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HomeMy WebLinkAbout1984-0241.Denapoli and Munroe.92-06-02SETTLEMENT RkGLEMENT DESGRIEFS IN TEE NATTER OF AN ARBITRATION Under THE CROWN EMPLOYEES COLLECTIVE BARGAINING ACT Before THE GRIEVANCE SBTTLENBNT BOARD BBTNBEN OPSEU (Denapoli/Munroe) - and - Grievor The Crown in Right of Ontario (Ministry of Health) Employer BEFORE: B. Fisher Vice-Chairperson S. Hennessy Member D. Olsen Member FOR THE m N. Roland Counsel Cornish, Roland Barristers & Solicitors FOR.TNB J. Zarudny EMPLOYEI( Counsel Crown Law Office - Civil Minitry of the Attorney General BEARING September 21, 1989 February 15, 1991 March 22, 1991 June 7, 1991 1 This is another in a long line of classification cases involving OHIP billing clerks. The Grievor was employed at the time of the filing of the grievance (Feb. 24, 1993) as a Claims Processing Clerk in the Pay Subscrlber department of the Hamllton district OHIP office. In part the Grlevor’s job was to process claims filed by patients who utflhed Ontario doctors who had opted out of OHIP Needless to say with the elimination of extra billing, this job no longer exists. The job was classified as a Clerk General 3. The Griever seeks reclassification as a Clerk General 4. Factually speaking this case Is similar to a prevlous declslon by the same panel entitled Laycock (0241/94). In fact it Is the Employer’s contentlon that ihls case Is so similar to Laycock that the same decision should be reached, namely the grievance should be dismissed. The Union admits that a certain portion of the Griever’s job, namely the processing of claims Is so similar to the task performed in Laycock that that asp8ct of the Grievor’s job Is properly classlfled. However the Union contends that due to the fact that a significant portion of the Grievor’s job entails direct dealing with the public, that this factor alone takes the Grievor’s job duties out of the Clerk General 3 classification and more properly puts her Into the Clerk General 4 classlfiwtion. The balance of this award will therefore locus on to what degree the Grlevor’s job entails dealing with the public and whether or not that factor entitles the Grlevor to a reclassification. r. r 2 The partles agreed during the course of the hearing that the decision In this case would be binding upon a grievance filed by Jan Munro (GSB #273/87). The Grievor dealt with the public in three ways, through written correspondence, telephone conversations and face to face encounters at the counter. The written inquiries numbered about 15 per day and of these about 75% were from doctors. In this sense the Grievor’s job was very similar to the Lavcock case. The remaining 25% of the written Inquiries were from subscribers, lawyers, MPP’s and insurance companies. The Grievor noted that written inquiries from subscribers were quite often deficient in terms of necessary Information. This would often require the Grievor to either write to the subscriber for more information or to telephone the subscriber. The Grievor received no specific training on how to handle this.component of her work, she just learned it as she went along. She signed her own name on correspondence: She would see an average of three walk In clients a week. The walk-ins were primarily subscribers who had already had some previous telephone contact with OHIP and by the time they came into the OHIP office they were quite often angry and irate. The non-irate walk-ins tended to be non-English speaking people or the elderly. In dealing with these people the Grievor had to be informative, tactful and diplomatic. Only if the members of the public became ,abusive did the Grievor have the choice of refusing to serve the person. By far the greatest contact the Grievor had with the general public (by this term I am excluding doctors and their staff) was by telephone. The Grlevor testified that she dealt with appmxlmately 20 Inquiries per day. Upon receiving an Inquiry the Grievor would fill out a form called an ‘Inquiry Record’ which required the Grlevor to obtaln lnformatlon regarding the name, address and OHIP number of the subscrlber, as well as the details of the medical claim. On this form the Grievor also reported the specific problem, which usually had to do with question of payment to the subscriber. Once the inquiry report had been filled out, either the Grievor or another Claims Processing Clerk In the Pay Subscriber Department would do the necessary research to find out whether the claim had been properly submitted, and If so, what progress had been made on its payment. Whoever completed the research would then contact the subscriber and report back her findings. Although the calls were supposed to be screened prior to being received by the Grlevor, it was not uncommon for the Grlevor to get calls unrelated to her sectlon. The Grtevor would listen to the subscriber’s concerns and thC redirect the phone call to the appropriate Ministry personnel. The Grievor emphasized that to a large degree she was dealing with subscribers whose English skills were poor or were generally quite lnartlculate and confused. It was often her responslblllty to explain to these people why they were not going to be repaid for the expenses they had Incurred. Thls required the ability to explain fairly complicated OHIP rules to members of the general public, which by deflnltion included people of various degree of intelligence and sophlstlcatfon. The Grievor at all Umes had to be able to detect possible attempts by lndlvlduals to obtain confidential information about others, i.e. parents about children over 16 years of age, spouses, 4 etc. As can be expected a constant complaint of the public was slow speed by which ,OHlP issued reimbursement cheques. It was the Grievor’s job