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MEMORANDUM OF UNDERSTANDINGBETWEENSTAFF AND PER DIEM NURSES, SEIU LOCAL 1021ANDCITY AND COUNTY OF SAN FRANCISCOJULY 1, 2019 - JUNE 30, 2022Revised Per Amendment #2PER DIEM RELATED PROVISIONS ARE IN ITALICSSEIU LOCAL 1021 (STAFF NURSE & PER DIEM)Memorandum of UnderstandingJuly 1, 2019 – June 30, 2022i

TABLE OF CONTENTSARTICLE I. REPRESENTATION . ECOGNITION . 1INTENT . 1NO WORK STOPPAGES . 2OBJECTIVE OF THE CITY. 2OFFICIAL REPRESENTATIVES AND STEWARDS . 2Official Representatives . 2Stewards . 3RELEASE TIME FOR SFGH CHAPTER PRESIDENT AND DESIGNEES 5DISSEMINATION OF UNION INFORMATION . 5Bulletin Boards . 5Location of Bulletin Boards . 6Distribution of Union Literature . 7CPHS PROFESSIONAL PERFORMANCE COMMITTEE. 7UNION ACCESS. 8MANAGEMENT RIGHTS & RESPONSIBILITIES . 8UNION SECURITY . 9GRIEVANCE PROCEDURE . 10Definition . 10Grievance Description. 10Procedure. 10Time Limits . 10Employee Grievance Procedure . 11Expedited Arbitration . 12Rights of Individuals . 13"Skelly Rights” . 13Disciplinary Action Appeal Procedure For P103 Per Diem Nurses . 14ARTICLE II. EMPLOYMENT CONDITIONS . 16II.A. NO DISCRIMINATION . 16Discrimination Prohibited . 16No Discrimination on Account of Union Activity . 16Reasonable Accommodation. 16II.B CIVIL SERVICE EXAMINATIONS . 171.CIVIL SERVICE EXAMS FOR STAFF NURSES . 172.PROBATIONARY PERIOD . 17II.C SUBCONTRACTING OF WORK . 18Required Notice to the Union on Prop J Contracts . 19Non-Prop J Contracts . 19II.D. REIMBURSEMENT OF WORK RELATED EXPENSES . 20Use of Private Automobiles . 20Auto Insurance Deductible. 21Reimbursement for Stolen Property . 21SEIU LOCAL 1021 (STAFF NURSE & PER DIEM)Memorandum of UnderstandingJuly 1, 2019 – June 30, 2022ii

Use of Personal Cell Phone . 21Recovery of Overpayment. . 21Payroll Procedures . 22II.E. LAYOFF . 22Severance . 22Mandatory Furloughs . 232328 Nurse Practitioner. 23Joint RN/DPH Monitoring Committee Meetings . 23Layoff Limitations . 23II.F. PUBLIC HEALTH NURSE DUTIES . 23Public Health Nurse Caseloads . 24Hazardous Situations. 24Home Care Program . 24II.G. NURSE PRACTITIONERS . 24Scope of Practice . 24Voluntary Job Sharing . 25Standardized Procedures . 25Primary Care Patient Caseload . 25Productivity . 25Advanced Practice Council . 26Professional Development . 26II.H. CLINICAL NURSE SPECIALISTS . 26II.I. INDEMNIFICATION AND DEFENSE OF CITY EMPLOYEES . 27II.J. CHANGES IN PERSONNEL POLICY . 27Departmental Changes . 27City Changes . 27II.K. CONSCIENTIOUS OBJECTOR . 27II.L. PERSONNEL FILES . 27II.M. PERFORMANCE EVALUATIONS . 28II.N. DEVELOPMENT PLANS . 28II.O. LOUNGES AND EATING FACILITIES. 29II.P. PARKING FACILITIES . 29II.Q. INACTIVE STATUS and STATUTORY LEAVES FOR EXTERNAL P103 PER DIEMNURSES . 30II.R. COMMITTEE ON DIVERSITY, EQUITY AND INCLUSION. 30ARTICLE III. PAY, HOURS AND BENEFITS . 32III.A. SCHEDULES OF COMPENSATION . 32Class 2830 Public Health Nurses . 33III.B. WORK SCHEDULE. 33Normal Work Schedules . 33Voluntary Reduced Workweek . 35Part-time Work Schedule . 36Part-Time Night Shift . 36III.C. COMPENSATION FOR VARIOUS WORK SCHEDULES . 36Normal Work Schedule . 36Part-time Work Schedules. 36III.D. ADDITIONAL COMPENSATION. 36SEIU LOCAL 1021 (STAFF NURSE & PER DIEM)Memorandum of UnderstandingJuly 1, 2019 – June 30, 2022iii

