HomeMy WebLinkAboutMINUTES - 12131988 - 1.74 1-0'74
TO: BOARD OF SUIPERVISORS
FROM: Joseph Tonda, y g
+
Cont Risk Manager r Contra
Harry Ci Sterman,I Di rector of Perso ell#.
Costa
DATE: December 13, 198IICul Ily
.I
SUBJECT: Report on Validation of Pre-Employment Medical
Standards for Courty Employees.
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SPECIFIC REQUEST(S) OR REC6MMENDATION(S) & BACKGROUND AND JUSTIFICATION
RECOMMENDED ACTIONS:
1. That, upon recommendation of the County Administrator and the County Risk
Manager, the Board of Supervisors accept findings and results of a Medical
Standards. Studyi conducted by Med-Tox Associates of Tustin, California
which has developed job-related medical screening guidelines for
pre-placement of County employees. Results of the study are contained in
the attached Executive Summary.
2. That, upon recommendation of the County Personnel Director, the Board of
Supervisors accept this report and the policy guidelines contained in it
for use by the "County Personnel Director, The County Medical Consultant,
County Departments and County Fire Districts to conduct a professionally
validated program of medical screening and pre-employment health
examination.
BACKGROUND
Section 13 Pre-Emplcoyment Health Examination of the Contra Costa County
Personnel Management Regulation (copy attached) provides that the
pre-employment (pre-placement) health examination program be administered by
the Director of Personnel with the advice of the County Medical Consultant.
The past decade has presented public and private employers with a unique set of
problems and dilemmas ' in efforts to hire and retain productive and safe
employees for physically demanding jobs. These problems center around the
unprecedented rise ij,n workers` compensation, disability retirement and health
benefit expenses. Employers, while attempting to limit their liability costs
through pre-placement medical examinations, have discovered a tangled web of
legal and medical considerations. It is now widely acknowledged that the
traditional pre-placement medical examination has. failed in practice and by
legal decree. Those examinations are no longer legally defensible or accepted
as being valid medical screens. These problems (regulatory, legal , medical and
administrative) can be solved by the development and use of a medical screening
system which uses job related medical standards. The County entered into a
contract with Med-To'x Associates to conduct job analyses on certain County job
classes, develop medical examination procedures and screening criteria, and
.recommend job related standards for pre-placement medical examinations for
those job classes.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
i
RECOMMENDATION OF COUNTY ADMINISTRATOR RECO NDA ION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON APPROVED AS RECOMMENDED L OTHER
VOTE OF SUPERVISORS
X UNANIMOUS (ABSENT ��- ) I HEREBY CERTIFY THAT THIS IS A TRUE
AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN
ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD
OF SUPERVISORS ON THE DATE SHOWN.
CC: County Administrator ATTESTED DEC 13 1988
Risk Management Phi!-Batchelor, Clerk cf the Board of
Personnel �', Supe visors and CourtyAemiaistratCr -
M382/7-88 BY DEPUTY
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To develop specific medical placement guidelines, Med-Tox assessed the physical
demands of 37 physically demanding and high risk job classifications. Job task
analyses were conducted by gathering and analyzing specific information
regarding the physical demands and work conditions under which the jobs were
performed. This also included the investigation and documentation of critical
and physically demanding tasks required by various jobs. They then reviewed
the job analyses information and set out specific validated medical guidelines
for use in pre-placement medical examinations.
The medical standards and guidelines for pre-placement will :
(1) Improve current :ipractices in the area of pre-placement medical selection
by providing examining physicians with more comprehensive and definitive'
information reg`'arding the physical abilities required for safe and
efficient job performance and a description of specific working conditions
encountered on 'the job. This will help prevent employee injury and
disability and ,ensure maximum access of disabled applicants to County
employment without increased risk to them or others;
(2) Reduce the exposure to discrimination suits in the area of pre-placement
medical, selection by enhancing legal defensibility. By establishing
medical standards and job analysis methodology, the County reduces the
likelihood of making medical employment decisions that can later be found
in violation of ,11
laws. Should complaints or suits occur, evidence
that hiring decisions are based on job related and content valid
information will, be readily available;
(3) Positively impaFt the occupational health of the employee population,
assist in employment decisions, and reduce injuries caused by improper
placement in a non-discriminatory manner.
