RECENT NEWS & ANNOUNCEMENTS
NORTH GEORGIA HEALTH DISTRICT
County Board of Health Personnel Policies #701
Cherokee, Fannin, Gilmer, Murray, Pickens, Whitfield
PERFORMANCE MANAGEMENT
EFFECTIVE DATE: May 1, 2006 RELEASE DATE: May 1, 2006
REFERENCES: Rules of the State Personnel Board - Rule 13 (Performance
Management)
Rules of the State Personnel Board - Rule 17 (Salary)
State Personnel Board Guidelines on Salary Increases
DHR Human Resource/Personnel Policy #701
County Board of Health (CBH) employees provide essential services for the citizens of
the State of Georgia. How well employees perform their job duties determines the quality
of services that are delivered. A performance management system is an essential tool in
evaluating the overall quality of performance by CBH employees. Evaluating supervisors
and reviewing managers must attend some type of formalized training on the
performance management process prior to developing, completing, or reviewing
performance plans or evaluations.
(Section A)
EVALUATION 1. The performance evaluation period begins on July 1 and
PERIOD ends on June 30 of the following year. Employees newly
hired in State government from July 1 through September
30 are not eligible to receive salary increases on October 1
of the same year.
2. Employees newly hired in State government during the
performance evaluation period are to be evaluated from the
date of hire through June 30.
3. Performance based salary increases are effective on
October 1 of each year.
4. Each year a deadline to change summary ratings will be set
by the District Personnel Office. After this deadline, no
changes can be made to any summary rating unless such
changes are in accordance with the decision of a designated
reviewing official following a request for review in
accordance with Section K of this policy.
(Section B)
DEVELOPING 1. Evaluating supervisors are responsible and accountable for
PMF PLANS developing performance management plans using the
PERFORMANCE MANAGEMENT FORM - #MS 10-60
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PERFORMANCE MANAGEMENT (continue)
(PMF). This form is available on the NGHD web site in
the Personnel Forms Section of the following Internet address:
http://10.155.0.90/nghd/personnel_documents.htm. This form
can be downloaded and completed on the system.
2. Every CBH classified and unclassified employee who is
eligible to be considered for a performance based salary
increase is to be provided with an individual PMF plan.
The plan is to specify responsibilities, performance
expectations and the terms and conditions of employment
that employees are expected to meet. Expectations are to
be written at the Met Expectations level.
NOTE: Employees on hourly positions, re -employed
retired employees or temporary employees on
positions not eligible for benefits are:
· not required to have PMF plans, and,
· not eligible for performance based salary
increases.
3. A limited number (generally three or less) of the
responsibilities listed on the PMF plan may be designated
as "critical." Only responsibilities that are essential for
success in a position should be marked "critical."
Employees who do not meet expectations in any critical
responsibility area most likely will receive an overall rating
of Did Not Meet Expectations.
4. Evaluating supervisors must discuss proposed PMF plans
with reviewing managers and receive approval before
meeting with employees or providing copies of the plans to
employees. Supervisors who do not comply with the above
are subject to disciplinary action.
5. Reviewing managers are to assume responsibility for
developing PMF plans if:
5.1 evaluating supervisors are absent for an extended
period of time;
5.2 evaluating supervisor positions are vacant; or,
Policy #701 Page 2 of 16
5.3 new supervisors have not been trained in the
performance management process.
(Section C)
PMF PLAN 1. Evaluating supervisors (or reviewing managers, if
MEETING necessary as indicated above) are to meet and present
individual PMF plans for the upcoming performance
evaluation period to every eligible employee.
1.1 Plans are to be presented to employees as soon as
possible following:
1.1.1 the beginning of the performance evaluation
period; or,
1.1.2 placement of employees in new/different
positions (e.g., appointments, transfers,
promotions, demotions).
1.2 Plans must be presented to employees no later than
forty-five (45) calendar days following the above.
