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A Day in the Life of a SAP - Drug & Alcohol Program

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The DOT-QualifiedSubstanceAbuseProfessional (SAP):RolesandResponsibilitiesADay in theLife ofa SAP
Tina TaylorSlidell, [email protected]
Who is Tina Taylor?
Born and raised in Thibodaux, LAWent to college -- Nicholls State University (Thibodaux)Graduate school -- Tulane University (New Orleans)My licensuresLCSWCEAPTrained in Critical Incident Stress Management
My private practice
My EAP business (EAP, Inc.)Acquired EAP, Inc. in 200050% of my business is direct service EAPSAP Transportation ServiceSAP return-to-duty processTraining for supervisorsMy private practice caseload40% of my business is SAP cases10% of my business is Critical Incident (as needed)
How to contact me
Office locationsLA (Slidell, Lafayette, Thibodaux)AL (Mobile)MS (Kiln)FL (Navarre Beach)Best way to reach meMon-Fri, 9:00 a.m. – 7:00 p.m.Cell phone: (504) 577-5333
Basics of DOT’s return-to-duty process
Initial EvaluationRecommend treatment/education (where? what? how long?)Send Initial Evaluation report to the employerMonitor employee’s progress in treatment/educationMake changes to the recommendation as necessary/appropriateFollow-up EvaluationDetermine complianceSet up a follow-up testing planRecommend aftercare, if appropriateSend Follow-up Evaluation report to the employer
How I make treatment determinations
Assessment instruments I useDepression screenSASSIMASTDrug / alcohol use history (frequency, patterns of use)Psycho-social historyHealth, work, family, personal and interpersonal problemsCurrent mental status
What I expect (and need) from an employer
Open communicationVerify the stories that the employee has told meWhat have you told the employee about returning to work?What are your policies about time off?What are this employee’s safety-sensitive functions?Do you use a return-to-work agreement? Should I prepare one for you?Information related to thetest (a copy of the CCF, if possible)Information about the test (or the refusal)MRO or BAT name and phone #Collector name and phone #Do not ask me for a release, signed by the employee (40.355[a])
“I can’t talk to you without a signed release”
A service agent (including SAP) cannot require an employee to sign a consent, release, waiver of liability or indemnification agreement with respect to any part of the drug and alcohol testing process. 40.355(a)As an employer, you must not require an employee to sign a consent, release, waiver of liability or indemnification agreement with respect to any part of the drug and alcohol testing process. 40.27In order for me to do my job as a SAP, I must have access to all information, without restrictions.A release gives the employee control over exchange of information.What would be my recourse if an employee revokes arelease?
“Does this employee really need treatment?”
A SAP is required to recommend treatment and/or educationDOT’s rule prohibits the use of illegal drugs,at any time.Definition ofaddiction:The employee knows there are serious consequences for a positive test, but he continues to use the very drug that he knows he will be tested forEducation is not an effective way to address addiction“Cutting back” on use, or “being more careful about when I use” is not “successful compliance” with a SAP’s recommendationDOT views the SAP as the “gatekeeper” for the return-to-duty processAn employee who can’t give up drugs shouldn’t be in a DOT job
“Help me with this follow-up testing plan”
Only the employer can order follow-up tests. This cannot be delegated to a SAP, or to any other service agent. 40.355(g)The SAP cannot determine dates for follow-up tests. 40.307(d)(3)An employer cannot add non-DOT tests (under independent authority) to the SAP’s testing plan. 40.307(d)(4)Look at follow-up tests as a tool to be used when something “isn’t right”, but it doesn’t meet criteria for a DOT test.Some follow-up tests can be random dates on a calendar.Some tests should be strategic. Example: On Friday--before a 3-day weekend, and then on Tuesday--when the employee returns to work
“Let’s cancel the remaining follow-up tests”
A SAP can cancel follow-uptestingafter 12 months. 40.307(f)Follow-up testing is an effective deterrent.If all the follow-up tests are negative, isn’t that what we want?If a driver has had no accidents for a year, would you consider canceling insurance on the bus?Some SAPs require a full 5 years of follow-up testing, and sometimes with only a few tests in the final 2 or 3 years.Critical: The follow-up testing plan is confidential, not to be shared with the employeeCritical: An employer’s labor agreement can’t limit the SAP’s authority, or place any restrictions on the SAP’s follow-up testing plan.
“Why is this taking so long?”
The employee may be “dragging his feet”.A marijuana violation often requires additional time.A SAP will usually want to know quantitation levels of the testThe MRO is not permitted to give quantitation levels to the employer 40.163(g)The MRO is permitted to provide quantitation levels to the SAP 40.163(g) and40.293(g)Depending on how much an employee was using marijuana, it could be 6-8 weeks before THC has cleared the bodyIf a return-to-duty test is positive, the employee will have another violation and must repeat the entire SAP process againMy treatment goal must be for the employee to stop using marijuana
“Can the employee return to work early?”
DOT permits the SAP to report compliance before the employee has completed the full treatment regimen. 40.301(c)(2)Once a SAP reports compliance, the SAP process is finished, and the SAP is no longer involved.Once the employee returns to work, the incentive to complete a treatment plan is gone.An unfinished treatment program is an ineffective way to treat addiction.
“How can I help an employee who returns early?”
In conjunction with the SAP, create a return-to-work agreement.The agreement spells out requirements and expectations for the employee to fully complete the SAP’s treatment recommendation.If the employee drops out of treatment, or fails other provisions of the agreement, the employee will be terminated from employment.If the employee tests positive on any subsequent DOT test, the employee will be terminated from employment.The agreement is signed by the employee, the SAP, and the employer.
“What is this aftercare stuff?”
Aftercare is critical to keeping the employee focused on sobriety.Monitoring aftercare can be provided by:The employer (whoever the DER designates)EAPThe SAPAftercare should be included in a return-to-work agreementDropping out of aftercare is a serious matter, and should have consequencesEmployees who are active in aftercare are more likely to succeed in maintaining sobriety and having no future violations
“Is it safe to return this employee to duty?”
A SAP can’t answer that question.A SAP’s only responsibility is to determine that the employee has “successfully complied” with the treatment recommendation.A SAP is not permitted to make a “fitness-for-duty” determination.It is the employer who must decide whether to put the employee back to work in a safety-sensitive position. 40.305(c)
“What if he goes to a new DOT job?”
The employee must sign a release of information that allows you to send test results and return-to-duty paperwork to the new employer.Copies of the SAP’s1) Initial SAP Report and2) Follow-up Evaluation ReportCopiesof the CCF for the employee’s return-to-duty test (negative result)Copies of the CCF for completed follow-up testsThe new employer will now be responsible for continuing the SAP’s follow-up testing plan.An auditor will want to see documentation (proof) that all follow-up tests that have been conducted according to the SAP’s plan.





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A Day in the Life of a SAP - Drug & Alcohol Program