Resolution No. 6696
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RBSOLU'.rJ:OB 110. 6696
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A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
VERNON APPROVING AND ADOPTING A FAMILY AND
MEDICAL LEAVE POLICY AND AMENDING SECTION 15 OF
RESOLUTION NO. 6651, BY DELETING SUBSECTION (f)
ON PAGE 18 WHICH ESTABLISHED A MATERNITY LEAVE
PROGRAM FOR FEMALE EMPLOYEES
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7 WHEREAS, in 1993, both the United States Congress and the
8 California Legislature passed legislation dealing with the subject
9 of family and medical leave; and
10 WHEREAS, the City Council of the City of Vernon desires to
11 adopt a Family and Medical Leave Policy which is consistent with the
12 requirements of this recent legislation and which grants jOb-
13 protected unpaid family and medical leave to eligible City
14 employees; and
15 WHEREAS, Resolution No. 6651 was adopted by the City of
16 Vernon on June 27, 1995, to be effective on June 27, 1995; and
17 WHEREAS, the City Council of the City of Vernon desires to
18 include the City'S Maternity Leave Program in the Family and Medical
19 Leave Policy which will be adopted by the City; and
20 WHEREAS, the City Council of the City of Vernon therefore
21 desires to amend Section 15 of Resolution No. 6651 by deleting
22 Subsection (f) on page 18, to eliminate the Maternity Leave Program
23 for female employees from that Resolution.
24 NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE
25 CITY OF VERNON AS FOLLOWS:
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SECTION 1: The City Council of the City of Vernon hereby
27 finds and determines that the recitals contained hereinabove are
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SECTION 2: The City Council of the City of Vernon hereby
2 approves and adopts the City of Vernon Family and Medical Leave
3 POlicy, a copy of which has been presented to the City Council
4 concurrently with this resolution, and the City Council hereby
5 orders said policy to be received and filed by the City Clerk.
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SECTION 3: The City Council of the City of Vernon hereby
7 authorizes the City Clerk to inform City employees about the
8 provisions of said Policy.
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SECTION 4:
Effective October 17, 1995, section 15 of
10 Resolution No. 6651 is amended to delete Subsection (f) in its
11 entirety.
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SECTION 5: In all other respects, Resolution No. 6651,
13 shall remain in full force and effect, and the provisions in
14 Resolution No. 6651 which are not consistent with or in conflict
15 with this resolution are hereby repealed.
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SECTION 6: The City Clerk of the City of Vernon shall
17 certify to the passage of this resolution, and thereupon and
18 thereafter the same shall be in full force and effect.
19 APPROVED AND ADOPTED this 17th day of October, 1995.
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ATTEST:
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24 BRUCE V. MALKENHORST, City Clerk
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STATE OF CALIFORNIA )
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COUNTY OF LOS ANGELES )
I, BRUCE V. MALKENHORST, ci ty Clerk of the ci ty of
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4 Vernon, do hereby certify that the foregoing Resolution, being
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Resolution No.
was duly adopted by the City Council of the
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6 City of Vernon at an adjourned regular meeting of the City Council
7 duly held on October 17, 1995, and thereafter was duly signed by the
8 Mayor/Mayor Pro Tem of the City of Vernon.
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BRUCE V. MALKENHORST, City Clerk
(SEAL)
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SUPPORTING
DOCUMENTS
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CITY OF VERNON
FAMILY AND MEDICAL LEAVE POLICY
I. STATEMENT OF POLICY
In accordance with the California Family Rights Act (Government
Code section 12945.2) and the Federal Family and Medical Leave Act
of 1993 (Title 29 U.S. Code, Sections 2601 et seq.), the City of
Vernon will grant job protected unpaid family and medical leave to
eligible employees for up to 12 weeks per 12-month period for any
one or more of the following reasons:
A. The birth of a child and in order to care for such child or
the placement of a child with the employee for adoption or
foster care (leave for this reason must be taken within the
12-month period following the child's birth or placement with
the employee); or
B. In order to care for an immediate family member (spouse,
child, or parent) of the employee if such immediate family
member has a serious health condition; or
C. The employee's own serious health condition that makes the
employee unable to perform the functions of his/her position.
