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Understanding the complexity of employment law and worker rights

Jan. 1, 2020
These are complicated times when it comes to workplace dynamics and employment law. Do your own due diligence. Know the rules. Remember, if you hold a license, it is at stake.

Figuring out where to work, how to work, and how to get paid fairly has been going on since biblical times. It is an important topic to every worker, and social media has ramped up the chat. Not a week goes by where these types of comments are posted:

  • OK, so I just did a working interview last Friday for four hours, from 2:00 p.m. to 6:00 p.m. Just spoke with the hiring manager who said, “We don’t pay for work interviews; only if you’re temping.” The manager says they “do it all the time.”
  • I’m temping and the office wants to pay me under the table but had me fill out a 1099. Is this legal?
  • We have a large practice and rather frequently need a temp hygienist. Are you saying that even if a hygienist only works for me for one day, I still need to “hire” them as a W2 employee?
  • I just found out that my clock-in times are being changed without my knowledge. I feel stupid for not noticing sooner, but I trusted that I was getting paid fairly for my time.
  • I thought you could be paid under the table without the 1099 as long as it was under $500.
  • I was contracted to work from 6:30 a.m. to 3:30 p.m. as a temp. While I was waiting for someone else to arrive, I got a text from the temp agency saying that the office didn’t need me until 8:00 a.m. I told the agency I would start working anyway. The office manager (OM) OK’d the plan. Then one of the dental assistants told me to leave the office and not come back until 8:00 a.m.
  • Just out of curiosity, how many of you in the dental field need to clock out if you need to pump breast milk at work? The assistant I work with loses about an hour’s pay every day due to having to clock out to pump.
  • Our longtime DDS retired two years ago. Certain things now have to be done “off the clock,” such as sharpening instruments. Has anyone else been told this? Management will not pay a “hygiene wage” for things like this.
  • Not working under a temp agency. Is a dentist allowed to 1099 us for working one shift in their office?

As you read through this article, you will see that there are some clear-cut answers to a few of these questions, while others are highly complex and need to be answered by a licensed employment attorney familiar with the laws in the state where you practice. As an employee, it is smart to dig deep and find the answers to your situation on both a federal and state level. And it is also smart to provide current information to those in your workplace. Remember, we’re in dentistry and focused on oral health, but getting better educated about workplace law is just plain smart. The smarter you are about your employment situation, the smoother the ride. You can avoid making the mistakes so many of us did years ago. 

Workers are confused, and justifiably so 

Years ago, the majority of dental hygienists worked in small local dental practices. Most expected long, fulfilling careers in single-practice settings, working as an employee either full-time or part-time. Our goal was to make a difference for patients while earning a living, and most hygienists felt like valuable team members. For decades, many practices were handed down through families, and staff members helped ease the transitions. 

While our clinical responsibilities were similar, our earning structures varied from practice to practice. Some hygienists received benefits while others did not, and for the most part we never questioned how we were paid. Few of us knew we had specific employee rights, and we didn’t pay much attention to employment law. We just accepted how we were paid, assuming that everything was managed in a fair and legal manner. 

The landscape of dental health-care worker employment 

Fast-forward to today’s changing work environment. The landscape is changing. Workers are on the move. They are working in multiple sites and need flexibility. Dental health-care workers (DHCWs) are now impacted in ways they never imagined. The individual or solo dental practice model is becoming an endangered species. The vast majority of new dental graduates are not opening their own dental practices. Employers are taking note of demographic changes and generational differences.

The employment future of a new dental or dental hygiene graduate is totally different than it was decades ago. The cost of opening a solo dental practice has become economically prohibitive for many dentists. New dental graduates, often saddled with around a half-million dollars of debt as they receive their diplomas, are now working as associates in small established practices or large corporate group practices with multiple locations. 

Many new dental graduates are delaying opening their own practices and others are uncertain if they will ever own their practice, a complete reversal in the employment landscape of just 30 years ago. The trickle-down effect is impacting the dental hygiene profession. With fewer independent dental practices, more and more hygienists in the future will be employed in corporate settings or provide services in models that are still being fleshed out legislatively. 

