COUNTY OF ORANGE CATASTROPHIC LEAVE PROCEDURES Effective July 4, 2008

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1 CATASTROPHIC LEAVE PROCEDURES Effective July 4, 2008 Purpose: Set forth procedures and requirements as required in Part I, Article I, Section 1.G. of the Personnel and Salary Resolution for a voluntary leave transfer program under which the unused accrued leave of an employee may be transferred for use by another employee who requests such leave because of a serious medical condition or other serious circumstance. Definitions A. Available paid leave means accrued or accumulated annual, vacation, PIP or Comp leave. B. Family member means the following relatives of the employee: 1. Spouse, and parents thereof; 2. Children, including adopted children; 3. Parents, including step-parents; 4. Brothers and sisters, and 5. Grandparent or legal guardian C. Donor means an employee whose voluntary written request for transfer of eligible leave to the leave account of a leave recipient is approved by the requesting agency. D. Donee means a current employee for whom the employing agency has approved an application to receive leave from the eligible leave accounts of one or more leave donors. E. Serious Medical Condition means a medical condition of an employee or a family member of such employee that is likely to require an employee s absence from duty for at least 14 calendar days and results in a substantial loss of income to the employee because of the unavailability of paid leave. F. Other Serious Circumstance means a serious circumstance other than medical that will be disclosed to employees. Eligibility for Donations A. To become eligible for catastrophic leave an employee must: 1. Have a catastrophic medical condition or other serious circumstance which will require the employee to be on unpaid leave for at least 14 calendar days. 2. Exhaust all accrued annual leave, sick leave, vacation, PIP and compensatory time. 3. For a medical condition, the employee must submit to the employee s Agency/Department Head (or his/her designee) a written request for donations. The request must be accompanied by: i. A medical statement from the attending physician which includes a brief statement of the nature of the illness or injury ii. An estimated time period the employee will be unable to work iii. County of Orange Request Form which certifies the employee s or their eligible family member s qualifying serious medical condition [EXHIBIT A]. 4. For other serious circumstances, the employee must submit to the employee s Agency/Department Head (or his/her designee) a written request for donations accompanied by

2 Catastrophic Leave Donations 2 i. County of Orange Request Form which certifies the nature of the serious circumstance [EXHIBIT B] ii. An estimated time period the employee will be unable to work iii. Any documentation to support the serious circumstance B. Employees who receive donations under this procedure and who exhaust all donated leave may request an additional donation period subject to the provisions above. C. Agency/Department Head has discretion to accept or reject request. D. An employee cannot request catastrophic leave retroactively but may request leave from the current pay period that the donated hours are needed onward. Donation Procedure A. Upon receipt of a valid request for donations from an eligible employee, the Agency/Department shall post a notice of the eligible employee s need for donations through to all agency/departments. B. If the request is for a medical condition, confidential medical information shall not be included in the posted notice. C. If the request is for a serious circumstance, the notice must clearly state this is due to other serious circumstance and all donations will be taxable income for the donor; the nature of the circumstance shall be included in the notice. D. Employees shall be provided a two week period to submit their donations. E. Donations should be date stamped as Departments receive them and kept in order by date received. F. Donations received after the 2 week submission period shall not be processed. G. All donations shall be voluntary. H. Employees may donate vacation, annual leave, PIP or compensatory time to the eligible employee. I. Sick leave may not be donated. J. Donations must be a minimum of two (2) hours, but cannot exceed twenty four (24) hours per donating employee; donations must be made in whole hour increments. Employee Donation Forms A. Donor employees must submit a catastrophic leave donation form to the requesting agency with the number of donated hours of accrued annual leave, vacation, comp and/or PIP balance(s) to be transferred from their leave account to the leave account of a donee. (Must use the County of Orange Catastrophic Leave Donation Form for Serious Medical Conditions [EXHIBIT C] or for Other Serious Circumstances [EXHIBIT D]) B. The donation form provides the following information: 1. the donee s name, agency/department, donation period, agency contact information and description of the other serious circumstance if relevant; 2. the donor s name; social security number, contact phone number, department name and agency number; 3. the number of hours and type of leave balance(s) to be donated; and 4. the donor s signature and date authorizing the transfer of the donated time. C. Donation authorizations which do not contain all of the information above shall not be processed.

