CATASTROPHIC ILLNESS LEAVE PROGRAM PROCEDURES
Regular Full Time District employees who have completed the probationary period may participate in the
Catastrophic Illness Leave Program by donating a maximum of one day of their own accumulated sick leave
balance, per academic year, to another District employee who has been diagnosed with a catastrophic illness.
For the purpose of this Program, “catastrophic illness” is defined as a medically-diagnosed condition, as
determined by a licensed medical practitioner, that is expected to incapacitate the employee for an extended
period of time (at least 30 calendar days) and prevent the employee from performing his/her duties.
Pursuant to the Education Code 87045, an employee must exhaust all accrued paid leave credits in order to be
eligible for catastrophic illness leave. Accumulated and donated sick leave, extended sick leave and long-term
disability benefits are used concurrently with employee leave entitlements under the Family and Medical Leave
and California Family Rights Acts. Donations of sick leave through this Program can be accepted from all regular
District employee groups.
PART A: PROCEDURES FOR RECIPIENTS
Step 1: District permanent full-time employees who have been medically diagnosed with a catastrophic illness
and would like to participate in this Program should contact the Office of Human Resource Services to obtain
information pertaining to medical absence reporting, required documentation, procedures for use of regular and
extended sick leave, and other related matters.
Step 2: The potential recipient must complete the required form titled, “Catastrophic Illness Leave Request Form”
in order to request participation in this Program. The request form and this information packet may be sent to you
electronically. These materials are also available on the Human Resources Web Page, and/or can be requested
from the Office of Human Resource Services.
Step 3: Once completed and signed, the Request Form is to be submitted to the Office of Human Resource
Services. The completed form must be accompanied by written medical verification from the treating physician
that documents the catastrophic nature of the employee’s illness and the estimated period of absence due to the
illness.
The completed request form and written medical verification will be reviewed by a designated Human Resources
staff member to determine eligibility for participation in the Program. The requester will then be notified of his/her
eligibility for Program participation. An employee may request Catastrophic Illness Leave donations once per
academic year.
If it is determined that the illness does not qualify for participation in this Program, Human Resources staff will
advise the requester about use of accumulated sick leave, extended sick leave, leaves of absence and other
applicable District benefits.
Step 4: The Office of Human Resource Services is responsible for notifying the District “community” about the
“open period” for sick leave donations and the opportunity to donate sick leave to the approved requester. If the
requesting employee wishes to remain anonymous in announcing the request for sick leave donations, the Office
of Human Resource Services will notify the District "community" that an employee who qualifies for sick leave
donations is requesting sick leave donations. The open period for accepting sick leave donations from District
employees will be ten (10) working days. The start and end dates for the open period will be determined by
Human Resources and clearly stated as part of the District wide notification process.
Step 5: Recipients may accept a maximum of one hundred (100) four-hour days of donated sick leave per
academic year.
Step 6: All donated sick leave that is not exhausted on or before June 30
th
will automatically be carried over into
the new academic year, and will become part of the recipient’s new academic year sick leave beginning
balance.
PART B: PROCEDURES FOR DONORS
Step 1: Once notice of the donation “open period” has been made by the Office of Human Resource
Services, potential donors should request this packet of information and forms through the District Human
Resources website OR call Human Resources directly to obtain a copy of the Program Procedures and the
required “Catastrophic Illness Leave Donation Form.” District employees must donate a minimum of eight
hours of sick leave during the specified “donation period.” A maximum of eight (8) hours of sick leave may be
donated to a single recipient during an academic year. Donors may, however, donate to several different
employees during the same academic year, a maximum of one day (eight hours) per year to each person.
Step 2: Once the Donation Form is completed and signed, please submit the form to the Office of Human
Resource Services, each donor’s own sick leave balance will be reviewed. In order to donate sick leave in this
Program, District employees must have an accumulated sick leave balance of twenty-three (23) days at 8
hrs/day of their own work days, so that they can retain at least twenty-two (22) days of sick leave after the
donation is made.
Step 3: Sick leave donations will be accepted in the order received in the Office of Human Resource
Services. Donations that are received AFTER the maximum of 100 four-hour days have been received for
the recipient, AND/OR those donations that are received after the close of the open period, will be returned to
the donors.
For details concerning District leave policies, please contact staff in the Office of Human Resource Services.
Revised October 2016
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CATASTROPHIC ILLNESS LEAVE
PARTICIPATION REQUEST FORM
NOTE TO REQUESTOR: Please read the Program procedures carefully prior to completing and submitting
this request form. Human Resources staff is available to assist you with Program details and information
that you will need concerning District illness leaves and other related benefits, such as extended sick leave.
Forward this completed and signed form to the Office of Human Resource Services.
P
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Attached is the required written medical verification from my treating physician that includes the projected
dates of my illness. If I am approved for participation in the Catastrophic Illness Leave Program, I understand
that the Office of Human Resources will notify District employees and invite their donations of illness leave.
The participants name can be listed as anonymous where the participants name is not listed on the
notification if the participant makes this request.
Requestor Signature: __________________________________ Date: _______
To be completed by the Office of Human Resource Services ONLY
Request is: ___Approved ___Denied. Donation open period: ____________ to ____________
Comments: _____________________________________________________________________________
Authorized HR Signature: ___________________________________________ Date: ________________
(Orig. to Requestor personnel file; copy to Requestor) Revised October 2016
CATASTROPHIC ILLNESS LEAVE
PARTICIPATION REQUEST FORM
NOTE TO REQUESTOR: Please read the Program procedures carefully prior to completing and submitting
this request form. Human Resources staff is available to assist you with Program details and information
that you will need concerning District illness leaves and other related benefits, such as extended sick leave.
Forward this completed and signed form to the Office of Human Resource Services.
Print Your Name:
ID#:
Job Title:
Division / Dept.:
Print Name of Employee Recipient: _________________________________
I have read the Catastrophic Illness Leave Program Procedures. I understand that I am donating
eight (8) hours of my own accumulated sick leave during this academic year to the employee named
above, and that my donation will become part of this employee’s regular sick leave balance, whether
the donated time is actually used or not. I further understand that this donation is permanent.
Donor’s Signature Require: __________________________ Date: ______
To be completed by the Office of Human Resource Services ONLY
Donor’s sick leave balance prior to making this donation: _____________hrs / _____________days
Donor ___is eligible (approved) to donate sick leave ___is not eligible (not approved) to donate.
Comments: _____________________________________________________________________________
Approved donor’s remaining sick leave balance after the donation: _____________hrs / _____________days
Authorized HR Signature: _________________________________________ Date: ________________
(Original to Donor’s personnel file; copy to Donor) Revised October 2016