1. Long Term Leave Management Program Eliza Carrillo County of Los Angeles Department of Human Resources March 24, 2011

2. The Chief Executive Office/Risk Management Branch and the Department of Human Resources work in partnership on the Long Term Leave Management Program Intent of the Program: Improve the management of employees on long term leave Reduce the number of employees on long term leave Long Term Leave Management Program

3. Components of the Program Components of the Program 1. 1.Develop and implement a countywide mechanism to monitor, report and assist County departments in managing employees on long term leave 2. 2.Provide training for departmental Return-to-Work Coordinators on long term leave and return to work procedures 3. 3.Provide information and guidelines to facilitate departments’ follow-up with employees on long-term leave 4. 4.Work with departments to facilitate employee’s return to safe and productive work compatible with work restrictions 5. 5.Work with departments to facilitate retirement, medical release, or termination of employment when appropriate 6. 6.Assist with job placement in another department if reasonable accommodation is not possible within the employee’s current department.

4. Policy, Procedures and Guidelines - PPG 621 Interdepartmental Placement of Employees Returning to Work Following Approved Leave (See Handout – December 23, 2008 Memo to Department Heads) PPG 621 addresses the 6 th component of the program “Assist with job placement in another department if reasonable accommodation is not feasible within the employee’s current department.” PPG 621 operates under the authority of the County’s Civil Service Rules (CSR) 15.02 (Interdepartmental Transfer) and CSR 15.03 (Change of Class)

5. Conditions of Interdepartmental Transfer (Employee Interdepartmental Placement Request- Form A) Ensure that you follow OAAC’s Employment Guidelines for the “Reasonable Accommodation Process.” Complete EIPR Form A in it’s entirety. Provide detailed information on attempts made in placing employee in a work hardening, light duty or an alternate assignment. Include any job modification (equipment changes, flexible schedule, part-time work), job restructuring and reassignment.

6. Completing the Employee Interdepartmental Placement Request Form A (EIPR Form A) Why do we need this information? Pay Schedule/Salary and Payroll Title/Classification information are needed to identify comparable class of positions by pay and class. If there is disciplinary action in progress, the request may be denied in accordance with Human Resources Policy 1044. Transfers are prohibited prior to completion of disciplinary process. Employee Information Employee Name: Employee No.: Employee Payroll Title: Appointment Date: Probation Completed (Date): Employee Encumbered Item No.: Employee Class Schedule Los Angeles County Code 6.26.040 : (Salary Range & Actual Salary) Is there any disciplinary action currently in progress? □ Yes □ No

7. Employee’s Work Restrictions Permanent Conditions: □ Yes □ No Temporary Conditions: □ Yes □ No Period Covered by Medical Certificate: Date of Latest Medical Certificate attached: Required Attachment: Medical Certificate citing specific work restriction. Please do not submit any medical diagnosis or assessment with this report. Black out all medical diagnosis or assessment if they were included in the medical certificate provided by the employee. Status of Disability & Work Restrictions If disability is temporary, department should already have explored a “light duty or transitional work hardening assignment.”

8. EIPR Form A - Employee’s Job Information Date Job Description prepared by: Job Description: In order to accomplish the above listed responsibilities, the employee must perform the following “critical and/or essential” functions and duties: 1. 2. 3. 4. Names and Payroll Title of persons providing information: (interviews with the employee and verification from the employee’s supervisor): Required Attachment: Employee’s last performance evaluation report prior to the disability. This should be the same information you provided to the employees’ physician at the onset of their injury or illness

9. History of Placement Effort Within Department (Attachment V - Example) What attempts have been made in placing the employee in a Work Hardening, Light Duty or an Alternate Assignment in the employee’s classification within the Department? Please provide the following information for each vacant position considered (use additional pages if necessary): 1.Class Title of the Vacant Position(s): 2.Description of assignment(s): 3.Essential Functions of the vacant position: a. b. c. d. 4.Which one of the essential functions/duties of the assignment cannot be performed by the employee due to his/her work restrictions? Complete this section with information from each manager or supervisor in the divisions or units that you approached for consideration of placement or accommodation of the employee.

10. Undue Hardship 5. 5.What accommodation was not possible for this assignment? If the operating unit were to make this accommodation, how would it negatively impact (staffing, finance & services) of the operations? Assessment Conducted by _______________________(Print Name of Hiring Authority) ________________________ _____________________ ___________________ Hiring Authority’s Signature Title Date Provide information and facts for each job considered and reason an accommodation was not possible. The Americans with Disabilities Act (ADA) Definition of Undue hardship An undue hardship means that a specific accommodation would require significant difficulty or expense. This determination, which must be made on a case-by-case basis, considers factors such as the nature and cost of the accommodation needed and the impact of the accommodation on the operations of the agency.

11. Funding & Responsibilities for Placement Home Department Hold an interactive meeting with the Receiving Department and the employee to discuss the terms and conditions of the temporary placement to ensure all parties understanding. Document the meeting, agreement for placement, get signatures from all parties present. Continues to employ individual and is responsible for funding the position (maintain the employee on item control) while individual is placed at “Receiving Department,” for a period of 6 months to a year. Responsible for the employee until the employee is offered a permanent placement by the “Receiving Department.” Periodically monitor the progress of employee placed in other department through interactive meetings until a permanent placement is made.

12. Receiving Department Is responsible for day-to-day supervision, communicating performance standards, discuss and document performance and any issues. Submit a recommended performance evaluation to “Home” department for approval and action. Notify DHR and home department immediately if the placement is not effective, in the judgment of senior management. Inform “Home” department and the Department of Human Resources whether a permanent offer is made to employee. Upon permanent appointment the “Receiving” department, funds the position with it’s own permanent item. See Handout – March 3, 2009 Memo - Frequently Asked Questions Funding & Responsibilities (Continued)

13. Where to obtain forms/where to send forms: Where to obtain forms/where to send forms: Eliza Carrillo Department of Human Resources Long Term Leave Management Unit 3333 Wilshire Blvd., #1000 Los Angeles, CA 90010 (213) 738-2255 ecarrillo@hr.lacounty.gov or Teresa Tsang (213) 738-2248 ttsang@hr.lacounty.gov