Six Steps to Alternate Work Schedules in California

UPDATED 04/11/25

There are times when proposing a new Alternative Work Schedule (AWS) would benefit your practice, and perhaps even your employees.

HR for Health has put together six steps that you must follow in order to implement an AWS in your practice.

An Alternate Work Schedule (AWS) refers to any work schedule which arranges work hours or work days in a way that deviates from the traditional 8-hour, 5-day working calendar. It frequently includes arrangements such as flextime, compressed work weeks, or job sharing. AWS can provide employees with greater autonomy over their work schedule and, depending on the specifics, potentially offer enhanced work-life balance.

However, before we get there let’s talk about what an AWS is.  For starters, an AWS is only applicable in the state of California. Other states would fall under the Flexible Work Schedule.

What is an Alternative Work Schedule in California?

Simply put, an AWS refers to a compressed or flexible work schedule – with a few more rules in place.  While there is some benefit for employers (i.e. overtime pay), AWSs are also popular amongst employees who prefer flexible work schedules and extra time off.  An AWS does require employees to waive their right to receive overtime pay.

California Labor Code Section 510(a)(1) states that “any work over 8 hours in one day shall be compensated at the overtime rate of time and a half. This does not apply, however, to an employee working pursuant to a properly adopted AWS.”

The two things we’d like to point out are

1. Time and a half does NOT apply to employees working an AWS AND
2. The fact that it says, “properly adopted AWS”

That’s right; there are measures in place that must be properly taken for an AWS to be legitimate.

The Growing Importance of AWS

Alternate Work Schedules (AWS) have become increasingly important in healthcare, offering teams greater control over their working hours and a more balanced approach to patient care. By enabling flexible or compressed scheduling, AWS can help prevent staff burnout and improve overall morale. In turn, these schedules allow practices to operate more efficiently, meet diverse patient needs, and maintain high-quality service.

Specific Challenges Faced by Different Healthcare Practices

• Medical Practices: Medical offices often deal with high patient volumes and unpredictable appointment schedules, making it tough to allocate shifts fairly. AWS can alleviate scheduling conflicts by providing flexible hours during peak times, but it also requires careful planning to ensure continuous patient care.
• Dental Practices: Dental offices handle a steady influx of procedures ranging from routine cleanings to more complex treatments, all of which can lead to extended patient visits. Implementing AWS could help stagger the workload, reduce wait times, and maintain quality service.
• Optometry Clinics: Optometry clinics experience fluctuating patient demands based on seasonal trends (e.g., back-to-school vision checks) and changing eyewear needs. AWS allows staff to adjust shifts in response to varying patient loads while still offering comprehensive care.
• Veterinary Practices: Veterinary clinics often handle emergency calls, routine checkups, and surgeries on unpredictable timelines. AWS can offer staff more autonomy and reduce fatigue from after-hours work, especially in 24-hour facilities.

Top Reasons Practices Adopt AWS

1. Enhanced Employee Morale: Flexible or compressed schedules can significantly boost staff satisfaction, making it easier to balance work and personal responsibilities.
2. Reduced Burnout: By spreading out long shifts or consolidating work hours, employees have more downtime to recharge, improving overall mental and physical health.
3. Improved Patient Access: Extended clinic hours or staggered schedules can accommodate more patients, cater to varying availability, and reduce bottlenecks.
4. Cost Efficiency: Practices can potentially lower overtime expenses and optimize staffing, leading to a more streamlined budget.
5. Higher Retention Rates: Employees who feel supported and empowered by a flexible schedule are more likely to stay, reducing turnover and training costs.
6. Adaptability to Seasonal Demand: Certain times of the year—like back-to-school or holiday seasons—see heightened patient visits, and AWS can help handle these surges.
7. Competitive Edge in Recruitment: Offering modern, flexible scheduling options attracts top-tier candidates, particularly those seeking a work environment that respects work-life balance.

