This policy protects three categories of individuals with disabilities:

POLICY: Jackson Health System (JHS) s committed to the philosophy and policies of Title II of the Americans with Disabilities Act (ADA) which prohibits discrimination against any qualified individual with a disability in employment, public services, public accommodations, state and local government, and telecommunications. Employees of Jackson Health System shall not discriminate against a qualified individual with a disability because of the disability of such individual in regard to job application procedures, the hiring, advancement, or discharge of employees, employee compensation, job training, and other terms, conditions, and privileges of employment. This policy protects three categories of individuals with disabilities: 1. Individuals who have a physical or mental impairment that substantially limits one or more major life activity or activities; 2. Individuals who have a record of a physical or mental impairment that substantially limits one or more of the individual s major life activities; and 3. Individuals who are regarded as having such an impairment, whether they have the impairment or not. Individuals with a permanent physical or mental disability who have reached Maximum Medical Improvement (MMI) may be covered by this policy. The following are examples of commonly disabling impairments: substantial orthopedic, visual, speech, hearing impairments, tuberculosis, epilepsy, HIV infection, AIDS, cerebral palsy, muscular dystrophy, heart disease, cancer, mental retardation, organic brain syndrome, mental illness, and specific learning problems. This policy usually does not apply to individuals with temporary, non-chronic impairments because they are of short duration with little or no long-term permanent impact. The following are examples of temporary impairments: broken limbs, sprained joints, concussions, appendicitis, normal pregnancy, colds, flu, etc. TERMINOLOGY Reasonable Accommodation Committee (RAC): The RAC reviews and makes recommendations when: (1) an accommodation cannot be provided at the department or division level or, (2) whenever a manager needs assistance in making an accommodation. The committee is composed of (but not limited to) representatives from Human Resources Capital Management (HRCM), Occupational DATE: 7/30/08 PAGE 1 OF 10

Health Services (OHS), and the Director of the affected department. Legal counsel is provided by the Miami-Dade County Attorney s office. Physical or Mental Impairment The phrase physical or mental impairment can include: (1) Any physiological disorder, or condition, cosmetic disfigurement, or anatomical loss affecting one or more of the following body systems: neurological, musculoskeletal, special sense organs, respiratory (including speech organs), cardiovascular, reproductive, digestive, genito-urinary, hematologic and lymphatic, skin and endocrine; or (2) Any mental or psychological disorder, such as mental retardation, organic brain syndrome, emotional or mental illness, and specific learning disabilities. Substantially Limiting Impairment An impairment, in and of itself, does not necessarily constitute a disability. The impairment must substantially limit one or more of the individual s major life activities on the job and off the job in order to fit within the first definition of disability. Major Life Activities Major life activities are those basic activities that the average person in the general population can perform with little or no difficulty. The term includes, but is not limited to, caring for oneself, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, working, sitting, standing, lifting, and reaching. An individual is not substantially limited if he or she is merely restricted from performing on the job. Qualified Individual with a Disability (QUID) The ADA protects a qualified individual with a disability (i.e. an individual who, with or without reasonable accommodation, can perform the essential functions of his or her employment position and has the required skills, experience, and education required for the position the individual holds or is applying for.) Essential Functions Essential functions are the basic duties that an employee must be able to perform, with or without reasonable accommodation. The term essential functions does not include the marginal functions of a position. If an employee cannot perform the essential functions of the job with or without reasonable accommodation, then the employee is not a qualified individual with a disability under the ADA. DATE: 7/30/08 PAGE 2 OF 10

