‘Back to Basics’ for Substance Abuse Professionals

therapist session

By: The U.S. Department of Transportation Office of Drug and Alcohol Policy & Compliance

As a SAP, remember the important role you play as “Gatekeeper” for DOT’s return-to-duty process.  You represent the major decision point (and in some cases, the only decision point) an employer may have in choosing whether or not to place an employee behind the steering wheel of a school bus, in the cockpit of a plane, at the helm of an oil tanker, at the throttle of a train, in the engineer compartment of a subway car, or at the emergency control valves of a natural gas pipeline.

Your responsibility to the public is enormous!  Your function is to protect the public interest in safety by professionally evaluating the employee and recommending appropriate education and/or treatment, follow-up tests, and aftercare.  Your decisions and actions have the potential to directly impact transportation safety.

Back to Basics is a reminder that every assessment you conduct is important to the employee, the employer, and public safety.  Do it Right the First Time and Every Time.

The following are important points to remember as the “Gatekeeper” of the return-to-duty process:

  • You are not an advocate for the employer or the employee.  Again, your function is to protect the public interest in safety.
  • You must meet all of the qualifications to be a SAP (§ 40.281).
  • You may contact an employer, former employer, or Medical Review Officer to discuss the employee’s violation without a written release from the employee.
  • You must conduct a comprehensive assessment and clinical evaluation unique to each employee.
    • It is never appropriate to provide employees with estimated return-to-duty timelines before conducting an initial SAP evaluation and assessment.
  • You must recommend a course of education and/or treatment unique to each employee
    • It is never appropriate to use a ‘cookie cutter’ approach and assign the same education and/or treatment to every employee.
  • You must conduct a follow-up evaluation and determine whether the employee has demonstrated successful compliance with your recommended education and/or treatment plan.
  • All assessments and evaluations must be done face-to-face (in-person or remotely).  (See § 40.291) The method of evaluation is up to you and not the employee or employer.
  • You must provide written reports directly to the employer’s DER explaining your recommendations and including a follow-up testing plan.
  • Written reports (initial and follow-up) must be on your own letterhead; make sure they contain all of the required elements (§ 40.311).
  • The employee can get copies of the reports you provided to the employer, but you must NEVER give an employee a copy of their follow-up testing plan.
  • You must require the employee to undergo at least 6 follow-up tests in the first 12 months, and you can require additional tests for up to 60 months.

Office of Drug & Alcohol Policy & Compliance (2023). Back to Basics article retrieved from the U.S. DOT ODAPC

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