Subpart OSubstance Abuse
Professionals and the Return-to-Duty Process
§ 40.281 Who is qualified to act as a SAP?
To be permitted to act as a
SAP in the DOT drug testing program, you must meet each of the requirements of this
section:
(a) Credentials. You must have one of the following credentials:
- You are a licensed physician (Doctor of Medicine or Osteopathy);
- You are a licensed or certified social worker;
- You are a licensed or certified psychologist;
- You are a licensed or certified employee assistance professional; or
- You are a drug and alcohol counselor certified by the National
Association of Alcoholism and Drug Abuse Counselors Certification Commission (NAADAC) or
by the International Certification Reciprocity Consortium/Alcohol and Other Drug Abuse
(ICRC).
(b) Basic knowledge. You must be
knowledgeable in the following areas:
- You must be knowledgeable about and have clinical experience
in the diagnosis and treatment of alcohol and controlled substances-related disorders.
- You must be knowledgeable about the SAP function as it
relates to employer interests in safety-sensitive duties.
- You must be knowledgeable about this part, the DOT agency
regulations applicable to the employers for whom you evaluate employees, and the DOT SAP
Guidelines, and you keep current on any changes to these materials. These documents are
available from ODAPC (Department of Transportation, 400 7th Street, SW., Room
10403, Washington DC, 20590 (2023663784), or on the ODAPC web site
(http://www.dot.gov/ost/dapc).
(c) Qualification training. You must receive
qualification training meeting the requirements of this paragraph (c).
- Qualification training must provide instruction on the following
subjects:
(i) Background, rationale, and coverage of the Departments drug and alcohol testing
program;
(ii) 49 CFR Part 40 and DOT agency drug and alcohol testing rules;
(iii) Key DOT drug testing requirements, including collections, laboratory testing, MRO
review, and problems in drug testing;
(iv) Key DOT alcohol testing requirements, including the testing process, the role of BATs
and STTs, and problems in alcohol tests;
(v) SAP qualifications and prohibitions;
(vi) The role of the SAP in the return-to-duty process, including the initial employee
evaluation, referrals for education and/or treatment, the follow-up evaluation, continuing
treatment recommendations, and the follow-up testing plan;
(vii) SAP consultation and communication with employers, MROs, and treatment providers;
(viii) Reporting and recordkeeping requirements;
(ix) Issues that SAPs confront in carrying out their duties under the program.
- Following your completion of qualification training under paragraph
(c)(1) of this section, you must satisfactorily complete an examination administered by a
nationally-recognized professional or training organization. The examination must
comprehensively cover all the elements of qualification training listed in paragraph
(c)(1) of this section.
- The following is the schedule for qualification training you must
meet:
(i) If you became a SAP before August 1, 2001, you must meet the qualification training
requirement no later than December 31, 2003.
(ii) If you become a SAP between August 1, 2001, and December 31, 2003, you must meet the
qualification training requirement no later than December 31, 2003.
(iii) If you become a SAP on or after January 1, 2004, you must meet the qualification
training requirement before you begin to perform SAP functions.
(d) Continuing education. During each three-year period from
the date on which you satisfactorily complete the examination under paragraph (c)(2) of
this section, you must complete continuing education consisting of at least 12
professional development hours (e.g., CEUs) relevant to
performing SAP functions.
- This continuing education must include material concerning new
technologies, interpretations, recent guidance, rule changes, and other information about
developments in SAP practice, pertaining to the DOT program, since the time you met the
qualification training requirements of this section.
- Your continuing education activities must include documentable
assessment tools to assist you in determining whether you have adequately learned the
material.
(e) Documentation. You must maintain
documentation showing that you currently meet all requirements of this section. You must
provide this documentation on request to DOT agency representatives and to employers and
C/TPAs who are using or contemplating using your services.
§ 40.283 How does a certification
organization obtain recognition for its members as SAPs?
(a) If you represent a certification organization that
wants DOT to authorize its certified drug and alcohol counselors to be added to §
40.281(a)(5), you may submit a written petition to DOT requesting a review of your
petition for inclusion.
(b) You must obtain the National Commission for Certifying Agencies
(NCCA) accreditation before DOT will act on your petition.
(c) You must also meet the minimum requirements of Appendix E to
this part before DOT will act on your petition.
§ 40.285 When is a SAP evaluation required?
(a) As an employee, when you have violated DOT drug and
alcohol regulations, you cannot again perform any DOT safety-sensitive duties for any
employer until and unless you complete the SAP evaluation, referral, and
education/treatment process set forth in this subpart and in applicable DOT agency
regulations. The first step in this process is a SAP evaluation.
