Macon County Health Department

Personnel Policy 
Manual

 MACON COUNTY HEALTH DEPARTMENT
PERSONNEL POLICY MANUAL 

TABLE OF CONTENTS

Introduction………………………………………………………. 4
Organization Chart………………………………………………. 5

I.	ORGANIZATIONAL PROTOCOL
	
	A.      Department Organization & Purpose……………..…6
	B.	Staff Meetings.……………………………………………… 6
	C.	Confidentiality………………………………………………..6
	D.	Incident Reports…………………………………………… 7
	E.	Fraud Policy Statement…………………………………. 7
	F.	Presentation of Programs………………………………. 7
	G.	Accounting…………………………………………………… 7
	H.	Purchase Orders…………………………………………… 8
	I.	Procurement………………………………………………… 9
	J.	Financial Segregation of Duty………………………... 11
	K.	Financial Policy – Client Services……………………. 15
	L.	Client Records……………………………………………… 16
	M.	Records Safeguarding and Retention……………… 17
	N.	Records Request……………………………………………17
	O.	Property, Time and Equipment……………………….18
	P.	Vaccine Count………………………………………..……. 19
	Q.	Religious Exempt……………………………………………20
R. 	Telephone Protocol…………………………………….… 21
	S.	Cell Phone & Social Media……………………………… 21
	T.	Information Technologies……………………………….24
	U.	Safe Driving…………………………………………………..25
	V. 	Fire Safety…………………………………………………….25
	W.	Severe Weather/Tornado………………………………..26
	X.	COVID-19 Response rescinded 9/8/21            27
	Y. 	Threat Policy………………………………………………… 28

II.	PERSONNEL POLICIES

A.	Employment Policies 
Ethics and Professional Conduct………………...... 30
		1.	Probationary Period………………………...… 31
		2.	Performance Evaluations……………………. 31
		3.	Promotion and Re-classification………….. 32
		4.	Disciplinary action………………………..…… 32
		5.	Resignation or Retirement……………….... 33
6.	Continuing Education……………………..…. 34
	B.	Job Conditions
		1.	Alcoholic Beverages and Controlled Substances. 34
		2.	Tobacco Restrictions……………………….… 34
		3.	Cardio-Pulmonary Resuscitation……….… 34
		4.	Annual TB Test/Immunizations……..…... 34
		5.	Conflict of Interest………………………….… 35
		6.	Inclement Weather…………………………… 35
		7. 	Visitors……………………………………………. 36
		8. 	Personal Security……………………………… 36
	C.	Leaves of Absence
		1.	Compassion Leave……………………………. 36
		2.	Leave of Absence without Pay………….… 37
		3.	Family Medical Leave Act………………….…37
		4.	Sick Leave…………………………………….…. 38
		5.	Workman’s Compensation…………………. 40
		6.	Unemployment Compensation………….….40
		7.	Vacation “Annual Leave” ………………….…40
		8. 	Leave Pool…………………………………………41
	D.	Hours of Work
		1.	Full/Part-Time……………………………………. 42
2.	Overtime/Compensatory Time Off…………43
3.	Flexible Time…………………………………….. 43
	E.	Use of Department Facilities…………………………. 44
	F.	Rest Periods……………………………………………….. 44
	G.	Holidays……………………………………………………… 44
	H.	Improvements and Grievance
		1.	Suggestions for Improvements……………. 44
		2.	Grievance Procedure………………………….. 45
	I.	Whistleblower Policy……………………………………..46

Attachments:  

Addendum to Social Media Policy – WIC Agency…………………. 47
Grievance Review Disposition Form…………………………………... 49
Grievance/Complaint Review Form…………………………………….. 50
Incident Report Form……………………………………………………….. 51
Request for Leave Form……………………………………………………. 52
Leave of Absence Without Pay Form………………………………….. 53
Leave Pool Request …………………………………………………………. 54
Leave Pool Donation ………………………………………………………… 55

INTRODUCTION

These policies have been established for employees of the Macon County Health Department as administered by the Board of Trustees.  Information regarding employment policies and benefits, as well as some of the responsibilities of Health Department employees, is provided for guidance in day-to-day operations.

Macon County Health Department’s current employment policies shall be construed as a contract, implied or otherwise.

The Macon County Health Department retains the right to change, modify, suspend, interpret or cancel in whole or in part any of its published or unpublished recommended policies.  If statements are found to be in conflict with existing or future state or federal laws, regulations, policies or procedures, such rules shall supersede and prevail over this manual. 

Policies may be waived or changed by the Board of Trustees after written proposals for change has been requested two weeks in advance of a regular meeting.  

In emergent situations the Administrator has the authority to contact the Chairman of the Board of Trustees, who is empowered to act temporarily for the Board and said decision is subject to review by the Board at its next regular meeting.

MACON COUNTY HEALTH DEPARTMENT
PERSONNEL POLICY MANUAL

Organizational Chart
Revised February 9, 2021

Medical Director:
Dr. James McDowell, MD

Mike Chambers
  Administrator

Barbara Graubins
Account Clerk

Crystal Phillips, RN
Nursing Supervisor

Shara Thrasher
Office Support Assistant

   Judy Rushton, RN	

Stacy Corbin, RN 

DeAnna Wiggans, RN

Alison Dowling, RN

Erin Main
WIC Nutritionist

Mark Snyder
Env. Public Health Specialist

Jessica Wooten, Clerk/BFPC

Julie Rudkin, Clerk Typist

Shaina Howatt, LPN

Jen Gordan, RN PRN

Cheryl Blaise
Volunteer Coordinator

I.	ORGANIZATIONAL PROTOCOL

A.	Department Organization and Purpose

1.	ORGANIZATION CHART 
The organization chart displays the hierarchy of the health department.

2.	STATEMENT OF PURPOSE - Mission
The Macon County Health Department has as its purpose, to: 

•	Promote wellness and prevent or minimize illness and disease.

•	Assess and promote wellness through education and awareness programs to encourage healthful lifestyles.

•	Identify and remove barriers to help prevent illness through various health screenings, immunization programs and environmental health.

•	Plan, prepare and respond to natural and manmade disasters.

The above is of equal importance and are interrelated.  The services provided are for the benefit of all residents of Macon County.

3.	NON-DISCRIMINATION
Macon County Health Department will not discriminate against any employee or client based on race, sex, age, religion, handicap, national origin, or other protected class of citizen as indicated by the Department of Health and Senior Services.  All services will be provided on a non-discriminatory basis.  The Health Department is an equal opportunity/affirmative action employer.

B.	STAFF MEETINGS

Staff meetings will be held monthly, with the office closing during the duration of the meeting. Meetings are held to review announcements concerning county, state and local changes or additions; continuing education (videos, handouts and speakers); information deemed pertinent by the Board of Trustees, Administrator, or Nursing Supervisor; and; as a forum by which employees can voice their ideas and/or opinions.

C.	CONFIDENTIALITY

	See MCHD HIPPA Manual

D.	INCIDENT REPORTS

All accidents or unusual occurrences during the course of health department business are to be reported to the Administrator/Nursing Supervisor and a written report made as soon as possible following the occurrence.  Statements will be kept on file and investigation conducted as needed. MCHD’s current liability provider may be notified depending upon the nature of the incident.  (See Incident Report Attachment)

	E.	FRAUD POLICY STATEMENT

The Macon County Health Department is committed to preventing fraud.  Macon County Health Department employees are responsible for preventing, identifying and reporting fraud.  Any incident that is suspected or detected must be reported immediately to the Administrator, Nursing Supervisor or to the Board of Health Center Trustees (Board of Trustees).

F.	PRESENTATION OF PROGRAMS

Presenting informational/educational programs to the public is a vital role of the Health Department and employees are to provide education when requested:

1.	All program plans are to be discussed with your supervisor prior to presentation.

2.	Programs presented are to focus around Health Department programs for preventive and/or proactive health education.

3.	All material and audio-visual equipment used in the presentation of the programs are to be returned to the lending source as soon as possible after the program is presented.

	G.	ACCOUNTING

Accounting transactions shall be recorded in a timely, accurate manner to 
produce records appropriate for business management on all levels, to include 
grant management and administrative and executive governance.  Transactions 
shall be of allowable costs as necessary to conduct health department business,
and as determined by the finance operations of the agency and dictated as 
specified by grant deliverables; and, financial and performance reports will be 
generated according to terms and conditions of the awarding agency.  

A budget drafted annually by the Administrator and approved by the Board of 
Trustees shall be used in the daily course of business as a financial control tool 
in the process of expending and receiving funds.  

Grant contract accounting shall maintain budget records through which to 
appropriately manage grant money expenditures.  Records will include the 
following identifying markers: (1) CFDA title and number; (2) federal award 
identification number and year; (3) name of federal funding agency; and, (4) 
name of pass-through entity.  The Administrator shall verify that costs 
expended against grant contracts are only claimed once and are claimed
against the correct contract.

	H.	PURCHASE ORDERS

All purchases must be approved by the Administrator or Nursing Supervisor.

1.	Requests for supplies are to be given to your supervisor.  Supplies should be anticipated in advance for purchases to be made in an efficient manner.  Routine effort is to be made to purchase supplies at the best price without compromising quality.  Routine purchase activities/ordering will be planned by the Administrator and/or Nursing Supervisor using the Procurement policy.

2.	A purchase order will be generated for each purchase transaction except those transactions as defined in the Procurement policy.  The purchase order will record date, vendor, item number/description, quantity, cost, and handling/freight charges.  Accounting codes for disposition are to be recorded in the body of the purchase order as is documenting the grant to be allocated against if applicable.  Both the Administrator and staff creating the purchase order are to sign every purchase order.

4.	Purchase order receipts will be inspected for damages and completeness of order with confirmation noted as such on packing slips, which will then be submitted to the Accounting Clerk.  Damaged receipts shall be reported immediately to the vendor for follow up. 

5.	The Accounting Clerk will verify the packing slip against the purchase order and input such information into the accounting system for payment upon receipt of invoice.  

6.	Accounting Clerk shall assign a property tag to each piece of equipment and maintain a log of such equipment through final disposition.
I.	Procurement 
Purchases must be approved by the Administrator or Nursing Supervisor with costs determined in accordance with generally accepted accounting principles and avoid unnecessary or duplicative purchases.  The following procedures are to be applied toward all funds expended including grant contract spending.
1.	Supplies should be anticipated in advance for purchases to be made in an efficient manner.  Routine effort is to be made to purchase supplies at the best price without compromising quality with costs reasoned using the “prudent person” test whereby cost for any purchase would not exceed what a prudent person would pay under the same circumstances.  Routine purchase activities/ordering will be planned by the Administrator or Nursing Supervisor.  Written purchase order requests for supplies are to be approved by the Administrator.   Grant contract purchases shall be evaluated and determined as necessary and reasonable for the purpose of the contract and conform to any limitations set forth in the contract.  