II. DEFINITIONS
A. "12-Month period" - means a rolling 12-month period measured
oackward from the date leave is taken and continuous with each
additional leave day taken.
B. "Spouse" - does not include unmarried domestic partners. If
both spouses work for the City of Vernon their total leave in
any 12-month period may be limited to an aggregate of 12 weeks
if the leave is taken for either the birth or placement for
adoption or foster care of a child or to care for a sick
parent.
C. "Child" - means a child either under 18 years of age, or 18
years of age or older who is incapable of self-care because of
a mental or physical disability. An employee's "child" is one
for whom the employee has actual day-to-day-responsibility for
care and includes a biological, adopted, foster or step-child.
D. "Parent" - means the biological parent of an employee or an
individual who stands or stood in loco parentis to the
employee when the employee was a child.
E. "Maternity" - means the quality or state of being pregnant.
F. "Serious Health Condition" means an illness, injury,
impairment, or a physical or mental condition that involves:
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1. Inpatient care; or
2. Any period of incapacity requiring absence from work for
more than three calendar days AND that involves
continuing treatment by a health care provider; or
3. Continuing treatment by a health care provider for a
chronic or long-term health condition that is incurable
or which, if left untreated, would likely result in a
period of incapacity of more than three calendar days: or
4. Prenatal care by a health care provider.
G. "continuinq Treatment" - means:
1. Two or more visits to a health care provider; or
2. Two or more treatments by a health care practitioner on
referral from, or under the direction of, a health care
provider; or
3. A single visit to a health care provider that results in
a regimen of continuing treatment; or
4. In the case of a serious, long-term or chronic condition
or disability that cannot be cured, being under the
continuing supervision of, but not necessarily being
actively treated by, a health care provider.
III. COVERAGE AND ELIGIBILITY
A. To be eligible for family/medical leave an employee must:
1. Have worked for the city of Vernon for at least 12
months, which need not be consecutive months; and
2. Have worked at least 1250 hours over the previous 12
month period.
3. Determination's of whether an employee meets the
requirements of 1 & 2 above will be made as of the date
leave commences.
IV. INTERMITTENT OR REDUCED LEAVE
A. An employee may take leave intermittently (a few days or a few
hours at a time) or on a reduced leave schedule to care for an
immediate family member with a serious health condition or
because of a serious health condition of the employee when
"medically necessary."
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1. "Medically necessary" means there must be a medical need
for the leave and that the leave can best be accomplished
through an intermittent or reduced leave schedule.
2. The employee may be required to transfer temporarily to
a position with equivalent pay and benefits that better
accommodates recurring periods of leave when the leave is
planned based on scheduled medical treatment.
B. An employee may take leave intermittently or on a reduced
leave schedule for birth or placement for adoption or foster
care of a child only with the department's consent.
c. For part-time employees who are eligible and those employees
who work variable hours and are eligible, the family and
medical leave entitlement is calculated on a pro rata basis.
A weekly average of the hours worked over the 12 weeks prior
to the beginning of the leave should be used for calculating
the employee's normal workweek.
V. SUBSTITUTION OF PAID VACATION TIME
Employees are required to use accrued paid vacation time and/or
accrued compensatory time for any part of a family/medical leave
taken for any reason. The accrued paid vacation and/or
compensatory time runs concurrently with the family and medical
leave.
VI. EMPLOYEE NOTICE OF LEAVE
Although the City of Vernon recognizes that emergencies arise which
may require employees to request immediate leave, employees are
required to give as much notice as possible of their need for
leave. If leave is foreseeable, at least 30 days notice is
required. In addition, if an employee knows that he/she will need
leave in the future, but does not know the exact date(s) (e.g. for
the birth of a child or to take care of a newborn), the employee
shall inform his/her supervisor as soon as possible that such leave
will be needed. If the City of Vernon determines that an
employee's notice is inadequate or the employee knew about the
requested leave in advance of the request, the City of Vernon may
delay the granting of the leave until it can, in its discretion,
adequately cover the position with a substitute.
