In an effort to provide the Employee with access to healthy food options at all times while at work, the Employer agrees to maintain uninterrupted access to the cafeteria or other food-providing service twenty-four hours per day, every day of the year. If food services are not available 24 hours a day, in the building complex the House Officer is assigned or reasonable proximity, the Employer will engage the HOA in a discussion to identify and implement an alternative solution. In the interim, should the need arise, the Employer will provide a method to provide fresh refrigerated food products within the House Officer Lounge or agreed upon alternative location. Food services will be reviewed on a yearly basis through the Labor-Management Committee (LMC). A mutually agreeable corrective action plan will be developed and implemented if this arrangement is found to be unsatisfactory to either party.

The Employer agrees to include house officers on appropriate committees or groups that pertain to food-related decisions.

The Employer agrees to encourage the consistent availability of healthy food options, and the expansion of the current menu to include items for non-traditional diets (possibly including Kosher, Vegan, Gluten-free, etc).

The Employer agrees to support the Employees in efforts to have local food establishments accept MCard (or equivalent) payment for food delivery.

Within 2-weeks upon hire, a House Officer will receive $100 on their MCards to alleviate the out-of-pocket expense and lapse in the meal allowance processing period. Amounts will be adjusted as follows:

A House Officer who works in the hospital eighteen (18) hours out of a twenty-four (24) hour period, beginning at 6:00 a.m., because they are required to do so, will receive a meal allowance from the University through procedures established by the Employer (funds added to the MCard), for the evening and the following morning meal weekdays. In addition, an allowance for the noon meal will be provided on Saturday and Sunday. This provision will only apply when the House Officer is on assignment at University of Michigan Health System. Meal allowances effective July 28, 2015, shall be for the following amounts: 1) Breakfast: $9.00 2) Lunch: $11.00 3) Dinner: $11.75

When patient care requires a House Officer to be in the hospital for equal to or greater than twelve (12) hours, and the hours worked include 7:00 p.m., the House Officer will receive a meal allowance for the evening meal. Any educational, clinical or administrative activity that is included in the calculation of clinical and educational work hours, as defined in Article VIII - Work Hours/Work Schedules, is considered appropriate to be included in this daily counting of 12 hours. When a House Officer has remained in-house for at least twelve (12) hours during the night shift and into the next morning, s/he will receive a meal allowance for the evening and breakfast meals. Management will encourage Program Administrators to send monthly communication to solicit any House Officers who have met the criteria for meal allowances. Any question regarding eligibility for meal allowance will be resolved by a House Officer's Program Director.

The Departments of Neurosurgery, Orthopedic Surgery, Surgery and Urology will preload $228 onto the MCard, prior to the start of each month, to qualifying House Officers based on the number of qualified House Officers.

A qualifying House Officer must be a house officer covered by this agreement on a clinical rotation at a University of Michigan Health System location.

If an issue arises with the availability of food options or the availability of meal allowances during a required rotation, that is a part of the standard curriculum, at an affiliated facility, then it is the duty of the House Officer to report these issues to the Program Director. If the issues cannot be resolved at a department level, then the issue can be brought forward to the LMC for further discussion.

Any meal allowance balance remaining on the House Officer's MCard upon separation of employment is forfeited, and it is not eligible to be cashed out or reimbursed to the House Officer.