Examples of an Alternative Work Schedule

Two of the most common AWSs in California are the “4/10” and the “9/80” schedules, but there are also structures for job sharing and flextime.  Here’s how they work:

• 4/10 Schedule: Under the 4/10 schedule, employees work for four days at 10 hours per day with no overtime pay, however, they will receive an additional day off from work.
• 9/80 Schedule: Under the 9/80 schedule, employees work for nine days in which 80 hours are compressed into those nine days.  Employees working the 9/80 schedule would not receive overtime pay despite working an additional eight hours but would however receive an extra day off from work every two weeks.
• Job Sharing: Let two veterinary assistants share a full-time role to provide consistent coverage without overburdening individual staff members.
• Flextime: Allow front-desk staff to stagger start times to meet patient demand during peak hours.

Key Steps To Follow Before Adopting AWS

The most important steps to follow before adopting AWS include:

1. Evaluating AWS Feasibility for Your Practice

Before adopting an alternative work schedule (AWS), it’s crucial to assess whether your practice has enough staff to handle potential shifts in scheduling. Consider how patient care might be impacted if certain team members work different hours or fewer days, affecting appointment availability. Also, gauge whether employees have shown interest in flexible scheduling, as their buy-in can significantly influence the success of any AWS initiative.

One effective way to gather this information is to conduct a brief internal survey, asking staff about their readiness and potential concerns regarding modified hours. This survey can reveal gaps in coverage, highlight preferences, and uncover any misconceptions employees might have. Armed with these insights, your practice can make an informed decision on whether an AWS is beneficial and practical.

1. Determine the work unit.

You first must determine the work unit or group of employees who will be affected by the change. This can mean a department, a job classification, a shift, or even an individual employee if he or she is the only person in that department, job classification, or shift. A work unit can also include a separate physical location if applicable.

Understand the needs of the practice, such as accommodating increased patient demand or covering employee absences, and consider how an AWS can help address those challenges. You might even want to include this information in the employee handbook.

2. Propose a written schedule to the affected work unit.

The proposed agreement must designate an alternate workweek, including a specified number of regularly recurring workdays and work hours. The schedule must provide no less than two consecutive days off within each workweek. You don’t have to specify specific days and hours, but you must say how many days a week and how many hours per day are proposed.

An example of this would be the referenced 4/10 alternate work schedule mentioned above.  The 4/10 work schedule is when an employer specifies that the employee must work 10 hours per day for four days out of the week.

Remember that this is a legally binding schedule which you cannot deviate from week to week. If the AWS is changed for a week, there must be proper notice between employer and employee, as well as a signed agreement. Also remember that you must account for a lunch. So, if you are scheduling them 10 work hours, the proposed AWS cannot be from 10am-8pm, but must include an additional 30 minutes to 1 hour for lunch. Also, if your proposal is approved, you are agreeing to pay employees for the proposed number of hours. Therefore, if you send a worker home early, you will still be required to pay him for the full number of promised hours (this is not required, however, if the employee chooses to leave early).

3. Provide a written disclosure of the effects of the proposed AWS

Discuss the potential AWS options with your team, gathering their feedback and addressing any concerns they may have. Involving your staff in the decision-making process can enhance their satisfaction and commitment to the chosen AWS.

This disclosure must be in both English and a non-English language if at least five percent of the affected employees primarily speak that language. You must hold a meeting at least 14 days prior to voting, in order to inform employees of the effects of the AWS on the employees’ wages, hours, and benefits. Additionally, employees must be given advance notice of this meeting. Any employees who cannot attend this meeting must be mailed a copy of the written disclosure.

4. Hold a secret ballot election.

All affected employees in the work unit are entitled to vote upon the proposed schedule, which requires a two-thirds vote to become effective. You must file the election results with the state’s Division of Labor Statistics and Research within 30 days after the results are final. You must then wait 30 days, as employees may not be required to work the AWS until 30 days have passed.