2.	Small purchases shall be made competitively, checking price and quality from an adequate number of qualified contractors, vendors, or suppliers.  All considered small purchase estimates will be approved by the Administrator prior to purchase.  Small purchase estimates in excess of $2,500.00 will be approved by the Board. 

3.	Micro-purchase items ($50.00 or less) from local stores (Wal-Mart, Westlake’s, etc.) necessary for the daily operations of the health department shall be made with store account, credit card or petty cash with approval from the Administrator, with receipts given to the Accounting Clerk for recording and payment.  All other micro-purchase items up to $2,500 shall be purchased through a written purchase order following MCHD Purchase Order policies.

4.	Formal purchases in excess of $50,000 shall follow competitive proposal methods (sealed bids, competitive proposals and/or noncompetitive proposals) whereby requests are publicized and identify all evaluation factors and their relative importance.  Proposals are solicited from an adequate number of qualified sources as able.  A written method is used for conducting technical evaluations of the proposals received and selecting recipients.  Contracts are to be awarded to the lowest responsive and responsible bidder, or the responsible firm whose proposal is most advantageous to the program with price and other factors considered.  Factors include integrity, compliance with public policy, record of past performance, and technical and financial resources.  The agency does not award contracts to parties that are ineligible for participation in Federal assistance programs or activities.  

5.	Records will be maintained that detail the procurement, including but not limited to rationale for the method of procurement, selection of contract type, contractor selection or rejection, and the basis for the contract price. 

6.	Procurement transactions are to be conducted with full and open competition and do not use geographic preferences.  Contractors that develop specifications, requirements, statements of work, or invitations for bids or requests for proposals are excluded from competing for procurements.

7.	Necessary affirmative action steps are to be taken to assure contracting with small and minority businesses, women’s business enterprises, and labor surplus area firms are used when possible.

8.	Supplies and equipment shall not be purchased by the health department to benefit or gain any employee; or, their immediate family unless such family member owns/works for a reputable firm representing items in need by the health department, and such items are of quality and competitive price, of which such purchases are approved by the Administrator (or the Board if it is the Administrator’s immediate family).  

9.	The Administrator will designate a person to make the approved purchase for items needed from local vendors as possible.

10.	Contract/construction work in excess of $2,000 shall be advertised for competitive bid and shall meet the requirements of the Davis-Bacon and Related Acts.  Contractors shall be bonded and insured, and follow the formal purchase competitive proposal process, bids to be reviewed at the Board of Trustees meeting.  Prequalified lists of contractors, vendors or suppliers are to be current and include enough qualified sources to ensure maximum open and free competition.  Descriptions, specifications, or technical requirements shall be developed for the desired goods and services that do not restrict competition among suitable contractors, suppliers or vendors.  MCHD shall establish the minimum essential characteristics and standards for the good or service to satisfy the intended use.  All requirements and other factors used in evaluating bids and proposals are identified.  The Board has the right to reject any and all bids.  

Contractual oversight will include:
1.	The Administrator maintaining oversight of awarded contractors to ensure contractors perform in accordance with the terms, conditions, and specifications of their contracts or purchase orders.
2.	Avoiding purchase of unnecessary of duplicative items.
3.	Ensuring responsible administrative practices and sound business judgement to settle procurement issues including source evaluation, protests, disputes and claims.  Documentation is maintained of any contractual and administrative issues that arise.

J.	Financial Segregation of Duty 

Macon County Health Department staff shall utilize the following segregation of duties in financial matters:

Receipt of Mail
1.	Incoming mail shall be opened by the Administrator, or designated staff, who will record the receipt date and initial for receipt of mail.  
2.	The Administrator, or designee, will deliver mail to the appropriate persons for disposition.
3.	Those receipts that are sent by fax or email shall be printed and contain the date of receipt and initials of the receiving party, and then delivered to the appropriate persons for disposition. 
4.	Electronic payment for receivables shall be recorded by the Accounting Clerk into the accounting system.

Bill Receipt and Payment
1.	The Accounting Clerk will receive all incoming bills, verify the bills contain accurate information, reconcile any invoices to grant contract budgets, and then record each bill in the health department’s accounting system. Costs are to be recorded consistently to the appropriate financial class accounts (i.e., a cost considered overhead/indirect cannot be claimed as direct).
2.	The Accounting Clerk will, bi-weekly, generate an accounts payable listing to be used for authorization of payment for said bills.  Payments for purchases will be made timely in order to take advantage of any early payment discounts or to avoid late payment penalties, once confirmation of receipt is verified.  
3.	The accounts payable listing and hard copy of each bill to be paid will be given to the Administrator and Nursing Supervisor for verification.  
•	The Administrator and Nursing Supervisor, or with Accounting Clerk in either’s absence, together will verify that each bill amount matches the accounts payable report. 
•	Any inaccuracies will be noted by the Administrator and Nursing Supervisor and be returned to the Accounting Clerk for correction.
•	Once the bills are accurately matched to the payables report, the Administrator or Nursing Supervisor in Administrator’s absence, will determine which bills will be paid during this payment cycle.  Such bills will be marked on the accounts payable report and the Administrator and Nursing Supervisor will date and sign the report.
4.	The report and bills will be returned to the Accounting Clerk who will run checks for each approved bill to be paid.  The checks are to be attached to the hard copy bill and returned to the Administrator and Nursing Supervisor for signature.
•	The Administrator and Nursing Supervisor, both together or separately, will verify the check amount to the bill amount, and each will sign every check. Checks may be signed by another authorized agent should the Administrator or Nursing Supervisor be unavailable as long as each check contains two authorized signatures.  Certain checks will require signature of an authorized signer of the Board of Trustees.  
•	Signed checks and bills are to be returned to the Accounting Clerk to mail.
5.	The Accounting Clerk will file the paid bills with the check receipt attached to their appropriate files.
6.	Monthly, a detailed payables report will be printed by the Accounting Clerk to present to the Board of Trustees for review.

Cash/Check Receipts
1.	Checks received through the mail are to be delivered by the Administrator, or designee, to the front desk (clerical or nursing) staff.  
2.	Front desk staff is to record checks and cash received for services, as well as checks received through the mail, into the payment receipt book at the front desk.
3.	The checks/cash and receipt book are to be handed to the Accounting Clerk for verification and input into the accounting system. 
4.	The Accounting Clerk will verify and balance the check and money receipts for the day and develop a corresponding deposit slip for the appropriate bank account.
5.	The Nursing Supervisor, or designee, will physically deposit the receipts at the appropriate bank each day.  Daily deposits of $150.00 or less, at the Administrator or Nursing Supervisor’s discretion, may be properly secured and deposited the following business day.
6.	The Accounting Clerk, upon return of bank deposit receipts, will verify deposit amounts to the deposit recorded in the deposit book; and, upon receipt of bank statements will reconcile amounts entered into the accounting system.
7.	Electronic receipts of funds are to be recorded by the Accounting Clerk in the accounting system.
8.	Monthly, a detailed accounts receivable report will be printed by the Accounting Clerk to present to the Board of Trustees for review.

Petty Cash
1.	Petty Cash is to be maintained in the amount of $300, where $250 is secured in the Accounting Clerk’s office and $50 is secured at the front desk for client transaction change. 
2.	All requests for petty cash disbursement are to be approved by the Administrator or Nursing Supervisor and made to the Accounting Clerk.  The Accounting Clerk shall count out the requested amount, with that count verified by the requestor.  The Accounting Clerk will make note of each petty cash disbursement in the petty cash log and place a copy of the request in the petty cash drawer.
3.	The requestor shall return any unused petty cash and a cash receipt for purchase, to the Accounting clerk.  The Accounting Clerk will make note in the petty cash log.
4.	The Accounting Clerk will input petty cash transactions into the accounting system.  Petty cash reimbursement will be made in the form of a check through the accounting system.  The Accounting Clerk will cash the check at the appropriate bank, and verify the cash received.  Prior to returning the cash to the petty cash drawer, a secondary count is to be made by an independent employee to verify correct cash reimbursement and enter this transaction into the petty cash log.
5.	Monthly, the Accounting Clerk and independent employee will verify petty cash transactions for the previous month.
6.	Monthly, a detailed petty cash report will be printed by the Accounting Clerk to justify the petty cash log and to present to the Board of Trustees for review.

Payroll and Expense Reports
1.	Payroll time sheets and expense reports (with receipts attached) are to be prepared by individual staff and is to be a true reflection of the hours worked and any vacation, sick, or comp time used; and, a true and accurate accounting of expenses incurred during the period.  
•	Nursing staff are to give their time sheets and expense reports to the Nursing Supervisor for verification and signature, who will then give to the Accounting Clerk.  
•	Other staff is to give their time sheets and expense reports to the Administrator for verification and signature, who will then give to the Accounting Clerk.
•	The Administrator’s time sheet and expense report shall be verified and signed by the Nursing Supervisor, and, the Nursing Supervisor’s time sheet and expense report shall be verified and signed by the Administrator, and both given to the Accounting Clerk.
2.	The Accounting Clerk will record the time sheet and expense report information into the accounting system and run a payroll summary report.
3.	The time sheets, expense reports, and payroll summary report shall be given to the Administrator and Nursing Supervisor, or Accounting Clerk in either’s absence, who together shall verify each time sheet and expense report against the payroll summary report.  Any inaccuracies will be noted by the Administrator and Nursing Supervisor and will be returned to the Accounting Clerk for correction.
4.	Once the time sheets and expense reports are accurately matched to the payroll report, the report is dated and signed as accurate by both the Administrator and Nursing Supervisor and returned to the Accounting Clerk for processing.
5.	The Accounting Clerk will process payroll in the accounting system, print a final report and payroll stubs.
6.	Payroll stubs are to be given each employee by the Accounting Clerk or the Administrator. 
7.	Monthly a detailed payroll report will be printed by the Accounting Firm to present to the Board of Trustees for review.