3 Catastrophic Leave Donations 3 D. The employing agency of a leave donor shall determine that the amount of annual leave, vacation time, PIP, or Comp time to be donated does not exceed the limitations on donation of leave (2 hrs minimum 24 hrs maximum). E. An employee who is on leave without pay at the time he or she receives a Catastrophic Leave Donation will be treated as if on an Official Leave of Absence for purposes of probation and merit increase eligibility. Accrual of annual leave or vacation time While an employee is in a shared leave status, annual leave, vacation time, or sick time shall accrue to the credit of the employee at the same rate as if the employee were in a paid leave status Use of transferred annual leave A leave recipient may use annual leave or vacation transferred to their account only for the purpose of a medical emergency or other serious circumstance for which the leave recipient was approved. Transferred leave may not be transferred to another leave recipient. Record Retention Each agency shall maintain the applications approved for medical emergencies or other serious circumstances affecting the employee and the applications approved for medical emergencies affecting an employee s family member for 5 years. Calculation of donated hours Donated time will be transferred on a straight hour to hour basis. Departments Submission of Donation Forms to Central Payroll A. At the close of the donation period, the department will batch the donation forms as close to 80 hours as possible up to a maximum of 96 hours on a first-in, first-used basis. B. The department shall confirm the hours donated by the employees to verify that they have sufficient time to cover the designated donation. C. The Auditor Controller Catastrophic Leave Memo for either Serious Medical Conditions [EXHIBIT E] or for Other Serious Circumstances [EXHIBIT F] will be attached to the current pay period batch for processing with the appropriate HR/Payroll signature. D. The department will change the status of the donee to L for leave with pay. This will allow the employee to accrue balances. Use the first day of the pay period the leave will become effective. Deadline for Donation Form Submission A. Regular Payroll Forms must to be received by central payroll no later than Monday following payday to be used on current pay period. (For example, forms need to be received by July 14, 2008 to be inputted on the employee s timesheet for Pay Period 15).

4 Catastrophic Leave Donations 4 B. Supplemental Payroll If forms are received after Monday, there is no guarantee that they will be input in the CAPS system for the current pay period. In this instance, once the time is in the system, a department can submit a supplemental to central payroll to pay the employee on pay day (For example, if forms are received July 17 and the time is inputted into the system by July 22, the department can submit a supplemental for Pay Period 15 hours on July 24 to be paid on pay day July 25) Termination of Donations A. Departments will destroy or return to employees any remaining donation forms (not submitted to Auditor-Controller Central Payroll, when a leave recipient s catastrophic leave is terminated; (death, returns to work, separates, approved for disability retirement etc.) B. When the medical emergency affecting a leave recipient terminates, no further requests for transfer of annual leave to the leave recipient may be granted. C. If an employee is receiving catastrophic leave and is approved for worker s comp, the departments must notify central payroll. All time that is to be reinstated to an employee approved for worker s comp will be adjusted so that the catastrophic leave hours donated to this employee are returned to the donor employee.

5 Catastrophic Leave Donations 5 EXHIBIT A EMPLOYEE S CATASTROPHIC LEAVE REQUEST FORM FOR SERIOUS MEDICAL CONDITIONS Employee s Name: Classification: Agency/Dept.: Expected Dates of Absence: Beginning Date: End Date: **Please attach Doctor s statement** This request is for the following: Self Family Member (If request is for family member, please indicate relationship) Relationship: I certify that my request for Catastrophic Leave Donations is due to a serious medical condition either for myself or for a family member and that the information provided is true and correct. Employee s Signature: Date: TO BE COMPLETED BY HUMAN RESOURCES DEPARTMENT 1. Date on which employee will have exhausted all leave balances: 2. Request was: Approved By Agency/Department Head (signature) Denied By Agency/Department Head (signature)

6 Catastrophic Leave Donations 6 EXHIBIT B EMPLOYEE S CATASTROPHIC LEAVE REQUEST FORM FOR OTHER SERIOUS CIRCUMSTANCES Employee s Name: Classification: Agency/Dept.: Expected Dates of Absence: Beginning Date: End Date: I am requesting Catastrophic Leave Donations for the following serious circumstance: (Please type in a brief explanation and attach documentation that will support your request) I understand that information provided stating the reason for my request will be disclosed and distributed with this form. Employee s Signature: Date: TO BE COMPLETED BY HUMAN RESOURCES DEPARTMENT 1. Date when employee will have exhausted all leave balances 2. Request was: Approved by Agency/Department Head (signature) Denied by Agency/Department Head (signature)

