HomeMy WebLinkAboutAgenda Packets - 2020/05/04CITY OF MOUNDS VIEW
CITY COUNCIL WORK SESSION AGENDA
MOUNDS VIEW CITY HALL
Monday, May 4, 2020 - NOTE TIME 5:30 p.m.
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ROLL CALL: Mueller, Gunn, Hull, Meehlhause, Bergeron
Council Workshops are informal gatherings of the council at which no final
decisions are made, rather consensus discussion to direct staff on council decision
items.
AGENDA ITEMS DISCUSSED BY CONSENSUS
1. Strategic Plan Quarter 1 2020 Department Updates - Brian Beeman
2. Highly Effective Teams – Goal of Workshop and Commission Appointments
3. Five Year Financial Plan
4. Mounds View Matters Publication Schedule
5. COVID 19 Related
a. Town Hall Meeting & Citizen of Year Selection – Rayla Ewald
b. Festival in the Park
c. Employee Appreciation Luncheon – Nyle Zikmund & Rayla Ewald
d. City Hall reopening
e. Playgrounds, Splash Down & COVID19
6. I & I Study – Results of the Metering
7. Personnel Manual – Open item for discussion if needed
NEXT COUNCIL WORK SESSION: Monday, June 1, 2020 at 6:30 pm
NEXT COUNCIL MEETING: Monday, May 11, 2020 at 6:30 pm
M EMORANDUM
to: Mounds View City Council
from: Nyle Zikmund, City Administrator
re: May 4 , 2019 Workshop
date: October 3, 2020
1. Brian will update council on Strategic Plan goals via a Power Point presentation.
Information only, no decision needed or requested
2. Highly effective teams – Goals and Benchmarking
Action Requested – Discuss “draft” document included in the packet and provide feedback to
staff for changes.
3. Five year Financial Plan
Action Requested – This is required by the Charter, draft plan is attached. Discussion and
direction to staff on any changes which will be brought back to Council for formal action at the
May 11, 2020 meeting.
4. Mounds View Matters Publication Schedule
Currently, we publish the MV Matters four times a year. We used to publish six times per year
but the combination of new “topical” information and cost resulted in a change a number of
years ago to four times. This is back on the agenda for discussion as it came up during the
highly effective team discussions – better communication with the public. However, shortly
after those discussions CTV made a presentation that included detail indicating our social media
and web (both of which we have increased postings on) has significant views.
Printing and mailing costs would increase from $12,000 per year to $17,000 per year and
additional staff time would be expended crafting articles.
Action Requested – Discuss and provide feedback to staff with direction on frequency of
publication.
5. COVID 19 Related
Current information – voluminous to say the least, points to the Pandemic lasting until
“herd immunity” is achieved. There is some debate on the percentage but 70% is a
frequently stated number and estimates for MN (per Ramsey County Health) are less than
5%. Herd immunity is most safely achieved by vaccine which is estimated to be 18
months (at best) as compared to unregulated interaction and viral infection.
Social distancing is proving effective along with PPE and in other countries; robust testing
AND contact tracing are allowing an accelerated return to normal. We (MN and USA)
continue to struggle with implementing both to the necessary level.
If council accepts this as the base, there are a number of items/issues to discuss and come
to a resolution of some kind. Action requested is to discuss and provide direction for each
item.
a. Town Hall Citizen of the Year – Unlikely we will be having a Town Hall meeting this
year but if council is so inclined to still “recognize” this person, we have included
the applications for review and discussions and could reach out to the candidate
selected to obtain a photograph and publish on our web page and social media.
b. Festival in the Park – Staff is recommending we advise the Festival in the Park
Committee they should cancel. Concerns over appearance, cleaning of the park,
and exposing our PW and Public Safety personnel. Numerous other communities
are canceling their community festivals.
c. Employee Appreciation Luncheon – Similar to Festival – inconsistent with social
distancing and staff is pleased to share our knowledge that employees have very
positive opinions regarding council and know that they are highly supportive of
staff. No action or alternative is required for this.
d. City Hall reopening – the vast majority of our Ramsey and Anoka County (as well as
Metro) are staying closed until June 1, and many longer. For those that open, they
are installing barriers. We are in the process of getting final quotes for the
reception enclosure but likely 2/3 months from completion. Staff discussed during
our department head meeting and feels the current model with several working
from home and PW and PD using window is working. However, if council wishes to
reopen city hall we would have PW install some type of glass/Plexiglas barrier until
construction is done.
e. Playgrounds/Parks – Cities are all over the place on this one with majority keeping
them closed and those that are opening them; are signing with play at your own
risk, not disinfected, maintain social distancing, etc. We have taken down
basketball hoops where we could and do not feel maintaining the yellow tape
barrier is a good use of time. Options include keeping them closed and
communicating that via the web page and social media, keeping them closed and
doing up signs, or opening them.
6. I & I Study
Don will share metering results.
7. Personnel Manual – Final review before placed on Council Agenda for Adoption. In past 20
months, staff did comprehensive overview with several items brought to council for
update, manual was then reviewed by League of Cities and final review was done by
Kennedy and Graven. Only substantive change from LMC or K & G was the At Will vs. Just
Cause. All other changes have been technical in nature or updates to current law.
City of Mounds View Highly Effective Teams
Goals and Benchmarking
March 2020
Purpose:
The purpose of this document is to formalize council discussion and decision specific to the
council’s commitment to continuous improvement to governance and operations.
Background:
The Council met in a retreat setting on March 16, 2020 for the specific focus of team building as
defined by Council/Staff, Council/Department Heads, and Council Commissions. City
Administrator Nyle Zikmund interviewed each council member individually discussing staff
strengths and weaknesses and council strengths and weaknesses. Weaknesses were defined as
those areas in which improvement would further strengthen the team. Aggregated feedback
was provided to Council at their retreat with a focus on sharing strengths and developing goals
and benchmarks for identified opportunities stemming from the feedback. The combination of
the Council’s significant investment of time to develop their strategic plan in combination with
the self-reflection occurring within the retreat demonstrates Council’s commitment to building
a highly effective team.
Identified Opportunities:
• Continue to work on community communication
• Improve relationships with Commissions.
• Improve council meetings
• Improve workshop
• Build stronger council relationships
Communication:
Goal – Continuous improvement in educating community on Council/City information
and events.
Benchmarks:
1. Leverage CTV capabilities to the greatest extent possible.
2. Minimum of 1 social media post per week (2 desired) - PD does own
3. Constant attention to the Web Site.
4. Explore 6 newsletters per year, fewer pages, plain paper
Commissions:
Commissions are an integral part of the governance team as the four (Park Recreation Forestry,
Planning and Zoning, Charter, Economic Development) have various responsibilities and
authority but all have a common function of being part of the overall governance structure.
Goal – Given importance of their role, improve the relationships with all Commissions.
Benchmarks:
1. Meet with each commission at least once a year.
2. Interview and appoint all commission members.
a. Council will advise all commissions of plan going forward with
implementation occurring in 2021.
b. Council will dedicate a retreat to establishing goals and guides in
commission member selection criteria
3. Have council liaison, as part of Council/EDA reports, provide brief
summary of Commission activity
Council Meetings:
Goal – Conduct the business of the City in as thoughtful and professional a manner as
practible.
Benchmarks:
1. Staff to set time guides for each item and overall time guide.
2. All operational questions asked and answered prior to meeting to that
extent possible.
3. All policy questions asked and answered with questions and answers
shared with all council.
4. Workshop all items requiring substantive discussion.
5. When discretionary time permits, table items and take back to workshop
if more discussion is needed.
6. Eliminate agenda items if not applicable (Special order of business, Public
Comment if no audience members)
7. Follow process
a. Staff Report
b. Council Questions of Staff
c. Public Hearing or Comment
d. Move and Second Item
e. Council Discussion
f. Council Action
Council Workshop:
Goal – Open exchange of ideas with sense of where everyone is at by the end of the
discussion.
Benchmarks:
1. Informal discussion
a. First names
b. No gavel
c. Polite conversation (free flow discussion Mayor intercedes only
when required due to time or nature of discussion)
2. Tape/record but do not live stream
3. Eliminate public comment (council time to have discussion)
4. Not the forum for final decisions/actions
a. Mayor ensures council has completed discussion
b. City Administrator captures and states understanding
i. Item needs further discussion
ii. Item will be placed on future agenda
iii. Other
Council Relationships:
Goal – Build stronger council relationships
Benchmarks:
1. Endeavor to have contact at least once a month one-to-one on a
more personal level.
2. When disagreement/difference of opinion occurs, reach out to
person to explore and understand the reasons on a one-to-one
basis.
Draft
2021 - 2025
Five Year
Financial Plan
City of Mounds View,
Minnesota
City of Mounds View
Five Year Financial Plan
General Fund Multi-year Operating Budget 2021 thru 2025
4.00%4.00%3.50%3.50%3.50%
2017 2018 2019 2020 Projected Projected Projected Projected Projected
Actual Actual Actual Budget 2021 2022 2023 2024 2025
0.50%0.75%1.25%1.50%1.50%
3.00%3.00%3.00%3.00%3.00%
Revenues:4.00%4.00%4.00%4.00%4.00%
Property taxes - Base levy 3,809,842$ 4,082,924$ 4,245,901$ 4,472,248$ 4,672,751$ 4,881,093$ 5,098,154$ 5,322,526$ 5,554,871$
Property taxes - Special levies (not subject to cap)244,145 244,145 349,145 369,145 364,145 374,145 379,145 394,311 410,083
Property taxes - debt levies (not subject to cap)90,835 90,835 165,800 171,190 171,654 171,268 132,014 91,778 92,534
Total taxes 4,144,822 4,417,904 4,760,846 5,012,583 5,208,550 5,426,506 5,609,313 5,808,615 6,057,488
Franchise tax 309,303 338,919 308,835 302,500 311,575 320,922 330,550 340,466 350,680
Other taxes 31,610 23,046 26,477 26,000 26,780 27,583 28,411 29,263 30,141
Hotel/motel tax 68,666 77,115 71,957 68,000 70,040 72,141 74,305 76,535 78,831
Licenses and permits 310,965 312,047 348,201 219,872 226,468 233,262 240,260 247,468 254,892
Intergovernmental 1,093,163 1,229,019 1,303,053 1,231,644 1,268,593 1,306,651 1,345,851 1,386,226 1,427,813
Charges for services 17,144 23,736 38,007 16,625 17,124 17,637 18,167 18,712 19,273
Fines & forfeitures 26,810 35,800 46,098 32,000 32,960 33,949 34,967 36,016 37,097
Interest 127,086 157,074 316,381 110,000 110,550 111,379 112,771 114,463 116,180
Miscellaneous 382,536 304,719 323,497 292,764 301,547 310,593 319,911 329,508 339,394
Transfers:3%3%3%3%3%3%3%3%3%
Water Fund (3%)- 78,103 80,446 82,859 85,345 87,905 90,542 93,259 96,056
Sewer Fund (3%)60,058 61,860 80,446 82,859 85,345 87,905 90,542 93,259 96,056
Street Light Fund (3%)2,690 2,771 2,854 2,940 3,028 3,119 3,213 3,309 3,408
Storm Water Fund (3%)7,832 8,067 8,309 8,558 8,815 9,079 9,352 9,632 9,921
Vehicle & Equipment Fund 21,600 - - 24,000 25,000 26,000 27,000 28,000 29,000
Debt issued (bonds, certificates or leases)172,427 175,191 - - - - - - -
Total revenues 6,776,712 7,245,371 7,715,407 7,513,204 7,781,720 8,074,633 8,335,155 8,614,731 8,946,231
6.52%6.92%6.49%-2.62%3.57%3.76%3.23%3.35%3.85%
Operating Expenditures:
Legislative Services:
City Council 55,479 58,903 58,013 62,235 64,724 67,313 69,669 72,108 74,632
Advisory Commissions 14,375 15,352 39,379 27,000 28,080 29,203 30,225 31,283 32,378
Subtotal 69,854 74,255 97,392 89,235 92,804 96,517 99,895 103,391 107,010
Administrative Services:
City Administrator 314,338 286,882 305,115 284,637 296,022 307,863 318,639 329,791 341,334
Elections 32,575 33,460 26,954 36,504 37,964 39,483 40,865 42,295 43,775
Finance 261,574 268,325 274,866 286,762 298,232 310,162 321,017 332,253 343,882
Central Services 259,405 261,610 298,124 305,496 317,716 330,424 341,989 353,959 366,348
Subtotal 867,892 850,277 905,059 913,399 949,935 987,932 1,022,510 1,058,298 1,095,338
Community Development 324,264 435,152 441,676 462,665 481,172 500,418 517,933 536,061 554,823
Police 2,814,764 2,969,790 3,325,570 3,329,395 3,462,571 3,601,074 3,727,111 3,857,560 3,992,575
Fire 386,738 431,873 467,982 471,756 490,626 510,251 528,110 546,594 565,725
Public Works Administration 129,775 149,353 153,706 120,292 125,104 130,108 134,662 139,375 144,253 1
Operating Expenditures: (continued)
Parks, Recreation & Forestry:
Recreation 109,071 123,961 125,940 134,771 140,162 145,768 150,870 156,151 161,616
Parks 280,084 286,911 342,429 449,337 467,310 486,003 503,013 520,618 538,840
Forestry 11,887 36,836 44,185 53,693 55,841 58,074 60,107 62,211 64,388
Subtotal 401,042 447,708 512,554 637,801 663,313 689,846 713,990 738,980 764,844
Public Works
Building & Grounds Mtnce 118,555 144,415 143,343 150,373 156,388 162,643 168,336 174,228 180,326
Vehicle & Equipment Mtnce 108,819 124,811 113,381 130,857 136,091 141,535 146,489 151,616 156,922
Subtotal 227,374 269,226 256,724 281,230 292,479 304,178 314,825 325,843 337,248
Streets:
Pavement Management 192,701 205,269 234,368 227,496 236,596 246,060 254,672 263,585 272,811
Snow & Ice Control 107,680 168,529 177,992 161,033 167,474 174,173 180,269 186,579 193,109
Sign Maintenance 44,676 47,325 47,318 68,060 70,782 73,614 76,190 78,857 81,617
Subtotal 345,057 421,123 459,678 456,589 474,853 493,847 511,131 529,021 547,537
Other
Convention & Visitor's Bureau 65,233 73,260 65,455 64,600 66,538 68,534 70,590 72,708 74,889
Social Service Coordination 20,461 20,748 35,329 36,779 38,250 39,780 41,172 42,614 44,105
Miscellaneous/contingency 5,238 3,766 3,662 6,500 6,500 6,500 6,500 6,500 6,500
Transfers to EDA 50,000 50,000 50,000 50,000 50,000 50,000 50,000 50,000 50,000
Transfers to Comm Ctr fund 190,000 190,000 190,000 200,000 200,000 200,000 210,000 210,000 210,000
Transfers to Vehicle fund 250,000 300,000 325,000 299,000 299,000 286,000 286,000 286,000 290,000
Transfers to Special Projects fund 275,000 100,000 125,000 75,000 75,000 75,000 75,000 75,000 75,000
Debt service - Fire Bonds 85,367 130,123 166,112 163,038 163,480 163,112 125,728 87,408 88,128
Debt service - Lease (ESP)24,495 24,495 24,495 24,495 24,496 24,496 24,496 24,496 24,496
Subtotal 965,794 892,392 985,053 919,412 923,264 913,422 889,487 854,725 863,118
Total operating expenditures 6,532,554 6,941,149 7,605,394 7,681,774 7,956,121 8,227,593 8,459,653 8,689,848 8,972,470
Percent increase(decrease) over PY 1.32%6.25%9.57%1.00%3.57%3.41%2.82%2.72%3.25%
Capital Expenditures:
Fire 213,082 240,227 59,761 77,430 50,000 150,000 125,000 200,000 175,000
Subtotal 213,082 240,227 59,761 77,430 50,000 150,000 125,000 200,000 175,000
Total expenditures 6,745,636 7,181,376 7,665,155 7,759,204 8,006,121 8,377,593 8,584,653 8,889,848 9,147,470
Revenue over (under) expenditures 31,076 63,995 50,252 (246,000) (224,401) (302,960) (249,498) (275,117) (201,239)
Beginning Fund Balance 9,445,463 9,476,539 9,540,534 9,590,786 9,344,786 9,120,386 8,817,426 8,567,928 8,292,811
Ending Fund Balance 9,476,539$ 9,540,534$ 9,590,786$ 9,344,786$ 9,120,386$ 8,817,426$ 8,567,928$ 8,292,811$ 8,091,572$
246,000 242,000 238,000 234,000 230,000 226,000
Assigned for Levy Reduction by Council Res.5,478,848 5,337,607 5,217,724 4,971,724 4,754,583 4,552,242 4,375,145 4,210,772 4,047,934
Assigned for Balancing Subsequent Budget (63,995) (50,252) 246,000 224,401 302,960 249,498 275,117 201,239 21,459
Unassigned Fund Balance 4,061,686 4,253,179 4,127,062 4,148,662 4,062,843 4,015,686 3,917,666 3,880,799 4,022,179
Total Fund Balance 9,476,539 9,540,534 9,590,786 9,344,786 9,120,386 8,817,426 8,567,928 8,292,811 8,091,572
Unassigned Fund Balance % of
subsequent years revenues 56.06%55.13%54.93%53.31%50.32%48.18%45.48%43.38%43.26%2
City of Mounds View
Vehicle and Equipment Replacement Fund
Target Actual
Estimated Age Replacement Replacement Balance New
Veh.Year Original Replace Replacement In Balance Balance Remaining To Be Annual
Department Manufacturer Model No.VIN Acq.Cost Year Life Cost 2020 as of 12/20 as of 12/20 Life Funded Cost
ComDev FORD Ranger Pickup 102 1FTYR10U26PA83660 2006 12,287.50 2022 16 - 14 - - 2 - -
Police FORD Interceptor (Unmarked)(repla 0141 1FAHP2MK3EG102967 2013 29,837.61 2022 9 - 7 - - 2 - -
Police FORD Interceptor 0142 1FAHP2MKXEG102965 2013 29,837.61 2022 9 - 7 - - 2 - -
ComDev CHEVY IMPALA LS (former PD staff car)106 2G1WB58K079377475 2007 19,252.33 2022 15 - 13 - - 2 - -
ComDev CHEVY IMPALA (deputy chief)(to ComDev)107 2G1WB58K569361240 2006 15,507.00 2021 15 - 14 - - 1 - -
Total Community Development -
Cent Ser Various Computers, servers, & switches Various 2018 23,318.72 2023 5 27,000 2 10,800.00 10,800.00 3 16,200.00 5,400.00
Cent Ser Various Computers, servers, & switches Various 2019 18,159.85 2024 5 28,000 1 5,600.00 5,600.00 4 22,400.00 5,600.00
Cent Ser Various Computers, servers, & switches Various 2015 21,315.85 2020 5 24,000 5 24,000.00 24,000.00 0 - -
Cent Ser Various Computers, servers, & switches Various 2016 22,102.23 2021 5 25,000 4 20,000.00 20,000.00 1 5,000.00 5,000.00
Cent Ser Various Computers, servers, & switches Various 2017 20,229.58 2022 5 26,000 3 15,600.00 15,600.00 2 10,400.00 5,200.00
Cent Ser Cisco IP Phones Various 2013 2023 10 15,000 7 10,500.00 10,500.00 3 4,500.00 1,500.00
Cent Ser Various Copiers (3) add pw copier replacement 2024 Various 2019 15,732.36 2024 5 19,000 1 3,800.00 3,800.00 4 15,200.00 3,800.00
Total Central Services 26,500.00
Police CHEVY Tahoe - Comm. Resource Officer 0112 1GNSK2EO5BR320699 2011 34,454.75 2022 11 - 9 - - 2 - -
Police FORD Interceptor (deputy chief/staff)0131 1FAHP2M87DG132282 2012 30,321.01 2022 10 - 8 - - 2 - -
Police FORD Interceptor (practice car)0143 1FAHP2MK1EG102966 2013 29,837.61 2022 9 - 7 - - 2 - -
Police FORD Interceptor SUV 0144 1FM5K8AR1EGC61627 2014 36,262.00 2021 7 51,000 6 43,714.29 43,714.29 1 7,285.71 7,285.71
Police CHEVY IMPALA (Detective)0145 2G1WA5E32E1176673 2014 22,562.82 2024 10 35,000 6 21,000.00 21,000.00 4 14,000.00 3,500.00
Police FORD Interceptor SUV (K-9 take home)0161 1FM5K8AR5GGA19524 2015 40,508.44 2022 7 52,000 5 37,142.86 37,142.86 2 14,857.14 7,428.57
Police CHEVY IMPALA (Police Chief)0162 2G1WA5E39G1109252 2015 27,678.37 2024 9 37,000 5 20,555.56 20,555.56 4 16,444.44 4,111.11
Police FORD Interceptor SUV (K-9 take home)0163 1FM5K8ARXGGC91888 2016 35,037.00 2023 7 53,000 4 30,285.71 30,285.71 3 22,714.29 7,571.43
Police FORD Fusion (Detective)0171 3FA6P0H75HR358333 2017 25,983.02 2027 10 38,000 3 11,400.00 11,400.00 7 26,600.00 3,800.00
Police FORD Interceptor SUV 0172 1FM5K8AR2HGC86265 2017 36,338.70 2023 6 53,000 3 26,500.00 26,500.00 3 26,500.00 8,833.33
Police FORD Interceptor SUV 0191 1FM5K8AR5KGB14500 2019 27,368.45 2025 6 55,000 1 9,166.67 9,166.67 5 45,833.33 9,166.67
Police FORD Interceptor 0192 1FAHP2MK6KG107947 2019 23,848.45 2025 6 55,000 1 9,166.67 9,166.67 5 45,833.33 9,166.67
Police FORD Interceptor SUV 0193 1FM5K8AR2KGB55070 2019 23,848.45 2026 7 56,000 1 8,000.00 8,000.00 6 48,000.00 8,000.00
Police FORD Interceptor SUV 0201 Ordered 2020 54,900.00 2026 6 56,000 0 - - 6 56,000.00 9,333.33
Police FORD Interceptor SUV 0202 Ordered 2020 54,900.00 2027 7 57,000 0 - - 7 57,000.00 8,142.86
Police Motorola 800 Mhz radios (25)2005 77,748.00 2021 16 101,000 15 94,687.50 94,687.50 1 6,312.50 6,312.50
Pub Safety ONAN Generator for EOC (City Hall)2011 26,692.04 2031 20 150,000 9 67,500.00 67,500.00 11 82,500.00 7,500.00
Pub Safety Civil Defense Siren (upgraded in 2017)2017 26,261.37 2037 20 40,000 3 6,000.00 6,000.00 17 2,000.00 117.65
Pub Safety Civil Defense Siren (upgraded in 2018)2018 15,593.00 2038 20 40,000 2 4,000.00 4,000.00 18 36,000.00 2,000.00
Pub Safety Civil Defense Siren (upgraded in 2018)2018 15,749.00 2039 21 40,000 2 3,809.52 3,809.52 19 36,190.48 1,904.76
Total Police 104,174.58
Street FORD Crown Victoria (parts car)(old K9)421 2FABP7BV5BX154316 2011 24,955.89 2022 11 - 9 - - 2 - -
Street CASE 621D Loader 423 JEE0135702 2003 89,800.39 2023 20 150,000 17 127,500.00 127,500.00 3 22,500.00 7,500.00
Street BOBCAT BCA125 Compactor 427 6814146-4916-11082 2003 14,052.50 2023 20 20,000 17 17,000.00 17,000.00 3 3,000.00 1,000.00
Street BOBCAT S595 T4 Skid Steer 430 B3NL19031 2019 37,197.40 2021 2 - 1 - - 1 - -
Street STERLING L 8500 (dump truck)437 2FZAAWDC84AN52061 2004 95,782.84 2021 17 210,000 16 197,647.06 197,647.06 1 12,352.94 12,352.94
Street BIG TOW Bobcat trailer 439 4KNUB16284L161539 2004 4,024.25 2029 25 8,000 16 5,120.00 5,120.00 9 2,880.00 320.00
Street FORD F350 Pickup (To be ordered)442 Ordered 2020 49,606.54 2033 13 69,500 0 - - 13 69,500.00 5,346.15
Street SPAULDING RMV Road Saver (Hot Box)443 T2DRS-07-0205-37 2007 19,191.30 2027 20 30,000 13 19,500.00 19,500.00 7 10,500.00 1,500.00
Street REDIHAUL Trailer (tilt bed)444 47SS121T881023934 2008 3,414.00 2033 25 6,000 12 2,880.00 2,880.00 13 3,120.00 240.00
Street FREIGHTLINER Dump truck 445 1FVAC3BS2BDBC6824 2012 133,244.95 2027 15 240,000 8 128,000.00 128,000.00 7 112,000.00 16,000.00
Street DOOSAN Air Compressor 446 435928UAWD95 2012 12,673.23 2032 20 32,000 8 12,800.00 12,800.00 12 19,200.00 1,600.00
Street FORD Bucket truck (used 2006)447 1FDAF56P86ED52058 2012 48,840.66 2022 10 75,000 8 60,000.00 60,000.00 2 15,000.00 7,500.00
Street FORD F350 Pickup 448 1FTRF3B60CEC70104 2012 37,353.06 2025 13 51,000 8 31,384.62 31,384.62 5 19,615.38 3,923.08
Street FORD F150 Pickup (Sup)(to PW Admin)450 1FTEX1EM1EKF28595 2014 26,355.96 2027 13 35,000 6 16,153.85 16,153.85 7 18,846.15 2,692.31
Street FORD F550 w/dump box and compressor 451 1FDUF5HTXFEA71029 2014 73,368.85 2027 13 92,000 6 42,461.54 42,461.54 7 49,538.46 7,076.92
Street FORD F150 4x4 Super Cab replaces 438 452 1FTFX1EG8HKD27473 2017 33,860.05 2030 13 45,000 3 10,384.62 10,384.62 10 34,615.38 3,461.54
Street MACK GU532 SBA (dump truck)453 1M2AX35C6JM010381 2017 201,553.00 2032 15 280,000 3 56,000.00 56,000.00 12 224,000.00 18,666.67
Street FELLING FT16-2 Trailer 454 5FTCF3127H1004474 2017 12,826.80 2042 25 20,000 3 2,400.00 2,400.00 22 17,600.00 800.00
Street TBD Floor Sweeper/Scrubber (New item)2019 13,000.00 2039 20 20,000 1 1,000.00 1,000.00 19 19,000.00 1,000.00
Total Streets 70,512.94 3
City of Mounds View
Vehicle and Equipment Replacement Fund
Target Actual
Estimated Age Replacement Replacement Balance New
Veh.Year Original Replace Replacement In Balance Balance Remaining To Be Annual
Department Manufacturer Model No.VIN Acq.Cost Year Life Cost 2020 as of 12/20 as of 12/20 Life Funded Cost
Park US CARGO Cargo trailer 306 4X4UTS2103W012414 2003 2,923.00 2028 25 5,000 17 3,400.00 3,400.00 8 1,600.00 200.00
Park AEBI TERRATRAC TT75 (Not replacing)307 14004 2005 74,839.81 2025 20 - 15 - - 5 - -
Park FORD F250 4X4 Pickup (CC)308 1FTNF215X5ED18387 2005 25,723.77 2023 18 40,000 15 33,333.33 33,333.33 3 6,666.67 2,222.22
Park FORD Sterling/Precision (Tanker)309 2FZACHDC66AV96438 2006 126,221.86 2026 20 200,000 14 140,000.00 140,000.00 6 60,000.00 10,000.00
Park FORD F350 Pickup (To be Ordered)310 Ordered 2020 54,976.89 2033 13 72,000 0 - - 13 72,000.00 5,538.46
Park JACOBSEN Turfcat JRM372 4WD 314 95723402186 2013 21,343.81 2023 10 29,000 7 20,300.00 20,300.00 3 8,700.00 2,900.00
Park BOB CAT 3400 Utility Vehicle 315 AJNT11764 2013 7,500.00 2023 10 9,000 7 6,300.00 6,300.00 3 2,700.00 900.00
Park TBD Place holder to replace AEBI 2013 2028 15 100,000 7 46,666.67 46,666.67 8 53,333.33 6,666.67
Park AEBI TERRATRAC TT705 (not replacing)316 9098 2013 130,384.23 2028 15 - 7 - - 8 - -
Park AEBI AEBI/SMWA Rev CF225 mower (not replacing)2013 10,686.49 2028 15 - 7 - - 8 - -
Park AEBI Lastec 126" Batwing mower (not replacing)2013 16,975.00 2028 15 - 7 - - 8 - -
Park FORD F350 w/service body and compressor 317 1FTBF3A6XFEA71021 2014 65,593.98 2027 13 87,000 6 40,153.85 40,153.85 7 46,846.15 6,692.31
Park TORO Groundmaster 4000 318 314000231 2015 57,212.00 2025 10 71,500 5 35,750.00 35,750.00 5 35,750.00 7,150.00
Park TORO Groundmaster 4000 319 314000237 2015 57,212.00 2025 10 71,500 5 35,750.00 35,750.00 5 35,750.00 7,150.00
Park BOB CAT 3400 Utility Vehicle (added 2017)320 AJNT30458 2017 7,900.00 2027 10 13,000 3 3,900.00 3,900.00 7 9,100.00 1,300.00
Park John Deere Z920M Mower 321 1TC920MELKT070096 2019 11,510.96 2029 10 15,000 1 1,500.00 1,500.00 9 13,500.00 1,500.00
Park Kromer FO-1 322 400 2019 36,660.50 2029 10 47,000 1 4,700.00 4,700.00 9 42,300.00 4,700.00
Total Parks 56,919.66
Total General Fund 258,107.18
Storm FORD F250 646 1FTBF2B67BEC30936 2011 25,923.55 2024 13 37,000 9 25,615.38 25,615.38 4 11,384.62 2,846.16
Storm Tymco 500X mounted on International 4300-M7 Chassis 647 1HTJTSKN1EH018891/201407SNF59502BAH 2015 272,612.45 2027 12 355,000 5 147,916.67 147,916.67 7 207,083.33 29,583.33
Storm Water Fund Total:32,429.49
Water Custom Water tower (fluted column)500,000 gallon 2012 517,019.07 2032 20 780,000 8 312,000.00 312,000.00 12 468,000.00 39,000.00
Water CAT 446B Backhoe 703 05BL00672 1995 88,281.05 2026 31 140,000 25 112,903.23 112,903.23 6 27,096.77 4,516.13
Water REDIHAUL WOLFPAC Trailer (Not replaced)705 47SS121T5K1005396 1989 2,129.75 2020 31 - 31 - - 0 - -
Water FORD 4X2 3/4 ton 706 1FTNF20L32EC81193 2002 25,761.85 2020 18 35,000 18 35,000.00 35,000.00 0 - -
Water ONAN Booster Station (generator)J910431288 1990 2021 31 125,000 30 120,967.74 120,967.74 1 4,032.26 4,032.26
Water BOBCAT S650 T4 skid steer 708 ALJ827772 2019 40,403.10 2021 2 3,570 1 1,785.00 1,785.00 1 1,785.00 1,785.00
Water FORD F350 Pickup 709 1FT8X3A64FEB55441 2014 64,414.70 2027 13 85,000 6 39,230.77 39,230.77 7 45,769.23 6,538.46
Water FORD F150 4x4 Super Cab (ordered)710 1FTFX1EG3HKD34430 2017 33,120.00 2030 13 45,000 3 10,384.62 10,384.62 10 34,615.38 3,461.54
Water Advance SC6000 36C Floor scrubber 711 3510191100158 2019 33,120.00 2030 11 45,000 1 4,090.91 4,090.91 10 40,909.09 4,090.91
Water BOBCAT Hydraulic Frost Breaker A00Y02317 2007 5,888.39 2022 15 7,500 13 6,500.00 6,500.00 2 1,000.00 500.00
Water Interstate Power Systems 150RJC6DT3 Generator 176142-0608 2008 83,125.61 2033 25 137,000 12 65,760.00 65,760.00 13 71,240.00 5,480.00
Water Fund Total:69,404.30
Sewer FORD F250 4X2 834 1FTNF20L11EA62781 2001 35,500.30 2031 30 82,500 19 52,250.00 52,250.00 11 30,250.00 2,750.00
Sewer INT'NATL Work Star (sewer jetter)836 1HTWGAZT4CJ591184 2011 346,416.78 2026 15 450,000 9 270,000.00 270,000.00 6 180,000.00 30,000.00
Sewer FORD F250 837 1FT7X2A60HEB80040 2016 43,064.00 2029 13 57,000 4 17,538.46 17,538.46 9 39,461.54 4,384.62
Sewer FORD Ordered 838 1FTSS34P44HB43679 2019 182,397.74 2039 20 292,000 1 14,600.00 14,600.00 19 277,400.00 14,600.00
Sewer Fund Total:51,734.62
4,331,417.43 5,953,070 2,821,757.10 2,821,757.10 3,099,312.90 411,675.58
2010 125,000.00 Fund Balance 12-31-2019 1,904,974.00
2011 100,000.00 916,783.10 2021 Budgeted transfers
2012 125,000.00 2020 Transfers In (454,000.00) General Fund 299,000.00
2013 155,000.00 2020 Budget Expenses 304,100.00 Water Fund 70,000.00
2014 155,000.00 Unfunded Balance 766,883.10 Sewer Fund 55,000.00
2015 120,000.00 Storm Water 33,000.00
2016 82,000.00 457,000.00
2017 92,000.00
954,000.00 Over (Under) funded Transfers 45,324.42 4
CITY OF MOUNDS VIEW, MINNESOTA
CAPITAL IMPROVEMENT PROGRAM WORKSHEET
2021 - 2026
Project / Improvement 451 480 485
Park
Dedication
Special
Projects
Street
Improvement
001 2020 PROJECT IMPROVEMENTS $ 5,442,212 $ 103,500 $ 475,108 $ 118,500
2020 002 Irrigation & landscaping improvements City Hall Park 45,000 45,000
2020 003 Rest room enclosures, roof, hockey lighting 58,500 58,500
2020 004 Comm Ctr HVAC Imp RTU-4-7, and VAV's DP switches (carryover 2019) 52,108 52,108
2020 005 Comm Ctr Sidewalk ADA imp, door locks, 4 cameras, basketball hoops 44,000 44,000
2020 006 Codification of City ordinances 21,000 21,000
2020 007 PW building floor sealing and ADA doors 25,000 25,000
2020 008 Community Center restrooms (reprogramed for lighting repairs) 30,000 30,000
2020 009 Divider wall replacement & front counter gate - Comm Ctr 128,000 128,000
2020 010 CH paint, carpet, front counter, other misc imp, PD remodel closeout 175,000 175,000
2020 011 Seal coating - Area F, G, 98,500 98,500
2020 012 Woodale Dr (Closeout) 20,000 20,000
2020 013 Quincy St from CR H2 to CR I (Construction)(2610 ft) 1,016,000
2020 014 Water Treatment System Upgrade WTP #3 and Booster Station 3,159,104
2020 015 Municipal Wells No. 5&6 Pump & Motor Rehabilitation 150,000
2020 016 Wastewater Collection System Rehabilitation (CIPP Lining) 175,000
2020 017 Manhole lining 25,000
2020 018 Upgrade Bronson lift station (carryover from 2019) 130,000
2020 019 Ardan Ave Storm Sewer cleaning 60,000
2020 020 Storm Water Collection System Rehabilitation 30,000
021 2021 PROJECT IMPROVEMENTS $ 4,411,260 $ 135,000 $ 220,000 $ 357,260
2021 022 Oakwood Park playground 45,000 45,000
2021 023 Lambert Park Hockey boards 35,000 35,000
2021 024 Rest room enclosures (carryover 2020) 30,000 30,000
2021 025 Trailway Development & ADA Transition Project 100,000 100,000
2021 026 CH Conference room, Dias upgrades 75,000 75,000
2021 027 Paint Community Center interior 45,000 45,000
2021 028 Replace carpet Comm Ctr (CC last replaced 2004) 70,000 70,000
2021 029 Seal Coating - Area A, B and misc Mustang Dr, Mustang Cir, Red Oak Ct. 172,260 172,260
2021 030 Quincy St from CR H2 to CR I (Closeout) 55,000 55,000
2021 031 Pleasant View Dr/84th Ave (Design)(approx. 3566 lineal feet) 130,000 130,000
2021 032 Water Treatment System Upgrade WTP #2, close-out booster station 1,631,000
2021 033 Water Treatment System Upgrade WTP #1 1,738,000
2021 034 Municipal Well No. 6 Pump & Motor Rehabilitation 50,000
2021 035 Wastewater Collection System Rehabilitation (CIPP Lining) 175,000
2021 036 Weir at Silverview Pond 75,000
2021 037 Storm Water Collection System Rehabilitation 30,000
038 2022 PROJECT IMPROVEMENTS $ 4,613,000 $ 80,000 $ - $ 2,162,000
2022 039 Random Park playground equipment 80,000 80,000
2022 040 Pavement Maintenance - Area C, & H 145,000 145,000
2022 041 Spring Lake Rd S of MV Blvd (Design) 130,000 130,000
2022 042 Pleasant View Dr/84th Ave Spring Lake Rd N of MV Blvd(Construction) 2,295,000 1,887,000
2022 043 Water Treatment System Upgrade WTP #1 1,738,000
2022 044 Wastewater Collection System Rehabilitation (Slip Lining) 175,000
2022 045 Stormwater Conveyance System Improvement Project 50,000
046 2023 PROJECT IMPROVEMENTS $ 1,574,897 $ 115,000 $ - $ 826,897
2023 047 Parking lot Random Park, Oakwood Park playground equip., trail maint 115,000 115,000
2023 048 Pavement Maintenance - Area D (2014), Business Park North (2018) 98,897 98,897
2022 049 Pleasant View Dr/84th Ave (Closeout) 50,000 50,000
2023 050 Spring Lake Road/Sherwood Pl (Construction) 1,041,000 633,000
2023 051 Bronson from Long Lake to Quincy (design) 45,000 45,000
2023 052 Wastewater Collection System Rehabilitation (CIPP Lining) 175,000
2023 053 Stormwater Conveyance System Improvement Project 50,000
054 2024 PROJECT IMPROVEMENTS $ 767,887 $ - $ - $ 462,887
2024 055 Pavement Maintenance - Area I (2014) 52,887 52,887
2024 056 Spring Lake Road (Closeout) 50,000 50,000
2024 057 Bronson from Long Lake to Quincy (construction) 360,000 360,000
2024 058 Municipal Well No. 1 Pump & Motor Rehabilitation 50,000
2024 059 Wastewater Collection System Rehabilitation (CIPP Lining) 175,000
2024 060 Storm Water Collection System Rehabilitation 30,000
2024 061 Stormwater Conveyance System Improvement Project 50,000
Year
Line
No. Estimated Total Cost
5
700 730 745 430
Water
Enterprise
San. Sewer
Enterprise
Stormwater
Enterprise TIF #3 City Bonds
Municipal
State Aid
Ramsey
County
State/Fed
Grants Tax Levy
Other Local
Funds
Unfunded
Amount
$ 150,000 $ 330,000 $ 90,000 $ 700,000 $ 6,000,000 $ 316,000 $ - $ - $ - $ - $ (2,840,896)
700,000 316,000
6,000,000 (2,840,896)
150,000
175,000
25,000
130,000
60,000
30,000
$ 3,419,000 $ 175,000 $ 105,000 $ - $ - $ - $ - $ - $ - $ - $ -
1,631,000
1,738,000
50,000
175,000
75,000
30,000
$ 1,738,000 $ 175,000 $ 50,000 $ - $ - $ 408,000 $ - $ - $ - $ - $ -
408,000
1,738,000
175,000
50,000
$ - $ 175,000 $ 50,000 $ - $ - $ 408,000 $ - $ - $ - $ - $ -
408,000
175,000
50,000
$ 50,000 $ 175,000 $ 80,000 $ - $ - $ - $ - $ - $ - $ - $ -
50,000
175,000
30,000
50,000
6
CITY OF MOUNDS VIEW, MINNESOTA
CAPITAL IMPROVEMENT PROGRAM WORKSHEET
2021 - 2026
Project / Improvement 451 480 485
Park
Dedication
Special
Projects
Street
Improvement Year
Line
No. Estimated Total Cost
062 2025 PROJECT IMPROVEMENTS $ 430,000 $ - $ - $ 125,000
2025 063 Pavement Maintenance - Business Park North 80,000 80,000
2025 064 Bronson from Long Lake to Quincy (closeout) 45,000 45,000
2025 065 Pavement rehabilitation - 2003 project area (place holder no costs yet) -
2025 066 Municipal Well No. 1 Pump & Motor Rehabilitation 50,000
2025 067 Wastewater Collection System Rehabilitation (Slip Lining) 175,000
2025 068 Storm Water Collection System Rehabilitation 30,000
2025 069 Stormwater Conveyance System Improvement Project 50,000
070 TOTAL 2020 - 2025 $ 17,239,256 $ 433,500 $ 695,108 $ 4,052,544
071
072 2026 and BEYOND IMPROVEMENTS $ 5,867,000 $ - $ 37,000 $ 632,500
2026 073 Municipal Well No. 2 Pump & Motor Rehabilitation 50,000
2026 074 Wastewater Collection System Rehabilitation (Slip Lining) 175,000
2026 075 Storm Water Collection System Rehabilitation 30,000
2026 076 Pavement Maintenance - Business Park North 80,000 80,000
2026 077 Pavement Maintenance 100,000 100,000
2026 078 Pavement rehabilitation - 2004 project area (place holder no costs yet) -
2026 079 Municipal Well No. 3 Pump & Motor Rehabilitation 50,000
2026 080 Wastewater Collection System Rehabilitation (Slip Lining) 175,000
2026 081 Sediment Removal - Silver View Pond (approx. 2026) 2,000,000
2027 082 Pavement Maintenance - 125,000 125,000
2027 083 Pavement Maintenance - Mustang Drive and Circle 60,000 60,000
2027 084 Municipal Well No. 5 Pump & Motor Rehabilitation 50,000
2027 085 Wastewater Collection System Rehabilitation (Slip Lining) 175,000
2027 086 Storm Water Collection System Rehabilitation 30,000
2027 087 Pavement Maintenance - 125,000 125,000
2028 088 Municipal Well No. 6 Pump & Motor Rehabilitation 50,000
2028 089 Wastewater Collection System Rehabilitation (Slip Lining) 175,000
2028 090 Storm Water Collection System Rehabilitation 30,000
2026+091 MV Blvd (CSAH 10) / Co. Rd. H2 Intersection Improvements 450,000 22,500
2026+092 CSAH 10 / Woodale Dr. Intersection Improvements 250,000 35,000
2026+093 CSAH 10 / Edgewood Dr. Intersection Improvements 250,000 35,000
2026+094 City Hall irrigation & landscape, Police parking lot lighting 37,000 37,000
2026+095 CSAH 10 Trail - Segment 8 (Knollwood Dr. - Silver Lake Rd.) 250,000
2026+096 CSAH 10 Trail - Segment 7 (Pleasant View Dr. - Knollwood Dr.) 300,000
2026+097 CSAH 10 / Spring Lake Rd. Intersection Improvements 150,000
2026+098 CSAH 10 / Groveland Rd. Intersection Improvements 150,000
2026+099 Other Pavement Maint - parking lots and trails 50,000 50,000
2026+100 CSAH 10 / Co. Rd. I Intersection Improvements 500,000
TOTAL 2019 - 2028 $ 23,106,256 $ 433,500 $ 732,108 $ 4,685,044
7
700 730 745 430
Water
Enterprise
San. Sewer
Enterprise
Stormwater
Enterprise TIF #3 City Bonds
Municipal
State Aid
Ramsey
County
State/Fed
Grants Tax Levy
Other Local
Funds
Unfunded
Amount
$ 50,000 $ 175,000 $ 80,000 $ - $ - $ - $ - $ - $ - $ - $ -
50,000
175,000
30,000
50,000
$ 5,407,000 $ 1,205,000 $ 455,000 $ 700,000 $ 6,000,000 $ 1,132,000 $ - $ - $ - $ - $ (2,840,896)
$ 200,000 $ 700,000 $ 2,090,000 $ - $ - $ - $ 232,500 $ 985,000 $ - $ - $ 990,000
50,000
175,000
30,000
50,000
175,000
2,000,000
50,000
175,000
30,000
50,000
175,000
30,000
22,500 405,000
35,000 180,000
35,000 180,000
- 250,000
- 300,000
20,000 110,000 20,000
20,000 110,000 20,000
100,000 360,000 40,000
$ 5,607,000 $ 1,905,000 $ 2,545,000 $ 700,000 $ 6,000,000 $ 1,132,000 $ 232,500 $ 985,000 $ - $ - $ (1,850,896)
8
City of Mounds View
Capital Improvement Plan 2021 thru 2025
Impact on Capital Projects Funds' Cash Balances
Fund 451 Fund 460 Fund 480 Fund 485
Park Vehicle and Special Street
Dedication Equipment Projects Improvement Total
Cash balance, Dec. 31, 2019 183,098$ 1,904,974$ 1,333,387$ 2,319,308$ 5,740,767
Revenues 2020:
Taxes - - - 150,000 150,000
Franchise fees - - - 302,500 302,500
Special assessments - - - 22,000 22,000
Intergovernmental:-
State - - - 275,000 275,000
Federal - - - - -
County - - - - -
Miscellaneous:-
Investment income 1,000 - 8,000 20,000 29,000
Developer payments 3,000 - - - 3,000
Proceeds from bond sale - - - - -
Operating transfer in - 441,000 75,000 - 516,000
Total revenue 4,000 441,000 83,000 769,500 1,297,500
Available Resources 187,098 2,345,974 1,416,387 3,088,808 7,038,267
Expenditures 2020:
Government buildings & equip - - 450,108 - 450,108
Public safety - 109,800 - - 109,800
Streets, highways, & utilities - 81,200 25,000 316,000 422,200
Sidewalks & trails - - - - -
Parks & recreation 103,500 54,000 - - 157,500
Operating transfers out - 59,000 - 701,000 760,000
Total expenditures 103,500 304,000 475,108 1,017,000 1,899,608
Surplus of revenues
over (under) expenditures (99,500) 137,000 (392,108) (247,500) (602,108)
Cash balance, Dec. 31, 2020:83,598$ 2,041,974$ 941,279$ 2,071,808$ 5,138,659$
9
City of Mounds View
Capital Improvement Plan 2021 thru 2025
Impact on Capital Projects Funds' Cash Balances
Fund 451 Fund 460 Fund 480 Fund 485
Park Vehicle and Special Street
Dedication Equipment Projects Improvement Total
Cash balance, Dec. 31, 2020 83,598$ 2,041,974$ 941,279$ 2,071,808$ 5,138,659$
Revenues 2021:
Taxes - - - 150,000 150,000
Franchise fees - - - 305,000 305,000
Special assessments - - - 25,000 25,000
Intergovernmental:-
State - - - 408,000 408,000
Federal - - - - -
County - - - - -
Miscellaneous:-
Investment income 836 - 9,413 20,718 30,967
Developer payments - - - - -
Proceeds from bond sale - - - - -
Operating transfer in - 457,000 75,000 - 532,000
Total revenue 836 457,000 84,413 908,718 1,450,967
Available Resources 84,434 2,498,974 1,025,692 2,980,526 6,589,626
Expenditures 2021:
Government buildings & equip - - 75,000 - 75,000
Public safety - 152,000 - - 152,000
Streets, highways, & utilities - 210,000 - 357,260 567,260
Sidewalks & trails 100,000 - - - 100,000
Parks & recreation 80,000 - 145,000 - 225,000
Operating transfers out - 150,000 - - 150,000
Total expenditures 180,000 512,000 220,000 357,260 1,269,260
Surplus of revenues
over (under) expenditures (179,164) (55,000) (135,587) 551,458 181,707
Cash balance, Dec. 31, 2021:(95,566)$ 1,986,974$ 805,692$ 2,623,266$ 5,320,366$
10
City of Mounds View
Capital Improvement Plan 2021 thru 2025
Impact on Capital Projects Funds' Cash Balances
Fund 451 Fund 460 Fund 480 Fund 485
Park Vehicle and Special Street
Dedication Equipment Projects Improvement Total
Cash balance, Dec. 31, 2021 (95,566)$ 1,986,974$ 805,692$ 2,623,266$ 5,320,366$
Revenues 2022:
Taxes - - - 150,000 150,000
Franchise fees - - - 310,000 310,000
Special assessments - - - 20,000 20,000
Intergovernmental:-
State - - - 408,000 408,000
Federal - - - - -
County - - - - -
Miscellaneous:-
Investment income (956) - 8,057 26,233 33,334
Developer payments - - - - -
Proceeds from bond sale - - - - -
Operating transfer in - 457,000 75,000 - 532,000
Total revenue (956) 457,000 83,057 914,233 1,453,334
Available Resources (96,522) 2,443,974 888,749 3,537,499 6,773,700
Expenditures 2022:
Government buildings & equip - - - - -
Public safety - 52,000 - - 52,000
Streets, highways, & utilities - 75,000 - 2,570,000 2,645,000
Sidewalks & trails - - - - -
Parks & recreation 80,000 - - - 80,000
Operating transfers out - 33,500 - - 33,500
Total expenditures 80,000 160,500 - 2,570,000 2,810,500
Surplus of revenues
over (under) expenditures (80,956) 296,500 83,057 (1,655,767) (1,357,166)
Cash balance, Dec. 31, 2022:(176,522)$ 2,283,474$ 888,749$ 967,499$ 3,963,200$
11
City of Mounds View
Capital Improvement Plan 2021 thru 2025
Impact on Capital Projects Funds' Cash Balances
Fund 451 Fund 460 Fund 480 Fund 485
Park Vehicle and Special Street
Dedication Equipment Projects Improvement Total
Cash balance, Dec. 31, 2022 (176,522)$ 2,283,474$ 888,749$ 967,499$ 3,963,200$
Revenues 2023:
Taxes - - - 150,000 150,000
Franchise fees - - - 315,000 315,000
Special assessments - - - 15,000 15,000
Intergovernmental:-
State - - - 408,000 408,000
Federal - - - - -
County - - - - -
Miscellaneous:-
Investment income (1,765) - 8,887 9,675 16,797
Developer payments - - - - -
Proceeds from bond sale - - - - -
Operating transfer in - 457,000 75,000 - 532,000
Total revenue (1,765) 457,000 83,887 897,675 1,436,797
Available Resources (178,287) 2,740,474 972,636 1,865,174 5,399,997
Expenditures 2023:
Government buildings & equip - - - - -
Public safety - 106,000 - - 106,000
Streets, highways, & utilities - 170,000 - 1,234,897 1,404,897
Sidewalks & trails - - - - -
Parks & recreation 115,000 78,000 - - 193,000
Operating transfers out - 27,000 - - 27,000
Total expenditures 115,000 381,000 - 1,234,897 1,730,897
Surplus of revenues
over (under) expenditures (116,765) 76,000 83,887 (337,222) (294,100)
Cash balance, Dec. 31, 2023:(293,287)$ 2,359,474$ 972,636$ 630,277$ 3,669,100$
12
City of Mounds View
Capital Improvement Plan 2021 thru 2025
Impact on Capital Projects Funds' Cash Balances
Fund 451 Fund 460 Fund 480 Fund 485
Park Vehicle and Special Street
Dedication Equipment Projects Improvement Total
Cash balance, Dec. 31, 2023 (293,287)$ 2,359,474$ 972,636$ 630,277$ 3,669,100$
Revenues 2024:
Taxes - - - 150,000 150,000
Franchise fees - - - 320,000 320,000
Special assessments - - - 10,000 10,000
Intergovernmental:-
State - - - 408,000 408,000
Federal - - - - -
County - - - - -
Miscellaneous:-
Investment income (2,933) - 9,726 6,303 13,096
Developer payments - - - - -
Proceeds from bond sale - - - - -
Operating transfer in - 457,000 75,000 - 532,000
Total revenue (2,933) 457,000 84,726 894,303 1,433,096
Available Resources (296,220) 2,816,474 1,057,363 1,524,579 5,102,196
Expenditures 2024:
Government buildings & equip - 47,250 - - 47,250
Public safety - 72,000 - - 72,000
Streets, highways, & utilities - - - 462,887 462,887
Sidewalks & trails - - - - -
Parks & recreation - 78,000 - - 78,000
Operating transfers out - 204,000 - - 204,000
Total expenditures - 401,250 - 462,887 864,137
Surplus of revenues
over (under) expenditures (2,933) 55,750 84,726 431,416 568,959
Cash balance, Dec. 31, 2024:(296,220)$ 2,415,224$ 1,057,363$ 1,061,692$ 4,238,059$
13
City of Mounds View
Capital Improvement Plan 2021 thru 2025
Impact on Capital Projects Funds' Cash Balances
Fund 451 Fund 460 Fund 480 Fund 485
Park Vehicle and Special Street
Dedication Equipment Projects Improvement Total
Cash balance, Dec. 31, 2024 (296,220)$ 2,415,224$ 1,057,363$ 1,061,692$ 4,238,059$
Revenues 2025:
Taxes - - - 150,000 150,000
Franchise fees - - - 320,000 320,000
Special assessments - - - 10,000 10,000
Intergovernmental:-
State - - - 408,000 408,000
Federal - - - - -
County - - - - -
Miscellaneous:-
Investment income (2,962) - 10,574 10,617 18,228
Developer payments - - - - -
Proceeds from bond sale - - - - -
Operating transfer in - 457,000 75,000 - 532,000
Total revenue (2,962) 457,000 85,574 898,617 1,438,228
Available Resources (299,182) 2,872,224 1,142,936 1,960,309 5,676,288
Expenditures 2025:
Government buildings & equip - 28,250 - - 28,250
Public safety - 110,000 - - 110,000
Streets, highways, & utilities - 51,000 - 125,000 176,000
Sidewalks & trails - - - - -
Parks & recreation - 143,000 - - 143,000
Operating transfers out - 28,000 - - 28,000
Total expenditures - 360,250 - 125,000 485,250
Surplus of revenues
over (under) expenditures (2,962) 96,750 85,574 773,617 952,978
Cash balance, Dec. 31, 2025:(299,182)$ 2,511,974$ 1,142,936$ 1,835,309$ 5,191,038$
14
City of Mounds View
Water Utility Rate Study
3.00%3.00%3.00%3.00%3.00%
Actual Actual Actual Budget Projected Projected Projected Projected Projected
2017 2018 2019 2020 2021 2022 2023 2024 2025
Expenses
Personnel services 345,353$ 328,983$ 401,656$ 448,387$ 461,839$ 475,694$ 489,965$ 504,664$ 519,803$
Supplies & materials 61,787 94,202 57,107 76,899 79,206 81,582 84,030 86,551 89,147
Contractual services 229,717 237,948 253,328 288,971 297,640 306,569 315,766 325,239 334,997
Water service line repairs 93,668 94,754 62,764 90,000 90,000 90,000 90,000 90,000 90,000
Depreciation 237,949 240,717 230,683 240,000 323,000 408,000 408,000 408,000 408,000
Debt service - interest - - - - 204,000 193,032 181,734 170,098 85,112
Transfers to other funds - 144,103 147,446 149,859 152,345 154,905 157,542 150,345 150,345
Contingency - - - 15,000 15,000 15,000 15,000 15,000 15,000
Total Expenses 968,474 1,140,707 1,152,984 1,309,116 1,623,030 1,724,782 1,742,037 1,749,896 1,692,404
Revenues
Metered water sales 1,016,067 1,161,536 1,035,481 1,273,305 1,279,351 1,333,684 1,401,182 1,578,830 1,623,087
Meter charge 5,896 4,601 3,675 - - - - - -
Water service line repair fee 88,165 88,775 89,385 89,385 89,385 89,385 89,385 89,385 89,385
Investment income (charges)1,595 7,370 21,328 5,000 71,655 2,991 (2,374) (7,005) (9,564)
Miscellaneous revenues 2,131 2,105 75,347 2,000 2,060 2,122 2,185 2,251 2,319
Transfers from vehicle & equipment fund 35,000 - - - - 4,400 - - -
Total Revenues 1,148,854 1,264,387 1,225,216 1,369,690 1,442,451 1,432,583 1,490,378 1,663,461 1,705,227
Change in net position 180,380 123,680 72,232 60,574 (180,578) (292,200) (251,659) (86,435) 12,823
Accounting change (GASB 68 pension)
Net position - begining of year 3,805,187 3,985,567 4,109,247 4,181,479 4,242,053 4,061,475 3,769,275 3,517,616 3,431,181
Net position - end of year 3,985,567$ 4,109,247$ 4,181,479$ 4,242,053$ 4,061,475$ 3,769,275$ 3,517,616$ 3,431,181$ 3,444,004$
Cash flows
Change in net position 180,380$ 123,680$ 72,232$ 60,574$ (180,578)$ (292,200)$ (251,659)$ (86,435)$ 12,823$
Deduct:
Capital outlays - equipment (45,003) (4,150) - (85,000) - (7,500) - - -
Construction (37,848) - (367,321) (3,309,104) (3,210,000) - - (50,000) -
Debt service - principal - - - - (365,613) (376,581) (387,878) (399,515) (280,000)
Add back:
Bonds issued - - - 6,000,000 - -
Depreciation 237,949 240,717 230,683 240,000 323,000 408,000 408,000 408,000 408,000
Change in receivables/payables (cashflow stmt.)(30,028) (67,566) 24,785 - - - - - -
Cash - Beginning of Year 117,782 423,232 715,913 676,292 3,582,762 149,571 (118,710) (350,246) (478,197)
Cash - End of Year 423,232$ 715,913$ 676,292$ 3,582,762$ 149,571$ (118,710)$ (350,246)$ (478,197)$ (337,374)$
Residential 4.44%12.45%11.07%6.57%4.57%4.37%5.65%5.34%2.44%
Base rate per connection 8.00$ 12.00$ 16.00$ 18.00$ 19.00$ 20.00$ 22.00$ 24.00$ 24.00$
Water rate 1st 12,000 gallons used 2.10 2.20 2.30 2.40 2.50 2.60 2.70 2.80 2.90
Water rate 2nd 13,000 gallons used 2.31 2.42 2.53 2.64 2.75 2.86 2.97 3.08 3.19
Water rate over 25,000 gallons used 2.66 2.78 2.91 3.04 3.16 3.29 3.42 3.54 3.67
Residential annual based on 18,000 gal. per qtr.188.24 211.68 235.12 250.56 262.00 273.44 288.88 304.32 311.76
C/I annual based on 150,000 gal. per qtr.1,334.00 1,412.00 1,490.00 1,560.00 1,626.00 1,692.00 1,762.00 1,804.00 1,865.00 15
City of Mounds View
Sewer Utility Rate Study
3%3%3%3%3%
Actual Actual Actual Budget Projected Projected Projected Projected Projected
2017 2018 2019 2020 2021 2022 2023 2024 2025
Expense
Personnel services 312,310$ 302,497$ 343,399$ 402,309$ 414,378$ 426,810$ 439,614$ 452,802$ 466,386$
Supplies & materials 16,590 35,407 23,926 28,302 29,151 30,026 30,926 31,854 32,810
Contractual services 56,166 78,565 70,683 111,227 114,564 118,001 121,541 125,187 128,943
MCES disposal charges (avg. since 2007 3.56%)916,035 974,798 991,993 1,030,104 1,071,308 1,114,160 1,158,727 1,205,076 1,253,279
Depreciation 95,362 101,597 97,840 100,000 96,000 96,000 96,000 96,000 96,000
Transfers to other funds 98,058 109,860 132,446 137,859 140,345 142,905 145,542 145,542 145,542
Contingency - - - 15,000 15,000 15,000 15,000 15,000 15,000
Total Expenses 1,494,521 1,602,724 1,660,287 1,824,801 1,880,746 1,942,901 2,007,350 2,071,461 2,137,960
Revenues 6.00%6.00%5.00%4.00%4.00%4.00%4.00%3.50%3.50%
Sanitary sewer service 1,595,904 1,676,325 1,736,097 1,797,923 1,861,520 1,935,980 2,013,420 2,083,889 2,156,825
Service availability charges 2,301 1,839 - - - - - - -
Investment income 25,073 31,077 65,558 24,000 41,271 40,131 39,216 38,541 37,981
Miscellaneous revenues 1,306 1,362 45,506 - - - - - -
Transfers from vehicle fund - - 100,000 - - - - - -
Total Revenues 1,624,584 1,710,603 1,947,161 1,821,923 1,902,790 1,976,112 2,052,635 2,122,431 2,194,806
Change in net position 130,063 107,879 286,874 (2,878) 22,044 33,210 45,285 50,969 56,846
Accounting change (GASB 68 pension)
