CAP's HR Resource Center

This year, numerous employment laws and updates to existing laws went into effect, and independent practitioners must stay current on what these mean for their practices. From new minimum wages and expanded employee rights and protection to how employers notify employees, this document provides a summary of the most important employment law updates affecting medical practices of all sizes.

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In this publication, you will find guidance for the top HR issues impacting medical practices. Compiled from the most frequently asked questions by our physician members, this free guide will help you streamline your HR processes and manage the staff who contribute to your practice’s success and patient care. 

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The California Division of Occupational Safety & Health has published and released a Model Workplace Violence Prevention Plan and information for employers and employees regarding the new workplace safety and violence prevention rules mandated by the recently enacted SB 553. The new law requires almost all California employers to implement a Workplace Violence Prevention Plan (WVPP) and complete training for all employees by the effective date of July 1, 2024. 

CAP recommends our members use the “Model Written WVPP for General Industry.”

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The Division’s Safety and Health Fact Sheet with information for employers can be found here.

The Division’s Safety and Health Fact Sheet with information for employees can be found here.

From recruiting and retaining top talent, to understanding when and how to terminate employees who may be jeopardizing your practice’s success, CAP’s webinar helps you manage the employment spectrum effectively and legally. This webinar shares free guidance from industry-leading employment attorneys who share proven and sound policies and procedures for maximizing your medical office staff’s performance. 

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California Senate Bill 553 (SB 553) was signed into law on September 30, 2023. The new law requires almost all California employers to establish, implement, and maintain a Workplace Violence Prevention Plan (WVPP) and complete training for all employees by the effective date of July 1, 2024.

Access an overview of the requirements for creating a WVPP, maintaining a violent incident log, training employees on workplace violence, recordkeeping, and more by reviewing the California Division of Occupational Safety & Health (Cal/OSHA) Fact Sheet: Workplace Violence Prevention in General Industry. Read More >

Training is available from these CAPAdvantage program participants.

• Traliant: Traliant provides a 30-minute training that complies with California’s workplace violence prevention law applicable to most California employers. CAP member practices can access the course for $27/person. This fee covers set up, support, a completion certificate, and audit-ready reporting. Enroll Now
   
• WorkWise Law, PC: CAP member practices can access discounted training via a California employment law firm and provide their employees with a recorded webinar for $16/person (regularly $18/person) or a live in-person training for $1,350 (regularly $1500), plus travel if beyond 20 miles from Calabasas. To learn more, email lillian@workwiselaw.com or call 818-591-6724.

All trainings require the individual employer to provide details specific to their WVPP and allow employees the opportunity to ask questions and offer input about the plan.

Under California’s Fair Employment and Housing Act, all employers with five or more employees must provide training to its supervisory and nonsupervisory employees on sexual harassment and abusive conduct prevention. 

• When counting employed individuals, employers must include full-time, part-time, and temporary workers, as well as unpaid interns, unpaid volunteers, and contractors. 
• Employers are required to train all California-based employees, even if the cumulative 5+ employees don’t reside in the state or work in the same location. 
• Training must occur every two years: 
  • Nonsupervisory training = 1 hour
  • Supervisory training = 2 hours 
• Newly hired employees must be trained within six months of hire date. 
• New supervisory employees must be trained within six months of assuming supervisory duties.
• Seasonal and temporary employees, or any employee that is hired to work for less than six months, must be provided training within 30 calendar days after the hire date or within 100 hours worked, whichever occurs first. 
• Temporary workers employed by an employment agency must be trained by the agency, not the client. 
• Once the employee completes the training, have them sign a certificate of completion and keep a copy in their personnel records. 

Not only does implementing this type of training help avoid regulatory penalties, but it’s also instrumental in helping to mitigate potentially harrowing harassment-related lawsuits filed by current and former employees. Learn more by visiting the State of California Department of Civil Rights website. Learn More >

There are three types of unpaid employee leaves that most commonly affect medical practices in California: Family & Medical Leave Act, Pregnancy Disability Leave, and California Family Rights Act Leave— Child Bonding. The following is an overview of each.

Family & Medical Leave Act (FMLA) This law provides leave for a serious health condition of the employee or a family member, pregnancy, prenatal medical care, childbirth, adoption, or foster care.

• The benefit grants 12 workweeks of unpaid leave during a single 12-month period, with the employee’s job remaining protected.
• Applies to organizations with 50 or more employees, all of whom must work within a 75-mile radius of each other.
• Employees must have worked 1,250 or more hours in the past year and have worked for the employer for 12 months to qualify.
• Group health benefits must continue during the leave. 

Pregnancy Disability Leave (PDL) PDL provides eligible employees with unpaid, job-protected leave in the event of a pregnancy, childbirth, loss of pregnancy, and/or pregnancy-related physical and mental conditions. 