Credit Cards
In order for the health department to procure goods and services in today’s economy, it is necessary for the health department to own and use credit cards.
1.	Personal use is strictly prohibited and will lead to disciplinary action, up to and including suspension of credit card privileges and/or termination of employment should willful negligence or fraud be determined.
2.	The Administrator and Nursing Supervisor are charged with maintaining and securing all agency credit cards.
3.	The Accounting Clerk maintains records of credit cards and employees who have possession of such cards.
4.	All purchases must be accompanied by a receipt or purchase order approved by the Administrator and/or Nursing Supervisor.
5.	The Accounting Clerk will match receipts with the credit card statement monthly and reconcile the credit card accounts with the accounting system.

K.	FINANCIAL POLICY – CLIENT SERVICES

The health department is committed to provide services to clients at a fair rate that is less than, or at minimum that which is usual and customary for the area.  Services are to be billed at the same rate regardless of the source of payment.  Payment method is to be determined prior to providing services in one of the following manners:
•	Self-pay: cash, check, or credit card
•	Insurance
Self-pay clients are to pay full costs prior to being provided services.
Insurance clients are to be approved prior to being provided services.  If an insurance claim is questionable, health department staff is to call the insurance company for verification in the presence of the client.  If an insurance company denies the service, the client is to self-pay prior to being provided services.

Cash Discount Policy
All self-pay clients are to be presented the full cost of services for which they are being seen.  Clients who reply that they are unable to pay the entire cost of services shall go through the following process:

1.	Client is to complete the Application for Financial Assistance
2.	Staff is to ask client what portion of the services they are able to pay and then mark this on the Application for Financial Assistance
3.	Application is to be considered for approval by the Administrator or Nursing Supervisor, or lacking communication with both, the application is to be considered for approval by the Accounting Clerk
4.	Client is to pay that portion that is approved prior to services rendered.
Deductibles, co-payments and co-insurance fees are not subject to a cash discount and are to be paid in entirety prior to services rendered.  The cash discount policy does not apply to educational classes.

Hardship Policy
Macon County Health Department’s mission is to protect, promote and improve the health and quality of life in Macon County.  As such, services will not be denied any client regardless of their ability to pay.  Clients who present without insurance or ability to self-pay, as determined by the Financial Policy, will complete the Application for Financial Assistance requesting a 100% discount for services, to be considered for approval by the Administrator or Nursing Supervisor or, lacking communication with both, the application will be considered for approval by the Accounting Clerk.  The hardship policy does not apply to educational classes.

Collection Policy
It is the intention of the Financial Policy to collect payment in its entirety from clients prior to services being rendered.  Should that not be possible, or should insurance deny a claim after services are provided, attempts will be made to collect payment from the client by mailing a statement.  Reminder statements are to be mailed monthly should payment not be made for eleven months.  Debt is to be written off after a year of attempting to collect payment.  

L.	CLIENT RECORDS (CHARTS)
	
1.	Charts are the permanent records of clients, therefore; in order to reduce the potential for loss or theft of client records, no records are to be removed from the office except for clinics and with supervisor permission. 

2.	    Client records are to be kept in a secure location at all times.  
Records are to be returned to the appropriate filing system after recording is complete. 

3.	    All client charts that are required or requested by another facility 
    are to be sent by encrypted email only to the person it is intended 
    unless other secure means have been approved or established.

M.	RECORDS SAFEGUARDING AND RETENTION

		All records containing sensitive information shall be protected using security 
safeguards such as locking file cabinets, locked offices, computer passwords 
and appropriate sleep mode time settings, and other measures to limit access to those whose responsibilities require access.  Sensitive information will be further safeguarded by encrypting when sending via email or ensuring appropriate receiving end when faxing.

Macon County Health Department shall follow the standards and protocols of
the Missouri Secretary of State for records retention, found on the web site
www.sos.mo.gov. 

	N.	RECORDS REQUEST

		According to Missouri law, all public records of public governmental bodies are 
open to the public for inspection and copying.  The Administrator shall act as 
the custodian of records and security officer.  

All requests for public records of the Health Department should be given, in 
writing, to the administrator.  A fee may be charged which does not exceed the 
actual cost of search and duplication, and payment may be requested prior to 
the making of copies.  Original public records of the Health Department shall 
not be removed from the premises.  Per Missouri Sunshine Law, fees may not 
exceed 10 cents per page plus the hourly rate of health department clerical 
staff for copying services.  Research time shall be billed at the actual cost of 
time expended.  Requests for access to public records shall be acted upon by 
the end of the third business day following the date the request is received by 
the Administrator, except for reasonable cause.  If access to records is denied, 
the Administrator shall provide, upon request, a written statement of grounds 
for denial.

Material which is open to the public shall be kept separate, as far as
practicable, from Materials which are closed to the public.

Examples of public records:
Activity reports
Notice of open meetings
Board meeting agendas
Minutes of Meetings of Board of Trustees (excluding closed session minutes)
Job descriptions
Assessed valuations
Annual Budget
Audit reports
Financial reports
Food inspections
Sewage permits
Motel inspections
Environmental complaints

Examples of closed records:
Minutes of Closed Session of Board of Trustees
Applications for employment
Personnel records
Grievance filings
Individual earnings records
Bank Statements
Vital records, unless allowed by statute
All patient medical records, except as allowed by statute
WIC client files
Car seat distribution records

References
•	RSMO 610.010 to 610.030
•	RSMO 167.183

O.	PROPERTY, TIME AND EQUIPMENT

This policy is to provide guidelines regarding the use of department time, 
equipment and property.  An employee’s time, while on the job, shall be used
 productively for health department matters.

The Department provides property, equipment, supplies, materials, computers, 
files and other resources for employees to effectively perform their assigned 
duties.  These resources are for official use only.  The use of department 
property, time, equipment, supplies or other resources for personal matters, 
unless otherwise allowed in this manual, is prohibited.  Authorized personal 
usage shall not provide any personal financial gain for the employee and the 
employee will pay any cost incurred.  

Assets purchase through grant monies shall only be used for their intended 
purposes. All equipment is to be inspected prior to each use and maintained in
good, working condition.  Non-functioning or damaged equipment is to be
reported immediately to the Nursing Supervisor or Administrator for repair. 
Lost equipment is to be reported immediately to the Nursing Supervisor or 
Administrator for investigation.  

The Accounting Clerk will maintain equipment records to include a description, 
the serial number or other identifying number, the source of funding for the 
property, who holds title, acquisition date; and the cost of equipment, the 
location, use and condition, and any ultimate disposition data including date of 
disposal and sale price of equipment.  The Administrator will initiate and 
manage a physical inventory of equipment with results reconciled on the 
equipment list, every even-numbered year; and, any loss, damage or theft is to 
be investigated by the Nursing Supervisor and Administrator.  

Negligently damaging property or losing equipment, supplies, material or other 
departmental resources by the employee or while in the care of the employee is 
prohibited.  Such action may result in the payment for the replacement or the
repair costs by the employee or former employee.

Knowingly damaging or destroying property, equipment, supplies, material or other departmental resources by the employee or while in the care of the employee is prohibited.  Such action may result in criminal prosecution as set forth in applicable laws and/or the payment for the replacement or the repair costs by the employee or former employee.

Equipment shall be maintained in good working condition.  Any required maintenance or repair, other than routine, shall be approved by the Administrator and then follow Procurement procedures.  Equipment at end of life, or otherwise deemed unnecessary to keep, shall be approved for disposition by the Board of Trustees.  Equipment purchased by grant monies shall follow disposition procedures set forth by the government agency from which equipment was purchased through.  Disposition records shall be maintained as governed by the records retention policy.

	P.	VACCINE COUNT POLICY

Vaccine for Children’s (VFC) vaccine and Private Pay vaccine will be counted weekly.  At minimum one nurse and one other staff member will count vaccine.  
Both staff members will ensure that all vaccine is placed back into the proper refrigerator or freezer once it is counted in order to maintain the cold chain at all times.  
1.	Per policy, two staff will count vaccine and reconcile the count if it is off to find the missing doses.  
2.	Both staff members will initial/sign and date the count sheet.
3.	The area where vaccine is counted will be double checked after counting to ensure all vaccine is put away and not left sitting out.
4.	During the counting process, the expiration date will also be verified on each vaccine and a note made on the white board hung outside the refrigerator of any vaccine expiring within the next 3 months in an attempt to minimize wasting of vaccine.

Q.	Religious Exemption Policy

The mission of Macon County Health Department is to protect, promote and improve the health and quality of life in Macon County. Since vaccines are the best protection against several serious and/or deadly diseases, the responsibility of health department staff is to educate citizens about vaccines. This includes the following: immunization schedules, vaccine guidelines, safety and effectiveness of vaccine, evidence-based information and the consequences of not vaccinating especially in an outbreak situation, among other effective educational data. Religious exemptions can be counter-intuitive to population health especially among the youth of our county. 

The following policy will apply in releasing religious exemption cards:

1)	Religious exemptions require a health department nurse consultation.
2)	Religious exemption forms are not to be distributed without parent/guardian consultation.
3)	Consultations by appointment only.
4)	Handout(s) provided on “what parents need to know”, offered by the DHSS-Immunizations, explained by a health department nurse and addressing all concerns.
5)	Positive validation of child safety must remain priority even if opinions differ, ex. “I can tell you are concerned about the safety and well-being of your child, let me tell you how vaccines can help keep your child safe from serious diseases.”
6)	If during the course of consultation, the nurse determines that the parent/guardian concern is medically inclined, then the nurse will refer the client to their primary care physician for consultation for a medical exemption.

If after the consultation the parent/guardian still requests an exemption, it shall be provided without further discussion.

R.	TELEPHONE PROTOCOL

It is the standard of Macon County Health Department to treat all clients, vendors, and visitors with respect and professional courtesy.  Telephone calls must be handled pleasantly and politely.  All clients, families and agencies desire a “user friendly” Health Department and as such, staff shall offer client-friendly service and respect to everyone, in person and via telephone.

1.	Client information is confidential and is not to be given via telephone.

2.	Calls for referrals, service, and questions regarding health problems or concerns are to be handled only by a nurse or the Administrator.

3.	Clerical staff is to obtain a name and telephone number of the caller and direct this information to the appropriate staff for follow-up if the staff member is unavailable at the time of the call.  Return calls are to be made in an expedient manner.

4.	Inquiries from clients regarding nurse availability may be answered when clerical staff is aware of nursing schedules.

5.	Health Department telephones are for business use only.  Employee personal calls of an urgent nature are acceptable and are to be taken in a private area away from clients.  Frequent, lengthy or recurrent personal calls are considered misuse of equipment and time and are unacceptable.