Net position - beginning of year 3,785,323 3,915,386 4,023,265 4,310,139 4,307,261 4,329,305 4,362,515 4,407,801 4,458,770
Net position - end of year 3,915,386 4,023,265 4,310,139 4,307,261 4,329,305 4,362,515 4,407,801 4,458,770 4,515,617
Cash Flows
Change in net position 130,063 107,879 286,874 (2,878) 22,044 33,210 45,285 50,969 56,846
Deduct:
Capital outlays - equipment - - (182,397) - - - - - -
Construction (64,286) (4,150) (81,750) (330,000) (175,000) (175,000) (175,000) (175,000) (175,000)
Add back:
Depreciation 95,362 101,597 97,840 100,000 96,000 96,000 96,000 96,000 96,000
Change in receivables/payables (46,990) (187,841) (13,881) - - - - - -
Cash - Beginning of Year 2,058,088 2,172,237 2,189,722 2,296,408 2,063,530 2,006,574 1,960,784 1,927,070 1,899,039
Cash - End of Year 2,172,237$ 2,189,722$ 2,296,408$ 2,063,530$ 2,006,574$ 1,960,784$ 1,927,070$ 1,899,039$ 1,876,885$
Residential equivalent connection rate 80.55$ 85.38$ 89.65$ 93.24$ 96.97$ 100.85$ 104.88$ 108.55$ 112.35$
Residential fixed rate 32.80 34.76 36.50 37.96 39.48 41.06 42.70 44.20 45.74
Residential variable rate 2.61 2.77 2.91 3.02 3.14 3.27 3.40 3.52 3.64
Annual based on 18,000 gal. per quarter 319.24 338.40 355.32 369.53 384.31 399.68 415.67 430.22 445.28
MCES Rate increase 1.94%6.41%1.76%3.24%4.00%4.00%4.00%4.00%4.00%16
City of Mounds View
Street Light Utility Rate Study
3%3%3%3%3%
Actual Actual Actual Budget Projected Projected Projected Projected Projected
2017 2018 2019 2020 2021 2022 2023 2024 2025
Expenses
Personnel services 7,550$ 7,540$ 9,445$ 9,728$ 10,020$ 10,321$ 10,630$ 10,949$ 11,278$
Supplies & materials 1,334 90 - - - - - - -
Contractual services 76,592 77,417 76,346 78,636 80,995 83,425 85,928 88,506 91,161
Lease debt service 2,328 2,118 1,902 9,252 9,252 9,252 9,252 9,252 9,252
Transfer to other funds 2,690 2,771 2,854 2,940 3,028 3,119 3,212 3,309 3,408
Total Expenses 90,494 89,936 90,547 100,556 103,295 106,117 109,023 112,016 115,099
Revenues
Street light service fee 104,224 104,322 104,867 104,412 104,412 110,213 110,213 110,213 110,213
Investment income (charges)1,480 1,921 4,085 2,485 2,966 3,048 3,191 3,278 3,308
Total Revenues 105,704 106,243 108,952 106,897 107,378 113,261 113,404 113,491 113,521
Net change in position 15,210 16,307 18,405 6,340 4,083 7,144 4,381 1,475 (1,578)
Net position - begining of year 58,547 73,757 90,064 108,469 114,810 118,893 126,037 130,418 131,893
Net position - end of year 73,757$ 90,064$ 108,469$ 114,810$ 118,893$ 126,037$ 130,418$ 131,893$ 130,315$
Cash flows
Net change in position 15,210$ 16,307$ 18,405$ 6,340$ 4,083$ 7,144$ 4,381$ 1,475$ (1,578)$
Add back:
Change in receivables/payables (3,053) (1,097) (5,252) - - - - - -
Debt service - principal (6,923) (7,133) (7,349) - - - - - -
Lease proceeds
Cash - Beginning of Year 122,858 128,092 136,169 141,973 148,314 152,397 159,541 163,922 165,397
Cash - End of Year 128,092$ 136,169$ 141,973$ 148,314$ 152,397$ 159,541$ 163,922$ 165,397$ 163,819$
6.25%0.00%0.00%0.00%0.00%5.56%0.00%0.00%0.00%
Quarterly residential service fee 4.50$ 4.50$ 4.50$ 4.50$ 4.50$ 4.75$ 4.75$ 4.75$ 4.75$
Annual fee 18.00$ 18.00$ 18.00$ 18.00$ 18.00$ 19.00$ 19.00$ 19.00$ 19.00$ 17
City of Mounds View
Storm Water Utility Rate Study
3%3%3%3%3%3%
Actual Actual Actual Budget Projected Projected Projected Projected Projected
2017 2018 2019 2020 2021 2022 2023 2024 2025
Expenses
Personnel services 120,849 114,323 128,546 142,296 146,565 150,962 155,491 160,155 164,960
Supplies & materials 17,756 19,428 15,175 200,675 206,695 212,896 219,283 225,861 232,637
Contractual services 53,672 61,228 86,637 201,684 207,735 213,967 220,386 226,997 233,807
Depreciation 35,344 39,016 36,566 35,000 35,000 35,000 35,000 35,000 35,000
Transfers to other funds 39,832 40,067 39,309 41,558 41,815 42,079 42,351 42,351 42,351
Total Expenses 267,453 274,062 306,233 621,213 637,810 654,903 672,510 690,365 708,755
Revenues 0%2%8%9%8%7%7%6%0%
Storm water service fee 285,814 292,431 317,034 347,100 373,800 400,500 427,200 453,900 453,900
Investment income 22,208 27,352 56,980 35,112 33,948 29,046 24,239 19,518 14,279
Other income 539 473 10,871 - - - - - -
Transfers from vehicle fund - - - - - - - 37,000 -
Total Revenues 308,561 320,256 384,885 382,212 407,748 429,546 451,439 510,418 468,179
Net change in position 41,108 46,194 78,652 (239,001) (230,062) (225,357) (221,071) (179,947) (240,577)
Accounting change (GASB 68 pension)- - - - - - - - -
Net position - beginning of year 3,141,720 3,182,828 3,229,022 3,307,674 3,068,673 2,838,611 2,613,253 2,392,182 2,212,235
Net position - end of year 3,182,828 3,229,022 3,307,674 3,068,673 2,838,611 2,613,253 2,392,182 2,212,235 1,971,658
Cash Flows
Net change in position 41,108$ 46,194$ 78,652$ (239,001)$ (230,062)$ (225,357)$ (221,071)$ (179,947)$ (240,577)$
Deduct:
Capital outlays - equipment - - - - - - - (37,000)
Construction (70,244) - - (105,000) (50,000) (50,000) (50,000) (80,000) (50,000)
Add back:
Depreciation 35,344 39,016 36,566 35,000 35,000 35,000 35,000 35,000 35,000
Change in receivables/payables (8,449) (35,650) 6,492 - - - - - -
Cash - begining of Year 1,837,349 1,835,108 1,884,668 2,006,378 1,697,377 1,452,315 1,211,957 975,886 713,939
Cash - end of year 1,835,108$ 1,884,668$ 2,006,378$ 1,697,377$ 1,452,315$ 1,211,957$ 975,886$ 713,939$ 458,362$
10%9%8%8%7%7%6%0%
Quarterly residential service fee 10.00$ 11.00$ 12.00$ 13.00$ 14.00$ 15.00$ 16.00$ 17.00$ 17.00$
Annual fee 40.00 44.00 48.00 52.00 56.00 60.00 64.00 68.00 68.00 18
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19
PERSONNEL
MANUAL
LAST UPDATED: May 11, 2020, Res. 9265
1
TABLE OF CONTENTS
Section Page
Introduction ..................................................................................................................... 5
Section One: Employment In General ....................................................... 7
1.01 Equal Employment Opportunity Policy ................................................................. 7
1.02 Hiring Practices .................................................................................................... 8
A. Position Vacancy Announcement .............................................................. 8
B. Application Forms ...................................................................................... 8
C. Selection of Candidates ............................................................................. 8
D. Disqualification ........................................................................................... 9
E. Medical Examination .................................................................................. 9
F. Pre-Employment Background Check ......................................................... 9
G. Residency Requirements ......................................................................... 10
H. Employment of Relatives ......................................................................... 10
I. Promotions ............................................................................................... 10
J. Veterans Preference ................................................................................ 10
K. Employment of Former Employees – Vacation Schedule ........................ 10
1.03 Probationary Period ............................................................................................ 11
Section Two: Compensation and Benefits .............................................. 12
2.01 Compensation .................................................................................................... 12
A. Five -Step Compensation Plan ................................................................. 12
B. Annual Compensation Adjustment ........................................................... 12
C. Pay Equity Compliance ............................................................................ 13
2.02 Payroll, Overtime, Compensatory Time .............................................................. 13
A. Payroll and Direct Deposit ....................................................................... 13
B. Employee Time Sheets ............................................................................ 14
C. Overtime Pay ........................................................................................... 14
D. Compensatory Time................................................................................. 14
E. Call Back Pay .......................................................................................... 15
2.03 Holidays .............................................................................................................. 15
2.04 Sick Leave .......................................................................................................... 16
A. Accrual ..................................................................................................... 16
B. Use ...................................................................................................... 17
2.05 Vacation ............................................................................................................. 18
A. Accrual Schedule ..................................................................................... 18
B. Donee Eligibility/Ineligibility ...................................................................... 18
C. Donor Eligibility/Ineligibility ....................................................................... 19
D. General Information ................................................................................. 19
2
E. Requesting/Approval of Donated Time .................................................... 20
F. Applying Donated Vacation Time ............................................................. 20
2.06 Insurance Benefits .............................................................................................. 21
A. Health, Dental and Life Insurance ............................................................ 21
B. Other Insurance Offered .......................................................................... 21
C. Enrollment ................................................................................................ 22
D. Coverage During Approved Leave of Absence Without Pay .................... 22
E. Workers’ Compensation Managed Care Services ................................... 22
2.07 Flex Time Leave ................................................................................................. 22
2.08 Miscellaneous Benefits ....................................................................................... 23
A. Health Club Membership ......................................................................... 23
B. Employee Workout Facility ...................................................................... 23
2.09 Retirement Benefits ............................................................................................ 23
A. PERA ...................................................................................................... 23
B. Deferred Compensation ........................................................................... 23
2.10 Retirement Health Savings Plan ......................................................................... 24
2.11 Severance .......................................................................................................... 25
2.12 Uniform Allowances ............................................................................................ 25
2.13 Department Head Base Benefits ........................................................................ 26
Section Three: Workplace Issues ............................................................. 27
3.01 Appearance and Dress ....................................................................................... 27
3.02 Conferences and Seminars ................................................................................ 27
3.03 Drug Free Workplace Policy and Federal Omnibus Transportation .................... 28
A. Drug Free Workplace Policy .................................................................... 28
B. Federal Omnibus Transportation Employee Testing Act.......................... 28
3.04 Employee Records and Data Privacy ................................................................. 28
3.05 Gifts and Gratuities ............................................................................................. 30
3.06 Discrimination and Accommodation ................................................................... 30
3.07 Keys and Security ............................................................................................... 31
3.08 Offensive Behavior and Harassment .................................................................. 31
3.09 Outside Employment .......................................................................................... 36
3.10 Performance Reviews ........................................................................................ 37
3.11 Political Activity ................................................................................................... 38
3.12 Safety Policies .................................................................................................... 38
3.13 Serving on Board or Commissions ..................................................................... 39
3.14 Smoke Free Work Place ..................................................................................... 39
3.15 Travel Expenses ................................................................................................. 40
A. Meals ...................................................................................................... 40
B. Lodging .................................................................................................... 40
C. Transportation .......................................................................................... 40
D. Reimbursement ....................................................................................... 40
3.16 Tuition Reimbursement ...................................................................................... 41
3.17 Worker’s Compensation (Injury on Duty) ............................................................ 42
3.18 Use of City Property ........................................................................................... 42
3
A. Copy Machine .......................................................................................... 43
B. Fax Machine ............................................................................................ 43
C. Postage Machine ..................................................................................... 43
D. Public Works Garage Facility ................................................................... 43
E. Telephone Use ........................................................................................ 43
F. Tools and Equipment ............................................................................... 43
G. Vehicles ................................................................................................... 43
3.19 Technology Use and Access .............................................................................. 45
A. Computer/Peripheral Equipment/Systems Use ........................................ 45
B. Electronic Document Retention ............................................................... 46
C. Passwords ............................................................................................... 46
D. Email ...................................................................................................... 47
E. Internet..................................................................................................... 48
F. Communications Technology & Usage .................................................... 48
G. Personal Social Media Sites .................................................................... 49
H. Phone Use ............................................................................................... 50
I. Monitoring & Confidentiality ..................................................................... 51
J. Disclaimer ................................................................................................ 51
K. Reporting Violations ................................................................................. 51
Section Four: Attendance and Leaves ..................................................... 52
4.01 Working Hours, Attendance and Breaks ............................................................. 52
A. Working Hours and Attendance ............................................................... 52
B. Meal and Rest Breaks.............................................................................. 52
4.02 Blood Donation ................................................................................................... 52
4.03 Bone Marrow/Organ Donation Leave ................................................................. 53
4.04 Job Related Injury or Illness ............................................................................... 53
4.05 Emergency Leave ............................................................................................... 53
4.06 Funeral Leave..................................................................................................... 53
4.07 Job Related Leave .............................................................................................. 54
4.08 Jury Duty ............................................................................................................ 54
4.09 Court Appearances ............................................................................................. 54
4.10 Victim or Witness Leave ..................................................................................... 55
4.11 School Conference Leave .................................................................................. 55
4.12 Severe Weather Conditions ................................................................................ 55
4.13 Sick or Injured Child Care Leave ........................................................................ 56
4.14 Reasonable Unpaid Work Leave for Nursing Mothers ........................................ 56
4.15 Voting Time ........................................................................................................ 56
4.16 Work-related Injury Leave................................................................................... 57
4.17 Family and Medical Leave .................................................................................. 57
A. Circumstances Covered by Medical Leave .............................................. 57
B. Eligibility ................................................................................................... 58
C. Insurance Continuation ............................................................................ 58
D. Status Benefits ......................................................................................... 59
E. Use of Vacation, Sick Time and Holiday Pay ........................................... 59
4
F. Intermittent Leave .................................................................................... 59
G. Return to Work ......................................................................................... 60
H. Basis for Leave ........................................................................................ 60
4.18 Pregnancy and Parenting Leave Act .................................................................. 62
4.19 Military Leave ..................................................................................................... 62
4.20 Military Leave Benefits ....................................................................................... 63
4.21 Special Leave Without Pay ................................................................................. 64
Section 5: Separations .............................................................................. 66
5.01 Separation of Employment ................................................................................. 66
A. Discharge ................................................................................................. 66
B. Layoff ...................................................................................................... 66
C. Resignation .............................................................................................. 67
D. Retirement ............................................................................................... 67
E. Death ...................................................................................................... 68
5.02 Insurance and Benefit Continuation .................................................................... 68
A. Health and Dental Insurance ................................................................... 68
B. Life Insurance .......................................................................................... 69
C. Flexible Benefits ...................................................................................... 69
5.03 Separation Procedures and Policies ................................................................... 69
A. Check Out ................................................................................................ 69
B. Exit Interviews .......................................................................................... 69
C. Return of City Property ............................................................................ 70
D. Separation Compensation ....................................................................... 70
Section 6: Discipline and Grievance Procedure ..................................... 71
6.01 Discipline ............................................................................................................ 71
A. Oral Reprimand ....................................................................................... 71
B. Written Reprimand ................................................................................... 72
C. Suspension With or Without Pay ............................................................. 72
D. Demotion and/or Transfer ........................................................................ 72
E. Salary ...................................................................................................... 73
F. Dismissal ................................................................................................. 73
6.02 Grievance Procedure .......................................................................................... 73
Employee Acknowledgement ................................................................... 75
Appendix ........................................................................................................
Non Federal Drug and Alcohol Policy........................................................................... A-1
FMCSA Federal Drug-Free Workplace Policy ............................................................. A-2
AWAIR Safety Manual .................................................................................................. A-3
5
INTRODUCTION
Welcome
Welcome to the City of Mounds View!
The purpose of the Personnel Manual and supporting documents is to introduce new
employees to the City of Mounds View and to provide all employees a source of general
information on the City and its personnel policies. You should keep this Manual for
reference in order that you may have a full understanding of your rights and obligations
as an employee of the City of Mounds View.
As a City employee, you are expected to conduct yourself, both on and off the job, in a
manner that demonstrates pride in your work and respect for the public trust that has
been placed in you. Employees are expected to work hard, be honest, assist fellow
employees and the public, apply common-sense and respect others. In return, the City
strives to provide a flexible, family-friendly workplace, competitive pay and benefits, and
opportunities to expand your knowledge and skills.
Scope
The policies outlined herein apply to all employees of the City. Except where specifically
noted, these policies do not apply to:
1. Elected officials
2. City Attorney
3. Members of City boards, commissions or committees
4. Consultants and contractors
5. Volunteers
The City reserves the right, at its discretion, to change or terminate any provision of this
handbook or to add new provisions at any time without prior notification. Responsibility
for final interpretation of any specific issues as they relate to policies, procedures, and
benefits lies with the City Council. Suggestions you have for changes in the City's
personnel policies are welcome and should be submitted in writing to the City
Administrator. If, and whenever, information in this packet conflicts with any collective
bargaining agreement or any State or Federal law, the collective bargaining agreement
and/or applicable law shall override the packet information. This Personnel Manual is
not intended by the City to constitute an employment contract, and nothing herein
should be construed as such.
These policies serve as an information guide to help employees become better
informed and to make their experience with the City more rewarding. Departments
may have special work rules deemed necessary by the supervisor and approved by the
City Administrator for the achievement of objectives of that department. Each
6
employee will be given a copy of such work rules by the department upon hiring and
such rules will be further explained, and enforcement discussed with the employee
by the immediate supervisor.
Any employee included in a collective bargaining agreement entered into accordance with
the 1984 Public Employee Labor Relations Act, Minnesota Statues Section 179A.01 to
179A.25, as amended, shall be exempt from any provision of the personnel policies which
is inconsistent with such agreement.
The City encourages you to review the material contained in this handbook. This
Personnel Manual supersedes any and all prior versions of any personnel policies or
handbooks issued by the City. If you need further clarification of policies, you are urged
to discuss them with your supervisor. Policies outlined in this handbook replace and
supersede all prior personnel policies, and such prior policies shall have no further force
or effect.
Employee Status
Your employment with the City is not for any specific length of time; it is at-will
employment. At-will employment means that both you and the City have the right to
terminate your employment at any time and for any reason or no reason at all. Your at-
will employment status can only be changed by a contract, in writing, that is signed by an
authorized representative of the City.
7
SECTION ONE: EMPLOYMENT IN GENERAL
Section 1.01 Equal Employment Opportunity Policy
The City of Mounds View provides equal opportunities to all employees and applicants
for employment.
The City will not discriminate, harass, nor retaliate against any employee or applicant for
employment because of race, color, creed, religion, national origin, sex, marital status,
familial status, military status, status with regard to public assistance, disability, sexual
orientation, age, political affiliations, or because of the exercise of rights under Minn. Stat.
sections 179A.01 to 179A.25, unless such discrimination is permitted based on a bona
fide occupational qualification. For more information on your rights, please visit:
www.eeoc.gov, www.gov/mdhr, www.dol.gov, and www.doli.state.mn.us.
Persons who believe that he or she has been subjected to discrimination shall report the
discrimination to his or her direct supervisor. If the direct supervisor is the source of the
complaint or otherwise not suitable, then reports may be made to Human Resources. If
Human Resources does not adequately respond to the report, then person(s) may
proceed to the City Administrator. If the City Administrator is the source of the complaint
or otherwise not suitable, then a report may be made to the City’s appointed City Attorney.
The City will take affirmative action to ensure that all employment practices are free of
such discrimination. Employment practices include, but are not limited to, hiring,
upgrading, demotion, transfer, recruitment or recruitment advertising, selection, layoff,
disciplinary action, termination, rates of pay or other forms of compensation, and selection
for training, including apprenticeship.
The City uses its best efforts to contract with small businesses and businesses owned
and controlled by women, people of color and persons with a disability. The City is
committed to achieving the goals of Equal Employment Opportunity and Affirmative
Action and fully supports the incorporation of non-discrimination and Affirmative Action
Rules and regulations in contracts.
Affirmative Action:
The City will review their involvement in achieving Affirmative Action objectives as well as
other established criteria. Any employee of the City who does not comply with the Equal
Employment Opportunities Policies and Procedures as set forth will be subject to
disciplinary action. Any subcontractor to the City not complying with all applicable Equal
Opportunity/Affirmative Action laws will be encouraged to come into compliance or risk
the loss of future contracts.
The Equal Employment Opportunity Program is managed by the City Administrator and
he/she will designate personnel to complete responsibilities including monitoring all Equal
Employment Opportunity activities and reporting the effectiveness of this Affirmative
Action Program, as required by federal, state and local agencies. If any employee or
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applicant for employment believes they have been discriminated against, they should
contact the City Administrator. If at any time this Manual is found to be in conflict with the
City’s Affirmative Action Plan, action shall be taken that will allow the goals of the
Affirmative Action Plan to be fulfilled.
Section 1.02 Hiring Practices
A. POSITION VACANCY ANNOUNCEMENT
Scope
The City Administrator or a designee will manage the hiring process for positions within
the City. While the hiring process may be coordinated by staff, the City Council is
responsible for the final hiring decision and must approve all hires to City employment.
All hires will be made according to merit and fitness related to the position being filled.
Features of the Recruitment System
The City Administrator or designee will determine if a vacancy will be filled through an
open recruitment or by internal posting, promotion, transfer, or some other method. This
determination will be made on a case-by-case basis. The majority of position vacancies
will be filled through an open recruitment process.
Position vacancies in the City are published by posting announcements at City Hall and
various media sources as determined by the Human Resources Department.
Announcements specify the title and salary range of the position; the nature of the work
to be performed; the qualifications required for the job; the time, place and manner of
making application; the closing date for receiving applications; and other pertinent
information. Deadline for application may be extended by the City Administrator. (Police,
temporary and seasonal hiring may vary from this procedure.)
Qualified internal candidates are encouraged to apply for position vacancies and will
follow the same application procedure described below.
B. APPLICATION FORMS
General application forms requiring information covering training, experience, and other
pertinent information, including Veterans Preference are available at City Hall. There may
also be a supplemental application for position vacancies. Applicants may be required to
submit certificates from examining physicians following a conditional offer, educational
and training institutions, and reasonable proof of any statements made. Applications will
be accepted when a position is vacant or becomes available. Deadline for application
may be extended by the City Administrator. The appropriate application must be
completed and signed by the person applying.
C. SELECTION OF CANDIDATES
Applicants are scored on a point system, which measures qualifications for the position
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and veteran status according to the DD Form 214 and other related forms. Based on the
scoring, candidates are then chosen for interviews. Examinations which will fairly test the
capacity and fitness of the candidate to discharge efficiently the duties of the position may
be conducted. Skill testing may also be performed for certain positions.
Recommendations requesting approval to hire regular full time and part time employees
will be presented by the City Administrator and/or the Human Resources Department to
the City Council for action.
D. DISQUALIFICATION:
An application may be rejected if:
• The application or supplemental application indicates the candidate does
not possess the minimum qualifications required for the position, including
a valid driver’s license for positions requiring operation of a motor vehicle;
• The candidate fails to file the application and supplemental application by
the announced closing date and time for receiving applications (Deadline
for application may be extended by the City Administrator);
• The candidate is not a citizen of the United States and does not possess
the appropriate documentation from U. S Citizenship and Immigration
Services;
• After a conditional offer of full-time employment has been made, the
candidate is found to be unable to perform the essential functions and duties
of the position with or without reasonable accommodation;
• After a conditional offer of full-time employment has been made, the
candidate is found to have a criminal record which disqualifies the applicant
from the position pursuant to Minnesota Statute §364.03; or
• The candidate has made a false statement of any material fact, omitted
material information or attempted to practice any deception or fraud in the
application process.
E. MEDICAL EXAMINATION
After a conditional offer of employment has been made to the candidate, a physical
examination may be conducted by a City approved physician. The City’s Drug and
Alcohol Testing Policies are set forth in this Manual. The medical examination may be
waived for part-time, temporary or seasonal positions. The physician will render an
opinion regarding whether the candidate can perform the essential functions of the
position, with or without reasonable accommodation. The physician’s report and any
supporting documentation will be kept in a confidential file separate from the personnel
file.
F. PRE-EMPLOYMENT BACKGROUND CHECK
In accordance with federal, state and local law, the City conducts pre-employment
background checks, including a criminal record check of candidates who have received
conditional offers of employment. Volunteers working with children are required to
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undergo a criminal background check, which may include property managers of
residential property, health care workers, and/or public school employer. Individuals hired
for public safety positions (law enforcement, firefighters) are required to have a
background check.
G. RESIDENCY REQUIREMENTS
Employees are not required to become a resident of Mounds View at any time.
H. EMPLOYMENT OF RELATIVES
To maintain proper control and accountability of City functions and operations and to
reduce potential organizational conflicts of interest or perceived conflicts of interest that
may arise due to employment of an employee’s relative, the policy stated in this section
was implemented.
The City permits the employment of relatives except as prohibited below. The term
“relative” when used in this policy means any two (2) or more individuals who reside in
the same dwelling unit or who are related to each other by blood, or adoption, where one
(1) of the individuals is the spouse, parent, grandparent, child, brother, or sister of the
other.
The City will not employ relatives under any of the following circumstances:
• Where an employee directly or indirectly supervises a relative.
• Where an employee is responsible for auditing the work of a relative.
• Where a conflict of interest or the perception of a conflict could exist.
I. PROMOTIONS
The City will fill vacancies by promotion of qualified full-time or part-time employees
whenever practicable and appropriate.
J. VETERANS PREFERENCE
A veteran’s preference in employment with the City shall be in accordance with Minnesota
Statutes and federal law.
K. EMPLOYMENT OF FORMER EMPLOYEES – VACATION SCHEDULE
Former employees who are rehired by the City within two (2) years or their separation
from the City will continue on the vacation schedule at the point of their departure. If over
two (2) years, consideration will be given as part of the negotiation process.
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Section 1.03 Probationary Period
New, promoted and otherwise transferred employees shall be deemed “probationary
employees” and shall be required to successfully complete a probationary period of not
less than six (6) months, or one (1) year for Public Works Maintenance employees and
Police Officers. During this time, the probationary employee becomes acquainted with
the work assigned to them and can decide whether they wish to continue their
employment in that position. At the same time, the City can decide whether it wishes to
continue to retain the employee in that position. Probationary employees may be
terminated by the City with or without cause at any time. If during the probationary period
the City determines that a transferred probationary employee is not able to adequately
perform the duties of the new position, the City may, at its discretion, reinstate the
transferred probationary employee to the position and rate of pay previously held, with no
loss of seniority. Probationary employees do not have the right to grieve employment
decisions made concerning them, including terminations.
The duration of the probationary period may be extended in excess of the initial period.
Successful completion of the probationary period does not reflect any right of continued
employment.
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SECTION TWO: COMPENSATION AND BENEFITS
Section 2.01 COMPENSATION
This section of the Personnel Manual establishes policies governing compensation. The
objectives of this section are as follows:
1. To develop and maintain a comprehensive policy which will attract and retain
competent personnel.
2. To provide an environment in which employees will be encouraged to develop their
abilities and effectiveness in performing their assigned duties.
3. To recognize the quality of job performance demonstrated by each employee.
There are three (3) components of the City’s Compensation Policy:
I. Five -Step Compensation Plan
II. Annual Compensation Adjustment; and
III. Pay Equity Compliance
A. FIVE-STEP COMPENSATION PLAN
The City uses a five (5) step compensation plan for regular, full-time and part-time
employees not represented by a collective bargaining unit. The five-step plan is the first
phase of the overall compensation policy and shall consist of five (5) increments with the
highest step, Step 5, representing 100% of the position’s maximum compensation rate.
The steps shall descend from Step 5 (100%) in increments of 5%, as shown below.
STEP 1 STEP 1.5 STEP 2 STEP 3 STEP 4 STEP 5
80% 82.5% 85% 90% 95% 100%
Progress through the Steps
Generally, new employees will begin at Step 1 of the five step plan. The City Council may
however authorize a new employee to start at a step other than Step 1 in consideration
of experience and qualifications. Employees hired to start at Step 1 will be eligible for a
half-step increase at six (6) months of service equivalent to 82.5% of the Step 5 wage.
Advancement to subsequent steps would occur on the employee’s anniversary date until
the employee reaches Step 5. Advancement to a subsequent step necessitates (1) a
performance evaluation rated satisfactory or better by the employee's supervisor, (2)
approval by the Department Head and City Administrator, and (3) approval by the City
Council. The progression from Step 1 to Step 5 represents a span of four (4) years.
B. ANNUAL COMPENSATION ADJUSTMENT
The Annual Compensation Adjustment (ACA) is the Council-approved adjustment often
referred to as a Cost of Living Adjustment (COLA).
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Compensation for seasonal and temporary employees will be set by the City Council at
the time of hire, or on an annual basis.
Implementation
When deemed appropriate by the City Council, the wages for each regular full-time and
part-time employee not represented by a collective bargaining unit may be adjusted,
effective January 1 of each year or at any other point in the year as determined by the
City Council. The percentage increase approved by the City Council represents the
second phase in the overall compensation policy.
Adjustment Criteria
The ACA shall be granted only when earned based on demonstrated on-the-job
performance, supported by the recommendation of the employee’s immediate supervisor
and preceded by a year-end performance evaluation rated satisfactory or above. All
recommendations will be reviewed by the City Administrator who will recommend
approval or denial of the ACA to the City Council for final approval. If a performance
evaluation is rated less than satisfactory or it is determined that the employee has areas
of job performance in need of improvement, the employee may receive less than the full
ACA percentage increase.
C. PAY EQUITY COMPLIANCE
The State of Minnesota's Pay Equity Act requires that "every political subdivision of this
state shall establish equitable compensation relationships between female-dominated,
male-dominated, and balanced classes of employees in order to eliminate sex-based
wage disparities in public employment in this state." (Minn. Stat. § 471.992, subd. 1)
The term “equitable compensation relationship” means “that the compensation for female-
dominated classes is not consistently below the compensation for male-dominated
classes of comparable work value as determined under section 471.994, within the
political subdivision.” (Minn. Stat. §. 471.991, subd. 5).
The City resolves to follow the statutory requirements of the Pay Equity Act as established
presently and as may be amended in the future. The pay equity analysis and any resulting
compensation adjustment necessary to achieve compliance represents the final step in
the overall compensation process.
Section 2.02 Payroll, Overtime, Compensatory Time
A. PAYROLL AND DIRECT DEPOSIT
Employees will be paid every two (2) weeks (26 times per year). Wages are paid for the
two -week period commencing at 12:01 a.m. on a Saturday and ending at 11:59 p.m. on
a Friday, 14 days later. When paydays fall on a holiday, checks are issued the day
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preceding the holiday. The City is required by law to make deductions from an
employee’s check including Social Security, PERA (Public Employees Retirement
Association), Federal Income Tax and State Income Tax.
Employees are responsible for notifying City of Mounds View of any changes in status,
including change in address, phone, name of beneficiaries, marital status, etc.
As provided under Minnesota law, the City requires direct deposit of payroll checks for all
employees. Your pay check will be automatically deposited in your account by completing
a brief form and submitting a voided check from your checking or savings account.
B. EMPLOYEE TIME SHEETS
Time sheets must be submitted to the Finance Department for payroll processing
completely and accurately filled out and properly signed by the employee and the
appropriate Department Head. The calculations of vacation, sick leave and
compensatory time should be reviewed and the sheets should bear all appropriate
signatures. Department Heads are responsible for verifying that the time sheets are
properly completed before they are submitted to the Finance Department. Failure to
report time correctly may lead to discipline.
C. OVERTIME PAY
Non-exempt employees will be paid overtime compensation for all hours worked in
excess of 40 hours per workweek.
Overtime pay is computed on time worked in excess of 40 hours (during a seven (7) day
work week) at a rate of one and one-half (1 ½) times the hourly rate of pay. Paid holidays,
vacation leave and sick hours are not counted as time worked for the purpose of
computing overtime hours. Overtime pay or compensatory time will not be paid for time
not worked.
Employees defined as “exempt” by the Fair Labor Standards Act are not entitled to
overtime pay.
D. COMPENSATORY TIME
Compensatory time-off in lieu of cash payment is allowed only in accordance with the Fair
Labor Standards Act for all permanent non-exempt employees. Compensatory time is
compensated at a rate of one and one-half (1 ½) times the hours worked in excess of the
established work-week.
An employee may not use any more than 80 hours of compensatory time per year. The
maximum total accrued compensatory time balance shall not exceed 50 hours per
employee. The respective Department Head or the City Administrator must give prior
approval for any accumulation of compensatory time by an employee. The respective
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Department Head or the City Administrator must give prior approval for any use of
compensatory time by an employee. If an employee is terminated from employment they
will be compensated for accumulated compensatory time earned up to the above stated
maximum.
Any accumulated compensatory time not used by the end of the last pay period in
November shall be cashed out.
E. CALL BACK PAY
A non-exempt employee called back to work at a time other than a normal scheduled shift
for reasons other than training shall receive a minimum of two (2) hours pay at one and
one-half (1 ½) times the employee’s regular straight-time hourly rate. Reporting early for
a shift or extension of a shift does not qualify for a call-back premium.
Information pertaining to Overtime pay, Compensatory time, Court Duty, or Call-Back pay
may vary for unionized personnel. Specific information pertaining to these procedures is
provided in the respective contracts.
Section 2.03 Holidays
All regular full-time, part-time employees averaging 20 or more hours per week and
probationary employees receive the following holidays:
1. New Year’s Day
2. Martin Luther King’s Birthday (3rd Monday in January)
3. President’s Day
4. Memorial Day
5. Independence Day
6. Labor Day
7. Veterans’ Day
8. Thanksgiving Day
9. Day after Thanksgiving
10. Christmas Eve Day
11. Christmas Day
12. New Year’s Eve Day
If a holiday falls on a Saturday, the preceding Friday will be the observed holiday. If a
holiday fall s on a Sunday, the following Monday will be considered a holiday.
Full-time employees will receive pay for official holidays at their normal straight time rates,
provided they are on paid status on the last scheduled day prior to the holiday and first
scheduled day immediately after the holiday. Part-time employees will receive prorated
holiday pay based on the number of hours normally scheduled. Any employee on a leave
of absence without pay from the City is not eligible for holiday pay.
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Floating Holidays
Due to the timing of when certain holidays fall, the City Administrator shall determine if a
floating holiday will be awarded in-lieu of a regular holiday when taking into consideration:
the day of the week the holiday falls, hours of operation by location (Public Works, Police
Department, City Hall), and an employee’s regularly scheduled shift (some employees
work five (5) days even though their location is only open four (4) days). Floating Holidays
are eight (8) hours and must be used as a full day. Floating holidays shall be used within
365 days AFTER said holidays occur or they will be forfeited. Unused floating holidays
shall not be included in any severance computation.
Working on a Holiday
In the case where a non-exempt employee works on a designated legal holiday, which
has been approved by their respective Department Head, the employee shall receive
eight (8) hours straight time or eight (8) hours compensatory time off as compensation for
the holiday. Exempt employees, who have received prior approval, who work on one (1)
of the holidays listed above shall receive eight (8) hours for the holiday and shall receive
the employee’s normal straight time pay for those hours worked.
Absences and Holiday Pay
Holidays which occur during vacation leave or sick leave shall not be charged against
said vacation or sick leave but shall be charged against holiday pay. Wages shall not be
paid for a holiday to an employee who is on leave of absence without pay the day before
the holiday.
Temporary and seasonal employees do not receive holiday pay.
Section 2.04 Sick Leave
Regular full-time and part-time employees averaging 20 hours or more per week are
eligible to receive sick leave with pay. Sick leave hours begin accruing on the first day of
employment. Employees are eligible to use the sick leave time as it accrues.
