Higher risk employees

A process is now in place to manage employees who may be at higher risk of serious illness should they contract COVID-19.

Screening checklist

This checklist is to assist employees and managers identify people who may be at greater risk of serious illness from COVID-19 and optimise their safety at work.

Process for managing Employees who may be at a higher risk

This process flowchart is to assist with managing employees who may be at risk of serious illness from COVID-19.

Acknowledgement of employer advice

The Acknowledgement of employer advice form should be downloaded and completed by employees who wish to continue in their role/area, despite being determined to be at higher risk of serious illness from COVID-19 and working in high-risk areas and/or patient-facing roles. See question 19 in the frequently asked questions, for more information.

Frequently asked questions

Monash Health is committed to the health and safety of all employees. The following frequently asked questions intend to clarify how Monash Health will mitigate risks to employees who may be at risk of serious illness from COVID-19.

Higher Risk Criteria

1. Who is considered to be at higher risk of serious illness from COVID-19?

An employee who meets any of the below criteria is considered to be at higher risk of serious illness from COVID-19:

  1. Aboriginal and Torres Strait Islander employees 50 years and older with one or more chronic medical conditions (as defined below)
  2. Employees 65 years and older with chronic medical conditions (as defined below)
  3. Employees 70 years and older
  4. Employees with compromised immune systems (as defined below)

Employees who are pregnant are considered potentially vulnerable, particularly from 28 weeks gestation.

The following chronic conditions are of concern in Aboriginal and Torres Strait Islander employees over 50 years and healthcare workers over 65 years:

  • Chronic renal failure
  • Coronary heart disease or congestive cardiac failure
  • Chronic lung disease (severe asthma for which frequent medical consultations or the use of multiple medications is required, cystic fibrosis, bronchiectasis, suppurative lung disease, chronic obstructive pulmonary disease, chronic emphysema)
  • Poorly controlled diabetes
  • Poorly controlled hypertension

Employees at any age with significant immunosuppression include those who:

  • Have haematologic neoplasms: leukemias, lymphomas, myelodysplastic syndromes
  • Are post-transplant: solid organ (on immunosuppressive therapy), haematopoietic stem cell transplant (within 24 months or on treatment for GVHD)
  • Are immunocompromised due to primary or acquired immunodeficiency (including HIV infection)
  • Are on current chemotherapy or radiotherapy
  • Are on high-dose corticosteroids (≥20 mg of prednisone per day, or equivalent) for ≥14 days
  • Are on all biologics and most disease-modifying anti-rheumatic drugs (DMARDs) as follows:
    • Azathioprine >3.0 mg/kg/day
    • 6-Mercaptopurine >1.5 mg/kg/day
    • Methotrexate >0.4 mg/kg/week
    • Prednisone >20 mg/day. If <14 days treatment, can resume work when treatment ceased
    • Tacrolimus (any dose)
    • Cyclosporine (any dose)
    • Cyclophosphamide (any dose)
    • Mycophenolate (any dose)
    • Combination (multiple) DMARDs irrespective of dose

General Advice for Healthcare Workers in the Higher Risk Population

2. What should healthcare workers in the higher risk population do?

They should complete the ‘Screening Checklist for Employees Who May Be at Higher Risk of Serious Illness from COVID-19’ and send it to COVID19employeeenquiries@monashhealth.org.

Employees should practice stringent physical distancing and hand hygiene measures (especially in lifts and hospital thoroughfares), and follow all relevant PPE requirements.

They should also:

  • Avoid areas where there are suspected or confirmed cases of COVID-19
  • Where possible, avoid higher risk clinical areas such as intensive care units, emergency departments and urgent care centres, acute respiratory assessment clinics and birth suites.

Where this is not possible, wear personal protective equipment at all times when in contact with suspected or confirmed cases of COVID-19.

For those with heart or lung disease, avoid all patient contact.

3. What should pregnant healthcare workers do?

Pregnancy is not considered a criteria for placing an individual at higher risk of serious illness from COVID-19. The DHHS guidelines state that employees who are pregnant are considered potentially vulnerable, particularly from 28 weeks gestation.

