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Beyond SARS: Developing Health- Related Emergency Policies

By: Anne Nicoll

While the SARS outbreak caught many by surprise, it is just the latest in a growing number of diseases that can disrupt businesses. Anne Nicoll, of Mercer Human Resource Consulting, discusses why companies need policies that deal with health-related emergencies.

The SARS outbreak in Asia and Canada caught health workers, government officials, and employers by surprise.

But SARS is just the latest in a growing list of biological concerns, including Norwalk Virus, West Nile Virus, and Anthrax. These health-related emergencies have the potential to significantly affect business. As illustrated by SARS, businesses were disrupted through loss of customer base and problems with the supply chain. Further, the potential for widespread facility quarantine is also a concern to employers. This concern grew after one Toronto area employer was hit with a mass quarantine of its worksite.

To address these issues in a timely and effective manner, organizations need to have substantive business continuity plans in place. This includes emergency response planning, business recovery, crisis management, and the management of the human resource issues that fall out of these plans. While organizations may have disaster recovery plans, they tend to deal with issues relating to the loss of, or damage to, the physical work site or technology. We are now faced with a situation that leaves the worksite intact but may limit the availability of employees to attend work.

In April 2003, Mercer Human Resource Consulting conducted a web-based survey of employers to better understand how Canadian employers were managing SARS-related absences. Of approximately, 350 respondents, surprisingly, only 11 per cent had a human resource policy in place that addresses health-related emergencies. The survey also found that more than 90 per cent of respondents would pay for SARS quarantine-related absences. Clearly, employers were making decisions around benefit and human resource policies without the benefit of a pre-established plan.

Although the urgent nature of the SARS situation has subsided in North America, now is the time for employers to conduct a review of their current emergency plans and policies to determine what adjustments are necessary in the event of other healthrelated emergencies. In developing a policy on health-related emergencies, employers should consider the following steps.

Step 1 – Assess the Risk of the Health- Related Emergency
This involves identifying the critical business functions that must continue to operate, as well as identifying key people dependencies. An organization should then evaluate the potential impact of the healthrelated emergency on the business and review the probability or likelihood that a significant health-related event could occur. Employers also need to consider potential employee behaviours that may result in the event of a healthrelated emergency.

Step 2 – Identify Alternatives to Mitigate the HR Business Impact
These activities can involve actions such as setting up separate work teams (offsite ‘clean teams’) on a permanent or temporary basis, or establishing work-at-home capability. Where the risk cannot be eliminated, there is a need to develop action and contingency plans in the event of a severe impact to ensure that the business can continue to operate.

Step 3 – Develop an HR Policy Response
Once the business risks are identified and action plans for both minimizing the impact and responding to the event are identified, the next step is to review the impact of these changes on human resource policies, contracts, and processes. These HR elements include the following factors:

Absence Management
Determine eligibility rules for payment of income/benefits in the event of a health-related emergency absence In the case of SARS, there was general agreement among employers that someone who had contracted SARS should be eligible for benefits under employer sick plans. There was, however, some debate about whether an employer should pay an employee who is in quarantine but was not actually sick. There were also concerns from employers about paying employees who wanted to go into quarantine who did not ‘qualify’ for quarantine but, due to fear of exposure, chose to self-quarantine. Others still were concerned about potential abuse of the quarantine situation by employees.

Even though 90 per cent of the survey respondents indicated that they would pay for a SARS quarantine absence, the method of payment differed.

Further, employers will need to decide if the circumstances of the emergency affect the eligibility rules for benefits. Would they consider extending payment for absences due to a health emergency to groups of employees who would not ordinarily receive such benefits?

Establish necessary protocols for proof of eligibility

In the survey, approximately 50 per cent of respondents would require a medical certificate as proof of absence. Employers need to consider how realistic their requirement for evidence may be in the event of a future emergency. For example, during the SARS situation, employees were not always able to obtain medical proof of their reasons for absence as access to the healthcare system was limited. If an employee cannot access the healthcare system, it is difficult for employers to validate that an employee qualifies for quarantine.

Alternative criteria would need to be established. For example, employers may be able to satisfy themselves that the employee’s assessment of their status is justified through structured telephone interviews. Essentially, employers should be aware that they may need to rely on the ‘honour system’ once an employee has claimed the need for self-quarantine.

