Tri-State Occupational Health Agreement Amendment Copyright 2014
City of Dubuque Consent Items # 16.
ITEM TITLE: Tri-State Occupational Health Agreement Amendment
SUMMARY: City Manager recommending approval of an Amendment to
the Agreement between Tri-State Occupational Health,
L.L.C. and the City of Dubuque for case management
services for workers compensation claims and Police and
Fire job related injuries and illnesses.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Approve
ATTACHMENTS:
Description Type
Amendment to Tri-State Occupational Health City Manager Memo
Agreement-MVM Memo
Staff Memo Staff Memo
Amendment to Tri-State Occ Health & City Agreement Supporting Documentation
Agreement Between Tri-State Occ Health & City 2015 Supporting Documentation
THE CITY OF Dubuque
DUB E i"
Masterpiece on the Mississippi 2007.2012.2013
TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: Amendment to Agreement between Tri-State Occupational Health, L.L.C.
and the City of Dubuque for Case Management Services for Workers
Compensation Claims and Police and Fire Job Related Injuries and
Illnesses
DATE: August 24, 2016
Personnel Manager Randy Peck recommends City Council approval of an Amendment
to the Agreement between Tri-State Occupational Health, L.L.C. and the City of
Dubuque for case management services for workers compensation claims and Police
and Fire job related injuries and illnesses. The amendment will continue the agreement
from October 1, 2016 through September 30, 2017. The cost of the service will
increase from $43.35 per hour to $44.20 per hour. The current rate has been in effect
for two years. It is anticipated that the City will continue to use their services for
approximately eight hours per week for a total annual cost of $18,387.
1 concur with the recommendation and respectfully request Mayor and City Council
approval.
6&zn'
Mic ael C. Van Milligen
MCVM:jh
Attachment
cc: Barry Lindahl, City Attorney
Cindy Steinhauser, Assistant City Manager
Teri Goodmann, Assistant City Manager
Randy Peck, Personnel Manager
THE CITY OF�&
Dubuque Du
'ff"1% p11 AmeAcaCitry
Masterpiece on the Mississippi 2007.2012.2013
TO: Michael C. Van Milligen, City Manag
FROM: Randy Peck, Personnel Manager
SUBJECT: Amendment to the Agreement between Tri-State Occupational Health,
L.L.C. and the City of Dubuque for Case Management Services for
Workers Compensation Claims and Police and Fire Job Related Injuries
and Illnesses
DATE: August 10, 2016
I have attached an amendment to the Agreement between Tri-State Occupational
Health, L.L.C. and the City of Dubuque for case management services for workers
compensation claims and police and fire job related injuries and illnesses. The
amendment will continue the agreement from October 1, 2016 through September 30,
2017. The cost of the service will increase from $43.35 per hour to $44.20 per hour.
The current rate has been in effect for two years. It is anticipated that the City will
continue to use their services for approximately 8 hours per week for a total annual cost
of $18,387.
The requested action is for the City Council to pass a motion approving the amendment
to the Agreement and authorizing you to sign the amendment.
RP:Imh
AMENDMENT TO AGREEMENT
BETWEEN
TRI-STATE OCCUPATIONAL HEALTH, L.L.C.
AND
CITY OF DUBUQUE
The Agreement between TRI-STATE OCCUPATIONAL HEALTH, L.L.C. (TSOH) and CITY OF
DUBUQUE, effective October 6, 2014, is hereby amended as follows:
1. Agreement Parameters. C, is deleted in its entirety and replaced with: '
C. The term of this Agreement shall begin on October 1, 2016, and shall continue
through September 30, 2017.
2. Reimbursement for Onsite Occupational Health Nursing Services. A. is deleted in
its entirety and replaced with:
A. For onsite occupational health nursing services the City will pay TSOI-I $44.20 per
hour,
This Amendment will become a part of the original Service Agreement of October 6, 2014. The
parties hereby ratify and affirm that all other terms and provisions of the original Agreement and their
intent shall remain in full force and effect.
TRI-STATE OCCUPATIONAL HEALTH
L.C.
Brian Schatz
President
CITY OF DUBUQUE
Michael Van illi gen
City Manager
7/7
Date
AMENDMENT TO AGREEMENT
BETWEEN
TRI-STATE OCCUPATIONAL HEALTH,L.L.C.
AND
CITY OF DUBUQUE
The Agreement between TRI-STATE OCCUPATIONAL HEALTH, L,L,C, (TSOH) and COPY OF
DUBUQUE,effective October 6,2014,is hereby amended as follows;
1.Agreement Parameters,c is deleted in its entirety and replaced with;
c. The term of this Agreement shall begin on October 1, 2015, and shall continue
through September 30,2016.
This Amendment will become a part of the original Service Agreement of October 6,2014.The
--parties-hereby ratify-and-affirm-that-all-other•-terms and-provisions-of-the-original-Agreement-and-their-- -----
intent shall remain in full force and effect.
TRI-STATE OCCUPATIONAL HEALTH,L.L.C.
Brian Schatz Date
President
CITY OF DUBUQUE
J 6
Michael V•n Milligen Da e
City Manager
Agreement
Between
Tri-State Occupational Health,L.L.C.
