Substance abuse professional (SAP)

Scope

These requirements apply to SAPs who evaluate drivers of commercial motor vehicles (CMVs) in interstate, intrastate, or foreign commerce.

Regulatory citations

• 49 CFR 40, Subpart O — Substance abuse professionals and the return-to-duty process

Key definitions

• Substance abuse professional (SAP): A person who evaluates drivers who have violated a Department of Transportation (DOT) drug and alcohol regulation and makes recommendations concerning education, treatment, follow-up testing, and aftercare.

Summary of requirements

An individual must have certain credentials, knowledge, and training to act as an SAP. An SAP must be a:

• Licensed physician (Doctor of Medicine or Osteopathy);
• Licensed or certified social worker;
• Licensed or certified psychologist;
• Licensed or certified employee assistance professional;
• State-licensed or certified marriage and family therapist; or
• Drug and alcohol counselor certified by an organization listed on the Office of Drug and Alcohol Policy & Compliance (ODAPC) website.
  

If an otherwise qualified SAP, the SAP must abide by the geographic limitations applicable to their credential when performing remote evaluations. They must not conduct an evaluation that exceeds your geographic limitations.

An SAP must also:

• Have knowledge and clinical experience in the diagnosis and treatment of alcohol and controlled substances-related disorders;
• Know the Part 40 regulations, other applicable DOT agency regulations, and the DOT’s SAP Guideline;
• Keep current on any changes to these materials, and must subscribe to the Office of Drug and Alcohol Policy and Compliance’s (ODAPC) listserve.

Qualification training. The SAP must receive qualification instruction on the following subjects:

• Background, rationale, and coverage of the DOT’s drug and alcohol testing program;
• Part 40 and DOT agency drug and alcohol testing rules;
• Key DOT drug testing requirements, including collections, laboratory testing, medical review officer (MRO) review, and problems in drug testing;
• Key DOT alcohol testing requirements, including the testing process, the role of breath alcohol technicians (BATs), screening test technicians (STTs), and problem in alcohol tests;
• SAP qualifications and prohibitions;
• The role of the SAP in the return-to-duty process;
• SAP consultation and communication with employers, MROs, and treatment providers;
• Reporting and recordkeeping requirements; and
• Issues that SAPs confront in carrying out their duties under the program.

Following completion of the qualification training, the SAP must pass an exam given by a nationally-recognized professional or training organization.

Continuing education. After passing the exam, the SAP is required to complete 12 professional development hours related to performing SAP functions once every three years.

SAP evaluation. A driver who has violated the DOT drug and alcohol regulations (alcohol concentration of 0.04 or greater, refusal to test, or failing a drug test) must complete the SAP evaluation, referral, and education/treatment process before the driver can again perform any safety-sensitive functions.

An employer must provide (free of charge) to a driver who has violated the DOT drug and alcohol regulations, a list of SAPs. The list must include SAP names, addresses, and telephone numbers.

An employer is not required to provide an SAP evaluation or recommended education or treatment. However, if the employer offers a driver the opportunity to return to safety-sensitive functions following a violation, the employer must make sure the driver has received an SAP evaluation and has successfully complied with the SAP’s recommendations.

The regulations do not address who should pay for an SAP evaluation. This is left to the driver and employer.

The basic responsibility of the SAP is to:

• Provide a comprehensive assessment and clinical evaluation of an employee who has engaged in prohibited behavior (Subpart B to Part 382), and
• Determine whether the employee needs assistance resolving alcohol or drug abuse-related problems.

At the SAP’s discretion, the initial and follow-up evaluations may be performed face-to-face in-person or remotely. If a SAP is not prohibited from using technology within the parameters of the SAP’s state-issued license or other credential(s), a remote evaluation must be must be conducted in accordance with the following criteria:

• The technology must permit real-time audio and visual interaction between the SAP and the employee; and
• The quality of the technology (e.g., speed of the internet connection and clarity of the video display) must be sufficient to allow the SAP to gather all the visual and audible information the SAP would otherwise gather in an in-person, face-to-face interaction, while providing security to protect the confidentiality of the communications at the level expected by industry standards for remote substance abuse evaluations.

When gathering information as part of the evaluation process, the SAP may consult with the MRO. The MRO may provide information without the driver’s consent.

The SAP is neither an advocate for the driver or the employer. The SAP’s job is to protect public interest in safety via professional evaluation and recommendation.

Seeking a second SAP evaluation is prohibited. Only the SAP may change an evaluation and recommendation. This change must be based on new or additional information.

Referral. The SAP cannot refer the driver to the SAP’s private practice or to a person or organization from which the SAP receives payment or has a financial interest.

A driver may be referred to the following providers regardless of the SAP’s relationship with them:

• A public agency operated by a state, county, or municipality;
• A person or organization under contract to the employer to provide treatment and/or education services;
• The only source of appropriate treatment under the driver’s health insurance program; or
• The only source of treatment reasonably available to the driver.

Follow-up evaluation — The SAP who prescribed assistance must re-evaluate the driver and determine if the driver successfully carried out the SAP’s treatment and/or education recommendations.

The SAP making the follow-up evaluation must:

• Confer with or obtain appropriate documentation from the education and/or treatment programs where the driver was referred; and
• Conduct an interview with the driver to determine if the driver demonstrates successful compliance with the SAP’s original evaluation recommendations.

If the driver has demonstrated successful compliance, the SAP must send a written report to the DER.

The SAP may determine that the driver has successfully demonstrated compliance even though the driver has not completed the treatment and/or education prescribed by the SAP, or if the driver needs additional assistance.

If the driver has not demonstrated successful compliance, the SAP must send a written report to the DER. The employer may not return the driver to safety-sensitive functions and may take action based on company policy.

If the SAP determines that the driver needs ongoing services, the SAP must provide recommendations in the follow-up evaluation report. The driver is required to comply with the SAP’s recommendations.

Return-to-duty and follow-up.   In order to return to the performance of safety-sensitive functions, the driver must:

• Successfully comply with the education and/or treatment prescribed by the SAP; and
• Take a return-to-duty test with a negative drug test result and/or alcohol test with an alcohol concentration of less than 0.02.

The SAP must determine the driver’s follow-up testing plan. The driver is subject to six unannounced follow-up tests in the first 12 months of safety-sensitive duty following the driver’s return to safety-sensitive functions.

The SAP may require additional follow-up tests for an additional 48 months following the first 12-month period. (A total of up to 60 months of testing.)

Record retention. SAPs must maintain documentation showing they currently meet all training/educational requirements. They must be able to provide this information on request to DOT agency representatives and to employers and consortium/third party administrators (C/TPAs) who are using or contemplating using the SAP’s services.