Probationary employees may make use of sick leave, however, if the sick leave exceeds
a total of five (5) working days, the probationary period shall automatically be extended
for an equivalent period of time.
A. ACCRUAL
Sick leave accrues at the rate of eight (8) hours per month unless otherwise established
by a collective bargaining agreement. Regular part-time employees eligible for paid leave
earn it on a pro-rated basis. While there are no limits imposed upon the actual accrual of
sick leave, the number of hours that can be (a) converted annually and (b) contributed via
separation into an employee’s Retirement Health Savings Plan (RHSP) shall be capped
according to Section 2.10. Sick leave does not accrue during an unpaid leave of absence.
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B. USE
Sick leave should not be considered a privilege or vested right that may be used at an
employee’s discretion but shall be considered as a type of insurance used for the case of
an illness, disability of the employee, or to receive dental or medical care when approved
by the employee’s Supervisor.
Sick leave may be used as follows:
• When an employee is unable to perform work duties due to illness, injury or
disability (including pregnancy).
• For medical, dental or other care provider appointments during working hours.
• To care for the employee’s injured or ill children, including stepchildren or foster
children, for such reasonable periods as the employee’s attendance with the child
may be necessary.
• To take children, or other family members to a medical, dental or other care
provider appointment.
• Employees may use up to 160 hours of sick leave in any 12-month period for
absences due to an illness of or injury to the employee’s adult child, spouse,
sibling, parent, grandparent, stepparent, parent-in-law (mother-in-law and father-
in-law), and grandchild (includes step-grandchild, biological, adopted, or foster
grandchild).
• Employees are authorized to use up to 160 hours of sick leave in any 12-month
period for reasonable absences for themselves or relatives (employee’s adult child,
spouse, sibling, parent, mother-in-law, father-in-law, grandchild, grandparent, or
stepparent) who are providing or receiving assistance because they, or a relative,
is a victim of sexual assault, domestic abuse, or stalking.
In order to be eligible for sick leave with pay an employee must:
• Report promptly to the employee’s Department Head or Supervisor the reason
for absence and keep the Department Head or Supervisor informed of the
employee’s condition if the absence continues for more than three (3) days.
• Keep the Department Head informed on a weekly basis of the condition. If the
absence is more than three (3) days a doctor’s note may be required.
• If deemed necessary by the City Administrator, a doctor’s statement may be
required for sick leave absences of less than three (3) days.
Claiming sick leave when physically fit, except as permitted in this section, may be cause
for disciplinary action, including transfer, suspension, demotion or dismissal. Employees
are not permitted to use sick leave in the same manner as vacation time off on dates
immediately preceding an employee’s termination or retirement date, except in the case
of disability.
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Section 2.05 Vacation
All regular full-time and part-time employees averaging 20 hours or more per week are
eligible to receive vacation with pay. Vacation hours will begin accruing on the first day
of employment. Employees are eligible to use the vacation leave time as it accrues.
Regular part-time employees eligible for paid vacation will receive it on a pro-rated basis.
A. ACCRUAL SCHEDULE
Years of Service Days per Year
6 months - 1 year 10 days
1 through 5 years 10 days
After 5 years through 10 years 15 days
After 11 years 16 days
After 12 years 17 days
After 13 years 18 days
After 14 years 19 days
After 15 years 20 days
After 20 years 25 days
Each department shall establish a vacation schedule to ensure the needs of the
department will be met while allowing employees to use accrued vacation time. Requests
for time off shall be made in advance, with the length of the notice to be determined by
the Department Head. All vacation time must be approved by the employee’s Supervisor
or Department Head.
The City encourages employees to use their full amount of vacation each year. If this is
not possible, an employee is permitted to carry over no more than ten (10) days’ vacation
time plus the amount accrued up to December 31 of the present year. The rate of
vacation pay is the employee’s normal base straight-time rate of pay.
The City recognizes that regular full-time and regular part-time employees or their
immediate family members may have an illness, injury or medical condition resulting in
an employees need to be away from work in excess of their accrued sick leave and
vacation balances. To address this situation, all eligible employees will be allowed to
voluntarily donate unused vacation time to a Vacation Donation Bank in order to assist
eligible employees in need of paid time off in accordance with this policy.
B. DONEE ELIGIBILITY/INELIGIBILITY
Employees who are eligible to receive time from the Donated Vacation Bank must:
1. Have completed their initial probationary period.
2. One of the following individuals must have a documented illness, injury or medical
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condition resulting in the employee’s need to be away from work in excess of their
accrued sick leave vacation balances:
a. The employee
b. The employee’s dependents
c. The employee’s spouse or domestic partner
3. Have exhausted all accumulated hours (sick leave, vacation holiday hours, flex or
comp time).
An employee is not eligible for this benefit if the employee is:
1. Receiving workers compensation benefits for the condition.
2. Has a condition that qualifies for payments under a long-term or short-term
disability insurance and is receiving payments from one of those programs.
The City Administrator shall have the right to deny use of donated vacation time from the
Vacation Donation Bank, or limit its use as determined necessary and in the best interest
of the City.
C. DONOR ELIGIBILITY/INELIGIBILITY
• All regular full -time and part-time, non-probationary employees are eligible to
donate vacation time to the Vacation Donation Bank under this policy.
• An employee must have at least 40 hours of vacation time in their own vacation
accrual after their donation.
• Employees who are currently on an approved leave of absence are ineligible to
make donations to the Vacation Donation Bank.
D. GENERAL INFORMATION
• The donor shall receive no consideration for donating vacation to the Vacation
Donation Bank.
• Vacation time will be donated based on the dollar value of the vacation donation.
• Vacation hours will be donated in whole hours (minimum of one (1) hour).
• The donated vacation will be converted to dollars by the City by multiplying the
number of hours donated by the donor’s hourly base pay rate at the time of
donation.
• The donor cannot borrow against future vacation time in order to donate.
• Donations may be revoked with approval by the City Administrator.
• Donations are submitted to the City by employees through a Vacation Donation
Authorization Form.
• The identity of donors will be kept confidential.
• The accumulation of time in the Vacation Bank will be used to serve future requests
for vacation donations.
• Employees are not required to donate their accrued vacation time.
• No provisions of this policy, or its administration, shall be subject to review under
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the grievance or arbitration provision of any collective bargaining agreement.
E. REQUESTING/APPROVAL OF DONATED TIME
An eligible employee must submit a Donation of Vacation Request Form to the Human
Resources Department.
In order to receive donated time from the Vacation Donation Bank, a Donation of Vacation
Request Form must be approved by the City Administrator.
F. APPLYING DONATED VACATION TIME
• The donee’s sick leave, vacation, holiday hours, flex or comp time balances, must
be exhausted prior to any donated vacation time being applied.
• Donated vacation time shall only be used for time off related to the medical leave.
• The Donated Vacation Bank will be tracked by the Finance Department (Payroll).
• Human Resources, the Department Head, and the City Administrator will evaluate
and consult with the employee during the medical leave to determine the extent of
time needed.
• The Vacation Donation Policy does not limit or extend the time available under the
Family Medical Leave Act (FMLA).
• The City Administrator will have the discretion to review vacation donation requests
if the employee is deemed unable to return to work or returns to work on a part-
time basis.
• Under a similar program, the IRS has ruled that these payments are to be
considered wages and therefore taxable income to the recipient. As a result, the
payments will be included in the recipients annual W-2 Form. State and Federal
income tax, FICA/Medicare tax, and Supplemental Retirement contributions,
depending on the eligibility of the recipient, will be withheld by the City at the time
of payment. The IRS has also ruled that the employee donating the vacation time
realized no income for those hours and incurs no tax-deductible expense or loss,
either upon surrender of leave or payment to the Vacation Donation Bank.
• The City specifically retains the right to administer the policy in any manner it
deems to be in the best interest of the City, including the right to amend, to alter,
to further limit, or to eliminate the policy without notice.
• Employees receiving wages through donated vacation time will continue to earn
their sick leave and vacation accruals.
• An employee who returns to work on a part-time basis may, with verification and
City Administrator approval, continue to use donated time.
• Once an employee returns to full duty or begins short term disability or long term
disability, the employee is no longer eligible to receive donations.
• Employees may receive up to a maximum of eight (8) weeks of donated vacation
time, more with City Administrator approval due to extraordinary circumstances.
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Section 2.06 Insurance Benefits
The outline of the following benefits should not be construed as a claim of entitlement.
These benefits may be changed from time to time. The City may change, delete, modify
or otherwise revise employee benefits, coverage, premium amounts, eligibility
requirements, and/or administrative procedures regarding benefits.
Provisions describing various plans and insurance policies are for information only. In all
instances the actual plan or policy language and statutory requirements are controlling.
A. HEALTH, DENTAL AND LIFE INSURANCE
The City currently contributes an amount specified by the City Council for employee
insurance, which can be used towards the cost of:
• $10,000 basic life insurance,
• Employee, spouse and dependent health and dental insurance and,
• Employee supplemental life insurance of up to $300,000.
Life Insurance
All regular full-time and regular part-time employees averaging 30 hours or more of work
each week, including new probationary employees, are provided $10,000 of basic Life
Insurance. (Supplemental Life Insurance is available up to $300,000.)
Health and Dental Insurance
All regular full-time and regular part-time employees averaging 30 hours or more of work
each week, including new probationary employees, and their dependents are eligible for
group health and dental insurance benefits.
The City pays a portion of the total cost for health and dental benefits offered through the
City. The City Council determines, by resolution, the City’s monthly contribution toward
the premiums for employees and their dependents. Employees pay any remaining
premium charges through payroll deductions. Regular part-time employees receive their
benefits on a pro-rated basis.
B. OTHER INSURANCE OFFERED DURING ENROLLMENT
The City also offers:
• HSA Savings Accounts
• FSA for Dependent Care and Health Care
• Vision Care
• Short Term Disability
• Long Term Disability
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Information pertaining to benefit coverages and brochures explaining each of the plans
are available from the Human Resources Department.
C. ENROLLMENT
All new probationary employees are eligible to enroll in the group insurance program with
the City. Insurance coverage will not commence until the first of the month following a
full month of employment. In the fall of each year an open enrollment period will occur
for the upcoming/next year. All eligible employees must update their benefit selection
during the annual open enrollment period.
D. COVERAGE DURING APPROVED LEAVE OF ABSENCE WITHOUT PAY
An employee can elect to continue life, health and dental coverage while on leave of
absence without pay. However, during this period, the employee shall be responsible for
all premiums due.
E. WORKER’S COMPENSATION MANAGED CARE SERVICES
The City is enrolled in a worker’s compensation certified management care plan.
Managed care allows employers to better coordinate medical care for injured employees
and control worker’s compensation costs. Under managed care, a trained case worker
actively manages the employee’s workers’ compensation claim. The case worker assists
the employee in getting proper medical treatment and ultimately returning to work.
Specific information pertaining to procedures are available from the Human Resources
Department.
Section 2.07 Flex Time Leave
The Flex Time Policy is an attempt to establish a consistent method of tracking regularly
scheduled work hours and additional non-regularly scheduled work hours which apply to
exempt status employees.
Flex time may be earned and accrued, one (1) hour for each extra hour worked over a 40
hour work week. Flex time should be used within a reasonable period from when it was
earned; preferably during the same week. Employees may use up to 40 hours per pay
period of their accrued Flex time with prior Supervisor approval. Recording of Flex time
should be accurately maintained by each employee.
Accrued Flex time balances for exempt employees will be reduced to 100 hours on
December 31 of each calendar year. Upon an employee’s termination from the City, there
will be no pay-out of Flex time accruals, either partial or total.
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Section 2.08 Miscellaneous Benefits
A. HEALTH CLUB MEMBERSHIP
Employees may request reimbursement for health club memberships in exchange for
accrued Sick Leave. An hour of Sick Leave is valued at the employee’s current rate of
pay. Employees can participate if a minimum balance of 80 hours sick leave is
maintained. The maximum monthly reimbursement amount is $75 or an annual maximum
reimbursement of $900. Balance and contribution amounts are pro-rated for part-time
employees.
B. EMPLOYEE WORKOUT FACILITY
The City provides a workout facility (fitness equipment) located in the City Hall basement
for employee use. In order to use the equipment employees must first sign a release of
liability and submit the form to Human Resources.
Section 2.09 Retirement Benefits
A. PERA
PERA (Public Employees Retirement Association) is available to elected and non-elected
public employees who meet eligibility requirements. If the employee meets income and
position requirements set by state statute, he or she automatically becomes a member
when employment commences. Membership is optional for qualified elected employees
or those appointed to an elected office. Any employee hired after January 1, 1968 is a
member of the Coordinated PERA program. To participate in this program, each
employee has a deduction from his or her paycheck and the City then pays a portion of
the employee’s salary as a “match” (match percentage varies for Patrol Officers).
(Refer to https://www.mnpera.org/employers/reporting-basics/contribution-rates/ to see
the PERA contribution rates.)
B. DEFERRED COMPENSATION
Deferred compensation is an IRS approved method for deferring federal and state income
taxes on savings until retirement. Taxes are paid on the savings and earnings when
withdrawn, usually during retirement when the employee is presumably in a lower tax
bracket.
Two (2) plans are currently available including ICMA Retirement Corporation (RC), and
Minnesota State Deferred Compensation Plan (Minnesota State Retirement System
MSRS). You may defer a maximum of 100% of your total salary or a maximum amount
as set by Federal regulations, whichever is less, with a minimum of $10.00 per payroll
period. Specific information pertaining to either plan is available from the Human
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Resources Department.
Section 2.10 Retirement Health Savings Plan
The City provides its employees with a Retirement Health Savings Plan (RHSP) pursuant
to Internal Revenue Code regulations through a third party administrator selected by the
City.
For purposes of Item A and D, eligible sick leave hours shall be capped. For each year
beyond 10 an additional 20 hours will be added to the cap.
The following contributions are required to the Retirement Health Savings Plan:
A. Employees who have a sick leave balance of 600 or more hours shall contribute
their excess balance to the RHSP at a 2 to 1 ratio with a maximum annual
contribution of 160 hours (80 hours converted) or that amount which brings the
employee’s sick leave balance down to 600 hours—whichever is less. The City
shall calculate and process the annual employee contribution to the RHSP on the
first payroll period of December of each year. At no point however shall an
employee’s cumulative contributions exceed the employee’s maximum eligible
hours, as defined above.
B. In addition to the provisions listed in Section A, the following table below and terms
shall apply to all non-exempt employees and are calculated on January 1:
Group Designation Age + Years of Service
Group A Up to 57
Group B 58 to 74
Group C 75 and above
1. Employees in Group A shall contribute 1% of their salary per payroll towards
the RHSP and in addition, upon separation, employees in this group who
have completed two (2) or more years of service and leave in good standing
shall contribute fifty percent (50%) of accrued vacation compensation to the
RHSP.
2. Employees in Group B shall contribute 5% of their salary per payroll towards
the RHSP, and in addition, upon separation, employees in this group who
have completed two (2) or more years of service and leave in good standing
shall contribute one hundred percent (100%) of accrued vacation
compensation to the RHSP.
3. Employees in Group C shall contribute 1% of their salary per payroll towards
the RHSP and in addition, upon separation, employees in this group who
have completed two (2) or more years of service and leave in good standing
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shall contribute one hundred percent (100%) of accrued vacation
compensation to the RHSP.
C. In addition to the provisions listed in Section A, non-union POST Certified
employees shall contribute two percent (2%) of their salary per payroll period
toward the RHSP, and, in addition, upon separation from the City, employees in
this classification who have completed two (2) or more years of service and leave
in good standing shall contribute 100% of accrued vacation compensation to the
RHSP.
D. Upon separation from the City, employees who have completed two or more years
of service and leave the City in good standing shall contribute their eligible sick
leave hours, converted at the rate of 50%, to their RHSP, in accordance with the
following:
1. For employees hired after January 1, 2008, sick leave hours paid out as
severance shall not exceed the employee’s maximum eligible hours cap less
any annual contributions made under Section A.
2. Employees with less than two years of service with the City are not eligible to
contribute sick leave hours to the RHSP and have no right to any payout of
unused sick leave hours.
3. Employees who had completed ten (10) years of service by January 1, 2008,
qualify for enhanced sick leave payout at the rate of 65%. Upon separation,
qualifying employees shall contribute their eligible sick leave hours to their
RHSP, at the enhanced rate. The enhanced conversion rate of 65% applies
ONLY to sick leave hours contributed at separation.
4. Sick leave balances in excess of the maximum eligible cap as defined above
are not eligible for contribution or payout in any form
Section 2.11 Severance
Subject to the provisions of Section 2.10 , upon separation of employment with the City,
employees shall be compensated for any accrued Vacation hours and Compensatory Time hours
not otherwise directed into their RHSP. Unused Floating Holidays are not eligible for Severance
payout. Employees with less than two (2) full years of service are not eligible for payout of Sick
Leave hours. Employees with two (2) or more years of service are subject to the terms and
provisions addressed in Section 2.10 regarding Sick Leave balances upon separation.
Section 2.12 Uniform Allowances
The non-union Mounds View Public Works employees are authorized the same uniform
allowance reimbursement as the Public Works Union employees as outlined in the Public
Works Union Contract.
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The sworn non-union Mounds View Police Department employees (Chief and Deputy
Chief) are authorized the same uniform allowance reimbursement benefits as outlined in
the Police L.E.L.S Union contract and the L.E.L.S. Police Sergeants Union Contract.
Employees working in the Police Department in the positions of Administrative Assistant
and Records/Evidence Technician shall be reimbursed up to a maximum of $350.00
annually for uniform items required by the City.
Section 2.13 Department Head Base Benefits
Department Heads (Public Works Director, Police Chief, Community Development
Director, Finance Director, Human Resources Coordinator/Director, and Assistant City
Administrator) will be subject to the City Personnel Manual unless otherwise noted.
• Subject to a six (6) month probationary period unless otherwise noted.
• Salary and step advancement is based on the salary grid adopted by the City
Council for the position and will be eligible for future market adjustments and cost-
of-living adjustments consistent with other non-union employees and at the
discretion of the City Council.
• Vacation accrual for Department Heads is as follows unless previously negotiated:
Years 1 thru 5 120 hours per year or 4.62 hours per pay period
Year 6 128 hours per year or 4.92 hours per pay period
Year 7 136 hours per year or 5.23 hours per pay period
Year 8 144 hours per year or 5.54 hours per pay period
Year 9 152 hours per year or 5.85 hours per pay period
Years 10 thru 15 160 hours per year or 6.15 hours per pay period
Year 16 200 hours per year or 7.69 hours per pay period
• A cell phone will be provided at City expense or the employee may elect to use
their personal cell phone and be reimbursed up to $50/month. Use of a personal
phone can subject the employee’s phone to discovery in the event of a public data
request.
• Tuition/Training Allocation.
• Increased Flex/Vacation Time Carryover to 100 hours for Flex and three (3) weeks
plus accrual on vacation.
• Pay for/provide Professional Membership Dues to those associations with a direct
relationship to the job/job duties.
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SECTION THREE: WORKPLACE ISSUES
Section 3.01 Appearance and Dress
The dress and appearance of City employees is a direct reflection on the professionalism
of our services. Personal appearance should be appropriate to the nature of the work
and contacts with other people and should present a positive image to the public.
Clothing, jewelry, or other items that could present a safety hazard are not acceptable in
the workplace. Dress needs vary by function. Employees who spend a portion of the day
in the field need to dress in a professional manner appropriate to their jobs, as determined
by their supervisor. Employees may dress in accordance with their gender identity, within
the constraints of the dress codes adopted by the City. City staff shall not enforce the
City’s dress code more strictly against transgender and gender diverse employees than
other employees.
Guidelines:
With prior approval from the City Administrator, Department Heads establish rules and
regulations governing appearance and dress code within their respective departments.
Because dress needs vary by job function, individuals need to dress in a manner
appropriate for their jobs. The Department Head will be responsible for determining if
attire is inappropriate.
Uniformed Personnel: Uniforms are provided to some City employees. Uniforms should
be worn while at work by all required employees unless an exception is made by the
Department Head.
The last working day of the week has been designated as “Casual Day,” which allows
employees to wear more informal dress on those days. The Department Head shall be
responsible for determining what type of dress is acceptable on Casual Day and shall
inform each employee. However, if an employee has a meeting off City premises, or a
meeting with customers on City premises where more formal attire is appropriate, more
business like attire shall be worn.
Employees who have questions concerning dress standards should inquire with their
immediate Supervisor or Department Head.
Section 3.02 Conferences and Seminars
National or regional (multi-state) conventions, seminars, workshops or conferences may
be attended by Department Heads. State and local conferences may be attended by
Department Heads or other staff if specifically related to their technical area. Under
certain circumstances, an employee who is not a Department Head may be approved to
attend national or regional conferences. The costs of all national and regional
conferences, seminars, and workshops are covered by the respective department’s
budget. (Out of state travel to conferences and seminars requires City Council prior
approval.) Supervisor approval is required prior to registration or attendance, subject to
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funding availability and subject to the City’s purchasing policy.
Section 3.03 Drug Free Workplace Policy and Federal Omnibus Transportation
A. DRUG FREE WORKPLACE POLICY
The City is committed to the health, well-being and safety of its employees and property.
All employees have a responsibility to report to and be at work in a fit condition to perform.
The policy has been established for the purpose of providing a safe workplace for all and
to comply with the Drug Free Workplace Act. The City’s complete Drug and Alcohol Policy
is contained in the Appendix. Violations of the policy may lead to discipline, including
discharge. Each situation will be evaluated on a case-by-case basis depending upon the
severity and circumstances.
B. FEDERAL OMNIBUS TRANSPORTATION EMPLOYEE TESTING ACT
The purpose of the policy is to establish programs designed to help prevent accidents
and injuries resulting from the misuse of alcohol or use of controlled substances by drivers
of commercial motor vehicles. The policy implements the requirements of the Federal
Omnibus Transportation Employee Testing Act of 1991 and the U.S. Department of
Transportation Regulations, 49 C.F.R. Pts. 40, 382. The policy is in addition to and
separate from the City’s Drug Free Workplace Act, which implements the requirements
of the federal Drug Free Workplace Act of 1988.
The policy is intended only to establish rules necessary under 49 C.F.R. Pts.40, 382. All
employees who operate commercial motor vehicles on behalf of the City shall comply
with the terms of this policy. The City requires that all employees report to work on time,
either scheduled work hours or call-back, in appropriate condition for work. Any employee
found to be in violation of this policy is subject to discipline up to and including termination
of employment. A copy of the FMSCA Federal Drug-Free Workplace Policy is included
in the Appendix.
Section 3.04 Employee Records and Data Privacy
The Human Resources Department maintains personnel records of each employee. A
separate file will be kept for any medical information collected regarding each employee.
Data Practices Advisory
Employee records are maintained in a location designated by the City Administrator.
Personnel data is retained in personnel files, finance files, and benefit/medical files.
Information is used to administer employee salary and benefit programs, process payroll,
complete state and federal reports, document employee performance, etc.
Employees have the right to know what data is retained, where it is kept, and how it is
used. All employee data will be received, retained, and disseminated according to the
Minnesota Government Data Practices Act.
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All data are subject to the Minnesota Data Practices Act and the City’s record retention
schedule. Such data are also subject to review, destruction, and investigation as allowed
or prescribed by law. In general, all electronically stored City data is considered public
information unless it is classified otherwise by law. As such, most City data is subject to
review by the public. Electronic data is not completely secure, and may be altered or
illegally accessed. As a result, employees are discouraged from sending data classified
as not public (private or confidential data on individuals, or nonpublic or protected data
not on individuals) through e-mail, Internet, or web.
The Minnesota Government Data Practices Act (MN Statute § Chapter 13) authorizes
cities to release certain information about current and former employees to the public
including employee’s name, education and training, title and job description, dates of
employment, honors and awards, work location and work phone number. This law is
subject to change so direct requests for information about employees to Human
Resources. Laws regarding data privacy are strictly followed. It is important that your
personnel records are kept accurate and up-to-date. It is your responsibility to notify
Human Resources and others as necessary when there is a change in any of the
following:
• Name (legally changed)
• Address
• Marital status
• Number of dependents (for insurance and tax purposes)
• Life insurance and retirement beneficiaries
• Telephone number
• Emergency contact information
• Life event that would cause a need to change your benefits (birth, divorce,
death, dependents eligibility change, loss of benefits through another
source)
• Job function limitations for leaves, workers compensation or ADA
Upon written request, employees may review their personnel files no later than seven (7)
working days after the request is made. The files are available in the Human Resources
Department. The City can deny employees access to their personnel records if access
has been granted within the preceding six (6) months unless new data has been collected
or created.
Any employee who contests the accuracy or completeness of their personnel record
should notify the City Administrator in writing of the objections to the contents of the file.
The employee should also supply names and addresses of individuals or entities believed
to have received information from the personnel file. Within 30 days, the City will either
correct the personnel file and attempt to notify individuals believed to have received the
incorrect information or will notify the employee that the City considers the data to be
correct. Information will not be disseminated from the personnel file without a copy of the
employee’s acknowledgment. The employee may appeal the City’s determination that the
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information is accurate pursuant to the Administrative Procedure Act (Minnesota Statutes
Chapter 14).
Section 3.05 Gifts and Gratuities
Occasionally, City employees are offered gifts from citizens or venders in appreciation of
service. If you are offered a gift or gratuity for a service performed, courteously decline
and explain that such service is available to residents without gratuity. Also, residents
may request recommendations for products or services. Keep in mind City employees
are prohibited from endorsing specific products or companies and must decline comment.
These policies are intended to avoid misunderstanding or misinterpretation concerning
outside influence on City departments and employees, and to comply with Minnesota
Statutes § 471.895. If an employee has any doubt about the propriety of the gift, the
employee should report such gift to his/her supervisor; and if the supervisor approves the
gift, the gift shall not be deemed to be improper. Any gift of cash or equivalent shall be
refused, as such is deemed to be given in the hope or expectation of receiving a favor or
better treatment.
This section shall not be interpreted or enforced in a manner which conflicts with the
provisions of the City Charter and/or laws of the State of Minnesota.
Section 3.06 Discrimination and Accommodation
It is the policy of the City to encourage the employment of individuals with disabilities and
medical restrictions. If you are an applicant that seeks accommodation in the hiring
process, please contact Human Resources to identify the need for an accommodation
and the accommodation requested.
Employees may be entitled to leave under the Family Medical Leave Act or other forms
of leave offered by the City as discussed elsewhere in the policy manual. However, you
are expected to return to work following an injury or illness as soon as you are able to do
so, even if subject to restrictions, if the restrictions can be accommodated without causing
an undue hardship to the City. If you are unable to work or perform a particular job duty
because of a medical condition and/or restriction, you must report the same to your direct
supervisor and as otherwise required by a collective bargaining agreement (“CBA”), if
applicable. Thereafter, you are expected to engage in an interactive process with the City
(and you’re Union, if applicable), regarding your ability to work which may include:
1. A discussion of the purpose of the job held by you and the essential functions
of that job, the precise job-related limitation(s), and the potential
accommodations to be made.
2. Communication with your medical provider and production of medical records
as necessary to evaluate the request for accommodation.
If you are not happy with the decision reached by your supervisor regarding your return
to work, the accommodation of restrictions, or his/her handling of the matter, you are
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expected to report the same to Human Resources (or, if applicable, under any other
manner allowed by your CBA).
The City is required to provide reasonable accommodations to qualified individuals with
disabilities who are employees or applicants for employment, except when such
accommodation would cause an undue hardship. A person is considered to be “disabled”
is defined as any person who (1) has a physical, sensory or mental impairment which
materially limits one or more major life activities; (2) has a record of such an impairment;
or (3) is regarded as having such an impairment. What constitutes a “reasonable
accommodation”, if not defined by an applicable CBA, will vary depending upon the job,
the restriction, and the needs of the employer.
"Undue hardship" means significant difficulty or expense to the City in relationship to the
cost or difficulty of providing a specific accommodation and includes requests that are
unduly extensive, substantial, or disruptive, or those that would fundamentally alter the
nature or operation of the business. If you believe that a particular accommodation is
required, and that the City has improperly failed to provide the requested accommodation,
you are expected to report the same to Human Resources. You may also proceed in any
other manner allowed by your CBA; or, if not applicable, other law.
Individuals who remain dissatisfied with the outcome of his/her accommodation request
may discuss the request with the City Administrator who will make a final determination.
Section 3.07 Keys and Security
Security of City buildings, offices, vaults, computers and files is of such extreme
importance that special efforts must be made to protect this property from unauthorized
theft.
Keys for City facilities and vehicles are issued only to employees with an absolute need.
Those keys are the responsibility of the employee and should not be shared with anyone
except an immediate Supervisor or Department Head. If you misplace City keys, report
it immediately to the Public Works Administrative Assistant.
Computer passwords are in place for several computers and programs. Passwords
should not be shared. (Section 3.19 Technology Use and Access – C – Passwords)
If you are entrusted with the custody of safes, vaults, or confidential files, you are
expected to assure yourself that these units are securely locked before leaving at the end
of the day.
Section 3.08 Offensive Behavior/Harassment
The City is committed to creating and maintaining a work place free of harassment and
discrimination and other related employment laws. In keeping with this commitment, the
City maintains a strict policy prohibiting unlawful harassment, related to any classification
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protected by state or federal law, including age, disability, religious and sexual
harassment. This policy prohibits harassment in any form, including verbal and physical
harassment.
This policy statement is intended to make all employees, volunteers, members of boards
and commissions, and council sensitive to the matter of harassment, to express the City’s
strong disapproval of unlawful harassment, to advise employees against this behavior
and to inform them of their rights and obligations.
This policy applies to all of the City’s employees, including elected officials, members of
boards and commissions, consultants rendering professional services to the City and
volunteer personnel.
The City acknowledges this policy cannot possibly predict all situations that might arise,
and also recognizes that some employees are exposed to disrespectful behavior, and
even violence, by the very nature of their jobs.
Applicability:
Maintaining a respectful public service work environment is a shared responsibility. This
policy is applicable to all City employees, volunteers, firefighters, members of boards and
commissions and City Council members.
Abusive Customer Behavior
While the City has a strong commitment to customer service, the City does not expect
employees to accept verbal and other abuse from any customer.
An employee may request that a supervisor intervene when a customer is abusive, or the
employee may defuse the situation themselves, including professionally ending the
contact.
If there is a concern about the possibility of violence, the individual should use his/her
discretion to call 911, and as soon as feasible, a supervisor. Employees should leave the
area immediately when violence is imminent unless their duties require them to remain
(such as Police Officers). Employees must notify their supervisor about the incident as
soon as possible.
Types of Disrespectful Behavior
The following behaviors are unacceptable and therefore prohibited, even if not unlawful
in and of themselves:
1. Violent behavior: Includes the use of physical force, harassment, bullying or
intimidation.
2. Discriminatory behavior: Includes inappropriate remarks about or conduct
related to a person’s race, color, creed, religion, national origin, disability, sex,
pregnancy, gender-biased statements, such as stereotypes about women or
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men, marital status, age, sexual orientation, gender identity, or gender
expression, familial status, or status with regard to public assistance.
3. Offensive behavior: May include such actions as: rudeness, angry outbursts,
inappropriate humor, vulgar obscenities, name calling, disparaging language,
or any other behavior regarded as offensive to a reasonable person based
upon violent or discriminatory behavior as listed above. It is not possible to
anticipate in this policy every example of offensive behavior. Accordingly,
employees are encouraged to discuss with their fellow employees and
supervisor what is regarded as offensive, taking into account the sensibilities
of employees and the possibility of public reaction.
Although the standard for how employees treat each other and the general public will be
the same throughout the City, there may be differences between work groups about what
is appropriate in other circumstances unique to a work group. If an employee is unsure
whether a particular behavior is appropriate, the employee should request clarification
from their supervisor or the City Administrator.
Sexual harassment:
Can consist of a wide range of unwanted and unwelcome sexually directed behavior such
as unwelcome sexual advances, requests for sexual favors, and other verbal or physical
conduct of a sexual nature when:
• Submitting to the conduct is made either explicitly or implicitly a term or condition
of an individual’s employment; or
• Submitting to or rejecting the conduct is used as the basis for an employment
decision affecting an individual’s employment; or
• Such conduct has the purpose or result of unreasonably interfering with an
individual’s work performance or creating an intimidating, hostile or offensive work
environment.
Sexual harassment includes, but is not limited to, the following:
• Unwelcome or unwanted sexual advances. This means stalking, patting, pinching,
brushing up against, hugging, cornering, kissing, fondling or any other similar
physical contact considered unacceptable by another individual.
• Verbal or written abuse, kidding, or comments that are sexually-oriented and
considered unacceptable by another individual. This includes comments about an
individual’s body or appearance where such comments go beyond mere courtesy,
telling “dirty jokes” or any other tasteless, sexually oriented comments, innuendos
or actions that offend others. The harassment policy applies to social media posts,
tweets, etc., that are about or may be seen by employees, customers, etc.
• Requests or demands for sexual favors. This includes subtle or obvious
expectations, pressures, or requests for any type of sexual favor, along with an
implied or specific promise of favorable treatment (or negative consequence)
concerning one’s current or future job.
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Expectations
All employees are expected to treat each other and the general public with respect and
to assist in fostering an environment that is free from unwanted harassment. Violations of
this policy may result in discipline, including possible termination. Each situation will be
evaluated on a case-by-case basis.
Employee Response to Disrespectful Workplace Behavior
All employees should feel comfortable calling their supervisor or another manager to
request assistance should they not feel comfortable with a situation. If situations involve
violent behavior call the police or ask the individual to leave the area.
If employees see or overhear a violation of this policy, employees should advise a
supervisor, the City Administrator, or City Attorney promptly. Employees who believe
disrespectful behavior is occurring are encouraged to deal with the situation in one of the
ways listed below. If there is a concern about the possibility of violence, the individual
should use his/her discretion to call 911, and as soon as feasible, a supervisor.
Step 1(a). If you feel comfortable doing so, professionally, but firmly, tell whoever is
engaging in the disrespectful behavior how you feel about their actions. Politely request
the person to stop the behavior because you feel intimidated, offended, or uncomfortable.
If practical, bring a witness with you for this discussion.
Step 1(b). If you fear adverse consequences could result from telling the offender or if
the matter is not resolved by direct contact, go to your supervisor or City Administrator.
The person to whom you speak is responsible for documenting the issues and for giving
you a status report on the matter.
In some situations with an offender from the public, it is preferable to avoid one on one
interactions. Talk to your supervisor about available options to ensure there are others
available to help with transactions with the offender.
Step 1(c). The City urges conduct which is viewed as offensive be reported immediately
to allow for corrective action to be taken through education and immediate counseling, if
appropriate. It is vitally important you notify a supervisor, the City Administrator, the
Mayor or Councilmember promptly of your concerns. Any employee who observes sexual
harassment or discriminatory behavior, or receives any reliable information about such
conduct, must report it promptly to a supervisor or the City Administrator.
Step 2. If, after what is considered to be a reasonable length of time (for example, 30
days), you believe inadequate action is being taken to resolve your complaint/concern,
the next step is to report the incident to the City Administrator or the Mayor.
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Supervisor’s Response to Allegations of Disrespectful Workplace Behavior
Employees who have a complaint of disrespectful workplace behavior will be taken
seriously. In the case of sexual harassment or discriminatory behavior, a supervisor must
report the allegations promptly to the City Administrator, who will determine whether an
investigation is warranted. A supervisor must act upon such a report even if requested
otherwise by the victim. In situations other than sexual harassment and discriminatory
behavior, supervisors will use the following guidelines when an allegation is reported:
Step 1(a). If the nature of the allegations and the wishes of the victim warrant a simple
intervention, the supervisor may choose to handle the matter informally. The supervisor
may conduct a coaching session with the offender, explaining the impact of his/her
actions and requiring the conduct not reoccur. This approach is particularly appropriate
when there is some ambiguity about whether the conduct was disrespectful.
Step 1(b). Supervisors, when talking with the reporting employee will be encouraged to
ask him or her what he or she wants to see happen next. When an employee comes
forward with a disrespectful workplace complaint, it is important to note the City cannot
promise complete confidentiality, due to the need to investigate the issue properly.
However, any investigation process will be handled as confidentially as practical and
related information will only be shared on a need to know basis and in accordance with
the Minnesota Data Practices Act.
Step 2. If a formal investigation is warranted, the individual alleging a violation of this
policy will be interviewed to discuss the nature of the allegations. The person being
interviewed may have someone of his/her own choosing present during the interview.
Typically, the investigator will obtain the following description of the incident, including
date, time and place:
• Corroborating evidence.
• A list of witnesses.
• Identification of the offender.
Step 3. The supervisor must notify the City Administrator about the allegations (assuming
the allegations do not involve the City Administrator).
Step 4. In most cases, as soon as practical after receiving the written or verbal complaint,
the alleged policy violator will be informed of the allegations, and the alleged violator will
have the opportunity to answer questions and respond to the allegations. The City will
follow any other applicable policies or laws in the investigatory process.
Step 5. After adequate investigation and consultation with the appropriate personnel, a
decision will be made regarding whether or not disciplinary action will be taken.
Step 6. The alleged violator and complainant will be advised of the findings and
conclusions as soon as practicable and to the extent permitted by the Minnesota
Government Data Practices Act.
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Special Reporting Requirements
When the supervisor is perceived to be the cause of a disrespectful workplace behavior
incident, a report will be made to the City Administrator who will determine how to proceed
in addressing the complaint as well as appropriate discipline.
If the City Administrator is perceived to be the cause of a disrespectful workplace behavior
incident, a report will be made to the City Attorney who will confer with the Mayor and City
Council regarding appropriate investigation and action.
If a councilmember is perceived to be the cause of a disrespectful workplace behavior
incident involving City personnel, the report will be made to the City Administrator and
referred to the City Attorney who will undertake the necessary investigation. The City
attorney will report his/her findings to the City Council, which will take the action it deems
appropriate.
Pending completion of the investigation, the City Administrator may at his/her discretion
take appropriate action to protect the alleged victim, other employees, or citizens.
If an elected or appointed City official (e.g., council member or commission member) is
the victim of disrespectful workplace behavior, the City Attorney will be consulted as to
the appropriate course of action.
Confidentiality
A person reporting or witnessing a violation of this policy cannot be guaranteed
anonymity. The person’s name and statements may have to be provided to the alleged
offender. All complaints and investigative materials will be contained in a file separate
from the involved employees’ personnel files. If disciplinary action does result from the
investigation, the results of the disciplinary action will then become a part of the
employee(s) personnel file(s).
Retaliation
Consistent with the terms of applicable statutes and City personnel policies, the City may
discipline any individual who retaliates against any person who reports alleged violations
of this policy. The City may also discipline any individual who retaliates against any
participant in an investigation, proceeding or hearing relating to the report of alleged
violations. Retaliation includes, but is not limited to, any form of intimidation, reprisal, or
harassment.
Section 3.09 Outside Employment
The City expects regular employees to consider City work their primary employment. Any
other job must be compatible, without conflict of interest or schedule. The primary
concern is that there be no conflict of interest between the outside work and the City
position. A secondary concern is that the scheduling of outside work could result in an
employee reporting to their City job without proper rest.
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Conflict of Interest
It is expected that every employee will exercise good judgment to avoid becoming
involved in a conflict of interest. Example of conflict of interest situations include:
• Those in which an employee’s official capacity with the City, or with the outside
organization, may enable him or her to influence the placing of City business.
• Those in which an employee accepts a paid or unpaid position elsewhere,
where such activity interferes with their duties and job performance at the City.
• Those in which an employee may gain access to information not generally
available to the public which may allow him or her to directly or indirectly gain
anything of value.
An employee must notify the City Administrator in writing with regards to outside
employment and must sign the following waiver:
"The undersigned, an employee of the City of Mounds View, does hereby
waive and release said City from liability, expense or cost because of any
injury or sickness incurred by reason of any employment accepted by the
undersigned other than as an employee of said City. During the absence
caused by an injury or sickness incurred by reason of non-City employment,
I waive any claims against the City for wages or other benefits except for
my ability to use previously accrued sick leave."
Section 3.10 Performance Reviews
The primary objective of a performance evaluation is to provide information to employees
concerning their success in accomplishing the responsibilities of their jobs. To meet this
objective, the City needs open and on-going communication between Supervisors and
staff members. The City’s goal is to conduct a performance review for each new regular
full-time and regular part-time employee prior to the sixth month of employment and after
one year of service. Performance reviews shall be conducted on an annual calendar basis
thereafter. If for any reason a performance review cannot be conducted pursuant to this
schedule, it will be conducted as soon thereafter as practicable. Supervisors and
Department Heads may choose to conduct performance reviews more frequently than
expected by the City.
All reviews shall be discussed with the employee before being submitted to the City
Administrator. Performance reviews will be maintained in each employee’s personnel
file.
Signing of the Performance Review document by the employee acknowledges the review
has been discussed with the supervisor and does not necessarily constitute agreement.
Failure to sign the document by the employee will not delay processing.
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Section 3.11 Political Activity
City employees are prohibited from participating in political activities during normal
working hours, while on City property or while wearing any uniform, device or equipment,
etc. which could serve as identification of the employee as a City employee.
Any employee seeking public office within the City shall terminate employment or have
an approved leave of absence prior to filing for such office and comply with the provisions
of Minnesota Statute 211.B. Any employee seeking public office in a different city shall
not permit such candidacy for office or performance of the office to interfere with his/her
duties with the City. Campaigning or the conducting of other business shall not take place
during work time.
The section shall not be interpreted or enforced in a manner which conflicts with the
provisions of the City Charter and/or laws of the State of Minnesota.
Section 3.12 Safety Policies
The health and safety of each employee of the City and the prevention of occupational
injuries and illnesses are of primary importance to the City. To the greatest degree
possible, management will maintain an environment free from unnecessary hazards and
will establish safety policies and procedures for each department. Adherence to these
policies is the responsibility of each employee. Overall administration of this policy is the
responsibility of each supervisor. Supervisors shall be responsible for:
• Establishing safety regulations within their department.
• Reviewing safety procedures with all employees
• Instructing employees in accident prevention.
It is the duty and responsibility of each employee to:
• Understand and follow rules and safety standards.
• Make sure they are familiar with the safe and proper use of any tool or piece of
equipment before it is used.
• Operate all tools and equipment in a safe and careful manner.
Reporting Accidents and Illnesses
Both Minnesota workers’ compensation laws and the state and federal Occupational
Safety and Health Acts require that all on the job injuries and illnesses be reported as
soon as possible by the employee, or on behalf of the injured or ill employee, to his/her
supervisor. The employee’s immediate supervisor is required to complete a First Report
of Injury and any other forms that may be necessary related to an injury or illness on the
job.
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Safety Equipment/Gear
Where safety equipment is required by federal, state, or local rules and regulations, it is
a condition of employment that such equipment be worn by the employee.
Unsafe Behavior
Supervisors are authorized to send an employee home immediately when the employee’s
behavior violates the City’s personnel policies, Department policies, or creates a potential
health or safety issue for the employee or others.
Section 3.13 Serving on Boards or Commissions
Employees will have the opportunity to be considered for openings on City advisory
committees and commissions within the following parameters:
Employees may not serve on committees or commissions on which their Supervisor or
Department Head is staff liaison. Employees must use the same application form and
meet the same criteria as any other citizen. The City Council will consider employees,
along with other applicants, at City Council meetings regarding filling the vacancy. The
City Administrator will advise the City Council prior to consideration of the employee if a
conflict of interest exists.
Section 3.14 Smoke Free Workplace
In accordance with the Minnesota Clean Indoor Air Act and in recognition of the need to
provide a smoke-free environment for City employees and visitors, smoking and use of
other tobacco products are not allowed in any City-owned building or equipment.
Policy
Smoking of any kind, including pipes, cigars, and cigarettes, e-cigarettes, vaping or the
use of chewing tobacco, will not be permitted in any Mounds View City building or City
owned vehicle. Smoking by City employees is not permitted outside of the front entrance
of City Hall. Smoking may only be allowed where it does not endanger life or property or
cause discomfort and unreasonable annoyance to other employees.
The Police Department is granted special discretion in regard to this policy when
questioning a witness or suspect of a crime. This smoking and tobacco use privilege may
only be granted to a member of the public and not to a City employee, including Police
Officers, unless they are being questioned.
Violations
Employees who violate the smoking and tobacco use policy will be subject to disciplinary
action as follows: First Violation - verbal warning; Second Violation - written warning; Third
Violation - suspension without pay; Subsequent Continual Violations - may result in
termination of employment.
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Section 3.15 Travel Expenses
An employee’s expenses incurred while conducting City business or attending approved
conferences or training are paid by the City, subject to the City’s purchasing policy.
Expenses incurred by a spouse or other person attending a conference with an employee
must be paid by the employee.
A. MEALS
Reimbursement for meals while on travel is only for actual expenditures. The
reimbursement rate within Minnesota will follow the IRS Guidelines. However, the
amount may be adjusted for travel outside of Minnesota. Liquor is not an allowable
expense.
B. LODGING
The actual cost for lodging is paid by the City. Room service, personal telephone calls
and other extras must be paid for by the employee. A telephone call home of reasonable
length will be paid if the employee’s schedule has changed, and the return time/date is
different than originally planned.
C. TRANSPORTATION
1. Airline
The actual cost for coach class is paid by the City. Prizes, bonuses or free trips
awarded by the airlines as a result of travel paid by the City, become the property
of the City and may not be accepted for personal use. (MN Statutes §15.435.)
This poli cy applies to all airline travel paid for by the City for City employees,
including elected officials.
2. Automobile
If an employee uses his or her own personal vehicle, he or she will be reimbursed
for the amount allowed by the IRS Guidelines. However, staff cars are to be used
in most instances. This amount will automatically be adjusted per IRS Guidelines
and recognized by the City.
D. REIMBURSEMENT
Employees must complete an expense statement form and attach receipts for any
allowable meals, lodging, transportation and/or parking expenses incurred. After
obtaining Supervisor approval, submit the completed form to the Finance Department.
All expenses must be supported by receipts.
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Section 3.16 Tuition Reimbursement
The City encourages its employees to improve job performance in their present position
and to prepare for advancement with the City through self-development. The City may
share the cost of education which directly relates to the performance of the employee in
the employee’s present assignment or which prepares the employee for advancement
with the City in the foreseeable future. The City may reimburse eligible regular full-time
employees upon presentation of their final grades. In order for a class to qualify for
reimbursement, the following conditions must be met:
A. The class must be job related. An employee may be reimbursed for 50%
of the costs, for courses which are directly relevant, 25% if somewhat
relevant and 0% if not relevant. The determination of relevancy shall be
made by the Department Head and City Administrator.
B. The class must be taken from accredited institutions of higher learning or
vocational-technical schools.
C. The employee must receive a passing grade of C or equivalent in order to
qualify for reimbursement.
D. The employee must complete a Tuition Reimbursement Form prior to class
registration. The maximum amount the City will reimburse is 50% of the
total cost of tuition for the course or courses being requested with a
maximum amount of $1200 annually, if sufficient funds are available. The
City Council may grant an exception on the $1200 limit on a case by case
basis.
E. The Department Head is responsible for reviewing the request and making
a recommendation to the City Administrator with an explanation of approval
or denial. The City Administrator has the final authority in approving or
denying the request. An explanation of approval or denial shall be provided.
F. After the class has been completed, the employee must provide a
photocopy of the grade sheet and the original receipt for tuition.
G. Participation in the program shall be on a voluntary basis, outside normal
working hours. However, in certain circumstances, a Department Head
may allow an employee to attend class during normal working hours. In
order to do so, the employee is to use personal or vacation leave or flex or
compensatory time.
H. If the employee wishes to not use personal or vacation time or flex or
compensatory time, unpaid leaves may be granted to attend class. The
tuition reimbursement program may not reimburse the employee for those
hours of the normal working day during which he/she is in class. However,
all Department Heads are encouraged to schedule work time to assist
employees with a flexible work schedule.
An employee may not receive assistance from other sources and receive tuition aid
reimbursement from the City for the same courses taken. The City may reimburse
individuals for selected job-related non-accredited courses at its sole discretion. This
program does not apply to seminars, mini-courses or other training authorized through
the normal training budget.
