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CHAPTER 2 Human Resources-Related Law

LEARNING OBJECTIVES

The student will be able to:

■■ Identify five strategies to prevent workplace bullying. ■■ Analyze five employment laws and their importance to the healthcare workplace. ■■ Discuss five strategies to protect employees from workplace violence. ■■ Understand the process of “Run, Hide, Fight” during an active shooter situation.

DID YOU KNOW THAT?

■■ The healthcare industry is one of the most regulated industries in the United States. ■■ According to a recent national survey, 60 million Americans have experienced workplace bullying. ■■ The National Defense Authorization Act of 2008 allows an employee to take 12 weeks of unpaid leave if a child, spouse, or parent has been called to active duty. ■■ The Occupational Safety and Health Administration (OSHA) reports that there are two million victims of workplace violence annually; which is considered an underreporting of this issue.

▸▸ Introduction and other healthcare providers’ offices, and skilled nursing facilities require constant surveil­ ccording to the federal OSHA, it is the lance by OSHA to monitor workplace standards. responsibility of the organization to As part of health and safety, the Joint Commis­ monitor and ensure a safe and healthy sion (formerly the Joint Commission on Accred­ Awork environment for employees (OSHA, itation of Healthcare Organizations) also reviews 2018a). Healthcare employees are exposed to the health and safety standards for both patients toxic chemicals, contaminated blood, bacteria, and employees. In collaboration with human and radiation. Hospitals, laboratories, physicians’ resources (HR) departments, OSHA provides 29 30 Chapter 2 Human Resources-Related Law training and educational materials to inform is created so that there is a minimal standard employees about the dangers of the workplace. of action required by individuals and orga­ With the increase in mass shooting inci­ nizations. There exist laws created by federal, dents across the country, the “me, too” move­ state, and local governments. When the judi­ ment, and workplace bullying, establishing a safe ciary system interprets previous legal decisions and fair workplace has broadened its scope. In with respect to a case, they create common concert with management, it is the responsibility law (Buchbinder & Shanks, 2007). The mini­ of the HR department to inform employees about mal standard for action is federal law, although the basic concepts of law, employment-related state law may be more stringent. Legislatures legislation, and workplace safety. This chapter create laws that are called statutes. Both com­ will provide an overview of HR-related legisla­ mon law and statutes are then interpreted by tion and strategies to prevent discrimination, administrative agencies by developing rules workplace bullying, and workplace violence. and regulations that interpret the law. For example, the Department of Labor and OSHA develop rules and regulations that interpret employment-­related legislation such as the ▸▸ Basic Concepts of Occupational Health and Safety Act of 1970. Healthcare Law The healthcare industry is one of the most regulated industries in the United States. It is The healthcare industry is one of the most the responsibility of the HR department to pro­ heavily regulated industries in the United vide training to employees, so they are familiar States. Those who provide, receive, pay for, and with employment-related laws that protect regulate healthcare services are affected by the them and the employers. The following sec­ law (Miller, 2006). Law is a body of rules for the tion outlines major HR-related legislation that conduct of individuals and organizations. Law apply to the healthcare industry (TABLE 2.1).

TABLE 2.1 Major Human Resource-Related Legislation

Equal Pay Act of 1963: All employers must provide equal pay to both genders that have the same position with equal responsibilities and skills. Enforced by the U.S. Department of Labor. Civil Rights Act of 1964, Title VII: Landmark legislation. Prohibits discrimination of protected classes based on gender, race, color, religion, and national origin. Enforced by the EEOC. Applies to employers with 15 or more employees. Age Discrimination in Employment Act of 1967 (ADEA): Protects employees and job applicants 40 years or older from discrimination in hiring, firing, promotion, layoffs, training, benefits, and assignments. Enforced by EEOC. Applies to employers with 20 or more employees. Occupational Safety and Health Act of 1970: This act requires employers to provide a safe and healthy work environment. Guidelines for working with hazardous chemicals and for working ergonomically. Enforced by the Occupational Safety and Health Administration. Rehabilitation Act of 1973: Employers with 50 or more employees and with federal funding of $50,000 must submit an affirmative action plan. Amended to ensure that healthcare facilities are accessible for the disabled. Enforced by the Office of Federal Contract Compliance Programs. Employee Retirement Income Security Act of 1974 (ERISA): Regulates pensions and benefit plans for employees. Forbids employers from firing employees so the employers do not have to pay the employee’s medical coverage. Gives employees the right to sue for breaches of any fiduciary duty. Enforced by the U.S. Department of Labor. Basic Concepts of Healthcare Law 31

Pregnancy Discrimination Act of 1978: Protects female employees who are pregnant against discrimination. Applied to employers with 15 or more employees. Enforced by the EEOC. Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA): Passed to ensure that if an individual changes jobs, he or she can still obtain health insurance. Enforced by the U.S. Department of Labor. Worker Adjustment and Retraining Notifi cation Act of 1989: Employers with 100 employees or more must give their employees 60 days notice of layoffs and closings. U.S. Department of Labor has no enforcement role but can assist with job placement. Americans with Disabilities Act of 1990 (ADA): Protects the disabled from employment discrimination. Encourages businesses to provide reasonable accommodation in the workplace for qualified individuals that have disabilities but are able to perform a job. Applies to employers with 15 or more employees. Enforced by the EEOC. Its 2008 amendments expanded the concept of disabilities. Older Workers Benefit Protection Act of 1990 (OWBA): Amended the ADEA. Benefi ts must be provided to both younger and older workers. Gives time to accept early retirement options and allows employees to change their mind if they want to litigate against their company. Enforced by the EEOC. Civil Rights Act of 1991: Amendment to 1964 Act. Enables individuals to receive monetary damages up to $300,000 because of intentional discrimination. Enforced by the EEOC. Applies to employers with 15 or more employees. This Act also established the Glass Ceiling Commission that examined the lack of protected classes in senior management positions. Family Medical Leave Act of 1993 (FMLA): Requires employers with 50 or more employees within a 75-mile radius who work more than 25 hours per week and who have been employed more than 1 year to provide up to 12 work weeks of unpaid leave to an employee during any 12-month period so the employee may provide care for a family member or obtain care for himself or herself. Enforced by the U.S. Department of Labor. Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA): Workers are entitled to return to their job after military service. Returning employees are not penalized from raises or promotions because they were in the military. The U.S. Department of Labor’s (DOL) Veterans’ Employment and Training Service (VETS) enforces USERRA. Health Insurance Portability and Accountability Act of 1996 (HIPAA): Increased restrictions on patient information confidentiality by creating a standard for patient information sharing. Enforced by U.S. Health and Human Services. Pension Protection Act of 2006: Amendment to Civil Rights Act of 1991. Landmark legislation that strengthens employer funding requirements for employee pension plans and creates a stronger pension insurance system. Enforced by the U.S. Department of Labor. National Defense Authorization Act of 2008: Expanded the FMLA to include families of military service members, which means that an employee may take up to 12 weeks of leave if a child, spouse, or parent has been called to active duty in the armed forces. Enforced by the U.S. Department of Labor. Genetic Information Nondiscrimination Act of 2008: Prohibits U.S. insurance companies and employers from discriminating based on genetic test results. Enforced by the EEOC. Lilly Ledbetter Fair Pay Act of 2009: An amendment to Title VII of the Civil Rights Act of 1964 that also applies to claims under the Age Discrimination in Employment Act of 1967 and ADA and provides protection for unlawful employment practices related to compensation discrimination. Enforced by the EEOC. Patient Protection and Affordable Care Act of 2010 (PPACA): Controversial legislation that requires individuals to purchase health insurance by 2014. Contested by several states for its constitutionality, provisions of the Act will be reviewed by the Supreme Court in 2012. 32 Chapter 2 Human Resources-Related Law

