509-473-3660
Fax (509) 473-7662
Deaconess Medical Center
Melanie Roberts
robertsm@empirehealth.org
Phone 509-473-3660
Fax (509) 473-7662
Deaconess Medical Center
Melanie Roberts
robertsm@empirehealth.org
Phone 509-473-3660
Fax (509) 473-7662
Deaconess Medical Center
Melanie Roberts
robertsm@empirehealth.org
Phone 509-473-3660
Fax (509) 473-7662
Deaconess Medical Center
Melanie Roberts
robertsm@empirehealth.org
Phone 509-473-3660
Fax (509) 473-7662



Criminal Background Check report
10-panel urine drug screen report
Student sends immunization



Criminal Background Check report
10-panel urine drug screen report
Student sends immunization



Criminal Background Check report
10-panel urine drug screen report
Student sends immunization



Criminal Background Check report
10-panel urine drug screen report
Student sends immunization



Criminal Background Check report
10-panel urine drug screen report
Student sends immunization



Criminal Background Check report
10-panel urine drug screen report
Student sends immunization



Criminal Background Check report
10-panel urine drug screen report
Student sends immunization
Valley Hospital
Sue Kent, RN


kents@empirehealth.org



Criminal Background Check report
10-panel urine drug screen report
CPR certification
Letter of Good Standing
Student sends immunization
Phone (509) 473-5744
Fax 509.473.5886
AND
Anna Salviejo
salviea@empirehealth.org
Phone (509) 473-5379
Fax (509) 473-5760
Spokane Shriner’s Hospital
Cheri Arman
Carman@shrinenet.org
Phone (509 623-0428




10-panel urine drug screen report
Letter of Good Standing
Student send immunization
Criminal Background Check Report
Allison Comer
OTO #687
Carla Salldin
Peds #668
Carla Salldin
Peds-Card
#636
Carla Salldin
Peds-Genetics
#674
Anna Nonis
Surgery #667
Deaconess Medical Center
Melanie Roberts
robertsm@empirehealth.org
Phone 509-473-3660
Fax (509) 473-7662
Deaconess Medical Center
Melanie Roberts
robertsm@empirehealth.org
Phone 509-473-3660
Fax (509) 473-7662



Criminal Background Check report
10-panel urine drug screen report
Student sends immunization



Criminal Background Check report
10-panel urine drug screen report
Student sends immunization
Valley Hospital
Sue Kent, RN


kents@empirehealth.org



Criminal Background Check report
10-panel urine drug screen report
CPR certification
Letter of Good Standing
Student sends immunization

Letter of Good Standing

Letter of Good Standing
Deaconess Medical Center
Melanie Roberts
robertsm@empirehealth.org
Phone 509-473-3660
Fax (509) 473-7662



Criminal Background Check report
10-panel urine drug screen report
Student sends immunization
Valley Hospital
Sue Kent, RN


kents@empirehealth.org



Criminal Background Check report
10-panel urine drug screen report
CPR certification
Letter of Good Standing
Student sends immunization



Criminal Background Check report
10-panel urine drug screen report
Student sends immunization
Phone (509) 473-5744
Fax 509.473.5886
AND
Anna Salviejo
salviea@empirehealth.org
Phone (509) 473-5379
Fax (509) 473-5760
Cindy Dionne
Cindy.dionne@providence.org
Melissa Locke
Melissa.locke@providence.org
Phone (509) 473-5744
Fax 509.473.5886
AND
Anna Salviejo
salviea@empirehealth.org
Phone (509) 473-5379
Fax (509) 473-5760
Rockwood Clinic
Sheryl Rose
srose@rockwoodclinic.com
AND
Megan Dunn
mdunn@rockwoodclinic.com