Direct Threat Direct threat is defined as a significant risk of substantial harm to the health or safety of the individual or others that cannot be eliminated or reduced by reasonable accommodation. This Direct Threat determination must be based upon an individualized assessment by the RAC of the individual s present ability to safely perform the essential functions of the job. Reasonable Accommodation Reasonable Accommodation is any change or adjustment to a job or work environment that permits a qualified applicant or employee with a disability to participate in the job application process, to perform the essential functions of a job, and to enjoy benefits and privileges of employment equal to those enjoyed by employees without disabilities. Whether an accommodation is reasonable requires a determination of whether the accommodation would (1) be effective, i.e., would address the job-related difficulties presented by the employee s disability, and (2) allow the employee to attain level of achievement, opportunity and participation equal to that which a non-disabled individual in the same position would be able to achieve. A reasonable accommodation can include, but is not limited to, the following possible actions: acquiring or modifying equipment or devices; job restructuring; part-time or modified work schedules; reassignment to a vacant position; adjusting or modifying examinations, leave of absence, training materials, and policies; and making the workplace readily accessible to and usable by individuals with disabilities. The Equal Employment Opportunity Commission (EEOC) has suggested the following process when an employee requests an accommodation: 1. Analyze the particular job in question and determine its purpose and essential functions. 2. Consult the individual with the disability to ascertain the precise jobrelated limitations imposed by the disability and how those limitations could be overcome with a reasonable accommodation. 3. In consultation with the individual to be accommodated, identify potential accommodations and assess the effectiveness each would have in enabling the individual to perform the essential functions of the position. 4. Consider the preference of the individual to be accommodated and select and implement the accommodation that is most appropriate for both the employee and employer. Undue Hardship DATE: 7/30/08 PAGE 3 OF 10

Undue hardship means that an accommodation would be unduly costly, extensive, substantial or disruptive, or would fundamentally alter the nature or operation of the business. If a particular accommodation would constitute an undue hardship, an employer must try to find another accommodation that will not pose such a hardship. If cost causes the undue hardship, the employer must also consider whether funding for an accommodation is available from an outside source, such as a vocational rehabilitation agency, and if the cost of providing the accommodation can be offset by state or federal tax credits or deductions. The employer must also give the applicant or employee with the disability the opportunity to provide the accommodation or pay for the portion of the accommodation that constitutes an undue hardship. Medical Examinations A medical examination is a procedure or test that seeks information about an individual s physical or mental impairment or health. Medical Records All medical records shall be kept confidential and cannot be released without a court order or the applicant s/employee s permission. However, Job Search 1. Supervisors and managers may be informed about necessary work restrictions/accommodations of persons with disabilities. 2. The Reasonable Accommodations Committee and Occupational Health Services may request additional medical examinations as necessary to clarify the Reasonable Accommodation request and/or disability. 3. OHS and safety personnel may be informed if the condition might require emergency treatment, or if any specific procedures are needed in the case of fire or other evacuations. 4. Government officials investigating compliance with the Rehabilitation Act of 1973 and Americans with Disabilities Act of 1990 shall be provided relevant information upon request. A 120-day period granted to a qualified individual with a disability and to a disabled employee who cannot perform the essential functions of their assigned position with or without an accommodation. This period will be used by the employee to locate a suitable position within or outside the PHT. The Talent Acquisition Services Office will assist qualified individuals with a disability to find a suitable position within JHS. Talent Acquisition will assist with locating suitable positions, identifying training/educational DATE: 7/30/08 PAGE 4 OF 10

needs and counseling on proper interviewing techniques. During this period, employees are encouraged to seek assistance from the Employee Work Life Services department, Vocational Development, and external educational institutions and government agencies as needed. Employees on a job search should contact the Chairperson, RAC to resolve problems and issues that occur during the job search period. All employees who are unable to locate a suitable position upon completion of the 120 day job search period will be recommended for termination by RAC. This recommendation will be sent to the employee s department head for review and appropriate action. Maximum Medical Improvement (MMI) Maximum Medical Improvement or MMI refers to a permanent medical condition in which no further improvement is expected. It must be medically determined, by the sick or injured employee s physician, that this condition has been attained. PROCEDURES: 1. The Reasonable Accommodation Request Form shall be available in the Occupational Health Services Office, Leave Management Office, Talent Acquisition Services (Recruitment) Office, Employee Work Life Services Office and Satellite Administrative offices. Notices regarding availability of Reasonable Accommodation will also be posted in those offices. A. Individuals with disabilities may complete and submit a Reasonable Accommodation Request Form to their immediate supervisor. B. Job applicants with disabilities are responsible for completing the Reasonable Accommodation Request Form and submitting it to the Talent Acquisition Services office. A job description, including job functions, shall be reviewed with each applicant before an offer is extended. C. If the employee or applicant is unable or declines to submit a written request, a written Reasonable Accommodation Request Form may be submitted on behalf of the disabled individual by the supervisor, recruiter, co-worker, spouse, family member, friend, pastor, or physician. The Reasonable Accommodation Request Form will be submitted to the supervisor of the employee and to Talent Acquisition Services for applicants or employees applying for a new position or reassignment. 2. Supervisors, OHS and recruiters will send all Reasonable Accommodation Request Forms to the RAC prior to providing an accommodation. A copy of all requests must be submitted to the RAC within two (2) working days of receipt of the request. The Talent Acquisition office shall consult with the RAC as necessary when providing an accommodation to an individual during the DATE: 7/30/08 PAGE 5 OF 10