Many current federal employment laws do not apply to small business entities such as traditional private dental offices. Typically, there are too few employees. Small solo practices are now banding together into group practices or joining larger health-care business structures. As dental service organizations (DSOs) become the primary employers of DHCWs, the nature of employment law issues will shift dramatically. Over the coming decade, an increasing number of DHCWs will be covered by both federal and state labor laws designed to protect employee rights. Having more dental workers covered by federal and state labor laws will serve to diminish many current worker abuses and is an unexpected worker benefit for many who will be employed for decades to come. 

With these shifts, savvy hygienists now recognize the value of understanding employment laws and tax regulations. The information provided in this discussion does not constitute legal advice and does not replace independent legal counsel. It is meant to cast light on burgeoning employment issues; alert you, the worker, to your potential rights; and help you create a satisfying and meaningful employment future. Contact a licensed attorney or tax professional regarding your specific questions or concerns.

The landscape of employment law

All DHCWs (dentists, hygienists, assistants, business staff, etc.) need to educate themselves in employment law issues relevant to their professions. Workers need to understand the laws that impact their employment classification, duties, compensation, and individual worker rights. This information ensures workers will be able to craft, or agree to, a legally appropriate business agreement that protects their licenses. 

The current landscape for DHCW employment presents unique complications in workplace dynamics and employment law. There is an increasing need for hygienists to work multiple jobs to make ends meet, while more employers elect to hire multiple part-time workers to avoid paying benefits. Also, it is not uncommon for compensation methods to be in direct conflict with federal or state employment laws. 

In addition to federal laws, every state is different. Do not assume anything. Do your own due diligence. Remember, if you hold a license, it is at stake. Your future or current employer may or may not understand the law. Their goal is to run a sustainable, profitable business. Your goal is to be treated fairly and legally. As an informed employee, you will be better able to protect your rights.

State and federal agencies enact rules to protect workers from unintentional and unnecessary abuse. Both the federal Department of Labor (DOL) and individual state labor boards support and protect employees, as well as provide employer processes and guidelines to ensure employer compliance. Regulatory agencies take a dim view of employers and employees who plead ignorance to the law in disputes.

State licensing boards, professional jurisdiction, and supervision

Each state has a dental board or commission, and a few states have independent dental hygiene licensing committees also. Responsibilities for these entities include, but are not limited to, issuance and renewal of professional licenses, writing rules and regulations based on state statutes, and disciplinary matters. 

It is our professional responsibility to know the details of our governing practice acts and all related rules pertaining to our licenses. Each state has different rules regarding permitted duties and the nature of supervision.1,2 There is no national or regional uniformity when it comes to general, indirect, remote, and direct supervision. Be familiar with the tasks that can be done under each supervision level for every state license you hold. Generally, it takes a special license or permit to practice in nursing homes and remote locations, or to provide care without a dentist on-site. This information is spelled out in each state’s practice act. 

Worker classification

Employment laws on the state and federal level do not share the same definitions as the IRS regarding classification. The IRS employee determination is based on behavioral and financial control and the relationship between the worker and the business.3-6 The DOL determines worker classification on a 11-factor test of independence.7 To complicate this even further, a state may have their own tests to determine who is truly an independent contractor. Although supervision language is an important factor for licensing, it is not the only factor in determining an employee status.

Unless one has a special license or permit, dental hygienists and dental assistants work under the supervision of a dentist so are generally classified as an employee. Employees fill out W4 forms which provide information about payroll deductions and receive W2 statements at the end of the tax year. not independent contractors (1099 income).8,9

There is common misconception that temporary workers can be classified as independent contractors, but this is simply not true. The duration one works as a temporary worker in dentistry has no bearing on worker classification, even if the assignment is only for a day or two.8-10 If a dental hygienist or dental assistant requires supervision of any sort, the worker must be classified as an employee. This is critical legal information for both dental hygienists and dental assistants. Again, licensure rules and supervision definitions contain the key points for determining the compliance of dental hygienists and dental assistants.

