A free service of the Office of Disability Employment Policy, U.S. Department of Labor

1. Job Accommodation Network A free service of the Office of Disability Employment Policy, U.S. Department of Labor Accommodation Ideas for Employees with HIV/AIDS Tracie D. Saab, M.S., JAN Lead Consultant with Linda Carter Batiste, J.D., JAN Principal Consultant

2. Positive Practice PresentationOverview • HIV and Infectious Disease Basic Facts • Accommodation Ideas & Positive Practices 3. Applying the ADA Amendments Act (ADAAA)

3. Infectious Disease The Basic Facts Oh no, not infectious diseases! • Causes • Bacteria, viruses, fungi or parasites passed by humans, animals, insects or food • Transmission • Direct transfer of bacteria, viruses or germs (e.g., cough, sneeze, insect bite, food, or birth) • Exchange of blood or body fluids from sexual contact, needle or transfusion • Indirect contact with germs on inanimate objects (e.g., door knobs or faucets) mayoclinic.com, 2009

4. Infectious Disease To Name a Few • Human Immunodeficiency Virus (HIV) • Acquired Immunodeficiency Syndrome (AIDS) • Hepatitis A, B & C • Influenza and H1N1 – “Swine Flu” • Methicillin-resistant Staphylococcus Aureus (MRSA) • Tuberculosis (TB) • Lyme Disease cdc.gov, 2009

5. Human Immunodeficiency Virus HIV • 56,000 people annually (CDC) • A virus that slowly weakens the body’s immune system, resulting in a variety of symptoms and limitations • Finds and destroys white blood cells (T cells or CD4 cells) that the immune system must have to fight disease • The virus that causes AIDS cdc.gov, 2009

6. Say Hello to Your Neighbor Did you know…

7. Misconceptions Continue Did you know… • One-third (34%) of Americans incorrectly believe or are unsure whether HIV can be transmitted by: • sharing a drinking glass (27%) • touching a toilet seat (17%) • swimming in a pool with an HIV positive person (14%) kff.org, 2009

8. HIV HIV is NOT transmitted through… • Food • Air (e.g., coughing or sneezing) • Everyday contact (e.g., sharing eating utensils, bathrooms, drinking fountains, hugging or casual kissing) • Giving blood • Insect bites thebody.com, 2009

9. HIV HIV IS transmitted through… • Unprotected sexual intercourse with someone who has HIV • Unprotected oral sex with someone who has HIV • Sharing needles or syringes with someone who has HIV • Infection during pregnancy, childbirth, or breast-feeding cdc.gov, 2009

10. HIV Working with HIV • What symptoms or limitations is the individual with HIV experiencing? • How are these symptoms or limitations affecting job performance? • What accommodations are available to reduce or eliminate these problematic job tasks? • What are the workplace hazards and what measures can be taken to correct them?

11. HIV Symptoms & Limitations • Flu-like Symptoms • Skin Rashes • Weight Loss • Fatigue • Chronic Diarrhea • Pneumonia • Vision Impairment • Neurological Impairment • Cognitive Impairment • Depression • AIDS-Defining Cancers • Side Effects of Treatment

12. Why Accommodate? Work/Life Balance • Good health contributes to successful business performance • Balance work expectations and medical needs • Reduce absenteeism and increase productivity • Implement individualized accommodations

13. HIV & Accommodations Modified or Flexible Scheduling • Adjusting arrival or departure times • Providing frequent or alternatively scheduled breaks with the opportunity to make-up the time or use unpaid leave • Altering when certain functions are performed • Exempting the worker from a rotating shift or overtime

14. HIV & Accommodations Flexible Leave & Modified Policies • To attend medical appointments or counseling, or to manage complications associated with HIV disease or treatment • Allowing use of accrued paid leave • Allowing intermittent leave as needed or providing extended unpaid leave • Allowing an employee to eat or drink at his or her workstation to counter medication side-effects • Modifying a “no-fault” leave policy

15. HIV & Accommodations Assistive Technology • AT is any equipment or device that will enable performance of essential job functions www.jan.wvu.edu/soar

16. Vision Aids Print Access AT Handheld Magnifier $7.95 KNFB Reading Tech. $1,995+/- Quick Look $695 Not an endorsement of products.