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Section 3.17 Worker’s Compensation (Injury on Duty)
The City provides a comprehensive workers’ compensation insurance program at no cost
to employees. This program covers any injury or illness sustained in the course of
employment that requires medical, surgical or hospital treatment. Subject to applicable
legal requirements, workers’ compensation insurance provides benefits under a short
waiting period or, if the employee is hospitalized, immediately. In appropriate instances,
workers’ compensation covers certain medical expenses and lost earnings.
To preserve an employee’s right to possible worker’s compensation coverage, the
employee must immediately report to Human Resources or to his/her supervisor
any accident, injury, or illness that occurs in the course of performing job duties-
even if the injury or illness does not seem serious.
If an employee is receiving workers’ compensation as a result of a compensable injury or
illness covered under the provisions of the Minnesota Workers’ Compensation Act,
employees may supplement their workers’ compensation payment with available vacation
or sick hours so that the net take home pay does not decrease as a result of the workers’
compensation payment.
Return to Work
After a medical absence, a physician’s statement may be required on the employee’s first
day back to work, indicating the nature of the illness or medical condition and attesting to
the employee’s ability to return to work and safely perform the essential functions of the
job with or without reasonable accommodation.
Any work restrictions must be stated clearly on the return-to-work form. Employees who
have been asked to provide such a statement may not be allowed to return to work until
they comply with this provision. Sick leave may be denied for any employee required to
provide a doctor’s statement until such a statement is provided.
The City has the right to obtain a second medical opinion to determine the validity of an
employee’s workers’ compensation or sick leave claim, or to obtain information related to
restrictions or an employee’s ability to work. The City will arrange and pay for an
appropriate medical evaluation when it has been required by the City.
Additional Information
Information regarding workers’ compensation is posted on the City’s official bulletin board,
located in the copy/work room at Mounds View City Hall. For additional information
contact Payroll or call the Minnesota Department of Labor and Industry at (651) 284-5032.
Section 3.18 Use of City Property
City equipment and property will not be loaned to citizens or employees for personal
purposes except as allowed by established City policy. No personal business of any kind
should be conducted during business hours. Also, equipment or property will not be
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borrowed from citizens or employees to do City projects. The City will purchase the
necessary items or will rent them and/or obtain them from another governmental agency.
A. COPY MACHINE
Employees may make personal photocopies on City machines and pay for any copies
made per fee established by City. Copies must be kept to a minimum.
B. FAX MACHINE
Employees may receive personal faxes at the City, provided the faxing does not interfere
with City business.
C. POSTAGE MACHINE
Employees are not allowed to use the postage machine for personal mail without prior
authorization from a Supervisor. Employees shall pay for the amount of the postage
used.
D. PUBLIC WORKS GARAGE FACILITY
Employees are not permitted to use the Public Works Garage or the equipment therein
for personal use.
E. TELEPHONE USE
Employees may make personal calls during business hours as long as the number and
length of personal calls are kept to a minimum. Any abuses of this limited privilege may
subject the employee to disciplinary action.
Employees receiving calls from citizens shall answer promptly and identify themselves
and the department which they represent. They shall be courteous, tactful, and use good
judgment at all times.
F. TOOLS AND EQUIPMENT
City tools and equipment are not to be used for anything other than City purposes. City
tools charged out to any employee, upon a written receipt, which are lost or broken
through misuse by the employee shall be replaced at the employee's expense.
G. VEHICLES
1. City Vehicles
City employees are encouraged to make use of City vehicles whenever
possible for City business. Vehicles are provided for the performance of
employee responsibilities relating to their job functions. The following rules
for City vehicle use apply to all City Vehicles:
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• Employees using City owned vehicles must be mindful of all traffic
regulations and courtesies of the road.
• Vehicles are only to be used by an employee conducting official City
business. Incidental stops (non-routine and unpredictable) are
permitted only on the normal route of travel between the employee’s
residence and the City or the route between the City and business
related activity. Stops for personal business other than for meals will
be limited to convenience stores, etc.
• City vehicles shall be operated only on official City business related
to the employee’s normal job. Special circumstances such as
transportation to and from meetings, training, conferences, out of
town training, etc. must be approved by the City Administrator. In
addition, vehicles shall not be taken home by departmental
employees and retained overnight without expressed authorization.
The only exception to this policy is for Public Works employees on
call and authorized uses of the Police Department personnel.
• Any employee operating a City vehicle may only carry City
employees on official City business and/or such other persons
whose transportation via City vehicle is in the best interest of the City.
At no time are members of an employee’s family to be passengers
or operators of City vehicles.
2. Employee-owned Vehicles
When a City vehicle is not available, an employee will be reimbursed for
using their own vehicle at the standard mileage rate of the IRS, determined
and as acknowledged by the City. Mileage and Expense forms are
available from the Finance Department.
3. Motor Vehicle Records
No employee shall be permitted to operate City owned vehicles unless they
have in their possession a valid driver’s license permitting them to drive in
the State of Minnesota. The City has the right to revoke any employee’s
privilege to operate a City vehicle at any time and may require an employee
to provide their Motor Vehicle records if they are assigned or authorized to
use City vehicles.
4. Traffic Violations
Any employee convicted of a traffic violation while traveling in a City vehicle
is responsible for payment of the associated fines and shall advise the City
immediately of such conviction or violation.
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Section 3.19 Technology Use and Access
Most City business is conducted with the use of desktop or notebook computers
dedicated to a single user's activity. It is essential to protect City information assets
created, gathered, shared or stored with desktop and notebook computers, related
computer media (e.g. CD ROMs, Personal Digital Assistants (PDAs), flash drives, etc.)
and peripheral equipment such as fax machines, printers and copiers.
The City provides most employees with electronic access, consisting of an email system,
network connection, and Internet/Intranet access. This policy applies to all individuals
granted access to the City network and information systems and includes all computers
(e.g., desktops and notebooks), standalones as well as those connected to the City
network even if mobile and remote.
The purpose of the provisions below are to establish standards of use and governance in
order to ensure secure, efficient, ethical and legal use of desktop and notebook
computers, electronic programs and operating systems, as well as all other related
computer media and peripheral equipment. This policy also complies with laws and
technology contracts, and sets out to minimize disruptions to services and activities. The
City Administrator or designee may authorize exceptions to this policy.
A. COMPUTER/ PERIPHERAL EQUIPMENT/SYSTEMS USE
Securing Equipment
The City’s IT Department is responsible for secure installations, configurations,
distribution, management and removal from service of City desktop and notebook
computers. The City may withdraw permission for any or all business or personal uses of
its network or information systems at any time.
The City will ensure reasonable physical safeguards to maintain desktop and notebook
computers and peripheral equipment in such a way to avoid inadvertent disclosure of City
information. However, each user is responsible to take measures to protect equipment
and data from theft or unauthorized access or use by:
1. Locking workstations when unattended.
2. Storing all physical equipment in a secure location and all confidential and
sensitive data on the network (shared directory) drive.
3. Clear peripheral equipment of confidential documents immediately and turn off all
equipment at the end of each work day.
4. Never altering or disabling security safeguards or virus detections that have been
installed.
Software / Viruses
Individual users shall not install or download software applications and/or executable files
to any City desktop or notebook computer without prior authorization from the IT
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Department. If you are both a user and an administrator, your user’s standard login
account cannot be a member of the local machine administrator’s group on the user’s
assigned desktop or notebook computer.
Suspected viruses must be reported immediately to the IT Department and not deleted
without assistance unless instructed by the IT Department. Desktop and notebook
computer users shall not write, compile, copy, knowingly propagate, execute or attempt
to introduce any computer code designed to self-replicate, damage or otherwise hinder
the performance of any computer system (e.g. virus, bacteria, worm, Trojan horse, or the
like).
General Use
Users at the City will comply with all Federal and State laws, City policy and contracts.
The City’s equipment, systems and services are not to be used for purposes that could
be reasonably expected to cause excessive strain on systems, interfere with staff
productivity, pre-empt any business activity or consume more than a trivial amount of
resources. Examples would be excessive personal use, use of systems and services for
unsolicited mass mailings, non-City commercial activity, political campaigning or
dissemination of chain letters.
B. ELECTRONIC DOCUMENT RETENTION
Certain paper documents must be retained, and electronic documents may be required
to be kept on file as well. For further information and requirements please refer to the
state retention schedule found on the Intranet under Links to State Forms.
C. PASSWORDS
Passwords Overview
Passwords are a critical part of information and network security. Passwords protect user
accounts, but if compromised, could put the entire network at risk of unauthorized access
and loss of electronic data. All employees are required to take appropriate steps to ensure
that they create strong, secure passwords and keep them safeguarded at all times. This
section is established to set a standard for creating, protecting and changing passwords
such that they are strong, secure and protected.
Password Construction
Passwords are used to access any number of City information systems, including the
network, database applications, email and internet. Poorly designed passwords are easily
cracked and put the entire system at risk. Therefore, strong passwords that contain at
least 8 characters are necessary to protect the integrity of the network and data. A strong
password will contain a series of numbers, letters and special characters and are not be
based on well-known or easily accessible personal information. Passwords must be
changed every 90 days and may not be reused for one year.
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Password Protection
Passwords should be treated as confidential information. No employee is to give, tell or
hint at their password to anyone including IT staff, administrators, superiors, other co-
workers, friends or family members.
Passwords are not to be transmitted electronically over the unprotected Internet, such as
via email. Unsecured written record of passwords or unencrypted electronic files should
not be kept. Do not use the “Remember Password” feature of applications. Passwords
used to gain access to City systems should not be used as passwords to access non-City
accounts or information.
IT staff will not reset a password unless the requester is communicating in person or from
a verifiable, secure source such as a City phone or internal email account. IT staff will
not accept password reset requests from a personal cell phone.
D. EMAIL
Email Overview
Email is a critical mechanism for business communications. Email access is gained
through a request from the department head and is controlled through individual accounts
and passwords. Temporary email accounts will be granted to third party non-employees
on a case-by-case basis and will be terminated when the employee or third party
terminates their association with the City.
Improper use of electronic mail systems and services can compromise the security of the
network or result in unnecessary legal liability. As a result, the provision of email to an
employee is a privilege, not a right, and must be used with respect and in accordance
with the goals and policies of the City. The City is under no obligation to store or forward
the contents of an individual’s email inbox/outbox after their employment has ceased.
Use Expectations
Important official communications are often delivered via email. Employees are
encouraged to use email to further the goals and objectives of the City. Employees with
email accounts are expected to check and respond to email in a consistent and timely
manner.
Email users are responsible for mailbox management, including organization and
cleaning. Email users are expected to comply with standards of professional and personal
courtesy and conduct. Email accounts are only to be used by the registered user. Viewing,
copying, altering or deletion of email accounts or files belonging to the City or another
individual without authorized permission are prohibited. Opening email attachments from
unknown or unsigned sources is also prohibited.
Attachments are the primary source of computer viruses and should be treated with
utmost caution.
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E. INTERNET
Internet Overview
Access to the Internet provides employees with the opportunity to locate and use current
and historical data from multiple sources worldwide in their educational, research and
decision-making processes. Employees are encouraged to develop the skills necessary
to effectively use these tools in the performance of their jobs.
Internet access at the City is controlled through individual accounts and passwords.
Department heads are responsible for defining appropriate Internet access levels for the
persons in their department and conveying that information to the Network Manager.
Use Expectations
Employees are encouraged to use the Internet to further the goals and objectives of the
City such as acquiring or sharing job related information and participating in educational
or professional development activities. Individual Internet use may not interfere with
others’ use of the Internet. Users will not violate the network policies of any network
accessed through their account.
Website Blocking and Filtering
The City employs filtering software to limit access to sites on the Internet. Restricted sites
typically contain adult or pornographic material. To preserve Internet bandwidth, websites
that use an inordinate amount of bandwidth will be filtered. These sites typically contain
streaming video and audio but also include sites that contain large file downloads.
F. COMMUNICATIONS TECHNOLOGY & USAGE
Communications Technology & Usage Purpose
Staff relies on communication technology to support and monitor activity and progress.
Effective and efficient use of communications technology is imperative to City operations.
Communications technology is also critical to effective response to emergencies and
other needs and can save lives.
Communications Technology & Usage Policy
Some positions require staff to carry and use current communication technology to ensure
operations are carried out efficiently and effectively and that response to needs are as
immediate as practical.
This may include cell phones or other personal electronic communications and tracking
devices. It is required that staff monitor communications and respond to all requests via
these devices, as assigned during the normal course of work activity, including lunch
hours and breaks. Staff being paid to be on call will carry communications devices as
necessary and may be tracked during their on-call period.
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Communications Technology & Usage Procedures
Staff may be assigned City-provided personal electronic communication and tracking
devices and/or cell phones. These devices are required to be turned on, operational,
monitored, and responded to during the normal work hours, overtime required work,
standby and emergency callbacks. These devices may be monitored by supervisors and
managers as to the location and use including through GPS, triangulation software, or
phone records. Use and monitoring is primarily for work efficiency and emergency
management purposes. However, it may be used for disciplinary action if it is determined
that the activity violates policy, contract, or work assignment. Disciplinary action due to
violation of this policy will follow established procedures and union contract requirements.
City- provided communication equipment will not be monitored outside of paid work hours,
with the exception of devices assigned to staff being paid to be on-call.
G. PERSONAL SOCIAL MEDIA SITES
Purpose
Staff members without explicit job duties involving social media that are detailed in a job
description are expected to follow the City’s existing Technology Use and Access when
it comes to using City-owned or operated technology to access social media sites.
City staff without official social media responsibilities likely use social media as private
citizens to keep in touch with friends, family, colleagues and groups with mutual interests.
City staff generally has the right to speak publically as private citizens on “matters of
public concern.” Staff never has the right to reveal non-public or private data.
Usage
Personal social media account names should not include information that could give the
wrong impression that the account is an official City site (e.g. “John Doe, Roseville
Statistician”). This will help clarify that the individual is not speaking officially on behalf of
the City. Staff members interested in using social media officially on behalf of the City
should talk with their supervisor.
Individuals who use personal social media accounts are not immune from the law.
Employees need to be aware that use of their personal social media accounts may need
to follow existing City policies such as the Respectful Behavior Policy, the Technology
Use and Access Policy and other policies the City may have adopted.
Individuals should refrain from uploading, posting, transmitting or making available
content known to be false, misleading or fraudulent. They should not post photos that
infringe on trademark, copyright or patent rights of others.
Individuals never have the right to post non-public and confidential information such as
information related to coworkers (without their expressed consent), personnel data,
medical information, claims or lawsuits against the City.
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Individuals should not use City-owned or operated equipment to post to personal sites
content that violates existing City policies, that exhibits hate, bias, discrimination,
pornography, libelous or otherwise defamatory content.
Individuals are encouraged to post to personal sites only that content which is suitable for
readers and viewers of all ages.
H. PHONE USE
Phone Use Purpose
To regulate the use of City-owned phones and to ensure that phone usage is consistent
with the best interests of the City within reasonable, practical parameters. Telephones
are assigned to employees who must remain accessible due to the nature of their duties.
This policy will be i mplemented to prevent the abuse of phone privileges.
City Phones and Voice Mail
City phones and voice mail are provided to conduct City business. It is recognized that
some non-business calls are necessary, and these calls shall be kept to a minimum.
Excessive personal use will not be tolerated. Personal long distance calls should only be
made in emergency situations, and the employees must reimburse the City for the cost
of any long distance calls not charged to a personal account. Personal long distance calls
should be charged to a credit card, a home telephone number or placed as a collect call.
Personal calls and email should never take precedence over City business.
Cell Phone Use
City-issued cell phones are for those employees who need to contact others or who need
to be contacted by others while outside of City buildings. City-issued cell phones are to
be used by employees to conduct City business in a professional manner. Employees are
responsible for all equipment in their possession and are to contact a supervisor if service
or repair is needed.
Department heads are responsible for the cell phones assigned to their departments and
shall exercise discretion in their use. Personal calls should be made or received only
when absolutely necessary when they do not interfere with working operations and should
be completed as quickly as possible. The IRS deems any personal usage on City owned
phones as a de minimis benefit and excluded from income. When an employee
terminates employment, the supervisor is responsible for making sure the employee
returns the City issued phone. Department heads may also prohibit employees from
carrying their own personal cell phones during working hours if it interferes with the
performance of their job duties.
The City strongly encourages employees to use common sense in regards to cell phone
use. For example, do not order ring tones or additional services online, as the City will not
pay for these charges. Keep in mind cell phone transmissions are not secure and
sensitive information should be relayed using a more secure form of communication. Your
supervisor will provide direction if your phone needs service.
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I. MONITORING & CONFIDENTIALITY
The equipment, systems and services assigned by the City are the property of the City.
The City has the right to monitor any use consistent with governing law. While the City
does not actively read end-user email, email messages may be read by IT staff during
the normal course of managing the email system. Employees should have no expectation
of privacy in any message or content that you store, receive, or send using City property
or systems.
Use extreme caution when communicating confidential or sensitive information via email
or over the internet or intranet. All email messages sent outside of the City and intranet
activity become the property of the receiver. A good rule is to not communicate or receive
anything that you wouldn’t feel comfortable being publicly known. Demonstrate particular
care when using the “Reply” command during email correspondence. In addition, backup
copies of email messages may exist, despite end-user deletion, in compliance with the
City’s records retention policy. The goals of these backup and archiving procedures are
to ensure system reliability and prevent business data loss.
J. DISCLAIMER
The City assumes no liability for direct and/or indirect damages arising from the use of
the City’s desktop computer, notebook computer or related computing device, software
or services. Users are solely responsible for any material that they access and
disseminate. The City is not responsible for any third-party claim, demand or damage
arising out of use the City’s equipment, systems or services. Use your access responsibly.
Should you have any questions regarding this policy, contact the IT Department.
K. REPORTING VIOLATIONS
Allegations of misuse must be promptly reported as other complaints or violations are
reported, through the chain of command. If you receive an offensive email, report it
immediately and do not forward, delete, or reply to the message. If an employee knows
or suspects that their password may have been compromised, report to the IT Department
and change the password immediately.
Violations
Violations of this policy will be treated like other allegations of wrongdoing at the City.
Allegations of misconduct will be adjudicated according to procedures of investigation.
Discipline for inappropriate use will be progressive up to and including termination of
employment and legal action.
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SECTION FOUR: ATTENDANCE AND LEAVES
Depending upon an employee’s situation, more than one form of leave may apply during
the same period of time (e.g., the Family and Medical Leave Act is likely to apply during
a workers’ compensation absence). An employee will need to meet the requirements of
each form of leave separately. Leave requests will be evaluated on a case-by-case basis.
Except as otherwise stated, all paid time off, taken under any of the City’s leave programs,
must be taken consecutively, with no intervening unpaid leave. The City will provide
employees with time away from work as required by state or federal statutes, if there are
requirements for such time off that are not described in the personnel policies.
Section 4.01 Working Hours, Attendance and Breaks
A. WORKING HOURS AND ATTENDANCE
Each employee is vital to the operation of the City and therefore each employee must
comply with City and department rules. Employees are expected to work the normal
hours and the minimum number of hours per week as established for the position. The
City expects each employee to come to work on time and regularly. From time to time,
absences and tardiness are unavoidable. If an employee must be absent or late, he or
she is expected to notify the Supervisor, or the person designated by his or her
Supervisor, as soon as possible. Excessive tardiness or absence may result in
disciplinary action, including discharge.
Each employee shall ensure that time worked and absences are correctly reported and
the distribution of hours worked are charged to their proper accounts. Supervisors are
also responsible for proper time sheet entries.
B. MEAL AND REST BREAKS
Employees who work eight (8) hours or more are allowed a 30 minute unpaid break for
lunch/meals and two (2) 15-minute rest break(s) for each four (4) hours of work
scheduled. Travel time, if any, will be included in the break period. With supervisor
approval, employees may combine one (1) or both of their 15 minute morning and
afternoon breaks with the lunch/meal break to take a longer lunch meal break.
Break periods should be scheduled, if possible, so that no department is left unattended
during the normal hours of operation.
Section 4.02 Blood Donation
Because the City recognizes the societal benefits derived from giving blood, employees
may take up to two (2) hours paid to give blood every eight (8) weeks. This time limit may
be extended in certain circumstances (i.e., rare blood type). Employees must request
time off from their respective supervisor in advance.
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Section 4.03 Bone Marrow/Organ Donation Leave
Employees who work an average of (20) or more hours per week may take up to forty
(40) paid hours to undergo a medical procedure to donate bone marrow or an organ. The
40 hours is over and above the amount of accrued time the employee has earned.
Verification by a physician of the purpose and length of leave is required. If there is a
medical determination that the employee does not qualify as a donor, the paid leave taken
before the medical determination is not forfeited. Vacation, sick leave and holiday time
will accrue during the leave.
Section 4.04 Job Related Injury or Illness
All employees are required to report any job-related illnesses or injuries to their supervisor
immediately (no matter how minor). If a supervisor is not available and the nature of injury
or illness requires immediate treatment, the employee is to go to the nearest available
medical facility for treatment and, as soon as possible, notify his/her supervisor of the
action taken. In the case of a serious emergency, 911 should be called.
If the injury is not of an emergency nature, but requires medical attention, the employee
will report it to the supervisor and make arrangements for a medical appointment.
Workers’ compensation benefits and procedures to return to work will be applied
according to applicable state and federal laws.
Section 4.05 Emergency Leave
In cases of serious emergency, including death or serious illness in the employee’s family,
or other emergency of a serious nature, a regular employee’s Department Head may
authorize use of sick leave benefits for such absences up to a maximum of three days for
each emergency. The number of emergency leaves per employee shall be determined
on a case-by-case basis by the City Administrator. For purposes of this Emergency Leave
Policy, the term “family” is defined in the Funeral Leave policy below.
Section 4.06 Funeral Leave
A maximum of up to three (3) days off with sick pay will be allowed following the death of
a family member, defined as a spouse, domestic partner, son, daughter, father, mother,
brother, sister, grandmother, grandfather, father-in-law, mother-in-law, sister-in-law,
brother-in-law, daughter-in-law or grandchild. Regular part-time employees will be
granted three (3) days (pro-rated) funeral leave, as requested. Additional days may be
approved by the Department Head, taken as needed and charged to accrued sick leave
and/or vacation. If sick time and/or vacation time is not available, the additional days may
be taken as time off without pay. The number of additional days taken off with or without
pay will be determined on a case-by-case basis by the City Administrator.
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Time off for the funeral leave of any other relative or friend may be granted by the
Department Head, but such time off shall not be eligible for funeral leave pay and shall
be charged to the employee’s vacation leave or taken as time off without pay.
Section 4.07 Job Related Leave
A job related leave policy has been established to grant employees an extended period
of time off without pay for job related reasons. A regular full-time employee may request
a period of time off without pay for a period of not less than three (3) or more than six (6)
months. The employee must substantiate the request for such leave by relating it to the
exploration of career change, to educational advancement which would enhance present
position performance, or because of stress factors associated with the employee's
present situation. Procedures for approval and policies regarding status of benefits and
continuation of insurance stated under “Unpaid Leave of Absence” shall also apply to job-
related unpaid leaves of absence.
Section 4.08 Jury Duty
Regular full-time and part-time employees will be granted paid leaves of absence for
required jury duty. Such employees will be required to turn over any compensation they
receive for jury duty, minus mileage reimbursement, to the City in order to receive their
regular wages for the period. Time spent on jury duty will not be counted as time worked
in computing overtime.
Employees excused or released from jury duty during their regular working hours will
report to their regular work duties as soon as reasonably possible or will take accrued
vacation or compensatory time to make up the difference.
Employees are required to notify their supervisor as soon as possible after receiving
notice to report for jury duty. The employee will be responsible for ensuring that a report
of time spent on jury duty and pay form is completed by the clerk of court so the City will
be able to determine the amount of compensation due for the period involved.
Temporary and seasonal employees are generally not eligible for compensation for
absences due to jury duty, but can take a leave without pay subject to department head
approval. However, if a temporary or seasonal employee is classified as exempt, he/she
will receive compensation for the jury duty time.
Section 4.09 Court Appearances
Employees will be paid their regular wage to testify in court for City-related business. Any
compensation received for court appearances (e.g. subpoena fees) arising out of or in
connection with City employment, minus mileage reimbursement, must be turned over to
the City.
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Section 4.10 Victim or Witness Leave
An employer must allow a victim or witness, who is subpoenaed or requested by the
prosecutor to attend court for the purpose of giving testimony, or is the spouse or
immediate family member (immediate family member includes parent, spouse, child or
sibling of the employee) of such victim, reasonable time off from work to attend criminal
proceedings related to the victim’s case.
Section 4.11 School Conference Leave
Employees who work an average of 20 or more hours per week and have worked for the
City for at least a year may take up to 16 hours during any 12 month period to attend
school-related activities of the employee’s child if under the age of 20 and still attending
school provided the conference or classroom activities cannot be scheduled during non-
work hours. When the leave cannot be scheduled during non-work hours and the need
for leave is foreseeable, the employee must make a reasonable effort to schedule the
leave so as to not disrupt the operations of the City. Employees may choose to use
vacation leave time for this event but are not required to do so. If the employee’s child
receives child-care service as defined in Minnesota Statutes § 119B.01, subd. 2 or
attends a pre-kindergarten regular or special education program, the employee may use
the leave time to attend an activity or to observe or monitor the services or program. The
leave is only available if the activity cannot be scheduled during non-work hours.
Employees must provide reasonable prior notice of the leave and make an attempt not to
disrupt the operations of the City. This is an unpaid leave; however, employees may use
accrued vacation leave. Sick leave may not be used. No more than 16 hours of Parental
Leave may be taken during a 12-month period.
Section 4.12 Severe Weather Conditions
As a general policy, City offices will be open for business during regular business hours
regardless of inclement weather conditions. Based on individual circumstances, each
employee will have to evaluate the weather and road conditions in deciding to report to
work and/or leave early. If an employee decides that he or she cannot report to work or
remain at work for reasons of personal safety, accommodations will be made to ensure
the employee’s pay is not reduced as a result of this absence by allowing the employee
to use accrued vacation time or compensation time, by modifying work schedules, or by
making any other reasonable adjustments with approval from the respective Department
Head.
However, when the following extraordinary circumstances exist, the City Administrator
may determine that City Offices should be closed:
• The building is unfit or unsafe for employees to occupy (e.g. a water main
break);
• Weather conditions make travel impossible (e.g. highways are closed); or
• A natural or man-made emergency jeopardizes the health and safety of
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employees.
If it is necessary to close City offices due to extraordinary circumstances, the office closing
will be announced on WCCO-AM radio and on a pre-recorded message on the City’s
main telephone number if possible. In such circumstances where City offices are officially
closed, the City Administrator may grant paid time off to employees. Employees who are
not scheduled to be at work on a day when offices are closed for extraordinary
circumstances will not receive paid time off.
Where the terms of any collective bargaining agreement differ from this policy, the
collective bargaining agreement shall supersede the provisions of this policy with respect
to employees covered by such agreement.
Section 4.13 Sick or Injured Child Care Leave
Employees are allowed to use sick leave for reasonable absences due to the illness of
the employee’s child on the same terms as the employee’s own illness.
Section 4.14 Reasonable Unpaid Work Time for Nursing Mothers
Nursing mothers will be provided reasonable unpaid break time to express milk for
nursing her child for one year after the child’s birth. The City will provide a room (other
than a bathroom) as close as possible to the employee’s work area, that is shielded from
view and free from intrusion from coworkers and the public and includes access to an
electrical outlet, where the nursing mother can express milk in private.
Reasonable Accommodations to an Employee for Health Conditions Relating to
Pregnancy
The City will attempt to provide a female employee who requests reasonable
accommodation with the following for her health conditions related to her pregnancy or
childbirth:
• More frequent restroom, food, and water breaks;
• Seating;
• Limits on lifting over 20 pounds; and/or
• Temporary transfer to a less strenuous or hazardous position, should one
be available.
Unless such accommodations impose an undue hardship on the City, the City will engage
in an interactive process with respect to an employee’s request for a reasonable
accommodation.
Section 4.15 Voting Time
An employee selected to serve as an election judge pursuant to Minnesota law, will be
allowed time off without pay for purposes of serving as an election judge, provided that
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the employee gives the City at least 20 days written notice.
All employees eligible to vote at a State general election, at an election to fill a vacancy
in the office of United States Senator or Representative, or in a Presidential primary, will
be allowed time off with pay to vote on the election day. Employees wanting to take
advantage of such leave are required to work with their supervisors to avoid coverage
issues.
Section 4.16 Work-related Injury Leave
Worker’s Compensation injury leave generally must be taken concurrently with Family
and Medical Leave if the condition meets the Family and Medical Leave and the employee
elects Medical Leave of Absence. Employees are allowed, but not required, to apply
accrued sick, vacation, holiday and personal leave to any portion of their salary which is
not covered by workers’ compensation insurance payments.
Public Employees Retirement Act
If an employee on a Work Related Injury leave uses accrued sick, vacation, or
holiday leave, the employee’s contributions for PERA will be deducted from the
payments from the City and the City will continue to make its contributions. If the
employee is not receiving compensation from the City while on a Work-Related
Injury Leave, the employee may receive service credits for up to one year by
making the City and employee contributions.
If, as part of the Worker’s Compensation process, the employee is offered a
medically approved “light duty” position, the employee may decline the position
and instead choose to exercise the right to a Medical Leave of Absence if a portion
of the 12-week period is available. If the employee accepts the “light duty” position
in lieu of taking an available Medical Leave of Absence, the employee is entitled
to be replaced in his or her original position or an equivalent position at the time
the Medical Leave of Absence would have ended.
Section 4.17 Family and Medical Leave
The Family Medical Leave Act (FMLA) is intended to balance the demands of the
workplace with the needs of families, to promote the stability and economic security of
families, and to promote national interests in preserving family integrity. It is intended to
benefit employees as well as employers by providing up to 12 weeks of unpaid, job
protected leave for the birth of a child, adoption, foster care and certain family and medical
reasons.
A. Circumstances Covered by Family Leave
Family and Medical Leave include the following types of leave of absences:
A. MEDICAL LEAVE. Leave of absences for personal illness.
B. FAMILY CARE LEAVE. Leave of absences for the illness of a family member.
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C. PARENTAL LEAVE. Leave of absence related to the birth of a child, adoption of
a child or placement of a child with the employee for foster care. If an employee
qualifies for FMLA Leave and Parental leave, these leaves occur simultaneously.
D. MILITARY FAMILY LEAVE: Leave of absence arising out of the fact that a spouse,
son, daughter, or parent of an employee is on active duty, or has been notified of
an impending call or order to active duty, in the Armed Forces in support of a
contingency operation.
E. MILITARY CAREGIVER LEAVE: Leave of absence arising out of the fact that a
spouse, son, daughter, parent, or next of kin is ill or injured in the line of duty during
active duty, An eligible employee who is the spouse, son, daughter, parent, or
next of kin (closest blood relative) of a covered military service member who is
recovering from a serious illness or injury sustained in the line of duty while on
active duty, is entitled Military Caregiver Leave to care for the military service
member.
The fundamentals of the City's policy regarding these various types of unpaid leaves in
accordance with the FMLA are set forth below. Certain circumstances may require
special interpretation of the policy or involve application of laws other than the FMLA. As
it is impossible to anticipate every circumstance which might arise under the policy,
employees are encouraged to contact the Human Resources Department if they believe
that the policy description below is applicable in whole or in part to their specific
circumstance.
C. Eligibility
Unless otherwise required by law or indicated below, the combined total of available leave
under this policy is 12 weeks in any 12-month period measured backwards from the date
an employee initially uses the Family or Medical Leave. Parental leave however, may be
allowed up to a maximum of six (6) months at the discretion of the City Administrator.
An employee is eligible for Family and Medical Leave if they:
• Have been employed by the City of Mounds View for at least 12 months, which
need not be 12 consecutive months; and
• Have worked a minimum of 1,250 hours within the previous 12-month period.
Hours of service are defined as the number of hours actually worked and do not
include other paid or unpaid leave taken by the employee during the previous 12-
month period.
• Parental leave may be available for employees who work less than 1,250 hours
pursuant to the Minnesota Parenting Leave Act, which provides for six (6) weeks
of unpaid leave for the birth or adoption of a child.
D. Insurance Continuation
Except where otherwise provided below, the City will continue to make group health
insurance available to an eligible employee during an approved FMLA leave. This means
the City will continue to pay its portion of the applicable premiums for the employee and
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his/her dependents during the time of leave. The employee is still responsible to continue
payment of the employee’s portion of the health, life and/or dental premiums. For leaves
without compensation for 30 days or less, the City will continue to pay its normal premium
contribution or as the policy allows.
If the FMLA leave extends beyond the approved period, the employee becomes
responsible for the full amount of the group health insurance premiums with no co-
payment from the City. In the event an employee elects not to return to work upon
completion of an approved FMLA leave, the City may recover from the employee the cost
of any payments made to maintain the employee's insurance coverage, unless failure to
return to work was for reasons beyond the employee's control. If an employee is laid off
during the FMLA leave and employment is terminated, the City's responsibility to maintain
group health insurance ceases at the time of the layoff unless otherwise required by law.
D. Status of Benefits
Unpaid Leave/Combination of Unpaid and Paid
The employee will not accrue benefits such as vacation leave, sick leave or holiday pay
while on unpaid FMLA leave. Employees using a combination of paid and unpaid leave,
or intermittent unpaid leave, will accrue benefits on a pro-rated basis. Step adjustments
will be extended by the length of the unpaid leave. Employees on intermittent leave will
be evaluated on a case-by-case basis with regard to extending the length of the step
increases.
Paid Leave
Employees using paid leave will continue to accrue benefits during paid FMLA leave time.
Step adjustments will occur at the regularly scheduled time.
Paid and Unpaid Leave does not constitute a break in service for purposes of eligibility
for pension and retirement benefits.
E. Use of Vacation, Sick Leave and Holiday Pay
The City may require an employee to use accrued paid vacation leave or sick leave in
conjunction with any part of the employee’s FMLA leave. If the City does not require the
employee to use accrued vacation or sick leave in conjunction with his or her FMLA leave,
the employee may choose to do so. If accrued vacation or sick leave is exhausted before
the end of the FMLA leave, the remainder of the FMLA leave may be taken without pay.
The use of accrued vacation and/or sick leave used in conjunction with FMLA leave does
not extend the length of the FMLA leave.
F. Intermittent Leave
When medically necessary, a medical leave of absence may be taken intermittently or as
part of a reduced work schedule. In such cases, the City may require the employee to
temporarily transfer to an available alternative position which better accommodates
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recurring periods of absences or part-time schedules, provided the position has
equivalent pay and benefits.
G. Return to Work
As a general rule, an employee that is granted FMLA leave under this policy will be
reinstated to the position the employee held when the leave commenced or to an
equivalent position with equivalent pay, benefits, and other terms and conditions of
employment.
If the employee on FMLA leave is a salaried employee who is within the highest paid 10%
of City employees and keeping the job open for the employee would result in substantial
economic injury to the City, reinstatement may be denied in accordance with the FMLA.
If during the FMLA leave, the City experiences a layoff and the employee would have lost
his/her position had the employee not been on leave, the employee is not entitled to
reinstatement in the former or comparable position.
An employee returning from an FMLA leave of more than one (1) month should notify
his/her immediate Supervisor at least two (2) weeks in advance of returning to work.
Upon approval of the employee's immediate Supervisor, an employee may return to part-
time work at any time during the Leave period. An employee shall commence normal
working hours when the Leave period has ended.
H. Basis for Leave
MEDICAL LEAVE OF ABSENCE
An unpaid medical leave of absence will be provided in accordance with the FMLA
to any employee who has a serious health condition that makes the employee
unable to perform the functions of his/her job. A "serious health condition" is
defined as any illness, injury, impairment, or physical or mental health condition
that requires:
- Inpatient care in a hospital, hospice, or residential medical care facility or
- Any period of incapacity due to pregnancy or prenatal care; or
- Any period of incapacity requiring absence from work, school, or other regular
activities, or more than three (3) calendar days, that also involves continuing
treatment by, or under the supervision of, a health care provider; or
- Continuing treatment by, or under the supervision of, a health care provider for
a chronic or long-term health condition that is incurable or so serious that, if not
treated would likely result in a period of incapacity of more than three (3)
calendar days.
Medical Certification
Before granting a medical leave of absence, the City will require sufficient
certification from the employee's health care provider. The certification must
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include a statement regarding the nature of the serious health condition, the
employee's inability to perform the functions of his/her position, and such other
factors as the City deems necessary. Certification must be provided, when
possible, in advance or at the start of the leave. If the City has reason to doubt the
validity of the certification, it will require the employee to obtain a second opinion
from the health care provider approved or designated by the City. In the case of
conflicting opinions, the City may require a third opinion. The health care provider
giving the third opinion shall be jointly approved or designated by the City and the
employee. The third health care provider's opinion is final and binding. Second
and third medical opinions are at the City’s expense.
Notice
When a medical leave of absence is foreseeable based on planned medical
treatment, the employee must make a reasonable effort to schedule the treatment
so as not to disrupt City operations and must give the City at least 30 days' notice
before the leave is to begin, or, in the case where such notice is not possible, the
employee should give as much notice as practicable.
The City may require periodic reporting from the employee as to his/her status and
intention to return to work. The City may also require periodic medical
recertification on a reasonable basis. As a condition of reinstatement, the City will
require a certification from the employee's health care provider that the employee
is able to resume work.
FAMILY CARE LEAVE
The City understands the need for employees to maintain the health and security
of their families and will comply with the FMLA. The City will grant an eligible
employee an unpaid leave so the employee may care for a spouse, child, or parent
who has a serious health condition or is unable to care for his/her own hygienic or
nutritional needs or safety due to medical impairment. The term "serious health
condition" is defined above. "Child" includes a biological, adopted or foster child,
a step child, legal ward or a child for whom the employee stands in loco parentis,
who is under 18 years of age, or 18 years of age or older and incapable of self-
care because of a mental or physical disability. "Spouse" is the legally recognized
marital partner of the employee. "Parent" means the biological parent or an
individual who stands or stood in loco parentis to an employee when the employee
was a child; the term does not include in-laws.
Medical Certificate
The City will require medical certification to support a claim for leave to care for a
seriously ill child, spouse, or parent. The certification must include an estimate of
the amount of time the employee will need to provide care.
Notice
When the need for a Family Care Leave is foreseeable based on planned medical
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treatment, the employee must give the City at least 30 days' notice before the date
the Family Care Leave is to begin. When the need for Family Care Leave is
unforeseeable, the employee must provide notice as soon as practicable.
Section 4.18 Pregnancy and Parenting Leave Act
Employees who work 20 hours or more per week and have been employed more than
one year are entitled to take an unpaid leave of absence under the Pregnancy and
Parenting Leave Act of Minnesota. Female employees for prenatal care, or incapacity
due to pregnancy, childbirth, or related health conditions as well as a biological or
adoptive parent in conjunction with after the birth or adoption of a child as eligible for up
to 12 weeks of unpaid leave and must begin within 12 months of the birth or adoption of
the child. In the case where the child must remain in the hospital longer than the mother,
the leave must begin within 12 months after the child leaves the hospital. Employee
should provide reasonable notice, which is at least 30 days. If the leave must be taken in
less than three (3) days, the employee should give as much notice as practicable.
Employees are required to use accrued leave (i.e., sick leave, vacation leave, etc.) during
Parenting Leave. If the employee has any FMLA eligibility remaining at the time this leave
commences, this leave will also count as FMLA leave. The two leaves will run
concurrently. The employee is entitled to return to work in the same position and at the
same rate of pay the employee was receiving prior to commencement of the leave.
Group insurance coverage will remain available while the employee is on leave pursuant
to the Pregnancy and Parenting Leave Act, but the employee will be responsible for the
entire premium unless otherwise provided in this policy (i.e., where leave is also FMLA
qualifying). For employees on an FMLA absence as well, the employer contributions
toward insurance benefits will continue during the FMLA leave absence.
Upon written request, the City Administrator may authorize leave in excess of 12 work
weeks up to a maximum period of six (6) months.
Notice
When the need for a Parental Leave is foreseeable, such as the expected birth, adoption
or placement of a child, the employee must provide the City with at least 30 days' written
notice. If the exact date of the birth, adoption or placement is unforeseeable, the
employee must provide notice as soon as practicable.
Section 4.19 Military Leave
State and federal laws provide protections and benefits to City employees who are called
to military service, whether in the reserves or on active duty. Such employees are entitled
to a leave of absence without loss of pay, seniority status, efficiency rating, or benefits for
the time the employee is engaged in training or active service not exceeding a total of 15
days in any calendar year.
The leave of absence is only in the event the employee returns to employment with the
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City as required upon being relieved from service, or is prevented from returning by
physical or mental disability or other cause not the fault of the employee, or is required
by the proper authority to continue in military or naval service beyond the 15 day paid
leave of absence. Employees on extended unpaid military leave will receive 15 days paid
leave of absence in each calendar year, not to exceed five (5) years.
Where possible, notice is to be provided to the City at least ten (10) working days in
advance of the requested leave. If an employee has not yet used his/her 15 days of paid
leave when called to active duty, any unused paid time will be allowed for the active duty
time, prior to the unpaid leave of absence.
Employees returning from military service will be reemployed in the job that they would
have attained had they not been absent for military service and with the same seniority,
status and pay, as well as other rights and benefits determined by seniority. Unpaid
military leave will be considered hours worked for the purpose of vacation leave and sick
leave accruals.
Eligibility for continuation of insurance coverage for employees on military leave beyond
15 days will follow the same procedures as for any employee on an unpaid leave of
absence.
Employees will be granted up to ten (10) working days of unpaid leave whose immediate
family member is a member of the United States armed forces who has been injured or
killed while engaged in active service. The ten (10) days may be reduced if an employee
elects to use appropriate accrued paid leave.
Unless the leave would unduly disrupt the operations of the City, employees whose
immediate family member, as a member of the United States armed forces has been
ordered into active service in support of a war or other national emergency, will be granted
an unpaid leave of absence, not to exceed one (1) day’s duration in any calendar year,
to attend a send-off or homecoming ceremony for the mobilized service member.
General Summary: This section intended to be a general summary of the law. Each
situation will be evaluated on a case-by-case basis. When this policy and Federal law
conflict, Federal law will prevail.
Section 4.20 Military Leave Benefits
The City supports employees who are members of the National Guard or other reserve
components of the armed forces of the United States. The City follows the Uniformed
Services Employment and Reemployment Rights Act (USERRA) and will grant leaves of
absence for active military duty or training.
When called to active military duty or training for up to 15 days, the employee must notify
the City Administrator at least three (3) weeks prior to the needed leave and provide the
City with a copy of the orders prior to their departure. The City will provide the following
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during the 15 day leave (or up to 15 days per calendar year):
• Payment of salary
• Continuation of enrollment in employer offered benefit coverages with
employer contribution toward the coverage
• Seniority will remain
• Vacation and sick leave will continue to accrue
When a deployment extends beyond 15 days, the City Council will be notified of the leave
and at Council discretion may consider by resolution, addressing compensation specific
to “differential pay” (employee’s salary less their military wage). The City Council will
weigh length of employee deployment and the fiscal impact to the City of Mounds View
when considering military differential pay. The City will provide the following during a
leave beyond 15 days:
• Seniority will remain
• Vacation and sick leave will continue to accrue
• Retirement deductions will cease during leave, however upon the
employees return, purchasing retirement time back will be allowed. If time
is repurchased the City will make their matching contribution.
• Employee will have an opportunity to continue benefits through COBRA
Regardless of training or deployment duration the employee must notify the City when
their leave ends and indicate the date they anticipate returning as an active City of
Mounds View employee as outlined by the USERRA.
Section 4.21 Special Leave Without Pay
The City may grant an unpaid leave of absence to an employee upon written request and
approval. An unpaid leave of absence requires advance written approval of the City
Administrator. The unpaid leave of absence may be granted at the discretion of the City
Administrator based on consideration of the following factors:
• Municipal service needs and work flow issues;
• The employee’s performance record and length of service;
• The reason(s) for the request;
• Any other relevant information; and
• The Supervisor’s and/or Department Head’s recommendation.
If granted, the unpaid leave of absence may not exceed ninety (90) continuous calendar
days. An extension beyond that period may be requested in writing and granted at the
discretion of the City Administrator based on the above considerations. An unpaid leave
of absence shall not exceed one (1) calendar year, except as noted below.
Employees serving in the armed forces or who have been disabled while performing job
duties at the City of Mounds View may have their unpaid leave of absence extended
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beyond one (1) calendar year, at the discretion of the City Administrator, based on the
above considerations.
Status of Benefits
The employee will not accrue benefits such as vacation leave, sick leave or holiday pay
while on Unpaid Leave. Step increases and probationary periods will be extended by the
length of the unpaid leave. The newly established anniversary date will be used for all
future step increases, however the employee’s hire date will not change because of such
leave.
Insurance Continuation
During unpaid leave, the employee may continue to be covered by group health, dental
and life insurance, but will be responsible for paying one hundred percent (100%) of the
premium costs. During the first and last calendar month, the employee will be responsible
for paying the pro-rated portion of their monthly insurance premiums for the days they are
on unpaid leave.
The employee must return to work the first day following the end of the leave and must
notify their Department Head or City Administrator at least one (1) month before the date
of their intended return to work.
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SECTION FIVE: SEPARATIONS
Section 5.01 Separation of Employment
Separation of employment from the City can occur as a result of an employee’s discharge,
termination, retirement, layoff or death. The following policies identify each type of
separation of employment as well as the procedures and payments to be made to the
employee upon separation.
A. DISCHARGE
Employees who are involuntarily terminated will be paid through their termination date.
In addition, employees will receive the value of any accrued vacation and sick leave,
under the conditions of Section 5.03, Separation Procedures and Policies.
Employees will be paid for wages earned within 24 hours of their termination if requested
by the employee. The basis of a discharge shall not be predicated on the employee’s
race, sex, creed, religion, color, age, national origin, disability, marital status, sexual
orientation, political affiliation, or status with regard to public assistance. New
probationary employees may be terminated at any time for any reason that does not
violate local, state or federal law with or without notice subject to the rights of veterans.
For additional information regarding employment termination procedures, see Section
6.01, Discipline.
B. LAYOFF
The City Administrator, with approval of the City Council, may lay-off any employee
whenever such action is deemed necessary by reason of shortage of work or funds, the
elimination of a position, changes in organization, or other causes. The duties performed
by any employee laid off may be reassigned to other employees who occupy positions in
other classifications, except the duties performed by veterans covered by the Veterans
Preference Act shall not in bad faith be transferred to non-veterans.
Order of Layoff
It is recognized that reductions in force may not impact all departments or divisions to the
same extent. Therefore, it may be necessary to transfer employees from one department
or division to another. When all other factors are equal, longevity shall be the determining
criterion for layoffs of employees in their respective classifications. Reductions in grade,
i.e., demotions may be made in conjunction with layoffs. Past performance and longevity
shall be considered in the event of a reduction in grade instead of a layoff. An employee
being demoted must be qualified for the position in which the employee will be employed.
No regular employee shall be laid off or reduced in grade while another provisional
appointment or probationary appointment or an appointment to a temporary position
exists in the same classification.
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Notice of Layoff
The City Administrator shall give written notice of a layoff to a regular or probationary
employee at least 14 calendar days before the effective date of the Layoff. A copy of the
notice shall be provided to the Human Resources Department.
This policy only applies to regular part-time and full-time employees. Written notice of
layoff may be given to provisional or temporary employees at any time prior to the
effective date of layoff.
C. RESIGNATION
When an employee voluntarily resigns from employment with the City, he or she must
submit a written notice at least two (2) weeks in advance. Advance notice will assist the
City in preparing to fill the position.
Procedures
The letter of resignation is submitted to the immediate Supervisor, and should include the
following:
• An indication that the resignation is voluntary
• The reason for leaving
• The last day of actual work
• The employee’s signature
Failure to Give Notice
If an employee fails to submit a letter of resignation two (2) weeks prior to their actual last
day of work, it may result in loss of “good standing” and influence future employment
opportunities with the City.
If an employee quits, but refuses to submit a letter of resignation, the Supervisor will need
to complete a written report on the circumstances surrounding the matter.
Unauthorized Absence
Unauthorized absences from work for a period of three (3) consecutive work days may
be considered as a resignation without proper notice.