Liaise with insurers/administrators/ EAP/other providers

STD coverage is a matter of contract wording and there is no obligation for an insurer to cover a situation that does not meet the strict language of the policy. Most insurers have determined that quarantine is not included in the definition of their plans and any payments they are making are extra-contractual. Employers should review the ‘definition of disability’ in their current plans, whether self-administered/selffunded or not, to determine whether ‘quarantine’ is included in the definition.

If it is not, a decision will need to be made to either amend the definitions, or to develop a different benefit plan to cover these circumstances in the future.

In addition, employers need to consider the need for any payments during the STD elimination period and how this would be handled.

Review other HR policies (including benefits) for consistency

Employers should review other policies that could be affected by any changes in definition for disability plans and any effects on other health benefits.

For example, paid leave programs may be revisited. It is interesting to note that 19 per cent of the respondents to the survey decided to treat these absences as paid leaves of absence. Employers often provide a paid leave for other public welfare type leaves, such as leave for jury duty.

Identify any linkages with the Employment Insurance program

Where an employee does not qualify for short-term disability benefits and cannot work from home, the employer may decide to treat the absence as an unpaid leave. The employer should consider whether this leave would qualify as a temporary layoff, emergency leave, or unpaid sick leave. The Ontario government has passed legislation to address emergency leave provisions for SARS-related absences.

Further, employees may qualify for Employment Insurance (EI) benefits. The EI regulations regarding medical certificates and the waiting period were eliminated for SARS-related quarantines. These changes will expire October 4, 2003, but, in future, the government may make similar adjustments for other health-related emergencies.

Given that both employers and HRDC recognize the importance of providing income continuity to individuals under medical quarantine, there was, until now, little consideration given to co-ordination of costs.

Now, HRDC has indicated that the concept of a Q-SUB plan would be acceptable, subject to receiving the appropriate registration. AQ-SUB plan could allow an employer to ‘top up’ EI benefits during a medical quarantine, without a clawback of the EI payment and without affecting an employer’s eligibility for EI premium reduction for their sick leave plans. While not for everybody, the QSUB plan can be an attractive, cost-sharing vehicle for many employers.

Health and Safety

Incorporate organization’s obligations regarding employee safety and safety of visitors/customers

The Canada Labour Code and provincial health and safety laws, such as the Occupational Health & Safety Act (Ontario), protect the employee’s right to a safe workplace. There are provisions that give employees the right to refuse work if they believe that the conditions in the workplace endanger them or other workers. Where an employee requests personal protective equipment – such as safety masks, for use in the workplace – employers must take these concerns seriously and investigate the situation. If the employee continues to refuse to work, then the formal process for reviewing a work refusal should continue to be followed, as set out in the relevant health and safety laws.

Address obligations with workers’ compensation requirements and business travel

In Ontario, the WSIB has stated that individuals with work-related exposure that has resulted in symptoms of SARS may be entitled to benefits. Entitlement is decided on a case-by-case basis. Employers are obligated to report these situations to the workers’ compensation authorities. There may also be issues relating to business travel and employees potentially contracting serious health conditions as a result of exposure from such travel.

Travel/Commuting

Evaluate the need for employee travel Travel could include other countries, as well as commuting between business sites locally, and travel to and from the workplace. Where movement of employees must continue, employers need to ensure there are mechanisms in place to assist employees with this travel. This would include decisions to cover any additional expenses associated with special arrangements for travel and how this affects their existing travel policies.

Address the impact of limited customer/ client travel

This may include the need to establish a log for all visitors, everyday, to trace individual activity and facilitate contact with visitors in the event of an occurrence.

Communication

Develop a strategy, process and tacticsCommunication with employees is a critical component of any emergency plan. Once the plans are developed, the employer should determine the necessary communication activities and audiences.

Since emergency situations change regularly, all communication efforts should have a built-in process to stay up-to-date on developments and update employee communications.

Your Health-Related Emergency (HRE) policy needs to recognize potential health emergencies in the future. The policy will need to be comprehensive, yet general enough in nature to be adaptable to each health-related emergency. Finally, your HRE policy needs to conform to all relevant legislation and consider any applicable labour agreement implications.


Anne Nicoll is a principal with Mercer Human Resource Consulting.

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