S.	CELL PHONE / SOCIAL MEDIA 

		Cell Phone

The Macon County Health Department recognizes and understands the need for personal communication in the event of emergent family situations.  In that regard, the Health Department does not prohibit employees from carrying personal cell phones.  But given its mission, MCHD places high value in promoting the health and welfare of its clients, and as such, a strong regard in the timely treatment of client needs.   Therefore, the following restrictions are enforced with regard to personal cell phone use:
		
1.	Cell phones are to be placed on silent/vibrate at all times while in the building, at meetings, or while in the community performing work on behalf of the Health Department;
2.	Personal calls or texts are not to be answered in the presence of clients; and, work with clients is not to be interrupted to answer personal calls or texts; 
3.	Personal calls and texts are to be returned, or taken in a quiet place away from clients, at a time when it will not disrupt operations, and kept at a minimum;
4.	Employees are prohibited from using personal cell phones to record or photograph patients, visitors, or other confidential aspects of the Health Department’s facility operations, unless with express permission from the Administrator;
5.	Frequent personal calls or texting is considered a misuse of Health Department time.

MCHD recommends that employees inform family members of this policy and request that they limit personal calls to break and lunch times when possible; and, at the very least, let them know that calls will be sent to voice mail when working with a client and that the call will be returned the first moment possible in order not to alienate the client.

Personal cell phones are permitted to be used for professional purposes during the conduct of Health Department business, both in the office and in the community.  Employees are cautioned to keep a firm separation of business use and personal use of cell phones during business hours and are to first and foremost care for client needs before responding to routine business calls or texts.  The exception to this rule is when using a cell phone to communicate information as a part of client care.  Health Department information sent or received on a personal device is subject to Health Department scrutiny at any time by the Administrator, Nursing Supervisor, or Board of Trustee member. 

Social Media

The use of social media can be a powerful way to reach the health department’s target audience with strategic and effective messages, to promote services and events.  It can also be used during times of public health emergencies as a means to educate and inform the community.  MCHD further recognizes how intricately woven social media has become in our lives and the value social media has in promoting the mission of the Health Department.  

Accessing social media on cell phones or the Health Department’s computers for personal use during work time is strictly forbidden.  MCHD suggests the following guidelines for employees when posting on social media for personal use outside of business time:

1.	Keep personal and professional communications separate at all times;
2.	Do not post anything related to Health Department work on personal sites.  Never discuss clients, your supervisor, your work day, the Health Department, or any other topics related to business;
3.	Maintain objectivity – avoid controversial issues;
4.	Remember that what is posted online is there forever;
5.	Be sure that you are comfortable with anything you post being seen by current or future employers, your clients, or your family members.
6.	Social media tracks posting times and coworkers can see when messages are posted during work hours.

Use of social media to promote the Health Department is to be approved by the Administrator or Nurse Supervisor to control the message content prior to posting.  MCHD’s social media is to be professional, educational, and informational in nature.  Avoid using a negative spin - message content is to be stated positively even when shedding light on a negative subject.  Use of client pictures and privileged information is strictly forbidden; however, client pictures may be posted on social media only with their written consent.  

Objectives
The role of social media will be to inform and educate the community on health department events and current and timely information pertinent to public health issues.  Some items may include, but are not limited to:
•	Promote services
•	Announce events
•	Advertise classes or support groups
•	Provide evidence-based information or resources
•	Link to state resources

Content
Content posted on MCHD social media sites is to be pre-approved messages that meet the objectives set out within this policy.  Social media postings shall be for health department business, and, information and website links shall be evidence-based and, where applicable, in line with information provided by the Missouri state government.  Information related to religion or politics shall not be posted.  Social media shall not be used to promote specific product brands.  Staff will not counsel participants or answer detailed questions through social media.
Roles and Responsibilities
Certain appointed MCHD staff will develop initial messages to be sent out on the health department’s social media sites.  These messages are to be approved by the health department Administrator or Nurse Supervisor prior to posting.

Review Schedule
All social media sites are to be reviewed monthly by the MCHD administrator and updated accordingly.  
Social Media sites authorized for promoting health department services are:
Web site:  http://www.maconmohealth.org
Facebook page:  https://www.facebook.com/macon-maconcounty-health-department-417355541682732/ 
The MCHD WIC Agency Social Media Policy may be found as an addendum to these policies and shall be followed when using social media to promote WIC activities, notices and education.
Violation of MCHD’s cell phone and social media policy is subject to disciplinary action.

T.	Information Technology

1.	E-mail, as well as other types of electronic communication, will be used in the legal and appropriate sharing of information to support and enhance the department’s business and all electronic communication must be legal and comply with HIPAA regulations and Macon County Health Department’s policies.

2.	Electronic communication must not be harassing, libelous, or disruptive
     to others’ operations and must follow all copyright laws.

3.	Electronic communication must follow all laws and regulations, including 
those governing the import and export of technology, software and data.

4.	Unauthorized access to an account of another user is prohibited.  The        Administrator has the authority to authorize and access employee accounts at any time.  All users should be aware that the use of intra-department systems may be recorded and archived due to the Sunshine Law, and that information contained within may be monitored, retrieved and reviewed if, at the Administrator’s discretion, there is a business reason to do so.           
5.	The e-mail system is not intended to be a tool for maintaining long-term records and e-mail messages that qualify as a business record are subject to printed record retention.

6.	Electronic communication content is a direct reflection of the Macon
     County Health Department’s reputation.  The Health Department will not 
     tolerate the use of threats, insults or obscenities within electronic 
communication documents.  Electronic communication that interferes with        work or other networks is prohibited.  Electronic communication may not be sent within the department that does not reflect the policies of Macon County Health Department or reflect poorly on the county’s reputation or image.

7.	The Health Department, in its discretion as owner of electronic communications systems, reserves and may exercise the right to monitor, access, retrieve, and delete any matter stored in, created, received or sent over MCHD e-mail system, for any reason without permission of any employee.

U.	Safe Driving Policy

Driver and pedestrian safety are important.  Staff who drive for health department business will observe all driving laws and posted speed limits.  Cell phone and/or hands-free mobile device use is prohibited while driving; and, seat belts are to be worn at all times whether driving or a passenger.
V.	Fire Safety Policy

Policy
This policy was established to provide guidance to MCHD staff to react to a fire in the health department facility.  It is further to be reviewed annually by all staff as a refresher and made a standard part of new employee training.

Procedure
Staff shall follow the RACE procedure when detecting a fire:
	Rescue – remove those clients from immediate danger of the fire.
Alarm – alert those in the building about the fire by either loudly calling out “FIRE” and “(LOCATION)” or announcing this information by overhead paging.
Call or direct another staff member to contact 9-1-1.
Contain – contain the fire if possible, by closing the door to the room if unable to extinguish.
Extinguish – if practical locate the nearest fire extinguisher and attempt to extinguish the fire.

Fire routes are posted in all public areas of the building and exit signs are attached to the ceiling above all exit doors.

The safe location has been designated to meet at the road sign at the corner of Missouri Street and Walnut Street.  Once assembled, the Administrator (Nursing Supervisor or Accounting Clerk in the Administrator’s absence) shall make a head count of all staff, clients and visitors to ensure everyone is safely departed from the building.
•	Front desk staff shall escort all clients in the waiting room area to the safe location, taking care to check the visitor restroom for occupants.
•	Nutritionist, BFPC and EPHS shall escort all clients in their areas to the safe location.
•	Nursing staff shall escort all clients in the clinic rooms to the safe location, taking care to check the west staff/client restroom.
•	The Administrator (Accounting Clerk or Nursing Supervisor in the Administrator’s absence) shall escort visitors in the kitchen area and conference room to the safe location, taking care to check the north staff/visitor restroom.  

Staff, clients and visitors are to wait at the safe location until directed by Fire or Law that it is safe to return to the building.
  
W.	Severe Weather/Tornado 

Policy
This policy was established to provide guidance to MCHD staff to react to severe weather or tornado warning.  It is further to be reviewed annually by all staff as a refresher and made a standard part of new employee training.

Procedure
Weather alert radios are positioned in the front office and in the education room of the facility, and are audible to staff in those areas.  Further, the City of Macon has a tornado warning siren.  

With regard to a tornado, a watch means that conditions are favorable for a tornado to occur. A warning means that a tornado has been seen or picked up by radar.  A warning requires staff to take shelter and brace for a potential tornado.

Once alerted to an immediate threat of weather danger, the staff member will announce by overhead paging “severe weather – take cover”.  Staff will then proceed to the dedicated safe room – the Education Room – following these guidelines:
	
o	Front desk staff shall escort all clients in the waiting room area to the safe location, taking care to check the visitor restroom for occupants.
o	Nutritionist, BFPC and EPHS shall escort all clients in their areas to the safe location.
o	Nursing staff shall escort all clients in the clinic rooms to the safe location, taking care to check the west staff/client restroom.
o	The Administrator (Accounting Clerk or Nursing Supervisor in the Administrator’s absence) shall escort visitors in the kitchen area and conference room to the safe location, taking care to check the north staff/visitor restroom.  

Once assembled, close the safe room door.

The Administrator (Nursing Supervisor or Accounting Clerk in the Administrator’s absence) shall make a head count of all staff, clients and visitors to ensure everyone is present.  Staff, clients and visitors are to wait in the safe location until the weather threat has been announced all clear.

