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What to look for in a Substance Abuse Professional that meets the requirements of the Department of Transportation

 From the Substance Abuse Professional Procedure Guidelines for Transportation Workplace Drug and Alcohol Testing Programs, June 1995 (amended by John H. Baxter , LCDC, NCACII May 16, 2001 )

(Provided as a general guide only, refer to 49 CFR Part 40 {Revised Alcohol and Drug Testing Rules} as final authority)

Definition:  DOT defines a Substance Abuse Professional (SAP) to be a licensed physician (MD or DO); a licensed or certified psychologist, social worker, or employee assistance professional; or a drug and alcohol counselor certified by the National Association of Alcoholism and Drug Abuse Counselors Certification Commission (NAADAC); or by the International Certification Reciprocity Consortium/Alcohol and Other Drug Abuse (ICRC); or by the National Board for Certified Counselors, Inc. and Affiliates/Master Addictions Counselor (NBCC).  A SAP who meets only state certification does not necessarily meet DOT's criteria.  All must have knowledge of and clinical experience in the diagnosis and treatment of substance abuse-related disorders.  (Emphasis by JHB)

The DOT does not certify, license, or approve individual SAPs.  The SAP must receive qualification training (see Drug and Alcohol Testing Rule 49, CFR Part 40, Subpart O-40.281, paragraph (c).  Current SAPs (prior to August 1, 2001 or become a SAP between August 1,2001 , and December 31, 2003 , must meet the qualification-training requirement no later than December 31, 2003 .  Anyone becoming a SAP on or after January 1, 2004 , must meet the qualification-training requirement before beginning to perform SAP functions.

Reports:  All reports the SAP makes to the employer should be in letter format with the SAP’s official letterhead, signed by the SAP, and should contain the following:

1.      Employee’s name & social security #;

2.      Employer’s name and address;

3.      Reason for the initial assessment (specific violation and date);

4.      Date(s) of the assessment;

5.      SAP’s education and/or treatment recommendation; and

6.      SAP’s telephone number.

Evaluation:  The evaluation should provide a face-to-face clinical assessment, assistance recommendations, and successfully complete.  After a SAP evaluates an employee the SAP must notify the employer in writing of the findings and recommendations. 

Referral:  If the evaluation indicates the employee requires assistance with associated drug or alcohol problems, the SAP refers the employee to the appropriate treatment program.  The SAP should consider employee insurance coverage, employee ability to pay for care, employer treatment contracts, employer policies regarding availability of leave for employees needing assistance, and availability of programs.  Community lectures and self-help groups (e.g., AA and NA) may qualify as education but do not qualify as treatment.  However, the SAP must, at a minimum (if actual SA Treatment, IOP, Inpatient, etc., is not indicated) recommend SA Education and/or Awareness as mentioned in previous sentence.

SAPs are prohibited from referring an employee to the SAP’s private practice or to a person or organization from which the SAP receives remuneration or to a person or organization in which the SAP has a financial interest. 

Follow-Up Evaluation: Before an employer can consider the employee for return to safety-sensitive functions, a SAP is required to re-evaluate the employee.  The employee should not be considered eligible for receiving a follow-up evaluation prior to completion of the required assistance.  Furnished with information from the treatment or education program that the employee has made sufficient progress, the SAP will meet with the employee to discuss the treatment or education effort, as well as return-to-duty and follow-up testing issues.  Based upon clinical judgment that the employee has made sufficient progress, the SAP will provide the employer with a recommendation and a follow-up testing plan.  The SAP may make recommendations for continuing care (treatment after care) and/or attendance at 12-Step meetings.  Who will monitor the continuing care is up to the arrangements made between the SAP and the Employer.

Or, believing the individual has not demonstrated successful compliance with the assistance recommendations; the SAP will so document in a letter to the employer, non-satisfactory compliance with the treatment process.  The SAP may reevaluate at a later date.  The employer will not return the employee to regulated duties until the SAP provides in writing a report of satisfactory compliance and completion of recommend treatment or education.    **SAP “shopping” is not allowed.**

In addition to the format described in “Reports” above, the notification to the employer should include:

·    Brief synopsis of the rehabilitation plan.

·    Name of practice or program providing the treatment.

·    Inclusive dates of the employee’s treatment program.

·    Clinical characterization of the employee’s participation in the treatment program.

·    SAP’s clinical determination as to the employee’s demonstration as to the employee’s demonstration of successful compliance.

·    Follow-up testing plan.

Follow-up testing: The SAP must present the employer and the employee a plan for follow-up testing.  The SAP can re-evaluate the plan and terminate the plan at any time following the completion of the minimum required six test during the first 12 months (not less).  Testing should be spread throughout the year, unpredictable, and unannounced.  An employee’s follow-up testing program can last up to 60 months.  The employer is responsible for ensuring that an individual is tested according to the plan.  This follow-up testing requirement is in addition to tests accomplished through the employer’s random testing program.

Record-keeping: Records pertaining to a determination by a SAP concerning an employee’s need for assistance and records concerning an employee’s ability to demonstrate successful compliance with recommendations of the SAP need to be maintained for a period of five years.  Records should be maintained in limited access areas that permit no unauthorized entry.