THE
THE
Section
2. Payroll Deductions.
Section
3. Time Off for Association Business.
Section
5. Members of the Board of Directors.
Management
Duties to the Association
Section 1. The City shall provide the
following materials to every officer:
Section 2. The City shall not engage in
the following practices:
Section 3. Consistent Interpretation.
Non-Discrimination
by the Association
Section
1. Labor Relations Committee.
Section
2. Labor Relations Subcommittees.
Section
3. Defense of Officials.
Section 2. Preventive
Vehicle Maintenance Program.
Section
7. Labor Relations Committee as
Equipment Advisory Committee.
Section
8. Reimbursement Procedures.
Section
9. Standardized Installation of
Equipment.
Section
3. Promotion to Detective
Investigator, Sergeant, Lieutenant and Captain.
Section
4. Requirements After Promotion.
Section
5. Appointment
to Commander.
Section
6. Appointment to Deputy Chief.
Section
7. Appointment of Assistant Chief.
Section
2. Six-Month Requirement.
Section
3. “All Other Things Being Equal”
Defined.
Section
4. Military or Duty-Connected
Disability.
Section
5. Seniority Tie-Breaker.
Section
6. Certain Officer Transfer Rights.
Section
7. Personnel Career Activity
System.
Section
1. General Provisions.
Section
2. Local Government Code Section
142.0015 Override.
Section
3. General Provisions.
Section 4. Hours for Certain Patrol
Division Units.
Section
5. Hours for Certain Units.
Section 6. Adjustment of Working
Hours.
City
Property/Off-Duty Employment Office
Section
3. Use of Sworn Personnel at
City Facilities.
Section
1. Scope of Procedure.
Section
3. Shift Differential Pay.
Section
6. Language Skills Pay.
Section
7. Helicopter Assignment Pay.
Section
8. Drug Recognition Experts.
Section
9. Volunteers in Policing.
Section 10. Overtime, Regular Rate, and
other Pay Calculations.
Section
3. Staffing of Holidays.
Miscellaneous
Leave Provisions
Section
2. Leave Pay Upon Separation.
Section
5. Compensatory Time Accrual.
Section
6. Holiday Leave Accrual.
Section
9. Injury-on-Duty Leave.
Section
12. Leaves of Absence.
Working
in a Higher Classification
Section 2. Acting In A Higher Position.
Section
3. Temporary Investigative/Undercover
Assignment.
Section
4. Exceptions and Grievability.
Section
2. Police Initial Probationary
Period.
Section
3. Special Assignment.
Section
5. Probationary Dismissal.
Section
6. Probationary Direct Deposit.
Section
1. Field Training Officer Program.
Section
2. FTO Minimum Requirements.
Section
3. Hours and Assignment, Emblem,
and Voluntary Service.
Section
5. Field Training Officer Pay.
Promotional
Probationary Period
Internal
Security Interview Procedure
Section
1. Investigations Through The Chain Of
Command.
Section
2. Internal Affairs Investigations.
Section
3. Chief’s Advisory Action Board.
Section
4. Chief’s City Vehicle Accident
Advisory Action Board.
Section 1. Police Active Health Benefits Working
Group...……………………………………61
Section 2. Active Police Officer Health
Benefits……………………………………………….62
Section 1. Existing Benefits and
Transition……………………………………………………..62
Section 2. Pending Legislation and Alternate Agreement………………………………………63
Section 3. Retired Police Officer Health
Benefits………………………………………………63
Section
2. Law Enforcement Related Courses.
Certification
and Instructors Pay
Section 2. Instructors Certificate.
Psychological
and/or Medical Examination
Section
1. Psychological and/or Medical
Evaluation.
Section
2. Commitment to Effective Drug
Interdiction Program.
City
Protection for Police Officers
Section
1. Police Personnel Unit.
Section
2. Non-Supplanting by Probationary
Officers.
Section
3. Thirty (30) Day Requirement.
Section
l. Service Handgun/Badge Upon
Retirement.
Section
2. Service-Connected Death.
Section
3. Special Assignments.
Section
4. Permanent Personnel File.
Section
5. Exception to Open Records
Act (Officer File Photo).
Section
7. Family Assistance Officer.
Section
8. Reimbursement for Lost,
Damaged, or Stolen Items.
Section
1. Stability of Agreement.
Section
3. Full and Final Scope of the
Agreement.
Section
5. No Bypass Agreement.
Studies and
Re-Openers………………………………………………………………………….77
Signature
Page…………………………………………………………………………………...79
ATTACHMENT
1 Expedited Labor Arbitration Rules
ATTACHMENT
2 Wage Table
ATTACHMENT
3 City Ordinance 58138
ATTACHMENT
4 City Ordinance 83927
ATTACHMENT
5 Benefits Table
ATTACHMENT
6 Master Contract Document
ATTACHMENT
7 Former Master Contract Document
This Agreement shall be
effective as of the 1st day of October, 2006. All pay increases,
leave, or changes in benefits, shall be implemented in accordance with the
respective timelines outlined herein. The retroactive provisions of this
contract shall only apply to those members who are City employees at the time
of the signing of this agreement or hired after the signing of this agreement.
This agreement shall remain in effect until the 30th day of
September, 2009, or until such time as it is superseded by a new agreement
between the parties, whichever occurs later provided however, that in no event
shall this Agreement continue in effect after
The City agrees that
negotiations for the contract beginning
A. “Association” means
the San Antonio Police Officers
B. “Board of
Directors” means those members of the Association who are duly
elected, or appointed and serve as members of the Board of Directors of the
organization pursuant to the Constitution and By-laws of the
Association. The Board of Directors shall include those members of the
Executive Board as defined above, and in no event shall more than twenty (20)
be allowed to attend meetings in an on-duty status.
C. “Calendar days” means each day inclusive of weekends
and holidays.
D. “Chief” means the Chief of Police of the City
of
E. “City” means
the City of
F. “City Manager”
means the City Manager of the City of
G. “Commission” means the Fire Fighters and
Police Officers Civil Service Commission of the City of
H. “Days” as used in Article 27 and Article 28 for disciplinary action
shall be defined as an eight (8) hour day.
J. “Employee” means
an employee of the City of
K. “Executive Board” means
those six (6) members of the Association who are elected, or appointed to fill
the offices of President, Vice President, Secretary, Treasurer,
Parliamentarian, and Sergeant-at-Arms of the Association.
L. “Gender” Reference
to the male gender throughout this Agreement shall have equal force and include
reference to the female gender.
M. “Grievance” means
any and all disputes arising under the Grievance Procedure in Article 15.
N. “Longevity” means
time in service in the department from the date the employee became a
probationary police officer.
O. “Member” means
either member of the Association or member of the bargaining unit.
P. “Officer” means
any sworn Police Officer employed in the Police Department of the City, with
the exception of the Chief of Police.
Q. “Strike” means,
whether done in concert or individually, a failure to report for duty, the
willful absence from one
R. “Working days” means
each day exclusive of weekends and holidays.
The City hereby recognizes
the Association as the sole and exclusive collective bargaining agent for the
unit consisting of all sworn Police Officers, except the Chief.
Section
2. Payroll Deductions.
A. The
City shall deduct monthly Association/POLPAC dues from each individual member
who has voluntarily authorized Association dues deductions. The letter
requesting Association dues deduction shall be signed by the President of the
Association.
B. The City shall deduct monthly CLEAT dues from each individual
member who has voluntarily authorized CLEAT dues deductions. The letter
requesting CLEAT dues deduction shall be signed by both the President of CLEAT
and the President of the Association.
C. The
City shall deduct monthly POLPAC dues from each member who has voluntarily
authorized POLPAC dues deductions. The letter signed by the President of
the Association requesting POLPAC dues deductions shall declare that the
request has been approved by a majority vote of the Board of Directors and of
the membership of the Association.
D. Any individual member of the bargaining unit
wishing to voluntarily withdraw his authorization for Association, CLEAT, or
POLPAC dues deductions and not in uniform, must identify himself and personally
sign the appropriate form in the Police Department Accounting Office at
Headquarters.
E. Effective
F. The
City shall notify the Association and/or CLEAT in writing of any member who
revokes or adds his authorization for dues deduction including POLPAC within
thirty (30) calendar days from the revocation or addition of the deduction.
G. The
City shall deduct special assessments upon written request of the Association
signed by the President, provided that the provisions of Section J below are
complied with. The City shall require payment by the Association for the
actual cost to set up each deduction plus fifteen percent (15%), not to exceed
Three Hundred Dollars ($300.00).
H. The
City shall deduct special assessments upon written request of CLEAT signed by
the President of CLEAT and the President of the Association, provided that such
request complies with the indemnification provisions of Section J
below. The City shall require payment by CLEAT for the actual cost to set
up each deduction plus fifteen percent (15%), not to exceed Three Hundred
Dollars ($300.00).
I. The
amount of dues or assessments shall be the amount set forth in the letter or
request signed by the President of the Association and/or CLEAT.
J. The
City shall not be obligated to deduct dues or deduct any sum provided for
herein until the respective organization provides a legal and binding letter
from the President or legally authorized agent of the Association and/or CLEAT
agreeing to indemnify, defend and hold the City harmless against any claims, demands,
suits, or any other form of liability that shall arise out of or as a result of
any action taken by the City for purposes of complying with the provisions of
this Article.
K. All
amounts deducted pursuant to this Article shall be paid to the legally
designated representative of the Association and/or CLEAT in accordance with
the procedures established by the Finance Director.
L. Whenever
an Association member dies, and the City is notified as provided herein, the
City will automatically deduct twice the amount of dues from each Association
member’s payroll during the month immediately following the Association
member’s death. In the case of multiple applicable deaths in a month the
Association may have the double deductions spread over a period of months upon
reasonable notice to the City. As with other deductions, said amount will be
forwarded directly to the Association, provided, however that the Association
will reimburse the amount of the increased deduction within fourteen (14) calendar
days to any member who makes a written request for such reimbursement to
the President of the Association. The Association will disburse the
additional dues collected to the designated beneficiary or beneficiaries of the
deceased member. Any member may designate or change beneficiaries as
provided by policy or rule of the Association. Any Association member who
requests reimbursement of dues collected from benefits after another member
dies, and officers who are not Association members, shall not be eligible for
the benefits provided in this Section. The Association shall be
responsible to notify the City before the deduction of the double dues
occurs.
Section 3. Time Off for Association Business.
A. The
Executive Board shall have the right to visit the premises of the Police
Department for the purpose of administering this Agreement. Such visits
shall be conducted in a manner so as not to interfere with the functions of the
Department.
B. The
Association
C. The City agrees
that the President of the Association will be placed on special
assignment during the term of his presidency. The special assignment
will give the Association President the latitude to deal with the duties of his
presidency while retaining the privileges of his employment, while the Chief of
Police retains the right to recall him to duty during an emergency or special
event involving overriding need for the protection of the citizens of
For the purposes of
accounting, the President of the Association will be assigned to the Accounting
Office. It will be the responsibility of the President of the Association
to notify and submit proper paperwork to the Accounting Office accounting for
all personal leave time to include but not limited to compensatory, vacation,
holiday, bonus day, military leave, and sick time.
The Chief of Police reserves
his existing authority to revoke special assignment for the Association
President during emergencies or when the welfare of the citizens of
D. The
City shall grant Association leave paid in accordance with Article 3, Section
2(E) to a maximum of ten (10) officers at any given time at the request of the
Association President. Such request will be granted, except in the case
of emergencies or where the same would impair the operations of the Department
or where the granting of the same would adversely affect the welfare of the
citizens of
A. The
Association may maintain one (1) bulletin board at each of the decentralized
stations or other police facilities and two (2) bulletin boards at the
central station. Bulletin boards may be located at the assembly room and
the lobby of the central station and in similar conspicuous locations at the
other police stations and/or facilities. The Association may utilize
Department e-mail and video technology to disseminate bulletin board
information subject to the following terms. All e-mail transmissions shall
have prior approval of the Chief. The use of video equipment is limited to
the playing of Association provided videotapes in compliance with Section 6 of
this Article. The Association representative who accompanies the video is
responsible for its content complying with Section 6. In the event no
Association representative is present, the Association President is responsible.
The President of the Association shall
have off-site access to the city mainframe computer and SAPD intranet.
B. The
bulletin boards, e-mail, and video presentations shall be used only for the
following notices:
(1) Recreation and
Social Affairs of the Association.
(2) Association
Meetings.
(3) Association
Elections.
(4) Reports
of Association Committees.
(5) Rulings
or policies of the State or National Association.
(6)
Legislative
Enactments and Judicial Decisions Affecting Public Employee Labor Relations.
Members of the Board of
Directors who are on duty shall be permitted to attend the two (2) regularly
scheduled board meetings each month, and up to two (2) specially called Board
of Directors meetings per fiscal year. Such members of the Board of Directors
who are on duty shall be subject to emergency recall, and the Association shall
insure the immediate response capability of these officers.
Section 6. Addressing
of Shift Roll Call Meetings, In-Service Training and
Members
of the Executive Board, members of the bargaining team, persons appointed by
the Association to represent the Association and Board of Directors shall be
permitted to speak at shift roll-call meetings about Association business for a
period not to exceed five (5) minutes. Prior to speaking at such roll calls,
the Association representative shall notify the appropriate supervisor that he
intends to speak.
Members of the
Executive Board, members of the bargaining team, persons appointed by the
Association to represent the Association and Board of Directors shall be
permitted to speak at in-service training for a period not to exceed
thirty (30) minutes. The President of the Association shall notify the Academy
Commander in writing in November of the preceding year of the Association’s
intent to use a thirty (30) minute block with the yearly in-service training
beginning in January of each year. The Academy Commander shall schedule the
thirty (30) minute block and notify the Association in writing of the dates and
time to appear.
Members of the
Executive Board, members of the bargaining team, persons appointed by the
Association to represent the Association and Board of Directors shall be
permitted to speak to each
Discussion by
Association representatives shall pertain only to the recreation and social
affairs of the Association; Association meetings; Association elections,
reports of Association committees; activities of the State or National
Association with whom the Association is affiliated; and legislative enactment,
judicial decisions affecting public employee labor relations, legal assistance
plans, and contract benefits and rights.
Discussions by Association representatives shall not contain anything
political or anything reflecting on the City or any of its employees or any
labor organization among its employees. There shall be no prior restraint
or censure by shift supervisors of Association representatives during roll-call
discussions. In the event an Association representative allegedly violates
this section, such alleged violation shall be subject to Article 15, Step 6, of
the Grievance Procedure.
Section 1. The
City shall provide the following materials to every officer:
A. A copy of
special orders, general orders, training bulletins, rules and regulations, and
Texas Penal Code, Traffic Laws & Code of Criminal Procedure; and
B. A
copy of this Agreement.
Section 2. The City shall not engage in the following practices:
A. Interfere
with, restrains, or coerces officers in the exercise of rights granted in this
Agreement.
B. Dominate,
interfere, or assist in the formation, existence or administration of any
employee organization; or contribute financial support to any such
organization.
C. Encourage
or discourage membership in any employee organization by discrimination in
hiring, tenure, training or other terms or conditions of employment.
D. Discharge
or discriminate against any officer because he has filed any affidavit,
petition, grievance, or complaint; or given any information or testimony
alleging violations of this Agreement; or because he has formed, joined, or
chose to be represented by any employee organization.
E. Make
or permit any agreement, understanding, or contract with any person, including
a member of the bargaining unit, which in any manner circumvents, alters,
amends, modifies, or contradicts any provision of this Agreement. For
example, condoning a practice of officers volunteering to circumvent this
Agreement on job assignments, relief days, hours worked, or compensation would
obviously violate this provision.
F. Discriminate
against any officer protected under Title
Section 3. Consistent
Interpretation.
The City recognizes its responsibility to a consistent
interpretation and application of Department Rules and Regulations, Special
Directives and Administrative Orders, which govern the conduct of officers on
the job.
Section 1.
No action shall be taken by
the Association or any officer in the bargaining unit which constitutes
discrimination under Title
Section 2.
The Association shall not
cause or attempt to cause an officer to discriminate against another employee
or officer because of the employee’s or officer’s membership or non-membership
in any employee organization; or discriminate against any employee or officer
because he has signed or filed an affidavit, petition or complaint or given any
information or testimony alleging violations of this Agreement.
The Association shall not
cause, counsel, or permit its members to strike, slow down, disrupt, impede or
otherwise impair the normal functions of the Department; nor to refuse to cross
any picket line by whomever established, where such refusal would interfere
with or impede the performance of the officer’s duties as an employee of the
City. The City shall not lock out any officer.
Section 1.
Subject to the terms of this
Agreement, the Association recognizes the management of the City of San Antonio
and the direction of the Police Department are vested exclusively in the City,
and nothing in this Agreement is intended to circumscribe or modify the
existing right of the City to operate and manage its affairs in all
respects. The Association recognizes the City
A. Direct
and schedule the work of its officers, to include the scheduling of overtime
work in a manner most advantageous to the City. Officer work schedules
shall not be changed solely to avoid or curtail overtime pay. The City
shall have the right to reschedule up to eighty (80) hours of training per
officer per year. These hours shall include required TCLEOSE training and may
include in-service hours but the City is not required to use the entire eighty
(80) hours each year.
B. Hire,
promote, demote, transfer, assign and retain officers in positions with the
City.
C. Discharge,
demote, or suspend officers, pursuant to the requirements of Chapter 143 Local
Government Code and further and fully agreed to in Article 27, Disciplinary
Actions, of this Agreement.
D. Maintain
the efficiency of governmental operations.
E. Lay
off officers from duty because of lack of work, consistent with Civil Service
Regulations, City ordinances and State laws.
F. Determine
the methods, processes, means, and personnel by which operations are to be
carried out.
G. Transfer
any City operation now conducted by it to another unit of government, and such
transfer shall not require any prior negotiations or the consent of any
association, group, organization, union or labor organization whatsoever.
H. Contract
and subcontract when it is in the best interest of the City.
I. Use
security personnel, which include, but are not limited to, such job
classifications incorporated within the Classification Manual as Airport Police
Officer, Park Police, Life Guard, School Crossing Guard, Municipal Guard, which
require training in law enforcement, safety and security duties, firefighting
skills, emergency medical treatment, water safety, and other similar related
skills.
J. Use
of civilians in the Police Department to perform duties which do not require a
Commissioned Officer or the power of arrest. The scope of such duties
include, but are not limited to, communications, information systems, records,
community services, clerical support, maintenance, school safety crossing, and
jail operations. Civilians performing such duties are not subject to the
terms of this Agreement. This subject is covered in detail in Article 38.
K. Establish
classifications, job descriptions, and standards which provide the basis for
recruiting and assignment. It is also understood that every duty connected
with operations enumerated in job descriptions is not always specifically
described. It is, nevertheless, intended that all duties relating to the
present mission of the Police Department, as a public safety organization,
shall be performed by the officers.
L. The
Association recognizes the City
M. Any person,
whether sworn or unsworn, wishing to address Police Officer roll calls on any
subject (except bargaining unit members who are running for Association office
or shift representative and wish to make a statement concerning an election
within the Association) must receive written permission from the Chief of
Police or President of the Association. When permission is granted by the
President of the Association, the restrictions involving subject matter and
time outlined in Article 3, Section 6, shall apply.
Section
2.
Subject
to review by the City Manager, the Chief shall have the exclusive right to:
A. Establish
departmental rules and regulations.
B. Transfer
officers within the Department to accomplish the mission of the Department in
the most efficient manner.
Section
3.
Except as otherwise
specifically provided in this Agreement, the City, acting through the City
Manager and the Police Chief, shall retain all rights and authority to which,
by law, it is its responsibility to enforce.
All standards, privileges,
and working conditions enjoyed by the City of San Antonio Police officers at
the effective date of this Agreement, which are not included in this Agreement,
shall remain unchanged for the duration of the Agreement.
Section
1. Labor Relations Committee.
The City and the
Association, having recognized that cooperation between Management and
employees is indispensable to the accomplishment of sound and harmonious labor
relations, shall jointly maintain and support a Labor Relations
Committee. The Labor Relations Committee shall discuss the working
conditions of officers, including, but not necessarily limited to, safety and
specifications for equipment, discipline, departmental policies and procedures,
and other areas of common officer interest. The Committee shall recommend
to the Police Chief changes in any of these working conditions where necessary,
and the Chief shall communicate his decision to the Committee in
writing. The Committee has no independent authority to bind either party
with respect to any individual grievable topic. The Labor Relations
Committee shall consist of four (4) members who shall serve for a one-year
term. The Association shall designate two (2) members, and the Police
Chief shall designate two (2) members. Vacancies shall be filled by the
appointing party for the balance of the term to be served. The
chairmanship of the Committee shall rotate once every three (3) months, and,
there shall be a written agenda of matters to be discussed. Officers
desiring items placed on the written agenda shall forward the matter in writing
to the Office of the Chief of Police with a copy to the President of the
Association. The Committee shall make its recommendations in writing to the
Chief with copies to the Association and the City Manager. The Chief shall
thereafter respond to the Committee
Section 2. Labor
Relations
Subcommittees.
The Labor Relations
Committee may appoint subcommittees as necessary. Such subcommittees shall
report to the Labor Relations Committee and the Labor Relations Committee shall
make final recommendations in writing to the Chief of Police as outlined above.
Section 3. Defense of Officials.
It is understood and agreed
that individual city employees serving on the committee are acting in the
course and scope of their employment, even though designated by the
Association, and as such are entitled to defense and indemnity under the terms
of the City’s existing risk management, insurance and defense programs, in the
event that the recommendations of the committee become the basis of claims or
litigation.
The City shall maintain at
all times an adequate quantity of modern, marked and unmarked vehicles, radios,
and other essential equipment in sound working condition to ensure a safe work
place for each officer and to maximize the Department
Section 2. Preventive
Vehicle Maintenance Program.
The City shall ensure that
all police vehicles assigned to the officers are in safe condition and shall
maintain a preventive maintenance program for police vehicles. The Chief
shall assign a supervisor to the vehicle maintenance shop for the purpose
of inspecting the safety of police vehicles. The Chief may assign either a
sworn officer or civilian to this position, except that in the event that a
civilian is assigned, there shall be no reduction or loss of sworn positions in
the Police Department as a result of the assignment of a civilian. If at
the discretion of an officer, an assigned vehicle is not in safe condition,
said officer shall notify the supervisor assigned to the vehicle maintenance
shop that the vehicle is not in a safe condition. The supervisor assigned
to the vehicle maintenance shop shall make the decision as to the safety of the
police vehicle. In the event that the supervisor assigned to the vehicle
maintenance shop deems the police vehicle to be in a safe condition, and the
employee disagrees with the supervisor’s decision, said officer may protest the
supervisor’s decision in writing. The supervisor assigned to the vehicle
maintenance shop shall acknowledge the officer’s protest in writing and forward
all copies to the officer’s division commander for final
disposition.
The Vehicle Maintenance
Supervisor shall maintain records on the maintenance of all police vehicles.
When a vehicle reaches the 30,000 miles odometer reading, a review of the
vehicle’s maintenance record will be conducted. If deemed necessary, the
Vehicle Maintenance Supervisor may request an exhaustive mechanical evaluation
be performed on the vehicle. Any officer may request an exhaustive
mechanical evaluation of police vehicle when the vehicle reaches the
30,000-mile mark. This inspection will be accomplished in a timely manner
or another vehicle will be provided for the officer.
Effective
Effective
The City shall provide to officers occupying the rank
of Lieutenant or above a City-owned vehicle for the officer
The City shall provide to
each employee so requesting, one (1) permanently assigned hand-held police
radio. A charger will be issued if necessary. These radios will be
replaced in accordance with Department policies and regulations. However,
in the event the radio needs to be replaced or repaired due to negligence or
intentional abuse on the part of the officer to whom the radio is issued, the
officer shall be required to reimburse the City for the costs. The cost of
said radio shall be, for purposes of the Section,
based upon its actual value at the time of loss. Negligence or
intentional abuse and the actual value considering, depreciation value of the
radio shall be determined by the Labor Relations Committee outlined in Article
9.
“Permanently issued or assigned radios” are those issued pursuant to an eligible officer
requesting to have one issued to them and does not imply that the officer
cannot later turn in their radios.
“Approved police functions” shall mean either a City function where the City
provides security or an official function sanctioned and approved by the Chief
of Police and functions for which a work permit has been issued.
The City shall provide to
all officers the option of selecting soft body armor with a minimum
standard of Threat Level III-A or Threat Level II. Such vests shall meet
the highest levels of specifications as determined by the Labor Relations
Committee outlined in Article 9. Vests shall be provided to all new
officers prior to the end of their first week as officers. Vests shall be
replaced every five (5) years by making a proper request to the Division
Commander, or at any time when obvious damage to the vest requires
replacement. However, if it is determined by the Labor Relations Committee
outlined in Article 9, that the damage done to the vest was caused by neglect
or misuse on the part of the officer, then the officer shall pay the actual value considering replacement costs,
depreciation, utility value, and market value of the vest as determined by the
Labor Relations Committee at the time of the loss. One free fitting per
year will be provided by the City.
Effective
Section
7. Labor Relations Committee as Equipment Advisory Committee.
A. The
Labor Relations Committee as outlined in Article 9, in addition to its other
duties, shall serve as the Equipment Advisory Committee. This committee
shall meet for the purpose of reviewing specifications, testing, and making
recommendations to the Chief as to the purchase of all police-related
equipment. For purposes of this Section, police-related equipment
includes, but is not limited to, communications equipment, vehicles,
vehicle light bars, weapons, specialized or technical investigative
equipment, training aids, and computer-related equipment and
materials. Police-related equipment does not include chairs, desks, office
supplies, maintenance supplies, or other non-specialized equipment or materials
purchased on a Citywide basis for all departments.
B. When
an officer loses and/or damages equipment assigned for purposes of employment
the Labor Relations Committee shall cause to be conducted an investigation
surrounding the facts causing the loss or damage. Upon completion of its
investigation, the committee will make a determination as to the cause of the
loss or damage and to what extent the officer is responsible for such loss
and/or damage. The committee shall write a report of its findings which shall
be forwarded to the Chief. An officer who disagrees with the findings of
the committee may appeal the committee’s recommendation to the Chief. The
Chief may adopt, in whole or in part, or reject the committee
Section
8. Reimbursement Procedures.
A. Officers
may utilize payroll deductions to reimburse the City for lost or damaged
equipment. Payroll deductions must be set at fifty dollars ($50.00) per
payday unless the officer agrees to higher payments. It shall be the
obligation of the officer to coordinate such repayment with the Police
Department Accounting Office.
B. Officers
desiring to reimburse the City for lost or damaged equipment outside of payroll
deductions may do so as long as such mandatory payments are no less than
fifty dollars ($50.00) per pay day. Nothing herein prohibits the officer
from agreeing to higher payments. All reimbursements paid outside of
payroll deduction are due within five (5) calendar days of the payday.
C. Regardless
of the method of payment, all payments must begin not less than the second pay
day after the final ruling by the Chief.
D. After
all administrative appeals are exhausted, officers failing to reimburse the
City or who fail to pay according to the selected pay schedule above shall be
deemed insubordinate to the Chief of Police and may be disciplined up to and
including termination.
Section
9. Standardized Installation
of Equipment.
The City agrees it will
standardize the location of all equipment in all marked vehicles whenever possible.
A.
Seniority - For purposes of this Section, each police officer
shall be given one (1) point on a promotional examination for each year as a
classified police officer in the San Antonio Police Department. In no
event shall the number of such seniority points exceed ten (10). “Classified
police officer” is meant to include service as an initial probationary police
officer and probation after promotion. Seniority is defined as all years
of service, whether interrupted or uninterrupted, on the San Antonio Police
Department, and not merely the last continuous period of service.
B. Eligibility
- Police promotional examinations shall be open to all police officers who have
held a classified position with the San Antonio Police Department for two (2)
years or more, immediately below the rank for which the examination is to be
held. Promotional examinations to the rank of Detective Investigator
shall be open to only those officers within the classification of a Class
C or higher patrol officer; no officer shall be permitted to take a promotional
examination to the rank of Detective Investigator until being in the
classification of a Class C or higher patrol officer.
C.
Seniority in Rank -
Time Within a Classified Police Officer Rank. The officer with the most
time in a classified rank shall be considered the senior. Officers
promoted on the same day shall be promoted at least one minute apart to
establish seniority in rank. Seniority in rank for newly hired police
officers shall be determined by their ranking on the eligibility list and
effective with their appointment to probationary police officer.
Section
2. Study Materials.
A. Study
Materials Committee - The Chief shall establish a committee for the
selection of proposed study materials for each written promotional
examination. This committee may vary in number and in composition, but
shall be chaired by the Training Academy Commander. This committee may be
composed of individuals who are selected from within or outside of the
Department, provided that if members from outside the department are selected,
they may not consist of more than 50% of the committee. This committee
shall meet at appropriate times to review submitted materials. When the
need arises to administer a promotional examination for any rank, this
committee shall convene and select proposed materials, which are pertinent to
the rank for which the promotional examination is being administered. Members
of the committee shall rank the material separately and forward their rankings
to the Chief. The Chief shall, after reviewing the rankings, make the
final decision and forward his decision to the Consulting Company hired by the
City to create the test. Study materials for all ranks shall not be the
same for any two consecutive years. The exceptions include, the Texas
Penal Code, the Code of Criminal Procedures, the General Manual, and the
Collective Bargaining Agreement.
B. Promotional
Text Materials - The City shall limit the promotional material for
all ranks to two hundred (200) pages of text except for text taken from the
Texas Penal Code, the Code of Criminal Procedures, the General Manual, and the
Collective Bargaining Agreement. For purposes of this section, two hundred
pages of text shall be defined as text that averages approximately 750 words
per page. An officer may not file any grievance or appeal based on the
limitations involving pages of text and words. The
City shall attempt to obtain the publisher’s permission to duplicate and
distribute to the candidates the study materials without incurring any fee,
cost, penalty or liability to the publishers, and if it does obtain this permission,
the City will bear the expense of the printing or reproduction of the study
materials for distribution to eligible candidates. However, the City will
not be required to perform the aforementioned printing, reproduction, and
dissemination of the study materials if the permission of the publishers to do
so cannot be obtained at any cost, or penalty, or liability to the
publishers. Where the City cannot obtain such permission, the City will
make arrangements to ensure that all of these study materials (e.g., textbooks)
are available at one or more locations within the city for purchase by the
candidates. Candidates who purchase study materials and who score seventy
percent (70%) or higher on each of the examinations applicable to the promotion
sought will be reimbursed for the price of the study materials.
After the Chief has
made his selections, the City Human Resources Department will pick up the study
materials. The study materials will be printed and/or reproduced under
circumstances, which will promote security. The Human Resources
Department will verify the completeness of the packets. No question will
be included in the examination unless it derives its source from the study
material.
The date and location
that the study materials will be made available for candidates to pick up or
the location where the study materials may be purchased will be announced in
the Daily Bulletin for five (5) consecutive working days. In accordance
with this Section, the study materials shall be either announced as to location
for purchase or provided to eligible candidates during a period which is not
more than twenty five (25) nor less
than fifteen (15) calendar days prior to the
examination.
Section
3. Promotion to Detective Investigator, Sergeant, Lieutenant and
Captain.
A.
The City shall engage an outside
bonded consultant to prepare written promotional examinations for each rank.
Beginning at least eighty-five (85)
calendar days before the administration of the examination, the City will
announce in the Daily Bulletin the date of the examination and with the
location and dates that any eligible officer may register for the
examination. This announcement will run for five (5) consecutive working
days. Candidates for the promotional examinations shall register for the
examination between eighty (80) and seventy (70) calendar days before the
written examination.
All eligible candidates for promotion to a
particular rank shall be given the identical examinations applicable to that
rank in the presence of each other. The examinations will consist of
multiple choice written questions, which shall have predetermined correct
answers to enhance the objectivity of the examination.
The preparer of the examination shall
deliver the examination sealed and numbered to the Civil Service
Director who is charged with the responsibility for the security of all
promotional examinations. The examination shall remain sealed until opened
in the presence of the participants.
All of the questions asked on the
examination must be prepared and composed in a manner that the grading of all
examination papers can be completed immediately after the examination is
held. All examination papers shall be graded as they are completed, at the
place where the examination is given, and in the presence of any candidates who
wish to remain during the grading. Examination grading may be performed
within fifty (50) feet of any entrance or exit from the examination room in
open view of all candidates. A score of seventy percent (70%) (out of a
possible 100%) on each examination applicable to the rank to which the officer
seeks promotion shall be considered a minimum passing score.
Each eligible promotional candidate shall
have the opportunity to examine test source materials and their own graded
examination paper and answers within five (5) consecutive working days after
the examination. The candidate may see the above material, but may not
remove the graded examination paper from the Human
Resources Department.
Candidates arriving after the appointed
starting time of the examination will not be admitted or allowed to participate
in the examination.
All questions formulated by the outside
consultant (and their correct answers) shall be derived from the materials
selected by the Chief as study materials in accordance with this Section.
Matters relative to the construction of
any promotional written examination which are appealable to the Civil Service
Commission pursuant to Chapter 143, Local Government Code, shall continue to be
appealable and the decision of the Commission shall be final.
B.
In addition to meeting the
requirements as set forth in Subsection A, promotional examinations for
Detective Investigator and Sergeant shall consist of one (1) examination
session which shall not exceed either one hundred (100) multiple choice
questions or two (2) hours in length.
C. In
addition to meeting the requirements as set forth in Subsection A, promotional
examinations for Lieutenant and Captain shall consist of an examination session
in the morning which shall not exceed one hundred (100) multiple choice
questions or two (2) hours in length and an afternoon session on the same day
with questions which may be based upon video and/or written scenarios as
determined by the outside consultant in consultation with the City. The
answers to the questions in the afternoon session shall also be multiple choice
with no set number of questions, but the examination shall be limited to two
(2) hours. All video presentations, written scenarios and questions shall
be validated as job-related. The afternoon session examination shall not
be weighted more than thirty percent (30%) of the overall written examination.
Section 4. Requirements
After Promotion.
The following applies to promotional examinations
given after
A. Officers
promoted to detective investigator, sergeant, lieutenant or captain shall
attend a mandatory investigator (detectives), supervisory or management
(sergeant, lieutenant and captain) training program designed for that rank of
no less than 40-hours nor more than 80-hours prior to or after being promoted.
Officers who are promoted to the rank of detective investigator, sergeant,
lieutenant, or captain and who have not attended the mandatory training program
shall be required to attend the required training within sixty (60) calendar
days of promotion.
B. Officers
promoted to detective investigator, sergeant, lieutenant or captain shall be
assigned to one or more officers of equal rank for on-the-job field training
for a period of no less than one (1) calendar month during their probationary
period. Officers promoted to the rank of captain shall be required to
complete their on-the-job field training, assigned to and physically working
with a captain assigned to the patrol division at a police substation.
C. Within
forty-eight (48) months after being promoted, officers promoted to lieutenant
shall be required as a condition of maintaining the rank to complete with a passing
grade at least sixty (60) hours of college credits or achieve an Associate’s
degree from an accredited college or university. Officers who have already
satisfied this requirement shall present proof to the Chief of
Police. Officers who fail to complete this requirement within the
specified time period shall be demoted to their previous rank and seniority.
D. Within sixty (60) months after being
promoted, officers promoted to captain shall be required as a condition of
maintaining the rank to obtain a Bachelor’s Degree from an accredited college
or university. Officers who have already satisfied this requirement shall
present proof of completion to the Chief of Police. Officers who fail to
complete this requirement within the specified time period shall be demoted to
their previous rank and seniority.
E. If the officer fails to complete the
mandatory college requirements within the prescribed time period after
promotion, the officer will be allowed to appeal the demotion only if exigent
circumstances or an emergency situation occurred which would have prevented the
officer from completing the requirements.
F. If an officer is promoted to the next
higher rank before completing the educational requirements for his previous
rank, the time requirements remain in effect for completion of the appropriate
educational requirements for that previous rank. For example, an officer
is promoted to Lieutenant on
Section 5. Appointment to Commander.
The Chief shall be entitled to create seven (7) Commander
positions only when actual staffing in the department reaches 2,194. This shall be above the rank of Captain and
below the rank of Deputy Chief, and shall be an appointed position. Higher ranking officers may be demoted to
Commander but if removed, entitled to return to their last tested rank. Only Captains shall be eligible for
appointment and serve at the discretion of the Chief of Police. After the initial appointment to each of the
seven Commanders positions, a minimum of one year time in rank shall be
required for eligibility for such appointment.
Appointment shall be at the sole discretion of the Chief. As vacancies occur in the rank of Commander,
the Chief of Police shall either appoint a Captain or permanently abolish the
position at his sole discretion within ninety (90) calendar days in accordance
with this Section. Should the Chief of
Police fail to appoint and the position is permanently abolished, the position
of Commander shall revert to the rank of Captain. The City shall not reduce or abolish
authorized positions in other ranks as a result of implementation of this
section.
Prior to making any permanent appointment to the rank
of Commander, the Chief shall adopt and publish a policy setting forth the
selection and appointment process, which shall be published for at least thirty
(30) calendar days prior to closing applications. The process may not change once the
applications process is closed.
The compensation for Commander
shall be set at not less than 7% above the rate of a 30 year Captain’s base pay
at Step B plus longevity. The officers
so assigned shall be entitled to all benefits as contained in the following
specified Articles of this Agreement: Articles 1; 2; 3; 4; 5; 6; 7; 9; 10
Section 3; 11 Section 5; 14 Section 1; 16 Sections 2; 17; 19; 20 (without
premium pay); 21; 22 Sections 2, 3, 4, 5, 6, 7, 8, 9, 10 and 11; 23; 28; 29;
30; 31; 32; 33; 34; 35; 36 Sections 1, 2, 4, 5, 6; and 37.
Officers appointed to this rank shall be subject to
overall City policies and regulations and while appointed to this rank shall
not be subject to the provisions of Chapter 143, Local Government Code, or any
provision of this Agreement, unless specifically so provided by this Article.
Officers appointed to Commander shall also be subject
to the education requirements of a Captain specified in Section 4(d), (e), and
(f) of this Article.
Any officer appointed to the rank of Commander may be
demoted to the rank of Captain at the sole discretion of the Chief of Police
without appeal to the Commission and/or Arbitration. Any officer appointed to this rank may,
further, voluntarily return to their last civil service rank of Captain at any
time. Upon demotion or voluntary return
to the last civil service rank pursuant hereto, the officer shall receive
thereafter the full benefits provided in Chapter 143, Local Government Code,
and this Agreement as if he had served in that rank on a continuous basis
throughout his tenure as Commander, and any other non tested appointed
rank. An officer appointed to the rank
of Commander may be terminated for cause, provided that such termination shall
be subject to appeal in the same manner as applicable to all classified
uniformed officers in the Department.