And
The City of Dubuque
This Agreement is made and entered into this
day
of r "2014, by and between Tri-State Occupational, L,L,C., a corporation
organized and established under the laws of Iowa, having its principal place of business
at 1940 Elm Street, Dubuque, Dubuque County, Iowa, ("TSOH"), and the City of
Dubuque, having its principal place of business at 50 West 13th Street, Dubuque,
Dubuque County, Iowa ("City"),
Scope
A. TSOH is in the business of providing Occupational medicine, worker's
compensation and related therapy services and as specifically relates to
--- — ---- - - this agreement; is-In-the--business`of-providing onsite occupational-health — ----
nursing services through its physicians, providers and clinical nursing
staff.
1
Recitals
A. City will;
1. Provide a facility location for the provision of onsite Occupational health
nursing services.
2, Assume all of the roles and responsibility for OSHA record-keeping
and related functions,
B, TSOH will;
1, Provide onsite Occupational health nursing services to the City,
2. Provide employee supervision, including clinical and medical direction
oversight of the onsite occupational health nursing services,
3. Provide onsite occupational nursing services for eight (8) hours per
work week,
4. Recommend all referral and follow-up treatment services(e.g. therapy,
orthopedics, surgery, etc.), to optimize qual ty of care and case
management. TSOH will direct care according to City's swishes, and
City acknowledges that care coordination and treatment outcomes
outside TSOhi recommendations may or may not meet TSOH's
standard of care,
6, Provide occupational therapy and rehabilitation services at City
request,
6, Manage the employee medical chart on-site, maintaining a separation
of occupational health and worker's compensation care notes from
personal health and medical care information. TSOH will retain
ownership of personal health Information,
7. Abide by the following Attachments:
• AAOHN Code of Ethics and Interpretative Statements
+ AAOHN Case Management: The Occupational and Environmental
Health Nurse Role
AAOHN Delivery. of Occupational and Environmental Health
Services-
Standards of Occupational and Environmental Health Nursing
In consideration of the matters described above, and of the mutual benefits and
obligations set forth in this agreement,the parties agree as follows:
Section 1
Agreoment Parameters
A. TSOH will provide onsite occupational health nursing services for an
average scheduled time frame of eight (n)-hours every work week. Start
and end times for coverage will be agreed to in advance by TSOH and
City.
B. Onsite occupational health nursing services will be provided by an
appropriately qualified TSOH nurse.
C. The Initial term of this Agreement shall from the Bth day of October,2014,
to midnight on the 30th day of September,2015,
Section 2
Reimbursement for Onsito Occupational Health Nursing Servicos
A. For onsite occupational health nursing services the City will pay TSOH
$43.35 per hour,
B. Onsito occupational health nursing services provided by TSOH to City will
be invoiced on a monthly basis,
AMENDMENT TO AGREEMENT
BETWEEN
TRI-STATE OCCUPATIONAL HEALTH,L.L.C.
AND
CITY OF DUBUQUE
The Agreement between TRI-STATE OCCUPATIONAL HEALTH, L,L,C. (TSOH) and CITY OF
DUBUQUE,effective October 6,2014,is hereby amended as follows;
1 Agreement Parameters c is deleted in its entirety and replaced with;
c. The term of this Agreement shall begin on October 1, 2015, and shall continue
through September 30,2016.
This Amendment will become a part of the original Service Agreement of October 6,2014.The
--partieshereby.-ratify-and-af r--m-that-all-othei-terms-and-provisions of-the-original-Agreement-and-their-- -----
intent shall remain in full force and effect.
TRI-STATE OCCUPATIONAL HEALTH,L.L.C.
Brian Schatz Date
President
CITY OF DUBUQUE
Michael Van Milligen Da e
City Manager
Agreement
Between
Tri-State Occupational Health,L.L.C.
And
The City of Dubuque
This Agreement is made and entered into this ' da
of i fs'r
� ''—2014, by and between Tri-State Occupational, L,L,C., a corporation
organized and established under the laws of Iowa, having its principal place of business
at 1940 Elm Street, Dubuque, Dubuque County, Iowa, ("TSOH"), and the City of
Dubuque, having Its principal place of business at 50 West 13th Street, Dubuque,
Dubuque County, Iowa("City"),
Scope
A. TSOH Is in the business of providing occupational medicine, worker's
compensation and related therapy services and as specifically relates to _
--- - --- — — --this agreement; is-In-the--buslness=of-providing onsite occupationai-hea t -----
nursing services through its physicians, providers and clinical nursing
staff.
Recitals
A. City will;
1. Provide a facility location for the provision of onsite Occupational health
nursing services.
