Family Medical Leave Changes
Staff and Labor Relations &
Employee Occupational Health and Wellness
Managing Family Medical Leave
• Current State
•
Growing concern for managers
– Belief utilization is high and increasing
•
•
•
–
Decentralized process
•
•
•
–
Incomplete FMLA work absence data
1533 DUHS employees had at least one FMLA leave, (continuous or
intermittent) during FY 2012
In the beginning of July 2012, DUH had 380 staff members on FMLA (74
continuous and 306 intermittent). 84% of all staff on leave of absence
was FMLA.
Variable level of understanding
Risks inconsistency in FMLA administration
Oversight and monitoring by leadership not in place
Concern growing across health care employers
DUHS Dashboard
FMLA Breakdown by Entity
1.1.11 - 4.23.12
FMLA Hours
Entity
DUH
Carry
Over
Bank
Long
Term
Short
Term
Unpaid
TOTAL
FMLA Hrs
Avg
FMLA EE Hours Per
Count
EE
4,137
2,453
108,675
22,330
137,596
879
157
834
446
26,495
26,628
54,402
317
172
1,361
17,960
8,966
28,287
194
146
72
1,234
8,599
4,278
14,183
97
146
633
175
5,969
4,156
10,933
73
150
DUHS - Corp Services 1,632
852
6,165
1,942
10,591
54
196
DUHS Clin Labs
735
898
5,014
1,702
8,350
75
111
40
172
2,347
156
2,715
21
129
54
1,294
1,348
17
79
PRMO
DRH
DRAH
DUAPS
DHCH
PDC
AHS/DASC
Grand Total
64
8
922
243
1,237
10
124
8,147
7,599
182,199
71,695
269,640
1,737
155
DUHS Dashboard
FMLA Breakdown by Entity
1.1.11 - 4.23.12
TOTAL FMLA Hrs
DUHS Clin Labs
DHCH PDC
DUHS - Corp Services 3%
1% 1%
4%
DUAPS
4%
DRAH
5%
DRH
11%
DUH
51%
PRMO
20%
Managing Family Medical Leave
• Current State
– Variable utilization of clinical oversight
• EOHW reviewed 300 FMLA requests from DUHS and
University in 2011
• Clinical review:
1.
2.
3.
4.
Establish parameters for use of FMLA work absence
Assess excessive/pattern absence for recertification
Address work restriction and reasonable accommodation
Evaluate safety concerns due to work restrictions
– Increasing complexity FML/ADA and Workers
Compensation overlaps
Managing Family Medical Leave
• Current State
– Lack of utilization of standardized reports
• Report Express for DUHS
1.
2.
3.
4.
Underutilized
Data reporting constraints
Difficult to track unpaid leave
Difficult to track intermittent leave and trends although opportunity
exists by broadening utilization of Active Staffer
• FMLA Exception Reports Available
• ID cases when FMLA leave is exhausted
• ID cases where leave data are not entered properly in payroll system
• situation may not be addressed by dept managers
•
Starting Sept. 1, 2012, all Duke University Health System employee requests for Family
Medical Leave Act (FMLA) leave must be reviewed by Employee Occupational Health
and Wellness (EOHW) for a medical determination of approval.
a. The new process does not change the supervisor’s responsibility for determining
the eligibility of an employee for FMLA in terms of hours worked.
b. The new process requires the Leave of Absence request form and the Health Care
Provider forms to be forwarded to EOHW the same day as the employee’s request
received.
c. Employee has option to provide forms directly to EOHW for high sensitivity
diagnosis. Supervisor is still required to meet with employee once approval
determination received from EOHW.
•
•
This change in process is mandatory in the Health System but not for the University. Duke
University Managers and supervisors can continue to send paperwork to EOHW for a
determination of eligibility, but are not required to do so. Resources for managing FMLA
workflow within EOHW have been designated.
Utilization metrics will be displayed on the Performance Services Website.
Next year, additional changes to enhance tracking of FMLA will be implemented.
FMLA Healthcare Provider forms, customized for Duke by the following changes from DOL
forms:
Employee condition form:


Shortened the form by compressing first page of DOL form: Omitted instructions to
employer, employee and shortened instructions to HCP.
Included Release of Information allowing clarification if needed.
I authorize Employee Occupational Health & Wellness, or its representative, to
contact the healthcare provider indicated on this form for clarification or
authentication of any of the information below. I also authorize my health care
provider to disclose the health information described in this Certification for the
purpose of clarification. I understand that I can revoke the above authorization
at any time by submitting a written request.

Inserted GINA disclosure.