Commanders appointed by the Chief of Police pursuant
to Article 11, Section 5 of this Agreement, may receive administrative leave
for work performed in excess of their regularly scheduled duties. Said leave time may be granted at the
discretion of the Chief of Police, subject to the scheduling and manpower
contingencies that may arise.
The provisions of §143.014(b) restricting appointment
of the classification immediately below Police Chief, and subsections (c), (d),
(f), (g) and (h) of Section 143.014 shall not apply.
The City agrees to defend, indemnify, and hold
harmless the Association and its officers, agents, representatives, and
officers from any action, at law or in equity, brought by any Commander or
other member(s) of the unit regarding this Section.
Section 6. Appointment to Deputy Chief.
The Chief of
Police shall have the right to appoint a total of five (5) Deputy Chiefs which
shall be one rank immediately above the rank of Commander and one rank
immediately below the Assistant Chief in the chain of command. This
Article shall create no positions within the rank of Deputy Chief other than by
this Article. As vacancies occur in the rank of Deputy Chief, the Chief of
Police shall either appoint an officer or permanently abolish the position
within ninety (90) calendar days in accordance with this Section. Should
the Chief of Police fail to appoint and the position is permanently abolished,
the position of Deputy Chief shall revert to the rank of Captain or Commander.
Positions within the rank of Deputy Chief up to five (5) shall be filled by the
Chief of Police at his sole discretion, within ninety (90) calendar days of a
vacancy occurring in that rank. Appointments to the rank of Deputy Chief
shall be by the Chief of Police at his sole discretion, provided that the
officer promoted is a Captain with a minimum of one (1) year in the rank or a
Commander.
Officers appointed to
this rank shall be subject to overall City policies and regulations and while
appointed to this rank shall not be subject to the provisions of Chapter 143,
Local Government Code, or any provision of this Agreement, unless specifically
so provided by this Article.
For clarification purposes,
effective upon execution of this agreement and effective with the promotion of
any officer to the rank of Deputy Chief after
Any officer appointed
to the rank of Deputy Chief may be demoted to their last tested civil service rank
at the sole discretion of the Chief of Police without appeal to the Commission
and/or Arbitration. Any officer appointed to this rank may, further,
voluntarily return to their last tested rank at any time. Upon demotion or
voluntary return to the previously-held rank pursuant hereto, the officer shall
receive thereafter the full benefits provided in Chapter 143, Local Government
Code, and this Agreement as if he had served in that rank on a continuous basis
throughout his tenure as Deputy Chief, and any other non tested appointed rank.
An officer appointed to the rank of Deputy Chief may be terminated for cause,
provided that such termination shall be subject to appeal in the same manner as
applicable to all classified uniformed officers in the Department.
Except for the
position of Deputy Chief, nothing in this Article shall be construed to require
the City to create the rank or establish and fill the maximum number of
positions authorized herein. Further, nothing in this Article shall be
construed to limit any existing right of the City to create ranks and establish
positions in accordance with State law and City Charter.
Deputy Chiefs appointed by the
Chief of Police pursuant to Article 11, Section 5 of this Agreement, may
receive administrative leave for work performed in excess of their regularly
scheduled duties. Said leave time may be granted at the discretion of the
Chief of Police, subject to the scheduling and manpower contingencies that may
arise.
Officers appointed to the Deputy
Chief position by the Chief of Police as provided for in Article 11, Section 6,
supra, of this Agreement, shall be compensated at an annual salary of not less
than fifteen percent (15%) above the rate of a 30-year Captain’s base pay at
Step B plus longevity. The officers so assigned shall be entitled to all
benefits as contained in the following specified Articles of this Agreement:
Articles 1; 2; 3; 4; 5; 6; 7; 9; 10 Section 3; 11 Section 6; 14 Section 1; 16
Sections 2; 17; 19; 20 (without premium pay); 21; 22 Sections 2, 3, 4, 5, 6, 7,
8, 9, 10 and 11; 23; 28; 29; 30; 31; 32; 33; 34; 35; 36 Sections 1, 2, 4, 5, 6;
and 37.
The City agrees to defend, indemnify, and hold
harmless the Association and its officers, agents, representatives, and
officers from any action, at law or in equity, brought by any Deputy Chief or
other member(s) of the unit regarding this Section.
The Chief of Police shall have the
right to appoint two (2) Assistant Chiefs which shall be one rank immediately
above the rank of Deputy Chief and one rank immediately below the Chief of
Police in the chain of command. This Article shall create no positions
within the rank of Assistant Chief other than by this Article. As
vacancies occur in the rank of Assistant Chief, the Chief of Police shall
either appoint an officer or permanently abolish the position within ninety
(90) calendar days in accordance with this Section. Should the Chief of
Police fail to appoint and the position is permanently abolished, the position
of Assistant Chief shall revert to the rank of Captain. Positions within
the rank of Assistant Chief shall be filled up to two (2) by the Chief of
Police at his sole discretion, within ninety (90) calendar days of a vacancy
occurring in that rank. Appointments to the rank of Assistant Chief shall
be by the Chief of Police at his sole discretion, provided that the officer
promoted is a Commander with one year in the rank or Deputy Chief.
Officers appointed to this rank
shall be subject to overall City policies and regulations and while appointed
to this rank shall not be subject to the provisions of Chapter 143, Local
Government Code, or any provision of this Agreement, unless specifically so
provided in this Article.
For clarification purposes, effective upon
execution of this agreement and effective with the promotion of any officer to
the rank of Assistant Chief after October 1, 2002, those officers
appointed to the rank of Assistant Chief shall be required as a condition of
maintaining the appointed rank to obtain a Master’s Degree from an accredited
college or university within twenty four (24) months after being
appointed. Effective October 1, 2005, as to officers appointed thereafter
only, officers appointed to the rank of Assistant Chief shall be required as a
condition of maintaining the appointed rank to obtain a Master’s Degree from an
accredited college or university within thirty-six (36) months after being
appointed. Assistant Chiefs appointed after October 1, 2002, who have
already obtained a Masters Degree prior to being appointed to the rank of
Assistant Chief, shall present proof of completion to the Chief of Police
within seven (7) calendar days of being appointed to the
rank. Assistant Chiefs who have not obtained a Masters Degree must
complete and make a passing grade on at least one-half of any Masters Degree
requirements they have left to obtain in an approved Masters
Degree program every twelve (12) months after being appointed to the rank of
Assistant Chief until such time as a Masters Degree is awarded. Effective
October 1, 2005, Assistant Chiefs who have not obtained a Masters
Degree must complete and make a passing grade on at least one-third of any
Masters Degree requirements they have left to obtain in an approved Masters
Degree program every twelve (12) months after being appointed to the rank of
Assistant Chief until such time as a Masters Degree is awarded. Assistant
Chiefs will submit proof of the completion of the required hours to the Chief
of Police and the Association on their annual promotion date until such time a
Masters Degree is obtained. Assistant Chiefs who fail to complete this
requirement within the specified time periods shall be demoted within ten
calendar days after verification by the Chief of Police of the Officer’s
non-compliance. Officers shall be demoted to their previous civil
service rank and seniority. Officers who were grandfathered as Deputy
Chief’s in Section 5 shall be additionally grandfathered under this section.
Any officer appointed to the rank of Assistant Chief
may be demoted to their last tested civil service rank at the sole discretion
of the Chief of Police without appeal to the Commission and/or
Arbitration. Any officer appointed to this rank may, further, voluntarily
return to their last tested rank at any time. Upon demotion or voluntary
return to the previously-held tested rank pursuant hereto, the officer shall
receive thereafter the full benefits provided in Chapter 143, Local Government
Code, and this Agreement as if he had served in that rank on a continuous basis
throughout his tenure as Assistant Chief, and any other non tested appointed
rank. An officer appointed to the rank of Assistant Chief may be
terminated for cause, provided that such termination shall be subject to appeal
in the same manner as applicable to all classified uniformed officers in the
Department.
Assistant Chiefs appointed by the
Chief of Police pursuant to Article 11, Section 6 of this Agreement, may
receive administrative leave for work performed in excess of their regularly
scheduled duties. Said leave time may be granted at the discretion of the
Chief of Police, subject to the scheduling and manpower contingencies that may
arise.
Officers appointed to the
Assistant Chief position by the Chief of Police as provided for in Article 11,
Section 7, supra, of this Agreement, shall be compensated at an annual salary
of not less than eight percent (8%) above the rate of a Deputy Chief’s base pay
plus longevity (a 30 year Captains base pay at Step B + .18 times that base
pay). The officers so assigned shall be entitled to all benefits as contained
in the following specified Articles of this Agreement: Articles 1; 2; 3; 4; 5;
6; 7; 9; 10 Section 3; 11 Section 7; 14
Section 1; 16 Sections 2; 17; 19; 20 (without premium pay); 21; 22 Sections 2,
3, 4, 5, 6, 7, 8, 9, 10 and 11; 23; 28; 29; 30; 31; 32; 33; 34; 35; 36 Sections
1, 2, 4, 5, 6; and 37.
The City agrees to defend, indemnify, and hold
harmless the Association and its officers, agents, representatives, and
officers from any action, at law or in equity, brought by any Assistant Chief
or other member(s) of the unit regarding this Section.
Seniority in this Article
shall be defined as the length of service by an officer within his civil
service classification. All other factors being equal, seniority is the
determining factor in the assignment of relief days and vacation days and
operates within a section, unit, or detail for purposes of this Article.
Assignment of sections or districts shall not be subject to the provisions of
this Article, except in Section 6.
Section
2. Six-Month Requirement.
When an Officer transfers
from one section, unit, or detail to another, there shall be no bumping of a
less senior officer out of relief days or vacation days to which the less
senior officer has been assigned. However, when prime relief days become
open, the incoming officer, including officers newly-promoted, may, after
serving in the section, unit, or detail for six (6) months, then exercise his
seniority in bidding for the prime time. Vacation shall be handled in the
same manner in that no officer shall be denied vacation already scheduled; but,
during the next round of vacation assignments, the senior officer chooses
before the junior officer. In the event of a simultaneous transfer, i.e.,
one officer is moved out at the same time another officer is moved in, the
incoming officer is not entitled to assume the relief days and vacation days of
the outgoing officer, even though his seniority is greater than other officers
in the section, unit, or detail; otherwise, the incoming officer is placed in
his respective position as to date of rank and bids with others as the next
days and dates become available.
“All other factors being equal”
is intended to relate to the total performance of an officer. In the event
an officer is denied prime time because of "unequal factors", it
shall not be for an isolated instance of poor or substandard performance, but
it may come about because of a consistent pattern of overall substandard
performance.
Time spent in the Armed
Forces on military leave of absence and other authorized leaves and time
lost because of duty-connected disability shall be included in length of
service.
Section
5. Seniority Tie-Breaker.
Seniority shall be a factor
in promotions and layoff or recall consistent with State law and City
ordinances and regulations. In the event of a tie in the seniority of two
or more officers, the officer placing highest on the hiring or promotional list
shall be the senior.
Section
6. Certain Officer Transfer
Rights.
This Section applies only to
those officers holding the rank of Patrol Officer assigned to the Day (A
Shift), Evening (B Shift), or Dog Watch (C Shift) shifts of the Uniformed
Patrol Division. To the extent that this Section differs with Sections 1,
2, 3, 4, or 5 above, this Section shall prevail so far as the affected shifts
are concerned.
When an assignment is
declared vacant in a section of the Day (A Shift), Evening (B Shift), or Dog
Watch (C Shift) shifts of the Patrol Division, the opening shall be awarded to
the most senior officer on that shift of the applicable rank who voluntarily
requests that assignment. In the event no officer of the applicable rank from
that shift requests the assignment, any officer of applicable rank from the
remaining two shifts may request the position and it shall be awarded to the
most senior officer.
Once an officer has been
transferred, he will then be able to exercise his seniority based on the next
available opening on that shift; provided, however, that officers transferring
from outside the three affected shifts shall not be eligible to exercise their
seniority rights until six months have expired from entry into the affected
shifts with the sole exception that officers transferring into or out of one of
the Uniformed Patrol shifts shall be entitled to use his seniority in bidding
on vacancies in conformance with this Section immediately.
Officers transferring from
one of the Uniformed Patrol shifts to another shift or to another unit or
division shall lose their vacation request time and will have to put in for a
new vacation schedule based on available openings on that shift.
Any officer covered by this
Section may be removed from a position he occupies to another position within
the three specified shifts, provided such is done on the basis of reverse
seniority (i.e., beginning with the least senior person). Probationary
officers have no protection under this article. The Resource Management
Unit or the
Nothing in this Article
shall be construed to limit in any fashion any right currently vested in the
City by virtue of this Agreement, except as explicitly modified by this Article
and such modification shall be limited solely to the specific provisions of
this Article. These rights include, but are not limited to, the right to
determine when a vacancy exists, to determine the number of positions to be
assigned to a division or shift, to transfer any person from the three shifts
covered by this Article to any position outside of those three shifts, to make
assignments of officers not covered by this Article, and to make assignments of
officers affected by this Article in conformance with the provisions contained
herein.
All officers
requesting transfers to positions outside of the three uniform patrol shifts
will utilize the Personnel Career Activity System (PCAS).
All officers who
hold the rank of patrol officer or detective investigator who apply for a
position through PCAS and who are not selected, and who request same in writing
through the chain of command to the Captain of the Unit to which the officer
was not selected, shall be given the true reason for rejection in writing
within fourteen (14) calendar days of the date the request was received by the
non-selecting Captain.
Within fourteen
(14) calendar days of receiving a written rejection, an affected officer may
submit a written appeal to the Deputy Chief who supervises the non-selecting
Captain. The Deputy Chief shall affirm the rejection or overturn the
rejection in writing within fourteen (14) calendar days of receipt of the appeal.
Appeals and
responses under this section are not subject to Article 15 (Grievance
Procedure) of this Agreement, nor may be used in any official proceeding,
unless such response includes a violation of Article 4, Section 2 (Management
Duties to the Association) of this Agreement.
Section 1. General
Provisions.
A. Work Period. Officers
will continue to work a seven-day work period in accordance with past practice,
as opposed to other work periods under the Fair Labor Standards Act. A “work
period” means a regularly repeating seven day calendar cycle that consists of
five, 8 hour or four 10 hours days.
B. Contractual Overtime
Provision. By past practice and through this Agreement, the City has
established a pay pattern that allows officers to receive overtime payment in
pay or compensatory time for any hours outside of the officer’s regularly
scheduled shift or workday. Nothing in the Agreement including Section
1(C) below is intended, designed, or will change this practice. The City
agrees it will continue to pay officers for overtime in pay or compensatory
time in accordance with this Agreement for any hours outside of the officer’s
regularly scheduled shift or workday.
C. FLSA 207k Partial
Exemption. The City
and the Association agree, that under the federal Fair Labor Standards Act, the
City is entitled to the 43-hour exemption from payment of FLSA statutory
overtime compensation. This means that the City is not required by federal
law to pay overtime to officers until after the officer has worked 43 hours in
a workweek. Within the context of this Agreement however, the City shall
continue to pay all contractual compensation in accordance with Article 8
Maintenance of Standards, and in accordance with Section B above, which is
enforceable by the grievance procedure of this Agreement. However, the
City retains the right under Article 7, Management Rights, to change any
process, accounting procedure, forms, periods, or other aspects of accounting
practices if it reasonably determines that such change is necessary to comply
with state or federal overtime law. The City and the Association agree that the
City shall not be obligated in any FLSA enforcement lawsuit to pay overtime
until a 43-hour threshold is reached.
Section 2. Local
Government Code Section
Section
Section
3. General Provisions.
Officers who are not subject
to shift work shall work eight (8) consecutive hours except for interruptions
for lunch periods. The workday shall conform to those hours set by the
City Manager for the other City employees who work regular non-shift
work. The hours presently prescribed are from 7:45 a.m. to 4:30 p.m., with
forty-five (45) minutes for lunch.
City policy has for some time
permitted two fifteen (15) minute coffee and/or rest breaks per day when they
can be taken without serious interference with the work at hand. Such breaks
are normally taken mid-morning and mid-afternoon for officers working
non-shift, and for shift workers at comparable time during the shift. This
policy shall continue to apply to the Department; however, the missing of any
coffee and/or rest breaks because of the press of business shall not be grounds
for overtime payment or for a grievance.
If an officer requests a
thirty (30) minute meal break and is denied such request because of press of
business a second time within such shift, and as a result thereof requests
thirty (30) minutes of compensatory time or pay at straight time, said officer
must submit an "incident report" to the Section Sergeant as to the
reasons why the officer could not take said meal break. The granting of or
the refusal to grant the compensatory time or pay at straight time by the
Section Sergeant shall be final and binding on the officer, with no rights of
appeal to the Commission and/or grievance and arbitration as provided elsewhere
in this Agreement.
The City will continue to
compensate officers who work shifts for the thirty minute lunch, coffee and/or
rest breaks; however, the time permitted by this article for those time periods
shall in no event constitute time actually worked by an officer unless that
officer is ordered by a supervisor to resume duties, or obtains supervisory
authorization to do so. Notwithstanding this provision for compensation
as to lunch, coffee, and/or rest breaks, officers remain within full coverage
and benefits, not limited to life insurance, health insurance, and Texas
Workers’ Compensation Act, if the officers are traveling to or from lunch or breaks
or during lunch or break time and are performing activities that are in
furtherance of the affairs or business of police work. This shall apply
unless the activities are specifically excluded by the provisions of the Texas
Worker’s Compensation Act and the rules of the Texas Workers’ Compensation
Commission, or are excluded by the standards set forth in Article 35 of this
Agreement.
Officers who have by
practice worked an eight (8) or ten (10) consecutive hour workday, which
included a thirty or forty-five minute lunch break, and are not specifically
covered by the sections below will continue to do so.
Section 4. Hours
for Certain Patrol Division Units.
Officers working on the
Daylight (A Shift), Evening (B Shift), or Dog Watch (C Shift) Shifts of the
Patrol Division or the daylight or night shift of CID shall work a
seven (7) day work period, with daily hours compensated at straight-time
according to assignments as follows:
The Patrol Daylight “A”
Shift shall work from 6:00 a.m. to 2:00 p.m. or from 6:30 a.m. to 2:30 p.m.,
with thirty (30) minutes for lunch and two fifteen (15) minute coffee breaks.
The Patrol Evening “B” Shift
shall work from 2:00 p.m. to 10:00 p.m. or from 2:30 p.m. to 10:30 p.m., with
thirty (30) minutes off for lunch and two fifteen (15) minute coffee breaks.
The Patrol Dog Watch or
Night “C” Shift shall work from 10:00 p.m. to 6:00 a.m. or from 10:30 p.m. to
6:30 a.m., with thirty (30) minutes off for lunch and two fifteen (15) minute
coffee breaks.
The Downtown Foot/Bicycle
Patrol Unit officers shall be assigned to work one of two (2) ten-hour shifts
per day, daylight shift 7:30 a.m. to 17:30 p.m. or 17:30 p.m. until 3:30 a.m.,
with thirty (30) minutes off for lunch and two fifteen (15) minute coffee
breaks.
Section 5. Hours for Certain Units.
Officers working on the
daylight or night shift of CID or who are assigned to positions equivalent to
those assigned to CID and who investigate criminal cases, file charges and
dispositions, or who work in an undercover capacity shall work a seven (7) day
work period with daily hours compensated at straight-time as follows:
A. Officers
below the rank of Lieutenant assigned to the daylight shift in CID or
equivalent as described above may work from 7:30 a.m. to 6:00 p.m., with thirty
(30) minutes off for lunch and two fifteen (15) minute coffee breaks.
B. Officers
below the rank of Lieutenant assigned to the night shift in CID or equivalent
as described above may work from 7:00 p.m. to 5:30 a.m., with thirty (30)
minutes off for lunch and two fifteen (15) minute coffee breaks.
C. Officers
above the rank of Sergeant in the units operating under the ten (10) hour work
day shall continue to work a tour of duty consisting of eight (8) hours and
forty-five (45) minutes, with forty-five (45) minutes for lunch and two fifteen
(15) minute coffee breaks, and shall be entitled to Saturday and Sunday as
their regularly assigned relief days.
D. Officers
subject to the ten (10) hours, four (4) day workweek shall include, but not be
limited to, the following:
Off-Duty Employment
Property Crimes
Homicide
Robbery
Sex Crimes
Night C.I.D. Detectives
Repeat Offenders Program
Surveillance Detail
Financial Crimes
Vehicle Crimes
Wrecker Service
Officers assigned to the
above units will continue to work the hours currently prescribed for those
units and with lunch and break hours currently provided. It is not
the intent of either the City or the Association to delete any unit currently
operating under a four (4) day workweek as of the effective date of this
Agreement.
Breaks are normally taken
midway through the first half and midway through the second half of a tour of
duty. The missing of any coffee and/or rest breaks because of the press
of business shall not be grounds for overtime payment or for a grievance.
Section 6. Adjustment
of Working Hours.
The Chief shall have the
right to adjust the working hours, and starting and ending time of any
shift, or the units of C.I.D. covered by the ten (10) hour work day provided
that such change does not cause an employee to work in excess of an average
forty (40) regularly scheduled hours in a work period. In no case
shall any changes in starting and ending times of shifts covered by
Section 4 and 5 above exceed one hour in each calendar year. In
the event the Chief decides to exercise his rights pursuant to this section, he
shall notify the President of the Association in writing of the anticipated
adjustment at least thirty (30) calendar days prior to implementation. The
Association shall have fourteen (14) days from the date so notified to submit
any comments or objections to the proposed change in writing to the
Chief. If objection is expressed by the Association, representatives of
the Association and the Chief shall meet to discuss the anticipated adjustment
within the next succeeding five (5) days. This right shall not be subject
to appeal pursuant to the grievance procedure contained in Article 15 of this
Agreement, with the sole exception that the issue of regularly scheduled work
in excess of the average forty (40) hours in a workweek may be appealed
pursuant to the grievance procedure. Nothing in this section shall be
construed in any fashion to limit the Chief
The existing policies for off-duty employment shall
prevail, except that on matters involving jurisdiction or conflict of interest,
the Chief shall have the right to amend the existing policies, subject to
grievance procedure outlined in Article 15 of this Agreement. Provided,
however, this article shall no longer permit a distinction between public and
private events nor between for-profit and non-profit entities.
The City shall establish an
office staffed with a minimum in rank of one Sergeant, sworn support personnel,
on-duty transportation and office equipment necessary to handle requests of
officers to work at City facilities. Such office shall be located in the
Convention Center complex. Office space only, without additional staffing,
shall be provided at the Alamodome.
Section
3. Use of Sworn Personnel at City Facilities.
A. The City shall utilize only sworn officers for the purposes
of providing security, crowd control, and other police-related activities at
all City facilities. This shall not include ticket takers, badge checkers,
or individuals whose duty is to enforce house rules. The Association
recognizes that the City has legitimate reasons to work with performers or
entertainer’s special security needs. The City shall include in every
contract for the use of City facilities that any vendor or lessee using said
facility shall use only sworn officers procured through the off-duty employment
office for security, crowd control and other police-related activities while
using the facility, and that number of officers determined to be necessary by
the off-duty employment office shall be paid by the vendor or lessee.
For
the purposes of this article, City facilities shall include only the following:
(1) The
Convention Center Exhibit Halls and Banquet Halls or
future expansions
(2) The
Lila Cockrell Theater
(5) La Villita
(6) The Alamodome
(7) Municipal Auditorium
B. All
officers assigned to work at City facilities on an off-duty basis shall be
compensated as follows. Police Officers, regardless of seniority or other
compensation, shall be paid at 1.2 times the
officer’s straight time rate (not including longevity) for an officer at Step C
of the salary schedule found in Attachment 2 of this agreement. All
supervisors, regardless of rank or seniority, shall be paid at 1.2 times the straight time hourly rate for a
Sergeant (not including longevity) if working in a supervisory capacity for the
vendor. The straight time rate shall be computed by multiplying the
officer’s appropriate monthly rate from Attachment 2 by twelve (12) months and
dividing that product by 2080 hours in a work year. All payments will be
made utilizing the officer’s bi-weekly payroll check.
C. The
office of the Chief of Police shall have the responsibility of staffing all
City facilities with sworn officers. The number of officers needed at any
one such property or facility shall be within the exclusive prerogative of the
Chief. The Chief shall establish and maintain a Department Procedure for
administering this Section. The special order shall include sign-up,
notification on a rotating basis, and other policies necessary for the
administration of this Section.
D. The City agrees to pay officers who work any Fiesta events
and related activities in an off-duty capacity at double their base pay plus
longevity. The City agrees to maximize the use of off-duty
personnel who have signed up on the volunteer roster, and to minimize the use
of on-duty personnel, subject to the other provisions herein. Fiesta
activities and events will be those that are defined in the Official Fiesta
Calendar published each year by the City and the Fiesta Commission. Events
such as basketball games, concerts, or trade shows unrelated to Fiesta during
the calendar days of Fiesta shall be paid at
the regular overtime rate unless insufficient volunteers sign up for such
events, then all volunteers whether or not from Fiesta volunteer roster shall
receive Fiesta pay. Easter Sunday will not be covered under this Section
but is covered under Article 20, Holidays, and Section 1.
E. The
City and the Association shall not grant any exceptions to this Article, with
the sole provision being that officers who “volunteer” their time without
remuneration, of any type, may work events for charitable events. “Volunteers”
are not exempt from the requirements for off-duty employment of City
facilities, even where such volunteers under this paragraph are working on City
facilities, and written permission for volunteers to work on City facilities
must be approved by the Office of the Chief or his designee.
F. Nothing
in this Article precludes the City from utilizing personnel from private
security companies to provide day-to-day security for any of the facilities
listed paragraph A, above.
G. The
City shall first be required to call or otherwise make available the
opportunity for off-duty placement to SAPD personnel, and then to non-SAPD
certified
H. The
Association, on behalf of the Department, will apply and coordinate any
paperwork necessary to comply with the Private Security Act of
Since the off-duty
employment provision was placed into the Agreement in 1988, the City and the
Association have worked together to assure compliance. The Agreement of
1988 established an off-duty employment office and established off-duty
compensation at the rate of 1.5 times an officers overtime rate in accordance
with the officer’s rank. This was renegotiated in 1994 and reduced to 1.2
times the straight time for an officer at Step C. Additionally in 1994,
the City agreed to provide officers the opportunity to take compensatory time
instead of pay for off-duty purposes. This was considered a pass through
of the pay benefit and was not intended or designed to impugn the separate and
independent employer relationship outlined in Section 7. This Agreement removes
the compensatory time payment allowance to eliminate any challenge to that
relationship. In furtherance of the Agreements, the City has paid officers
in the rare instances where vendors did not pay. This was considered an
important benefit to officers and not designed or intended to alter the
separate and independent status of outside interests utilizing city facilities.
The City and the Association have a continued relationship within the scope of
the Agreement that allows the City to negotiate officer pay rates and
conditions of off-duty employment while maintaining a separate and independent
status from the individuals contracting to utilize city facilities and off-duty
police officers.
J. Officers
participating in the off-duty employment opportunities provided through this
Agreement are working off-duty for the lessees of city facilities and not for
the City or the Department. In the event of any ruling or holding by a
Court or any determination by the Department of Labor that non-payment by
vendors makes the City liable for FLSA overtime as the employer of officers,
the City may require that officers sign an agreement agreeing to look solely to
the vendor for payment; provided, however, that the City will implement
reasonable practices for collection of accounts in order to achieve collection
of such amounts in a commercially reasonable manner
K. In the
event of any ruling or holding by a Court or any determination by the
Department of Labor that results in altering or changing the benefits provided
by this Agreement under this Article or challenges the ability of the City to
determine compensation under this Article, the Association agrees that the City
shall not be subject to provide additional wages, compensation, or incentives
of any kind beyond that which is specified in this Article for purpose of
off-duty employment at city facilities. To assure this outcome, the City and
the Association agree to meet within ten (10) calendar days of the ruling,
holding, or determination in an effort to resolve any conflicts with this
Agreement. In the event that a compromise cannot be reached within the ten (10)
calendar day window period, the City and the Association will submit all
unresolved issues within thirty (30) calendar days before a neutral arbitrator
selected by the parties. If the parties are unable to agree on an arbitrator,
the parties will each submit the name of a qualified neutral person with
L. Officers
shall be paid, in addition to the compensation for hours worked for lessees
using City facilities, the City “special event” parking rate, which shall be an
additional cost charged to the lessee as a part of total officer security
costs. This parking reimbursement shall be paid for one parking rate
per day.
The City and the Association
agree that the purpose of this grievance procedure is to provide a just and
equitable method for resolving disagreements between the parties regarding the
interpretation of the provisions of this Agreement. Only matters involving
the interpretation, application, or alleged violation of a specific provision
of this collective bargaining Agreement shall be subject to this grievance
procedure. Disciplinary matters which are subject to the jurisdiction of
the Commission pursuant to Chapter 143 Local Government Code are not subject to
this procedure but are covered in Article 27 of this Agreement. Where a
statutory claim is asserted before any administrative agency or court, which
claim(s) arises from the same factual occurrence made the basis of a grievance,
the grievance shall be abated until final disposition or settlement of such claim(s),
unless the officer agrees with the employer and the Association to submit all
claims arising from the same factual occurrence, including statutory claims, to
the grievance procedure herein. Any alleged violation(s) of Article 4,
Section 2(F), of this Agreement shall not be the subject of a grievance unless
there is an Agreement between the parties hereto and the officer to submit such
issue(s) to the grievance
procedure.
The parties shall adhere to
the time limits as set forth in the procedure. In the event the officer
or Association fails to meet the time limits at any step of the procedure, the
grievance shall be considered satisfied and no further action shall be taken.
Failure by the City to meet the time limits at any step shall be considered an
unsatisfactory response and shall automatically allow the grievance to proceed
to the next step. Such time limits may be waived, however, by mutual
consent of the parties in writing.
A grievance within the scope
of this procedure as defined in Section 1 above shall be handled as follows:
Step 1. Any officer having a matter which is felt to be a grievance, first must
within twenty-one (21) calendar days of the actual or constructive knowledge of
the occurrence or the event causing the problem submit such grievance in
writing to the Association with a copy to his immediate supervisor. Said
determination of whether a grievance exists shall be made by
an association grievance committee. The Chief may appoint one (1)
non-voting member of the committee. The committee may exclude the Chief’s
appointed member from deliberations. The grievance committee shall
meet and render its decision in writing within thirty (30) calendar days
of the receipt of the written grievance by the officer. If the Association
exercises this right, the Chief of Police shall be entitled to exclude
Association representatives from any administrative meeting, procedure, or
process, where their presence or participation has been allowed, notwithstanding
the provisions of Article 8.
In
the event that the grievance committee decides that a grievance exists, the
Association, representing the aggrieved officer, shall prepare a formal written
grievance on behalf of the aggrieved officer and proceed to Step 2. Nothing
herein prohibits the city from challenging whether a grievance is timely.
It
is the intent of the parties to attempt to resolve disputes and grievances over
the application, interpretation and enforcement of the Agreement at the lowest
level. Nothing herein shall prevent the Association from meeting and conferring
with the City, Chief or their designees in an attempt to resolve the alleged
grievance before the time limits in Step 1 expire.
Step 2. If a grievance is believed to exist, it shall
be presented in writing to the Chief. The Chief shall have fourteen (14)
calendar days to act on the grievance and render a decision in writing.
Step 3. If the grievance is not
resolved at Step 2, the matter shall be submitted in writing to
the Human Resources Director within seven (7) calendar days from
the decision at Step 2.
The Human
Resources Director shall within five (5) calendar days submit the matter
to the City Manager who shall review the matter and shall render a decision in
writing within fourteen (14) calendar days. The Human Resources
Director shall obtain the response from the City Manager or his representative
and contact the President of the Association of the response and results within
five (5) calendar days.
If the grievance has not
been settled at Step 3, the parties shall have seven (7) calendar days from the
date the Human Resources Director notified the President of the
Association, in which to appeal the grievance to arbitration for
adjustment. An appeal from the Association shall be submitted in writing
to the Human Resources Director. Since the City may also grieve
against the Association, any grievance by the City against the Association will
be filed directly with the President of the Association; and, if not settled
within seven (7) calendar days, may be submitted to arbitration for adjustment.
A grievance contesting
action by the City Council or City Manager shall be filed at Step 3 instead of
Step 2.
The President of the
Association may file a class action grievance on behalf of bargaining unit
members similarly situated at Step 1 within twenty-one (21) calendar days of
the officer or officers’ actual or constructive knowledge of the occurrence or
event causing the problem.
The chief’s representative
to the Association grievance committee may submit for the committee’s
consideration any evidence that the grievance has been addressed or resolved in
a previous grievance or an arbitrator’s award. If the current grievance, or an
issue of the current grievance, is determined by the Grievance Committee to
have been previously resolved, the current grievance, or the issue of the
current grievance, will be deemed as denied by the Grievance Committee and the
grievant will be bound by the previous resolution.
With the exception of all grievances
filed prior to the date of execution of this Agreement, if a grievance has not
been finally resolved within three hundred and sixty five (365) calendar days
from the date of appeal to arbitration, and no mutually agreed time extensions
exist or are requested by either party to the grievance, the grievance will be
deemed to have expired. Grievance extensions will not be unreasonably
denied under this paragraph.
If a grievance is submitted
to arbitration, within fourteen (14) calendar days, the City and the
Association shall agree upon an arbitrator. The parties may mutually agree to
elect to use a panel arbitrator or expedited process pursuant to the provisions
in Article 27 (Disciplinary Actions). For this purpose, the parties may agree
in writing to utilize one or more arbitrators for a specified period of time,
provided that either party may request selection on any specific matter as
follows: If the parties fail to agree upon an arbitrator, a list of seven (7)
qualified neutrals shall be requested from the American Arbitration Association
(
The conduct of the hearing
shall be governed by the standard rules of the American Arbitration
Association. The parties, by mutual agreement, may request that the
hearing be held in accordance with the Expedited Labor Arbitration
Rules which are found as Attachment 1 to this Agreement and are
incorporated herein by reference.
Upon written request
delivered at least seven (7) calendar days prior to the date of the hearing, a
party to the proceeding shall provide to the opposing party the names and
addresses of witnesses expected to be called at the hearing. In the
absence of good or excusable cause, the arbitrator may exclude the testimony of
a witness upon the failure of a party to disclose such a witness. The
parties, in writing, may request discovery from each other concerning the
grievance. Should the opposing party not agree to provide the requested
information within seven (7) calendar days of the request, the request shall be
deemed denied. The requesting party may then apply to the Arbitrator, who
shall order such discovery as is appropriate to the nature of the case,
consistent with, but not bound by, the rules of discovery in Texas civil
cases. In considering the application, the Arbitrator, shall consider the
burden and expense of producing the information, the need of the requesting
party, the amount of time available prior to the hearing, and such other
matters as he may deem material. In no event shall discovery be requested
within seven (7) calendar days prior to the hearing.
The arbitrator shall not
have the power to add to, amend, modify, or subtract from the provisions of
this Agreement in arriving at his decision on the issue or issues presented and
shall confine his decision to the interpretation of this Agreement. The
arbitrator shall confine himself to the precise issue submitted for arbitration
and shall have no authority to determine any other issues not so submitted to
him. The decision of the arbitrator shall be final and binding upon the
City and the Association.
The City shall bear the
expense of any witnesses called by the City. The Association shall bear
the expense of any witnesses called by the Association. The City and the
Association shall share equally the fees and expenses of the arbitrator.
Effective
Effective
Effective
Effective
Effective
A. Police
Officer Rank Step Schedule.
Wages shall be paid in
accordance with the schedule outlined in Attachment No. 2, and incorporated
herein. Upon successful completion of thirty (30) weeks, an officer
becomes a Police Officer, Class 600, Step A, and shall be entitled to all pay
and benefits of that class. A Police Officer shall serve one (1) year in
Step A and then will be moved to Step B of the pay schedule, upon completion of
the education requirements contained in Article 31, Section 2. Upon
completion of five (5) years of commissioned service, an officer is moved from
Step B of the pay schedule to Step C.
Police Officers
with at least ten (10) years seniority in rank and forty (40) accredited
college hours or fifteen (15) years seniority in rank shall be eligible for
Step D which shall be two percent (2%) increase above a Step C.
Police Officers
with at least fifteen (15) years seniority in rank and sixty (60) accredited
college hours or twenty (20) years seniority in rank shall be eligible for Step
E which shall be two percent (2%) increase above a Step D.
Effective
Those police
officers who have achieved Step D, E or F may be identified by an appropriate
insignia approved by the Chief to be worn on the sleeve of the uniform shirt
and/or jacket.
B. Detective
Rank Step Schedule.
Detectives with
at least five (5) years seniority in rank and forty (40) accredited college
hours or ten (10) years seniority in rank shall be eligible for Step B which
shall be three percent (3%) increase above Step A, i.e., entry level into the
Detective rank.
Detectives with at least ten
(10) years’ seniority in rank and sixty (60) accredited college hours or
fifteen (15) years seniority in rank shall be eligible for Step C that shall be
three percent (3%) increase above Step B.
Effective
C. Sergeant Rank Step Schedule.
Sergeants with
at least five (5) years seniority in rank and sixty (60) accredited college
hours or ten (10) years seniority in rank shall be eligible for Step B which
shall be two percent (2%) increase above Step A, i.e., entry level into the
Sergeant rank.
Effective
D. Lieutenant Rank Step Schedule.
Lieutenants with
at least five (5) years seniority in rank and sixty (60) accredited college
hours or ten (10) years seniority in rank shall be eligible for Step B which
shall be two percent (2%) increase above Step A, i.e., entry level into the
Lieutenant rank.
Effective
E. Captain
Rank Step Schedule
Captains with at
least five (5) years seniority in rank and a Bachelors degree or ten (10) years
seniority in rank shall be eligible for Step B which shall be two percent (2%)
increase above Step A, i.e., entry level into the Captain rank.
Effective
Where an officer is eligible
for more than one rate of overtime pay, he shall receive only one of those
rates at a time, though it shall be the higher rate.
Section
3. Shift Differential Pay.
A. All police
officers permanently assigned to begin work after 12:00 p.m.; including but not
limited to shifts currently referred to as the Evening “B” or "Dog
Watch" “C” shifts are to receive $350 per month differential pay.
B. Only
officers permanently assigned to or on Special Assignment approved through the
offices of Division Commanders to begin work after 12:00 p.m. shall receive
shift differential pay. Officers on special assignment must work an
applicable shift for eighty (80) hours or more of any calendar month to be
entitled to differential pay for that assignment for the full month.