2. If evaluating supervisors are unable to meet with
employees during this time frame due to unusual or
extenuating circumstances on the part of employees (e.g.,
employees are absent for an extended period of time), the
circumstances must be explained on the PMF plans. The
plans are to be presented and discussed with the employees
upon their return to duty.
3. If evaluating supervisors are unable to meet with
employees due to their own absence for an extended period
of time, reviewing managers are to hold PMF plan
meetings.
4. Evaluating supervisors and employees are to meet to
discuss the responsibilities and expectations of employees'
positions and the terms and conditions of employment.
5. Efforts are to be made to resolve disagreements between
employees and evaluating supervisors on responsibilities
and expectations on PMF plans.
6. Employees may be given a specified period of time, not to
exceed five (5) work days, to review their PMF plans
before signing. At or before the end of the specified review
period, the PMF plans must be returned to evaluating
supervisors for processing.
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PERFORMANCE MANAGEMENT (continue)
7. If employees do not sign the PMF plans, evaluating
supervisors are to note on the plans that they were
presented and that the employees chose not to sign.
8. Employees' signatures on PMF plans do NOT waive the
right of employees to request reviews.
9. Evaluating supervisors are to provide employees with
copies of the completed PMF plans after signatures of
employees (if signed), evaluating supervisors and
reviewing managers have been added.
10. If responsibilities and expectations change during a
performance evaluation period, changes are to be discussed
with employees and modifications made to PMF plans.
10.1 Minor modifications to PMF plans may be made
without prior review and approval from reviewing
managers.
10.2 Significant modifications to PMF plans should be
reviewed and approved by reviewing managers
prior to implementing new responsibilities or
expectations.
10.3 Employees must be provided copies of modified
PMF plans and offered the opportunity to sign.
(Section D)
REQUEST FOR 1. Employees may request a review of their PMF Plans.
REVIEW
1.1 If employees express the belief that their PMF plans
are arbitrary, capricious, non job-related or
unrealistic, and efforts to resolve the differences are
not successful, evaluating supervisors must inform
employees of their right to request a review.
1.2 This written notice is to be provided to employees
within two (2) work days of being advised of the
employees' intent to request a review. The name
and address of the appropriate reviewing official is
to be provided to employees.
2. Evaluating supervisors should verify the name of the
appropriate designated reviewing official prior to providing
this information to employees.
Policy #701 Page 4 of 16
2.1 The District Health Director is responsible for
designating reviewing officials for the North
Georgia Health District.
2.2 Designated reviewing officials cannot be the first or
second level supervisors of employees requesting
reviews or involved with developing the employees'
PMF plan.
3. A written request for review must be submitted to the
designated reviewing official within five (5) work days of
receiving completed PMF plans.
(Section E)
REVIEW OF 1. Designated reviewing officials are to review PMF plans
PMF PLAN and information provided by employees and evaluating
supervisors. Discussions should be held with employees
and evaluating supervisors regarding the requests for
review.
2. Designated reviewing officials will determine if PMF plans
are arbitrary, capricious, non job-related or unrealistic and
issue findings that either uphold PMF plans as written or
determine that changes are to be made.
3. Designated reviewing officials are to issue their findings in
writing to the employees, evaluating supervisors and
reviewing managers within fifteen (15) work days of
receiving employees' requests for review.
4. If changes are to be made to PMF plans, determinations
will be made on a case by case basis regarding the
appropriate official to make the changes (i.e., the
evaluating supervisor, reviewing manager or designated
reviewing official) and the appropriate official(s) to sign
modified PMF plans.
5. If changes are made to PMF plans, employees are to be
given an opportunity to review and sign the modified PMF
plans. If employees do not sign modified PMF plans,
evaluating supervisors are to note on the modified plans
that they were presented and that the employees chose not
to sign.
6. Evaluating supervisors are to provide employees with
copies of the completed modified PMF plans after
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PERFORMANCE MANAGEMENT (continue)
signatures of employees (if signed) and the appropriate
official(s) have been added.
7. Decisions made by designated reviewing officials are final.
Issues concerning the performance management process are
not grievable or appealable to the State Personnel Board.