5. Send the results to register your AWS schedule.

You must send your proposed Alternate Work Schedule to the Department of Industrial Relations. You can find the address here.

Post-Implementation Suggestions

Regularly review the effectiveness of the AWS, make adjustments as necessary, and solicit employee feedback to ensure the arrangement continues to meet the needs of both the practice and its team members.

• Gather feedback from employees after 30, 60, and 90 days.
  During each milestone, encourage open dialogue about how the new schedule is impacting work-life balance and patient care duties. This allows the team to voice any emerging concerns or unforeseen challenges, enabling management to address them promptly.
• Track metrics like employee satisfaction, patient scheduling efficiency, and overtime costs.
  Monitoring these key indicators helps you measure both the financial and human impact of the alternative work schedule. Data on employee satisfaction can uncover morale boosters or stressors, while patient scheduling efficiency metrics spotlight areas for process improvements.
• Highlight the importance of flexibility to make adjustments as needed.
  Even with thorough planning, unforeseen circumstances like staff turnover or seasonal patient fluctuations can prompt the need for quick schedule changes. Demonstrating flexibility shows employees that leadership is committed to refining the AWS to meet evolving demands rather than rigidly enforcing a one-size-fits-all policy.

By following these guidelines, you can successfully implement an AWS in your dental practice while maintaining a high level of service and productivity.

Legal Considerations and Common Pitfalls

When implementing an Alternative Work Schedule (AWS) in California, you must ensure you are following all required procedures set by state law. One key mandate involves filing deadlines with the Division of Labor Statistics and Research, which must be met promptly to avoid penalties and to solidify the AWS’s legality. Equally important is maintaining proper records of employee votes and approvals, as the state may request proof that each step was conducted in a transparent and compliant manner.

Beyond these requirements, many employers stumble over a few common mistakes that can undermine the entire AWS process. One frequent error is failing to provide written disclosures in multiple languages when the affected workforce includes employees who primarily speak languages other than English. Another pitfall involves implementing alternative work schedules without proper documentation, such as omitting details on hours, days off, or legally mandated disclaimers. Thorough preparation and attention to these compliance details safeguard your practice against costly fines and help preserve a positive relationship with your team.

Addressing Common Employee Concerns

It is not unusual for employees to have concerns with a schedule shift. Some of the most common questions, and your potential answers, include:

1. Will I lose overtime pay?
   Under a properly adopted AWS, overtime generally applies only to hours worked beyond the agreed-upon schedule. However, if you exceed the daily or weekly limits set by state law, overtime pay still applies.
2. How will this affect my current schedule?
   The practice will aim to create schedules that align with patient needs while considering staff preferences whenever possible. You’ll receive clear notice in advance about any changes, giving you time to adjust.
3. Can I opt-out if AWS doesn’t work for me?
   While some AWS models allow for individual opt-outs, availability may depend on staffing requirements and approval from management. If you have legitimate concerns, bring them up early so they can be addressed or accommodated.
4. Will my pay or benefits change under AWS?
   Your base pay rate and benefits package typically remain the same unless the new schedule impacts hours worked or eligibility criteria. Always review updated documentation to confirm how any change might affect paid time off, health insurance, or other benefits.
5. Will I still be able to request time off?
   Yes, the existing policies for requesting leave or PTO remain in place, though coordination with the AWS calendar may be required. As always, submit your requests in advance to help ensure adequate coverage and smooth patient care.

How HR for Health Can Help

Generally speaking, the overall process to implement an Alternative Work Schedule in your California practice can take around two months from the date of the proposal to the implementation.  It is imperative that you follow the above steps to ensure the AWS is properly adopted within your practice to avoid any possible penalties or violations.

The State of California Department of Industrial Relations has a database of employers who have filed alternate workweek election results with the Division of Labor Standards Enforcement and can be found here: https://www.dir.ca.gov/databases/oprl/DLSR-AWE.html

For further information or guidance on creating an AWS for your California-based practice, HR for Health is ready to assist. Schedule a call today!