C. Officers
who are permanently assigned to begin work after 12:00 p.m. and who by
assignment have the discretion in their working hours must work an
applicable shift for eighty (80) hours or more of any calendar month to be
entitled to differential pay for that assignment for the full month.
In addition to wages as set forth
in the pay schedule, each officer
All qualified officers assigned to the S.W.A.T., including, K-9, Bomb, Bomb alternates, Meth Lab
Certified Detectives, and Crisis Negotiating teams shall receive One
Hundred Fifty-Seven Dollars ($157.00) per month standby pay during each month
of active assignment. All officers assigned to the K-9 Detail
shall receive three (3) hours of overtime compensation per workweek and an additional hour-and-one-half (1-1/2) hours of
overtime compensation per workweek for each additional animal. Such
overtime compensation shall be provided for the housing and feeding of assigned
canines. The parties agree that an accurate
computation of hours of work caring for a police dog is difficult or impossible
to determine and that the compensation provided herein is a fair and reasonable
agreement considering all pertinent facts and circumstances. If a police dog is retired (taken out of
service by the City) the Chief of Police shall award the police dog to the
officer if the officer so desires. The City shall have no further obligation
for the care, maintenance and support of the police dog.
Each officer shall be
entitled to Language Skills Pay upon satisfactory completion of the testing
requirements for proficiency as set forth in Administrative Directive
4.38. The amount shall not be less than the amount payable to other City
employees. Any officer who has not taken or passed the proficiency test
shall not be assigned to or required to use second language skills on the job,
provided that any officer whose personal judgment indicates that using a second
language is appropriate to the safe and expeditious handling of police business
should be willing to do so. No discipline may be imposed for differences
in the exercise of such judgment.
Section
7. Helicopter Assignment Pay.
All officers who are assigned to the helicopter unit
shall be compensated at One Hundred Fifty-Seven Dollars ($157.00) per month of
active assignment. The City shall pay the costs of all required training
and seminars needed to maintain the officer’s flight eligibility,
certifications and licensing. The City shall continue to provide all safety
equipment, including flight helmets, flight suits, and gloves.
Section 8. Drug
Recognition Experts.
Officers who are certified by the
Section 9. Volunteers
in Policing.
Officers (not to exceed the
rank of sergeant) assigned, as Volunteers in Policing coordinators, up to
a maximum of seven (7), shall receive One Hundred Fifty-Seven Dollars
($157.00) per month for each month of active assignment. The Chief may at
his discretion cancel (or reactivate) the Volunteers in Policing assignment pay
at any station should the number of civilian volunteers actively participating
in the program drop to a number no longer justifying the Volunteers in Policing
assignment pay.
Section 10. Overtime, Regular Rate, and other Pay
Calculations.
A. Overtime,
pension, Fiesta pay, court and call-back pay, holiday pay, longevity,
education, shift differential,
B. The
Association agrees that, for the term of this agreement (including any extension
period), all past pay practices under the terms “regular rate of pay,” “rate of
pay,” or “regular pay” in the previous agreement, including those which have
been calculated and paid based on base pay or base pay plus longevity (examples
below) are deemed as proper pay practices under the prior agreement and will
remain proper under this agreement. Should any grievance contesting the
definition or calculation of pay or “regular rate of pay” be filed after
C. Therefore, in the event of any successful officer(s) claims,
by grievance or lawsuit, under the terms “regular rate of pay,” “rate of pay,”
or “regular pay’” the Association agrees to share in the liability by special
assessment and pay for such claims at the ratio of 50% Association, 50%
City. To the extent that any such matters are asserted by suit, the
Association shall provide and pay for cooperating joint defense counsel, or pay
50% of the City’s cost of defense.
D. Notwithstanding
this agreement the City and the Association agree that “regular rate of pay” is
negotiable, and that upon resolution or settlement of the FLSA lawsuit (Matthew Jackson and Steve Christian, et. al.,
Plaintiffs, v. The City of
E.
In accordance with arbitration rulings, sick
leave buy back and sick leave upon separation pay shall be calculated to
include all incentives as used in that calculation for an individual officer.
For purposes of Section 9 of this Article, incentives are defined as those pay
additions that apply to an individual officer. This would include but not be
limited to the various assignments pays such as
F. Should
this Agreement create any new pay categories, such categories shall be included
for overtime, pension, and leave upon separation computation unless
specifically excluded by wording within the applicable section.
G. This
section does not have the effect of altering the duty to pay overtime when
required by the FLSA at 1.5 times the “regular rate of pay” as defined by
federal law; the parties recognize, however, that this agreement, portions of
which predate the FLSA, has not used the term “regular rate of pay” in the
manner defined by the statute.
H. The
computation for the calculation of longevity pay will be base pay at the
officer’s appropriate step multiplied by the percentage increase of the
officer’s longevity position plus $8 for each additional year up to a maximum
of 4 years.
|
5 Years |
3% |
|
10 Years |
6% |
|
15 Years |
9% |
|
20 Years |
12% |
|
25 Years |
15% |
|
30 Years |
18% |
I. Pay
Examples
Longevity: A 22-year patrol
officer in step E would make $3,985 for base pay times 12% for longevity plus
an additional sixteen dollars total for years 21 and 22. (($3,985 * .12) +16 =
$494.20).
Fiesta Pay shall be double
time: Base plus longevity times two (2).
All
Past Pay Practices in relation to Court and Call-Back shall continue, except as
changed and modified by this agreement.
Court and Call back shall
continue to be paid at one and one-half (1.5) x “regular rate of pay” for
actual time worked. However, Court and Call back shall never be paid in an
amount less than 3 hours x 1.5 x base pay plus longevity. The officer
will be given whichever amount of pay is higher but not both.
The Holiday and Premium
Holiday rate of pay shall be as follows:
Holiday pay shall be compensated at double
time, the regular rate of pay (inclusive of all the subject officer’s
incentives or add-on pays) for the day
worked, plus credit for the holiday, which is accrued additional leave
time; and double time and one half (2.5) on a Premium Holiday, (which is pay
for the day worked and accrued additional leave time or payment), depending on
which type of Holiday was worked. This is inclusive of all incentive pays
for calculation of regular rate of pay for this article.
Example:
Regular
Example: Premium
In this example for a
premium holiday, the officer would receive 20 hours (8 hrs. X 2.5 rate) compensation
for an 8 hour day. (20 X $32.87 = $657.40),
which may be taken as follows:
1. Eight hours regular day wages plus 12 hours
compensatory time.
2. Eight
hours regular day wages plus 12 hours at $32.87 per hour.
3. Eight hours regular day wages plus 8 hours
compensatory time and 4 hours at $32.87 per hour.
4. Eight hours regular day wages plus 4 hours
compensatory time and 8 hours at $32.87 per hour In the event that an officer
works a ten (10) hour work day then the same logic would apply in calculating
their compensability.
In the event of a death in
the immediate family of an officer, the officer shall be
granted consecutive working days off with pay according to the following
schedule:
Officers working a five-day
forty hour week, will be granted four (4) consecutive working days off.
Officers working a four-day
forty hour week, will be granted three (3) consecutive working days off.
The immediate family shall
be defined as mother, father, legal spouse, child, brother, sister,
half-siblings, grandparents, spouses’ grandparents, great-grandparents, spouses’
great-grandparents, mother-in-law, father-in-law, grandchildren, step-parent,
step-children and other members of the immediate household residing with
the officer.
Unless
exclusive permission is received from the Chief of Police, the working days as
outlined by this Section shall be taken within fourteen (14) calendar days from
the date of the death of the family member.
Officers on military leave
during the time of death of an immediate family member shall not be entitled to
the provisions of this Article.
In the case of a death of
friends or relatives outside the immediate family, or if an officer wishes to
perform service as a pallbearer, an officer may request other types of accrued
leave. The leave must be approved in advance by the officer’s supervisor.
Section 1.
"Call back" as
used in this Article means an officer having been released from duty for fifteen (15) or more minutes and called back to
report to duty by an appropriate supervisor or authority. Officers
failing to complete assigned duties and/or tasks within their assigned tour of
duty and are called back or held over to complete the assigned duties and/or
tasks within fifteen (15) minutes from being released from duty are not subject
to “call-back” as outlined in this Article. Additionally, officers who
voluntarily report to duty prior to roll call and are ordered to perform a duty
and/or task are not subject to “call-back” as provided in this
Article. However, officers may submit for time and a half (1-1/2) overtime
extending from the end of their tour of duty until such time the
assignment has been completed (including court time) and they are released
by the appropriate supervisor or from the time they are ordered to perform a
duty and/or task upon reporting early to work until the beginning of the tour
of duty.
Off-duty
court time and call back shall be paid at the rate of time and one-half, with a
three (3) hour minimum and paid at double time with a three (3) hour minimum on
vacation and relief days.
An
off-duty officer who attends court or a pretrial conference and is dismissed
for the remainder of the day before three (3) hours time has elapsed is
entitled to three (3) hour minimum. An off-duty officer who attends court or a
pretrial conference in the morning, is released for lunch, and returns to
complete his attendance in court or the pretrial conference, is compensated for
the actual time spent in court or conference, inclusive of the time he
initially reported until final dismissal by the appropriate authority. For
example:
·
Off-duty Officer
Jones attends 150th District Court or Municipal Court 6 at 1000
hours. The judge releases Officer Jones for lunch at 1200 hours with
instructions to return at 1300 hours. Ultimately, Officer Jones is dismissed
from court at 1400 hours. Officer Jones submits one card for four (4) hours
compensation.
When
an off-duty officer attends one court and is released or dismissed prior to the
expiration of the three (3) hour time frame and is required to attend a second
court immediately after the expired three (3) hours, the officer will be
compensated for two (2) separate three (3) hour court callbacks, For example:
·
Off-duty Officer
Sanchez attends 150th District Court or Municipal Court 6 at 0800
hours and is finally released at 0900 hours. He then attends 130th
District Court or Municipal Court 1 at 1100 hours and is dismissed at 1130
hours. Officer Sanchez submits two (2) cards, each for a three (3) hour
minimum.
When
an off-duty officer is requested in more than one court/pretrial conference on
the same day, he will be compensated for attending only one (1), if the other
appearance times are within three (3) hours of the first one. For example:
·
Off-duty Officer
Jones attends 130th District Court or Municipal Court 1 at 1000
hours and is dismissed at 1100 hours. He then appears in County Court 2 at 1130
hours and is finally dismissed at 1200 hours, Officer Jones submits one card
for three (3) hours compensation.
This
provision applies to the following courts in work-related matters or the course
of employment only:
A. District Courts.
B. County Courts-at-Law.
C. Grand Juries.
D. Justice of the Peace Courts.
E. Municipal Courts.
F. Civil Service Commission or Arbitration Hearing
(when an officer is subpoenaed by the City).
G. Texas Alcoholic Beverage Commission hearings.
H. Federal Court.
I. Administrative License revocation Hearings
(ALR).
J.
Pre
trial conferences.
K. Pardon and Parole hearings.
For
purposes of this Article, a vacation period shall be defined as any three (3)
consecutive days of paid leave (comp. time, holidays, annual leave) and any
relief days occurring within that time period which has been previously
scheduled in accordance with regular departmental policies. Relief days
shall not be counted as a part of the three (3) day minimum specified above,
provided, however, any relief days occurring during the scheduled vacation
period which covers the time from the last hour worked before the start of the
vacation period and continues until the first hour worked after the scheduled
vacation period shall be considered a vacation day for the purpose of this
Article. Relief day shall be defined as covering the time from the last hour
worked before the start of the relief day and continues until the first hour
worked after the scheduled relief day for the purposes of this Article unless
it occurs within one and a half (1 ˝) hours of the end of the officer’s duty
shift on the last day the officer worked.
An off-duty officer who is
subpoenaed for and participates in a telephone ALR Hearing set by a judge will
be compensated for one (1) hour at a rate of time and one-half and paid at
double time rate if he is on vacation or on his relief day. In the event the
telephone ALR Hearing exceeds one (1) hour, the officer will be compensated for
the actual time spent testifying in the ALR Hearing.
When an officer is subpoenaed
by the respondent to a Civil Service or Arbitration hearing he will be granted
compensatory time at the rate of one hour per hour required to satisfy the
subpoena to a maximum of three (3) hours.
Section 2.
It is understood that the
Chief is responsible to deliver subpoenas issued by
A. Stand-by,
off-duty and regular work is one-hour compensation at time and one-half.
B. Stand-by,
off-duty on vacation or relief day is one-hour compensation at double time.
C. When an
officer is placed on standby, the officer must be available by his phone during
the specified time period. If the officer is not available by his phone during
the specified time period, the officer will not be compensated.
D. For an
officer to be placed on standby, he must receive specific notification from
Court Liaison Detail personnel, from a judge, or from a district/county
prosecutor. When an officer is placed on standby by a judge or district/county
court prosecutor, he must notify the Court Liaison Detail.
E. Officers who are notified by court liaison to
appear in court and are subsequently canceled by a proper authority will
receive the following:
1. If canceled after 4:30 p.m. of the day before the assigned
court appearance date, compensation will be paid according to Section 2, A or B
above.
2. If canceled upon arrival at the assigned court, Section 1 of
this Article applies.
Section 3.
When
an officer, on off-duty status, is required to be on stand-by for several days
in succession on the same subpoena, compensation may be claimed as in Section 2
above, for each successive day on standby at the applicable rate. Approval
for standby for more than three (3) days must be received from the Court
Liaison prior to being on standby.
Section 4.
Officers who are
subpoenaed by other jurisdictions and have received compensation from those
jurisdictions shall not be entitled to compensation as provided in this Article
unless the officer turns over all funds received from the other jurisdiction to
the office of the Chief of Police and validates his attendance by completing
the necessary forms.
Section 5.
For purposes of
this Article, an officer shall be paid for all hours worked, including travel
time, when traveling to courts outside a sixty (60) mile radius of the city.
The clothing
allowance shall be $480.00 per year, payable monthly at $40.00 per month. In
addition, each new officer shall receive an initial clothing allowance of
$480.00.
Effective
Section 1.
Each officer shall be
credited with one day of accrued holiday leave for each holiday adopted by the
City Council for each year. Any officer whose start time for the work
shift is on a premium holiday shall receive regular pay plus one and one-half
times their base pay plus longevity (with the accrued holiday plus ˝ time in
pay or compensation time, or without the accrued holiday in pay or compensatory
time, at the officer’s discretion). Any overtime accrued in excess of the
officer’s regular duty hours, during the premium holiday, shall be at one and
one half (1 ˝) times their base pay plus longevity (in pay or in compensatory
time at the officer’s discretion).
Premium Holidays include:
1.
New Year’s Day,
2.
Easter Sunday,
3.
Independence Day,
4.
Thanksgiving Day,
5.
Christmas Eve Day,
6.
Christmas Day,
7.
New Year’s Eve Day
Section 2. Hours of
For purposes of this
Article, holiday pay and premium holiday pay shall be paid to the officer if
the start time for the officer’s work shift begins during the holiday or
premium holiday.
Section 3. Staffing of Holidays.
The Chief has sole
discretion to staff the Department on scheduled City holidays in accordance
with Article 7, Section 1(A), of this Agreement. Such assignments are not
subject to grievance or arbitration procedures. Any decrease in staffing on
these days will be done by reverse seniority within the details of the
unit. Article 12, Seniority, Section 2, applies to this section in that
no junior officer will be bumped out of working a premium holiday, if the
senior officer has not been assigned to the section, unit, or detail six months
prior to the premium holiday.
Section 1. The City shall provide
officers vacation time on the basis of the following schedule:
|
Completed Years of
Service |
Vacation Time |
|
1 through 10 |
124 working hours |
|
11 through 15 |
164 working hours |
|
16 & Over |
204 working hours |
Effective
|
Completed Years of
Service |
Vacation Time |
|
1 through 10 |
126 working hours |
|
11 through 15 |
166 working hours |
|
16 & Over |
206 working hours |
Section 2. Vacation time shall be
accrued and credited as follows:
A. Officers
having 1 through 10 years of completed service shall accrue vacation at the
rate of ten (10) hours per month.
B. On
the date an officer completes ten (10) years of service and on each anniversary
date thereafter, he will be credited (on a lump sum basis) with forty (40)
additional hours of vacation time.
C. On
the date an officer completes fifteen (15) years of service and on each
anniversary date thereafter, he will be credited (on a lump sum basis) with
forty (40) additional hours of vacation time for a total of eighty (80) hours.
D. For
purposes of this Article, anniversary date is defined as the annual anniversary
of the officer
All other leave policies in
effect at the beginning of this agreement year shall remain in effect for the
duration of the Agreement.
Section
2. Leave Pay Upon Separation.
A police officer who leaves
the classified service for any reason shall receive a lump-sum payment in the
full amount of his ending salary for the period of his accumulated compensatory
time, holidays, sick leave (in accordance with entitlements as provided for by
statute), bonus days, and vacation time, provided that such payment, in the
case of vacation time, shall be based upon not more than ninety (90) days of
accumulated vacation leave. The beneficiaries of any
police officer who loses his life as the result an injury or illness in the
course and scope of employment shall be paid the full amount of his salary for
the total number of his days of accumulated leave.
The City will buy back or
convert either in “pay” or in “other forms of leave,” at the officer’s
discretion up to ten (10) unused sick leave days for the preceding year
(October 1 to September 30) on a one-for-one basis provided that the officer
requests same in writing on a form provided by the City by the end of the first
pay period in October; and the officer has a balance after the buy back of not
less than fifty (50) accumulated sick days.
In addition, the City will buy back or convert either in “pay” or in
“other forms of leave,” at the officer’s discretion up to five (5) remaining
unused sick leave days for the preceding year (October 1 to September 30) on a
two-for-one basis, provided that the officer requests same in writing, on a
form provided by the City, by the end of the first pay period in October; and
the officer has a balance after the buy back of not less than fifty (50)
accumulated sick days. Effective
The City shall distribute
funds in cash or as other forms of leave. The City agrees to allow
officers to adjust their paycheck the pay period before or after the sale of
leave days in order for the officer to make contributions to their deferred
compensation plan.
The Accounting Unit will run
in the Daily Bulletin during the month of September notification to the officer
to file, in writing, for the buy back. An officer may not "sell" back
sick leave accumulated prior to the year (October 1 to September 30) and may
only "sell" back those unused days of the fifteen (15) days currently
accumulated. The City will pay the officer his amount due at the same time
as other City employees are paid for their sick leave buy back but not later
than Christmas Eve day.
Section
4. Bonus Days Leave.
Each officer shall be
entitled to one (1) additional day of leave for each quarter of a calendar year
(beginning January 1) of "perfect attendance". Officers off from
duty for one of the following reasons are not eligible to receive the one (1)
day perfect attendance bonus: time off for sick leave; off-job injury leave;
military leave in excess of fifteen (15) days in a calendar year; leave without
pay; stress leave; and suspensions. Full vacation days, holidays, and/or
compensatory time usage that has not been scheduled and documented by the
supervisor prior to the end of that officer
A day as used in this
Section of this Article shall equate to eight (8) hours, regardless of the
number of hours in an officer
In the event that an officer
has reached the maximum number of Bonus Days that may be accrued, the
excess Bonus Days may be converted to vacation leave or holiday leave at the
discretion of the officer.
Section
5. Compensatory Time Accrual.
Each officer may accumulate
480 hours of compensatory time.
Section
6.
Each officer may accumulate
up to a maximum of three hundred and twenty (320) hours of holiday leave at the
rate of eighty (80) hours per year.
For purpose of clarification only, the following chart
details the type of leave and what amounts over the accumulated maximum may be
converted into at the discretion of the officer. Officers who have maximum
accumulation in leave accrual that cannot be converted into other categories
because of maximum accumulation in those categories are subject to Section 8 of
this Article.
No
officer covered by this agreement shall lose any holidays, vacation, or
compensatory time he accumulated during the duration of this agreement
that exceeds the maximum permitted accrual amount allowed by this Agreement,
unless, after being given written individual notice to take the holidays,
vacation, or compensatory time within a specified period not less than thirty (30)
days, the officer fails to do so.
Any
officer may be granted Injury-on-Duty (IOD) Leave by the Chief of Police after
three hundred and sixty-five (365) calendar days from the original date of
injury if:
A. Medical
documentation from the officer
B. When
presented with such medical documentation, the Chief shall have the right to require
the officer to be evaluated by a physician as designated by the City for
confirmation of the findings of the officer
If this third physician
C. The
officer will not be charged any sick leave during any second or other occurring
period of an original IOD incident, but will be granted immediate IOD leave.
D. If
it is determined by licensed physicians and reviewed by the Chief of Police
that the second or subsequent treatment period is not a result of the original
injury, the officer will have the IOD time rescinded and charged sick
time. In the event the officer has no sick time on the books, he will
forfeit any other type of accumulated leave on the books to equal this IOD time
taken off. In the event the officer has no time on the books, he or she
shall pay back the time at one-half of all vacation, holiday, and sick time
accumulated until all IOD leave is satisfied.
E. The
Chief of Police shall have the final authority and it will no longer be
necessary to submit such requests to the City Manager
A leave of absence, without loss of regular pay, shall
be granted to an officer upon his actual jury duty service, unless excused
therefrom; provided, however, that such officer waives or remits to the City
his jury fee and provides proof of jury service verified by the court liaison
section and submitted to Police Accounting.
Each officer shall
accumulate fifteen (15) days of sick leave, with pay, per calendar
year.
When the total number of
sick leave pool days drops below seven hundred (700), one (1) day of sick leave
with pay from each officer participating in the program shall become part of
the sick leave pool, and any remaining days shall continue to be credited to
the individual officer.
Officers having opted not to
participate will not, under any circumstances, be allowed to enter the pool at
any later date. Any officer who voluntarily drops out of the pool may not,
under any circumstances, be allowed to re-enter the pool. Notification to
the Accounting Unit must be provided, in writing, by the officer who drops out
of the pool. The Accounting Unit shall include a copy of this report in the
officer
Upon completion of the
initial two-month period of employment after graduation from the Academy, each
officer shall have one and one-half (1.5) days of sick leave credited to the
pool. In the event of separation from employment prior to completion of
the probationary period, the City may adjust the pool for any sick leave
credits not actually earned by the contributing probationary officer. When an officer retires or dies, any sick
leave accumulated by the officer that would have otherwise been forfeited shall
be credited to the sick leave pool.
The
Chief of Police and the President of the Association shall each appoint an
equal amount of officers to a committee in rank to administer the sick
leave pool. The committee shall then elect a chairman. The
resulting vacancy will be filled by the opposite appointing officer from that
receiving the chairmanship. Example: If the Chief of Police appointee is
elected chairman, the Association President shall appoint for the created
vacancy.
The Chief of Police will
select one sergeant, one detective and one patrol officer. The Association
President will select one detective and two patrol officers. In cases
where an officer applies for sick leave pool benefits and holds a rank
higher than sergeant, the Chief and President of the Association will each
appoint one person of rank equal to or higher than held by the requesting
officer.
All committee members shall
be appointed on or before October 1 of each year and shall serve one-year
terms. Any vacancies occurring during the course of the term shall be
filled within twenty-one (21) calendar days. No person shall be allowed to
serve more than one (1) consecutive term. The City shall indemnify,
defend, and hold harmless each committee member.
The following requirements
determine when a committee may consider when sick leave pool days may be
drawn. A decision by the committee shall be final.
A. Officers
may be considered for sick leave pool days after taking off fifteen (15)
consecutive working days (or comparable hours) of continuous non-job-related
illness or injury. The fifteen (15) consecutive working days used for eligibility
shall not be refundable by committee or otherwise.
B. No
officer shall be permitted to use more than 180 pool days for a single illness
or injury.
C. Pool
days may not be used for injuries or illnesses sustained in the line of duty.
D. The number of
days in the pool shall be solely for the benefit of officers with extended
injuries or illnesses, and such days shall not revert to the accumulated sick
leave of individual officers.
E. Pool
time may only be used for disability, which is defined as a non-job-related
injury or illness, which prevents an officer from fully performing assigned
duties in all major divisions of the department.
F. The
committee chairman may at any time or at the request of the Chief of Police
reconvene the committee for further consideration should evidence come forward
that would affect the outcome of a committee decision after a decision has been
reached. The committee by majority vote may extend, reduce, approve, cancel, or
deny a pool usage, as the evidence requires.
G. Officers
desiring consideration for pool usage may be required to submit to medical
examination by a City doctor and may be required to produce medical records,
doctor
H. Upon
any officer being absent from duty ninety (90) working days as a result of a
single illness or injury, the Chief may require the officer to submit to a
medical examination to determine whether the officer is permanently
disabled. When it is determined that an officer is permanently disabled,
the Chief shall be entitled to terminate or retire the officer, whichever is
applicable, according to law existing.
Section
12. Leaves of Absence.
The
Chief may grant a leave of absence, without pay, to a maximum of five (5)
officers, which granting shall not be unreasonably withheld. The primary
purpose of which shall be to provide to the officer with additional education
in law enforcement-related areas. Request for leave under this section
for the purpose of the officer continuing full-time formal education at an
institution of higher learning shall be given priority. The
duration of the leave shall be for a period of time as determined by the
Chief, but in no event for a period to exceed three (3) calendar
years. Should the leave be for the purpose of pursuing continued formal
education at an accredited college or university of higher learning, the leave
shall be granted on a semester-by-semester basis.
A leave of absence under
this Section shall not be considered a break in service for promotional or
seniority purposes. Officers on leave of absence shall not be eligible to
apply for or take promotional examinations while on such leave.
An officer on an approved
leave of absence under this Section must return to regular
assignment with the City for a period at least equal to the length of his
leave. Should an officer fail to return to his regular assignment for such
period, the leave taken shall be considered as a break in service for purposes
of promotion, seniority, pay, and/or pension.
The Chief of Police may
recall an officer from a leave of absence granted under this Section in
the case of an emergency for the duration of the emergency.
Officers on leave of
absence may continue pension payments, and the City shall match such
payments according to the requirements of state law. However, all other
forms of compensation shall be withheld until such officer returns to full-time
status with the Department.
“Vacancy” is an encumbered position that is not currently
filled.
“Absence” is a position that is currently filled but the
individual currently occupying that position is not currently present for duty.
“Investigative
assignment” is any assignment
that requires investigation where that individual, as part of his job
assignment, is from time to time responsible for filing a charge and
disposition if one is necessary.
“Undercover assignment” is any assignment that requires investigation where
that individual, as part of his job assignment, will work in plainclothes
without revealing his identity or occupation in furtherance of an assigned
police function and is working for a unit within Criminal Investigation and
Intelligence.
Support and assistance
functions shall include telephone answering, transport of materials or
property, initial or follow-up information intake, or filing or copying
functions.
Section 2. Acting
In A Higher Position.
When an absence occurs in
the positions of Sergeant, Lieutenant, Captain, Deputy Chief or Assistant
Chief, and said absence continues from day to day for a period in excess of
seven (7) calendar days, the Chief shall assign an officer to act in the
capacity of the absent position. [If it be determined that an absence will
continue in excess of seven (7) calendar days, and said position is determined
by the Chief to be of critical importance, he may, at his sole discretion, fill
said absence by appointing from the first day of absence. If another
officer of the equivalent or higher rank is in a position to assume the
responsibilities of the absent officer’s position, then the Chief is not
required to assign an officer to such position. During service in the acting
capacity, the officer, so assigned, shall be compensated at the base salary of
the higher position, plus his or her own longevity or seniority pay
beginning on the rate of such acting assignment by the
Chief. Excepted from this provision is any absence created by operation of
Article 3 of this agreement.
If a vacancy is not filled
within thirty (30) calendar days in the rank of Sergeant, Lieutenant, Captain,
Deputy Chief or Assistant Chief, and the position is not eliminated, then the
Chief shall appoint temporarily from the next lower rank some officer to fill
that position until a permanent officer is assigned to fill said vacancy.
Section 3. Temporary Investigative/Undercover
Assignment.
A. When
an officer holding the rank of Patrol Officer is temporarily assigned to
perform investigative, or undercover work, outside his/her regular duties in
the Criminal Investigative Division, the Traffic Investigation Unit, or
Intelligence Unit (or its successors in function) said officer shall be compensated
at the base salary of a Detective Investigator with the longevity or
seniority pay of his/her permanent rank for all hours worked in that
assignment beginning on the date of such acting assignment.
B. The City is
entitled to assign Patrol Officers to support and assistance functions in
criminal investigative divisions without paying higher classification
pay. The City may also assign Patrol Officers within the department, for
support and assistance functions, as workload requires, without paying higher
classification pay.
C. It
is understood and recognized that the City may assign Patrol Officers to
undercover functions within the department, or with outside agencies, provided
that higher classification pay shall be applicable.
Section 4.
Exceptions and Grievability.
A. All appointments to a higher
classification position shall be done in writing with the approval of the Chief
of Police. No officer will be paid for the performance of higher level work
without prior written authorization. The Chief of Police shall unilaterally
determine the guidelines for working in a higher classification position and
the procedures for which such authorization will be obtained.
B. Any
officer who works voluntarily in an assignment for which sole compensation
is in an overtime capacity shall not be eligible to receive higher
classification in addition to the overtime pay. (i.e. Patrol officer working
overtime vice assignment will only receive their normal overtime rate for hours
worked in said assignment.)
A. A
position may not be occupied by officer(s) of lower rank, as described above
for a period in excess of one hundred and eighty (180) calendar days except for
officers working for or assigned to outside agencies (i.e. Drug Enforcement
Administration, Federal Bureau of Investigation, etc.) or officers working
temporary undercover assignments for the Police Department.
B. An
officer who works in the acting capacity of a higher position will only be
compensated for the hours or days that the officer actually works in that
position and is present to carry on the duties of the higher
position. Officers will be compensated in whole hours with a minimum of
one-hour. Any hours actually worked over four (4) shall be compensated for a
full day.
C. If
an officer requests in writing the assignment of appropriate supervision
and his request is unreasonably denied, the Chief of Police shall review such
request and make the determination if appropriate supervision is available and
make such adjustment as deemed necessary to rectify the situation. This
may be accomplished by making a temporary higher classification appointment, a
reassignment or any other action as determined by the Chief of Police. The
determination by the Chief of Police shall be final and not subject to a
grievance.
Prior to becoming a Police
Officer (probationary), Class 601, an employee is a Police Cadet (602)
(civilian) and is not in the bargaining unit. Upon successful completion
of the requirements of Police Cadet, the employee becomes a Police Officer
(601) (Probationary). On becoming a Probationary Police Officer (601)
he/she shall serve a fifty-two (52) week probationary period.
Section 2.
Police Initial Probationary Period.
The fifty-two (52) week
period following completion of the
During the fifty-two (52)
week initial period, the officer will be assigned to performing actual police
patrol duties and shall not be eligible for any other special
assignment during the term of this initial period.
In no event shall
probationary patrol officers supplant assigned positions or relief
days. Probationary officers may only assume the Field Training Officer’s
relief days while actually riding with the Field Training Officer or temporary
RD’s as assigned by the Patrol Assignment Coordinator for training and review
procedures.
Section 5.
Probationary Dismissal.
Following graduation from
the
Upon completion of the
requirements of the initial Academy, all officers shall be entitled to request
the City to make direct deposits of their payroll checks, as are other
non-probationary officers.
The Chief shall continue the
Field Training Officer Program (FTOP) as a section of the
Section
2.
The minimum requirements for
The hours and
assignment of
Section
4.
The program will be headed
by a "Coordinator" who shall hold the rank of Lieutenant or
above. The Coordinator shall have the power to recommend to the Chief the
dismissal of any officer from the program on the basis of the officer
All officers permanently
assigned to the
Section 1.
There shall be a six (6)
month probationary period for all civil service promotional ranks commencing the date the officer is actually promoted. Salary,
benefits and seniority within the promotional rank commences the date the
officer was eligible for the promotion pursuant to this Agreement and Chapter
143 of the Local Government Code. During the promotional
probationary period, an officer may be demoted by the Chief to the rank from
which he was promoted on the basis of the officer’s inefficiency, incompetence,
or inability to supervise.
Section 2.
In
the event that an officer is demoted under Section 1 above, said officer may
file a grievance pursuant to the grievance procedure in this Agreement. If
the grievance proceeds to Section 4 of the grievance procedure, the officer
shall only raise to the arbitrator the issue of whether or not the officer was
demoted for some reasons other than inefficiency, incompetency, or inability to
supervise. The burden of proof shall be on the officer to demonstrate that
the demotion was for some reason other than inefficiency, incompetency, or
inability to supervise. In the event that the arbitrator rules that the
demotion was for some reason other than incompetency, inefficiency, or
inability to supervise, the arbitrator shall rescind the demotion and restore
the officer to the promotional rank from which the officer was demoted.
Section 3.
Upon demotion while holding
a probationary promotion, an officer shall resume the competitive rank from
which appointed and the salary shall be in accordance with said competitive
rank with service time credited as continuous time in that competitive rank and
with all salary increases to which the officer would have been automatically
entitled had the officer continuously remained in said competitive rank.
Section 1.
The Chief shall have authority to demote and/or
suspend not to exceed forty-five (45) calendar days, or indefinitely suspend (as provided for in Chapter 143 of Local Government Code)
any officer for the causes set forth in the Rules and Regulations of the
Commission. The officer may appeal such actions, if any, as provided for
herein. Nothing contained herein prevents the Chief and the accused officer
from reaching an agreed settlement on any matter so long as both parties concur
in writing in advance of said settlement. Officers suspended for three (3) days
or less who appeal the suspension shall not serve the suspension unless a
suspension with loss of pay is awarded by an arbitrator.
Section 2.
Prior to any such disciplinary action, the officer
shall be given notice of contemplated disciplinary action by personal service,
stating the action or actions contemplated and the reasons therefore, and
notifying the officer that he may rebut the charges to the Chief, either
orally, or in writing, within seven (7) calendar days. If the Chief should
be unable to secure personal service after due diligence, service may be made
by placing the notice in the mail addressed to the officer’s last known address
along with delivery of the statement to the Association, and proof of such
service shall be sufficient to support any disciplinary action.
Section 3.
After the notice and
opportunity for rebuttal provided in the preceding paragraph, the Chief may
demote, suspend, or indefinitely suspend an officer by personal service on the
officer of a written statement of charges. If the Chief should be unable
to secure personal service after due diligence, service may be made by placing
it in the mail addressed to the officer’s last known address along with
delivery of the statement to the Association, and proof of such service shall be
sufficient to support any disciplinary action. Service of notice in
accordance with this section shall constitute suspension or other disciplinary
action for purposes of adherence to any contractual or statutory limitations
period. A copy of such statement shall be promptly filed with
the Human Resources Director of the City.
Section 4.
The written statement shall
point out the particular rule or rules alleged to have been violated by the
officer and the specific act or acts alleged to be in violation. In the
event of demotion, suspension, or indefinite suspension, the statement
informing the officer of disciplinary action and the reason(s) therefore shall
also inform the officer that an appeal may be had by filing same in writing
with the Human Resources Director, within ten (10) calendar days after
receipt of said written statement, or, if alternate service is had as provided
herein, within ten (10) calendar days from service upon the Association.
Section 5.
For the purposes of this
Article, the term arbitrator shall mean the same as a third-party hearing
examiner as referred to in Chapter 143 of the Local Government
Code. Appeal from demotion, suspension or indefinite suspension shall be
decided by one (1) arbitrator, selected according to this agreement. Upon
receiving an appeal from the officer, the Human Resources
Director shall act promptly to notify the Association, the Chief, and the
City Manager of the appeal.
Within ten (10) calendar
days of the execution of this Agreement, a panel of ten (10) arbitrators will
be established by the City and the Association, either by agreement, or by
striking names from a list of twenty (20) names, ten (10) names being submitted
by each party. The Association will strike the first name. Persons whose names
are submitted to act as arbitrators under this Agreement, must be
The established panel of
arbitrators will expire at the end of this Agreement. The City and the
Association may fill any vacancy which occurs on the panel by agreement, or
when two (2) vacancies occur, by striking names from a list of ten (10) names, five
(5) names being submitted by each party, with the Association striking the first
name. The parties by mutual agreement may permanently remove one or more panel
arbitrators at any time.
Section 6. Arbitration
Process.
(a) Suspensions of forty-five (45) calendar
days or less.
If the officer chooses to
appeal a suspension of forty-five (45) calendar days or less to an arbitrator,
the officer and the Chief may attempt to mutually agree on a particular
arbitrator. If the parties fail to agree on an arbitrator within seven (7) calendar
days after the day the appeal is filed, the Human Resources Director will
select as arbitrator, by rotation, the name of the next arbitrator from the
list of ten (10) pre-selected arbitrators. The arbitrator must be promptly
notified of his or her selection, and asked to provide available dates within
the next ninety (90) calendar days for the arbitration to be heard.
If the officer and the
Chief cannot agree within ten (10) calendar days on a date for the hearing from
the list of dates offered by the arbitrator, the parties must promptly schedule
a telephone conference between the arbitrator, and the arbitrator will set a
date for the hearing within the next one hundred and twenty (120) calendar
days.
The parties will not have ex parte communication with
the arbitrator. Communication with the
arbitrator will be through the counsel for the Chief and the counsel for the officer
jointly.
No briefs shall be filed and the arbitrator shall
issue an award within seven (7) calendar days of the conclusion of the hearing
for panel arbitration. The parties may waive this requirement by mutual
agreement in writing.
(b) Indefinite suspensions and demotions.
If the appeal is for
arbitration of an indefinite suspension or demotion, the counsel for the officer
and the counsel for the Chief shall attempt to mutually agree on an
arbitrator. If the parties fail to agree on an arbitrator within fourteen
(14) calendar days after the appeal is filed, the Director shall promptly
request a list of seven (7) qualified neutrals from the American
Arbitration Association.
The parties may mutually
agree on one of the seven (7) neutrals. If they do not so agree, the
parties shall alternately strike the names on the list within twenty-one (21)
calendar days after receipt of the list, and the remaining name shall be the
arbitrator. All parties shall act to complete the selection process at the
earliest possible date. The arbitrator shall be promptly notified of his
selection.
Nothing herein prohibits an
officer from opting to appeal an indefinite suspension or demotion to a panel
arbitrator, if in the notice of appeal the officer elects to take the next
available arbitrator on the panel.
Section 7.
The hearing shall be commenced, but need not be
completed, within ninety (90) calendar days of the arbitrator's selection.
