Unpaid family and medical leave will be granted up to twelve (12) weeks per year to assist employees in balancing family and work life. For purposes of this policy, year is defined as a “rolling” twelve (12) month period measured backward from the date of any FMLA leave usage. Requests for family and medical leave will be made to the superintendent.
Employees may be allowed to substitute paid leave for unpaid family and medical leave by meeting the requirements set out in the family and medical leave administrative rules. Employees eligible for family and medical leave must comply with the family and medical leave administrative rules prior to starting family and medical leave.
It is the responsibility of the superintendent to develop administrative rules to implement this policy.
Links:
https://www.dol.gov/whd/regs/compliance/posters/fmlaen.pdf
WH-380-E Certification of Health Care Provider for Employee’s Serious Health Condition (PDF)
WH-380-F Certification of Health Care Provider for Family Member’s Serious Health Condition (PDF)
WH-381 Notice of Eligibility and Rights & Responsibilities (PDF)
WH-384 Certification of Qualifying Exigency For Military Family Leave (PDF)
Legal Reference:
29 U.S.C. §§ 2601 et seq.
Iowa Code §§ 20; 85; 216; 279.40.
Whitney v. Rural Ind. School District, 232 Iowa 61, 4 N.W.2d 394 (1942).
Cross Reference:
409.2 Employee Leaves of Absence
Approved: 12/9/96 Reviewed: 04/10/2023 Revised: 8/10/2020
This document is available at https://www.dol.gov/sites/dolgov/files/WHD/legacy/files/fmlaen.pdf
NOTE: FMLA section 109 (29 U.S.C. § 2619) requires FMLA covered employers to post a notice. Regulations 29 C.F.R. § 825.300(a) may require additional disclosures.
Date:____________________
I, ______________________________, request family and medical leave for the following reason: (check all that apply)
_____ for the birth of my child;
_____ for the placement of a child for adoption or foster care;
_____ to care for my child who has a serious health condition;
_____ to care for my parent who has a serious health condition;
_____ to care for my spouse who has a serious health condition; or
_____ because I am seriously ill and unable to perform the essential functions of my position.
_____ because of a qualifying exigency arising out of the fact that my ___spouse; ___ son or daughter; ___parent is on active duty or call to active duty status in support of a contingency operation as a member of the National Guard or Reserves.
_____ because I am the ___ spouse; ___ son or daughter; ___ parent; ___next of kin of a covered service member with a serious injury or illness.
I acknowledge my obligation to provide medical certification of my serious health condition or that of a family member in order to be eligible for family and medical leave within 15 days of the request for certification.
I acknowledge receipt of information regarding my obligations under the family and medical leave policy of the school district.
I request that my family and medical leave begin on ____________________ and I request leave as follows: (check one of the three (3) options)
_____ continuous, and I anticipate that I will be able to return to work on ___________.
_____ intermittent leave for the:
_____ birth of my child or adoption or foster care placement subject to agreement by the district;
_____ serious health condition of myself, parent, or child when medically necessary;
_____ because of a qualifying exigency arising out of the fact that my ___spouse; ___ son or daughter; ___parent is on active duty or call to active duty status in support of a contingency operation as a member of the National Guard or Reserves.
_____ because I am the ___ spouse; ___ son or daughter; ___ parent; ___next of kin of a covered service member with a serious injury or illness.
Details of the needed intermittent leave:
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I anticipate returning to work at my regular schedule on _________________.
_____ reduced work schedule for the:
_____ birth of my child or adoption or foster care placement subject to agreement by the district;
_____ serious health condition of myself, parent, or child when medically necessary;
_____ because of a qualifying exigency arising out of the fact that my ___spouse; ___ son or daughter; ___parent is on active duty or call to active duty status in support of a contingency operation as a member of the National Guard or Reserves.
_____ because I am the ___ spouse; ___ son or daughter; ___ parent; ___next of kin of a covered service member with a serious injury or illness.
Details of needed reduction in work schedule as follows:
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I anticipate returning to work at my regular schedule on ___________________.