2, Assume all of the roles and responsibility for OSHA record-keeping
and related functions,
B. TSOH will;
1, Provide onsiteeccupational health nursing services to the City,
2. Provide employee supervision, Including clinical and medical direction
oversight of the onsite occupational health nursing services,
3. Provide onsite occupational nursing services for eight (S) hours per
work week,
4. Recommend all referral and follow-up treatment services(e.g. therapy,
orthopedics, surgery, etc,), to optimize quality of care and case
management. TSOH will direct care according to City's wishes, and
City acknowledges that care coordination and treatment outcomes
i
outside TSOH recommendations may or may not meet TSOH's
standard of care,
5, Provide occupational therapy and rehabilitation services at City
request,
6, Manage the employee medical chart onsite, maintaining a separation
of occupational health and worker's compensation care notes from
personal health and medical care information. TSOH will retain
ownership of personal health Information,
7. Abide by the following Attachments:
• AAOHN Code of Ethics and Interpretative Statements
• AAOHN Case Management: The Occupational, and Environmental
Health Nurse Rale
• AAOHN Delivery. of Occupational and Environmental Health
Services-
• Standards of Occupational and Environmental Health Nursing
In consideration of the matters described above, and of the mutual benefits and
obligations set forth in this agreement, the parties agree as follows:
-- --------------- - - Section 1
Agreement Parameters
A. TSOH will provide onsite occupational health nursing services for an
average scheduled time frame of eight (a) hours every work week, Start
and end times for coverage will be agreed to In advance by TSOH and
City.
B. Onsite occupational health nursing services will be provided by an
appropriately qualified TSOH nurse.
C. The initial term of this Agreement shall from the 6th day of October,2014,
to midnight on the 30th day of September,2015.
Section 2
Reimbursement for Onsite Occupational Health Nursing Services
A. For onsite occupational health nursing services the City will pay TSOFI
$43.35 per hour,
B. Onsite occupational health nursing services provided by TSOH to City will
be invoiced on a monthly basis,
Section 3
Compliance with All Applicable taws
TSOH and City agree that they are bound by and will comply with all applicable
federal,state, local laws,ordinances or regulations,TSOH and City agree to defend,
Indemnify and hold harmless each-other against loss or damage, including,but not
limited to, reasonable attorneys'fees,resulting from their respective negligence in the
performance or nonperformance of this Agreement.
Section 4
Independent Contractor Relationship
The parties agree that the relationship between TSOH and City in one of owner-
independent contractor and nothing herein shall be construed or interpreted in anyway
to create an employer-employee relationship between TSOH and City or between City
and any of TSOH's officers, agents or employees.
Section 5
City Responsibilities
} A. City will provide a minimum one (1)week notice to TSOH If the regularly
agreed to City work schedule for the onsite occupational health nurse Is to
be cancelled. Such notice shall be provided by contacting the TSOH
Manager or Clinical Manager.
B. City will pay TSOH invoiced fees within 30 days.
Section 6
Agreement Not To Hire Nor Solicit Employees
City agrees that for a period of two(2)years from the date of termination of this
Agreement,neither City nor any of its members shall hire, solicit,or attempt to hire or
solicit any of TSOH's employees that are or were subject to this Agreement. City and
its members further agree that the rernedy at law for any breach by City and Its
members of this Section 0 witl be inadequate and that TSOH shall be entitled to
Injunctive relief in case of any such breach,and TSOI-1 shall be entitled to recover Its
costs Incurred In conducting any lawsuit, Including reasonable attorneys'fees and
expenses. This provision can be waived by mutual agreement of T501-1 and City,
received and acknowledged In writing.
f
i
it
i
Section T
Payment of Taxes or Benefits
TSOH shall pay any and all employment-related taxes and benefits for the TSOH
employee(s)subject to this Agreement.
Section 8
Use of Trade Names and Signs
City shall not use in any manner directly or indirectly, or in whole or in part, the
signature, monogram or any other trademark or name that Is now or may In the future
be owned by TSOH, except in a manner; and to an extent that TSOH may specifically
consent In writing, If any trademark or name Is used in any way by City with the
express written approval of TSOH, City on the termination of this Agreement, shall
discontinue all such use and shall not subsequently use any name,title or expression In
connection with any business in which City may be engaged that, in the judgment of
TSOH, so nearly resembles any trademark or name, owned by TSOH as may be likely
to lead to confusion or uncertainty on the part of the public,
- Section-g-------- ----- - — ---
Transferability
All benefits and duties of either party under this Agreement are non-transferable,
t
Section 10
Termination Notice Clause
This agreement may be terminated by either party,with or without cause,upon
thirty(30)days written notice to the other party.
Section 11
Liability Of Parties To The Agreement Upon Termination Of Agreement
Upon termination of this agreement, City shall remain liable to TSOH for any
payments then owed to TSOH.
Section 12
Modification
This Agreement reflects all the agreements, understandings, representations,
conditions and warranties by and between the parties. Neither party shall be liable for
any representation made unless It is expressly set forth in this Agreement, and this
Agreement may not be modified or amended except in a writing signed by both of the
parties,
1
Section 13
Severabillty
If any provision of this Agreement shall be declared by any court of competent
Jurisdiction to be Illegal, void or unenforceable, all other provisions of this Agreement
shall not be affected and shall remain in full force and effect
Section 14
Governing Law
This Agreement shall be governed by the laws of the State of Iowa.
