Implementation Guidelines - Federal Transit Administration - U.S. ...

Implementation Guidelines - Federal Transit Administration - U.S. ... Implementation Guidelines - Federal Transit Administration - U.S. ...

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SAP, many employers have looked to their EAPs for SAP services. On the surface, this appears to be a wise decision. However, many transit systems have found that an EAP may not be the best environment to find SAPs who are philosophically aligned with DOT programs, and they may not be the best location to house SAP services. FTA audits frequently found that SAPs in general misunderstand their role as the gatekeeper of the return-to-duty process, and therefore, compromise the integrity of the process and public safety. This misunderstanding is associated with the philosophical misalignment of EAP counselors and SAPs. EAP counselors are often viewed as advocates for the employee and as such, attempt to return employees who have tested positive back to duty as soon as possible. This approach is consistent with the training that counselors often receive that emphasizes getting the person back into a stable work environment as soon as possible, where they must be accountable. This philosophy, however, is contrary to the basic premise upon which the SAP’s function was established. Due to the safetysensitive nature of the positions the employees fill, the SAP should be very conservative in his/her assessment of the employee and the progress made in education/treatment programs. “Putting in the time” is simply not enough for an individual returning to a safety-sensitive position. Similarly, if the SAP rushes the return-to-duty test, the employee may be putting the public at risk. The SAP must not release the individual to come back to work until the SAP has a reasonable level of assurance that the individual will stay drug and alcohol free based on the individual’s attitude, support structure, participation in the treatment program, motivation, and Chapter 9. Substance Abuse Professionals, Rehabilitation, and Treatment demonstrated behavior changes. The SAP is the advocate for the public interest, not the employee. Given this difference of philosophical viewpoints, some transit systems have chosen to separate the SAP function from the EAP function. In the traditional role, the EAP remains available to employees to help them deal with issues in confidence and, if needed, self refer to a treatment program for drug or alcohol problems. The SAP does not become involved unless there is a positive test result or a test refusal on a DOT test. However, if an FTA rule violation occurs, the individual falls under the purview of the SAP and must be subject to the consequences and return-to-duty process defined in the regulations that were summarized previously in this chapter. By separating the functions, the credibility and effectiveness of the EAP program as an employee benefit is not compromised, and the seriousness and rigor of the SAP process is not diluted. Employees can better understand the roles of the two entities rather than being confused by one counselor that presents two different approaches, standards of confidentiality, and advocacy depending on whether they act as the EAP counselor or the SAP gatekeeper. If separation of the functions is not possible, the SAP should be cautioned about the difference of approach, philosophy, and confidentiality that defines the two roles. Employees should also be made aware of the differences. Self Referrals. One of the positive outcomes of the FTA drug and alcohol testing program is that it makes employees aware of the effects and consequences of prohibited drug use and alcohol misuse on personal health, safety, and the work 9-8 August 2002

environment. Employees are also aware of the consequences should they test positive or refuse a test under the employer’s policy. As a result, individuals with drug or alcohol problems may seek help to address their problems prior to being detected through the employer’s FTA drug and alcohol testing program. Employees are more likely to seek help if they can do so in a confidential manner, where the programs are easy to access. Thus, transit employers have found that EAP programs serve an important role in terms of self-referrals. If the employer encourages selfreferrals, the process must be clearly defined, with the elimination of as many barriers as possible. The employee should be made aware of the confidentiality protections, nature of management reports, treatment requirements, testing requirements, leave policy, and interrelationship with the FTA testing program. Employees should know that selfreferral does not in any way shield them from FTA tests or the consequences for a positive result. The employee should be made aware if they will be removed from duty, assigned non-safety-sensitive tasks, or be allowed to continue with their regular job duties during their self-referred treatment period. The employee must be informed if they will be required to participate in an after care program and if they will be required to sign a return-to-duty agreement. Section 4. DRUG AND ALOCHOL REHABILITATION AND TREATMENT As noted earlier, the FTA regulations do not require you to provide or pay for rehabilitation and treatment programs. However, rehabilitation and treatment programs are often an integral part of Chapter 9. Substance Abuse Professionals, Rehabilitation, and Treatment successful substance abuse programs. Additionally, research and experience have demonstrated that such programs can be highly cost-effective. The decision to provide rehabilitation to affected employees should be made with both the employer and employee’s needs in mind. Two basic types of treatment are available that include various inpatient and outpatient services. Inpatient treatments often involve a 1- to 4-week stay in the hospital or residential treatment center and may be recommended for the more severely addicted person. Outpatient treatment is appropriate for persons who are employed and can benefit from education and behavior modification to remain drug- and/or alcoholfree. Outpatient services predominate in the transit industry; 75 percent of persons receiving treatment for drug addiction and/or alcoholism are treated as outpatients. Intensive Inpatient Services. Inpatient centers treat dependent people with physical and/or psychological complications. Patients in intensive treatment may need supervised detoxification and may suffer physical withdrawal symptoms. As part of treatment, patients will attend education and awareness lectures and group therapy sessions. Frequently, family members are involved in treatment since dependency affects the entire family. Residential intensive inpatient treatment may last from 1 to 4 weeks. Intensive Outpatient Services. These services treat dependent patients who have fewer physical or psychological complications. They offer effective and less expensive alternatives to residential care for individuals with relatively stable home environments and supportive employers. The patient receives education, group therapy, and individual counseling for up to 9-9 August 2002

