DAY ONE OF NEW EMPLOYEE ORIENTATION 8:00 AM Sign-in, ID ...
DAY ONE OF NEW EMPLOYEE ORIENTATION 8:00 AM Sign-in, ID ...
DAY ONE OF NEW EMPLOYEE ORIENTATION 8:00 AM Sign-in, ID ...
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<strong>DAY</strong> <strong>ONE</strong> <strong>OF</strong> <strong>NEW</strong> <strong>EMPLOYEE</strong> <strong>ORIENTATION</strong><br />
8:<strong>00</strong> <strong>AM</strong> <strong>Sign</strong>-<strong>in</strong>, <strong>ID</strong> Badges and Park<strong>in</strong>g, Breakfast April Mize, HRD Consultant<br />
8:15 <strong>AM</strong> Introductions and Housekeep<strong>in</strong>g<br />
8:45 <strong>AM</strong> Corporate Compliance Presentation Salena Stalker, Corporate Compliance<br />
9:30 <strong>AM</strong> HIPAA Presentation Kathleen Street, HIPAA Privacy Officer<br />
Pam Atk<strong>in</strong>s, HIPAA Security Officer<br />
10:15 <strong>AM</strong> Risk Management Kathleen Street, HIPAA Privacy Officer<br />
10:30 <strong>AM</strong> Employee Health Presentation Debra Mitchell, BSN, RN<br />
10:40 <strong>AM</strong> Break to discuss appo<strong>in</strong>tments with Debra<br />
10:50 <strong>AM</strong> Employee Wellness Benefits Kenyatta Stroud, BSN, RN<br />
11:<strong>00</strong> <strong>AM</strong> Benefits (first session – medical) C<strong>in</strong>dy Connell, HRIS/Benefits/Comp<br />
11:45 <strong>AM</strong> Lunch<br />
12:15 PM Foundation Andrea Mart<strong>in</strong>, Director of Development<br />
12:20 PM Overview of Employee Handbook / Completion April Mize, HRD Consultant<br />
of Tax papers and I-9 Forms<br />
1:30 PM Customer Service at CHS<br />
2:<strong>00</strong> PM Fire/Safety and Security Presentation Michael McCall, Security Manager<br />
2:45 PM <strong>ID</strong> Badges-Ground floor of Park Place Park<strong>in</strong>g Deck<br />
Employee Health Nurse – 4 th Floor of Bradley Lecture Center<br />
Health Screen<strong>in</strong>gs – 4 th Floor of Bradley Lecture Center
HOSPITAL <strong>ORIENTATION</strong> <strong>DAY</strong> 2<br />
AGENDA<br />
WELCOME TO THE CLINICAL PORTION <strong>OF</strong> HOSPITAL <strong>ORIENTATION</strong><br />
TIME TOPIC SPEAKER<br />
8:<strong>00</strong> TIME CLOCK PROCEDURE / CHEX April Mize<br />
8:30 PERFORMANCE IMPROVEMENT Khisha Waldrop, PI & Accreditation<br />
8:55 JUST-IN-TIME COACH/CLEAN HANDS CLUB Katie Stockton, Risk Management<br />
9:05 INFECTION CONTROL Brenda Vason, RN, BSN, CIC<br />
10:15 BREAK<br />
10:25 NURSING EDUCATION <strong>ORIENTATION</strong> Charlie Gooch, RN, CPN<br />
10:30 EMOTIONAL WELLNESS Lou Lacey, LPC<br />
10:45 BENEFITS - SECOND SESSION Stephanie Tsimpide, Benefits Specialist<br />
11:30 LUNCH<br />
12:<strong>00</strong> BASIC GROWTH AND DEVELOPMENT Joy Hardy, Child Life<br />
1:<strong>00</strong> RESTRAINT & SECLUSION Charlie Gooch, RN, CPN<br />
3:<strong>00</strong> CPR Charlie Gooch, RN, CPN<br />
5:30 Dismiss<br />
RNs and LPNs <strong>in</strong> off-site practices only<br />
1:<strong>00</strong> - Report back to your practice unless CPR is needed<br />
Everyone is expected to be present until 11:30 <strong>AM</strong>.<br />
Your attendance to the below sessions are determ<strong>in</strong>ed by your<br />
Department as noted below:<br />
Basic Growth and Development:<br />
Restra<strong>in</strong>ts:<br />
CPR:<br />
Nurs<strong>in</strong>g Service Nurs<strong>in</strong>g Service Nurs<strong>in</strong>g Service<br />
Pharmacy Pharmacy Pharmacy<br />
Pediatric Imag<strong>in</strong>g Pediatric Imag<strong>in</strong>g Pediatric Imag<strong>in</strong>g<br />
OR / PACU / ODAC ODAC OR / PACU / ODAC<br />
CTD CTD CTD<br />
PT / OT PT / OT PT / OT<br />
Hear<strong>in</strong>g and Speech Hear<strong>in</strong>g and Speech Hear<strong>in</strong>g and Speech<br />
Cl<strong>in</strong>ical Nutrition Respiratory Therapy Cl<strong>in</strong>ical Nutrition<br />
Respiratory Therapy Specialty Care Services Respiratory Therapy<br />
Specialty Care Services Security Specialty Care Services<br />
Security After Hours Security<br />
Offsite practice cl<strong>in</strong>ical staff (non-RN or LPN)<br />
Offsite practice RNs and LPNs<br />
Food Service (Sr. Aides & Supervisors)<br />
Lab<br />
Lab<br />
After Hours<br />
After Hours<br />
Access Center<br />
RNs & LPNs <strong>in</strong> Nurs<strong>in</strong>g Service and Specialty Care Services only (not off-site practices)<br />
Nurs<strong>in</strong>g Orientation - 8:<strong>00</strong> am - 4:30 pm, Wednesday through Friday<br />
Please report to the Nurs<strong>in</strong>g Education & Research Department<br />
Suite 410 - Children's Harbor Build<strong>in</strong>g (beh<strong>in</strong>d Bradley Lecture Hall)
Contact Sheet for New Employees<br />
Department / Person Phone Location<br />
Emergency 939-9288<br />
Switchboard 939-91<strong>00</strong><br />
Human Resources 939-5190 2101 Magnolia Ave, 2 nd Floor<br />
• Stephanie Tsimpides – Benefits<br />
939-9864 2101 Magnolia Ave, 2 nd Floor<br />
Communications Specialist<br />
• Teet Gober – Benefits Specialist<br />
939-9187 2101 Magnolia Ave, 2 nd Floor<br />
Health Insurance, Life Insurance, Tuition<br />
Reimbursement<br />
• C<strong>in</strong>dy Connell – Benefits/HRIS/Compensation 939-5858 2101 Magnolia Ave, 2 nd Floor<br />
401K, Adoption Assistance, Life Insurance<br />
Claims, Fidelity and F<strong>in</strong>ancial F<strong>in</strong>esse<br />
workshops<br />
• Debra Mitchell – Employee Health/Workers’ 558-2928 Park Place I, 2 nd floor<br />
Comp<br />
• Kenyatta Stroud – Employee Wellness 939-5171 Park Place I, 2 nd floor<br />
• Mercedes Hawk<strong>in</strong>s – Extended Illness (EIB) 939-5829 2101 Magnolia Ave, 2 nd Floor<br />
• Hartford Group – Medical Leave/FMLA<br />
• Lou Lacy – Director, Emotional Wellness 558-2482 Park Place I, Suite 210<br />
• April Mize – Tra<strong>in</strong><strong>in</strong>g and Development 939-5196 2101 Magnolia Ave, 2 nd Floor<br />
• Michelle Galipeau – Employee Relations 939-6657 2101 Magnolia Ave, 2 nd Floor<br />
Director<br />
Corporate Compliance Hotl<strong>in</strong>e 939-6851<br />
• Kathleen Street – HIPAA Privacy Officer 939-5959 Hospital, 1 st Floor, Physicians<br />
Resource Center<br />
• Pam Atk<strong>in</strong>s – HIPAA Security Officer 939-6556 Park Place II, 2 nd Floor<br />
• Peggy Panos – Corporate Compliance Officer 939-9524 The Plaza Bldg, 2112 11 th Ave. S<br />
• Andrea Mart<strong>in</strong> – Director of Development 939-9017 The Plaza Bldg, 2112 11 th Ave. S<br />
Security 939-9682 Entrance to Park Place Park<strong>in</strong>g Deck<br />
• Park<strong>in</strong>g 939-9091 Entrance to Park Place Park<strong>in</strong>g Deck<br />
Payroll 939-9870 The Plaza Bldg, 2112 11 th Ave. S<br />
Risk Management 939-9877 Hospital, 1 st Floor, Physicians<br />
Resource Center<br />
Performance Improvement 939-6716 Children’s Harbor, 4 th Floor<br />
Infection Control 939-9265 Park Place, 4 th floor<br />
Corporate Communications 939-6660 The Plaza Bldg, 2112 11 th Ave. S<br />
• Kathy Bowers – Media Relations 939-9<strong>00</strong>2 The Plaza Bldg, 2112 11 th Ave. S<br />
Nurs<strong>in</strong>g Education 939-9128 Children’s Harbor, 4 th Floor<br />
CHECK Center (Comprehensive Health Education<br />
Hospital, 1 st Floor<br />
Center for Kids)<br />
Information Systems Customer Support Desk 939-6568 Park Place II<br />
Near and Dear Childcare 939-5983 Children’s Harbor, 2 nd Floor<br />
Volunteer Services 939-9696 The Plaza Bldg, 2112 11 th Ave. S<br />
Patient Relations 939-9191 Hospital, 1 st Floor<br />
• Dial 8 to get an outside l<strong>in</strong>e.<br />
• When dial<strong>in</strong>g on campus, you may dial only the last 4 digits.
Betty Klie<br />
HR Consultant<br />
939-6640<br />
Cl<strong>in</strong>ics<br />
Adolescent Park Place<br />
Angie Saia<br />
HR Consultant<br />
939-5197<br />
Nurs<strong>in</strong>gs Services<br />
4 East<br />
Paula Preston<br />
HR Consultant<br />
558-2950<br />
Surgical Services<br />
Anesthesia/APASS<br />
L<strong>in</strong>dsey Skelton<br />
HR Consultant<br />
939-5192<br />
Laboratory Services<br />
ACC Lab<br />
After Hours<br />
Ambulatory Care<br />
Children's Behavioral Health-<br />
Shades Creek Only<br />
Dental Cl<strong>in</strong>ic<br />
Endrocr<strong>in</strong>ology<br />
ENT<br />
ENT-South<br />
General Surgery/Plastics Cl<strong>in</strong>ic<br />
GI/Infectious Disease<br />
Hematology/Oncology<br />
Infusion Park Place<br />
Nephrology<br />
Neurology/Infusion<br />
Neurology/Urology<br />
Orthopedic Cl<strong>in</strong>ic<br />
Pediatric Pathology<br />
Pulmonary/Allergy<br />
Renal Dialysis<br />
Rehab Medic<strong>in</strong>e<br />
Rheumatology/Immu/Allergy<br />
4 Southeast<br />
4 Tower<br />
4 West<br />
5 East<br />
5 Northwest<br />
5 Southeast<br />
5 Tower<br />
5 West<br />
6 Northwest<br />
7 Northwest<br />
Burn<br />
Case Management<br />
C.H.E.C.K.<br />
ECMO<br />
Emergency Department<br />
Floatpool<br />
Medicaid Screen<strong>in</strong>g<br />
N.E.R.D.<br />
NICU<br />
Nurs<strong>in</strong>g Adm<strong>in</strong>istration<br />
Children's South-Outpatient<br />
Surgery<br />
One Day Surgery<br />
Operat<strong>in</strong>g Room<br />
PACU<br />
Sterile Process<strong>in</strong>g<br />
Cl<strong>in</strong>ical Nutrition<br />
Early Intervention<br />
Lactation<br />
Pharmacy<br />
PT/OT<br />
Social Services<br />
Volunteer Services<br />
Elizabeth Baker<br />
HR Consultant<br />
939-6089<br />
Adm<strong>in</strong>istration<br />
Amelia Center<br />
Child Safety Institute<br />
Children's Harbor<br />
EEG<br />
Laboratory<br />
Park Place North Lab<br />
PSG<br />
Respiratory Care<br />
Sleep Lab<br />
Account<strong>in</strong>g<br />
F<strong>in</strong>ance<br />
Internal Audit<br />
Medical Staff Services<br />
Patient Relations<br />
Performance Improvement<br />
Risk Management<br />
Access Center<br />
Central Distribution<br />
Infection Control<br />
Information Systems<br />
Speciality General-CS<br />
PICU<br />
CHIPS<br />
Transplant Services<br />
Sports Medic<strong>in</strong>e<br />
Pre-Admit Screen<strong>in</strong>g<br />
SCU<br />
Community<br />
Development/Foundation<br />
Child Life/Sunsh<strong>in</strong>e School<br />
Berthetta Wilson<br />
HR Consultant<br />
Practices<br />
SCTU<br />
Corporate Communications<br />
and Market<strong>in</strong>g<br />
939-5194<br />
Dr. Soares'<br />
Greenvale-Brook Highland<br />
Greenvale-Hoover<br />
Greenvale-Alabaster<br />
Mayfair<br />
Midtown<br />
Over The Mounta<strong>in</strong><br />
Pediatrics East-Deerfoot<br />
Pediatrics East-Roebuck<br />
Pediatric ENT<br />
Pediatrics West<br />
Pell City<br />
Physcians to Childrens<br />
Vestavia<br />
Transport<br />
Trauma<br />
Utilization Review<br />
Family Services<br />
Human Resources<br />
Near and Dear<br />
Pastoral Care<br />
Pediatric Imag<strong>in</strong>g<br />
Security<br />
Telecommunications/PBX<br />
Telephone Triage<br />
Customer Service<br />
Biomedical<br />
Eng<strong>in</strong>eer<strong>in</strong>g<br />
Bradley Center<br />
Central Transporation<br />
Children's Hear Center<br />
Customer Service-South<br />
EVS/Housekeep<strong>in</strong>g<br />
EVS/Transportation<br />
Food Services<br />
Facilities Development<br />
Hear<strong>in</strong>g and Speech<br />
Hear<strong>in</strong>g and Speech-CS<br />
Ma<strong>in</strong>tenance/Eng<strong>in</strong>eer<strong>in</strong>g<br />
Materials Management<br />
Medical Records<br />
©Children’s of Alabama 2012
Table of Contents
CHILDREN’S <strong>OF</strong> ALAB<strong>AM</strong>A BENEFIT MANUAL<br />
TABLE <strong>OF</strong> CONTENTS<br />
SECTION 1<br />
Welcome ......................................................................................................1.1<br />
Mission/Vision/Values ............................................................................... 1.2<br />
Use of the Manual ...................................................................................... 1.3<br />
Equal Employment Opportunity Policy Statement ................................... 1.5<br />
No Harassment Policy ............................................................................... 1.6<br />
No Discrim<strong>in</strong>ation Policy ........................................................................... 1.9<br />
No Retaliation Policy .................................................................................. 1.11<br />
Infraction of Health System Rules ............................................................. 1.13<br />
Family Medical Leave ............................................................................... 1.16<br />
Employment ................................................................................................1.19<br />
Pay Procedures ............................................................................................ 1.21<br />
General Information ....................................................................................1.22<br />
SECTION 2<br />
Incident Report<strong>in</strong>g ..................................................................................... 2.2<br />
Safe Medical Device Act ........................................................................... 2.2<br />
Product Recalls ........................................................................................... 2.2<br />
Medical Gas Shut-off Valves ..................................................................... 2.4<br />
Electrical Safety ..........................................................................................2.4<br />
Emergency Numbers and Code Words ...................................................... 2.5<br />
Personal Protective Equipment .................................................................. 2.7<br />
Hazardous Chemicals ................................................................................. 2.7<br />
Material Safety Data Sheets (MSDS) ........................................................ 2.8<br />
Fire Safety .................................................................................................. 2.12<br />
Security Facts .............................................................................................. 2.13<br />
©Children’s of Alabama 2012<br />
TOC1
SECTION 3<br />
Welcome ..................................................................................................... 3.1<br />
Irrevocable Elections .................................................................................. 3.2<br />
Employee Onl<strong>in</strong>e Service Center ............................................................... 3.3<br />
Benefit Election Form ................................................................................ 3.4<br />
Affidavit of Spousal Health Care Coverage .............................................. 3.5<br />
Group Life Enrollment Form ...................................................................... 3.6<br />
Time Off Plan ............................................................................................. 3.7<br />
Flexible Spend<strong>in</strong>g Accounts........................................................................... 3.13<br />
Health Sav<strong>in</strong>gs Account.............................................................................. 3.17<br />
BCBS Consumer Driven Plan Preventive Care Chart ................................ 3.19<br />
Teladoc........................................................................................................ 3.20<br />
Employee Assistance Program ................................................................... 3.22<br />
Diabetes Care Awards Program ................................................................. 3.2<br />
SECTION 4<br />
Pay Date ...................................................................................................... 4.1<br />
Introduction to Time Clock Function ......................................................... 4.2<br />
Diversity...................................................................................................... 4.5<br />
Child Abuse Red Flags ............................................................................... 4.6<br />
Patient/Parent Bill of Rights and Responsibilities ...................................... 4.7<br />
Address<strong>in</strong>g Ethical Issues ........................................................................... 4.16<br />
Guidel<strong>in</strong>es for Complet<strong>in</strong>g Quality Assurance Reports ............................. 4.17<br />
SECTION 5<br />
Basic Life Support Recretification.............................................................. 5.1<br />
Department Location .................................................................................. 5.2<br />
Advance Directives Policy ......................................................................... 5.3<br />
CHEX Instructions...................................................................................... 5.8 <br />
©Children’s of Alabama 2012<br />
TOC2
FORMS<br />
Employee Health Form<br />
Payroll Deduction Authorization Form<br />
I-9, Employment Eligibility Verifications<br />
Federal Form W-4<br />
State Form A-4<br />
W-2 Electronically<br />
Authorization For Automatic Payroll Deposits<br />
Receipt of Employee Orientation Manual<br />
Customer Service Standards<br />
Orientation Checklist<br />
Confidentiality Statement<br />
Voluntary Affirmative Action Information<br />
<strong>NEW</strong> <strong>EMPLOYEE</strong> <strong>ORIENTATION</strong> FEEDBACK FORMS<br />
Corporate Compliance Feedback Form<br />
HIPAA Feedback Form<br />
Health / Dental / Vision Presentation<br />
Tax Papers / Forms Preparation Feedback Form<br />
Risk Management Presentation Feedback Form<br />
Security Presentation Feedback Form<br />
Patient Safety / Performance Improvement Presentation Feedback Form<br />
Benefits Presentation Feedback Form<br />
Basic Growth and Development<br />
©Children’s of Alabama 2012<br />
TOC3
Section 1
Welcome to Children’s of Alabama<br />
where “Children are the center of our lives.”<br />
Dear Children’s of Alabama Employee:<br />
As you are aware, these are <strong>in</strong>terest<strong>in</strong>g times <strong>in</strong> the health care <strong>in</strong>dustry. The challenges of an<br />
<strong>in</strong>creas<strong>in</strong>gly competitive marketplace make every job, and every employee, <strong>in</strong> Children's all<br />
the more important. Today, when provid<strong>in</strong>g cost-effective care is so critical, we must be careful<br />
stewards of all our resources. You are here because you are an important member of a team of good<br />
people stand<strong>in</strong>g watch over the health of children every moment of every day.<br />
Dur<strong>in</strong>g your orientation, you will hear about our mission and your role <strong>in</strong> help<strong>in</strong>g us meet the needs<br />
of the children and families we are privileged to serve. You also will learn how your particular job <strong>in</strong><br />
your department fits <strong>in</strong> to this seamless system of health care we endeavor to provide for every child.<br />
As you beg<strong>in</strong> your work here, listen closely to what your family, friends and neighbors have to say.<br />
You may be surprised by the number of people you know who have had some experience with our<br />
hospital or health system -- as a parent, a grandparent or maybe even as a former patient. You also<br />
will have contact with families of our current patients. No matter what your job, you will likely have<br />
the opportunity to ease the stress of a child, a parent or some other family member. Interactions like<br />
these are very important to our mission, and we have a reputation for hav<strong>in</strong>g excellent “guest<br />
relations.”<br />
We hope you will take pride <strong>in</strong> your new role and responsibility with Children’s of Alabama.<br />
Welcome once aga<strong>in</strong> to this wonderful organization with its rich history of service to children. With<br />
your help, our hospital and health system will cont<strong>in</strong>ue to set the standard for pediatric health care<br />
for years to come.<br />
©Children’s of Alabama 2012<br />
1.1
CHILDREN’S <strong>OF</strong> ALAB<strong>AM</strong>A MISSION/VISION/VALUES<br />
The mission of Children’s of Alabama is to provide the f<strong>in</strong>est pediatric health services<br />
to all children <strong>in</strong> an environment that fosters excellence <strong>in</strong> research and medical<br />
education. Children’s of Alabama will be an advocate for all children and work to<br />
educate the public about issues affect<strong>in</strong>g children's health and well-be<strong>in</strong>g.<br />
The vision of Children’s of Alabama is a better childhood for all children. We envision<br />
childhood where all children have access to healthcare, live <strong>in</strong> safe neighborhoods,<br />
grow up <strong>in</strong> economically-stable families, and attend functional schools with<strong>in</strong><br />
communities that value each child as a unique human be<strong>in</strong>g.<br />
Children’s of Alabama values trust, <strong>in</strong>novation, teamwork, commitment to children,<br />
and compassion for employees, patients and families.<br />
Quality improvement at Children’s of Alabama is the cont<strong>in</strong>ual, systematic search<br />
for opportunities to improve. We strive for an environment of cooperation to achieve<br />
improved patient outcomes and satisfied customers.<br />
©Children’s of Alabama 2012<br />
1.2
USE <strong>OF</strong> THE MANUAL<br />
OVERVIEW<br />
This manual is designed to provide you with an overview of the policies and procedures of Children’s of<br />
Alabama (also referred to throughout as Children’s of Alabama) and is not considered to be an employment<br />
contract. While the manual does provide you with important, general <strong>in</strong>formation it does not cover all<br />
aspects of your employment with Children’s of Alabama. You are responsible for familiariz<strong>in</strong>g yourself<br />
with both the contents of this booklet and the Children’s of Alabama Policy and Procedures Manual.<br />
Manuals are ma<strong>in</strong>ta<strong>in</strong>ed <strong>in</strong> each department for your easy reference. The official policy manual is<br />
ma<strong>in</strong>ta<strong>in</strong>ed by the Human Resources Department and is available for your review dur<strong>in</strong>g normal office<br />
hours or by appo<strong>in</strong>tment after hours. In the event of a conflict between this manual and the official policy,<br />
the policy will govern. Children’s of Alabama reserves the right to revise, add or delete policies at its<br />
discretion without notice.<br />
HANDBOOK - NOT A CONTRACT<br />
As questions arise, we encourage you to seek answers from your supervisor or a member of the<br />
Department of Human Resources. We welcome the opportunity to talk with you about your job or the<br />
policies of Children’s of Alabama!<br />
Neither this handbook nor any of the Children’s of Alabama's policies or statements of benefits are<br />
<strong>in</strong>tended to be, nor should they be construed to be, an employment contract between you and Children’s<br />
of Alabama or its affiliates. Employment with Children’s of Alabama is at will. "At will" allows both<br />
Children’s of Alabama and you, the employee, to end the employment relationship at any time for any<br />
reason or for no reason.<br />
MANAGEMENT RIGHTS<br />
From time to time, Children’s of Alabama, like any large organization, has to make operational decisions to<br />
meet the demands of the chang<strong>in</strong>g bus<strong>in</strong>ess market. Children’s of Alabama management may exercise its<br />
discretion and right to make bus<strong>in</strong>ess decisions <strong>in</strong> the best <strong>in</strong>terest of the organization. This would <strong>in</strong>clude,<br />
but not be limited to, the discretion to supervise, hire, promote, reassign, suspend, dismiss and discipl<strong>in</strong>e<br />
employees; to determ<strong>in</strong>e the size and composition of the work force; to establish, change and/or abolish<br />
policies, procedures, rules and regulations; to determ<strong>in</strong>e and modify job duties and job classifications, to<br />
assign work to employees based on the needs and requirements of the organization and to subcontract all<br />
or any portion of work outside of Children’s of Alabama.<br />
HISTORY<br />
Children’s of Alabama has grown from a 21-room cottage on Birm<strong>in</strong>gham's Southside to an <strong>in</strong>tegrated<br />
health care network that <strong>in</strong>cludes a Hospital complex licensed for 275 beds, and other health care facilities<br />
located throughout our state staffed with pediatricians, pediatric subspecialists, nurse managers and health<br />
care educators. We have over 3,5<strong>00</strong> employees serv<strong>in</strong>g <strong>in</strong> various communities and neighborhoods. S<strong>in</strong>ce<br />
its beg<strong>in</strong>n<strong>in</strong>gs <strong>in</strong> 1911, Children’s of Alabama has been the only healthcare network <strong>in</strong> Alabama,<br />
Mississippi and the Florida panhandle solely dedicated to the needs of children and young people. Today,<br />
Children’s of Alabama provides <strong>in</strong>patient and specialty cl<strong>in</strong>ic care to children from around the world.<br />
Children’s of Alabama is an <strong>in</strong>dependent, not-for-profit health system governed by a volunteer Board of<br />
Trustees. Our medical staff <strong>in</strong>cludes approximately 560 physicians and dentists who adm<strong>in</strong>ister care<br />
©Children’s of Alabama 2012<br />
1.3
that totals over 6<strong>00</strong>,<strong>00</strong>0 <strong>in</strong>patient and outpatient visits annually. We also provide the facilities for teach<strong>in</strong>g<br />
and research for the Department of Pediatrics of the School of Medic<strong>in</strong>e, University of Alabama at<br />
Birm<strong>in</strong>gham.<br />
The Children's Hospital complex, located <strong>in</strong> south central Birm<strong>in</strong>gham, is adjacent to the medical facilities<br />
of the University of Alabama at Birm<strong>in</strong>gham and provides a wide range of patient services, health,<br />
education and research activities which have led it to become one of the nation's major pediatric centers.<br />
HUMAN RESOURCES DEPARTMENT<br />
The Human Resources staff members are available to assist you with questions you may have regard<strong>in</strong>g<br />
your employment at Children’s of Alabama. We are open Monday through Friday from 8:<strong>00</strong> a.m. to 4:30<br />
p.m. Meet<strong>in</strong>g times outside these regular office hours can be arranged by call<strong>in</strong>g ahead to make an<br />
appo<strong>in</strong>tment. If you want to meet with a member of the Human Resources staff, please call us at 939-<br />
5190.<br />
"HARASSMENT" & "SEXUAL HARASSMENT" WILL NOT BE TOLERATED<br />
Children’s of Alabama is committed to ma<strong>in</strong>ta<strong>in</strong><strong>in</strong>g an environment free from any form of harassment.<br />
This would <strong>in</strong>clude harass<strong>in</strong>g behavior directed towards or <strong>in</strong>itiated by any employee (i.e. supervisory or<br />
non-supervisory) or non-employee based on race, sex, religion, color, national orig<strong>in</strong>, age, disability or<br />
any other factor protected by law.<br />
Children’s of Alabama's policy is to protect all members of our community and work team from sexual<br />
harassment. As a result, the responsibility for report<strong>in</strong>g <strong>in</strong>cidents of sexual harassment also must rest<br />
with all members of our work team. Any employee who has knowledge of sexual harassment is<br />
required to report it to the appropriate supervisor or department manager. If the employee is<br />
uncomfortable discuss<strong>in</strong>g the matter with these <strong>in</strong>dividuals, the employee may contact the Children’s of<br />
Alabama Employee Relations Manager at 939-6657. Compla<strong>in</strong>ts shall be dealt with and appropriate<br />
action taken. Harassment will not be tolerated.<br />
©Children’s of Alabama 2012<br />
1.4
EQUAL EMPLOYMENT OPPORTUNITY<br />
POLICY STATEMENT<br />
It is the policy of Children’s of Alabama to pledge its full support to equal employment opportunity<br />
for all persons, regardless of race, color, religion, sex, national orig<strong>in</strong>, physical handicap, medical<br />
condition, age, status as a disabled veteran or veteran of the Vietnam Era with respect to recruitment,<br />
hir<strong>in</strong>g, tra<strong>in</strong><strong>in</strong>g, promotion and other terms and conditions of employment, provided the <strong>in</strong>dividual is<br />
qualified to perform the work available. An executive of the Hospital, Doug Dean, has been<br />
designated to adm<strong>in</strong>ister the Children’s affirmative action program and will monitor that program and<br />
make reports on a periodic and cont<strong>in</strong>u<strong>in</strong>g basis to senior management.<br />
Accord<strong>in</strong>gly, all employment decisions shall be consistent with the pr<strong>in</strong>ciples of equal employment<br />
opportunity (EEO). All promotion decisions shall be consistent with the pr<strong>in</strong>ciples of EEO, and only<br />
valid qualifications will be required for promotion.<br />
All other personnel actions or programs such as compensation, benefits, transfers, layoffs, recalls’<br />
company sponsored tra<strong>in</strong><strong>in</strong>g, education, tuition assistance and social and recreational programs<br />
will be adm<strong>in</strong>istered <strong>in</strong> a non-discrim<strong>in</strong>atory manner with respect to m<strong>in</strong>orities, women, disabled persons,<br />
veterans of the Vietnam Era and disabled veterans provided the <strong>in</strong>dividual is qualified to perform the work<br />
available.<br />
Pursuant thereto, this policy establishes -- effective immediately and <strong>in</strong> compliance with regulations<br />
provided by the Secretary of Labor <strong>in</strong> 41 C.F.R. Chapter 60 -- an affirmative action program<br />
composed of specific steps that will be undertaken <strong>in</strong> order to implement this policy. The Affirmative<br />
Action Plan is available for <strong>in</strong>spection by applicants and employees <strong>in</strong> the Human Resources Department<br />
between the hours of 9:<strong>00</strong> a.m. and 3:<strong>00</strong> p.m. Monday through Friday.<br />
©Children’s of Alabama 2012<br />
1.5
NO HARASSMENT POLICY<br />
Human Resource Policy A-01<br />
Reissue Date: November 3, 2<strong>00</strong>8<br />
Children’s of Alabama does not authorize and will not tolerate any form of harassment of any employee or<br />
by any employee (i.e., supervisory or non-supervisory) or non-employee based on race, sex, religion, color,<br />
national orig<strong>in</strong>, age, disability, citizenship or veteran status or any other factor protected by law.<br />
The term “harassment” <strong>in</strong>cludes, but is not limited to, offensive language, jokes, or other verbal, graphic,<br />
electronic or physical conduct, or <strong>in</strong>timidat<strong>in</strong>g, threaten<strong>in</strong>g or offensive behaviors relat<strong>in</strong>g to an employee’s<br />
race, sex, religion, color, national orig<strong>in</strong>, age, disability, citizenship or veteran status or other factor<br />
protected by Children’s of Alabama’s EEO policy and law which would make the reasonable person<br />
experienc<strong>in</strong>g such harassment uncomfortable <strong>in</strong> the work environment or which could <strong>in</strong>terfere with the<br />
person’s job performance.<br />
This policy applies to each and every employee at Children’s of Alabama, both management and nonmanagement.<br />
It is Company policy that all employees have a right to work <strong>in</strong> an environment free of<br />
discrim<strong>in</strong>ation, which encompasses freedom from any form of harassment. This <strong>in</strong>cludes the behavior of<br />
peers, superiors, subord<strong>in</strong>ates, customers and visitors to the premises. Such conduct by an employee may<br />
result <strong>in</strong> discipl<strong>in</strong>ary action up to an <strong>in</strong>clud<strong>in</strong>g term<strong>in</strong>ation.<br />
Sexual Harassment<br />
Although it is not the only type prohibited, one form of prohibited harassment is sexual harassment.<br />
Specifically, no supervisor may threaten or <strong>in</strong>s<strong>in</strong>uate, either explicitly or implicitly, that an employee’s<br />
submission to or rejection of sexual advances will <strong>in</strong> any way <strong>in</strong>fluence any personnel decision regard<strong>in</strong>g<br />
that employee’s employment, evaluation, wages, advancement, assigned duties, work hours, or any other<br />
condition of employment or career development.<br />
Sexual harassment may be overt or subtle. Some behavior which is appropriate <strong>in</strong> a social sett<strong>in</strong>g may not<br />