III.E.III.F.III.G.III.H.III.I.III.J.III.K.Shift Differential . 36Bilingual Pay . 36Supervisory Differential Adjustment . 37Standby Pay. 37Callback Pay. 38Quality of Care Premium . 38Health at Home On-Call Premium . 38Weekends Off For Nurses . 38Weekend Premium . 39Court Duty Compensation and Jury Duty . 39Charge Nurse and Acting Assignment Pay . 40Preceptor and MERT Premiums . 41Class 2323 Clinical Nurse Specialist Pager Premium . 41Jail Health Services Premium . 42OVERTIME COMPENSATION . 42HOLIDAYS AND HOLIDAY PAY . 43Holiday Compensation for Time Worked . 44Holidays for Employees on Work Schedules Other Than Monday Through Friday45Holiday Pay for Employees Laid Off. 45Employees Not Eligible for Holiday Compensation. 45Part-time Employees Eligible for Holidays . 46Holiday Scheduling . 46SALARY STEP PLAN AND SALARY ADJUSTMENTS . 46Promotive Appointment in a Higher Class . 47Provisional to Promotive . 47Nonpromotive Appointment . 47Appointment Above Entrance Rate . 48Determination of Pay for Position Formerly Exempt . 48Appointive Position. 48Reappointment with Six (6) Months . 49Compensation Adjustments . 49Compensation Upon Transfer or Reemployment . 50CHANGE IN STATUS . 51Dual Status Nurses . 51SENIORITY INCREMENTS . 51Step Advancement for As-Needed Nurses . 52Date Increment Due . 52Exceptions . 52SENIORITY INCREMENTS/P103 PER DIEM NURSES . 52Step Advancement for External P103 Per Diem Nurses . 52Retiree P103 and As-Needed Nurses . 53SENIORITY AND SHIFT ASSIGNMENT/STAFF NURSES . 53Seniority Defined . 53Seniority for Purposes of Layoff . 53Seniority for Purposes of Shift Assignment . 53Guidelines for Shift Changes for Worksites with Multiple Shifts . 53Twelve (12) Hour Shifts (S.F. General Hospital) . 54(S.F. General Hospital Inpatient Nursing Department Only) . 54SEIU LOCAL 1021 (STAFF NURSE & PER DIEM)Memorandum of UnderstandingJuly 1, 2019 – June 30, 2022iv