Misclassified workers

For years, many dental offices and dental health-care workers have operated in an employment vacuum. Although common employment practices spanned the country, the argument  of “that is the way things have always been done,” does not make a practice legal. Accepting wages as an independent contractor (1099 income) presents a different set of issues than do employee wages (W2 income).

Specific IRS guidelines determining if a worker is an independent contractor or an employee have been around for decades. Most licensed dental hygienists simply do not qualify as independent contractors based on supervision rules. Even for those who provide some of their own equipment, the dental practice provides the bulk of the equipment and supplies used to perform services; schedules the patients; sets the work schedule and time allotted for services; bills and collects fees; and manages third-party reimbursement.10 Dentists hired as associates or temporary workers do not need supervision, but the employing dental practice generally maintains significant control over the dentist’s schedule, patient scheduling, and location where services are rendered. In many cases, dentists working as associates fall under the employee classification.8-10 

Challenges of independent contractors

Conflicts in classification arise when a worker’s practice act requires supervision by a dentist, but the worker is paid as an independent contractor. These workers are misclassified and technically are now working outside the scope of their license, which is a violation of the state’s dental practice act. 

Misclassification creates additional problems. Professional liability coverage, carried by either the employer or misclassified worker, may be null and void due to a breach in supervision requirements, creating a risk-management issue for all involved. What if something happens during a patient appointment? Are you willing to risk your license? And is the practice willing to assume that type of risk?

When an independent contractor is injured on the job, worker’s compensation coverage does not apply, nor do unemployment benefits, unless you choose to pay for yourself as a “self-employed” worker. Both federal and state labor departments have laws in place to protect employees, with mechanisms to recover unpaid wages, resolve overtime issues, and correct improper wage rates. There are specific guidelines employers are required to follow related to a number of employment issues, such as clocking out when there is a change in the schedule or paying workers for attendance at mandatory meetings and time to complete required trainings.11-20

In addition to licensure, liability, and remuneration issues, workers misclassified as independent contractors bear the full burden of both Federal Insurance Contributions Act (FICA) and Medicare taxes, which can double the taxes the worker pays.

Responsibility to know the law

The DOL does not make allowances for ignorance of the law—neither does the IRS or state labor boards.21 Ultimately, the responsibility to understand employment laws related to dental workers lies with both workers and employers. The fines for ignoring state and federal laws are staggering, let alone the sheer inconvenience of insuring things are right. Repeat offenders are flagged and may be subject to increased jurisdictional scrutiny. 

Random advice on the internet or from a friendly, but unqualified, tax preparer can lead to trouble. To protect yourself, seek solid legal and tax advice from a qualified professional, and make sure that person is aware of how your state dental practice act weighs in on your licensure status and the nature of your employment.

What’s the big deal?

The DOL is a cabinet-level agency that has a wide reach in labor law across the country. The DOL administers and enforces a large number of federal laws. Its mandates and regulations cover workplace activities for millions of employers and workers. Here are a number of key items that apply to our roles as dental health-care workers: 

Occupational Safety and Health Administration (OSHA)—OSHA’s jurisdiction is worker safety and health. Its focus is to reduce recognized serious health hazards, including exposure to hazardous chemical materials, biological waste and infectious materials, unsafe physical environments, and ergonomic risks that lead to development of musculoskeletal disorders.

Businesses with 10 or fewer employees are exempt from OSHA injury and incident reporting rules as well as programmed inspections by OSHA inspectors.22 

Fair Labor Standards Act (FLSA)—FSLA is administered by the DOL  Wage and Hour Division and covers wages and overtime pay rules. Employees must be compensated for all time at work. In the dental office this includes activities such as office huddles, cleanup, setup, and recording clinical records—not just clinical time with patients.14

Hygienists must be compensated for the time they wait for patients to arrive for appointments, a time frame known as being engaged to wait. Engaged to wait is considered work.14 Off-duty waiting time is not considered compensable work. Four specific criteria must be met to qualify as off-duty waiting time. A close examination of the criteria describes a model that is rarely met during the clinical day:

  1. The employee is completely relieved of duty and free to leave the business premises.
  2. The employee is definitely told in advance.
  3. The employee must be able to use the time effectively for his or her own purposes.
  4. The employee is told the exact time to return to work.23

Dental hygienists are frequently misclassified as employees who are exempt from overtime pay. Under federal regulations, dental hygienists must receive a minimum salary that is paid on a salary basis and be employed 40 hours a week by the employer to qualify for exempt status.13

Family and Medical Leave Act (FMLA)—FMLA is administered by the DOL Wage and Hour Division. Approved FMLA requests provide for 12 weeks of unpaid, job-protected leave for birth, adoption, or serious illness (personally or for a family member). Businesses with 50 or more employees are required to comply with FMLA rules.24,25

Veterans’ Preference Act—Veterans’ preference gives eligible veterans special rights over nonveteran applicants in the hiring process when seeking employment in federal government jobs.26 Veterans’ preference does not guarantee veterans a job. The three types of veterans’ preferences are: disabled, nondisabled, and sole survivorship.

Nursing Mothers’ Rights (rights under FLSA)—All employers, regardless of their size or number of employees, must comply with the Break Time for Nursing Mothers law. Employers are required to provide a reasonable break time for an employee to express breast milk for one year after a child’s birth. Employers are required to provide a place (other than a bathroom) that is shielded from view and intrusion by coworkers and the public.27 All 50 states, the District of Columbia, Puerto Rico, and the Virgin Islands have laws that specifically allow women to breastfeed in any public or private location.28

Businesses with fewer than 50 employees may be able to apply for an undue hardship exemption. Until they are granted an exemption by the DOL, however, the business must comply with the law.29

Equal Employment Opportunity Commission (EEOC) 

The EEOC is an independent federal agency that promotes equal opportunity in employment. It is responsible for enforcing federal laws that make it illegal to discriminate against a job applicant or an employee because of the person’s race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age (40 or older), disability, or genetic information.16-20,29,30

It is illegal to retaliate against a person because the person complained about discrimination, filed a charge of discrimination, or participated in an employment discrimination investigation or lawsuit. The laws apply to all types of work situations, including hiring, firing, promotions, harassment, training, wages, and benefits. Most EEOC laws apply to employers with 15 or more employees. Age discrimination cases are covered when the worker is over the age of 40 and there are 20 or more employees.16-20,29,30

State labor boards

Generally state labor boards are responsive to worker and employer differences. These agencies are charged with protecting workers in their states. While dentistry is not their primary target, they are currently taking a stand on the misclassification of workers. Not all states have actual labor boards or workforce commissions. For example, issues regarding worker and employee rights in the state of Florida are spread across a variety of state agencies, rather than being housed under one governmental agency. 

State labor boards deal with workers’ compensation and unemployment claims, as well as weigh in on situations such as payment disputes and hostile work environments.31,32 

At-will employment

An at-will employee can be fired at any time for any reason and with or without notice. Most jobs are considered at will. The term at will may be used, but language stating that you can be fired at any time, without cause, or for any reason indicates that the employer follows an at-will policy. The language can be found in an offer letter, employee manual, written workplace policy, or an employee agreement.33

What Is your role in employment law?

Navigating all of these laws is tricky. Responsible employers appreciate smart employees. The most valuable way to share this responsibility is to have a written agreement with each employer and update that agreement on a regular basis. Keep duplicate copies of all agreements, additions, and amendments. 

Obtain copies of all office employee manuals and keep them in a safe place. Study standard operating procedures and guidelines for each practice and follow the rules. In the event of a dispute, these manuals set the stage for resolution.

Keep comprehensive records of all hours worked and copies of all wage statements and withholdings. If you have an employment concern or dispute, document all conversations and interactions with other employees and your employer. The clearer your records and agreements, the less chance of employment misunderstandings. Professional communication and collaboration benefit all parties.

Remember to keep calm if something comes up that troubles you. Getting emotional or creating drama will not help resolve issues. Most problems can be solved when people understand the laws and are willing to play by those rules and laws. Always maintain a duplicate of your employment file for your protection. And good luck in navigating your employment journey!