(Section F)
PMF PLAN NOT 1. If PMF plans are not provided to employees within forty-
RECEIVED five(45) calendar days of:
1.1 the beginning of a new performance evaluation
period; or,
1.2 placement in new/different positions, employees
may file a complaint with the District Personnel
Office. Employees may contact this office at
706/272-2342 to discuss concerns.
2. The District Personnel Office will take appropriate steps to
ensure that employees receive individual PMF plans within
fifteen (15) calendar days of notification. Evaluating
supervisors and reviewing managers are subject to
disciplinary action, up to and including separation, if PMF
plans are not prepared and presented to employees in a
timely manner.
(Section G)
INTERIM 1. Evaluating supervisors should meet with each employee on
REVIEWS an on- going basis to give performance feedback throughout
the evaluation period.
2. Evaluating supervisors must meet with each employee at
least once during the performance evaluation period to
conduct interim reviews of employees' work performance
and adherence to terms and conditions of employment.
3. Evaluating supervisors may use any of the following
methods to document interim reviews:
· The PERFORMANCE MANAGEMENT FORM (PMF)
may be completed;
· The MANAGEMENT REVIEW FORM - #MS 10-61
(MRF) may be completed;
· Notations of meetings may be made in supervisory
files; or,
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PERFORMANCE MANAGEMENT (continue)
· Other methods of documenting reviews may be used.
NOTE: The PMF and MRF can be downloaded from
the NGHD web site in the Personnel Forms
Section and completed on the system.
http://10.155.0.90/nghd/personnel_documents.htm
(Section H)
COMPLETING 1. PERFORMANCE MANAGEMENT FORMS must be
PMF PROCESS completed using employees' individual PMF plans to
evaluate employees who are eligible to be considered for
performance based salary increases. (See exception in #4
below)
1.1 Evaluating supervisors should begin preparing PMF
evaluations in early July in order to allow sufficient
time for completion, review and processing.
1.2 Evaluating supervisors will be advised of time
frames for processing completed PMF evaluations
each year.
2. Employees may submit a brief summary of major
accomplishments achieved during the performance
evaluation period to their evaluating supervisors.
3. Evaluating supervisors should closely review performance
and adherence to terms and conditions of employment to
determine if performance based salary increases are
appropriate. Specific attention should be given when
evaluating employees who have not been present at work
for at least 90 days for the following reasons:
3.1 Employees are new on the job; or,
3.2 Employees have been or are currently absent from
work for an extended period of time during the
evaluation period.
4. Eligible employees hired between April 1 and June 30 of
the current evaluation period should be evaluated using the
PMF if evaluating supervisors have had sufficient time to
adequately evaluate performance. At a minimum,
evaluating supervisors must submit to reviewing managers
written recommendations to either grant or deny
performance based salary increases for employees hired
between April 1 and June 30. Performance based salary
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PERFORMANCE MANAGEMENT (continue)
increases that are granted based on written
recommendations without a completed PMF evaluation are
at the Met Expectations level.
5. CBH evaluating supervisors are required to complete PMF
evaluations on employees who are promoted, demoted or
transferred to other positions within CBH or in other state
agencies. This includes `close out' evaluations when
employees leave during the evaluation period, as well as
performance evaluations ending June 30.
5.1 If the employee leaves the position before the
evaluating supervisor is able to complete the
evaluation and review it with the employee, then a
comment is to be added to show that the evaluation
was completed but not discussed with the employee.
5.2 The evaluation is to be forwarded to the District
Personnel Office for placement in the employee's
official CBH personnel file. A copy is to be
provided to the new evaluating supervisor, if
known.
6. Employees who are promoted, demoted or transferred after
the performance evaluation period ends on June 30
must be evaluated by the supervisors who supervised them
at the end of the evaluation period ending June 30.
6.1 CBH officials who hire employees from other state
agencies or other organizations within CBH
between the period of July 1 September 30 are to
request completed PMF evaluations from previous
supervisors.