(b) For purposes of this subpart, a verified positive DOT drug test
result, a DOT alcohol test with a result indicating an alcohol concentration of 0.04 or
greater, a refusal to test (including by adulterating or substituting a urine specimen) or
any other violation of the prohibition on the use of alcohol or drugs under a DOT agency
regulation constitutes a DOT drug and alcohol regulation violation.
§ 40.287 What information is an employer
required to provide concerning SAP services to an employee who has a DOT drug and alcohol
regulation violation?
As an employer, you must provide to each employee
(including an applicant or new employee) who violates a DOT drug and alcohol regulation a
listing of SAPs readily available to the employee and acceptable to you, with names,
addresses, and telephone numbers. You cannot charge the employee any fee for compiling or
providing this list. You may provide this list yourself or through a C/TPA or other
service agent.
§ 40.289 Are employers required to provide
SAP and treatment services to employees?
(a) As an employer, you are not required to provide a
SAP evaluation or any subsequent recommended education or treatment for an employee who
has violated a DOT drug and alcohol regulation.
(b) However, if you offer that employee an opportunity to return to
a DOT safety-sensitive duty following a violation, you must, before the employee again
performs that duty, ensure that the employee receives an evaluation by a SAP meeting the
requirements of § 40.281 and that the employee successfully complies with the SAPs
evaluation recommendations.
(c) Payment for SAP evaluations and services is left for employers
and employees to decide and may be governed by existing management-labor agreements and
health care benefits.
§ 40.291 What is the role of the SAP in the
evaluation, referral, and treatment process of an employee who has violated DOT agency
drug and alcohol testing regulations?
(a) As a SAP, you are charged with:
- Making a face-to-face clinical assessment and evaluation to determine
what assistance is needed by the employee to resolve problems associated with alcohol
and/or drug use;
- Referring the employee to an appropriate education and/or treatment
program;
- Conducting a face-to-face follow-up evaluation to determine if the
employee has actively participated in the education and/or treatment program and has
demonstrated successful compliance with the initial assessment and evaluation
recommendations;
- Providing the DER with a follow-up drug and/or alcohol testing plan
for the employee; and
- Providing the employee and employer with recommendations for
continuing education and/or treatment.
(b) As a SAP, you are not an advocate for the employer or employee.
Your function is to protect the public interest in safety by professionally evaluating the
employee and recommending appropriate education/treatment, follow-up tests, and aftercare.
§ 40.293 What is the SAPs function
in conducting the initial evaluation of an employee?
As a SAP, for every employee who comes to you following
a DOT drug and alcohol regulation violation, you must accomplish the following:
(a) Provide a comprehensive face-to-face assessment and clinical evaluation.
(b) Recommend a course of education and/or treatment with which the
employee must demonstrate successful compliance prior to returning to DOT safety-sensitive
duty.
- You must make such a recommendation for every individual who has
violated a DOT drug and alcohol regulation.
- You must make a recommendation for education and/or treatment that
will, to the greatest extent possible, protect public safety in the event that the
employee returns to the performance of safety-sensitive functions.
(c) Appropriate education may include, but is not limited to,
self-help groups (e.g., Alcoholics Anonymous) and community lectures, where
attendance can be independently verified, and bona fide drug and alcohol education
courses.
(d) Appropriate treatment may include, but is not limited to,
in-patient hospitalization, partial in-patient treatment, out-patient counseling programs,
and aftercare.
(e) You must provide a written report directly to the DER
highlighting your specific recommendations for assistance (see § 40.311(c)).
(f) For purposes of your role in the evaluation process, you must
assume that a verified positive test result has conclusively established that the employee
committed a DOT drug and alcohol regulation violation. You must not take into
consideration in any way, as a factor in determining what your recommendation will be, any
of the following:
- A claim by the employee that the test was unjustified or inaccurate;
- Statements by the employee that attempt to mitigate the seriousness
of a violation of a DOT drug or alcohol regulation (e.g., related
to assertions of use of hemp oil, medical marijuana use,
contact positives, poppy seed ingestion, job stress); or
- Personal opinions you may have about the justification or rationale
for drug and alcohol testing.
(g) In the course of gathering information for purposes of your
evaluation in the case of a drug-related violation, you may consult with the MRO. As the
MRO, you are required to cooperate with the SAP and provide available information the SAP
requests. It is not necessary to obtain the consent of the employee to provide this
information.