I realize I may be moved to an alternative position during the period of the family and medical intermittent or reduced work schedule leave. I also realize that with foreseeable intermittent or reduced work schedule leave, subject to the requirements of my health care provider, I may be required to schedule the leave to minimize interruptions to school district operations.
While on family and medical leave, I agree to pay my regular contributions to employer sponsored benefit plans. My contributions will be deducted from moneys owed me during the leave period. If no monies are owed me, I will reimburse the school district by personal check or cash for my contributions. I understand that I may be dropped from the employer-sponsored benefit plans for failure to pay my contribution.
I agree to reimburse the school district for any payment of my contributions with deductions from future monies owed to me or the school district may seek reimbursement of payments of my contributions in court.
I acknowledge that the above information is true to the best of my knowledge.
Signed: |
________________________________________________________________ |
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Date: |
_____________________________ |
If the employee requesting leave is unable to meet the above criteria, the employee is not eligible for family and medical leave.
Approved: 12/13/2015 Reviewed: 4/10/2023 Revised: 8/10/2020
EMPLOYEE FAMILY AND MEDICAL LEAVE REGULATIONS
A. School District Notice
1. The school district will post the notice in Exhibit 409.3E1 regarding family and medical leave.
2. Information on the Family and Medical Leave Act and the board policy on family and medical leave, including leave provisions and employee obligations will be provided annually. The information will be in the employee handbook.
3. When an employee requests family and medical leave, the school district will provide the employee with information listing the employee's obligations and requirements. Such information will include:
a. a statement clarifying whether the leave qualifies as family and medical leave and will, therefore, be credited to the employee's annual 12-week entitlement or 26 week entitlement depending on the purpose of the leave;
b. a reminder that employees requesting family and medical leave for their serious health condition or for that of an immediate family member must furnish medical certification of the serious health condition and the consequences for failing to do so or proof of call to active duty in the case of military family and medical leave;
c. an explanation of the employee's right tosubstitute paid leave for family and medical leave including a description of when the school district requires substitution of paid leave and the conditions related to the substitution; and
d. a statement notifying employees that they must pay and must make arrangements for paying any premium or other payments to maintain health or other benefits.
B. Eligible Employees
Employees are eligible for family and medical leave if the following criteria are met:
1. The employee has worked for the school district for at least twelve (12) months or fifty-two (52) weeks (the months and weeks need not be consecutive); and
2. The employee has worked at least 1,250 hours during the 12 months immediately before the FMLA leave is to begin. Full-time professional employees who are exempt from the wage and hour law may be presumed to have worked the minimum hour requirement.
C. Employee Requesting Leave - two types of leave
1. Foreseeable family and medical leave
a. Definition - leave is foreseeable for the birth or placement of an adopted or foster child with the employee or for planned medical treatment.
b. Employees must give at least thirty (30) days notice for foreseeable leave. Failure to give the notice may result in the leave beginning thirty (30) days after notice was received. For those taking leave due to military family and medical leave, notice should be given as soon as possible.
c. Employees must consult with the school district prior to scheduling planned medical treatment leave to minimize disruption to the school district. The scheduling is subject to the approval of the health care provider.
2. Unforeseeable family and medical leave.
a. Definition - leave is unforeseeable in such situations as emergency medical treatment or premature birth.
b. Employee must give notice as soon as possible but no later than one to two work days after learning that leave will be necessary.
c. A spouse or family member may give the notice if the employee is unable to personally give notice.
D. Eligible Family and Medical Leave Determination. The school district may require the employee giving notice of the need for leave to provide reasonable documentation or a statement of family relationship.