to explain this delay to the subscriber. The Grlevor testified that other than some minimal guidance In the Security Manual dealing with confidentiality, she received no trainlng on how to deal with the public. She testified that she had not received any training on how to detect a caller whose had improper motives for obtaining the information. In the course of their phone calls, subscribers often complained about their dqctors, the fees and the medical system In general. Although the evidence on the exact portion of the day the Grlevor actually spent on dealing with the public is unclear, it seems that it consisted of anywhere between 25-50% of her’day. Suffice it to say that dealing with the public was a core duty of this job and therefore one that is significant in terms of classification. The level of supervision under which the Grievor operated seems to be comparable to that in fhe Lavcock case which was found to be at to the Clerk General 3 level. The degree of knowledge of technical data would also be comparable to that of the Lavcock case, which was found to be at the Clerk General 3 level. In other words, other than the extensive dealing with the general public, the Grtevor clearly fits within the Clerk General 3 serles. To what degree then is the extensive dealing wlth the public a significant factor? In the first of this llne of cases, Gooble (240/84) ViceChaIrperson Verity discussed In detail this aspect of dealing with the public. The followlng excerpts from pages 35-39 Illustrate Mr. Verity’s analysis. The Clerk 3 General Standard refers to ‘routine clerical work of some complexiw, while the Clerk 4 Standard refers to ‘a variety of responsible clerlcal tasks’. Of the three main components, processing applications came closest to the Clerk standard. However, regardlng that task, the work was ‘responsible’ Inasmuch as the Grlevor made ellglbility determlnatlons. General enquiries fell between the two Standards, but somewhat closer to the Clear 3 than to the Clerk 4. With respect to the Grlevor’s core resoonslbllitv. namelv the handlino of OHIP related enaulries. the Board has no hesltatlon In findlnn that It fell sauarefv wlthln the Clerk 4 ranae. UnauesUonablv. lf was ‘responsible’ work. and while the maiorltv of enauirles were more or less routine in substance, the Board finds, on the evidence. that with resoect to elicitlna Informatlon. communlcatlno effectlvelv with callers of varvlna 6 levels of soohlstlcatlon. and manaoino the heavy workload, the work was sianificantlv more than merely “some comolexitv’. The Clerk 3 General Standard refers to work performed according to “established procedure” and ‘requiring a background knowledge of specific regulations, statutes or local practices”. The corresponding requirement of the Clerk 4 General Standard refers to the performance of tasks “requiring a good background knowledge of specific regulations, statutes or local practices”. There is little dispute on the evidence that the knowledge requirement In the Grievor’s job was in excess of the Clerk 3 Standard. This was true not only with respect to the volume of material the Grlevor was required to digest and comprehend concerning OHIP practices, policies and procedures, but also with respect to the addltlonal requirements that she commit the bulk of this materlal to memory, and that she constantly renew her knowledge as practices, policies and procedures changed. While processina applications was clearly performed accordina to “established procedures”, and while In resolvlna OHIP-related enauiries, the Grlevor was clearly bound bv such procedures, there was no “established procedure” to direct her in the communication and relational aspects of her work. The Clerk 3 Standard refers to decision-maklna which ‘involves some judament In the selection of alternatives within a comprehensive framework of guidelines”. The Clerk 4 Standard refers to decision-making which “Involves 7 iudament In deallna with vartatlons from established auldellnes or standards’. Processinn anpllcatlons fitted the Clerk 3 Standard at best The communication and relatlonal asoects of the other two tasks Involved the exerclsa of substantial judament. well bevond selectfna amonn speclfled alternatfves. and even bevond deallno with varlatlons from established ouldellnes Inasmuch as few If anv real nuldellnes can be said to have existed for this asoect of the lob. The Clerk 3 Standard refers to Initiative, ‘In the form of followInS up errors or omissions and in maklng corrections as necessarf”. The parallel provlslon In the Clerk 4 Standard specifies that ‘normallv. emolovees receive specific Instructions onlv n unusual or soeclflc problems as the work Is performed under conditions that permit little oooortunltv for direct suoenrlsion bv others’. To the extent that Mrs. Gooble’s work Involved deallna with oaoer. she exercised lnltlatlve at the Clerk 3 level. To the extent that her work Involved deallna with oeople, the Clerk 4 lanauaoe aooears to us to describe the sltuatlon more closefv. So far as ‘condltlons that permit little opportunity for direct supetvlslon’ are concerned, there Is no doubt that the Grlevor’s supenrlsor was normally present In the room where she worked. The Supervisor had ample opportunity to directly supervise the Grlevor’s paperwork. In our opinion, she did not have tfre same opportunity to supervise the Grlevor’s handlln(f of telephone calls; certainly not on a regular and effective basls. For his part, Mr. Glaze monitored Clerks telephone 0 calls only very occasionally. With respect to supervision, the Clerk 3 Standard states that “doubtful matters not covered by precedent are referred to Supervisors’. The Board Is satisfied that most of the Grlevor’s work, if reviewed at all, was reviewed only