Section 15
Arbitration
If a dispute arises with respect to this Agreement, it shall be decided finally by an
arbitrator In an arbitration proceeding conforming to the Rules of the American
Arbitration Association applicable to commercial arbitrations, The arbitrator shall be
-selectedin-ac�arda�ice to the-Rules of the Amer)can�rboiration Assocotion, The
arbitration shall take place In Dubuque, Iowa, and the decision of the arbitrator shall be
conclusively binding upon the parties and final and such decision shall be enforceable
as a judgment in any court of competent jurisdiction. The arbitrator shall assess the
j cost of arbitration to the non-prevailing party, and award reasonably Incurred attorney's
fees and costs,in favor of the substantially prevailing party at the arbitration.
Section 16
Acts of Governments, War,Terrorism, Natural Disaster Clause
If either party to this Agreement is affected in such a way by changes In law,acts
of war, acts of foreign governments, acts of terrorism, natural disasters, or similar
catastrophes; to such an extent that they cannot fulfill their obligations undar this
Agreement, that party will be excused from performing under the Agreement, and the
Agreement will be terminated,
r
i
i
Section 17
Notice
Unless otherwise provided for In this Agreement, all notices whlch are required or
may be given pursuant to the terms of this Agreement shall be In writing and shall be
deemed duly given If delivered personally, mailed by registered or certified mail,
Postage prepaid, return receipt requested, or sent by facsimlie with confirmation.
Notices shall be sent as follows:
A. To: Tri-State Occupational Health, L.L.C.
Attention: TSOH Manager
1940 Elm Street Dubuque, Iowa 52001
Telephone:(563)584.4600
Facsimile:(563)582-7847
B. To: City of Dubuque
Attn: Personnel Manager
50 West 13�h Street
— -- — -- --- --_---- --Dubuque, lawa 52001
Telephone:(563)589.4125
Facsimile: (563)690-6Q25
Section 18
Insurance
TSOH shall at all times during the performance of this Agreement maintain
insurance as required by the attached Insurance Schedule,
Tri-State Occupational Health, L,L.C. City of Dubuque
By:
�- ,d• c.�w,ems'
By:
Michael C,Van Milligen, City Manager
Date: D 9 /`�, Date:
Insurance Schedule
i
City of Dubuque Insurance Requirements for Professional Services
Insurance Schedule C
1, rsOH shall furnish a signed Certificate of Insurance to the City of Dubuque,Iowa for the
coverage required in Exhibit I prior to commencing work and at the end of the project if the term of work
Is longer than 60 days, Providers presenting annual certificates shall present a Certificate at the end of
each project with the final billing, Each Certificate shall be prepared on the most current ACORD form
approved by the Iowa Department of Insurance or an equivalent. Each certificate shall Include a
statement under Description of Operations as to why Issued,Eg: Project H or Protect location at
or construction of
2. All policies of Insurance required hereunder shall be with a carrier authorized to do business In Iowa and
all carriers shall have a rating of A or better in the currentA.M,Best's Rating Guide.
3, Each Certificate shall be furnished to the contracting department of the City of Dubuque.
4, Failure to provide minimum coverage shall not be deemed a walver of these requirements bythe City of
Dubuque, Failure to obtain or maintain the required insurance shall be considered a material breach of
this agreement.
5, Subconsultants and sub subconsultants performing work or service shall provide a Certificate of Insurance
In accord with Exhibit 1,
6. All required endorsements to various policies shall be attached to Certificate of insurance.
7. Whenever a specific ISO form is listed,an equivalent form may be substituted subject to the provider
identifying and listing in writing all deviations and exclusions that differ from the ISO form,
8. Provider shall be required to carry the minimum coverage/limits,or greater If required by law or other
legal agreement,In Exhibit 1. If provider's limits of liability are higher than the required minimum limits
then the provider's limits shall be this agreement's required limits,
9. Whenever an ISO form Is referenced the current edition of the form must be used.
Page 1 of 3 Schedule CProfessional Services July 2015.Doc
City of Dubuque Insurance Requirements for Professional Services
Insurance Schedule C (continued)
Exhibit I
A) COMMERCIAL GENERAL LIABILITY
General Aggregate Limit $2,000,000
Products-Completed Operations Aggregate Limit $1,000,000
Personal and Advertising Injury Limit $1,000,000
Each Occurrence $1„000,000
Fire Damage Limit(any one occurrence) $ 50,000
Medical Payments $ 5,000
a) Coverage shall be written on an occurrence,not claims made,form. The general liability
coverage shall be written In accord with ISO form CG0001 or business owners form BP0002,
All deviations from the standard ISO commercial general liability form CG 0001,or Business
owners form BP 0002,shall be clearly Identified
b) Include ISO endorsement form CG 25 04"Designated Location(s)General Aggregate Limit"
or CG 25 03"Designated Construction Project(s)General Aggregate Limit"as appropriate,
c) Include endorsement Indicating that coverage Is primary and non-contributory,
d) Include endorsement to preserve Governmental Immunity,(Sample attached).
e) Include an endorsement that deletes any fellow employee exclusion.
f) Include additional Insured endorsement for;
The City of-Dubuque,including.all-its_efected_and_appolnted.offfclals,-all its employees-----
and volunteers,all Its boards,commissions and/or authorities and their board members,
employees and volunteers,Use ISO form CG 2026,
B) AUTOMOBILE LIABILITY $1,000,000(Combined Single Limit)
C) WORKERS'COMPENSATION&EMPLOYERS LIABILITY
Statutory benefits covering all employees Injured on the Job by accident or disease as prescribed by
Iowa Code Chapter 85 as amended.