X.		Policies for MCHD COVID-19 Response – Rescinded 9/8/2021

1.	Positive client in the building
a.	Contact tracing within facility
b.	Close impacted areas per CDC’s cleaning and disinfecting guidance
i.	Consider altered rooms for continued provision of services within the building
ii.	Consider altered routes entrance/exit for continued provision of services
c.	Disinfect all impacted rooms per CDC’s cleaning and disinfecting guidance

2.	Positive staff member
a.	Contact tracing within facility
b.	Close facility per CDC’s cleaning and disinfecting guidance
c.	Disinfect all areas per CDC’s cleaning and disinfecting guidance
d.	Monitor all staff for 14 days
e.	All staff mask for duration and glove when providing services
i.	N95 and cloth when providing clinical services
ii.	Cloth mask when providing non-clinical, office services
iii.	Only one RN per service 
f.	Consider suspending services for 14 days
i.	Contact clients for comfort in coming in for services
ii.	Provide services in parking lot
g.	Employee may return to work with 2 negative test results taken 3 days apart
h.	Employee shall be off on administrative leave unless it is demonstrated that the virus was contracted due to employee negligence then employee is to use accrued leave time, or, leave will be unpaid if no accrued time is available

3.	Staff member coming in direct contact with a positive case outside of facility
a.	Quarantine staff member for 14 days 
b.	Return to work if remains asymptomatic
c.	Employee shall be off on administrative leave unless it is demonstrated that the contact was made due to employee negligence then employee is to use accrued leave time, or, leave will be unpaid if no accrued time is available

4.	Staff member living with a positive case
a.	Quarantine for 14 days or until meeting the clinical guideline for release
b.	Return to work if asymptomatic for 14 days
i.	Mask until positive case is released
ii.	Mask (N95 and cloth) and glove if providing clinical client services
c.	Employee shall be off on administrative leave 

5.	Staff member travels to Missouri hotspot or travels out of state
a.	If travelling by private vehicle, employee may return to work wearing mask for 14 days – glove if providing services
b.	If travelling by airplane, employee shall be placed on 14 days quarantine using their accrued leave time, or, leave will be unpaid if no accrued time is available

Y.	Threat Policy
	
Macon County Health Department staff interacts with a variety of clients through phone, electronic media, and in-person.  It is anticipated that these interactions would remain professional and mutually respectful.  However, there are times where client interaction can be considered aggressive and threatening.  MCHD staff are expected to remain calm and work to de-escalate client temper.  However, there are times when de-escalation does not work and a client will lodge a credible threat.  
Credible threats will not be tolerated.  Threats in any manner through any media, including social media, phone calls, or in person, will be deemed credible and acted upon through a formal complaint to the Prosecuting Attorney’s office.
Phone Threats:  MCHD staff will work to identify all callers at the onset of conversations.  If unable to solicit the caller name, the MCHD phone system does provide caller ID where the phone number is identified on the phone screen.  When a caller turns aggressive MCHD staff will write down the name and/or number of the caller.  
Social Media Threats:  Threats made through social media either as a result of a MCHD post or unsolicited, MCHD PIO will take a screen shot of the threat for action.
In-Person Threats:  Threats made by a client in person will follow the Personal Security policy in the MCHD Personnel Policies handbook.
Action: Staff receiving a threat will immediately report the threat to the Administrator.  Staff will then write a summary of the situation to include name, phone number, and address if known of the person voicing the threat.  The Administrator will file a complaint with the city police, sheriff’s office, or the Prosecuting Attorney’s office that same day.  

II.	PERSONNEL POLICIES

A.	EMPLOYMENT POLICIES 

EHICS AND PROFESSIONAL CONDUCT 

Macon County Health Department employees will present themselves and conduct their business with professionalism and respect for the public which they serve.  Employees will conduct their business to meet the mission of public health for the safety and welfare of the community, by adhering to the following principles.

Principles of the Ethical Practice of Public Health
1.	Public health should address principally the fundamental causes of disease and requirements for health, aiming to prevent adverse health outcomes.
2.	Public health should achieve community health in a way that respects the rights of individuals in the community.
3.	Public health policies, programs, and priorities should be developed and evaluated through processes that ensure an opportunity for input from community members.
4.	Public health should advocate for, or work for the empowerment of, disenfranchised community members, ensuring that the basic resources and conditions necessary for health are accessible to all people in the community.
5.	Public health should seek the information needed to implement effective policies and programs that protect and promote health.
6.	Public health institutions should provide communities with the information they have that is needed for decisions on policies or programs and should obtain the community's consent for their implementation.
7.	Public health institutions should act in a timely manner on the information they have within the resources and the mandate given to them by the public.
8.	Public health programs and policies should incorporate a variety of approaches that anticipate and respect diverse values, beliefs, and cultures in the community.
9.	Public health programs and policies should be implemented in a manner that most enhances the physical and social environment.
10.	Public health institutions should protect the confidentiality of information that can bring harm to an individual or community if made public. Exceptions must be justified on the basis of the high likelihood of significant harm to the individual or others.
11.	Public health institutions should ensure the professional competence of their employees.
12.	Public health institutions and their employees should engage in collaborations and affiliations in ways that build the public's trust and the institution's effectiveness.
Disciplinary action may result from willful violation of these standards.  
(The Principles of the Ethical Practice of Public Health was printed from A Code of Ethics for Public Health written by Thomas, Sage, et al, and published on the NCBI web site https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447186/)

1.	PROBATIONARY PERIOD

All employees are required to serve a three-month probationary period following original appointment, reinstatement or re-employment. The probationary period is utilized for closely observing the employee’s’ work performance, for securing the most effective adjustment of the employee to his/her position and for determining whether the employee is a proper fit within the Health Department.  It is also used as a time for the employee to determine whether MCHD is their right employment.

An employee may be terminated at any time during the probationary period for unsatisfactory work performance or misconduct, without right of appeal.

At the end of the three (3) month period the employee will receive an evaluation.  If an evaluation warrants, the probationary period may be extended at the discretion of their supervisor.

2.	EVALUATIONS

The purpose of the evaluation is an informally open discussion between an employee and his/her supervisor about the employee’s performance, jointly set goals for the next performance period, and to improve health department processes and working conditions.  Evaluations are reviewed at the completion of the initial probationary period and then periodically throughout the year thereafter as determined by the employee and their supervisor.  Evaluations can be given when performance falls below standard or when an employee transfers to another position.

Performance expectations through written job descriptions are provided as a part of employment orientation and job training requirements.

Evaluations are a part of your permanent personnel record.  They are considered when determining salary increases, under applicable rules and policies, and as a factor in promotions.  

3.	PROMOTION AND RECLASSIFICATION

The Board of Trustees supports and encourages the career development and advancement of employees. All qualified employees will be considered for promotion as opportunities arise.

Official announcements of vacancies within the Department of Health & 
Senior Services or other Public Health Agencies are listed online in the DHSS Friday Facts and are accessible to all staff.

4.	DISCIPLINARY ACTION

		Disciplinary action is used to correct unsatisfactory behavior when coaching 
		proves to be ineffective.  The following are causes for disciplinary action, 
		including suspension, demotion or dismissal, depending on the severity 
of the infraction.  However, this is not to be considered an exhaustive list and 
discipline may be based upon causes other than these:

A.	Has willfully violated any of the rules, regulations, policies, procedures, or provisions of the Health Department to include willful violation of HIPAA policies.
B.	Is incompetent, inadequate, careless or inefficient in the performance of duties (specific instances to be charged) or has failed to meet established minimum standards in the performance of such duties.
D.	Has been careless or negligent in the care of the property of the Health Department or State.
E.	Presents with a permanent or chronic physical or mental ailment or defect which incapacitates him/her for the proper performance of the duties of the position for which no reasonable accommodation can be determined, including un-rehabilitated alcoholism or narcotics addiction.
F.	Has been habitually tardy in reporting for duty or has absented himself/herself frequently from duty during the course of regular working hours or has been completely absent from duty without prior or subsequent authorization for such absences.
G.	Has been convicted of a felony or of a misdemeanor involving moral turpitude.
H.	Has been found guilty of scandalous and disgraceful conduct which brings the department into public disrepute or has exhibited behavior which adversely affects the employee’s job performance and/or the Health Department.
I.	Has been found guilty of abusive or improper treatment of guests or
clients.
J.	Has submitted false statement of a material fact or has practiced or examined or has otherwise attempted to secure employment subject to the provisions of these rules.  
K.	Has been guilty of insubordination or has failed to respond in a reasonable manner to the lawful orders or instructions of persons with duly delegated authority over the employee.
L.	Has been abusive or physically violent toward other employees while on duty or in the duty area or has willfully exhibited behavior which is disruptive to the work activities of other employees.
M.	Has been intoxicated or under the influence of a controlled substance while on duty, except as may have been required by a licensed medical physician.
N.	Has practiced or attempted to practice fraud or deception in securing or attempting to secure benefits or grants from a state agency either for himself or for another applicant.

Discipline normally will be administered in four progressive steps with a signed record of each step maintained in the employee’s personnel file:
1.	Oral counseling 
2.	Written reprimand
3.	Suspension
4.	Dismissal or demotion

Discipline may be initiated and administered at any one of these steps, including suspension or dismissal/demotion, depending upon the nature of the cause for disciplinary action.

5.	 RESIGNATION OR RETIREMENT

In order to resign in good standing, an employee must submit a letter of resignation to the Administrator at least (15) calendar days prior to the effective date of resignation.  The administrator may agree to accept notice of less than fifteen (15) days due to extenuating circumstances.  The last day on the job is considered the effective resignation date unless on sick leave or leave of absence immediately prior to termination.  Payment for accrued annual leave after the last day worked will not be considered as active duty and will not count as employment for purposes of earning leave even if the effective date on the letter of resignation or the Personnel Transaction Record is after the last day worked. 
An employee will be paid for accrued annual leave and unused compensatory time when employment is terminated.  Unused sick leave will not be paid upon employee termination.

When an employee voluntarily terminates employment, they will be requested to participate in an exit interview or to complete an Exit Interview Survey form prior to their last day on active duty.  The purpose of the exit interview survey is to identify employment conditions and factors from the employee’s perspective, to determine reasons for turnover, and, to identify problem areas.  Information will be treated as confidential.

6.	CONTINUING EDUCATION

Continuing Education Hours must have prior approval by the Administrator or Nursing Supervisor.

B.	JOB CONDITIONS

1.	ALCOHOLIC BEVERAGES AND CONTROLLED SUBSTANCES

No alcoholic beverages or controlled substances are permitted on the premises, or is an employee allowed to be under the influence of alcohol or a controlled substance while on duty.  Disciplinary action will be taken against any employee who reports to work in this condition.  A urine screen will be provided at the expense of the Health Department if the suspected condition has the potential for disciplinary action.  An employee testing positive for alcoholic beverages or controlled substances may be re-tested to refute the health department’s outcome, at an accredited lab and at the employee’s own expense. This policy does not apply to legally prescribed drugs which an employee is required to have for medical reasons.

	2.	TOBACCO RESTRICTIONS 
		
The Macon County Health Department is a Tobacco-Free Campus.  The Health 
Department provides a tobacco-free environment for employees and clients. 
Tobacco use is not permitted in any area of the Health Department or on 
Health Department property.  Tobacco use, including smoking, e-cigarettes and 
vaping, is not permitted outdoors on property owned by the health department.  

	3. 	CARDIO PULMANARY RESUSCITATION 

All nurses are to hold a current certification in American Heart Association’s Basic Life Support Health Care Provider CPR course.  All other staff is to be certified in American Heart Association’s First Aid/CPR/AED course.  
	
	These courses are provided by an approved American Heart Association 
	instructor at the cost of the Health Department.