Delay in commencement of the hearing within these time periods may occur due to
unavoidable conflicts between the arbitrator and the parties’ schedules, or by
mutual agreement of parties and for no other reason. However, if the
arbitrator selected cannot commence the hearing within ninety (90) calendar
days from his selection, and there is no agreement to extend the hearing to a
later date by the parties, the parties shall attempt to agree on a substitute
arbitrator. If the parties cannot agree upon a substitute within seven (7)
calendar days of so learning, another arbitrator shall be selected from a new
list of seven (7) names promptly requested from the American Arbitration
Association, according to the procedure set out herein. The arbitrator
shall make an award within thirty (30) calendar days of the close of evidence
or after receipt of brief’s if any in standard arbitration hearings, and within
seven (7) calendar days of the close of evidence in expedited arbitration
hearings under 143.057 of the Local Government Code. Post hearing briefs
shall only be permitted in standard arbitration hearings, and must be mailed to
the arbitrator within such time as is agreed to by the parties, or as directed
by the arbitrator.
Section 8.
A stenographic transcription of the
proceedings shall be made only upon
written agreement of the parties prior to the commencement of the
hearing. Should there be no agreement, the party desiring the transcript
may have the transcript made at its sole expense.
Section 9.
The award of the Arbitrator
shall state which particular factual charges he finds to be true, if any, and
the particular rules he finds such conduct to have violated, if any. Where the
charges are upheld, the award shall state whether the discipline imposed is
upheld, or whether some lesser discipline is substituted.
Section 10.
The following rules shall
govern the conduct of arbitration hearings under this Section, and of certain
preliminary matters.
A. Upon written request delivered at least
seven (7) calendar days prior to the date of the hearing, a party to the
proceeding shall provide to the opposing party the names and addresses of
witnesses expected to be called at the hearing. In the absence of good or
excusable cause, the arbitrator may exclude the testimony of a witness upon the
failure of a party to disclose such a witness. The parties, in writing,
may request discovery from each other concerning the case. Should the
opposing party not agree to provide the requested information within seven (7)
calendar days of the request, the request shall be deemed denied. The
requesting party may then apply to the Arbitrator who shall order such
discovery as is appropriate to the nature of the case, consistent with, but not
bound by, the rules of discovery in Texas civil cases. In considering the
application, the Arbitrator shall consider the burden and expense of producing
the information, the need of the requesting party, the amount of time available
prior to the hearing, and such other matters as he may deem material. In
no event shall discovery be requested within seven (7) calendar days prior to
the hearing.
B. The
Arbitrator shall have the power to subpoena witnesses. Where the subpoena
request is not opposed by a party, the Human Resources Director shall
issue the subpoena in the name of the Arbitrator and such issuance shall be
considered the act of the arbitrator. If the subpoena is opposed, the
moving party shall apply to the arbitrator for issuance of the subpoena.
C. In
all hearings under this Section, the City shall prove its case by a
preponderance of the evidence.
D. All
hearings shall be public unless it is expressly agreed in writing by the
parties that the hearing shall be closed to the public. In any event, the
final decision of the arbitrator shall be public, although public announcement
may be reasonably delayed upon request of the parties.
E. Unless
otherwise provided in this Agreement, the conduct of the hearing shall be
governed by the rules of the American Arbitration Association.
Section 11.
Unless otherwise provided in
this Agreement, the Arbitrator shall have all those powers and only those
powers vested in the Commission under Chapter 143 of the Local Government Code
and the Commission Rules, with respect to suspensions, terminations, and
demotions, with the sole exception of the power to amend such rules.
Section 12.
Any notice or statement
required to be filed by the Chief of Police or the officer in a disciplinary
proceeding under Chapter 143 of the Local Government Code, under Commission
Rules, or under this Agreement, shall be filed with the Human Resources
Director of the City.
Section
13.
Hearings
conducted by the Commission shall be in accordance with Chapter 143 of the Local
Government Code.
Section 14.
With respect to suspensions,
indefinite suspension, temporary suspensions as defined in Chapter 143 of the
Local Government Code and demotions, the officer shall have such right to
appeal the arbitrator's decision to district court as he is given in Chapter
143 of the Local Government Code to appeal the Commission's decision, and no
greater right.
Section 15.
Unless otherwise provided in this
Agreement, in cases of conflict, the provisions of this Agreement will control
over Chapter 143 of the Local Government Code, and any other civil service
provision, and American Arbitration Association Rules; and Chapter 143 of the
Local Government Code, and any other civil service provision, and Civil Service
Rules promulgated pursuant to it shall control over American Arbitration
Association Rules. Once an officer
receives a formal notification from Internal Affairs, the officer may initiate
a written request to the Chief to waive the normal investigative track through
Internal Affairs for the investigation to be submitted to an expedited
disciplinary track, however in no event can the expedited disciplinary track be
requested within sixty (60) calendar days of the expiration of the complaint’s one-hundred-and-eighty
(180) calendar day timeline in Chapter 143 of the Local Government Code. Both
the officer and the Chief must agree to submit a matter to the expedited
disciplinary track for an expedited disciplinary finding. An expedited
disciplinary finding is an agreement by the officer and the Chief that
disciplinary action is warranted and enacted, but did not proceed through the
conventional track. Any disciplinary action resulting from the expedited
disciplinary track must be agreed upon by the officer and the Chief, and must
be enacted within thirty (30) calendar days of the parties’ agreement to
expedite the disciplinary process, but under no circumstances later than the
time limitation as expressed and proscribed in Chapter 143 of the Local
Government Code, as applicable. Absent an agreement by both the Chief and the
officer, the matter will continue through the regular investigative
procedure.
Section 16.
Notwithstanding any other provision of this Agreement,
the Chief shall have authority to suspend an officer for a period of not more
than ninety (90) calendar days, or implement an agreed disciplinary action,
only where the officer agrees to the disciplinary action in writing. An agreed
disciplinary action is an agreement between the officer and the Chief that may
include, but is not limited to, any one, or combination of, a suspension,
demotion, or non-disciplinary actions such as professional counseling,
re-training, or re-assignment. The officer shall have no right to appeal such
agreed disciplinary actions, and no administrative or judicial body shall have
power to review such a suspension or alter the terms of the Agreement.
Section 17.
Any deadline or time restrictions set out in this
Agreement with respect to disciplinary proceedings may be modified by written
agreement of the parties. However, neither party may be compelled to waive
its right to insist upon the deadline and time restrictions provided by the
Agreement.
Section 18.
Officers suspended up to a
maximum of forty-five working days may, at the Chief's discretion, forfeit
either accumulated compensatory time, vacation, bonus
time or holiday leave equal to the suspension. Approval of
forfeiting time by the Chief shall not be unreasonably withheld and may only be
denied because of a consistent overall pattern of substandard
performance. The officer shall have ten (10) calendar days from receipt of
notice of the suspension to decide whether or not he wishes to forfeit
accumulated leave or exercise his appeal rights pursuant to Chapter 143 of the
Local Government Code or the Grievance and Arbitration Procedures of this
Agreement. The provisions of this Article shall apply solely to
suspensions which are agreed to by the officer, and no appeal to the Commission
or to arbitration may be instituted on suspensions where the officer has
forfeited accumulated compensatory, vacation, bonus time or holiday leave
pursuant to the terms of this Article.
Section 19.
Except as provided in this
section of this Article, the Chief and City are precluded from the introduction
of evidence or otherwise complaining of any acts or occurrences earlier than
the one hundred and eightieth (180th) calendar day immediately
preceding the date on which the Chief suspends the officer. The Chief may
introduce evidence or otherwise complain of any felony Penal Code violation or
a felony violation of the Controlled Substance Act committed by an officer so
long as the evidence or complaint is filed within one hundred and eighty (180)
calendar days of the Department’s first knowledge of the act, provided however,
that the statute of limitation for criminal judicial action against the officer
involved has not expired. This amendment language shall not be applied
retroactively. Only upon written notice in the original written statement
of the Chief may any act or occurrence be admissible in a disciplinary hearing
in accordance with this section. Solely to aid the Commission or
arbitrator in the assessment of appropriate discipline and not to prove a
charge of a violation of Civil Service Rules or for any other purpose, the
Chief and the City may introduce evidence of prior disciplinary actions which
have not been set aside on appeal as follows:
A. Where
the Chief's original written charges include alleged violations of Civil
Service Rules constituting acts of intentional violence, the Chief and the City
may introduce prior discipline on such other violations found to have been
committed within five (5) years immediately preceding the date of said written
charges;
B. Where
the Chief's original written charges include alleged violations of Civil
Service Rules concerning drug or alcohol abuse, any prior discipline on such
violations found to have been committed within ten (10) years immediately
preceding the date of said written charges;
C. Where
the Chief's original written charges allege acts of incompetence, all prior
discipline for acts of incompetence may be introduced by the Chief or the City
so long as adequate records are maintained in accordance with Section 20 below,
at the time of the act for which discipline was assessed; and
D. Where
the Chief's original written charges allege a violation of any other Civil
Service Rule, the Chief and the City may introduce prior discipline for a
violation(s) of the same rule within two (2) years immediately preceding the
date of said written charges, so long as adequate records are maintained in
accordance with Section 20 below, at the time of the act for which discipline
was assessed.
E. Upon execution of this Agreement,
suspensions of three (3) days or less that were not appealed by the officer
shall be automatically reduced to a written reprimand two (2) years after the
date the suspension was served on the officer if the officer did not have a
sustained complaint for the same rule within two (2) years from the date the
suspension was served on the officer. Suspensions that were appealed to the
Commission or Arbitrator by the officer are not eligible to be reduced to a
written reprimand under this Section. The original suspension paperwork sent to
the Commission will reflect the conditions of this Section to reduce the
applicable suspension to a written reprimand. The reduction of any suspension
contained within this subsection does not qualify for any form of reimbursement
to the employee.
Section 20.
The City shall develop records, which, to
the fullest extent possible, quantify the work done by each officer in each
assignment. Such records shall be available by assignment upon specific request of officers appealing disciplinary
actions or their representatives.
Section 21.
Section 143.056 of the Local
Government Code regarding procedures after felony indictment and certain
misdemeanor complaints shall be modified to provide:
A. Should
the Chief fail to charge the officer with a violation of Civil Service Rules
within thirty (30) calendar days following acquittal or dismissal of the
criminal charges, the officer shall be reinstated with all back pay and
benefits; and
B. In
the event an officer has been demoted or suspended, either temporarily or
indefinitely, for any action which results in the officer being indicted for a
felony or charged with a misdemeanor of Class B or above, no further action may
be taken on the officer’s appeal until the completion of trial on the merits on
those charges; except that a hearing on an officer’s appeal may be initiated
prior to completion of trial on the merits by mutual agreement between the City
and the officer. Delay of an appeal pending the results of criminal
proceedings as specified above shall apply both to appeals to arbitration and
appeals to the Commission pursuant to this Article.
This
procedure shall apply to all non-criminal investigations of misconduct by
officers.
A. An
interview of the charged officer shall take place at a location designated by
the investigating officer, usually at the police facility to which the officer
is assigned or the Internal Affairs Office. If the officer is required to
complete written interrogatories, at the officer’s request, such
interrogatories shall be provided to the officer on a computer disk so that the
officer may complete such interrogatories at a location other than a police
facility. The officer must return the completed interrogatories in accordance
with a written agreement between the officer and the investigator in charge of
the investigation. An officer who requests to complete the interrogatories in
this manner will do so during their off duty time and will not be compensated
by the department in any way. When the interrogatories are completed, the
officer shall return the computer disk and their responses to the investigator
in charge of the investigation for review and clarification by either party.
The officer will sign the printed copy of the report in the presence of the
investigator.
B. The
officer shall be informed of the rank, name and command of the officer in
charge of the investigation, and the identity of all persons present during the
interview. If an officer is directed to leave his post and report for
interview to another command, the officer’s assigned command shall be promptly
notified of the officer’s whereabouts.
C. The officer under
investigation shall be informed forty-eight (48) hours prior to being
interrogated or asked to otherwise respond to an investigation of the general
nature of the investigation, and sufficient information to reasonably apprise
the officer of the allegations shall be provided. The officer shall be
allowed to review but not copy verbatim or photocopy any complaints,
affidavits, other written statements,
D. The
interview shall be completed with reasonable dispatch. Reasonable respites
shall be allowed. Time shall be provided also for personal necessities,
meals, telephone calls, and rest periods as are deemed necessary. Except in
exigent circumstances where the seriousness of the complaint warrants an
extended interrogation, or when the complaint will expire within sixty (60) calendar
days, an officer shall not be required to submit to any single interview for
longer than six (6) hours. The interviewing officer shall advise the officer
being interviewed of an estimated time for the interview process. Interview
sessions may be held on consecutive days until the interview process is
completed. Provisions in Subsection A regarding the removal of interrogatories
do not apply to this subsection.
E. The officer shall not be
subjected to any offensive language, nor shall he be threatened with transfer,
dismissal or other disciplinary punishment. No promise of reward shall be
made as an inducement to answering questions. Nothing herein is to be
construed so as to prohibit the investigating officer from informing the
officer under investigation that this conduct can become the subject of
disciplinary action resulting in disciplinary punishment.
F. In all cases where an
officer is to be interviewed concerning an alleged act which, if proven, may
result in any disciplinary action, the officer under investigation shall be
afforded a reasonable opportunity and facilities to contact and consult
privately with an attorney of his own choosing or a representative of the
Association before being interviewed. An attorney of his own choosing or a
representative may be present during the interview. A representative may
not be a police officer who is related to the respondent, or a supervisor with
involvement in the incident being investigated. Such representative may
not participate in the interview except to counsel the officer, or to assert
any rights afforded to the officer under this article in a manner which does
not impair the ability of the investigator to conduct the interview and obtain
information directly from the officer. At any
time during the interview the officer under investigation may request to
consult with his attorney or representative in private, prior to continuing the
interview, provided that the investigator may impose reasonable limits on such
conferences in order to complete a meaningful investigative interview and to
obtain a written statement or response from the officer in the officer’s own
words.
G. If an
officer is or maybe likely to be placed under arrest, that is if the officer
under investigation is a suspect or the target of a criminal investigation, the
officer shall be given his rights pursuant to the Miranda
Decision. Nothing in this subsection shall be construed to limit the
authority of the Chief to conduct administrative investigations nor shall
anything in this subsection be construed to relieve the officer of his
obligation to fully cooperate with said investigations, to comply with the
Rules and Regulations and Procedures of the San Antonio Police Department, or
to provide thorough, complete and truthful responses to requests for written
statements and written interrogatories in connection with said administrative
investigations. In all
investigations where the officer is subject to a companion or concurrent
criminal investigation, the Department shall ensure that any officer’s
statement gathered as part of the administrative investigation shall not be
released to the criminal investigating entity, except as required by a subpoena
or required to be disclosed by law or Court decision.
H. The officer under
investigation shall be given an exact copy of any written statement he may
execute.
I. The refusal by an
officer to answer pertinent questions concerning any administrative matter may
result in disciplinary action.
J. An
officer shall have the right to have the interview tape recorded, provided the
officer furnishes the tape and the recorder and advises all parties of the
recording prior to the beginning of the interview session. The tapes shall
remain in the custody of the Internal Affairs Unit of the Police Department but
shall be available for review by the officer or the officer’s designated
representative in the event the interview may result in disciplinary action, or
a grievance.
K. Neither
an officer nor a representative of the Chief shall tape record a conversation
between an officer and a representative of the Chief without disclosing intent
to record prior to the conversation. Possession of a tape recording
device within the Internal Affairs Unit, or possession while being interviewed
by a representative of the Chief without disclosing its presence at the time of
entry into the Internal Affairs Unit or at the time the interview commences
outside the Unit shall be prima facie evidence of a violation under this
section. Officers violating this section shall be subject to disciplinary
action by the Chief.
Nothing in this section is
to be construed to limit the authority of the Chief to authorize the wearing of
a recording device during the investigation of criminal activity, which may
include officer involvement.
L. A
polygraph examination may be required of an officer by the Chief only in the
strictest confidence and where the complainant, and any complaining witnesses
who give a written statement have been examined and found wholly truthful by a
licensed examiner. The fact that an examination is ordered or administered
and the results thereof shall not be disclosed by the Chief or the examiner to
any person, except following execution of a written agreement between the Chief
and the examined officer.
M. The Chief's
office shall provide written notice, in a sealed envelope, to the individual
officer of the final status of any complaint filed with the Internal Affairs
Unit where the officer in question had to respond in writing to the complaint.
N. The results
of a formal investigation will be forwarded to the Advisory Action Board for
recommendations.
Chief’s
Advisory Action Board (CAAB) as used in this section shall mean the combined
Police portion of the Advisory Action Board and the Citizen’s portion of the
Advisory Action Board.
A. The
Police portion of the Chief’s Advisory Action Board shall consist of seven (7) voting
members: a Deputy Chief until replaced by a Commander upon implementation, one
Captain; one Lieutenant; one Sergeant; one Detective Investigator; and two
Patrol Officers. The members shall be appointed by the Chief. The
Chief may appoint a Deputy Chief as a Chairperson who will be a non-voting
member of the Chief's Advisory Action Board. Those members shall serve for
one hundred and eighty (180) calendar days.
B. Except
as specifically provided for in this article, the Chief’s Advisory Action Board
(CAAB) will be conducted in accordance with the San Antonio Police Department’s
General Manual.
C. Citizen Advisory Action Board
1. This Board shall consist of four (4) members
sitting for each Board session. The members to serve at each meeting shall
be selected on a rotating basis from a panel of eight (8) citizens of
2. Members of the panel for the Citizen Advisory
Action Board shall be selected by the City Council, which shall first nominate
and submit to the association a list of not less than sixteen (16) individuals for service. The
association, or its designated committee, shall have fourteen (14) calendar
days to strike the list, approving at least eight (8) individuals. Each
party agrees that the selections and the final list shall be representative of
the diversity of the community. The City Council may select a new
member to replace anyone removed from the panel by selecting from any remaining
names on a list previously approved by the association, or by submitting names
to the association, which shall have one-week to strike the list, approving a
replacement individual.
3. Citizens appointed to serve
on the panel shall meet the minimum requirements for eligibility established
under state statute for service on the Fire and Police Civil Service Commission
and shall take an oath of office as members of the panel. In addition, no
person shall be appointed to serve on this panel who has been indicted for a
felony or a crime of moral turpitude. Members of the panel shall serve at
the pleasure of the City Council, which may remove them, or replace them at any
time, with or without cause. Members shall have no right to the position,
and shall not be entitled to removal proceedings or a hearing. If not
removed or replaced, a member shall serve for a two (2) year period. The
City Ethics ordinance shall apply to all members of the Citizen Advisory Action
Board.
4. Appointment and selection for the
meetings of the Board shall be accomplished in sufficient time to be able to
provide each appointee with not less than twenty-four (24) hours of training,
including orientation work at Professional Standards, and one shift on the ride
along program. The responsibility for the training of each new member of
the panel shall fall upon the Commander of the Professional Standards Section.
5. An accused officer has a right to
privacy and all members of the CAAB shall respect that right to
privacy. Each member of the uniform and citizen Board shall sign a pledge
of confidentiality, agreeing to maintain the right of privacy as to privileged
matters under applicable law. Any violation of this right shall be
grounds for disqualification or removal from the panel, as set forth
below. "Right to privacy" shall mean only the right of any
accused officer of the department to have the allegations, facts, testimony and
evidence brought before the Board held in confidence by the members hearing the
case, and shall not extend to include any public information or information
imparted to the Board members from public information, or from individuals not
officially connected to the Internal Security process. The Chairman shall
keep and maintain all records of the Board, and no members shall have or
maintain any records other than during the meetings of the Board, or on department
premises, in connection with their official duties. This article shall not
be interpreted to impair or effect the right of any person, including the
citizens on the Board, to make report of facts to the Chief of Police, the
District Attorney, or the FBI, or to testify under subpoena, the rules of
discovery, or order of any court; nor shall this article be interpreted to
impair or affect the rights of any officer under Garrity vs. New Jersey or its progeny and Miranda vs. Arizona or
its progeny.
6. If any member of the Citizen Advisory
Action Board is accused by an officer of a violation of the right to privacy,
the Civil Service Commission shall convene and if a determination is made that
a member of the Citizen Advisory Action Board violated an officer’s right to
privacy, then the Civil Service Commission may remove that member. If the
breach of privacy involves a direct report of confidential information by the
member to the public or the press, removal by the Civil Service Commission
shall be mandatory. In any event, the Civil Service Commission shall send
a report of its findings and action to the City Council. The purpose of
these hearings shall be to protect the interests of accused officers and the
complainants, and shall not give rise to any rights on the part of the member
accused of a breach of right to privacy.
D. The
CAAB shall meet in the Chief
E. All
members of the Chief’s Advisory Action Board shall be given the opportunity to
review each case that will be presented for consideration subject to the
Chief’s approval of exceptions, based on workload, as noted above.
F. The
Chairperson of the Chief’s Police Advisory Action Board shall be responsible
for the maintenance of the confidentiality of all files submitted for review by
the CAAB.
G. The
Chairperson of the CAAB, on recommendation from any member of the CAAB may
elect to hear testimony from complainants or defendants. Attendance to
these boards meetings where testimony is requested are entirely voluntary and
complainants or defendants may elect to remove themselves at any stage of the
questioning by either board without fear of reprisal. The Chairperson of
the CAAB shall determine the manner in which all meetings shall be conducted
and shall be the determining factor as to the hearing of testimony or
attendance by any person. No officer or witness shall have the right to be
represented by counsel.
H. Each
board shall make independent recommendations and forward these recommendations
to the Chief of Police. Such recommendations are advisory only and are not
binding on the Chief. The Citizen Advisory Action Board may not conduct a
separate independent investigation but may recommend to the Chief of Police
that further investigations should be undertaken.
I. Any matter which is brought before the
CAAB, where a final ruling by the Chief of Police has occurred, the Chief of
Police shall direct the Commander of the Professional Standards Section to
notify the Complainant(s) and accused officer(s) as to the final disposition of
the case within twenty-one (21) calendar days.
“Right
to privacy” shall mean only the right of any accused officer of the department
to have the allegations, facts, testimony and evidence brought before the Board
held in confidence by the members hearing the case, and shall not extend to or
include any public information or information imparted to the Board members
from public information, or from individuals not officially connected to the
Internal Security process. This paragraph shall not impair or effect the
right of any person to make a report of facts to the Chief of Police, the
District Attorney or the FBI, or to testify under subpoena, the rules of
discovery, or order of any court.
Section 4.
Chief’s City Vehicle Accident
Advisory Action Board.
A. Effective
with the execution of this Agreement, the Chief’s Advisory Action Board as
described in Section 2 of this Article will no longer review cases involving
city motor vehicle accidents. All cases involving city motor vehicle
accidents previously assigned to the Chief’s Advisory Action Board will be
assigned to the Chief’s City Vehicle Accident Advisory Action Board in
accordance with this section.
B. The City Vehicle Accident Advisory
Action Board will consist of one (1) Captain, one (1) sergeant, one (1)
detective investigator and two (2) patrol officers appointed by the
Chief. The Captain shall serve as chairperson. Members shall serve
from January through June or from July through December of each calendar year.
C. Except as specifically provided for in
this Article, the Chief’s City Vehicle Accident Advisory Action Board will be
conducted in accordance with General Manual provisions and the Chief’s Advisory
Action Board outlined in this Article.
D. An
officer will be retrained for an accumulation of points or the number of
accidents within a two-year period at the Chief’s discretion. The
occurrence of two chargeable accidents within a two-year period will serve as a
baseline for the Chief or the board to review individual cases and training
needs. Ultimately, retraining will be determined on the basis of severity
of the accidents, which may drastically differ from one case to another.
Section 1. Police
Active Health Benefits Working Group.
The City and the Association agree in principle that
health benefit costs and market based health plans are issues that will be reviewed
in the next collective bargaining cycle.
The City and the Associations further agree to establish a health
benefits working group. The City will
provide access to claims information of a statistical and financial nature
(consistent with medical privacy laws), third party vendor contracts, and other
information necessary to perform its function.
The Working Group shall be afforded training opportunities which shall
be paid for respectively by each representing organization (
The working group will have the following
responsibilities:
1.
2. Identify
Master Contract Document language clarification issues for discussion in the
next round of negotiations.
3. Participate
in future Requests for Proposals for vendors as to benefits products and
services, by providing input, evaluation and suggestions to the City officials
designated by the City Manager to carry out the selection and administration
process.
4. Conduct
or purchase a health benefits survey of other public entities for comparison
with City’s plan and design and experience.
5. Create
an educational forum to inform officers of the costs associated with health
benefits and the increasing need to address increasing costs.
6. Provide
the City and the Associations with suggestions regarding possible cost-saving
initiatives to incorporate into future benefits programs.
A. The City shall provide all active Police
Officers who are eligible with family medical benefits and shall pay the full cost of said benefits as agreed upon herein. The minimum benefits provided are those as
stated in the Master Contract Document for the City of
B. Active Police Officers covered under
this Agreement shall be granted the option of entering into or exiting from the civilian
benefits program as provided for by the City to substitute for the basic
program as outlined in this Agreement.
Said option must be exercised by the active Police Officer during the re-enrollment
period between the dates of October 1, and December 31, of each calendar year.
Section 3. This
agreement, and the Master Contract Document for health benefits adopted herein, shall control
the available health benefits during the term of this agreement, for active
police officers.
Section 4. Health care
benefits for active Police Officers shall not be terminated, altered, modified
or reduced during the term of the Agreement, except by amendments or successors
to this Agreement.
Section 5. It is
understood and agreed that the provisions of this agreement and the Master
Contract Document for health benefits have been drafted in substantial
and material reliance upon existing provisions of federal and state law
concerning employee health benefits. Any
change in federal or state law or regulations which changes the obligations of either party, the applicability or
extent of Medicare benefits, or materially alters the assumptions relied upon
in negotiations shall entitle the City or the Association to reopen negotiations concerning health benefits.
Section 1. Existing
Benefits and Transition.
This article assumes the passage and implementation of
substantially the same terms and conditions currently set forth in Committee
Substitute House Bill (
Section 2. Pending Legislation and Alternate Agreement.
The City and
the Association have agreed upon the terms for providing retiree health
insurance, including the contributions, definitions and scope of coverage, and
authority of the Board of Trustees as set forth in such pending legislation. In
the event that such legislation does not become enacted into law, the parties
adopt the provisions of the legislation verbatim as their contractual agreement
during the term of this contract, effective on
A. Retiree
Benefits. This Agreement assumes
continuing the prefunded retiree benefit program on modified terms of
contribution and benefits, as additionally provided for under the pending
legislation. The Former Master Contract
Document statement of terms of coverage, payments, deductibles and other
definitions of benefits for active employees also applies to retirees, subject
to future adjustment under the provisions below. The new provisions in this Agreement and the
pending legislation (see identified above) for adjustments have been agreed to
in order to assure that the long term cost of the benefits provided do not
exceed the agreed contribution levels for the City and Police Officers.
Except
as provided elsewhere in this Agreement and under the proposed legislation
retiree medical benefits shall be secondary to Medicare benefits, to the
maximum extent allowable under Federal law.
Retirees shall not be required to purchase Medicare coverage if they
have not qualified with the full 40 quarters for Medicare, Part A. Upon reaching the age and established
qualification criteria for Medicare eligibility, medical benefits under the Former
Master Contract Document as primary coverage shall no longer be applicable,
and-medical benefits provided under the Former Master Contract Document shall
convert to secondary coverage only, in accordance with the provisions set forth
in the Former Master Contract Document.
Once the retiree is eligible for Medicare, the retiree is required to
apply for, purchase and maintain Medicare, Part B benefits. The benefits provided prior to Medicare
eligibility are stated in the Former Master Contract Document.
Provisions and benefits
specified in the Former Master Contract Document shall not be reduced during
the life of this Agreement; however, the City reserves the right to change
carriers or plan administrators at its discretion. While the City is prohibited from reducing
the provisions and benefits specified in the Former Master Contract Document
during the life of this agreement, except as provided in the pending
legislation; however, any reasonable determination of what medical service is
medically necessary for a particular patient, or any reduction in the usual and
customary charge will not be construed
as a reduction in benefits, provided that the determination is made in
accordance with the procedures and criteria described in the Former Master
Contract Document and any document authorized by the Board that supersedes it
in the future.
B. Spouses of retired Police Officers shall be eligible to receive the benefits as set forth in the Former Master
Contract Document. Medical benefits shall be secondary to Medicare benefits
once the spouse individually qualifies for Medicare coverage. Spouses of retired Police Officers shall pay
a portion of the annual health plan to
retain coverage at a rate based on the tenure of the Police Officer to whom the spouse was
married. Beginning with a Police
Officer, who served 20 years or less, the spousal rate will be 30% of the health plan premium (the COBRA formula premium
as enumerated in Chapter 2 of the Former Master Contract Document). From 21 years to 30 years of tenure, for each year of tenure above 20, the
spousal rate will decrease by 3% of the health plan premium until it is 0% for
a spouse of a Police Officer with 30 years of tenure. Once the retired Police Officer becomes
eligible for Medicare, the spousal rate will become 0% of the annual health
plan premium.
C. Spouses
of deceased police officers shall be entitled to benefits provided for spouses
of retired police officers, in the event that the deceased officer died in the
line of duty, or was eligible for retirement at the time of death. Line of duty
shall mean any occurrence wherein the officer was exercising the power and
authority of a certified peace officer, whether or not scheduled for duty at
the time of death. Spouses of officers
not eligible for retirement or acting in the line of duty at the time of death
shall be entitled to continue coverage by paying the applicable COBRA formula
premium (as enumerated in Chapter 2 of the Former Master Contract Document),
until death or remarriage.
D. Upon
retirement, the Police Officer may elect to cover any other
eligible dependents (other than spouse) in accordance with the
Master Contract Document. The retiree
shall pay 100% of the health plan premium (the COBRA formula premium as
enumerated in Chapter 2 of the Former Master Contract Document) for each other
eligible dependent.
E. Contributions. The City has established
a trust fund for prefunded retiree health care benefits for all eligible retired Police Officers (hereinafter referred to as
“the Fund”) and, along with the police officers has increased its contribution
levels for the purpose of establishing an actuarially sound retiree health
benefit fund, evaluated over thirty years.
The parties agreed in principle in 1995 that once an actuarially sound
fund was established by current contribution levels, the responsibility for
future contributions (made necessary by changes in circumstances, the economy,
and the medical care system) would be jointly shared by the parties, and would
be quantified and allocated by negotiation in future agreements, as necessary. In keeping with this principle, the
contribution levels to the trust fund and their effective dates shall continue
at 9.4% (% of base pay + longevity/month) by the City and $70 per month by each
Police Officer until
Section 4. Officers
who retire from the San Antonio Police Department and who become employed by
the City as a full time permanent civilian employee shall have the option of
enrolling in the civilian flexible benefits program provided by the City as
primary coverage at which time medical benefits provided under the prefunded
retiree program shall convert to secondary coverage in accordance with the
provisions set forth in the applicable retiree plan document. A retired police
officer may choose not to enroll in the civilian flexible benefits program in
which case the medical benefits provided under the applicable retiree plan
document shall be primary.
Section
5. Medical benefits provided for herein as to retirees and
their spouses shall be secondary to Medicare/Medicaid benefits. Once the spouse is individually eligible for Medicare, each such person is
required to apply for, purchase, and maintain Medicare benefits. Upon the death of a retiree police officer who became a
police officer on or after
Section 6. The secondary insurance coverage provisions for retired police officers and spouses shall control available health benefits during the term of this agreement for retired police officers and spouses, except as provided elsewhere in this Article, or as modified by the Board of Trustees or under the proposed legislation.
Section 7. Health care
benefits for retired Police Officers shall not be terminated, altered, modified
or reduced except by amendments or successors to this Agreement, or under the
proposed legislation, or as modified by the Board of Trustees.
Section 8. It is
understood and agreed that the provisions of this agreement and the Former Master
Contract Document for health benefits have been
drafted in substantial and material reliance upon existing provisions of
federal and state law concerning employee health benefits. Any change in federal or state law or
regulations which changes the obligations of either party, the
applicability or extent of Medicare benefits, or materially alters the
assumptions relied upon in negotiations shall entitle the City or the
Association to reopen negotiations concerning health benefits.
The City will provide each on-duty officer with free
parking on the Police lot itself or a lot adjacent to the Police building to
which the officer is assigned. Should
the City not provide such parking, the Association may acquire such parking and require the City to
fully compensate it for all related costs and expenses.
A. Definitions. The term
“Trusts” as used in this section shall refer to the San Antonio Police Officers
and Fire Fighters Benefit Plan and Trust, which provides optical and dental
services, and San Antonio Police Officers and Fire Fighters Prepaid Legal Plan
and Trust, which provides legal services to members of the San Antonio Police
Department and the San Antonio Fire Department.
B. Amounts.
During
the term of this Agreement the City will pay a monthly amount for each officer
as shown by the schedule below for dental, optical and prepaid legal benefits
under the Trusts. Furthermore, neither the City nor the Association
may change the amounts paid or allocated for the respective benefits as shown
in the schedule during the term of this Agreement.
|
|
Optical/Dental |
Prepaid Legal Plan |
|
Employees
with dependents |
$89.50 |
$32.00 |
|
Employees without dependents |
$43.50 |
$32.00 |
Additional
Supplemental Amounts:
Optical/Dental
Plan - The City and the Association
agree that during the term of this Agreement, the Trustees of the Dental and
Optical Trust may request that the Association Board by majority vote, assess
one continuous supplemental assessment to all officers up to, but not exceeding
$10.00 per pay period. Such continual assessment may utilize any number of
continuous pay periods, however in no case shall the total number of continual
assessed pay periods exceed 26 periods.
Prepaid Legal Plan - The City and the Association agree
that during the term of this Agreement, the Trustees of the Legal Trust may
request that the Association Board by majority vote assess one continuous
supplemental assessment to all officers up to, but not exceeding $10.00 per pay
period. Such continual assessment may utilize any number of continuous pay
periods, however in no case shall the total number of continual assessed pay
periods exceed 26 periods.
The City shall not be obligated to deduct and payout
any sum provided for herein until the Trust and the Association provides a
legal and binding letter from the President or legally authorized agent of the
Association and Trusts agreeing to indemnify, defend and hold the City harmless
against any claims, demands, suits, or any other form of liability that shall
arise of or as a result of any act or omission taken by the City for purposes
of complying with the provisions of this Article.
New Members Required -
Prior to completion of an officers initial probationary period, new officers
shall be required to sign a payroll deduction card authorizing an assessment in
an amount equal to the amount paid by officer under this Section. New members
may elect a one-time payment or may elect a payment schedule equal to the
number of pay periods in the original certified assessment letter. This section
is applicable to members who begin their probationary period after the onset of
either assessment.
C. Audits. The
Association shall ensure that the Trusts will conduct annual
independent audits at no additional cost to the City.
The Association shall further ensure that the Trusts shall provide a copy
of each annual independent audited financial report to the City, through its
Finance Director, within thirty (30) calendar days of receipt of the audit by
the respective Trust.
The
City reserves the right, at its sole discretion, to conduct an audit of said
benefit plans at the City’s expense any time during the term of this Agreement. Should the
City decide to conduct such an audit, the Association shall ensure that the Trusts make available to the
City all relevant documentation within a reasonable time.
D. Use of
Benefits. With
respect to the Prepaid Legal Benefits, it is understood that no officer may use
the benefits for the purpose, in whole or in part, of implementing and/or initiating
legal action against the City, any of its agents, officers, and/or assigns.
E. Exclusive
Trust. The Association shall ensure
that all funds paid by the City pursuant to this Section are used for the
exclusive benefit of the employees and that said funds shall not be commingled
with the funds of any other organization, entity, or Association, nor shall
said funds be used for any other purpose other than that provided for
herein.
F. Payment
and Change in Plans. During the term
of this Agreement, the Association may change providers for Supplemental Benefits (Dental/Optical
and Legal). In the event that the Association makes a proposal to change
benefit providers, the Association shall submit the same in writing to the
City.
G. Copies
of Trust Plan. The Association will
provide up-to-date copies of the Trust Plan Documents to the Human Resources
Department of the City and the Association Office.
H. Determination Letter. It shall be the sole responsibility of
the Association to maintain the tax- exempt status of the benefit received
under this Section. In accordance
therewith, the Association shall provide to the City, through its Director of Finance,
a copy of the Internal Revenue Service Determination Letter regarding the
tax-exempt status of the benefit received under this Section. The City shall receive said letter no later
than ten (10) calendar days from commencement of this Agreement.
I. In an effort to coordinate the
provisions outlined in this Article with the scheduled collective bargaining
cycle with the San Antonio Professional Firefighters’ Association, due to begin
prior to the expiration of that agreement in 2005. The City and the Association
agree to reopen any portions of this Article during such negotiations in order
to facilitate the development of a consistent approach and language in both
Agreements. The parties shall have the
same statutory duty to bargain in good faith as to all issues which relate to
the benefits under this Agreement.
Educational Incentive
Pay shall be provided immediately to officers who qualify for such payment
by furnishing documented proof of an Associate's, Bachelor's or Master’s Degree
to the
Payment shall be made
monthly.
Officers without college or
university degrees shall be paid Educational Incentive Pay for college hours
earned at the following rates:
|
65 to 94
college hours |
$60.00 per month |
|
95 to 124 college
hours |
$90.00 per month |
|
125 to 154 college hours |
$120.00 per month |
|
155 to 184 college hours |
$150.00 per month |
|
185 to 214 college hours |
$180.00 per month |
|
215 to 229 college hours |
$210.00 per month |
|
230 or more college hours |
$240.00 per month |
Officers with college or
university degrees shall be paid Educational Incentive Pay at the
following rates:
|
Associates Degree |
$215.00 per month |
|
Bachelors Degree |
$315.00 per month |
|
Masters Degree |
$335.00 per month |
|
Doctors or Equivalent |
$350.00 per month |
Nothing in this article
should be construed to entitle an officer to receive educational incentive pay
pursuant to this section for both college hours and a college degree.
Section
2. Law Enforcement Related
Courses.
A. Officers
graduating from the Academy shall be required to have a minimum of thirty-one
(31) college accredited hours before the expiration
of one year after the completion of the fifty-two (52) week period following
graduation from the Academy. The City shall ensure that, upon entrance to
the Academy, each cadet is informed in writing of this requirement, the cadet
acknowledges his understanding in writing, and the writing is made a permanent
part of his file.
B. Officers
who fail to complete the above requirement(s) shall not be allowed to move into
the "Class B" police officer pay status until the requirements are
met. Officers shall be required to show proof of achieving the above
required college hours prior to being moved into "Class B" police
officer pay status. Officers who have all the college accredited hours
required by this section shall not be required to meet the additional standards
outlined above.