Examples of LGBTQ-Related Sex ▸▸ HR-Related Law Discrimination Claims The Fair Labor Standards Act of 1938 Some examples of LGBTQ-related claims that established a minimum wage for employees, the EEOC views as unlawful sex discrimina­ overtime provisions, and child labor laws. Title VII of the Civil Rights Act of tion include: 1964 is a landmark act that prohibits dis­ ■■ Failing to hire an applicant because she is crimination based on race, sex, color, reli­ a transgender woman. gion, and national origin. Discrimination ■■ Firing an employee because he is planning means treating people differently. This legis­ or has undergone a gender transition. lation is the key legal piece to equal oppor­ ■■ Denying an employee equal access to a tunity employment. Two components to this common restroom corresponding to the legislation are disparate treatment and dispa­ employee’s gender identity. rate impact. It applies to employers with 15 ■■ Harassing an employee because of a gender or more employees. This act is enforced by transition, such as by intentionally and per­ the EEOC. sistently failing to use the name and gen­ It created a concept of protected der pronoun that correspond to the gender classes from employment discrimination in identity with which the employee identifies compensation and conditions or privileges of and which the employee has communi­ employment. The protected classes include cated to management and employees. sex, age, national origin, race, and religion. ■■ Denying a promotion to an employee A current major issue within the purview because she/he is gay or straight. of discrimination legislation is ­sexual ■■ Discriminating in terms, conditions, or ­harassment. According to the EEOC, sex­ privileges of employment, such as provid­ ual harassment is defined as unwelcome sex­ ing a lower salary to an employee because ual conduct that has a negative impact on the of sexual orientation or denying spou­ employee. There are two major categories of sal health insurance benefits to a female sexual harassment: (1) quid pro quo sex­ employee because her legal spouse is a ual harassment (which occurs when sexual woman, while providing spousal health activities occur in return for an employment insurance to a male employee whose legal benefit) and (2) hostile work environment, spouse is a woman. which occurs when the behavior of cowork­ ■■ Harassing an employee because of his or ers is sexual in nature and creates an uncom­ her sexual orientation, for example, by fortable work atmosphere. The creation using derogatory terms, making sexually of a hostile work environment is the more oriented comments, or remarking dispar­ common type of sexual harassment. Several agingly with respect to associating with a court decisions indicate that repeated sug­ person of the same or opposite sex. gestive joke telling and lewd photos on dis­ ■■ Discriminating against or harassing an play can be legally considered to be a hostile employee because of his or her sexual work environment. In the healthcare indus­ orientation or gender identity, in combi­ try, nurses sometimes experience sexual nation with another unlawful reason, for harassment from colleagues, physicians, and example, based on transgender status and patients. There might also be discrimination race, or sexual orientation and disability against Lesbian Gay Bisexual Transgender (What you should know about the EEOC Questioning (LGBTQ) individuals. and the LGBTQ worker, 2018). HR-Related Law 33