GINA NOTICE: The Genetic information nondiscrimination Act of 2008 (GINA) prohibits employers from requesting
or requiring genetic information of an individual or family member of the individual, except as specifically allowed
by this law. To comply with this law, we are asking that you not provide any genetic information when responding
to this request for medical information. “Genetic information” as defined by GINA, includes an individual’s family
medical history, the result of an individual’s or family member’s genetic test, the fact that an individual or an
individual’s family member sought or received genetic services, and genetic information of a fetus carried by an
individual or an individual’s family member or an embryo lawfully held by an individual or family member
receiving assistive reproductive service.




Rearranged questions to improve flow of document.
Clarified inpatient treatment dates by requesting date of admission and discharge date
Clarified incapacity dates by requesting beginning date and date employee can return to work.
Clarified when an employee is unable to perform job functions due to condition by asking: Is inability continuous
or episodic?
Indicated to HCP that when the estimate of frequency and duration of episodic unscheduled leave is omitted a
default estimate 4 times per year for 1 day will be assumed.
Added a question to clarify absence during a flare-up of condition: Are there job modifications that could be
implemented during the flare-up to allow employee to remain at work?


Family Member condition form:
 Shortened the form by compressing first page of DOL form: Omitted instructions to
employer, employee and shortened instructions to HCP.
 Included Release of Information allowing clarification if needed as above, to be signed by
family member.
 Added checkboxes for category of relationship of family member: spouse, parent, son or
daughter, Duke registered same sex spouse equivalent.
 Inserted GINA disclosure, as above.
 Rearranged questions to improve flow of document.
 Minor changes in wording of some phrases for clarity, e.g., inserted ….needs care “from
family member”…
 Email to Supervisor and Employee within 1-2 days or email
supervisor instructing to send Designation notice that
clarification is pending.
 What is included in the form elements?
• Approval / Denial
• Specification of Approval
• Recertification dates
• Estimated Frequency of episodic absence
• Type of Leave (Intermittent, continuous)
 New Staff member added to assist with flow
 Note: If the employee has no email access, department still
provides the determination information along with Designation
notice
Just in Time Learning
E-learning currently being developed including:
•
New FMLA self-paced online tutorial including
changes offered via SABA LMS for tracking completion
•
Saba LMS User Tutorial offered as pre-requisite
•
New FMLA Mini Tutorials offered via the HR website
for Just-In-Time learning
Business Process (Current)
PHASE ONE
PHASE TWO
PHASE THREE
PHASE FOUR
PHASE FIVE
Employee
requests
leave of
absence
Department
determines
eligibility (1250
hours and 1 year
in last 7 yrs.
eligibility)
If approved,
determine how FMLA
will be taken
Determine
type of paid
time staff
member will
use.
Track and
maintain
records
5 days – Provide
Employee Rights
and
Responsibility
Consult with
EOHW as needed
The way in which
FMLA is taken will
depend on:
• Medical guidance
provided by the staff
member’s health care
provider and if
necessary, confirmed
with Employee
Occupational Health &
Wellness
Approval /Denial
Designation Notice
Provided to employee
within 5 days for
approval or denial
Forward
payroll leave
of absence
form to
corporate
payroll
Business Process (Future)
PHASE ONE
PHASE TWO
PHASE THREE
PHASE FOUR
PHASE FIVE
Employee
requests
leave of
absence
Department
determines eligibility
(1250 hours and 1
year in last 7 yrs.
eligibility)
EOHW emails
determination form
to supervisor and
employee within 1-2
days or instructs
supervisor to send
Designation notice
that clarification is
pending
Determine
type of paid
time staff
member will
use.
Track and
maintain
records
5 days – Provide
Employee Rights and
Responsibility
Same day-Forward
LOA Request, HCP,
and EE Right and
Responsibility to
EOHW for
determination of
FMLA Approval
Medical Approval or
Denial decision made
by EOHW
Employee and
supervisor meet and
discuss EOHW
determination form
and provide
designation notice
to employee for
approval or denial
Forward
payroll leave
of absence
form to
corporate
payroll
New Audit Process
 SLR will conduct audit
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Request for Leave of Absence form
Health Care Provider form
Notice of Eligibility and Rights & Responsibilities form
Notice of Eligibility and Rights & Responsibility form provided to the employee
within 5 business days of when the employee submitted the FMLA paperwork.
EOHW provides FMLA determination Notice form
EOHW provides FMLA determination Notice form or instructs supervisor to send
Designation notice that clarification is pending to the department and the
employee via email within 1-2 business days.
Designation Notice
Department must provide Designation Notice to employee within 5 business days
of the Health Care Provider notice being submitted.
Payroll Leave of Absence Form
Confidential File for Staff Member