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

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

Infectious Disease 3 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 The Basic Facts Oh no, not infectious diseases!

Infectious Disease 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 4 cdc.gov, 2009 To Name a Few

Human Immunodeficiency Virus 56,000 people annually (CDC) A virus that slowly weakens the bodys 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 5 HIV cdc.gov, 2009

Say Hello to Your Neighbor 6 Did you know…

Misconceptions Continue 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%) 7 Did you know… kff.org, 2009

HIV 8 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

HIV 9 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

HIV 10 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?

HIV 11 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

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

HIV & Accommodations 13 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 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 HIV & Accommodations

AT is any equipment or device that will enable performance of essential job functions 15 Assistive Technology HIV & Accommodations

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

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

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 18 Assistive Technology HIV & Accommodations

19 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 HIV & Accommodations

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

HIV & Safety On the Job 21 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

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 22 Direct Threat & the ADAAA HIV & Safety On the Job

HIV & Accommodations 23 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)

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 24 Key Considerations *JANs Accommodation and Compliance Series: The ADA Amendments Act of 2008 ADA Amendments Act

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 Responding to a Request 25 Resources All resources found at

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

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 Medical Inquiries of Employees 27 Medical Inquiries

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 Medical Documentation 28 Medical Inquiries

Accommodate When You Can Assume Coverage If You Dont Know Communicate With Employees 29 Practical Tips for ADA Coverage Medical Inquiries

JAN at Centers for Disease Control and Prevention (CDC) at Centers for Disease Control (CDC) and Prevention, Business Responds to AIDS/Labor Responds to AIDS (BRTA/LRTA) at lrta.org The Body at 30 Resources HIV & Infectious Disease

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(800) (V) (877) (TTY) Please call, or visit JAN on the Web! How to Contact JAN 32 JAN improves the workplace one successful accommodation at a time. JAN improves the workplace one successful accommodation at a time.