§ 40.295 May employees or employers seek a
second SAP evaluation if they disagree with the first SAPs recommendations?
(a) As an employee with a DOT drug and alcohol
regulation violation, when you have been evaluated by a SAP, you must not seek a second
SAPs evaluation in order to obtain another recommendation.
(b) As an employer, you must not seek a second SAPs evaluation
if the employee has already been evaluated by a qualified SAP. If the employee, contrary
to paragraph (a) of this section, has obtained a second SAP evaluation, as an employer you
may not rely on it for any purpose under this part.
§ 40.297 Does anyone have the authority to
change a SAPs initial evaluation?
(a) Except as provided in paragraph (b) of this
section, no one (e.g., an employer, employee, a managed-care provider, any service
agent) may change in any way the SAPs evaluation or recommendations for assistance.
For example, a third party is not permitted to make more or less stringent a SAPs
recommendation by changing the SAPs evaluation or seeking another SAPs
evaluation.
(b) The SAP who made the initial evaluation may modify his or her
initial evaluation and recommendations based on new or additional information (e.g., from
an education or treatment program).
§ 40.299 What is the SAPs role and what
are the limits on a SAPs discretion in referring employees for education and
treatment?
(a) As a SAP, upon your determination of the best
recommendation for assistance, you will serve as a referral source to assist the employees
entry into a education and/ or treatment program.
(b) To prevent the appearance of a conflict of interest, you must
not refer an employee requiring assistance to your private practice or to a person or
organization from which you receive payment or to a person or organization in which you
have a financial interest. You are precluded from making referrals to entities with which
you are financially associated.
(c) There are four exceptions to the prohibitions contained in
paragraph (b) of this section. You may refer an employee to any of the following providers
of assistance, regardless of your relationship with them:
- A public agency (e.g., treatment
facility) operated by a state, county, or municipality;
- The employer or a person or organization under contract to the
employer to provide alcohol or drug treatment and/or education services (e.g.,
the employers contracted treatment provider);
- The sole source of therapeutically appropriate treatment under the
employees health insurance program (e.g., the single
substance abuse in-patient treatment program made available by the employees
insurance coverage plan); or
- The sole source of therapeutically appropriate treatment reasonably
available to the employee (e.g., the only treatment facility
or education program reasonably located within the general commuting area).
§ 40.301 What is the SAPs function
in the follow-up evaluation of an employee?
(a) As a SAP, after you have prescribed assistance
under § 40.293, you must re-evaluate the employee to determine if the employee has
successfully carried out your education and/or treatment recommendations.
- This is your way to gauge for the employer the employees
ability to demonstrate successful compliance with the education and/or treatment plan.
- Your evaluation may serve as one of the reasons the employer decides
to return the employee to safety-sensitive duty.
(b) As the SAP making the follow-up evaluation determination, you
must:
- Confer with or obtain appropriate documentation from the appropriate
education and/or treatment program professionals where the employee was referred; and
- Conduct a face-to-face clinical interview with the employee to
determine if the employee demonstrates successful compliance with your initial evaluation
recommendations.
(c) 1. If the employee has demonstrated successful
compliance, you must provide a written report directly to the DER highlighting your
clinical determination that the employee has done so with your initial evaluation
recommendation (see § 40.311(d)).
2. You may determine that an employee has
successfully demonstrated compliance even though the employee has not yet completed the
full regimen of education and/or treatment you recommended or needs additional asssitance.
For example, if the employee has successfully completed the 30-day in-patient program you
prescribed, you may make a successful compliance determination
even though you conclude that the employee has not yet completed the out-patient
counseling you recommended or should continue in an aftercare program.
(d) 1. As the SAP, if you believe, as a
result of the follow-up evaluation, that the employee has not demonstrated successful
compliance with your recommendations, you must provide written notice directly to the DER
(see § 40.311(e)).
2. As an employer who receives the SAPs
written notice that the employee has not successfully complied with the SAPs
recommendations, you must not return the employee to the performance of safety-sensitive
duties.
3. As the SAP, you may conduct additional
follow-up evaluation(s) if the employer determines that doing so is consistent with the
employees progress as you have reported it and with the employers policy
and/or labor-management agreements.
4. As the employer, following a SAP
report that the employee has not demonstrated successful compliance, you may take
personnel action consistent with your policy and/or labor-management agreements.
§ 40.303 What happens if the SAP believes the
employee needs additional treatment, aftercare, or support group services even after the
employee returns to safety-sensitive duties?