Coverage A Statutory—State of Iowa
Coverage B Employers Liability
Each Accident $100,000
Each Employee-Disease $100,000
Policy Limit-Disease $500,000
Policy shall include an endorsement providing a waiver of subrogation to the City of Dubuque
Coverage B limits shall be greater If required by Umbrella Carrier,
D) UMBRELLA LIABILITY $1,000,000
Umbrella liability coverage must be at least following form with the underlying policies included
herein,
E) PROFESSIONAL LIABILITY $1,000,000
F) CYBER LIABILITY $1,000,000
Coverage for First and Third Party liability Including but not limited to lost data and
restoration,loss of Income and cyber breach of information.
Yes X No
Page 2 of 3 Schedule C Professional Services July 2015.Doc
e
• i
j
I
City of Dubuque Insurance Requirements for Professional Services
Preservation of Governmental Immunities Endorsement
I
1. Nonwalver of Governmental Immunity.The insurance carrier expressly agrees and states that the
purchase of this policy and the including of the City of Dubuque,Iowa as an Additional Insured does
not waive any of the defenses of governmental immunity available to the City of Dubuque,Iowa
under Code of Iowa Section 670A as it is now exists and as it may be amended from time to time.
2. Claims Coverage.The insurance carrier further agrees that this policy of Insurance shall cover only
those claims not subject to the defense of governmental immunity under the Code of Iowa Section
670.4 as it now exists and as it may be amended from time to time.Those claims not subject to
Code of Iowa Section 670.4 shall be covered by the terms and conditions of this Insurance policy.
3. Assertion of Government Immunity.The City of Dubuque,Iowa shall be responsible for asserting any
defense of governmental immunity,and may do so at any thne and shall do so upon the timely
--- -written request of the Insurance carr er, - ---- - ---- "-
4. Non-Denial of Coverage,The insurance carrier shall not deny coverage under this policy and the
Insurance carrier shall not deny any of the rights and benefits accruing to the City of Dubuque,Iowa
underthis policy for reasons of governmental immunity unless and until a court of competent
jurisdiction has ruled in Favor of the defense(s)of governmental immunity asserted by the City of
Dubuque,Iowa.
No Other Change In Policy.,The above preservation of governmental immunities shall not otherwise
change or alter the coverage available under the policy.
SPECIMEN
Page 3 of 3 Schedule C Professional Services lily 2015.Doc
CODE OF ETHICS AND INTERPRETATIVE STATEMENTS
Preamble
The American Association of Occupational Health.Nurses, Inc. (AAOHN)Code of Ethics has
been developed in response to the nursing profession's acceptance of its goals and values and
the trust conferredupon it by society to guide the conduct and practices of the profession,As
professionals,occupational and environmental health nurses(OHNs)accept the responsibility
and inherent obligation to uphold these values.
The Code of Ethics is based on the belief that the goal of occupational and environmental heath
nurses is-to p-rorriote the wo"rke�,N�orkar population an�c ccommunity health and safety.This
specialized practice focuses on promotion and restoration of health, prevention of illness and
injury and protection from occupational and environmental hazards.The occupational and
environmental nurse has a unique role in protecting the integrity of the workplace and the work
environment.
The client can be workers,workers'families/significant others,worker populations, community
groups and employers.The purpose of the AAOHN Code of Ethics is to serve as a guide for
registered professional nurses to maintain and pursue professionally recognized ethical
behavior in providing occupational and environmental health and safety services.
Ethics is synonymous with moral reasoning. Ethics is not law, but a guide for moral action.
Professional nurses,when making judgments related to the health and welfare of the client,
utilize these significant universal moral principles.
• These principles are;
• Right.of self-determination
• Confidentiality
• Truth telling
• lacing or producing good
• Avoiding harm
• Fair and nondiscriminatory treatment
i
Occupational and environmental health nurses recognize that dilemmas may develop that do
not have guidelines, data or statutes to assist with problem resolution; thus, occupational and
environmental health nurses use problem-solving, collaboration and appropriate resources to
resolve dilemmas.The Code is not intended to establish nor replace standards of care or
minimal levels of practice, In summary, the Code of Ethics and Interpretative Statements
provide a guiding ethical framework for decislon-making and evaluation of nursing actions as
occupational and environmental health nurses fulfill their professional responsibilities to society
and the profession.
9
1.Occupational and environmental health nurses provide Health,wellness,safety and
other related services to clients with regard for human dignity and rights,unrestricted
by considerations of social or economic status, personal attributes or the nature of the
health status,
• Adhere to the obligation to treat clients fairly; respecting their dignity and worth, while
recoghizing the existence of a vast spectrum of beliefs and values in society.
