Seeing The Forest AND T he Trees

1. Seeing The Forest AND The Trees The Role of the Substance Abuse Professional (SAP) Jeannie James, LPC/S, NCACII, SAP

2. 1st Group Activity The Macarena: • It is a 16 step dance – turning clockwise each sequence. • 1st 4 moves – right hand straight out palm down,now the left; then right hand palm up and then the left. • Next, cross right hand to grab inside of the arm and same with the left hand; then place right hand on right side of neck and left hand on left side of the neck (moves 5-8). • Next take right hand and place on left @ waist and left hand on right @ waist then place right hand on right glute and left hand on left glute (moves 9-12). • Finally shake, shake, shake (your bootie) 3 times, turn and clap (moves 13-16). • REPEAT until you return to starting position (ideally 4 times)… :] • *IT IS OPTIONAL TO LIST THIS SKILL ON YOUR RESUME.

3. WHAT does the Macarena have to do with being an SAP?

4. SAP – what does that really mean? Substance Abuse Professional • This is NOT someone who has just started in the field of addiction. This person MUST be someone who is alicensed physician; licensed or certified social worker;licensed or certified employee assistance professional; • alcohol and drug abuse counselor certified by the NAADAC Certification Commission (NCC) or the International Certification Reciprocity Consortium/Alcohol and Other Drug Abuse (ICRC). • To even qualify for those licenses/certifications, one must have years of experience. • IN ADDITION, a SAP must receive qualification training and pass a test administered by a nationally recognized professional or training organization.

5. SAP – What do they do? • The GATEKEEPER of the return to duty process. • The responsibility of the SAP is tremendous, and at every step in the process, the SAP must be aware of the impact his/her decisions make on the employee, the employer, and the general public. • Public safety is the first and foremost priority.

6. When are SAP services needed? • An employee comes to the SAP because of a verified positive drug test, a refusal to test (this includes a substituted or adulterated urine specimen), a breath alcohol test of .04 or higher, or a violation of the prohibitions on the use of alcohol or drugs under a DOT agency regulation.

7. Role of the SAP in the Returnto Duty Process The SAP must perform the following functions: • Conduct a face to face initial evaluation/assessment. • Provide a recommendation for either education or treatment. • Conduct a face to face follow-up evaluation. • Provide continuing treatment/aftercare recommendations when appropriate once the employee has returned to a safety-sensitive position. • Provide a follow-up testing plan.

8. Initial evaluation/assessment – Step 1 • Should be a comprehensive psycho-social-bio assessment using interview questions, standardized testing tools and collateral contacts. • SAP is responsible for appropriately assessing for any co-existing mental health problem. **Initial evaluation MUST include a diagnosis, treatment recommendation(s) and a treatment plan.

9. Group Activity #2 – Part 1 • Put yourself in the place of the client in scenario #1. What is your feedback about this experience?

10. Group Activity #2 – Part 2 • Put yourself in the place of the client in scenario #2. What is your feedback about this experience?

11. Level of Care Recommendation and Referral – Step 2 • Should be based on OBJECTIVE data and clinical history; for example – ASAM Placement Criteria for the Treatment of Substance Related Disorders. • Per DOT, ALL employees must be given some recommended course of education or treatment.

12. Follow-Up Evaluation – Step 3 • The clinically based question to be answered is whether or not the employee has successfully complied with the initial treatment plan. • The employer is dependent on the SAP’s evaluation at this stage in the process to gauge the employee’s ability to return to a safety-sensitive position. • The follow-up evaluation is clinically based on the face-to face meeting and information received from the treatment resource.

13. Continuing Treatment/Aftercare (When Appropriate) • It is permissible for the SAP to recommend additional services to ensure an employee returning to a safety-sensitive position remain clean and sober, as part of the return-to-duty agreement. • If the follow-up evaluation indicated the employee did not comply with the SAP’s initial recommendations, the SAP must write a letter to the employer or designated rep indicating dates for further follow-up evaluations and the clinical reasons for determining the employee has not demonstrated compliance to the initial recommendations. • The employer may take personnel action per their policies/procedures and must not return the employee to a safety-sensitive position.

14. Follow-Up Testing – Step 4 • SAP is sole determiner of the number/frequency of the follow-up tests and whether these tests will be for drugs, alcohol, or both. • SAP MUST recommend a minimum of six unannounced follow-up tests within the first 12 months following the employee’s return to a safety-sensitive position and can recommend up to 60 months follow-up testing. • Employer is responsible for determining the actual dates of the testing and may not impose additional requirements that go beyond the SAP’s plan.

15. SAP Consultation • S • SAP can act as consultant to DOT regulated companies – should know the limits of their knowledge and should refer employers directly to the appropriate operating administration for regulation questions.

16. References • The Substance Abuse Professional’s U.S. DOT Alcohol and Drug Testing Regulation Qualification Course, January 2003, NAADAC. • Federal Motor Carrier Safety Regulations, Management Edition, October Revisions, Label Master. • La Macarena by Los Del Rio. • Acknowledgements: • -THANKS to Terry Turner, my co-worker and amateur actor. • -THANKS to Bill Gilmer, my co-worker and IT consultant for my presentation. • -THANKS to Randy Cole, my supervisor/CEO for letting me attend this conference.

17. QUESTIONS???

18. THANKS SO MUCH FOR YOUR TIME AND ATTENTION!