SAP, many employers have looked to their<br />

EAPs for SAP services. On the surface, this<br />

appears to be a wise decision. However,<br />

many transit systems have found that an<br />

EAP may not be the best environment to<br />

find SAPs who are philosophically aligned<br />

with DOT programs, and they may not be<br />

the best location to house SAP services.<br />

FTA audits frequently found that SAPs<br />

in general misunderstand their role as the<br />

gatekeeper of the return-to-duty process, and<br />

therefore, compromise the integrity of the<br />

process and public safety. This<br />

misunderstanding is associated with the<br />

philosophical misalignment of EAP<br />

counselors and SAPs. EAP counselors are<br />

often viewed as advocates for the employee<br />

and as such, attempt to return employees<br />

who have tested positive back to duty as<br />

soon as possible. This approach is<br />

consistent with the training that counselors<br />

often receive that emphasizes getting the<br />

person back into a stable work environment<br />

as soon as possible, where they must be<br />

accountable.<br />

This philosophy, however, is contrary to<br />

the basic premise upon which the SAP’s<br />

function was established. Due to the safetysensitive<br />

nature of the positions the<br />

employees fill, the SAP should be very<br />

conservative in his/her assessment of the<br />

employee and the progress made in<br />

education/treatment programs. “Putting in<br />

the time” is simply not enough for an<br />

individual returning to a safety-sensitive<br />

position. Similarly, if the SAP rushes the<br />

return-to-duty test, the employee may be<br />

putting the public at risk. The SAP must not<br />

release the individual to come back to work<br />

until the SAP has a reasonable level of<br />

assurance that the individual will stay drug<br />

and alcohol free based on the individual’s<br />

attitude, support structure, participation in<br />

the treatment program, motivation, and<br />

Chapter 9. Substance Abuse<br />

Professionals, Rehabilitation, and<br />

Treatment<br />

demonstrated behavior changes. The SAP is<br />

the advocate for the public interest, not the<br />

employee.<br />

Given this difference of philosophical<br />

viewpoints, some transit systems have<br />

chosen to separate the SAP function from<br />

the EAP function. In the traditional role, the<br />

EAP remains available to employees to help<br />

them deal with issues in confidence and, if<br />

needed, self refer to a treatment program for<br />

drug or alcohol problems. The SAP does not<br />

become involved unless there is a positive<br />

test result or a test refusal on a DOT test.<br />

However, if an FTA rule violation occurs,<br />

the individual falls under the purview of the<br />

SAP and must be subject to the<br />

consequences and return-to-duty process<br />

defined in the regulations that were<br />

summarized previously in this chapter.<br />

By separating the functions, the<br />

credibility and effectiveness of the EAP<br />

program as an employee benefit is not<br />

compromised, and the seriousness and rigor<br />

of the SAP process is not diluted.<br />

Employees can better understand the roles of<br />

the two entities rather than being confused<br />

by one counselor that presents two different<br />

approaches, standards of confidentiality, and<br />

advocacy depending on whether they act as<br />

the EAP counselor or the SAP gatekeeper.<br />

If separation of the functions is not<br />

possible, the SAP should be cautioned about<br />

the difference of approach, philosophy, and<br />

confidentiality that defines the two roles.<br />

Employees should also be made aware of<br />

the differences.<br />

Self Referrals. One of the positive<br />

outcomes of the FTA drug and alcohol<br />

testing program is that it makes employees<br />

aware of the effects and consequences of<br />

prohibited drug use and alcohol misuse on<br />

personal health, safety, and the work<br />

9-8 August 2002

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