be appropriate <strong>in</strong> the work place. Sexual harassment does not refer to behavior or occasional compliments<br />
of a socially acceptable nature. It refers to behavior that is unwelcome, offensive, and affects an<br />
<strong>in</strong>dividual’s employment or work conditions.<br />
Some examples of conduct that may constitute sexual harassment <strong>in</strong>clude: (a) mak<strong>in</strong>g unwelcome sexual<br />
flirtations, advances, requests for sexual favors, or other verbal, visual or physical conduct of a sexual<br />
nature a condition of employment; or (b) creat<strong>in</strong>g an <strong>in</strong>timidat<strong>in</strong>g, hostile or offensive work<strong>in</strong>g<br />
environment by such conduct as:<br />
(1) sexual <strong>in</strong>nuendo or sexually suggestive comments – <strong>in</strong>clud<strong>in</strong>g but not limited to – sexually oriented<br />
“kidd<strong>in</strong>g,” “teas<strong>in</strong>g,” or “practical jokes;” jokes about gender specific traits, foul or obscene language<br />
or gestures.<br />
(2) subtle or direct pressure or request for sexual activities;<br />
(3) unnecessary touch<strong>in</strong>g of an <strong>in</strong>dividual, such as p<strong>in</strong>ch<strong>in</strong>g, patt<strong>in</strong>g or brush<strong>in</strong>g up aga<strong>in</strong>st another’s body;<br />
(4) graphic comments about an <strong>in</strong>dividual’s body or appearance;<br />
©Children’s of Alabama 2012<br />
1.6
(5) sexually degrad<strong>in</strong>g words used to describe an <strong>in</strong>dividual;<br />
(6) the read<strong>in</strong>g or display<strong>in</strong>g <strong>in</strong> the workplace of sexually suggestive or reveal<strong>in</strong>g words, objects, images<br />
or pictures;<br />
(7) sexually explicitly or offensive jokes;<br />
(8) physical assault; or<br />
(9) other explicit or implied conduct of a sexual nature which relates to or affects an <strong>in</strong>dividual’s<br />
employment.<br />
No employee, supervisor, manager or other person, whether employed by Children’s of Alabama, or not,<br />
shall threaten or suggest that an employee’s refusal to submit to sexual harassment will adversely affect<br />
that person’s employment, work status, evaluation, wages, advancement, assigned duties, hours of work<br />
or any other terms or conditions of employment. Similarly, no employee - regardless of job title - shall<br />
promise, imply or grant any preferential treatment <strong>in</strong> return for another employee’s acceptance of conduct<br />
which is sexual harass<strong>in</strong>g.<br />
OTHER HARASSMENT<br />
Statements, behaviors or the display or use of words, objects, images or pictures that others could <strong>in</strong>terpret<br />
as be<strong>in</strong>g <strong>in</strong>sult<strong>in</strong>g or derogatory as well as slurs toward persons based upon their race, color, national orig<strong>in</strong>,<br />
religion, sex, age, disability, citizenship or veteran status or any other factor protected by law are prohibited<br />
by this policy. Also prohibited are statements or actions that are threaten<strong>in</strong>g, <strong>in</strong>timidat<strong>in</strong>g, vulgar, or hostile.<br />
Such conduct may make a reasonable person uncomfortable <strong>in</strong> the work environment or could <strong>in</strong>terfere<br />
with an employee’s ability to perform his or her job, regardless of whether the actions are from a fellow<br />
employee, supervisor, customer or visitor.<br />
Comments or actions of this type, even if <strong>in</strong>tended as a jok<strong>in</strong>g matter among friends, are always<br />
<strong>in</strong>appropriate <strong>in</strong> the work place and will not be tolerated. The conduct forbidden by this policy specifically<br />
<strong>in</strong>cludes; but is not limited to:<br />
epithets, slurs, negative stereotyp<strong>in</strong>g, kidd<strong>in</strong>g, teas<strong>in</strong>g, jok<strong>in</strong>g, or <strong>in</strong>timidat<strong>in</strong>g acts that are based on a<br />
person’s protected status, and<br />
written or graphic materials circulated with<strong>in</strong> the workplace that shows hostility or ar degrad<strong>in</strong>g toward a<br />
person or a group because of that person’s protected status or characteristic(s).<br />
No supervisor or manager should participate <strong>in</strong> such behavior and must take immediate action to stop<br />
those who are known to be or suspected of be<strong>in</strong>g <strong>in</strong>volved <strong>in</strong> such conduct. The supervisor must also<br />
contact and report the <strong>in</strong>formation to one of the <strong>in</strong>dividuals whose job title is listed on page 3 of this<br />
policy.<br />
HOW TO REPORT AN INSTANCE <strong>OF</strong> HARASSMENT<br />
An employee who has a compla<strong>in</strong>t or concern relat<strong>in</strong>g to any form of harassment, abusive, taunt<strong>in</strong>g or<br />
demean<strong>in</strong>g behavior, <strong>in</strong>clud<strong>in</strong>g concerns about such conduct from non-employees, should immediately<br />
report the conduct to his or her supervisor or other management personnel. If the employee is<br />
©Children’s of Alabama 2012<br />
1.7
uncomfortable mak<strong>in</strong>g the report to his or her immediate supervisor or another manager for any reason, the<br />
report should be made to the Director of Employee Relations, or the department’s HR Consultant. An<br />
employee should report the behavior or concern even if the behavior compla<strong>in</strong>ed if is not directed towards<br />
the employee who reports it.<br />
HOW WILL CHILDREN’S <strong>OF</strong> ALAB<strong>AM</strong>A INVESTIGATE COMPLAINTS<br />
Children’s of Alabama takes it prohibition aga<strong>in</strong>st harassment very seriously. Compla<strong>in</strong>ts of<br />
discrim<strong>in</strong>ation or harassment will be promptly <strong>in</strong>vestigated by Children’s of Alabama. The <strong>in</strong>vestigation<br />
will be conducted as impartially and confidentially as possible. However, although each <strong>in</strong>vestigation will<br />
be tailored specific to the particular alleged facts, such an <strong>in</strong>vestigation will oftentimes <strong>in</strong>clude (A)<br />
<strong>in</strong>terviews with the compla<strong>in</strong><strong>in</strong>g employee, the subject of the compla<strong>in</strong>t, and other who may have<br />
knowledge of the situation; and (B) review of relevant files and other tangible evidence. The <strong>in</strong>vestigator<br />
will reasonably attempt to rationally and objectively resolve any questions of credibility between the<br />
compla<strong>in</strong><strong>in</strong>g party and the accused. Individuals who make false statements dur<strong>in</strong>g the course of an<br />
<strong>in</strong>vestigation may be subject to discipl<strong>in</strong>e, which may <strong>in</strong>clude discharge. All employees are expected to<br />
cooperate fully with such <strong>in</strong>vestigation. Failure to cooperate fully may lead to discipl<strong>in</strong>e, which may<br />
<strong>in</strong>clude discharge.<br />
At the conclusion of the <strong>in</strong>vestigation, Company officials will advise the compla<strong>in</strong><strong>in</strong>g employee of the<br />
results of the <strong>in</strong>vestigation and any discipl<strong>in</strong>ary actions to be taken, if any.<br />
If it is determ<strong>in</strong>ed that a compla<strong>in</strong>t is valid, Children’s of Alabama will take appropriate discipl<strong>in</strong>ary<br />
action aga<strong>in</strong>st the offender based on the severity of the harassment and the <strong>in</strong>dividual’s employment<br />
history. Discipl<strong>in</strong>ary action may <strong>in</strong>clude a written warn<strong>in</strong>g, suspension, demotion, term<strong>in</strong>ation of<br />
employment, and/or other measures pursuant to Children’s of Alabama’s discipl<strong>in</strong>ary policies. In the<br />
case of non-employees such as customers or suppliers who violate this policy, they will be warned that<br />
their conduct violates Children’s of Alabama policy and potentially will be asked to leave the premises<br />
and not return and their conduct will be reported to whomever else Children’s of Alabama determ<strong>in</strong>es<br />
has a need to know.<br />
YOUR COMMITMENT TO AN EFFECTIVE NO HARASSMENT POLICY<br />
For Children’s of Alabama policy aga<strong>in</strong>st harassment to be fully effective, it is essential that each<br />
employee comply with this policy and take affirmative measures to assist management <strong>in</strong> ma<strong>in</strong>ta<strong>in</strong><strong>in</strong>g a<br />
work environment free of harassment. You can do so by do<strong>in</strong>g the follow<strong>in</strong>g:<br />
Report any violations; and cooperate with any <strong>in</strong>vestigation by provid<strong>in</strong>g complete and truthful responses<br />
to questions.<br />
Children’s of Alabama takes very seriously it prohibition aga<strong>in</strong>st harassment. It is also a violation of<br />
policy for anyone to retaliate, threaten or seek any type of reprisal aga<strong>in</strong>st an <strong>in</strong>dividual act<strong>in</strong>g <strong>in</strong> good<br />
faith who reports harassment or who participates or cooperates <strong>in</strong> an <strong>in</strong>vestigation regard<strong>in</strong>g harassment. If<br />
an employee believes that reprisal, <strong>in</strong>timidation or retaliation has occurred, it should immediately be<br />
reported to one of the <strong>in</strong>dividuals whose job title is listed above. Further, anyone who believes that<br />
Children’s of Alabama has not adequately <strong>in</strong>vestigated and/or responded to his or her report of alleged<br />
harassment with<strong>in</strong> a reasonable time must escalate his or her report to the next level supervisor or one of<br />
the other persons designated above to ensure that Children’s of Alabama has an adequate opportunity to<br />
<strong>in</strong>vestigate and remedy any alleged harassment.<br />
©Children’s of Alabama 2012<br />
1.8
NO DISCRIMINATION POLICY<br />
Human Resource Policy A-02<br />
Reissue Date: November 3, 2<strong>00</strong>8<br />
PURPOSE<br />
Children’s of Alabama does not authorize and will not tolerate any form of discrim<strong>in</strong>ation of any<br />
employee or by any employee or non-employee based on race, sex, religion, color, national orig<strong>in</strong>, age,<br />
disability, citizenship or veteran status or any other factor protected by law.<br />
The term discrim<strong>in</strong>ation <strong>in</strong>cludes, but is not limited to, tak<strong>in</strong>g any adverse employment action due to an<br />
employee’s race, sex, religion, color, national orig<strong>in</strong>, age, disability, citizenship or veteran status, or other<br />
factors protected by law. This policy applies to all employment actions taken by any person at Children’s<br />
of Alabama <strong>in</strong>clud<strong>in</strong>g, but not limited to, compensation, benefits, transfers, term<strong>in</strong>ations, layoffs, recalls,<br />
Company sponsored tra<strong>in</strong><strong>in</strong>g, education, social and recreational programs, and all other employment<br />
actions or decisions at Children’s of Alabama.<br />
This policy will be distributed to all employees and posted.<br />
HOW TO REPORT INSTANCES <strong>OF</strong> DISCRIMINATION<br />
An employee who has a compla<strong>in</strong>t or concern relat<strong>in</strong>g to discrim<strong>in</strong>ation should immediately report such<br />
conduct to his or her immediate supervisor or other management personnel with whom the employee feels<br />
comfortable. If the employee is uncomfortable mak<strong>in</strong>g the report to the supervisor or another management<br />
person for any reason, the employee should immediately report the compla<strong>in</strong>t or concern to the Director of<br />
Employee Relations, or the department’s HR Consultant. An employee should report the behavior or<br />
concern even if the behavior compla<strong>in</strong>ed of is not directed toward the employee who reports it.<br />
HOW CHILDREN’S <strong>OF</strong> ALAB<strong>AM</strong>A WILL INVESTIGATE COMPLAINTS<br />
Children’s of Alabama takes it prohibition aga<strong>in</strong>st discrim<strong>in</strong>ation very seriously. Compla<strong>in</strong>ts of<br />
discrim<strong>in</strong>ation will be promptly <strong>in</strong>vestigated as impartially and confidentially as possible. However,<br />
although each <strong>in</strong>vestigation will be tailored specific to the particular alleged facts, such an <strong>in</strong>vestigation will<br />
oftentimes <strong>in</strong>clude (A) <strong>in</strong>terviews with the compla<strong>in</strong><strong>in</strong>g employee, the subject of the compla<strong>in</strong>t, and others<br />
who may have knowledge of the situation, and (B) review of relevant files other tangible evidence. The<br />
<strong>in</strong>vestigator will reasonably attempt to rationally and objectively resolve any questions of creditability<br />
between the compla<strong>in</strong><strong>in</strong>g party and the accused. Individuals who make false statements dur<strong>in</strong>g the course<br />
of an <strong>in</strong>vestigation may be subject to discipl<strong>in</strong>e, which may <strong>in</strong>clude discharge. All employees are expected<br />
to cooperate fully with such <strong>in</strong>vestigations. Failure to cooperate fully may lead to discipl<strong>in</strong>e, which may<br />
<strong>in</strong>clude discharge.<br />
At the conclusion of the <strong>in</strong>vestigation, Company officials will advise the compla<strong>in</strong><strong>in</strong>g employee of the<br />
results of the <strong>in</strong>vestigation and any discipl<strong>in</strong>ary actions to be taken, if any.<br />
If it is determ<strong>in</strong>ed that a compla<strong>in</strong>t is valid, Children’s of Alabama will take appropriate discipl<strong>in</strong>ary action<br />
aga<strong>in</strong>st the offender based on facts and the <strong>in</strong>dividual’s employment history. Discipl<strong>in</strong>ary action may<br />
<strong>in</strong>clude a written warn<strong>in</strong>g, suspension, demotion, and term<strong>in</strong>ation of employment and/or other measure<br />
pursuant to Children’s of Alabama’s discipl<strong>in</strong>ary policies. In the case of non-employees such as customers<br />
and suppliers who violate this policy, they will be warned that their conduct violates Children’s of Alabama<br />
policy and potentially will be asked to leave the premises and not return and their conduct will be reported<br />
to whomever else Children’s of Alabama determ<strong>in</strong>es has a need to know.<br />
©Children’s of Alabama 2012<br />
1.9
YOUR COMMITMENT TO AN EFFECTIVE NO DISCRIMINATION POLICY<br />
For Children’s of Alabama’s Policy aga<strong>in</strong>st discrim<strong>in</strong>ation to be fully effective, it is important for you to<br />
comply with this policy. You can do so by do<strong>in</strong>g the follow<strong>in</strong>g:<br />
• Report any violations; and<br />
• Cooperate with any <strong>in</strong>vestigation by provid<strong>in</strong>g complete and truthful responses to questions.<br />
OUR COMMITMENT TO AN EFFECTIVE NO DISCRIMINATION POLICY<br />
Children’s of Alabama takes very seriously it prohibition aga<strong>in</strong>st discrim<strong>in</strong>ation. It is a violation of<br />
policy for anyone to retaliate, threaten or seek any type of reprisal aga<strong>in</strong>st an <strong>in</strong>dividual act<strong>in</strong>g <strong>in</strong> good<br />
faith who reports discrim<strong>in</strong>ation or who participates or cooperates <strong>in</strong> an <strong>in</strong>vestigation regard<strong>in</strong>g<br />
discrim<strong>in</strong>ation. If an employee believes that reprisal, <strong>in</strong>timidation or retaliation has occurred, it should be<br />
immediately reported to the employee’s immediate supervisor, another member of management <strong>in</strong> the<br />
employee’s cha<strong>in</strong> of command or to one of the <strong>in</strong>dividuals whose job title is listed on page 1 of this policy.<br />
Anyone who feels that Children’s of Alabama has not met its obligations under this policy should contact,<br />
at least one of the <strong>in</strong>dividuals whose job title is listed on page 1 of this policy.<br />
©Children’s of Alabama 2012<br />
1.10
NO RETALIATION POLICY<br />
Human Resource Policy A-03<br />
Reissue Date: November 3, 2<strong>00</strong>8<br />
PURPOSE<br />
Children’s of Alabama does not authorize and will not tolerate any form of retaliation of any employee<br />
or by any employee (i.e., supervisory or non-supervisory) or non-employee.<br />
The term “retaliation” <strong>in</strong>cludes, but is not necessary limited to, any adverse employment action taken<br />
because an employee has engaged <strong>in</strong> protected conduct. Protected conduct under this policy <strong>in</strong>cludes, but<br />
is not limited to; report<strong>in</strong>g or compla<strong>in</strong><strong>in</strong>g <strong>in</strong> good faith about any discrim<strong>in</strong>ation or harassment, engag<strong>in</strong>g<br />
<strong>in</strong> any EEO process (such as testify<strong>in</strong>g, fill<strong>in</strong>g an EEOC charge, or fil<strong>in</strong>g an EEO lawsuit; or testify<strong>in</strong>g,<br />
whether verbally or <strong>in</strong> writ<strong>in</strong>g, <strong>in</strong> an EEOC <strong>in</strong>vestigation or EEO lawsuit).<br />
HOW TO REPORT INSTANCES <strong>OF</strong> RETALIATION<br />
An employee who has a compla<strong>in</strong>t or concern relat<strong>in</strong>g to retaliation should immediately report such conduct<br />
to his or her immediate supervisor or any other management personnel with whom the employee feels<br />
comfortable. If the employee is uncomfortable mak<strong>in</strong>g the report to the supervisor or another management<br />
person for any reason, the employee should immediately report the compla<strong>in</strong>t or concern to the Employee<br />
Relations Director or the department’s HR Consultant. An employee should report behavior or concern<br />
even if the behavior compla<strong>in</strong>ed of is not directed toward the employee who reports it.<br />
HOW CHILDREN’S <strong>OF</strong> ALAB<strong>AM</strong>A WILL INVESTIGATE COMPLAINTS<br />
Children’s of Alabama takes it prohibition aga<strong>in</strong>st retaliation very seriously. Compla<strong>in</strong>ts of retaliation will<br />
be promptly <strong>in</strong>vestigated by the Company. The <strong>in</strong>vestigation will be conducted as impartially and<br />
confidentially as possible. However, although each <strong>in</strong>vestigation will be tailored specific to the particular<br />
alleged facts, such an <strong>in</strong>vestigation will oftentimes <strong>in</strong>clude (A) <strong>in</strong>terviews with the compla<strong>in</strong><strong>in</strong>g employee,<br />
the subject of the compla<strong>in</strong>t, and others who may have knowledge of the situation; and (B) review of<br />
relevant files and others who may have evidence. The <strong>in</strong>vestigator will reasonably attempt to rationally<br />
and objectively resolve any questions of credibility between the compla<strong>in</strong><strong>in</strong>g party and the accused.<br />
Individuals who make false statements dur<strong>in</strong>g the course of an <strong>in</strong>vestigation may be subject to discipl<strong>in</strong>e,<br />
which may <strong>in</strong>clude discharge. All employees are expected to cooperate fully with such <strong>in</strong>vestigations.<br />
Failure to cooperate fully may lead to discipl<strong>in</strong>e, which may <strong>in</strong>clude discharge.<br />
At the conclusion of the <strong>in</strong>vestigation, Company officials will advise the compla<strong>in</strong><strong>in</strong>g employee of the<br />
results of the <strong>in</strong>vestigation and any discipl<strong>in</strong>ary actions to be taken, if any.<br />
If it is determ<strong>in</strong>ed that a compla<strong>in</strong>t is valid, the Company will take appropriate discipl<strong>in</strong>ary action aga<strong>in</strong>st<br />
the offender based o the severity of the retaliation and the <strong>in</strong>dividual’s employment history. Discipl<strong>in</strong>ary<br />
action may <strong>in</strong>clude a written warn<strong>in</strong>g, suspension, demotion, and term<strong>in</strong>ation of employment and/or other<br />
measures pursuant to Children’s of Alabama’s discipl<strong>in</strong>ary policies. In the case of non-employees such as<br />
customers and suppliers who violate this policy, they will be warned that their conduct violates Children’s<br />
of Alabama policy and potentially will be asked to leave the premises and not return and their conduct will<br />
be reported to whomever else the Company determ<strong>in</strong>es has a need to know.<br />
©Children’s of Alabama 2012<br />
1.11
YOUR COMMITMENT TO AN EFFECTIVE NO RETALIATION POLICY<br />
For Children’s of Alabama’s policy aga<strong>in</strong>st retaliation to be fully effective, it is important for you to<br />
comply with this policy. You can do so by do<strong>in</strong>g the follow<strong>in</strong>g:<br />
• Report any violations; and<br />
• Cooperate with any <strong>in</strong>vestigation by provid<strong>in</strong>g complete and truthful responses to questions.<br />
OUR COMMITMENT TO AN EFFECTIVE NO RETALIATION POLICY<br />
Children’s of Alabama takes very seriously its prohibition aga<strong>in</strong>st retaliation. It is a violation of policy for<br />
anyone to threaten, retaliate aga<strong>in</strong>st or seek any type of reprisal aga<strong>in</strong>st an <strong>in</strong>dividual act<strong>in</strong>g <strong>in</strong> good faith<br />
who reports retaliation or who participates or cooperates <strong>in</strong> an <strong>in</strong>vestigation regard<strong>in</strong>g retaliation. If an<br />
employee believes that reprisal, <strong>in</strong>timidation or retaliation has occurred, it should immediately be reported<br />
to the supervisor or one of the <strong>in</strong>dividuals whose job title is listed on page 1 of this policy. Further, anyone<br />
who feels that Children’s of Alabama has not met its obligations under this policy should contact, at least,<br />
one of the <strong>in</strong>dividuals whose job title is listed on page 1 of this policy.<br />
©Children’s of Alabama 2012<br />
1.12
Infraction of Children’s Rules<br />
Human Resource Policy F-05<br />
Reissue Date: November 3, 2<strong>00</strong>8<br />
It is the policy of Children’s of Alabama to provide an equitable, uniform procedure for adm<strong>in</strong>ister<strong>in</strong>g<br />
discipl<strong>in</strong>ary action and to address <strong>in</strong>adequate or unsatisfactory job performance, an employees’ misconduct,<br />
and the corrective measures associate with such performance. It is a process of education that may range<br />
from timely warn<strong>in</strong>gs for m<strong>in</strong>or offenses or omissions to discipl<strong>in</strong>ary suspension without pay or<br />
term<strong>in</strong>ation for serious or repeated <strong>in</strong>fractions of established policies or standards of conduct. This policy<br />
sets forth guidel<strong>in</strong>es of progressive discipl<strong>in</strong>e to be utilized when employees behavior violates Children’s<br />
of Alabama policies and procedures. Note that the list is not all-<strong>in</strong>clusive.<br />
The employee’s immediate supervisor is responsible for <strong>in</strong>itiat<strong>in</strong>g timely discipl<strong>in</strong>ary action <strong>in</strong> accordance<br />
with the follow<strong>in</strong>g steps:<br />
Written Counsel<strong>in</strong>g is used for first occurrence of m<strong>in</strong>or <strong>in</strong>fractions or as counsel<strong>in</strong>g. Verbal<br />
warn<strong>in</strong>gs are to be documented and reta<strong>in</strong>ed <strong>in</strong> the employee’s personnel file.<br />
Written Warn<strong>in</strong>g is used when one or more verbal warn<strong>in</strong>gs have not been sufficient to correct an<br />
employee’s behavior or when the offense is of a more serious nature. Written warn<strong>in</strong>gs are reta<strong>in</strong>ed<br />
<strong>in</strong> the employee’s personnel file.<br />
Suspension is <strong>in</strong>itiated when an offense is of a serious nature or when previous verbal and written<br />
warn<strong>in</strong>gs have not brought about the necessary change <strong>in</strong> behavior. Suspensions are to be approved<br />
by the Department Head and Human Resources prior to action be<strong>in</strong>g taken. Suspensions are<br />
generally three (3) to seven (7) work<strong>in</strong>g days <strong>in</strong> length. When necessary, an employee may be<br />
suspended from duty when a serious <strong>in</strong>fraction of rules has occurred or appears to have occurred<br />
before the discipl<strong>in</strong>ary action is determ<strong>in</strong>ed.<br />
Term<strong>in</strong>ation results from flagrant or repeated abuse of the policies or standards of conduct, or it<br />
can be for repeated lesser <strong>in</strong>fractions for which lesser discipl<strong>in</strong>ary action has been taken.<br />
Term<strong>in</strong>ations must be approved by the Department Director <strong>in</strong> consultation with Human Resources<br />
prior to action be<strong>in</strong>g taken.<br />
These steps are guidel<strong>in</strong>es, which will generally be followed, but all steps are not mandatory. Risks to<br />
patients, staff or other serious offense may warrant deviation from these guidel<strong>in</strong>es, <strong>in</strong>clud<strong>in</strong>g skipp<strong>in</strong>g<br />
steps as appropriate.<br />
Group Violations<br />
Cooperation of all members of the organization <strong>in</strong> observance of rules and regulations are designed for our<br />
common protection and benefit. The list below is not to be construed as all-<strong>in</strong>clusive and is provided only<br />
as a reference for consistent application and to communicate expectations.<br />
©Children’s of Alabama 2012<br />
1.13
Group I--Infraction of Rules and Regulations<br />
1. Loiter<strong>in</strong>g or loaf<strong>in</strong>g dur<strong>in</strong>g work hours on Children’s of Alabama premises dur<strong>in</strong>g duty or off<br />
duty.<br />
2. Repeated failure to be at workstation or <strong>in</strong> other work area for non-bus<strong>in</strong>ess reasons dur<strong>in</strong>g<br />
scheduled work time.<br />
3. Smok<strong>in</strong>g, except <strong>in</strong> designated areas and at designated times.<br />
4. Creat<strong>in</strong>g or contribut<strong>in</strong>g to unsanitary conditions.<br />
5. Failure to prevent or report any accident occurr<strong>in</strong>g on Children’s of Alabama property.<br />
6. Disregard concern<strong>in</strong>g personal appearance, hygiene and uniform<br />
7. Excessive use of cologne/perfume.<br />
8. Unauthorized use of assigned park<strong>in</strong>g areas.<br />
9. Abuse of break or meal periods.<br />
10. Misuse of assigned time clock.<br />
11. Failure to perform the standards of the job requirements.<br />
12. Failure to ma<strong>in</strong>ta<strong>in</strong> Children’s of Alabama annual mandatory <strong>in</strong>-services and healthcare<br />
screen<strong>in</strong>gs<br />
Penalties for Group I Violations<br />
First Offense: Written Counsel<strong>in</strong>g<br />
Second Offense: Written Warn<strong>in</strong>g and/or Suspension for a period up to seven (7)<br />
work<strong>in</strong>g days.<br />
Third Offense: Term<strong>in</strong>ation of employment<br />
Group II--Infraction of Rules and Regulations<br />
1. Use of obscene language<br />
2. Horseplay or throw<strong>in</strong>g th<strong>in</strong>gs.<br />
3. Gambl<strong>in</strong>g, lottery or any other games of chance of Children’s of Alabama property.<br />
4. Lack of cooperation or failure to show respect and consideration <strong>in</strong> medical staff relationships,<br />
management relationships, employee relationships, or patient relationships.<br />
5. Mistreatment of patients/parents or <strong>in</strong>attention to patient care.<br />
6. Intentional or repeated violation of safety rules or safety practices.<br />
7. Improper use of another employee’s identification badge or computer log<strong>in</strong> access codes.<br />
8. Failure to follow departmental call-<strong>in</strong> procedures.<br />
9. Solicitation of Children’s of Alabama staff or post<strong>in</strong>g of signs of electronic solicitation without<br />
proper authorization.<br />
10. Excessive use of non-work related computer usage (<strong>in</strong>ternet, personal graphics).<br />
11. Failure to follow work <strong>in</strong>structions as assigned by supervisor.<br />
12. Failure to ma<strong>in</strong>ta<strong>in</strong> Children’s of Alabama annual mandatory <strong>in</strong>-services and healthcare screen<strong>in</strong>gs<br />
Penalties of Group II Violations<br />
First Offense: Written warn<strong>in</strong>g and/or immediate suspension for a period up to 7<br />
work<strong>in</strong>g days.<br />
Second Offense: Term<strong>in</strong>ation of employment<br />
Group III--Infraction of Rules and Regulations<br />
1. Violation of Children’s of Alabama No Harassment, No Discrim<strong>in</strong>ation, No Retaliation, or<br />
Conduct and Work<strong>in</strong>g Environment.<br />
2. Refus<strong>in</strong>g to obey <strong>in</strong>structions and/or requests of supervisory personnel perta<strong>in</strong><strong>in</strong>g to work<br />
(<strong>in</strong>subord<strong>in</strong>ation).<br />
©Children’s of Alabama 2012<br />
1.14
3. Deliberate destruction, damage, misappropriation or unauthorized use or possession of hospital<br />
property, property of fellow employees, patients/parents or visitors <strong>in</strong> any manner.<br />
4. Threaten<strong>in</strong>g, <strong>in</strong>timidat<strong>in</strong>g, or coerc<strong>in</strong>g fellow employees at any time for any purpose.<br />
5. Theft of property of the hospital or other employees, visitors or patients/parents, or refusal to<br />
submit to <strong>in</strong>spection by Security on premises.<br />
6. Report<strong>in</strong>g for work under the <strong>in</strong>fluence of alcoholic beverages, illegal substances, or<br />
unauthorized prescribed medication.<br />
7. Willfully falsify<strong>in</strong>g applications for employment or other Children’s of Alabama records, reports,<br />
documents, etc.<br />
8. Conduct considered <strong>in</strong>decent by hospital management while on duty.<br />
9. Possession of weapons on hospital property.<br />
10. Fight<strong>in</strong>g<br />
11. Conduct<strong>in</strong>g organizational activities for any group or groups on hospital time and premises<br />
without written permission from the Human Resources or Adm<strong>in</strong>istration.<br />
12. Sleep<strong>in</strong>g while on duty.<br />
13. Solicit<strong>in</strong>g gratuities from patients or their relatives or vendors.<br />
14. Breach of ethics concern<strong>in</strong>g confidentiality of employee and/or patient <strong>in</strong>formation or any other<br />
hospital records.<br />
15. Failure to report to work two successive scheduled days without notify<strong>in</strong>g a supervisor.<br />
16. Refusal to complete assigned schedule or walk<strong>in</strong>g off the job without notify<strong>in</strong>g a supervisor.<br />
17. Conviction of a crim<strong>in</strong>al offense, which has an impact on the employee’s position with<br />
Children’s of Alabama as determ<strong>in</strong>ed by Adm<strong>in</strong>istration.<br />
18. Failure to follow duties as described <strong>in</strong> the Disaster Plan/Inclement Weather Plan.<br />
19. Failure or refusal to respond to emergency call-<strong>in</strong> or accept hours scheduled or duty, as<br />
assigned.<br />
20. Failure to observe fire/safety/disaster rules or procedures.<br />
21. Provid<strong>in</strong>g false <strong>in</strong>formation to obta<strong>in</strong> Leave of Absence.<br />
22. Failure to accurately record time and/or hav<strong>in</strong>g another employee swipe his/her badge <strong>in</strong> or out.<br />
23. Falsify<strong>in</strong>g testimony related to any Children’s of Alabama <strong>in</strong>vestigation.<br />
24. Receipt of three written warn<strong>in</strong>gs and/or two suspensions or any equivalent for unrelated<br />
violations with<strong>in</strong> eighteen (18) months.<br />
25. HIPAA Violations<br />
26. Mistreatment of patients/parents or <strong>in</strong>attention to patient care.<br />
Penalty for Group III Violations<br />
Cause for immediate term<strong>in</strong>ation of employment without warn<strong>in</strong>g.<br />
