Is Donning and Doffing About to Change in Health Care?

Los Angeles, CAThe relationship between overtime pay laws and donning and doffing (in other words, getting into and climbing out of uniforms or protective gear depending upon the job at hand), has always been a contentious one, landing many a plaintiff into a California court arguing that if an employer requires special equipment necessary for the job, then the respective dressing and undressing out of mandated clothing and equipment should be compensable.

The Fair Labor Standards Act (FLSA) carries provisions for donning and doffing with rare exceptions, depending upon the case involved.

However, could potential changes to how hospitals manage serious infections remove donning and doffing as an issue for health care workers?

The October issue of the Patient Safety Monitor Journal (10/01/16) highlights mounting evidence that contact precautions may not be necessary, as it turns out, to prevent the transmission of certain infections. Were hospitals to make changes in their guidelines, the net result could impact whether, or not hospital workers and care givers are required to don, and doff protective gowns currently required to minimize transmission of infection.

A California-based study undertaken by researchers at the University of California-Los Angeles (UCLA) Health and published this past July in Infection Control and Hospital Epidemiology (ICHE) found that discontinuing contact precautions for patients with MRSA and vancomycin-resistant Enterococcus (VRE) had a negligible impact on infection rates. Further, infection rates for both MRSA and VRE declined slightly after one year of study, without the use of previously-mandated contact precautions.

It should be noted that the results were achieved in tandem with expanded use of chlorhexidine gluconate.

Researchers further estimate that during the study savings in health care costs amounted to $643,776 for isolation gowns and $4.6 million in clinician time spent donning and doffing personal protective equipment used primarily to protect healthcare workers from infection, and to help prevent the spread of infection.

While advocates note that further study is warranted before hospitals and the healthcare system adopt such changes in protocol and infection prevention, the study sheds light onto the costs associated with donning and doffing for job-specific applications – the costs to the employer, together with the costs to the court system and to plaintiffs who are made to don, and then doff protective clothing and equipment at the behest of the employer, without being paid for the time needed to undertake the requirements – and the resulting non-compliance with overtime laws.

Angst over the donning and doffing of uniforms and gear – and the issue over the potential for unpaid overtime – is not new in California. It was on May 5, 2009 – more than seven years ago – that a US District Court in Los Angeles ruled in Nolan et al. v. City of Los Angeles et al. (Case No. CV03-02190GAF) that donning and donning was not only compensable under FLSA, donning and doffing was also compensable if performed at home before, and after work.

The case revolved around the Los Angeles Police Department (LAPD), and the various uniforms and pieces of equipment – all required to be worn in a specific fashion for standards involving safety and protocol – needed to perform the job and the various tasks at hand, including Kevlar body armor and Sam Browne belts.

While the Court ruled that officers did not require compensation for cleaning and maintaining their equipment, given the existence of a clause in their collective bargaining agreement with respect to a stipend paid for maintaining their equipment in good order, the Court nonetheless ruled that donning and doffing their uniforms and protective gear was compensable and therefore qualified for overtime pay according to California overtime law and the FLSA.