Age Discrimination in Employment pay discrimination may file a lawsuit without Act (ADEA) of 1967 protects employees and informing the EEOC. job applicants 40 years of age and older from An affirmative action plan outlines the discrimination as it applies to hiring, firing, employer’s standard on recruitment and hiring promotion, layoffs, training, assignments, and process to increase the diversity of the com­ benefits. Older employees file lawsuits for age pany’s workforce. This plan is created to cor­ discrimination in job termination. It applies to rect past discrimination in a company. These employers with 20 or more employees and is potential employees must be qualified for enforced by the EEOC. the job. Although an affirmative action plan During difficult economic times, older encourages hiring protected-class candidates, employees might have a greater tendency to an employer cannot set quotas for this pro­ file complaints with the EEOC because of their cess. They can develop strategies to encourage termination. Many older workers tend to have applications from diverse candidates. higher salaries, and businesses may lay them An employer who develops an affirmative off illegally. The EEOC found that Ohio State action plan must perform an analysis of the had discriminated against two older female demographics of the current workforce com­ employees. The younger employees were given pared to the eligible pool of qualified applicants. choice assignments and better office space. The employer must also calculate the percent­ Supervisors referred to the older workers as age of those protected classes in the qualified “Dead Wood.” These older workers eventually applicants. The percentages are compared to retired years earlier than anticipated because determine if there was an underrepresentation of the stressful work environment. They filed of diverse employees in the organization. If it an age discrimination suit against Ohio State. is determined that the current workforce is not For the two women who were rehired and were diverse, then an employer develops a timetable repaid their wages, the EEOC found that age that is aimed at hiring diverse employees and is often overlooked when developing diversity that also includes a recruitment plan. policies (Span, 2018). OSHA of 1970 is also important to the The Equal Pay Act of 1963, which healthcare industry because of the high inci­ amended the Fair Labor Standards Act, is dence of employee injury. In healthcare jobs, enforced by the U.S. Department of Labor there is a higher risk of exposure to workplace and mandates that all employers award pay hazards, such as airborne and blood-borne fairly to men and women if it is determined infectious diseases, physical injuries from lift­ that their jobs have equal responsibilities and ing patients, and needle stick injuries. This law require the same skills. It can be difficult to was passed to ensure that employers have a assess whether two employees are performing general duty to provide a safe and healthy work exactly the same job. One employee may have environment for their employees, which is additional duties, which would affect his or important for the healthcare industry, because her salary. The current trend in business is pay of potential exposure to bacteria, viruses, and for performance, so some employees may earn contaminated fluids. more if they perform better. However, research Employers are also required to inform consistently states that women earn less than employees of potentially hazardous conditions men. Industries most impacted by gender sal­ and OSHA standards. Posters and other mate­ ary discrimination are business, office man­ rials are displayed for employees’ education. agement, agriculture, information technology, OSHA is responsible for enforcing these provi­ construction, transportation, sales, education, sions. The National Institute for Occupational and industrial work. An individual who alleges Safety and Health was established as part of 34 Chapter 2 Human Resources-Related Law this act to provide research to support the The Rehabilitation Act of 1973 applies standards. OSHA enforces the Hazard Com- to organizations that receive financial assis­ munication Standard that requires compa­ tance from federal organizations, including the nies to label hazardous materials. Information U.S. Department of Health and Human Ser­ is contained on Material Safety Data Sheets vices, and forbids discriminating against indi­ (MSDSs), which are provided to employees via viduals with disabilities in terms of employee the Internet or on site. OSHA has also issued benefits and job opportunities. These organi­ a standard for exposure to human immuno­ zations and employers include many hospitals, deficiency virus, hepatitis B virus, and other nursing homes, mental health centers, and blood-borne pathogens. This standard is human services programs. Employers with crucial to the healthcare industry because of 50 or more employees and federal contracts increased risk of exposure to nurses and lab­ of $50,000 or more must submit written affir­ oratory workers. mative action plans. The Affordable Care OSHA has also developed standards for Act of 2010 amended this act by requiring all personal protective equipment (PPE), healthcare manufacturers to redesign medical which is required when employees might be equipment so healthcare providers can accom­ exposed to hazardous materials or working con­ modate individuals with disabilities. Health­ ditions. Companies must also maintain records care provider locations must also be accessible of employee accidents. OSHA provides workers to those with disabilities. This act is enforced with the rights to receive training, keep a copy of by the Office of Federal Contract Compliance their medical records, and request OSHA inspec­ Programs. tions of their workplace (Occupational Safety & The Employee Retirement Income Health Administration [OSHA], 2018b). Security Act of 1974 (ERISA) regulates pen­ OSHA has also developed standards for sion and benefit plans for employees, includ­ ergonomics, which is the study of working ing medical and disability benefits. One of the conditions that affect the physical condition most important documents participants are of employees. Studies indicate that repetitive entitled to receive automatically when becom­ motion can create employee injuries. A com­ ing a participant of an ERISA-covered retire­ mon disorder is carpal tunnel syndrome, a ment or health benefit plan or a beneficiary wrist injury that often occurs from repetitive receiving benefits under such a plan is a sum­ hand motions in jobs, such as grocery cashiers mary of the plan, which is called the summary and computer users. Employers can provide plan description. It protects employees because ergonomic-friendly equipment and guidelines it forbids employers from firing an employee for ergonomic actions to eliminate these types to prevent the employee from receiving health of injuries. Ergonomic equipment and actions benefits. Employers may change the benefits are important to the healthcare industry provided under their plans, but employers because many workers often lift patients to and cannot force an employee to leave so that the from beds, operating tables, and wheelchairs employer does not have to pay the employee’s (OSHA, U.S. Department of Labor, 2018b). medical coverage. The Consumer Credit Protection Act The Pregnancy Discrimination Act of (Title III) of 1968 prohibits employers from 1978 was an amendment to Title VII of the terminating an employee if the individual’s Civil Rights Act of 1964. This act protects female earnings are subject to garnishment due to employees who are discriminated against based debt issues. This act also limits the weekly gar­ on pregnancy-related conditions, which con­ nishment amount from the employee’s pay and stitutes illegal sex discrimination. A pregnant is enforced by the Federal Deposit Insurance woman must be treated like anyone with a med­ Corporation. ical condition. For example, an organization HR-Related Law 35 must allow sick leave for pregnant women cannot provide this information, he or she with morning sickness if the organization also must provide documentation in both Catego­ allows sick leave for other ­nausea-causing ill­ ries B and C. This prohibits any company from nesses (Gomez-­Mejia, Balkin, & Cardy, 2012). hiring illegal aliens and penalizes employers This act applies to employers with at least 15 who hire illegal aliens. However, immigrants employees and is enforced by EEOC. with special skill sets or those who can satisfy The Consolidated Omnibus Budget a labor shortage in the United States, such as Reconciliation Act of 1986 (COBRA), an nurses, will be permitted to work in the United amendment to ERISA, was passed to protect States. This act is enforced by the U.S. Depart­ employees who lost jobs or changed employ­ ment of Labor. ers, so they could keep their health insur­ The Worker Adjustment and Retrain- ance if they paid 102% of the full premium ing Notification Act of 1989 (WARN) (Anderson, Rice, & Kominski, 2007). The requires that employers with 100 employees Act was passed because, at the time, people or more must give their employees 60 days’ were afraid to change jobs, resulting in the written notice of layoffs and business closings. concept of job lock (Emanuel, 2008). With An employer who violates the WARN provi­ the establishment of the Healthcare Insur­ sions by ordering a plant closing or mass layoff ance Marketplace by the Affordable Care Act, without providing appropriate notice is liable individuals may find more affordable health to each aggrieved employee for an amount, insurance plan options rather than using the including back pay and benefits for the period COBRA option. of violation, up to 60 days. This act is enforced The Drug-Free Workplace Act of 1988 by the U.S. Department of Labor. requires any employers who receive federal The Americans with Disabilities Act grants or have a federal contract of $25,000 of 1990 (ADA) focuses on individuals in the or greater to certify that they operate a drug- workplace who are considered disabled. There free workplace. They must provide education are three sections: Section I contains employ­ to their employees about drug abuse. Many ment limitations, while Sections II and III employers now offer drug testing. The act is target local government organizations, hotels, enforced by the U.S. Department of Labor. restaurants, and grocery stores. This act applies The Immigration Reform and Control to employers who have 15 employees or more Act of 1988 requires employers with one or and is enforced by the EEOC. According to the more employees to verify that all job applicants law, a disabled person is someone who has a are U.S. citizens or are authorized to work in physical or mental impairment that limits the the United States. Most employees are only ability to hear, see, speak, or walk. The act was aware of this legislation because of the I-9 form passed to ensure that those individuals who all new employees must complete. There are have a disability but who can perform primary three categories—A, B, and C—on the form. job functions are not discriminated against. Category A establishes identity and eligibility According to the act, disabilities included to work, such as a passport, a permanent res­ learning, mental health, epilepsy, cancer, ident card, or a permanent alien registration arthritis, mental retardation, AIDS, asthma, receipt card. Category B establishes the indi­ and traumatic brain injury. A nursing home vidual’s identity. Acceptable proof of identity cannot refuse to admit a person with AIDS includes a driver’s license and different types who requires nursing service if the facility has of identification cards with photographs. Cat­ that type of service available (U.S. Department egory C focuses on an employee’s eligibility to of Labor (DOL), 2018d). Individuals with work. Documentation includes a social secu­ alcohol and other drug abuse are not covered rity card or a birth certificate. If an employee under the ADA. Individuals who are morbidly 36 Chapter 2 Human Resources-Related Law obese can be considered disabled if their obe­ not oppose community-based treatment, and sity is related to a physical cause. (3) community-­based services can be reason­ Title I of the ADA states that employment ably accommodated, considering the resources discrimination is prohibited against individu­ available to the public entity and the needs of als with disabilities who can perform essential others who are receiving disability services functions of a job with or without reasonable from the entity (Olmstead, Community Inte­ accommodation. Essential functions are job gration for Everyone, 2018). duties that must be performed to be a satis­ Older Workers Benefit Protection Act factory employee. Reasonable accommodation of 1990 amended the ADEA. Its goal is to is an employer’s reasonable action to accom­ ensure that older workers’ employee benefits modate a disabled individual, such as provid­ are protected and that organizations provide ing special computer equipment or furniture the same benefits to both younger and older to accommodate a physical limitation. The workers. The act also gives employees time to reasonable accommodation should not cause decide if they would accept early retirement undue financial hardship to the employer. options and allows employees to change their Individuals with disabilities have mental minds if they have signed a waiver of their or physical limitations in areas, such as walking, right to sue. The act is enforced by the EEOC. speaking, breathing, sitting, seeing, and hear­ Title VII only allowed damages for back ing. Individuals with intellectual ­disabilities pay. The Civil Rights Act of 1991 enables have an IQ less than 70–75 and problems with individuals to receive both punitive dam- social skills, and the disability must have been ages, which are damages that punish the evident before the age of 18 years. Intellectual defendant, and compensatory damages disabilities must significantly limit major life for financial or psychological harm. This act activities, such as walking, seeing, hearing, applies to employers with 15 or more employ­ thinking, speaking, learning, concentrating, ees. The upper limit to damages is based on and working. The ADA amendments of 2008 the size of the company: $50,000 for employ­ expanded living activities to include bodily ers with 15–100 employees; $100,000 for com­ functions, such as bladder, circulatory, neuro­ panies with 101–200 employees; $200,000 logical, and digestive functions. On June 22, for employers with 201–500 employees; and 1999, the U.S. Supreme Court held in Olmstead $300,000 for employers with more than 500 v. L.C. that unjustified segregation of persons employees. This act is enforced by the EEOC. with disabilities constitutes discrimination in The 1991 law extended the possibility of violation of Title II of the ADA. This care arose individuals collecting damages related to sex, because of two Georgia women, Lois Curtis religious, or disability-related discrimination. and Elaine Wilson, who had been voluntarily Some organizations had developed a policy institutionalized in state psychiatric hospitals of adjusting scores on employment tests, so a since they were very young. They requested to certain percentage of a protected class would be released, and they wanted to receive com­ be hired. This amendment to Title VII spe­ munity services for their disabilities; how­ cifically prohibits quotas, which are diversity ever, their requests were denied. They sued goals to increase the number of protected in 1995, and the lower courts supported their class members in a workforce (Gomez-Mejia, case with appeals from the state of Georgia. Balkin, & Cardy, 2012). Eventually, the case was heard by the Supreme The Family and Medical Leave Act Court, which held that public entities must of 1993 requires employers with 50 or more provide community-based services to per­ employees within a 75-mile radius who work sons with disabilities when (1) such services more than 25 hours per week and who have are appropriate, (2) the affected persons do been employed more than 1 year to provide HR-Related Law 37 up to 12 weeks of unpaid leave, during any The HIPAA National Standards of 2002 12-month period, to provide care for a family or Privacy Rule is intended to further protect member or the employee. This benefit can also patients’ personal medical records and other include post childbirth or adoption. Employ­ personal health information maintained by ers must provide healthcare benefits, although healthcare providers, hospitals, insurance they are not required to provide wages during companies, and health plans. It gives patients the leave. Individuals who are among the orga­ new rights to access their records, restricts the nization’s highest paid 10% of all employees amount of patient information released, and are not covered by the act. The employer is also establishes new restrictions on researchers’ supposed to provide the same job or a compa­ access (U.S. Department of Health & Human rable position upon the employee’s return. The Services, 2018a). U.S. Department of Labor announced a final Releasing patient information is more rule in 2015 to amend the term “spouse” to complex because of the introduction of infor­ include legal-same-sex-marriage spouses (U.S. mation technology to the healthcare indus­ Department of Labor (DOL), 2018e). try. For example, patient information may be The Health Insurance Portability and faxed, as long as only necessary information Accountability Act of 1996 (HIPAA) was is transmitted, and safeguards are imple­ passed to promote patient information and mented. Physicians may also communicate via confidentiality in a secure environment. The email as long as safeguards are implemented. Standards for Privacy of Individually Iden- Violations of these regulations could result tifiable Health Information (the Privacy in termination. This act is enforced by the Rule) established the first set of national stan­ Department of Health and Human Services’ dards for the protection of certain health infor­ Office for Civil Rights and the U.S. Depart­ mation. The major goal of the Privacy Rule is ment of Justice. to ensure that individuals’ health information The Equal Employment Opportunity is properly protected while allowing the flow Commission (EEOC), created by Title VII of of health information needed to provide and the Civil Rights Act of 1964, is responsible for promote high-quality health care for patients processing complaints, issuing regulations, and protect the public’s health and well-­being. and collecting information from employers. There are two exceptions to the Privacy Rule: if the patient requests the disclosure of their information or if there is an investigation. It Processing Complaints is important that patient information is pro­ An individual who thinks he or she is being tected in accordance with HIPAA. With the discriminated against can file a complaint with increased use of technology in health care, the EEOC, which notifies the employer. The patient information may be more at risk. employer is responsible for safeguarding any The Mental Health Parity Act of 1996 written information regarding the complaint. requires the equality or parity of lifetime and The EEOC then investigates the complaint to annual limits of health insurance reimburse­ determine whether the employer did violate ments for mental health care. Unfortunately, any laws. If a violation is found, the EEOC the act did not require employers to offer men­ uses conciliation or negotiation to attempt to tal health coverage, it did not impose limits resolve the issue without going to court. If con­ on deductibles or coinsurance payments, and ciliation is not successful, litigation or going it did not cover substance abuse. This federal to trial is the next step. Most employers pre­ legislation spurred several states to implement fer to avoid litigation because it is costly and their own parity legislation (Anderson, Rice, & might damage their reputation. Most cases are Kominski, 2007). resolved by conciliation. 38 Chapter 2 Human Resources-Related Law