If the employee, who has passed their <strong>in</strong>troductory period, does not agree with the reasons and<br />
action taken, they may file an appeal through the established grievance procedure. This policy<br />
should not be construed as a contract of employment or a guarantee. All discipl<strong>in</strong>ary action is a<br />
serious matter for employees and for Children’s of Alabama, but <strong>in</strong>dividual circumstances may<br />
warrant action different from published guidel<strong>in</strong>es.<br />
Exempt employees who are suspended will not be paid for any full day dur<strong>in</strong>g which they are<br />
suspended as part of this discipl<strong>in</strong>e, even if the employee is suspended for a period of less<br />
than an entire work-week.<br />
©Children’s of Alabama 2012<br />
1.15
Family Medical Leave<br />
Human Resource Policy D-03<br />
Reissue Date: January 16, 2<strong>00</strong>9<br />
Basic Leave Entitlement<br />
Children’s of Alabama will provide up to 12 weeks of unpaid, job-protected leave dur<strong>in</strong>g any roll<strong>in</strong>g<br />
calendar year to eligible employees for the follow<strong>in</strong>g reasons:<br />
• For <strong>in</strong>capacity due to pregnancy, prenatal medical care or child birth;<br />
• To care for the employee’s child after birth, or placement for adoption or foster care;<br />
• To care for the employee’s spouse, son or daughter, or parent, who has a serious health<br />
condition; or<br />
• For a serious health condition that makes the employee unable to perform the employee’s job.<br />
Military Family Leave Entitlements<br />
Servicemember Family Leave. Eligible employees with a spouse, son, daughter, or parent on active duty or<br />
call to active duty status <strong>in</strong> the National Guard or Reserves <strong>in</strong> support of a cont<strong>in</strong>gency operation may use<br />
their 12-week leave entitlement to address certa<strong>in</strong> qualify<strong>in</strong>g exigencies. Qualify<strong>in</strong>g exigencies may<br />
<strong>in</strong>clude attend<strong>in</strong>g certa<strong>in</strong> military events, arrang<strong>in</strong>g for alternative childcare, address<strong>in</strong>g certa<strong>in</strong> f<strong>in</strong>ancial and<br />
legal arrangements, attend<strong>in</strong>g certa<strong>in</strong> counsel<strong>in</strong>g sessions, and attend<strong>in</strong>g post-deployment re<strong>in</strong>tegration<br />
brief<strong>in</strong>gs. Eligible employees should contact FML Specialist with questions regard<strong>in</strong>g whether a<br />
qualify<strong>in</strong>g exigency is present.<br />
Servicemember Caregiver Leave. FMLA also <strong>in</strong>cludes a special leave entitlement that permits eligible<br />
employees to take up to 26 weeks of leave to care for a covered servicemember dur<strong>in</strong>g a s<strong>in</strong>gle 12-month<br />
period measured from the first date that Caregiver leave is taken. A covered servicemember is a current<br />
member of the Armed Forces, <strong>in</strong>clud<strong>in</strong>g a member of the National Guard or Reserves, who has a serious<br />
<strong>in</strong>jury or illness <strong>in</strong>curred <strong>in</strong> the l<strong>in</strong>e of duty on active duty that may render the servicemember medically<br />
unfit to perform his or her duties for which the servicemember is undergo<strong>in</strong>g medical treatment,<br />
recuperation, or therapy; or is <strong>in</strong> outpatient status; or is on the temporary disability retired list.<br />
Benefits and Protections<br />
Dur<strong>in</strong>g FMLA leave, Children’s of Alabama will ma<strong>in</strong>ta<strong>in</strong> the employee’s health coverage under any<br />
“group health plan” on the same terms as if the employee had cont<strong>in</strong>ued to work. The employee will be<br />
responsible for mak<strong>in</strong>g arrangements to pay the employee portion of any applicable premiums. Upon return<br />
from FMLA leave, most employees must be restored to their orig<strong>in</strong>al or equivalent positions with equivalent<br />
pay, benefits, and other employment terms. Certa<strong>in</strong> key employees, who are notified of their status when<br />
they first request FMLA Leave, are re<strong>in</strong>stated to their former or equivalent positions only if hold<strong>in</strong>g the<br />
position for them and their re<strong>in</strong>statement does not cause Children’s of Alabama substantial economic <strong>in</strong>jury.<br />
Additionally, note that an employee on FMLA leave may be transferred, promoted, demoted, discipl<strong>in</strong>ed or<br />
term<strong>in</strong>ated if changes <strong>in</strong> the work environment would have demanded that action even if the employee had<br />
not taken leave.<br />
Use of FMLA leave will not result <strong>in</strong> the loss of any employment benefit that accrued prior to the start of<br />
an employee’s leave.<br />
©Children’s of Alabama 2012<br />
1.16
Eligibility Requirements<br />
Employees are eligible if they have worked for Children’s of Alabama for at least one year and for<br />
1,250 hours over the previous 12 months.<br />
Def<strong>in</strong>ition of Serious Health Condition<br />
A serious health condition is an illness, <strong>in</strong>jury, impairment, or physical or mental condition that <strong>in</strong>volves<br />
either an overnight stay <strong>in</strong> a medical care facility, or cont<strong>in</strong>u<strong>in</strong>g treatment by a health care provider for a<br />
condition that either prevents the employee from perform<strong>in</strong>g the functions of the employee’s job, or<br />
prevents the qualified family member from participat<strong>in</strong>g <strong>in</strong> school or other daily activities.<br />
Subject to certa<strong>in</strong> conditions, the cont<strong>in</strong>u<strong>in</strong>g treatment requirement may be met by a period of <strong>in</strong>capacity<br />
of more than 3 consecutive calendar days comb<strong>in</strong>ed with at least two visits to a health care provider or one<br />
visit and a regimen of cont<strong>in</strong>u<strong>in</strong>g treatment, or <strong>in</strong>capacity due to pregnancy, or <strong>in</strong>capacity due to a chronic<br />
condition. Other conditions may meet the def<strong>in</strong>ition of cont<strong>in</strong>u<strong>in</strong>g treatment.<br />
Use of Leave<br />
An employee does not need to use the leave entitlement for a serious health condition <strong>in</strong> one block. Leave<br />
can be taken <strong>in</strong>termittently or on a reduced leave schedule when medically necessary. Employees must<br />
make reasonable efforts to schedule leave for planned medical treatment so as not to unduly disrupt the<br />
employer’s operations. Leave due to qualify<strong>in</strong>g exigencies may also be taken on an <strong>in</strong>termittent basis.<br />
Substitution of Paid Leave for Unpaid Leave<br />
Employees tak<strong>in</strong>g FMLA leave will be required to exhaust any accrued paid leave while tak<strong>in</strong>g FMLA<br />
leave prior to tak<strong>in</strong>g any unpaid FMLA leave. In order to use paid leave for FMLA leave, employees must<br />
comply with Children’s of Alabama’s normal paid leave policies.<br />
Employee Responsibilities<br />
Employees must provide 30 days advance notice of the need to take FMLA leave when the need is<br />
foreseeable. When 30 days notice is not possible, the employee must provide notice as soon as practicable<br />
and generally must comply with Children’s of Alabama normal call-<strong>in</strong> procedures.<br />
Employees must provide sufficient <strong>in</strong>formation for Children’s of Alabama to determ<strong>in</strong>e if the leave may<br />
qualify for FMLA protection and the anticipated tim<strong>in</strong>g and duration of the leave. Sufficient <strong>in</strong>formation<br />
may <strong>in</strong>clude that the employee is unable to perform job functions, the family member is unable to perform<br />
daily activities, the need for hospitalization or cont<strong>in</strong>u<strong>in</strong>g treatment by a health care provider, or<br />
circumstances support<strong>in</strong>g the need for military family leave. Employees also must <strong>in</strong>form Children’s of<br />
Alabama if the requested leave is for a reason for which FMLA leave was previously taken or certified.<br />
Employees also may be required to provide a certifications and periodic recertification support<strong>in</strong>g the need<br />
for leave.<br />
Children’s of Alabama may require that the employee submit a fitness for duty certification prior to resum<strong>in</strong>g<br />
employment.<br />
Employer Responsibilities<br />
Children’s of Alabama will <strong>in</strong>form employees request<strong>in</strong>g leave whether they are eligible under FMLA.<br />
If an employee is eligible, the notice will specify any additional <strong>in</strong>formation required as well as the<br />
employees’ rights and responsibilities. If the employee is not eligible, Children’s of Alabama will<br />
provide a reason for the <strong>in</strong>eligibility. Children’s of Alabama will <strong>in</strong>form employees if leave will be<br />
designated as FMLA-protected and the amount of leave counted aga<strong>in</strong>st the employee’s leave<br />
entitlement. If Children’s of Alabama determ<strong>in</strong>es that the leave is not FMLA- protected, Children’s of<br />
Alabama will notify the employee.<br />
©Children’s of Alabama 2012<br />
1.17
Unlawful Acts by Employers<br />
FMLA makes it unlawful for any employer to:<br />
• Interfere with, restra<strong>in</strong>, or deny the exercise of any right provided under FMLA;<br />
• Discharge or discrim<strong>in</strong>ate aga<strong>in</strong>st any person for oppos<strong>in</strong>g any practice made unlawful by<br />
FMLA or for <strong>in</strong>volvement <strong>in</strong> any proceed<strong>in</strong>g under or relat<strong>in</strong>g to FMLA.<br />
Enforcement<br />
An employee may file a compla<strong>in</strong>t with the U.S. Department of Labor or may br<strong>in</strong>g a private lawsuit<br />
aga<strong>in</strong>st an employer.<br />
FMLA does not affect any Federal or State law prohibit<strong>in</strong>g discrim<strong>in</strong>ation, or supersede any State or local<br />
law or collective barga<strong>in</strong><strong>in</strong>g agreement which provides greater family or medical leave rights.<br />
Noth<strong>in</strong>g here<strong>in</strong> is <strong>in</strong>tended to create any entitlement to leave greater than that mandated by the FMLA. In<br />
all respects, Children’s of Alabama will <strong>in</strong>terpret and apply its leave policies <strong>in</strong> manner that is consistent<br />
with the FMLA. The effective date for this policy is January 16, 2<strong>00</strong>9.<br />
223953.doc<br />
©Children’s of Alabama 2012<br />
1.18
EMPLOYMENT<br />
EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER<br />
Children’s of Alabama is an equal opportunity/affirmative action employer. Recruitment, hir<strong>in</strong>g,<br />
tra<strong>in</strong><strong>in</strong>g, promotion and other terms and conditions of employment will be without regard to race, color,<br />
religion, sex, national orig<strong>in</strong>, physical handicap, medical condition, age, status as a disabled veteran or<br />
veteran of the Vietnam Era, provided the <strong>in</strong>dividual is qualified to perform the work available.<br />
<strong>ORIENTATION</strong><br />
A Children’s of Alabama orientation, conducted by Human Resources, is held biweekly throughout the<br />
year. Every new employee is required to attend. Your department will provide additional orientation<br />
with<strong>in</strong> the first month of employment. Please use your orientation time to ask questions and learn about<br />
your job and Children’s of Alabama.<br />
INTRODUCTORY PERIOD<br />
Each new employee is required to serve a six-month <strong>in</strong>troductory period dur<strong>in</strong>g which time performance and<br />
behavior receive extra attention. Some benefits are not available until you have successfully completed your<br />
<strong>in</strong>itial <strong>in</strong>troductory period.<br />
Employees who are promoted or transferred to new jobs with<strong>in</strong> the Children’s of Alabama will serve a<br />
90-day <strong>in</strong>troductory period while learn<strong>in</strong>g the duties and responsibilities of their new jobs.<br />
CLASSIFICATIONS<br />
All employees are classified <strong>in</strong> one of the follow<strong>in</strong>g categories:<br />
Regular<br />
Temporary<br />
Flexipool<br />
"Non-exempt" personnel are eligible for payment for overtime hours worked. "Exempt" personnel are not<br />
eligible for overtime payment.<br />
WORK HOURS<br />
Scheduled work hours are assigned by the department directors to meet the needs of Children’s of<br />
Alabama. While most employees work a set schedule, revisions are sometimes necessary to provide<br />
adequate coverage. You will be expected to abide by the scheduled hours assigned by your supervisor,<br />
which may <strong>in</strong>clude overtime hours. Employees may be expected to work overtime which is not previously<br />
scheduled, based upon the needs of Children’s of Alabama.<br />
AGE LIMITS<br />
Children’s of Alabama abides by the laws established by local, state and federal agencies regard<strong>in</strong>g<br />
m<strong>in</strong>imum ages for employment.<br />
PERSONNEL FILES<br />
Official personnel files are ma<strong>in</strong>ta<strong>in</strong>ed by the Human Resources Department. You may schedule an<br />
appo<strong>in</strong>tment to review your employee file by call<strong>in</strong>g Human Resources at 939-5190.<br />
©Children’s of Alabama 2012<br />
1.19
LICENSES<br />
If your job requires licensure or certification, you must present proof of such upon employment and<br />
periodically thereafter. Loss of license or certification could result <strong>in</strong> demotion or term<strong>in</strong>ation.<br />
Misrepresentation of license status is grounds for immediate term<strong>in</strong>ation.<br />
JOB POSTING<br />
Vacant positions <strong>in</strong> the Children’s of Alabama are posted for your <strong>in</strong>formation on an automated<br />
telephone record<strong>in</strong>g called the "Job L<strong>in</strong>e." The telephone number for the "Job L<strong>in</strong>e" is 1-888-248-9856.<br />
Please refer to the Children’s of Alabama Policy Manual for <strong>in</strong>formation regard<strong>in</strong>g how to apply for<br />
these positions. Additionally, jobs are posted on the hospital's <strong>in</strong>ternet site at childrensal.org and<br />
employees can apply on l<strong>in</strong>e. Current employees must meet the m<strong>in</strong>imum qualifications as <strong>in</strong>dicated on<br />
the "Job L<strong>in</strong>e" <strong>in</strong> order to be considered for a posted open<strong>in</strong>g.<br />
TRANSFERS/PROMOTIONS<br />
An employee who has completed their <strong>in</strong>troductory period may apply to be considered for Children’s of<br />
Alabama positions for which they qualify. Please refer to the policy manual for the procedure and<br />
requirements for transfers and promotions.<br />
EMPLOYMENT <strong>OF</strong> RELATIVES<br />
The Children’s of Alabama allows for the employment of relatives of employees with the provision that<br />
one relative may not directly or <strong>in</strong>directly supervise another.<br />
PERFORMANCE EVALUATIONS<br />
Criteria-based performance evaluations are conducted annually by your supervisor. You are encouraged to<br />
obta<strong>in</strong> at least a copy of the criteria for your job and review this thoroughly so that you will be aware of<br />
your supervisor's expectations.<br />
REFERENCES<br />
Any requests for references or verification of employment from an outside entity/organization regard<strong>in</strong>g a<br />
current or previous Children’s of Alabama employee are handled by the Human Resources staff. Dates of<br />
employment and positions held at Children’s of Alabama are the standard <strong>in</strong>formation released.<br />
RESIGNATIONS<br />
If you resign from employment, you are required to provide a written notice to your supervisor at least two<br />
weeks prior to your f<strong>in</strong>al day of work. Management personnel and certa<strong>in</strong> designated positions are<br />
required to provide at least four weeks' notice. Any payment for eligible unused vacation time will be<br />
forfeited if the required notice is not given. All Children’s of Alabama property (keys, identification<br />
badge, park card, etc.) must be returned before leav<strong>in</strong>g employment.<br />
©Children’s of Alabama 2012<br />
1.20
PAY PROCEDURES<br />
TIME CLOCKS<br />
All HOURLY paid employees (also called nonexempt) should clock <strong>in</strong> and out at their assigned home<br />
clock. SALARIED employees (also called exempt) are not required to clock <strong>in</strong> and out. Managers will<br />
enter PTO, EIB, or FMLA for exempt staff <strong>in</strong>to PeopleSoft. PLEASE REPORT ANY<br />
OR DIFFICULTIES USING THE TIME CLOCKS TO HUMAN RESOURCES<br />
PAY PERIODS<br />
Pay periods are two weeks <strong>in</strong> length beg<strong>in</strong>n<strong>in</strong>g on a Monday and end<strong>in</strong>g on a Sunday, 14 calendar days<br />
later. There are 26 pay periods each year.<br />
PAYCHECKS<br />
Pay periods last for 14 days, start<strong>in</strong>g on a Monday and end<strong>in</strong>g on a Sunday. Paychecks are issued every<br />
other Tuesday. Please see the calendar on p. 4.1 for specific dates. Direct deposit is mandatory at<br />
Children’s of Alabama. You should check with your supervisor regard<strong>in</strong>g when you will receive your<br />
paycheck. If you want to have someone else collect your check, you will need to provide that person with<br />
a written permission slip. Only “live” paychecks will be paper checks. Paper stubs will no longer be given<br />
out. You will be able to view your paycheck stub on My Service Center. Please see <strong>in</strong>structions on p. 3.3<br />
Salary advances are not granted. Paychecks will not be issued early to any employee.<br />
OVERTIME<br />
Overtime payments are made for non-exempt employees at 1½ times their hourly rate of pay based on<br />
hours actually worked. Exempt employees are not eligible for overtime. All overtime must be authorized<br />
<strong>in</strong> advance by your supervisor and adm<strong>in</strong>istrative officer.<br />
SHIFT DIFFERENTIAL<br />
Shift differential may be paid to employees <strong>in</strong> specified eligible job classifications for hours worked on the<br />
even<strong>in</strong>g and night shifts.<br />
ON-CALL PAY<br />
Compensation is provided for non-exempt employees who are placed <strong>in</strong> an on-call status due to the nature<br />
of their work or the needs of Children’s of Alabama. Your supervisor will discuss on-call procedures with<br />
you should you be placed on-call.<br />
GARNISHMENTS<br />
Children’s of Alabama honors court ordered garnishments or tax levies. You are expected to handle your<br />
personal f<strong>in</strong>ances such that we will not be required to withhold wages to satisfy a garnishment.<br />
SALARY INFORMATION<br />
Information regard<strong>in</strong>g your salary will be communicated to you by your supervisor. Your salary<br />
<strong>in</strong>formation is also ma<strong>in</strong>ta<strong>in</strong>ed by Human Resources and is available upon your request. Please remember,<br />
salary <strong>in</strong>formation is confidential. You are urged to keep your salary <strong>in</strong>formation confidential.<br />
Salary/Pay range <strong>in</strong>formation for a position you are <strong>in</strong>terested <strong>in</strong> transferr<strong>in</strong>g to is available through<br />
Human Resources.<br />
©Children’s of Alabama 2012<br />
1.21
GENERAL INFORMATION<br />
APPEARANCE<br />
You are expected to meet the dress code for your area and always project a clean, professional appearance.<br />
Remember, your appearance makes a statement about the Children’s of Alabama to our patients, their<br />
families and other visitors.<br />
ATTENDANCE<br />
Children’s expects you to report for work on time on the shifts or days you are scheduled to work. We do<br />
understand that an employee will occasionally be late or absent from work. Repeated <strong>in</strong>cidents of arriv<strong>in</strong>g<br />
late to work, unscheduled absences or leav<strong>in</strong>g work early on an unscheduled basis, regardless of the reason,<br />
will result <strong>in</strong> discipl<strong>in</strong>ary action which may <strong>in</strong>clude term<strong>in</strong>ation. You are encouraged to review the<br />
"Attendance Policy" to familiarize yourself with our system of document<strong>in</strong>g attendance.<br />
BAD WEATHER<br />
In the event of <strong>in</strong>clement weather (snow, tornadoes, etc.), Children’s of Alabama will implement the<br />
Inclement Weather Plan. You are responsible for be<strong>in</strong>g aware of impend<strong>in</strong>g bad weather and mak<strong>in</strong>g<br />
arrangements to be at work at your assigned time dur<strong>in</strong>g such weather. The Inclement Weather policy<br />
outl<strong>in</strong>es the pay practices utilized dur<strong>in</strong>g such times.<br />
BREAKS<br />
A 30-m<strong>in</strong>ute, unpaid meal break is allowed for employees who work shifts of more than four hours. A 15-<br />
m<strong>in</strong>ute, paid rest break may be provided if the work schedule permits. Your supervisor will expla<strong>in</strong> how<br />
breaks are scheduled <strong>in</strong> your area.<br />
BULLETIN BOARDS<br />
Your department manager may ma<strong>in</strong>ta<strong>in</strong> a bullet<strong>in</strong> board <strong>in</strong> your area which will conta<strong>in</strong> schedules,<br />
announcements and other <strong>in</strong>formation of importance. You are responsible for read<strong>in</strong>g posted material.<br />
Employees may not post <strong>in</strong>formation anywhere except on official boards and only after obta<strong>in</strong><strong>in</strong>g<br />
appropriate authorization.<br />
CONDUCT<br />
We expect all employees to conduct themselves <strong>in</strong> a manner favorable to the Children’s of Alabama at all<br />
times. Your conduct reflects on our organization and <strong>in</strong>fluences how patients, parents, visitors, physicians<br />
and the community perceive Children’s of Alabama.<br />
DISCIPLINE<br />
As with any organization our size, rules and regulations are necessary. The rules established by the<br />
Children’s of Alabama are for the protection of the rights of the employees, patients and visitors and are<br />
<strong>in</strong>tended to facilitate productivity and positive work<strong>in</strong>g relationships. The Personnel Policy entitled<br />
"Infraction of Children’s of Alabama Rules" outl<strong>in</strong>es many of the expectations of the Children’s of<br />
Alabama. Although not all <strong>in</strong>clusive, the list will give examples of the k<strong>in</strong>ds of offenses for which<br />
discipl<strong>in</strong>e may occur. These types of discipl<strong>in</strong>ary actions may be taken when an <strong>in</strong>fraction of rules or<br />
regulations occurs:<br />
Verbal Warn<strong>in</strong>g - A first warn<strong>in</strong>g for m<strong>in</strong>or <strong>in</strong>fractions or to po<strong>in</strong>t out areas need<strong>in</strong>g<br />
improvement but are not yet problem areas.<br />
Written Warn<strong>in</strong>g - Notice of repeated m<strong>in</strong>or <strong>in</strong>fractions or first warn<strong>in</strong>g of a more serious<br />
<strong>in</strong>fraction of a Children’s of Alabama rule or policy.<br />
©Children’s of Alabama 2012<br />
1.22
Suspension - Time off without pay as a second warn<strong>in</strong>g for more serious <strong>in</strong>fractions or first<br />
Warn<strong>in</strong>g of major offense. May be used for cont<strong>in</strong>ued <strong>in</strong>fractions of m<strong>in</strong>or offenses.<br />
Term<strong>in</strong>ation - A last resort action for offenses deemed to be major or when previous steps<br />
have not brought about desired results. Certa<strong>in</strong> serious offenses may result <strong>in</strong> immediate<br />
term<strong>in</strong>ation without warn<strong>in</strong>g.<br />
Serious <strong>in</strong>fractions of Children’s of Alabama rules may warrant a suspension or immediate term<strong>in</strong>ation.<br />
There is no implied guarantee that a discipl<strong>in</strong>ary matter must <strong>in</strong>volve a warn<strong>in</strong>g or suspension prior to<br />
term<strong>in</strong>ation.<br />
In any <strong>in</strong>cident requir<strong>in</strong>g discipl<strong>in</strong>ary action, the severity of the <strong>in</strong>fraction and the employee's past<br />
performance is taken <strong>in</strong>to consideration. Written warn<strong>in</strong>gs, suspensions and term<strong>in</strong>ations are reviewed by<br />
Human Resources Department staff and will become a permanent part of the personnel file.<br />
GRIEVANCE PROCEDURE<br />
Procedures are available for an employee with at least six months of service to request a formal review of<br />
an action taken which the employee feels is <strong>in</strong>appropriate. All appeals are handled by the Human<br />
Resources Department. Some may <strong>in</strong>clude review by a panel of employees. Guidel<strong>in</strong>es for this process<br />
can be found <strong>in</strong> the "Grievance/Adm<strong>in</strong>istrative Review Procedure Policy." While the formal grievance<br />
procedure is available to employees with at least six months of service, employees with less than six<br />
months service are expected to come forward and report any alleged violations of the harassment or equal<br />
opportunity policy.<br />
HEALTH ASSESSMENT<br />
All employees are required to successfully complete a health screen<strong>in</strong>g prior to employment. Children’s of<br />
Alabama will regularly monitor required health functions and may request further medical <strong>in</strong>formation.<br />
Children’s of Alabama may, at any time, require an employee to submit to a physical exam<strong>in</strong>ation, drug<br />
screen<strong>in</strong>g or laboratory tests at the organization's expense. Failure to submit to a physical, drug screen<strong>in</strong>g or<br />
laboratory test may be grounds for term<strong>in</strong>ation.<br />
<strong>ID</strong>ENTIFICATION<br />
It is the policy of Children’s of Alabama to issue identification (<strong>ID</strong>) badges to employees, UAB physicians<br />
and students with demonstrated need, volunteers or any other <strong>in</strong>dividuals employed or assigned to work at<br />
Children’s of Alabama, vendors, contractors and visitors. While on Children’s of Alabama premises, <strong>ID</strong><br />
badges must be worn face forward, near the collar <strong>in</strong> a highly visible manner.<br />
LOST AND FOUND<br />
A lost and found system is ma<strong>in</strong>ta<strong>in</strong>ed by the Security Department. You should contact Security if you<br />
have lost an item, whether personal or Children’s of Alabama property, or if you f<strong>in</strong>d an item which<br />
appears to have been lost.<br />
PARKING<br />
Park<strong>in</strong>g is available for a monthly fee which is deducted from your paycheck. The Human Resources<br />
Department and Security Department handles all park<strong>in</strong>g assignments and related concerns.<br />
PATIENT INFORMATION<br />
All patient <strong>in</strong>formation is confidential and may only be discussed with other Children’s of Alabama<br />
employees who have a need to know <strong>in</strong> order for patient care to proceed.<br />
©Children’s of Alabama 2012<br />
1.23
PUBLIC RELATIONS<br />
Children's Corporate Communications Department provides a wide range of services to meet the needs of<br />
both <strong>in</strong>ternal and external customers <strong>in</strong> a variety of areas. Corporate Communications is responsible for<br />
generat<strong>in</strong>g and distribut<strong>in</strong>g timely and accurate <strong>in</strong>formation about Children's to the public. The department<br />
handles all of the Children's public relations, media relations, public affairs, advertis<strong>in</strong>g, market<strong>in</strong>g and<br />
<strong>in</strong>ternal communications. The department also produces all pr<strong>in</strong>ted materials for both on and off campus<br />
constituencies.<br />
Some of the services available <strong>in</strong>clude:<br />
• Media Relations<br />
• Employee Communications<br />
• Speaker's Bureau<br />
• Tours<br />
• Photography/Video Development<br />
• Pr<strong>in</strong>t/Material Development<br />
• Event Plann<strong>in</strong>g<br />
• Web Development<br />
• Internships<br />
Our office is located on the first floor of the Plaza Build<strong>in</strong>g at Magnolia Office Park at 2112 11th Avenue<br />
South <strong>in</strong> Birm<strong>in</strong>gham. Office hours are weekdays from 7:30 a.m. until 4:30 p.m.<br />
SECURITY<br />
Security officers are employed by Children’s of Alabama to provide protection for employees, patients and<br />
visitors. They also <strong>in</strong>vestigate <strong>in</strong>cidents <strong>in</strong>volv<strong>in</strong>g theft, destruction, etc. The officers conduct a periodic<br />
search of packages, purses and coats of employees as they leave our facilities. Failure to comply with a<br />
search may result <strong>in</strong> term<strong>in</strong>ation.<br />
SIGNAGE<br />
All signs with<strong>in</strong> the Children’s of Alabama are ordered and <strong>in</strong>stalled by the Eng<strong>in</strong>eer<strong>in</strong>g Department to ensure<br />
accuracy and consistency. No post<strong>in</strong>g of unauthorized signs on walls, elevators, doors, etc. is allowed.<br />
SMOKING<br />
A comprehensive No Smok<strong>in</strong>g Policy is <strong>in</strong>cluded <strong>in</strong> the Adm<strong>in</strong>istrative Policies and prohibits smok<strong>in</strong>g <strong>in</strong><br />
Children’s of Alabama build<strong>in</strong>gs. Employees are expected to set an example for parents and visitors by<br />
adher<strong>in</strong>g to the policy.<br />
SOLICITATION<br />
Solicitation dur<strong>in</strong>g an employee's designated work time is prohibited. Solicitation is prohibited at all times<br />
<strong>in</strong> Children’s of Alabama work areas and patient/visitor access areas (example: the cafeteria).<br />
TELEPH<strong>ONE</strong> USAGE/COURTESY<br />
Telephones with<strong>in</strong> Children’s of Alabama are for bus<strong>in</strong>ess purposes. Personal calls should be limited <strong>in</strong><br />
length and number and should not <strong>in</strong>terfere with the performance of your work. The charg<strong>in</strong>g of personal,<br />
long distance calls to Children’s of Alabama is prohibited. All employees are expected to exercise<br />
telephone courtesy at all times.<br />
VALUABLES<br />
Employees are encouraged to leave valuables and personal items at home. Purses and other items should<br />
be kept <strong>in</strong> a locked or secured area while at work.<br />
VISITING<br />
Employees should not receive personal visitors with<strong>in</strong> their work area dur<strong>in</strong>g assigned shifts.<br />
©Children’s of Alabama 2012<br />
1.24
Section 2
CHILDREN'S SAFETY<br />
IN-SERVICE TABLE <strong>OF</strong> CONTENTS<br />
Electrical Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.4<br />
Emergency Numbers and Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.5<br />
Code Yellow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.6<br />
Fire Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.12<br />
Hazardous Chemical and MSDS Information . . . . . . . . . . . . . . . . . . . . .2.7<br />
Incident Report<strong>in</strong>g . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.2<br />
Incident Report<strong>in</strong>g Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.3<br />
Lift<strong>in</strong>g Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.10<br />
Medical Gas Shut-off Valves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.4<br />
Personal Protective Equipment (PPE) . . . . . . . . . . . . . . . . . . . . . . . . . . .2.7<br />
Product Recalls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.2<br />
Safe Medical Devices Act . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.2<br />
Security Facts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2.13<br />
©Children’s <br />
2.1
INC<strong>ID</strong>ENT REPORTING<br />
All <strong>in</strong>cidents/accidents MUST be reported, no matter how m<strong>in</strong>or it may seem.<br />