application process, and forward the Reasonable Accommodation Request Form to the RAC within two (2) days after the accommodation is provided. 3. The RAC shall review all requests for reasonable accommodation and at its discretion refer request to the RAC for evaluation on a case-by-case basis. The RAC shall notify the appropriate supervisor(s) and employee in writing of the RAC s recommendations. 4. When an accommodation cannot be provided during the application process by Talent Acquisition Services, the disabled individual s request will be referred to the Senior Vice President, Chief Human Resources Officer for review. 5. The RAC will determine whether the individual is a Qualified Individual with a Disability, if he or she poses a direct threat, and if a reasonable accommodation is feasible. A report of the committee s findings will be sent to the Senior Vice President, Chief Human Resources Officer for review and approval. Upon approval, the RAC will notify the Management Leadership Team (MLT) member in charge of the affected department of the recommended action(s). 6. Individuals who are determined to be QUIDs and cannot be reasonably accommodated, and individuals who cannot perform the essential functions with or without a reasonable accommodation, will be allowed a 120-day Job Search to locate a suitable position within or outside JHS. Those employees who do not find a suitable position during the 120-day Job Search period will be noticed for termination by their department head. 7. Individuals may request an alternative, as outlined in Section 8 below, to termination by writing to the MLT representative in charge of the Department within seven (7) business days after receipt of written notice of termination. The department head will submit the request to the Senior Vice President, Chief Human Resources Officer for approval. 8. Exceptions may be made if the individual: (a) Asks to begin retirement or disability retirement procedures. (b) Requests that they be allowed to remain in their current position and perform the essential functions of that position. The RAC will determine if this option poses a direct threat. (c) Submits a resignation. 9. Requests for an extension of the 120-day period must be submitted in writing to the MLT in charge of the department within (14) business days prior to the end of the 120-day period. The department head will submit the request to the Sr. Vice President, Chief Human Resources Officer for determination. Individuals may ask to extend the 120-day period for the following reasons: DATE: 7/30/08 PAGE 6 OF 10

(a) (b) (c) Pending a decision to be hired in a suitable position when interviews have been completed. To complete training or educational program that will lead to a suitable position. Pending the completion of retirement procedures. 10. Job Transfers for a Qualified Individual with a Disability A QUID who is accepted for transfer to a new position within JHS shall be reevaluated by OHS prior to reporting to the new assignment. A medical examination is required to ensure that the QUID s physical/mental restrictions are not incompatible with the essential functions of the new position. If OHS does not provide medical clearance the decision may be appealed to the RAC. Unfavorable decisions from the RAC may be appealed to the Senior Vice President, Chief Human Resources Officer. Appeals of OHS and RAC decision may be submitted by the QUID and/or the Department/Division that will gain the employee. The Senior Vice President, Chief Human Resources Officer will notify the RAC, Talent Acquisition Office, employee and Department/Division of the decision. 11. Applicants: Physical/Mental limitations and/or restrictions determined during the OHS medical screening process. RESPONSIBILITIES: New hires or internal applicants requesting a transfer within JHS who are determined to have a physical/mental limitation and/or restriction that prevents the performance of the essential functions of the position applied for will submit a Reasonable Accommodation Request to the RAC for review. Reasonable Accommodation Requests from new hires that are submitted during the application process and disapproved by the RAC are final. Qualified internal applicants may appeal RAC decisions to the Senior Vice President, Chief Human Resources Officer. The gaining Department/Division may also appeal RAC decisions to the Senior Vice President, Chief Human Resources Officer. Applicants (internal or external) shall: 1. Complete the Reasonable Accommodation Request Form as needed during the pre-employment process. 2. Submit the Reasonable Accommodation Request Form to the RSO. 3. Discuss their needs and recommend appropriate accommodations to the RSO. 4. Provide documentation of physical and mental impairment upon request by the DATE: 7/30/08 PAGE 7 OF 10