There is limited evidence at this time regarding the risk of COVID-19 in pregnant people. Based on currently available information, pregnant people do not appear to be at higher risk of severe COVID-19 illness than the general population. However, due to changes in their bodies and immune systems, we know that pregnant people can be badly affected by some respiratory infections, including influenza.

Pregnant people should therefore be considered a potentially vulnerable group until further information is known.

Pregnant people should be encouraged to follow the standard advice to protect themselves against COVID-19, such as good hand hygiene and physical distancing practices. They should report possible symptoms (including fever, cough or difficulty breathing) to their manager. Pregnant people should also be encouraged to have the seasonal influenza vaccine, as this will help to prevent them and their baby from catching influenza.

We should assess the risks for pregnant healthcare workers; the measures available to mitigate risk, such as personal protective equipment; and consider alternative duties and patient allocation from 28 weeks gestation.

Pregnant employees should complete the ‘Screening Checklist for Employees Who May Be at Higher Risk of Serious Illness from COVID-19’ and follow the related process.

Employees who are over 28 weeks pregnant and cannot be reassigned to a safe workplace or work from home will be entitled to ‘paid no safe job leave’ in accordance with the relevant Enterprise Agreement and employment legislation. We will continue to explore suitable reassignment opportunities.

Please note that nothing in the DHHS guidelines or this advice replaces or diminishes a pregnant employee’s rights or entitlements with respect to any ‘no safe job’ provisions in their relevant Enterprise Agreement or under the Fair Work Act 2009 (Cth).

4. What happens when a pregnant employee completes the checklist?

Pregnancy is not considered a criteria for placing an individual at higher risk of serious illness from COVID-19. The DHHS guidelines state that employees who are pregnant are considered potentially vulnerable, particularly from 28 weeks gestation.

Considering these guidelines, employees who are less than 28 weeks pregnant can continue to work in their current work areas (irrespective of whether they are working in a high risk or low risk area). However, your manager is required to assess and mitigate risks, if any, associated with your work role and area for when you are over 28 weeks pregnant.

Therefore, once you complete and submit a checklist, the following will occur:

  • If you are less than 28 weeks pregnant, you will receive an email from the COVID-19 Employee Enquiries Helpdesk team informing you that you can continue to work in your current role and work area. Should there be any adjustment that can be made to support any health and safety concerns, you will be advised to discuss these with your manager.
  • If you are greater than 28 weeks pregnant, the COVID-19 Employee Enquiries Helpdesk team will email your manager, copying you and your relevant People and Culture Business Partner, informing them that you are considered potentially vulnerable as you are over 28 weeks pregnant. At this point, managers will be expected to assess and mitigate risks, if any, associated with your work role and area. Measures available to mitigate risks include utilising PPE and considering alternative duties and patient allocation. They will be advised that the next step is for them to meet with you to determine the best and safest option for the employee going forward.

Additionally, please note that nothing in the DHHS guidelines or this checklist replaces or diminishes a pregnant employee’s rights or entitlements with respect to any ‘no safe job’ provisions in their relevant Enterprise Agreement or under the Fair Work Act 2009 (Cth).

5. What should I do if I may be at higher risk of serious illness from COVID-19 and I am concerned about continuing to work in my current work area?

If you meet any of the criteria that places you at higher risk of serious illness from COVID-19 (specified in Q1) and are concerned about continuing to work in your current area, complete and submit the ‘Screening Checklist for Employees Who May Be at Higher Risk of Serious Illness from COVID-19’. In the case of chronic health conditions, pregnancy, immunosuppression or other medical conditions, you will be required to support your completed checklist with evidence. This would normally include a medical certificate where possible. Submitting supporting information with your checklist will facilitate a prompt response. If a statutory declaration is provided please note additional evidence may be requested

Screening Checklist

6. Who should complete the ‘Screening Checklist for Employees Who May Be at Higher Risk of Serious Illness from COVID-19’?

