Substance Abuse Professional

The U.S. Department of Transportation (DOT) published Alcohol and Drug Testing Rules for safety-sensitive transportation workers on February 15, 1994. The rules identify Certified Employee Assistance Professionals (CEAPs), and five other types of professionals, as eligible to carry out the functions of a Substance Abuse Professional (SAP) if the professional meets two other criteria provided in the rules.

CommunityCare has two (2) Substance Abuse Professionals (SAPs) who provide services for over 100 Department of Transportation companies covering over 20,000 safety-sensitive employees.

What is a SAP? What are SAP Functions?

In order to legally function as a SAP, a professional must be one of the following:

• Licensed or Certified Employee Assistance Professional
• Licensed M.D. or D.O.
• Licensed or Certified Social Worker
• Licensed or Certified Psychologist
• Alcohol and drug abuse counselor certified at the national level by the National Association of Alcohol and Drug Abuse Counselors.
• Substance abuse counselor certified by the NAADAC Certification Commission or ICRC Certification Commission.

In addition, to qualify as a SAP, eligible professionals must meet two additional criteria:

• "Knowledge of," and,
• "Clinical experience in" the diagnosis and treatment of alcohol and drug-related disorders.

SAP Referral

A SAP who evaluates a person may not refer that person to his or her private practice, or to a place where the SAP is employed or has a financial relationship. The rules do not prohibit, however, a SAP from referring a person who tested positive for assistance through:

• A public agency
• The employer, or a person under contract to the employer to provide treatment for alcohol or drug problems on behalf of the employer;
• The sole source of therapeutically appropriate treatment under the person's health insurance program; or,
• The sole source of therapeutically appropriate treatment reasonably accessible to the person.

SAP Services

If an employer has a plan for retaining an employee who tests positive in a safety-sensitive position, the rules* require that the employee must be referred to a SAP. As outlined in the rules, SAPs are to perform the following functions:

• assessment and evaluation of employees who test positive,
• present recommendations and referral for treatment,
• tracking of client through the treatment process,
• follow-up evaluations to determine if an employee is compliant with treatment or has successfully complied with the recommended treatment, and
• directs a minimum of six follow-up tests (required during the first 12 months but may extend through 60 months) and monitors the follow-up program.

The SAP may also be required to:

• Monitor the Employee to insure the they have completed all phases of the referral
• SAP can require up to 5 years of follow-up testing if needed
• SAP follows the employee until the return to work test is negative
• Advise the client company to the regulations compliance

SAP Duties

Initial Assessment Planning

• Identify the type of test or rule the employee has failed or violated.
• Identify who made the referral to the SAP.
• Gather any necessary releases.
• Create a reference file for the client.
• Review the client's benefits.
• Review company policies and collective bargaining agreements.

Initial Assessment

• Explain to the client your role as a SAP as defined by the DOT regulations and the employer's substance abuse policy.
• Make a subjective review of the client's physical appearance and demeanor.
• Take a psychological and social history of the client.
• Review client's work history.
• Administer a standardized formal assessment tool.
• Determine the level of care placement according to ASAM criteria.
• Review the client's health care benefits and financial resources that are available to pay for treatment.
• Recommend a level of care and the most appropriate education and/or treatment resource.
• Obtain employee signature on release forms.
• Report to employer and other designated individuals.

Follow-up Assessment

• Assess level of participation and completion of treatment.
• Decide on follow-up monitoring support.
• Explain the RTD agreement.
• Recommend a follow-up testing program.
• Submit a report to the employer.

Monitoring after Return-to-Duty

• Monitor ongoing participation in post treatment care.
• Monitor the RTD testing program.
• If there is a DOT or RTD agreement violation, send notification to the employer.

*The Department of Transportation Guidelines differ between each operational area.