III.L. SENIORITY AND SHIFT ASSIGNMENT/P103 PER DIEM NURSES . 55Definitions . 55Utilization of Outside Per Diems versus Inside Per Diems . 56Scheduling Procedures. 57Short Call Assignment . 57Cancellation . 58III.M. HEALTH INSURANCE . 591.HEALTH INSURANCE . 592.HEALTH INSURANCE /P103 PER DIEM NURSES . 60III.N. DENTAL INSURANCE . 60III.O. BENEFITS WHILE ON UNPAID STATUS . 60III.P. LONG TERM DISABILITY . 60III.Q. RETIREMENT CONTRIBUTION. 60III.R. TIME OFF FOR VOTING . 61III.S. LONGEVITY LEAVE . 61III.T. VACATION SCHEDULING . 61III.U. CHILDCARE . 62Dependent Care Assistance Program (DCAP). 62Child Care Referral Fair and Enhanced Referral Package . 63III.V. MATERNITY/CHILD CARE LEAVE . 64Adoption. 64III.W. REQUESTS FOR VOLUNTARY REASSIGNMENTS . 65III.X. MUNICIPAL TRANSPORTATION AGENCY PASSES . 681.Staff Nurses . 682.Per Diem Nurses . 68III.Y. STAFF NURSE EXPENSES ALLOWANCE . 681.Staff Nurses . 682.Per Diem Nurses . 68III.Z. STATE UNEMPLOYMENT AND DISABILITY INSURANCE . 681.Staff Nurses . 682.Per Diem Nurses . 69III.AA. PAID SICK LEAVE ORDINANCE . 69III.BB. LIFE INSURANCE . 69ARTICLE IV. TRAINING AND CAREER DEVELOPMENT . 70IV.A. EDUCATIONAL OPPORTUNITIES. 701.Special Educational Leave for Health Personnel . 702.Mandatory Class Scheduling and Testing . 714.Tuition Reimbursement. 715.Orientation and In-Service Education . 736.Out of Specialty Assignments . 737.Continuing Education . 748.Registered Nurse Crosstraining Program . 74IV.B. TRAINING CLASSES FOR P103 PER DIEM NURSES . 75IV.C. CHARGE NURSE TRAINING . 75IV.D. NURSING SPECIALTY AREA TRAINING. 751.STAFF NURSES . 752.PER DIEM NURSES . 76SEIU LOCAL 1021 (STAFF NURSE & PER DIEM)Memorandum of UnderstandingJuly 1, 2019 – June 30, 2022v

IV.E. REIMBURSEMENT FOR MANDATORY STATE OF CALIFORNIA LICENSES76ARTICLE V. WORKING CONDITIONS . 77V.A.V.B.V.C.V.D.V.E.STAFFING . 771.Commitment to Staffing Levels . 772.Staffing . 77Standards of Care . 77a.S.F. General Hospital . 77Medical-Surgical . 78Critical Care . 79Maternal Child Health . 80Psychiatric as of July 1, 2016. 82Psychiatric Emergency Service Staffing (PES) as of July 1, 2016 . 82SFGH Emergency Department (ED) . 83Determination of Acuity . 86Evaluation of Staffing Methodology. 87b.Laguna Honda Hospital (LHH). 87c.Jail Health Services (JHS). 88d.Clinical Services at Juvenile Justice Center – Special Programs for Youth (“SPY”)Clinic 89e.Tom Waddell Clinics . 90f.San Francisco Behavioral Health Center (SFBHC) Mental Health RehabilitationFacility . 90g.Health at Home . 90h.Filling of Positions . 91i.Overtime. 91j.Dispute Resolution . 91SFGH SKILLED NURSING FACILITY - HOURS PER PATIENT DAY (HPPD)94Skilled Nursing Facility . 94STAFFING AS OF 7/1/19 . 96JOINT RN/DPH MONITORING COMMITTEE . 98HEALTH AND SAFETY . 100Commitment to Safe and Healthy Work Environment . 100The Department of Public Health Bloodborne Pathogen Safety Devices Committee 100Information. 103Alternative Assignments . 103Labor Code Compliance . 103SMART Training . 103Battery Leave with Pay for Assaulted Employees . 104Traumatic Event . 104SFGH Violence Prevention Team . 104Safe Patient Handling and Movement Policy . 104Joint Labor-Management Occupational Safety and Health Committee . 106Assault Prevention . 106Mandatory HIV Testing . 107Reassignment Following Assault . 107SEIU LOCAL 1021 (STAFF NURSE & PER DIEM)Memorandum of UnderstandingJuly 1, 2019 – June 30, 2022vi