Where is the future? California employment law: A model for professional collaboration

Efforts in California provide an example of how taking an active role in crafting and enforcing labor laws can clearly support workers’ rights. California can be examined as a model for how the dental hygiene profession is regulated and practiced. 

A decade ago, the Dental Hygiene Committee of California came into existence, a new regulatory board to oversee all licensing matters pertaining to the practice of dental hygiene in the state. California is the only state where dental hygienists control their profession with board authority. Two years ago, during the sunset review process, California legislatures renamed the regulatory group. It is now known as the Dental Hygiene Board of California. In other states dental hygiene practice acts and disciplinary authority fall under the jurisdiction of individual state dental boards. 

With respect to employment law, both the California Dental Hygienists’ Association (CDHA) and the California Dental Association (CDA) play an active role in educating their memberships about a wide variety of employment issues. While these efforts may be specific to California, much of the information is based on federal labor laws, which affect dental hygienists all over the country. 

Over the past few years, the CDHA has spearheaded many educational activities on both a state and local level to provide both members and students with accurate, and timely information about employment law issues affecting those practicing in California. Local components have sponsored continuing education activities that discuss employment law. In addition, the CDHA has supported regional student conferences that provided students with critical employment information to prepare them to enter the workforce upon graduation.  

The CDA has an extensive collection of documents on its website that explain various aspects of employment law as it relates to dental workers, along with information on best practices. Topics include classification, hiring and paying temporary workers, using a temporary or referral agency, paid sick and family leave, mandatory sexual harassment training, lactation accommodation, voluntary separation versus performance-based termination, job abandonment, employment practices during natural disasters, treatment of employees taking a leave of absence to perform emergency duties, itemized wage statements, orientation/onboarding, and sample interview questions and offer letters. A wide variety of topics about employment law are found in chapter 4 of the Legal Reference Guide for California Dentists (http://bit.ly/CDA-ref), and additional information can be found on the CDA website.

The CDA encourages all dentists to have an employee manual that is specific to the individual practice. Employee manuals protect both workers and employers as well as reduce the risk of unnecessary misunderstandings. Policies and standard operating procedures should be clearly spelled out and contain rules and regulations for federal, state, and local labor laws. A well-written employee manual is objective, applies to all employees, sets expectations, details benefits, ensures consistency, and outlines the practice’s culture. Employee manuals should outline legally mandated laws and ordinances and cover what is expected for compliance.

Additional resources regarding California law and best employment practices

• New lactation accommodation requirements take effect Jan. 1, 2020. Law provides additional protections for nursing mothers. California Dental Association website. https://www.cda.org/Home/News-and-Events/Newsroom/Article-Details/new-lactation-accommodation-requirements-take-effect-jan-1-2020#. Published December 11, 2019. Accessed December 16, 2019.

• Hiring temporary employees toolkit. California Dental Association website. https://www.cda.org/Home/Practice/Practice-Support/Resource-Library/employment-practices-associates-toolkit-hiring-temporary-employees. Accessed December 16, 2019.

• Compliance essentials: Hiring and paying temporary employees. California Dental Association website. https://www.cda.org/Home/News-and-Events/Newsroom/Newsroom-Archives/compliance-essentials-hiring-and-paying-temporary-employees. Published April 9, 2019. Accessed December 16, 2019.

• How do dental hygienists spend their working time? California Dental Association website. https://www.cda.org/Home/Practice/Practice-Support/Resource-Library/employment-practices-laws-and-regulations-how-do-dental-hygienists-spend-their-working-time. Accessed December 16, 2019.

• 'ABC test' is now the law, but it's not a free ticket for independent contractors. California Dental Association website. https://www.cda.org/Home/News-and-Events/Newsroom/Article-Details/category/laws-regulations/abc-test-is-now-the-law-but-its-not-a-free-ticket-for-independent-contractors. Published October 15, 2019. Accessed December 16, 2019.