An <strong>in</strong>cident is any happen<strong>in</strong>g <strong>in</strong>volv<strong>in</strong>g a patient, visitor or employee which is not consistent with the<br />
normal operation of the hospital or rout<strong>in</strong>e care of a patient. Injury does not have to occur. The potential<br />
for <strong>in</strong>jury and/or property damage is sufficient for an occurrence to be considered an <strong>in</strong>cident.<br />
An accident is the negative result of an <strong>in</strong>cident.<br />
To report an Incident/Accident, use the Quality Assurance/Incident Report.<br />
Employee Incidents must be documented and reported to the Employee Health Nurse, if an <strong>in</strong>jury has<br />
occurred the Health Nurse must be notified with<strong>in</strong> 24 hours.<br />
Non-employee Incidents should be documented by the person who discovered the <strong>in</strong>cident or who has<br />
the best knowledge of the <strong>in</strong>cident. This report must be completed immediately after the <strong>in</strong>cident is<br />
discovered and forwarded to the Risk Management Department with<strong>in</strong> 24 hours.<br />
SAFE MEDICAL DEVICE ACT<br />
The Safe Medical Device Act is a Federal law designed to allow the FDA and manufacturer to quickly<br />
learn when a medical device has caused a patient or employee illness, <strong>in</strong>jury, or death, and to ensure that<br />
hazardous devices are removed from healthcare facilities <strong>in</strong> a timely manner.<br />
Report<strong>in</strong>g medical device related <strong>in</strong>cidents should be done us<strong>in</strong>g the Quality Assurance/Incident Report.<br />
If a serious <strong>in</strong>jury or death occurs <strong>in</strong>volv<strong>in</strong>g a medical device, notify Risk Management immediately.<br />
What to report: Any event or problem <strong>in</strong>volv<strong>in</strong>g an <strong>in</strong>strument, apparatus or other article that is used to<br />
prevent, diagnose, mitigate or treat a disease or to affect the structure or function of the body. Examples<br />
of <strong>in</strong>cidents would be: failure, malfunction, improper or <strong>in</strong>adequate design, manufactur<strong>in</strong>g defects,<br />
label<strong>in</strong>g or user error.<br />
PATIENT SAFETY IS FOREMOST, IF THE ABOVE OCCURS, FOLLOW GU<strong>ID</strong>ELINES<br />
FOUND IN THE STAFF INFORMATION GU<strong>ID</strong>E (Flip-chart).<br />
Examples of medical devices would be: Catheters, <strong>in</strong>fusion pumps, hospital beds, patient restra<strong>in</strong>ts,<br />
suture materials, syr<strong>in</strong>ges, defibrillators etc.<br />
PRODUCT RECALLS<br />
Product recalls are handled through Bio-Med, Pharmacy and Risk Management. If you receive a product<br />
recall from anyone other than the above mentioned, contact Risk Management.<br />
©Children’s of Alabama 2012<br />
2.2
©Children’s of Alabama 2012<br />
2.3
MEDICAL GAS SHUT-<strong>OF</strong>F VALVES<br />
Dur<strong>in</strong>g an emergency, such as a fire, it may be necessary to turn off Medical Gases <strong>in</strong> the affected<br />
area. This is preferably done by the Eng<strong>in</strong>eer<strong>in</strong>g Staff or someone from Respiratory Therapy;<br />
however, if they are not available the department supervisor may authorize the shut-off.<br />
ELECTRICAL SAFETY<br />
Extension Cords for permanent use are prohibited. The Eng<strong>in</strong>eer<strong>in</strong>g Department may issue extension<br />
cords on a temporary basis. Multiple outlet strips are permitted <strong>in</strong> non-patient care areas and must have<br />
built-<strong>in</strong> circuit breakers.<br />
Adapters which convert three prongs to two prongs are not allowed and are not needed.<br />
Portable Space Heaters are not allowed.<br />
Patient-owned Electrical Equipment is generally not allowed, exceptions MUST be approved by<br />
Bio-Med..<br />
Emergency Power Supply is provided, through out most of the Children’s of Alabama<br />
Campus, by a series of strategically located generators.<br />
Emergency Electrical Outlets are either RED or the cover plate has EMERGENCY stamped on it.<br />
Power is constantly supplied to these outlets.<br />
©Children’s of Alabama 2012<br />
2.4
EMERGENCY NUMBERS AND CODES<br />
HOSPITAL EMERGENCY NUMBER: 9288<br />
This number should be used to report emergencies such as Dr. Redbird and Code P<strong>in</strong>k,<br />
Resident Physician etc.<br />
SECURITY EMERGENCY NUMBER: 9682<br />
This number should be used to report person with a weapon, fights or other<br />
disturbances.<br />
OVERHEAD PAGES AND CODES<br />
RES<strong>ID</strong>ENT PHYSICIAN<br />
Medical Emergency; special teams respond to the area announced.<br />
DR. REDBIRD<br />
Fire or smoke is located <strong>in</strong> the area announced.<br />
CODE YELLOW ALERT<br />
An Emergent Incident has occurred or a drill is about to take place. Follow the directions located <strong>in</strong> the<br />
Staff Information Guide (flip-chart) or <strong>in</strong> the Information and Guidel<strong>in</strong>es Manual.<br />
CODE YELLOW+(ALPHA/NUMERIC CODE)<br />
Emergency Management Plan has been activated. Follow the directions <strong>in</strong> the Information and<br />
Guidel<strong>in</strong>es Manual.<br />
CODE YELLOW INTERNAL<br />
An emergency situation exists <strong>in</strong>side of our facility; follow the directions of your supervisor.<br />
PREPARE CODE T<br />
Severe weather may be head<strong>in</strong>g towards Children’s; we need to take precautions <strong>in</strong> the event that it<br />
impacts the facility.<br />
CODE T<br />
Severe weather is go<strong>in</strong>g to impact Children’s; follow the <strong>in</strong>structions <strong>in</strong> the Information and Guidel<strong>in</strong>es<br />
Manual.<br />
CODE PINK<br />
Possible <strong>in</strong>fant abduction is tak<strong>in</strong>g place. Follow the directions <strong>in</strong> the Information and Guidel<strong>in</strong>es Manual<br />
or the Staff <strong>in</strong>formation Guide (flip-chart).<br />
NOTE: The above list does not comprise the total list of codes and announcements that may be used at<br />
Children’s; please refer to Children’s of Alabama Policies and Procedures, Staff Information Guide, the<br />
Environment of Care Center and your supervisor for additional codes and announcements.<br />
©Children’s Health System 2<strong>00</strong>3<br />
2.5
CODE YELLOW<br />
(Emergent situations that may impact<br />
Children’s of Alabama)<br />
CODE YELLOW ALERT<br />
“Code Yellow ALERT’ is the overhead announcement you will hear when an <strong>in</strong>cident outside of our<br />
facility has occurred and may impact daily rout<strong>in</strong>e at Children’s. Examples would be: Severe weather,<br />
major traffic accidents, an act of terrorism or even a major utility failure. This is the signal for Children’s<br />
of Alabama to be ready <strong>in</strong> the event our Emergency Management Plan is activated; dur<strong>in</strong>g this time<br />
quickly review your role <strong>in</strong> the EMP by look<strong>in</strong>g at your departmental plan.<br />
CODE YELLOW (Followed by an Alpha/Numeric code)<br />
“Code Yellow” followed by an Alpha/Numeric code <strong>in</strong>dicates that our Emergency Management Plan has<br />
been activated and we are anticipat<strong>in</strong>g the arrival of casualties from the <strong>in</strong>cident that has taken place.<br />
When the plan is activated respond<strong>in</strong>g employees must report to the Labor Pool and receive their<br />
assignments. The Alpha/Numeric code <strong>in</strong>dicates the type of <strong>in</strong>cident and the number of casualties<br />
expected, an example would be: “Code Yellow Charlie 4”, this would mean an <strong>in</strong>cident <strong>in</strong>volv<strong>in</strong>g<br />
chemical exposure and up to 60 casualties.<br />
CODE YELLOW INTERNAL<br />
“Code Yellow Internal” will be announced, if there is a major <strong>in</strong>ternal <strong>in</strong>cident. The announcement will<br />
be followed by the location and level. Response is the same as for a regular Code Yellow.<br />
KNOW YOUR ROLE DURING PLAN ACTIVATION<br />
It is vital that you know how to respond, if Children’s activates the Emergency Management Plan, your<br />
departmental plan is located on the Desktop of every Children’s of Alabama computer. Look for the<br />
Bull’s Eye icon and click on it to open the program. F<strong>in</strong>d the Departmental Plans folder and click on it to<br />
open, and then f<strong>in</strong>d your departmental plan. Ask your Supervisor what roles you may be ask to do when<br />
the plan is activated and learn all of the responsibilities of those roles.<br />
REMEMBER: JCAHO requires that we test our plan twice per year, so, you may wish to pr<strong>in</strong>t a copy to<br />
refer back to occasionally.<br />
Additional <strong>in</strong>formation may also be found <strong>in</strong> the Staff Information Guide (flip-chart).<br />
©Children’s Health System 2<strong>00</strong>3<br />
2.6
HAZARDOUS CHEMICALS<br />
Hazardous Materials and Waste: Any chemical, material agent or gas which is a physical or health hazard.<br />
MATERIAL SAFETY DATA SHEETS (MSDS)<br />
MSDS provide:<br />
Critical <strong>in</strong>formation on the proper use, transportation, and storage of chemicals used <strong>in</strong> our<br />
facility.<br />
Information on the proper response <strong>in</strong> case of an emergency, spill or over exposure.<br />
On the desktop of every Children’s of Alabama computer is a direct l<strong>in</strong>k to 3E, the l<strong>in</strong>k looks like test<br />
tubes and has the title of MSDS Info. 3E is our web based MSDS service and has over 10,<strong>00</strong>0 of the<br />
most commonly used products for the healthcare sett<strong>in</strong>g.<br />
The 3E service is simple to use: click on the l<strong>in</strong>k, click on SEARCH, select method of search (product,<br />
manufacture etc.), then enter the item under SEARCH CRITERIA, and click SEARCH.<br />
You can make your search more or less specific. You may pr<strong>in</strong>t out the MSDS or read it on the screen.<br />
It is suggested to pr<strong>in</strong>t out the more commonly used item <strong>in</strong> your department. If you do not f<strong>in</strong>d an<br />
MSDS for a product that we are us<strong>in</strong>g contact the Safety Officer at 9842.<br />
In the event of a spill, follow the direction listed <strong>in</strong> the Staff Information Guide (flip-chart).<br />
PERSONAL PROTECTIVE EQUIPMENT (PPE)<br />
PPE is designed to help reduce the risk of exposure to health and/or safety hazards while you are do<strong>in</strong>g<br />
a specific task. Some Examples of PPE are gloves, gowns, masks, protective eyewear, hard hats and<br />
foot protection.<br />
Before us<strong>in</strong>g any chemical consult the MSDS for the proper PPE and wear everyth<strong>in</strong>g that is required<br />
dur<strong>in</strong>g use of the chemical. If you are miss<strong>in</strong>g a piece of PPE contact your supervisor. DON’T USE<br />
THE PRODUCT until you have ALL of the PPE.<br />
Know when and under what conditions PPE must be worn.<br />
Know how to properly put on, adjust, wear and remove PPE.<br />
Know the limitations of the PPE you are us<strong>in</strong>g.<br />
Know how to properly store, ma<strong>in</strong>ta<strong>in</strong> and dispose of the used PPE.<br />
©Children’s of Alabama 2012<br />
2.7
©Children’s of Alabama 2012<br />
2.8
©Children’s of Alabama 2012<br />
2.9
©Children’s of Alabama 2012<br />
2.10
©Children’s of Alabama 2012<br />
2.11
FIRE SAFETY<br />
Any fire can be a scary, serious event, especially <strong>in</strong> the healthcare sett<strong>in</strong>g where some patients are unable<br />
to take care of themselves.<br />
Any fire or visible smoke must be reported immediately. The follow<strong>in</strong>g acronyms, R.A.C.E. and P.A.S.S.<br />
will help enable you <strong>in</strong> respond<strong>in</strong>g to a potential fire situation.<br />
R.A.C.E. is used to report and respond to a fire <strong>in</strong>cident.<br />
Rescue and remove anyone <strong>in</strong> immediate danger to a safe location.<br />
Alarm by pull<strong>in</strong>g the handle on the nearest pull station, then call 9288 and tell the operator<br />
exactly where the fire is located and what is burn<strong>in</strong>g.<br />
Then call 911 and tell them the same.<br />
Conta<strong>in</strong> the fire by clos<strong>in</strong>g doors and w<strong>in</strong>dows.<br />
Ext<strong>in</strong>guish the fire if possible or Escape the area, if the fire is too big.<br />
P.A.S.S. is used IF the fire is small enough to fight with a portable fire ext<strong>in</strong>guisher.<br />
Pull the safety p<strong>in</strong> that prevents the ext<strong>in</strong>guisher from be<strong>in</strong>g accidentally discharged.<br />
Aim the nozzle at the base of the fire.<br />
Squeeze the handle.<br />
Sweep the nozzle from side to side.<br />
NEVER be any closer than 10 feet from the fire (your cloth<strong>in</strong>g can spontaneously combust).<br />
Fire Drills are conducted once per shift per calendar quarter, a wooden REDBIRD is used to simulate a<br />
fire. If you f<strong>in</strong>d the REDBIRD, follow the same procedure that you would dur<strong>in</strong>g an actual fire, WITH<br />
TWO EXCEPTIONS, DO NOT CALL THE FIRE DEPARTMENT and DO NOT DISCHARGE A<br />
FIRE EXTINGUISHER.<br />
When mov<strong>in</strong>g patient and others away from the fire, do so <strong>in</strong> a HORIZONTAL manner, move to an<br />
adjacent Smoke Compartment on the same floor you are currently on. Smoke Compartments are<br />
identified by RED LABELS above the corridor doors. You should identify these compartments <strong>in</strong> your<br />
work area.<br />
DO NOT ride an elevator dur<strong>in</strong>g a fire.<br />
©Children’s of Alabama 2012<br />
2.12
C<br />
E<br />
C<br />
U<br />
R<br />
I<br />
FACTS<br />
Y<br />
Here to protect and serve<br />
24 hours a Day<br />
Security can be reached at extension #9682, 24 hours a day, seven days a week.<br />
Our office is located at the ground floor entrance of the Park Place Deck on 5th Avenue and<br />
16th Street.<br />
We assume responsibility for the safety, security and well-be<strong>in</strong>g of the patients, visitors,<br />
staff and hospital property.<br />
The Dispatch Office, located at Park Place, monitors cameras <strong>in</strong> the hospital as well as the<br />
park<strong>in</strong>g decks, answers emergency call boxes located on 4th Avenue and 16th & 17th Street<br />
South, the 7th Avenue Deck, hospital crosswalks as well as the panic and security alarms.<br />
Along with escort<strong>in</strong>g staff, visitors, and patients to their vehicles between the hours of<br />
dusk and dawn upon request, Security assists those experienc<strong>in</strong>g vehicle trouble.<br />
Provides storage for lost and found items <strong>in</strong> a centrally located area for recovery as well as<br />
transport<strong>in</strong>g money and valuables from various departments.<br />
Officers make rounds of the hospital campus to deter theft and vandalism.<br />
Security will <strong>in</strong>vestigate all disturbances and take the necessary action to ma<strong>in</strong>ta<strong>in</strong> peace and<br />
order with visitors, staff and patients.<br />
We assist all hospital staff with different needs as they arise, such as disorderly<br />
patients, external and <strong>in</strong>ternal disasters, Dr. Redbirds, …etc.<br />
<strong>ID</strong> Badges, which must be worn at all times while on the premises (whether Children's or contract),<br />
are issued at our Park Place Office.<br />
Security will enforce park<strong>in</strong>g rules through the pag<strong>in</strong>g system, by issu<strong>in</strong>g warn<strong>in</strong>gs as<br />
well as by tow<strong>in</strong>g.<br />
If at any time you have questions regard<strong>in</strong>g Security or any other Children's issue, feel free to<br />
contact our department. If we can't give you an answer, we will assist by referr<strong>in</strong>g you to someone<br />
who can better meet your needs.<br />
Remember, we are here to help!<br />
©Children’s of Alabama 2012<br />
2.13
Section 3
WELCOME TO CHILDREN’S <strong>OF</strong> ALAB<strong>AM</strong>A<br />
Where Children are the Center of Our Lives®<br />
Congratulations on your decision to become a part<br />
of a very special organization.<br />
Our mission is to provide the f<strong>in</strong>est pediatric<br />
health services to all children <strong>in</strong> an environment<br />
that fosters excellence <strong>in</strong> research and medical education.<br />
As Alabama's foremost not-for-profit pediatric health care provider,<br />
we can offer you all the challenges and<br />
opportunities for development you desire -<br />
as well as competitive pay, comprehensive benefits<br />
and a special sense of community that values every <strong>in</strong>dividual<br />
and rewards dedication and excellence.<br />
We wish you a long and successful career at<br />
Children’s of Alabama.<br />
If Human Resources can be of service,<br />
Please call us at<br />
205-939-5190<br />
©Children’s of Alabama 2012<br />
3.1
IRREVOCABLE ELECTIONS<br />
As you read through the follow<strong>in</strong>g <strong>in</strong>formation, please make your benefit selections carefully. Accord<strong>in</strong>g<br />
to IRS regulations, you may change your pre-tax coverage (medical, dental, vision, basic life <strong>in</strong>surance and<br />
flexible spend<strong>in</strong>g accounts) only at open enrollment or dur<strong>in</strong>g the 31 days follow<strong>in</strong>g an eligible family status<br />
change such as<br />
‣ A change <strong>in</strong> family size through marriage, divorce, legal separation, birth or adoption, or<br />
death of a dependent;<br />
‣ A change <strong>in</strong> your spouse's employment such as beg<strong>in</strong>n<strong>in</strong>g/return<strong>in</strong>g from an unpaid leave<br />
of absence, beg<strong>in</strong>n<strong>in</strong>g/end<strong>in</strong>g employment, change of employment status which effects<br />
benefits eligibility;<br />
‣ A significant change <strong>in</strong> your or your spouse's coverage;<br />
‣ A dependent is no longer eligible for coverage<br />
Your benefit changes must be made <strong>in</strong> with<strong>in</strong> 31days of the qualify<strong>in</strong>g event. Children’s of Alabama<br />
Human Resources will require written documentation show<strong>in</strong>g proof of the qualify<strong>in</strong>g family status change<br />
(e.g. marriage license, birth certificate). Changes will be effective the date of the qualify<strong>in</strong>g family status<br />
change, except for changes to vision coverage which will be effective the first day of the month follow<strong>in</strong>g<br />
the event.<br />
Please remember!<br />
Your benefit election forms are due by<br />
.<br />
©Children’s of Alabama 2012<br />
3.2
Questions: Customer Support Desk gethelp@childrensal.org 205.939.6568<br />
Human Resources benefits@childrensal.org 205.939.5190<br />
Payroll payroll@childrensal.org 205.939.9609<br />
3.3
2012 Benefit Election Form<br />
Section I: PERSONAL INFORMATION<br />
Employee Name: Social Security #: Date of birth: / /<br />
Current Address: Apt #:<br />
City: State: Zip Code: Daytime Telephone #:<br />
SECTION II: REASON FOR COMPLETING FORM<br />
Date of event: ______/______/_________ (return form with<strong>in</strong> 31 days of event)<br />
Hired/Newly Eligible Divorce/Dissolution Addition/Term<strong>in</strong>ation of Domestic Partner Coverage<br />
Open Enrollment Obta<strong>in</strong>ed Other Coverage Addition/Term<strong>in</strong>ation of Domestic Partner Child Coverage<br />
Birth/Adoption/Legal Guardianship Loss of Other Coverage Change <strong>in</strong> Dependent Eligibility<br />
Marriage<br />
Other (describe)<br />
SECTION III: HEALTH PLAN COVERAGE SELECTION: (THESE <strong>AM</strong>OUNTS ARE DEDUCTED EVERY PAY PERIOD)<br />
Insurance Plan<br />
Employee<br />
Only<br />
EE +<br />
Spouse<br />
EE + Child(ren)<br />
Family<br />
Domestic<br />
Partner<br />
Domestic<br />
Partner +<br />
Child(ren)<br />
BCBS Consumer Driven $43.<strong>00</strong> $70.<strong>00</strong> $64.<strong>00</strong> $87.<strong>00</strong> $27.<strong>00</strong> $44.<strong>00</strong> $0<br />
BCBS PPO $69.<strong>00</strong> $120.<strong>00</strong> $109.<strong>00</strong> $151.<strong>00</strong> $51.<strong>00</strong> $82.<strong>00</strong> $0<br />
VIVA Health $87.<strong>00</strong> $155.<strong>00</strong> $140.<strong>00</strong> $197.<strong>00</strong> $68.<strong>00</strong> $110.<strong>00</strong> $0<br />
BCBS Dental Buy-Up $9.23 $20.30 $15.72 $34.07 $11.07 $25.85 $0<br />
BCBS Dental $7.69 $16.92 $13.10 $29.23 $9.23 $21.54 $0<br />
Vision Care $3.44 $6.85 $6.51 $9.37 $3.42 $5.93 $0<br />
*Employed Spouse/Domestic Partner Provision: Your spouse/domestic partner may not be covered as primary on your CHS medical plan if<br />
he/she is eligible for coverage with his/her employer AND that employer pays at least 50% of the premium for <strong>in</strong>dividuals. (Does not apply to vision<br />
and dental)<br />
*Note: Domestic Partners and Nondependent Children are not eligible for pre-tax treatment of health <strong>in</strong>surance costs per the IRS. Please consult<br />
your tax advisor! Also a Domestic Partner Affidavit/Application for Domestic Partner Benefits must accompany this form.<br />
SECTION IV: ELIGIBLE DEPENDENT ENROLLMENT INFORMATION<br />
Waive<br />
Name<br />
Relationship<br />
Birth<br />
Social Security Choose coverage for each eligible<br />
Gender<br />
Date:<br />
Number<br />
dependent<br />
(required) Medical Dental Vision<br />
(M/D/Y) M F YES NO YES NO YES NO<br />
3.4
2012 Benefit Election Form<br />
PERSONAL INFORMATION<br />
Employee Name: Social Security #: Date of birth: / /<br />
SECTION V: BASIC LIFE INSURANCE BENEFICIARY (COA provided)<br />
Primary Beneficiary<br />
Name<br />
Relationship<br />
Birth<br />
Date:<br />
Gender<br />
(M/D/Y) M F<br />
Social Security Number<br />
(required)<br />
Percentage<br />
Cont<strong>in</strong>gent Beneficiary<br />
Name<br />
Relationship<br />
Birth<br />
Date:<br />
Gender<br />
(M/D/Y) M F<br />
Social Security Number<br />
(required)<br />
Percentage<br />
SECTION VI: PRE-TAX SPENDING/SAVINGS ACCOUNTS<br />
*Excludes Domestic Partners and their dependents<br />
Flexible Spend<strong>in</strong>g Accounts Annual Amount Health Sav<strong>in</strong>gs Account Annual Amount<br />
Health Care spend<strong>in</strong>g<br />
Dependent Care spend<strong>in</strong>g<br />
Health Sav<strong>in</strong>gs Account*<br />
SECTION VII: AUTHORIZATION & ACKNOWLEGMENT<br />
I have read the explanation of the benefits program and understand my benefit choices. I authorize the selections I have made as well as the<br />
payments required for those selections. I understand that the above selections are effective for the entire plan year unless I experience a recognized<br />
change <strong>in</strong> status. I also understand that I can establish an HSA only if I am covered under the BCBS Consumer-Driven health plan and that I must<br />
not be covered under any other health <strong>in</strong>surance plan, Medicare or Medicaid, and I cannot be claimed as a dependent on another person’s tax<br />
return. I also understand that any money placed <strong>in</strong>to either the Flexible Spend<strong>in</strong>g Health Care or Dependent Care accounts and not used by the end<br />
of the plan year will be forfeited. I also understand that the amount I have elected to contribute to the Dependent Care account cannot exceed the<br />
amount of my <strong>in</strong>come or my spouse’s <strong>in</strong>come, whichever is smaller. F<strong>in</strong>ally, I understand that these benefit elections will carry over <strong>in</strong>to future plan<br />
years, with the exception of the Flexible Spend<strong>in</strong>g Accounts, if I do not submit a change form to Human Resources. I hereby accept all designations<br />
made on this application and decl<strong>in</strong>e all other benefits that were not elected.<br />
_______________________________________________________<br />
___________________________<br />
<strong>EMPLOYEE</strong> SIGNATURE DATE CHS-HUMAN RESOURCES / DATE<br />
Return completed form to: Human Resources, Fax: (205)939-5111 or email: benefits@childrensal.org<br />
3.4a
2012 Affidavit of Spousal Health Care Coverage<br />
Employee Name: (Pr<strong>in</strong>ted) _______________________ Spouse’s Name: (Pr<strong>in</strong>ted) _________________________<br />
Section I: Spousal Benefits<br />
To cont<strong>in</strong>ue medical coverage for your spouse for the 2012 plan year you must complete this affidavit and return to<br />
Human Resources by November 14th. Please answer the follow<strong>in</strong>g questions completely. Your response or lack<br />
thereof may impact the health care coverage of your spouse.<br />
1. Is your spouse employed?<br />
□ Yes □ Yes, Self-Employed without Group Benefits □ No, Retired □ No, Disabled □ No<br />
□ Yes, COA Employee □ Yes, Self-Employed with Group Benefits □ No, Unemployed □ No, Student<br />
If ‘No’ or ‘Yes’ and your spouse is a COA employee’ or ‘self-employed without Group Benefits, please proceed to Section III –<br />
no additional documentation is required.<br />
2. If you answered yes to the question above, is your spouse enrolled <strong>in</strong> health care benefits through his/her<br />
employer?<br />
YES _____ NO _____<br />
Please note that if your spouse’s employer provides health care benefits and pays 50% or more of the costs for<br />
“employee only” or S<strong>in</strong>gle coverage, your spouse is NOT eligible for primary coverage through your Children’s of<br />
Alabama plan. However, he or she may ma<strong>in</strong>ta<strong>in</strong> secondary coverage through this plan.<br />
3. If you answered YES to questions 1 and 2, do you elect to ma<strong>in</strong>ta<strong>in</strong> secondary coverage through the Children’s of<br />
Alabama plan for your spouse?<br />
YES _____ NO _____<br />
Note: To elect secondary coverage you must provide a copy of the spouse’s <strong>in</strong>surance identification card through his or her employer<br />
(primary coverage) with this completed affidavit.<br />
Section II: Certification of Spousal Employment<br />
Please have your spouse’s employer complete this section <strong>in</strong> reference to:<br />
1. Is the employee eligible for health care benefits? YES _____ NO _____<br />
2. What portion of the “employee only” or s<strong>in</strong>gle coverage is paid by the employee and by the employer?<br />
Employee _____ % Employer _____ % (This amount should add up to 1<strong>00</strong>%)<br />
Is the employee currently enrolled <strong>in</strong> health care benefits through this plan?<br />
3. If you answered YES to the previous question, please provide the follow<strong>in</strong>g <strong>in</strong>formation:<br />
Medical Plan Name: ___________________________<br />
Effective Date of Coverage: ___________________________<br />
4. Name of Employer ___________________________________________________<br />
Address ___________________________________________________________<br />
___________________________________________________________<br />
(City, State, and Zip Code)<br />
Name of Representative (Pr<strong>in</strong>ted) ________________________________ Phone: (<br />
YES _____ NO _____<br />
Group Number/Member <strong>ID</strong>: ______________________<br />
) _____________<br />
<strong>Sign</strong>ed Name of Representative __________________________________ Title: ___________________<br />
Section III: Acknowledgement (By Children’s of Alabama Employee)<br />
I certify under penalty of perjury, that the forego<strong>in</strong>g is true and correct. I understand as an employee that willful<br />
falsification of <strong>in</strong>formation on this Affidavit may lead to discipl<strong>in</strong>ary action, up to and <strong>in</strong>clud<strong>in</strong>g term<strong>in</strong>ation. Fraud or<br />
<strong>in</strong>tentional misrepresentation may result <strong>in</strong> retroactive term<strong>in</strong>ation of my spouse’s medical coverage.<br />
______________________________________________<br />
Employee <strong>Sign</strong>ature<br />
___________________________________<br />
Date<br />
3.5
Employed Spouse Provision Frequently Asked Questions<br />
Why is Children’s of Alabama conduct<strong>in</strong>g this audit?<br />
Children’s of Alabama is sensitive to the ris<strong>in</strong>g cost of health care and recognizes that cover<strong>in</strong>g<br />
dependents who have access to benefit coverage elsewhere drives up the cost of healthcare for all plan<br />
participants. The purpose of this audit is to ensure that benefit dollars are be<strong>in</strong>g spent <strong>in</strong> the most cost<br />
effective manner possible.<br />
How often am I required to complete an Affidavit? A new affidavit must be completed annually<br />
dur<strong>in</strong>g open enrollment AND whenever a change occurs that affects your spouse’s eligibility for medical<br />
coverage with his/her employer.<br />
My spouse is not employed. How am I impacted by this provision?<br />
If your spouse is not employed, this provision does not impact you or the benefits provided to your<br />
spouse. On the Affidavit, please check “NO” for question 1 <strong>in</strong> Section I then go to Section III and sign the<br />
form. Return the signed Affidavit to Human Resources by the deadl<strong>in</strong>e or your spouse’s coverage will be<br />
term<strong>in</strong>ated due to <strong>in</strong>sufficient response.<br />
My spouse is self employed. How am I impacted by this provision?<br />
If your spouse is self employed and not eligible for benefits through a group plan, this provision does not<br />
impact you or the benefits provided to your spouse. On the Affidavit, please check “YES” for question 1<br />
<strong>in</strong> Section I (and check the self-employed box) and “NO” for question 1 <strong>in</strong> Section II then go to Section III<br />
and sign the form. Return the signed Affidavit to Human Resources by the deadl<strong>in</strong>e or your spouse’s<br />
coverage will be term<strong>in</strong>ated due to <strong>in</strong>sufficient response.<br />
How am I affected if my spouse is also an employee of Children’s of Alabama?<br />
If your spouse is employed by Children’s of Alabama this provision does not impact you or the benefits<br />
provided to your spouse. On the Affidavit, please check “YES” for question 1 <strong>in</strong> Section I (and check the<br />
box <strong>in</strong>dicat<strong>in</strong>g employment by Children’s of Alabama) then go to Section III and sign the form and return it<br />
to Human Resources.<br />
What if I have to term<strong>in</strong>ate my spouse’s benefits through the Children’s of Alabama and it is not<br />
yet time for Open Enrollment through my spouse’s employer sponsored health plan?<br />
A change <strong>in</strong> eligibility of this type is typically considered a Qualify<strong>in</strong>g Event <strong>in</strong> most employer sponsored<br />
health plans. Other plans may not have a limited enrollment clause at all. If your spouse is found to be<br />
<strong>in</strong>eligible for cont<strong>in</strong>ued coverage under the Children’s of Alabama plan, he or she will receive a Letter of<br />
Creditable Coverage which can be used by your spouse <strong>in</strong> apply<strong>in</strong>g for benefits through his or her<br />
employer sponsored group plan.<br />
What is the deadl<strong>in</strong>e for provid<strong>in</strong>g my documentation?<br />
All documentation is required to be submitted to Children’s of Alabama Human Resources with<strong>in</strong> 31 days<br />
of eligibility and annually dur<strong>in</strong>g Open Enrollment. Failure to respond to this verification process and<br />
provide the required documentation may result <strong>in</strong> the removal from coverage of your enrolled spouse.<br />
Can I fax my response? If so, what is your fax number?<br />
Yes. Human Resources fax number is 205-939-5111 or 205-939-5188. You may fax your documents<br />
24 hours a day, 7 days a week. Please reta<strong>in</strong> a copy of your fax confirmation.<br />
Whom can I contact for assistance?<br />
You may e-mail your questions to benefits@childrensal.org or call Human Resources at 939-5190<br />
Monday through Friday 8<strong>AM</strong> – 4:30PM. Customer care representatives are also available toll-free at<br />
(866) 274-4743 Monday through Friday 7<strong>AM</strong> – 7PM CST<br />
Before return<strong>in</strong>g the Affidavit of Spousal Health Coverage:<br />
1. Carefully review the guidel<strong>in</strong>es of the Employed Spouse Provision as detailed above.<br />
2. Complete the enclosed Affidavit of Spousal Health Care Coverage.<br />
3. Have a representative of your spouse’s employer, if applicable, complete Section II of the Affidavit.<br />
4. <strong>Sign</strong> and date the enclosed Affidavit.<br />