          4. 	ANNUAL TB TEST/IMMUNIZATIONS
	
	All employees will have an annual TB skin test administered at no charge to the employee.  Immunizations are to remain current and MCHD will provide the following vaccines at no cost to the employee: Hepatitis A, Hepatitis B, Td/Tdap, and annual flu vaccine.  If the employee has a contraindication to any of these vaccines, a waiver is to be signed by the employee.

5.	CONFLICT OF INTEREST (Acceptance of Gifts or Other Benefits)

Health Department employees are prohibited from accepting compensation, gifts, favors or any benefits from any individual, firm or organization for work performed as an employee or for any reason associated with an official assignment within the Health Department.  Employees are to report to their supervisor any attempt by an individual, firm or organization to influence official actions by the offering of personal benefits or favors, and that supervisor is to conduct an investigation into the matter and address any attempt with that organization in an appropriate and expedient manner.

Employees are prohibited from using their official capacities as Health Department employees to solicit or otherwise influence others for personal reasons or benefits.  No employee, officer or agency may participate in the selection, award or administration of a contract, especially those supported by Federal funding, if he or she has a real or apparent conflict of interest.  Such a conflict of interest would arise when the employee, officer or agent, any member of his/her immediate family, his/her partner, or an organization which employs or is about to employ any of those individuals, has a financial or other interest in or a tangible personal benefit from a firm considered for a contract.

Violation of these policies will result in disciplinary action up to and including termination.

An employee may accept an honorarium for Health Department related activities provided that the employee is on approved annual leave, or leave without pay, and provided there is no conflict of interest as determined by the Administrator.

Donations to the Health Department can be accepted and will be handled by the Administrator.

6.	INCLEMENT WEATHER

During inclement weather employees are to use common sense and judgment about driving the area in which they reside.  If an employee feels there exists unsafe travel conditions in their area, they are to contact their supervisor to decide a plan of action.  If together they decide the employee is unable to safely drive to work, then vacation leave or compensatory time will be used.  If the Health Department is closed or alternate work hours are determined, employees will be notified as described on the ‘Phone Tree’.  Administrative leave will then apply.  If an employee is concerned with road conditions in their area while at the office, they are to check with their supervisor and may be given permission to leave.  Vacation leave or compensatory time will be used.  If the Health Department is closed early by the Administrator, then administrative leave will apply. 

7.	VISITORS

The Health Department is a professional agency conducting confidential matters.  Friends and relatives of employees are not prohibited from visiting; but should limit visits to not hinder the conduct of normal business.  Employees are required to ensure that all confidential information is not accessible to any friends, relatives or visitors.  

8.	PERSONAL SECURITY

Personal security is in reference to an armed and/or dangerous individual who threatens violence, or, in case of a hostage situation.  Employees are the greatest asset of the Health Department.  The most important tool employees have for their own security is awareness. If an armed individual(s) is observed, gunshots are heard, someone is threatening, or word is received that such an event is occurring, immediately inform a co-worker or supervisor and call 911.  If able, move clients and visitors from the area and close and lock doors between you and the individual.  If the situation allows, page overhead the phrase “Will the (Administrator) please come to (location)”, or, push one of the panic buttons located at the clerical stations at the reception desk.  Either option indicates there is a violent intruder in the building.  DO NOT RUSH TO THE AREA! This is to alert the office that there is a situation and that it should be evacuated.  If employees are unable to evacuate the building, they should proceed to a secure area preferably away from harm, lock doors and turn off the lights.  Hide behind objects that prevent them from being seen or help shield them from gunshots.  To further assure the security of employees and others, office keys or door security codes should never be given to any unauthorized individuals and without the approval of the Administrator.   

C.	LEAVES OF ABSENCE

	1.	COMPASSION LEAVE

Funeral leave may be granted by the Administrator up to a maximum of three (3) working days as paid leave.  Additional unpaid leave may be used as requested.  Funeral leave is limited to immediate family including children, spouse, parents, employee siblings, and parents of the employee’s spouse.  If additional time-off is requested, annual vacation leave rules will apply.  Passing of a Grandparent will allow an employee one day of paid leave.

Paid administrative leave may be granted for funerals of co-workers.  Employees may attend the funeral of a co-worker or member of a co-worker’s immediate family as a representative of the Health Department, not chargeable to annual vacation leave but with the approval of the Administrator.

2.	LEAVE OF ABSENCE WITHOUT PAY 

A written leave of absence request will be submitted by an employee as early as possible for evaluation and approval by the Administrator and/or Nursing Supervisor.  Upon decision, the Administrator and/or Nursing Supervisor will provide the employee a written notice of approval or denial.  Due to the precedential nature of public health, many positions are unable to be left vacant for an extended period of time.  When an extended leave is granted, this is considered leave without pay and will take effect upon approval and generally after all other leave has been exhausted.  Leave of absence may be granted for extenuating circumstances but may be denied if the position cannot remain vacant for any length of time.  Continued employment is not guaranteed.  Should an employee be unable to return to work following a leave of absence, or if leave is denied but the employee deems it necessary and chooses to remain absent, employment will terminate (see attached form).

3.	FAMILY MEDICAL LEAVE ACT

		The Macon County Health Department, as a county government agency, follows
the Department of Labor’s guidelines for determining and granting FMLA as 
outlined on their web site http://www.dol.gov/whd/fmla/.  

To summarize salient FMLA points and further define MCHD’s policy:
1.	FMLA eligibility for a qualifying event is that employee will have worked for MCHD for at least 12 months; and, for at least 1,250 hours during the previous 12-month period.
2.	FMLA provides for up to 12 weeks eligible leave in a year and MCHD has elected to use a rolling 12-month period measuring backward from the date an employee uses FMLA. 
3.	The FMLA period is defined as 12 work weeks of leave and shall be tracked from the employee’s timesheets by the Administrator.
4.	Employee is required to give 30-day advance notice of anticipated leave date.  If 30 days’ notice is not practicable, because of a medical emergency or changed circumstances, the employee must give notice as soon as practicable generally within one or two business days of becoming aware of the need for FMLA leave.
5.	Certain FMLA requests will require medical certification to determine whether it is a qualifying event.
6.	While on leave, employee is required to report to the Administrator four weeks prior to the end of leave, and, then again one week prior to end of leave.
7.	For certain types of qualified leave, employee will be required to provide a fitness-for-duty certification by their physician to return to work.

Eligibility for benefits are as follows:  MCHD provided health insurance will continue throughout the leave period on the same terms as if the employee had continued to work, to include dependent coverage, supplemental insurances, and flexible spending account.  The employee must continue to make normal contributions to these premium costs.  Employee is required to use their accrued vacation and sick time while on FMLA leave.  During this paid portion of leave, vacation and sick time will continue to accrue and all premiums will be deducted accordingly.  If/once accrued time off is expended, FMLA will continue as unpaid time off through the duration of the leave period.  If an employee does not have enough accrued time to cover the duration of their leave, they must work with the Administrator prior to the start of their leave to determine payment method through a means voluntarily agreed-to by the employee and Administrator.   Employee failure to pay health plan premiums may result in the cancellation of those plans.  If an employee’s premium payment is more than 30 days late, MCHD may drop the employee’s insurance coverage.
If employee is unable to return to work after FMLA leave expires, they are required to notify the Administrator immediately upon discovery to determine whether authorization for additional time off will be allowed.  MCHD will follow DOL guidelines to administer the FMLA in accordance with the Americans with Disabilities Act.  
These points are not inclusive of all FMLA guidelines as outlined by the Family Medical Leave Act.  More defined guidelines and explanations can be found on the Department of Labor’s website.  

  4.	SICK LEAVE

Full time employees earn sick leave at the rate of ten (10) hours per month. Employees who work intermittently, or on an hourly or PRN basis, are not eligible to earn sick leave. Part-time employees will accrue sick leave as listed on the chart below.

The number of hours accrued per month is calculated by the number of hours the employee is in paid status.  This includes hours worked, hours on paid leave, and paid holidays.  Hours of paid leave following termination of employment are not used in calculating sick leave.  

Sick leave is earned at the maximum rate of ten hours per month regardless of length of service.  There is cap of 500 hours of sick leave that may be accrued. 

Hours in Active Pay Status			Hours Earned
	160 or more						10
120-159	7.5
80-119						5
Less than 80						0

Sick leave may not be used prior to the time it is earned but may be used in multiples of 15 minutes.

Request for sick leave in excess of 3 days must be accompanied by a physician’s verification or if employee is hospitalized then no verification is necessary.  Request for sick leave in excess of 3 days may qualify for Extended Leave similar to Family Medical Leave.  Sick leave is granted for employee illness, employee’s spouse, children in the home, and doctor appointments.  

When an employee is sick and unable to report to work or need to stay home to care for an ill dependent, they are to notify the office at least 30 minutes prior their scheduled work time when able, but not later than their scheduled start time.  The employee will speak directly to the Nursing Supervisor or Administrator so that they will be informed of the employee’s absence.  The employee will only report to other Health Department staff should the Nursing Supervisor or Administrator not be available.  The absence will be posted on the Message Bulletin Board by the staff taking the call.  It is the employee’s responsibility to inform the Nursing Supervisor or Administrator of their health status daily, or the status of their sick dependent, and whether there is work that requires coverage that day.

If sickness occurs during business hours, notify the Nursing Supervisor or Administrator as soon as possible, informing them of any job duty that requires coverage.  

Extended or planned, sick, or similar to FMLA leave should be scheduled in advance whenever possible and approved by the Administrator.

Sick leave is verified by the Administrator/Nursing Supervisor at each payroll.  If sick leave is not approved due to either insufficient leave accumulated or inappropriate use, the absence will be recorded as annual leave or leave without pay.  Unused sick leave will not be paid upon employee termination.  

5.	WORKMEN’S COMPENSATION

As an employee of the Macon County Health Department, employees are covered by Workman’s Compensation Insurance for job related injuries.  If injured while on duty and require medical attention, the employee should go to the emergency room in an approved hospital.  Compensable medical or hospital expenses are paid by the State Worker’s compensation Insurance rather than the employee’s medical insurance.  An employee may elect to go to their own physician; however, Workers’ Compensation may not cover the cost – it is the employee’s responsibility to notify their primary care physician of a work-related injury prior to seeking medical attention for injury.  Non-life-threatening injuries shall be reported immediately to the Administrator or Nursing Supervisor and an incident report filed per the claim reporting process of the health department’s current Workers Compensation carrier.  If an employee is injured while performing their job, report to the Nursing Supervisor or Administrator immediately and an incident report will be filed on their behalf.

