A Substance Abuse Professional (SAP) is a person who evaluates employees who have violated a DOT drug and alcohol regulation and makes recommendations concerning education, treatment, follow-up testing, and aftercare in order to return the employee to his/her work duties as soon as is safely possible. In accordance with DOT regulations, a SAP possesses knowledge and clinical experience in the diagnosis and treatment of substance abuse-related disorders and provides the following services:
- Consultation and coordination of services with the employer
- Comprehensive face-to-face assessment and clinical evaluation to determine the appropriate level of assistance
- Referral for treatment and case management
- Follow-up assessment and monitoring of compliance with recommended services
- Employee drug and alcohol education and treatment (for individuals recommended to attend education and/or treatment as a result of a SAP evaluation conducted by another SAP provider).
SAP – Drug & Alcohol Evaluation
A SAP will provide a comprehensive face-to-face assessment and clinical evaluation to determine what level of assistance the employee needs in resolving problems associated with alcohol use or prohibited drug use. After the assessment, the SAP will recommend a course of education and/or treatment which the employee must successfully complete before returning to DOT safety-sensitive duty. Treatment recommendations can include but are not limited to in-patient treatment, partial in-patient treatment, out-patient treatment, education programs, and aftercare. Education recommendation can include but are not limited to drug and alcohol education courses, self-help groups, and community lectures.
Employees and employers are prohibited from seeking a second SAP evaluation to obtain another recommendation after a qualified SAP evaluated the employee. Employers are not to rely on a second evaluation if the employee receives one contrary to this prohibition. No one may change in any way the SAP’s evaluation or recommendations for assistance. Only the SAP who made the initial assessment may modify the evaluation and recommendations based on new or additional information.
Before the employee’s return to safety-sensitive duties, the SAP has to provide a face-to-face follow-up evaluation with the employee to determine if the employee has demonstrated successful compliance with recommendations of the initial assessment. This evaluation must be accomplished before an employer can consider the employee for return to safety-sensitive functions. Therefore, the assessment serves to provide the employer with assurance that employee has made appropriate clinical progress sufficient to go back to duty.
After violating a DOT alcohol and drug regulation and before performing safety-sensitive functions in any DOT regulated industry, the employee must receive a SAP evaluation and demonstrate satisfactory compliance with the recommendations. Employers are responsible for making sure that newly hired employees, who had violated the DOT alcohol and drug regulation prior to being hired, obtain a SAP evaluation and successfully complete the recommendations before performing any safety-sensitive duties. The current employer is responsible for administering the follow-up drug and alcohol testing recommended by the SAP.
For more information on SAP evaluations and DOT services.
A SAP will develop and direct a follow-up testing plan for the employee returning to work following successful compliance. The number and frequency of unannounced follow-up tests are led by a SAP and must consist of at least six tests in the first 12 months following the employee’s return to safety-sensitive duties. Follow-up testing can last up to 60 months. The employer is responsible for ensuring that the employee is tested according to the plan. The employer must conduct all of the follow-up tests as well as the return-to-duty test as directly observed collections, which includes a procedure for ensuring the employee does not have a prosthetic and other devices designed to carry clean urine or a urine substitute. Follow-up testing is an important way that the employer has to determine if the employee has stopped using controlled substances or misusing alcohol.
If the SAP determines that an employee referred for alcohol abuse also uses drugs, or that an employee referred for drug use also abuses alcohol, the SAP can require that the individual is tested for both substances. The SAP’s decision to test for both can be based on information gathered during the initial evaluation, the SAP’s consultation contacts with the treatment program, and/or the information presented during the follow-up evaluation.
Follow-up testing is directly related to a rule violation and subsequent return to safety-sensitive duty. Random tests are independent of rule violations. Therefore, the two test types are to be separated – one cannot be substituted for the other or be conducted in place of the other. Follow-up testing should be unpredictable, unannounced, and conducted no less than six times throughout the first 12 months after the employee returns to safety-sensitive functions. Follow-up testing should be spread throughout the 12-month period and not be grouped into a shorter interval, although the testing can be more frequent during the initial months and less frequent during the final period. Follow-up testing can last up to 60 months. An employee subject to follow-up testing will continue to be subject to an employer’s random testing program. It is important to note that a follow-up test that is canceled is not a complete test; a canceled follow-up test must be recollected.
Follow-up testing is not to be conducted in a randomized way. An employee’s follow-up testing program is to be individualized and designed to ensure that the employee is tested the appropriate number of times as directed by the SAP. Random testing is neither individualized nor can it ensure that the employee receives the required number of tests.
Employees testing positive or refusing a test while in a follow-up testing program are subject to specific DOT rules regarding rules violations. In addition, the employees are subject to employer policies related to second violation of DOT rules. At a minimum, the employee must be removed immediately from safety-sensitive duties and must go through the entire SAP process again before returning to safety-sensitive duties.
Occasionally an employee will need continuing assistance with an alcohol and drug problem even if the employee is ready to return to work. If needed a SAP will provide the employee and employer with recommendations for aftercare – continuing education and/or treatment needed after return to safety-sensitive duties.
Payment for SAP Services and Drug and Alcohol Testing
Payment for any SAP services as well as education and/or treatment is to be determined by employers and employees and may be regulated by existing management-labor agreements, employer policies, or health care benefits. Likewise, the DOT rules do not mandate responsibility for payment of follow-up testing upon any single party. DOT has left the decision regarding payment to employer policies and to labor-management agreements. Whether the employer pays or the employee pays, if the employee returns to safety-sensitive functions, the employer must ensure that follow-up testing occurs as required. The employer will be held accountable if the follow-up testing plan is not followed.