The screening checklist should be completed by:

  • Employees who meet any of the categories specified in Q1 of the FAQ.
  • Employees who are concerned about continuing to work in their current roles/areas as they are concerned they may be at higher risk of serious illness from COVID-19 because of other medical conditions (i.e. not specified in the screening checklist/FAQ).
  • Employees who are concerned about continuing to work in their current roles/areas as they are living with and/or caring for those who fall into any of the categories specified in Q1 of the FAQ or other medical condition.

7. Can I get assistance in completing the form?

If you require assistance in completing the form you may request the support of your manager or send an email to COVID19employeeenquiries@monashhealth.org  requesting assistance. You will be contacted within 24 hours and a member of the COVID-19 Employee Enquiries Helpdesk will help you to complete the form.

8. Am I required to complete the ‘Screening Checklist for Employees Who May Be at Higher Risk of Serious Illness from COVID-19’ if I have a medical certificate stating that I am not fit to work?

No, you will not be required to complete the screening checklist if you have a medical certificate stating that you are not fit to work.

Employees who are unwell or whose underlying medical condition prevents them from working are expected to use their personal leave in the first instance.

Working in High Risk Areas

9. Which areas are considered high risk areas for employees at higher risk of serious illness from COVID-19?

The following work areas have been identified as high risk areas (as at 26/06/2020) for employees at higher risk of serious illness from COVID-19, due to the proximity to potential COVID-19 patients if working in these areas.

Updated 26 June

AreasClaytonDandenongCasey
Admission Wards31SSouth West 2Ward C
COVID-19
Positive Wards
32AAUWard C
ICUCICUAAUBICU
*TheatresAllAllAll
*Birth SuitesAllAllAll
*Emergency DepartmentAllAllAll
*Cath LabAllN/AN/A
*Diagnostic Imaging (Interventional only)AllAllAll
Screening ClinicsAll sites

Note: In areas marked with * separation of vulnerable persons may be possible from the high risk zones, depending on area layout and caseload and will be individually assessed.

10. What should I do if I may be at higher risk of serious illness and I am working in an area considered high risk, but I am comfortable in continuing to work in my current work area?

If you meet the higher risk criteria specified in Q1 of this FAQ and work in a high risk area, you should complete the ‘Screening Checklist for Employees Who May Be at Higher Risk of Serious Illness from COVID-19’ (above) and follow the related process. As part of this process your manager will meet with you to discuss suitable alternatives including working from home or reassignment to another area.

However, at this point, if you are comfortable with continuing in your current role/work area and do not wish to make any changes to your current role/work area, please complete and sign the ‘Acknowledgement of Employer Advice’ (above) and email it to COVID19employeeenquiries@monashhealth.org.

11. What should I do if I may be at higher risk of serious illness from COVID-19 and I am working in a non-patient facing role and/or an area considered low risk, and I am comfortable in continuing to work in my current work area?

You may complete the screening checklist and follow the related process. If you are determined to be at higher risk of serious illness and working in a low risk area, it is likely that no changes will be required to your current work arrangements. However, should you have a health condition that requires that you do not work in any roles that require patient contact, but you are comfortable continuing to work in your current role/work area, please complete and sign the ‘Acknowledgement of Employer Advice’ (above) and email it to COVID19employeeenquiries@monashhealth.org.

Alternatively, you could discuss this with your manager so we can ensure that you are in a safe workplace and not putting yourself or other employees in your work area at risk. If appropriate you may wish to seek guidance from your medical practitioner. If service or work arrangements in your area change we may need to review your working arrangements. As with all employees it is of critical importance that you follow the relevant infection control and PPE guidelines.

Process for Managing Employees Who May Be at Higher Risk

12. What should I do after I complete the ‘Screening Checklist for Employees Who May Be at Higher Risk of Serious Illness from COVID-19’?

Email the completed checklist to COVID19employeeenquiries@monashhealth.org. In the case of chronic health conditions, pregnancy, immunosuppression or other medical conditions, you will be required to support your completed checklist with evidence. This would normally include a medical certificate where possible. If a statutory declaration is provided please note additional evidence may be requested.

Most assessments should be completed within 24 – 48 hours and you should remain in your role while this is completed. However, if you have any immediate concerns, discuss it with your manager.