• Demonstrate respect for these beliefs and...yalues inherent in their clients and
themselves by providing services for and with that client accordingly,
• Respect human dignity by recognizing clients'rights, particularly,the right of self-
determination.
• Be knowledgeable about clients'rights(as client advocates).
• Avoid abandonment,even in cases when the client refuses care or the nurse's personal
convictions prohibit participation,
• Recognize that there are situations in which the rights of Individual self-determination
may be outweighed or limited by the rights of others, One must weigh the risk of harm or
endangerment to self and/or others, particularly in relation to public health,
2. Occupational and environmental health nurses, as licensed health care professionals,
—accep.t_obllgatians_to_society.-as-professional-and-responsible-members -of-the------------ ----
community.
• Adhere to all laws and statutes(local., state,federal, and international), including those
governing occupational and environmental health practice.
• Observe professional codes and uphold practice standards,
• Respect clients'and society's right to know and to receive factual information about
potential and actual job and environmental hazards.
• Be knowledgeable of issues and dilemmas affecting the health, safety and welfare of
society and take appropriate action,
• Participate,as appropriate, in decision-making processes that pertain to occupational
and environmental health and safety.
• Recognize situations in which the interests of management and workers may conflict,
Demonstrate fairness in conflict resolution.
• Refer and/or delegate to appropriate services.
• Strive to protect clients and the profession from incompetent professionals and
individuals who misrepresent themselves and the profession,
• ,Report to licensing, accrediting and certifying authorities, as may be appropriate, any
person or persons who exhibit incompetence or engage in unethical or illegal activities.
• . Contribute to the growth of the profe'ssion's body of knowledge through development,
implementation and evaluation.of programs.
• Have moral obligations to self,clients, the profession and society to conduct sound
ethical research.
• Seek approval of appropriate bodies, such as institutional review boards, in conducting
research activities.
• Communicate and disseminate research findings as appropriate.
3, Occupational and environmental health nurses strive to safeguard clients' rights to
privacy by protecting confidential information and releasing information only as
required or permitted by law.
• Maintain the confidentiality of health information.
• Adhere to the organizational, local, state, federal and intemational laws, regulations,
guidelines, and policies governing access to confidential information,
in
• Have written policies and procedures to guide the access,release, transmittal, and
storage of health information, including electronic records,
• Respect and protect the autonomy, rights and privacy of clients'data and personally
.identifiable information,
• Respect and protect the autonomy, rights and privacy of resaarch subjects through
mechanisms such as voluntary informed consent,
4. Occupational and environmental health nurses promote collaboration with other
professionals, community agencies, and stakeholders in order to meet the health,
wellness, safety and other related needs of the client.
• Function both interdependently and independently in promoting the welfare bf clienis.
• Contribute, through an interdisciplinary approach,to interdependent nursing practice by
working with members of the health and safety professions, human resources, benefits
and other related entitles in the provision of services.
• Commit to collaborative planning with members of the health and safety team and other
representatives internal and external to the organization in providing services to clients.
• Collaborate by seeking assistance, expertise and resources from other recognized
health and safety professionals in the provision of services.
• Function within the scope of nursing practice and delegate responsibility appropriately. .
_ - —Adhere to.the_obli.gation-to_promote-.adequate distribution-of health-and-safety-services-- ----- —
and nursing resources to meet clients'needs.
• Weigh professional responsibilities and obligations with values/perspective of multiple
parties(e.g, employer,management,supervisor,etc,.) in protecting the health and safety
of workers,worker populations and community groups,
5. Occupational and environmental health nurses maintain individual competence in
nursing practice, based on scientific knowledge, and recognize and accept
responsibility for individual judgments and actions,while complying with appropriate
laws and regulations.
• Strive for excellence and maintain a level of knowledge,judgment,technical skills and
professional values necessary for delivering health services, -
• Utilize professional and educational activities to improve professional practice,
• Engage in professional,educational and quality improvement activities, and
acknowledge the importance of continued and advanced educational activities beyond
the basic level of nursing education.
• Maintain competence in practice as a personal and professional responsibility.
• Be accountable for actions and for compliance with nurse practice acts, standards of
practice and other laws/regulations governing occupational and environmental health
practice.
• Participate in the development of policies to promote competent, ethical, and legal
nursing practice,
• Utilize research findings within practice.
I
AAOHV acknowledges the contributions of the following owners/members in revising the
AAOHN Code of Ethics. The AA OHN Code of Ethics Task Force:Phyllis Berryman, Chairman;
Kay Campbell, Michelle Kom Gochnour, Kira Gordon, Margie Matsui, Barb Maxwell, Kim
Olszewski, Diana Scott, Bill Thomack, Dee Tyler and Janice bVhita.