• Anyone who is pregnant can take this leave, but employers are advised to ask for medical certification.
• PDL applies to employers with five or more employees (part-time and full-time).
• Leave can be taken for up to four months per pregnancy (all at once or intermittently), based on hours worked per week and duration of the disability.
• Employees can be paid if they have access to Temporary  Disability through the employer or apply for State Disability Insurance (SDI) through the Employment Development Department (EDD), and/or they may use accrued vacation, or sick leave in addition.
• Group health benefits must continue during the disability leave.

California Family Rights Act Leave—Child Bonding (CFRA) CFRA provides up to 12 weeks of unpaid, job-protected leave for employees who need time off to care for a serious health condition, either their own or a family member’s, or to bond with a new child.

• Employees who have a new child via birth, adoption, or foster placement are eligible for CFRA benefits.
• Like PDL, CFRA applies to employers with five or more employees (part-time and full-time).
• Employees must have worked over 12 months for the employer and at least 1,250 hours in the past year to qualify.
• Leave can be taken for up to 12 weeks starting from the time of the birth, adoption, or foster care.
• CFRA runs after PDL and may be taken all at once, or intermittently.
• Employees may be paid, depending on the practice policy or if they are receiving Paid Family Leave (PFL) from the EDD. 
• Group health benefits must continue during the leave.

For comprehensive up-to-date information about these types of leaves and more, visit the State of California Employment Development Department website at  https://edd.ca.gov and the U.S. Department of Labor website at https://www.dol.gov. 

Senate Bill 525 (SB 525) establishes a minimum wage schedule for covered entities, which includes hospitals, skilled nursing facilities, home health agencies, and physician groups that have 25 or more physicians and will require these entities to increase the minimum wage for many categories of workers to up to $25 per hour. Groups and independent practices that have fewer than 25 physicians are excluded with a few exceptions based on contracts with covered facilities.

Implementation of SB 525 will now go into effect on October 15, 2024, but only if tax receipt revenue levels exceed three percent of projection in the first quarter of the fiscal year. Should the requirement not be reached, implementation will be pushed to January 1, 2025.

If you are concerned about whether the law applies to you, we recommend consulting an attorney. Visit the CAP Marketplace for a list of legal services and resources.

A commonly asked question is how to determine whether a position is exempt or nonexempt. The answers are often complicated and nuanced, but below are some general guidelines that can help to determine classification: 

• Primary job duties
• Rate of pay and total annual compensation
• Decision-making authority 
• Required education level 
• Location of the work
• Level of responsibility 
• Amount of discretionary and independent judgment with respect to matters of significance

Remember, all exempt employees are salaried and do not have to be paid overtime; nonexempt employees are hourly and must be paid overtime. Employers cannot use exempt status as a means of not paying overtime to employees who would otherwise be classified as nonexempt.

A few words about independent contractors:

• To determine if your employee is eligible to be an independent contractor, apply the A-B-C Test developed by the California Labor & Workforce Development Agency at  www.labor.ca.gov/employmentstatus/abctest/
• Employees do not get to decide if they are independent contractors.
• You must complete a 1099 tax form for all independent contractors.

The California Chamber of Commerce (www.calchamber.com/californialabor-law/exempt-nonexempt-employees) and Indeed (www.indeed. com/hire/c/info/exempt-vs-non-exempt-employees-in-california) are both good resources for additional information on this topic.

While California is an “at-will” state where employer and employee can end the working relationship at any time, there are steps we strongly recommend you take to protect yourself from wrongful termination claims.

Verbal and Written Warnings 

Before resorting to terminating an employee, execute a formalized warning process that begins with a verbal warning, followed by a formal written warning, then the final written warning. When conducting the warnings:

• Identify the issue (behavior, attendance, and/or performance).
• Counsel the employee with specific feedback, pinpointing deficiencies.
• Provide practical advice and resources to help the employee meet expectations.
• Have the employee sign the written warning and keep in their personnel file. If an employee refuses to sign a warning, write “employee refused to sign” with your initials and the date.

The Termination Process

If all performance improvement efforts have failed and you’ve concluded that termination is the most prudent option, we recommend the following steps, to help ease the transition for both employer and employee.

• Write a termination letter that briefly outlines what has happened since counseling resulting in the termination.
• Coordinate the discontinuance of the employee’s access to computer systems as of the date of termination.
• Have the employee’s final paycheck prepared, including unused vacation hours and paid time off.
• Conduct the termination in a private room. Keep the discussion centered on the purpose of the meeting and avoid engaging in small talk. Cover all the facts that have led to the decision to terminate. If preferred, have another senior staff member present to witness the event.
• Collect all work-related materials in the employee’s possession, including keys, computer equipment, and corporate credit cards, no later than the termination date.
• Provide the employee with boxes, and accompany them to their work area to remove their personal belongings. The employee may wish to remove these items immediately or, upon approval, return after hours to collect the items. If possible, be flexible and accommodate reasonable requests.
• Escort the former employee out of the office/building.
• Meet with the former employee’s department members and advise them that the employee is no longer working for the practice. Resist disclosing details regarding the event.

For advice about a specific situation, contact your employment law attorney.