1. Six purposes:
a. The birth of a son or daughter of the employee and in order to care for that son or daughter prior to the first anniversary of the child's birth;
b. The placement of a son or daughter with the employee for adoption or foster care and in order to care for that son or daughter prior to the first anniversary of the child's placement;
c. To care for the spouse, son, daughter or parent of the employee if the spouse, son, daughter or parent has a serious health condition;
d. Employee's serious health condition that makes the employee unable to perform the essential functions of the employee's position;
e. Because of a qualifying exigency arising out of the fact that an employee’s _____spouse, _____son or daughter or _____parent is on active duty or call to active duty status in support of a contingency operation as a member of the National Guard or Reserves; or
f. Because the employee is the _____spouse, _____son or daughter, _____parent or _____next of kin of a covered service member with a serious injury or illness.
2. Medical certification.
a. When required:
1. Employees shall be required to present medical certification of the employee's serious health condition and inability to perform the essential functions of the job;
2. Employees shall be required to present medical certification of the family member's serious health condition and that it is medically necessary for the employee to take leave to care for the family member; and/or
3. Employees shall be required to present certification of the call to active duty when taking military family and medical leave.
b. Employee's medical certification responsibilities:
1. The employee must obtain the certification from the health care provider who is treating the individual with the serious health condition;
2. The school district may require the employee to obtain a second certification by a health care provider chosen by and paid for by the school district if the school district has reason to doubt the validity of the certification an employee submits. The second health care provider cannot, however, be employed by the school district on a regular basis;
3. If the second health care provider disagrees with the first health care provider, then the school district may require a third health care provider to certify the serious health condition. This health care provider must be mutually agreed upon by the employee and the school district and paid for by the school district. This certification or lack of certification is binding upon both the employee and the school district.
c. Medical certification will be required fifteen (15) days after family and medical leave begins unless it is impracticable to do so. The school district may request recertification every thirty (30) days. Recertification must be submitted within fifteen (15) days of the school district's request.
d. Employees taking military caregiver family and medical leave to care for a family service member cannot be required to obtain a second opinion or to provide recertification.
Family and medical leave requested for the serious health condition of the employee or to care for a family member with a serious health condition which is not supported by medical certification will be denied until such certification is provided.
E. Entitlement.
1. Employees are entitled to twelve (12) weeks unpaid family and medical leave per year. Employees taking military caregiver family and medical leave to care for a family service member are entitled to twenty-six (26) weeks of unpaid family and medical leave but only in a single twelve (12) month period.
2. Year is defined as the twelve (12) month period beginning July 1 any year and ending June 30 the following year.
3. If insufficient leave is available, the school district may:
a. Deny the leave if entitlement is exhausted;
b. Award leave available; and/or
c. Award leave in accordance with other provisions of board policy or the collective bargaining agreement.
F. Type of Leave Requested.
1. Continuous - employee will not report to work for set number of days or weeks
2. Intermittent - employee requests family and medical leave for separate periods of time.
a. Intermittent family and medical leave is available for:
_____The birth or adoption of the employee’s child, foster care placement subject to agreement by the district;
_____Serious Health condition of myself spouse, parent or child, when medically necessary;
_____Because a qualifying exigency arising out of the fact that the _____ spouse, _____son or daughter, _____ parent is on active duty or call to active duty status in support of a contingency operation as a member of the National Guard or Reserves; and/or
_____Because I am the _____spouse, _____son or daughter, _____parent or _____next of kin of a covered service member with a serious injury or illness.
b. In the case of foreseeable intermittent leave, the employee must schedule the leave to minimize disruption to the school district operation.
c. During the period of foreseeable intermittent leave, the school district may move the employee to an alternative position with equivalent pay and benefits. (For instructional employees, see G below.)
3. Reduced work schedule - employee requests a reduction in the employee's regular work schedule.
a. Reduced work schedule family and medical leave is available for:
_____ The birth or adoption of the employee’s child, foster care placement subject to agreement by the district;
_____Serious health condition of myself, spouse, parent or child, when medically necessary;
_____because of a qualifying exigency arising out of the fact that my _____ spouse, _____son or daughter, _____parent is on active duty or call to active duty status in support of a contingency operation as a member of the National Guard or Reserves; and/or
_____the employee is the spouse, son or daughter, parent or next of kin of a covered service member with a serious injury or illness.
b. In the case of foreseeable reduced work schedule leave, the employee must schedule the leave to minimize disruption to the school district operation.
c. During the period of foreseeable reduced work schedule leave, the school district may move the employee to an alternative position with equivalent pay and benefits. (For instructional employees, see G below.)