13. Will my information and details remain confidential?

Yes. All completed screening checklists and supporting medical evidence will be stored on a confidential and secure database with access restricted to employees involved in the assessment process.

14. What can I expect to happen after I submit the checklist?

Your completed checklist will initially be reviewed by the COVID-19 Employee Enquiries Helpdesk team, which consists of a nursing panel. In the case they are unable to complete the assessment as they require additional advice, they will forward the checklist to the Clinical Panel. The Panel is comprised of senior clinicians.

The Helpdesk and/or Clinical Panel member(s) will review your checklist and assess if you are:

  1. At higher risk of serious illness from COVID-19 and
  2. If the area you are working in places you at low/high risk of contracting COVID-19, considering proximity to potential COVID-19 patients if working in these areas.

Should the Helpdesk staff and/or Clinical Panel members require additional information from you or your treating physician, they will get in touch with you directly.

If it is determined that you are not at higher risk, the Helpdesk team will email you to inform you of the assessment outcome and that no changes are required to your current work arrangements.

If it is determined you are at higher risk of serious illness from COVID-19, the Helpdesk team will send through a standard email to your Manager and relevant People and Culture Business Partner, with a copy marked to you. The email will include only your name, location of work and contact information and that you have been identified as being part of the higher risk group. The email will also specify if the area in which you work is considered to be at low or high risk of contracting COVID-19. Please refer to question 4 for specific information on communications in the case an employee is pregnant.

If you already work in a low-risk area nothing may have to change with your current work role. However, if you work in an area that is identified as high risk, your manager and People and Culture Business Partner will work with you to make a plan about how to keep you safe (refer to question 16).

15. If I am not satisfied with the outcome of the assessment, what can I do?

You will be required to email COVID19employeeenquiries@monashhealth.org  outlining why you are not satisfied with the decision and provide additional medical or other supporting evidence that could be considered by the Clinical Panel when reassessing your checklist.

16. What are the options that will be available to protect employees identified to be at higher risk of serious illness from COVID-19 who are currently working in areas that are considered to be high risk due to proximity to potential COVID-19 patients if working in these areas?

Your manager and People and Culture Business Partner will explore the following options:

  1. Is the employee able to perform their role from home?
  2. Is the employee able to perform the same or related work in a safe environment?
  3. Is the employee able to be reassigned to another role?

Pay and Leave Arrangements

17. What pay and leave arrangements will apply for higher risk employees?

Higher risk employees who are unwell or whose underlying medical condition prevents them from working it is expected that the employee will use their personal leave in the first instance.

Higher risk employees who are not unwell and not prevented from working by an underlying medical condition should ask their employers about alternative duties/work site opportunities, working from home arrangements or other flexible working arrangements to minimise their risk.

If we cannot place you in a safe environment or provide an alternative work arrangement you will be entitled to paid special leave, and we will continue to explore suitable reassignment opportunities. Paid special leave will be accessible for up to 20 days (pro-rata for part-time employees). The capped amount of paid special leave is reset from 20 July 2020 meaning up to 20 days (pro-rata for part-time employees) will be available regardless of the amount of paid special leave that was taken prior to 20 July 2020.

Where a higher risk employee exhausts the 20 days paid special leave (pro-rata for part-time employees), the employee will be expected to utilise other accrued paid or unpaid leave entitlements such as personal/carers leave or annual leave.

Where a higher risk employee on paid special leave becomes unwell – whether diagnosed with COVID-19 or another illness – or they are required to care for an immediate family member or household member, the paid special leave will cease. The employee will then be required to use their accrued paid personal/carer’s leave entitlement.

If you can be placed in a safe environment but choose not to accept the reassignment you will need to discuss taking paid leave (annual leave or long service leave) and/or unpaid leave with your manager.

Reassignment

18. What are the next steps if reassignment is recommended?

Your manager and People and Culture Business Partner will consult with you to discuss your experience and skills and identify areas you may be suitable to work in. Should you be required to work in a new location or work area, this move will be temporary and last the period of our COVID-19 response.

19. Where can I find answers to questions I may have in relation to my being reassigned?

A FAQ for ‘Reassignment in Response to COVID-19’ has been developed. Refer to the FAQ for questions in relation to reassignment.