5. Return the completed Affidavit by the deadl<strong>in</strong>e via fax to 205-939-5111 or 205-939-5188 or mail to:<br />
Children's of Alabama Human Resources, 16<strong>00</strong> 7 th Avenue South, Birm<strong>in</strong>gham, Alabama 35233<br />
6. Keep a copy of the completed Affidavit and fax confirmation for your records.<br />
3.5a
(Please Pr<strong>in</strong>t)<br />
Children’s of Alabama<br />
Supplemental Term Life Enrollment<br />
Employee Name: Social Security Number: Employee Date of Birth:<br />
/ /<br />
Employee Address: Apt. # City State Zip Code<br />
□ Newly Eligible / / □ Family Status Change (Marriage/Divorce/Birth/etc…) / / □Open Enrollment / /<br />
Employee Coverage (Select Amount): Current Benefit Amount:<br />
New Benefit Amount:<br />
You may elect coverage <strong>in</strong> $10,<strong>00</strong>0 <strong>in</strong>crements up to the lesser of 5 times your annual salary or $5<strong>00</strong>,<strong>00</strong>0. *Conditional Guarant ee Issue is available up to<br />
$2<strong>00</strong>,<strong>00</strong>0 and if apply<strong>in</strong>g with<strong>in</strong> 31 days of FIRST becom<strong>in</strong>g eligible for this <strong>in</strong>surance. An Evidence of Insurability** must be submitted with applications<br />
over $2<strong>00</strong>,<strong>00</strong>0; coverage will not be effective until approved by HARTFORD LIFE AND ACC<strong>ID</strong>ENT INSURANCE COMPANY.<br />
Spouse Coverage (Select Amount): Current Benefit Amount:<br />
New Benefit Amount:<br />
Your spouse may elect $10,<strong>00</strong>0 to $1<strong>00</strong>,<strong>00</strong>0 <strong>in</strong> $10,<strong>00</strong>0 <strong>in</strong>crements, rounded to the next higher $10,<strong>00</strong>0. *Conditional Guarantee I ssue available up to $30,<strong>00</strong>0 if<br />
your spouse is able to perform the normal activities of a person the same age and gender (A spouse who is disabled is not eligible). An Evidence of<br />
Insurability** must be submitted with applications over $30,<strong>00</strong>0; coverage will not be effective until approved by HARTFORD LI FE AND ACC<strong>ID</strong>ENT<br />
INSURANCE COMPANY.<br />
Dependent Coverage (Select Amount): □ $2,<strong>00</strong>0 □ $4,<strong>00</strong>0 □ $6,<strong>00</strong>0 □ $8,<strong>00</strong>0 □ $10,<strong>00</strong>0<br />
You may elect $2,<strong>00</strong>0 to $10,<strong>00</strong>0 <strong>in</strong> <strong>in</strong>crements of $2,<strong>00</strong>0 to a maximum of $10,<strong>00</strong>0. An Evidence of Insurability** must be submitted with all late<br />
applications; coverage will not be effective until approved by HARTFORD LIFE AND ACC<strong>ID</strong>ENT INSURANCE COMPANY.<br />
($1,<strong>00</strong>0 of coverage for 14 days to six months)<br />
*If any person(s) proposed to be <strong>in</strong>sured is not actively at work or apply<strong>in</strong>g after 31 days of becom<strong>in</strong>g eligible for this co verage, or apply<strong>in</strong>g for a benefit<br />
amount over the Conditional Guaranteed Issue Coverage, please complete the HARTFORD LIFE AND ACC<strong>ID</strong>ENT INSURANCE COMPANY Evidence<br />
of Insurability Form.<br />
**Please see reverse side to determ<strong>in</strong>e if you need to fill out the Evidence of Insurability Form<br />
DEPENDENT INFORMATION<br />
Name:<br />
(Complete only if dependent coverage is available and elected)<br />
Date of Birth: Relationship: Social Security Number: Sex:<br />
Name: Date of Birth: Relationship: Social Security Number: Sex:<br />
Name: Date of Birth: Relationship: Social Security Number: Sex<br />
BENEFICIARY INFORMATION<br />
(Beneficiaries can be updated anytime onl<strong>in</strong>e at myservicecenter.childrensal.org)<br />
Supplemental Term Life (use additional page if needed):<br />
Primary Beneficiary Name: Primary’s Relationship to Employee: Primary’s Date of Birth Primary’s SSN#: Benefit %<br />
Cont<strong>in</strong>gent Beneficiary Name: Relationship to Employee: Cont<strong>in</strong>gent’s Date of Birth Cont<strong>in</strong>gent’s SSN#: Benefit %<br />
Spouse Supplemental Term Life: Employee is primary beneficiary of Spouse Life unless another primary beneficiary is named.<br />
Primary Beneficiary Name: Primary’s Relationship to Employee: Primary’s Date of Birth Primary’s SSN#:<br />
Cont<strong>in</strong>gent Beneficiary Name: Cont<strong>in</strong>gent’s Relationship to Employee: Cont<strong>in</strong>gent’s SSN #: Benefit %<br />
AUTHORIZATION AND ACKNOWLEDGMENT<br />
Your signature on this form requests the coverage provided and authorizes the required deduction(s) from your wages. Elections over the Guaranteed Issue amount<br />
or late applications require an Evidence of Insurability form to be completed. You may revoke this authorization by provid<strong>in</strong>g written notice to your employer or<br />
Hartford Life and Accident Company. In the event of any differences between the enrollment form and the <strong>in</strong>surance policy, I agree to be bound by the <strong>in</strong>surance<br />
policy. For any questions, please contact Hartford Life and Accident Company Customer Service at 1-8<strong>00</strong>-331-7234.<br />
Employee <strong>Sign</strong>ature:<br />
Date:<br />
3.6
DO I NEED TO FILL OUT THE<br />
EV<strong>ID</strong>ENCE <strong>OF</strong> INSURABILITY FORM?<br />
The follow<strong>in</strong>g questions will help you determ<strong>in</strong>e if you need to fill out the<br />
Evidence of Insurability Form.<br />
Employee Life Insurance:<br />
1. Are you a Newly Eligible Employee (31 days from date of hire to turn <strong>in</strong> all benefit elections to HR)?<br />
Yes – cont<strong>in</strong>ue to question 3<br />
No – cont<strong>in</strong>ue to question 2<br />
2. Are you add<strong>in</strong>g coverage dur<strong>in</strong>g Open Enrollment?<br />
Yes – Evidence of Insurability Form is required<br />
No – cont<strong>in</strong>ue to question 3<br />
3. Are you elect<strong>in</strong>g over $2<strong>00</strong>,<strong>00</strong>0 <strong>in</strong> employee supplemental coverage?<br />
Yes – Evidence of Insurability Form is required<br />
No – Evidence of Insurability Form is NOT required<br />
Spouse Life Insurance:<br />
1. Are you a Newly Eligible Employee (31 days from date of hire to turn <strong>in</strong> all benefit elections to HR)?<br />
Yes – cont<strong>in</strong>ue to question 3<br />
No – cont<strong>in</strong>ue to question 2<br />
2. Have you and your spouse been married for less than 31 days?<br />
Yes – cont<strong>in</strong>ue to question 3<br />
No – Evidence of Insurability Form is required for all amounts<br />
3. Are you elect<strong>in</strong>g over $30,<strong>00</strong>0 <strong>in</strong> spouse coverage?<br />
Yes – Evidence of Insurability Form is required<br />
No – Evidence of Insurability Form is NOT required<br />
Dependent Life Insurance:<br />
1. Are you a Newly Eligible Employee (31 days from date of hire to turn <strong>in</strong> all benefit elections to HR)?<br />
Yes – Evidence of Insurability Form is NOT required<br />
No – cont<strong>in</strong>ue to question 2<br />
2. Did you acquire this dependent (birth or adoption) with<strong>in</strong> the last 31 days?<br />
Yes – Evidence of Insurability Form is NOT required<br />
No – Evidence of Insurability Form is required<br />
3.6a
REST AND RELAXATION<br />
Children’s of Alabama believes that employees need time off to "recharge" their batteries and that<br />
employees actually perform better <strong>in</strong> their jobs when we take time off as needed. Children’s of Alabama<br />
provides time off plans to help employees balance their work and life. Please review your paid time off<br />
benefit plans below so that you can make the most of your time off - for yourself and your loved ones.<br />
These plans give you flexibility and many options for use, and most importantly, help protect your <strong>in</strong>come<br />
from unexpected work absences. Your two key time off benefits provided are Paid Time Off (PTO) Bank<br />
and Extended Illness Bank (EIB). Employees work<strong>in</strong>g standard hours equal to .5 or higher are benefit<br />
eligible and covered under PTO and EIB. 7/7 employees are eligible for EIB only.<br />
Paid Time Off Bank (PTO)<br />
Your Paid Time Off Bank (PTO) comb<strong>in</strong>es vacation, holiday and sick leave time <strong>in</strong>to a flexible plan. Your<br />
PTO Bank represents time off that is available to use as you decide (with your manager's approval to be off)<br />
for…<br />
Vacation<br />
Personal / Family Needs (Parent/Teacher meet<strong>in</strong>g, appo<strong>in</strong>tments, etc.)<br />
Holidays (whichever holiday you prefer and can take off)<br />
Short-term sickness - the first 5 days of any illness<br />
(your own illness or that of your spouse, children or parents)<br />
PTO is your time! You beg<strong>in</strong> accru<strong>in</strong>g PTO from your date of hire, and you may take approved time off<br />
immediately. Also, you will accrue more PTO time as your service with Children’s of Alabama <strong>in</strong>creases.<br />
Children’s of Alabama provides an amount of time off that is very competitive with other companies and<br />
hospitals. Th<strong>in</strong>k of your PTO Bank as just that - your bank of hours - so that you decide when to use it as<br />
needs arise provided your manager is able to give you the time off.<br />
©Children’s of Alabama 2012 3.7
Years of<br />
Service<br />
Total PTO<br />
Days per Year*<br />
Total PTO<br />
Annual Hours<br />
Hourly Accrual<br />
Rate**<br />
Maximum<br />
Banked Hours<br />
0 - 5 years 23 184 .0885 304<br />
6 - 10 years 27 216 .1038 336<br />
11 - 15 years 30 240 .1154 360<br />
16 - 20 years 33 264 .1269 384<br />
21+ years 35 280 .1346 4<strong>00</strong><br />
* Based on a full time employee with 2,080 hours worked or paid PTO <strong>in</strong> the year.<br />
** PTO accrues on an hourly basis for regular hours up to 80 hours per payperiod or paid PTO<br />
hours.<br />
What you need to know about accru<strong>in</strong>g PTO…<br />
+ To be eligible to accrue PTO, you must work 20 or more standard<br />
hours a week.<br />
+ Benefit eligible full-time and part-time employees accrue PTO hours<br />
based on the PTO bank accrual schedule above. 7/7 employees do<br />
not accrue PTO.<br />
+ PTO accrues hours based on your hourly accrual rate times each<br />
regular hour worked up to a maximum of 80 per pay period or PTO<br />
hour paid each pay period.<br />
+ You do not accrue PTO time when you use your EIB hours.<br />
+ You do not accrue PTO on Overtime hours.<br />
+ You will see your PTO bank balance on each paycheck summary you<br />
receive. Keep track of your PTO balance to carefully plan your time<br />
off. If you see your balance gett<strong>in</strong>g low, use time off spar<strong>in</strong>gly until<br />
you accrue more time. If you see your balance reach<strong>in</strong>g the<br />
maximum (120 hours over your annual accrual), plan some time off<br />
soon or elect the annual PTO sell<strong>in</strong>g feature.<br />
+ Your PTO hourly accrual factor will <strong>in</strong>crease on the pay period you<br />
reach your anniversary date of hire for the next higher accrual<br />
level (start of the 6th year, 11th year, 16th year and 21st<br />
year of service).<br />
©Children’s of Alabama 2012<br />
3.8
What you need to know about tak<strong>in</strong>g PTO…<br />
+ PTO must be accrued before it can be used.<br />
+ There is no wait<strong>in</strong>g period for new hires; you can take PTO as soon as you<br />
accrue it with manager approval.<br />
+ PTO will be used for all approved absences from work with the exception of<br />
bereavement (funeral) leave and jury duty.<br />
+ Nonexempt (hourly) staff use PTO <strong>in</strong> 1-hour <strong>in</strong>crements (round<strong>in</strong>g from the<br />
½ hour).<br />
+ Exempt (salaried) staff use PTO time <strong>in</strong> 8-hour <strong>in</strong>crements (whole day) for<br />
vacation or holidays and <strong>in</strong> 1-hour <strong>in</strong>crements for short-term sick time.<br />
+ Your PTO bank cannot have a negative balance. If your PTO bank is at zero<br />
and you must take off, it will be unpaid.<br />
Us<strong>in</strong>g PTO for Sickness<br />
When you must miss work due to your own illness or due to your children who live with you, your spouse,<br />
or your parent, your pay is cont<strong>in</strong>ued through your PTO bank for the first 5 consecutive days of an illness.<br />
This is why PTO accrues at a high enough level to <strong>in</strong>clude enough days for you to meet all comb<strong>in</strong>ed<br />
vacation, holiday and short-term sick days.<br />
If you must miss work due to an hospital admission or an outpatient procedure, medically necessary under<br />
general anesthesia or IV sedation, you are eligible to use your accrued Employee Illness Bank, Children’s<br />
of Alabama short- term sick plan.<br />
If your reason for be<strong>in</strong>g out is covered under the Family Medical Leave Act, you must complete the FML<br />
paperwork for your supervisor; you may also need to provide physician certifications of the illness.<br />
If the illness requires your absence beyond the 5 days, your pay will be cont<strong>in</strong>ued through your Extended<br />
Illness Bank up to the amount accrued.<br />
Children’s of Alabama policy requires all absences from work to be approved by your supervisor. If you<br />
will miss work due to sickness, contact your supervisor at least 3 hours before the start of your shift so that<br />
work and staff<strong>in</strong>g needs can be met. This is dependent on departmental policy; some departments use other<br />
time frames.<br />
©Children’s of Alabama 2012<br />
3.9
Sell<strong>in</strong>g PTO Hours<br />
PTO Sell<strong>in</strong>g is an attractive feature <strong>in</strong> those years where you were not able to take off enough time or prefer<br />
the cash. You may elect to sell 20 to 120 PTO hours and receive it <strong>in</strong> the form of cash, less required tax<br />
withhold<strong>in</strong>gs, on an annual basis. However, you must keep a balance of 40 PTO hours <strong>in</strong> your bank after<br />
the PTO check is cut.<br />
To participate <strong>in</strong> PTO Sell<strong>in</strong>g, you must complete a PTO Sell<strong>in</strong>g Form onl<strong>in</strong>e at My Service Center no<br />
later than December 30th, for a PTO check to be distributed to you the follow<strong>in</strong>g November. IRS rules<br />
require your irrevocable election prior to the start of the plan year.<br />
Example: You see on your paycheck summary that you have 80 hours <strong>in</strong><br />
your PTO bank <strong>in</strong> December. You expect to accrue at least 216 PTO hours<br />
next year, but only take 184 hours; this will leave you a balance on 112 PTO<br />
hours. So you decide to sell 40 PTO hours to follow<strong>in</strong>g November to use for<br />
Christmas shopp<strong>in</strong>g. This will leave 72 hours for the "unexpected", which is<br />
more than the required 40 hours you must keep <strong>in</strong> your PTO bank.<br />
Donat<strong>in</strong>g PTO time<br />
You may donate PTO time to a fellow employee who is <strong>in</strong> need and who qualifies for FML. This option is<br />
totally voluntary. To do so, complete a PTO Donation form located on the Human Resources <strong>in</strong>tranet<br />
page. Your PTO bank will then be reduced by those hours, and the recipient's PTO bank will be <strong>in</strong>creased<br />
by the same amount. The recipient is then able to use the PTO hours at their rate of pay.<br />
©Children’s of Alabama 2012<br />
3.10
Extended Illness Bank (EIB)<br />
Children’s of Alabama provides an Extended Illness Bank to meet pay cont<strong>in</strong>uation needs dur<strong>in</strong>g<br />
absences due to serious illness or maternity leave; time can be taken for your own illness/maternity leave<br />
or the illness of your spouse, parents or children. Benefit eligible and 7/7 employees accrue EIB as<br />
follows:<br />
Days Per Year Accrued* Hourly EIB Accrual Rate Maximum EIB Hours<br />
10 days .0385 720 hours (90 days)<br />
* Assumes 2,080 regular hours worked or paid PTO. EIB accrues on regular hours worked or hours paid<br />
PTO. EIB does not accrue on paid EIB hours.<br />
EIB may be used for the follow<strong>in</strong>g reasons:<br />
The employee's serious illness or maternity leave of the employee (maternity leave up to the<br />
FMLA approved period of 12 weeks), with physician certification of the illness and required<br />
time of absence.<br />
The serious illness of the employee's spouse, parents or children who live with them.<br />
The reason for the illness must relate to the same criteria under the guidel<strong>in</strong>es of the Family<br />
Medical Leave Act.<br />
S<strong>in</strong>ce EIB accrues at a slower rate it may take several years to accure sufficient hours for a 5-6<br />
week medical absence. To help fill this gap you may choose to purchase a voluntary short term<br />
disability policy to coord<strong>in</strong>ate with your EIB balance. Refer to the Section on Voluntary<br />
Benefits.<br />
Important! Select procedures are eligible for immediate EIB use. See Family Medical Leave Specialist<br />
<strong>in</strong> Human Resources to determ<strong>in</strong>e if your condition qualifies. However, the first 5 consecutive days<br />
(40 hours) of any other illness must first be paid from your PTO bank. If the illness cont<strong>in</strong>ues beyond<br />
5 days, your pay will be cont<strong>in</strong>ued from your EIB Bank with approved documentation.<br />
©Children’s of Alabama 2012<br />
3.11
Other Leave Time<br />
Bereavement (Funeral) Leave<br />
Children’s of Alabama provides paid time off (not charged to your PTO or EIB bank) for<br />
bereavement as follows: Up to 3 days paid leave for the death of:<br />
Spouse<br />
Brother, sisters, stepbrothers, stepsisters<br />
Child, stepchild, foster child who lives with you<br />
Parents, step-parents<br />
Grandparents and grandchildren<br />
Current parents-<strong>in</strong>-law<br />
Up to 1 day paid leave for the death of:<br />
Brothers-<strong>in</strong>-law, sisters-<strong>in</strong>-law<br />
Sons-<strong>in</strong>-law, daughters-<strong>in</strong>-law<br />
Remember that you may use PTO bank hours if you need additional time off follow<strong>in</strong>g the loss of a loved<br />
one.<br />
Bereavement leave is <strong>in</strong>tented to fill the gap between your standard hours scheduled to work and your<br />
actual hours worked. Example: If you are normally scheduled to work 40 hours, but due to funeral leave<br />
you work only 24, you will receive 2 days (16 hours) of bereavement pay rather than the maximum 3 days<br />
allowed. In no circumstance will bereavement pay be allowed to <strong>in</strong>crease your hours beyond the standard<br />
hours you are scheduled to work.<br />
Jury Duty<br />
You receive paid leave for any required jury duty or witness duty service; time will not be charged to your<br />
PTO bank.<br />
Military Leave<br />
You may use your PTO bank hours for <strong>in</strong>active duty or field tra<strong>in</strong><strong>in</strong>g. Active duty will be paid subject to<br />
the Uniformed Services Employment Rights Act.<br />
Children’s of Alabama Human Resources Discipl<strong>in</strong>ary Policies<br />
Children’s of Alabama Human Resources policies def<strong>in</strong>e progressive discipl<strong>in</strong>e for tard<strong>in</strong>ess or unplanned<br />
absences from work. These policies have been updated with the <strong>in</strong>itiation of the PTO plans. Your<br />
supervisor can expla<strong>in</strong> these policies to you.<br />
©Children’s of Alabama 2012<br />
3.12
FSA Covered Expenses<br />
KNOW WHAT YOU CAN BUY WITH YOUR FSA DOLLARS<br />
Your Flexible Spend<strong>in</strong>g Account (FSA) dollars can be used to pay for co-payments, co-<strong>in</strong>surance,<br />
and deductibles. But that’ s not all. You can also use your FSA sav<strong>in</strong>gs to pay for many expenses<br />
<strong>in</strong> the follow<strong>in</strong>g categories: Medical, Dental Care, Eye Care, and Over-the-Counter (OTC)<br />
medications and products. Eligible items can vary by employer , so check the speci f cs of your<br />
particular FSA plan.<br />
Potentially Eligible Medical Expenses<br />
Acupuncture<br />
Alcoholism treatment<br />
Ambulance<br />
Artif cial limb<br />
Autoette/Wheelchair<br />
Bandages<br />
Birth control pills<br />
Braille books and magaz<strong>in</strong>es 3<br />
Breast reconstruction surgery 2<br />
Chiropractor<br />
Christian Science Practitioner 4<br />
Crutches<br />
Diagnostic services<br />
Disabled dependent medical care<br />
Drug addiction treatment<br />
Drugs and medic<strong>in</strong>es (prescription & OTC eligible for<br />
Health Care FSA)<br />
Fertility treatment<br />
Guide dog or other service animal<br />
Hear<strong>in</strong>g aids<br />
Home care 5<br />
Hospital services<br />
Laboratory fees<br />
Lead-based pa<strong>in</strong>t removal<br />
Lodg<strong>in</strong>g essential to medical care 6<br />
Maternity care & related services<br />
Meals for <strong>in</strong>patients 6<br />
Medical <strong>in</strong>formation plan (fees to ma<strong>in</strong>ta<strong>in</strong><br />
medical <strong>in</strong>fo <strong>in</strong> databank for your care)<br />
Medical services (e.g., physician, surgeon, specialist)<br />
Mentally disabled (special home) 7<br />
Nurs<strong>in</strong>g home<br />
Nurs<strong>in</strong>g services<br />
Operations<br />
Organ donor’s medical expenses & transportation<br />
Osteopath<br />
Oxygen<br />
Prosthesis<br />
Psychiatric care<br />
Psychoanalysis<br />
Psychologist<br />
Special education 8<br />
Sterilization<br />
Stop-smok<strong>in</strong>g program<br />
Surgery<br />
Telephone for hear<strong>in</strong>g impaired<br />
Television adapted for hear<strong>in</strong>g impaired<br />
Therapy<br />
Transplants<br />
Transportation essential to medical care<br />
Vasectomy<br />
Weight-loss program 9<br />
Wig to replace hair lost to disease<br />
X-ray<br />
1<br />
Assumes that your employer’s Flexible Spend<strong>in</strong>g Account (FSA) under the plan document and/or Summary Plan Description<br />
(SPD) permits the reimbursement for expenses for “medical care” as de f ned <strong>in</strong> Internal Revenue Code §213(d). The SPD<br />
is the communication about this plan provided to you by your employer. Some plans will be more narrowly def ned than this.<br />
See your employer or benef ts adm<strong>in</strong>istrator for details about what expenses are reimbursable through your FSA.<br />
2<br />
You can <strong>in</strong>clude <strong>in</strong> medical expenses the amount you pay for breast reconstruction surgery follow<strong>in</strong>g a mastectomy for<br />
cancer.<br />
3<br />
Only the amount above the cost of regular pr<strong>in</strong>ted material will qualify.<br />
4<br />
You can <strong>in</strong>clude <strong>in</strong> medical expenses the fees you pay to Christian Science Practitioners for medical care.<br />
3.13
FSA Covered Expenses<br />
KNOW WHAT YOU CAN BUY WITH YOUR FSA DOLLARS<br />
5<br />
Nurs<strong>in</strong>g services are eligible (e.g., adm<strong>in</strong>ister medication, chang<strong>in</strong>g dress<strong>in</strong>gs, bath<strong>in</strong>g, groom<strong>in</strong>g, etc.), but not expenses<br />
for household or personal services.<br />
6<br />
You can <strong>in</strong>clude <strong>in</strong> medical expenses the cost of meals and/or lodg<strong>in</strong>g at a hospital or similar <strong>in</strong>stitution if a pr<strong>in</strong>cipal reason<br />
for be<strong>in</strong>g there is to get medical care. You cannot <strong>in</strong>clude <strong>in</strong> medical expenses the cost of meals and/or lodg<strong>in</strong>g that are not<br />
part of <strong>in</strong>patient care.<br />
7<br />
May qualify where provided on doctor’s recommendation to aid transition to <strong>in</strong>dependent liv<strong>in</strong>g or, where receiv<strong>in</strong>g treatment<br />
for disabl<strong>in</strong>g medical condition.<br />
8<br />
You can <strong>in</strong>clude <strong>in</strong> medical expenses fees you pay on a doctor ’s recommendation for a child’s tutor<strong>in</strong>g by a teacher who is<br />
specially tra<strong>in</strong>ed and qualif ed to work with children who have learn<strong>in</strong>g disabilities caused by mental or physical impairments,<br />
<strong>in</strong>clud<strong>in</strong>g nervous system disorders.<br />
9<br />
Qualif es if recommended by physician to treat specif c condition;(e.g., obesity, heart disease, diabetes; however cost of food<br />
does not qualify).<br />
Potentially Eligible Prescription Medication Care Expenses<br />
You can use your Flexible Spend<strong>in</strong>g Account (FSA) dollars to pay out-of-pocket expenses for<br />
prescription drug co-payments and co-<strong>in</strong>surance. Please refer to the speci f cs of your particular FSA<br />
plan, as eligible items can vary by employer.<br />
Potentially Eligible Eye Care Expenses<br />
Contact Lenses<br />
Eyeglasses<br />
Optometrist<br />
Prescription Sunglasses<br />
Eye Exam<strong>in</strong>ations<br />
Eye Surgery (e.g. LASIK)<br />
Potentially Eligible Over-the-Counter<br />
Medication Expenses without a Prescription<br />
(As of Jan. 1, 2011)<br />
Band Aids<br />
Birth Control<br />
Braces & Support<br />
Contact Lens Supplies<br />
Denture Adhesives<br />
Diagnostic Tests & Monitors<br />
Elastic Bandages & Wraps<br />
First Aid Supplies<br />
Insul<strong>in</strong> & Diabetic Supplies<br />
Ostomy Products<br />
Read<strong>in</strong>g Glasses<br />
Wheelchairs, Walkers, Canes<br />
Potentially Eligible Dental Care Expenses<br />
Artif cial teeth<br />
Dental treatment<br />
Potentially Eligible Over-the-Counter<br />
Medication Expenses WITH a Prescription<br />
(As of Jan. 1, 2011)<br />
Acid Controllers<br />
Allergy & S<strong>in</strong>us<br />
Antibiotic Product<br />
Antidiarrheal<br />
Baby Rash O<strong>in</strong>tment<br />
Cold Sore Medic<strong>in</strong>es<br />
Cough, Cold & Flu Medic<strong>in</strong>e<br />
Digestive Aids<br />
Laxatives<br />
Motion Sickness<br />
Pa<strong>in</strong> Relief<br />
Respiratory Treatments<br />
3.13a
FSA Covered Expenses<br />
KNOW WHAT YOU CAN BUY WITH YOUR FSA DOLLARS<br />
Potentially INELIGIBLE Health Care Expenses<br />
The follow<strong>in</strong>g products and services, with<strong>in</strong> the health care and Over-the-Counter medication<br />
categories, are NOT eligible for Flexible Spend<strong>in</strong>g Account (FSA) sav<strong>in</strong>gs.<br />
Baby-sitt<strong>in</strong>g, Childcare, and Nurs<strong>in</strong>g Services for<br />
a Normal, Healthy Baby<br />
Household Help<br />
Illegal Operations and Treatments<br />
Insurance Premiums (other than specif cally for<br />
health <strong>in</strong>surance)<br />
Maternity Clothes<br />
Medical Sav<strong>in</strong>gs Account (MSA)/Health Sav<strong>in</strong>g<br />
Account (HSA) Contributions<br />
Nutritional Supplements 2<br />
Personal Use Items 3<br />
Swimm<strong>in</strong>g Lessons<br />
Teeth Whiten<strong>in</strong>g<br />
Veter<strong>in</strong>ary Fees<br />
Weight-Loss Program not part of specif c disease<br />
treatment<br />
Ineligible Over-the-Counter Products<br />
Aromatherapy<br />
Baby Products (e.g., Bottles, Wipes, Baby Oil)<br />
Breast Enhancements<br />
Cosmetic Products (e.g., Makeup, Perfumes)<br />
Dental Products (e.g., Toothbrush, Toothpaste,<br />
Dental Floss)<br />
Dietary/Nutritional Supplements (e.g., Ensure®,<br />
Glucerna®, Slimfast®)<br />
Fem<strong>in</strong><strong>in</strong>e Care (e.g., Tampons)<br />
Herbal Supplements<br />
Sun Tann<strong>in</strong>g Products<br />
Toiletries (e.g., Deodorant, Shampoo,<br />
ChapStick®)<br />
Vitam<strong>in</strong>s (for General Health/Rout<strong>in</strong>e Use)<br />
1. You cannot <strong>in</strong>clude <strong>in</strong> medical expenses the amount you pay for unnecessary cosmetic surgery . This <strong>in</strong>cludes any procedure<br />
that is directed at improv<strong>in</strong>g the patient’s appearance and does not mean<strong>in</strong>gfully promote the proper function of the body<br />
or prevent or treat illness or disease. You cannot <strong>in</strong>clude <strong>in</strong> medical expenses the amount you pay for procedures such as face<br />
lifts, hair transplants, hair removal (electrolysis), teeth whiten<strong>in</strong>g and liposuction.<br />
2. You cannot <strong>in</strong>clude <strong>in</strong> medical expenses the cost of nutritional supplements, vitam<strong>in</strong>s, herbal supplements, etc. unless they<br />
are recommended by a medical practitioner as treatment for a specif c medical condition diagnosed by a physician.<br />
3. You cannot <strong>in</strong>clude <strong>in</strong> medical expenses the cost of an item used by personal liv<strong>in</strong>g, or family purposes unless it is used<br />
primarily to prevent or alleviate a physical or mental defect or illness.<br />
3.13b
FLEXIBLE SP E ND ING ACC OUNT<br />
Reimbursement Request Form<br />
Instructions: Please pr<strong>in</strong>t or type and complete all items under Personal Information. In order to receive reimbursement, you must<br />
submit an Explanation of Benefits Statement (if applicable) from your <strong>in</strong>surance carrier, or an itemized statement that <strong>in</strong>cludes the provider<br />
name, patient name, date of service, description of service, <strong>in</strong>surance responsibility (if applicable), and patient responsibility for each health<br />
care claim. For dependent care reimbursement you have two choices: (1) Fill out all items <strong>in</strong> the Dependent Care Expenses section and<br />
attach a receipt of your payment, OR (2) Fill <strong>in</strong> your dependent’s name, age, date of service and the requested amount, and have your Day<br />
Care provider fill out the Affidavit of Dependent Care Provider. You must sign and date this form and attach any correspond<strong>in</strong>g receipts<br />
<strong>in</strong> order for us to process this claim. You have permission to photocopy this form.<br />
Employer’s Name<br />
Employee’s Name<br />
Employee’s Social Security Number<br />
P E R S O N A L I N F O R M A T I O N<br />
Email Address<br />
Date of Request<br />
Daytime Phone Number<br />
1.<br />
2.<br />
3.<br />
4.<br />
5.<br />
6.<br />
7.<br />
8.<br />
Patient Name Relationship Age<br />
H E A L T H C A R E E X P E N S E S<br />
Date of<br />
Service<br />
Type of Service (Medical,<br />
Dental, etc.)<br />
Total:<br />
Requested<br />
Amount<br />
1.<br />
2.<br />
3.<br />
D E P E N D E N T C A R E E X P E N S E S<br />
Dependent’s Name Age Date of Service<br />
From<br />
Total:<br />
To<br />
Requested<br />
Amount<br />
A F F I D A V I T O F D E P E N D E N T C A R E P R O V I D E R<br />
I have provided adult/child care for _______________________________________, age _______, for the period beg<strong>in</strong>n<strong>in</strong>g ________<br />
And end<strong>in</strong>g __________. Services were provided by __________________________________________for a fee of $_____________.<br />
________________________________________________ _____________________________ _____________________<br />
<strong>Sign</strong>ature of Provider Tax <strong>ID</strong># or SS Date<br />
I, the undersigned, hereby certify that the above listed expenses have not been previously reimbursed from my Flexible Spend<strong>in</strong>g Account, nor are reimbursable from<br />
any other source. I hereby authorize Flexible Corporate Plans, Inc. to obta<strong>in</strong> necessary <strong>in</strong>formation from all physicians, hospitals, daycare providers, employers and<br />
all other agents <strong>in</strong> order to adjudicate the claim for reimbursement under the Benefit Plan established by my employer.<br />
Employee <strong>Sign</strong>ature<br />
Date<br />
Flexible Corporate Plans, Inc.<br />
P.O. Box 381717, Birm<strong>in</strong>gham, AL 35238 (205) 995-1222 Toll Free: 1-888-505-4557 Fax: (866) 238-8224<br />
3.14
Flexible Spend<strong>in</strong>g Accounts<br />
Benefits Frequently Asked Questions<br />
Q: What types of Flexible Spend<strong>in</strong>g Accounts are available?<br />
A: A Health Care Account for healthcare reimbursement and a Dependent Care Account for child or elder<br />
care reimbursement.<br />
Q: How is us<strong>in</strong>g an FSA like giv<strong>in</strong>g myself a raise?<br />
A: When you’re enrolled <strong>in</strong> an FSA, the money you contribute is deducted from your paycheck before it’s<br />
taxed. The deducted money isn’t taxed and s<strong>in</strong>ce its money you already use on health care expenses, you<br />
end up sav<strong>in</strong>g. That means you’ll have more <strong>in</strong> your pocket for yourself.<br />
Q: How do FSAs work?<br />
A: First, estimate what your out-of-pocket healthcare and child/elder care expenses will be for the year.<br />
