4-10 Medical Leave Policy - Section V: Definitions

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Approved: Board of Supervisors
Authority: Human Resources
Resolution: 24-0130
Revised Date: April 16, 2024

12-Month Period: A rolling 12-month period measured backward from the date leave first occurs. Each time an employee takes FMLA/CFRA leave, the remaining leave available is any balance of the 12 weeks that has not been used during the immediately preceding 12 months. Example: If the employee used four weeks beginning February 1, 2024, four weeks beginning June 1, 2024, and four weeks beginning December 1, 2024, the employee would not be entitled to any additional FMLA/CFRA leave until February 1, 2025. (See CFR 825.102)

California Family Rights Act (CFRA)-Defined Family Members (See 2 CCR 11087): Family member means an employee's child, parent, grandparent, grandchild, sibling, spouse, domestic partner, or designated person.

• Child: A biological, adopted, or foster child, a stepchild, a legal ward, a child of an employee or the employee's domestic partner, or a person to whom the employee stands in loco parentis. “In loco parentis” means in the place of a parent; instead of a parent; charged with a parent's rights, duties, and responsibilities. It does not require a biological or legal relationship.
• Designated Person: any individual related by blood or whose association with the employee is the equivalent of a family relationship. The designated person may be identified by the employee at the time the employee requests the leave. An employer may limit an employee to one designated person per 12-month period for family care and medical leave.
• Domestic Partner: Two adults who have established a registered domestic partnership in accordance with the requirements of California Law or have signed a County Domestic Partner affidavit. Domestic partner has the same meaning as defined in Family Code section 297 for the purposes of CFRA.
• Grandchild: The child of an employee’s child.
• Grandparent: A parent of the employee’s parent.
• Parent: a biological, foster, or adoptive parent, a parent-in-law, a stepparent, a legal guardian, or other person who stood in loco parentis to the employee when the employee was a child. A biological or legal relationship is not necessary for a person to have stood in loco parentis to the employee as a child.
• Parent-in-law: the parent of a spouse or domestic partner.
• Sibling: a person related to the employee by blood, adoption, or by having a common legal or biological parent.
• Spouse: means a partner in marriage as defined in Family Code section 300 or a registered domestic partner, within the meaning of Family Code sections 297 through 297.5. As used in this article and the Family Code, “spouse” includes same-sex partners in marriage.

COBRA (Consolidated Omnibus Budget Reconciliation Act): Gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan. For more information go to: www.dol.gov/dol/topic/health-plans/cobra.htm.

County: County of Sonoma, including the agencies and special districts named in the introduction section of this policy.

Covered Active Duty: (1) in the case of a member of a regular component of the Armed forces, duty during the deployment of the member with the Armed Forces to a foreign country, or (2) in the case of a member of a reserve component of the Armed Forces, duty during the deployment of the member with the Armed Forces to a foreign country under a Federal call or order to active duty in support of a contingency operation pursuant to Section 688 of Title 10 of the United States Code. (See 29 CFR 825.126)

Covered Servicemember: (1) A current member of the Armed Forces, including a member of the National Guard or Reserves, who is undergoing medical treatment, recuperation, or therapy, is otherwise in outpatient status, or is otherwise on the temporary disability retired list, for a serious injury or illness, or (2) A covered veteran who is undergoing medical treatment, recuperation, or therapy for a serious injury or illness. See also 29 CFR 825.122, 29 CFR 825.127.

Employee: Full-time and part-time employees, extra-help employees, and all other persons employed by the County, whether in permanent or probationary status.

Family and Medical Leave Act (FMLA)-Defined Family Members (See 29 CFR 825.102):