6.2 The performance ratings determined by these
supervisors are to be reported to the District
Personnel Office.
6.3 Any difficulty in receiving performance evaluations
and ratings should be reported to the District
Personnel Office.
7. When employees have been promoted, demoted or
transferred to new positions during a performance
evaluation period,
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evaluating supervisors as of June 30 are to complete PMF
evaluations and make the salary increase eligibility
determinations. Evaluating supervisors may take into
consideration any PMF completed during the performance
evaluation period by previous evaluating supervisors.
8. The entire review period should be evaluated. Consideration
should be given to rating(s) from previous position(s), but the
weight to be accorded to any previous ratings rests with the
evaluating supervisor.
9. Evaluating supervisors are to rate employees' performance
on responsibilities according to the following scale:
· Did Not Meet Expectations;
· Met Expectations; or,
· Exceeded Expectations.
10. Extraordinary circumstances beyond an employee's control
should be closely reviewed prior to recording a rating of
Did Not Meet Expectations for any "critical" responsibility.
11. Evaluating supervisors are to rate employees' adherence to
terms and conditions of employment according to the
following scale:
· Did Not Meet Expectations;
· Needs Improvement; or,
· Met Expectations.
12. Appropriate corrective action must be taken against employees
who do not meet expectations or need improvement.
12.1 Appropriate action includes, but is not limited to,
adverse action, other disciplinary action, placement
on a Work Plan or placement on an Attendance
Plan.
12.2 Evaluating supervisors should contact the District
Personnel Office at 706/272-2342 for assistance in
this area.
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13. Evaluating supervisors should provide comments on actual
performance for each Responsibility area and Terms and
Conditions of Employment area. Specific comments
which support ratings of Did Not Meet Expectations, Needs
Improvement and Exceeded Expectations are required.
14. Evaluating supervisors must discuss proposed PMF
evaluations with reviewing managers and receive approval
BEFORE meeting with employees or providing copies of
evaluations to employees. Supervisors who do not comply
with the above are subject to disciplinary action.
15. Reviewing managers are to assume the responsibility of
completing PMF evaluations if:
15.1 evaluating supervisors are absent for an extended
period of time;
15.2 evaluating supervisor positions are vacant;
15.3 new supervisors have not been trained in the
performance management process; or,
15.4 new supervisors have not had sufficient time to
evaluate employees' performance and adherence to
the terms and conditions of employment.
16. Reviewing managers are responsible for reviewing PMF
evaluations prepared by evaluating supervisors to ensure
consistency, accuracy and timeliness.
17. Reviewing managers have the authority to change the
ratings proposed by evaluating supervisors if the managers
disagree with the ratings and are able to articulate a
reasonable basis for the disagreement.
17.1 This should be considered a `last resort' as the
expectation is that in most instances in which there
is an initial disagreement, the reviewing manager
and evaluating supervisor will engage in discussions
sufficient to resolve the disagreement and reach
consensus.
17.2 If the disagreement cannot be resolved, the
reviewing manager will make the rating and
comment changes. A comment should be entered
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PERFORMANCE MANAGEMENT (continue)
on the PMF evaluation that it was completed by the
reviewing manager. The reviewing manager will
present the evaluation to the employee, sign the
PMF as both evaluating supervisor and reviewing
manager and complete the process. The original
evaluating supervisor will not be required to meet
with the employee or sign the PMF, but will be
required to accept the reviewing manager's decision
as the final agency action.
18. The District Personnel Office will review PMF evaluations
to ensure consistency, accuracy and timeliness through out
the District.
(Section I)
PMF 1. Evaluating supervisors are to meet with employees to
EVALUATION discuss their completed PMF evaluations.
MEETING
1.1 If evaluating supervisors are unable to meet with
employees due to unusual or extenuating
circumstances on the part of employees, (e.g.,
employees are absent for an extended period of
time) the circumstances must be explained on their
PERFORMANCE MANAGEMENT FORMS. The
PMF evaluations are to be presented to the
employees upon their return to duty.