VII. MEDICAL CERTIFICATION
Employees who request leave for their own serious health condition
or to care for a child, parent or a spouse who has a serious health
condition must provide written certification from the health care
provider of the individual requiring care. If the leave is
requested because of the employee's own serious health condition,
the certification must include a statement that the employee is
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unable to perform the essential functions of his/her position.
If the City of Vernon has reason to doubt the validity of a
certification, the City of Vernon may require a medical opinion of
a second health care provider chosen by the City of Vernon. If the
second opinion is different from the first, the City of Vernon may
require the opinion of a third provider jointly approved by the
ci ty of Vernon and the employee. The opinion of the third provider
will be binding.
If an employee requests leave intermittently (a few days or a few
hours at a time) or on a reduced leave schedule to care for an
immediate family member with a serious health condition, the
employee must provide medical certification that such leave is
medically necessary. "Medically necessary" means there must be a
medical 'need for the leave and that the leave can best be
accomplished through an intermittent or reduced leave schedule.
VIII. EFFECT ON BENEFITS
An employee granted a leave under this policy will continue to be
covered under the City of Vernon group medical/dental insurance
plan and life insurance plan under the same conditions as coverage
would have been provided if they had been continuously employed
during the leave period.
If an employee fails to return from unpaid family/medical leave for
reasons other than (1) the continuation of a serious health
condition of the employee or a covered family member or (2)
circumstances beyond the employee's control (certification required
within 30 days of failure to return for either reason), the City of
Vernon may seek reimbursement from the employee for the premiums
paid by the City of Vernon on behalf of that employee during the
leave.
An employee does not accrue seniority and is not entitled to
employment benefit accrual during periods of unpaid leave; this
includes longevity, annual merit increase consideration and
vacation. However, the employee will not lose any seniority or
benefits which were accrued prior to the unpaid family/medical
leave.
IX. JOB PROTECTION
If an employee returns to work within the time permitted by this
policy following the commencement of family/medical leave, he/she
will be reinstated to his/her former position or an equivalent
position with equivalent pay, benefits, status and authority.
Employee's restoration rights are the same as they would have been
had the employee not been on leave. Thus, if an employee's
position would have been eliminated or the employee would have been
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terminated but for the leave, the employee would not have the right
to be reinstated upon return from leave.
If an employee fails to return within the time permitted by this
policy following a family/medical leave the employee will be
reinstated to his/her same or similar position, only if available.
If the employee's same or similar position is not available, the
employee may be terminated.
X. PREGNANCY DISABILITY
In accordance with Government Code section 12945 (b) (2) a female
employee may take leave for disability associated with pregnancy,
childbirth or a related medical condition leave not to exceed four
months. Leave under this section is separate and distinct from
family/medical care leave.
XI. MATERNITY LEAVE PROGRAM
A maternity leave program with pay is established at six (6) weeks
for female employees who have completed five (5) years of
continuous uninterrupted service. Leave under this section is not
in addition to family/medical care leave. If an eligible employee
takes any of the six (6) weeks of paid maternity leave provided in
this section, the time taken shall be deducted from the available
twelve (12) weeks of family/medical care leave. Any additional
family/medical care leave taken by the eligible employee shall be
without pay.
All other employees and probationary employees shall not be
entitled to maternity leave with pay. All other employees and
probationary employees on maternity leave may use any compensatory
or vacation time accrued, if any; the remainder of the time shall
be treated as leave without pay.
XII. REQUIRED FORMS
1. "Request For Family or Medical Leave Form" prepared by the
City of Vernon to be eligible for leave;
2. Medical certification - either for the employee's own serious
health condition or for the serious health condition of a
child, parent or spouse;
3. Fitness for duty to return from leave form.
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PHYSICIAN OR PRACTITIONER CERTIFICATION
FAMILY MEMBER - SERIOUS HEALTH CONDITION
1. Employee's Name:
2. Patient's Name:
3. Does the employee's child, parent, or spouse have an
illness, injury, impairment, or physical or mental
condition which constitutes a "serious health
condition." A "serious health condition"is described
on the attached sheet (attachment "An). Does the
patient's condition qualify under any of the categories
described? If so, please check the applicable
category.
