Applies to: All Faculty & Staff
Issued by (dept.): Faculty and Staff Counseling and Consultation Office
SPG number: 201.15
Procedure A: Assess preliminary level of impairment
Please read all of these procedures before making a decision, and, if possible, call a central Human Resource staff member, a Michigan Medicine HR staff member, FASCCO or the Michigan Medicine Office of Counseling and Workplace Resilience.
Level I. Severely Impaired
If an employee is severely impaired (e.g., unconscious, staggering, or incoherent, or exhibiting extreme physical symptoms):
- Call 911 immediately and request assistance.
- Have someone stay with the employee until medical or emergency personnel arrive, if at all possible.
- Make sure the employee is safely in the custody of medical or emergency personnel.
- Complete a Fitness for Duty Checklist.
Level II. Violent, Verbally Abusive, or Otherwise Threatening (Impaired)
If an employee is violent, verbally abusive, or otherwise threatening:
- Call 911 for assistance immediately.
- Do NOT attempt to physically restrain the employee or interfere with her/his free movement in any way.
- Take steps to assure your own safety.
- Make reasonable efforts to protect the impaired employee and others.
- Complete a Fitness for Duty Checklist.
Level III. Other Cases of Impending Threat or Impairment
If the employee is not severely impaired, violent, verbally abusive, or otherwise threatening (i.e., not Level I or II), but behavior otherwise indicates he or she is unable to safely perform job duties, the supervisor or administrator in charge of the unit/department should consult with a Human Resource representative and/or FASCCO or the Office of Counseling and Workplace Resilience. The supervisor should also observe the individual's behavior and complete a Fitness for Duty Checklist.
If the supervisor is satisfied that there is a reasonable indication of a Level III impairment, the supervisor should tell the employee that he or she:
- is being released from duty due to suspected impairment and will be referred for a fitness for duty evaluation
- must provide a Return to Work/Fitness for Duty form from the independent evaluator to the coordinating party (WorkConnections, FASCCO or the Office of Counseling and Workplace Resilience) indicating his or her ability to safely perform job duties before the employee can return to the workplace
Procedure B: Initiate a request for Fitness for Duty evaluation
Consult with your designated Human Resource Representative:
- Note observations; check all behavioral examples that apply and fill in time, date, and location, etc. (see the Fitness for Duty Checklist).
- Obtain a witness for your private interaction with the employee, if possible.
Meet with the employee and do the following:
- Relieve the employee from duty and arrange for removal from worksite.
- State your concerns for the safety and well-being of the employee. Note your observations (see the Fitness for Duty Checklist).
- Inform the employee that you are relieving him or her from duty at this time and that he or she is required to leave the worksite.
- Inform the employee that failure to comply with the directive to be relieved from duty will result in suspension and disciplinary investigation.
Assure Safe Transportation:
- Explore options for the employee to arrange a ride (friend, family member). Do not let the employee drive if it appears it would be a risk to themselves or someone else, and call the Department of Public Safety if necessary.
- Do not drive the employee. If s/he cannot arrange transportation, make arrangements with the Department of Public Safety.
- Inform the employee of responsibilities/ procedures for their return to work.
- Check off (on the Fitness for Duty Checklist) items from #4 above as you complete them.
- Sign and date the form on the bottom. Note if you had a witness and include their name.
Procedure C: Set up a Return-to-Work Meeting
In the event that a preliminary determination of a Level I or II impairment and 911 intervention is sought, the employee must meet with his/her supervisor before returning to work to discuss any unresolved issues