1.2 If evaluating supervisors are unable to meet with
employees due to their own absence for an extended
period of time, the reviewing managers are to hold
the PMF evaluation meetings.
2. Evaluating supervisors are to advise employees that they
may add comments on the PMF evaluation. Employees
may be given a specified period of time, not to exceed five
(5) work days, to review their PMF evaluations and add
comments. At or before the end of the specified review
period, PMF evaluations must be returned to evaluating
supervisors for processing.
3. If employees do NOT sign their PMF evaluations,
evaluating supervisors are to note on the evaluations that
they were discussed with the employees and that the
employees chose not to sign.
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PERFORMANCE MANAGEMENT (continue)
4. Employees' signatures on PMF evaluations indicate that
the PMF ratings and salary increase eligibility were
discussed. Employees' signatures do NOT necessarily
indicate agreement with the PMF evaluations and do NOT
waive the right of employees to request a review of an
overall summary rating of Did Not Meet Expectations for
either Responsibilities or Terms and Conditions of
Employment.
5. Evaluating supervisors are to provide employees with
copies of their completed PMF evaluations after signatures
of employees (if signed), evaluating supervisors and
reviewing managers have been added. At that time, the
name, title, address and telephone number of the
appropriate designated reviewing official are also to be pro-
vided in writing to employees who receive an overall
summary rating of Did Not Meet Expectations for either
Responsibilities or Terms and Conditions of
Employment.
6. Evaluating supervisors should verify the name of the
appropriate designated reviewing official prior to providing
this information to employees.
6.1 The District Health Director is responsible for
designating reviewing officials for the North
Georgia Health District.
6.2 Designated reviewing officials cannot be the first or
second level supervisors of employees requesting
reviews or involved with completing the PMF
evaluation.
7. PMF evaluations are to be forwarded to the District
Personnel Office for placement in official personnel files.
(Section J)
REQUEST 1. Evaluating supervisors are to advise employees who
FOR REVIEW receive an overall rating of Did Not Meet Expectations for
either Responsibilities or Terms and Conditions of
Employment that they may request a review if they believe
the rating is arbitrary, capricious, or not reflective of their
actual performance or adherence to terms and conditions of
employment.
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PERFORMANCE MANAGEMENT (continue)
2. Requests for review must be submitted in writing to the
specific designated reviewing official within five (5) work
days of employees receiving their completed PMF
evaluations.
3. Employees who receive at least an overall rating of Met
Expectations or higher for Responsibilities and an overall
rating of Needs Improvement or higher for Terms and
Conditions of Employment cannot request a review of
their PMF evaluations.
(Section K)
REVIEW OF 1. Designated reviewing officials are to review PMF
PMF evaluations and supporting documentation provided by
EVALUATION employees and evaluating supervisors. Discussions should
be held with employees and evaluating supervisors
regarding the requests for review.
2. Designated reviewing officials will determine if PMF
evaluations are arbitrary, capricious, or not reflective of
actual performance or adherence to terms and conditions of
employment and issue findings that either uphold PMF
evaluations as written or determine that changes are to be
made.
3. Designated reviewing officials are to issue their findings in
writing to the employees, evaluating supervisors and
reviewing managers within fifteen (15) work days of
receiving employees' requests for review.
4. If changes are to be made to PMF evaluations,
determinations will be made on a case by case basis
regarding the appropriate official to make the changes (i.e.,
the evaluating supervisor, reviewing manager or designated
reviewing official) and the appropriate official(s) to sign
modified PMF evaluations.
5. If changes are made to PMF evaluations, employees are to
be given an opportunity to review and sign the modified
PMF evaluations. If employees do not sign their modified
PMF evaluations, evaluating supervisors are to note on the
evaluations that they were discussed with the employees
and that the employees chose not to sign.
6. Evaluating supervisors are to provide employees with
copies of their completed modified PMF evaluations after
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PERFORMANCE MANAGEMENT (continue)
signature of employees (if signed) and the appropriate
official(s) have been added.