G. Special Rules for Instructional Employees.
1. Definition - an instructional employee is one whose principal function is to teach and instruct students in a class, a small group or an individual setting. This includes, but is not limited to, teachers, coaches, driver's education instructors and special education assistants.
2. Instructional employees who request foreseeable medically necessary intermittent or reduced work schedule family and medical leave greater than twenty percent (20%) of the work days in the leave period may be required to:
a. Take leave for the entire period or periods of the planned medical treatment; or
b. Move to an available alternative position, with equivalent pay and benefits, but not necessarily equivalent duties, for which the employee is qualified.
3. Instructional employees who request continuous family and medical leave near the end of a semester may be required to extend the family and medical leave through the end of the semester. The number of weeks remaining before the end of a semester does not include scheduled school breaks, such as summer, winter or spring break.
a. If an instructional employee begins family and medical leave for any purpose more than five weeks before the end of a semester, the school district may require that the leave be continued until the end of the semester if the leave will last at least three weeks and the employee would return to work during the last three weeks of the semester if the leave was not continued.
b. If the employee begins family and medical leave for a purpose other than the employee's own serious health condition during the last five weeks of a semester, the school district may require that the leave be continued until the end of the semester if the leave will last more than two weeks and the employee would return to work during the last two weeks of the semester.
c. If the employee begins family and medical leave for a purpose other than the employee's own serious health condition during the last three weeks of the semester and the leave will last more than five working days, the school district may require the employee to continue taking leave until the end of the semester.
4. The entire period of leave taken under the special rules is credited as family and medical leave. The school district will continue to fulfill the school district's family and medical leave responsibilities and obligations, including the obligation to continue the employee's health insurance and other benefits, if an instructional employee's family and medical leave entitlement ends before the involuntary leave period expires.
H. Employee responsibilities while on family and medical leave.
1. Employees must continue to pay health care benefit contributions or other benefit contributions regularly paid by the employee unless the employee elects not to continue the benefits.
2. The employee contribution payments will be deducted from any money owed to the employee or the employee will reimburse the school district at a time set by the superintendent.
3. An employee who fails to make the health care contribution payments within thirty (30) days after they are due will be notified that their coverage may be canceled if payment is not received within an additional fifteen (15) days.
4. An employee may be asked to re-certify the medical necessity of family and medical leave for the serious medical condition of an employee or family member once every thirty (30) days and return the certification within fifteen (15) days of the request.
5. The employee must notify the school district of the employee's intent to return to work at least once each month during their leave and at least two (2) weeks prior to the conclusion of the family and medical leave.
6. If an employee intends not to return to work, the employee must immediately notify the school district, in writing, of the employee's intent not to return. The school district will cease benefits upon receipt of this notification.
I. Use of paid leave for family and medical leave.
An employee may substitute unpaid family and medical leave with appropriate paid leave available to the employee under board policy, individual contracts or the collective bargaining agreement. Paid leave includes, but is not limited to, sick leave, family illness leave, vacation, personal leave, bereavement leave and professional leave. When the school district determines that paid leave is being taken for an FMLA reason, the school district will notify the employee within two business days that the paid leave will be counted as FMLA leave.
Approved: 8/8/2016 Reviewed: 4/10/2023 Revised: 4/10/2023
EMPLOYEE FAMILY AND MEDICAL LEAVE DEFINITIONS
Active Duty - duty under a call or order to active duty under a provision of law referring to in section 101(a)(13) of title 10, U.S. Code.
Common Law Marriage - according to Iowa law, common law marriages exist when there is a present intent by the two parties to be married, continuous cohabitation, and a public declaration that the parties are husband and wife. There is no time factor that needs to be met in order for there to be a common law marriage.