Issuing Regulations must also be informed of the breach. These new rules apply to any associates of the health The EEOC is responsible for developing regula­ organizations. In addition to the Privacy Rule, tions for any EEOC law and its amendments. It the Security Rule was implemented; it applies has written regulations for the ADA, the ADEA, to e-PHI or electronic patient information. and the Equal Pay Act. It also issues guidelines The Security Rule was developed because of on other issues, such as sexual harassment and the increased use of electronic patient records. affirmative action. These new rules also apply to any associates of the health plans. It also increased HIPAA’s civil and criminal penalties for violating con­ Information and Education sumers’ privacy regarding health information. The EEOC acquires information from employ­ Civil penalties were increased to $1.5 million ers regarding their practices. Employers with per calendar year, which was a considerable 100 or more employees must file an EEO-1 increase in the original penalty cap of $25,000. report that reflects the number of women and The criminal penalties of up to $50,000– minorities who hold positions. This report is $250,000 and 10 years’ incarceration remained used to assess any potential discrimination the same. trends. The EEOC also provides employers Releasing patient information is more with written and electronic media education complex because of the introduction of infor­ on discrimination. It sends this information to mation technology to the healthcare indus­ HR departments, which disseminate the infor­ try. For example, patient information may be mation with training classes. faxed as long as only necessary information is These pieces of legislation focus on equal transmitted and safeguards are implemented. employment opportunity in the workplace. Physicians may also communicate via email as These laws ensure that protected classes, as long as safeguards are implemented. outlined in the Civil Rights Act of 1964, are The Wellstone Act or the Mental Health provided opportunities for equal employment Parity and Addiction Equity Act of 2008 without bias or discrimination. In addition to amends the Mental Health Parity Act of 1996 this landmark legislation, the ADEA, the Older to include substance abuse treatment plans as Workers Benefit Protection Act, and the ADA part of group health plans. The Genetic Infor- establish standards for treating individuals who mation Nondiscrimination Act of 2008 pro­ are older than 40 years and those individuals hibits U.S. insurance companies and employers who have a disability are treated fairly in terms from discriminating based on information of employment. Both the ADEA and the ADA derived from genetic tests. Genetic informa­ were further strengthened by passage of the tion includes information about an individ­ Lilly Ledbetter Fair Pay Act (FPA) regarding pay ual’s genetic tests and the genetic tests of an discrimination. In addition, the Pregnancy Dis­ individual’s family members, as well as infor­ crimination Act and the Equal Pay Act target dis­ mation about the manifestation of a disease crimination against women. Despite the amount or disorder in an individual’s family members of antidiscrimination legislation, discrimination (i.e., family medical history). Family medical continues to exist in the work environment. history is included in the definition of genetic The Health Information Technology information because it is often used to deter­ for Economic and Clinical Health Act of mine whether someone has an increased risk 2009 amends HIPAA by requiring stricter of getting a disease, disorder, or condition in notification protocols for breach of any patient the future. Genetic information also includes information. The notification must occur an individual’s request for, or receipt of, within 60 days of the breach, and the media genetic services, or the participation in clinical HR-Related Law 39 research that includes genetic services by the Sexual harassment has been illegal for individual or a family member of the individ­ many years as the result of the Civil Rights ual, and the genetic information of a fetus car­ Act of 1964. However, this type of abuse was ried by an individual or by a pregnant woman underreported. The MeToo Movement was who is a family member of the individual and started years ago by Tarana Burke, a social the genetic information of any embryo legally activist against sexual abuse. In 2017, it became held by the individual or family member using a national movement with the multiple sexual an assisted reproductive method. Specifically, allegations of Hollywood producer, Harvey it forbids insurance companies from discrim­ Weinstein. The hashtag MeToo provided an inating through reduced coverage or price opportunity to tweet about sexual harassment increases. It also prohibits employers from and abuse experiences. This online tool gave making adverse employment decisions based individuals a voice that was previously silent. on a person’s genetic factors (SAMSHA, 2018). Time magazine named the Silence Breakers, The Lilly Ledbetter FPA of 2009, an those who came forward, the 2017 Person of amendment to Title VII of the Civil Rights Act the Year award because they brought interna­ of 1964, also applies to claims under the Age tional attention to this important social issue, Discrimination Act of 1967 and the ADA and and they found the courage to speak out against provides protection against unlawful employ­ powerful people who abused their power and ment practices related to compensation dis­ create a cultural change (Langone, 2018). crimination. This act was named after Lilly While the healthcare industry overwhelm­ Ledbetter, an employee of Goodyear Tire and ingly employs females, males typically domi­ Rubber Company who found out at the time nate senior positions in health organizations. of her retirement that her male colleagues were When there is a large difference in power in a paid more than she was, and she subsequently work environment, if an enforced policy is not brought suit. The U.S. Supreme Court ruled in place, sexual harassment occurs. In a recent that she should have filed a suit within 180 days survey, 30% of women who were on medical fac­ of the date that Goodyear paid her less than her ulties experienced sexual harassment. Female peers. This act allows the statute of limitations physicians, who are specialists in areas, such as to restart every 180 days from the time the cardiology, that are predominantly male, have worker receives a paycheck (EEOC, 2018). reported sexual harassment. Sexual harassment To avoid litigation, Sedhom (2009) sug­ can also occur between female health profes­ gests the implementation of a program coor­ sionals and their male patients (Jewett, 2018). dinated by senior management and HR to Annette Katz, a nurse who worked for the help protect employers from being accused of Veterans Administration, filed a suit against unfair employment practices. The following them for mishandling her sexual misconduct summarizes the steps of the program: complaint before and after she formally made the complaint. She was sexually assaulted by 1. Establish compensation criteria. another employee in 2013. She complained but 2. Develop pay audits and document her supervisor did not report the incident. She these audits for several years. was afraid to report the incident because she 3. Document retention processes was a single mother, and she was fearful of los­ related to pay. ing her job. The Veterans Administration was 4. Train managers on providing found liable, and she was awarded $161,500. objective performance evaluations. This entire process consumed her life for years 5. Develop and implement a rig­ (Heisig, 2018). orous statistical analysis of pay There is a detrimental impact to the vic­ distributions. tim as a result of these types of behaviors. 40 Chapter 2 Human Resources-Related Law