Based on your estimate, you will then specify the amount of dollars you want to contribute to your FSA<br />
for the year. You may contribute up to $5,<strong>00</strong>0 to your Health Care Account and $5,<strong>00</strong>0 to your<br />
Dependent Care Account. Once you beg<strong>in</strong> deposit<strong>in</strong>g money <strong>in</strong>to your FSA, you can start gett<strong>in</strong>g<br />
reimbursed for eligible expenses. You can be reimbursed up to the full amount of your annual Health<br />
Care Account contribution, regardless of the amount you have deposited <strong>in</strong> your account. For your<br />
Dependent Care Account, you can be reimbursed up to the amount you have deposited.<br />
Q: Who is eligible to use a Dependent Care Spend<strong>in</strong>g Account?<br />
A: The IRS designed DCSA to provide a tax benefit so you and your spouse can work or attend school fulltime.<br />
If you are married, your spouse must be work<strong>in</strong>g or look<strong>in</strong>g for work, attend school full-time, or<br />
be physically or mentally unable to care for himself/herself. If you are divorced or legally separated,<br />
then you may use a DCSA to pay for work-related dependent care expense dur<strong>in</strong>g the time of year your<br />
child lives with you.<br />
Q: Who qualifies as an eligible dependent?<br />
A: A dependent under the age of 13, or a dependent of any age who lives with you and is mentally or<br />
physically unable to care for himself/herself.<br />
Q: Who is eligible to use a Health Care Spend<strong>in</strong>g Account?<br />
A: All benefits eligible employees except those that participate <strong>in</strong> the Consumer Driven Health Plan<br />
(CDHP). CDHP participants may participate <strong>in</strong> a Limited Purpose FSA only. See the explanation of a<br />
Limited Purpose FSA below.<br />
Q: What is a limited purpose FSA?<br />
A: If you are a participant <strong>in</strong> the Consumer Driven Health Plan then your Flex Card is a limited purpose<br />
FSA. This means the IRS limits your eligible reimbursements to vision & dental expenses; post<br />
deductible expenses (out of pocket expenses <strong>in</strong>curred after you meet the medical deductible under the<br />
health plan) and over the counter drugs if prescribed by a physician. You should not make a<br />
contribution to a Limited Purpose FSA unless you have already elected the maximum allowable<br />
contribution under the HSA and anticipate your qualify<strong>in</strong>g expenses will exceed this limit.<br />
3.15
Q: When do I choose my contribution amount and can I change it anytime?<br />
A: You choose your FSA contribution amount dur<strong>in</strong>g your <strong>in</strong>itial new hire eligibility period and annually<br />
dur<strong>in</strong>g open enrollment (usually <strong>in</strong> October). Open enrollment elections will be effective January 1st. Once<br />
your contribution election becomes effective, you won’t be able to change it until the next open enrollment<br />
period, unless there is a change <strong>in</strong> your eligibility status (e.g., marital status, hav<strong>in</strong>g or adopt<strong>in</strong>g a child,<br />
etc.). Remember you cannot be reimbursed for expenses <strong>in</strong>curred prior to your effective date.<br />
Q: When can I use my FlexCard?<br />
A: You can use your FlexCard at approved providers to <strong>in</strong>stantly access your account. It allows you to pay<br />
for eligible expenses and services at the po<strong>in</strong>t of service by automatically deduct<strong>in</strong>g the amount from<br />
your FSA. No hassle and no wait<strong>in</strong>g!<br />
Q: What OTC products will be covered by FSA <strong>in</strong> 2011?<br />
A: Beg<strong>in</strong>n<strong>in</strong>g Jan. 1, 2011 some OTC drugs will require a prescription to purchase. In some cases a<br />
merchant may not accept your FlexCard for the purchase of OTC meds. In this case you may submit a<br />
manual claim along with a copy of the prescription.<br />
Q: How do I check my balance?<br />
A: Contact Flexible Corporate Plans at 205.995.1222 or onl<strong>in</strong>e at www.flexcorp.com<br />
Q: How do I set up direct deposit?<br />
A: Direct Deposit forms along with <strong>in</strong>structions are available onl<strong>in</strong>e at www.flexcorp.com and at<br />
myservicecenter.chsys.org<br />
Q: How do I set up my onl<strong>in</strong>e account?<br />
A: Onl<strong>in</strong>e access is available at www.flexcorp.com. When sett<strong>in</strong>g up your account you will be asked for<br />
your employee id number which for this website is your social security number. If you have questions<br />
or problems, contact Flexible Corporate Plans at 205.995.1222.<br />
Q: How do I request a replacement card or second card?<br />
A: Contact Flexible Corporate Plans at 205.995.1222 if you need a replacement card or to report a stolen<br />
card. To request a second card, pr<strong>in</strong>t off Additional Card request form and submit it to Flexible<br />
Corporate Plans.<br />
Q: What if I do not use all the money <strong>in</strong> my account by the end of the year?<br />
A: Accord<strong>in</strong>g to IRS guidel<strong>in</strong>es, any unused funds will be lost. For this reason, it is important to carefully<br />
estimate your out-of-pocket expenses AND to <strong>in</strong>cur those expenses by December 31 st . You may be<br />
reimbursed for eligible expenses <strong>in</strong>curred dur<strong>in</strong>g the year until March 31 st .<br />
3.16
Health Sav<strong>in</strong>gs Accounts<br />
Q. What is a Health Sav<strong>in</strong>gs Account (HSA)?<br />
A. The Health Sav<strong>in</strong>gs Account – or HSA – is designed to help you<br />
build tax-free sav<strong>in</strong>gs for health care throughout your lifetime. You,<br />
CHS, or anyone else can put money <strong>in</strong> the account.<br />
Money contributed goes <strong>in</strong> tax-free, earns <strong>in</strong>terest taxfree,<br />
and can be used tax-free for IRS-approved expenses.<br />
Contribut<strong>in</strong>g to a HSA can help you plan for your<br />
healthcare expenses under the BCBS Consumer Driven<br />
Health Plan.<br />
The account is established with HSA Bank, and is similar<br />
to an IRA except you can access these funds at any time<br />
for the payment of qualified medical expenses.<br />
Q. Who is eligible to establish an HSA?<br />
A. You can establish an HSA if you are covered under the Blue Cross Consumer Driven<br />
Health Plan. Also, you (or a covered dependent) must not be covered under any other health<br />
<strong>in</strong>surance plan or Medicare, and you cannot be claimed as a dependent (other than spouse)<br />
on another person’s tax return.<br />
Q. Who can make contributions <strong>in</strong>to an HSA?<br />
A. Contributions can be made by the Children’s Health System, the participant, or any other<br />
person on behalf of the employee/participant.<br />
Q. What is the maximum Annual contribution <strong>in</strong>to the HSA?<br />
IRS limits for 2012 are:<br />
‣ $3,1<strong>00</strong> maximum allowed contribution for <strong>in</strong>dividual plans (employee + employer)<br />
‣ $6,250 maximum allowed contribution for family plans (employee + employer)<br />
‣ $1,<strong>00</strong>0 catch-up contribution allowed for <strong>in</strong>dividuals 55 and older<br />
Q. What are the Advantages of an HSA?<br />
‣ Contributions are made on a Pre-taxed basis<br />
‣ Investment earn<strong>in</strong>gs are exempt from current <strong>in</strong>come tax<br />
‣ Withdrawals are tax free when used for qualified medical expenses.<br />
‣ Account balances roll-over from year-to-year<br />
‣ 1<strong>00</strong>% Employee owned and 1<strong>00</strong>% portable<br />
Q. What are other HSA rules?<br />
‣ Distributions are subject to penalties if not used for qualified expenses.<br />
‣ Distributions cannot exceed current account balance<br />
‣ Must be used <strong>in</strong> conjunction with High Deductible Medical plans only.<br />
3.17
Q. What happens to balance if not used by the end of the year?<br />
A. Account balances roll-over from year-to-year.<br />
Q. How do I get reimbursed from the HSA?<br />
A. You may use your current HSA balance anytime you <strong>in</strong>cur qualified medical expenses.<br />
You may withdraw funds from the HSA at any time. However, you as the owner must<br />
ma<strong>in</strong>ta<strong>in</strong> records of all medical expenses. It is you responsibility to prove the medical<br />
expense was a qualified expense. Distributions are tax-free as long as the expenses are<br />
qualified.<br />
Q. Are <strong>in</strong>surance premiums reimbursable from my HSA?<br />
A. Health <strong>in</strong>surance premiums do not qualify as medical expense. However, funds may<br />
qualify for distribution if use for:<br />
COBRA premiums<br />
Long-term care <strong>in</strong>surance premiums (subject to annual dollar limits based on age)<br />
Medicare Part B premiums<br />
Early Retiree Health premiums for employer provided coverage<br />
Q. How do I keep track of the account balance?<br />
A. You will receive a statement of your account balance from HSA Bank.<br />
Q. If I leave my job at Children’s, what happens to my HSA?<br />
A. You own the account and immediately own any funds contributed to it, as well as any<br />
earn<strong>in</strong>gs. The HSA is portable.<br />
Q. What happens to my account upon death?<br />
A. You have the right to designate the beneficiary of your choice. If your spouse is your<br />
beneficiary, then he/she may cont<strong>in</strong>ue to use the account for medical expenses. Anyone<br />
other than your spouse will have the value <strong>in</strong>cluded as gross <strong>in</strong>come.<br />
Q. If I have any questions regard<strong>in</strong>g my HSA, who do I call?<br />
A. HSA Bank at 1-8<strong>00</strong>-357-6246.<br />
3.18
©Children’s of Alabama 2012<br />
3.19
Gett<strong>in</strong>g started<br />
with Teladoc<br />
You are only a few steps away from hav<strong>in</strong>g 24/7 access to quality medical care with<br />
Teladoc. Teladoc physicians are available to resolve your rout<strong>in</strong>e medical issues when<br />
you need it, from wherever you happen to be. Complete the steps below to set up your<br />
Teladoc account. Then when you want to Teladoc, we're just a call or click away.<br />
Set up your account.<br />
We've made the process quick and easy onl<strong>in</strong>e. If you do not have access to a<br />
computer, call 1-8<strong>00</strong>-Teladoc for assistance.<br />
1. Visit www.Teladoc.com.<br />
2. Click Set up account.<br />
3. Provide the required <strong>in</strong>formation.<br />
Complete your Medical History Disclosure (MHD).<br />
Your MHD provides Teladoc physicians with the <strong>in</strong>formation they need to make<br />
an accurate diagnosis. Complete your MHD for the most complete care.<br />
Onl<strong>in</strong>e: Visit www.Teladoc.com and log <strong>in</strong> to your account. Complete<br />
the My Health Record section.<br />
Paper: Paper MHDs may be provided by your organization. Allow 14<br />
days for account setup from the time Teladoc receives your form(s).<br />
Call 1-8<strong>00</strong>-Teladoc: Teladoc can help you complete your MHD over the<br />
phone. There is a $12 charge for this service, unless otherwise noted by<br />
your organization.<br />
Request a consultation.<br />
Once your account is set up, request a<br />
consultation with a Teladoc physician<br />
anytime and anywhere you need it.<br />
Onl<strong>in</strong>e: www.Teladoc.com<br />
Phone: 1-8<strong>00</strong>-Teladoc<br />
When can you Teladoc?<br />
In two words: Anytime. Anywhere.<br />
Teladoc is simply a more convenient,<br />
more affordable way for you to resolve<br />
your rout<strong>in</strong>e medical issues.<br />
• If you’re consider<strong>in</strong>g the ER, urgent<br />
care center or m<strong>in</strong>ute cl<strong>in</strong>ic for a<br />
non-emergency issue<br />
• When you can’t reach your primary<br />
care physician due to time,<br />
weather, remote location, or a<br />
disability<br />
• On vacation, on a bus<strong>in</strong>ess trip, or<br />
away from home<br />
• For short-term prescription refills<br />
What can you use it for?<br />
Our physicians can diagnose,<br />
recommend treatment and prescribe<br />
medication for non-emergency<br />
medical issues <strong>in</strong>clud<strong>in</strong>g:<br />
• Sore throat<br />
• Bronchitis<br />
• Allergies<br />
• Stuffy nose<br />
• Poison ivy<br />
• P<strong>in</strong>k eye<br />
• Ur<strong>in</strong>ary tract <strong>in</strong>fections<br />
• Respiratory <strong>in</strong>fections<br />
• S<strong>in</strong>us <strong>in</strong>fections<br />
24/7 on-demand access to board-certified physicians<br />
Visit us: www.Teladoc.com or Call us: 1-8<strong>00</strong>-Teladoc (835-2362)<br />
Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc operates subject to state regulation and may not be<br />
available <strong>in</strong> certa<strong>in</strong> states. Teladoc does not prescribe DEA controlled substances, non-therapeutic drugs and certa<strong>in</strong> other drugs which may be harmful because of their potential for<br />
abuse. Teladoc physicians reserve the right to deny care for potential misuse of services. 09012010<br />
3.20
Member FAQ<br />
1. Does Teladoc replace my doctor?<br />
No. Teladoc physicians do not replace your primary care physician.<br />
2. Is the consult fee the same price, regardless of the time of day or night?<br />
Yes! Teladoc charges one flat rate, 24 hours a day, 7 days a week.<br />
3. How do I request an appo<strong>in</strong>tment to talk with a physician?<br />
After enroll<strong>in</strong>g as a member, logon to your account at www.Teladoc.com and request a<br />
consult. You can also call 1.8<strong>00</strong>.Teladoc any time day or night and a representative will<br />
request your medical consult.<br />
4. How quickly can I talk to the doctor?<br />
Our average call back time is usually under thirty m<strong>in</strong>utes, but all calls are guaranteed<br />
with<strong>in</strong> three hours or the consult is free. Note: If a member misses the call from the<br />
consult<strong>in</strong>g physician (away from phone or anonymous call blocker is on), he is returned to<br />
the wait<strong>in</strong>g list and his three hour guaranteed time period starts over. After three missed<br />
calls, the consult request is cancelled.<br />
5. How do I pay for a prescription called <strong>in</strong> by Teladoc?<br />
When you go to your pharmacy of choice to pick up your prescription, you may use your<br />
health/prescription <strong>in</strong>surance card to help pay for the medication. You will be responsible<br />
for the co-pay based on the type of medication and your plan benefits.<br />
6. Can I get this <strong>in</strong>formation to my doctor?<br />
Yes. You have access to your portable electronic medical record. You can access your<br />
account onl<strong>in</strong>e or by call<strong>in</strong>g 1.8<strong>00</strong>.Teladoc and have your medical record mailed or faxed to<br />
you to give to your doctor.<br />
7. Can you provide services related to psychiatric or dental care needs?<br />
No. At this time, Teladoc is provid<strong>in</strong>g medical care related to rout<strong>in</strong>e medical issues only.<br />
8. If I call Teladoc and the recommendation is that I see my primary care physician or a<br />
specialist, do I still have to pay the consult fee?<br />
Yes. Just like any doctor appo<strong>in</strong>tment, you must pay for the consult<strong>in</strong>g physician’s time.<br />
9. How can I pay for the consult?<br />
You may pay with a credit card, debit card or check<strong>in</strong>g account.<br />
24/7 on-demand access to board-certified physicians<br />
Visit us: www.Teladoc.com or Call us: 1-8<strong>00</strong>-Teladoc (835-2362)<br />
Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc operates subject to state regulation and may not be<br />
available <strong>in</strong> certa<strong>in</strong> states. Teladoc does not prescribe DEA controlled substances, non-therapeutic drugs and certa<strong>in</strong> other drugs which may be harmful because of their potential for<br />
abuse. Teladoc physicians reserve the right to deny care for potential misuse of services. 09012010<br />
3.21
American Behavioral<br />
Employee Assistance Program<br />
Children’s of Alabama<br />
BASIC Employee Assistance Program SERVICES<br />
Marital Problems<br />
Disagreements over money, gett<strong>in</strong>g to know each other all over aga<strong>in</strong> when the last child<br />
has left home, deal<strong>in</strong>g with a spouse's attraction to someone else, or <strong>in</strong>ability to<br />
communicate, can <strong>in</strong>dicate trouble <strong>in</strong> a marriage. Professionals can help sort out the<br />
problem areas, so that families can look at possible solutions and make appropriate .<br />
decisions toward resolv<strong>in</strong>g the problem.<br />
Family Relationships<br />
Troubles with<strong>in</strong> a family may <strong>in</strong>clude hav<strong>in</strong>g difficulty communicat<strong>in</strong>g with a rebellious<br />
teenager over alcohol or other drug experimentation; disagreements with <strong>in</strong>-laws or help<strong>in</strong>g<br />
children accept divorce, when appropriate. We can help f<strong>in</strong>d the resources for cop<strong>in</strong>g with<br />
them.<br />
Emotional Difficulties<br />
Most people experience periods of depression, grief, loss, or lonel<strong>in</strong>ess som etime dur<strong>in</strong>g<br />
their lives. Others experience undue anxiety or panic attacks and phobias. If one of these<br />
cont<strong>in</strong>ues for a long period of time, affect<strong>in</strong>g relationships and/or productivity at work, the<br />
assistance of a professional can be helpful.<br />
Work Related Problems<br />
Whether it is adjust<strong>in</strong>g to a new position, not gett<strong>in</strong>g along with some of the co-workers or<br />
want<strong>in</strong>g to advance <strong>in</strong> o ne's career, job related problems could be stressful. Professionals<br />
can direct employees to appropriate resources for confront<strong>in</strong>g these issues.<br />
F<strong>in</strong>ancial Stressors<br />
Some participants who have over-extended themselves, have been unable to make monthly<br />
payments, or unable to save for retirement. We will provide <strong>in</strong>formation on deal<strong>in</strong>g with<br />
budget<strong>in</strong>g and money management. In more severe cases, we will refer to professionals<br />
who teach practical money management or to consumer credit counsel<strong>in</strong>g for more options.<br />
Alcohol and Other Dependency Assessment<br />
Chemical dependency, which <strong>in</strong>cludes alcoholism and other drug addiction, disrupts the<br />
whole family. Chemical dependency is an illness, and it can be treated. We offer complete<br />
assessments and referral to the most appropriate resource. Our services <strong>in</strong>clude supervisor<br />
orientation to aid <strong>in</strong> the recognition and <strong>in</strong>tervention of impaired employees.<br />
EAP services are free to employees, spouses and dependent children. Call 879-7957 with<strong>in</strong> the greater<br />
Birm<strong>in</strong>gham, Alabama area or 1-8<strong>00</strong>-925-5327 outside the local area. All calls are strictly confidential<br />
and you have access to a competent staff with 24-Hour availability for crisis and non-crisis issues.<br />
©Children’s of Alabama 2012 3.22
Manag<strong>in</strong>g your<br />
Diabetes has its own<br />
Rewards.<br />
Plus we’ll give you a<br />
few more.<br />
BLUE CROSS BLUE SHIELD <strong>OF</strong> ALAB<strong>AM</strong>A CDHP HEALTH PLAN MEMBERS<br />
WHY PARTICIPATE?<br />
Monitor<strong>in</strong>g your diabetes helps to improve your health.<br />
Manag<strong>in</strong>g your diabetes helps you reduce your risk for heart disease and stroke.<br />
Complet<strong>in</strong>g the program steps allows you to keep your diabetes <strong>in</strong> check and earn $35 monthly<br />
rewards—that’s $420 a year.<br />
PROGR<strong>AM</strong> STEPS<br />
Step 1: Register on the Good Health Gateway Diabetes Care Rewards Program website at<br />
www.GoodHealthGateway.com<br />
If you do not have access to a computer or you are not comfortable register<strong>in</strong>g onl<strong>in</strong>e, call our HelpL<strong>in</strong>e.<br />
We will be happy to register you and send you <strong>in</strong>formation <strong>in</strong> the mail.<br />
Call us toll-free at (8<strong>00</strong>) 643-8028.<br />
Step 2: Complete each important medical exam<strong>in</strong>ation and lab test listed below to help you manage your<br />
diabetes.<br />
There is a great chance your doctor is already recommend<strong>in</strong>g and hav<strong>in</strong>g you complete these activities.<br />
Annual foot exam (complete once a year)<br />
Annual eye exam, if recommended by your physician, or physician waiver (complete once a year)<br />
Annual laboratory work-up of your fast<strong>in</strong>g blood lipid levels (complete once a year)<br />
Annual laboratory work-up of your ur<strong>in</strong>e/prote<strong>in</strong> levels (complete once a year)<br />
Laboratory work-up of your Hemoglob<strong>in</strong> A1c levels every 6 months (complete every 6 months)<br />
Many people are already meet<strong>in</strong>g the program requirements and will only need to have their<br />
Provider Confirmation Form described <strong>in</strong> Step 3 below completed. Health activities you have<br />
already completed <strong>in</strong> the past year count towards meet<strong>in</strong>g the program requirements.<br />
Step 3: Provide us with documentation from your health care provider(s) to show that you have<br />
completed the diabetes exams and lab tests listed above <strong>in</strong> Step 2.<br />
Please pr<strong>in</strong>t out the Provider Confirmation Form from our website. Give the form to your health care<br />
provider(s) to complete, sign, and then fax to us at (877) 378-4480. When we receive your form(s), you<br />
will start receiv<strong>in</strong>g your $35 monthly reward.<br />
Note: You will need to submit a new form EACH time you update an exam/lab test.<br />
Participation <strong>in</strong> the program is voluntary. Under no circumstances will any medical or health <strong>in</strong>formation<br />
about you or your participation <strong>in</strong> this program be shared with Children’s of Alabama.<br />
3.23
Manag<strong>in</strong>g your<br />
Diabetes has its own<br />
Rewards.<br />
Plus we’ll give you a<br />
few more.<br />
BLUE CROSS BLUE SHIELD <strong>OF</strong> ALAB<strong>AM</strong>A PPO AND VIVA HEALTH PLAN MEMBERS<br />
WHY PARTICIPATE?<br />
Monitor<strong>in</strong>g your diabetes helps to improve your health.<br />
Manag<strong>in</strong>g your diabetes helps you reduce your risk for heart disease and stroke.<br />
Complet<strong>in</strong>g the program steps allows you to receive diabetes medications and most diabetic supplies<br />
for $0 co-pays which means they are absolutely FREE to you. When you complete the steps below, we<br />
will send you a GHG Rx Rewards Card to use at your local, <strong>in</strong>-network pharmacy or the program specific<br />
mail order service, CAREMARK ® .<br />
PROGR<strong>AM</strong> STEPS<br />
Step 1: Register on the Good Health Gateway Diabetes Care Rewards Program website at<br />
www.GoodHealthGateway.com<br />
If you do not have access to a computer or you are not comfortable register<strong>in</strong>g onl<strong>in</strong>e, call our HelpL<strong>in</strong>e.<br />
We will be happy to register you and send you <strong>in</strong>formation <strong>in</strong> the mail.<br />
Call us toll-free at (8<strong>00</strong>) 643-8028.<br />
Step 2: Complete each important medical exam<strong>in</strong>ation and lab test listed below to help you manage your<br />
diabetes.<br />
There is a great chance your doctor is already recommend<strong>in</strong>g and hav<strong>in</strong>g you complete these activities.<br />
Annual foot exam (complete once a year)<br />
Annual eye exam, if recommended by your physician, or physician waiver (complete once a year)<br />
Annual laboratory work-up of your fast<strong>in</strong>g blood lipid levels (complete once a year)<br />
Annual laboratory work-up of your ur<strong>in</strong>e/prote<strong>in</strong> levels (complete once a year)<br />
Laboratory work-up of your Hemoglob<strong>in</strong> A1c levels every 6 months (complete every 6 months)<br />
Many people are already meet<strong>in</strong>g the program requirements and will only need to have their<br />
Provider Confirmation Form described <strong>in</strong> Step 3 below completed. Health activities you have<br />
already completed <strong>in</strong> the past year count towards meet<strong>in</strong>g the program requirements.<br />
Step 3: Provide us with documentation from your health care provider(s) to show that you have<br />
completed the diabetes exams and lab tests listed above <strong>in</strong> Step 2.<br />
Please pr<strong>in</strong>t out the Provider Confirmation Form from our website. Give the form to your health care<br />
provider(s) to complete, sign, and then fax to us at (877) 378-4480. When we receive your form(s), you<br />
can start receiv<strong>in</strong>g your diabetes medications and supplies for free us<strong>in</strong>g your GHG Rx Rewards Card.<br />
Note: You will need to submit a new form EACH time you update an exam/lab test.<br />
Participation <strong>in</strong> the program is voluntary. Under no circumstances will any medical or health <strong>in</strong>formation<br />
about you or your participation <strong>in</strong> this program be shared with Children’s of Alabama.<br />
3.24
Section 4
Sunday Monday Tuesday Wednesday Thursday Friday Saturday<br />
New Year’s Day<br />
Mart<strong>in</strong> Luther K<strong>in</strong>g Jr.<br />
Day<br />
Sunday Monday Tuesday Wednesday Thursday Friday Saturday<br />
Mother’s Day<br />
Memorial Day<br />
May Day<br />
C<strong>in</strong>co de Mayo<br />
Sunday Monday Tuesday Wednesday Thursday Friday Saturday<br />
Grandparents Day<br />
Labor Day<br />
First Day of Fall<br />
Sunday Monday Tuesday Wednesday Thursday Friday Saturday<br />
Valent<strong>in</strong>e’s Day<br />
Presidents’ Day Mardi Gra Ash Wednesday<br />
Leap Day<br />
Groundhog Day<br />
Sunday Monday Tuesday Wednesday Thursday Friday Saturday<br />
Father’s Day<br />
First Day of Summer<br />
Flag Day<br />
Sunday Monday Tuesday Wednesday Thursday Friday Saturday<br />
Columbus Day<br />
Halloween<br />
Sunday Monday Tuesday Wednesday Thursday Friday Saturday<br />
Daylight Sav<strong>in</strong>g Time<br />
Beg<strong>in</strong>s<br />
First Day of Spr<strong>in</strong>g<br />
St. Patrick’s Day<br />
Sunday Monday Tuesday Wednesday Thursday Friday Saturday<br />
Canada Day<br />
Independence Day<br />
Sunday Monday Tuesday Wednesday Thursday Friday Saturday<br />
Daylight Sav<strong>in</strong>g Time<br />
Ends<br />
Veterans Day<br />
Election Day<br />
All Sa<strong>in</strong>t’s Day<br />
Thanksgiv<strong>in</strong>g<br />
Sunday Monday Tuesday Wednesday Thursday Friday Saturday<br />
April Fool’s Day<br />
Palm Sunday Good Friday Passover Beg<strong>in</strong>s<br />
Easter Sunday<br />
Earth Day<br />
Sunday Monday Tuesday Wednesday Thursday Friday Saturday<br />
Sunday Monday Tuesday Wednesday Thursday Friday Saturday<br />
Christmas Eve<br />
New Year’s Eve (31) Christmas Day Kwanzaa Beg<strong>in</strong>s<br />
Pearl Harbor<br />
Remembrance Day<br />
First Day of W<strong>in</strong>ter<br />
Hanukah Beg<strong>in</strong>s<br />
JANUARY<br />
S M JANUARY T W 2012 T F S<br />
1 2 3 4 5 6 7<br />
Corporate SpeCial ServiCeS, <strong>in</strong>C.<br />
2012<br />
205.987.48<strong>00</strong> 8<strong>00</strong>.239.2774 Fax 205.987.9363<br />
Pay Dates for Children’s of Alabama<br />
Order reports onl<strong>in</strong>e at www.cssi.net<br />
FEBRUARY<br />
S M FEBRUARY T W 2012 T F S<br />
29 30 31 1 2 3 4<br />
2011<br />
MARCH<br />
S M MARCH T W 2012 T F S<br />
26 27 28 29 1 2 3<br />
APRIL<br />
S M T APRIL W 2012 T F S<br />
1 2 3 4 5 6 7<br />
8 9 10 11 12 13 14<br />
5 6 7 8 9 10 11<br />
4 5 6 7 8 9 10<br />
8 9 10 11 12 13 14<br />
15 16 17 18 19 20 21<br />
12 13 14 15 16 17 18<br />
11 12 13 14 15 16 17<br />
15 16 17 18 19 20 21<br />
22 23 24 25 26 27 28<br />
19 20 21 22 23 24 25<br />
18 19 20 21 22 23 24<br />
22 23 24 25 26 27 28<br />
29 30 31 1 2 3 4<br />
26 27 28 29 1 2 3<br />
25 26 27 28 29 30 31<br />
29 30 1 2 3 4 5<br />
MAY<br />
S M T MAY W 2012T F S<br />
29 30 1 2 3 4 5<br />
JUNE<br />
S M T JUNE W 2012T F S<br />
27 28 29 30 31 1 2<br />
JULY<br />
S M T JULY W 2012T F S<br />
1 2 3 4 5 6 7<br />
AUGUST<br />
S M AUGUST T W 2012 T F S<br />
29 30 31 1 2 3 4<br />
6 7 8 9 10 11 12<br />
3 4 5 6 7 8 9<br />
8 9 10 11 12 13 14<br />
5 6 7 8 9 10 11<br />
13 14 15 16 17 18 19<br />
10 11 12 13 14 15 16<br />
15 16 17 18 19 20 21<br />
12 13 14 15 16 17 18<br />
20 21 22 23 24 25 26<br />
17 18 19 20 21 22 23<br />
22 23 24 25 26 27 28<br />
19 20 21 22 23 24 25<br />
27 28 29 30 31 1 2<br />
24 25 26 27 28 29 30<br />
29 30 31 1 2 3 4<br />
26 27 28 29 30 31 1<br />
SEPTEMBER<br />
S M SEPTEMBER T W 2012 T F S<br />
26 27 28 29 30 31 1<br />
OCTOBER<br />
S M OCTOBER T W 2012 T F S<br />
30 1 2 3 4 5 6<br />
NOVEMBER<br />
S M NOVEMBER T W T 2012 F S<br />
28 29 30 31 1 2 3<br />
DECEMBER<br />
S M DECEMBER T W 2012 T F S<br />
25 26 27 28 29 30 1<br />
2 3 4 5 6 7 8<br />
7 8 9 10 11 12 13<br />
4 5 6 7 8 9 10<br />
2 3 4 5 6 7 8<br />
9 10 11 12 13 14 15<br />
14 15 16 17 18 19 20<br />
11 12 13 14 15 16 17<br />
9 10 11 12 13 14 15<br />
16 17 18 19 20 21 22<br />
21 22 23 24 25 26 27<br />
18 19 20 21 22 23 24<br />
16 17 18 19 20 21 22<br />
23<br />
/30 24 25 26 27 28 29<br />
28 29 30 31 1 2 3<br />
25 26 27 28 29 30 1<br />
23<br />
/30<br />
24<br />
/31 25 26 27 28 29<br />
Elected Deduction Schedule:<br />
² First check of each month<br />
• Aetna LTC<br />
² Second check of each month<br />
• United Way<br />
² Each check<br />
• Medical<br />
• Dental<br />
• Vision<br />
• Life<br />
• Flexible Spend<strong>in</strong>g Account<br />
• Health Sav<strong>in</strong>gs Account<br />
• 401k Contributions, <strong>in</strong>clud<strong>in</strong>g loan repayments<br />
• MetLife<br />
• Park<strong>in</strong>g<br />
• Unum Provident Whole Life<br />
• Red checks <strong>in</strong>dicate an actual check<br />
• Log onto myservicecenter.chsys.org to view your paycheck<br />
© Children’s of Alabama 2012<br />
4.1
Introduction<br />
The time and labor system <strong>in</strong> use at Children’s of Alabama is a part of the PeopleSoft<br />
Human Resources Management Applications suite of software. This system has a large<br />
scope of functionality but this class is focused on only the time and labor part. The<br />
PeopleSoft time and labor <strong>in</strong>tegrates an electronic collection method, punch time<br />
process<strong>in</strong>g, reports, and payroll.<br />
Time Clock Procedures (Non Exempt Employees)<br />
The devices used to collect punched time are TimeL<strong>in</strong>k time clocks. The clocks are used<br />
to capture the follow<strong>in</strong>g punch types:<br />
1. Punch<br />
2. Out Punch<br />
3. Callback<br />
4. Education/Sem<strong>in</strong>ar<br />
5. Orientation/Paid Non-Productive<br />
6. Transfers<br />
Card Swip<strong>in</strong>g<br />
Before swip<strong>in</strong>g your card select a function on the clock. Place badge with face side up<br />
and such that the first letter of you first name goes <strong>in</strong>to the slot. Your badge should have<br />
the bar code part of the <strong>ID</strong> placed <strong>in</strong>side the bar code reader. Swipe your card <strong>in</strong> any<br />
direction. Please note that you have a limited time to swipe your card.<br />
If you have successfully swiped three th<strong>in</strong>gs should have happened.<br />
1. Your badge <strong>ID</strong> number should have displayed <strong>in</strong> the clock w<strong>in</strong>dow.<br />
2. A s<strong>in</strong>gle beep should have been heard.<br />
3. The green light above the reader should have shown.<br />
© Children’s of Alabama 2012<br />
4.2
Button Functions on Time Clock<br />
• Button #1 (box with arrow po<strong>in</strong>t<strong>in</strong>g <strong>in</strong> the box): This is the<br />
clock <strong>in</strong> function to use this function press the button. Now you<br />
will be prompted to swipe your badge.<br />
• Button #2 (arrow out of box with d<strong>in</strong>ner plate): Clock out for<br />
lunch.<br />
• Button #3 (arrow <strong>in</strong> box with d<strong>in</strong>ner plate): This does noth<strong>in</strong>g<br />
and is not used or activated.<br />
• Button #4 (box with arrow po<strong>in</strong>t<strong>in</strong>g out of box): This is the<br />
clock out function to use this function press the button. Now<br />
you will be prompted to swipe your badge.<br />
• Button #5 (box with question mark): This is the Total Hours<br />