17. Vision Aids Computer Access AT ZoomText Screen Magnification $395 Not an endorsement of products.

18. HIV & Accommodations Assistive Technology • Ergonomic equipment to counter-act the effects of weight loss and fatigue • ergonomic chair or workstation, anti-fatigue matting, or sit-lean stool • Memory and organizational aids • desk calendars and electronic organizers • Safety equipment • cut-resistant work gloves to prevent injury, or an air filtration system to avoid exposure to airborne bacteria, viruses and other contaminants

19. HIV & Accommodations Telework & Alternative Workspace • Working from home full-time, several days a week, or as-needed • Providing a workstation or office close to a restroom and/or break room • Providing a workstation or office with access to a refrigerator to store food and/or medication

20. HIV & Accommodations Cognitive & Emotional Limitations • Provide significant levels of structure • Provide written job assignments • Allow a self-paced workload • Minimize distractions • Reduce stress • Allow phone calls to emotional supports • Approve time off for counseling or therapy

21. HIV & Safety On the Job Education & Precautions • Many “at risk” occupations and bloodborne pathogens • Valuable for everyone to be aware of risks and ways to prevent exposure • Assume that all blood and body fluids are infectious -"universal" precautions • Appropriate barrier precautions – personal protective equipment – to prevent exposure during contact with blood or body fluids • Eliminate the need to use sharp objects • Dispose of waste

22. HIV & Safety On the Job Direct Threat & the ADAAA • Significant risk of harm to self or others • Cannot be speculative • Based on factual evidence • Must be an ongoing, current risk • Reduce risk through accommodation • Individualized assessment based on objective evidence

23. HIV & Accommodations Positive Practices • Develop and implement workplace policies and programs on HIV/AIDS • Educate your workforce about HIV • Respond with “universal" precautions • Keep all medical information – including HIV status – confidential • Understand direct threat under the Americans with Disabilities Act Amendments Act (ADAAA)

24. ADA Amendments Act Key Considerations • January 1, 2009 • Broadened the definition of disability • Substantially limited standard reduced • Ignore effects of mitigating measures • Consider limitations in active state for person with episodic condition • Bodily functions are major life activities • “Regarded as” interpreted more broadly *JAN’s Accommodation and Compliance Series: The ADA Amendments Act of 2008

25. Responding to a Request Resources Responding to a Request for Accommodation • Engage in an informal process • Reasonable accommodation policy • Free resources • Employer's Practical Guide to Reasonable Accommodation Under the ADA • Sample accommodation request and medical inquiry forms • Accommodation A-Z • HIV All resources found at www.jan.wvu.edu

26. Medical Inquiries Restrictions • Limitations on disability-related questions and medical examinations during all stages: • Pre-employment • Post-offer • Employment • Non-biased consideration of non-medical qualifications

27. Medical Inquiries Medical Inquiries of Employees • Employer restricted • Must be job-related and consistent with business necessity • May request when: • Performance of job functions may be impaired by a medical condition; or • Employee may pose a direct threat; or • After accommodation request, when the disability or need for accommodation is not known or obvious

28. Medical Inquiries Medical Documentation • Should substantiate: • Existence of an ADA disability • Need for reasonable accommodation • Documentation should include: • Nature, severity, and duration of the employee's impairment; • Activity or activities the impairment limits; and • Extent to which the impairment limits the employee's ability to perform the activity or activities

29. Medical Inquiries Practical Tips for ADA Coverage • Accommodate When You Can • Assume Coverage If You Don’t Know • Communicate With Employees

30. HIV & Infectious Disease Resources • JAN at www.jan.wvu.edu • Centers for Disease Control and Prevention (CDC) at www.cdc.gov • Centers for Disease Control (CDC) and Prevention, Business Responds to AIDS/Labor Responds to AIDS (BRTA/LRTA) at www.brta-lrta.org • The Body at www.thebody.com

31. “At work, it’s what people can do that matters.” Learn more by visiting: www.whatcanyoudocampaign.org

32. (800) 526-7234 (V) (877) 781-9403 (TTY) www.jan.wvu.edu jan@jan.wvu.edu Please call, e-mail or visit JAN on the Web! How to Contact JAN JAN improves the workplace one successful accommodation at a time.