Annette Katz suffered from posttraumatic 6. Implement bystander training so stress disorder. Sexual harassment has been those individuals can recognize linked to depression and substance abuse. Work this type of observed behavior ­performance can be impacted with higher (Bryant, 2018). turnover rates. This type of work environment The MeToo movement has created an impacts patient care (Bryant, 2018). Like other opportunity for healthcare organizations to industries, female employees in health care review their policies. The HR department and have been discouraged to report sexual harass­ management can play a pivotal role in chang­ ment. With the advent of this new movement, ing the culture. there is now #MeTooMedicine as an avenue of encouragement to report this abuse. Most organizations have a mandated training in place for all employees. Senior ▸▸ Workplace Bullying management must take the lead in developing The antibullying movement began in Sweden a zero-tolerance policy of sexual harassment. by Dr. Heinz Leimann, who studied worker However, in a 2018 study of governing boards trauma. As a result of his advocacy, Swe­ across the country, nearly 60% have not den became the first country to enact a law addressed this issue because they feel it may against workplace bullying in 1994 (The Mob­ be threatening to the CEO, a low priority, or bing Portal, 2018). In 1992, Andrea Adams, a irrelevant. This attitude needs to change. Hir­ BBC journalist, coined the term “workplace ing more females in executive positions may bullying,” describing an ongoing harassing be an opportune way to demonstrate support. workplace behavior among employees, which They owe it to their employees and their health results in negative health outcomes for the consumers to create an organizational culture targeted employees (Adams, 1992). The Work­ that adopts a zero-tolerance policy for this place Bullying Institute was founded in June type of behavior (Rappleye, 2018). The C-suite 1997 by Drs. Gary and Ruth Namie, both psy­ needs to collaborate with HR and managers to chologists, whose goal is to educate the public ensure that the policies are being enforced. about workplace bullying and lobby for mak­ David Ballard of the American Psycho­ ing this behavior illegal. The Institute is the logical Association recommends the following only U.S. organization that is dedicated to the actions: eradication of this negative workplace behav­ ior. Their definition of workplace bullying is 1. Employee behavior expectations verbal abuse, threatening, intimidating, or are clearly communicated. Develop humiliating behaviors (including nonverbal) and enforce a code of conduct with or work interference (sabotage), which prevent employee input. getting work done or a combination of these 2. Conduct pre- and post training behaviors (What is workplace bullying? 2018). assessments to assess employees’ Since 2010, the Institute have imple­ understanding of this issue. mented four national surveys regarding 3. Develop enforcement mechanisms workplace bullying. Their 2017 survey results with penalties. indicate the following: 4. Consider hiring a chief psycholog­ ical officer to monitor the work­ 1. 61% of Americans are aware of place for sexual harassment issues. abusive behavior to others in the 5. Develop multiple avenues for workplace. reporting the incident with one 2. 70% of the bullies are men. being anonymous, such as an 3. 60% of targets are women. anonymous hotline. 4. 61% of bullies are bosses. Workplace Bullying 41

