Workplace Regulations - Substance Abuse Professional

What You Should Expect From A DOT-Knowledgeable Substance Abuse Professional

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 an alcohol and drug abuse counselor certified by the National Association of Alcoholism and Drug Abuse Counselors (NAADAC) Certification Commission, or the International Certification Reciprocity Consortium/Alcohol & Other Drug Abuse (ICRC). 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.

The DOT does not certify, license, or approve individual SAPs. The SAP must be able to demonstrate to the employer qualifications necessary to meet DOT rule requirements.

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 and social security number. 2. Employer's name and address. 3. Reason for the initial assessment (specific violation and date). 4. Date(s) of initial and subsequent SAP assessment(s). 5. SAP's telephone number.

Evaluation: The evaluation should provide a face-to-face clinical assessment, treatment recommendations, and a treatment plan to be successfully complied with prior to the employee becoming eligible for follow-up evaluation and subsequent return to safety-sensitive functions. After a SAP evaluates and employee, the SAP must notify the employer in writing of the findings and recommendations. In addition to the format described in "Reports" above, the notification to the employer should include:

• (If SAP determines no treatment is necessary): SAP's reasons determining that the employee needs no assistance in resolving a drug or alcohol problem.
• (If SAP determines treatment is necessary) SAP's treatment recommendation and follow-up testing plan.

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.

SAP's 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 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 an inpatient or partial inpatient/day-treatment program. Furnished with information form the treatment program that the employee has made sufficient progress, the SAP will meet with the employee to discuss the treatment 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.

Or, believing the individual has not demonstrated successful compliance with the treatment recommendation; the SAP will postpone the re-evaluation pending the employee's further compliance with the treatment plan. 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 date 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 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 tests 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 an addition to tests accomplished through the employer's random testing program.

Release of information: The SAP will need to be able to receive and communicate pertinent information regarding the employee's evaluation and treatment progress. For confidentiality considerations, the SAP needs to obtain from the employee specific releases authorizing disclosure of information.

Exceptions to confidentiality primarily occur if the client poses a clear and imminent danger to self or others, if there is known or suspected child abuse or neglect, when medical records are court ordered by a judge compelling disclosure, or when the counselor seeks medial or legal consultation. Client record information can also be released to DOT for audit and review purposes in accordance with federal disclosure rules.

Record keeping: Records pertaining to a determination by a SAP concerning and 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.