D. RET IREMENT
Retirement is defined as separation from City employment when the employee is
immediately eligible, based on age and/or service requirements, for an annuity from a
Minnesota public pension plan such as Public Employees Retirement Association
(PERA). Service can be all PERA service credits, or combined service with one (1) or
more of the other state covered funds. Employees who intend to retire are encouraged
to obtain forms and benefit information from their retirement program administrator well
in advance of their estimated retirement date.
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E. DEATH
If termination of employment is caused by death of the employee, any wages earned but
not paid and any unused vacation benefits will be paid to the estate of the deceased
employee. All such payments are subject to ordinary State and Federal payroll
deductions.
In some instances the guidelines listed above may not be practicable. The City
Administrator reserves the right to make exceptions to the above policy in unusual
circumstances.
Section 5.02 Insurance and Benefit Continuation
The City is required under federal and state laws to offer employees the continuation of
certain benefits when qualifying events have occurred, such as termination of
employment, retirement, disability or death. This policy is intended to be a general
summary of the applicable continuation laws but if this information conflicts with the
applicable state or federal law, the law will supersede and be implemented by the City.
A. HEALTH AND DENTAL INSURANCE
State and federal laws allow for the continuation of health and dental insurance benefits
for terminated or laid off employees of the City for up to 18 months at the former
employee’s expense. In the event an employee is separated from their employment with
the City based on their total disability, health and dental insurance benefits will be
available at the former employee’s expense for an additional period of time as established
by state and federal law.
Pursuant to applicable state law, retired employees will be allowed to continue on the
City’s group health insurance plan and/or dental plan at their own expense as long as
they are either (1) receiving disability benefits or retirement annuity benefits from a
Minnesota public pension plan (such as PERA) other than a volunteer firefighter plan; or
(2) have met the age and service requirements necessary to receive an annuity from a
public pension plan, but have opted not to draw upon the funds at the time they retire.
Employees who retire before age 65 must be allowed to stay in the group benefit plans
at the same rate as the active employees until age 65. Retirees 65 and older will be
offered an option to continue on some City-sponsored benefit plan, but they do not have
to be offered the same benefit plan as active employees and early retirees.
The City will provide continued health insurance coverage pursuant to applicable
Minnesota law for peace officers and firefighters disabled or killed in the line of duty and
for dependents meeting the applicable eligibility criteria.
The City will comply with all state and federal laws with regard to providing proper notice
to former employees of their right to continued health and dental insurance coverage.
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B. LIFE INSURANCE
Whenever a covered employee ceases employment with the City, insurance coverage
will be discontinued on the first day of the month following the date of termination. An
employee separated from their employment with the City may elect to continue life
insurance for a period up to 18 months at the terminating employee’s expense.
C. FLEXIBLE BENEFITS
FSA Dependent Care Expenses
Employees have until the end of the plan year (December 31st) to submit dependent care
claims to receive any funds that have been contributed to the plan for the current plan
year.
FSA Medical Expenses
The FSA Medical benefit ends on the separation date. Employees have 90 days after
their separation date to submit any claims incurred on or before the last day worked.
Section 5.03 Separation Procedures and Policies
A separated employee is someone who is leaving City employment as a result of
discharge, retirement, layoff or resignation. The following procedures will assist the
employee in a smooth transition when leaving the City of Mounds View.
A. CHECK OUT
The Supervisor/Department Head should notify Human Resources of the employee’s
separation of employment and forward the original letter of resignation to the Human
Resources Department. In the event the termination is a discharge or layoff, a copy of
the notice to the employee should be forwarded in place of the resignation letter. It is
important to notify Human Resources well in advance of the last day of employment so
arrangements may be made to prepare the final paycheck and necessary paperwork.
The last day on the job is the last day the employee works a regularly scheduled shift. If
the employee is eligible to receive vacation and/or compensatory accumulated time, that
time will also be paid effective the last day. All outstanding expense reports or monetary
advances shall also be resolved.
B. EXIT INTERVIEW
Exit interviews may be conducted by the City Administrator if deemed appropriate.
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C. RETURN OF CITY PROPERTY
Employees leaving City employment are required to return all property and equipment
issued by the City prior to his or her last day of employment. This equipment includes,
but is not limited to, building keys, gas pump and vehicle keys, identification badges, and
all such other property issued to employees during the course of their employment.
Employees may be asked to sign a form indicating they have returned all such property.
D. SEPARATION COMPENSATION
Vacation
An employee will be compensated for accrued vacation and compensatory time upon
separation.
Sick Leave Severance
Severance pay shall be granted to employees who leave in good standing, which means
the employee provides adequate notice and the decision is voluntary. The severance
pay will be in the amount of fifty percent (50%) of unused sick leave to employees who
have completed two (2) years of service. Sick leave hours will not be computed in
severance pay, except as noted in Section 2.10 or subject to Collective Bargaining
Agreements.
The spouse or family of an employee is eligible for severance benefits, if the following
conditions are met:
• Employee worked for the City for two (2) years prior to the termination
of employment; and;
• The employee died while an employee of the City.
Severance benefits will be paid at the employee’s regular rate of pay on the last date as
an employee.
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SECTION SIX: DISCIPLINE AND GRIEVANCE PROCEDURE
Section 6.01 Discipline
Supervisors are responsible for maintaining compliance with City standards of employee
conduct. The objective of this policy is to establish a standard disciplinary process for
employees of the City of Mounds View. City employees will be subject to disciplinary
action for failure to fulfill their duties and responsibilities at the level required, including
observance of work rules and standards of conduct and applicable City policies.
Discipline will be administered in a non-discriminatory manner. An employee who
believes that discipline applied was either unjust or disproportionate to the offense
committed may pursue a remedy through the grievance procedures established in the
City’s personnel policies. The supervisor and/or the City Administrator will investigate
any allegation on which disciplinary action might be based before any disciplinary action
is taken.
This policy is not to be construed as contractual terms and is intended to serve only as a
guide for employment discipline.
The City may elect to use progressive discipline, a system of escalating responses
intended to correct the negative behavior rather than to punish the employee. There may
be circumstances that warrant deviation from the suggested order or where progressive
discipline is not appropriate. Nothing in these personnel policies implies that any City
employee has a contractual right or guarantee (also known as a property right) to the job
he/she performs.
Documentation of disciplinary action taken will be placed in the employee’s personnel file
with a copy provided to the employee.
The following are descriptions of the types of disciplinary actions:
A. Oral Reprimand
This measure will be used where informal discussions with the employee’s supervisor
have not resolved the matter. All supervisors have the ability to issue oral reprimands
without prior approval.
Oral reprimands are normally given for first infractions on minor offenses to clarify
expectations and put the employee on notice that the performance or behavior needs to
change, and what the change must be. The supervisor will document the oral reprimand
including date(s) and a summary of discussion and corrective action needed.
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B. Written Reprimand
A written reprimand is more serious and may follow an oral reprimand when the problem
is not corrected, or the behavior has not consistently improved in a reasonable period of
time.
Serious infractions may require skipping either the oral or written reprimand, or both.
Written reprimands are issued by the supervisor with prior approval from the City
Administrator.
A written reprimand will: (1) state what did happen; (2) state what should have happened;
(3) identify the policy, directive or performance expectation that was not followed; (4)
provide history, if any, on the issue; (5) state goals, including timetables, and expectations
for the future; and (6) indicate consequences of recurrence.
Employees will be given a copy of the reprimand to sign acknowledging its receipt.
Employees’ signatures do not mean the employee agrees with the reprimand. Written
reprimands will be placed in the employee’s personnel file.
C. Suspension With or Without Pay
The City Administrator may suspend an employee with or without pay for up to 30 days
for disciplinary reasons. Suspension without pay may be followed with immediate
dismissal as deemed appropriate by the City Council, except in the case of veterans.
Qualified veterans, who have completed their initial probationary period, will not be
suspended without pay in conjunction with a termination.
The employee will be notified in writing of the reason for the suspension either prior to the
suspension or shortly thereafter. A copy of the letter of suspension will be placed in the
employee’s personnel file.
An employee may be suspended or placed on involuntary leave of absence pending an
investigation of an allegation involving that employee. The leave may be with or without
pay depending on a number of factors including the nature of the allegations. If the
allegation is proven false after the investigation, the relevant written documents will be
removed from the employee’s personnel file and the employee will receive any
compensation and benefits due had the suspension not taken place.
D. Demotion and/or Transfer
An employee may be demoted or transferred if attempts at resolving an issue have failed
and the City Administrator determines a demotion or transfer to be the best solution to
the problem. Employees who are demoted or transferred to a new position are required
to complete a new probationary period.
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The employee must be qualified for the position to which they are being demoted or
transferred. The City Council must approve this action.
E. Salary
An employee’s salary increase may be withheld or the salary may be decreased due to
performance deficiencies.
F. Dismissal
The City Administrator, with the concurrence of the City Council, may dismiss an
employee for substandard work performance, serious misconduct, or behavior not in
keeping with City standards.
If the disciplinary action involves the removal of a qualified veteran, who has completed
his/her initial probationary period, the appropriate hearing notice will be provided and all
rights will be afforded the veteran in accordance with Minnesota law.
Section 6.02 Grievance Procedure
Any dispute between an employee and the City relative to the application, meaning or
interpretation of these personnel policies will be settled in the following manner:
Step 1: The employee must present the grievance in writing, stating the nature of the
grievance, the date at which the incident allegedly occurred, the facts on which it is based,
the provision or provisions of the personnel policies allegedly violated and the remedy
requested, to the proper supervisor within 21 days after the alleged violation or dispute
has occurred. The supervisor will respond to the employee in writing within seven (7)
calendar days.
Step 2: If the grievance has not been settled in accordance with Step 1, it must be
presented in writing, stating the nature of the grievance, the date at which the incident
allegedly occurred, the facts on which it is based, the provision or provisions of the
Personnel Policies allegedly violated, and the remedy requested, by the employee to the
City Administrator within seven (7) days after the supervisor’s response is due. The City
Administrator or his/her designee will respond to the employee in writing within seven (7)
calendar days.
Step 3: If the grievance has not been settled in accordance with Step 2, it must be
presented in writing, stating the nature of the grievance, the date at which the incident
allegedly occurred, the facts on which it is based, the provision or provisions of the
Personnel Policies allegedly violated, and the remedy requested, by the employee to the
City Council within seven (7) days after the City Administrator’s response is due. The
City Council will respond to the employee’s grievance in writing in due course. The
decision of the Council is final for all disputes with the exception of those specific
components in a performance evaluation subject to challenge thru the Minnesota
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Department of Administration.
Waiver
If a grievance is not presented within the time limits set forth above, it will be considered
“waived.” If a grievance is not appealed to the next step in the specified time limit or any
agreed extension thereof, it will be considered settled on the basis of the City’s last
answer. If the City does not answer a grievance or an appeal within the specified time
limits, the employee may elect to treat the grievance as denied at that step and
immediately appeal the grievance to the next step. The time limit in each step may be
extended by mutual agreement of the City and the employee without prejudice to either
party.
The following actions are not grievable:
• While certain components of a performance evaluation, such as disputed facts
reported to be incomplete or inaccurate are challengeable, other performance
evaluation data, including subjective assessments, are not.
• Pay increases or lack thereof; and
• Merit pay awards.
The above list is not meant to be all inclusive or exhaustive.
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Employee Acknowledgement of Receipt of Personnel Manual
The Personnel Manual describes important information about the City of Mounds View
and I understand that I should consult the City Administrator regarding any questions not
answered in the policy. Since the information, policies, and benefits described in the
Personnel Manual are necessarily subject to change, I acknowledge that revisions to the
Manual may occur. All such changes will be communicated in writing through official
notices and I understand that revised information may supersede, modify, or eliminate
existing policies. Only the City Council of the City of Mounds View has the ability to adopt
any revisions to the policies in the Personnel Manual.
I acknowledge that I have received a copy of the Personnel Manual, and I understand
that it is my responsibility to read and comply with the policies contained in the Manual
and any revisions made to it.
Signature Date
Print Name
A-1
A-1
City of Mounds View Policy and Procedure for
Non-Federal Drug and Alcohol Testing
I. INTRODUCTION
The City of Mounds View has adopted this Policy and Procedure for Drug and
Alcohol Testing (“Policy”) for the purpose of helping to ensure that all City of
Mounds View employees are able to enjoy a safe and efficient working
environment. This Policy contains the City’s drug and alcohol policy and rules and
the City’s drug and alcohol testing policy and procedures.
THIS POLICY IS NOT AN EMPLOYMENT CONTRACT AND DOES NOT ALTER
THE AT-WILL EMPLOYMENT RELATIONSHIP. THE CITY MAY CHANGE,
ALTER, OR ELIMINATE ANY OR ALL PORTIONS OF THIS POLICY AT ANY
TIME, UNLESS PROHIBITED BY ANY APPLICABLE LAW.
The CITY will provide all affected employees with notice of any material change,
alteration or elimination of all or any part of this Policy, or as otherwise required by
applicable law.
II. DRUG AND ALCOHOL POLICY AND RULES
1. Possessing illegal drugs or drug paraphernalia at work, while on City or
customer property, while operating the City’s vehicles, machinery or
equipment, or while engaged in City business, is prohibited.
2. Consuming alcohol or using or taking illegal drugs during working hours,
including breaks, while on City or customer property, while operating the
City’s vehicles, machinery or equipment, or while engaged in City business,
is prohibited.
3. The distribution or sale of illegal drugs while at work, while on City or
customer property, while operating the City’s vehicles, machinery or
equipment, or while engaged in City business, is prohibited.
4. Being under the influence of illegal drugs or alcohol, or having illegal drugs
or their metabolites in one’s body, while at work, while on City or customer
property, while operating the City’s vehicles, machinery or equipment, or
while engaged in City business, is prohibited. The City of Mounds View has
a zero tolerance drug policy this includes the presence of illegal drugs,
prescription drugs being taken that could impact safety on the job, and an
alcohol level of 0.02 or greater which is confirmed by a blood alcohol test.
5. Making arrangements during working time, while at work, or while on City
or customer property for the sale, purchase, or transfer of illegal drugs is
strictly prohibited, even if the actual sale, purchase, or transfer of illegal
drugs occurs during non-working time or off City property.
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6. All employees must notify the City of any criminal drug statute conviction for
a drug law violation occurring at work. The notice must be given to the City
no later than five (5) days after the conviction.
7. The City reserves the right to search employee possessions, lockers,
storage areas, work stations and locations, and vehicles at any time. Any
employee whose vehicle, possessions, locker, work station or location, or
storage area is found to contain an illegal drug or drug paraphernalia will be
discharged. Unless otherwise required by law, an employee’s refusal to
cooperate with any such search may result in disciplinary action up to and
including discharge.
8. The City reserves the right to investigate and to interview employees in the
course of implementing, applying and enforcing this Policy, and to require
truthful answers to inquiries in connection with any such investigation.
Employees who refuse to cooperate in any such investigation, or who
provide false or misleading information, will be subject to disciplinary action,
up to and including discharge.
9. An employee violating these rules will be subject to immediate discipline up
to and including discharge.
10. After receipt and review of this Policy, all employees and job applicants
must sign a consent form acknowledging that they have read and
understand the Policy. Failure to do so may be grounds for termination in
the case of employees, or rejection of the application in the case of job
applicants.
III. DRUG AND ALCOHOL TESTING
1. What Will Be Screened: When drug and alcohol tests are performed, the
testing will only be for illegal drugs, alcohol, and their metabolites. This
includes prescription drugs being taken with or without a prescription that
could impact safety on the job, and an alcohol level of 0.02 or greater which
is confirmed by a blood alcohol test.
2. No other substances or medical conditions will be tested for. Alcohol tests
will be conducted only when job-related and consistent with business
necessity.
3. Consent Form: When an employee or job applicant is asked to be tested,
the employee or job applicant will receive a consent form to complete. Only
those individuals who consent to testing will be tested.
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4. Right to Refuse: All employees and job applicants have the legal right to
refuse to be tested.
a. Effect of Refusal to Submit to Testing: Employees who refuse to be
tested will be discharged or, if the testing is due to a customer
requirement, will not be assigned to that customer. Job applicants
who refuse to be tested will have their conditional job offer revoked
and will not be hired.
b. Interference with Testing: Employees and applicants are expected
to comply with the City of Mounds View’s drug and alcohol testing
policy, and to cooperate and to refrain from interfering with drug and
alcohol tests. Any employee or applicant who tampers, adulterates,
or otherwise interferes with a drug or alcohol test will be deemed to
have refused to take a test and, if an employee, will be terminated
or, if an applicant, will have his/her conditional job offer revoked. If
a sample is diluted or untestable, the City reserves the right to require
the employee or applicant to submit a second sample to be tested.
A refusal to submit a second sample will be considered a refusal to
submit to testing. In the event a second sample is also diluted or
untestable, the City will revoke a conditional job offer made to a job
applicant and the City reserves the right to discipline an employee,
up to and including termination of employment. If the testing is due
to a customer requirement, the employee will not be assigned to that
customer.
5. Employee Drug and Alcohol Testing:
a. Reasonable Suspicion Testing: The City will require an employee to
undergo drug and alcohol testing when the City has a reasonable
suspicion that the employee:
1. Is under the influence of drugs or alcohol. “Reasonable
suspicion” means a basis for forming a belief based on specific
facts and rational inferences drawn from those facts.
2. Has violated the City of Mounds View’s written work rules
prohibiting the use, possession, sale, or transfer of drugs or
alcohol while the employee is working or while the employee is
on the City’s premises or operating the City’s vehicles, machinery
or equipment.
3. Has sustained a personal injury, or has caused another employee
to sustain a personal injury, and the injury requires medical
treatment.
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4. Has caused a work-related accident or was operating or helping
to operate machinery, equipment, or vehicles involved in a work-
related accident.
b. Treatment Program Testing: When the City has referred an
employee for chemical dependency treatment or evaluation or when
the employee is participating in a chemical dependency treatment
program under an employee benefit plan, the employee may be
tested, without prior notice, during the evaluation or treatment period
and for a period of up two (2) years following the completion of any
prescribed chemical dependency treatment program.
c. Routine Physical Examination Testing: The City may require drug
and alcohol testing as part of a routine physical examination. An
employee will receive at least two (2) weeks’ written notice that a
drug and alcohol test may be requested or required as part of the
physical examination, which drug and alcohol test will occur no more
than once annually.
d. Random Testing: The City may require drug and alcohol testing on
a random selection basis for employees who are employed in safety-
sensitive positions. “Safety-sensitive positions” are jobs in which an
impairment caused by drug or alcohol usage would threaten the
health or safety or any person.
5. Job Applicant Testing: Job applicants who have received a job offer
conditioned upon the applicant submitting to and passing a drug and alcohol
test will be required to undergo drug and alcohol testing. The conditional
job offer will be revoked and the applicant will not be hired if one or more of
the following occur:
a. The applicant leaves the testing clinic before giving a suitable
specimen or the applicant refuses to take the test.
b. The applicant tests positive (fails) the test, and the result has been
verified by a confirmatory test.
c. The applicant tampers, adulterates, or otherwise interferes with a
drug and alcohol test
d. The applicant has had two (2) diluted or untestable specimens.
6. Testing as a Result of a Customer Requirement: Certain customers of the
City of Mounds View may require that City’s employees, prior to working on
an assignment for them, be subject to drug and alcohol testing in
accordance with the customer’s drug and alcohol testing policy. Before
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assigning an individual to such a customer, the City will attempt to advise
its employees or applicants who may be assigned to such customer, of any
such requirement. No employee or applicant will be tested as a result of
such a requirement unless the employee or applicant consents to work on
the customer assignment and consents to testing. Of course, if an individual
refuses to be tested, he/she will not be assigned to the customer requiring
such testing.
7. Test Results, Notification, and Individual’s Rights Following Testing:
a. Initial Screening Test
1. An initial screening test will be conducted first. If the initial
screening test is negative, the City will inform the employee or job
applicant of the negative result.
2. If the initial screening test is positive, the testing laboratory will
run a confirmatory test.
b. Confirmatory Test
1. If the confirmatory test is negative, the City will notify the
employee or job applicant of the negative result.
2. If the confirmatory test is positive, a Medical Review Officer
(“MRO”) will notify the employee or job applicant of the positive
result. The MRO is a licensed physician responsible for receiving
laboratory results generated by the City’s testing program. The
MRO has appropriate medical training to interpret and evaluate
an individual’s test result.
a. Opportunity to Explain:
The employee or job applicant will be given written notice of
the right to explain a positive test result and the right to
indicate any over-the-counter or prescription medication that
the employee or job applicant is currently taking, or has
recently taken, and any other information relevant to the
reliability of, or explanation for, a positive test result.
In addition, within three (3) working days after notice of a
positive test result on a confirmatory test, the employee or job
applicant may submit any other information to the MRO to
explain that result.
b. Right to Request a Confirmatory Retest: After receiving notice
of a positive test result on a confirmatory test, the employee
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or job applicant may request in writing a confirmatory retest of
the original sample at the employee’s or job applicant’s own
expense.
1. Within five (5) working days after notice of the confirmatory
test result, the employee or job applicant must notify the
City in writing of the employee’s or job applicant’s intention
to obtain a confirmatory retest.
2. Within three (3) working days after receipt of the notice,
the City will notify the original testing laboratory that the
employee or job applicant has requested the laboratory to
conduct a confirmatory retest or to transfer the sample to
another laboratory licensed under Minnesota law to
conduct the confirmatory retest.
3. The confirmatory retest must use the same drug and
alcohol threshold detection levels as used in the
confirmatory test.
8. Disciplinary Action:
a. Employee Rehabilitation Opportunity: If an employee receives a
positive test result on a confirmatory test, and that result is the first
such result for the employee on a drug or alcohol test requested by the
City, the employee will be given an opportunity to participate in either
a drug or alcohol counseling or rehabilitation program. The City will
consult with a certified chemical use counselor or a physician trained
in the diagnosis and treatment of chemical dependency to determine
which program is appropriate. Payment for any portion of the
treatment which is not covered by insurance is the responsibility of the
employee. If the employee accepts the City of Mounds View’s offer to
participate in the program, he or she will receive leave without pay for
the duration of the treatment program. Upon successful completion of
the program, the employee will be returned to work with the City.
Refusal to participate in the counseling or rehabilitation program, or
failure to successfully complete the program, as evidenced by
withdrawal from the program before its completion or by a positive test
result on a confirmatory test after completion of the program, will be
grounds for discharge.
b. Temporary Suspension or Transfer: A positive test result on an initial
screening test that has not yet been verified by a confirmatory test and,
if requested by the employee, a confirmatory retest, may be grounds
to temporarily suspend the tested employee or to transfer the tested
employee to another position at the same rate of pay pending the
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retest, if the City believes such action is reasonably necessary to
protect the health or safety of the employee, co-workers, or the public.
If the test result of the confirmatory test or requested retest is negative,
an employee who was suspended without pay will be reinstated with
back pay.
c. No Discipline if Confirmatory Retest is Negative: No disciplinary action
will be taken if a confirmatory retest does not confirm an original
positive test result.
d. Revocation of Job Offer to Applicant Who Tests Positive: Any job offer
made to a job applicant that was contingent on the applicant passing
a drug and alcohol test will be withdrawn if the confirmatory test result
is positive. The City will inform the job applicant of the reason for its
withdrawal of the offer.
e. Discharge: An employee who tests positive for the second time on a
drug or alcohol test requested by the City will be discharged.
f. Right to Appeal: Employees and job applicants may appeal adverse
employment decisions involving drug or alcohol testing by, within
three (3) days of receiving notice of the adverse employment
decision, delivering a written statement to the City Administrator at
the City of Mounds View, detailing the basis for the appeal. The
City’s decision on the appeal will be final and binding.
9. Questions: Questions concerning City’s Policy and Procedure for Drug and
Alcohol Testing should be directed to the Human Resources Department at
763-717-4016.
10. Confidentiality and Access to Results:
a. Any employee or job applicant may request in writing from the City a
copy of the test results report on any drug or alcohol test taken by
that employee or job applicant.
b. Employees will be given access to any information in their personnel
files relating to positive drug and/or alcohol test result reports and
other information acquired in the drug and/or alcohol testing process
and conclusions drawn from and actions taken based on the reports
or other acquired information.
c. Drug and alcohol test result reports and all other information acquired
in the testing process is private and confidential information which
will not be disclosed to another employer, third-party individual,
governmental agency or private organization without the written
8
consent of the employee or job applicant, with the following
exceptions:
1. Evidence of a positive test result on a confirmatory test may be
used in an arbitration proceeding pursuant to a collective
bargaining agreement, in an administrative hearing, or in a
judicial proceeding, where the test result is relevant to the hearing
or proceeding.
2. Evidence of a positive test result on a confirmatory test may be
disclosed to any federal agency or United States government unit
as required under federal law, regulation or order, or in
accordance with compliance requirements of a federal
government contract.
3. Evidence of a positive test result on a confirmatory test may be
disclosed to a substance abuse treatment facility for the purpose
of evaluation or treatment of the employee.
d. Positive test results from the City’s drug and alcohol testing program
will not be used as evidence in a criminal action against the
employee or job applicant tested.
e. All results of alcohol tests will be maintained in confidential medical
files, separate from employees' personnel files.
9
NON-FEDERAL
Drug & Alcohol Testing Consent Form
Current Employees – MRO
I acknowledge that I have received, read and understand the City of Mounds View’s Policy
and Procedure for Drug and Alcohol Testing (“Policy”). I understand that this Policy does
not alter the at-will nature of my employment.
I hereby agree to submit to drug and alcohol testing under the City’s Policy.
I also understand that test results and other information acquired in the drug and alcohol
testing process may be disclosed to and discussed with a Medical Review Officer
(“MRO”). I hereby consent to such test results and other information being disclosed to
and discussed with an MRO.
Employee Information:
Signature Date
Print Name
Witnessed by:
Signature Date
Print Name
A-2
City of Mounds View
U.S. Department of Transportation
Federal Motor Carrier Safety Administration
(FMCSA)
Drug-Free Workplace Policy
1502 13th Avenue West, STE 201 – PO Box 1452, Williston ND 58802
(877) 537-7588 ♦ (701) 577-0498 ♦ Fax: (701-577-0708
*City of Mounds View*
DOT Drug -Free Workplace Policy 2020 Version 1
Table of Contents
Page
Purpose and Coverage ......................................................................................................................... 2
Non-Discrimination ................................................................................................................................. 2
Criteria for Employees Subject to Testing ............................................................................................. 2
Definition of Safety-Sensitive ................................................................................................................. 3
Definitions............................................................................................................................................... 3
Tests Required ....................................................................................................................................... 5
Pre-Employment/Pre-Placement ............................................................................................... 5
Post-Accident............................................................................................................................. 6
Random ..................................................................................................................................... 8
Reasonable Suspicion ............................................................................................................... 8
Return-to-Duty ........................................................................................................................... 9
Post-Rehabilitation/Follow-Up ................................................................................................... 9
Policy Prohibitions ................................................................................................................................ 10
Consequences for Policy Violations .................................................................................................... 11
Clearing House https://www.law.cornell.edu/cfr/text/49/382.701( January 2020).......................11
Voluntary Admission of Drug/Alcohol Use ........................................................................................... 12
Summary of Alcohol Testing Procedures ............................................................................................ 13
Summary of Drug Testing Procedures ................................................................................................ 14
Education and Training ........................................................................................................................ 16
Acknowledgement ................................................................................................................................ 17
Reservation of Rights ........................................................................................................................... 17
Signs and Symptoms of a Drug -Alcohol Problem ............................................................................... 18
Effects of Alcohol and Drugs................................................................................................................ 18
Acknowledgement of Receipt of Policy................................................................................................ 21
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DOT Drug -Free Workplace Policy 2020 Version 2
PURPOSE AND COVERAGE
The U.S. Department of Transportation (DOT) and the Federal Motor Carrier Safety Administration
(FMCSA), an agency within the DOT, have issued regulations (49 CFR, Parts 40 & 382, hereinafter
referred to as “DOT regulations”) which govern the use of drugs and alcohol by employees who hold
a Commercial Driver’s License (CDL) and drive a Commercial Motor Vehicle (CMV). The DOT
requires an employer conduct drug and alcohol testing of its drivers at the times and under the
conditions described in this Policy. The regulations apply to every person who operates a CMV in
interstate, foreign, or intrastate commerce, to all employers of such persons and to all states. Please
direct all questions regarding this Policy to *Rayla Ewald*, the Company’s Designated Employer
Representative (DER).
It is the Company’s intention to comply fully with DOT regulations. In the event DOT regulations are
amended or revised, the Policy and the applicable terms, conditions, and/or requirements shall be
deemed to have been amended automatically. Redrafting will not be necessary in order to reflect and
be in compliance with DOT regulations. The Company reserves the right to apply the amended or
revised requirements immediately, without giving prior notice to drivers and/or applicants or other
employees covered by the Company Policy, unless DOT regulations or other applicable law requires
such notice.
The goal of the Company’s Policy and the testing of drivers is to ensure a drug and alcohol free
transportation and work environment, to reduce and eliminate drug and alcohol related accidents,
injuries, fatalities, and damage to Company property. For the purpose of this Policy, any employee
performing under the definitions described below will be referred to as “driver.”
NON-DISCRIMINATION
In accordance with the requirements of the Americans with Disabilities Act, the Company does not
discriminate against employees or applicants who are qualified individuals with a disability who are
not currently engaged in the use of illegal drugs and who do not otherwise violate the provisions of
this Policy, including but not limited to individuals who: 1) have successfully completed or who are
currently participating in a supervised rehabilitation program and are no longer engaging in such use;
or 2) have otherwise been rehabilitated successfully and are no longer engaging in such use.
CRITERIA FOR EMPLOYEES SUBJECT TO TESTING
Under the Company’s Policy and DOT Federal Motor Carrier Safety Administration (FMCSA)
regulations, drivers who hold a CDL and drive a CMV are subject to the drug and alcohol testing in
accordance with federal regulations. CMV means a motor vehicle or a combination of motor vehicles
used in commerce to transport passengers or property if the motor vehicle:
⇒ Has a gross combination weight rating of 11,794 or more kilograms (26,001 or more
pounds), inclusive of a towed unit with a gross vehicle weight rating of more than 4,536
kilograms (10,000 pounds); or
⇒ Has a gross vehicle weight rating of 11,794 or more kilograms (26,001 or more pounds);
or
⇒ Is designed to transport 16 or more passengers, including the driver; or
⇒ Is of any size and is used in the transportation of materials found to be hazardous for
the purposes of the Hazardous Materials Transportation Act and which require the motor
vehicle to have a placard under the Hazardous Materials Regulations.
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All applicants for positions as a driver or for a safety-sensitive position, which includes driving, will be
notified of the Company’s Drug-Free Workplace Program (DFWP) at the time they apply for the
position.
DEFINITION OF “SAFETY-SENSITIVE”
Safety-sensitive function means all time, from the time a driver begins to work, or is required to be in
readiness to work, until the time he or she is relieved from work and all responsibility for performing
work.
For the purpose of this Policy and the Company’s drug and alcohol testing program, employees are
considered to be performing a safety-sensitive function and subject to drug and/or alcohol t esting at
the following times:
⇒ All time at an employer or shipper plant, terminal, facility, or other property, or on any
public property, waiting to be dispatched, unless the driver has been relieved from duty
by the employer;
⇒ All time inspecting equipm ent as required by 49 CFR §§ 392.7 and 392.8 or otherwise
inspecting, servicing, or conditioning any commercial motor vehicle at any time;
⇒ All time spent at the driving controls of a commercial motor vehicle in operation;
⇒ All time, other than driving time, in or upon any commercial motor vehicle except time
spent resting in a sleeper berth;
⇒ All time loading or unloading a vehicle, supervising, or assisting in the loading or
unloading, attending a vehicle being loaded or unloaded, remaining in readiness to
operate the vehicle, or in giving or receiving receipts for shipments loaded or unloaded;
and
⇒ All time repairing, obtaining assistance, or remaining in attendance upon a disabled
vehicle.
DEFINITIONS
Definitions as used under this Policy are set forth below and in greater detail in 49 CFR §§ 40.3 and
382.107.
Drug:
For purposes of this Policy, “drug” means a controlled substance, as defined in Schedules I
through V of Section 202 of the Controlled Substances Act, 21 USC § 812. The term includes
prescribed drugs not legally obtained, prescribed drugs not being used for prescribed
purposes, and any prescribed drugs not taken in accordance with a prescription. In other
words, medications prescribed for someone other than the driver will be consider ed unlawfully
used under any circumstances. Pursuant to DOT regulations, all DOT-required drug tests
must test for the following substances identified in 49 CFR § 40.85 and § 40.871: marijuana
metabolites, cocaine metabolites, amphetamines, opioids (e.g., heroin, morphine, codeine,
hydrocodone and oxycodone) and phencyclidine (i.e. PCP or “angel dust”). The Company
reserves its independent authority and discretion to prohibit and test for other drugs, as defined
above, within the limits of applicable state law.
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DOT Drug -Free Workplace Policy 2020 Version 4
Confirmation Test:
Alcohol: A second test, following a screening test with a result of 0.02 or greater, which
provides quantitative data of alcohol concentration.
Drugs: A second analytical procedure to identify and quantify the presence of a
specific drug or metabolite that is independent of the screening test.
Disabling Damage:
Damage, which precludes departure of a motor vehicle from the scene of the accident in its
usual manner in daylight after simple repairs.
Included: 1. Damage to motor vehicles that could have been driven, but
would have been further damaged if so driven.
Excluded: 1. Damage, which can be remedied temporarily at the scene of
the accident without special tools or parts.
2. Tire disablement without other damage even if no spare tire is
available.
3. Headlight or taillight damage.
4. Damage to turn signals, horn, or windshield wipers, which
makes them inoperative.
Driver:
Any person who holds a CDL and operates a CMV, which falls under the specific DOT criteria.
This includes, but is not limited to, full-time or part-time, regularly employed drivers; casual,
intermittent or occasional drivers; leased drivers and independent owner -operator contractors.
Refuse to Submit:
A refusal to submit to a required drug and/or al cohol test (also "refusal to test") means that a
driver:
1. Fails to appear for any test (except a pre-employment test) within a reasonable time,
as determined by the Company, consistent with applicable DOT agency regulations,
after being directed to do so by the Company. This includes the failure of an
employee (including an owner-operator) to appear for a test when called by the
Company’s Consortium/Third-Party Administrator (C/TPA).
2. Fails to remain at the testing site until the testing process is complete.
3. Fails to provide a urine specimen for any drug test, or fails to provide an adequate
amount of saliva or breath for any alcohol test required by Part 382 or other DOT
agency regulations.
4. In the case of a directly observed or monitored collection in a drug test, fails to permit
the observation or monitoring of the driver’s provision of a specimen;
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DOT Drug -Free Workplace Policy 2020 Version 5
5. Fails to provide a sufficient amount of urine, saliva or breath when directed, and/or,
with respect to urine or breath, it has been determined through a required medical
evaluation that there was no adequate medical explanation for the failure;
6. Fails or declines to take a second test the Company or collector has directed the
driver to take (see, for instance, 49 CFR § 40.197(b));
7. Fails to undergo a medical examination or evaluation as directed by the MRO as part
of the verification process, or as directed by the DER pursuant to 49 CFR § 40.193
or 49 CFR § 40.265(c);
8. Fails to sign the certification at Step 2 of the ATF;
9. Fails to cooperate or behaves in a confrontational way that disrupts any part of the
testing process (e.g., refuse to empty pockets when so directed by the collector,
behave in a confrontational way that disrupts the collection process); or
10. Is reported by the MRO as having a verified adulterated or substituted test result.
11. The employee admits to the collector that he or she adulterated or substituted their
specimen.
Any driver who refuses to submit to a required drug and/or alcohol test or otherwise fails to
cooperate with any part of the testing process is in violation of this Policy. Any driver who
refuses such a test will be subject to the consequences described in the "Consequences for
Policy Violations" section.
TESTS REQUIRED
In general, DOT regulations require the Company conduct, and a driver submit to, drug and/or alcohol
tests at the following times and under the following conditions:
PRE-EMPLOYMENT/PRE-PLACEMENT
A drug test is required before any driver-applicant will be hired to perform a safety-sensitive function.
A drug test will also be required before any current employee in a non-regulated position will be
assigned, transferred or otherwise permitted to operate a commercial motor vehicle on behalf of the
Company for the first time. Prior to taking a pre-employment/pre-placement drug test, the applicant
will be given forms notifying the applicant to report for a drug test. All offers by the Company to hire
an applicant for, or to assign or transfer an applicant to, a driver position are conditioned upon the
applicant:
⇒ Signing the Company’s “Pre-Employment Acknowledgement Form”
⇒ Taking and providing a negative drug test as directed by the Company;
⇒ Authorizing the Company to obtain past drug and alcohol test results. The “Previous
DOT-Testing History Form ” permits the Company to obtain past drug and alcohol test
results, including any refusals to test, from each DOT-regulated employer for whom the
driver either worked, took, or refused to take, a drug and/or alcohol test during the past
two (2) years;
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DOT Drug -Free Workplace Policy 2020 Version 6
⇒ Providing the company with information regarding whether they have tested positive or
refused to test on any DOT required pre-employment drug or alcohol test in which the
applicant applied for, but did not obtain a safety-sensitive position in the preceding two
(2) years;
⇒ Passing DOT-required physical exam required for driver positions;
⇒ Complying with any other conditions or requirements of which the Company advises the
applicant at the time of the offer.
Pursuant to DOT regulations, the Company must make a “good faith effort” to obtain a driver’s previous
testing information from the driver’s prior DOT-regulated employers, and such prior employers are
required to provide the previous testing information to the Company. This information should be
obtained before the driver first performs safety-sensitive functions, unless this is not feasible, in which
case the information should be obtained as soon as possible. In any event, a driver will not be allowed
to perform a safety-sensitive function after 30 days from the date he or she first performed a safety-
sensitive function, unless the Company has obtained or made and documented a good faith effort to
obtain the previous testing information. A separate release for each prior employer must be
signed by the applicant for the prospective employer to legally receive and utilize information.
In addition, applicants must also complete that section of the form indicating whether they have tested
positive or refused to test on any pre-employment drug or alcohol test administered by an employer
to which the applicant applied for, but did not obtain, safety-sensitive transportation work covered by
DOT agency drug and alcohol rules during the past two (2) years.
Prior to the first time a current employee performs a safety-sensitive function for the Company, the
employee will undergo a drug test. The Company will not allow an employee to perform a safety-
sensitive function unless and until the Company has received a negative test result for the employee.
A verified positive drug test will disqualify an applicant/employee from a safety-sensitive position and
the conditional offer of employment in such a position will be withdrawn. Before an applicant/employee
with a verified positive pre-employment drug test may be reconsidered for a safety-sensitive position
with the Company or any other DOT-regulated employer, the applicant/employee must complete the
DOT-required Post-Violation/Return-to-Duty process as described herein.
POST-ACCIDENT
A driver who is performing a safety-sensitive f unction must submit to a post-accident drug and alcohol
test as soon as possible after any occurrence that meets the description of a “DOT Accident.” For
purposes of this Policy and the Company’s drug and alcohol testing program, a “DOT Accident” is
defined as an occurrence involving a commercial motor vehicle operating on a public road in
commerce which results in:
⇒ A loss of human life; or
⇒ The driver receiving a citation under state or local law for a moving traffic violation arising
from the accident if the accident involved:
1. Bodily injury to a person who, as a result of the injury, immediately receives
medical treatment away from the scene of the accident; and/or;
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DOT Drug -Free Workplace Policy 2020 Version 7
2. One or more motor vehicles incurring disabling damage as a result of the
accident, requiring the motor vehicle to be transported away from the scene by
a tow truck or other motor vehicle.
A driver may be directed to submit to a drug and/or alcohol test at the accident scene by a federal,
state, or local law enforcement officer. Whenever a test is conducted by a law enforcement officer,
the driver is required to immediately contact his/her supervisor or other Company official to report the
drug and/or alcohol test result and to provide the Company with the name, badge number, and
telephone number of the law enforcement officer who conducted the test.
Whenever a driver is involved in a DOT Accident and is not tested for drugs and/or alcohol by a law
enforcement official, the driver is required to immediately contact his/her supervisor or other Company
official and remain available to be tested. A driver who is subject to post-accident testing must remain
available for testing or the Company may consider the driver to have refused to submit to testing. (See
Post-Accident Flowchart to determine if testing is required).
As permitted by DOT guidance and based on the Company's independent authority, drivers involved
in a DOT Accident and required to take a Post-Accident drug and/or alcohol test will be removed from
safety-sensitive duties until the Post-Accident test results are reported to the Company. While awaiting
the Post-Accident test results, the driver will be placed on non-disciplinary suspension. Hourly (non-
exempt) employees will not be compensated for time missed from work if the test result is positive,
adulterated or substituted, but will be compensated if the test result is negative.
Alcohol:
Tests should be administered within two (2) hours of an accident. If unable to test within the two (2)
hour time period, the employer must document the reason(s) for the time delay. If the test was not
performed within eight (8) hours, cease attempts to administer the test and document the reason(s)
why the test was not conducted.
The driver must refrain from consuming alcohol for eight (8) hours after an accident and/or until the
test has been completed. A driver who is subject to post-accident testing must remain available or the
employer may consider the driver to have refused to submit to testing.
Drugs:
Tests should be administered within thirty-two (32) hours after an accident. If the test was not
performed within thirty-two (32) hours, the employer will cease attempts and prepare and maintain a
record stating the reason(s) why the test was not conducted.
In the event of a DOT Accident that involves a traffic citation, the citation must have been issued within
the foregoing prescribed time periods (8 hours for alcohol and 32 hours for drugs from the time of the
accident) to trigger a referral for a DOT post-accident test. In the event a traffic citation is not issued
within the prescribed time periods and no DOT post-accident test is performed, the Company reserves
the right, as recognized by the DOT, to require a non-DOT post-accident test based on its independent
authority and discretion, and within the limits, if any, of applicable law. Drivers may refer to the
Company’s non-DOT policy, if any, concerning non-DOT testing.
RANDOM
Every driver shall submit to random testing as directed by the Company pursuant to DOT regulations.
All such tests will be unannounced and performed at reasonable intervals throughout the year.
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DOT Drug -Free Workplace Policy 2020 Version 8
Whenever a driver is randomly selected to be tested, he/she will be notified of their selection and
instructed to immediately report to the collection site. A driver who tests positive or refuses to submit
to a test is medically unqualified to drive and/or perform any other safety-sensitive function.
Each driver selected for random testing shall be tested during the selection period. If a driver selected
for random testing is on vacation, temporary layoff, medical leave or otherwise not at work, the driver
must be referred for a random test upon his/her return to work. The Company will not skip or select
an alternate in the event a selected driver is unavai lable for testing on any particular day during the
random selection period. If a driver selected for random testing does not return to work before the
beginning of a new random selection period (i.e., the next random draw), the Company will ensure
that a sufficient number of drivers are subsequently selected so the annual testing rate is not less than
the minimum annual percentage rates established by the FMCSA for random drug and alcohol testing.
Alcohol:
The annual rate for random alcohol testing is set by the FMCSA. Drivers may be tested just before,
during, or just after performing a safety-sensitive function.
Drugs:
The annual rate for random drug testing is set by the FMCSA. Drivers may be tested at any time while
the employee is at work for the employer.
REASONABLE SUSPICION
Each driver is required to submit to a drug and/or alcohol test whenever the Company has reasonable
suspicion (also referred to as “reasonable cause”) to believe that a driver has used drugs/alcohol in
violation of DOT regulations. Reasonable suspicion will exist when a driver’s appearance, behavior,
speech, and/or body odors indicate drug/alcohol use, or the chronic and withdrawal effects of
drugs/alcohol. Whenever a driver is notified that there is reasonable suspicion to be tested, the driver
is expected to report to the test/collection site immediately and will be escorted. Documentation of the
employee’s conduct and/or appearance leading to a reasonable suspicion drug/alcohol test must be
prepared and signed by the supervisor or Company official who made the observations within twenty-
four (24) hours of the observed behavior, or before the results of the drug/alcohol test are released,
whichever is earlier.
As permitted by DOT guidance and based on the Company's independent authority, following a
reasonable suspicion determination that leads to a Reasonable Suspicion drug and/or alcohol test, a
driver will be removed from safety-sensitive duties until the Reasonable Suspicion test results are
reported to the Company. While awaiting the Reasonable Suspicion test results, the driver will be
placed on non-disciplinary suspension. Hourly (non-exempt) employees will not be compensated for
time missed from work if the test result is positive, adulterated or substituted, but will be compensated
if the test result is negative.
Alcohol:
Observations must be made just before, during, or just after the driver performs a safety-sensitive
function. The person who makes the reasonable suspicion determination cannot conduct the alcohol
test.
Alcohol tests should be administered within two (2) hours of observation. If unable to test within the
two (2) hour period, the employer must document the reasons for the time delay. If the test is not
performed within eight (8) hours, cease attempts to administer the test and document the reason(s)
why the test was not conducted.
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If reasonable suspicion is observed and a test has not yet been performed, a driver will not perform a
safety-sensitive function until:
⇒ An alcohol test has been performed and the result is less than 0.02; or
⇒ Twenty-four (24) hours have passed following the reasonable suspicion determination.
Drugs:
Drug testing should be administered as soon as possible after making a reasonable suspicion
determination. If unable to drug test within thirty-two (32) hours, the employer must cease attempts
and document the reason(s) why the test was not conducted.
RETURN-TO-DUTY
A driver who has been removed from his/her safety-sensitive function due to a DOT drug or alcohol
regulation violation (e.g., a positive test, refusal to test, etc.) must provide a negative drug and/or
alcohol test before being allowed to return to a safety-sensitive function. This test is required to be
observed and must be completed after an initial and follow-up evaluation by a Substance Abuse
Professional (SAP), after the SAP’s determination that the driver has successfully complied with
prescribed education and/or treatment, and before resuming performance of a safety-sensitive
function. The result of the alcohol test must be less than 0.02.
The return-to-duty drug test is not limited to a specific substance (i.e. the particular drug for which the
driver tested positive). Additionally, if the SAP determines that a multiple-substance abuse problem
exists, a drug test may be performed in conjunction with an alcohol test.
POST–REHABILITATION/FOLLOW-UP
A driver who has violated a DOT drug and/or alcohol regulation (e.g., a positive test, refusal to test,
etc.) must be evaluated by a SAP and follow the prescribed rehabilitation/treatment program.
Following the determination that an employee needs to resolve problems associated with drug abuse
and/or alcohol misuse, each employer will ensure that the employee is subject to unannounced ,
observed, follow-up drug and/or alcohol testing as determined by the SAP. At a minimum, such testing
must consist of at least six unannounced follow -up tests in the first 12-months following the driver’s
return to safety-sensitive functions. The choice of the SAP and the assignment of costs shall be made
in accordance with employer/driver agreements and employer policies. Follow-up alcohol testing must
only be conducted just before, during, or just after a driver performs a safety-sensitive function. DOT
regulations require all Follow-up tests be observed collections.
POLICY PROHIBITIONS
Employee involvement with drugs and/or alcohol can adversely affect the work environment, job
performance, and safety of all employees. Viol ation of the prohibitions of this Policy will be considered
to be serious misconduct and may result in termination.
Drug Prohibitions:
The regulations prohibit any drug use that could affect performance of a safety-sensitive function.
Listed below are the prohibitions with respect to drug use.
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⇒ No driver shall report for duty or remain on duty requiring the performance of safety-
sensitive functions when the driver uses any drugs, except when the use is pursuant to
the instructions of a licensed medical practitioner who has advised the driver that the
drug will not adversely affect the driver’s ability to safely operate a CMV.
⇒ No employer having actual knowledge that a driver has used a controlled substance
shall permit the driver to perform or continue to perform a safety-sensitive function.
⇒ An employer may require a driver to inform the employer of any therapeutic drug use.
⇒ No driver shall report for duty, remain on duty or perform a safety-sensitive function if
the driver tests positive for controlled substances. No employer having actual
knowledge that a driver has tested positive for controlled substances shall permit the
driver to perform or continue to perform safety-sensitive functions.
⇒ No driver shall refuse to submit to a drug test required pur suant to DOT regulations.
Alcohol Prohibitions:
The regulations prohibit any alcohol use that could affect performance of a safety-sensitive function.
Listed below are the prohibitions with respect to alcohol use.
⇒ No driver shall report for duty or remain on duty requiring the performance of safety-
sensitive functions while having an alcohol concentration of 0.02 or greater. No
employer having actual knowledge that a driver has an alcohol concentration of 0.02 or
greater shall permit the driver to perform or continue to perform safety-sensitive
functions.