5. 29% of the victims do not report Callan, & Hartel, 2003; Djurkovic, workplace bullying. ­McCormack, & Casimir, 2008; 6. 71% of employer and 60% of ­Vartia, 2001). coworker reactions are harmful to The Center for American Nurses, the the victims. American Association of Critical-Care Nurses, 7. 77% of Americans feel there should the International Council of Nurses, and the be new legislation (WBI Workplace National Student Nurses Association have Bullying Survey, (June 2017, 2018). all issued statements regarding the need for According to Murray (2009), there healthcare organizations to eliminate bullying are four categories of bullying: (1) in the healthcare workplace. Often, repeated verbal bullying, which consists of verbal abuse and other forms of bullying also threats, name calling, and insults; occur toward nurses by physicians or patients (2) indirect relational bullying, and their families. which consists of exclusionary An unusual form of workplace bullying behavior, such as exclusion from is lateral or horizontal violence, which is meetings and accusing the victim defined as “nurse to nurse” aggression and is as not being part of the team; (3) demonstrated by both verbal and nonverbal cyberbullying, which uses elec­ behavior (Christie & Jones, 2014). In a 2014 tronic methods to inflict emotional Kaplan Survey of 2,000 nursing graduates, 48% stress on the target; and (4) retalia­ indicated they were concerned about being tion, which consists of blaming the bullied or working in a hostile work environ­ victim for the bully being passed ment, and 38% knew nurses who were bullied over for a promotion or causing the or who worked in a hostile work environment bully to get in trouble. Other defi­ (Kaplan Survey, 2014). nitions include repeated negative There is no federal legislation in the verbal or nonverbal behavior, such United States that forbids workplace bully­ as snide comments, verbal or phys­ ing. Since 2003, 30 states have introduced ical threats, or items being thrown. anti-­workplace-bullying bills (WBI, 2018). Employees have also reported However, there are two federal laws that can less aggressive behavior, such as be applied in workplace bullying: the OSHA demeaning comments about the Act of 1970 and Title VII of the Civil Rights victim’s work. Workplace bullying Act of 1964. The OSHA Act of 1970 states that is receiving increased attention employers must provide a safe and healthy worldwide as a negative organiza­ working environment for their employees. tional issue. It is considered a seri­ Under Title VII of the Civil Rights Act, if an ous and chronic workplace stressor employee in a protected class (e.g., gender, reli­ that can lead to diminished work gion, ethnicity) is bullied by another employee, productivity and work quality the action might be illegal based on the con­ (Hoel, ­Faragher, & Cooper, 2004). cept of a hostile work environment. This negative behavior is consid­ To reduce the prevalence of workplace bul­ ered bullying if it is repeated over lying, it is important that employers implement an extended period of time. It can policies to eliminate this behavior. The Ameri­ occur between colleagues, super­ can Psychological Association has provided rec­ visors, or supervisees, although ommendations on how to stop office bullying: the bully is often the supervisor. The literature has reported an 1. Improve communication skills increased incidence of bullying in among employees. The Veterans healthcare organizations (Ayoko, Affairs implemented a pilot ­program 42 Chapter 2 Human Resources-Related Law

called Collaborative Inquiry, which federal legislation against antibullying, so bul­ encourages employee groups to lying will continue to be legal, unfortunately. assess a problem through data col­ HR management, in collaboration with the lection and then decide how to solve institution’s management, can implement the problem through reflection and workplace bullying educational programs and action. The groups that were trained organizational policies to ensure that employ­ in this method reported less aggres­ ees will be protected against this type of nega­ sion and more satisfaction with their tive behavior. Without such policies, the results work environment. can be devastating at both the organizational 2. Teach employees how to under­ and individual levels. stand each other. Small groups of In 2008, The Joint Commission devel­ workers assess how they perceive oped a standard for workplace bullying called violent behaviors in the workplace. “intimidating and disruptive behaviors in For example, someone kicking a the workplace.” They issued the following wall or throwing something may statement: make someone feel better but scare someone else. These types of Intimidating and disruptive behaviors exercises helped people see other can foster medical errors, contribute people’s perspectives and develop to poor patient satisfaction and to pre­ healthy ways to relieve stress. ventable adverse outcomes, increase 3. Identify root causes of anger and the cost of care, and cause qualified frustration. Employees at one orga­ clinicians, administrators, and man­ nization felt there was favoritism agers to seek new positions in more among certain employees, and professional environments. Safety and others felt their concerns were not quality of patient care is dependent being heard by management. After on teamwork, communication, and implementing an employee survey, a collaborative work environment. management randomly selected To assure quality and to promote a employees to attend meetings to culture of safety, health care organi­ hear their concerns. Follow-up zations must address the problem of surveys indicated there was less behaviors that threaten the perfor­ bullying and aggressive behavior. mance of the health care team. 4. Establish a workplace policy of (The Joint Commission, 2008, p. 1) respect. Define an antibullying policy with an enforcement policy Two leadership standards are now part of is important and include it in an The Joint Commission’s accreditation provi­ employee manual. Implement train­ sions: The first requires an institution to have ing to address this issue so employees “a code of conduct that defines acceptable and understand this issue (How to Deal disruptive and inappropriate behaviors.” The with a Bully at Work, 2018). second requires an institution “to create and Workplace bullying continues to be a implement a process for managing disruptive pervasive organizational problem worldwide. and inappropriate behaviors” (Yamada, 2004). In the United States, the Workplace Bullying The Joint Commission standard focused Institute has developed a Healthy Workplace on the impact of these types of behavior on Bill that precisely defines workplace bullying patient care quality. The Joint Commission and extends protection to employees against requires healthcare institutions to create a code this type of behavior. There is no specific of conduct that defines appropriate behavior Active Shooter Situation 43 and has a system in place to manage inappro­ updated their violence prevention guidelines priate behavior, such as workplace bullying. for this industry. In addition to the stance of The Joint Com­ OSHA has identified organizational risk mission, the Center for Professional Health at factors as follows: the Vanderbilt University Medical Center has 1. Transporting patients developed a program for treating and reme­ 2. Home visits diating disruptive behaviors by physicians 3. Poor building design that prohibits (Minding the Workplace, 2016). In a Joint employee escape Commission newsletter dated June 23, 2018, 4. Poorly lit corridors, rooms, and the focus was on physical and verbal violence parking lots against healthcare workers and was intended 5. No crisis communication protocol to remind healthcare organizations that it is 6. No employee training for crisis unacceptable to condone that type of behavior situations and that a process must be in place, including 7. Inadequate security on site the development of an incident report (Senti­ 8. Unrestricted movement of clients nel Event Alert, 2018). and patients in the building In July 2015, the American Nurses Associ­ 9. Long waits for patients ation updated its code of ethics to include this 10. Perception that violence is tolerated statement: Leadership needs to be fully committed All registered nurses and employers to developing a violence prevention program in all settings, including practice, aca­ to eliminate many of these risk factors. The demia, and research must collaborate program should be customized for the site, so to create a culture of respect, free of a workplace analysis should be initiated first incivility, bullying, and workplace vio­ to evaluate the potential hazards before mov­ lence. Best practice strategies based on ing forward with a program. The program evidence must be implemented to pre­ must include an employee safety and train­ vent and mitigate incivility, bullying, ing program that will provide strategies that and workplace violence; to promote the can be used during a crisis. There should be health, safety, and wellness of registered practice drills for crisis situations. Managers nurses; and to ensure optimal outcomes and supervisors need to be assigned roles in across the health care continuum. a violence prevention program and be held (ANA, 2015) accountable. There also needs to be a debrief­ ing after an incident occurs with mental health This code of ethics can be applied to any counselors available for all of the employees. stakeholder in the healthcare industry. Employees should be surveyed during pro­ gram development to ensure that all of their needs are addressed. ▸▸ Workplace Violence ▸ According to OSHA, the healthcare workforce ▸ Active Shooter faces significant risk to workplace violence Situation because of violent behavior from their patients and residents. They identified five healthcare The Department of Homeland Security settings of risk: hospitals, nursing homes, men­ defines an Active Shooter incident as an tal health centers, community care centers, “individual actively engaged in killing or and home health worker visits. In 2016, OSHA attempting to kill people in a confined area” 44 Chapter 2 Human Resources-Related Law