periodically, principally for adherence to policy and procedure. The Clerk 4 Standard states that “matters involving decisions that depart radically from established procedures are referred to supervisors”. On balance, we consider that the Grlevor’s supervisory situation is better described by the clerk 3 than the Clerk 4 Standard. It is necessary to add once aoain, however, that with respect to the communication and relational asoect of her core resoonsibilitv. the Grievor was not subiect to “establlshed procedures” in anv meaninaful way. Takina the iob as a whole, and comparino it to each Standard as a whole, I we are satisfied that the Grlevor’s work responsibilities with respect to communicatina OHIP pollcv and procedure lo members of the general public. and assistlno them actlvelv in securino and maintaining health Insurance coveraae within the scooe of that oolicv. involved sianificantlv more knowledae. complexitv, resoonslbllltv. and discretion than are contemplated bv the Cierk 3 General Standard. In our view. these factors outweioh others that would place the iob properlv within the Clerk 3 General Standard. On balance, the Board finds that Mrs. Goobie’s position was misclassified as Clerk 3 General and would have been prooerfv classified at the Clerk 4 General level. (emphasis added) Similarly in another OHIP case entttled Ashley (343/85 et al) VIceChaIrperson Enrich said at page 16-18 of the decision: Difficult problems are referred as well by lnformatfon and Assistance Clerks working at District Gfficas throughout Ontario to DSP clerks at the head office In Kingston for resolution. Resolution of such problems may entail research Into various resources to trace what action has transpired to date, then contact with the pay-direct subscriber to ascertain the nature of the problem or to communicate the resolution. Mr. Mason agreed that DSP clerks are frequently required to have direct contact with subscribers by telephone or mall, or occaslonally person-to- person. In the course of carnlno out their functions. the LISP clerks are expected to orovlde prompt. efflclent and courteous service to the public. The DSP clerk must be able to analvse the nature of the problem Presented. desolte vanlng abilities on the Dart of those maklnn enaulrles to articulate their emblem. LISP clerks are exoected to deal with aoorehensive. emotion and Irate subscribers In a manner which allavs their anxletv and molllfles their anoer. In the Gooble award, the Board found that OHIP Information and Assistance Clerks are reaulred to exercise a ranae of Interpersonal communication skills and these are enumerated at 11.23 and 24, The evidence of Ms. Ashlev and of Mr. Mason demonstrates that these interpersonal communlcatlon skills are raauired of DSP clerks as well. Indeed, ‘demonstrated oral and written communication skills’ are reaulred as minimal entn auallflcatlons In Part 4 of the Posltlon Soeclflcatlon. There Is no manual which the LISP clerks can consult concemlna 611s asoect of their work. Gather ludaement Is honed as thee skills are utllbed and refined with on-the-lob experience. Indeed. tact and dlplomacv are reauired In order for the DSP clerks to carry out their resoonslbilltles In a manner which safeauards the confidentiality _ /~ ,,~ ., ,:-. : 10 f subscribers’ medical Information. and which protects OHIP’s Interest in prevent fraudulent claims for coveraoe or oavment for services. No doubt virtually all the employees of OHIP are aware that the confidentiality of subscriber lnformatlon Is to be respected and that there Is an obligation to protect OHIP from fraudulent claims. However, the extensive evidence provided as to the nature of the DSP clerk’s responsibllltles makes It clear that the LISP clerk must be circumspect In deallnn with a wide varletv of contact, both with the public and other aovernmental departments. From all the evidence, the Board concludes that the DSP clerk functions at the level of the Clerk 4 standard In respect to the index of decision-making and judgement. In this renard. the Board finds the nature and comolexltv of the DSP clerk’s position to be more analoaous to the iob of intemretina and aoolvlna statements from non-Ontario doctors to Ontario standards as set forth In the Peters decision than the task of codlna In- Province claims described in the Lavcock award. Furthermore, the evidence Indicates. that the compiexltv of the Grlevor’s work. the varietv and extent of the DSP clerk‘s contacts, would serve to dlstlnaulsh this case from the Alnslle decision which dealt with Group Processina Clerks at the OHIP head office in Kinoston. (emphasis added) It should be noted that In both Goobie and m, the clerks duty was not exclusively related to dealing with the public as both of them also performed form-filling out functions like this Grlevor. In essence It was the dealInS with the diverse public In terms of translating complex governmental regulations and policies In a manner that could be readily understood by the public which was largely responsible for brInGInS the Grlevors up to a Clerk General 4 level. Therefore In considering the Grlevor’s job duties, It appears that since a slgnlflcant portion of her job duties Involved dealing with the general public In a similar fashion to that of @&jp and Ashley It follows that the “best fit” for the Grlevor is as of a Clerk General 4. 11 The Grlevor Is to be compensated retroactlva to 20 days prfor to the flllng of the award. At the request of the parties we are not beln(f asked to decide the Issue of Interest at this time but specifically retain jurlsdictlon over mat matter or any other artslnq from the lmplementatlon of this award. Dated this z n d day Of June ,1992. S.R. HENNESSY -u n,I,nr--. MEMBER ,>*g D.P. OLSEN - ’ --- MEMBER