POLICY GUIDELINES
1] Validated Pre-Employment Medical Standards are in effect for the following
job classifications:
- Airport Operation Specialist (9BVB)
- Animal Control Officer (BJWA)
- Animal Center Technician (BJWC)
-- Apprentice �Mechanic (PM7A)
- Building Inspector I (FAWB)
- Building Inspector II (FAVD)
- Custodian I (GK7A)
- Custodian II (GKWB)
- Lead Custodian (GKTB)
- Detention Services Worker (64VD)
- Driver Clerk (9QWA)
- Electrical � Inspector (FATA)
- Equipment Mechanic .(PMWB)
- Equipment Operator I (PSVA)
- Firefighter (RPWA)
- Groundskeeper (GP7A)
- Gardener (GPWA)
- Lead Gardener (GPTA)
- Grounds Maintenance Specialist - Irrigation (GPVD)
- Grounds Maiintenance Specialist - Pest Control (GPVE)
- Group Counsellor I (7KWA)
- Group Counsellor II (7KVA)
- Group Counsellor III (7KTA)
- Home Health Aide I (VKWA).
- Home Health Aide II (VKVA)
- Institutional Services Worker - Environmental Services (1KVB)
- Institutional Services Worker - Food Services (1KVB)
- Laborer (PSWB)
- Licensed Vocational Nurse I (VT7D)
- Licensed Vocational Nurse II (VT7C)
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Mechanical Inspector (FATE)
Operating Engineer I (GWWA)
Operating Engineer II (GWVB)
Psychiatric Technician (VQWB)
Public Health Nurse (VVXA)
Registered Nurse (VWXA)
Security Guard (64WD)
Storekeepet' (91VA)
Storeroom Clerk (91WC)
21 Departments seeking to initiate pre-placement medical examination for
persons being permanently appointed to any class not included in (1) above
shall request that the Personnel Director develop job-related medical
standards utilizing validated methodology and documentation for such
classes. Departments will be responsible to assist in development of
necessary data.
31 Pre-placement medical standards for new classes shall be independently
developed by the Personnel Director utilizing validated methodology with
the advice of the County Medical Consultant. In consultation with the
appointing authority(s) and employee organization(s) as required, the
Personnel Director will now determine that pre-placement medical standards
are necessary for any existing job classification not specified in (1)
above.
4] Departments may 'request pre-placement physical examinations and screening
procedures in the absence of validated medical standards for the purpose
of establishing 'a base-line health profile of new employees.
51 Departments may ,request periodic health screening of employees if working
conditions require that exposure to communicable disease, toxic or
hazardous substances or adverse environmental conditions be monitored.
Standards for such periodic screening shall be as required by statute or
developed by Departments in consultation with the County Medical
Consultant.
6] Final determination as to physical suitability for current employment on
the basis of medical evidence shall be the sole determination of the
County Medical Consultant subject to review and appeal procedures
contained in the Personnel Management Regulations.
7] ' An advisory committee shall be established by the Director of Personnel
for the purpose„of assisting the County Medical Examiner in administration
of the pre-placement medical examination program. The advisory committee
shall be composed of the Manager-Employment Programs, the County Risk
Manager, the County Worker's Compensation Claims Manager and the County
Employee Relations Officer. Representatives of Departments affected by
specific medical standards issues may be invited to participate on the
advisory committee when the issues are considered.
8] It is the policy of the Board of Supervisors that a program of medical
screening be adopted for limited-term (temporary) employees. The Director
of Personnel shall take necessary steps to initiate such a program by
setting up necessary administrative procedures with departments. This
program will apply to persons hired on a limited term basis in all classes
listed in (1) above and in any other classes deemed appropriate by the
Director of Personnel .
FINANCIAL IMPACT
Total cost for this study was $37,000 which was met from the County's Workers
Compensation Insurance .Trust Fund. It is anticipated that significant long
term savings can be achieved by the County through use of valid medical
standards in a pre-placement medical screening program which will avoid unsafe
job placements and reduce industrial injuries.
