Family and Medical Leave Act

In accordance with the Family and Medical Leave Act of 1993 (FMLA) and the Rhode Island Parental and Family Medical Leave Act, the Company has created a Family and Medical Leave Act (FMLA) policy that is associated with the sick time, medical leave of absence and worker's compensation policies. Under the Federal and Rhode Island Family and Medical Leave Acts, employees are guaranteed the right to an unpaid leave of absence under certain circumstances. Employees may be eligible for up to a maximum of 13 weeks (520 hours) of approved FMLA related leave in a 12-month period.

The approved FMLA circumstances include:

  1. The birth, adoption or foster care placement of a child and/or care of that child.  Leave must be completed within 12 months of the child’s birth, adoption or foster care placement. The leave must also be taken as a block absence, intermittent leave is not allowed.
  2. Leave to care for a seriously ill or injured spouse, parent, mother in-law, father in-law, or child under the age 18, or over the age of 18 and are incapable of self-care.  Time to care for in-law family members may only be taken in block form once in a two (2) year period.
  3. Leave due to the employee’s own serious health condition that makes him or her unable to perform his or her job functions.
  4. Because of any qualifying exigency arising out of the fact that the employee's spouse, son, daughter, or parent is a covered military member on active duty (or has been notified of an impending call or order to active duty) in support of a contingency operation.
  5. To care for a covered service member with a serious injury or illness if the employee is the spouse, son, daughter, parent, or next of kin of the service member.


Covered Family Members
The following are guidelines for those family members who are covered under the Family and Medical Leave Act:
· Spouse – legally married spouse
· Child – biological child, adopted child, foster child, step child, legal ward child, a child to whom the employee stands in loco parentis
· Parent – biological parent, step parent who cared for the employee as a minor child  

If you will be requiring FML for any of the approved circumstances, please notify the FMLA office as soon as possible by telephone or email.  When leave is foreseeable, 30 days’ notice is required.  When leave is unforeseeable, 2 days’ notice is required. 

FML Forms are available throughout the facility.  Administrators Jackie Christensen (D915), Catharine Ravenelle (D913), and Ruth Correia (D921) all have the full variety of FMLA forms available in their offices.  Forms are also available at the Dispensary and the Employment Office as well as electronically through the links below.

Employees should fill out section II and Health Care Providers should fill out Section III.  Upon completion, drop off the form with Department Administrator or fax directly to the Benefits Office at 401-268-2423.

Employee Rights and Responsibilities
QP Certification of Health Care Provider for Employee’s Serious Health Condition
QP Certification of HealthCare Provider for Family Member’s Serious Health Condition
QP Certification of Health Care Provider for Birth of a Child
Certification of Qualifying Exigency for Military Family Leave
Certification for Serious Injury or Illness of Covered Service-member for Military Family Leave
QP Certification of Health Care Provider for Bonding Time