⇒ No driver shall use alcohol while performing safety-sensitive functions or perform such
functions within four (4) hours after using alcohol. No employer hav ing actual knowledge
that a driver has used alcohol while performing safety-sensitive functions, or used
alcohol within four (4) hours immediately preceding the performance of such functions,
shall permit a driver to perform or continue to perform safety-sensitive functions.
⇒ No driver required to take a post-accident alcohol test shall use alcohol for eight (8)
hours following the accident, or until he/she undergoes a post-accident alcohol test,
whichever occurs first.
⇒ No driver shall refuse to submit to an alcohol test required pursuant to DOT regulations.
NOTE: A regulated employee found to have an alcohol concentration of 0.02 or greater but less than
0.04 shall not perform, nor be permitted to perform, safety-sensitive functions for at least twenty-four
(24) hours.
CONSEQUENCES FOR POLICY VIOLATIONS
Removal from Safety-Sensitive Function:
Employees and applicants shall not perform, nor be permitted to perform, a safety-sensitive function,
including driving a commercial motor vehicle as previously defined in this Policy, if any of the above
prohibitions, or the drug and/or alcohol rule of another DOT agency, are violated. Employees and
applicants who violate a DOT drug and alcohol regulation will be advised by the Company of the
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resources available in evaluating and resolving drug and/or alcohol problems, including the names,
addresses, and telephone numbers of Substance Abuse Professionals (SAPs) and counseling and
treatment programs.
Additionally, employees subject to Post-Accident or Reasonable Suspicion testing will be removed
from safety-sensitive functions and receive a non-disciplinary suspension until the Company receives
the test results. Hourly (non-exempt) employees will not be compensated for time missed from work
if the test is positive, adulterated or substituted, but will be compensated if the test is negative.
Post-Violation/Return-to-Duty Procedures:
An employee who has violated a DOT drug and/or alcohol regulation cannot again perform any DOT
safety-sensitive duties for the Company or any DOT-regulated employer until and unless the employee
has completed the SAP evaluation, referral and education/treatment process. For purposes of this
Policy, a DOT drug and/or alcohol regulation violation includes a verified positive DOT drug test, a
DOT alcohol test with a result indicating an alcohol concentration of .04 or greater, a refusal to test
(including by adulterating or substituting a urine specimen) or any other violation of the prohibition on
the use of alcohol or drugs under a DOT agency regulation.
Before a driver who has violated a DOT drug and/or alcohol regulation can return to a safety-sensitive
position, he or she must:
⇒ Meet with a Substance Abuse Professional (SAP) for an initial evaluation;
⇒ Properly follow all SAP evaluation recommendations for assistance and referrals, to an
education and/or treatment program;
⇒ Meet with the SAP for a follow-up evaluation to determine whether the individual has
successfully complied with the SAP’s education and/or treatment recommendations;
⇒ Take and provide a negative return-to-duty drug and/or alcohol test; and
⇒ Be subject to post-rehabilitation/follow-up testing as determined by the SAP for up to
sixty (60) months, to include a minimum of six (6) follow-up tests in the first twelve (12)
months after the return-to-duty test with an alcohol concentration of less than 0.02 and
a negative drug test. The SAP may terminate the requirement for the follow -up testing
at any time after the first six (6) tests have been administered, if the SAP determines
that such testing is no longer necessary.
Employee Discipline:
Employees who engage in any of the prohibited conduct listed above are in violation of this Policy and
are subject to discipline, up to and including termination, at the Company’s sole discretion pursuant to
the Company’s authority independent of federal requirements.
Any employee who refuses to submit to testing or attempts to adulterate or substitute a specimen will
be terminated.
In no case will the Company continue to employ an individual who has had two occurrences.
⇒ An “occurrence” is defined as a verified positive drug test result or a confirmed alcohol
level of 0.04 or greater.
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DOT Drug -Free Workplace Policy 2020 Version 12
A driver found to have an alcohol concentration of 0.02 or greater, but less than 0.04, shall not perform
nor be permitted to work for at least twenty-four (24) hours.
VOLUNTARY ADMISSION OF DRUG/ALCOHOL USE
The Company encourages all employees who need assistance in dealing with alcohol abuse or drug
dependency problems to seek appropriate counseling and/or treatment through various private and
public organizations that are available. Accordingly, employees who voluntarily come forward and
admit to alcohol misuse or drug use will not be subject to disciplinary action or the Post-
Violation/Return-to-Duty Procedures described above (i.e. the SAP evaluation, referral and treatment
requirements set forth in Parts 40 and 382). Rather, employees who self-identify their need for
assistance will be allowed sufficient opportunity to seek evaluation, education or treatment to establish
control over their drug or alcohol problem.
Employees must make any such admission or self -identification of a drug and/or alcohol problem prior
to performing a safety-sensitive function (i.e. prior to reporting for duty). Employees may not self -
identify a drug or alcohol problem to avoid testing required under DOT regulations. Employees also
may not escape discipline or the Post-Violation/Return-to-Duty Procedures by self -identifying a drug
or alcohol problem after being referred for testing or after a DOT drug and alcohol regulation violation
has occurred. Costs associated with any counseling or treatment program may be covered by the
employee’s medical insurance plan (if any); however, any costs not covered by the employee’s
medical insurance plan and which are not otherwise required to be paid by any applicable plan are
entirely the employee’s sole responsibility. The Company will comply with any applicable medical
leave law, disability discrimination law or applicable leave law in the event a leave is requested.
Employees who admit to a drug or alcohol problem will be referred to a drug and alcohol abuse
evaluation expert (i.e. employee assistance professional, SAP, or qualified drug and alcohol
counselor) for evaluation and recommendations for an appropriate education or treatment program.
Such employees will not be permitted to return to a safety-sensitive function until the Company is
satisfied that the employee has been evaluated by a drug and alcohol abuse evaluation expert and
successfully completed the expert’s recommendations for an educational or treatment program.
Before the employee’s return to a safety-sensitive function, the employee must also undergo a return-
to-duty test with a result indicating an alcohol concentration of less than .02 and/or a verified negative
drug test result. Except as otherwise required by applicable law or policy, the Company cannot
guarantee that the employee will return to the same or a comparable position upon return to duty. The
Company reserves the right, as recognized by the DOT, to require employee monitoring and/or non-
DOT follow -up testing based on its independent authority and discretion, and within the limits, if any,
of applicable law. All returning employees are required to comply with the Company’s normal
standards with respect to work performance and conduct.
SUMMARY OF ALCOHOL TESTING PROCEDURES
The DOT regulations discuss alcohol-testing procedures in greater detail in 49 CFR, Part 40.
1. Alcohol testing is done at locations determined by the Company in a private setting. The
testing technician, who has been trained, will ask test subjects to verify their identity. Drivers
must cooperate with that request. Drivers may ask the technician for identification also. The
driver’s identity will be recorded on a DOT alcohol testing form.
2. A breath or saliva testing device approved by the federal government will be used for all alcohol
tests. A screening test will be done first. If a breath-testing device is used, drivers will be
instructed to exhale forcefully into the mouthpiece of the screening device. If a saliva-testing
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device is used, a swab will be placed in the driver’s mouth and saturated with saliva. After the
saliva is collected, the swab will be inserted into the saliva-testing device.
3. The technician will show the result displayed on the screening device to the driver. If the
reading is less than 0.02, the driver has passed the alcohol test and the DOT alcohol testing
form will be completed.
4. If the screen test result is more than 0.02, a confirmation breath test, using a federally approved
evidential breath-testing device, will be performed after at least a 15-minute waiting period
from the completion of the screening test. During that time, for their own protection, drivers
should not eat or drink anything.
5. For the confirmation test, the driver will have to exhale into the evidential breath-testing device
until the technician tells the driver to stop. The driver will be shown the printed and displayed
results.
6. A confirmation test result under 0.02 means the driver has passed. A confirmation alcohol
concentration level of 0.02 or higher will result in the driver’s removal from safety-sensitive
functions. The DOT prohibits any driver whose confirmation test registers 0.02 or greater but
less than 0.04 from performing or from continuing to perform a safety-sensitive function until
the driver’s next regularly-scheduled duty period, but for no less than twenty-four (24) hours.
If the confirmation level is 0.04 or more, or if the driver refuses to cooperate, the driver is in
violation of DOT alcohol regulations and subject to the Consequences for Policy Violations
and Post-Violation/Return-to-Duty Procedures described above.
7. If a driver tries, but fails to provide a breath specimen adequate for testing, the driver will be
asked to try again. If the driver still does not provide an adequate specimen, the driver’s failure
will be noted on the DOT alcohol testing form and the Company’s DER will be informed. The
driver will be removed from performing “safety-sensitive” functions for a 24 hour time period
and required to see a doctor, acceptable to the Company, within five days for an evaluation.
If the doctor provides a written statement to the employer concluding that it is highly probable
a medical condition prevented the driver from providing an adequate breath specimen, the
driver will not be disciplined for refusing to cooperate.
SUMMARY OF DRUG TESTING PROCEDURES
The DOT regulations discuss drug -testing procedures in greater detail in 49 CFR, Part 40.
1. Drivers subject to drug testing will be directed to provide a urine specimen at a Company
designated facility. The driver will be driven or sent to the facility and required to verify his or
her identity. In return, a driver may ask collection site personnel to disclose their identity.
2. The driver’s urine specimen will be collected by a trained collection site person (the Collector)
in accordance with DOT rules, using a DOT Custody and Control Form (CCF), also known as
chain-of -custody form. To protect themselves, drivers should ensure that the entries on the
form are accurate, that their collected urine specimens have been sealed, and that their
specimens are labeled with the same number as appears on the CCF and are placed in a
container with copies of the correct CCF.
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3. The Collector shall require drivers to remove unnecessary outer garments that might conceal
items used to tamper with the collection process. The Collector shall also retain personal
belongings like briefcases and purses during the collection process. Drivers may keep their
wallets and ask for a receipt for any belongings they surrender. The Collector will direct the
driver to empty his or her pockets and display the items in them and the driver must allow the
Collector to make this observation.
4. Drivers will be given a collection container and allowed to provide a urine specimen in private
unless: the laboratory reports a specimen was invalid and the MRO reports there was no
adequate medical explanation for the result; the original positive, adulterated, or substituted
test result had to be cancelled because the test of the split specimen could not be performed;
the laboratory reports a specimen as having a low creatinine concentration (i.e., a creatinine
concentration greater than or equal to 2 mg/dL and less than or equal to 5 mg/dL) and the
MRO reports the specimen as negative and dilute; the Company directs a return-to-duty test
or follow-up test be performed under direct observation; the Collector observes materials
brought to the collection site or the driver’s conduct clearly indicates an attempt to tamper with
a specimen; the temperature on the original specimen was out-of-range; or the original
specimen appeared to have been tampered with. In such circumstances, the DER will be
notified and drivers will be requir ed to provide a specimen while being observed.
5. If the driver does not provide a sufficient amount of urine for testing (at least 45 ml), the
Collector will discard the specimen, tell the driver to drink additional fluids, wait up to three (3)
hours and try again to provide a specimen. If the driver refuses to drink those fluids or provide
another specimen, the Collector shall notify the Company’s DER of the driver’s refusal to
cooperate. If the driver cooperates, but still does not provide an adequate specimen, testing
will stop and the driver will be sent to a doctor acceptable to the Company’s MRO within five
working days for an evaluation. If that doctor states in writing to the Company’s MRO that it is
highly probable that a medical condition prevented the driver from providing an adequate
specimen, the driver will not be disciplined on grounds of refusing to provide a specimen.
6. If the driver provides a sufficient amount of urine for testing, it will be inspected by the Collector
and its temperature will be measured. If there is a reason to believe an altered or substituted
specimen has been provided, the DER will be notified and a second, observed specimen will
be collected. Collected specimens will be poured into two containers (i.e. a split-specimen
collection). The collector will seal the bottles by placing the tamper -evident bottle seals over
the bottle caps/lids. The collector will date the seals and instruct the donor to initial the tamper-
evident bottle seals for the purpose of certifying the bottles contain the specimens he or she
provided.
7. Both specimen containers will be sent to a federally certified laboratory designated by the
Company. The lab will review the CCF and check the specimens for apparent tampering. Any
apparent tampering or CCF problems will be reported to the DER.
8. If the specimens appear to be in order, the lab will run an initial screening test on the primary
specimen. If the screening test is negative, the lab will report the result as negative and the
driver has passed the drug test. If the screening test is positive, the lab will conduct a
confirmation test and analyze the specimen using Gas Chromatography/Mass Spectrometry
(GC/MS). The laboratory will send the test results to the Company’s Medical Review Officer
(MRO).
9. The MRO is a trained doctor the Company has retained to review test results and to evaluate
any explanation a driver may have for a positive, adulterated, substituted (because of a
creatinine concentration of less than 2 mg/dL), or invalid drug test result. The MRO will
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DOT Drug -Free Workplace Policy 2020 Version 15
telephone drivers at the numbers given on the CCF. If a driver believes a mistake was made
at the collection site or lab, or on a CCF, or that the drug test result is caused by lawful
substance use, the driver should tell the MRO. Drivers should cooperate with the MRO. If a
driver does not cooperate, the Company will be notified and the driver may be removed from
duty and disciplined or discharged pursuant to the Company’s independent authority (or not
hired, if the driver is an applicant).
10. If a driver wants his or her split specimen to be tested by another certified lab at the driver’s
expense, the driver should tell the MRO within 72 hours of notice of a positive, adulterated or
substituted drug test result. The driver will not have the opportunity to provide another
specimen. The retest will be conducted on the secondary container of the original specimen.
The driver’s secondary specimen will then be sent to a different Company-approved, certified
laboratory for re-analysis. If that second lab does not find any evidence of the drug(s) that the
first lab found or the split specimen cannot be tested, the MRO will cancel the test results and
the driver will not be subject to discipline. If the second laboratory finds evidence of the drugs,
adulteration or substitution that the first laboratory found, the MRO will tell the DER the split
specimen was positive, adulterated or substituted. As provided in 49 CFR § 40.187(a)(3), in
the case of a reconfirmed substituted result in which the creatinine concentration for the
primary specimen was less than 2 mg/dL and the creatinine concentration of the split specimen
is between 2 and 5 mg/dL (inclusive), the MRO will report the result as "dilute" and the driver
will be required to undergo an immediate recollection under direct observation.
11. If the MRO informs the Company that a negative drug test was dilute, the following will apply.
• Dilute Negative with Low Creatinine: If the MRO indicates that a recollection under direct
observation is required because the creatinine concentration of the specimen was equal
to or greater than 2 mg/dL but less than or equal to 5 mg/dL, the Company must
immediately instruct the driver to undergo a recollection under direct observation. The
DOT's stated purpose for this requirement is so that people who may naturally produce
low creatinine levels will not be reported to employers as having substituted their
specimens.
The DOT prohibits any driver who has a verified positive, adulterated or substituted drug test result,
from performing or from continuing to perform a safety-sensitive function until he/she has met the
proper DOT requirements as described in the “Post-Violation/Return-to-Duty Procedures” section
above under Consequences for Policy Violations.
Medications prescribed for someone other than the driver, will be considered unlawfully
used under any circumstance. The DOT also indicates that a driver’s purported use of
marijuana for medical purposes (even if pursuant to state “medical marijuana” law) or
use of hemp or marijuana-related products does not constitute a legitimate medical
explanation for a positive test result and these are insufficient grounds for the MRO to
verify the test result as negative.
EDUCATION AND TRAINING
The Company has available information, education and training regarding problems associated with
drug and alcohol abuse in the workplace and otherwise. One important source of information is the
“Employee Handbook.” We also provide training for supervisors and managers thr ough, among other
things, the “Supervisor Training Manual.”
The Company's educational and training materials include information on available methods of
intervening when an alcohol or controlled substances problem is suspected, including confrontation,
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DOT Drug -Free Workplace Policy 2020 Version 16
referral to any employee assistance program and/or referral to management. If there are concerns
regarding a suspected substance abuse problem, the Company encourages employees to contact the
DER or other Company designee to obtain referrals to any employee assistance program and/or
appropriate counseling or treatment programs through various private or public organizations. Contact
the Company's Designated Em ployer Representative, Rayla Ewald at 763-717-4016, for more
information.
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DOT Drug -Free Workplace Policy 2020 Version 17
ACKNOWLEDGEMENT
Driver s must sign an acknowledgement form (a copy of which is attached hereto and made a part
hereof) after receiving a copy of this Policy and prior to testing.
RESERVATION OF RIGHTS
This Policy supersedes and revokes any other Company practice or policy relating to the use of drugs
and alcohol in the workplace and drug and/or alcohol testing. The Company reserves the right to
interpret and administer this Policy, and at any time and at its sole discretion, amend or change this
Policy, in whole or in part, with or without notice. This Policy automatically incorporates any changes
to DOT or FMCSA regulations (49 CFR, Parts 40 and 382) or related regulations or statutes that
govern the use of drugs and alcohol by employees who hold a CDL and drive a CMV. This Policy is
not an express or implied contract of employment nor is it to be interpreted as such. Additionally, this
Policy does not in any way affect or change the status of any at-will employee. Nothing in this Policy
is a promise or guarantee or should be construed as a promise or guarantee that the Company will
follow in any particular circumstances any particular course of action, disciplinary, rehabilitative or
otherwise.
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DOT Drug -Free Workplace Policy 2020 Version 18
Attachment to FMCSA Drug-Free Workplace Policy
SIGNS AND SYMPTOMS OF A DRUG-ALCOHOL PROBLEM
Drugs and alcohol can result in such work-related problems as absenteeism and tardiness, lower
productivity, missed deadlines, poor work quality, unsafe driving, and increased injuries and accidents.
Problems relating to or communicating with supervisors, co-workers or customers, following directions,
concentrating or remembering things may also indicate a drug or alcohol problem.
Drugs and alcohol slow reaction times, cause confusion, harm coordination and motor skills and can
impair decision-making and memory. People misusing alcohol and using illegal drugs may be
withdrawn, lethargic, depressed, erratic, “hyper” or unusually anxious, hostile or paranoid.
Drugs and alcohol misuse can also result in health problems like chronic gastritis, headaches, chronic
respiratory infections and liver problems. They may also show up as poor hygiene, a sloppy
appearance, financial problems, DUIs or family problems.
Evidence of use can include paraphernalia such as pipes, syringes, foil packets, pills, powders and
empty alcohol containers. Physical symptoms of use can include:
⇒ Marijuana and alcohol odors
⇒ Puffy or droopy eyelids, bloodshot eyes, dilated or pinpoint pupils
⇒ Nosebleeds, excessive sniffling, chronic sinus problems, nasal sores
⇒ Needle tracks or blood spots on clothing
⇒ Tremors, racing or irregular heartbeats
⇒ Slurred or incoherent speech
⇒ Confusion, anxiety, paranoia
⇒ Coordination problems
⇒ Lethargy and sleepiness
EFFECTS OF ALCOHOL AND DRUGS
Drugs and alcohol can harm health and the workplace in a variety of ways.
Alcohol
Alcohol is a central nervous system depressant that acts like a poison if used in large quantities. Each
year the lives of tens of thousands of Americans are shortened or ended by alcohol misuse.
Alcohol quickly reaches the brain after drinking. It impairs self -control and other learned behaviors.
This loss of self-control can lead to aggressive driving (or overly cautious driving), as well as the other
kinds of aggressive behaviors associated with drinking. Even small doses of alcohol, i.e. a single
drink, can harm driving performance. In large doses, alcohol significantly impairs coordination,
memory and judgment.
Over time, alcohol misuse damages the liver, the heart, the digestive system and can cause
permanent brain damage. On average, alcoholics shorten their life span by about 10 years.
Alcohol misuse harms the ability to think clearly, harms judgment and can affect the ability to get along
with and work constructively with co-workers and customers. Alcoholics often have attendance and
work performance problems and get fired because of the consequences of alcohol misuse. Because
of its adverse effects on coordination, reflex time, vision, driving ability, judgment and the ability to
evaluate and quickly process information, alcohol is especially dangerous for drivers of commercial
motor vehicles.
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A small glass of wine, a can of beer and a one and one-half ounce shot of liquor all contain about the
same amount of alcohol. It takes the body about one hour to metabolize and eliminate each “drink” of
alcohol. Coffee, exercise and cold showers do not speed up this process or magically produce
sobriety. While individuals differ greatly, each drink on an empty stomach by an average-sized adult
male may lead to an alcohol concentration of about .02. Thus, drinking more than two drinks raises a
serious risk of having an alcohol concentration in excess of DOT rules, especially for people with low
body weights. Any drinking while on duty or during the 4 hour s before working violates DOT rules.
Cocaine
Cocaine is a powerful stimulant that can be inhaled up the nose, injected or smoked. It greatly
increases heart rate and blood pressure. Partly because of its effects on the circulatory system,
cocaine use ca n lead to seizures. Every time cocaine is used, there is some unquantifiable risk of a
fatal stroke or heart attack. Cocaine can also cause tremors, convulsions, vomiting and raises body
temperature to dangerous levels. Repeated snorting damages nasal tissues, sometimes permanently.
Needle use carries risks of infection and overdose.
Initially, cocaine use brings a rush of euphoria and exaggerated overconfidence. Sometimes these
effects are so strong that safe driving is impossible. Cocaine wears off in about an hour after it is
snorted and in just a few minutes after it is smoked. When it wears off, the user may become
depressed, anxious, paranoid and exhausted.
Cocaine users may exhibit rapid mood swings and changes in activity level. They may gr ind their
teeth, repeatedly wash their hands or engage in other compulsive behaviors.
Amphetamines
Amphetamines, also known as “speed,” are powerful stimulants that are often abused by truck drivers
because they make it easy to stay awake. Amphetamines, however, are dangerous drugs with a high
potential for abuse. Amphetamines may also be known as uppers, black beauties, white crosses or
dexies.
Use brings feelings of alertness and a loss in appetite. The user may also become very talkative or
physically active or feel very strong after ingesting amphetamines. In a few hours however, the
amphetamines wear off and restlessness, anxiety, paranoia and headaches set in.
In large doses, amphetamines can produce serious toxic effects. The user’s blood pressure can rise
to the point where strokes or heart attacks occur. Long -term users often have acne, tooth problems
and may exhibit symptoms of permanent brain damage.
Marijuana
Marijuana is a hallucinogen that alters the user’s sense of time and reduces the user’s ability to perform
tasks requiring coordination, swift reactions and concentration. Taken in large quantities, marijuana
can act like a depressant.
While some people may regard marijuana as harmless, there is evidence its use is unhealthy and
dangerous for the driver. Marijuana causes significant increases in blood pressure and pulse rate
and, thus, can aggravate or cause heart disease. Marijuana smoke also contains a number of known
carcinogens. Many experts believe that marijuana is actually unhealthier to smoke than tobacco.
Studies have shown that smoking marijuana affects the ability to perform tasks like driving, which
require both thinking and motor skills, for at least 24 hours. Users, however, often believe that all the
impairing effects of smoking have worn off after 4 to 6 hours. Marijuana significantly impairs short-
term memory and can harm the user’s ability to concentrate or plan for and achieve long -term goals.
There is also significant evidence that marijuana harms the reproductive systems of men and women
and is dangerous for children and non-smokers who live with the user.
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Opiates
Opiates are a class of narcotics and sedatives derived from the opium poppy plant. Heroin is the
strongest opiate. Heroin use has been increasing in recent years because of the availability of cheap,
strong heroin from Asia. This new stronger heroin can be smoked or snorted. Heroin can also be
injected using needles.
Morphine and codeine are opiates that are often used to relieve pain or induce sleep. However, they
can be stolen from hospitals or pharmacies and abused.
Opiate misuse causes a number of health problems. Because of variations in dosages and strength,
heroin use carries a risk of overdose and death. Addicts who use needles also risk contracting AIDS
or hepatitis. Heroin is often contaminated with other drugs or toxins or combined with other narcotics.
Opiate use slows down and depresses a number of body functions, including brain functioning. Heroin
users may act sleepy or euphoric for a while and then become anxious or irritated after the heroin
wears off. Heroin users tend to have a number of related health problems and tend to also abuse
alcohol and tobacco. Together, these drugs and the unhealthy lifestyles of heroin users result in
decreased life expectancy.
PCP
Phencyclidine, or PCP, is also called angel dust or dust. PCP is an extremely dangerous hallucinogen
that has unusual and unpredictable side effects. It was developed as an anesthetic in the late 1950’s
and used for a while as a tranquilizer both for humans and animals. Because of its dangers, it now
has no legal uses and is no longer legally manufactured. Rather, PCP is manufactured in underground
laboratories. It often contains dangerous adulterants but is very dangerous all by itself.
PCP can produce violence and bizarre behavior in anyone who uses it. Occasionally, PCP users
attack nurses and policemen or jump out of windows because they believe they can fly. PCP somehow
scrambles the brain’s internal stimuli and seriously changes how users feel, see and deal with their
environment.
In low doses, PCP produces a feeling of numbness. Increased doses produce excitement, confusion
and delirium. The user’s body may become rigid or go into convulsions. Routine activities like driving
become dangerous and unpredictable.
Users may walk with strange uncoordinated steps. PCP users may have a blank stare, sweat heavily,
have thick slurred speech or engage in some of the violent and bizarre behaviors mentioned above.
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DOT Drug -Free Workplace Policy 2020 Version 21
Acknowledgement of Receipt of Policy
I hereby acknowledge that I have received, read, and understand my Company’s Drug-Free
Workplace Program Policy required by Department of Transportation (DOT) regulations. I understand
that I am subject to and must adhere to the DOT regulations, and must abide by the terms of the
Company’s Policy as a condition of employment.
I understand that during my employment I may be required to submit to drug and/or alcohol tests
based on Department of Transportation regulations as directed by the Company. I agree to comply
with the Company’s Policy on drugs and/or alcohol and understand failure to comply is grounds for
disciplinary action, up to and including termination, in addition to any action required by DOT
regulations.
I also understand that refusal to submit to a controlled substances or alcohol test is a violation of DOT
regulations, as well as the Company's Policy, and may result in disciplinary action, including but not
limited to suspension (with or without pay) or termination of employment, in addition to action required
by DOT regulations. I further understand the consequences related to controlled substances use or
alcohol misuse as prohibited by Company's Policy.
I acknowledge that the provisions of Company's Drug -Free Workplace Program Policy are part of the
terms and conditions of my employment, and that I agree to abide by them.
THE UNDERSIGNED STATES THAT HE OR SHE HAS READ THE FOREGOING
ACKNOWLEDGEMENT AND UNDERSTANDS THE CONTENTS THEREOF.
Employee Name: _______________________________________ Date:
Employee Signature:
Company Name: City of Mounds View
I am the parent/guardian of_____________________________________________________, and I
acknowledge that I understand the company’s Drug-Free Workplace policy. I hereby agree to his/her
participation in the Company’s Drug -Free Workplace Program.
Parent/Guardian Signature: Date:
Parent/Guardian Printed Name: Date:
NOTE: This certificate should be retained in a secured file.
A-3
CITY OF
Mounds View
AWAIR
A Workplace Accident & Injury Reduction Program
Safety Manual
Table of Contents
Page(s)
Introduction .............................................................................. 1
Safety Policy Statement .......................................................... 2
Revision of Program ................................................................ 3
Application ............................................................................... 3
Goals and Objectives ............................................................... 4
Safety Committee ..................................................................... 4
Roles and Responsibilities .................................................... 5-7
Enforcement Of Safety and Health Programs ......................... 8
Hazard Identification, Analysis and Control ............................ 9
Communication ...................................................................... 10
Contractor Duties .................................................................. 11
Accident Investigation ........................................................... 12
Figure 1: Accident and Injury Flowchart ........................ 13
Program Evaluation ................................................................ 14
1
Introduction
In 1990, the State of Minnesota amended the Occupational Safety and Health Act.
Minnesota Statutes Chapter 182.653 subd.8 requires employers in certain industries
to develop written, comprehensive workplace safety and health programs which are
based on the NAICS (North American Industry Classification System) system. This
legislation is known as A Workplace Accident and Injury Reduction (AWAIR) Act.
Programs developed to comply with the act are known as AWAIR programs. The
requirements of the legislation that are addressed and complied within our program
are as follows:
1. How managers, supervisors and employees are responsible for implementing
the program and how continued participation of management will be
established, measured and maintained;
2. The methods used to identify, analyze and control new or existing hazards,
conditions and operations;
3. How the plan will be communicated to all affected employees so they are
informed of work-related hazards and controls;
4. How workplace accidents will be investigated and corrective action
implemented; and
5. How safe work practices and rules will be enforced
MNOSHA has adopted a list of NAICS codes that we have determined to exist within
our jurisdiction as a public entity. These departments are under our blanket AWAIR
program. The NAICS codes for the departments under our AWAIR Program are
highlighted on the listing in Appendix A.
2
Safety Policy Statement
The administration of the City of Mounds View is aware that our employees are our
most valuable resource. Our safety policy reinforces our commitment to providing a
safe, injury and illness free work place. The success of our safety program requires
clearly defined goals, specific objectives and the identity of those that will share the
responsibility of accomplishing those goals and objectives.
Our AWAIR Program provides an “umbrella” under which all other safety policies and
procedures will be administered.
3
Revision of Program
The Safety Committee annually reviews this program and may make necessary revisions.
The Approving Authority shall retain the responsibility for all policy revisions.
DATE REVIEWED SIGNATURE
Application
This AWAIR program is intended to serve as an overview of all currently applicable Safety
and Health programs. This program outlines the philosophy by which the City of Mounds
View will develop, implement and maintain all other safety and health programs which
concern more specific topics.
While compliance with the law and OSHA standards is an important objective, an effective
AWAIR program must be tailored to the City of Mounds View’s particular needs. This
program shall look beyond specific legal requirements to identify and analyze existing
hazards. It shall seek to prevent injuries and illnesses, even when compliance is not an
issue. Ultimately, the program’s effectiveness in practice is what is important.
Should a department’s operations require the need for a specific addition to this program,
said specifics will be added as an addendum for that department and be maintained by
that department within their operations.
4
Goals and Objectives
Central to our AWAIR program are the goals and objectives we, as an organization,
have set for our overall safety and health program. The goals establish the direction
for our program and state what we are attempting to achieve through this program.
Our goals are generally challenging to reach or complete, but are also possible to
achieve. The goals are specific to the City of Mounds View. Our objectives are specific
actions that we will be taking to attempt to achieve those goals. Our objectives can
either be measured or demonstrated.
Safety Committee
The City of Mounds View has established a safety committee pursuant to Minnesota
Statutes through the League of Minnesota Cities Insurance Trust Regional Safety Group
program. The group of cities hold safety committee meetings on a regular basis.
All departments within the city’s operations may have Representatives on the Safety
Committee. Management/Supervisory personnel may have a representative on the safety
commi ttee.
The City Council may have a representative on the safety committee.
Safety Committee members will be able to perform their duties without fear of
discrimination or retaliation by management or the governing body.
5
Roles and Responsibilities
For Everyone in the Organization:
All employees, including supervisors and managers, must follow all safety rules at all
times.
For Employees:
1. Employees must promptly report any safety and health hazards they observe
to their supervisor or safety committee representative.
2. An employee’s first priority is to perform each job task safely. If an employee
is unsure how to perform the task safely, he or she must consult with their
supervisor.
3. Employees must wear personal protective equipment as required for their
protection and maintain the equipment in a sanitary manner.
4. Employees must report all accidents and near misses to their supervisor
immediately upon occurrence.
For Supervisors:
1. Supervisors must discuss any current safety issues with their employees at the
beginning of all regularly scheduled staff safety meetings or at the
tailgate/toolbox meetings.
2. Supervisors will address all safety concerns raised by staff by initially
investigating the issue, determining if the concern is valid and taking
appropriate corrective action whenever necessary. Corrective action can
include ordering new equipment, issuing maintenance work orders or
consulting with the safety director, the safety committee or upper
management.
3. Immediately upon learning of an accident or near miss the supervisor must
initiate an investigation and submit the completed accident investigation report
to the safety director.
4. Supervisors will actively and positively participate in all safety committee
inspections of their assigned areas.
For Human Resources Director/Human Resources Representative:
1. The Human Resources Director or Representative will serve as the lead person
in the organization for safety and health issues and will serve as an ex officio
member of the safety committee.
2. The Human Resources Director or Representative must review all First Reports
of Injury and Accident Investigation Reports with the safety committee and
take appropriate action to prevent recurrence.
6
3. The Human Resources Director or Representative will ensure that all safety
training required by regulation or identified by management, supervision or
the safety committee is addressed as needed to assure a safe workplace.
4. The Human Resources Director or Representative will recommend
improvements in physical plant, machinery, equipment, raw materials and
personal protective equipment to management, supervision and the safety
committee.
For Safety Committees:
1. The safety committee will conduct meetings, assist in area inspections, review
accident reports, identify hazards, and address any and all safety concerns
raised by employees, first-line supervision or the safety director.
2. The safety committee representatives will review their respective AWAIR
program at least annually and make recommendations concerning updates and
revisions to the program to senior management and the safety director.
3. Safety committee members each represent their particular work area and,
therefore, should address all safety concerns brought to them by their
coworkers. These concerns should be handled by initially investigating the
issue with the area supervisor to determine if the concern is valid and then, as
necessary and appropriate, bring the issue to the safety director or the full
safety committee.
For Management/Administration:
1. Managers will communicate to all employees and supervisors the importance
of worker safety and health throughout the organization.
2. Management shall review all safety concerns brought forward by the safety
director, the safety committee or first-line supervision and take appropriate
action.
3. Management shall review the AWAIR program and any recommended
revisions from the safety committee at least annually, make the appropriate
revisions and work with the safety director, the safety committee and first-line
supervision to communicate the revisions throughout the organization.
4. Management also establishes the importance of the AWAIR program, both by
the priority they give workplace safety and health issues and by the example
they set by initiating safety and health improvements, correcting hazards,
enforcing safety rules, rewarding excellent performance in safety and health,
and by following all safety rules. Safety and health programs are similar to
quality improvement and other efforts organizations engage in to continually
improve performance, customer service, competitiveness, organizational
culture, etc.
7
For Elected/Appointed Officials:
1. Officials will communicate to all Managerial/Administrative personnel the
importance of safety and health throughout the city/utility.
2. Elected/Appointed Officials will provide the resources to improve safety and
health throughout the entire organization. This includes providing employees
and supervisors with the authority to identify and correct hazards, the budget
to purchase new equipment or make repairs, the training necessary to work
safely and to recognize hazards, and the systems to get repairs made,
materials ordered and other improvements accomplished.
8
Enforcement of Safety and Health
Programs
Enforcement of safe work practices should be fair, consistent throughout the
city/utility, and based on established policy. Management and supervision should be
conscious of the examples they set for the workplace and should obey the same rules
as the rest of the workforce.
Unsafe or unhealthy work action by all employees shall be corrected in a timely
manner based on the severity of the hazards. The enforcement of the program is
based on the following methods:
1. Verbal warning
2. Written warning
3. Leave without pay
4. Termination
Or Take Safety Program Enforcement from union contract language agreement or
current personnel manual.
Disciplinary action will follow the above sequence unless the situation warrants more
severe action.
Not only should negative behavior be discouraged, but positive behavior should be
reinforced as well. Exceptional performance or efforts in workplace safety and health
should be recognized by the organization.
9
Hazard Identification, Analysis
and Control
The City of Mounds View will use the following steps to Identify, Analyze and Control
hazards:
Walk-around inspections by Supervisors, Management or the Safety
Committee members
Job or safety hazard analyses of different parts of the operation
Inspections should be done on a regular basis to identify both newly developed
hazards and those previously missed
Periodic industrial hygiene monitoring and sampling for agents such as
hazardous substances, noise and heat
Job hazard identification checklists
Employee reporting of workplace safety and health hazards
Employee hazard abatement suggestions
Preventative maintenance inspections
Engineering controls
Administrative controls
Personal Protective Equipment
Management and Employee Training
The City of Mounds View may use the enclosed forms to assist in the Identification,
Analysis and Control of hazards:
SP 1 – Hazard Inventory
SP 2 – Safety Inspection Checklist
SP 3 – Report of Unsafe Conditions
SP 4 – Hazard Elimination Evaluation Control Worksheet
SP 5 – Job Hazard Analysis
SP 6 – Indoor Environmental Audit
SP 7 – Personal Exposure Monitoring
SP 8 – Certification of Employee Training
SP 10 – Accident/Injury Investigation
10
Communication
All managers and supervisors are responsible for communicating with all workers
about occupational safety and health in a form readily understandable by all workers.
Our communication system encourages all workers to inform their managers and
supervisors about workplace hazards without fear of reprisal.
Our communication system may include one or more of the following items:
New worker orientation including a discussion of safety and health policies
and procedures
Review of our program
Training programs
Regularly scheduled safety meetings
Posted or distributed safety information
A system for workers to anonymously inform management about
workplace hazards
11
Contractor Duties
All contractors shall follow any and all Minnesota OSHA, Federal OSHA, MN DOT, MPCA
and other regulatory agency’s rules that pertain to their worksites in the State
of Minnesota. All contractors shall be responsible for initiating, maintaining and
supervising safety and health related policies, programs and work practices in
connection with the performance of contractual work.
Duties to Sub-contractors
Contractors that use sub-contractors shall be responsible for communicating any and
all safety and health related information to those sub-contractors and shall ensure
that sub-contractors initiate, maintain and supervise safety and health related polices,
programs and work practices while performing sub-contracted work.
Imminent Danger
In the event of an imminent danger situation, the City of Mounds View reserves the
right to suspend contracted work if said work exposes the employees of either
employer to imminent danger.
Imminent Danger Definition per MNOSHA:
Imminent danger situations are given top priority. An imminent danger is any condition or practice that
presents a substantial probability that death or serious physical harm could occur immediately or before the
danger can be eliminated through normal enforcement procedures. MNOSHA becomes aware of these
situations through reports received from employees, the general public or direct observation by an
investigator.
If an imminent danger situation is identified, the safety and health investigator will ask the employer to
voluntarily eliminate the hazard and to remove the endangered employees from exposure. If the employer
fails to do this, MNOSHA may "red tag" the equipment or job site for 72 hours.
12
Accident Investigation
Procedures for investigating workplace accidents, hazardous substance exposures,
and near misses include:
1. Interviewing injured workers and witnesses;
2. Examining the workplace for factors associated with the accident/exposure;
3. Determining the most probable cause of the accident/exposure;
4. Taking corrective action to prevent the accident/exposure from re-occurring;
and
5. Recording the findings and actions taken. It should not be to affix blame.
Each contributing factor should be traced back to its root cause. A written report that
describes the accident and its causes and recommendations for corrective action and
prevention will be prepared and presented to management.
The ultimate goal of the investigation is to determine the basic and root causes and
to determine appropriate corrective action so the incident does not happen again. To
simply attribute an accident to “employee error,” without further consideration of the
basic causes, deprives the organization of the opportunity to take real preventive
action. Possible use of engineering controls, improved work practices and
administrative controls should be considered to help employees do their jobs safely.
Management practices may also be considered as a possible basic factor. For
example, if there is managerial or supervisory pressure to increase production or cut
costs, employees may take unsafe shortcuts in work procedures or delay or skip
necessary preventive maintenance.
The Accident/Injury Investigation Form (Form SP 10) may be used.
13
Figure 1: Accident and Injury Flowchart
14
Program Evaluation
The AWAIR Act requires employers to review the entire program at least annually and
document the findings. Program review is vital because it serves as a check to see if
the organization is making progress towards its goal of creating a safer, healthier
workplace for all employees. The annual review keeps the program fresh, accurate
and an integral part of the organization.
67
City of Mounds View
FORM SP-1 HAZARD INVENTORY
Check (√) those hazards that are present or likely to be present in the work place. Identify source and location of each hazard that is present or likely to be present in the workplace. Evaluate and provide
for control of all hazards identified in accordance with applicable regulations. Provide for employee information and training on all hazards identified in accordance with applicable regulations.
Facility: Area/Operation:
Affected Positions: Compiled By: Date:
(√)
If Present Potential Hazard Potential Harm
Source And Location Of Hazard
(identify hazard)
ENVIRONMENTAL HAZARDS
Noise May cause stress, fatigue, and/or loss of
hearing. May interfere with communication, and
thereby contribute to accidents/injuries.
Air contaminants May cause illness, injury, and/or death.
Hot environments May cause heat cramps, heat exhaustion,
and/or heat stroke. Serious cases may cause
delayed injury or death.
Cold environments May cause frostbite and/or hypothermia.
Wet environments May cause illness or worker to slip, trip, or fall.
May result in injury or death.
Confined spaces May contain atmospheric, entrapment,
engulfment, and/or other serious hazards. May
result in injury or death.
Lighting May interfere with worker’s ability to recognize
job site safety and health hazards. May result in
injury or death.
Biological organisms or agents May cause disease. May cause illness or
death.
Microwave and other non-ionizing
radiation
May cause thermal burns and heat build up in
body tissues or other bodily injury. May result in
injury or death.
This checklist provides general guidance for the identification of common work place hazards. It is not all-inclusive. The employer must customize the form for the specific work place.
68
(√)
If Present Potential Hazard Potential Harm
Source And Location Of Hazard
(identify hazard)
HAZARDOUS MATERIALS
Toxic substances May cause illness, injury, or death.
Flammable substances May cause fire/explosion and/or illness, injury,
or death.
Reactive substances May react violently with other substances
and/or cause illness, injury, or death.
Corrosive substances May corrode metal, react violently with other
substances, and/or cause illness, injury, or
death
Compressed gasses Cylinder may rupture and/or become a missile.
Gas may be toxic, flammable, reactive, toxic
and/or corrosive. May cause illness, injury, or
death.
Infectious materials or disease
causing agents/organisms
May cause disease. May cause illness or
death.
Radioactive materials May cause radiation burns and radiation
sickness.
Asbestos containing materials Asbestos is known to cause asbestosis, lung
cancer, and mesothelioma.
Lead containing materials Lead is known to cause acute or chronic lead
poisoning and/or injury to reproductive system.
Know to cause birth defects.
Known carcinogens Cancer. May result in illness, deformations,
genetic changes, or death.
Hot or molten materials May cause thermal burns. May produce harmful
fumes.
Cryogenic liquids May cause frostbite. High expansion ratio (liquid
to gas). Gas may be toxic, flammable, reactive,
and/or corrosive.
This checklist provides general guidance for the identification of common work place hazards. It is not all-inclusive. The employer must customize the form for the specific work place.
69
(√)
If Present Potential Hazard Potential Harm
Source And Location Of Hazard
(identify hazard)
PHYSICAL HAZARDS
Wet, slippery or cluttered floors, stairs,
or landings
May cause worker to slip, trip, or fall. May result
in injury or death.
Floor openings or holes May cause worker to slip, trip, or fall. May result
in injury or death.
Unguarded platforms Worker may fall. May result in injury or death.
Rotating or moving machinery Worker may become caught between moving
parts. May result in injury or death.
Hand and power tools Use may cause lacerations, abrasions,
fractures, amputations, and/or electrocutions.
May result in injury or death.
Abrasive grinders Use results in flying particles. Wheel may
explode. May cause face/eye injuries.
Compressed air for cleaning Use may result in flying particles. May cause
face/eye injuries.
Pressure vessels - air, steam, water,
or gas
Mechanical explosion. May result in injury or
death.
Fixed electrical equipment Electrocution and/or fire. May result in injury or
death.
Portable electrical equipment and
extension cords
Electrocution and/or fire. May result in injury or
death.
Head hazards (e.g. falling
objects/bumps to head)
Worker could be struck. May result in injury or
death.
Eye/face hazards (e.g. flying particles,
harmful light and chemicals)
May cause blindness or injuries to face (e.g.
cuts, thermal burns, and chemical
exposure/burns). May result in injury or death.
Hand hazards (e.g. sharp objects,
heat/fire, and chemicals)
May cause lacerations, abrasions, thermal
burns, and chemical burns/exposure. May result
in injury or death.
This checklist provides general guidance for the identification of common work place hazards. It is not all-inclusive. The employer must customize the form for the specific work place.
70
(√)
If Present Potential Hazard Potential Harm
Source And Location Of Hazard
(identify hazard)
PHYSICAL HAZARDS, continued
Torso hazards (e.g. sharp objects
heat/fire, and chemicals)
May cause lacerations, abrasions, thermal
burns, and chemical burns/exposure. May result
in injury or death.
Foot hazards (e.g. rolling or falling
objects)
May cause lacerations and/or fractures. May
also result in chemical exposure/burns.
Belt, chain, and screw conveyors Worker may become caught between moving
parts. May result in injury or death.
Hot surfaces/equipment Worker could receive thermal burns. Could
ignite a fire. May result in injury or death.
Material storage May result in fire, falling object, and/or slip, trip
and fall hazards. May result in injury or death.
Hoists, cranes, slings, and chains Equipment could fail. Employee could be struck
by a falling object. May result in injury or death.
Limited exits and/or complex floor plan Workers may become trapped in a fire. May
result in injury or death.
This checklist provides general guidance for the identification of common work place hazards. It is not all-inclusive. The employer must customize the form for the specific work place.
71
(√)
If Present Potential Hazard Potential Harm
Source And Location Of Hazard
(identify hazard)
ERGONOMIC HAZARDS
Workers routinely perform the same or
pattern of motion within 30 seconds
May cause injuries to muscles, tendons, and
joints. May result in injury and/or disability.
Workers routinely maintain a fixed or
awkward posture
May cause injuries to muscles, tendons, and
joints. May result in injury and/or disability.
Workers routinely use vibrating tools
or equipment
May cause injuries to muscles, tendons, and
joints. May result in injury and/or disability.
Workers engage in unassisted
frequent heavy lifting
May cause injuries to muscles, tendons, and
joints. May result in injury and/or disability.
Workers routinely use forceful hand
exertions
May cause injuries to muscles, tendons, and
joints. May result in injury and/or disability.
Workers use tools, which are not
designed for the job
May cause injuries to muscles, tendons, and
joints. May result in injury and/or disability.
SHIFT WORK
Employees frequently work an
extended or rotating shift schedule
May cause stress and fatigue. May contribute to
injuries and accidents.
Employees may be required to work
double shifts
May cause stress and fatigue. May contribute to
injuries and accidents.
This checklist provides general guidance for the identification of common work place hazards. It is not all-inclusive. The employer must customize the form for the specific work place.
72
(√)
If Present Potential Hazard Potential Harm
Source And Location Of Hazard
(identify hazard)
WORK RELATED HAZARDS
Employees handle/use hazardous
chemicals
May cause illness, injury, or death.
Employees remove or encapsulate
asbestos
Asbestos is known to cause asbestosis, lung
cancer, and mesothelioma. May result in illness
and death.
Employees sand, grind, cut, or weld
on lead containing materials
Lead is known to cause acute or chronic lead
poisoning and/or injury to repr oductive system.
May result in illness and death.
Employees service or perform
maintenance on equipment/machines
Worker may become caught between moving
parts. May result in injury or death.
Employees perform maintenance on
electrical equipment
Electrocution. May result in injury or death.
Employees enter permit confined
spaces
May contain atmospheric, entrapment,
engulfment and/or other serious hazards May
result in injury or death.
Employees perform work from
unguarded elevated surfaces
Worker may fall. May result in injury or death.
Employees perform work in
excavations and trenches
Trench may cave-in. May result in injury or
death.
Employees perform work on
streets/roads
Worker may be struck by a vehicle. May result
in injury or death.
Employees perform work in close
proximity to heavy equipment
Worker may be struck by a vehicle. May result
in injury or death.
Employees operate heavy equipment
(e.g. end loaders, trucks, etc.)
Vehicular accidents. May result in injury or
death.
Employees operate forklifts Vehicular accidents. May result in injury or
death.
Employees operate aerial lift trucks Boom could contact power line. Employee could
fall. May result in injury or death.
This checklist provides general guidance for the identification of common work place hazards. It is not all-inclusive. The employer must customize the form for the specific work place.
73
(√)
If Present Potential Hazard Potential Harm
Source And Location Of Hazard
(identify hazard)
WORK RELATED HAZARDS, continued
Employees operate fixed/mobile
cranes and hoists
Worker could be struck by a falling object.
Boom could contact a power line - worker
electrocuted. May result in injury or death.