Officers shall
be entitled to receive reimbursement for tuition, fees, on-campus parking
and the price of required text(s) at a college or university for course hours
in an accredited degree program irrespective of other sources of aid or
funding. Reimbursement shall be made in accordance with the following
schedule:
|
Course Grade |
Amount of
Reimbursement |
|
A |
100% |
|
B |
90% |
|
C |
80% |
|
D or F |
0 |
Such reimbursements for
tuition and fees shall not exceed amounts set by
C. Officers
who are enrolled in an accredited college or university and who under an
approved college or university master’s or doctorate degree plan are required
to complete any course that is not assigned a grade, will upon successful
completion of the course, be reimbursed by the City at 100% upon presentation
of documentation of payment to the registrars office of the college or
university at the end of the semester of the required course.
Basic Certification
Officers who hold a Basic
Certificate issued by the Texas Commission on Law Enforcement Officer Standards
and Education shall receive Fifty ($50.00) Dollars per month.
Officers who hold an
Intermediate Certificate shall receive One Hundred and Sixty Dollars ($160.00)
per month.
Officers who hold an
Advanced Certificate shall receive Two Hundred Dollars ($200.00) per month).
Officers who hold a Master’s
Certificate shall receive Two Hundred and Forty Dollars ($240.00) per month).
Section 2. Instructors
Certificate.
Officers who hold an active
or inactive Instructors Certificate issued by the Texas Commission on Law
Enforcement Standards and Education shall receive Twenty Dollars ($20.00) per
month regardless of the Certificate held.
Payment shall be made
monthly. The Chief shall have the right to require the officer to produce
a copy of the certificate or other valid verification prior to approval for the
employee to receive such payments. Only officers who have obtained Texas
Instructors Certificate (T.I.C.) through departmental approval will be eligible
for T.I.C. pay. Officers who possess T.I.C., whether active or in-active
prior to
Officers who are actively
involved in teaching or instructing citizens or other police officers may
request, through their chain-of-command, inclusion in the next academy
sponsored Texas Commission on Law Enforcement Standards and Education
Instructors Training Course. Admittance shall not be unreasonably denied,
however, admittance shall be at the discretion of the Academy Commander and
limited based on available classroom size.
Payment shall be made
monthly. The Chief shall have the right to require the officer to produce
a copy of the certificate or other valid verification prior to approval for the
employee to receive such payments.
Section
1. Psychological and/or Medical Evaluation.
The Chief shall have the
authority at any time to require an officer to submit to psychological
evaluation or treatment and/or medical evaluation, at the City
Section
2. Commitment to Effective
Drug Interdiction Program.
The City and the Association
agree that officers may be called upon in hazardous situations without warning,
and that it is imperative to the interest of officers and the public to ensure
that officers are not substances impaired. In order to further their joint
interest in protecting officers and the public, the City and the Association
agree to mandatory drug testing as described in this section.
One Hundred Percent (100%)
of officers of all ranks, including the Chief, shall be susceptible to mandatory drug testing during each calendar year
on a fair and impartial statistical basis at the City’s expense. The fair
and impartial statistical basis (in which each officer has an equal chance of
being selected during a calendar year) shall be by a non-discriminatory
computerized program operated and certified as non-discriminatory by an
independent firm hired by the City, and the officer shall be tested upon being
selected by the computer.
The City and the Association
have a mutual interest in ensuring that drug impaired officers do not perform
law enforcement duties. The City and the Association agree that the
purpose of the mandatory drug testing policy is not to punish an officer who
has not violated the Police Department’s rules, regulations, policies or
procedures. The City and the Association are committed to the principle that
the mandatory drug testing policy for officers is designed and shall be
administered to result in disciplinary action only against those officers who
have violated the Police Department’s rules, regulations, policies or
procedures.
Where an officer appears
unable or unwilling to give a specimen at the time of the test, testing will
document the circumstances surrounding the inability or unwillingness. The
officer will be permitted no more than four (4) hours to provide the sample
during which time he will remain in the testing area under
observation. Reasonable amounts of fluids may be given to the officer to
encourage urination. Failure to provide a sample may be considered a
refusal to submit to a drug test.
Officers shall have the
right to request that their urine sample be stored in case of legal
disputes. The urine sample will be submitted to the designated testing
facility where a sample will be maintained for a period of one-year. Officers
may at their own expense request to have the test administered at a
qualified physician’s office or certified testing laboratory, accompanied
by the testing personnel provided such testing is administered within five
(5) hours after notification by the Chief (and the sample shall be
properly handled by a certified testing laboratory).
Drug testing shall consist
of a two-step procedure:
A. Initial
screening test.
B. Confirmation
test.
Should a confirmation test
be required, the test procedure will be technologically different and more
sensitive than the initial screening test.
The City and the Association
will agree within one hundred and eighty (180) calendar days as to a SAMHSA/
All records
pertaining to the department required drug tests shall remain confidential
except to the extent used in a disciplinary process and appeal. Drug test results and records shall be stored
in a locked file under the control of the Chief. The Chief will maintain
original copies submitted by the laboratory. No access to these files
shall be allowed without written approval of the Chief.
Nothing in this section
shall be construed to prohibit the Chief from conducting a drug test on an
officer based upon reasonable suspicion in accordance with the guidelines as
set forth by this section.
For the purposes of this
section:
A. “drug testing” shall be defined as the
compulsory production and submission of urine by an officer for chemical
analysis to detect the presence of prohibited drug usage.
B. “reasonable suspicion” shall be defined
as a judgment/conclusion that a person is unable to safely and/or effectively
perform their duties due to the suspected influence of drugs, alcohol, or
inhalants. Reasonable suspicion is based on specific, observable facts
that an officer may be under the influence of drugs, alcohol, or inhalants.
The City will defend in or
out of court any Police Officer who incurs a charge or lawsuit as a result of
the lawful performance of his duties pursuant to the provisions of City
guidelines as adopted and approved under City Ordinance No. 83927 incorporated as
Attachment "4", excluding Section 1.
“Definitions” Subsection 8B, V and VI, which shall not apply, or as otherwise
provided by law.
Section
1. Police Personnel Unit.
A. The City
shall implement a Police Personnel Unit. Such unit shall be staffed with
a minimum of one (1) Sergeant or above, support personnel, and the operational
equipment, i.e., computers. At the discretion of the Chief and without
limiting his authority to determine the manpower and/or staffing needs of any
unit and/or the Department as a whole, this unit's primary functions shall be
to make recommendations to the Chief:
1. To set the amount and type of relief
days assigned to each station, including Police Headquarters;
2. To set the number of officers assigned
to each work station; and
3. The actual personnel on a seniority
basis assigned to each patrol shift at each police station, including
Headquarters,
B. Additionally,
this unit shall:
1. Maintain an updated, City-wide file of
all officer requests for relief days and work station assignments;
and
2. Process assignment of relief days,
from said office, by seniority of requests on file pursuant to Article 12
of this Agreement.
Section
2. Non-Supplanting by Probationary
Officers.
In no event shall
probationary patrol officers supplant assigned positions or relief
days. Probationary officers may only assume the Field Training Officers'
or Sergeants' relief days while actually riding with the Field Training Officer
and may assume the Sergeant's relief days for the remainder of their initial
fifty-two (52) week period.
Section
3. Thirty (30) Day
Requirement.
All premium
relief days shall be filled or abolished in accordance with current practice
within thirty (30) calendar days. For purposes of this section, premium
relief days shall be defined as Thursday/Friday, Friday/Saturday,
Saturday/Sunday, and Sunday/Monday.
The thirty (30) calendar day
requirement shall be waived from February 24 through the last day of Fiesta
each year. Officers having transferred into any assignment and who meet
their six (6) month requirement for seniority eligibility during the Fiesta
break will be eligible only for premium days that become available after their
six month eligibility has been met.
For example, an officer who
meets his six-month requirement on March 15th would not be eligible
for any premium relief days that become available before that date.
It is agreed and understood
that only prime relief days that become available during the waived Fiesta
period can be guaranteed to the most eligible officer under this exception
clause. All non-premium relief days that would have become available as a
result of the guaranteed transfer that would have taken place were it not
within the Fiesta period, and that are not premium relief days will be filled
in accordance with available openings after the waived Fiesta period
ends. All premium relief days being vacated during the Fiesta period shall
be filled within thirty (30) calendar days after the last day of Fiesta.
While it is understood that
situations may arise when there will be legitimate reasons for eliminating a
particular set of relief days, premium relief days shall not be abolished for
the purpose of compliance with this section.
No officer shall be allowed
to work under the direct supervision of a relative. Relatives may be
co-workers in the same division. No officer shall be allowed to exercise
his seniority in applying for positions that would place him under the direct
supervision of a relative. No supervisory officer shall be allowed to
exercise his seniority in applying for positions that would place him in direct
supervision of a relative. For the purposes of this section, relative
means persons related through blood or marriage, and include spouses, parents,
children, brothers or sisters, and in-laws standing in the same relationships.
Each officer who retires
from the force shall be given his service handgun and badge at no charge.
Section
2. Service-Connected Death.
In the event of an officer’s
death in the course and scope of employment, over and
above the City
Section
3. Special Assignments.
A. Except
as provided elsewhere in this Agreement, the City shall have a right to place
officers on special assignment. Officers placed on special assignment on
an involuntary basis shall work the assignment for a maximum of sixty (60)
calendar days. At the end of the sixty (60) calendar day period, the Chief
of Police may extend the term, based on extenuating
circumstances. Officers whose assignment exceeds the original sixty (60)
calendar day period shall relinquish their seniority and relief days from the
original, permanent assigned unit. Officers who object to the continuation of
the special assignment after the sixty (60) calendar day period shall be
returned to their assigned unit. Officers returning to an original unit
from a special assignment that exceeded the sixty (60) calendar day limit must
re-bid on relief days, based on the next available opening (no six (6)-month
waiting period unless the special assignment goes beyond one hundred and eighty
(180) calendar days, in which case the officer will be required to wait the six
(6) months).
B. Officers
placed on special assignment on a voluntary basis may work the assignment for a
maximum of one hundred and eighty (180) calendar days. Officers whose
assignment exceeds the original one hundred and eighty (180) calendar day
period shall relinquish their seniority and relief days from their original,
permanent assigned unit. Officers returning to their original unit from a
special assignment that exceeded one hundred and eighty (180) calendar days
must re-bid on relief days, based on the next available opening.
Section
4. Permanent Personnel File.
The City shall be
required to maintain a permanent personnel file on each officer, pursuant to
the requirements as outlined in Section 143.089, Local Government Code or its successor in function.
Contained within each
officer
A. The
officer is under indictment or charged by an offense by information; or
B. The
officer is a party in a Civil Service hearing or a case in arbitration; or
C. The
photograph is introduced as evidence in a judicial proceeding.
The City will utilize
payroll check stubs with current data and new slots showing accrued balances of
sick leave, bonus days, holidays unused, compensatory time, vacation time, and
military leave.
Section
7. Family Assistance Officer.
The Chief shall appoint a
Family Assistance Officer. The Family Assistance Officer will be relieved
of regular duty on a case-by-case basis in order to assist the families of
officers who die or are seriously injured while on active duty, or suffer a
catastrophic illness in making appropriate arrangements and completing
necessary paperwork.
Section
8. Reimbursement for Lost, Damaged, or Stolen Items.
The Chief shall have
discretion to reimburse any officer, the replacement value (up to a maximum of
$250.00), for any personal item lost, damaged, or stolen (including clothing)
as a result of on-duty employment. The Chief
The City and the Association
are committed to a healthy, physically fit and well-trained police department.
In demonstrating this commitment, officers who participate and meet standards
as established in a police academy sponsored wellness program or who score the
standards set out in this section during annual in-service training shall be
awarded the administrative leave incentives outlined herein.
During October of each year
preceding the starting date of each yearly in-service training, the Chief and
the President of the Association shall appoint three (3) members each (six
total) to a physical fitness panel. It will be the sole responsibility of this
panel to set point values, time limits, and the necessary requirements for the
wellness program and for achieving incentives for the next year’s in-service.
The Chief and Association shall provide written notice of their appointees to
the physical fitness panel at least thirty (30) calendar days before the panel
is scheduled to meet. Through the use of both the most current Physical Fitness
Standard number scale criteria, and the previous year testing results, the
committee will set standards which best create a performance curve of the
department and provide incentives based on performance according to sex and age
groupings. The panel shall reach an agreement on all items relating to point
values, time limits, or necessary requirements, and all recommendations shall
be forwarded to the Chief. The Chief can veto any recommendation and return the
recommendation to the panel for re-examination. The Training Academy Commander
shall act as the non-voting moderator and will be responsible to ensure the
panel meets at the required stated time.
A.
Academy Sponsored Wellness Program.
Officers may elect to
participate in a personalized wellness program individually designed for the
officer by the fitness panel. Officers participating in personalized programs
will have administrative leave incentives set by fitness panel. Personalized
incentives will be awarded in accordance with personalized goals and objectives
met by the individual officer involved. The Chief or designee will approve all
panel approved individual wellness programs and award incentives of one (1) to
five (5) days in accordance with this Agreement and the success of the
individual officer in achievement of the designed goals and objectives which
will be measured by the fitness test.
B. In-Service
Physical Standards.
A PT staff member will
monitor each officer’s sit-ups, push-ups, vertical jump, mile and one-half run,
dummy drag and stationary or bicycle ride. The sit-ups, push-ups, weight
control and vertical jump will be monitored on a one-on-one basis.
C. Incentives.
Officers who successfully
complete any combination of exercises and who score within the pre-designated
total point range will receive the corresponding physical fitness incentive of
two (2) to five (5) administrative leave days.
Officers who participate in
the physical fitness program for three consecutive years during in-service and
who do not receive an incentive shall receive one-day administrative leave for
their participating in the program. For purposes of this section the physical
fitness panel shall define participation for each year.
Officers may select five of
the six events (which may include but shall not be limited to, sit ups, push
ups, vertical jump, mile and one half run and/or walk, stationary or bicycle
ride, and sprint, wall, drag) in which to participate in to achieve their goal.
Weight loss is not an event but will be counted towards the officers overall
score. No points will be subtracted for not participating in any individual
event.
Officers on light duty, that
have a documented injury will need to provide the Academy PT staff with a copy
of their 172-form in order to reschedule a make-up with the PT staff. Officers
who cannot participate in the physical fitness portion of their scheduled
in-service due to a documented injury will have sixty (60) calendar days from
the date they return to full duty in order to complete this portion of their
in-service and qualify for the administrative leave hours.
Officers who attend their
scheduled in-service but miss participating in the physical fitness portion due
to departmental business or other emergency, but not a documented injury, have
thirty (30) calendar days from their scheduled in-service date to reschedule a
make-up with the PT staff.
The award of administrative
leave or lack thereof shall not be the grounds for a grievance. Decision by
academy staff as to the actual individual completion times or individual
completion of exercise requirements shall be final. This leave shall be awarded
the second pay period of the following quarter in which the officer earned the
administrative leave hours and the officer has 365 calendar days from that pay
period to use it.
Section 1.
Notwithstanding any provision in this agreement to the
contrary (if any), and without altering any other provision of this Agreement, the City is
authorized to civilianize the following positions or units, and any
civilianization action heretofore taken by the
City is hereby ratified and approved by the Association.
1. Court Liaison
2. Facilities Management
3. Communications
4. Research and Planning
5. Municipal Integrity
6. ICE
7. Youth Services (effective
8. Vehicle Storage (effective
The City agrees to maintain staffing levels in the ICE Unit at no less
than 30% sworn officers, not to include supervisors, it being understood that any
reduction in the percentage of sworn officers shall be by attrition or enhanced
authorized staffing only. The Chief will meet with Association
representatives from time to time to make sure that implementation protocols
and procedures for patrol and dispatch sufficiently provide for the safety of
officers, the safety of civilian employees and the public generally, and
effective prosecution. The lead incident
commander of the shooting investigation team shall be a sworn officer.
Officers and Detectives assigned to Vehicle Storage,
Communications and Youth Services at the time of the City Council approval of
this Agreement who also receive shift differential pay will retain the shift
differential pay if they are involuntarily reassigned due to civilianization of
the units until they voluntarily transfer to a job assignment without shift
differential.
The City shall notify the Association President at
least ninety (90) calendar days prior to civilianization of Vehicle Storage,
Communications, Youth Services and jobs traditionally performed by sworn
officers and shall consult, and reach mutual agreement, with the Association
President over the effects of such civilianization. The City agrees the effect of civilianization
shall not reduce the authorized number of sworn police officers, detectives or
supervisors.
Section 2.
The City of
Should any provision of this
Agreement be found to be inoperative, void or invalid by a court of competent
jurisdiction, all other provisions of this Agreement shall remain in full force
and effect for the duration of this Agreement, it being the intention of
the parties that no portion of this Agreement or provision herein shall become
inoperative or fail by reason of the invalidity of any other portion or
provision.
No agreement, understanding,
alteration or variation of the Agreement, terms or provisions herein contained
shall bind the parties unless made and executed in writing by the parties
hereto. The failure of the City or the officers to insist in any one or more
instances, upon performance of any of the terms or conditions of this
Agreement, shall not be considered as a waiver or relinquishment of the right
of the City or the officers to future performance of any such term or
condition, and the obligations of the City and the officers as to such future
performance shall continue in full force and effect.
In the event that any provision of this Agreement
conflicts or is inconsistent with any provision of Chapter 141, 142, or 143 of
the Local Government Code or any other civil service provision, this Agreement
shall prevail, notwithstanding any such provision of Chapter 141, 142, or 143
of the Local Government Code or any other civil service provision.
The
parties agree that each has had the full and unrestricted right and opportunity
to make, advance, and discuss all matters properly within the province of
collective bargaining. The above and foregoing Agreement constitutes the
full and complete Agreement of the parties and there are no others, oral or
written, except as herein contained. Each party for the term of this
Agreement specifically waives the right to demand or petition for changes
herein, whether or not the subjects were known to the parties at the time of
execution hereof as proper subjects for collective bargaining. Subject to
the Maintenance of Standards clause (Article 8), it is agreed that the City
shall not be subject to provide additional wages, compensation, or emoluments
of any kind beyond that which is specified in this agreement; and should any
future State law be enacted which requires cities to compensate City Police in
any manner beyond the scope of this Agreement, the compensation or emolument
levied against the City shall be waived and disclaimed in-toto. It is
additionally agreed that, except as specifically modified by this Agreement,
benefits and emoluments provided police officers by State legislation shall
remain in effect throughout the term of the Agreement, notwithstanding the fact
that during the life of this Agreement, legislation may become effective which
would negate certain benefits or emoluments.
In the event the
City and the Association reach an impasse in collective bargaining negotiations,
as such impasse is defined in Chapter 174 of the Local Government Code, the
parties shall abide by the impasse procedure set forth in City Ordinance No.
51838, which ordinance is set forth in Attachment 3 hereto and incorporated
herein by reference. This agreement, and the “contract” referred to in the
ordinance are one and the same.
Section
5. No Bypass Agreement.
The parties hereto agree
that all negotiations will be conducted exclusively between the designated
representatives of the City and the Association. Neither party will make
any effort to bypass the spokesman of the other party during the period of
negotiations up to and including impasse resolution attempts.
The City and Association
agree that a number of unresolved issues need to be discussed and studied
during the term of this Agreement. For that purpose, the City Manager shall
appoint at least one (1) member, the Chief shall appoint up to four (4)
members, and the Association shall appoint up to four (4) members to serve on
each committee. The parties agree to make their appointments on or before
1. Implementation of the four (4) day, ten
(10) hour compressed work cycle and other alternative work schedules, including
but not limited to, hours of work, shift schedules, regular days off, seniority
for sign up process, marked and unmarked vehicles needed to implement the work
cycle, mileage limitations by contract on marked and unmarked vehicles, and
two-man vehicles for certain high risk assignments.
2. Creation of career ladder incentives
including, but not limited to, recognition of senior patrol officers, grades
for detectives, and educational and skill level goals for all ranks.
3. Review and recommendations on a
promotional examination process for all civil service ranks.
4. Creation of hiring alternatives which
enhance the City’s ability to expedite the hiring of new officers without
compromising quality or standards.
The committees shall issue
their recommendations to the City and Association on or before
FOR THE
_____________________________ _____________________________
Chief Negotiator City
Manager
Date: Date:
_____________________________ _____________________________
William McManus Erik Walsh
Police Chief Assistant
City Manager
Date: Date:
_____________________________
Michael Bernard
City Attorney
Date:
FOR THE
_____________________________ _____________________________
John Burpo Teddy
Stewart
Chief Negotiator President,
SAPOA
Date: Date:
1. Agreement of Parties
These procedures shall apply whenever the parties have agreed to arbitrate under them, the Streamlined Labor Arbitration Rules, or the Expedited Labor Arbitration Rules of the American Rules, or the Expedited Labor Arbitration Rules of the American Arbitration Association, in the form obtaining when the arbitration is initiated.
2. Appointment of Neutral Arbitrator
The
3. Qualifications of Neutral Arbitrator
No person shall serve as a
neutral arbitrator in any arbitration in which that person has any financial or
personal interest in the result of the arbitration. Prior to accepting an appointment, the
prospective arbitrator shall disclose any circumstance likely to prevent a
prompt hearing or to create a presumption of bias. Upon receipt of such information, the
The
5. Date, Time and Place of Hearing
The arbitrator shall fix the date, time and place of hearing, notice of which must be given at least 24 hours in advance. Such notice may be given orally or by facsimile.
There shall be no stenographic record of the proceedings.
The hearing shall be conducted by the
arbitrator in whatever manner will most expeditiously permit full presentation
of the evidence and arguments of the parties.
The arbitrator shall make an appropriate minute of the proceedings.
There shall be no posthearing briefs.
The award shall be rendered promptly by the arbitrator and, unless otherwise agreed by the parties, no later than seven days from the date of the closing of the hearing.
The award shall be in writing and shall be signed by the arbitrator. If the arbitrator determines that an opinion is necessary, it shall be in summary form.
|
A. The following
monthly wage scales shall become effective |
|
|
||||
|
|
|
|
|
|
|
|
|
Title |
A |
B |
C |
D |
E |
F |
|
Police Officer
(Probationary) |
$2,866 |
|
|
|
|
|
|
Police Officer |
$3,300 |
$3,971 |
$4,237 |
$4,322 |
$4,407 |
|
|
Police Detective
Investigator |
$4,621 |
$4,758 |
$4,899 |
|
|
|
|
Police Sergeant |
$5,249 |
$5,353 |
|
|
|
|
|
Police
Lieutenant |
$5,878 |
$5,996 |
|
|
|
|
|
Police Captain |
$6,745 |
$6,880 |
|
|
|
|
|
Police Commander |
$8,687 |
|
|
|
|
|
|
Police Deputy
Chief |
$9,337 |
|
|
|
|
|
|
Police Assistant
Chief |
$10,084 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
B. The following
monthly wage scales shall become effective |
|
|
||||
|
|
|
|
|
|
|
|
|
Title |
A |
B |
C |
D |
E |
F |
|
Police Officer
(Probationary) |
$2,924 |
|
|
|
|
|
|
Police Officer |
$3,366 |
$4,050 |
$4,322 |
$4,408 |
$4,496 |
|
|
Police Detective
Investigator |
$4,713 |
$4,853 |
$4,997 |
|
|
|
|
Police Sergeant |
$5,354 |
$5,460 |
|
|
|
|
|
Police
Lieutenant |
$5,996 |
$6,116 |
|
|
|
|
|
Police Captain |
$6,880 |
$7,018 |
|
|
|
|
|
Police Commander |
$8,861 |
|
|
|
|
|
|
Police Deputy
Chief |
$9,523 |
|
|
|
|
|
|
Police Assistant
Chief |
$10,285 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
C. The following
monthly wage scales shall become effective |
|
|
||||
|
|
|
|
|
|
|
|
|
Title |
A |
B |
C |
D |
E |
F |
|
Police Officer
(Probationary) |
$3,012 |
|
|
|
|
|
|
Police Officer |
$3,467 |
$4,172 |
$4,452 |
$4,541 |
$4,630 |
|
|
Police Detective
Investigator |
$4,854 |
$4,998 |
$5,147 |
|
|
|
|
Police Sergeant |
$5,514 |
$5,624 |
|
|
|
|
|
Police
Lieutenant |
$6,176 |
$6,299 |
|
|
|
|
|
Police Captain |
$7,087 |
$7,229 |
|
|
|
|
|
Police Commander |
$9,127 |
|
|
|
|
|
|
Police Deputy
Chief |
$9,809 |
|
|
|
|
|
|
Police Assistant
Chief |
$10,594 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
D. The following
monthly wage scales shall become effective |
|
|
||||
|
|
|
|
|
|
|
|
|
Title |
A |
B |
C |
D |
E |
F |
|
Police Officer
(Probationary) |
$3,072 |
|
|
|
|
|
|
Police Officer |
$3,536 |
$4,255 |
$4,541 |
$4,631 |
$4,723 |
|
|
Police Detective
Investigator |
$4,951 |
$5,098 |
$5,249 |
|
|
|
|
Police Sergeant |
$5,625 |
$5,736 |
|
|
|
|
|
Police
Lieutenant |
$6,299 |
$6,425 |
|
|
|
|
|
Police Captain |
$7,229 |
$7,373 |
|
|
|
|
|
Police Commander |
$9,309 |
|
|
|
|
|
|
Police Deputy
Chief |
$10,005 |
|
|
|
|
|
|
Police Assistant
Chief |
$10,806 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
E. The following
monthly wage scales shall become effective |
|
|
||||
|
In addition the
following becomes effective |
|
|||||
|
Step D -
Detectives, Step C - Sergeants, Step C - Lieutenants, Step C - Captain |
|
|
||||
|
|
|
|
|
|
|
|
|
Title |
A |
B |
C |
D |
E |
F |
|
Police Officer
(Probationary) |
$3,195 |
|
|
|
|
|
|
Police Officer |
$3,678 |
$4,425 |
$4,723 |
$4,817 |
$4,912 |
$5,010 |
|
Police Detective
Investigator |
$5,150 |
$5,302 |
$5,459 |
$5,569 |
|
|
|
Police Sergeant |
$5,850 |
$5,966 |
$6,085 |
|
|
|
|
Police
Lieutenant |
$6,551 |
$6,682 |
$6,816 |
|
|
|
|
Police Captain |
$7,518 |
$7,668 |
$7,821 |
|
|
|
|
Police Commander |
$9,682 |
|
|
|
|
|
|
Police Deputy
Chief |
$10,406 |
|
|
|
|
|
|
Police Assistant
Chief |
$11,238 |
|
|
|
|
|
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|
ITEM |
Current Plan |
COSA Proposal |
|
MONTHLY PREMIUMS |
|
|
|
Employee Only |
$0 |
$0 |
|
Employee + Child(ren) |
$0 |
$0 |
|
Employee + Spouse |
$0 |
$0 |
|
Employee + Family |
$0 |
$0 |
|
|
|
|
|
Office Co-pay |
N/A |
N/A |
|
In-Network Co-insurance |
80% |
80% |
|
OON Co-insurance |
80% |
60% |
|
Ind ded – Net/OON |
$200/$200 |
$250/$500 |
|
Fam ded – Net/OON |
$400/$400 |
$500/$1000 |
|
|
$500/$500 |
$600/$1,200 |
|
Fam OOP – Net / OON |
$1,500/$1,500 |
$1,500/$3,000 |
|
Lifetime Maximum |
$1,500,000 |
$1,500,000 |
|
Pharmacy
Program |
|
|
|
Coordination w/ med ded/OOP |
Yes |
No |
|
In-Network Rx Deductible |
Applies
to med ded |
None |
|
In-Network Rx Out of
Pocket Max |
Applies
to med OOP Max |
$150
individual/$300 family |
|
In-Network Co-Pays |
|
|
|
Generic 1-30 day supply |
$0 |
$0 |
|
Brand (preferred) 1-30 day supply |
20% |
20% |
|
Brand (non-preferred) 1-30 day
supply |
20% |
30% |
|
Retail/Mail 90-day Generic |
$0 |
$0 |
|
Retail/Mail 90-day Brand (pref) |
20% |
10% |
|
Retail/Mail 90-day Brand
(non-pref) |
20% |
20% |
|
Out-of-Network
Co-Pays** |
|
|
|
Generic 1-30 day supply |
20%
after med ded |
20%
after OON med ded |
|
Brand (preferred) 1-30 day supply |
40%
after med ded |
40%
after OON med ded |
|
Brand (non-preferred) 1-30 day
supply |
50%
after med ded |
50%
after OON med ded |
|
Retail/Mail 31-90-day Generic |
20%
after med ded |
20%
after OON med ded |
|
Retail/Mail 31-90 day Brand (pref) |
40%
after med ded |
40%
after OON med ded |
|
Retail/Mail 31-90 day Brand
(non-pref) |
50%
after med ded |
50%
after OON med ded |
OTHER (Services are provided per provisions above, with following provisos) |
|
|
|
Occupational, Speech and Physical Therapy |
No annual limit |
No annual limit *speech includes child born under
the plan with developmental disorder or birth defects |
|
Serious Mental Health Physician Services – Office Visits |
Annual limit 60 visits |
Annual limit 60 visits |
|
Chiropractic |
80% |
In: 80% OON: Not covered |
|
In-Vitro Coverage |
Covered, no limit |
In: 80% ; 60%OON Limit to six attempts per lifetime |
|
Routine Physical Exams (annual for age 2 and up) |
80% , limited to specific services |
In: 100% to $300 OON: 60% to $300 |
|
Dependent Children Well Visits |
Not covered |
In: 100% birth to age 2 with no
annual $ limit OON: 60% after deductible up to $300 per
year |
|
Pap, Mammogram, |
80% |
Covered at 100%, annually, age and
gender appropriate (60% OON) |
|
Immunizations |
100%, limited to |
In: 100% OON: 60% |
City of
for the
Health Benefit Program
Introduction...................................................................................................................................... IV
General Information........................................................................................................................... V
Plan and Claims Administration ........................................................................................................ VI
CHAPTER 1 GENERAL
PLAN COVERAGE FOR ELIGIBLE PARTICIPANTS.............. 1
CHAPTER 2 COBRA........................................................................................................ 4
CHAPTER 3 HIPAA PRIVACY........................................................................................ 7
CHAPTER 4 DEFINITIONS............................................................................................ 10
CHAPTER 5 COVERED
MEDICAL EXPENSES............................................................. 21
CHAPTER 6 LIMITATIONS............................................................................................ 27
CHAPTER 7 EXCLUSIONS............................................................................................. 29
CHAPTER 8
CHAPTER 9 SUPPLEMENTAL
ACCIDENT BENEFITS................................................ 33
CHAPTER 10
CHAPTER 11 HOSPITAL
CHAPTER 12 PREFERRED PROVIDER NETWORK....................................................... 37
CHAPTER 13 PRESCRIPTION
DRUG COVERAGE………………………………………...38
CHAPTER 14 EMPLOYEE
SELF AUDIT PROGRAM...................................................... 47
CHAPTER 15 COORDINATION
OF BENEFITS............................................................... 48
CHAPTER 16 SUBROGATION/THIRD
PARTY CLAIMS................................................ 51
CHAPTER 17 GENERAL
PROVISIONS........................................................................... 52
CHAPTER 18 CLAIM
FILING
CHAPTER 19 REVIEW & APPEAL PROCESS............................................................... 57
CHAPTER 20 APPENDICES............................................................................................. 58
Specific Provisions Applicable to Police Active
Employees (Cadets are covered under the Flex Plan Document as those provisions
apply to Non-Uniform City Employees) ........................................................................... 58
APPENDIX B
Specific Provisions Applicable to Fire Active
Employees (Cadets are covered under the Flex Plan Document as those provisions
apply to Non-Uniform City Employees) )
........................................................................ 62
|
MASTER CONTRACT |
The purpose of the Employee Health Benefit Program is
to provide the City of
This Master Contract defines and provides for coverage
and administration for the benefits common to uniformed City employees. The variations in coverage applicable to such
classes are set forth in specific appendices to this Master Contract, including
but not limited to Firefighters and Police Officers. The coverage provisions applicable to a
covered person shall collectively be referred to as the Plan, and the
provisions of this Master Contract and the applicable appendices for any
covered person shall be referred to as the Plan Document.
This Plan Document does not provide for any premium
payment or contributions to the cost of coverage. The obligation and amount of such payments
are separately determined from the Ordinances of the City Council or any
applicable Collective Bargaining Agreements.
This plan is open to uniformed City employees.
The benefits provided and defined in this Master
Contract are self-funded by the City of San Antonio at the time this document
was drafted, but the City of San Antonio is entitled to reinsure any portion of
its obligations hereunder, and additionally may contract for any carrier
acceptable to the City Council to assume and administer coverage and benefits
under this document.
ANY BENEFITS UNDER THE
The City of
PLAN YEAR: January
1 through December 31.
PLAN SPONSOR: City of
PLAN ADMINISTRATOR: Employee
Benefits
City of
Human Resources Department
CLAIMS ADMINISTRATOR:
Community
First
4801
N.W.
Local
Out
of Area
FAX:
www.cfhp.com
PREFERRED PROVIDER
ORGANIZATION (PPO):
NETWORK:
Or
EDI to: TTCEC
www.texastruechoice.com
PRESCRIPTION NETWORK: Walgreens
Health Initiatives
Customer
Service
RX
Group# 274316
www.walgreenshealth.com
EFFECTIVE DATE: The
effective date of this plan for uniform City employees is
PLAN
Administration and payment of claims under the Plan
Documents shall be carried out by the Claims
The Plan
The Plan
(a) To
make and enforce reasonable rules and regulations as the Plan
(b) To
interpret the contract, including, but not limited to, all questions of
coverage and eligibility. The Plan
(c) To
coordinate with and supervise the Claims
|
CHAPTER 1 GENERAL
PLAN COVERAGE FOR ELIGIBLE PARTICIPANTS |
ELIGIBILITY REQUIREMENTS
Eligible Employee
Full-time City employees (authorized full-time
equivalent) are eligible to participate in the Plan on the date their
employment begins. Coverage begins on
the date of hire, or upon taking office and performing work for the City of
A new employee who is not actively at work for any
reason other than due to medical disability on his scheduled effective date of
coverage will not become covered under the Plan until such time as the employee
returns to active employment.
Eligible Dependent
An Eligible Dependent is:
(1) The
Eligible Employee's spouse. A spouse
that is legally separated under a court decree under the laws of another state
shall not be an eligible dependent,
(2) All
natural children including legally adopted, under legal guardianship of the
Covered Employee and who have not yet reached their twentieth birthday,
provided the children have never been married and are principally dependent
upon the Eligible Employee, as directed by court order, for support and
maintenance. Foster children are not
Eligible Dependents under this Plan, unless there has been an application for
adoption accepted by the Texas Department of Human Services. Stepchildren are Eligible Dependents during
the marriage between the Eligible Employee and the natural parent of the child,
so long as (a) they permanently reside in the employee's household, and (b) are
principally dependent on the employee.
In addition to the above, children will be considered
as Eligible Dependents from age twenty (20) through age twenty-three (23), if
they are full-time students, have never been married, and are principally
dependent upon the Eligible Employee for support and maintenance.
The term "Eligible Dependent" shall not
include anyone who is covered as an Eligible Employee. An Eligible Dependent shall not be entitled
to any additional benefits or coverage by virtue of the fact that both parents,
step parents or guardians are employed by the City.
Incapacitated Dependent
An Eligible Dependent child who is physically or
mentally incapable of self-support upon attaining the age of twenty (20) years,
shall continue to be an Eligible Dependent while remaining incapacitated, unmarried
and continuously covered under the Plan.
An eligible incapacitated dependent must be solely dependent on the
employee, and must be incapacitated by a disability that arose while such
dependent was a covered dependent. To
continue eligibility under this provision, proof of incapacity must be
submitted by the employee at least thirty-one (31) days prior to such child's
attainment of age twenty (20).
Effective Date of Coverage
Coverage does not become effective until the Eligible
Employee completes the City's enrollment document.
Newborn infants will be covered from the date of birth
as long as the employee is covered under this plan and coverage for the newborn
child is requested within 31 days of the child's date of birth. If coverage of a newborn is not requested
within 31 days of the child's date of birth, then coverage cannot become
effective until the next re-enrollment period.
Eligible Dependents who are enrolled after the
effective date of this Plan will become covered on the date such dependent is
acquired, provided that the covered Employee enrolls such dependent within 31
days of the date the dependent is acquired.
If coverage of a dependent is not requested within 31 days of the date
the dependent was acquired, the coverage cannot become effective until the next
re-enrollment period.
Change of Family Status
If
there is a legal change in family status, the employee has thirty-one (31)
calendar days to notify the Employee Benefits Office in writing. The notice may be given by personally
appearing in the Benefits Office and completing a change of dependent coverage
form.
If
there is no change in family status or if notice is not given for additional
coverage within thirty-one (31) days after the legal change in status, no
change can become effective until the next re-enrollment period, which shall be
not less than thirty–one (31) days, occurring during the months of October or
November, as the Plan
A
legal change in family status includes: divorce; marriage; birth or adoption of
a child, including a child living with the adopting parents during the period
of probation; change in employment status for the employee's spouse; or
ineligibility of a child due to age, or change in student status.
Termination of Coverage for
Individuals
The coverage of any Covered
Person under the Plan shall terminate on the earliest of the following dates:
(1) The date of termination of the Plan;
(2) The
date employment terminates;
(3) The date all coverage or certain benefits are terminated in a
particular class by modification of the Plan; and
(4) The date an active Eligible Employee is
covered under a qualified Health Maintenance Organization (HMO) or any other
available alternative health care delivery system for the employee or
dependents of the employee.
Termination of Coverage for
Dependents
Coverage
with respect to the Covered Person's dependents shall terminate under the Plan
at the earliest time specified below:
(1) Upon termination of employment for the covered employee;
(2) On the date dependents cease to be eligible as defined in the
Plan.
Termination of Coverage for
Failure to Pay Premium
Coverage
with respect to any Covered person for which a premium or contribution is
required shall terminate 31 days after the due date for such premium, or as
soon thereafter as otherwise allowed by law.
Documentation
The
Plan
|
CHAPTER 2 COBRA
PROVISIONS |
On
“Qualified Beneficiary" means:
a.
you,
as a Covered Employee, for termination or reduced hours;
b.
your spouse or
your dependent child if he/she was a dependent under the Plan on the day before your Qualifying Event occurred; or
c.
a child who is
born to a Covered Employee during a period of COBRA continuation coverage.
"Qualifying Event for
a Covered Employee" means a loss of coverage due to:
a.
termination
of employment for any reason other than gross misconduct; or
b.
reduction
in hours of employment.