6.	UNEMPLOYMENT COMPENSATION

Macon County Health Department employees are covered by unemployment compensation paid entirely by the employer.

7.	VACATION “ANNUAL LEAVE”

One benefit provided to employees by the Health Department is vacation or “annual leave”.   Vacation time accrual is demonstrated in the following tables.  Employees working intermittently on an hourly or daily basis do not earn paid vacation leave.  The number of hours earned per month is based on the number of hours the employee is in pay status.  This includes hours worked, hours on paid leave and paid holidays.  Hours of paid leave following termination of employment are not counted for purposes of earning vacation leave.

One month to 10 years’ service – 240 hours maximum
		Hours per Month in Active Pay Status	Hours Earned
		160 or more						10
		120-159						7.5
		80-119						5
		Less than 80						0

10 years to 15 years’ service – 288 hours maximum
Hours per Month in Active Pay Status	Hours Earned
			160 or more						12
			120-159						9
			80-119						6
			Less than 80						0
15 years or more of service – 336 hours maximum
Hours per Month in Active Pay Status	Hours Earned
160 or more						14
120-159	10.5
80-119	7
Less than 80						 0

Annual vacation leave may not be used prior to the time it is earned but may be used in 15-minute increments once it is earned.  Vacation leave is not charged for Holidays that fall within a period of annual leave.  All annual vacation leave must be requested as far in advance as possible in writing and approved by the Administrator and can be canceled by the Administrator when necessary for the changing needs of the Health Department.  Vacations will be posted on a calendar on a first come, first served basis, with no two employees requesting vacation during the same time period unless approved by the Administrator or Nursing Supervisor.  An employee will be paid for accrued annual vacation leave when employment is terminated. (See attached request for leave form)

8.	Leave Pool 

Macon County Health Department’s personnel policy allows full time employees with benefits to accrue up to 500 hours of sick leave time.  While the Family and Medical Leave Act protects an employee’s position, it does not provide for compensation during FMLA leave.  Employees are allowed to accrue annual vacation leave and sick leave which can be used for compensation during a leave of absence.  The health department Board of Trustees does recognize that there may be times of extenuating circumstances when an employee experiences catastrophic illness or injury that exhausts their vacation and sick leave hours.  This Leave Pool is designed to assist employees during such times.

The Leave Pool will accumulate hours from one of two ways, or both.  Under current sick leave policy employees can accrue no more than 500 hours.  Traditionally any hours over and above 500 would be removed.  This policy will allow any hours accrued above 500 to be placed in the Leave Pool.  The pool will be updated each payperiod by the Administrator where any employee exceeds 500 hours accrued sick time.  

The second way the Leave Pool will accumulate hours is through employee donation.  Employees will be allowed to donate up to 10 hours twice annually (total of 20 hours in a calendar year), from either vacation or sick time, or a combination of both, when the Leave Pool is low on hours as determined by the health department Administrator.  

The Leave Pool will accumulate hours without a dollar value.  The dollar value of those hours will be based on the hourly salary of the employee requesting time from the pool.  

Any full-time employee is eligible to apply for hours from the Leave Pool.  The employee must be designated for Leave without Pay and be eligible for catastrophic illness or injury as determined by the Board of Trustees at the time of application.  An employee in need may apply for up to 80 hours at a time as long as the Leave Pool has enough accumulated hours.  Hours will be available on a first come, first serve basis.

The Leave Pool will accumulate hours and be capped at 640 hours.  Forms required to be submitted to the Board of Trustees for their determination are the Leave Without Pay designation; the Leave Pool Donation form; and, the Leave Pool Request application (see attached forms).

D.	HOURS OF WORK

1	FULL-TIME/PART-TIME

The health department is open for normal operations 40 hours per week.  The regular hours of work for full-time employees are 8:00 a.m. to 6:00 p.m. with a half hour for lunch, or, 7:30 a.m. to 5:30 p.m. with a half hour for lunch.  The health department does not close to clients during lunch and as such, lunch is on a rotating basis, Monday through Thursday. Some positions may require varying work schedules.  As a benefit, full time employees are paid for their lunch time. 

Break time and lunch time cannot be combined for an extended lunch period.  The allowed time for lunch is 30 minutes and only earned after 4 hours of work for an 8-hour day and 5 hours of work for a 10-hour day. Lunch times will be staggered to accommodate clinics start times.

Employees working a half day are not allowed to include their lunch break as time paid for that day. 

Employees are required to notify co-workers before leaving the premises for lunch and gain permission from the Nursing Supervisor or Administrator for an early lunch.  Lunch times may vary depending on scheduling, but normally fall between 11:30 am and 1:00 pm.

Employees in part-time positions normally work on specified days or a specified number of hours during the day.  An employee serving on a part-time unclassified appointment may work intermittently on an “as needed” basis.

2.	OVER-TIME/COMPENSATORY TIME OFF

When required to work outside of regular business hours, employees will adjust their work hours on that day or within the week when practical, to avoid the accumulation and reporting of overtime.  When the work schedule cannot be restructured, overtime must have the prior approval of the Nursing Supervisor or Administrator. 

Overtime for Non-exempt employees will be computed in the same manner as prescribed by the Fair Labor Standards Act: Work more than 40 hours in a normal payroll week will be compensated at one and a half times the regular rate of compensatory time (i.e. work one hour, receive one and a half hours in compensatory time off).  

Approved leave as described in these policies may not be used in accumulation of overtime – overtime is based on accumulation of time in excess of 40 hours worked during a payroll week.  Computation for overtime will begin when an employee works more than 40 hours in a normal payroll week, any additional time worked in that week will be considered compensatory at an hourly rate. Compensatory time off will be approved by the Nursing Supervisor or Administrator in advance.  

Compensatory time off should be scheduled at the employee’s convenience; however, the Nursing Supervisor and Administrator are both responsible to maintain the appropriate staffing for their work unit.  Compensatory time should be taken throughout the month so that none accumulates from month to month.  Compensatory time off may be taken in 15-minute increments.  Exceptions to any of the conditions set forth in this policy will be made only under unusual circumstances and with the approval of the Administrator.

Exempt employees may flex their schedules to manage hours worked over 40 within a pay week, but do not earn overtime/comp time.  Exempt employees, per the Department of Labor definition, will be compensated their full-time rate of pay regardless the hours worked each day/pay week, unless full days are taken due to vacation, sick, holiday or other administrative leave.  

3.	FLEXIBLE TIME

In emergency situations (illness, car trouble, or other unexpected circumstances), in which the employee will be late reporting to work, the employee will notify the Administrator or Nursing Supervisor immediately.  If the employee reports to work within an hour, they are able to make that time up on that day or at least within that pay week.  If the time they report late exceeds an hour, they will be required to use sick or vacation time (if they are accruing sick/vacation hours).

E.	USE OF DEPARTMENT FACILITIES

Employees desiring to use Macon County Health Department facilities for work-elated 
	group meetings after regular working hours must have prior approval from the 
	Administrator or designee.

F.	REST PERIODS

Employees are allowed two 15-minute rest periods (one in the morning and one in the afternoon).  Under certain circumstances such as emergencies or workload deadlines, it may not be possible to take breaks.  Because rest periods are paid, time worked during a period normally designated as a rest period is not considered as overtime and may not be used in adjusting a work schedule for lunch, late arrival or early departure.  The employee is responsible for rest-periods and missed rest-periods cannot be recovered at lunch or the end of the day. 

G.	HOLIDAYS

	The Board will decide on the list of paid Holidays each year. 

Office hours and paid time off for the holiday depend upon the date and weekday of the holiday.  A holiday observed on a Friday may or may not be observed the previous business day depending upon the holiday observed and is subject to the Board’s discretion.

Full-time employees will be paid for 10 hours on approved holidays and part-time employees working at least 80 hours a month will be paid for 8 hours if the holiday falls on their regularly scheduled day to work. 

Christmas Eve and New Year’s Eve holidays may have varying hours and employees may be asked to use personal leave/vacation time depending upon the office hours for that date.

H.	IMPROVEMENTS AND GRIEVANCE 

1.	SUGGESTIONS FOR IMPROVEMENTS

	All programs and procedures can be modified and improved.  All citizens of Macon County, Health Department employees and members of the departments’ Board of Trustees are encouraged to submit written suggestions detailing ways to improve services.  All suggestions shall receive careful consideration, and notification will be provided to the person suggesting ideas about the final disposition of their suggestion.

 	2.	GRIEVANCE PROCEDURE
	
This grievance procedure has been established pursuant to Personnel Division Rule 1 CSR 20-4.020 to provide employees of the Health Department a means for formal discussion and resolution of employment problems which they have been unable to resolve through informal channels.

	The grievance procedure may be utilized for employment conditions and related matters over which the management of the Health Department has complete or partial jurisdiction.  A grievance must be a formal submission of complaint filed to the Administrator; or, if the grievance is against the Administrator, then the complaint is to be filed with the Chair Person of the MCHD Board of Trustees.  The Administrator or Chair Person is then charged with investigation and follow-up of the grievance, through to its final resolution and disposition.  

This grievance procedure does not limit the authority of management to administer the affairs and operations of the Health Department and the following issues are not allowable grievances under this procedure:

A.	The contents of personnel policies and procedures.

B.	Work activities accepted by the employee as a condition of employment, or, work activities or assignments which may reasonably expect to be part of the job content.

C.	Establishment of wages, salaries and position classifications consistent with the budget and the Health Department’s policies.

D.	Termination or demotion because of shortage of work funds, the abolition of a position, or, other material changes in duties or organization.

The Administrator of the Health Department is responsible for notifying current 
and new employees of the existence of the grievance procedure.

Individual or group grievances may be filed.  An employee may file a grievance without fear of retaliation or harassment due to filing such grievance, and supervisory and administrative staff shall not coerce an employee to refrain from filing a grievance.  No record of the grievance process will be placed in the employee’s official personnel file.  Failure of supervisory and administrative staff to comply with the grievance procedure and to implement grievance dispositions will be considered for disciplinary action.  The person filing a grievance may or may not learn of its resolution and/or disposition, depending upon the nature of the grievance and how it is regulated under HIPPA rules.  

I.	Whistleblower Policy 

If any employee reasonably believes that some policy, practice or activity of Macon County Health Department is in violation of law, a written complaint may be filed by that employee with the Administrator.  The complaint is to be typewritten on MCHD letterhead, dated, with pertinent information detailing the alleged violation, and signed by the employee submitting the alleged violation.