Revised and approved January 2009
lr
l
lg a
POSITION STATEMENT
Case Management: The Occupational and
Environmental Health Nurse Role
Occupational and environmental health nurse case RATIONALE
managers are the Ideal professionals to coordinate
workers' health care services from the onset of Effective occupational and environmental health and
Illness or Injury to safe return-to-work or an optimal safety programs address overall health care,
altsrnative.___ ._- ___.____. ___.disability-and-workers'-compensation-costs,-These------ ---- -
programs:
INTRODUCTION . focus on primary, secondary, and tertiary
preventlon and health promotion strategies to
Since the late 1800'x, occupational and minimize accidents and Illnesses
environmental health nurses(OHNs)have delivered
primary care, managed occupational and non- . provide quality health care by knowledgeable
occupational illnesses and Injuries, and and experienced occupational and
Implemented and evaluated a myriad of programs to environmental health professionals
benefit workers. To assist workers in achieving
optimal health outcomes, occupational and Incorporate case management strategies
environmental health nursing professionals use their
expertise In health care delivery,knowledge diverse facilitate effective communication between
service options,experience in implementing return- management and Injured or ill workers
to-work policies, and detailed, site-specific
understanding of how workers Interface with the teach workers to be more knowledgeable,
work environment. responsible,and confident consumers of heal;h
Based on the complexities of health care and care services.
business environments,case management services
must be delivered by qualiFled health care Skyrocketing Increases in basic health care
professionals with sufficient knowledge and premiums and workers' compensation costs have
expertise' to perform this function competen'Jy forced employers to focus on cost containment
(CMSA), strategies. Many corporations now offer their
workers health benefit plans that Include Integrated
Case maragemer.t Is a process of coordinating options. With an Increasing focus on health care
comprehensive health care services, following cost containment,the case management function Is
illness or Injury, to achieve optimum quality care valuable to the employer and Insurers (Mulehy&
delivered In a cost effective manner. The process Jensen). However, case management Is complex
integrates assessment, plannirg, implementation, and requires well-preparad health care professionals
and evaluation components. Occupational and who possess necessary knowledge and skills(e.g.
environmental health nurses as case managers occupational and environmental health and safety,
provide all or a portion of these services In addition return-to-work policies,health care delivery systems,
to coordination of all care delivered (American payor systems,laws and regulations),
Association of Occupational Health Nurses
[AAOHN), Case Management Society of America
[CMSA),and Mullahy&Jonser).
AMERICAN ASSOCIATION OF OCCUPATIONAL HEALTH NURSES,INC.
7794 Grow Drvo,Pensacola,FL 32614 1 (800)24+-8014 1 FAX(850)484-8762 1 wwnv.aaohn,org
CONCLUSION REFERENCES
Today's proactive practitioners are cognizant of: American Association of Occupational Health
the workers'needs and desired outcomes, Nurses.(n,d.).Occupational and Environmental
Nurses Today;Case Management.Retrieved
the employer's priorities and focus on cost from htlp://wym.aaohn.org/car,,ers/P--rofesslon
containment strategies of•occuoetion-gnvlronmental-health-
nurslna,html
the many service options available.
Case Management Society of America,(2010).
Effective case management is one strategy for Standards of Practice for Case Management,
employers to not only quantify their health care Retrieved from
costs but also savings through coordination of llttp://Ivwvi.cmsg.org/Indiv(dua[/MejnborTooiIKIU
services. StandardsofPractice/tabid/89/Default asox
The OHN professional, acting as a coordinator of Mullahy,C.M,&Jensen,D.K.(2010),Case
health services, rehabilitation, return-to-work and &tanager's Handbook(4th ed.),Sudbury,MA:
case management, Is the key to workers' health Jones&Bartlett,
care quality and cost containment strategies.
Revised 04/1995;05/1996,12/12(AgOHN Practice
Committee)
- -- - --- - --— ----—---- ----Reviewed 06/2003;-08/2004,09/20127AAOHN------ -
Practice Committee)
AMERICAN ASSOCIATION OF OCCUPATIONAL HEALTH NURSES,INC.
7794 Grow Drive,Pensacola,FL 32514 i (800)241.8014 1 FAX(850)484-8762 1 www.aaohn,org
m II
POSITION STATEMENT
Delivery of Occupational and Environmental
Health Services
INTRODUCTION comprehensive occupational and environmental
health program promotes better worker health,
Occupational and environmental health nursing Is decreases health-related costs,Improves employee
the specialty practice that focuses on promotion and morale, Increases productivity, decreases
--.... -
tor
resatipn ofhealth,-prevention of.lf6]e�s_and_Injury,_.____-absenteeism,_and—facilitates—continuity--of—care--- ---- —and protection from work-related and environmental Occupational and environmental health nurses work
hazards. Tremendous changes have occurred In within the guidarce of the AAOHN Scope of Practice
recent years within the occupatlonal and to:
environmental health care delivery system such as:
collaborate with workers, employers,members
• A focus on health care costs that result in of the occupational and environmental health
increased economic constraints,competition for and safety team,and other professionals to
services, and outsourcing or displacement of
qualified health care providers o Identify health and safety needs
• A proliferation of health care providers from a o prioritize Interventions
variety of professional specialties offering
services o develop and Implement interventions
• A continued interest In alternatives to traditional and programs
provider models o evaluate care and service delivery.