"Qualifying Event for
a Covered Dependent" means a loss of coverage due to:
a.
a Covered
Employee's termination of employment for any reason other than a gross
misconduct or reduction in hours of employment;
b.
a Covered
Employee's death; a spouse's divorce or legal separation from a Covered
Employee;
c.
a Covered
Employee's entitlement to Medicare; or
d.
a dependent
child's loss of dependent status under the Plan.
"Timely contribution
payment” means contribution payment must be made within 30 days of the due
date or within such longer period as applies to or under the Plan.
Continuation of Health
Coverage. Continuation of health coverage shall be
available to you and/or your Covered Dependents upon the occurrence of a
Qualifying Event. To continue health
coverage, the Plan
a. the
Employer, within 30 days of such event, if the Qualifying Event is:
1.
for a
Covered Dependent, the Covered Employee's death;
2.
the
Covered Employee's termination other than for gross misconduct or reduction in
hours;
3.
for a
Covered Dependent, the Covered Employee's entitlement to Medicare.
b. you or a Qualified
Beneficiary, within 60 days of such event, if the Qualifying Event is:
1.
for a
spouse, divorce, or legal separation from a Covered Employee; or
2.
for a
dependent child, loss of dependent status under the Plan.
The Plan
Upon termination of employment or reduction in hours, to continue
health coverage for 29 months, a Qualified Beneficiary who is determined under
Title II or Title XVI of the Social Security Act to be disabled on such date or
at any time during the first 60 days of COBRA continuation coverage, must
notify the Plan
Qualified Beneficiaries who are disabled under Title II or Title
XVI of the Social Security Act must notify the Plan
A Qualified Beneficiary must elect Continuation of Health Coverage
within 60 days from the later of the date of the Qualifying Event or the date
notice was sent by the Plan
A newborn child of a Qualified Beneficiary or a child placed with
a Qualified Beneficiary for adoption may be added according to the enrollment
requirements for dependent coverage under the Eligibility Requirements of the
Plan.
Any election by you or your spouse shall be deemed to be an
election by any other Qualified Beneficiary, though each Qualified Beneficiary
is entitled to an individual election of continuation coverage.
Upon election to continue health coverage, a Qualified Beneficiary
must, within 45 days of the date of such election, pay all required
contribution to date to the Plan
A Qualified Beneficiary will be notified by the Plan
Termination of Coverage.
Coverage will end upon the earliest of the following:
a.
termination
or reduction of hours:
1.
18
months from the date of the Qualifying Event; or
2.
29 months from the
date of the Qualifying Event if the Qualified Beneficiary is determined under
Title II or Title XVI of the Social Security Act to be disabled on such date or
at any time during the first 60 days of COBRA continuation coverage and
provides notice as required by law (including, COBRA continuation coverage of
non-disabled family members of the Qualified Beneficiary entitled to the
disability extension).
b. the
day, after the 18 month continuation period, which begins more than 30 days
from the date of a final determination under Title II or Title XVI of the
Social Security Act that a Qualified Beneficiary, entitled to 29 months, is no
longer disabled (including COBRA continuation coverage of non-disabled family
members of the Qualified Beneficiary entitled to the disability extension who
is no longer disabled).
c.
for a Covered
Dependent, 36 months from the date of the Qualifying Event if the Qualifying
Event is:
1. the
Covered Employee's death;
2. the
Covered Employee's entitlement to Medicare;
3. a spouse's divorce or legal separation from a Covered
Employee; or
4. a
dependent child's loss of dependent status under the Plan.
d.
if any of the
Qualifying Events listed in (c) occurs during the 18-month period after the
date of the initial Qualifying Event listed in (a), coverage terminates 36
months after the date of the Qualifying Event listed in 1.
e.
the
date on which the Employer ceases to provide any group health plan to any
employee;
f.
the date on which
a Qualified Beneficiary fails to make timely payment of the required
contribution;
g.
the date on which
a Qualified Beneficiary first becomes (after the date of the election) covered
under any other group health plan (as an employee or otherwise) which does not
contain any exclusion or limitation with respect to any pre-existing condition
of such Qualified Beneficiary;
h.
the
first day of the month in which a Qualified Beneficiary becomes entitled to
Medicare; or
i. the date this Plan terminates.
Continuation of health coverage under this provision shall not
duplicate health care coverage continued under any state or federal law.
_____________________________________________________________________
Any questions about COBRA should be directed to the
City's Employee Benefits Office
506 Dolorosa ,
_____________________________________________________________________
|
CHAPTER 3 HIPAA
PRIVACY |
A. Use and
Disclosure of Protected Health Information (
The Plan will use protected health information (
Payment includes activities undertaken by the Plan to
determine or fulfill its responsibility for coverage and provision of plan
benefits that relate to an individual to whom health care is provided. These
activities include, but are not limited to, the following:
·
determination of
eligibility, coverage and cost sharing amounts (for example, cost of a benefit,
plan maximums and co-insurance as
determined for an individual’s claim);
·
coordination of
benefits;
·
adjudication of
health benefit claims (including appeals and other payment disputes);
·
billing,
collection activities and related health care data processing;
·
claims management
and related health care data processing, including auditing payments,
investigating and resolving payment disputes and responding to participant
inquiries about payments;
·
obtaining payment
under a contract for reinsurance (including stop-loss and excess of loss
insurance);
·
medical necessity
reviews or review of appropriateness of care or justification of charges;
·
utilization
review, including pre-certification, preauthorization, concurrent review and
retrospective review;
·
disclosure to
consumer reporting agencies related to the collection of premiums or
reimbursement (the following
·
reimbursement to
the plan.
Health Care Operations include, but are not limited
to, the following activities:
·
quality
assessment;
·
population-based
activities relating to improving health or reducing health care costs, protocol
development, case management and care coordination, disease management,
contacting health care providers and patients with information about treatment
alternatives and related functions;
·
rating provider and plan performance, including
accreditation, certification, licensing or credentialing activities;
·
underwriting,
premium rating and other activities relating to the creation, renewal of
replacement of a contract of health insurance or health benefits, and ceding,
securing or placing a contract for reinsurance of risk relating to health care
claims (including stop-loss insurance and excess of loss insurance);
·
conducting or
arranging for medical review, legal services and auditing functions, including
fraud and abuse detection and compliance programs;
·
business planning
and development, such as conducting cost-management and planning-related
analyses related to managing and operating the Plan, including formulary
development and administration, development or improvement of payment methods
or coverage policies;
·
business
management and general administrative activities of the Plan, including, but
not limited to:
(a) management activities relating to the implementation
of and compliance with HIPAA’s administrative simplification requirements, or
(b) customer service, including the provision of data
analysis for management; and
·
resolution of
internal grievances.
B. The Plan Will Use and Disclose
C. For
Purposes of This Section, the City of San Antonio is the Plan Sponsor
The Plan will disclose
D. With
Respect to
The Plan Sponsor agrees to:
·
not use or
further disclose
·
ensure that any
agents, including a subcontractor, to whom the Plan Sponsor provides
·
not use or
disclose
·
not use or
disclose
·
report to the
Plan any
·
make
·
make
·
make available
the information required to provide an accounting of disclosures;
·
make internal
practices, books and records relating to the use and disclosure of
·
if feasible,
return or destroy all
E. Adequate Separation
Between the Plan and the Plan Sponsor Must Be Maintained
In accordance with HIPAA, only the following employees
may be given access to
·
the staff of the
Employee Benefits Division of the Human Resources Department
·
the staff of the
Finance Department assigned to the Self Insurance Fund and
·
the staff of
Legal Department assigned to the Employee Benefits Division.
If the persons described in section E do not comply
with this plan document, the Plan Sponsor shall provide a mechanism for
resolving issues of noncompliance, including disciplinary sanctions.
|
CHAPTER 4 DEFINITIONS |
"ACCIDENTAL
INJURY" means a condition caused by an accidental means which results
in traumatic damage to the Covered Person's body from an external force that is
unexpected at the time, but which occurrence was definite as to time and
place.
"ACTIVELY
AT
"ALLOWABLE
EXPENSE" relates to coordination of benefits, under Chapter 13 of this
Plan Document. Allowable expenses shall
mean any necessary usual, customary and reasonable expenses incurred while
eligible for benefits under the Plan, part or all of which would be covered
under any of the plans, but not including any expenses contained in the
Exclusions chapter.
"AMBULATORY
SURGICAL CENTER" means a specialized facility which is established,
equipped, operated and staffed primarily for the purpose of performing surgical
procedures on an outpatient basis and which fully meets one of the following
two tests:
(a) It is
licensed as an ambulatory surgical facility in the state in which it is
located; or
(b) Where
licensing is not required:
1. it is
operated under the full-time supervision of a physician;
2. it
permits surgical procedures to be performed only by physicians who are
privileged to perform the procedure in at least one local hospital;
3. it
requires in all cases, except for those using only local infiltration
anesthetics, that a licensed anesthesiologist either administers the anesthetic
or supervises an anesthetist who administers it and that the anesthesiologist
or anesthetist remains present throughout the surgical procedure;
4. it
provides at least one operating room and at least one post-anesthesia recovery
room;
5. it is
equipped to perform diagnostic x-ray and laboratory examinations or has an
arrangement to obtain these services;
6. it has
trained personnel and necessary equipment to handle emergencies;
7. it has
immediate access to a blood bank or blood supplies;
8. it
provides the full-time services of one or more registered graduate nurses
(R.N.) for patient care in the operating room and post-anesthesia recovery
room; and
9. it
maintains an adequate medical record for each patient that contains an admitting
diagnosis that includes, except for patients undergoing a procedure under local
anesthesia, a preoperative examination report, medical history and laboratory
tests and/or x-rays, and operative report and discharge summary.
"ANNUAL MEDICAL CO-INSURANCE OUT OF POCKET"
is the sum of the co-insurance under the Plan Document. When the annual out of pocket is reached
(which can be for an individual or a family, cumulative) covered expenses
incurred during that plan year will be paid at 100%.
Out of Pocket does not include:
* Charges beyond usual & customary fees;
* Penalties resulting from non-compliance with
pre-certification;
* Co-insurance for inpatient or outpatient mental
& nervous benefits;
* Charges not covered under the Plan.
* Pharmacy in or out of network co-insurance
“ANNUAL
PRESCRIPTION CO-INSURANCE OUT-OF-POCKET”
the sum of in-network prescription co-insurance under the Plan Document. When the annual out of pocket is reached
(which can be for an individual or a family, cumulative) covered expenses
incurred during that plan year will be paid at 100%. Coinsurance amounts paid toward
out-of-network prescriptions do not apply to the out of pocket maximum under
the group health care coverage. The
amount a member pays for any non-covered
drug will not be included in calculating the Annual Out-of-Pocket
maximum. The member is responsible for paying 100% of the cost for any
non-covered drug and the contracted rates will not be available.
"BODY ORGAN"
means the following (a) a kidney; (b) a heart; (c) a heart/lung; (d) a liver,
(e) a pancreas, when the condition is not treatable by use of insulin therapy;
(f) bone marrow; and (g) a cornea.
"CALENDAR
YEAR" a period of 12 consecutive months beginning with January 1
through December 31 of the same year.
For new employees and dependents, the calendar year is the effective
date of their coverage through December 31 of the same year.
"
"CLAIMS
ADMINISTRATOR" means the Third Party
"COINSURANCE"
is the Covered Person's obligation to pay a percentage of the costs of care in
accordance with the terms and provisions of this Plan document. For example, if this plan provides for
payment of 80% of eligible medical expense, the remaining 20% is the employee's
obligation, and is referred to as "coinsurance." If the plan provides for out of network
payment of 60% of eligible medical expense, the remaining 40% employee obligation
is referred to as “coinsurance.” If the
plan provides for an in-network prescription payment of 80%, the remaining 20%
is the employee’s obligation and is referred to as “co-insurance.”
"COMPLICATIONS
OF PREGNANCY" means:
(a) conditions
requiring hospital confinement (when the pregnancy is not terminated) whose
diagnoses are distinct from pregnancy but are adversely affected by pregnancy
or caused by pregnancy, such as: acute
nephritis; nephrosis; cardiac decompensation; missed abortion; and similar
medical and surgical conditions of comparable severity; or
(b) non-elective
caesarean section; ectopic pregnancy which is terminated; or spontaneous
termination of pregnancy which occurs during a period of gestation in which a
viable birth is not possible.
"Complications of pregnancy" does not
mean: false labor; occasional spotting;
physician prescribed rest during pregnancy; morning sickness; hyperemesis
gravidarum; preeclampsia; or similar conditions associated with the management
of a difficult pregnancy not constituting a nosologically distinct complication
of pregnancy.
"COSMETIC
PROCEDURES" mean any surgical procedure or any portion of a surgical
procedure performed primarily to improve physical appearance and does not
promote the proper function of the body or treat any illness or injury.
"COVERED
PERSON" means an eligible Employee, retiree, official or eligible
Dependent covered under this Plan.
"COVERED
PROVIDER" means an ambulatory surgical center, a home health care
agency, a licensed hospice care center, a hospital, a physician, a surgeon, a
psychiatric day treatment facility, a rehabilitation facility and a skilled
nursing facility.
"CUSTODIAL
"DEDUCTIBLE"
means the amount of Covered Medical Expenses a Covered Person must incur and
pay each calendar year before benefits are payable under the Plan.
"FAMILY DEDUCTIBLE
LIMIT" means that, once the sum of the family deductible has been
satisfied by the cumulative Covered Medical Expenses of the eligible employee
and one (1) or more of his eligible dependents in a Calendar Year, no further
deductible need be satisfied in that Calendar Year for any other eligible
member of the family.
For example (in-network):
Employee $ 85.00
Spouse $250.00 Satisfied the Individual Deductible
Child $ 90.00
Child 2 $100.00
Total submitted $525.00
Family Deductible
Accumulation $500.00
$ 25.00
reimbursed at coinsurance level
Where a City employee, by virtue of his relationship to another
City employee, would be considered an eligible dependent but for his employment
with the City, the higher of the two (2) family deductibles of these two (2)
City employees need only be satisfied.
"DENTIST"
means a currently licensed dentist practicing within the scope of the license
or any physician furnishing dental services which the physician is licensed to
perform.
"DIABETES EQUIPMENT"
means the following:
a.
blood
glucose monitors, including monitors designed to be used by blind individuals;
b.
insulin
pumps and associated appurtenances;
c.
insulin
infusion devices; and
d.
podiatric
appliances for the prevention of complications associated with diabetes.
“DIABETES SUPPLIES” means the following:
a.
test
strips for blood glucose monitors;
b.
visual
reading and urine test strips;
c.
lancets and lancet devices;
d.
insulin
and insulin analogs;
e.
injection
aids; syringes;
f.
prescriptive
and non-prescriptive oral agents for controlling blood sugar levels; and
g.
glucagon
emergency kits.
"DONOR" means
a person who undergoes a surgical operation for the purpose of donating a body
organ(s) for transplant surgery.
"DURABLE
MEDICAL EQUIPMENT" means equipment prescribed by the attending
physician which meets each of the following:
a) medically necessary; b) is not
primarily or customarily used for non-medical purposes; c) is designated for prolonged use; and d)
serves a specific therapeutic purpose in the treatment of any injury or
illness.
“EFFECTIVE DATE”, when applied to an
individual’s coverage under the Plan, means the first day of the individual’s
coverage. The individual’s effective
date may or may not be the same as the individual’s enrollment date (as
“enrollment date” is defined by the Plan).
"ELIGIBLE
EXPENSE" is any expense, which is eligible for payment, in whole or in
part under this plan document.
“EMERGENCY SERVICES” Emergency Services are health care services
provided in a Hospital emergency facility or comparable facility to evaluate
and stabilize medical conditions, including a behavioral health condition, of a
recent onset and severity including, but not limited to, severe pain that would
lead a prudent lay person, possessing an average knowledge of medicine and
health to believe that his or her condition, Illness, or Injury is of such a
nature that failure to get immediate medical care could result in:
1.
placing his or her health in serious jeopardy;
2.
serious impairment to bodily functions;
3.
serious dysfunction of any body organ or part;
4.
serious disfigurement; or
5.
in the case of a pregnant woman, serious jeopardy to the health of the fetus.
This definition is only for purposes of determining whether out of
network emergency services will be paid at in-network benefit levels.
"EMPLOYEE"
means a person who is directly employed by the City of
"EMPLOYER" means the City of
"
(a) Is
employed by the City's Fire Department;
(b) Has
been hired in substantial compliance with Chapter 143 of the Local Government
Code;
(c) Has
successfully completed the
(d) Has
received his or her certificate from the Fire Chief.
"FULL TIME
STUDENT" means a participant's dependent child who is enrolled in and
regularly attending an accredited college, university or institution on a full
time basis as determined by the institution attended by the student. Evidence of the child's status as a full time
student satisfactory to the claims administrator must be furnished by the
covered person in the event of a claim or enrollment. A person ceases to be a full time student at
the end of the month during which the person graduates or otherwise ceases to
be enrolled and in attendance at the institution on a full time basis. A person continues to be a full time student
during periods of vacation established by the institution, unless the person
does not continue as a full time student immediately following the period of
vacation.
"HOME
HEALTH
(1) It is
licensed and primarily engaged in providing skilled nursing care and other
therapeutic services;
(2) It has
policies established by a professional group associated with the agency or
organization and includes at least one physician and one registered graduate
nurse (R.N.) who provide full time supervision of such services;
(3) It
maintains complete medical records on each individual;
(4) It has
a full time administrator.
"HOSPICE” means an
agency which:
a.
is primarily
engaged in providing counseling, medical services or room and board to
terminally ill persons;
b.
has professional
service policies established by a group associated with it. This group must
include one (1) Physician, one (1) Registered Nurse (RN) and one (1) social
service coordinator;
c.
has
full-time supervision by a Physician;
d.
has a
full-time
e.
provides
services 24 hours a day, seven (7) days a week;
f.
maintains
a complete medical record of each patient; and
g.
is
licensed in accordance with state law.
"HOSPITAL"
means only an institution constituted and operated pursuant to any applicable
law, engaged in providing, on an inpatient basis at the patient's expense,
diagnostic and therapeutic facilities for the surgical and medical diagnosis,
treatment, and care of injured and sick individuals by or under the supervision
of a licensed physician or surgeon and continuously providing 24-hour-a-day
services by registered nurses. The term
"hospital" shall not include any institution or part thereof which is
other than incidentally a place for rest, a residential treatment center, or a
nursing home or convalescent hospital.
"INTENSIVE
(a) It is
solely for the treatment of patients who require special medical attention
because of their critical condition;
(b) It
provides within such area special nursing care and observation of a continuous
and constant nature not available in the regular rooms and wards of the
hospital;
(c) It
provides a concentration of special lifesaving equipment immediately available
at all times for the treatment of patients confined within such area; and
(d) It
provides at least one professional registered nurse who continuously and
constantly attends to the patient confined in such area on a twenty-four (24)
hour a day basis; or
(e) An
alternate hospital that is approved by the Plan
(i) to
facilitate provision of medical services by a particular physician;
(ii) the
covered person's physician certifies in writing to the Plan
(iii) proximity
of the covered person's immediate family members;
(iv) the
medical condition of the covered person
indicates that it would be inadvisable to transfer to another hospital.
"LIFETIME
MAXIMUM" is the cumulative maximum amount payable during the lifetime
of the covered person, during periods of eligibility, as set forth in the
Schedule of Benefits.
"MASTER
CONTRACT" means and refers to this Plan Document, which sets forth the
provisions of universal applicability to the City's various health benefit
plans.
"MEDICALLY
NECESSARY" means any care, treatment, service or supply provided for
the diagnosis and treatment of a specific illness, injury or condition which
meets all of the following.
(a) The
care and treatment is appropriate given the symptoms, and is consistent with
the diagnosis, if any.
"Appropriate" means that the type, level, and length of
service and the setting are needed to provide safe and adequate care and
treatment;
(b) It is
rendered in accordance with generally accepted medical practice and
professionally recognized standards in the
(c) It is
not treatment that is generally regarded as experimental, educational or
unproven; and
(d) It is
specifically allowed by the licensing statutes that apply to the provider that
renders the service.
With respect to confinement in a hospital
"medically necessary" further means that the medical condition
requires confinement and that safe and effective treatment cannot be provided
as an outpatient.
The Claims
Medical necessity specifically does not include any:
(a) Repeated
test which would not be necessary if initially done correctly, or is not
necessary at current intervals;
(b) Care,
treatment, service or supply which is for the psychological support, education
or vocational training of the Covered Person;
Criteria used in determining that a procedure is
experimental includes:
(a) Whether
there is an appropriate rationale for the treatment;
(b) Whether
there is evidence that the treatment is effective;
(c) Whether
there is evidence that the treatment is harmful;
(d) Whether
the benefits justify the immediate and delayed risks of treatment;
(e) Whether
the treatment has been endorsed or approved by the appropriate medical authorities,
such as the FDA, the AMA or other medical specialty societies or specialists or
whether the treatment is covered by Medicare or other public programs;
(f) Whether
the device or treatment is the subject of ongoing investigation or research;
(g) Whether
the treatment is legal;
(h) Whether
controlled medical trials have been carried out that demonstrate the
treatment's efficacy.
"NEWBORN
"OTHER
COVERAGE" means any other contract or policy under which the Covered
Person is enrolled, such as:
* Group or blanket insurance;
* Group practice, group Blue Cross, group Blue Shield,
individual practice offered on a group basis, or other group prepayment
coverage;
* Labor management trusteed plans, union welfared
plans, employee organization plans, or employee benefit organization plans;
* Government programs, such as Medicare, or coverage
required or provided by statute;
* Any group coverage of a child sponsored by, or
provided through, any educational institution;
* Group arrangements for members of associations or
individuals.
"OTHER
COVERED PROVIDER" means a certified social worker (CSW) licensed
professional counselor (LPC), licensed occupational therapist (
"PHYSICIAN
OR SURGEON" means any professional practitioner who holds a lawful
license authorizing the person to practice medicine or surgery in the locale in
which the service is rendered, limited to a Doctor of Medicine (M.D.), a Doctor
of Osteopathy (D.O.), a Doctor of
Podiatric Medicine (D.P.M.), a Doctor of Dental Surgery (D.D.S.), a
Doctor of Chiropractic (D.C.), a Clinical Psychologist (Ph.D), who has met the standards of the National
Register of Health Service Providers in Psychology.
"PLAN" whenever used herein without qualification means this
Plan Document.
"PLAN
ADMINISTRATOR" means the City of
"PLAN
DOCUMENT" means this Master Contract and any Addendum, which
collectively provide and define coverage for particular employees and
dependents.
"PLAN SPONSOR" means the City of
"PLAN
SUMMARY" is the information provided to City employees concerning coverage
and benefits to assist in understanding and using available benefits. THE PLAN SUMMARY DOES NOT DEFINE COVERAGE,
WHICH IS THE SOLE PURPOSE OF THE MASTER CONTRACT. ANY STATEMENT ABOUT COVERAGE IN THE SUMMARY
IS A GENERAL INTERPRETATION ONLY,
"POLICE
OFFICER" means any full time, permanent, paid employee who:
(a) Is
employed by the City's Police Department;
(b) Has
been hired in substantial compliance with Chapter 143 of the Local Government
Code;
(c) Has
successfully completed the
(d) Has
received his or her certificate from the Police Chief.
"POST DELIVERY
"PRINCIPALLY
DEPENDENT" shall have the meaning defined in Sections 151 and 152 of
the Internal Revenue Code and the regulations thereunder.
"PSYCHIATRIC
DAY TREATMENT FACILITY" means an institution which meets all of the
following requirements:
(a) It is
a mental health facility which: provides treatment for individuals suffering
from acute mental, nervous or emotional disorders, in a structured psychiatric
program utilizing individualized treatment plans with specific attainable goals
and objectives appropriate both to the patient and the treatment modality of
the program; and is clinically supervised by a doctor of medicine who is
certified in psychiatry by the American Board of Psychiatry and Neurology.
(b) It is
accredited by the Program for Psychiatric Facilities or its successor, or the
Joint Commission on Accreditation of Hospital; and
(c) Its
patients are treated for not more than eight (8) hours in any twenty-four (24)
hour period.
"QUALIFIED INSURED”
means an individual eligible for coverage under the Plan who has been diagnosed
with:
a.
insulin
dependent or non-insulin dependent diabetes;
b.
elevated
blood glucose levels induced by pregnancy; or
c.
another
medical condition associated with elevated blood glucose levels.
"RECIPIENT"
means an insured person who undergoes a surgical operation to receive a body
organ transplant.
"REHABILITATION
FACILITY" means a facility that provides services of acute
rehabilitation. All services are
provided under the direction of a physician with a specialty in rehabilitation
and physical medicine. The facility is
staffed around the clock by registered nurses and it does not provide services
of a custodial nature. The facility must
be Medicare certified, licensed by the State Department of Health as a
"special hospital" and accredited by the Joint Commission on
Accreditation of Healthcare Organizations.
It is also accredited by the Commission on Accreditation of
Rehabilitation Facilities.
"SKILLED
NURSING FACILITY" means a legally operated institution, or a distinct
part of an institution, primarily engaged in providing skilled nursing care to
patients recovering from injury or illness and which:
(a) Is
under the resident supervision of a physician or registered nurse (R.N.);
(b) Provides
continuous skilled nursing care for 24 hours of every day;
(c) Requires
that the health care of every patient be under the supervision of a physician;
(d) Provides
that a physician be available at all times to furnish necessary medical care in
emergencies;
(e) Maintains
clinical records for each patient;
(f) Has an
effective utilization review plan;
(g) Has a
transfer agreement with at least one (1) hospital;
(h) Is
not, other than incidentally, a clinic, a place devoted to care of the aged or
a place for treatment of mental disorders or mental retardation;
(i) Is
not a place for custodial care.
“TEMPORARY MECHANICAL
EQUIPMENT" means any non-organic device used in conjunction with the
recipient's own body organ for the purpose of sustaining a bodily function for
which a transplant has been deemed necessary by the attending physician.
"TRANSPLANT SURGERY" means the
transfer of body organ(s) from a donor to a recipient.
"USUAL
& CUSTOMARY CHARGE" means charges for Medically Necessary services
and supplies which would usually be provided for cases the same as or similar
to the one being treated. The Usual and
Customary charge is limited to the lesser of:
(a) The
fee usually charged by the provider for similar services and supplies; and
(b) The
fee usually charged for the same service or supply by other providers who are
in the same area. "Area" means
a geographical area as determined by the Claims
|
CHAPTER 5 COVERED
MEDICAL EXPENSES |
Covered Medical Expenses shall be the portion, set
forth in the Schedule of Benefits, of the usual and customary charges for the
following services, supplies, and treatment when medically necessary and when
ordered by a licensed physician or surgeon.
Medical expenses exceeding usual and customary expenses covered by this
plan will be the obligation of the Covered Person.
1. Daily
semi-private room charge in a hospital or rehabilitation facility.
2. Services
and supplies furnished by a hospital.
3. Treatment
by a physician or surgeon.
4. Treatment
by an other covered provider not related by blood or marriage.
5. Anesthetic
and its administration.
6. "Surgery
in mouth or oral cavity" is limited to:
(a) removal
of non-odontogenic lesions, tumors or cysts;
(b) incision
and drainage of non-odontogenic cellulitis;
(c) surgery
on accessory sinuses, salivary glands and ducts and tongue;
(d) surgical
treatment of fractures and dislocation of the jaw resulting from an accidental
injury.
7. Diagnostic
radiology, radiation therapy and laboratory examinations.
8. Ambulance
charges to or from the nearest medically appropriate hospital by an ambulance
service operated in accordance with State law.
9. Medical
supplies and equipment as follows:
(a)
drugs and
medicines which can be obtained only by numbered prescription for the specified
illness or injury for which the patient is being treated;
(b) birth
control pills, injections and medication implants are covered for employees and
dependent spouses only. No other
contraceptive methods or devices are covered;
(c) blood
and blood plasma;
(d) charges
for drawing and storing autologous blood;
(e) prosthetic
appliances such as artificial limbs or eyes, not including their replacement
except when required due to growth or development of a dependent child. After a covered mastectomy, breast implants
or prostheses are also covered.
Replacement of breast prosthesis is covered only when original
prosthesis was required due to a major catastrophic illness or injury;
(f) crutches. The rental (but not to exceed the total cost
of purchase) or, at the option of the Claims
(g) medical
supplies such as lancets, autolets, syringes, dextrowash and dextrostix, ostomy
supplies, casts, splints, trusses and braces;
(h) orthopedic shoes when prescribed by a
physician.
10. Dental
treatment for fractured jaw or for injury to sound natural teeth including
replacement of such teeth within six months after the date of accident,
provided that such accident occurs while the insurance is in force as to the
covered person.
11.
Expenses incurred
for maternity care and services shall be covered on the same basis as for any
other illness incurred by the covered person or the dependent spouse. There is no coverage for expenses for
maternity care and services incurred by a dependent child except for
complications of pregnancy which shall be treated as any other illness.
The attending physician shall make the determination
as to whether a delivery is complicated.
Under Federal law, group health plans generally may not restrict
benefits for any hospital length of stay in connection with childbirth for the
mother or newborn child to less than 48 hours following a vaginal delivery, or
less than 96 hours following a cesarean section. The 48-hour period (or 96-hour period if
applicable) begins at the time a delivery occurs in the hospital (or in the
case of multiple births, at the time of the last delivery) or, if the delivery
occurs outside the hospital, at the time a mother and/or newborn are
admitted. However, Federal law generally
does not prohibit the mother’s or newborn’s attending provider, after consulting
with the mother, from discharging the mother or her newborn earlier than 48
hours (or 96 hours if applicable) following the delivery.
If
a decision is made to discharge a mother or her newborn child from inpatient
care before the expiration of the minimum hours of coverage of inpatient care
as provided above, the Plan will provide coverage for timely Post Delivery Care
as defined herein. Such care may be
provided to the mother and the child by a physician, registered nurse or other
appropriate licensed health care provider and may be provided at the mother's
home, a health care provider’s office, a health care facility or another
location determined to be appropriate under rules adopted by the Commissioner
of Insurance.
12. Newborn
care.
13. Services
of a licensed speech therapist are covered when therapy is rendered in
accordance with physician’s specific instructions as to type and duration when
speech was present before the illness and/or injury, and for a child born under
the plan with developmental disorder or birth defects.
14.
Services of a
licensed physical therapist are covered only for those services that require
the technical medical proficiency and skills of a licensed physical therapist
and which are rendered in accordance with a physician's specific instructions
as to type and duration.
15. Acupuncture
or hypnosis when performed by a covered provider and in lieu of anesthesia.
16. Psychiatric
Treatment. Serious mental illness includes the following; (1)
schizophrenia; (2) paranoia and other psychotic disorders; (3) bipolar
disorders (mixed, manic, depressive, and hypomanic); (4) major depressive
disorders (single episode or recurrent); (5) schizo-affective disorders
(bipolar or depressive); (6) pervasive developmental disorders; (7) obsessive-compulsive
disorders; and (8) depression in childhood and adolescence. Treatment of the above-listed serious mental
illnesses is limited to 45 days of inpatient treatment per calendar year and 60
visits for outpatient treatment, including group and individual outpatient
treatment, per calendar year. Coverage
for such treatment does not include addiction to a controlled substance or
marihuana that is used in violation of law or mental illness resulting from the
use of a controlled substance or marihuana in violation of law. The above-listed serious mental illnesses
will be covered as any other illness subject to applicable deductibles,
coinsurance, limits and exclusions, pre-certification and non-pre-certification
penalties. Any diagnosis other than
those listed in the sub-paragraph will be subject to the current Plan design in
each program.
17. Chemical
dependency and substance abuse will be treated as any other illness.
18. Voluntary
sterilization is covered.
19. Preventive
services:
(a) One routine pap smear (doctor's procedure charge, lab
expenses and office visit) per calendar year for female covered persons;
(b)
One routine mammogram per calendar year for female covered persons age
thirty-five (35) and over;
(c) One (1) routine physical examination per
calendar year for an eligible employee only
1. If performed by the employee’s own physician, covered
services will be limited to a preventative medical examination, blood chemistry
profile, thyroid function (
2. If performed at the Occupational Health Clinic, at 401 West
Commerce, the Plan will cover a complete blood count, cholesterol and glucose
screening; blood pressure check; height and weight evaluation; and a health
assessment questionnaire at 100%.
(d) A physical examination for the
detection of prostate cancer and prostate-specific Antigen test used for the
detection of prostate cancer for each male enrolled in the Plan who is;
1.
at
least 50 years of age and asymptomatic; or
2.
at
least 40 years of age with a family history of prostate cancer or another
prostate cancer risk factor.
20. (a) Gamma globulin injections and the
following immunizations for Covered Dependents from
birth through the date the child is six (6) years of age shall be covered: (a) DTP, (b) polio (OPV), (c)
(b)
Synagis (Palivizumab)
administration for the prevention of respiratory syncytial virus (RSV) among
high risk infants meeting prescribing criteria set forth by American Academy of
Pediatrics (
21. Expenses
for Attention Deficit Disorder.
22.
Occupational
Therapy.
23.
Diabetes. Coverage
shall be provided to each Qualified Insured as defined herein for:
a.
diabetes
equipment;
b.
diabetes
supplies; and
c.
diabetes
self-management training programs as defined herein.
A
health care practitioner or provider who is licensed, registered, or certified
in
a.
training provided
to a Qualified Insured after the initial diagnosis of diabetes in the care and
management of that condition, including nutritional counseling and proper use
of diabetes equipment and supplies;
b.
additional
training authorized on the diagnosis of a physician or other health care
practitioner of a significant change in the Qualified Insured's symptoms or
condition that requires changes in the Qualified Insured's self-management
regime; and
c.
periodic
or episodic continuing education training when prescribed by an appropriate
health care practitioner as warranted by the development of new techniques and
treatments for diabetes.
24.
Temporomandibular
Joint. Medically necessary diagnostic or
surgical treatment of conditions affecting the temporomandibular joint (jaw and
the craniomandibular joint) resulting from one of the following shall be
covered:
a.
an
accident;
b.
a
trauma;
c.
a
congenital defect;
d.
a
developmental defect; or
e.
a
pathology.
Such coverage is subject to the same Plan provisions as for any
surgical treatment including, but not limited to, the requirements for
pre-certification of benefits.
25.
Mastectomy. Coverage for inpatient care for a Covered
Person is as follows:
a.
48
hours following a mastectomy; and
b.
24
hours following a lymph node dissection for the treatment of breast cancer.
For reconstruction of the breast on which a medically necessary
mastectomy has been performed; surgery and reconstruction of the other breast
to produce a symmetrical appearance; prostheses and treatment of physical
complications for all stages of the mastectomy, including lymphedemas are
covered under this Plan.
If the Covered Person and the
Covered Person's attending physician determine that a shorter period of
inpatient care is appropriate, the Plan is not required to provide the minimum
hours of coverage of inpatient care stated above.
26.
Treatment
for Mental and Nervous Conditions
a.
There
is a limit of 30 days on the number of days for hospital confinement (20%
coinsurance applies).
b.
There
is a limit of 60 days on the number of days for treatment at psychiatric day
treatment facility (20% coinsurance applies).
c.
Psychiatric
counseling will be paid at 50% of usual and customary.
27.
Hospice
Care. Hospice care is an alternative to
the Hospital Confinement of a terminally ill person. Hospice Benefits are available for Covered
Persons with a life expectancy of six (6) months or less provided the attending
Physician approves the program. Failure
to pre-certify will result in no benefit allowances. Hospice care is subject to the deductibles
and co-insurance as provided in the applicable appendix for each class of City
employee, retiree, and official.
Eligible Hospice Charges are charges made by a Hospice for:
a.
room
and board;
b.
private
duty nursing care provided by or under the supervision of a Registered Nurse
(R.N.);
c.
part-time or
intermittent home health aide services which consist primarily of caring for
the patient by employees of the Hospice;
d.
social work
performed by a licensed social worker, routinely provided by the Hospice
agency;
e.
nutritional
services, including, special meals, if included in the per diem;
f.
emotional support
services routinely provided by the Hospice agency, if included in the per diem;
g.
bereavement
counseling sessions for eligible dependents covered under the Plan, if included
in the per diem; and
h.
drugs and
medication.
28.
Organ
Transplants. If covered expenses are
incurred as a result of a body organ transplant, the Plan will pay the
applicable co-insurance percentage of the Covered Expenses, as defined herein,
after the deductible is applied, subject to the lifetime maximum benefit and
the following conditions:
a.
Benefits
are available for body organ transplantation, subject to determination made on
an individualized case by case basis in order to establish medical necessity;
b.
Benefits
will be provided only when the hospital and physician customarily charge a
transplant recipient for such care and services;
c.
When
only the transplant recipient is a Covered Person, the benefits of the Plan
will be provided for the donor to the extent that such benefits are not
provided under any other form of coverage.
In no such case under the Plan will any payment of a "personal
service" fee be made to any donor.
Only the necessary hospital and physician’s medical care and services
expenses with respect to the donor will be considered for benefits;
d.
When
only the donor is a Covered Person, the donor will receive benefits for care
and services necessary to the extent such benefits are not provided under any
coverage available to the recipient.
Benefits will not be provided to any recipient who is not a Covered
Person; and
e.
When
the recipient and the donor are both Covered Persons, as provided herein,
benefits will be provided for both in accordance with their respective Covered
Expenses.
If
the recipient is the Covered Person and/or pursuant to the conditions set forth
above, the following coverage shall be provided:
a.
The
use of temporary mechanical equipment, pending the acquisition of
"matched" body organ(s);
b.
Transplant
surgery of a body organ(s) as defined herein;
c.
Multiple
transplant(s) during one (1) operative session;
d.
Replacement(s)
or subsequent transplant(s); and
e.
Follow-up
expenses for covered services, including immunosuppressant therapy.
If the donor is a Covered
Person and pursuant to the conditions set forth above, the following coverage
shall be provided:
a.
The
acquisition of a body organ(s) from the donor;
b.
The
life support of a donor pending the removal of a usable body organ(s); and
c.
Transportation
of a body organ(s). However,
transportation of a body organ(s) shall not include transportation of a living
donor and/or a donor on life support.
|
CHAPTER 6 LIMITATIONS |
Benefit limitations apply to the following conditions
and services:
Abortions will be covered when the attending physician
certifies that the mother's life would be endangered if the fetus were carried
to term.