It is the intent of MCHD to adhere to all laws and regulations that apply to the organization, and the underlying purpose of this policy is to support the organization’s goal of legal compliance.  The support of all employees is necessary to achieving compliance with various laws and regulations.  An employee is protected from retaliation only if the employee brings the alleged unlawful activity, policy, or practice to the attention of the Administrator and provides the Administrator with a reasonable opportunity to investigate and correct the alleged unlawful activity.  The protection described below is only available to employees that comply with this requirement.  An employee who intentionally files a false report of wrongdoing will be subject to discipline up to and including termination.  

The Administrator will not retaliate against an employee who, in good faith, has made a protest or raised a complaint against some practice of MCHD, or of another individual or entity with whom MCHD had business relationship, on the basis of a reasonable belief that the practice is in violation of law or a clear mandate of public policy.  Any whistleblower who believes he/she is being retaliated against must contact the MCHD Board of Trustees’ Chair immediately.  The right of a whistleblower for protection against retaliation does not include immunity for any personal wrongdoing that is alleged and investigated. 

The Administrator will not retaliate against an employee who discloses or threatens to disclose to a supervisor or a public body any activity, policy, or practice of MCHD that the employee reasonably believes is in violation of a law, or a rule, or regulation mandated pursuant to law or is in violation of a clear mandate or public policy concerning health, safety, welfare, or protection of the environment.

Addendum to Social Media Policy
Macon County Health Department WIC Agency

Policy Area:  	Social Media Policy (WOM ER# 1.02150)

Purpose:  	To provide guidance to Macon County Health Department WIC agency and staff on appropriate use of social media, appropriate persons to use social media and the type of information that may be posted on the site(s). 

Policy:	The use of social media can be a powerful way to reach our target audience with strategic and effective messages.  Macon County Health Department may use social media to provide information to applicants and participants about the Missouri WIC program and to promote WIC services and benefits.  Social media sites facilitated by Macon County Health Department will be monitored by designated personnel to ensure all content is appropriate.  Staff shall not use their personal social media accounts to represent Macon County Health Department or the WIC program. 

Procedures: 
1.	Social media sites are considered an extension of the Macon County Health Department WIC Agency and may be used to:
a.	Promote WIC services.
b.	Announce upcoming events.
c.	Advertise breastfeeding promotion or nutrition events, classes or support groups.
d.	Invite participants to classes or support groups.
e.	Promote the fully breastfeeding food package.
f.	Communicate information on WIC approved foods.
g.	Help new mothers connect with breastfeeding peer counselors.
h.	Provide evidence-based breastfeeding and nutrition information and resources.
i.	Post recipes using WIC approved foods.
j.	Link to state WIC nutrition and breastfeeding resources.

2.	Macon County Health Department WIC agency staff shall be responsible for what they write and the messages conveyed to WIC participants. 

a.	Participant Confidentiality Policy WOM ER#1.01700 will be followed and the WIC agency staff shall not post any WIC participant information.  Violation of this policy could result in disciplinary action up to and including termination.
b.	All information and website links posted on a social media site shall be evidence-based and in line with information provided by the state WIC program.
c.	All information shall be culturally sensitive and professional.
d.	The health department Administrator or designee will be responsible for monitoring the social media sites on a monthly basis.
e.	Only the Macon County Health Department WIC address and telephone numbers shall be provided through social media.
f.	Local WIC social media sites shall be used for WIC related business.
g.	Content for the social media sites shall be developed by WIC staff (WIC Coordinator, CPA, Nutrition Coordinator, Registered Dieticians, Breastfeeding Coordinator or Peer Counselor) and approved by the agency Administrator or Nursing Supervisor.
h.	Information regarding or related to religion and politics shall not be posted on the social media sites.
i.	Social media sites shall not allow comments from the public.
j.	Social media sites must include the current USDA non-discrimination statement.
k.	Social media sites include a disclaimer that advice from other participants should never replace the advice from medical professionals.
l.	Social media sites shall not be used to promote or advertise specific product brands.
m.	Agency staff shall not counsel participants or answer detailed questions through social media.
n.	Local agency staff shall not use their personal social media accounts to represent the local WIC agency.
o.	Disparaging remarks about a participant or health care provider will not be tolerated and can result in disciplinary action up to and including termination.

Social Media sites authorized for promoting health department services include:

Web site:  http://www.maconmohealth.org
Facebook page:  https://www.facebook.com/macon-maconcounty-health-department-417355541682732/ 

MACON COUNTY HEALTH DEPARTMENT
GRIEVANCE REVIEW DISPOSITION

TO:	___________________________________		STEP DESIGNATION
( Name )				(Check appropriate box)

	___________________________________			STEP I
			( Title )

FROM:		______________________________			STEP II
		( Name )

		______________________________			STEP III
			( Title )

___________________________________
Signature

DATE OF RECEIPT OF GRIEVANCE REVIEW REQUEST:____________________

DATE OF CONFERENCE OR HEARING:__________________________________

GRIEVANCE DISPOSITION

(Indicate those present if Hearing.  Attach additional sheets or documents if necessary)

__________________________________
Signature

MACON COUNTY HEALTH DEPARTMENT

GRIEVANCE / COMPLAINT REVIEW

COMPLAINANT:		NAME:  ________________________________________

				ADDRESS:  _______________________________

						_______________________________

BIRTHDATE:__________  REC #:__________  TEL #:______________

COMPLAINT:______________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

EMPLOYEE COUNSELED: _____________________________________________

REVIEW & CONSULTATION:  _________________________________________

RESOLUTION: ________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

___________________________________________________________________________

Macon County Health Department
503 N. Missouri Street
Macon, MO  63552

Incident Report Form

Date of Incident: ___________________ Time of Incident: ________ a.m./p.m.

Reported to Supervisor (Name)______________________________________

Date Reported: ___________________________________________________

Client Name: ____________________________________________________

Type of Incident: __________________________________________________

Others Present____________________________________________________
(Attach any additional notes from staff members)

Description of Incident:

Action Taken:

Was Family/Client Contacted?   Yes        No         N/A   (circle as appropriate)

Did client require medical treatment?  Yes    No      (circle)

If yes, who saw client: _________________________  Date: ______________

Providers’ recommendation:			        

MCHD Medical Advisor Consulted?   Yes       No            Date: ______________

MoPerm Notified?    Yes    No   			      Date: ______________

Supervisory Action:

Signature of Staff: ______________________________Date: ______________

Supervisor’s Signature: __________________________ Date:______________

Administrator’s Signature: _______________________ Date: _______________
Rev. 9-05

Macon County Health Department
503 NORTH MISSOURI STREET
MACON, MO  63552
PHONE (660) 395-4711     FAX (660) 385 2014

Request For Leave

_________  Request for Leave

_________  Leave Scheduled by Supervisor

Employee Name _____________________________________________________

_________  Compensatory Time

_________  Annual (Vacation) Leave

_________  Electing (voting) Leave

_________  Sick Leave – Self

_________  Sick Leave – Personal Care of __________________________________

_________  FMLA – Reason _____________________________________________

_________  Leave without Pay.  Reason ____________________________________

_________  Military Leave

_________  Jury or Witness Leave

Dates ____________________               Amount of time to be used ___________________
				
     Time to be gone:  ___________am/pm to ________ am/pm

Signature of Requestor ______________________________     Date __________________

Approval Signature _________________________________     Date ___________________

Revised 3-09

AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER
Services provided on a nondiscriminatory basis

Leave of Absence without Pay Notification

Employee Name: ______________________________________________________

Date of Leave Request: _________________________________________________

Anticipated Length of Leave: ____________________________________________

Leave Determination:		Approved _____	Denied _____

Administrator Signature: ________________________________________________

A written leave of absence request will be submitted by an employee as early as possible for evaluation and approval by the Administrator and/or Nursing Supervisor.  Upon decision, the Administrator and/or Nursing Supervisor will provide the employee a written notice of approval or denial.  Due to the precedential nature of public health, many positions are unable to be left vacant for an extended period of time.  When an extended leave is granted, this is considered leave without pay and will take effect upon approval and generally after all other leave has been exhausted.  Leave of absence may be granted for extenuating circumstances but may be denied if the position cannot remain vacant for any length of time.  Continued employment is not guaranteed.  Should an employee be unable to return to work following a leave of absence, or if leave is denied but the employee deems it necessary and chooses to remain absent, employment will terminate.

Employee:	I have discussed my leave of absence without pay determination with my Administrator and I understand and agree to abide by the health department’s policy and all of its implications.

Employee Signature: _______________________________________Date: _________________

Administrator Signature: ____________________________________ Date: ________________

AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER
Services provided on a nondiscriminatory basis

Leave Pool Request

Date: __________________________
Name: __________________________________________________________________
Any full time Macon County Health Department employee is eligible to apply for hours from the Leave Pool.  The employee must be designated for Leave Without Pay and be eligible for catastrophic illness or injury as determined by the Board of Trustees.  An employee in need may apply for up to 80 hours at a time as long as the Leave Pool has enough accumulated hours.  Hours will be available on a first come, first serve basis.  
Description of catastrophic illness or injury:  ______________________________________
__________________________________________________________________________
Amount of time anticipate off work: ______________________________
Amount of current accrued vacation time: _________________________
Amount of current accrued sick time: _____________________________
Amount of Leave Pool hours requested: ___________________________
Signature: _________________________________________________________________

Board of Trustees’ Decision
__________ approved	Number of hours approved: _____________________	
__________ denied
Date: ____________________________
Board Chair signature: _______________________________________________________
Administrator signature: _____________________________________________________		
AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER
Services provided on a nondiscriminatory basis

Leave Pool Donation

Date: _______________________

Name: _____________________________________________________________

The Leave Pool is designed to assist full time Macon County Health Department employees who are experiencing a catastrophic illness or injury, who have depleted their accrued vacation and sick time, and need compensation assistance for medical leave.  Ability for an employee to use pool time will be approved by the health department Board of Trustees.  
When the pool is close to being depleted, as determined by the Administrator, an employee will be permitted to donate up to 10 hours at a time, twice a year, of either vacation or sick hours, or a combination of both.  This pool is available to all full-time health department employees, and donated hours cannot be designated to a specific co-worker.  Once hours are donated to the pool, the donor’s accrued hours will be reduced accordingly.  

Number of vacation hours to be donated: ___________________

Number of sick leave hours to be donated: __________________

Employee Signature: ________________________________________________________

Administrator Signature: _____________________________________________________

AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER
Services provided on a nondiscriminatory basis