1. The DOT-Qualified Substance Abuse Professional (SAP) Roles and Responsibilities Scott J. Watson, MA, LCAC, SAP, BRI Heartland Intervention, LLC Indianapolis, IN

2.  Explore the purpose and utility of the Part 40 Rule  Examine the stated roles and limitations of the SAP  Examine the stated roles and limitations of the employer and covered employee.  Review challenging cases, errors and suggestions relevant to the Return to Duty Process. Objectives

3.  Face to face assessment  Recommendations for education/treatment  Monitor progress  Follow up assessment  Determine compliance  Follow up testing plan  Aftercare plan if appropriate SAP Overview

4.  Meet and comply with all rules  Designate a DER  Ensure qualification of service agents  Obtain testing from previous employers (2yrs)  Conduct all required tests  Receive (via DER) all communication from MRO, SAP, etc.  Provide training according to rule Employer Overview

5.  Inquire of previous employers  Remove verified positives from duty  Provide names of SAPs  Conduct all required tests  Function as custodian of records  Cooperate in all audits  Submit reports as required Employer Overview

6.  Qualifications  Medical Doctor, Psychologist, Social Worker, MFT, EAP, Addictions Counselor  Must complete Qualifying SAP Training  Must satisfy a SAP examination  Must have knowledge and experience in dx & tx of substance use disorders The Substance Abuse Professional

7. So…  What about the Certified or Licensed SAP?  How do you KNOW that your SAP is qualified? The Substance Abuse Professional

8.  Employer  Employee  C-TPA  Union  Travelling Public Who is the SAP Client?

9.  Any verified positive result from an MRO is considered a violation….  Pre-employment  Random  Follow up  Return to Duty  Post Accident  Reasonable Suspicion Do I Need a SAP?

10.  Employee is given permission to use a company bus while off duty to transport some kids from his baseball team to a clinic.  With no one else on the bus, it gently brushes a parked car and knocks off a rear view mirror.  Police are called to complete an accident report after which the employee is charged with DUI. Violation……or Not?

11.  Any verified positive result from an MRO is considered a violation….  Pre-employment  Random  Follow up  Return to Duty  Post Accident  Reasonable Suspicion Do I Need a SAP?

12.  8 year employee goes for his DOT physical on a yearly basis. This year it includes a UDS.  The new collector sees it’s for a “DOT” physical and marks the form as a “pre-employment” which subsequently comes back positive for THC.  Violation? Violation…..or Not?

13.  Initial Evaluation  Must be clinical in nature  Million nosey questions  Must be face to face (40.291a)  Must include an assessment tool  Recommendation of Assistance (40.293 b1 and c/d)  Education and/or Treatment SAP Requirements

14.  Initial Letter to DER (40.311a)  Must be on SAP’s letterhead  Must be written  Must have signature, phone # and date  Also must include (40.311c)  Employee’s name and SSN  Employers name and address  Specific violation and date  Date of assessment  Recommendation of education and/or treatment SAP Requirements

15.  Initial Letter  Must be sent directly to the DER (40.311a)  Copy MAY be sent to 3 rd party  Does NOT require a release  May not be changed or amended (40.311b) SAP Requirements

16.  Insurance coverage and/or financial issues  Employment based agreements for treatment  Policies regarding leave or similar  SAP word is final and trumps the above which still may be considered SAP Considerations

17.  Must monitor treatment progress  Contact with providers  Appropriate documentation  Need to revise recommendations  Follow up recommendations SAP Requirements

18.  Complete follow-up evaluation  Face to face  Assessment tool  Determination of employee compliance SAP Requirements

19.  Letter of Compliance  Employee name and SSN  Employer name and address  Specific violation and date  Dates of evaluations and summary of plan  Dates of program participation  Clinical characterization of compliance  Follow up testing plan  OPTION of continuing care  SAP signature, phone # and date SAP Requirements

20.  Letter of NON-Compliance  Employer may NOT return employee to duty  More time needed or personnel action needed?  Letter contains same basic info as when compliant SAP Requirements

21.  Employer is responsible party  Not just “more randoms” but a TOOL for employers  At least 6 in first 12 months  Can last up to 5 years  Designed to be individual in nature  Can include alcohol and/or drugs  Not to be given to employee  Goal: Monitor employee to ensure no drug use Follow Up Testing

22.  EFG company purchases the HIJ and LMNOP company. The EFG DER becomes the DER for the new company.  She realizes that:  3 drivers inherited from the purchase were fired from EFG 2 yrs. ago for DOT violation. There is no documentation at new company.  1 employee has a follow up testing plan from 3 years ago but there is no documentation a follow up has EVER occurred. Scenario

23.  Small town has there bus driver’s in for a meeting. During a break it is suggested that Sandy smells like ETOH.  Small town calls their local police department who gives PBT and determines BAC=.065.  Employee is above threshold but not drunk. She is sent (not driven) home and a SAP is contacted the next week to do an eval according to city policy. Scenario

24.  Understand Follow Up tests for what they are  Maintain a company substance use policy  Consider a “Return to Work” agreement for all SAP cases  Develop a relationship with a SAP Five Friendly Suggestions