• Job descriptions: Best practices, tools & samples. California Dental Association website. https://www.cda.org/Home/Practice/Practice-Support/Resource-Library/employment-practices-hiring-and-firing-job-description-a-valuable-tool. Accessed December 16, 2019.

• Sample meal and rest break policy. California Dental Association website. https://www.cda.org/Home/Practice/Practice-Support/Resource-Library/employment-practices-office-policies-and-manuals-sample-meal-and-rest-break-policy. Accessed December 16, 2019.

• Performance evaluations: A necessary component for employee management. California Dental Association website. https://www.cda.org/Home/Practice/Practice-Support/Resource-Library/employment-practices-office-policies-and-manuals-performance-evaluations-a-necessary-component-for-employee-management. Accessed December 16, 2019.

References

1. Dental hygiene practice act overview: Permitted functions and supervision levels by state. American Dental Hygienists’ Association website. https://www.adha.org/resources-docs/7511_Permitted_Services_Supervision_Levels_by_State.pdf. Updated July 2019. Accessed March 4, 2019.

2. Direct access states. American Dental Hygienists’ Association website. https://www.adha.org/resources-docs/7513_Direct_Access_to_Care_from_DH.pdf. Updated June 2019. Accessed March 1, 2019.

3. Employee (common-law employee). IRS website. https://www.irs.gov/businesses/small-businesses-self-employed/employee-common-law-employee. Updated March 29, 2019. Accessed December 16, 2019.

4. Independent contractor (self-employed) or employee? IRS website. https://www.irs.gov/businesses/small-businesses-self-employed/independent-contractor-self-employed-or-employee. Updated October 4, 2019. Accessed December 16, 2019.

5. Understanding employee vs. contractor designation. IRS website. https://www.irs.gov/newsroom/understanding-employee-vs-contractor-designation. Updated December 12, 2019. Accessed December 16, 2019.

6. Topic no. 762 independent contractor vs. employee. IRS website. https://www.irs.gov/taxtopics/tc762. Updated October 7, 2019. Accessed December 16, 2019.

7. Frequently asked questions – Employer-Employee relationship. https://www.dol.gov/ofccp/regs/compliance/faqs/EmpRelationship.html#Q4.  Accessed December 16, 2019.

8. Independent contractor or employee? Department of the Treasury. Internal Revenue Service website. https://www.irs.gov/pub/irs-pdf/p1779.pdf. Updated March 2012. Accessed March 1, 2019.

9. Know your rights: Misclassification as independent contractor. US Department of Labor’s Wage and Hour Division (WHD). YouTube video. https://www.youtube.com/watch?v=BTUkKFYBdrU&feature=youtu.be. Published September 29, 2017. Accessed March 1, 2019.

10. Get the facts on misclassification under the Fair Labor Standards Act. Are you an employee or a contractor? Wage and Hour Division. US Department of Labor website. https://www.dol.gov/whd/workers/Misclassification/misclassification-facts.pdf. Accessed August 12, 2019.

11. Fact Sheet #3: Professional offices under the Fair Labor Standards Act (FLSA). Wage and Hour Division. US Department of Labor website. https://www.dol.gov/whd/regs/compliance/whdfs3.pdf. Updated July 2008. Accessed August 10, 2019.

12. Fact Sheet #17D: Exemption for professional employees under the Fair Labor Standards Act (FLSA). Wage and Hour Division. US Department of Labor website. https://www.dol.gov/whd/overtime/fs17d_professional.pdf. Updated January 2018. Accessed August 12, 2019.

13. Executive, administrative, professional, computer, and outside sales exemptions. In: Department of Labor Wage and Hour Division. Department of Labor Wage and Hour Division. Field Operations Handbook. Washington, DC: Department of Labor Wage and Hour Division; 2016: 22i14. https://www.dol.gov/whd/FOH/FOH_Ch22.pdf. Accessed August 8, 2019.

14. Fact Sheet #22: Hours worked under the Fair Labor Standards Act (FLSA). Wage and Hour Division. US Department of Labor website. https://www.dol.gov/whd/regs/compliance/whdfs22.pdf. Published June 26, 2018. Accessed August 10, 2019.