RKH:amc
PART 13
PRE-EMPLOYMENT HEALTH EXAMINATION
1301. ADMINISTRATION, OF THE PROGRAM. The Director of Personnel shall
administer the Pre-Em'Ployment Health Examination Program with the advice of the
Medical Consultant who shall be the County Health Services Director.
1302. THE PRE-EMPLOYMENT HEALTH EXAMINATION REQUIREMENT. Each candidate for
employment in a job classification designated by the Board of Supervisors, or
the Director of Personnel, in consultation with the appointing authority(s) and
the Medical Consultant, shall be required to- take a pre-employment health
examination and shall' be 'required to meet job related health standards as a
condition precedent to appointment.
1303. EMPLOYMENT OF,THE HANDICAPPED. Persons who are handicapped, (as defined
by federal and state laws), who are otherwise qualified shall be considered for
employment. An applicant must be able to perform essential job functions effec-
tively and safely, shall not pose a threat to the safety of others and shall not
be placed in a job which could be self-injurious. Referrals of such candidates
shall take into account the recommendations of the Medical Consultant and the
needs of the appointing authority.
1304. HEALTH STANDARDS. The Medical Consultant shall establish job related
health 'standards for', each job classification subject to a pre-employment health
examination. The' standards shall be based on information developed by the
Director of Personnel, the appointing authority, or the Medical Consultant.
1305. 'EXAMINATION CONTENT. The health examination shall be conducted by the
Medical Consultant or a designated licensed physician approved by the Director
of Personnel , and may include a complete case history, x-rays, laboratory tests
and any other pertinent medical reports and tests.
1306. 'SCHEDULING OF EXAMINATIONS. The health examination shall be given prior
LO the effective date of appointment, unless the Director of Personnel determines
that circumstances clearly make this impractical in which case it shall be
scheduled immediately on reporting. The appointing authority at the time of
selection shall arrange through the Director of Personnel for the examination to
take place prior to the reporting date.
1307. ELIGIBILITY PROCEDURE. The Medical Consultant shall decide as to the health
qualification or disqualification of candidates, and may make recommendations as
to the possible employment of handicapped persons. The Director of Personnel
shall notify the appointing authority and the candidate, in writing, as to the
results of the health examination. The notice shall be mailed to the candidate's
last known address., The Director of Personnel shall consult with the appointing
authority to determine whether or not reasonable accommodation can be made for
the employment of handicapped persons within specified limitations of federal and
state law. Subject,1 to decisions and recommendations of the Medical Consultant
the Director of Personnel may certify candidates for appointment; may suspend
eligibility until disabilities are corrected; or may restrict eligibility to
particular positions within a classification as appropriate to the. individual
case.
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1308. REVIEW OF HEALTH EXAMINATION RESULTS. A candidate who has been
disqualified for failure to meet the health standards for a position may request,
a review within fifteen (15) calendar days after the mailing of notice of the
health examination results. The request must be submitted to the Director of
Personnel in writing and must include written medical reports or evidence in
support of the request. The Medical Consultant will review the material and
advise the Director as to whether or not the original disqualification should be
reversed or modified. The Director of Personnel shall mail the candidate notice
of the results of the; review. Within five (5) calendar days after the mailing
of the notice, a candidate may appeal the decision to the Merit Board only on
the basis of specific allegations of unlawful discrimination. In reviewing the
appeal the Merit Board may order an additional health examination and a report
and recommendation by a licensed physician of its choosing. The costs of the
additional examination and report and recommendation shall be borne by the
County.
1309. CONFIDENTIALITY OF MEDICAL RECORDS. Medical examination records shall be
retained by.the Medical Consultant and shall remain confidential except in the
following circumstances:
(a) The records "may be opened for inspection by the candidate or
a person authorized in writing by the candidate.
(b) . The records ;shall be released to the Merit Board in cases
where there 'is an appeal from medical disqualification.
(c) The records shall be opened for inspection in Worker's
Compensation cases or in other claims or actions against
the County.
(d) That portion of the records relevant to employment shall be
opened to inspection by the Director of Personnel and the
appointing authority.
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