(1)____(2)____(3)____(4)____(5)____(6)____, or None of the
above____
4. Date medical condition or need for treatment commenced:
5. Probable duration of medical condition or need for
treatment:
6. Regimen of treatment to be prescribed (indicate number of
visits, general nature and duration of treatment, including
referral to other provider of health services. Include
schedule of visits or treatment if it is medically necessary
for the employee to be off work on an intermittent basis or
to work less than the employee's normal schedule of hours
per day or days per week) :
A. By Physician or Practitioner:
B. By other provider of health services, if referred by
Physician or Practitioner:
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Check Yes or No in the space below, as appropriate.
7.
Yes
No
Is inpatient hospitalization of the
family member (patient) required?
Does (or will) the patient require
assistance for basic medical, hygiene,
nutritional needs, safety or
transportation?
8.
Yes
No
9.
Yes
No
After review of the employee's signed
statement (see Item 11 below), is the
employee's presence necessary or would
it be beneficial for the care of the
patient? (This may include
psychological comfort and/or the
arranging for third-party care for the
family member.)
10. Estimate the period of time care that is needed or the
employee's presence would be beneficial:
ITEM 11 TO BE COMPLETED BY THE EMPLOYEE REQUESTING
FAMILY LEAVE
11. When Family Leave is needed to care for a seriously ill
family member, the employee shall state the care he or she
will provide and an estimate of the time period during which
this care will be provided, including a schedule if leave is
to be taken intermittently or on a reduced leave schedule:
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Employee Signature: Date:
12. Signature of Physician or Practitioner:
13. Date:
14. Type of Practice (Field of specialization, if any):
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PHYSICIAN OR PRACTITIONER CERTIFICATION
EMPLOYEE - SERIOUS HEALTH CONDITION
1. Employee's Name:
2. Does the employee have an illness, injury, impairment, or
physical or mental condition which constitutes a nserious health
condition." A "serious health condition" is described on the
attached sheet (attachment "A"). Does the employee's condition
qualify under any of the categories described? If so, please
check the applicable category.
(1)____(2)____(3)____(4____(5)____(6)____, None of the above____
3. Date medical condition or date for treatment commenced:
4. Probable duration of medical condition or need for
treatment:
5. Regimen of treatment to be prescribed (indicate number of
visits, general nature and duration of treatment, including
referral to other provider of health services. Include
schedule of visits or treatment if it is medically necessary
for the employee to be off work on an intermittent basis or
to work less than the employee's normal schedule of hours
per day or days per week) :
A. By Physician or Practitioner:
B. By other provider of health services, if referred by
Physician or Practitioner:
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Check Yes or No in the space below, as appropriate.
6.
Yes
No
Is inpatient hospitalization of the
employee required?
7.
Yes
No
Is employee able to perform work of any
kind? (If "No", skip to Item 9.)
8.
Yes
No
Is employee able to perform the
functions of employee's position?
(Answer after reviewing job description
from employer describing essential
functions of employee's position, or, if
none provided, after discussing with
employee. )
9. Signature of Physician or Practitioner:
10. Date:
11. Type of Practice (Field of Specialization, if any):
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Signature of Employee:
Date:
13. Diagnosis (OPTIONAL- AN EMPLOYEE IS NOT OBLIGATED TO RELEASE
HIS/HER DIAGNOSIS)
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REQUEST FOR FAMILY/MEDICAL LEAVE
Employee Name:
Date of
Request:
Department:
position
Title:
Hire Date:
I request a Family/Medical Leave for the following reason (check
one) :
A. The birth of a child and/or in order to care
for such child.
B. The placement of a child for adoption or
foster care.