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  • Child (also Son or Daughter): A biological, adopted, or foster child, a stepchild, a legal ward, or a child of a person standing in loco parentis, who is either under age 18, or age 18 or older and “incapable of self-care because of a mental or physical disability” at the time that FMLA leave is to commence. “In loco parentis” means persons with day-to-day responsibilities to care for and financially support a child, or, in the case of an employee, who had such responsibility for the employee when the employee was a child. A biological or legal relationship is not necessary.
  • Child (also Son or Daughter) of a covered servicemember: A covered servicemember's biological, adopted, or foster child, stepchild, legal ward, or a child for whom the covered servicemember stood in loco parentis, and who is of any age.
  • Child (also Son or Daughter) on covered active duty or call to covered active duty status: The employee's biological, adopted, or foster child, stepchild, legal ward, or a child for whom the employee stood in loco parentis, who is on covered active duty or call to covered active duty status, and who is of any age.
  • Next of kin of a covered servicemember: The nearest blood relative other than the covered servicemember's spouse, parent, son, or daughter, in the following order of priority: blood relatives who have been granted legal custody of the covered servicemember by court decree or statutory provisions, brothers and sisters, grandparents, aunts and uncles, and first cousins, unless the covered servicemember has specifically designated in writing another blood relative as his or her nearest blood relative for purposes of military caregiver leave under the FMLA. When no such designation is made, and there are multiple family members with the same level of relationship to the covered servicemember, all such family members shall be considered the covered servicemember's next of kin and may take FMLA leave to provide care to the covered
  servicemember, either consecutively or simultaneously. When such designation has been made, the designated individual shall be deemed to be the covered servicemember's only next of kin.
  • Parent: A biological, adoptive, step or foster father or mother, or any other individual who stood in loco parentis to the employee when the employee was a son or daughter as defined below. This term does not include parents “in law.”
  • Parent of a covered servicemember: A covered servicemember's biological, adoptive, step or foster father or mother, or any other individual who stood in loco parentis to the covered servicemember. This term does not include parents “in law.”
  • Spouse: As defined in the statute, means a husband or wife. For purposes of this definition, husband or wife refers to the other person with whom an individual entered into marriage as defined or recognized under state law for purposes of marriage in the State in which the marriage was entered into or, in the case of a marriage entered into outside of any State, if the marriage is valid in the place where entered into and could have been entered into in at least one State. This definition includes an individual in a same-sex or common law marriage that either:

Was entered into in a State that recognizes such marriages; or
If entered into outside of any State, is valid in the place where entered into and could have been entered into in at least one State.

Health Care Provider: The definition of Health Care Provider varies depending on the type of leave as follows:

• CFRA: Either (1) an individual holding either a physician's and surgeon's certificate issued pursuant to Article 4 (commencing with section 2080) of Chapter 5 of Division 2 of the Business and Professions Code or an osteopathic physician's and surgeon's certificate issued pursuant to Article 4.5 (commencing with section 2099.5) of Chapter 5 of Division 2 of the Business and Professions Code, or any other individual duly licensed as a physician, surgeon, or osteopathic physician or surgeon in another state or jurisdiction, including another country, who directly treats or supervises the treatment of the serious health condition, or (2) any other person who meets the definition of others “capable of providing health care services,” as set forth in FMLA and its implementing regulations. (See 2 CCR 11087)
• FMLA: A doctor of medicine or osteopathy who is authorized to practice medicine or surgery (as appropriate) by the State in which the doctor practices; or any other person determined by the Secretary to be capable of providing health care services as defined in CFR 825.102. (See CFR 825.102)
• CPDL: (1) A medical or osteopathic doctor, physician, or surgeon, licensed in California, or in another state or country, who directly treats or supervises the treatment of the applicant's or employee's pregnancy, childbirth or a related medical condition, or "a condition related to pregnancy, childbirth, or a related medical condition," as set forth in Government Code section 12945, or (2) A marriage and family therapist or acupuncturist, licensed in California or in another state or country, or any other persons who meet the definition of "others capable of providing health care services" under FMLA and its implementing regulations, including nurse practitioners, nurse midwives, licensed midwives, clinical psychologists, clinical social workers, chiropractors, physician assistants, who directly treats or supervises the treatment of the applicant's or employee's pregnancy, childbirth or a related medical condition, or "a condition
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related to pregnancy, childbirth, or a related medical condition," as set forth in Government Code section 12945, or (3) A health care provider from whom an employer or a group health plan's benefits manager will accept medical certification of the existence of a health condition to substantiate a claim for benefits. (See 2 CCR 11035)

Hours Worked: Hours the employee actually worked – not including paid sick leave, vacation leave, compensatory time off, paid administrative leave, mandatory time off (MTO), paid parental leave, compassionate leave, holidays, or any leave without pay.

Incapable of self-care: The individual requires active assistance or supervision to provide daily self-care in three or more of the “activities of daily living” (ADLs) or “instrumental activities of daily living” (IADLs). Activities of daily living include adaptive activities such as caring appropriately for one’s grooming and hygiene, bathing, dressing and eating. Instrumental activities of daily living include cooking, cleaning, shopping, taking public transportation, paying bills, maintaining a residence, using telephones and directories, using a post office, etc. (See 29 CFR 825.102)

Intermittent: Leave taken in separate, random, or scheduled blocks of time due to a single qualifying reason, rather than for one continuous period of time.

Key employee: A salaried FMLA-eligible employee who is among the highest paid 10 percent of all the employees (salaried and non-salaried, eligible and ineligible) employed by the employer within 75 miles of the employee's worksite. (See 29 CFR 825.217)

Mental or physical disability: A physical or mental impairment that limits one or more of the major life activities of an individual. Regulations at 29 CFR 1630.2(h), (i), and (j), issued by the Equal Employment Opportunity Commission under the Americans with Disabilities Act (ADA), 42 U.S.C. 12101 et seq., define these terms.