(Active Shooter, 2018). With the number of The federal government has endorsed mass shootings that have occurred across the a protocol of “Run, Hide, Fight” if an active country in different industries, it is important shooter is nearby: Call 911 when it is safe to do to discuss a strategy that occurs if employees so, identify the two closest exits, close and lock are in this type of situation. The Federal Emer­ the door, and as a last resort, attempt to take gency Management Agency recommends that the shooter down (TABLE 2.2). organizations should offer an active shooter When a traumatic incident occurs in the training that includes: (1) informing employ­ workplace, psychological counseling and other ees that if they see something suspicious, they emotional support group services need to be should say something to HR or management; offered. The HR department will have a pro­ (2) invite community resources so they can tocol in place for these types of events. Col­ explain what their role is; (3) identify the laborating with employee assistance programs exits and places to hide; and (4) provide first (EAPs), if they are available, can be instrumen­ aid training and instruction on how to use tal in helping employees deal with this type of tourniquets. experience.

TABLE 2.2 Department of Homeland Security Active Shooter Guide

Department of Homeland Security Active Shooter Guide

Coping with an Active Shooter Situation

■■ Be aware of your environment and any possible dangers. ■■ Take note of the two nearest exits in any facility you visit. ■■ If you are in an office, stay there and secure the door. ■■ Attempt to take down the active shooter as a last resort.

Profile of an Active Shooter

An active shooter is an individual actively engaged in killing or attempting to kill people in a confined and populated area, typically through the use of firearms.

Characteristics of an Active Shooter Situation

■■ Victims are selected at random. ■■ The event is unpredictable and evolves quickly. ■■ Law enforcement is usually required to contact your building management or end an active shooter situation and encourage HR department to provide more information and training on active shooter response in your workplace. CALL 911 WHEN IT IS SAFE TO DO SO.

How to Respond When an Active Shooter Is in Your Vicinity

Run ■■ Have an escape route and plan in mind. ■■ Leave your belongings behind. ■■ Keep your hands visible. Employee Assistance Programs 45

Hide ■■ Hide in an area out of the shooter’s view. ■■ Block the entry to your hiding place and lock the doors. ■■ Silence your cell phone and/or pager.

Fight ■■ Fight as a last resort and only when your life is in imminent danger. ■■ Attempt to incapacitate the shooter. ■■ Act with physical aggression and throw items at the active shooter. CALL 911 WHEN IT IS SAFE TO DO SO.

How to Respond When Law Enforcement Arrives

■■ Remain calm and follow instructions. ■■ Put down any items in your hands (i.e., bags, jackets). ■■ Raise hands and spread fingers. ■■ Keep hands visible at all times. ■■ Avoid quick movements toward officers, such as holding on to them for safety. ■■ Avoid pointing, screaming, or yelling. ■■ Do not stop to ask officers for help or directions when evacuating.

Information You Should Provide to Law Enforcement or 911 Operator

■■ Location of the active shooter ■■ Number of shooters ■■ Physical description of shooters ■■ Number and type of weapons held by shooters ■■ Number of potential victims at the location

Active shooter recovery guide (2015). Department of Homeland Security. Retrieved from https://www.dhs.gov/sites/default/files/publications /active-shooter-recovery-guide-08-08-2017-508.pdf

▸ role with managers and supervisors to address ▸ Employee Assistance employee and organizational challenges and Programs needs. Many EAPs are active in helping organi­ zations prevent and cope with workplace vio­ According to the Office of Personnel Man­ lence, trauma, and other emergency response agement, Employee Assistance Programs situations (What is an Employee Assistance (EAPs) are voluntary, work-based programs Program (EAP)? 2018). that offer free and confidential assessments, Despite the number of services offered by short-term counseling, referrals, and follow-up EAPs, many employees are not aware of these services to employees who have personal and/ services although 97% of large companies offer or work-related problems. EAPs address a these services either in place or outsource these broad and complex body of issues affect­ services for their employees. Some employ­ ing mental and emotional well-being, such ees do not use them because they are afraid as alcohol and other substance abuse, stress, of confidentiality issues and stigma regard­ grief, family problems, and psychological dis­ ing the use of their services. Typically, EAPs orders. EAP counselors work in a consultative are staffed by psychologists, social workers, 46 Chapter 2 Human Resources-Related Law substance abuse counselors, and psychiatric are confidential (Active Shooter Recovery nurses. They also coordinate with other health Guide, 2015). and wellness programs. These are a wonder­ ful resource for addressing issues regarding workplace bullying, workplace violence, and ▸▸ Conclusion other personnel matters. HR departments col­ laborate with EAPs to ensure that the services According to OSHA, it is the responsibility of are customized for the organization and their the employer to provide a safe and fair work­ employees. ing environment. There were over 20 laws dis­ Organizations should promote the EAP cussed in this chapter that provide the legal by issuing periodic statements from top man­ basis for HR departments to maintain these agement endorsing the program and remind­ goals. This chapter also discussed the impor­ ing employees of the services offered by the tance of implementing institutional policies EAP; having counselors attend staff meetings that interpret these regulations to protect to familiarize employees with the counsel­ employees and their employers. Issues, such ors; having counselors give special briefings as workplace bullying, discrimination, sexual and seminars for managers, employees, and harassment, and workplace violence, need to union stewards; and reminding employees be addressed to provide a safe and fair work­ that by law, all services provided by the EAP place environment.