Contingency Operation - has the same meaning given such terms in section 101(a)(13) of title 10, U.S. Code.
Continuing Treatment - a serious health condition involving continuing treatment by a health care provider includes any one or more of the following:
Covered Servicemember - a current member of the Armed Forces, including a member of the National Guard or Reserves, who is undergoing medical treatment, recuperation, or therapy, is otherwise in outpatient status, or is otherwise on the temporary disability retired list, for a serious injury or illness.
Eligible Employee - The employee has worked for the district for at least twelve months and has worked at least 1250 hours within the previous year.
Essential Functions of the Job - those functions which are fundamental to the performance of the job. It does not include marginal functions.
Employment Benefits - all benefits provided or made available to employees by an employer, including group life insurance, health insurance, disability insurance, sick leave, annual leave, educational benefits, and pensions, regardless of whether such benefits are provided by a practice or written policy of an employer or through an "employee benefit plan."
Family Member - individuals who meet the definition of son, daughter, spouse or parent.
Group Health Plan - any plan of, or contributed to by, an employer (including a self-insured plan) to provide health care (directly or otherwise) to the employer's employees, former employees, or the families of such employees or former employees.
Health Care Provider-
In Loco Parentis - individuals who had or have day-to-day responsibilities for the care and financial support of a child not their biological child or who had the responsibility for an employee when the employee was a child.
Incapable of Self-Care - that the individual requires active assistance or supervision to provide daily self-care in several of the "activities of daily living" or "ADLs." Activities of daily living include adaptive activities such as caring appropriately for one's grooming and hygiene, bathing, dressing, eating, cooking, cleaning, shopping, taking public transportation, paying bills, maintaining a residence, using telephones and directories, using a post office, etc.
Instructional Employee - an employee employed principally in an instructional capacity by an educational agency or school whose principal function is to teach and instruct students in a class, a small group, or an individual setting, and includes athletic coaches, driving instructors, and special education assistants such as signers for the hearing impaired. The term does not include teacher assistants or aides who do not have as their principal function actual teaching or instructing, nor auxiliary personnel such as counselors, psychologists, curriculum specialists, cafeteria workers, maintenance workers, bus drivers, or other primarily noninstructional employees.
Intermittent Leave - leave taken in separate periods of time due to a single illness or injury, rather than for one continuous period of time, and may include leave or periods from an hour or more to several weeks.
Medically Necessary - certification for medical necessity is the same as certification for serious health conditions.
"Needed to Care For" - the medical certification that an employee is "needed to care for" a family member encompasses both physical and psychological care. For example, where, because of a serious health condition, the family member is unable to care for his or her own basic medical, hygienic or nutritional needs or safety or is unable to transport himself or herself to medical treatment. It also includes situations where the employee may be needed to fill in for others who are caring for the family member or to make arrangements for changes in care.
Next of Kin - an individual's nearest blood relative
Outpatient Status - the status of a member of the Armed Forces assigned to one of the following:
Parent - a biological parent or an individual who stands in loco parentis to a child or stood in loco parentis to an employee when the employee was a child. Parent does not include parent-in-law.
Physical or Mental Disability - a physical or mental impairment that substantially limits one or more of the major life activities of an individual.
Reduced Leave Schedule - a leave schedule that reduces the usual number of hours per workweek, or hours per workday, of an employee.
Serious Health Condition -
Serious Injury or Illness - an injury or illness incurred by a member of the Armed forces, including the National Guard or Reserves in the line of duty on active duty in the Armed Forces that may render the member medically unfit to perform the duties of the member's office, grade, rank, or rating.
Son or daughter - a biological child, adopted child, foster child, stepchild, legal ward, or a child of a person standing in loco parentis. The child must be under age 18 or, if over 18, incapable of self-care because of a mental or physical disability.
Spouse - a husband or wife recognized by Iowa law including common law marriages.
Cross References:
409.2 Employee Leaves of Absence
Approved: 8/8/2016 Reviewed: 4/10/2023 Revised: 4/10/2023