function it will give you your cumulative hours worked. To<br />
use this function press the button. Now you will be prompted<br />
to swipe your badge.<br />
• Button #6<br />
• Button #7 and #8 (arrows up or down respectively): These<br />
button are used to scroll the displayed <strong>in</strong>formation up and<br />
down <strong>in</strong> conjunction with the use button # 5 and/or #6.<br />
© Children’s of Alabama 2012<br />
4.3
• Button F1: This button is used to start Callback. To use this<br />
function press the F1 button. Now you will be prompted to<br />
swipe your badge. After you have f<strong>in</strong>ished callback use the<br />
button #4 to end callback (see Button #4 <strong>in</strong>structions).<br />
• Button F2: This button is used for Education/Sem<strong>in</strong>ar. To use<br />
this function press the F2 button. Now you will be prompted to<br />
swipe your badge. After you have f<strong>in</strong>ished Education/Sem<strong>in</strong>ar<br />
use the button #4 to end Education/Sem<strong>in</strong>ar (see Button #4<br />
<strong>in</strong>structions).<br />
• Button F3: This button is used for Orientation/Paid Non-<br />
Productive. To use this function press the F3 button. Now you<br />
will be prompted to swipe your badge. After you have f<strong>in</strong>ished<br />
Orientation/Paid Non-Productive use the button #4 to end<br />
Orientation/Paid Non-Productive (see Button #4 <strong>in</strong>structions).<br />
• Button F4: This button is used to transfer time to another department. To use this<br />
function press the F4 button. Now you will be prompted to swipe your badge.<br />
You will then be prompted to key the department number that you will be<br />
work<strong>in</strong>g <strong>in</strong>. After you keyed the four digit number select the check mark button to<br />
f<strong>in</strong>ish. Please note you have a limited time to key the department code <strong>in</strong> to the<br />
time clock. After you have f<strong>in</strong>ished work<strong>in</strong>g <strong>in</strong> the other department use the<br />
button #4 to end (see Button #4 <strong>in</strong>structions).<br />
© Children’s of Alabama 2012<br />
4.4
Diversity<br />
People are identified <strong>in</strong> several different ways:<br />
• Whether they are male or female<br />
• Country of their birth<br />
• The color of their sk<strong>in</strong><br />
• Their accent (southern, northern, western, etc.)<br />
• Their jobs (pharmacy, eng<strong>in</strong>eer<strong>in</strong>g....)<br />
• Their titles (staff, manager, ...)<br />
• Where they live (Homewood, Pell City, Birm<strong>in</strong>gham, Shelby County...)<br />
• Age<br />
• Physical appearance (weight, height, body built. ..)<br />
• Religion<br />
• What they eat (vegetarian)<br />
• Where they attended school (Alabama, Auburn, Jefferson State....)<br />
• Their values and beliefs<br />
• Hear<strong>in</strong>g, sight, and language<br />
• How they like to learn<br />
• Perception of time (Do they focus on the future? Do they focus on the<br />
now? Do they expect immediate answers to their questions?)<br />
Patients and families seen at Children’s of Alabama come from many walks of life,<br />
vary<strong>in</strong>g religious preferences, ages, ethnic backgrounds and many other differences. We<br />
see patients that are from Alabama, Georgia, Mississippi, Florida, Mexico, Korea, Ch<strong>in</strong>a,<br />
and many other areas.<br />
They have many religious beliefs. Some <strong>in</strong>clude:<br />
• Baptist<br />
• Muslim<br />
• Presbyterian<br />
• Catholic<br />
• Jewish<br />
At Children’s of Alabama all patients and families can expect to be treated respectfully<br />
by all employees. They should be provided an <strong>in</strong>terpreter, when needed. Their treatment<br />
should <strong>in</strong>clude considerations for their beliefs, values, and preferences.<br />
At Children’s of Alabama "Children are the Center of our Lives" and can expect to<br />
be respected as an <strong>in</strong>dividual with their beliefs and needs <strong>in</strong>cluded <strong>in</strong> their<br />
treatment.<br />
© Children’s of Alabama 2012 4.5
Red Flags Re: Child Abuse<br />
What Is Child Abuse<br />
Child abuse or child maltreatment is harm (or risk of harm) caused by a parent, caretaker, or another person<br />
who is responsible for the care and safety of a child.<br />
The four major types of child abuse or child maltreatment are:<br />
1. Neglect: failure to provide for a child's basic needs<br />
2. Physical Abuse: physical <strong>in</strong>jury as a result of punch<strong>in</strong>g, beat<strong>in</strong>g, kick<strong>in</strong>g, bit<strong>in</strong>g, burn<strong>in</strong>g,<br />
shak<strong>in</strong>g, stabb<strong>in</strong>g, chok<strong>in</strong>g, or otherwise harm<strong>in</strong>g a child.<br />
3. Sexual Abuse:<strong>in</strong>cludes fondl<strong>in</strong>g a child's genitals, penetration, <strong>in</strong>cest, rape, sodomy, <strong>in</strong>decent<br />
exposure, commercial exploitation through prostitution or the production of pornographic<br />
materials.<br />
4. Emotional Abuse: <strong>in</strong>cludes constant criticism, threats, or rejection as well as withhold<strong>in</strong>g<br />
love, affection, support, or guidance.<br />
Risk Factors<br />
Child abuse and neglect occur <strong>in</strong> all segments of our society, but the risks are greater <strong>in</strong> families where<br />
parents:<br />
• abuse alcohol and drugs<br />
• are isolated from family, friends, communities, and other sources of support<br />
• have difficulty controll<strong>in</strong>g their anger<br />
• appear un<strong>in</strong>terested <strong>in</strong> the care, nourishment, or safety of their children<br />
• have serious economic, hous<strong>in</strong>g, or personal problems<br />
• <strong>in</strong>volved with domestic violence<br />
Warn<strong>in</strong>g <strong>Sign</strong>s<br />
Common warn<strong>in</strong>g signs that children are likely victims of abuse <strong>in</strong>clude:<br />
• nervousness around adults<br />
• aggressions towards adults and other children<br />
• <strong>in</strong>ability to stay awake or concentrate for extended periods of time<br />
• sudden dramatic changes <strong>in</strong> personality or activities<br />
• act<strong>in</strong>g out sexually or show<strong>in</strong>g <strong>in</strong>terest <strong>in</strong> sex that is <strong>in</strong>appropriate for his or her age<br />
• frequent or unexpla<strong>in</strong>ed bruises or <strong>in</strong>juries<br />
• low self-esteem<br />
• poor hygiene<br />
Report<strong>in</strong>g Child Abuse<br />
As a healthcare professional, you are mandated by law to report <strong>in</strong>cidents of suspected abuse. With<strong>in</strong> the<br />
Children’s of Alabama, when abuse is suspected the Social Services Department <strong>in</strong> conjunction with medical<br />
and nurs<strong>in</strong>g staff makes the reports to the appropriate authorities (Department ofHuman Resources and/or<br />
law enforcement) so that an <strong>in</strong>vestigation can be done. If you suspect that a child is be<strong>in</strong>g harmed or is at<br />
risk for be<strong>in</strong>g harmed, please contact The Social Services Department at 939-9684. The Jefferson County<br />
Department of Human Resources may be contacted at 324-2135.<br />
Portions of the above <strong>in</strong>formation was taken from the publication, What Everyone Can Do To Prevent<br />
Child Abuse, U.S.Department of Health and Human Services<br />
© Children’s of Alabama 2012 4.6
Section: Patient Care<br />
Adm<strong>in</strong>istrative Policy and<br />
Procedure Manual<br />
ADM-PC <strong>00</strong>: Patient/Parent<br />
Bill of Rights and<br />
Responsibilities<br />
Written: 9/79<br />
Current Review/Revised: 1/10<br />
Next Scheduled Review: 1/13<br />
Disclaimer: This policy resc<strong>in</strong>ds<br />
any previous publication cover<strong>in</strong>g<br />
the same material<br />
Page 1 of 9<br />
Purpose<br />
To identify and state the rights and responsibilities applicable to patients secur<strong>in</strong>g care<br />
at Children’s of Alabama.<br />
Policy<br />
It is the policy of this <strong>in</strong>stitution to treat all patients with respect and courtesy<br />
recogniz<strong>in</strong>g their rights as human be<strong>in</strong>gs.<br />
Patient/Parent Rights<br />
Parents and legal guardians have the duty and authority to provide for the health<br />
care needs of their children. As a result, Children’s of Alabama relies, to the extent<br />
allowed by law, upon the consent of a custodial parent, legal guardian, or other<br />
legally-authorized person when admitt<strong>in</strong>g or treat<strong>in</strong>g un-emancipated m<strong>in</strong>or<br />
children (18 years of age or younger), except <strong>in</strong> those <strong>in</strong>stances where Alabama law<br />
grants a m<strong>in</strong>or the authority to consent or when a physician has the right to proceed<br />
without consent. Parents, legal guardians, or other legally authorized persons may<br />
expect the follow<strong>in</strong>g concern<strong>in</strong>g the care and treatment of an un- emancipated<br />
m<strong>in</strong>or child, to the extent allowed by law:<br />
A. The hospital’s reasonable response to his/her request and need for<br />
treatment or service, with<strong>in</strong> the hospital’s capacity, its mission, and<br />
applicable law and regulation.<br />
B. Impartial access to medical treatment or accommodations that is<br />
available and medically <strong>in</strong>dicated without consideration of race, creed,<br />
sex, religion, national orig<strong>in</strong>, ethnicity, or source of payment for care.<br />
C. The right to have cultural, psychosocial, spiritual, and personal values,<br />
beliefs and preferences respected, <strong>in</strong>clud<strong>in</strong>g the right to pastoral and<br />
other spiritual services.<br />
D. Considerate and respectful care with the recognition of personal dignity<br />
supportive of a positive self-image.<br />
E. Personal and <strong>in</strong>formational privacy as manifested by the follow<strong>in</strong>g rights:<br />
4.7
Section: Patient Care<br />
Title: ADM-PC <strong>00</strong> Patient/Parent<br />
Bill of Rights and<br />
Responsibilities<br />
Page 2 of 9<br />
1. The right to limit visitors or visits by other persons not directly<br />
<strong>in</strong>volved <strong>in</strong> the patient’s care.<br />
2. The right of the patient to wear appropriate personal cloth<strong>in</strong>g and<br />
religious or other symbolic items, as long as these do not <strong>in</strong>terfere<br />
with diagnostic procedures or treatment.<br />
3. The right of the patient to be <strong>in</strong>terviewed and exam<strong>in</strong>ed <strong>in</strong><br />
surround<strong>in</strong>gs designed to assure reasonable visual and auditory<br />
privacy.<br />
4. To expect that any discussion or consultation <strong>in</strong>volv<strong>in</strong>g his/her<br />
case will be conducted discreetly and that <strong>in</strong>dividuals not directly<br />
<strong>in</strong>volved <strong>in</strong> his/her care will not be present without the patient’s<br />
permission.<br />
5. To expect all communications, cl<strong>in</strong>ical and other records<br />
perta<strong>in</strong><strong>in</strong>g to his/her care, <strong>in</strong>clud<strong>in</strong>g the source of payment for<br />
treatment, be treated as confidential.<br />
6. The right to access <strong>in</strong>formation conta<strong>in</strong>ed <strong>in</strong> records <strong>in</strong> a<br />
reasonable time frame.<br />
7. The right of the patient to be placed <strong>in</strong> protective privacy when<br />
considered necessary for personal safety.<br />
8. The right to personal privacy for the patient and confidentiality of<br />
<strong>in</strong>formation relat<strong>in</strong>g to the patient with<strong>in</strong> limits of the law. The<br />
patient and the patient’s legally authorized representative have the<br />
right of access to the <strong>in</strong>formation conta<strong>in</strong>ed <strong>in</strong> the patient’s<br />
medical record with<strong>in</strong> limits of the law.<br />
9. The right of the patient to receive the privacy rights granted by the<br />
federal health care privacy law called the Health Insurance<br />
Portability and Accountability Act of 1996 (HIPAA).<br />
F. The right to have family or a designated representative notified of your<br />
admission to the hospital upon request.<br />
G. The right of the patient to have his/her personal physician notified of<br />
admission to the hospital upon request.<br />
H. The right of the patient to timely <strong>in</strong>formation necessary to enable<br />
him/her to make treatment decisions that reflect his/her wishes.<br />
I. The right of the patient to participate <strong>in</strong> dilemmas or ethical questions<br />
about his/her care.<br />
J. Adult <strong>in</strong>patients (19 years of age or older or 18 years of age if married)<br />
have the right to formulate advance directives, <strong>in</strong>clud<strong>in</strong>g the designation<br />
of a surrogate decision maker, and to have hospital staff and<br />
practitioners who provide care <strong>in</strong> the Children’s of Alabama comply with<br />
these directives.<br />
K. The right to <strong>in</strong>clude or exclude any family members from participat<strong>in</strong>g <strong>in</strong><br />
health care decisions.<br />
4.8
Section: Patient Care<br />
Title: ADM-PC <strong>00</strong> Patient/Parent<br />
Bill of Rights and<br />
Responsibilities<br />
Page 3 of 9<br />
L. Reasonable safety <strong>in</strong>sofar as the hospital practices and environment are<br />
concerned.<br />
M. The right to be treated <strong>in</strong> a secure environment.<br />
N. The right to know the identity and professional status of <strong>in</strong>dividuals<br />
provid<strong>in</strong>g service and to know which physician or other practitioner is<br />
primarily responsible for his/her care. This <strong>in</strong>cludes the patient’s right to<br />
know of the existence of any professional relationship among <strong>in</strong>dividuals<br />
who are treat<strong>in</strong>g him/her, as well as the relationship to any other health<br />
care or educational <strong>in</strong>stitutions <strong>in</strong>volved <strong>in</strong> his/her care. Participation by<br />
patients <strong>in</strong> cl<strong>in</strong>ical tra<strong>in</strong><strong>in</strong>g programs or <strong>in</strong> the gather<strong>in</strong>g of data for<br />
research purposes should be voluntary.<br />
O. The right to obta<strong>in</strong> from the practitioner responsible for coord<strong>in</strong>at<strong>in</strong>g<br />
his/her care, complete and current <strong>in</strong>formation concern<strong>in</strong>g diagnosis (to<br />
the degree known), treatment, outcomes of care, <strong>in</strong>clud<strong>in</strong>g unanticipated<br />
outcomes, and any known prognosis. This <strong>in</strong>formation should be<br />
communicated <strong>in</strong> terms the patient can reasonably be expected to<br />
understand. When it is not medically advisable to give such <strong>in</strong>formation to<br />
the patient, the <strong>in</strong>formation should be made available to a legally<br />
authorized <strong>in</strong>dividual.<br />
P. The right to refuse care, treatment, and services <strong>in</strong> accordance with law<br />
and regulation and the right to be <strong>in</strong>formed of the medical<br />
consequences of refus<strong>in</strong>g treatment to the extent permitted by law.<br />
Q. The right to be free from all forms of abuse, neglect, harassment, and<br />
exploitation <strong>in</strong>clud<strong>in</strong>g mental, physical, sexual, and verbal.<br />
R. The right of the patient to have reasonable access to people outside of<br />
the hospital by means of visitors, and by verbal and written<br />
communication (<strong>in</strong>clud<strong>in</strong>g access to an <strong>in</strong>terpreter, if necessary) as is<br />
medically appropriate.<br />
S. The right to the reasonable, <strong>in</strong>formed participation <strong>in</strong> decisions <strong>in</strong>volv<strong>in</strong>g<br />
his/her health care. To the degree possible, this should be based on a<br />
clear, concise explanation of his/her condition and of all proposed<br />
technical procedures, <strong>in</strong>clud<strong>in</strong>g the possibilities of any risk of mortality<br />
or serious side effects, problems related to recuperation, and probability<br />
of success. The patient should not be subjected to any procedure<br />
without the voluntary, competent, and understand<strong>in</strong>g consent of a<br />
person authorized to give effective consent, unless a physician has the<br />
right to proceed without consent. Where medically significant<br />
alternatives for care or treatment exist, that <strong>in</strong>formation should be<br />
communicated to the person(s) mak<strong>in</strong>g the decision regard<strong>in</strong>g care or<br />
treatment.<br />
4.9
Section: Patient Care<br />
Title: ADM-PC <strong>00</strong> Patient/Parent<br />
Bill of Rights and<br />
Responsibilities<br />
Page 4 of 9<br />
T. The right to know the name of the physician(s) and other practitioners<br />
authoriz<strong>in</strong>g and deliver<strong>in</strong>g care, treatment, and services.<br />
U. The right to be <strong>in</strong>formed if Children’s of Alabama proposes to<br />
engage <strong>in</strong> or perform human experimentation or other research or<br />
educational projects affect<strong>in</strong>g the patient’s care or treatment and the<br />
right to refuse to participate <strong>in</strong> any such activity.<br />
V. The right to be <strong>in</strong>formed of and ga<strong>in</strong> to access protective and advocacy<br />
services.<br />
W. The right to consult with a specialist (at his/her own request and<br />
expense).<br />
X. The right not to have the patient transferred to another facility unless<br />
you have received a complete explanation of the need for the transfer<br />
and of the alternatives to such a transfer has been given. Further, the<br />
transfer must be acceptable to the other facility.<br />
Y. The right to be <strong>in</strong>formed by the practitioner responsible for care or<br />
his/her delegate of any cont<strong>in</strong>u<strong>in</strong>g health care requirements follow<strong>in</strong>g<br />
discharge from the Children’s of Alabama needed to facilitate<br />
cont<strong>in</strong>uity of care.<br />
Z. The right to request and receive an itemized and detailed explanation of<br />
the total bill for services rendered <strong>in</strong> the Children’s of Alabama.<br />
AA.<br />
BB.<br />
CC.<br />
The right to be <strong>in</strong>formed of the Children’s of Alabama rules and<br />
regulations applicable to the patient’s conduct.<br />
The right to be free from the use of seclusion or restra<strong>in</strong>ts of any form<br />
that are not medically necessary.<br />
The right to appropriate pa<strong>in</strong> assessment and management.<br />
Patients who are emancipated m<strong>in</strong>or children and adults shall also have the rights<br />
stated here<strong>in</strong>.<br />
Patient/Parent Responsibilities<br />
Patients, and their parents, legal guardians, or other persons legally responsible for<br />
the patient, have the follow<strong>in</strong>g responsibilities:<br />
1. To provide, to the best of your knowledge, accurate and complete<br />
<strong>in</strong>formation about present compla<strong>in</strong>ts, past illnesses, hospitalizations,<br />
medications, unexpected changes <strong>in</strong> condition, and other matters relat<strong>in</strong>g to<br />
the patient’s health, <strong>in</strong>clud<strong>in</strong>g any patient safety risks or concerns and<br />
4.10
Section: Patient Care<br />
Title: ADM-PC <strong>00</strong> Patient/Parent<br />
Bill of Rights and<br />
Responsibilities<br />
Page 5 of 9<br />
unexpected changes <strong>in</strong> condition.<br />
2. To ask questions if you do not understand what you have been told about<br />
your medical condition, care, treatment, and services, or what you are<br />
expected to do and to report whether a contemplated course of action has<br />
been adequately expla<strong>in</strong>ed.<br />
3. To follow the treatment plan recommended by the patient’s health care team<br />
and express any concerns about <strong>in</strong>ability to follow such plans. Patients and<br />
families are responsible for accept<strong>in</strong>g the consequences of not follow<strong>in</strong>g the<br />
care, treatment, and service plan.<br />
4. To assure that the f<strong>in</strong>ancial obligations of the patient’s health care are<br />
fulfilled as promptly as possible.<br />
5.To follow hospital rules and regulations affect<strong>in</strong>g patient care and conduct.<br />
6. To be considerate of the rights of other patients and hospital personnel,<br />
<strong>in</strong>clud<strong>in</strong>g respect<strong>in</strong>g the property of other patients and Children’s of<br />
Alabama, their right to personal and <strong>in</strong>formational privacy, and to assist <strong>in</strong> the<br />
control of noise, smok<strong>in</strong>g, and the number of visitors. their right to personal<br />
and <strong>in</strong>formational privacy,<br />
Mechanism Of Initiation, Review, and Resolution Of Patient/Parent<br />
Compla<strong>in</strong>ts/Grievances or Concerns<br />
1. Children’s of Alabama has Patient Representatives who are responsible for<br />
the review, and follow-up of all patient compla<strong>in</strong>ts/grievances.<br />
Compla<strong>in</strong>ts/grievances received by the Patient Representative are obta<strong>in</strong>ed<br />
through personal contact with the patient, parent, or legal guardian, or<br />
through letters or survey questionnaires or referrals from hospital or<br />
Medical Staff. The Patient Representative can be reached at 939-9191 or by<br />
request<strong>in</strong>g the Nurs<strong>in</strong>g Supervisor through the hospital’s Switchboard. An<br />
<strong>in</strong>dividual is available 24 hours per day to respond to compla<strong>in</strong>ts/grievances.<br />
In addition to phone or face-to-face contact, compla<strong>in</strong>ts/grievances may be<br />
submitted <strong>in</strong> writ<strong>in</strong>g to: Children’s of Alabama, Patient Relations Department,<br />
16<strong>00</strong> 7 th Avenue South, Birm<strong>in</strong>gham, Alabama 35233.<br />
2. All <strong>in</strong>ternal and external customer compla<strong>in</strong>ts and process problems will be<br />
addressed at the time of the occurrence <strong>in</strong> an effort to resolve the<br />
customer compla<strong>in</strong>t and/or review and improve the process. Grievances<br />
will be responded to <strong>in</strong> writ<strong>in</strong>g with<strong>in</strong> seven days <strong>in</strong> most cases.<br />
3. Compla<strong>in</strong>ts may also be submitted verbally to the Alabama Quality<br />
Assurance Foundation at their toll-free number (8<strong>00</strong>) 760-3540 or <strong>in</strong><br />
writ<strong>in</strong>g to Alabama Quality Assurance Foundation, Suite 2<strong>00</strong> West, Two<br />
4.11
Section: Patient Care<br />
Title: ADM-PC <strong>00</strong> Patient/Parent<br />
Bill of Rights and<br />
Responsibilities<br />
Page 6 of 9<br />
Perimeter Park South, Birm<strong>in</strong>gham, AL 35243 or to the Alabama State<br />
Department of Public Health at their toll-free number (8<strong>00</strong>) 356-9596 or<br />
<strong>in</strong> writ<strong>in</strong>g to Alabama State Department of Public Health, Division of<br />
Health Care Facilities, 201 Monroe Street, Suite 6<strong>00</strong>, Montgomery,<br />
Alabama 36104. Compla<strong>in</strong>ts/Grievances may be submitted to the<br />
Alabama Quality Assurance Foundation and to the Alabama State<br />
Department of Health regardless of whether or not the<br />
compla<strong>in</strong>t/grievance has been reported to the Children’s of Alabama.<br />
Patients are <strong>in</strong>formed of whom to contact with<strong>in</strong> the hospital and are<br />
provided the phone number of the Alabama Quality Assurance<br />
Foundation and the Alabama State Department of Public Health hotl<strong>in</strong>e <strong>in</strong><br />
the <strong>in</strong>formational packet received upon admission. In addition, these<br />
numbers are listed <strong>in</strong> the Patient/Parent Bill of Rights and Responsibilities<br />
<strong>in</strong>formation given upon admission to the Hospital and <strong>in</strong> the Patient<br />
Information Booklet. The Children’s of Alabama website provides access<br />
to the Jo<strong>in</strong>t Commission's Office of Quality Monitor<strong>in</strong>g.<br />
5. The Board of Trustees has delegated the Patient Relations Department as<br />
the coord<strong>in</strong>ator of the compla<strong>in</strong>t and grievance processes. Compla<strong>in</strong>ts<br />
and process problems will be collected and trended by the Patient<br />
Relations Department. Identified trends will be forwarded to the<br />
appropriate Hospital or Medical Staff director for action. If necessary, the<br />
Patient Relations Department may directly refer issues (regardless of<br />
whether they are resolved or unresolved) to the appropriate Adm<strong>in</strong>istrator<br />
or other decision mak<strong>in</strong>g body. Identified <strong>in</strong>dividual trends will be<br />
<strong>in</strong>cluded <strong>in</strong> the employee or physician quality profile.<br />
6. The Grievance Committee shall be comprised of the Manager of Patient<br />
Relations, the Medical Director, the Patient Safety/Risk Management<br />
Officer, and the Director of Performance Improvement. The HIPAA Privacy<br />
Officer and the HIPAA Security Officer will serve on the Committee on an<br />
ad hoc basis if there are any privacy and/or security issues, respectively.<br />
The Grievance Committee has been delegated the responsibility of<br />
review<strong>in</strong>g and resolv<strong>in</strong>g grievances by the Board of Trustees.<br />
Procedure<br />
1. The patient or his/her representative may ask to file a grievance with any<br />
staff member. The staff member will immediately contact the Department<br />
of Patient Relations or House Supervisor (when Patient Relations is<br />
unavailable). The staff member review<strong>in</strong>g the grievance with the grievant<br />
will advise the grievant of the process and time frame for resolution. When<br />
compla<strong>in</strong>ts or grievances are received by the Patient Relations Department,<br />
the Patient Representative will make every effort to obta<strong>in</strong> the full name,<br />
phone number, and address of the compla<strong>in</strong>ant.<br />
A compla<strong>in</strong>ant may file a compla<strong>in</strong>t at the po<strong>in</strong>t of care/service with any<br />
staff member and expect an <strong>in</strong>quiry with the goal of expla<strong>in</strong><strong>in</strong>g the<br />
situation or resolv<strong>in</strong>g the compla<strong>in</strong>t. Any compla<strong>in</strong>ant may request<br />
4.12
Section: Patient Care<br />
Title: ADM-PC <strong>00</strong> Patient/Parent<br />
Bill of Rights and<br />
Responsibilities<br />
Page 7 of 9<br />
assistance from the Patient Representative or his/her designee <strong>in</strong> fil<strong>in</strong>g a<br />
compla<strong>in</strong>t. Compla<strong>in</strong>ts which cannot be resolved at the departmental<br />
level will be referred to the Patient Representative or House Supervisor (if<br />
the Patient Representative is unavailable).<br />
The Patient Representative or other designated staff present will respond<br />
to the patient or his/her designee, <strong>in</strong>dicat<strong>in</strong>g the compla<strong>in</strong>t has been<br />
received. The Patient Representative or other designated staff present<br />
will obta<strong>in</strong> the details from the compla<strong>in</strong>ant. The compla<strong>in</strong>t will be<br />
resolved. If the compla<strong>in</strong>t cannot be resolved at the time of the<br />
compla<strong>in</strong>t by the staff present, it will be treated as a grievance. NOTE:<br />
Those post-care verbal communications regard<strong>in</strong>g patient care that<br />
would rout<strong>in</strong>ely have been managed by staff present if the<br />
communication had occurred dur<strong>in</strong>g the stay/visit are not required to be<br />
def<strong>in</strong>ed as a grievance.<br />
2. The Patient Representative will review the issue identified and determ<strong>in</strong>e if<br />
the compla<strong>in</strong>t should be def<strong>in</strong>ed as a grievance or compla<strong>in</strong>t.<br />
Def<strong>in</strong>itions<br />
Compla<strong>in</strong>t: A verbal expression of dissatisfaction by a Children’s of<br />
Alabama patient, family member, guardian, surrogate<br />
decision maker, or authorized representative about care<br />
and/or services provided by Children’s of Alabama. A<br />
compla<strong>in</strong>t may address dissatisfaction with care, health<br />
services, or other ancillary services (such as park<strong>in</strong>g or<br />
food). Claims of malpractice are not addressed <strong>in</strong> this<br />
process, but <strong>in</strong> a legal forum. A compla<strong>in</strong>t is a situation<br />
that can be resolved by staff present at the time the<br />
compla<strong>in</strong>t is received.<br />
Compla<strong>in</strong>ant: A person who expresses a compla<strong>in</strong>t.<br />
Staff Present: Includes any Children’s of Alabama staff or physician<br />
present at the time of the compla<strong>in</strong>t or who can quickly<br />
be at the patient’s location (i.e. department director,<br />
Patient Relations staff, Nurs<strong>in</strong>g Supervisor, Adm<strong>in</strong>istrator,<br />
etc.) to resolve the patient’s compla<strong>in</strong>t.<br />
Grievance:<br />
A written or verbal compla<strong>in</strong>t (when the verbal compla<strong>in</strong>t is<br />
not resolved at the time of the compla<strong>in</strong>t by staff present)<br />
by a patient, or patient’s representative to any Children’s<br />
of Alabama staff regard<strong>in</strong>g the patient’s care, abuse or<br />
neglect, issues related to the hospital’s compliance with the<br />
CMS Hospital Conditions of Participation, or a Medicare<br />
beneficiary bill<strong>in</strong>g compla<strong>in</strong>t related to patient rights,<br />
Exceptions would be disagreements regard<strong>in</strong>g lost or<br />
4.13
Section: Patient Care<br />
Title: ADM-PC <strong>00</strong> Patient/Parent<br />
Bill of Rights and<br />
Responsibilities<br />
Page 8 of 9<br />
damaged personal property, park<strong>in</strong>g, food, and non-patient<br />
care issues. Examples of grievances <strong>in</strong>clude:<br />
All written letters, e-mails, or faxes from patients or<br />
their representative or any written attachment to a patient<br />
satisfaction survey where the patient’s identify is known.<br />
All compla<strong>in</strong>ts alleg<strong>in</strong>g abuse, neglect, patient harm, or noncompliance<br />
with any CMS requirement,<br />
Any time a patient or his/her representative requests a compla<strong>in</strong>t<br />
be managed as a grievance.<br />
Grievant: Person who files a grievance.<br />
3. If it is determ<strong>in</strong>ed that the patient’s concerns are consistent with the<br />
def<strong>in</strong>ition grievance, the Patient Representative will <strong>in</strong>vestigate, and notify the<br />
Grievance Committee, who has been delegated the responsibility for the<br />
management of the grievance process by the Children’s of Alabama Board of<br />
Trustees, of the results of the <strong>in</strong>vestigation where resolution is not achieved.<br />
The Grievance Committee and or the Patient Representative will determ<strong>in</strong>e a<br />
resolution and will provide the patient or his/her representative with a written<br />
notice of the decision <strong>in</strong> a language and manner that the patient or the<br />
patient’s representative understands. The written notification of the<br />
grievance resolution to the grievant will <strong>in</strong>clude:<br />
a. name of a contact person<br />
b. steps taken on behalf of the patient to <strong>in</strong>vestigate the grievance<br />
c. result of the grievance process<br />
d. date of completion.<br />
All resolutions will be sent to the patient’s address via standard mail. No e-mail<br />
responses will be made even if the grievance is filed via e-mail. However, a<br />
representative of the Grievance Committee may respond via e-mail that a<br />
written response will be forthcom<strong>in</strong>g via standard mail. A copy of all<br />
correspondence will be kept by the Patient Relations Department and the<br />
Grievance Committee, or its designee.<br />