Employees perform welding, cutting,
and brazing
Fire and explosion. Electrocution. Workers may
be exposed to toxic metal fumes. May result in
illness, injury, or death.
Employees perform abrasive blasting Workers may be exposed to respirable silica
dust and/or lead dust. May result in illnes s,
injury, or death.
Employees perform spray painting Workers may be exposed to toxic mists and
sprays. Fire/explosion hazard. May result in
illness, injury, or death.
Employees come into close contact
with soil or trash
May result in tetanus if worker receives a cut,
scrape, or puncture wound.
Employees come into close contact
with blood and other body fluids
May be exposed to HIV or HBV. May result in
illness and death.
Employees operate noisy tools and
equipment
May cause stress, fatigue, and/or loss of
hearing.
Employees work on or near high
voltage electrical equipment
Electrocution. May result in injury or death.
Employees perform work from ladders
and/or scaffolds
Worker may fall. May result in injury or death.
Employees control processes that
involve hazardous chemicals
Fire, explosion, and/or exposure to a toxic or
corrosive chemical. May result in illness, injury,
or death.
Employees operate fixed machines
and equipment
Equipment failures may result in fire/explosion,
electrocution, and/or flying material. May result
in injury or death.
74
(√)
If Present Potential Hazard Potential Harm
Source And Location Of Hazard
(identify hazard)
EMPLOYEE EMERGENCY RESPONSE DUTIES
Designated employees have a duty to
provide first aid/CPR
May be exposed to HIV or HBV. May result in
illness and death.
Designated employees have a duty to
extinguish fires
May result in thermal burns and/or the
inhalation of hot/toxic smoke. May result in
injury or death.
Designated employees have a duty to
respond to hazardous chemical spills
May be exposed to flammable, reactive, toxic,
or corrosive chemicals. May result in illness,
injury, or death.
Designated employees have a duty to
perform rescues
May be exposed to an atmospheric,
entrapment, engulfment, fire, fall, electrical,
and/or moving equipment hazards. May result
in injury or death.
OTHER HAZARDS
This checklist provides general guidance for the identification of common work place hazards. It is not all-inclusive. The employer must customize the form for the specific work place.
75
(√)
If Present Potential Hazard Potential Harm
Source And Location Of Hazard
(identify hazard)
OTHER HAZARDS
This checklist provides general guidance for the identification of common work place hazards. It is not all-inclusive. The employer must customize the form for the specific work place.
OSHA/Safety Assistance 9/04
Handouts #5.2 - 133
FORM SP-2 SAFETY INSPECTION CHECKLIST
This checklist provides general guidance for the identification and correction of common work place hazards. It is not all-inclusive. The
employer must customize the form for the specific work place. Draw a line through those items that do not apply.
Check (√) all unsatisfactory items/conditions and indicate location if applicable. Correct those unsatisfactory items/conditions that you are
capable of correcting. Identify those items/conditions that need further action on reverse side. Note any new hazards. Review completed
checklist with supervisor. Supervisors are to schedule corrective actions as required and submit completed checklist to safety committee.
Postings
OSHA poster
OSHA 300 (post 2/1 to 4/30 of each year)
Hazards identified by signage
Permit confined spaces signed
Non-potable water identified by signage
Floor load limits identified by signage
No smoking areas identified by signage
Emergency telephone numbers posted
Escape routes/exits identified by signage
Emergency equipment identified by signage
NFPA 704 signs posted
Written Programs: Available To Employees
Hazard Communication Program
Respiratory Protection Program
Hearing Conservation Program
Hazardous Energy Control (Lo/To) Program
Permit Confined Spaces Program
Infection Control Program
Fire Prevention/Emergency Action Plan
Occupational Medicine Program
Tools/Equipment
Condition of electrical cords
Condition of hand/power tools
Condition of abrasive grinders
Air nozzles - pressure reduced to 30 psi
Power tools - point of operation guarded
Electrical
Breakers/panels identified
Boxes/panels closed/covered
Exposed conductors guarded
Lights guarded/protected
Condition of extension cords
Circuits properly grounded
Fixed Machinery/Equipment
Belts/pulleys guarded
General maintenance
Disconnects provided/identified
Equipment properly grounded
Material Handling
Condition of hoists/cranes
Condition of slings/chains
Condition of conveyors - trip line functional
Condition of fork lifts
Material Storage
Material neatly stacked and stable
Shelves organized - no falling object hazard
Accum ulations of Class A combustibles
Aisle clear and free from obstructions
General housekeeping
Hazardous Materials
Proper containers
Containers labeled
MSDS available
Proper storage
Flammables stored in approved cabinets
Incompatibles separated
Proper storage of compressed gas cylinders
Flammable waste - containers emptied daily
Damaged/deteriorated ACM
Working Surfaces/Housekeeping/Sanitation
Aisle/floors/stairs kept clear/clean/dry
General housekeeping
Floor openings - covered/guarded
Platforms/stai rs guarded by railing
Proper waste disposal
Restrooms/locker rooms - clean/sanitary
Eating areas - clean/sanitary
Ladders/Scaffolds
Ladders - condition/proper use
Fixed ladders - condition/fall protection
Scaffolds - condition/proper use
Confined Space Entry Equipment
Personal monitors - availability/calibration
Retrieval equipment - availability/condition
front
OSHA/Safety Assistance 9/04
Handouts #5.2 - 134
Emergency Equipment
First aid kit - in place/completely stocked
Availability of persons trained in F.A./CPR
Fire extinguishers - in place/charged
Fire alarm operates when activated
Eye washes/showers - accessible/functional
Emergency lights - proper operation
Exits - accessible/not blocked
SCBA’s/PPE - availability/condition
PPE: Condition/Storage
Respirators
Hard hats
Face/eye protectors
Gloves
Protective footwear
Protective clothing
Electrical protective equipment
Personal fall protective equipment
Safe Work Practices: Employees
Use proper lockout/tagout procedures
Use proper confined space entry procedures
Use suitable personal protective equipment
Barricade hazardous work areas
Guard temporary floor openings
Use proper excavation/trenching procedures
Use personal fall protective equipment
Use GFI’s
Vehicles/Mobile Equipment
Tires/brakes/steering/lights
General maintenance
Proper operation of special equipment
First aid kit - in place/completely stocked
Fire Extinguishers - in place/charged
Employee Medical/Exposure Records
Available for employee review
Describe Other Unsatisfactory Items/Conditions and/or New Hazards
1.
2.
3.
4.
5.
Summary Of Unsatisfactory Items That Need Further Action
Item Location
Area/Vehicle Inspected:
Conducted By: _________________________________________________ Date: ____________
Back
69
FORM SP-3 REPORT OF AN UNSAFE CONDITION
Instructions to employees: Briefly describe the location and nature of the unsafe condition. Identify any possible
corrective actions. Sign/date the report. Submit report to your immediate supervisor.
To be completed by employee reporting the unsafe condition
Location:
Describe unsafe condition:
Suggested corrective actions:
Reported by: Date:
To be completed by work unit supervisor
Received by: Date:
Suggested corrective actions taken
Referred to safety committee
Comments/actions taken:
To be completed by safety committee
Date reviewed/acted upon:
Recommendation of safety committee:
Corrective actions initiated by safety committee
Corrective actions referred to work unit manager for review/initiation
To be completed by work unit manager
Date acted upon:
Actions taken:
70
FORM SP-4 HAZARD EVALUATION AND ELIMINATION/CONTROL WORKSHEET
This checklist provides general guidance for the evaluation and elimination/control of workplace safety and health hazards. It is not all inclusive. The employer must customize the form for the specific
work place.
Use this worksheet to identify how hazards identified in the workplace hazard survey will be eliminated or controlled. (The worksheet may also be used to analyze specific operations or areas). Identify the
source and location of each hazard in column 1. Identify the cause and severity of the hazard in column 2. Identify the means/methods of hazard elimination/control in column 3.
Facility: Area/Operation:
Affected Positions: Compiled By: Date:
Hazard Source/Location Hazard Evaluation
Identify cause and severity of hazard.
Include results of personal monitoring,
if applicable.
Methods/Means Of Hazard Elimination/Control
Identify means and methods that will be used to eliminate or control the hazard.
Consider hazard elimination, engineering controls, administrative controls, procedures,
work practices, employee training, and personal protective equipment.
71
FORM SP-5 JOB HAZARD ANALYSIS
Instructions: Refer to OSHA publication 3071, Job Hazard Analysis, for additional information and instructions.
Task: Conducted By: Date:
Job Step Hazard Cause Preventive Measure
Page: of:
72
FORM SP-6 INDOOR ENVIRONMENTAL AUDIT
This checklist provides general guidance for the identification of common work place hazards. It is not all inclusive. The employer must customize the form for the specific work place.
Name of Facility:
Conducted By: Date:
Location Airborne Contaminants
Lighting Noise Temperature
Humidity
Oxygen
(percent) Carbon
Monoxide
(ppm)
% of LEL Ventilation
Light Level
(foot-candles)
Noise Level
(dB-A) Temperature
(Fo) Relative
Humidity
(percent)
Comments:
70
FORM SP-7 RESULTS OF PERSONAL EXPOSURE MONITORING
Facility:
Department
or Area:
Employee:
Operation:
Employee
SS Number: Date: Temperature: Relative
Humidity:
Type of Respirator Used By Employee:
Comments/Observations:
Sample Type:
Sampling Device and ID. No:
Calibration (date and results): Settings/Range:
Collection Media: Analysis Method:
Sample
Number
Start
Time
Stop
Time
Duration
(minutes)
Calibration
Flow Rate
Volume
(liters)
Substance
Sampled
Amount
Collected
Concentration
In Air
Substance Sampled Actual Employee Exposure Permissible Exposure Limit
(PEL)
Recommendations: Sampling Conducted By:
Form SP-8
OSHA/Safety Assistance 9/04
Handouts #10.7 - 159
City of Mounds View
Employee Training History
Department:
Division:
Employee:
Training How Often Date
1 AWAIR/ Safety Program Initial/Annual
2 Employee Right -To-Know Annual
3 New Employee Safety Orientation Initial
4 Powered Trucks/Forklifts Every two years
5 Hearing Conservation Annual
6 Lock-out/Tag-out Annual Review
7 PPE Initial/Annual
8 Confined Space Entry Annual
9 Trenching/Shoring/Competent Person Annual
10 CPR/ First Aid Initial/Bi-annual
11 Bloodborne Pathogens Annual
12 Respirator Initial/Annual
13 Fire Extinguishes/Emergency Response Annual
14 Traffic/Driving Safety On assignment
15 Welding/ Compressed Gas Initial
16 Back Injury Prevention As needed
17 Ladder Safety Initial
18 Accident ID and Reporting Initial
74
FORM SP-9 SAFETY AND HEALTH PROGRAM AUDIT WORKSHEET
This worksheet provides general guidance for evaluating safety and health program effectiveness. It is not all inclusive. The compnay must customize the form for the specific work place.
Consider each program element to; (1) determine whether or not the element is in place, (2) estimate the element’s overall effectiveness, and (3) identify specific deficiencies and actions that can be taken
to improve the effectiveness of the element.
Program Element In Place
(√)
Effectiveness
(√)
Identify Specific Deficiencies and Actions That
Can Be Taken To Improve Program Effectiveness
Yes
No
1
(poor)
2 3
(fair)
4 5
(Excellent)
1. Company Commitment
The city has adopted and endorsed
an effective and proactive written
safety and health program (AWAIR)
that encourages employee
participation.
The city has adopted a safety and
health related vision (or policy)
statement. Vision (or policy)
statement has been communicated to
managers, supervisors, and
employees.
The city has adopted safety and
health related policies, procedures,
and practices. Safety related policies,
procedures, and practices have been
communicated to managers,
supervisors, and employees.
The city has committed those human
and material resources necessary to
implement and manage the safety
and health program.
75
Program Element In Place
(√)
Effectiveness
(√)
Identify Specific Deficiencies and Actions That
Can Be Taken To Improve Program Effectiveness
Yes
No
1
(poor)
2 3
(fair)
4 5
(Excellent)
The city has (established and
communicated) safety and health
related responsibilities for managers,
supervisors, and employees.
The city has provided means and
methods for managers, supervisors,
and employees to meet assigned
safety and health related
responsibilities.
The city has assigned accountability
by adopting and enforcing a safety
program compliance policy.
Managers, supervisors, and
employees are required to comply
with safety related, policies,
procedures, and practices and are
held accountable for their actions.
The city includes work place safety
and health as an agenda item in staff
meetings.
76
Program Element In Place
(√)
Effectiveness
(√)
Identify Specific Deficiencies and Actions That
Can Be Taken To Improve Program Effectiveness
Yes
No
1
(poor)
2 3
(fair)
4 5
(Excellent)
The city requires managers and
supervisors to take a visible and
active role in safety meetings and
training sessions.
2. Employee Involvement
The city provides for employee input
and involvement in safety and health
program. Employees (or their
designated representative) have
endorsed the safety and health
program.
The city provides for employee
involvement (and solicits employee
input) in all matters pertaining to work
place safety and health, including but
not limited to; work place hazard
assessments and inspections, hazard
mitigation, and training.
77
Program Element In Place
(√)
Effectiveness
(√)
Identify Specific Deficiencies and Actions That
Can Be Taken To Improve Program Effectiveness
Yes
No
1
(poor)
2 3
(fair)
4 5
(Excellent)
The city has provided employees with
an effective means to report unsafe
working conditions. Employees are
not subjected to retaliation or
harassment for reporting unsafe acts
or conditions.
The city schedules safety meetings
and training sessions during normal
working hours and/or with employees
in pay status.
The city has established an effective
and proactive safety committee.
Safety committee has defined goals
and objectives. Safety committee
meets on a scheduled basis. Safety
committee activities are
communicated to managers,
supervisors, and employees.
78
Program Element In Place
(√)
Effectiveness
(√)
Identify Specific Deficiencies and Actions That
Can Be Taken To Improve Program Effectiveness
Yes
No
1
(poor)
2 3
(fair)
4 5
(Excellent)
3. Hazard Control
A Systematic survey has been
conducted to identify all work place
safety and health hazards. Results
have been communicated to
managers, supervisors, and
employees.
Hazards posed by new processes,
machines, and chemical products are
identified. Results are communicated
to managers, supervisors, and
employees.
Frequent walk-through safety
inspections are conducted to identify
unsafe acts and unsafe conditions.
Results are communicated to
managers, supervisors, and
employees.
As a matter of routine first-line
supervisors and employees report
and/or correct unsafe acts and
conditions.
79
Program Element In Place
(√)
Effectiveness
(√)
Identify Specific Deficiencies and Actions That
Can Be Taken To Improve Program Effectiveness
Yes
No
1
(poor)
2 3
(fair)
4 5
(Excellent)
Appropriate methods are used to
evaluate hazards to determine cause,
severity and effective methods of
elimination/control. Results are
communicated to managers,
supervisors, and employees.
Appropriate and suitable methods are
used to eliminate or control safety and
health hazards. When practical and
feasible hazards are either eliminated
or controlled by engineering and/or
administrative controls. The city
solicits employee input when
considering hazard mitigation options.
Managers, supervisors, and
employees promptly correct work
place safety and health hazards.
Written safety and health programs
have been implemented (and
communicated to managers,
supervisors, and employees) as
required by work place hazards,
employee job duties, and applicable
OSHA regulations. Each program is
effective in meeting its intended
purpose as is periodically reviewed.
80
Program Element In Place
(√)
Effectiveness
(√)
Identify Specific Deficiencies and Actions That
Can Be Taken To Improve Program Effectiveness
Yes
No
1
(poor)
2 3
(fair)
4 5
(Excellent)
Written safety operation procedures
and work practices (SOP’s) have
been implemented (and
communicated to managers,
supervisors, and employees) as
required by work place hazards,
employee job duties, and applicable
OSHA regulations. Each SOP is
effective in meeting the intended
purpose and is periodically reviewed.
4. Facility Maintenance
Structures, vehicles and equipment
are properly maintained in
accordance with applicable
regulations, codes, and manufacture’s
instructions through an effective work
order system that facilitates planned
maintenance and the reporting of
items in need of repair.
Effective housekeeping procedures
and assignments have been
established (and communicated to
managers, supervisors, and
employees). Facility is maintained in a
clean and sanitary condition.
81
Program Element In Place
(√)
Effectiveness
(√)
Identify Specific Deficiencies and Actions That
Can Be Taken To Improve Program Effectiveness
Yes
No
1
(poor)
2 3
(fair)
4 5
(Excellent)
5. Accident Analysis
Managers, supervisors, and
employees are required to report all
accidents and injuries including close
calls.
All accidents, injuries, and close calls
are investigated to determine root
cause and appropriate corrective
measures. Results are acted upon
and communicated to managers,
supervisors, and employees.
Accident and injury records are
reviewed and analyzed to identify
recurrent hazards. Results are acted
upon and communicated to
managers, supervisors, and
employees.
82
Program Element In Place
(√)
Effectiveness
(√)
Identify Specific Deficiencies and Actions That
Can Be Taken To Improve Program Effectiveness
Yes
No
1
(poor)
2 3
(fair)
4 5
(Excellent)
6. Occupational Medicine
An affective and proactive
occupational medicine program has
been established as required by work
place hazards and applicable
regulations. All affected personal
participate in the program. Results
and recommendations are
appropriately communicated and
acted upon.
7. Contractor Safety
The company has established (and
abides by) a policy of retaining only
qualified contractors with a
demonstrable record of employee
safety and health and regulatory
compliance.
Safety and health related duties and
responsibilities for contractors (and
subcontractors) are clearly stated in
bid and/or contract documents.
83
Program Element In Place
(√)
Effectiveness
(√)
Identify Specific Deficiencies and Actions That
Can Be Taken To Improve Program Effectiveness
Yes
No
1
(poor)
2 3
(fair)
4 5
(Excellent)
Contractors are informed of work
place hazards, safety related policies,
procedures, and practices in
accordance with applicable
regulations.
Contractors are required to observe
(or exceed) the cities safety and
health related p olicies, procedures,
and practices.
8. Employee Training
Employees are informed of their rights
and responsibilities under the OSHA
Act by posting of the OSHA poster
and are informed of work place
injuries and illnesses by posting of the
OSHA 300 Log between February 1
and April 1 of each year.
Employees are provided with access
to safety and health related
information including; applicable
regulations, policies, procedures,
material safety data sheets (MSDS)
and to their training, medical, and
exposures records. Location of said
information is communicated to
employees.
84
Program Element In Place
(√)
Effectiveness
(√)
Identify Specific Deficiencies and Actions That
Can Be Taken To Improve Program Effectiveness
Yes
No
1
(poor)
2 3
(fair)
4 5
(Excellent)
Employees are informed of work
place safety and health hazards by
appropriate signs, labels, and tags.
New employees are provided with
effective training that includes
information on work place hazards,
safety related policies, procedures,
and practices, and instruction on
specific job duties. First line
supervisors and experienced
employees take an active role in the
training of new employees. The
training is documented.
In-service topical and refresher
training and instruction is provided on
routine and scheduled basis as
required by applicable regulations,
new hazards, procedural changes,
and deficient work practices. The
training is documented.
Work unit supervisors conduct
frequent job briefings, tool box safety
talks, and/or tailgate safety talks to
communicate safety and health
related information and/or work
specific hazards and hazard control
procedures.
85
Program Element In Place
(√)
Effectiveness
(√)
Identify Specific Deficiencies and Actions That
Can Be Taken To Improve Program Effectiveness
Yes
No
1
(poor)
2 3
(fair)
4 5
(Excellent)
Employees actively participate in
safety training and communicate
training needs to management.
Appropriate means and methods are
used to evaluate the effectiveness of
training.
9. Emergency Response
Effective and proactive policies,
procedures, and practices have been
established (and communicated to
managers, supervisors, and
employees) to prevent fires and other
work place emergencies. Procedures
are established in an emergency
action plan.
86
Program Element In Place
(√)
Effectiveness
(√)
Identify Specific Deficiencies and Actions That
Can Be Taken To Improve Program Effectiveness
Yes
No
1
(poor)
2 3
(fair)
4 5
(Excellent)
Emergency equipment (exits and exit
ways, fire extinguishers, first aid kits,
emergency eye wash stations,
showers, and emergency lights) if
installed, must be inspected and
maintained in accordance with
applicable regulations. Emergency
telephone numbers are consciously
posted.
Duties and procedures, to be followed
in all reasonably foreseeable
emergencies, have been identified in
an emergency action plan. Plan has
been communicated to managers,
supervisors, and employees.
Managers, supervisors, and
employees are provided with
emergency response training as
required by assigned duties and
applicable regulations.
Personnel trained in CPR/first aid are
readily available at work place.
Local fire department has been
informed of work place hazards in
accordance with applicable
regulations, has toured the facility,
and has developed emergency plan.
87
Program Element In Place
(√)
Effectiveness
(√)
Identify Specific Deficiencies and Actions That
Can Be Taken To Improve Program Effectiveness
Yes
No
1
(poor)
2 3
(fair)
4 5
(Excellent)
Audit Conducted By: Date:
A-1
City of Mounds View Policy and Procedure for
Non-Federal Drug and Alcohol Testing
I. INTRODUCTION
The City of Mounds View has adopted this Policy and Procedure for Drug and
Alcohol Testing (“Policy”) for the purpose of helping to ensure that all City of
Mounds View employees are able to enjoy a safe and efficient working
environment. This Policy contains the City’s drug and alcohol policy and rules and
the City’s drug and alcohol testing policy and procedures.
THIS POLICY IS NOT AN EMPLOYMENT CONTRACT AND DOES NOT ALTER
THE AT-WILL EMPLOYMENT RELATIONSHIP. THE CITY MAY CHANGE,
ALTER, OR ELIMINATE ANY OR ALL PORTIONS OF THIS POLICY AT ANY
TIME, UNLESS PROHIBITED BY ANY APPLICABLE LAW.
The CITY will provide all affected employees with notice of any material change,
alteration or elimination of all or any part of this Policy, or as otherwise required by
applicable law.
II. DRUG AND ALCOHOL POLICY AND RULES
1. Possessing illegal drugs or drug paraphernalia at work, while on City or
customer property, while operating the City’s vehicles, machinery or
equipment, or while engaged in City business, is prohibited.
2. Consuming alcohol or using or taking illegal drugs during working hours,
including breaks, while on City or customer property, while operating the
City’s vehicles, machinery or equipment, or while engaged in City business,
is prohibited.
3. The distribution or sale of illegal drugs while at work, while on City or
customer property, while operating the City’s vehicles, machinery or
equipment, or while engaged in City business, is prohibited.
4. Being under the influence of illegal drugs or alcohol, or having illegal drugs
or their metabolites in one’s body, while at work, while on City or customer
property, while operating the City’s vehicles, machinery or equipment, or
while engaged in City business, is prohibited. The City of Mounds View has
a zero tolerance drug policy this includes the presence of illegal drugs,
prescription drugs being taken that could impact safety on the job, and an
alcohol level of 0.02 or greater which is confirmed by a blood alcohol test.
5. Making arrangements during working time, while at work, or while on City
or customer property for the sale, purchase, or transfer of illegal drugs is
strictly prohibited, even if the actual sale, purchase, or transfer of illegal
drugs occurs during non-working time or off City property.
2
6. All employees must notify the City of any criminal drug statute conviction for
a drug law violation occurring at work. The notice must be given to the City
no later than five (5) days after the conviction.
7. The City reserves the right to search employee possessions, lockers,
storage areas, work stations and locations, and vehicles at any time. Any
employee whose vehicle, possessions, locker, work station or location, or
storage area is found to contain an illegal drug or drug paraphernalia will be
discharged. Unless otherwise required by law, an employee’s refusal to
cooperate with any such search may result in disciplinary action up to and
including discharge.
8. The City reserves the right to investigate and to interview employees in the
course of implementing, applying and enforcing this Policy, and to require
truthful answers to inquiries in connection with any such investigation.
Employees who refuse to cooperate in any such investigation, or who
provide false or misleading information, will be subject to disciplinary action,
up to and including discharge.
9. An employee violating these rules will be subject to immediate discipline up
to and including discharge.
10. After receipt and review of this Policy, all employees and job applicants
must sign a consent form acknowledging that they have read and
understand the Policy. Failure to do so may be grounds for termination in
the case of employees, or rejection of the application in the case of job
applicants.
III. DRUG AND ALCOHOL TESTING
1. What Will Be Screened: When drug and alcohol tests are performed, the
testing will only be for illegal drugs, alcohol, and their metabolites. This
includes prescription drugs being taken with or without a prescription that
could impact safety on the job, and an alcohol level of 0.02 or greater which
is confirmed by a blood alcohol test.
2. No other substances or medical conditions will be tested for. Alcohol tests
will be conducted only when job-related and consistent with business
necessity.
3. Consent Form: When an employee or job applicant is asked to be tested,
the employee or job applicant will receive a consent form to complete. Only
those individuals who consent to testing will be tested.
3
4. Right to Refuse: All employees and job applicants have the legal right to
refuse to be tested.
a. Effect of Refusal to Submit to Testing: Employees who refuse to be
tested will be discharged or, if the testing is due to a customer
requirement, will not be assigned to that customer. Job applicants
who refuse to be tested will have their conditional job offer revoked
and will not be hired.
b. Interference with Testing: Employees and applicants are expected
to comply with the City of Mounds View’s drug and alcohol testing
policy, and to cooperate and to refrain from interfering with drug and
alcohol tests. Any employee or applicant who tampers, adulterates,
or otherwise interferes with a drug or alcohol test will be deemed to
have refused to take a test and, if an employee, will be terminated
or, if an applicant, will have his/her conditional job offer revoked. If
a sample is diluted or untestable, the City reserves the right to require
the employee or applicant to submit a second sample to be tested.
A refusal to submit a second sample will be considered a refusal to
submit to testing. In the event a second sample is also diluted or
untestable, the City will revoke a conditional job offer made to a job
applicant and the City reserves the right to discipline an employee,
up to and including termination of employment. If the testing is due
to a customer requirement, the employee will not be assigned to that
customer.
5. Employee Drug and Alcohol Testing:
a. Reasonable Suspicion Testing: The City will require an employee to
undergo drug and alcohol testing when the City has a reasonable
suspicion that the employee:
1. Is under the influence of drugs or alcohol. “Reasonable
suspicion” means a basis for forming a belief based on specific
facts and rational inferences drawn from those facts.
2. Has violated the City of Mounds View’s written work rules
prohibiting the use, possession, sale, or transfer of drugs or
alcohol while the employee is working or while the employee is
on the City’s premises or operating the City’s vehicles, machinery
or equipment.
3. Has sustained a personal injury, or has caused another employee
to sustain a personal injury, and the injury requires medical
treatment.
4
4. Has caused a work-related accident or was operating or helping
to operate machinery, equipment, or vehicles involved in a work-
related accident.
b. Treatment Program Testing: When the City has referred an
employee for chemical dependency treatment or evaluation or when
the employee is participating in a chemical dependency treatment
program under an employee benefit plan, the employee may be
tested, without prior notice, during the evaluation or treatment period
and for a period of up two (2) years following the completion of any
prescribed chemical dependency treatment program.
c. Routine Physical Examination Testing: The City may require drug
and alcohol testing as part of a routine physical examination. An
employee will receive at least two (2) weeks’ written notice that a
drug and alcohol test may be requested or required as part of the
physical examination, which drug and alcohol test will occur no more
than once annually.
d. Random Testing: The City may require drug and alcohol testing on
a random selection basis for employees who are employed in safety-
sensitive positions. “Safety-sensitive positions” are jobs in which an
impairment caused by drug or alcohol usage would threaten the
health or safety or any person.
5. Job Applicant Testing: Job applicants who have received a job offer
conditioned upon the applicant submitting to and passing a drug and alcohol
test will be required to undergo drug and alcohol testing. The conditional
job offer will be revoked and the applicant will not be hired if one or more of
the following occur:
a. The applicant leaves the testing clinic before giving a suitable
specimen or the applicant refuses to take the test.
b. The applicant tests positive (fails) the test, and the result has been
verified by a confirmatory test.
c. The applicant tampers, adulterates, or otherwise interferes with a
drug and alcohol test
d. The applicant has had two (2) diluted or untestable specimens.
6. Testing as a Result of a Customer Requirement: Certain customers of the
City of Mounds View may require that City’s employees, prior to working on
an assignment for them, be subject to drug and alcohol testing in
accordance with the customer’s drug and alcohol testing policy. Before
5
assigning an individual to such a customer, the City will attempt to advise
its employees or applicants who may be assigned to such customer, of any
such requirement. No employee or applicant will be tested as a result of
such a requirement unless the employee or applicant consents to work on
the customer assignment and consents to testing. Of course, if an individual
refuses to be tested, he/she will not be assigned to the customer requiring
such testing.
7. Test Results, Notification, and Individual’s Rights Following Testing:
a. Initial Screening Test
1. An initial screening test will be conducted first. If the initial
screening test is negative, the City will inform the employee or job
applicant of the negative result.
2. If the initial screening test is positive, the testing laboratory will
run a confirmatory test.
b. Confirmatory Test
1. If the confirmatory test is negative, the City will notify the
employee or job applicant of the negative result.
2. If the confirmatory test is positive, a Medical Review Officer
(“MRO”) will notify the employee or job applicant of the positive
result. The MRO is a licensed physician responsible for receiving
laboratory results generated by the City’s testing program. The
MRO has appropriate medical training to interpret and evaluate
an individual’s test result.
a. Opportunity to Explain:
The employee or job applicant will be given written notice of
the right to explain a positive test result and the right to
indicate any over-the-counter or prescription medication that
the employee or job applicant is currently taking, or has
recently taken, and any other information relevant to the
reliability of, or explanation for, a positive test result.
In addition, within three (3) working days after notice of a
positive test result on a confirmatory test, the employee or job
applicant may submit any other information to the MRO to
explain that result.
b. Right to Request a Confirmatory Retest: After receiving notice
of a positive test result on a confirmatory test, the employee
6
or job applicant may request in writing a confirmatory retest of
the original sample at the employee’s or job applicant’s own
expense.
1. Within five (5) working days after notice of the confirmatory
test result, the employee or job applicant must notify the
City in writing of the employee’s or job applicant’s intention
to obtain a confirmatory retest.
2. Within three (3) working days after receipt of the notice,
the City will notify the original testing laboratory that the
employee or job applicant has requested the laboratory to
conduct a confirmatory retest or to transfer the sample to
another laboratory licensed under Minnesota law to
conduct the confirmatory retest.
3. The confirmatory retest must use the same drug and
alcohol threshold detection levels as used in the
confirmatory test.
8. Disciplinary Action:
a. Employee Rehabilitation Opportunity: If an employee receives a
positive test result on a confirmatory test, and that result is the first
such result for the employee on a drug or alcohol test requested by the
City, the employee will be given an opportunity to participate in either
a drug or alcohol counseling or rehabilitation program. The City will
consult with a certified chemical use counselor or a physician trained
in the diagnosis and treatment of chemical dependency to determine
which program is appropriate. Payment for any portion of the
treatment which is not covered by insurance is the responsibility of the
employee. If the employee accepts the City of Mounds View’s offer to
participate in the program, he or she will receive leave without pay for
the duration of the treatment program. Upon successful completion of
the program, the employee will be returned to work with the City.
Refusal to participate in the counseling or rehabilitation program, or
failure to successfully complete the program, as evidenced by
withdrawal from the program before its completion or by a positive test
result on a confirmatory test after completion of the program, will be
grounds for discharge.
b. Temporary Suspension or Transfer: A positive test result on an initial
screening test that has not yet been verified by a confirmatory test and,
if requested by the employee, a confirmatory retest, may be grounds
to temporarily suspend the tested employee or to transfer the tested
employee to another position at the same rate of pay pending the
7
retest, if the City believes such action is reasonably necessary to
protect the health or safety of the employee, co-workers, or the public.
If the test result of the confirmatory test or requested retest is negative,
an employee who was suspended without pay will be reinstated with
back pay.
c. No Discipline if Confirmatory Retest is Negative: No disciplinary action
will be taken if a confirmatory retest does not confirm an original
positive test result.
d. Revocation of Job Offer to Applicant Who Tests Positive: Any job offer
made to a job applicant that was contingent on the applicant passing
a drug and alcohol test will be withdrawn if the confirmatory test result
is positive. The City will inform the job applicant of the reason for its
withdrawal of the offer.
e. Discharge: An employee who tests positive for the second time on a
drug or alcohol test requested by the City will be discharged.
f. Right to Appeal: Employees and job applicants may appeal adverse
employment decisions involving drug or alcohol testing by, within
three (3) days of receiving notice of the adverse employment
decision, delivering a written statement to the City Administrator at
the City of Mounds View, detailing the basis for the appeal. The
City’s decision on the appeal will be final and binding.
9. Questions: Questions concerning City’s Policy and Procedure for Drug and
Alcohol Testing should be directed to the Human Resources Department at
763-717-4016.
10. Confidentiality and Access to Results:
a. Any employee or job applicant may request in writing from the City a
copy of the test results report on any drug or alcohol test taken by
that employee or job applicant.
b. Employees will be given access to any information in their personnel
files relating to positive drug and/or alcohol test result reports and
other information acquired in the drug and/or alcohol testing process
and conclusions drawn from and actions taken based on the reports
or other acquired information.
c. Drug and alcohol test result reports and all other information acquired
in the testing process is private and confidential information which
will not be disclosed to another employer, third-party individual,
governmental agency or private organization without the written
8
consent of the employee or job applicant, with the following
exceptions:
1. Evidence of a positive test result on a confirmatory test may be
used in an arbitration proceeding pursuant to a collective
bargaining agreement, in an administrative hearing, or in a
judicial proceeding, where the test result is relevant to the hearing
or proceeding.
2. Evidence of a positive test result on a confirmatory test may be
disclosed to any federal agency or United States government unit
as required under federal law, regulation or order, or in
accordance with compliance requirements of a federal
government contract.
3. Evidence of a positive test result on a confirmatory test may be
disclosed to a substance abuse treatment facility for the purpose
of evaluation or treatment of the employee.
d. Positive test results from the City’s drug and alcohol testing program
will not be used as evidence in a criminal action against the
employee or job applicant tested.
e. All results of alcohol tests will be maintained in confidential medical
files, separate from employees' personnel files.
9
NON-FEDERAL
Drug & Alcohol Testing Consent Form
Current Employees – MRO
I acknowledge that I have received, read and understand the City of Mounds View’s Policy
and Procedure for Drug and Alcohol Testing (“Policy”). I understand that this Policy does
not alter the at-will nature of my employment.
I hereby agree to submit to drug and alcohol testing under the City’s Policy.
I also understand that test results and other information acquired in the drug and alcohol
testing process may be disclosed to and discussed with a Medical Review Officer
(“MRO”). I hereby consent to such test results and other information being disclosed to
and discussed with an MRO.
Employee Information:
Signature Date
Print Name
Witnessed by:
Signature Date
Print Name
A-2
City of Mounds View
U.S. Department of Transportation
Federal Motor Carrier Safety Administration
(FMCSA)
Drug-Free Workplace Policy
1502 13th Avenue West, STE 201 – PO Box 1452, Williston ND 58802
(877) 537-7588 ♦ (701) 577-0498 ♦ Fax: (701-577-0708
*City of Mounds View*
DOT Drug -Free Workplace Policy 2020 Version 1
Table of Contents
Page
Purpose and Coverage ......................................................................................................................... 2
Non-Discrimination ................................................................................................................................. 2
Criteria for Employees Subject to Testing ............................................................................................. 2
Definition of Safety-Sensitive ................................................................................................................. 3
Definitions............................................................................................................................................... 3
Tests Required ....................................................................................................................................... 5
Pre-Employment/Pre-Placement ............................................................................................... 5
Post-Accident............................................................................................................................. 6
Random ..................................................................................................................................... 8
Reasonable Suspicion ............................................................................................................... 8
Return-to-Duty ........................................................................................................................... 9
Post-Rehabilitation/Follow-Up ................................................................................................... 9
Policy Prohibitions ................................................................................................................................ 10
Consequences for Policy Violations .................................................................................................... 11
Clearing House https://www.law.cornell.edu/cfr/text/49/382.701( January 2020).......................11
Voluntary Admission of Drug/Alcohol Use ........................................................................................... 12
Summary of Alcohol Testing Procedures ............................................................................................ 13
Summary of Drug Testing Procedures ................................................................................................ 14
Education and Training ........................................................................................................................ 16
Acknowledgement ................................................................................................................................ 17
Reservation of Rights ........................................................................................................................... 17
Signs and Symptoms of a Drug -Alcohol Problem ............................................................................... 18
Effects of Alcohol and Drugs................................................................................................................ 18
Acknowledgement of Receipt of Policy................................................................................................ 21
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PURPOSE AND COVERAGE
The U.S. Department of Transportation (DOT) and the Federal Motor Carrier Safety Administration
(FMCSA), an agency within the DOT, have issued regulations (49 CFR, Parts 40 & 382, hereinafter
referred to as “DOT regulations”) which govern the use of drugs and alcohol by employees who hold
a Commercial Driver’s License (CDL) and drive a Commercial Motor Vehicle (CMV). The DOT
requires an employer conduct drug and alcohol testing of its drivers at the times and under the
conditions described in this Policy. The regulations apply to every person who operates a CMV in
interstate, foreign, or intrastate commerce, to all employers of such persons and to all states. Please
direct all questions regarding this Policy to *Rayla Ewald*, the Company’s Designated Employer
Representative (DER).
It is the Company’s intention to comply fully with DOT regulations. In the event DOT regulations are
amended or revised, the Policy and the applicable terms, conditions, and/or requirements shall be
deemed to have been amended automatically. Redrafting will not be necessary in order to reflect and
be in compliance with DOT regulations. The Company reserves the right to apply the amended or
revised requirements immediately, without giving prior notice to drivers and/or applicants or other
employees covered by the Company Policy, unless DOT regulations or other applicable law requires
such notice.
The goal of the Company’s Policy and the testing of drivers is to ensure a drug and alcohol free
transportation and work environment, to reduce and eliminate drug and alcohol related accidents,
injuries, fatalities, and damage to Company property. For the purpose of this Policy, any employee
performing under the definitions described below will be referred to as “driver.”
NON-DISCRIMINATION
In accordance with the requirements of the Americans with Disabilities Act, the Company does not
discriminate against employees or applicants who are qualified individuals with a disability who are
not currently engaged in the use of illegal drugs and who do not otherwise violate the provisions of
this Policy, including but not limited to individuals who: 1) have successfully completed or who are
currently participating in a supervised rehabilitation program and are no longer engaging in such use;
or 2) have otherwise been rehabilitated successfully and are no longer engaging in such use.
CRITERIA FOR EMPLOYEES SUBJECT TO TESTING
Under the Company’s Policy and DOT Federal Motor Carrier Safety Administration (FMCSA)
regulations, drivers who hold a CDL and drive a CMV are subject to the drug and alcohol testing in
accordance with federal regulations. CMV means a motor vehicle or a combination of motor vehicles
used in commerce to transport passengers or property if the motor vehicle:
⇒ Has a gross combination weight rating of 11,794 or more kilograms (26,001 or more
pounds), inclusive of a towed unit with a gross vehicle weight rating of more than 4,536
kilograms (10,000 pounds); or
⇒ Has a gross vehicle weight rating of 11,794 or more kilograms (26,001 or more pounds);
or
⇒ Is designed to transport 16 or more passengers, including the driver; or
⇒ Is of any size and is used in the transportation of materials found to be hazardous for
the purposes of the Hazardous Materials Transportation Act and which require the motor
vehicle to have a placard under the Hazardous Materials Regulations.
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All applicants for positions as a driver or for a safety-sensitive position, which includes driving, will be
notified of the Company’s Drug-Free Workplace Program (DFWP) at the time they apply for the
position.
DEFINITION OF “SAFETY-SENSITIVE”
Safety-sensitive function means all time, from the time a driver begins to work, or is required to be in
readiness to work, until the time he or she is relieved from work and all responsibility for performing
work.
For the purpose of this Policy and the Company’s drug and alcohol testing program, employees are
considered to be performing a safety-sensitive function and subject to drug and/or alcohol t esting at
the following times:
⇒ All time at an employer or shipper plant, terminal, facility, or other property, or on any
public property, waiting to be dispatched, unless the driver has been relieved from duty
by the employer;
⇒ All time inspecting equipm ent as required by 49 CFR §§ 392.7 and 392.8 or otherwise
inspecting, servicing, or conditioning any commercial motor vehicle at any time;
⇒ All time spent at the driving controls of a commercial motor vehicle in operation;
⇒ All time, other than driving time, in or upon any commercial motor vehicle except time
spent resting in a sleeper berth;
⇒ All time loading or unloading a vehicle, supervising, or assisting in the loading or
unloading, attending a vehicle being loaded or unloaded, remaining in readiness to
operate the vehicle, or in giving or receiving receipts for shipments loaded or unloaded;
and
⇒ All time repairing, obtaining assistance, or remaining in attendance upon a disabled
vehicle.
DEFINITIONS
Definitions as used under this Policy are set forth below and in greater detail in 49 CFR §§ 40.3 and
382.107.
Drug:
For purposes of this Policy, “drug” means a controlled substance, as defined in Schedules I
through V of Section 202 of the Controlled Substances Act, 21 USC § 812. The term includes
prescribed drugs not legally obtained, prescribed drugs not being used for prescribed
purposes, and any prescribed drugs not taken in accordance with a prescription. In other
words, medications prescribed for someone other than the driver will be consider ed unlawfully
used under any circumstances. Pursuant to DOT regulations, all DOT-required drug tests
must test for the following substances identified in 49 CFR § 40.85 and § 40.871: marijuana
metabolites, cocaine metabolites, amphetamines, opioids (e.g., heroin, morphine, codeine,
hydrocodone and oxycodone) and phencyclidine (i.e. PCP or “angel dust”). The Company
reserves its independent authority and discretion to prohibit and test for other drugs, as defined
above, within the limits of applicable state law.
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Confirmation Test:
Alcohol: A second test, following a screening test with a result of 0.02 or greater, which
provides quantitative data of alcohol concentration.
Drugs: A second analytical procedure to identify and quantify the presence of a
specific drug or metabolite that is independent of the screening test.
Disabling Damage:
Damage, which precludes departure of a motor vehicle from the scene of the accident in its
usual manner in daylight after simple repairs.
Included: 1. Damage to motor vehicles that could have been driven, but
would have been further damaged if so driven.
Excluded: 1. Damage, which can be remedied temporarily at the scene of
the accident without special tools or parts.
2. Tire disablement without other damage even if no spare tire is
available.
3. Headlight or taillight damage.
4. Damage to turn signals, horn, or windshield wipers, which
makes them inoperative.
Driver:
Any person who holds a CDL and operates a CMV, which falls under the specific DOT criteria.
This includes, but is not limited to, full-time or part-time, regularly employed drivers; casual,
intermittent or occasional drivers; leased drivers and independent owner -operator contractors.
Refuse to Submit:
A refusal to submit to a required drug and/or al cohol test (also "refusal to test") means that a
driver:
1. Fails to appear for any test (except a pre-employment test) within a reasonable time,
as determined by the Company, consistent with applicable DOT agency regulations,
after being directed to do so by the Company. This includes the failure of an
employee (including an owner-operator) to appear for a test when called by the
Company’s Consortium/Third-Party Administrator (C/TPA).
2. Fails to remain at the testing site until the testing process is complete.
3. Fails to provide a urine specimen for any drug test, or fails to provide an adequate
amount of saliva or breath for any alcohol test required by Part 382 or other DOT
agency regulations.
4. In the case of a directly observed or monitored collection in a drug test, fails to permit
the observation or monitoring of the driver’s provision of a specimen;
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DOT Drug -Free Workplace Policy 2020 Version 5
5. Fails to provide a sufficient amount of urine, saliva or breath when directed, and/or,
with respect to urine or breath, it has been determined through a required medical
evaluation that there was no adequate medical explanation for the failure;
6. Fails or declines to take a second test the Company or collector has directed the
driver to take (see, for instance, 49 CFR § 40.197(b));
7. Fails to undergo a medical examination or evaluation as directed by the MRO as part
of the verification process, or as directed by the DER pursuant to 49 CFR § 40.193
or 49 CFR § 40.265(c);
8. Fails to sign the certification at Step 2 of the ATF;
9. Fails to cooperate or behaves in a confrontational way that disrupts any part of the
testing process (e.g., refuse to empty pockets when so directed by the collector,
behave in a confrontational way that disrupts the collection process); or
10. Is reported by the MRO as having a verified adulterated or substituted test result.
11. The employee admits to the collector that he or she adulterated or substituted their
specimen.
Any driver who refuses to submit to a required drug and/or alcohol test or otherwise fails to
cooperate with any part of the testing process is in violation of this Policy. Any driver who
refuses such a test will be subject to the consequences described in the "Consequences for
Policy Violations" section.
TESTS REQUIRED
In general, DOT regulations require the Company conduct, and a driver submit to, drug and/or alcohol
tests at the following times and under the following conditions:
PRE-EMPLOYMENT/PRE-PLACEMENT
A drug test is required before any driver-applicant will be hired to perform a safety-sensitive function.
A drug test will also be required before any current employee in a non-regulated position will be
assigned, transferred or otherwise permitted to operate a commercial motor vehicle on behalf of the
Company for the first time. Prior to taking a pre-employment/pre-placement drug test, the applicant
will be given forms notifying the applicant to report for a drug test. All offers by the Company to hire
an applicant for, or to assign or transfer an applicant to, a driver position are conditioned upon the
applicant:
⇒ Signing the Company’s “Pre-Employment Acknowledgement Form”
⇒ Taking and providing a negative drug test as directed by the Company;
⇒ Authorizing the Company to obtain past drug and alcohol test results. The “Previous
DOT-Testing History Form ” permits the Company to obtain past drug and alcohol test
results, including any refusals to test, from each DOT-regulated employer for whom the
driver either worked, took, or refused to take, a drug and/or alcohol test during the past
two (2) years;
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DOT Drug -Free Workplace Policy 2020 Version 6
⇒ Providing the company with information regarding whether they have tested positive or
refused to test on any DOT required pre-employment drug or alcohol test in which the
applicant applied for, but did not obtain a safety-sensitive position in the preceding two
(2) years;
⇒ Passing DOT-required physical exam required for driver positions;
⇒ Complying with any other conditions or requirements of which the Company advises the
applicant at the time of the offer.
Pursuant to DOT regulations, the Company must make a “good faith effort” to obtain a driver’s previous
testing information from the driver’s prior DOT-regulated employers, and such prior employers are
required to provide the previous testing information to the Company. This information should be
obtained before the driver first performs safety-sensitive functions, unless this is not feasible, in which
case the information should be obtained as soon as possible. In any event, a driver will not be allowed
to perform a safety-sensitive function after 30 days from the date he or she first performed a safety-
sensitive function, unless the Company has obtained or made and documented a good faith effort to
obtain the previous testing information. A separate release for each prior employer must be
signed by the applicant for the prospective employer to legally receive and utilize information.
In addition, applicants must also complete that section of the form indicating whether they have tested
positive or refused to test on any pre-employment drug or alcohol test administered by an employer
to which the applicant applied for, but did not obtain, safety-sensitive transportation work covered by
DOT agency drug and alcohol rules during the past two (2) years.
Prior to the first time a current employee performs a safety-sensitive function for the Company, the
employee will undergo a drug test. The Company will not allow an employee to perform a safety-
sensitive function unless and until the Company has received a negative test result for the employee.
A verified positive drug test will disqualify an applicant/employee from a safety-sensitive position and
the conditional offer of employment in such a position will be withdrawn. Before an applicant/employee
with a verified positive pre-employment drug test may be reconsidered for a safety-sensitive position
with the Company or any other DOT-regulated employer, the applicant/employee must complete the
DOT-required Post-Violation/Return-to-Duty process as described herein.
POST-ACCIDENT
A driver who is performing a safety-sensitive f unction must submit to a post-accident drug and alcohol
test as soon as possible after any occurrence that meets the description of a “DOT Accident.” For
purposes of this Policy and the Company’s drug and alcohol testing program, a “DOT Accident” is
defined as an occurrence involving a commercial motor vehicle operating on a public road in
commerce which results in:
⇒ A loss of human life; or
⇒ The driver receiving a citation under state or local law for a moving traffic violation arising
from the accident if the accident involved:
1. Bodily injury to a person who, as a result of the injury, immediately receives
medical treatment away from the scene of the accident; and/or;
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2. One or more motor vehicles incurring disabling damage as a result of the
accident, requiring the motor vehicle to be transported away from the scene by
a tow truck or other motor vehicle.