Outpatient status: With respect to a covered servicemember, the status of a member of the Armed Forces assigned to either: (1) a military medical treatment facility as an outpatient; or (2) a unit established for the purpose of providing command and control of members of the Armed Forces receiving medical care as outpatients.

Paid Sick Leave (PSL)-Defined Family Members:

• Child: A biological, adopted, or foster child, stepchild, legal ward, or a child to whom the employee stands in loco parentis. This definition of a child is applicable regardless of age or dependency status.
• Parent: A biological, adoptive, or foster parent, stepparent, or legal guardian of an employee or the employee’s spouse or registered domestic partner, or a person who stood in loco parentis when the employee was a minor child.
• A spouse, a registered domestic partner, a grandparent, a grandchild, or a sibling.
• Designated Person: A person identified by the employee at the time the employee requests paid sick days. An employer may limit an employee to one designated person per 12-month period for paid sick days.

Qualifying exigencies: May include attending certain military events, arranging for alternative childcare, handling certain school issues, addressing certain financial and legal arrangements, attending certain counseling sessions, spending up to five (5) days of leave with a covered military member who is on short-term temporary, rest and recuperation leave during a period of deployment, and attending post-deployment reintegration briefings. Specific definitions exist under both FMLA and CFRA (See 29 CFR 825.126, CA UIC 3302.2).

Reduced Schedule: A leave schedule that reduces an employee's usual number of working hours per workweek, or hours per workday. A reduced leave schedule is a change in the employee's schedule for a period of time.

Serious Health Condition: The definition of Serious Health Condition varies depending on the type of leave as follows:

• CFRA: an illness, injury (including, but not limited to, on-the-job injuries), impairment, or physical or mental condition of the employee or a family member of the employee that involves either inpatient care or continuing treatment, including, but not limited to, treatment for substance abuse. (See 2 CCR 11087)

(1) “Inpatient care” means a stay in a hospital, hospice, or residential health care facility, any subsequent treatment in connection with such inpatient care, or any period of incapacity. A person is considered an “inpatient” when a health care facility formally admits the person to the facility with the expectation that the person will remain at least overnight and occupy a bed, even if it later develops that such person can be discharged or transferred to another facility and does not actually remain overnight.
(2) “Incapacity” means the inability to work, attend school, or perform other regular daily activities due to a serious health condition, its treatment, or the recovery that it requires.
(3) “Continuing treatment” means ongoing medical treatment or supervision by a health care provider, as detailed in 2 CCR 11097.

• FMLA: An illness, injury, impairment or physical or mental condition that involves inpatient care as defined in 29 CFR 825.114 or continuing treatment by a health care provider as defined in 29 CFR 825.115. Conditions for which cosmetic treatments are administered (such as most treatments for acne or plastic surgery) are not serious health conditions unless inpatient hospital care is required or unless complications develop. Restorative dental or plastic surgery after an injury or removal of cancerous growths are serious health conditions provided all the other conditions of this regulation are met. Mental illness or allergies may be serious health conditions, but only if all the conditions of 29 CFR 825.113 are met. (See 29 CFR 825.102).

Serious Injury or Illness (See 29 CFR 825.127): Pertaining only to FMLA Military Caregiver Leave:

(1) In the case of a current member of the Armed Forces, including a member of the National Guard or Reserves, means an injury or illness that was incurred by the covered servicemember in the line of duty on active duty in the Armed Forces or that existed before the beginning of the member’s active duty and was aggravated by service in the line of duty on active duty in the Armed Forces, and that may render the member medically unfit to perform the duties of the member’s office, grade, rank or rating; and, (2) In the case of a covered veteran, means an injury or illness that was incurred by the member in the line of duty on active duty in the Armed Forces (or existed before the beginning of the member’s active duty and was aggravated by service in the line of duty on active duty in the Armed Forces) and manifested itself before or after the member became a veteran, and is:

• A continuation of a serious injury or illness that was incurred or aggravated when the covered veteran was a member of the Armed Forces and rendered the servicemember unable to perform the duties of the servicemember’s office, grade, rank, or rating; or
• A physical or mental condition for which the covered veteran has received a U.S. Department of Veterans Affairs Service-Related Disability Rating (VASRD) of 50 percent or greater, and such VASRD rating is based, in whole or in part, on the condition precipitating the need for military caregiver leave; or
• A physical or mental condition that substantially impairs the covered veteran’s ability to secure or follow a substantially gainful occupation by reason of a disability or disabilities related to military service, or would do so absent treatment; or
• An injury, including a psychological injury, on the basis of which the covered veteran has been enrolled in the Department of Veterans Affairs Program of Comprehensive Assistance for Family Caregivers.

Written Request: A written request from an employee can take the form of an email, a letter or other type of note, or completion of applicable forms.

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