• Renewed Interest in wellness Initiatives and The OI-IN is the key to the coordination of a holistic,
worker productivity programs multidisciplinary approach to delivery of safe,
quality, and comprehensive occupational and
• Emphasis on Implementing evidenced-based environmental health programs and services that
programs. Include:
The American. Association of Occupational Health . clinical and primary care,Including assessment,
Nurses believes that the training, education and diagnosis,management,and documentation of
experience-base of licensed occupat!onal and occupational and non-occupational Illnesses
environmental health nurses(OHfds)prepares these and injures
health care professionals to be in the best position
to deliver comprehensive occupational and case management for occupational and ror-
environmental health services In the workplace, occupational illnesses and injuries
RATIONALE • health hazard assessment and surveillance of
worker populations, workplaces, and
The employment of well-qualified licensed community groups
professional OHNs to develop and Implement a
AMERICAN ASSOCIATION OF OCCUPATIONAL HEALTH NURSES,INC,
7794 Grow Drive,Pensacola,FL 32514 1 (800)241-8014 I FAX(850)484-8762 1 wr 1w.aaohn.org
• Investigation,monitoring,and analysis of illness • conduct a feasibility study to prioritize the
and Injury episodes and trends, as well as worker health services needs and determine
methods to promote and protect worker health the extent to which full-time and/or part-lime
and safety occupational and environmental health nurses
would be cost effective
• compliance with laws, regulations, and
standards governing health and safely for . promote certification In occupational and
workers and the environment environmental health nursing among the nurses
employed at the facility
• compliance with laws, regulations, and
standards related to confldentlality and medical establish partner relationships with adjunct
records management professions as part of an occupational and
environmental health services delivery plan
• management and administration of coordinated by the OHN
occupational and environmental health services
• hire contract providers who employ OHNs for
• health promotion and disease prevention all or part of the delivery of occupational and
strategies using primary prevention principles; environmental health services when It Is not
early detection, prompt treatment, and feasible to directly employ nurses on staff
prevention of disease progression using
secondary prevention principles,and restoring employ occupational and environmental health
worker health as much as possible using nursing entrepreneurs and consultants to
tertiary prevention principles address the overall health needs of the
employee population,
----•----counseling—health--coaohingc—and—tralning--- -- --- ----------- ------
programs using adult learning approaches REFERENCES
• research related to occupational and Strasser,P.B.(2012).Occupational and
environmental health, Environmental Health Nursing:The
Foundations of Quallb/Practice,Vverirplace
A coordinated and cost-effective plan that Health and Safety,4(60),151.157,
maximizes the use of services for workers can be
best administered by a qualified OHN who has Virginia Department of Health.(2012),Transltioning
knowledge of the needs and various services to the new national EMS scope of practice and
available and works within the scope of practice education standards.Retrieved from
within his/her licensure state. htto://wvvw.vdlistate va us/OEMS/T,aininci/I7an
sillorl.htm
CONCLUSION/RECOMMENDATIONS
The American Association of Occupational Health
Nurses believes that well trained OHNs are Revised 4/95;1/96;5/98;10/12(AAOHN Practice
essential for cost effective management of the Committee)
workplace occupational and environmental health
program,and recommends.that employers hire the Reviewed 6/02;6/03;8/04,9112(AAOHN Practice
nurse on a full-time basis whenever possible. Committee)
The American Association of Occupational Health
Nurses (AAOHN) acknowledges that In'sorne
situations it Is not feasible or appropriate to hire full-
time OHNs to provide these services. In those
instances,AAOHN recommerds that employers:
AMERICAN ASSOCIATION OF OCCUPATIONAL HEALTH NURSES,INC,
7794 Grow Drive,Pensacola,FL 32514 1 (800)241.8014 1 FAX(850)484-8762 1 www.aaehr-org
Standards of Occupational and Environmental Health Nursing
Standard 1.Assessment
The occupational and environmental health nurse systematically assesses the health status of the
client(s).
Standard fl,Diagnosis
The occupatiohal and environmental health nurse analyzes assessment data to formulate diagnoses,
-Standard III.Outcome Idantificatlon
The occupational and environmental health nurse Identifies outcomes specific to the client(s),
Standard IV.Planning.
The occupational and environmental health nurse develops a goal-directed plan that is comprehensive
and formulates Interventions to attain expected outcomes.
Standard V.Implementation
The occupational and environmental health nurse implements Interventions to attain desired outcomes
identified in the plan.
Standard Vi.Evaluation
_ The occupational and environmental health nurse systematically and continuous).y_evaktes�esponses_to____
Interventions and progress toward the achievement of desired outcomes.
Standard VII.Resource Management
The occupational and environmental health nurse secures and manages the resources that support
occupational health and safety programs and services.
Standard VIIL Professional Development
The occupational and environmental health nurse assumes accountability for professional development to
enhance professional growth and maintain competency.
Standard 1X,Collaboration
The occupational and environmental health nurse collaborates with clients for the promotion,prevention
and restoration of health within the context of a safe and healthy environment.
Standard X.Research
The occupational and environmental health nurse uses research findings in practice and contributes to
the scientific base In occupational and environmental health nursing to improve practice and advance the
profession.
Standard Xi.Ethics
The occupational and environmental health nurse uses an ethical framework as a guide for decision
making in practice.
!2