V.F.V.G.V.H.JAIL HEALTH SERVICES DIVISION . 108THE IMPAIRED NURSE . 108SFGH BUILDING 25 . 108ARTICLE VI. SCOPE . 109VI.A. ADMINISTRATIVE PROVISIONS . 1091.STAFF NURSES . 1092.PER DIEM . 109VI.B. SCOPE OF AGREEMENT. 109VI.C. CIVIL SERVICE COMMISSION JURISDICTION . 109VI.D. SAVINGS CLAUSE . 109VI.E. DURATION . 110APPENDIX A: PROPOSED WORKPLAN FOR THE LABOR/MANAGEMENT OSHCOMMITTEE . 114APPENDIX B . 118APPENDIX C: UNION ACCESS TO NEW EMPLOYEES PROGRAM . 119SIDE LETTER OF AGREEMENT: SFGH LABOR MONITORING COMMITTEE. 124SIDE LETTER OF AGREEMENT: VOLUNTARY REDUCED WORK PERIOD FOR PUBLICHEALTH NURSES . 125SIDE LETTER OF AGREEMENT: SFGH JUST CULTURE PROCESS PILOT PROGRAM(PILOT PROGRAM) . 126RE: SIDE LETTER - CREATION OF AN EVENING SHIFT PARKING PILOT PROGRAM 127SIDE LETTER OF AGREEMENT: ED STAFFING . 129SIDE LETTER OF AGREEMENT: LHH NEW GRADUATE PROGRAM. 130SIDE LETTER OF AGREEMENT: NURSE STAFFING AND HIRING . 131INFORMATION ITEMS . 133CIVIL SERVICE RULE 120, LEAVES OF ABSENCE . 133PUBLIC HEALTH NURSE FLEX-TIME POLICY CRITERIA FOR REASSIGNMENTOF PUBLIC HEALTH NURSES . 133JANE DOE STIPULATION . 133HANDLING OF HIV CLAIMS . 133CITY ATTORNEY LETTER/JANE DOE. 133ABOUT YOUR VACATION AND SICK PAY BENEFITS . 133BEFORE THE WORKERS' COMPENSATION APPEALS BOARD . 134OF THE STATE OF CALIFORNIA . 134CITY AND COUNTY OF SAN FRANCISCO,) . 134IT IS SO ORDERED: . 136SEIU LOCAL 1021 (STAFF NURSE & PER DIEM)Memorandum of UnderstandingJuly 1, 2019 – June 30, 2022vii

ARTICLE I – REPRESENTATIONARTICLE I. REPRESENTATIONI.A.1.RECOGNITIONThe City acknowledges that the Union has been certified by the Civil Service Commission as therecognized employee representative, pursuant to the provisions of the City's Employee RelationsOrdinance for the following classifications included in the non-supervisory registered nurse unit:2320232323252330234028302328P103Registered Nurse - Unit 42Clinical Nurse Specialist - Unit 42Nurse Midwife – Unit 42Anesthetist - Unit 42Operating Room Nurse - Unit 42Public Health Nurse - Unit 42Nurse Practitioner - Unit 42Per Diem Registered Nurses, Unit 422.The terms and provisions of this MOU shall also be automatically applicable to any classificationsdesignated for inclusion in this unit for which the Union has become appropriately recognized duringthe term of this agreement.3.It is the intent of the parties signatory hereto that the provisions of this MOU shall not become bindinguntil adopted or accepted by the Board of Supervisors and the City and County of San Francisco byappropriate action and ratified by the Registered Nurse membership of the Union. Moreover, it is theintent of the Board of Supervisors acting on behalf of the City to agree to wages, hours and other termsand conditions of employment as are within the Board's jurisdiction, powers and authority to act asdefined by the Charter, state law, California Constitution and other applicable bodies of the law. TheBoard does not intend nor attempt to bind any board, commission or officer to any provisions of thisagreement over which t

SEIU LOCAL 1021 (STAFF NURSE & PER DIEM) Memorandum of Understanding July 1, 2019 - June 30, 2022 ii