Elective procedure performed solely to improve
appearance is not covered. Nor are the
complications that may arise from or are the direct result of such procedure
covered. A procedure utilized as
treatment of neurosis, psychoneurosis, psychopathy, psychosis and other mental,
nervous and emotional illnesses is not covered. However, expenses incurred for a cosmetic
procedure for the prompt repair or alleviation of damage caused solely by
accidental bodily injury, or congenital defects of children, or for the
correction of a congenital anomaly in a newborn child, or for the
reconstruction of the breast on which a medically necessary mastectomy has been
performed; surgery and reconstruction of the other breast to produce a
symmetrical appearance; prostheses and treatment of physical complications for
all stages of the mastectomy, including lymphedemas are covered under this
Plan.
3. Treatment in Mouth or Oral Cavity
The care and treatment of the teeth, gums or alveolar
process or for dentures, appliances or supplies used in such care and treatment
is not covered, except for charges incurred as a result of and within six
months after an accident suffered while covered hereunder for treatment of
injuries to sound, natural teeth, including replacement of such teeth, or for
setting of a jaw fractured or dislocated in such accident; provided, however,
that this exclusion shall not be applicable to services and supplies rendered
to a newborn child which are necessary for treatment or correction of a
congenital defect.
Maternity care and services rendered to a dependent
child are limited to treatment of Complications of Pregnancy.
5. Mental and Nervous Conditions
Subject to the applicable percentage payable as stated
in the Schedule of Benefits, charges for services provided by a physician
(M.D., D.O., clinical psychologist, certified social worker or licensed
professional counselor) including group therapy, and collateral visits with
members of the patients immediate family for the treatment of mental, nervous,
emotional, drug or substance abuse illness or disorders of any type are payable
as follows:
Covered physician charges provided on an inpatient
basis are covered at the applicable percentage rate stated in the Schedule of
Benefits.
No coverage is provided for physical or psychological
therapy in an in or out patient setting where art, play, music, drama, reading,
nutrition, massage, education, home economics or recreational activities is the
method of treatment.
Psychological testing, evaluation or assessment is
covered at the applicable percentage rate listed in the Schedule of Benefits.
Expenses for treatment in a psychiatric day treatment
facility for a mental, nervous or emotional disorder, if the attending
physician certifies that such treatment is in lieu of hospitalization, will be
covered as if incurred on an inpatient basis.
Any benefits so provided shall be determined as if necessary care and
treatment in a psychiatric day treatment facility were inpatient care and
treatment in a hospital; each full day or treatment in a psychiatric day
treatment facility shall be considered equal to one-half day of hospital
confinement for purposes of determining benefits and benefit maximums under the
Plan.
When private room accommodations have been used,
charges will be reimbursed at the average semi-private room rate in the
facility. If a hospital has private
rooms available only, then the maximum eligible charge will be based on the
usual and customary semi-private room charge in the community.
|
CHAPTER 7 EXCLUSIONS |
No coverage is provided under the Plan for services
and supplies:
1. For
which the patient or employee has no legal obligation to pay, or for which no
charge would be made if the employee had no health coverage.
2. Any
treatment or service rendered by a Covered Provider related by blood or
marriage.
3. Not
medically necessary for the diagnosis and treatment of an illness or injury or
which exceed the usual and customary charges.
4. For
intentionally self-inflicted injury, whether sane or insane.
5. For
diseases contracted or injuries sustained as a result of service in any branch
of the armed forces.
6. For
accidental bodily injury or illness which is covered by Workers' Compensation
or an Occupational Medical Policy, or any expenses payable under compromise
settlement agreements arising from a Workers' Compensation Claim.
7. For
marital, family, vocational and other counseling services, except for nutritional counseling for diabetics.
8. For
sex transformation surgery and all expenses in connection with such surgery.
9. For
reversal or attempted reversal of sterilization.
10. For
services, therapy and counseling for sexual dysfunction or inadequacies or for
implants or aids to sexual function except due to a disease or injury which is
otherwise covered by this plan.
11. Family
planning, infertility treatment and services including but not limited to:
artificial insemination and personal therapy for infertility, except in-vitro
coverage as allowed in the Schedule of Benefits..
12. For a
dependent child's pregnancy except for complication as defined by the Plan
arising from a dependent child's pregnancy.
13. For
smoking cessation seminars, services, devices or medications.
14. For
the surgery or treatment of obesity, morbid obesity, dietary control, or for
weight reduction.
15. For
nutritional supplements, including prescription and over the counter vitamins.
16. For
exercise equipment or exercise programs.
17. For
orthotics (arch supports, etc.) and other supportive devices for feet that are
not prescribed by a physician.
18. For
air conditioners, filters, humidifiers, dehumidifiers, and purifiers.
19. For
eye exercises, visual training (orthoptics), eyeglasses, including contact
lenses, hearing aids, or examinations for the purpose of determining visual
acuity or level of hearing.
20. For
radial keratotomy surgery and orthokeratology.
21. For
medical, dental or surgical treatment including associated diagnostic
procedures of orthognathic conditions.
22. For vocational therapy.
23. For preparing medical reports or itemized bills.
24. For travel or accommodations, whether or not recommended by a
physician.
25. For
charges associated with non-emergency hospital admissions on either a Friday or
a Saturday unless a surgical procedure is performed within 24 hours of
admission.
26. For
special education, counseling or care for learning deficiencies or behavioral
problems whether or not associated with a manifest mental disorder or other
disturbance.
27. For
care in a health resort, rest home, nursing home, residential treatment center,
or any institution primarily providing convalescent, or custodial care.
28. For custodial care.
29. For
any claims filed more than one (1) year from the month the covered service or
supply was provided.
30. For
admissions aimed at primarily overcoming the after effects of a specific
episode of drug abuse (detoxification), or to keep the patient from access to
drugs (maintenance care).
31.
For sales tax,
transportation, tariffs, immigration fees for international travel, or federal
excise taxes are not covered under this plan document.
32.
For routine
physical examinations for eligible dependents and for eligible employees not
covered in Chapter 5, paragraph 19(c).
33.
No
coverage is provided for services and supplies for routine or preventative
immunizations or vaccinations except for gamma globulin injections and child
immunizations.
34.
Coverage
for Hospice Care does not include
the following charges:
a. nutritional
services, including special means not included in the per diem;
b. emotional
support services not routinely provided by the Hospice agency and/or not
included in the per diem;
c. bereavement
counseling sessions for eligible dependents covered under the Plan not included
in the per diem;
d. funeral
arrangements;
e. pastoral
counseling; and
f. financial
or legal counseling.
35. Coverage
for Organ Transplant Surgery does
not include the following charges:
a.
Experimental treatment
for new procedures, and treatments, services or supplies which are still
considered experimental or investigational and not "generally
accepted" by the medical profession.
The judgment whether a procedure, treatment, service or supply is
experimental is based upon all of the relevant facts and circumstances,
including, but not limited to:
1.
Approval
by the U.S. Food and Drug Administration, the American Medical Association or
the appropriate Medical Specialty Society;
2.
Medical
and scientific literature;
3.
Scientifically
demonstrated health benefits;
4.
Safety
and effectiveness compared to alternatives; and
5.
Safety,
effectiveness and benefits when used outside of a research setting;
b. Any
animal organ or mechanical equipment, mechanical device, or mechanical
organ(s), except as provided herein;
c. Any
financial consideration to the donor other than for a covered service or supply
which is incurred in the performance of or in relation to transplant surgery;
and
d. Transportation
of a donor, except as provided herein.
CHAPTER 8 |
The following terms shall
mean:
|
CHAPTER 9 SUPPLEMENTAL
ACCIDENT BENEFITS |
This provision provides you and your dependents with
supplemental benefits for hospital and medical expenses resulting from an
Accidental Injury occurring while you are covered by this Plan.
Covered medical expenses directly related to the
accident and incurred within the first ninety (90) calendar days of the date of
the accident, are covered at 100% up to a maximum of $500. Deductible does not apply.
|
CHAPTER 10 |
If a Covered Person who is scheduled for inpatient
surgery in a hospital, has preoperative testing relating to this surgery
performed within ten (10) days prior to the scheduled surgery and the testing
is performed at a physician's office, diagnostic laboratory, ambulatory surgery
center or on a hospital outpatient basis, the Plan will pay pre-operative
testing at 100% provided:
1. The
charge for the surgery is a covered expense;
2. The
tests would have been covered had the patient been confined as a hospital
inpatient;
3. The
tests are not repeated when the patient is confined for the surgery;
4. The
test results are a part of the patient's medical record;
5. The
surgery is performed in a hospital;
6. The
service is identified as pre-admission or preoperative testing.
The deductible does not
apply.
|
CHAPTER 11 HOSPITAL |
Certification of
Certification of all outpatient surgery, performed in
an ambulatory surgery center or hospital outpatient facility, is required prior
to or on the day of the surgery.
Emergency outpatient surgery must be certified within forty-eight (48)
hours following the surgery.
Confirmation of the outpatient surgery will be provided by the
Utilization Review Nurse to the Covered Person, the outpatient facility and the
physician.
The Covered Person is responsible for the
certification of hospital admission and outpatient surgery.
For all hospital admissions and outpatients surgeries:
The
patient, a family member, the physician or the hospital must call the City of
For regular admissions and outpatient surgery:
Call prior to the scheduled
admission or surgery date.
For emergency admissions and outpatient surgery:
Call within forty-eight (48) hours of admission or
surgery. The number to call for
pre-certification is listed on the back of the Plan identification card
provided by the Claims
If Pre-Certification Authorization is not obtained the
maximum benefit paid for the doctor and hospital will be fifty percent (50%) of
the usual and customary charges. The fifty
percent (50%) not reimbursed by the Plan will not count toward satisfaction of
the Plan year out-of-pocket maximum.
Pursuant to State
law, the Plan will not restrict benefits for any hospital length of stay in
connection with a mastectomy or lymph node dissection of less than 48 hours
following a mastectomy or less than 24 hours following a lymph node dissection
or require that a provider obtain authorization from the Plan for prescribing a
length or stay within the above periods.
Certification is required for a length of stay, which is in excess of
the above periods.
Pursuant to State
law, the Plan will not restrict benefits for any hospital length of stay in
connection with childbirth for the mother or newborn child of less than 48
hours following an uncomplicated vaginal delivery or less than 96 hours
following an uncomplicated cesarean section, or require that a provider obtain
authorization from the Plan for prescribing a length of stay within the above
periods. Certification is required for a
length of stay, which is in excess of the above periods.
|
CHAPTER 12 PREFERRED PROVIDER NETWORK |
The City of
A current listing of the Preferred Provider Network
contracting hospitals, physicians and other providers is available in the
Employee Benefits Office. A Covered
Person may choose any health care provider.
The City reserves the right to terminate or modify the
Preferred Provider Network program, or any portion thereof, at any time. In the event the City changes the PPO
provider, the City will ensure that the employees will not be substantially
affected by a disruption of available in-network providers.
The "In-Network
Benefit" level will be paid if a covered person receives services from a
Non-Participating Provider only in the
following situations:
1. Emergency
Services. If you receive Emergency Services from a Non-Participating Provider.
(a) In
the case of a Covered Person who is past the 24th week of pregnancy,
through the delivery of the child, immediate postpartum care, and the follow-up
checkup within the first six (6) weeks of delivery;
(b) In
the case of other special circumstances, (e.g. terminally ill), for 90
days;
(c) If
a Participating Provider, including a facility or a specialist is not available
to a covered person within the service area to provide Medically Necessary
services covered by the Plan, the Claims
|
CHAPTER
13
PRESCRIPTION DRUG COVERAGE |
With
this program you can obtain prescriptions from three different sources,
depending on your needs.
The
retail network of pharmacies is available for prescriptions you need right away
or for a short time only (such as antibiotics). You can obtain up to a
30-day supply of medication from thousands of participating retail network
pharmacies nationwide. The retail network for the City of San Antonio
(COSA) includes all Walgreen’s,
Prescriptions
for maintenance medications or chronic long-term health conditions can be
ordered through the Walgreen’s mail service pharmacy. Ordering through
the mail is both a safe and easy way to receive prescriptions and save money
To
order, simply obtain a new prescription from your doctor for a 90-day
supply. Then complete a COSA mail registration and order form and send it
with your original prescription and appropriate co-insurance payment to the
When
you need prescriptions for chronic or long-term health conditions (such as but
not limited to high blood pressure, diabetes, or asthma) you can purchase a
three-month supply at any Walgreen’s retail
pharmacy. The Physician must write the prescription for an 84 – 90 day
supply, or the medication will only be filled based on a 30-day supply.
|
In-Network Benefits Only |
Generic |
Preferred Brand (Formulary) |
Non-Preferred Brand (Non-Formulary) |
|
Up to a 30-Day Supply
at Network Participating Retail Pharmacies |
0% co-insurance |
20%
co-insurance |
30%
co-insurance |
|
Three Month Supply at
any Walgreen’s Retail Pharmacies |
0%
co-insurance |
10%
co-insurance |
20%
co-insurance |
|
Three Month Supply
through the Walgreen’s Healthcare Plus Mail Order Facility |
0%
co-insurance |
10%
co-insurance |
20%
co-insurance |
Co-insurance
paid toward prescription medications under the
Coinsurance
amounts paid toward out-of-network prescriptions do not apply to the out of
pocket maximum under the group health care coverage.
The
amount a member pays for any non-covered
drug will not be included in calculating the Annual Out-of-Pocket
maximum. The member is responsible for paying 100% of the cost for any
non-covered drug and the contracted rates will not be available.
The
following items are covered under the prescription program, unless specifically
listed in the “Exclusions and Limitations” section below.
·
Federal legend
drugs (drugs that federal law prohibits dispensing without a prescription)
·
Compound
prescriptions containing at least one legend ingredient
·
Insulin
and diabetic supplies such as disposable needles and syringes, blood test
strips, and lancets and any other items
mandated under Texas Insurance Code
·
Topical acne
agents through age 23 (over age 23, prior authorization required)
·
ADHD/Narcolepsy
drugs through age 19 (over age 19, prior authorization required)
·
Oral
contraceptives for Employee or eligible spouse only
·
Only
prescriptions which are prescribed for the condition for which they are
labeled
·
Drugs
used for cosmetic purposes, including but not limited to certain anti-fungals,
hair loss treatments and those used for pigmenting/depigmenting and reducing
wrinkles
·
Diabetic alcohol
swabs
·
Fluoride
supplements
·
Nutritional/Dietary
Supplements
·
Over-the-counter
medications and other over the counter items
·
Vitamins
·
Miscellaneous
medical supplies
·
Anti-obesity
drugs
·
Smoking cessation
medications
·
Experimental or
Investigational drugs or for drugs labeled “Caution – limited by federal law to
Investigational use”
·
Immunization
agents, allergens, serums, blood or blood plasma
·
Therapeutic
devices or appliances, support garments or other non-medical appliances, except
those listed as covered drugs
·
Coverage for
prescription drug products for an amount which exceeds the supply limit (days
supply or quantity limit)
·
Prescription drug
products for any condition, injury, sickness or mental illness arising out of,
or in the course of, employment for which benefits are available under any
workers’ compensation law or other similar laws
·
Drugs purchased
during time of no coverage
·
Drugs for any
treatment or condition which is listed under expenses not covered in the
medical plan
·
Charges to
administer or inject any drug
·
Prescription
drugs that are not Medically Necessary
·
Charges for
delivering any drugs, except through the mail order benefit. Express or over
night delivery is at the member’s expense.
·
Experimental or
Investigational medications
·
Prescription
drugs purchased from an institutional pharmacy for use while the member is an
in-patient in that institution regardless of the level-of-care
·
Reimbursement for
prescription drugs purchased outside of your prescription drug benefit is
subject to review under the Direct Member Reimbursement Process and
reimbursement may be limited to contract rate less Coinsurance
·
Medication which
is to be taken by or administered to an individual, in whole or in part, while
he or she is a patient in a Hospital, extended care facility, or similar
institution which operates on its premises, or allows to be operated on its
premises, a facility for dispensing pharmaceuticals.
·
Off labeled drugs
·
Penlac
Formulary
Management
A
Formulary is a list of medications that have received FDA approval as safe and
effective, and have been chosen for inclusion on the Formulary by a committee
of Physicians and pharmacists. The Formulary drug list can help the
member and Physician to maximize benefits while minimizing overall prescription
drug costs to the member and
the Plan.
·
Therapeutically
Unique – Clinical effectiveness of the drug is superior to existing drugs with
an acceptable safety profile prompting automatic addition to the Formulary
·
Therapeutically
Equivalent – Clinical effectiveness and safety profile are comparable to
existing drugs
·
Therapeutically
Inferior – Clinical effectiveness of the drug is no greater than existing drugs
and the safety profile is less favorable prompting automatic non-Formulary
status
Products
classified by the P&T as therapeutically equivalent are further evaluated
from an economic perspective to determine which clinically appropriate drugs
are most cost-effective for clients. The P&T evaluation is based
solely on clinical criteria. It is only after the P&T clinical
assessment is made that the economics of the drug are considered.
New
FDA approved drugs that arrive on the market are automatically available to the
members and are initially placed into the third tier (non-Formulary brand)
except those excluded under the benefit plan. Based on the P&T
decision, the new drug may then be placed in the second tier (Formulary
brand). Additions to the Formulary are made on a quarterly basis
throughout the year with deletions most often occurring annually.
|
Three-Tier Co-insurace
Level |
Type of Medication |
|
Lowest Coinsurance –
Generic Tier 1 |
Medications classified as
generic by “First Data Bank” |
|
Middle Coinsurance –
Preferred Brand Tier 2 |
Preferred Brand
medications on the Formulary list with no generic available |
|
Highest Coinsurance –
Non-Preferred Brand Tier 3 |
Non-preferred brands (not
on Formulary list) or brands with a generic available as classified by “First
Data Bank” |
The
most up-to-date Formulary guide is available on the
Note:
Drugs listed on the
Certain
prescriptions require “clinical prior authorization” or approval from your Plan
before they will be covered.
A
Clinical Prior Authorization (CPA) can be initiated by you or your Physician by
calling 1-877-665-6609. To initiate a clinical prior authorization,
the caller should have available the name of the medication, Physician’s name,
telephone number (and fax number, if available), member’s ID number, and the Rx
group number (274316).
After
the initial call is placed, the Clinical Services Representative obtains
information and verifies that COSA participates in a CPA program for the
particular drug category. The Clinical Services Representative generates
a drug specific form and faxes it to the prescribing Physician. Once the
fax form is received back into the
If
the prior authorization request is APPROVED, the
If
the prior authorization request is DENIED, the
The
categories/medications that require prior authorization include, but are not
limited to:
·
Attention Deficit
Hyperactivity Disorder (ADHD)
·
Narcolepsy
·
Anabolic steroids
(all forms)
·
Anti-Fungals (i.e., Lamisil,
Sporanox)
·
Botulinum
Toxins (Botox)
·
Contraceptives
(for dependents)
·
Crinone
8%
The
criteria for the Clinical Prior Authorization programs are based on nationally
recognized guidelines; FDA approved indications and accepted standards of practice.
Each specific guideline has been reviewed and approved by
To
confirm whether you need clinical prior authorization and/or to request a CPA,
call toll free to
·
Name of your
Medication
·
Physician’s Name
·
Physician’s Phone
Number
·
Physician’s Fax
Number, if available
·
·
City of San
Antonio Group Number: 274316
Some medications are subject to age and quantity limits. Your
prescription will be denied at time of purchase if it exceeds these
limitations. Limitations are based on criteria developed with guidelines
from various national medical agencies and in conjunction with
Certain medications having an age limitation include but are not
limited to, the following health conditions:
·
Topical
Acne
·
Attention
Deficit Hyperactivity Disorder (ADHD)
·
Narcolepsy
If
your prescription is “denied” due to age limitations, but you and your
Physician believe it is Medically Necessary for you to take the medication to
treat one of the above conditions, you may request a clinical prior
authorization. Refer to the previous section titled “Prior
Authorizations” for details.
Certain medications having quantity limitations include but are not
limited to, the following health conditions and medications:
·
Impotency
·
Insomnia
·
Migraine
·
Butorphanol
·
Oral
Antiemetics
·
Diflucan
150mg
If
your prescription is “denied” due to quantity limitations, and you and your
Physician believe it is Medically Necessary for you to take a larger quantity
of the medication, you may request a clinical prior authorization. Refer
to the previous section titled “Prior Authorizations” for details.
Walgreen’s Specialty Pharmacy provides convenient, dependable
access to medications for people living with complex health conditions.
The programs and services focus on injectibles and medication therapies
involving strict compliance requirements, special storage/handling/delivery,
complex administration methods, and education /monitoring/ ongoing
support. Drugs that fall under
this category can only be dispensed at a Walgreen’s retail pharmacy or via a
home delivery method through the Walgreen’s mail service pharmacy. These
drugs are limited to a 30-day supply regardless if dispensed at a retail
pharmacy or at mail service. The retail co-insurance will apply for
specialty pharmacy medications regardless if the medication is obtained at
retail or mail.
Certain classifications of specialty pharmacy medications will
require prior authorization or approval before they will be covered by your
plan. Drugs include the following, but are not limited to:
·
Asthma
(Xolair)
·
Endometriosis
(Lupron)
·
Growth
Hormone Deficiency (Genotropin, Nutropin)
·
Osteoarthritis
( Synvisc)
·
Osteoporosis
(Forteo)
·
Parkinson’s
Disease (Apokyn)
·
Precocious
Puberty (Lupron-Ped)
·
Prostate
Cancer (Lupron, Viadur)
A member may enroll in the Specialty Pharmacy Program by
contacting the Walgreen’s
Direct Member Reimbursement
There
may be instances where you need to fill a prescription but are unable to have
your claim processed through a
You
can receive reimbursement for covered prescriptions you’ve paid for under the
Plan by following these steps:
·
Pay the
pharmacist the full amount of your prescription. Keep your receipt(s).
·
Obtain and
complete a Direct Member Reimbursement claim form available from the COSA
Employee Benefits Office.
·
Send your
completed form and itemized receipts to the COSA Benefits Office at 506
Dolorosa, Room 124;
The
Benefits Office will make a determination, and if approved, will forward your
claim(s) to
Please
note that
Drug Utilization Alerts at Time of
Purchase
Drug
Utilization Review (DUR) is an effective tool in monitoring drug use to assure
that it is appropriate, safe, and effective. At the time of purchase,
A
drug/drug interaction is a potentially harmful result that can occur when a
patient is taking two or more drugs at the same time. The possible
results of the interaction may include the increase or decrease in drug
effectiveness or an increase in the adverse effects of one or both of the
drugs.
When
these occur, the
The
submission of prescription drug claims across all contracted pharmacies is
monitored. When a pharmacy claim request is received, the
Therapeutic Duplication Monitoring
Duplicate
therapy monitoring informs the dispensing pharmacist that the newly prescribed
drug may duplicate the therapeutic effects of another drug already prescribed
for the patient. This duplication can occur even when the two drugs are
prescribed for different medical conditions.
When
a duplication of therapy is detected,
|
CHAPTER 14 EMPLOYEE SELF-AUDIT PROGRAM |
On inpatient hospital bills under $3,000.00 the Plan
will make a cash presentation to any employee who (1) detects a billing
overcharge made by a hospital as a result of an inpatient confinement to any
covered family member and (2) receives a billing adjustment and (3) the Plan
realizes a savings.
Upon discharge from the hospital, simply review the
bill. If there is any error, it may be
in one of the following area:
A charge for service the
patient did not receive.
The patient received a
service but not in the quantity indicated.
Remember, take the original bill and obtain a
corrected bill and present both to the City Claims
|
CHAPTER 15 COORDINATION OF BENEFITS ( |
The
If a Covered Person's benefits under another health
plan are reduced due to cost containment provisions, such as a second surgical
opinion, pre-certification, HMO or preferred provider arrangements, the amount
of the reduction shall not be considered as an allowable expense under this
Plan.
The benefits provided by the plans listed below are
considered in determining duplication of coverage:
1. This
Plan;
2. Any
other group insurance or prepayment plan, Health Maintenance Organizations
(HMOs); Blue Cross/Blue Shield;
3. Any
labor-management trusteed plan, union welfare plan, employer organization plan
or employee benefit organization plan;
4. Any
government plan or statute providing benefits for which
Order of Benefit Determination
Certain rules are used to determine which of the plans
will pay benefits first. This is done by
using the first of the following rules which applies:
1. A plan
with no
2. A plan
that covers a person other than as a Dependent will determine its benefits
before a plan that covers such person as a Dependent;
3. Any
labor-management trusteed plan, union welfare plan, employer organization plan
or employee benefit organization plan will determine its benefits before this
plan;
4. When a
claim is made for a dependent child who is covered by more than one (1) plan:
(a) the
benefits of the plan of the parent whose birthday falls earlier in the year
will be determined before the benefits of the plan of the parent whose birthday
falls later in that year; but
(b) if
both parents have the same birthday, the benefits of the plan which covered the
parent longer will be determined before those of the plan which covered the
other parent for a shorter period of time.
This method of determining the order of benefits will
be referred to as the "Birthday Rule." The Birthday Rule will be used to determine
the order of benefits for dependent children in all cases except those
described below.
(c) if the
other plan does not have the Birthday Rule, then the plan which covers the
child as a dependent of the male parent will pay its benefits first.
(d) if the
parents are legally separated or divorced, benefits for the child will be
determined in this order:
(i) first,
the plan of the parent with custody of the child will pay its benefits;
(ii) then,
the plan of the spouse of the parent with custody of the child will pay its
benefits; and
(iii) finally,
the plan of the parent not having custody of the child will pay its benefits.
However, if there is a court decree stating which
parent is responsible for the health care expenses of the child, then a plan
covering the child as a dependent of that parent will determine its benefits
before any other plan.
5. A plan
that covers a person as:
(a) a laid
off employee; or
(b) a
retired employee; or
(c) a
dependent of such employee;
will determine its benefits after the plan that does
not cover such person as:
(a) a laid
off employee; or
(b) a
retired employee; or
(c) a
dependent of such employee.
If one of the plans does not have this rule, and if,
as a result, the plans do not agree on the order of benefits, this rule will
not apply.
6. If one
of the above rules establishes the order of payment, a plan under which the
person has been covered for the longer time will determine its benefits before
a plan covering that person for a shorter time.
Two successive plans of the same group will be
considered one plan if the person was eligible for coverage under the new plan
within twenty-four (24) hours after the old plan terminated. A change in the amount or scope of benefits,
or a change in the carrier, or a change from one type of plan to another (e.g.,
single employer plan to multiple employer plan) will not constitute the start
of a new plan.
When the
(a) each
benefit will be reduced proportionately; and
(b) only
the reduced amount will be charged against any benefit limits under the Plan.
The
Benefits under a governmental plan will be taken into
consideration without expanding the definition of "Allowable Expense"
beyond the hospital, medical and surgical benefits as may be provided by such
governmental plan.
When a plan provides benefits in the form of services
rather than cash payments, the reasonable cash value of each service rendered
will be deemed to be both an Allowable Expense and a benefit paid.
The Plan has the right to release to, or obtain from,
any other organization or person any information necessary for the
administration of this provision and to pay to any organization any amounts
necessary to satisfy the intent of this provision.
If the Plan has paid any amounts in excess of those
necessary to satisfy the intent of this provision, it has the right to recover
such excess from the person, to or for whom, such payments were made or from an
insurance company or organization.
When you claim benefits under the Plan, you must
furnish information about other coverage, which may be involved in applying
this coordination provision.
A payment made under another Plan may include an
amount which should have been paid under this Plan. If it does, the Claims
Compliance with Cost
Containment Health Plan Provisions
If
the Covered Person's benefits are reduced by a health plan that has cost
containment provisions, such as a second surgical opinion, HMO,
pre-certification or preferred provider arrangements, the amount of such
reduction shall not be an allowable expense.
|
CHAPTER 16 SUBROGATION/THIRD PARTY CLAIMS |
PROVISION FOR SUBROGATION
A third party may be liable or legally responsible for
expenses incurred by a Covered Person for an illness or a bodily injury.
Benefits may also be payable under the Plan for such
expenses. When this happens, the Plan
may, at its option:
1. Take
over the Covered Person's right to receive payment of the benefits from the
third party. The Covered Person will:
(a) transfer
to the Plan any rights he may have to take legal action against the third party
with respect to benefits paid by the Plan which are subject to this provision;
and
(b) cooperate
fully with the Plan in asserting its right to subrogate. This means the Covered Person must supply the
Plan with all information and sign and return all documents reasonably
necessary to carry out the Plan's right to recover from the third party any
benefits paid under the Plan which are subject to this provision.
2. Recover
from the Covered Person any benefits paid under the Plan which the Covered
Person is entitled to receive from the third party. The Plan will have a first lien upon any
recovery, whether by settlement, judgment or otherwise, that the Covered Person
received from:
(a) the
third party; or
(b) the
third party's insurer or guarantor; or
(c) the
Covered Person's uninsured motorist insurance.
This lien will be for the amount of benefits paid by
the Plan for the treatment of illness or bodily injury for which the third
party is liable or legally responsible.
If the Covered Person:
(a) makes
any recovery as set forth in this provision; and
(b) fails
to reimburse the Plan fully for any benefits paid under this provision; then he
will be personally liable to the Plan to the extent of such recovery up to the
amount of the first lien. The Covered
Person must cooperate fully with the Plan in asserting its right to recover.
|
CHAPTER 17 GENERAL PROVISIONS |
Written proof of loss must be furnished to the Claims
No action at law or in equity shall be brought to
recover on the Plan unless the employee or retiree has exhausted administrative
remedies provided in the review and appeal process in Chapter 16.
The Claims
4. Conformity with Federal Statutes
Any provision of this Plan, which on its effective
date is in conflict with federal statutes, is hereby amended to conform to the
minimum requirements of such federal statutes.
The Covered Person shall have free choice of any
physician, as defined in this Plan, practicing legally. Benefits may vary depending on the
physician's participation in the City's Preferred Provider Network.
The Plan Document constitutes the entire contract of
coverage between the Plan Sponsor and the Covered Person.
All changes to the Plan shall become effective as of a
date established by the Plan
No increase or reduction in benefits shall be
effective with respect to covered expenses incurred prior to the date a change
was adopted by the Plan Sponsor, regardless of the effective date of the
change; and
Any written notice required under the Plan shall be
deemed received by a Covered Person sent by regular mail, postage prepaid, to
the last address of the Covered Person on the records of the Employer.
Clerical errors made on the records of the Plan
Sponsor, Plan
The Plan is not in lieu of and does not affect any
requirement for coverage by Workers' Compensation insurance.
Statements made by or on behalf of any person to
obtain coverage under the Plan shall be deemed representations and not
warranties.
(b)
Misstatements on
Enrollment or Claim Form
If any relevant material fact has been misstated by or
on behalf of any person to obtain coverage under the Plan, the true fact shall
be used to determine whether coverage is in force and the extent, if any, of
coverage. Upon the discovery of any
misstatement, an equitable adjustment of any benefit payments will be made.
(c) Time Limit for Misstatement
No misstatement made to obtain coverage under the Plan
will be used to void the coverage of any person which has been in force for a
period of two (2) years or to deny a claim for a loss incurred or disability
commencing after the expiration of the two (2) year period. The provisions of this paragraph shall not
apply if any misstatement has been made fraudulently.
No statement made by or on behalf of any person will
be used in any context unless a copy of the written instrument containing the
statement has been or is furnished to any person or to any person claiming a
right to receive benefits with respect to the person.
Identification card(s) will be issued, which indicate
coverage by the City of
13. Protection Against Creditors
No benefit payment under this Plan shall be subject in
any way to alienation, sale, transfer, pledge, attachment, garnishment,
execution or encumbrance of any kind, and any attempt to accomplish same shall
be void. If the City finds that such an
attempt has been made with respect to any payment due or to become due to any
covered person, the City in its sole discretion may terminate the interest of
such covered person or former covered person in such payment. And in such case the City shall apply the
amount of such payment to or for the benefit of such covered person or former
covered person, his/her spouse, parent, adult child, guardian or a minor child,
brother or sister, or other relative of a dependent of such covered person or
former covered person, as the City may determine, and any such application
shall be a complete discharge of all liability with respect to such benefit
payment. However, at the discretion of
the City, benefit payments may be assigned to health care providers.
|
CHAPTER 18 CLAIM FILING |
1. Claim
Filing
(a) Medical
claims (doctor's visits, prescription drugs, exams, hospital, etc.) shall be filed
on a claim form available from the Employee Benefits Office or Claims
(b) The
claim form shall include medical bills (itemized only) and the explanation of
benefit statement (EOB) from other health insurance policies, if any. The bill should contain the following:
(i) the
official letterhead of the hospital, doctor, clinic, pharmacy, etc.;
(ii) type
of service;
(iii) date
of service received;
(iv) amount
charged;
(v) name
of patient; and
(vi) diagnosis.
(c) Only
one (1) detailed claim form must be completed per person per year, even for
different claims and/or diagnoses. Any
additional claims throughout the year may be filed on a short claim form
available through the Employee Benefits Office.
If a claim is for an accidental injury, then a detailed claim form must
be completed for each accident occurrence.
All items on the front of the detailed claim form must be
completed. It is not necessary to complete
the back of the form. The blocked
section regarding secondary insurance coverage must be completed.
(d) The
original claim form with the attached bills shall be mailed to the City's
claims administrator.
2. Limitation
of Liability
The Plan Sponsor shall not be obligated to pay any
benefits under the Plan for any claim that is not timely filed.
3.
Time of Claims
Processing
Benefits for
incurred medical expenses which are covered under the Plan will be processed
immediately upon receipt of proper written proof of loss by the Claims
Periodic Payment: Payment of accrued periodic payments
for continuing losses which are covered under the Plan will be made immediately
upon receipt of proper proof of loss by the Claims
4. Payment
of Benefits
All benefits under the Plan are payable to the Covered
Employee whose illness or injury or whose covered dependent's illness or injury
is the basis of a claim.
In the event of the death or incapacity of a Covered
Employee and in the absence of written evidence to the Plan of the
qualification of a guardian for his estate, the Plan may, in its sole
discretion, make any and all payments to the individual or institution which,
in the opinion of the Plan
Benefits for medical expenses covered under the Plan
may be assigned by a Covered Employee to the person or institution rendering
the services for which the expenses were incurred. No assignment will bind the Plan Sponsor
unless it is in writing and unless it has been received by the Claims
5. Discharge
of Liability
Any payment made in accordance with the provisions of
this section will fully discharge the liability of the Plan Sponsor to the
extent of payment.
6. Recovery
of Payments
If the following circumstances apply, the Plan Sponsor
reserves the right to deduct from any benefits properly payable under the Plan
or recover from the Covered Employee or assignee who received the payment:
(a) the
amount of any payment which has been made in error; or
(b) pursuant
to a misstatement contained in a proof of loss; or
(c) pursuant
to a misstatement made to obtain coverage under the Plan within two (2) years
after the date coverage commences.
|
CHAPTER 19 REVIEW & APPEAL PROCESS |
Review Process for Disputed Claims
The review process for disputed claims shall include
the following:
1. The
Employee or Retiree may request a review by writing the Claims
2. This
request must be made within ninety (90) calendar days after the receipt of the
original explanation of benefits.
3. Upon
receipt of the request, the claim will be reviewed by the Claims
4. The
Claims
5. Either
the Employee/Retiree or the Claims
6. A
review may be made within fifteen (15) calendar days by a Claims Review
Committee upon the request of the Plan
|
CHAPTER 20 APPENDICES-SUMMARY OF ACCIDENT |
APPENDIX A- Specific
Provisions Applicable to Police Active Employees effective
Maximum per individual per calendar year .......................... $250 in
network/$500 out of network
Maximum per family per calendar year ............................ $500 in
network/$1,000 out of network
Coinsurance ...................................................................... 80%
in network/60% out of network
Out-of-pocket maximum (does not include deductible)
Maximum per individual per calendar year ................................... $600
in-network/$1,200 out-of-network
Maximum per family per calendar year ..................................................... $1,500
in-network cumulative
Maximum per family per calendar year……………………...$3,000
out-of-network cumulative
Supplemental accident benefits ........................................................................................ 100%
up to $500. No
deductible
All age appropriate immunizations recommended by a
physician for
(other services provided at the same time as the
immunizations, including, but not limited to, office
visit charges will be subject to the deductibles and
co-insurance) in network.................................................................................................. 100%
out of network................................................................................................................... 60%
Lifetime maximum per individual (medical)............................................................................. $1,500,000
2. Prescription Benefits
Prescription Drug Benefits effective
In Network Pharmacy* using prescription drug program:
Participant Co-Insurance
Retail
30 day supply (Full Walgreens Network)
Generic $0
Brand
(preferred) 20%
Brand
(non-preferred) 30%
Retail
90 day supply (Advantage 90- Walgreens location only)
Generic $0
Brand
(preferred) 10%
Brand
(non-preferred) 20%
Mail
Order 90 day supply
Generic $0
Brand
(preferred) 10%
Brand
(non-preferred) 20%
Out of Network Pharmacy or without utilization of
prescription drug program
Participant Co-Insurance
Retail
30 day supply
Generic 20% after
CitiMed deductible**
Brand
(preferred) 40% after
CitiMed deductible**
Brand
(non-preferred) 50% after
CitiMed deductible**
Retail
90 day supply
Generic 20% after
CitiMed deductible**
Brand
(preferred) 40% after
CitiMed deductible**
Brand
(non-preferred) 50% after
CitiMed deductible**
Mail
Order 90-day supply
Generic 20% after
CitiMed deductible**
Brand
(preferred) 40% after
CitiMed deductible**
Brand
(non-preferred) 50% after
CitiMed deductible**
*Out of Area Benefit – Participants who live over 30
miles from a participating network pharmacy may submit Out of Network Pharmacy
charges for reimbursement at a plan coverage and benefit level.
**This deductible is not an additional deductible. Out
of network co-insurance does not apply to annual out of pocket.
In Network
Pharmacy separate out of pocket maximum per calendar year…$150 individual/$300
family, cumulative
The following provisions apply to the Police Active
Employees as stated herein:
1.
Review and Appeal
Process.
The review and appeal process in Chapter 17 shall not be construed
to supersede, and is in addition to, any grievance procedure set forth in the
Collective Bargaining Agreements between the City and the San Antonio Police
Officers' Association, in regard to Police Officers and Local 624 of the
International Association of Fire Fighters, in regard to Fire Fighters.
2.
Amendment
or Termination of Plan
The City may amend the provisions of this Plan, from time to time,
as the need arises in order to assure the fair and equitable administration of
Benefits to be provided eligible Employees in compliance with the terms of the
respective Collective Bargaining Agreements.
The City may terminate the provisions of the Plan only during
negotiations over the terms to be contained in Collective Bargaining Agreements
with Local 624 of the International Association of Firefighters in regard to
Fire Fighters and the San Antonio Police Officers' Association, in regard to
Police Officers, for any period covered by a Collective Bargaining Agreement.