Notification of Rights and Responsibilities to Families:<br />
1. Patients, parents, or the patient’s legal guardian will have access to a written<br />
copy of their rights. A written summary of the patient’s rights and<br />
responsibilities with<strong>in</strong> Children’s of Alabama will be provided to the patient,<br />
parent, or the patient’s legal guardian upon request made to the<br />
4.14
Section: Patient Care<br />
Title: ADM-PC <strong>00</strong> Patient/Parent<br />
Bill of Rights and<br />
Responsibilities<br />
Page 9 of 9<br />
Patient Relations Department. This summary will conta<strong>in</strong> the mechanism by<br />
which patient/parent/legal guardian compla<strong>in</strong>ts/grievances will be<br />
<strong>in</strong>vestigated.<br />
2. The Parent/Patient Bill of Rights and Responsibilities <strong>in</strong>formation and the<br />
Patient Information Handbook conta<strong>in</strong> the rights and responsibilities for<br />
patients.<br />
3. If telephone consent is obta<strong>in</strong>ed, the registration personnel will <strong>in</strong>form the<br />
parent or legal guardian of the Patient/Parent Bill of Rights and<br />
Responsibilities, and the <strong>in</strong>formation will be sent to the nurs<strong>in</strong>g unit.<br />
4. Patient Rights and Responsibilities are posted <strong>in</strong> the admissions areas of<br />
Children’s of Alabama.<br />
5. Patient/parent/legal guardian will be <strong>in</strong>formed of the patient’s HIPAA<br />
privacy rights. Children’s of Alabama will provide a separate privacy notice<br />
to the patient/parent/legal guardian. The privacy notice will expla<strong>in</strong> how<br />
the patient’s confidential patient <strong>in</strong>formation will be used and disclosed.<br />
(Please refer to the Children’s of Alabama HIPAA Privacy Manual).<br />
Date Written Reviewed Revised<br />
9/79 x<br />
2/83 x<br />
1/86 x<br />
7/88 x<br />
9/91 x<br />
9/94 x<br />
5/97 x<br />
11/99 x<br />
11/02 x<br />
12/05 x<br />
6/06 x<br />
1/10 x<br />
4.15
ADMINISTRATIVE POLICY<br />
Page 1 of 1<br />
ADM F-05 Address<strong>in</strong>g Ethical Issues<br />
I. PURPOSE: To outl<strong>in</strong>e the provisions for address<strong>in</strong>g ethical issues <strong>in</strong>volv<strong>in</strong>g patient care<br />
throughout the Children's Health system. For ethical employment or non-patient care<br />
issues, consult the Hospital's Personnel Policies and Procedures.<br />
II.<br />
PROCEDURES: Any Hospital or Medical staff can report an ethical concern or issue via<br />
the medical staffhotl<strong>in</strong>e number 939-9876. Once received the Medical Staff Coord<strong>in</strong>ator<br />
will immediately forward the concern to the Chair of the Ethics Committee. The Chair of<br />
the Ethics Committee will br<strong>in</strong>g the matter to the Ethics Committee. The Chair will<br />
appo<strong>in</strong>t two Ethics Committee members to <strong>in</strong>vestigate and report on the matter at their<br />
next scheduled meet<strong>in</strong>g. The Committee will review and recommend appropriate action.<br />
The Chair may call meet<strong>in</strong>gs with<strong>in</strong> 24 to 48 hours for issues where immediate<br />
consultation is needed or requested.<br />
THE ETHICS COMMITTEE:<br />
The Ethics committee of the Health system will serve <strong>in</strong> the follow<strong>in</strong>g capacity:<br />
The purpose of the Ethics Committee is to consult and advise on the ethical issues of a<br />
cl<strong>in</strong>ical nature <strong>in</strong> specific cases, for education and policy review or to consult and advise<br />
for education and policy review on general ethical issues as the Chair deems appropriate.<br />
The duties of the Committee shall <strong>in</strong>clude:<br />
1. Provid<strong>in</strong>g timely consultative services on request to facilitate the exam<strong>in</strong>ation and<br />
where possible the resolution of specific or general cl<strong>in</strong>ical ethical issues by the<br />
pr<strong>in</strong>cipal <strong>in</strong>volved (who might <strong>in</strong>clude the medical and nurs<strong>in</strong>g staff as well as the<br />
patient, family members or their representative).<br />
2. To determ<strong>in</strong>e the need for an Ethics Committee review.<br />
3. To provide education as <strong>in</strong>dicated.<br />
4. To review and recommend revision of policies or new policies which address<br />
ethical issues.<br />
5. To communicate policy/procedure changes which occur as a result of the<br />
Committee's activities to all personnel through established channels.<br />
6. To communicate the consensus of Ethics Review and the reasons for its<br />
conclusions to the referr<strong>in</strong>g party.<br />
7. Report all matters com<strong>in</strong>g before it to the Medical Executive Committee.<br />
Should a committee need to be called, the Medical Staff office (939-9433) will assist the Chair<br />
of the Ethics Committee <strong>in</strong> mak<strong>in</strong>g arrangements for the meet<strong>in</strong>g.<br />
Written:<br />
Revised:<br />
Revised:<br />
December 1994<br />
May, 1997<br />
May, 2<strong>00</strong>0 - Approved by Medical Executive Committee - May 30, 2<strong>00</strong>0<br />
February,2<strong>00</strong>3<br />
©Children's of Alabama 2012<br />
4.16
GU<strong>ID</strong>ELINES FOR COMPLETING QUALITY<br />
ASSURANCE REPORTS<br />
I. Def<strong>in</strong>ition of an Incident<br />
An <strong>in</strong>cident can be def<strong>in</strong>ed as any happen<strong>in</strong>g which is not consistent with the rout<strong>in</strong>e care of a<br />
patient or normal operation of the hospital or department. Injury does not have to occur. The<br />
potential for <strong>in</strong>jury and/or property damage is sufficient for an occurrence to be considered an<br />
<strong>in</strong>cident.<br />
II.<br />
Purpose of Report<strong>in</strong>g Incidents<br />
The Quality Assurance Report is the primary tool for collect<strong>in</strong>g data about an <strong>in</strong>cident, analyz<strong>in</strong>g<br />
the data, and translat<strong>in</strong>g the <strong>in</strong>formation <strong>in</strong>to a strategy for change.<br />
Quality Assurance Reports are used to:<br />
• Identify occurrences that <strong>in</strong>jure or have the potential to <strong>in</strong>jure patients or visitors<br />
• Develop corrective action and implement changes aimed at improv<strong>in</strong>g or modify<strong>in</strong>g the system<br />
to prevent or reduce further similar occurrences<br />
• Provide a record of the <strong>in</strong>cident and to document the facts<br />
• Alert Risk Management to a possible claim situation and to respond immediately for complete<br />
<strong>in</strong>vestigation and documentation<br />
III. Examples of Reportable Events<br />
• Adverse/unexpected result from treatment or procedure<br />
• An <strong>in</strong>jury<br />
• Patient dissatisfaction<br />
• Foreign body left <strong>in</strong> patient<br />
• Accidental burns<br />
• IV complications -<strong>in</strong>filtrations<br />
• Medication errors<br />
• Severe drug reactions<br />
• Unexpected death<br />
• Falls<br />
• Consent-related issues -procedure done without consent, consent for wrong procedure,<br />
<strong>in</strong>adequate consent<br />
• Equipment- malfunction, failure, <strong>in</strong>jury, burn, not available<br />
• Treatment/Test errors -specimen lost, specimen mislabeled, results for wrong patient, delayed<br />
results, wrong results, unplanned repeat of diagnostic procedure, omitted test<br />
• Unordered treatment -unordered medication, blood, x-ray, etc.<br />
• Cardio-pulmonary arrest<br />
• <strong>Sign</strong>ed out <strong>AM</strong>A<br />
• Unplanned return to surgery<br />
• Unplanned transfer to <strong>in</strong>tensive care unit<br />
• Re-<strong>in</strong>tubation<br />
• Breach of policy/procedure that has potential to cause <strong>in</strong>jury<br />
• Hospital-acquired <strong>in</strong>fections<br />
©Children’s of Alabama 2012<br />
4.17
IV.<br />
Facts to Consider Regard<strong>in</strong>g Quality Assurance Reports<br />
• The Quality Assurance Report should be completed by the <strong>in</strong>dividual who discovered the<br />
<strong>in</strong>cident or who has the best knowledge of the <strong>in</strong>cident.<br />
• The Quality Assurance Report should be completed immediately after the <strong>in</strong>cident is discovered<br />
and forwarded to the Risk Management Department with<strong>in</strong> 24 hours. The longer the wait before<br />
report completion, the less clear the facts will be.<br />
• Document known relevant facts on the reports. Be concise and objective. Do not criticize or<br />
place blame.<br />
• Do not file or reference the Quality Assurance Report <strong>in</strong> the medical record. The medical record<br />
should document only the occurrence, with NO reference that a Quality Assurance Report was<br />
completed.<br />
• Quality Assurance Reports are CONF<strong>ID</strong>ENTIAL and should not be freely discussed with<strong>in</strong> the<br />
Hospital.<br />
• NO COPIES of the Quality Assurance Report should be made for any reason.<br />
Examples of Reportable Occurrences for Operat<strong>in</strong>g Room<br />
1. Incorrect sponge, <strong>in</strong>strument or needle count<br />
2. Break <strong>in</strong> sk<strong>in</strong> <strong>in</strong>tegrity<br />
3. Intubation/extubation <strong>in</strong>jury (i.e. tooth dislodged, aspiration)<br />
4. Postoperative nerve damage or neurological deficit<br />
5. Instrument breakage dur<strong>in</strong>g surgery<br />
6. Wrong patient operated on<br />
7. Wrong surgical procedure performed<br />
8. No written or improper consent for surgical procedures<br />
9. Unplanned removal or repair of an organ or body part (Nicked an organ or vessel requir<strong>in</strong>g<br />
additional OR time or results <strong>in</strong> patient <strong>in</strong>jury)<br />
10. Patient <strong>in</strong>jured dur<strong>in</strong>g transfer to/from the OR or Day surgery<br />
11. Equipment malfunction caus<strong>in</strong>g term<strong>in</strong>ation/cancellation of procedure or patient <strong>in</strong>jury<br />
12. Contam<strong>in</strong>ation of sterile field<br />
13. Death <strong>in</strong> OR<br />
14. Medication/transfusion error<br />
15. IV <strong>in</strong>filtration result<strong>in</strong>g <strong>in</strong> tissue damage<br />
16. Life threaten<strong>in</strong>g complication of anesthesia<br />
17. Unplanned return to OR or unplanned postoperative admit to ICU<br />
18. Specimen lost or <strong>in</strong>correctly labeled<br />
19. Reta<strong>in</strong>ed <strong>in</strong>strument, sponge, needle, etc.<br />
©Children’s of Alabama 2012<br />
4.18
Examples of Reportable Occurrences for Intensive Care Units<br />
1. Unexpected death <strong>in</strong> ICU<br />
2. ICU <strong>in</strong>curred trauma (e.g. falls, burns, procedure complications)<br />
3. ICU equipment malfunction or misutilization<br />
4. Medication/transfusion error<br />
5. Patient <strong>in</strong>jured dur<strong>in</strong>g transfer to/from ICU<br />
6. Readmit to ICU with<strong>in</strong> 48 hours of transferr<strong>in</strong>g to floor<br />
7. Transfer to ICU with<strong>in</strong> 24 hours of admission to floor<br />
8. IV <strong>in</strong>filtration result<strong>in</strong>g <strong>in</strong> tissue damage<br />
9. Hospital acquired <strong>in</strong>fection<br />
10. Patient / visitor falls result<strong>in</strong>g <strong>in</strong> <strong>in</strong>jury<br />
11. Patient <strong>in</strong>jury due to :<br />
a. ) untimely response by MD/RN<br />
b. ) failure to carry out MD order appropriately or <strong>in</strong> a timely manner<br />
c. ) poor response by ancillary service<br />
d.) complication of procedure (to <strong>in</strong>clude postoperative complications)<br />
12. Patient <strong>in</strong>jury due to transcription error (i.e. delays, missed, etc.)<br />
Examples of Reportable Occurrences for Emergency Department<br />
1. Return to the Emergency Department with<strong>in</strong> 7 days after discharge or prior visit<br />
2. Patient <strong>in</strong>jured due to complication of procedure dur<strong>in</strong>g Emergency Department treatment,<br />
<strong>in</strong>clud<strong>in</strong>g cardiac/respiratory arrest<br />
3. Death <strong>in</strong> Emergency Department designated as "Coroner's Case"<br />
4. Patient / visitor fall result<strong>in</strong>g <strong>in</strong> <strong>in</strong>jury<br />
5. Patient discharged with altered conscious/neurological deficit<br />
6. Unexpected diagnostic results returned to Emergency Department after patient discharged<br />
7. Medication/transfusion error <strong>in</strong> Emergency Department<br />
8. No written or improper consent for treatment<br />
9. Misidentification of patient result<strong>in</strong>g <strong>in</strong> unnecessary treatment procedure<br />
10. Triage occurr<strong>in</strong>g greater than 30 m<strong>in</strong>utes from the time of arrival <strong>in</strong> Emergency Department<br />
Examples of Reportable Occurrences for Outpatient Cl<strong>in</strong>ics<br />
1. Patient <strong>in</strong>jury due to complication of procedure or (a) missed, <strong>in</strong>accurate or untimely diagnosis<br />
result<strong>in</strong>g <strong>in</strong> delay of treatment or lack of treatment (b) Failure to carry out MD order appropriately or<br />
<strong>in</strong> a timely fashion (c) Medication error and/or allergic reaction<br />
2. Patient / visitor falls<br />
3. No written or improper consent for procedure<br />
4. Failure to report suspected child abuse<br />
5. Break <strong>in</strong> confidentiality<br />
6. Cardiac arrest or death<br />
7. Failure to delay <strong>in</strong> abnormal Jab follow-up or <strong>in</strong>ability to follow-up<br />
8. Patients who express or who are suspected of be<strong>in</strong>g dissatisfied with care or who express litigious<br />
concerns<br />
9. Medication error<br />
10. IV <strong>in</strong>filtration with tissue damage<br />
©Children’s of Alabama 2012<br />
4.19
Section 5
Basic Life Support Recertification<br />
On Tuesday of Orientation, Nurs<strong>in</strong>g Education and Research Department offers Basic Life Support (BLS)<br />
Recertification for the New Hired Nurses. Any Nurse with a BLS card that is go<strong>in</strong>g to expire with<strong>in</strong> the<br />
next three months should attend. At Children’s of Alabama Nurses that perform at the bedside have to<br />
have a current BLS card to practice.<br />
The class will be held <strong>in</strong> the Nurs<strong>in</strong>g Education and Research Department Classroom located on the fourth<br />
floor of the Harbor Build<strong>in</strong>g <strong>in</strong> suite 410 at approximately 3:15 PM after the Restra<strong>in</strong>ts and Seclusion<br />
Class.<br />
The American Hearth Association Guidel<strong>in</strong>es are used when teach<strong>in</strong>g BLS Classes at Children’s of Alabama.<br />
If you are plann<strong>in</strong>g on renew<strong>in</strong>g your BLS, BLS Healthcare Provider student manuals are available for<br />
check out <strong>in</strong> Nurs<strong>in</strong>g Education and Research for review before the class.<br />
If you have any questions you can stop by or call 939.9127.<br />
Welcome to Children’s of Alabama<br />
©Children’s of Alabama 2012<br />
5.1
CHILDREN'S DEPARTMENT LOCATIONS<br />
Ground Floor<br />
1st Floor<br />
2nd Floor<br />
3rd Floor<br />
4th Floor<br />
5th Floor<br />
6th Floor<br />
7th Floor<br />
Emergency Department<br />
Pharmacy<br />
Central Supply<br />
Lactation Center<br />
Lobby<br />
Gift Shop<br />
Specialty Cl<strong>in</strong>ics<br />
Comprehensive Health Education Center for Kids-(CHECK)<br />
Child Safety Institute<br />
One-Day Surgery (ODAC)<br />
Operat<strong>in</strong>g Room (OR)<br />
Post-Anesthesia Care Unit<br />
Pediatric Imag<strong>in</strong>g<br />
Lab<br />
Dialysis<br />
Burn Unit (BU)<br />
Pediatric Intensive Care Unit (PICU)<br />
Special Care Unit (SCU)<br />
Respiratory Care Department (3E)<br />
Med/Surg (4SE)<br />
Hematology/Oncology (4T)<br />
Orthopedics/Rehab (4W)<br />
Infant-Toddler Unit (ITU/4E)<br />
Child Psych Unit (5E)<br />
Adolescent Psych (5W)<br />
Pulmonary Care Unit (PCU/5T)<br />
Adolescent & Young Adult Unit (5SE)<br />
Med/Surg (5NW)<br />
Stem Cell Transplant Unit Surgical<br />
Unit Post-Op (6NW) Neonatal<br />
Intensive Care Unit (NICU)<br />
Med/Surg/Renal (7NW)<br />
To reach your <strong>in</strong>structor, dial operator and request an overhead<br />
page to your unit's extension.<br />
©Children’s of Alabama 2012<br />
5.2
ADMINISTRATIVE POLICY<br />
Page 1 of 5<br />
ADM - 11 Patient Self Determ<strong>in</strong>ation Act (Advance Directives)<br />
I. PURPOSE: These procedures are <strong>in</strong>tended to enable Children’s of Alabama to<br />
comply with the Patient Self Determ<strong>in</strong>ation Act (PSDA), as required by the Omnibus<br />
Budget Reconciliation Act of 1990. The purpose of the PSDA is to protect all adult<br />
<strong>in</strong>patient's right to participate <strong>in</strong> healthcare decision-mak<strong>in</strong>g to the maximum extent of<br />
their ability and to prevent discrim<strong>in</strong>ation based on whether or not patients have executed<br />
advance healthcare directives.<br />
II.<br />
III.<br />
POLICY: The health system supports an adult <strong>in</strong>patient’s right to actively participate <strong>in</strong><br />
the health decision-mak<strong>in</strong>g process. Through education and <strong>in</strong>quiry about the existence<br />
of an advance directive, this health system will support adult patients as they<br />
communicate their wishes. These decisions by the adult patient will enable healthcare<br />
providers, family, and friends to know what the adult patient's wishes are and what they<br />
would be if they were to become <strong>in</strong>capacitated or otherwise unable to communicate those<br />
wishes.<br />
PROCEDURE:<br />
ADULT INPATIENTS<br />
A. Children’s of Alabama shall provide each adult <strong>in</strong>patient (19 years of age or<br />
older or 18 years of age if married, divorced, or widowed) with a summary of<br />
his/her rights as required by the PSDA. As part of the admission process, each<br />
competent adult <strong>in</strong>patient shall be provi ded a written statement outl<strong>in</strong><strong>in</strong>g his/her<br />
rights, under Alabam a law, to participate <strong>in</strong> the healthcare decision-mak<strong>in</strong>g<br />
process. This shall <strong>in</strong>clude: the right to accept or refuse medical or surgical<br />
treatment, <strong>in</strong>clud<strong>in</strong>g life-susta<strong>in</strong><strong>in</strong>g treatment; the right to m ake a liv<strong>in</strong>g will; the<br />
use of a durable power of attorney to designate a surrogate decision m aker for<br />
specific healthcare decisions. This statement shall also advise the adult patient of<br />
his/her right to forego any advance directive. Further, it shall state that the<br />
patient's decisions regard<strong>in</strong>g whether or not to have an advance directive will <strong>in</strong><br />
no way af fect the level or <strong>in</strong>tensity of services he/she will receive, except as<br />
directed by an advance directive. The patient shall also be provided with "A<br />
Summary of the law <strong>in</strong> Alabama" as published by Medicaid, (supp. 9/30/94,<br />
chapter 560-X-28).<br />
B. Provide each adult <strong>in</strong>patient with a summary of the health system's policies and<br />
procedure deal<strong>in</strong>g with advance directives, as required by the PSDA. The written<br />
statement referred to <strong>in</strong> A (above) should <strong>in</strong>clude any pert<strong>in</strong>ent <strong>in</strong>formation about<br />
specified health system policy and procedures regard<strong>in</strong>g advance directives. This<br />
would <strong>in</strong>clude, but would not be limited to:<br />
5.3
ADM - 11 Patient Self Determ<strong>in</strong>ation Act (Advance Directives) Page 2 of 5<br />
1. the right of the health system to make reasonable <strong>in</strong>quiries relative to any<br />
liv<strong>in</strong>g will or durable power of attorney presented by or on behalf of any<br />
adult <strong>in</strong>patient;<br />
2. the right of the health system, pursuant to Alabama law, to reject an<br />
offered liv<strong>in</strong>g will or durable power of attorney if it is not <strong>in</strong> substantial or<br />
specific compliance with Alabama law as the law may dictate;<br />
3. the fact that the health system will make available liv<strong>in</strong>g will forms, but<br />
cannot provide witnesses for the execution of same;<br />
4. the fact that the health system is not able to provide the adult <strong>in</strong>patient<br />
with legal assistance regard<strong>in</strong>g the preparation of an advance directive or<br />
to suggest the name of an attorney to do so;<br />
5. the fact that if the adult <strong>in</strong>patient has an advance directive, he/she should<br />
present it at time of admission (or as soon as possible thereafter) for<br />
<strong>in</strong>clusion <strong>in</strong> the patient's medical record; and<br />
6. a summary of health system policy honor<strong>in</strong>g advance directives and on<br />
objections of conscience.<br />
C. Admission Registration personnel will <strong>in</strong>quire about the existence of advance<br />
directives. All adult <strong>in</strong>patients must complete the “Advance Directive<br />
Information” on the Admission Consent form MRD #<strong>00</strong>40B.<br />
1. The completed “Advance Directive Information” form shall be<br />
immediately faxed to Social Services (6074) and the Risk Management<br />
Department (2468). The Advance Directive Information form will then be<br />
placed <strong>in</strong> the patient’s medical record.<br />
2. IF THE ADULT INPATIENT HAS AN ADVANCE DIRECTIVE:<br />
Admission personnel must request a copy of the Advance Directive. A<br />
copy must be placed <strong>in</strong> the patient’s medical record at that time. A sticker<br />
denot<strong>in</strong>g that the patient has an advance directive must be placed with the<br />
admission packet to be placed on the b<strong>in</strong>der conta<strong>in</strong><strong>in</strong>g the medical record.<br />
3. The Risk Manager will review the document to ensure that the directive<br />
was properly executed and substantially <strong>in</strong> compliance with Alabama law.<br />
4. ADULT INPATIENT HAS ADVANCE DIRECTIVE AND ADULT<br />
INPATIENT HAS PROV<strong>ID</strong>ED COPY ON A PREVIOUS<br />
ADMISSION: If the adult <strong>in</strong>patient <strong>in</strong>dicates that an advance directive<br />
has been provided on a previous admission, Social Services shall contact<br />
Medical Information Services (MIS) to determ<strong>in</strong>e if a copy is on file. If<br />
5.4
ADM - 11 Patient Self Determ<strong>in</strong>ation Act (Advance Directives) Page 3 of 5<br />
no copy is on file <strong>in</strong> the medical record one will need to be obta<strong>in</strong>ed. If a<br />
copy is available, an <strong>in</strong>quiry of the adult <strong>in</strong>patient should be made to<br />
determ<strong>in</strong>e if the directive is still valid. If the adult <strong>in</strong>patient is <strong>in</strong>capable<br />
of respond<strong>in</strong>g to such an <strong>in</strong>quiry (emergency, <strong>in</strong>capacity, or otherwise),<br />
then the prior declaration shall be deemed valid and controll<strong>in</strong>g unless the<br />
health system is specifically notified that the advance directive has been<br />
revoked. The advance directive should be placed <strong>in</strong> the current admission<br />
record.<br />
5. ADULT INPATIENT HAS ADVANCE DIRECTIVE BUT A COPY<br />
IS NOT AVAILABLE: Registration personnel shall notify the treat<strong>in</strong>g<br />
physician, who should speak with the adult <strong>in</strong>patient regard<strong>in</strong>g their<br />
wishes. These wishes should be witnessed and documented <strong>in</strong> the adult<br />
<strong>in</strong>patient’s medical record.<br />
6. The adult <strong>in</strong>patient has the right to, and may at any po<strong>in</strong>t, make<br />
clarifications, modifications, or revocations to the advance directive.<br />
These revisions must be documented <strong>in</strong> the medical record and the adult<br />
<strong>in</strong>patient’s physician should be <strong>in</strong>formed.<br />
7. NO ADVANCE DIRECTIVE: Should the adult <strong>in</strong>patient not have an<br />
advance directive but wish more <strong>in</strong>formation, then the person receiv<strong>in</strong>g<br />
this request shall contact Social Services, the chapla<strong>in</strong>s, or the adult<br />
<strong>in</strong>patient representative to respond to basic questions regard<strong>in</strong>g advance<br />
directives.<br />
D. If an adult <strong>in</strong>patient is <strong>in</strong>capacitated at the time of admission and is unable to<br />
receive <strong>in</strong>formation (due to the <strong>in</strong>capacitat<strong>in</strong>g condition or a mental disorder) or<br />
articulate whether the adult <strong>in</strong>patient has an advance medical directive, the<br />
registration personnel shall give the <strong>in</strong>formation to the family and <strong>in</strong>quire of them<br />
as to whether the adult <strong>in</strong>patient has an advance medical directive. The<br />
procedures above should be followed. If dur<strong>in</strong>g the admission, the treat<strong>in</strong>g<br />
physician determ<strong>in</strong>es that the adult <strong>in</strong>patient is capable of receiv<strong>in</strong>g the<br />
<strong>in</strong>formation, Social Services should provide the <strong>in</strong>formation to the adult <strong>in</strong>patient<br />
promptly and document <strong>in</strong> the medical record that the adult <strong>in</strong>patient has received<br />
the <strong>in</strong>formation. Social Services should also ask the adult <strong>in</strong>patient if he or she<br />
has an advance medical directive or, if one has been provided by the family,<br />
whether the adult <strong>in</strong>patient wants it to be honored. The response should be<br />
documented <strong>in</strong> the medical record. If the adult <strong>in</strong>patient revokes the advance<br />
directive, Social Services should notify the treat<strong>in</strong>g physician and Risk<br />
Management immediately.<br />
OUTPATIENT (ED, <strong>AM</strong>BULATORY CARE CLINICS, PEDIATRIC<br />
PRACTICES, CHILDREN’S SOUTH)<br />
5.5
ADM - 11 Patient Self Determ<strong>in</strong>ation Act (Advance Directives) Page 4 of 5<br />
E. No <strong>in</strong>quiries as to the existence of an advance directive will be made to adult<br />
outpatients. However, if an adult outpatient <strong>in</strong>forms Children’s of Alabama<br />
personnel of the existence of an advance directive the follow<strong>in</strong>g procedure will<br />
apply:<br />
1. Notify the patient’s physician.<br />
2. Fax a copy of the advance directive to Risk Management (2468)<br />
3. Place the directive <strong>in</strong> the patient’s medical record.<br />
4. If the adult outpatient does not have a copy of the directive, ask them to<br />
br<strong>in</strong>g a copy on their next visit.<br />
F. Provid<strong>in</strong>g <strong>in</strong>formation/assistance relative to advance directives.<br />
1. INPATIENTS: The health system may only provide <strong>in</strong>formation relative to<br />
the basic operation of the various advance directive methods and is neither<br />
required nor <strong>in</strong> a position to advise adult <strong>in</strong>patient and/or their families as to<br />
which methods to use.<br />
a. Registration personnel will provide each adult <strong>in</strong>patient with<br />
“Mak<strong>in</strong>g Decisions” which conta<strong>in</strong>s “A summary of Alabama<br />
Law” published by Medicaid.<br />
b. Health system employees will answer medical term<strong>in</strong>ology and<br />
health system policy questions only.<br />
c. Health system employees shall not witness or assist <strong>in</strong> complet<strong>in</strong>g<br />
a written advance directive.<br />
2. OUTPATIENTS: Should an <strong>in</strong>quiry be made by the adult outpatient for<br />
<strong>in</strong>formation regard<strong>in</strong>g advance directives, the staff should refer the adult<br />
outpatient to Social Services, Patient Relations, or Pastoral Care who will<br />
provide <strong>in</strong>formation as <strong>in</strong> number F.1.<br />
G. Staff Education. Educational <strong>in</strong>formation about advance directives and the health<br />
system's policies and procedures regard<strong>in</strong>g advance directives will be provided to<br />
the medical and nurs<strong>in</strong>g staffs, allied health professional, and other health system<br />
staff and volunteers. Staff education will be ongo<strong>in</strong>g, <strong>in</strong>cluded <strong>in</strong> the health<br />
system's employee orientation, and performed on an annual basis.<br />
H. Community Education. In order to educate the community served by Children’s<br />
of Alabama about advance directives, education will be provided through<br />
community forums or through distribution or post<strong>in</strong>g of written materials<br />
regard<strong>in</strong>g advance directives.<br />
Written materials will, at a m<strong>in</strong>imum, def<strong>in</strong>e what constitutes an advance<br />
directive (emphasiz<strong>in</strong>g that an advance directive is designed to enhance an<br />
<strong>in</strong>capacitated <strong>in</strong>dividual's control over medical treatment) and describe applicable<br />
State law concern<strong>in</strong>g advance directives.<br />
5.6
ADM - 11 Patient Self Determ<strong>in</strong>ation Act (Advance Directives) Page 5 of 5<br />
IV.<br />
Policy Regard<strong>in</strong>g Implementation of Advance Directives.<br />
A. Children’s of Alabama will honor a Liv<strong>in</strong>g Will that requires withdrawal or<br />
withhold<strong>in</strong>g of life-susta<strong>in</strong><strong>in</strong>g treatment after determ<strong>in</strong>ation has been made that<br />
the Liv<strong>in</strong>g Will is properly executed and is substantially <strong>in</strong> compliance with<br />
Alabama Law. (Refer to "No Extraord<strong>in</strong>ary Treatment Order” policy (ADM H-<br />
01) for procedures to implement the Liv<strong>in</strong>g Will).<br />
B. Children’s of Alabama will honor a Durable Power of Attorney only upon the<br />
advice of Children’s Legal Counsel or pursuant to a court order.<br />
C. Alabama's Natural Death Act permits providers to refuse to im plement a liv<strong>in</strong>g<br />
will on the basis of conscience and requires the physician to transfer the patient to<br />
a provider who will implement it. An <strong>in</strong>dividual physician at Children’s of<br />
Alabama may refuse to withhold or withdraw life-susta<strong>in</strong><strong>in</strong>g treatment on the<br />
basis of conscience. The physician must promptly <strong>in</strong>form the patient and<br />
transfer the patient to another provider who will honor the directive. If the<br />
transfer is to another facility, health system personnel will assist <strong>in</strong> the transfer as<br />
necessary. Risk Management must be notified immediately by the physician if the<br />
physician objects to implement<strong>in</strong>g the directive on the basis of conscience.<br />
D. No patient at this health system shall be discrim<strong>in</strong>ated aga<strong>in</strong>st because of his or her<br />
decision regard<strong>in</strong>g an advance directive.<br />
Written: November, 1991<br />
Effective: December 1, 1991<br />
Reviewed: September, 1994<br />
Revised: August, 1995<br />
Revised: July, 1997<br />
Reviewed: December, 1999<br />
Revised: August, 2<strong>00</strong>1<br />
Revised: February, 2<strong>00</strong>3<br />
Revised: September, 2<strong>00</strong>6<br />
5.7
Tak<strong>in</strong>g Computer<br />
Based Tra<strong>in</strong><strong>in</strong>g (CBT’s)<br />
at Children’s of<br />
Alabama<br />
Logg<strong>in</strong>g In<br />
• Double Click the Internet Explorer Icon<br />
from any Children’s PC –<br />
• This will take you to the Children’s<br />
Intranet<br />
5.8 8
Logg<strong>in</strong>g In<br />
• From the Intranet Click on Education, then<br />
click on CHEX<br />
Logg<strong>in</strong>g In<br />
• This is the CHEX Log<strong>in</strong> Screen<br />
5.9
Logg<strong>in</strong>g In<br />
• Your Log <strong>in</strong> Name is C<br />
• Your <strong>in</strong>itial password is your Last Name<br />
Welcome to CHEX!<br />
5.10
Click the Green “Go!” Button<br />
to See Your To Do List<br />
New Employee To Do List<br />
5.11
New Hire Curriculum<br />
Launch<strong>in</strong>g a Course<br />
5.12
Notes
NOTES
NOTES
NOTES
NOTES
NOTES