7. The copies of modified PMF evaluations are to be forwarded
to the District Personnel Office for placement in official
personnel files. Any previous PMF evaluation that has been
forwarded to the District Personnel Office must be retrieved
and destroyed by the evaluating supervisor.
8. Decisions made by designated reviewing officials are final.
Issues concerning the performance management process are
not grievable or appealable to the State Personnel Board.
(Section L)
PMF 1. Employees who have not received their PMF evaluations
EVALUATION by September 15 in a calendar year should contact their
NOT RECEIVED evaluating supervisors to discuss the status of the
evaluations.
2. If no resolution is reached after five (5) calendar days,
employees should contact the District Personnel Office at
706/272-2342.
3. The District Personnel Office will take appropriate steps to
ensure that eligible employees receive PMF evaluations.
(Section M)
FAILURE TO Evaluating supervisors and reviewing managers who fail to carry
COMPLY WITH out the responsibilities outlined in this policy and/or who do not
POLICY meet the required performance management deadlines will be
subject to disciplinary action, up to and including separation. In
addition, evaluating supervisors and reviewing managers who do
not comply with the provisions of this policy without justification
will receive a rating of Did Not Meet Expectations for the "critical"
performance management responsibility on their PMF. The District
Personnel Representatives are responsible for ensuring that the
provisions of this policy are met.
(Section N)
PERFORMANCE 1. Performance based salary increases are effective on
BASED SALARY October 1 each year for eligible employees.
INCREASES
2. Employees must receive at least an overall summary rating
of Met Expectations or higher for Responsibilities and an
overall summary rating of Needs Improvement or higher for
Policy #701 Page 14 of 16
PERFORMANCE MANAGEMENT (continue)
Terms and Conditions of Employment on their
performance evaluations in order to receive performance
based salary increases.
3. Employees who receive an overall summary rating of Did
Not Meet Expectations for either Responsibilities or
Terms and Conditions of Employment on their
performance evaluations will not receive performance
based salary increases on October 1 for the performance
evaluation period ending on the previous June 30. (Please
see Section H, Paragraph 12 of this policy.)
4. Employees not approved to receive performance based
salary increases on October 1 are not eligible for such
increases at any other time during the year.
5. Employees who are not in pay status on October 1, but are
approved for performance based salary increases, will
receive such increases upon their return to pay status.
6. The State Personnel Board releases guidelines that will be
followed by CBH to implement salary increases for each
evaluation period for employees who Met or Exceeded
Expectations.
6.1 Employees who receive an overall summary rating
of Met Expectations on PMF evaluations will
receive the standard increase based on the amount
identified for the evaluation period.
6.2 Employees who receive an overall summary rating
of Exceeded Expectations on PMF evaluations will
receive the standard increase plus a lump sum
payment identified for the evaluation period.
6.3 Special provisions regarding the calculation of
performance based salary increases for employees
who transfer between State agencies during the
period of July 1 through September 30 may be
included in the State Personnel Board guidelines.
6.4 The CBH budget for performance based salary
increases will be reviewed at least on an annual
basis. Each year, a specific amount of funding is
allocated for performance based salary increases.
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PERFORMANCE MANAGEMENT (continue)
6.4.1 Due to limited funds, the increase amounts
may be reduced if the Board exceeds its
allocated budget.
6.4.2 If the increase amounts must be reduced, the
reduction percentage will be the same for all
employees of the Board who receive
performance based salary increases.
6.5 Unless otherwise authorized by the State Personnel
Board, the following limitations apply:
6.5.1 Employees who are at or above the pay
grade maximum salary for their jobs on
October 1 are not eligible for performance
based salary increases.
6.5.2 Performance based salary increases for
employees who are near the pay grade
maximum can only be granted up to the pay
grade maximum.
For additional information or assistance, please contact the District Personnel Office at
706/272-2342.
