HomeMy WebLinkAboutCatastrophic Leave Program
Augusta Richmond GA
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Catastrophic Leave Program
1. General
The Catastrophic Leave Program is a voluntary program which allows Augusta-
Richmond County employees to donate a portion of their vacation leave to assist other
"regular" employees who have exhausted all paid leave and are unable to work because
of a catastrophic illness and/or injury to themselves or an immediate family member
which has caused or is likely to cause the employee to take leave without payor
terminate his or her employment. Immediate family members shall include: spouse,
children (naturally, legally adopted, or step-children) or in situations that place primary
responsibility for cclre on the employee.
All requests for Catastrophic Leave time must be accompanied by a physician's
statement (chosen by employee), subject to reconfirmation by a physician chosen by
Augusta-Richmond County which states:
a description of the illness
the beginning date of the condition
a prognosis for recovery
the anticipated return to work date
If the time is being requested to care for a family member, the request must also
include:
the relationship
a statement concerning to what extent the family member is dependent on the
employee for continuing care
All requests should be forwarded to the Human Resource Department. The Human
Resources Department in conjunction with the Equal Opportunity Officer will review the
Catastrophic Leave request for proper justification and past compliance with department
sick leave use guidelines. These individuals will have 5 working days in which to
approve all or part of the request, or to deny the request. Options to maintain employee
in pay status (modified duty/work hours, intermittent/reduced leave schedules) are to be
considered first.
2. Eligible Donators
Any "regular" employee as defined in the Augusta-Richmond County Personnel Policies
and Procedures Manual is eligible to participate in the program after completing the
initial 12-month probationary period. Employee must have leave available.
3. Recipient Eligibility
Employees who are eligible to receive catastrophic transfers of leave are those who are
eligible to earn and use vacation hours, have exhausted all forms of paid leave(
vacation, sick leave and compensatory time) prior to the transfer of leave hours and are
not receiving WOrkE!r's compensation benefits. Employee must be suffering from a
serious medical hardship, catastrophic illness or injury to either themselves or an
immediate family member. Employees are ineligible if they have been disciplined
(written) for abuse of sick leave. Employees may apply for up to 60 days maximum per
year.
4. Donations
All donations are voluntary and are made to an individual. Donations must be of
accrued vacation leave only. Donations must be 8 hours or more of the donor's vacation
leave. The annual maximum donation is 50% of the donor's vacation balance at the time
of the transfer or SO% of the donor's annual leave accrual entitlement, whichever is less.
Donated vacation leave hours will be converted into sick leave, and transferred to the
recipient employee on an hour for hour basis. Donations will only be made at the time of
an authorized reqUi3st for assistance. The donated vacation leave hours will be reported
through an approv'3d catastrophic leave form. This allows the Payroll Department to
make the necessary adjustments to vacation leave balances.
5. Application for Leave
To request assistance, an employee must submit a leave form request to his
Department Director, who forwards the request and appropriate medical verification to
Human Resources. The Department Director may request that members within the
department donate vacation leave, and may request that other Department Directors
request the same of their employees. The prospective donor must submit a written
request to the dep;artment head or designee, indicating the amount to be donated (8
hours or more) and the name and department of the recipient. The request should also
state that :the donor understands that the donation is voluntary and will not be returned jf
unused. . Donation forms should be forwarded to Human Resources. Upon
approval/denial of the request, Human Resources will forward all necessary paperwork
to the Payroll department. If approved, the granted leave is meant to cover only the
duration of the illness/injury for which it was granted.
6. Administration
The program will be a pilot for six months. After six months of operation, the progress of
the program will be reviewed and consideration will be given as to its continuation.
C:\My Documents\AGENDA \Catastrophic Leave Program. doc
AUGUSTA-RICHMOND COUNTY
CATASTROPHIC LEAVE PROGRAM
VACATION LEAVE DONATION FORM
I would like to donate ANNUAL LEAVE to:
in the amount of :
[ ] 8 hours
other C3mount
The minimal amount of donation is 8 hours - the maximum amount allowable is
50% of the donor's vacation balance at the time of the transfer or 50% of the
donor's annual/eave accrual entitlement, whichever is less.
I understand that the Payroll Department will deduct the above specified hours of
vacation leave from my vacation leave balance. I affirm that this leave is given
freely, without any promise of benefit or threat of reprisal if I fail to make this
donation.
SIGNATURE:
DATE:
FULL NAME:
(Please print or type)
DEPARTMENT:
********************'1~*********************************************************************
TO BE COMPLETED BYTHE PAYROLL DEPARTMENT
Vacation Leave Balance Before Donation
Number of Hours Donated
New Vacation Balance
Sick Leave Balance
AUGUSTA-RICHMOND COUNTY
CATASTROPHIC LEAVE PROGRAM APPLICATION
Return application to Department Head:
DATE:
NAME:
HOME ADDRESS:
DEPARTMENT:
JOB TITLE:
TELEPHONE NO: WORK:
HOME:
NUMBER OF HOURS YOU ARE REQUESTING:
BEGINNING DATE:
ENDING DATE:
DATE OF HIRE:
LAST DAY WORKED:
PHYSICIAN NAME:
(ATTACH PHYSICIAN STATEMENT)
NATURE OF ILLNESS:
IS THIS WORK RELATED:
IS SURGERY REQUIRED?
DATE OF ONSET OF CURRENT ILLNESS:
HAVE YOU HAD THIS ILLNESS PREVIOUSLY?
HAVE YOU REQUESTED CATASTROPHIC LEAVE FOR THIS CONDITION
PREVIOUSL Y?
YES
NO
IF SO, WHEN?
APPLICANT'S SIGNATURE:
********************************************************************************************
REQUEST APPROVED
REQUEST DENIED
HUMAN RESOURCES DIRECTOR AND EEO OFFICER SIGNATURE/DATE
Please provide ALL infc:>rmation requested. Incomplete applications will not be processed.