Occupational Health Services office. Employees shall: 1. Make supervisors aware of the need for reasonable accommodation. 2. Provide documentation of physical or mental impairment upon request of the Reasonable Accommodations Committee. 3. Submit the Reasonable Accommodation Request form to the supervisor for signature and discuss their needs and required reasonable accommodations. Talent Acquisition Services Office shall: 1. Post notices of JHS s obligation to provide reasonable accommodation for qualified individuals with disabilities and of the availability of the Reasonable Accommodation Request Form. 2. Forward all completed Reasonable Accommodation Request forms to the Leave Management Office within two (2) working days of receipt of the request and after an accommodation is provided. 3. Complete Reasonable Accommodation request form when an applicant is unable or declines to submit a written request. 4. Provide reasonable accommodation for internal and external applicants as directed by the RAC. 5. Maintain reasonable accommodation for internal and external applicants as directed by the RAC. Supervisors shall: 1. Acknowledge Reasonable Accommodation Request forms by signing and dating the form. 2. Complete Reasonable Accommodation Request form when an employee is unable or declines to submit a written request. 3. Discuss with employee the need for reasonable accommodation and attempt to identify and list potential accommodations. 4. Attach job description to the Reasonable Accommodation Form, circling all functions considered essential to the position. DATE: 7/30/08 PAGE 8 OF 10

5. Forward the form, job description and list of potential accommodations to the Leave Management Office. 6. Provide reasonable accommodation as recommended by the RAC that are approved by the Senior Vice President, Chief Human Resource Officer and appropriate MLT representative. RAC shall: 1. Meet on a regular basis to review new and pending requests. 2. Request job analyses or special assessments of employee s/applicant s limitations, as needed. 3. Review the appropriateness of the request, the nature of the reasonable accommodation, and provide recommendations to the Sr. Vice President, Chief Human Resources Officer for approval. Leave Management Office shall: 1. Process all Reasonable Accommodation Request forms, and present selected requests to the RAC. 2. Discuss requests for reasonable accommodation with employees and supervisors. 3. Request fitness for duty examinations from OHS as needed. 4. Coordinate and lead the efforts of the RAC to ensure the process is fair, consistent, and timely. 5. Notify the Senior Vice President, Chief Human Resources Officer, supervisors and employees of the Committee s recommendations, applicable provisions, and procedures under the Reasonable Accommodation policy. Occupational Health Services shall: 1. Conduct Fitness-for-Duty examinations and arrange for independent medical examinations and job analyses at the direction of the RAC. A. Review employee s medical/workers compensation/independent medical examination/job analyses to validate medical information, extent and duration of disability, and determine the individual s restrictions. B. Visit work areas for assessment, as needed. DATE: 7/30/08 PAGE 9 OF 10

2. Provide recommendations regarding the employee s ability to perform the essential job functions with or without reasonable accommodation. 3. Submit a written summary of findings and recommendations to the RAC when an investigation is completed. 4. If the employee is reassigned to a new position, review all new job assignments to determine if the demands are compatible with employee s restrictions/limitations. Leave Management Office hall: 1. Notify the RAC, the employee s immediate supervisor, and the corresponding MLT, of workers compensation cases with permanent restrictions resulting in an employee s inability to perform the essential job functions of their current position. 2. Notify employees of Jackson s obligation to provide reasonable accommodations for qualified individuals with disabilities, and the availability of the Reasonable Accommodation Request form. Flow charts describing the Reasonable Accommodation process may be obtained from the Leave Management Office. Employee/Labor Relations and Workforce Compliance, HRCMD. Note: If information or assistance is required in regards to the ADA or the Reasonable Accommodation policy and procedure, please contact Occupational Health Services. AUTHORIZATION: Marvin O Quinn, President, Public Health Trust DATE: 7/30/08 PAGE 10 OF 10