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Policy #701 Page 16 of 16
NORTH GEORGIA HEALTH DISTRICT
County Board of Health Personnel Policy #1703
Cherokee, Fannin, Gilmer, Murray, Pickens, Whitfield
MODIFIED DUTY ASSIGNMENT DUE TO NON-WORK-RELATED
INJURY/ILLNESS
EFFECTIVE DATE: June 1, 2006 RELEASE DATE: June 1, 2006
REFERENCES : DHR Human Resource/Personnel Policy #1703
Employees who are absent from work due to a non-work-related injury/illness should
return to work on a temporary, modified duty assignment as soon as possible. Modified
duty assignments may be modifications in employees' usual duties and/or responsibilities
or may be temporary assignments of different duties within the organization.
(Section A)
ELIGIBLE All full-time and part-time employees in classified and unclassified
EMPLOYEES positions, except for temporary employees [time-limited duties not
expected to exceed nine (9) months] and hourly employees, are
eligible for modified duty assignments.
(Section B)
TIME FRAMES 1. Modified duty assignments may be made for the length of
time that is determined necessary by the attending health
care provider, not to exceed sixty (60) calendar days
within a 12-month period.
2. Management has the option of extending modified duty
assignments for up to ten (10) calendar days beyond the
60-calendar day limit, if the additional time is needed to
make work-related arrangements for employees.
(Section C)
PROCEDURES 1. Eligible employees who are medically released by the
attending health care provider to return to work with
temporary restrictions should be considered for modified
duty.
NOTE: Modified duty assignments may be
requested by employees or required by
managers .
2. Each employee should be evaluated individually for a
modified duty assignment based on the following:
2.1 Limitations established by the attending health care
provider;
2.2 Skills of the employee; and,
Policy #1703 Page 1 of 3
MODIFIED DUTY ASSIGNMENT DUE TO NON-WORK-RELATED
INJURY/ILLNESS (continued)
2.3 Needs of the organization.
3. Modified duty assignments require a signed medical
statement from the attending health care provider, which
identifies any work-related limitations and the expected
length of time for the limitations.
3.1 If additional information is needed, employees will
be given the ATTENDING PHYSICIAN'S
STATEMENT OF FUNCTIONAL CAPABILITY
Form (Attachment 1) to be completed by the
attending health care provider.
3.2 A completed DETAILED JOB ANALYSIS Form
(Attachment 2) or other relevant job description
information will be attached to assist the attending
health care provider in completing a medical
evaluation in relation to the essential functions of
the position.
(Section D)
NON- If employees refuse to report for (or otherwise through their
COMPLIANCE actions decline) modified duty assignments when properly released
by the attending health care provider, supervisors should notify the
District Personnel Office. Employees may be subject to disciplinary
action, up to and including separation from employment.
(Section E)
EXPIRATION 1. At the expiration of modified duty assignments, employees
OF MODIFIED will be returned to regular duties and responsibilities with
DUTY ASSIGNMENT or without reasonable accommodation if approved by the
attending health care provider.
2. If the attending health care provider does not release an
employee for unrestricted duty at the expiration of the
modified duty assignment, the employee must request the
appropriate leave or leave of absence without pay to cover
the absence from work. An employee who does not
appropriately request approval for absence from work may
be subject to disciplinary action, up to and including
separation from employment.
(Section F)
FAMILY AND Employees are to be placed on available family and medical leave
MEDICAL (FML) when absent from work due to a non-work-related
LEAVE injury/illness which also qualifies as a serious health condition
under FML. This includes absences from work while employees
Policy #1703 Page 2 of 3
MODIFIED DUTY ASSIGNMENT DUE TO NON-WORK-RELATED
INJURY/ILLNESS (continued)
work on an intermittent or reduced schedule as part of a modified
duty assignment.
For additional information or assistance, please contact the District Personnel
Office at 706/272-2342.
ATTACHMENTS:
Attachment #1 NGHD ATTENDING PHYSICIAN'S STATEMENT OF FUNCTIONAL
CAPABILITY
Attachment #2 WORKERS' COMPENSATION AND SPECIAL INJURY RETURN TO
WORK PROGRAM
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Policy #1703 Page 3 of 3