15. Fact Sheet #21: Recordkeeping requirements under the Fair Labor Standards Act (FLSA). Wage and Hour Division. US Department of Labor website. https://www.dol.gov/whd/regs/compliance/whdfs21.pdf. Accessed August 12, 2019.

16. Pay discrimination. You have the right to be paid fairly for your work. US Department of Labor website. https://www.worker.gov/concerns/fair-pay/. Accessed August 12, 2019.

17. Pay for hours worked. You have the right to be paid fairly. US Department of Labor website. https://www.worker.gov/concerns/pay-hours-worked/. Accessed August 12, 2019.

18. Asking about, discussing, or disclosing pay. You have the right to be treated equally. US Department of Labor website. https://www.worker.gov/concerns/discussion-of-pay/. Accessed August 12, 2019.

19. Harassment. You have the right to be treated equally. US Department of Labor website. https://www.worker.gov/concerns/harassment/. Accessed August 12, 2019.

20. Protection against retaliation. You have the right to be protected from retaliation for exercising your rights and the rights of others. US Department of Labor website. https://www.worker.gov/concerns/protection-against-retaliation/. Accessed August 12, 2019.

21. Resources for job creators. US Department of Labor website. https://www.employer.gov/. Accessed August 12, 2019.

22. Small business handbook. Small business safety and health management series. US Department of Labor. Occupational Safety and Health Administration website. https://www.osha.gov/Publications/smallbusiness/small-business.pdf. Published 2005. Accessed August 28, 2019.

23. elaws (employment laws assistance for workers and small businesses) - FLSA hours worked advisor. Off duty waiting time. United States Department of Labor website. https://webapps.dol.gov/elaws/whd/flsa/hoursworked/screenER79.asp. Accessed October 21, 2019.

24. Family and Medical Leave Act. Wage and Hour Division. US Department of Labor website. https://www.dol.gov/whd/fmla/index.htm. Updated August 5, 2019. Accessed August 12, 2019.

25. Family and Medical Leave Act Employee Guide. Wage and Hour Division. US Department of Labor website. https://www.dol.gov/whd/fmla/employeeguide.htm. Accessed August 12, 2019.

26. Veterans’ preference. US Department of Labor website. https://www.worker.gov/concerns/veterans-preference/. Accessed August 11, 2019.

27. Fact Sheet #73: Break Time for Nursing Mothers under the FLSA. Wage and Hour Division. US Department of Labor website. https://www.dol.gov/whd/regs/compliance/whdfs73.htm. Updated April 2018. Accessed August 10, 2019.

28. Breastfeeding state laws. National Conference of State Legislatures website. http://www.ncsl.org/research/health/breastfeeding-state-laws.aspx. Published April 30, 2019. Accessed August 10, 2019.

29. Prohibited employment policies/practices. US Equal Employment Opportunity Commission website. https://www.eeoc.gov/laws/practices/index.cfm. Accessed August 10, 2019.

30. Age discrimination. US Equal Employment Opportunity Commission website. https://www.eeoc.gov/laws/types/age.cfm. Accessed August 10, 2019.

31. State labor offices. Commissioners, directors, and secretaries. Wage and Hour Division. US Department of Labor website. https://www.dol.gov/whd/contacts/state_of.htm. Updated December 2018. Accessed August 10, 2019.

32. State payday requirements. Wage and Hour Division. US Department of Labor website. https://www.dol.gov/whd/state/payday.htm. Published January 1, 2019. Updated January 2019. Accessed August 10, 2019.

33. Guerin L. Employment at will: What does it mean? Nolo website. https://www.nolo.com/legal-encyclopedia/employment-at-will-definition-30022.html. Accessed October 21, 2019.

ANNE NUGENT GUIGNON, MPH, RDH, CSP, provides popular programs, including topics on biofilms, power- driven scaling, ergonomics, hypersensitivity, and remineralization. Recipient of the 2004 Mentor of the Year Award and the 2009 American Dental Hygienists’ Association Irene Newman Award, Guignon has practiced clinical dental hygiene in Houston since 1971. You may contact her at [email protected].