Nothing in the Document or any related Bargaining Agreements
between the City and the Bargaining Agents of the Police Officers is intended
to imply vesting or irrevocable Benefits for current, active Police Officers
beyond the provisions of the the 2006-2009 Collective Bargaining Agreement
between the City and the San Antonio Police Officers’ Association, in regard to
Police Officers.
Termination, continuance, alteration, or any related activity on
the Plan will be determined by the provisions of future Collective Bargaining
Agreements between the City and the San Antonio Police Officers' Association,
in regard to Police Officers.
3.
Covered
Medical Expenses
Chapter 5, Covered Medical Expenses, item 19,
Preventive services effective
(a) One routine pap smear (doctor's procedure charge, lab
expenses and office visit) per calendar year for female covered persons; will
be covered at 100%, deductible waived;
(b) One routine mammogram per calendar year for female
covered persons age thirty-five (35) and over will be covered at 100%,
deductible waived.
(c) One (1) routine physical examination per calendar year
for an eligible employee and covered dependent over the age of 2 is
covered.
1) The Plan will cover 100% of the cost of the
exam by a licensed Physician to a maximum benefit of $300 per calendar year per
Employee and $300 per year per covered dependent.
2) If performed at the Occupational Health
Clinic, at 401 West Commerce, the Plan will cover a complete blood count,
cholesterol and glucose screening; blood pressure check; height and weight
evaluation; and a health assessment questionnaire at 100%.
(d) A physical examination for the detection
of prostate cancer and prostate-specific Antigen test used for the detection of
prostate cancer will be covered at 100%, deductible waived for each male
enrolled in the Plan who is;
1) at least 50 years of age and asymptomatic;
or
2) at least 40 years of age with a family
history of prostate cancer or another prostate cancer risk factor.
(e) Well baby and children’s routine services
for covered dependents Birth to age two (2) will be covered at 100% deductible
waived.
Chapter 5, Item 20 Immunizations effective
(a) Expenses
for all age appropriate immunizations recommended by a physician are covered at
100%, deductible waived, through an in-network provider and subject to
deductible and 60% co-insurance for out of network providers. Other services provided at the same time as the
immunizations, including, but not limited to, office visit charges, shall be
subject to the deductible and coinsurance and/or Child Wellness benefits as
appropriate.
(b) Synagis
(Palivizumab) administration for the prevention of respiratory syncytial virus
(RSV) among high risk infants meeting prescribing criteria set forth by
American Academy of Pediatrics (
4.
Limitations
The following limitations are included in Chapter 6, Limitations,
for the Uniformed Police Officers effective
Chiropractic Care Services are limited to in-network coverage as
listed in the Schedule of Benefits. Out
of network chiropractic services are not covered under this plan.
Invitro Fertilization is limited to six (6) attempts per lifetime per covered female
effective
APPENDIX B Specific
Provisions Applicable to Fire Active Employees effective
Maximum per individual per
calendar year .......................... $250
in-network/$500 out-of-network
Maximum per family per
calendar year ........................... $500
in-network/ $1,000 out-of-network
Coinsurance ..................................................................... 80%
in-network/ 60% out-of-network
Out-of-pocket maximum (does
not include deductible)
Maximum per individual per
calendar year ................................... $500
in-network/$1,000 out-of-network
Maximum per family per
calendar year ..................................................... $1,500
in-network cumulative
Maximum per family per
calendar year……………………...$3,000 out-of-network cumulative
Supplemental accident
benefits ........................................................................................ 100%
up to $500. No deductible
Immunizations for Covered
Dependents from
birth through the date the
child is six (6) years of age
(other services provided at
the same time as the
immunizations, including,
but not limited to, office
visit charges will be
subject to the deductibles and
co-insurance)
…………………………………………….100% in-network/60% out-of-network
Lifetime maximum per
individual (medical)…………………………………………..……..
$1,500,000
2. Prescription
Benefits
Prescription Drug Benefits
effective
In Network Pharmacy* using
prescription drug program:
Participant Co-Insurance
Retail 30 day supply (Full Walgreens Network)
Generic $0
Brand (preferred) 20%
Brand (non-preferred) 30%
Retail 90 day supply (Advantage 90- Walgreens location
only)
Generic $0
Brand (preferred) 10%
Brand (non-preferred) 20%
Mail Order 90 day supply
Generic $0
Brand (preferred) 10%
Brand (non-preferred) 20%
Out-of-Network Pharmacy or
without utilization of prescription drug program
Participant Co-Insurance
Retail 30 day supply
Generic 20%
after CitiMed deductible**
Brand (preferred) 40% after CitiMed deductible**
Brand (non-preferred) 50% after CitiMed deductible**
Retail 90 day supply
Generic 20%
after CitiMed deductible**
Brand (preferred) 40% after CitiMed deductible**
Brand (non-preferred) 50% after CitiMed deductible**
Mail Order 90-day supply
Generic 20%
after CitiMed deductible**
Brand (preferred) 40% after CitiMed deductible**
Brand (non-preferred) 50% after CitiMed deductible**
*Out of Area Benefit –
Participants who live over 30 miles from a participating network pharmacy may
submit Out of Network Pharmacy charges for reimbursement at a plan coverage and
benefit level.
**This deductible is not an
additional deductible. Out of network co-insurance does not apply to annual
out-of-pocket.
In Network Annual
Prescription Co-insurance out of pocket maximum …$150 individual/$300 family,
cumulative
The following provisions
apply to the Fire and Police Active Employees as stated herein:
1. Review and Appeal
Process.
The review and appeal process in Chapter
17 shall not be construed to supersede, and is in addition to, any grievance
procedure set forth in the Collective Bargaining Agreements between the City
and the San Antonio Police Officers' Association, in regard to Police Officers
and Local 624 of the International Association of Fire Fighters, in regard to
Fire Fighters.
2. Amendment or Termination of Plan
The City may amend the provisions of
this Plan, from time to time, as the need arises in order to assure the fair
and equitable administration of Benefits to be provided eligible Employees in
compliance with the terms of the respective Collective Bargaining Agreements.
The City may terminate the provisions of
the Plan only during negotiations over the terms to be contained in Collective
Bargaining Agreements with Local 624 of the International Association of
Firefighters in regard to Fire Fighters and the San Antonio Police Officers'
Association, in regard to Police Officers, for any period covered by a
Collective Bargaining Agreement.
Nothing in the Document or any related
Bargaining Agreements between the City and the Bargaining Agents of the Fire
Fighters and Police Officers is intended to imply vesting or irrevocable
Benefits for current, active Fire
Fighters and Police Officers beyond the provisions of the 2005-2009 Collective
Bargaining Agreement between the City and Local 624 of the International
Association of Firefighters, in regard to Fire Fighters and the provisions of
the 2006-2009 Collective Bargaining Agreement between the City and the San
Antonio Police Officers’ Association, in regard to Police Officers.
Termination, continuance, alteration, or
any related activity on the Plan will be determined by the provisions of future
Collective Bargaining Agreements between the City and the San Antonio Police
Officers' Association, in regard to Police Officers and Local 624 of the
International Association of Firefighters, in regard to Fire Fighters.
3. Covered Medical Expenses
Chapter 5, Covered Medical
Expenses, item 19, Preventive services effective
(f) One routine pap smear
(doctor's procedure charge, lab expenses and office visit) per calendar year
for female covered persons; will be covered at 100%, deductible waived;
(g) One routine mammogram per
calendar year for female covered persons age thirty-five (35) and over will be
covered at 100%, deductible waived.
(h) One (1) routine physical
examination per calendar year for an eligible employee and covered dependent
over the age of 2 is covered.
(1. The Plan will cover 100% of
the cost of the exam by a licensed Physician to a maximum benefit of $300 per
calendar year per Employee and $300 per year per covered dependent.
(2. If performed at the
Occupational Health Clinic, at 401 West Commerce, the Plan will cover a
complete blood count, cholesterol and glucose screening; blood pressure check;
height and weight evaluation; and a health assessment questionnaire at 100%.
(i)
A physical examination for the detection of prostate cancer
and prostate-specific Antigen test used for the detection of prostate cancer
will be covered at 100%, deductible waived for each male enrolled in the Plan
who is;
1)
at least 50 years of age and asymptomatic; or
2) at least 40
years of age with a family history of prostate cancer or another prostate
cancer risk factor.
(j) Well baby and
children’s routine services for covered dependents Birth to age two (2) will be
covered at 100% deductible waived.
4. Limitations
The following limitations are included
in Chapter 6, Limitations, for the Uniformed Fire Fighters effective
Chiropractic Care Services are subject
to the Schedule of Benefits deductibles, coinsurance and out of pocket maximums
for in-network or out-of-network providers.
Invitro
Fertilization coverage is subject to the Schedule of Benefits deductibles,
coinsurance and out of pocket maximums for in-network and out-of-network
providers.
City of
for the
City of
Health Benefit Program
Introduction...................................................................................................................................... III
General Information.......................................................................................................................... IV
Plan and Claims Administration ......................................................................................................... V
CHAPTER 1 GENERAL
PLAN COVERAGE FOR ELIGIBLE PARTICIPANTS.............. 1
CHAPTER 2 COBRA........................................................................................................ 4
CHAPTER 3 HIPAA PRIVACY........................................................................................ 7
CHAPTER 4 DEFINITIONS............................................................................................ 10
CHAPTER 5 COVERED
MEDICAL EXPENSES............................................................. 20
CHAPTER 6 LIMITATIONS............................................................................................ 26
CHAPTER 7 EXCLUSIONS............................................................................................. 28
CHAPTER 8
CHAPTER 9 SUPPLEMENTAL
ACCIDENT BENEFITS................................................ 32
CHAPTER 10
CHAPTER 11 HOSPITAL
CHAPTER 12 PREFERRED PROVIDER
NETWORK....................................................... 36
CHAPTER 13 EMPLOYEE
SELF AUDIT PROGRAM...................................................... 37
CHAPTER 14 COORDINATION
OF BENEFITS............................................................... 38
CHAPTER 15 SUBROGATION/THIRD
PARTY CLAIMS................................................ 42
CHAPTER 16 GENERAL
PROVISIONS........................................................................... 43
CHAPTER 17 CLAIM
FILING
CHAPTER 18 REVIEW & APPEAL PROCESS............................................................... 48
CHAPTER 19 APPENDICES............................................................................................. 49
ATTACHMENT A COMMITTEE
SUBSTITUTE HOUSE BILL (
ATTACHMENT B RUDD
& WISDOM Revised Actuarial Analysis
Specific Provisions Applicable to Fire and Police
Prefund Retirees (Fire and Police Retirees who retired prior to
|
FORMER MASTER CONTRACT |
The purpose of the Employee Health Benefit Program is
to provide the City of
This Master Contract defines and provides for coverage
and administration for the benefits common to uniform City employees, and
retirees. The variations in coverage
applicable to such classes are set forth in specific appendices to this Master
Contract, including but not limited to Firefighters and Police Officers. The coverage provisions applicable to a
covered person shall collectively be referred to as the Plan, and the
provisions of this Master Contract and the applicable appendices for any
covered person shall be referred to as the Plan Document.
This Plan Document does not provide for any premium
payment or contributions to the cost of coverage. The obligation and amount of such payments
are separately determined from the Ordinances of the City Council or any
applicable Collective Bargaining Agreements.
This plan is open to uniform City employees and retired uniform City
employees.
The benefits provided and defined in this Master
Contract are self-funded by the City of San Antonio at the time this document
was drafted, but the City of San Antonio is entitled to reinsure any portion of
its obligations hereunder, and additionally may contract for any carrier acceptable
to the City Council to assume and administer coverage and benefits under this
document.
ANY BENEFITS UNDER THE
The City of
PLAN YEAR: January
1 through December 31.
PLAN SPONSOR: City of
PLAN ADMINISTRATOR: Employee
Benefits
City of
Human Resources Department
CLAIMS ADMINISTRATOR:
Fiserv
PREFERRED PROVIDER
ORGANIZATION (PPO):
NETWORK:
Or
EDI to: TTCEC
www.texastruechoice.com
PRESCRIPTION NETWORK: Walgreens
Health Initiatives
Customer
Service
RX Group#
514595
www.walgreenshealth.com
EFFECTIVE/TERMINATION
DATES: The effective date of
this plan for uniform prefund retirees is
PLAN
Administration and payment of claims under the Plan
Documents shall be carried out by the Claims
The Plan
The Plan
(a) To
make and enforce reasonable rules and regulations as the Plan
(b) To
interpret the contract, including, but not limited to, all questions of
coverage and eligibility. The Plan
(c) To
coordinate with and supervise the Claims
CHAPTER 1 GENERAL
PLAN COVERAGE FOR ELIGIBLE PARTICIPANTS |
ELIGIBILITY REQUIREMENTS
Eligible Employee
Full-time City employees (authorized full-time
equivalent) are eligible to participate in the Plan on the date their
employment begins. Coverage begins on
the date of hire, or upon taking office and performing work for the City of
A new employee who is not actively at work for any
reason other than due to medical disability on his scheduled effective date of
coverage will not become covered under the Plan until such time as the employee
returns to active employment.
Eligible Dependent
An Eligible Dependent is:
(1) The
Eligible Employee's spouse. A spouse
that is legally separated under a court decree under the laws of another state
shall not be an eligible dependent,
(2) All
natural children including legally adopted, under legal guardianship of the
Covered Employee and who have not yet reached their twentieth birthday,
provided the children have never been married and are principally dependent
upon the Eligible Employee, as directed by court order, for support and
maintenance. Foster children are not
Eligible Dependents under this Plan, unless there has been an application for
adoption accepted by the Texas Department of Human Services. Stepchildren are Eligible Dependents during
the marriage between the Eligible Employee and the natural parent of the child,
so long as (a) they permanently reside in the employee's household, and (b) are
principally dependent on the employee.
In addition to the above, children will be considered
as Eligible Dependents from age twenty (20) through age twenty-three (23), if
they are full-time students, have never been married, and are principally
dependent upon the Eligible Employee for support and maintenance.
The term "Eligible Dependent" shall not
include anyone who is covered as an Eligible Employee. An Eligible Dependent shall not be entitled
to any additional benefits or coverage by virtue of the fact that both parents,
step parents or guardians are employed by the City.
Eligible Retiree
Any eligible City employee that retires under the
rules of the Fire and Police Pension Fund will be eligible for the City's
retiree health program.
Retired Employee's Dependents
If you retire and are eligible to receive retirement benefits
you may continue your dependents' coverage, subject to the payment of any
applicable premiums without lapse. Only
Dependents who participate in the Plan at the time of the eligible employee's
retirement are eligible. Eligible
dependent children shall not include anyone who is covered as an eligible
employee under the Plan.
Incapacitated Dependent
An Eligible Dependent child who is physically or
mentally incapable of self-support upon attaining the age of twenty (20) years,
shall continue to be an Eligible Dependent while remaining incapacitated,
unmarried and continuously covered under the Plan. An eligible incapacitated dependent must be
solely dependent on the employee, and must be incapacitated by a disability
that arose while such dependent was a covered dependent. To continue eligibility under this provision,
proof of incapacity must be submitted by the employee at least thirty-one (31)
days prior to such child's attainment of age twenty (20).
Effective Date of Coverage
Coverage does not become effective until the Eligible
Employee completes the City's enrollment document.
Newborn infants will be covered from the date of birth
as long as the employee is covered under this plan and coverage for the newborn
child is requested within 31 days of the child's date of birth. If coverage of a newborn is not requested
within 31 days of the child's date of birth, then coverage cannot become
effective until the next re-enrollment period.
Eligible Dependents who are enrolled after the
effective date of this Plan will become covered on the date such dependent is
acquired, provided that the covered Employee enrolls such dependent within 31
days of the date the dependent is acquired.
If coverage of a dependent is not requested within 31 days of the date
the dependent was acquired, the coverage cannot become effective until the next
re-enrollment period.
Change of Family Status
If
there is a legal change in family status, the employee has thirty-one (31)
calendar days to notify the Employee Benefits Office in writing. The notice may be given by personally
appearing in the Benefits Office and completing a change of dependent coverage
form.
If
there is no change in family status or if notice is not given for additional
coverage within thirty-one (31) days after the legal change in status, no
change can become effective until the next re-enrollment period, which shall be
not less than thirty –one (31) days, occurring during the months of October or
November, as the Plan
A
legal change in family status includes:
divorce; marriage; birth or adoption of a child, including a child
living with the adopting parents during the period of probation; change in
employment status for the employee's spouse; or ineligibility of a child due to
age, or change in student status.
Termination of Coverage for
Individuals
The coverage of any Covered
Person under the Plan shall terminate on the earliest of the following dates:
(1) The date of termination of the Plan;
The date employment terminates;
(2) The date all coverage or certain benefits are terminated in a
particular class by modification of the Plan; and
(3) The date an active Eligible Employee is
covered under a qualified Health Maintenance Organization (HMO) or any other
available alternative health care delivery system for the employee or
dependents of the employee.
Termination of Coverage for
Dependents
Coverage with respect to the
Covered Person's dependents shall terminate under the Plan at the earliest time
specified below:
(1) Upon termination of employment for the covered employee;
(2) On the date dependents cease to be eligible as defined in the
Plan.
Termination of Coverage for
Failure to Pay Premium
Coverage
with respect to any Covered person for which a premium or contribution is
required shall terminate 31 days after the due date for such premium, or as
soon thereafter as otherwise allowed by law.
Documentation
The
Plan
|
CHAPTER 2 COBRA
PROVISIONS |
On
“Qualified Beneficiary" means:
a.
you,
as a Covered Employee, for termination or reduced hours;
b.
your spouse or
your dependent child if he/she was a dependent under the Plan on the day before your Qualifying Event occurred; or
c.
a child who is
born to a Covered Employee during a period of COBRA continuation coverage.
"Qualifying Event for
a Covered Employee" means a loss of coverage due to:
a.
termination
of employment for any reason other than gross misconduct; or
b.
reduction
in hours of employment.
"Qualifying Event for
a Covered Dependent" means a loss of coverage due to:
a.
a Covered
Employee's termination of employment for any reason other than a gross
misconduct or reduction in hours of employment;
b.
a Covered
Employee's death; a spouse's divorce or legal separation from a Covered
Employee;
c.
a Covered
Employee's entitlement to Medicare; or
d.
a dependent
child's loss of dependent status under the Plan.
"Timely contribution
payment” means contribution payment must be made within 30 days of the due
date or within such longer period as applies to or under the Plan.
Continuation of Health
Coverage. Continuation of health coverage shall be
available to you and/or your Covered Dependents upon the occurrence of a
Qualifying Event. To continue health
coverage, the Plan
a. the Employer, within 30 days of such
event, if the Qualifying Event is:
1.
for a
Covered Dependent, the Covered Employee's death;
2.
the
Covered Employee's termination other than for gross misconduct or reduction in
hours;
3.
for a
Covered Dependent, the Covered Employee's entitlement to Medicare.
b. you or a Qualified Beneficiary, within
60 days of such event, if the Qualifying Event is:
1. for a spouse, divorce, or legal separation from a Covered
Employee; or
2. for a dependent child, loss of dependent status under the
Plan.
The Plan
Upon termination of employment or reduction in hours, to continue health
coverage for 29 months, a Qualified Beneficiary who is determined under Title
II or Title XVI of the Social Security Act to be disabled on such date or at
any time during the first 60 days of COBRA continuation coverage, must notify
the Plan
Qualified Beneficiaries who are disabled under Title II or Title
XVI of the Social Security Act must notify the Plan
A Qualified Beneficiary must elect Continuation of Health Coverage
within 60 days from the later of the date of the Qualifying Event or the date
notice was sent by the Plan
A newborn child of a Qualified Beneficiary or a child placed with
a Qualified Beneficiary for adoption may be added according to the enrollment
requirements for dependent coverage under the Eligibility Requirements of the
Plan.
Any election by you or your spouse shall be deemed to be an
election by any other Qualified Beneficiary, though each Qualified Beneficiary
is entitled to an individual election of continuation coverage.
Upon election to continue health coverage, a Qualified Beneficiary
must, within 45 days of the date of such election, pay all required
contribution to date to the Plan
A Qualified Beneficiary will be notified by the Plan
Termination of Coverage.
Coverage will end upon the earliest of the following:
a. termination
or reduction of hours;
1. 18 months from the date of the
Qualifying Event; or
2. 29 months from the date of the
Qualifying Event if the Qualified Beneficiary is determined under Title II or
Title XVI of the Social Security Act to be disabled on such date or at any time
during the first 60 days of COBRA continuation coverage and provides notice as
required by law (including, COBRA continuation coverage of non-disabled family
members of the Qualified Beneficiary entitled to the disability extension).
b. the
day, after the 18 month continuation period, which begins more than 30 days
from the date of a final determination under Title II or Title XVI of the
Social Security Act that a Qualified Beneficiary, entitled to 29 months, is no
longer disabled (including COBRA continuation coverage of non-disabled family
members of the Qualified Beneficiary entitled to the disability extension who
is no longer disabled).
c.
for a Covered
Dependent, 36 months from the date of the Qualifying Event if the Qualifying
Event is:
1. the
Covered Employee's death;
2. the
Covered Employee's entitlement to Medicare;
3. a spouse's divorce or legal separation from a Covered
Employee; or
4. a
dependent child's loss of dependent status under the Plan.
d.
if any of the
Qualifying Events listed in (c) occurs during the 18-month period after the
date of the initial Qualifying Event listed in (a), coverage terminates 36
months after the date of the Qualifying Event listed in 1.
e.
the
date on which the Employer ceases to provide any group health plan to any
employee;
f.
the date on which
a Qualified Beneficiary fails to make timely payment of the required
contribution;
g.
the date on which
a Qualified Beneficiary first becomes (after the date of the election) covered
under any other group health plan (as an employee or otherwise) which does not
contain any exclusion or limitation with respect to any pre-existing condition
of such Qualified Beneficiary;
h.
the
first day of the month in which a Qualified Beneficiary becomes entitled to
Medicare; or
i. the date this Plan terminates.
Continuation of health coverage under this provision shall not
duplicate health care coverage continued under any state or federal law.
_____________________________________________________________________
Any questions about COBRA should be directed to the
City's Employee Benefits Office, 506 Dolorosa ,
_____________________________________________________________________
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CHAPTER 3 HIPAA
PRIVACY |
A. Use and
Disclosure of Protected Health Information (
The Plan will use protected health information (
Payment includes activities undertaken by the Plan to
determine or fulfill its responsibility for coverage and provision of plan
benefits that relate to an individual to whom health care is provided. These
activities include, but are not limited to, the following:
·
determination of
eligibility, coverage and cost sharing amounts (for example, cost of a benefit,
plan maximums and co-payments as determined for an individual’s claim);
·
coordination of
benefits;
·
adjudication of
health benefit claims (including appeals and other payment disputes);
·
billing,
collection activities and related health care data processing;
·
claims management
and related health care data processing, including auditing payments,
investigating and resolving payment disputes and responding to participant
inquiries about payments;
·
obtaining payment
under a contract for reinsurance (including stop-loss and excess of loss
insurance);
·
medical necessity
reviews or review of appropriateness of care or justification of charges;
·
utilization
review, including pre-certification, preauthorization, concurrent review and
retrospective review;
·
disclosure to
consumer reporting agencies related to the collection of premiums or
reimbursement (the following
·
reimbursement to
the plan.
Health Care
Operations include, but are not
limited to, the following activities:
·
quality
assessment;
·
population-based
activities relating to improving health or reducing health care costs, protocol
development, case management and care coordination, disease management,
contacting health care providers and patients with information about treatment
alternatives and related functions;
·
rating provider
and plan performance, including accreditation, certification, licensing or
credentialing activities;
·
underwriting,
premium rating and other activities relating to the creation, renewal of
replacement of a contract of health insurance or health benefits, and ceding,
securing or placing a contract for reinsurance of risk relating to health care
claims (including stop-loss insurance and excess of loss insurance);
·
conducting or
arranging for medical review, legal services and auditing functions, including
fraud and abuse detection and compliance programs;
·
business planning
and development, such as conducting cost-management and planning-related
analyses related to managing and operating the Plan, including formulary
development and administration, development or improvement of payment methods
or coverage policies;
·
business
management and general administrative activities of the Plan, including, but
not limited to:
(a) management activities relating to the implementation
of and compliance with HIPAA’s administrative simplification requirements, or
(b) customer service, including the provision of data
analysis for management; and
·
resolution of
internal grievances.
B. The Plan Will Use and Disclose
C. For
Purposes of This Section, the City of San Antonio is the Plan Sponsor
The Plan will disclose
D. With
Respect to
The
Plan Sponsor agrees to:
·
not use or
further disclose
·
ensure that any
agents, including a subcontractor, to whom the Plan Sponsor provides
·
not use or
disclose
·
not use or
disclose
·
report to the
Plan any
·
make
·
make
·
make available
the information required to provide an accounting of disclosures;
·
make internal
practices, books and records relating to the use and disclosure of
·
if feasible,
return or destroy all
E. Adequate
Separation Between the Plan and the Plan Sponsor Must Be Maintained
In accordance with HIPAA, only the following employees
may be given access to
·
the staff of the
Employee Benefits Division of the Human Resources Department
·
the staff of the
Finance Department assigned to the Self Insurance Fund and
·
the staff of
Legal Department assigned to the Employee Benefits Division.
If the persons described in section E do not comply
with this plan document, the Plan Sponsor shall provide a mechanism for
resolving issues of noncompliance, including disciplinary sanctions.
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CHAPTER 4 DEFINITIONS |
"ACCIDENTAL
INJURY" means a condition caused by an accidental means which results
in traumatic damage to the Covered Person's body from an external force that is
unexpected at the time, but which occurrence was definite as to time and
place.
"ACTIVELY
AT
"ALLOWABLE
EXPENSE" relates to coordination of benefits, under Chapter 13 of this
Plan Document. Allowable expenses shall
mean any necessary usual, customary and reasonable expenses incurred while
eligible for benefits under the Plan, part or all of which would be covered
under any of the plans, but not including any expenses contained in the
Exclusions chapter.
"AMBULATORY
SURGICAL CENTER" means a specialized facility which is established,
equipped, operated and staffed primarily for the purpose of performing surgical
procedures on an outpatient basis and which fully meets one of the following
two tests:
(a) It is
licensed as an ambulatory surgical facility in the state in which it is
located; or
(b) Where
licensing is not required:
1. it is
operated under the full-time supervision of a physician;
2. it
permits surgical procedures to be performed only by physicians who are
privileged to perform the procedure in at least one local hospital;
3. it
requires in all cases, except for those using only local infiltration
anesthetics, that a licensed anesthesiologist either administers the anesthetic
or supervises an anesthetist who administers it and that the anesthesiologist
or anesthetist remains present throughout the surgical procedure;
4. it
provides at least one operating room and at least one post-anesthesia recovery
room;
5. it is
equipped to perform diagnostic x-ray and laboratory examinations or has an
arrangement to obtain these services;
6. it has
trained personnel and necessary equipment to handle emergencies;
7. it has
immediate access to a blood bank or blood supplies;
8. it
provides the full-time services of one or more registered graduate nurses
(R.N.) for patient care in the operating room and post-anesthesia recovery
room; and
9. it
maintains an adequate medical record for each patient that contains an
admitting diagnosis that includes, except for patients undergoing a procedure
under local anesthesia, a preoperative examination report, medical history and
laboratory tests and/or x-rays, and operative report and discharge summary.
"ANNUAL OUT OF POCKET" is the sum
of the deductible and any co-insurance under the Plan Document. When the annual out of pocket is reached
(which can be for an individual or a family) covered expenses incurred during
that plan year will be paid at 100%.
Out of Pocket does not include:
* Charges beyond usual & customary fees;
* Penalties resulting from non-compliance with
pre-certification;
* Co-insurance for inpatient or outpatient mental
& nervous benefits;
* Charges not covered under the Plan.
"BODY ORGAN"
means the following (a) a kidney; (b) a heart; (c) a heart/lung; (d) a liver,
(e) a pancreas, when the condition is not treatable by use of insulin therapy;
(f) bone marrow; and (g) a cornea.
"CALENDAR
YEAR" a period of 12 consecutive months beginning with January 1
through December 31 of the same year.
For new employees and dependents, the calendar year is the effective
date of their coverage through December 31 of the same year.
"
"CLAIMS
ADMINISTRATOR" means the Third Party
"COINSURANCE"
is the Covered Person's obligation to pay a percentage of the costs of care in
accordance with the terms and provisions of this Plan document. For example, if this plan provides for
payment of 80% of eligible medical expense, the remaining 20% is the employee's
obligation, and is referred to as "coinsurance."
"COPAYMENT"
is the covered person's obligation to pay a fixed dollar amount for the
services rendered, e.g., $10 for prescription medications.
"COMPLICATIONS
OF PREGNANCY" means:
(a) conditions
requiring hospital confinement (when the pregnancy is not terminated) whose
diagnoses are distinct from pregnancy but are adversely affected by pregnancy
or caused by pregnancy, such as: acute
nephritis; nephrosis; cardiac decompensation; missed abortion; and similar
medical and surgical conditions of comparable severity; or
(b) non-elective
caesarean section; ectopic pregnancy which is terminated; or spontaneous
termination of pregnancy which occurs during a period of gestation in which a
viable birth is not possible.
"Complications of pregnancy" does not
mean: false labor; occasional spotting;
physician prescribed rest during pregnancy; morning sickness; hyperemesis
gravidarum; preeclampsia; or similar conditions associated with the management
of a difficult pregnancy not constituting a nosologically distinct complication
of pregnancy.
"COSMETIC
PROCEDURES" mean any surgical procedure or any portion of a surgical
procedure performed primarily to improve physical appearance and does not
promote the proper function of the body or treat any illness or injury.
"COVERED
PERSON" means an eligible Employee, retiree, official or eligible
Dependent covered under this Plan.
"COVERED
PROVIDER" means an ambulatory surgical center, a home health care
agency, a licensed hospice care center, a hospital, a physician, a surgeon, a
psychiatric day treatment facility, a rehabilitation facility and a skilled
nursing facility.
"CUSTODIAL
"DEDUCTIBLE"
means the amount of Covered Medical Expenses a Covered Person must incur and
pay each calendar year before benefits are payable under the Plan.
"FAMILY DEDUCTIBLE
LIMIT" means that, once the sum of the family deductible has been
satisfied by the cumulative Covered Medical Expenses of the eligible employee
and one (1) or more of his eligible dependents in a Calendar Year, no further
deductible need be satisfied in that Calendar Year for any other eligible
member of the family.
For example:
Employee $ 85.00
Spouse 200.00
Satisfied the Individual Deductible
Child 90.00
Child 2 50.00
Total submitted $ 425.00
Family Deductible Accumulation
- 400.00
$ 25.00
reimbursed at coinsurance level
Where a City employee, by virtue of his relationship to another
City employee, would be considered an eligible dependent but for his employment
with the City, the higher of the two (2) family deductibles of these two (2)
City employees need only be satisfied.
"DENTIST"
means a currently licensed dentist practicing within the scope of the license
or any physician furnishing dental services which the physician is licensed to
perform.
"DIABETES EQUIPMENT"
means the following:
a.
blood
glucose monitors, including monitors designed to be used by blind individuals;
b.
insulin
pumps and associated appurtenances;
c.
insulin
infusion devices; and
d.
podiatric
appliances for the prevention of complications associated with diabetes.
“DIABETES SUPPLIES” means the following:
a.
test
strips for blood glucose monitors;
b.
visual
reading and urine test strips;
c.
lancets and lancet devices;
d.
insulin
and insulin analogs;
e.
injection
aids; syringes;
f.
prescriptive
and non-prescriptive oral agents for controlling blood sugar levels; and
g.
glucagon
emergency kits.
"DONOR" means
a person who undergoes a surgical operation for the purpose of donating a body
organ(s) for transplant surgery.
"DURABLE
MEDICAL EQUIPMENT" means equipment prescribed by the attending
physician which meets each of the following:
a) medically necessary; b) is not
primarily or customarily used for non-medical purposes; c) is designated for prolonged use; and d)
serves a specific therapeutic purpose in the treatment of any injury or
illness.
“EFFECTIVE DATE”, when applied to an
individual’s coverage under the Plan, means the first day of the individual’s
coverage. The individual’s effective
date may or may not be the same as the individual’s enrollment date (as
“enrollment date” is defined by the Plan).
"ELIGIBLE
EXPENSE" is any expense, which is eligible for payment, in whole or in
part under this plan document.
"EMPLOYEE"
means a person who is directly employed by the City of
"EMPLOYER"
means the City of
"
(a) Is
employed by the City's Fire Department;
(b) Has
been hired in substantial compliance with Chapter 143 of the Local Government
Code;
(c) Has
successfully completed the
(d) Has
received his or her certificate from the Fire Chief.
"FULL TIME
STUDENT" means a participant's dependent child who is enrolled in and
regularly attending an accredited college, university or institution on a full
time basis as determined by the institution attended by the student. Evidence of the child's status as a full time
student satisfactory to the claims administrator must be furnished by the
covered person in the event of a claim or enrollment. A person ceases to be a full time student at
the end of the month during which the person graduates or otherwise ceases to
be enrolled and in attendance at the institution on a full time basis. A person continues to be a full time student
during periods of vacation established by the institution, unless the person
does not continue as a full time student immediately following the period of
vacation.
"HOME
HEALTH
(1) It is
licensed and primarily engaged in providing skilled nursing care and other
therapeutic services;
(2) It has
policies established by a professional group associated with the agency or
organization and includes at least one physician and one registered graduate
nurse (R.N.) who provide full time supervision of such services;
(3) It
maintains complete medical records on each individual;
(4) It has
a full time administrator.
"HOSPICE” means an
agency which:
a.
is primarily
engaged in providing counseling, medical services or room and board to
terminally ill persons;
b.
has professional
service policies established by a group associated with it. This group must
include one (1) Physician, one (1) Registered Nurse (RN) and one (1) social
service coordinator;
c.
has
full-time supervision by a Physician;
d.
has a
full-time
e.
provides
services 24 hours a day, seven (7) days a week;
f.
maintains
a complete medical record of each patient; and
g.
is
licensed in accordance with state law.
"HOSPITAL"
means only an institution constituted and operated pursuant to any applicable
law, engaged in providing, on an inpatient basis at the patient's expense,
diagnostic and therapeutic facilities for the surgical and medical diagnosis,
treatment, and care of injured and sick individuals by or under the supervision
of a licensed physician or surgeon and continuously providing 24-hour-a-day
services by registered nurses. The term
"hospital" shall not include any institution or part thereof which is
other than incidentally a place for rest, a residential treatment center, or a
nursing home or convalescent hospital.
"INTENSIVE
(a) It is
solely for the treatment of patients who require special medical attention
because of their critical condition;
(b) It
provides within such area special nursing care and observation of a continuous
and constant nature not available in the regular rooms and wards of the
hospital;
(c) It
provides a concentration of special lifesaving equipment immediately available
at all times for the treatment of patients confined within such area; and
(d) It
provides at least one professional registered nurse who continuously and
constantly attends to the patient confined in such area on a twenty-four (24)
hour a day basis; or
(e) An
alternate hospital that is approved by the Plan
(i) to
facilitate provision of medical services by a particular physician;
(ii) the
covered person's physician certifies in writing to the Plan
(iii) proximity
of the covered person's immediate family members;
(iv) the
medical condition of the covered person
indicates that it would be inadvisable to transfer to another hospital.
"LIFETIME
MAXIMUM" is the cumulative maximum amount payable during the lifetime
of the covered person, during periods of eligibility, as set forth in the
Schedule of Benefits.
"MASTER
CONTRACT" means and refers to this Plan Document, which sets forth the
provisions of universal applicability to the City's various health benefit
plans.
"MEDICALLY
NECESSARY" means any care, treatment, service or supply provided for
the diagnosis and treatment of a specific illness, injury or condition which
meets all of the following.
(a) The
care and treatment is appropriate given the symptoms, and is consistent with
the diagnosis, if any.
"Appropriate" means that the type, level, and length of
service and the setting are needed to provide safe and adequate care and
treatment;
(b) It is
rendered in accordance with generally accepted medical practice and
professionally recognized standards in the
(c) It is
not treatment that is generally regarded as experimental, educational or
unproven; and
(d) It is
specifically allowed by the licensing statutes that apply to the provider that
renders the service.
With respect to confinement in a hospital
"medically necessary" further means that the medical condition
requires confinement and that safe and effective treatment cannot be provided
as an outpatient.
The Claims
Medical necessity specifically does not include any:
(a) Repeated
test which would not be necessary if initially done correctly, or is not
necessary at current intervals;
(b) Care,
treatment, service or supply which is for the psychological support, education
or vocational training of the Covered Person;
Criteria used in determining that a procedure is
experimental includes:
(a) Whether
there is an appropriate rationale for the treatment;
(b) Whether
there is evidence that the treatment is effective;
(c) Whether
there is evidence that the treatment is harmful;
(d) Whether
the benefits justify the immediate and delayed risks of treatment;
(e) Whether
the treatment has been endorsed or approved by the appropriate medical
authorities, such as the FDA, the AMA or other medical specialty societies or
specialists or whether the treatment is covered by Medicare or other public
programs;
(f) Whether
the device or treatment is the subject of ongoing investigation or research;
(g) Whether
the treatment is legal;
(h) Whether
controlled medical trials have been carried out that demonstrate the
treatment's efficacy.
"NEWBORN
"OTHER
COVERAGE" means any other contract or policy under which the Covered
Person is enrolled, such as:
* Group or blanket insurance;
* Group practice, group Blue Cross, group Blue Shield,
individual practice offered on a group basis, or other group prepayment
coverage;
* Labor management trusteed plans, union welfared
plans, employee organization plans, or employee benefit organization plans;
* Government programs, such as Medicare, or coverage
required or provided by statute;
* Any group coverage of a child sponsored by, or
provided through, any educational institution;
* Group arrangements for members of associations or
individuals.
"OTHER
COVERED PROVIDER" means a certified social worker (CSW) licensed
professional counselor (LPC), licensed occupational therapist (
"PHYSICIAN
OR SURGEON" means any professional practitioner who holds a lawful
license authorizing the person to practice medicine or surgery in the locale in
which the service is rendered, limited to a Doctor of Medicine (M.D.), a Doctor
of Osteopathy (D.O.), a Doctor of
Podiatric Medicine (D.P.M.), a Doctor of Dental Surgery (D.D.S.), a
Doctor of Chiropractic (D.C.), a Clinical Psychologist (Ph.D), who has met the standards of the National
Register of Health Service Providers in Psychology.
"PLAN" whenever used herein without qualification means this
Plan Document.
"PLAN
ADMINISTRATOR" means the City of