Resolution No. 73441
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RESOLUTION NO. 7344
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF
VERNON AMENDING THE CITY OF VERNON FAMILY AND
MEDICAL LEAVE POLICY
WHEREAS, in 1993, both the United States Congress and the
California Legislature passed legislation dealing with the subject
of family and medical leave; and
WHEREAS, pursuant to Resolution No. 6696, the City
Council of the City of Vernon approved and adopted a Family and
Medical Leave Policy; and
WHEREAS, pursuant to Resolution No. 7295, the City
Council of the City of Vernon amended the Family and Medical Leave
Policy by deleting Section XI, entitled "Maternity Leave Policy";
and
WHEREAS, the City Council of the City of Vernon desires
to adopt further amendments to the Family and Medical Leave
Policy.
NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE
CITY OF VERNON AS FOLLOWS:
SECTION 1: The City Council of the City of Vernon does
hereby find and determine that the recitals contained hereinabove
are true and correct.
SECTION 2: The City Council of the City of Vernon hereby
approves and adopts the Amended City of Vernon Family and Medical
Leave Policy, a copy of which has been presented to the City
Council concurrently with this resolution, and the City Council
hereby orders said Amended Policy to be received and filed by the
City Clerk.
1 SECTION 3: The City Council of the City of Vernon hereby
2 authorizes the City Clerk to inform City employees about the
3 provisions of said Amended Policy.
4 SECTION 4: The City Clerk of the City of Vernon shall
5 certify to the passage of this resolution and thereupon and
6 thereafter the same shall be in full force and effect.
7 APPROVED AND ADOPTED this 1st day.of June, 1999.
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.17-11TEONIS C. MA URG, M yor
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ATTESZ:
11 BRUCE V. MALKENHORST, City Clerk
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STATE OF CALIFORNIA )
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COUNTY OF LOS ANGELES )
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I, BRUCE V. MALKENHORST, City Clerk of the City of
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Vernon, do hereby certify that the foregoing Resolution, being
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Resolution No. 7344, was duly adopted by the City Council of the
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City of Vernon at a regular meeting of the City Council duly held
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on Tuesday, June 1, 1999, and thereafter was duly signed by the
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Mayor of the City of Vernon.
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BRUCE V. MALKENHORST, City Clerk
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(SEAL)
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SUPPORTING
DOCUMENTS
OFFICE OF THE CITY ADMINISTRATOR/
CITY CLERK
INTER -OFFICE MEMORANDUM
DATE: June 2, 1999
TO: Kevin Wilson, Director of Community Services & Water
Lewis Pozzebon, Director of Environmental Health
Kenneth DeDario, Director of Utilities
Bruce Olsen, Chief of Police
Dave Telford, Fire Chief
FROM: Gloria J. Orose(&ef Deputy City Clerk
RE: Amended Family and Medical Leave Policy
Transmitted herewith, for your files, is a copy of the Amended
Family and Medical Leave Policy which was approved by City
Council on June 1, 1999 through Resolution No. 7344. The changes
that were made to the policy are outlined on the attached memo.
Cc: Martha Valenzuela
Sharon Johnson
Joan Francone
As you know, Peter Brown of Liebert, Cassidy and Frierson reviewed the City's
Family and Medical Leave Policy amended March 16, 1999. The following
additional corrections are recommended to the policy.
Page 1 Section II DEFINITIONS
Remove item E. The City no longer has a "Maternity" leave program.
Re -letter item F to E and item G to F.
Page 3 Remove Item B (paragraph 3)
Intermittent or reduced leave is not required for birth or placement for
adoption or foster care of a child.
Re -letter item C to B.
Section V SUBSTITUTION OF PAID VACATION TIME
Remove requirement to use compensatory time. Insert sentence to
use at employee's discretion to run concurrently with family and
medical leave.
Page 4 Line 3 - Clarify sentence.
".... validity of a certification regarding the employee's serious health
condition."
Page 5 Remove Section X PREGNANCY DISABILITY
Pregnancy Disability is a separate law and should not be included in
FMLA.
Remove Section XI REQUIRED FORMS
Should be renumbered as Section X.
CITY OF VERNON
FAMILY AND MEDICAL LEAVE POLICY
(Amended June 1, 1999)
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 backward 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 . " - 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. "Serious Health Condition" - means an illness, injury, impairment, or a physical or mental
condition that involves:
1. Inpatient care; or
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2. Any period of incapacity requiring absence from work for more than three calendar
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.
F. "Continuing 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. Determinations 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."
"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. 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= x= 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 for any part of a family/medical leave
taken for any reason. The accrued paid vacation runs concurrently with the family and medical
leave. Employees may, at their discretion, use accrued compensatory time concurrently with
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 unable
to perform the essential functions of his/her position.
If the City of Vernon has reason to doubt the validity of a certification regarding the employee's
serious health condition, 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
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of Vernon may require the opinion of a third provider jointly approved by the City 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 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.
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X. 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
Employee's Name:
2. Patient's Name:
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 "A"). Does the patient's condition qualify under any of the
categories described? If so, please check the applicable category.
(1)_(2) (3) (4L- (5L— (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:
Check Yes or No in the space below, as appropriate.
7. Yes _ No _ Is inpatient hospitalization of the family member (patient)
required?
8. Yes _ No _ Does (or will) the patient require assistance for basic medical,
hygiene, nutritional needs, safety or transportation?
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 EMPLQYEE 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:
Employee Signature: Date:
12. Signature of Physician or Practitioner:
13. Date:
14. Type of Practice (Field of Specialization, if any):
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 "serious 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) (4L— (5)— ft- , or 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):
12. Employee Signature:
Date:
REQUEST FOR FAMILY/MEDICAL LEAVE
Employee Name: Date of Request:
Department:
Hire Date:
Position Title:
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)
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.
If my same, equivalent or comparable position is not available, I understand that I may be
terminated.
Date:
Signature:
Employee:
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On
�I i =-I
date employee commenced 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 that he/she is medically/psychologically fit to return to
date of medical examination of employee
employee's job
with the following limitations:
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 Condition" 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. AbsencQ Plus T
(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) Treatments 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 treatmene under the supervision of the health care provider.
"07UMM",.
Any period of incapacity due to pregnancy, or for prenatal care.
4. Chronic Conditions Requiring 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;
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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n, or +
(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).
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.
903MUIT LI . I. R\ 1 ImejI_ 1 l 1 1 1 I L
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 of 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).
last updated 05/26/99
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