A driver may be directed to submit to a drug and/or alcohol test at the accident scene by a federal,
state, or local law enforcement officer. Whenever a test is conducted by a law enforcement officer,
the driver is required to immediately contact his/her supervisor or other Company official to report the
drug and/or alcohol test result and to provide the Company with the name, badge number, and
telephone number of the law enforcement officer who conducted the test.
Whenever a driver is involved in a DOT Accident and is not tested for drugs and/or alcohol by a law
enforcement official, the driver is required to immediately contact his/her supervisor or other Company
official and remain available to be tested. A driver who is subject to post-accident testing must remain
available for testing or the Company may consider the driver to have refused to submit to testing. (See
Post-Accident Flowchart to determine if testing is required).
As permitted by DOT guidance and based on the Company's independent authority, drivers involved
in a DOT Accident and required to take a Post-Accident drug and/or alcohol test will be removed from
safety-sensitive duties until the Post-Accident test results are reported to the Company. While awaiting
the Post-Accident test results, the driver will be placed on non-disciplinary suspension. Hourly (non-
exempt) employees will not be compensated for time missed from work if the test result is positive,
adulterated or substituted, but will be compensated if the test result is negative.
Alcohol:
Tests should be administered within two (2) hours of an accident. If unable to test within the two (2)
hour time period, the employer must document the reason(s) for the time delay. If the test was not
performed within eight (8) hours, cease attempts to administer the test and document the reason(s)
why the test was not conducted.
The driver must refrain from consuming alcohol for eight (8) hours after an accident and/or until the
test has been completed. A driver who is subject to post-accident testing must remain available or the
employer may consider the driver to have refused to submit to testing.
Drugs:
Tests should be administered within thirty-two (32) hours after an accident. If the test was not
performed within thirty-two (32) hours, the employer will cease attempts and prepare and maintain a
record stating the reason(s) why the test was not conducted.
In the event of a DOT Accident that involves a traffic citation, the citation must have been issued within
the foregoing prescribed time periods (8 hours for alcohol and 32 hours for drugs from the time of the
accident) to trigger a referral for a DOT post-accident test. In the event a traffic citation is not issued
within the prescribed time periods and no DOT post-accident test is performed, the Company reserves
the right, as recognized by the DOT, to require a non-DOT post-accident test based on its independent
authority and discretion, and within the limits, if any, of applicable law. Drivers may refer to the
Company’s non-DOT policy, if any, concerning non-DOT testing.
RANDOM
Every driver shall submit to random testing as directed by the Company pursuant to DOT regulations.
All such tests will be unannounced and performed at reasonable intervals throughout the year.
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Whenever a driver is randomly selected to be tested, he/she will be notified of their selection and
instructed to immediately report to the collection site. A driver who tests positive or refuses to submit
to a test is medically unqualified to drive and/or perform any other safety-sensitive function.
Each driver selected for random testing shall be tested during the selection period. If a driver selected
for random testing is on vacation, temporary layoff, medical leave or otherwise not at work, the driver
must be referred for a random test upon his/her return to work. The Company will not skip or select
an alternate in the event a selected driver is unavai lable for testing on any particular day during the
random selection period. If a driver selected for random testing does not return to work before the
beginning of a new random selection period (i.e., the next random draw), the Company will ensure
that a sufficient number of drivers are subsequently selected so the annual testing rate is not less than
the minimum annual percentage rates established by the FMCSA for random drug and alcohol testing.
Alcohol:
The annual rate for random alcohol testing is set by the FMCSA. Drivers may be tested just before,
during, or just after performing a safety-sensitive function.
Drugs:
The annual rate for random drug testing is set by the FMCSA. Drivers may be tested at any time while
the employee is at work for the employer.
REASONABLE SUSPICION
Each driver is required to submit to a drug and/or alcohol test whenever the Company has reasonable
suspicion (also referred to as “reasonable cause”) to believe that a driver has used drugs/alcohol in
violation of DOT regulations. Reasonable suspicion will exist when a driver’s appearance, behavior,
speech, and/or body odors indicate drug/alcohol use, or the chronic and withdrawal effects of
drugs/alcohol. Whenever a driver is notified that there is reasonable suspicion to be tested, the driver
is expected to report to the test/collection site immediately and will be escorted. Documentation of the
employee’s conduct and/or appearance leading to a reasonable suspicion drug/alcohol test must be
prepared and signed by the supervisor or Company official who made the observations within twenty-
four (24) hours of the observed behavior, or before the results of the drug/alcohol test are released,
whichever is earlier.
As permitted by DOT guidance and based on the Company's independent authority, following a
reasonable suspicion determination that leads to a Reasonable Suspicion drug and/or alcohol test, a
driver will be removed from safety-sensitive duties until the Reasonable Suspicion test results are
reported to the Company. While awaiting the Reasonable Suspicion test results, the driver will be
placed on non-disciplinary suspension. Hourly (non-exempt) employees will not be compensated for
time missed from work if the test result is positive, adulterated or substituted, but will be compensated
if the test result is negative.
Alcohol:
Observations must be made just before, during, or just after the driver performs a safety-sensitive
function. The person who makes the reasonable suspicion determination cannot conduct the alcohol
test.
Alcohol tests should be administered within two (2) hours of observation. If unable to test within the
two (2) hour period, the employer must document the reasons for the time delay. If the test is not
performed within eight (8) hours, cease attempts to administer the test and document the reason(s)
why the test was not conducted.
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If reasonable suspicion is observed and a test has not yet been performed, a driver will not perform a
safety-sensitive function until:
⇒ An alcohol test has been performed and the result is less than 0.02; or
⇒ Twenty-four (24) hours have passed following the reasonable suspicion determination.
Drugs:
Drug testing should be administered as soon as possible after making a reasonable suspicion
determination. If unable to drug test within thirty-two (32) hours, the employer must cease attempts
and document the reason(s) why the test was not conducted.
RETURN-TO-DUTY
A driver who has been removed from his/her safety-sensitive function due to a DOT drug or alcohol
regulation violation (e.g., a positive test, refusal to test, etc.) must provide a negative drug and/or
alcohol test before being allowed to return to a safety-sensitive function. This test is required to be
observed and must be completed after an initial and follow-up evaluation by a Substance Abuse
Professional (SAP), after the SAP’s determination that the driver has successfully complied with
prescribed education and/or treatment, and before resuming performance of a safety-sensitive
function. The result of the alcohol test must be less than 0.02.
The return-to-duty drug test is not limited to a specific substance (i.e. the particular drug for which the
driver tested positive). Additionally, if the SAP determines that a multiple-substance abuse problem
exists, a drug test may be performed in conjunction with an alcohol test.
POST–REHABILITATION/FOLLOW-UP
A driver who has violated a DOT drug and/or alcohol regulation (e.g., a positive test, refusal to test,
etc.) must be evaluated by a SAP and follow the prescribed rehabilitation/treatment program.
Following the determination that an employee needs to resolve problems associated with drug abuse
and/or alcohol misuse, each employer will ensure that the employee is subject to unannounced ,
observed, follow-up drug and/or alcohol testing as determined by the SAP. At a minimum, such testing
must consist of at least six unannounced follow -up tests in the first 12-months following the driver’s
return to safety-sensitive functions. The choice of the SAP and the assignment of costs shall be made
in accordance with employer/driver agreements and employer policies. Follow-up alcohol testing must
only be conducted just before, during, or just after a driver performs a safety-sensitive function. DOT
regulations require all Follow-up tests be observed collections.
POLICY PROHIBITIONS
Employee involvement with drugs and/or alcohol can adversely affect the work environment, job
performance, and safety of all employees. Viol ation of the prohibitions of this Policy will be considered
to be serious misconduct and may result in termination.
Drug Prohibitions:
The regulations prohibit any drug use that could affect performance of a safety-sensitive function.
Listed below are the prohibitions with respect to drug use.
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⇒ No driver shall report for duty or remain on duty requiring the performance of safety-
sensitive functions when the driver uses any drugs, except when the use is pursuant to
the instructions of a licensed medical practitioner who has advised the driver that the
drug will not adversely affect the driver’s ability to safely operate a CMV.
⇒ No employer having actual knowledge that a driver has used a controlled substance
shall permit the driver to perform or continue to perform a safety-sensitive function.
⇒ An employer may require a driver to inform the employer of any therapeutic drug use.
⇒ No driver shall report for duty, remain on duty or perform a safety-sensitive function if
the driver tests positive for controlled substances. No employer having actual
knowledge that a driver has tested positive for controlled substances shall permit the
driver to perform or continue to perform safety-sensitive functions.
⇒ No driver shall refuse to submit to a drug test required pur suant to DOT regulations.
Alcohol Prohibitions:
The regulations prohibit any alcohol use that could affect performance of a safety-sensitive function.
Listed below are the prohibitions with respect to alcohol use.
⇒ No driver shall report for duty or remain on duty requiring the performance of safety-
sensitive functions while having an alcohol concentration of 0.02 or greater. No
employer having actual knowledge that a driver has an alcohol concentration of 0.02 or
greater shall permit the driver to perform or continue to perform safety-sensitive
functions.
⇒ No driver shall use alcohol while performing safety-sensitive functions or perform such
functions within four (4) hours after using alcohol. No employer hav ing actual knowledge
that a driver has used alcohol while performing safety-sensitive functions, or used
alcohol within four (4) hours immediately preceding the performance of such functions,
shall permit a driver to perform or continue to perform safety-sensitive functions.
⇒ No driver required to take a post-accident alcohol test shall use alcohol for eight (8)
hours following the accident, or until he/she undergoes a post-accident alcohol test,
whichever occurs first.
⇒ No driver shall refuse to submit to an alcohol test required pursuant to DOT regulations.
NOTE: A regulated employee found to have an alcohol concentration of 0.02 or greater but less than
0.04 shall not perform, nor be permitted to perform, safety-sensitive functions for at least twenty-four
(24) hours.
CONSEQUENCES FOR POLICY VIOLATIONS
Removal from Safety-Sensitive Function:
Employees and applicants shall not perform, nor be permitted to perform, a safety-sensitive function,
including driving a commercial motor vehicle as previously defined in this Policy, if any of the above
prohibitions, or the drug and/or alcohol rule of another DOT agency, are violated. Employees and
applicants who violate a DOT drug and alcohol regulation will be advised by the Company of the
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resources available in evaluating and resolving drug and/or alcohol problems, including the names,
addresses, and telephone numbers of Substance Abuse Professionals (SAPs) and counseling and
treatment programs.
Additionally, employees subject to Post-Accident or Reasonable Suspicion testing will be removed
from safety-sensitive functions and receive a non-disciplinary suspension until the Company receives
the test results. Hourly (non-exempt) employees will not be compensated for time missed from work
if the test is positive, adulterated or substituted, but will be compensated if the test is negative.
Post-Violation/Return-to-Duty Procedures:
An employee who has violated a DOT drug and/or alcohol regulation cannot again perform any DOT
safety-sensitive duties for the Company or any DOT-regulated employer until and unless the employee
has completed the SAP evaluation, referral and education/treatment process. For purposes of this
Policy, a DOT drug and/or alcohol regulation violation includes a verified positive DOT drug test, a
DOT alcohol test with a result indicating an alcohol concentration of .04 or greater, a refusal to test
(including by adulterating or substituting a urine specimen) or any other violation of the prohibition on
the use of alcohol or drugs under a DOT agency regulation.
Before a driver who has violated a DOT drug and/or alcohol regulation can return to a safety-sensitive
position, he or she must:
⇒ Meet with a Substance Abuse Professional (SAP) for an initial evaluation;
⇒ Properly follow all SAP evaluation recommendations for assistance and referrals, to an
education and/or treatment program;
⇒ Meet with the SAP for a follow-up evaluation to determine whether the individual has
successfully complied with the SAP’s education and/or treatment recommendations;
⇒ Take and provide a negative return-to-duty drug and/or alcohol test; and
⇒ Be subject to post-rehabilitation/follow-up testing as determined by the SAP for up to
sixty (60) months, to include a minimum of six (6) follow-up tests in the first twelve (12)
months after the return-to-duty test with an alcohol concentration of less than 0.02 and
a negative drug test. The SAP may terminate the requirement for the follow -up testing
at any time after the first six (6) tests have been administered, if the SAP determines
that such testing is no longer necessary.
Employee Discipline:
Employees who engage in any of the prohibited conduct listed above are in violation of this Policy and
are subject to discipline, up to and including termination, at the Company’s sole discretion pursuant to
the Company’s authority independent of federal requirements.
Any employee who refuses to submit to testing or attempts to adulterate or substitute a specimen will
be terminated.
In no case will the Company continue to employ an individual who has had two occurrences.
⇒ An “occurrence” is defined as a verified positive drug test result or a confirmed alcohol
level of 0.04 or greater.
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A driver found to have an alcohol concentration of 0.02 or greater, but less than 0.04, shall not perform
nor be permitted to work for at least twenty-four (24) hours.
VOLUNTARY ADMISSION OF DRUG/ALCOHOL USE
The Company encourages all employees who need assistance in dealing with alcohol abuse or drug
dependency problems to seek appropriate counseling and/or treatment through various private and
public organizations that are available. Accordingly, employees who voluntarily come forward and
admit to alcohol misuse or drug use will not be subject to disciplinary action or the Post-
Violation/Return-to-Duty Procedures described above (i.e. the SAP evaluation, referral and treatment
requirements set forth in Parts 40 and 382). Rather, employees who self-identify their need for
assistance will be allowed sufficient opportunity to seek evaluation, education or treatment to establish
control over their drug or alcohol problem.
Employees must make any such admission or self -identification of a drug and/or alcohol problem prior
to performing a safety-sensitive function (i.e. prior to reporting for duty). Employees may not self -
identify a drug or alcohol problem to avoid testing required under DOT regulations. Employees also
may not escape discipline or the Post-Violation/Return-to-Duty Procedures by self -identifying a drug
or alcohol problem after being referred for testing or after a DOT drug and alcohol regulation violation
has occurred. Costs associated with any counseling or treatment program may be covered by the
employee’s medical insurance plan (if any); however, any costs not covered by the employee’s
medical insurance plan and which are not otherwise required to be paid by any applicable plan are
entirely the employee’s sole responsibility. The Company will comply with any applicable medical
leave law, disability discrimination law or applicable leave law in the event a leave is requested.
Employees who admit to a drug or alcohol problem will be referred to a drug and alcohol abuse
evaluation expert (i.e. employee assistance professional, SAP, or qualified drug and alcohol
counselor) for evaluation and recommendations for an appropriate education or treatment program.
Such employees will not be permitted to return to a safety-sensitive function until the Company is
satisfied that the employee has been evaluated by a drug and alcohol abuse evaluation expert and
successfully completed the expert’s recommendations for an educational or treatment program.
Before the employee’s return to a safety-sensitive function, the employee must also undergo a return-
to-duty test with a result indicating an alcohol concentration of less than .02 and/or a verified negative
drug test result. Except as otherwise required by applicable law or policy, the Company cannot
guarantee that the employee will return to the same or a comparable position upon return to duty. The
Company reserves the right, as recognized by the DOT, to require employee monitoring and/or non-
DOT follow -up testing based on its independent authority and discretion, and within the limits, if any,
of applicable law. All returning employees are required to comply with the Company’s normal
standards with respect to work performance and conduct.
SUMMARY OF ALCOHOL TESTING PROCEDURES
The DOT regulations discuss alcohol-testing procedures in greater detail in 49 CFR, Part 40.
1. Alcohol testing is done at locations determined by the Company in a private setting. The
testing technician, who has been trained, will ask test subjects to verify their identity. Drivers
must cooperate with that request. Drivers may ask the technician for identification also. The
driver’s identity will be recorded on a DOT alcohol testing form.
2. A breath or saliva testing device approved by the federal government will be used for all alcohol
tests. A screening test will be done first. If a breath-testing device is used, drivers will be
instructed to exhale forcefully into the mouthpiece of the screening device. If a saliva-testing
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device is used, a swab will be placed in the driver’s mouth and saturated with saliva. After the
saliva is collected, the swab will be inserted into the saliva-testing device.
3. The technician will show the result displayed on the screening device to the driver. If the
reading is less than 0.02, the driver has passed the alcohol test and the DOT alcohol testing
form will be completed.
4. If the screen test result is more than 0.02, a confirmation breath test, using a federally approved
evidential breath-testing device, will be performed after at least a 15-minute waiting period
from the completion of the screening test. During that time, for their own protection, drivers
should not eat or drink anything.
5. For the confirmation test, the driver will have to exhale into the evidential breath-testing device
until the technician tells the driver to stop. The driver will be shown the printed and displayed
results.
6. A confirmation test result under 0.02 means the driver has passed. A confirmation alcohol
concentration level of 0.02 or higher will result in the driver’s removal from safety-sensitive
functions. The DOT prohibits any driver whose confirmation test registers 0.02 or greater but
less than 0.04 from performing or from continuing to perform a safety-sensitive function until
the driver’s next regularly-scheduled duty period, but for no less than twenty-four (24) hours.
If the confirmation level is 0.04 or more, or if the driver refuses to cooperate, the driver is in
violation of DOT alcohol regulations and subject to the Consequences for Policy Violations
and Post-Violation/Return-to-Duty Procedures described above.
7. If a driver tries, but fails to provide a breath specimen adequate for testing, the driver will be
asked to try again. If the driver still does not provide an adequate specimen, the driver’s failure
will be noted on the DOT alcohol testing form and the Company’s DER will be informed. The
driver will be removed from performing “safety-sensitive” functions for a 24 hour time period
and required to see a doctor, acceptable to the Company, within five days for an evaluation.
If the doctor provides a written statement to the employer concluding that it is highly probable
a medical condition prevented the driver from providing an adequate breath specimen, the
driver will not be disciplined for refusing to cooperate.
SUMMARY OF DRUG TESTING PROCEDURES
The DOT regulations discuss drug -testing procedures in greater detail in 49 CFR, Part 40.
1. Drivers subject to drug testing will be directed to provide a urine specimen at a Company
designated facility. The driver will be driven or sent to the facility and required to verify his or
her identity. In return, a driver may ask collection site personnel to disclose their identity.
2. The driver’s urine specimen will be collected by a trained collection site person (the Collector)
in accordance with DOT rules, using a DOT Custody and Control Form (CCF), also known as
chain-of -custody form. To protect themselves, drivers should ensure that the entries on the
form are accurate, that their collected urine specimens have been sealed, and that their
specimens are labeled with the same number as appears on the CCF and are placed in a
container with copies of the correct CCF.
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3. The Collector shall require drivers to remove unnecessary outer garments that might conceal
items used to tamper with the collection process. The Collector shall also retain personal
belongings like briefcases and purses during the collection process. Drivers may keep their
wallets and ask for a receipt for any belongings they surrender. The Collector will direct the
driver to empty his or her pockets and display the items in them and the driver must allow the
Collector to make this observation.
4. Drivers will be given a collection container and allowed to provide a urine specimen in private
unless: the laboratory reports a specimen was invalid and the MRO reports there was no
adequate medical explanation for the result; the original positive, adulterated, or substituted
test result had to be cancelled because the test of the split specimen could not be performed;
the laboratory reports a specimen as having a low creatinine concentration (i.e., a creatinine
concentration greater than or equal to 2 mg/dL and less than or equal to 5 mg/dL) and the
MRO reports the specimen as negative and dilute; the Company directs a return-to-duty test
or follow-up test be performed under direct observation; the Collector observes materials
brought to the collection site or the driver’s conduct clearly indicates an attempt to tamper with
a specimen; the temperature on the original specimen was out-of-range; or the original
specimen appeared to have been tampered with. In such circumstances, the DER will be
notified and drivers will be requir ed to provide a specimen while being observed.
5. If the driver does not provide a sufficient amount of urine for testing (at least 45 ml), the
Collector will discard the specimen, tell the driver to drink additional fluids, wait up to three (3)
hours and try again to provide a specimen. If the driver refuses to drink those fluids or provide
another specimen, the Collector shall notify the Company’s DER of the driver’s refusal to
cooperate. If the driver cooperates, but still does not provide an adequate specimen, testing
will stop and the driver will be sent to a doctor acceptable to the Company’s MRO within five
working days for an evaluation. If that doctor states in writing to the Company’s MRO that it is
highly probable that a medical condition prevented the driver from providing an adequate
specimen, the driver will not be disciplined on grounds of refusing to provide a specimen.
6. If the driver provides a sufficient amount of urine for testing, it will be inspected by the Collector
and its temperature will be measured. If there is a reason to believe an altered or substituted
specimen has been provided, the DER will be notified and a second, observed specimen will
be collected. Collected specimens will be poured into two containers (i.e. a split-specimen
collection). The collector will seal the bottles by placing the tamper -evident bottle seals over
the bottle caps/lids. The collector will date the seals and instruct the donor to initial the tamper-
evident bottle seals for the purpose of certifying the bottles contain the specimens he or she
provided.
7. Both specimen containers will be sent to a federally certified laboratory designated by the
Company. The lab will review the CCF and check the specimens for apparent tampering. Any
apparent tampering or CCF problems will be reported to the DER.
8. If the specimens appear to be in order, the lab will run an initial screening test on the primary
specimen. If the screening test is negative, the lab will report the result as negative and the
driver has passed the drug test. If the screening test is positive, the lab will conduct a
confirmation test and analyze the specimen using Gas Chromatography/Mass Spectrometry
(GC/MS). The laboratory will send the test results to the Company’s Medical Review Officer
(MRO).
9. The MRO is a trained doctor the Company has retained to review test results and to evaluate
any explanation a driver may have for a positive, adulterated, substituted (because of a
creatinine concentration of less than 2 mg/dL), or invalid drug test result. The MRO will
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telephone drivers at the numbers given on the CCF. If a driver believes a mistake was made
at the collection site or lab, or on a CCF, or that the drug test result is caused by lawful
substance use, the driver should tell the MRO. Drivers should cooperate with the MRO. If a
driver does not cooperate, the Company will be notified and the driver may be removed from
duty and disciplined or discharged pursuant to the Company’s independent authority (or not
hired, if the driver is an applicant).
10. If a driver wants his or her split specimen to be tested by another certified lab at the driver’s
expense, the driver should tell the MRO within 72 hours of notice of a positive, adulterated or
substituted drug test result. The driver will not have the opportunity to provide another
specimen. The retest will be conducted on the secondary container of the original specimen.
The driver’s secondary specimen will then be sent to a different Company-approved, certified
laboratory for re-analysis. If that second lab does not find any evidence of the drug(s) that the
first lab found or the split specimen cannot be tested, the MRO will cancel the test results and
the driver will not be subject to discipline. If the second laboratory finds evidence of the drugs,
adulteration or substitution that the first laboratory found, the MRO will tell the DER the split
specimen was positive, adulterated or substituted. As provided in 49 CFR § 40.187(a)(3), in
the case of a reconfirmed substituted result in which the creatinine concentration for the
primary specimen was less than 2 mg/dL and the creatinine concentration of the split specimen
is between 2 and 5 mg/dL (inclusive), the MRO will report the result as "dilute" and the driver
will be required to undergo an immediate recollection under direct observation.
11. If the MRO informs the Company that a negative drug test was dilute, the following will apply.
• Dilute Negative with Low Creatinine: If the MRO indicates that a recollection under direct
observation is required because the creatinine concentration of the specimen was equal
to or greater than 2 mg/dL but less than or equal to 5 mg/dL, the Company must
immediately instruct the driver to undergo a recollection under direct observation. The
DOT's stated purpose for this requirement is so that people who may naturally produce
low creatinine levels will not be reported to employers as having substituted their
specimens.
The DOT prohibits any driver who has a verified positive, adulterated or substituted drug test result,
from performing or from continuing to perform a safety-sensitive function until he/she has met the
proper DOT requirements as described in the “Post-Violation/Return-to-Duty Procedures” section
above under Consequences for Policy Violations.
Medications prescribed for someone other than the driver, will be considered unlawfully
used under any circumstance. The DOT also indicates that a driver’s purported use of
marijuana for medical purposes (even if pursuant to state “medical marijuana” law) or
use of hemp or marijuana-related products does not constitute a legitimate medical
explanation for a positive test result and these are insufficient grounds for the MRO to
verify the test result as negative.
EDUCATION AND TRAINING
The Company has available information, education and training regarding problems associated with
drug and alcohol abuse in the workplace and otherwise. One important source of information is the
“Employee Handbook.” We also provide training for supervisors and managers thr ough, among other
things, the “Supervisor Training Manual.”
The Company's educational and training materials include information on available methods of
intervening when an alcohol or controlled substances problem is suspected, including confrontation,
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referral to any employee assistance program and/or referral to management. If there are concerns
regarding a suspected substance abuse problem, the Company encourages employees to contact the
DER or other Company designee to obtain referrals to any employee assistance program and/or
appropriate counseling or treatment programs through various private or public organizations. Contact
the Company's Designated Em ployer Representative, Rayla Ewald at 763-717-4016, for more
information.
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DOT Drug -Free Workplace Policy 2020 Version 17
ACKNOWLEDGEMENT
Driver s must sign an acknowledgement form (a copy of which is attached hereto and made a part
hereof) after receiving a copy of this Policy and prior to testing.
RESERVATION OF RIGHTS
This Policy supersedes and revokes any other Company practice or policy relating to the use of drugs
and alcohol in the workplace and drug and/or alcohol testing. The Company reserves the right to
interpret and administer this Policy, and at any time and at its sole discretion, amend or change this
Policy, in whole or in part, with or without notice. This Policy automatically incorporates any changes
to DOT or FMCSA regulations (49 CFR, Parts 40 and 382) or related regulations or statutes that
govern the use of drugs and alcohol by employees who hold a CDL and drive a CMV. This Policy is
not an express or implied contract of employment nor is it to be interpreted as such. Additionally, this
Policy does not in any way affect or change the status of any at-will employee. Nothing in this Policy
is a promise or guarantee or should be construed as a promise or guarantee that the Company will
follow in any particular circumstances any particular course of action, disciplinary, rehabilitative or
otherwise.
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DOT Drug -Free Workplace Policy 2020 Version 18
Attachment to FMCSA Drug-Free Workplace Policy
SIGNS AND SYMPTOMS OF A DRUG-ALCOHOL PROBLEM
Drugs and alcohol can result in such work-related problems as absenteeism and tardiness, lower
productivity, missed deadlines, poor work quality, unsafe driving, and increased injuries and accidents.
Problems relating to or communicating with supervisors, co-workers or customers, following directions,
concentrating or remembering things may also indicate a drug or alcohol problem.
Drugs and alcohol slow reaction times, cause confusion, harm coordination and motor skills and can
impair decision-making and memory. People misusing alcohol and using illegal drugs may be
withdrawn, lethargic, depressed, erratic, “hyper” or unusually anxious, hostile or paranoid.
Drugs and alcohol misuse can also result in health problems like chronic gastritis, headaches, chronic
respiratory infections and liver problems. They may also show up as poor hygiene, a sloppy
appearance, financial problems, DUIs or family problems.
Evidence of use can include paraphernalia such as pipes, syringes, foil packets, pills, powders and
empty alcohol containers. Physical symptoms of use can include:
⇒ Marijuana and alcohol odors
⇒ Puffy or droopy eyelids, bloodshot eyes, dilated or pinpoint pupils
⇒ Nosebleeds, excessive sniffling, chronic sinus problems, nasal sores
⇒ Needle tracks or blood spots on clothing
⇒ Tremors, racing or irregular heartbeats
⇒ Slurred or incoherent speech
⇒ Confusion, anxiety, paranoia
⇒ Coordination problems
⇒ Lethargy and sleepiness
EFFECTS OF ALCOHOL AND DRUGS
Drugs and alcohol can harm health and the workplace in a variety of ways.
Alcohol
Alcohol is a central nervous system depressant that acts like a poison if used in large quantities. Each
year the lives of tens of thousands of Americans are shortened or ended by alcohol misuse.
Alcohol quickly reaches the brain after drinking. It impairs self -control and other learned behaviors.
This loss of self-control can lead to aggressive driving (or overly cautious driving), as well as the other
kinds of aggressive behaviors associated with drinking. Even small doses of alcohol, i.e. a single
drink, can harm driving performance. In large doses, alcohol significantly impairs coordination,
memory and judgment.
Over time, alcohol misuse damages the liver, the heart, the digestive system and can cause
permanent brain damage. On average, alcoholics shorten their life span by about 10 years.
Alcohol misuse harms the ability to think clearly, harms judgment and can affect the ability to get along
with and work constructively with co-workers and customers. Alcoholics often have attendance and
work performance problems and get fired because of the consequences of alcohol misuse. Because
of its adverse effects on coordination, reflex time, vision, driving ability, judgment and the ability to
evaluate and quickly process information, alcohol is especially dangerous for drivers of commercial
motor vehicles.
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A small glass of wine, a can of beer and a one and one-half ounce shot of liquor all contain about the
same amount of alcohol. It takes the body about one hour to metabolize and eliminate each “drink” of
alcohol. Coffee, exercise and cold showers do not speed up this process or magically produce
sobriety. While individuals differ greatly, each drink on an empty stomach by an average-sized adult
male may lead to an alcohol concentration of about .02. Thus, drinking more than two drinks raises a
serious risk of having an alcohol concentration in excess of DOT rules, especially for people with low
body weights. Any drinking while on duty or during the 4 hour s before working violates DOT rules.
Cocaine
Cocaine is a powerful stimulant that can be inhaled up the nose, injected or smoked. It greatly
increases heart rate and blood pressure. Partly because of its effects on the circulatory system,
cocaine use ca n lead to seizures. Every time cocaine is used, there is some unquantifiable risk of a
fatal stroke or heart attack. Cocaine can also cause tremors, convulsions, vomiting and raises body
temperature to dangerous levels. Repeated snorting damages nasal tissues, sometimes permanently.
Needle use carries risks of infection and overdose.
Initially, cocaine use brings a rush of euphoria and exaggerated overconfidence. Sometimes these
effects are so strong that safe driving is impossible. Cocaine wears off in about an hour after it is
snorted and in just a few minutes after it is smoked. When it wears off, the user may become
depressed, anxious, paranoid and exhausted.
Cocaine users may exhibit rapid mood swings and changes in activity level. They may gr ind their
teeth, repeatedly wash their hands or engage in other compulsive behaviors.
Amphetamines
Amphetamines, also known as “speed,” are powerful stimulants that are often abused by truck drivers
because they make it easy to stay awake. Amphetamines, however, are dangerous drugs with a high
potential for abuse. Amphetamines may also be known as uppers, black beauties, white crosses or
dexies.
Use brings feelings of alertness and a loss in appetite. The user may also become very talkative or
physically active or feel very strong after ingesting amphetamines. In a few hours however, the
amphetamines wear off and restlessness, anxiety, paranoia and headaches set in.
In large doses, amphetamines can produce serious toxic effects. The user’s blood pressure can rise
to the point where strokes or heart attacks occur. Long -term users often have acne, tooth problems
and may exhibit symptoms of permanent brain damage.
Marijuana
Marijuana is a hallucinogen that alters the user’s sense of time and reduces the user’s ability to perform
tasks requiring coordination, swift reactions and concentration. Taken in large quantities, marijuana
can act like a depressant.
While some people may regard marijuana as harmless, there is evidence its use is unhealthy and
dangerous for the driver. Marijuana causes significant increases in blood pressure and pulse rate
and, thus, can aggravate or cause heart disease. Marijuana smoke also contains a number of known
carcinogens. Many experts believe that marijuana is actually unhealthier to smoke than tobacco.
Studies have shown that smoking marijuana affects the ability to perform tasks like driving, which
require both thinking and motor skills, for at least 24 hours. Users, however, often believe that all the
impairing effects of smoking have worn off after 4 to 6 hours. Marijuana significantly impairs short-
term memory and can harm the user’s ability to concentrate or plan for and achieve long -term goals.
There is also significant evidence that marijuana harms the reproductive systems of men and women
and is dangerous for children and non-smokers who live with the user.
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Opiates
Opiates are a class of narcotics and sedatives derived from the opium poppy plant. Heroin is the
strongest opiate. Heroin use has been increasing in recent years because of the availability of cheap,
strong heroin from Asia. This new stronger heroin can be smoked or snorted. Heroin can also be
injected using needles.
Morphine and codeine are opiates that are often used to relieve pain or induce sleep. However, they
can be stolen from hospitals or pharmacies and abused.
Opiate misuse causes a number of health problems. Because of variations in dosages and strength,
heroin use carries a risk of overdose and death. Addicts who use needles also risk contracting AIDS
or hepatitis. Heroin is often contaminated with other drugs or toxins or combined with other narcotics.
Opiate use slows down and depresses a number of body functions, including brain functioning. Heroin
users may act sleepy or euphoric for a while and then become anxious or irritated after the heroin
wears off. Heroin users tend to have a number of related health problems and tend to also abuse
alcohol and tobacco. Together, these drugs and the unhealthy lifestyles of heroin users result in
decreased life expectancy.
PCP
Phencyclidine, or PCP, is also called angel dust or dust. PCP is an extremely dangerous hallucinogen
that has unusual and unpredictable side effects. It was developed as an anesthetic in the late 1950’s
and used for a while as a tranquilizer both for humans and animals. Because of its dangers, it now
has no legal uses and is no longer legally manufactured. Rather, PCP is manufactured in underground
laboratories. It often contains dangerous adulterants but is very dangerous all by itself.
PCP can produce violence and bizarre behavior in anyone who uses it. Occasionally, PCP users
attack nurses and policemen or jump out of windows because they believe they can fly. PCP somehow
scrambles the brain’s internal stimuli and seriously changes how users feel, see and deal with their
environment.
In low doses, PCP produces a feeling of numbness. Increased doses produce excitement, confusion
and delirium. The user’s body may become rigid or go into convulsions. Routine activities like driving
become dangerous and unpredictable.
Users may walk with strange uncoordinated steps. PCP users may have a blank stare, sweat heavily,
have thick slurred speech or engage in some of the violent and bizarre behaviors mentioned above.
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Acknowledgement of Receipt of Policy
I hereby acknowledge that I have received, read, and understand my Company’s Drug-Free
Workplace Program Policy required by Department of Transportation (DOT) regulations. I understand
that I am subject to and must adhere to the DOT regulations, and must abide by the terms of the
Company’s Policy as a condition of employment.
I understand that during my employment I may be required to submit to drug and/or alcohol tests
based on Department of Transportation regulations as directed by the Company. I agree to comply
with the Company’s Policy on drugs and/or alcohol and understand failure to comply is grounds for
disciplinary action, up to and including termination, in addition to any action required by DOT
regulations.
I also understand that refusal to submit to a controlled substances or alcohol test is a violation of DOT
regulations, as well as the Company's Policy, and may result in disciplinary action, including but not
limited to suspension (with or without pay) or termination of employment, in addition to action required
by DOT regulations. I further understand the consequences related to controlled substances use or
alcohol misuse as prohibited by Company's Policy.
I acknowledge that the provisions of Company's Drug -Free Workplace Program Policy are part of the
terms and conditions of my employment, and that I agree to abide by them.
THE UNDERSIGNED STATES THAT HE OR SHE HAS READ THE FOREGOING
ACKNOWLEDGEMENT AND UNDERSTANDS THE CONTENTS THEREOF.
Employee Name: _______________________________________ Date:
Employee Signature:
Company Name: City of Mounds View
I am the parent/guardian of_____________________________________________________, and I
acknowledge that I understand the company’s Drug-Free Workplace policy. I hereby agree to his/her
participation in the Company’s Drug -Free Workplace Program.
Parent/Guardian Signature: Date:
Parent/Guardian Printed Name: Date:
NOTE: This certificate should be retained in a secured file.
A-3
CITY OF
Mounds View
AWAIR
A Workplace Accident & Injury Reduction Program
Safety Manual
Table of Contents
Page(s)
Introduction .............................................................................. 1
Safety Policy Statement .......................................................... 2
Revision of Program ................................................................ 3
Application ............................................................................... 3
Goals and Objectives ............................................................... 4
Safety Committee ..................................................................... 4
Roles and Responsibilities .................................................... 5-7
Enforcement Of Safety and Health Programs ......................... 8
Hazard Identification, Analysis and Control ............................ 9
Communication ...................................................................... 10
Contractor Duties .................................................................. 11
Accident Investigation ........................................................... 12
Figure 1: Accident and Injury Flowchart ........................ 13
Program Evaluation ................................................................ 14
1
Introduction
In 1990, the State of Minnesota amended the Occupational Safety and Health Act.
Minnesota Statutes Chapter 182.653 subd.8 requires employers in certain industries
to develop written, comprehensive workplace safety and health programs which are
based on the NAICS (North American Industry Classification System) system. This
legislation is known as A Workplace Accident and Injury Reduction (AWAIR) Act.
Programs developed to comply with the act are known as AWAIR programs. The
requirements of the legislation that are addressed and complied within our program
are as follows:
1. How managers, supervisors and employees are responsible for implementing
the program and how continued participation of management will be
established, measured and maintained;
2. The methods used to identify, analyze and control new or existing hazards,
conditions and operations;
3. How the plan will be communicated to all affected employees so they are
informed of work-related hazards and controls;
4. How workplace accidents will be investigated and corrective action
implemented; and
5. How safe work practices and rules will be enforced
MNOSHA has adopted a list of NAICS codes that we have determined to exist within
our jurisdiction as a public entity. These departments are under our blanket AWAIR
program. The NAICS codes for the departments under our AWAIR Program are
highlighted on the listing in Appendix A.
2
Safety Policy Statement
The administration of the City of Mounds View is aware that our employees are our
most valuable resource. Our safety policy reinforces our commitment to providing a
safe, injury and illness free work place. The success of our safety program requires
clearly defined goals, specific objectives and the identity of those that will share the
responsibility of accomplishing those goals and objectives.
Our AWAIR Program provides an “umbrella” under which all other safety policies and
procedures will be administered.
3
Revision of Program
The Safety Committee annually reviews this program and may make necessary revisions.
The Approving Authority shall retain the responsibility for all policy revisions.
DATE REVIEWED SIGNATURE
Application
This AWAIR program is intended to serve as an overview of all currently applicable Safety
and Health programs. This program outlines the philosophy by which the City of Mounds
View will develop, implement and maintain all other safety and health programs which
concern more specific topics.
While compliance with the law and OSHA standards is an important objective, an effective
AWAIR program must be tailored to the City of Mounds View’s particular needs. This
program shall look beyond specific legal requirements to identify and analyze existing
hazards. It shall seek to prevent injuries and illnesses, even when compliance is not an
issue. Ultimately, the program’s effectiveness in practice is what is important.
Should a department’s operations require the need for a specific addition to this program,
said specifics will be added as an addendum for that department and be maintained by
that department within their operations.
4
Goals and Objectives
Central to our AWAIR program are the goals and objectives we, as an organization,
have set for our overall safety and health program. The goals establish the direction
for our program and state what we are attempting to achieve through this program.
Our goals are generally challenging to reach or complete, but are also possible to
achieve. The goals are specific to the City of Mounds View. Our objectives are specific
actions that we will be taking to attempt to achieve those goals. Our objectives can
either be measured or demonstrated.
Safety Committee
The City of Mounds View has established a safety committee pursuant to Minnesota
Statutes through the League of Minnesota Cities Insurance Trust Regional Safety Group
program. The group of cities hold safety committee meetings on a regular basis.
All departments within the city’s operations may have Representatives on the Safety
Committee. Management/Supervisory personnel may have a representative on the safety
commi ttee.
The City Council may have a representative on the safety committee.
Safety Committee members will be able to perform their duties without fear of
discrimination or retaliation by management or the governing body.
5
Roles and Responsibilities
For Everyone in the Organization:
All employees, including supervisors and managers, must follow all safety rules at all
times.
For Employees:
1. Employees must promptly report any safety and health hazards they observe
to their supervisor or safety committee representative.
2. An employee’s first priority is to perform each job task safely. If an employee
is unsure how to perform the task safely, he or she must consult with their
supervisor.
3. Employees must wear personal protective equipment as required for their
protection and maintain the equipment in a sanitary manner.
4. Employees must report all accidents and near misses to their supervisor
immediately upon occurrence.
For Supervisors:
1. Supervisors must discuss any current safety issues with their employees at the
beginning of all regularly scheduled staff safety meetings or at the
tailgate/toolbox meetings.
2. Supervisors will address all safety concerns raised by staff by initially
investigating the issue, determining if the concern is valid and taking
appropriate corrective action whenever necessary. Corrective action can
include ordering new equipment, issuing maintenance work orders or
consulting with the safety director, the safety committee or upper
management.
3. Immediately upon learning of an accident or near miss the supervisor must
initiate an investigation and submit the completed accident investigation report
to the safety director.
4. Supervisors will actively and positively participate in all safety committee
inspections of their assigned areas.
For Human Resources Director/Human Resources Representative:
1. The Human Resources Director or Representative will serve as the lead person
in the organization for safety and health issues and will serve as an ex officio
member of the safety committee.
2. The Human Resources Director or Representative must review all First Reports
of Injury and Accident Investigation Reports with the safety committee and
take appropriate action to prevent recurrence.
6
3. The Human Resources Director or Representative will ensure that all safety
training required by regulation or identified by management, supervision or
the safety committee is addressed as needed to assure a safe workplace.
4. The Human Resources Director or Representative will recommend
improvements in physical plant, machinery, equipment, raw materials and
personal protective equipment to management, supervision and the safety
committee.
For Safety Committees:
1. The safety committee will conduct meetings, assist in area inspections, review
accident reports, identify hazards, and address any and all safety concerns
raised by employees, first-line supervision or the safety director.
2. The safety committee representatives will review their respective AWAIR
program at least annually and make recommendations concerning updates and
revisions to the program to senior management and the safety director.
3. Safety committee members each represent their particular work area and,
therefore, should address all safety concerns brought to them by their
coworkers. These concerns should be handled by initially investigating the
issue with the area supervisor to determine if the concern is valid and then, as
necessary and appropriate, bring the issue to the safety director or the full
safety committee.
For Management/Administration:
1. Managers will communicate to all employees and supervisors the importance
of worker safety and health throughout the organization.
2. Management shall review all safety concerns brought forward by the safety
director, the safety committee or first-line supervision and take appropriate
action.
3. Management shall review the AWAIR program and any recommended
revisions from the safety committee at least annually, make the appropriate
revisions and work with the safety director, the safety committee and first-line
supervision to communicate the revisions throughout the organization.
4. Management also establishes the importance of the AWAIR program, both by
the priority they give workplace safety and health issues and by the example
they set by initiating safety and health improvements, correcting hazards,
enforcing safety rules, rewarding excellent performance in safety and health,
and by following all safety rules. Safety and health programs are similar to
quality improvement and other efforts organizations engage in to continually
improve performance, customer service, competitiveness, organizational
culture, etc.
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For Elected/Appointed Officials:
1. Officials will communicate to all Managerial/Administrative personnel the
importance of safety and health throughout the city/utility.
2. Elected/Appointed Officials will provide the resources to improve safety and
health throughout the entire organization. This includes providing employees
and supervisors with the authority to identify and correct hazards, the budget
to purchase new equipment or make repairs, the training necessary to work
safely and to recognize hazards, and the systems to get repairs made,
materials ordered and other improvements accomplished.
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Enforcement of Safety and Health
Programs
Enforcement of safe work practices should be fair, consistent throughout the
city/utility, and based on established policy. Management and supervision should be
conscious of the examples they set for the workplace and should obey the same rules
as the rest of the workforce.
Unsafe or unhealthy work action by all employees shall be corrected in a timely
manner based on the severity of the hazards. The enforcement of the program is
based on the following methods:
1. Verbal warning
2. Written warning
3. Leave without pay
4. Termination
Or Take Safety Program Enforcement from union contract language agreement or
current personnel manual.
Disciplinary action will follow the above sequence unless the situation warrants more
severe action.
Not only should negative behavior be discouraged, but positive behavior should be
reinforced as well. Exceptional performance or efforts in workplace safety and health
should be recognized by the organization.
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Hazard Identification, Analysis
and Control
The City of Mounds View will use the following steps to Identify, Analyze and Control
hazards:
Walk-around inspections by Supervisors, Management or the Safety
Committee members
Job or safety hazard analyses of different parts of the operation
Inspections should be done on a regular basis to identify both newly developed
hazards and those previously missed
Periodic industrial hygiene monitoring and sampling for agents such as
hazardous substances, noise and heat
Job hazard identification checklists
Employee reporting of workplace safety and health hazards
Employee hazard abatement suggestions
Preventative maintenance inspections
Engineering controls
Administrative controls
Personal Protective Equipment
Management and Employee Training
The City of Mounds View may use the enclosed forms to assist in the Identification,
Analysis and Control of hazards:
SP 1 – Hazard Inventory
SP 2 – Safety Inspection Checklist
SP 3 – Report of Unsafe Conditions
SP 4 – Hazard Elimination Evaluation Control Worksheet
SP 5 – Job Hazard Analysis
SP 6 – Indoor Environmental Audit
SP 7 – Personal Exposure Monitoring
SP 8 – Certification of Employee Training
SP 10 – Accident/Injury Investigation
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Communication
All managers and supervisors are responsible for communicating with all workers
about occupational safety and health in a form readily understandable by all workers.
Our communication system encourages all workers to inform their managers and
supervisors about workplace hazards without fear of reprisal.
Our communication system may include one or more of the following items:
New worker orientation including a discussion of safety and health policies
and procedures
Review of our program
Training programs
Regularly scheduled safety meetings
Posted or distributed safety information
A system for workers to anonymously inform management about
workplace hazards
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Contractor Duties
All contractors shall follow any and all Minnesota OSHA, Federal OSHA, MN DOT, MPCA
and other regulatory agency’s rules that pertain to their worksites in the State
of Minnesota. All contractors shall be responsible for initiating, maintaining and
supervising safety and health related policies, programs and work practices in
connection with the performance of contractual work.
Duties to Sub-contractors
Contractors that use sub-contractors shall be responsible for communicating any and
all safety and health related information to those sub-contractors and shall ensure
that sub-contractors initiate, maintain and supervise safety and health related polices,
programs and work practices while performing sub-contracted work.
Imminent Danger
In the event of an imminent danger situation, the City of Mounds View reserves the
right to suspend contracted work if said work exposes the employees of either
employer to imminent danger.
Imminent Danger Definition per MNOSHA:
Imminent danger situations are given top priority. An imminent danger is any condition or practice that
presents a substantial probability that death or serious physical harm could occur immediately or before the
danger can be eliminated through normal enforcement procedures. MNOSHA becomes aware of these
situations through reports received from employees, the general public or direct observation by an
investigator.
If an imminent danger situation is identified, the safety and health investigator will ask the employer to
voluntarily eliminate the hazard and to remove the endangered employees from exposure. If the employer
fails to do this, MNOSHA may "red tag" the equipment or job site for 72 hours.
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Accident Investigation
Procedures for investigating workplace accidents, hazardous substance exposures,
and near misses include:
1. Interviewing injured workers and witnesses;
2. Examining the workplace for factors associated with the accident/exposure;
3. Determining the most probable cause of the accident/exposure;
4. Taking corrective action to prevent the accident/exposure from re-occurring;
and
5. Recording the findings and actions taken. It should not be to affix blame.
Each contributing factor should be traced back to its root cause. A written report that
describes the accident and its causes and recommendations for corrective action and
prevention will be prepared and presented to management.
The ultimate goal of the investigation is to determine the basic and root causes and
to determine appropriate corrective action so the incident does not happen again. To
simply attribute an accident to “employee error,” without further consideration of the
basic causes, deprives the organization of the opportunity to take real preventive
action. Possible use of engineering controls, improved work practices and
administrative controls should be considered to help employees do their jobs safely.
Management practices may also be considered as a possible basic factor. For
example, if there is managerial or supervisory pressure to increase production or cut
costs, employees may take unsafe shortcuts in work procedures or delay or skip
necessary preventive maintenance.
The Accident/Injury Investigation Form (Form SP 10) may be used.
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Figure 1: Accident and Injury Flowchart
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Program Evaluation
The AWAIR Act requires employers to review the entire program at least annually and
document the findings. Program review is vital because it serves as a check to see if
the organization is making progress towards its goal of creating a safer, healthier
workplace for all employees. The annual review keeps the program fresh, accurate
and an integral part of the organization.