Acknowledgement of Employer Advice

20. When should an employee complete the ‘Acknowledgement of Employer Advice’?

The ‘Acknowledgement of Employer Advice’ (above) should be completed by employees who wish to continue in their role/area, despite being determined to be at higher risk of serious illness from COVID-19 and working in high-risk areas and/or patient-facing roles.

Examples of such cases are as follows:

  • An employee greater than 28 weeks pregnant who wishes to continue working in a patient-facing role.
  • An employee who meets the higher risk criteria and wishes to continue working in a high-risk area.
  • An employee who has heart or lung disease and wishes to continue working in a patient-facing role.

Your decision to continue working can be reviewed and/or changed at any time for as long as you remain a person who may be at higher risk of serious illness from COVID-19.

General Advice for Managers

21. If I am a manager/supervisor and I am concerned about my direct report who may be at higher risk of serious illness from COVID-19, what should I do?

You should discuss your concerns individually with each employee. Should the employee be concerned about continuing to work in the current area, you should direct them to complete the ‘Screening Checklist for Employees Who May Be at Higher Risk of Serious Illness from COVID-19’.

If the employee is not working in a work area considered high risk due to proximity to potential COVID-19 patients if working in these areas, and is not concerned about continuing to work in the current area, they may continue to work as normal. Please make sure that the employee is aware of infection control and PPE guidelines relevant to their area of work.

If the employee is working in a work area considered high risk due to proximity to potential COVID-19 patients if working in these areas, and refuses to complete the screening checklist and/or you still hold a reasonable belief that the employee is unable to perform their duties without risk to their health and safety, contact your relevant People and Culture Business Partner.

22. If I am a manager/supervisor and I am concerned my direct report may be at higher risk of serious illness from COVID-19, can I fill out the ‘Screening Checklist for Employees Who May Be at Higher Risk of Serious Illness from COVID-19’ on behalf of my direct report(s)?

No, you cannot complete a screening checklist for another employee. If an employee requests your support or assistance in completing the screening checklist, it is fine to assist.

23. If I am a manager and I have already made arrangements with my direct reports who may be at higher risk of serious illness from COVID-19, what should I do?

All employees who may be at higher risk of serious illness from COVID-19 will be required to follow this process, irrespective of any arrangements that have already been made. Therefore, ensure you advise your employees to complete and submit the ‘Screening Checklist for Employees Who May Be at Higher Risk of Serious Illness from COVID-19’ and follow the related process.

Recrediting of leave may also apply where employees in higher-risk categories were required to be absent from work and had already accessed other leave types, where the employee commenced that absence before 19 April 2020 (when access to paid special leave for this purpose was first announced).

Employees who are on personal leave and have submitted medical certificates stating that they are not fit to work will be exempted from this process.

Living with/Caring for Individuals in the Higher Risk Population

24. What can I do if I am concerned about continuing in my current role because I live with and/or am caring for someone who meets the at higher risk criteria?

If the person you live with and/or care for meets any of the higher risk criteria specified in Q1 and you are concerned about continuing to work in your current area, you can complete and submit a ‘Screening Checklist for Employees Who May Be at Risk of Serious Illness from COVID-19’. The checklist has a section for you to indicate that it relates to a person you live with and/or care for.

The assessment will be completed in the same manner as for employees and require the same supporting evidence where appropriate. You will be advised of the outcome of the assessment by email.

If you work in a low-risk area, no change will be made to your work arrangements. If you work in a high-risk area, we will make every attempt to reassign you, noting that priority will be given to employees at higher risk of serious illness from COVID-19.

If you do not wish to continue in your current role and you cannot be reassigned to a suitable role you will need to take annual or long service leave.

More Information

25. Where can I find out more information about COVID-19 and being at higher risk?

For Victorian updates: www.dhhs.vic.gov.au/novelcoronavirus

For national updates: www.health.gov.au/news/latest-information-about-novel-coronavirus

For international updates: www.who.int/westernpacific/emergencies/novel-coronavirus

WHO resources: www.who.int/health-topics/coronavirus

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