(a) As a SAP, if you believe that ongoing services (in
addition to follow-up tests) are needed to assist an employee to maintain sobriety or
abstinence from drug use after the2employee resumes the performance of safety-sensitive duties, you
must provide recommendations for these services in your follow-up evaluation report (see
§ 40.311(d)(10)).
(b) As an employer receiving a recommendation for these services
from a SAP, you may, as part of a return-to-duty agreement with the employee, require the
employee to participate in the recommended services. You may monitor and document the
employees participation in the recommended services. You may also make use of SAP
and employee assistance program (EAP) services in assisting and monitoring employees
compliance with SAP recommendations. Nothing in this section permits an employer to fail
to carry out its obligations with respect to follow-up testing (see § 40.309 ).
(c) As an employee, you are obligated to comply with the SAPs
recommendations for these services. If you fail or refuse to do so, you may be subject to
disciplinary action by your employer.
§ 40.305 How does the return-to-duty process
conclude?
(a) As the employer, if you decide that you want to
permit the employee to return to the performance of safety-sensitive functions, you must
ensure that the employee takes a return-to-duty test. This test cannot occur until after
the SAP has determined that the employee has successfully complied with prescribed
education and/or treatment. The employee must have a negative drug test result and/or an
alcohol test with an alcohol concentration of less than 0.02 before resuming performance
of safety-sensitive duties.
(b) As an employer, you must not return an employee to
safety-sensitive duties until the employee meets the conditions of paragraph (a) of this
section. However, you are not required to return an employee to safety-sensitive duties
because the employee has met these conditions. That is a personnel decision that you have
the discretion to make, subject to collective bargaining agreements or other legal
requirements.
(c) As a SAP or MRO, you must not make a fitness for
duty determination as part of this re-evaluation unless required to do so
under an applicable DOT agency regulation. It is the employer, rather than you, who must
decide whether to put the employee back to work in a safety-sensitive position.
§ 40.307 What is the SAPs function in
prescribing the employees follow-up tests?
(a) As a SAP, for each employee who has committed a DOT
drug or alcoholregulation violation, and who seeks to resume the performance of
safety-sensitive functions, you must establish a written follow-up testing plan. You do
not establish this plan until after you determine that the employee has successfully
complied with your recommendations for education and/or treatment.
(b) You must present a copy of this plan directly to the DER (see §
40.311(d)(9)).
(c) You are the sole determiner of the number and frequency of
follow-up tests and whether these tests will be for drugs, alcohol, or both, unless
otherwise directed by the appropriate DOT agency regulation. For example, if the employee
had a positive drug test, but your evaluation or the treatment program professionals
determined that the employee had an alcohol problem as well, you should require that the
employee have follow-up tests for both drugs and alcohol.
(d) However, you must, at a minimum, direct that the employee be
subject to six unannounced follow-up tests in the first 12 months of safety-sensitive duty
following the employees return to safety-sensitive functions.
- You may require a greater number of follow-up tests during the first
12-month period of safety-sensitive duty (e.g., you may require one test a month
during the 12-month period; you may require two tests per month during the first 6-month
period and one test per month during the final 6-month period).
- You may also require follow-up tests during the 48 months of
safety-sensitive duty following this first 12-month period.
- You are not to establish the actual dates for the follow-up tests you
prescribe. The decision on specific dates to test is the employers.
- As the employer, you must not impose additional testing requirements (e.g.,
under company authority) on the employee that go beyond the SAPs follow-up testing
plan.
(e) The requirements of the SAPs follow-up testing plan
follow the employee to subsequent employers or through breaks in
service. Example 1 to Paragraph (e): The employee returns to duty with Employer A.
Two months afterward, after completing the first two of six follow-up tests required by
the SAPs plan, the employee quits his job with Employer A and begins to work in a
similar position for Employer B. The employee remains obligated to complete the four
additional tests during the next 10 months of safety-sensitive duty, and Employer B is
responsible for ensuring that the employee does so. Employer B learns of this obligation
through the inquiry it makes under § 40.25.
Example 2 to Paragraph (e): The employee returns to duty with Employer A. Three
months later, after the employee completes the first two of six follow-up tests required
by the SAPs plan, Employer A lays the employee off for economic or seasonal
employment reasons. Four months later, Employer A recalls the employee. Employer A must
ensure that the employee completes the remaining four follow-up tests during the next nine
months.