▸▸ Wrap-Up Vocabulary Active shooter Drug Free Workplace Act Health Information Affirmative action plan of 1988 Technology for Economic Affordable Care Act of Employee assistance and Clinical Health Act 2010 (Patient Protection programs (EAPs) of 2009 and Affordability Employee Retirement Health Insurance Portability Care Act) Income Security Act of and Accountability Act of Age Discrimination in 1974 (ERISA) 1996 (HIPAA) Employment Act of 1967 Equal Employment HIPAA National Standards Americans with Disabilities Opportunity Immigration Reform and Act of 1990 (ADA) Commission (EEOC) Control Act of 1988 Carpal tunnel syndrome Equal Pay Act of 1963 Intellectual disabilities Civil Rights Act of 1964, Ergonomics Job lock Title VII Fair Labor Standards Act Lateral or horizontal Civil Rights Act of 1991 of 1938 violence Common law Family Medical Leave Act Law Compensatory damages of 1993 Lilly Ledbetter Fair Pay Act Consolidated Omnibus Genetic Information of 2009 Budget Reconciliation Nondiscrimination Act Material Safety Data Sheets Act of 1986 (COBRA) of 2008 (MSDSs) Consumer Credit Protection Hazard Communication Mental Health Parity Act Act (Title III) of 1968 Standard of 1996 References 47

Mental Health Parity and Pregnancy Discrimination Run, Hide, Fight Addiction Equity Act Act of 1978 Security rule of 2008 Privacy rule (Standards for Sexual harassment MeToo movement Privacy of Individually Statutes Occupational Safety and Identifiable Health The Joint Commission Health Act of 1970 Information) Worker Adjustment and Older Workers Benefit Protected classes Retraining Notification Protection Act of 1990 Punitive damages Act of 1989 (WARN) Personal protective Rehabilitation Act of 1973 Workplace bullying equipment (PPE) Rules and regulations

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▸▸ Notes 50 Chapter 2 Human Resources-Related Law

Student Activity 2-1 In Your Own Words Based on this chapter, please explain in your own words the following concepts as they apply to healthcare law. DO NOT RECITE the text. Statutes:

Common law:

Lateral violence:

Rules and regulations:

Affirmative action plan: Student Activity 2-2 51

Job lock:

Privacy rule:

Student Activity 2-2 Complete the following case scenarios based on the information provided in the chapter. Your answer must be IN YOUR OWN WORDS.

Real-Life Applications: Case Scenario One As a new healthcare administrator, you are in charge of orientation regarding employment law for four new employees. One of the employees is a woman, one has a disability, one is African Amer­ ican, and one is a Muslim. You feel it is important to emphasize laws that were passed to protect employees from discrimination.

Activity Select three federal laws you feel are the most important to new employees. Describe briefly each law and its impact on new employees.

Responses 52 Chapter 2 Human Resources-Related Law

Case Scenario Two You were just promoted to management in your hospital. You were assigned a difficult unit with some personnel issues, including aggressive behavior. You have been asked to develop a plan to improve communication among your employees.

Activity Using the text and Internet, develop a communication plan to create a more cohesive unit.

Responses Student Activity 2-2 53

Case Scenario Three As manager of your unit, you have been assigned to work on a team with the goal of performing a risk assessment of your organization and preparing a strategic plan for preventing workplace violence.

Activity Using the text and Internet, develop a list of possible organizational risk factors for workplace violence.

Responses 54 Chapter 2 Human Resources-Related Law

Case Scenario Four You just joined a company and one of the benefits was an employee assistance program. You were not sure what type of program it is and whether you would use the program.

Activity Perform research on employee assistance programs and learn how they can benefit employees.

Responses Student Activity 2-3 55

Student Activity 2-3 Internet Exercises Write your answers in the spaces provided. ■■ Visit each of the websites listed here. ■■ Name the organization. ■■ Locate the organization’s mission statement on the website. ■■ Provide a brief overview of the activities of the organization. ■■ How do these organizations participate in the U.S. healthcare system?

Websites http//:www.workplacebullying.org Organization Name:

Mission Statement: 56 Chapter 2 Human Resources-Related Law

Overview of Activities:

Importance of Organization to U.S. Health Care:

http://www.psychiatry.org Organization Name:

Mission Statement:

Overview of Activities:

Importance of Organization to U.S. Health Care: Student Activity 2-3 57 http://www.apa.org Organization Name:

Mission Statement:

Overview of Activities:

Importance of Organization to U.S. Health Care:

http://www.eeoc.gov Organization Name:

Mission Statement: 58 Chapter 2 Human Resources-Related Law

Overview of Activities:

Importance of Organization to U.S. Health Care:

http://www.theeap.com Organization Name:

Mission Statement:

Overview of Activities:

Importance of Organization to U.S. Health Care: Student Activity 2-4: Discussion Boards for Online, Hybrid, and Traditional Classes 59 http://www.nsc.org Organization Name:

Mission Statement:

Overview of Activities:

Importance of Organization to U.S. Health Care:

Student Activity 2-4: Discussion Boards for Online, Hybrid, and Traditional Classes Discussion Board Guidelines The discussion board is used in online and web-enhanced courses in place of classroom lectures and discussion. The board can also be used to enhance traditional onground classes. The discussion board is the way in which the students “link together” as a class. The following are guidelines to help focus on the discussion topic and define the roles and responsibilities of the discussion coordinator and other members of the class. The educator will be the discussion moderator for this course. 1. The educator will post the discussion topic and directions for the upcoming week. These postings should all be responses to the original topic or responses to other students’ responses. When people respond to what someone else has posted, they 60 Chapter 2 Human Resources-Related Law

should start the posting with the person’s name, so it is clear which message they are responding to. A response such as “Yes” or “I agree” does not count for credit. Your responses must be in your own words. You cannot copy and paste from the text. 2. Postings (especially responses) should include enough information so the message is clear but should not be so long that it becomes difficult to follow. Remember, this is like talking to someone in a classroom setting. The postings should reflect the content of the text or other assignments. If you retrieve information from the Internet, the hyperlink must be cited. 3. Students should check the discussion daily to see if new information has been posted that requires their attention and response. A good discussion will often include different points of view. Students should feel free to dis­ agree or “challenge” others to support their positions or ideas. All discussions must be handled in a respectful manner. The following are discussion boards for this chapter. 1. Discuss three ways workplace bullying impacts the healthcare organization.

2. Identify three ways to protect employees from workplace violence. Student Activity 2-4: Discussion Boards for Online, Hybrid, and Traditional Classes 61

3. Discuss three employment-related legislation that you feel are important and explain why.

4. What is an affirmative action plan? Perform an Internet search and discuss with your classmates the issues regarding this type of plan. 62 Chapter 2 Human Resources-Related Law

Student Activity 2-5 Current Events Perform an Internet search and find a current events topic during the last 3 years that is related to this chapter. Provide a summary of the article and the link to the article and explain how the article relates to the chapter.