7 Catastrophic Leave Donations 7 EXHIBIT C CATASTROPHIC LEAVE DONATION FOR SERIOUS MEDICAL CONDITION OF EMPLOYEE OR EMPLOYEE S FAMILY MEMBER NAME OF EMPLOYEE AND TITLE from AGENCY ASSIGNED TO is eligible for catastrophic leave donations. Any assistance is greatly appreciated. Donation period is ENTER DONATION PERIOD. Those desiring to donate hours should send/pony the completed form to EMPLOYEE NAME AND LOCATION. Please complete information below. Type information, print form, sign and date, and submit to requesting agency. If you have any questions, contact EMPLOYEE NAME AND PHONE NUMBER. Catastrophic Leave Donation I understand this contribution is for catastrophic medical leave. I understand it is my responsibility to ensure that I have adequate leave balances available since donations will be processed in 80 hour increments for the duration of the catastrophic leave period and my donation may not be used until a future date. I further understand if the recipient s catastrophic leave ends before my donation is used, my donated hours will not be taken from my balances. I hereby authorize the transfer of hours indicated below to this employee. Leave Donor Name: Social Security #: Contact Phone #: Agency/Dept: Number of Hours Donated (2 hrs minimum 24 hrs maximum): Annual Leave: Vacation: COMP: PIP: Sick leave may NOT be donated. EMPLOYEE SIGNATURE & DATE _ (Must be signed by donating employee in order to process)

8 Catastrophic Leave Donations 8 EXHIBIT D CATASTROPHIC LEAVE DONATION FOR OTHER SERIOUS CIRCUMSTANCES NAME OF EMPLOYEE AND TITLE from AGENCY ASSIGNED TO is eligible for catastrophic leave donation due to a serious circumstance which is DESCRIBE SERIOUS CIRCUMSTANCE Any assistance is greatly appreciated. Donation period is ENTER DONATION PERIOD. Those desiring to donate hours should send/pony the completed form to EMPLOYEE NAME AND LOCATION. Please complete information below. Type information, print form, sign and date, and submit to requesting agency. If you have any questions, contact EMPLOYEE NAME AND PHONE NUMBER. Catastrophic Leave Donation I understand this contribution is being made pursuant to a request that will be subject to tax withholding and my donation will be reported as taxable income to me that will be included on my W2. I understand it is my responsibility to ensure that I have adequate leave balances available since donations will be processed in 80 hour increments for the duration of the catastrophic leave period and my donation may not be used until a future date. I further understand if the recipient s catastrophic leave ends before my donation is used, my donated hours will not be taken from my balances. I hereby authorize the transfer of hours indicated below to this employee. Please initial the box to indicate you have read and understand the above paragraph. Leave Donor Name: Social Security #: Contact Phone #: Agency/Dept: Number of Hours Donated (2 hrs minimum 24 hrs maximum): Annual Leave: Vacation: COMP: PIP: Sick leave may NOT be donated. EMPLOYEE SIGNATURE & DATE (Must be signed by donating employee in order to process)

9 Catastrophic Leave Donations 9 EXHIBIT E CATASTROPHIC LEAVE MEMO FOR SERIOUS MEDICAL CONDITION OF EMPLOYEE OR EMPLOYEE S FAMILY MEMBER Date: To: From: Subject: XX/XX/XX Auditor Controller, Payroll Section Include name and contact number Catastrophic Leave Donation for a Serious Medical Condition Catastrophic Leave Donation for: Recipient Name: Social Security #: Department: Title: Total Number of Hours: 96 hrs maximum per pay period Pay Period: I certify that I have reviewed the above information and to the best of my knowledge it is true and correct. I herby certify that our department has received written verification from the employee regarding the nature of the personal or family SERIOUS MEDICAL CONDITION and the above claimant is authorized to receive Catastrophic Leave Donations. HR/Payroll Department Certification

10 Catastrophic Leave Donations 10 EXHIBIT F CATASTROPHIC LEAVE MEMO FOR OTHER SERIOUS CIRCUMSTANCES Date: To: From: Subject: XX/XX/XX Auditor Controller, Payroll Section Include name and contact number Catastrophic Leave Donation for Other Serious Circumstances Catastrophic Leave Donation for: Recipient Name: Social Security #: Department: Title: Total Number of Hours: 96 hrs maximum per pay period Pay Period: I certify that I have reviewed the above information and to the best of my knowledge it is true and correct. I hereby certify that our department has received written verification from the employee and the above claimant is authorized to receive Catastrophic Leave Donations for other serious circumstances. I further certify that our department has notified all leave donors that their donations are taxable income and will be included on their W2s. HR/Payroll Department Certification