- As the SAP, you may modify the determinations you have made
concerning follow-up tests. For example, even if you recommended follow-up testing beyond
the first 12-months, you can terminate the testing requirement at any time after the first
year of testing. You must not, however, modify the requirement that the employee take at
least six follow-up tests within the first 12 months after returning to the performance of
safety-sensitive functions.
§ 40.309 What are the employers
responsibilities with respect to the SAPs directions for follow-up tests?
(a) As the employer, you must carry out the SAPs follow-up testing requirements. You
may not allow the employee to continue to perform safety-sensitive functions unless
follow-up testing is conducted as directed by the SAP.
(b) You should schedule follow-up tests on dates of your own
choosing, but you must ensure that the tests are unannounced with no discernable pattern
as to their timing, and that the employee is given no advance notice.
(c) You cannot substitute any other tests (e.g., those
carried out under the random testing program) conducted on the employee for this follow-up
testing requirement.
(d) You cannot count a follow-up test that has been cancelled as a
completed test. A cancelled follow-up test must be recollected.
§ 40.311 What are the requirements concerning SAP
reports?
(a) As the SAP conducting the required evaluations, you must send the written reports
required by this section in writing directly to the DER and not to a third party or entity
for forwarding to the DER (except as provided in § 40.355(e)). You may, however, forward
the document simultaneously to the DER and to a C/TPA.
(b) As an employer, you must ensure that you receive SAP written
reports directly from the SAP performing the evaluation and that no third party or entity
changed the SAPs report in any way.
(c) The SAPs written report, following an initial evaluation
that determines what level of assistance is needed to address the employees drug
and/or alcohol problems, must be on the SAPs own letterhead (and not the letterhead
of another service agent) signed and dated by the SAP, and must contain the following
delineated items:
- Employees name and SSN;
- Employers name and address;
- Reason for the assessment (specific violation of DOT regulations and
violation date);
- Date(s) of the assessment;
- SAPs education and/or treatment recommendation; and
- SAPs telephone number.
(d) The SAPs written report concerning a follow-up evaluation
that determines the employee has demonstrated successful compliance must be on the SAPs
own letterhead (and not the letterhead of another service agent), signed by the SAP and
dated, and must contain the following items:
- Employees name and SSN;
- Employers name and address;
- Reason for the initial assessment (specific violation of DOT
regulations and violation date);
- Date(s) of the initial assessment and synopsis of the treatment plan;
- Name of practice(s) or service(s) providing the recommended education
and/or treatment;
- Inclusive dates of employees program participation;
- Clinical characterization of employees program participation;
- SAPs clinical determination as to whether the employee has
demonstrated successful compliance;
- Follow-up testing plan;
- Employees continuing care needs with specific treatment,
aftercare, and/or support group services recommendations; and
- SAPs telephone number.
(e) The SAPs written report concerning a follow-up evaluation
that determines the employee has not demonstrated successful compliance must be on the SAPs
own letterhead (and not the letterhead of another service agent), signed by the SAP and
dated, and must contain the following items:
- Employees name and SSN;
- Employers name and address;
- Reason for the initial assessment (specific DOT violation and date);
- Date(s) of initial assessment and synopsis of treatment plan;
- Name of practice(s) or service(s) providing the recommended education
and/or treatment;
- Inclusive dates of employees program participation;
- Clinical characterization of employees program participation;
- Date(s) of the first follow-up evaluation;
- Date(s) of any further follow-up evaluation the SAP has scheduled;
- SAPs clinical reasons for determining that the employee has not
demonstrated successful compliance; and
- SAPs telephone number.
(f) As a SAP, you must also provide these written reports directly
to the employee if the employee has no current employer and to the gaining DOT regulated
employer in the event the employee obtains another transportation industry
safety-sensitive position.
(g) As a SAP, you are to maintain copies of your reports to
employers for 5 years, and your employee clinical records in accordance with Federal,
state, and local laws regarding record maintenance, confidentiality, and release of
information. You must make these records available, on request, to DOT agency
representatives (e.g., inspectors conducting an audit or safety investigation) and
representatives of the NTSB in an accident investigation.
(h) As an employer, you must maintain your reports from SAPs for 5
years from the date you received them.
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| § 40.313 Where is
other information on SAP functions and the return-to-duty process found in this
regulation?
You can find other information on the role and functions of SAPs in the following
sections of this part:
§ 40.3Definition.
§ 40.347Service agent assistance with SAP-required follow-up
testing.
§ 40.355Transmission of SAP reports.
§ 40.329(c)Making SAP reports available to employees on
request.
Appendix E to Part 40SAP Equivalency Requirements for
Certification Organizations. |
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