C. In order to care for an immediate family
member because such family member has a
serious health condition. circle one: CHILD
- SPOUSE -PARENT (Must submit "Physician
certification" within 15 days)
METHOD OF LEAVE REQUESTED
A. Consecutive Leave
B. Intermittent or Reduced Leave Schedule
(Specify Schedule Below) :
Date leave is to begin:
Expected duration of leave:
If the duration of my family/medical leave (total of paid and
unpaid time) does not exceed 12 weeks, I will be returned to my
same, equivalent or comparable position. I understand that if my
family/medical leave should exceed 12 weeks I will be returned to
my same, equivalent or comparable position, only if available.
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If my same, equivalent or comparable position is not available, I
understand that I may be terminated.
Date:
Employee:
Signature:
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FITNESS FOR DUTY TO RETURN FROM EMPLOYEE'S
MEDICAL LEAVE CERTIFICATION
On
date employee cOl1l1lenced leave for serious health condition,
employee's name,
began a period of medical care leave from
name of agency employer
for
diagnosis
Based on my examination of
on
employee'S name
I certify
medically/psychologically fit to return to
date of medical examination of employee
that
he/she
is
with the following limitations:
employee'S job - list limitations if applicable
Date:
Signature of Physician or Practitioner
Type of Practice (Field or Specialization, if any):
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SERIOUS HEALTH CONDITION
A "Serious Health Conditi6n~ means an illness, injury,
impairment, or physical or mental condition that involves one of
the following:
1. Hospital Care
Inpatient care (i.e., an overnight stay) in a hospital, hospice,
or residential medical care facility, including any period of
incapacity or subsequent treatment in connection with or
consequent to such inpatient care.
2. Absence Plus Treatment
(a) A period of incapacity of more than three consecutive
calendar days (including any subsequent treatment or period of
incapacity relating to the same condition), that also involves:
(1) Treatment1 two or more times by a health care provider,
by a nurse or physician's assistant under direct supervision of a
health care provider, or by a provider of health care services
(e.g., physical therapist) under orders of, or on referral by, a
health care provider; or
(2) Treatment by a health care provider on at least one
occasion which results in a regimen of continuing treatment2
under the supervision of the health care provider.
3. Preqnancv
Any period of incapacity due to pregnancy, or for prenatal
care.
1Treatment includes examination to determine if a serious
condition exists and evaluations of the condition. Treatment does
not include routine physical examinations, eye examinations, or
dental examinations.
2A regimen of continuing treatment includes, for example, a
course of prescription medication (e.g. an antibiotic) or therapy
requiring special equipment to resolve or alleviate the health
condition. A regimen of treatment does not include the taking of
over-the-counter medications such as aspirin, antihistamines, or
salves; or bed-rest, drinking fluids, exercise, and other similar
activities that can be initiated without a visit to a health care
provider.
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4. Chronic Conditions Requirinq Treatments
A chronic condition which:
(1) Requires periodic visits for treatment by a health care
provider, or by a nurse,physician's assistant under direct
supervision of a health care provider;
(2) Continues over an extended period of time (including
recurring episodes of a single underlying condition); and
(3) May cause episodic rather than a continuing period of
incapacity (e.g., asthma, diabetes, epilepsy, etc).
5. Permanent/Lonq term Conditions Requirinq supervision
A period of incapacity which is permanent or long-term due
to a condition for which treatment may not be effective. The
employee or family member must be under the continuing
supervision of, but need not be receiving active treatment by, a
health care provider. Examples include Alzheimer's, a severe
stroke, or terminal stages of a disease.
6. Multiple Treatments (Non-Chronic Conditions)
Any period of absence to receive multiple treatments
(including any period of recovery therefrom) by a health care
provider or by a provider of health care services under orders,
of, or any referral by, a health care provider, either for
restorative surgery after an accident or other injury, of for a
condition that would likely result in a period o.f incapacity of
more than three consecutive calendar days in the absence of
medical intervention or treatment, such as cancer (chemotherapy,
radiation, etc), severe arthritis (physical therapy), kidney
disease (dialysis).
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