TABLE OF CONTENTS
400 SERIES

STATEMENT OF GUIDING PRINCIPLES	Code No. 400.1
DEFINITIONS FOR PERSONNEL						Code No. 400.2
RECRUITMENT OF PERSONNEL						Code No. 400.3
NEW EMPLOYEE ORIENTATION						Code No. 401.1
EQUAL EMPLOYMENT OPPORTUNITY					Code No. 401.2
AFFIRMATIVE ACTION COMPLIANCE CODE					Code No. 401.2 R1
PERSONNEL CONFLICT OF INTEREST					Code No. 401.3
NEPOTISM									Code No. 401.4
PERSONNEL CONCERNS	Code No. 401.5
PERSONNEL RECORDS		Code No. 401.6
EMPLOYEE RECORDS REGULATION	Code No. 401.6R
PERSONNEL COMMUNICATIONS, ADMINISTRATION & BOARD	Code No. 401.7
PERSONNEL INPUT IN DECISION MAKING	Code No. 401.8
PERSONNEL USAGE OF EQUIPMENT/FACILITIES	Code No. 401.9
ACCESS TO SCHOOL FACILITIES	Code No. 401.10
TRANSPORTING STUDENTS BY SCHOOL PERSONNEL	Code No. 401.11
SCHOOL PERSONNEL TRAVEL COMPENSATION	Code No. 401.12
ACTIVITY PASSES FOR SCHOOL PERSONNEL	Code No. 401.13
RELEASE OF CREDIT INFORMATION	Code No. 402.1
REPORTING CHILD ABUSE	Code No. 402.2
CHILD ABUSE REPORTING REGULATION	Code No. 402.2R
SOLICITATION			Code No. 402.3
GIFTS TO SCHOOL PERSONNEL	Code No. 402.4
PUBLIC RELATIONS OF SCHOOL PERSONNEL	Code No. 402.5
OUTSIDE EMPLOYMENT OF PERSONNEL	Code No. 402.6
TUTORING				Code No. 402.7
PERSONAL BUSINESS/TELEPHONE USE	Code No. 402.8
PHYSICAL AND MENTAL EXAMINATIONS	Code No. 403.1
INJURY ON THE JOB		Code No. 403.2
INJURY ON THE JOB - EMC ACCIDENT REPORT 	Code No. 403.2 E1
INJURY ON THE JOB - SUPERVISOR’S INSTRUCTIONS	Code No. 403.2 E2
INJURY ON THE JOB - PHYSICIAN AUTHORIZATION FORM	Code No. 403.2 E3
COMMUNICABLE DISEASES-PERSONNEL	Code No. 403.3
COMMUNICABLE DISEASE CHART	Code No. 403.3 E1
REPORTABLE INFECTIOUS DISEASES	Code No. 403.3 E2
HAZARDOUS CHEMICAL DISCLOSURE	Code No. 403.4
HAZARDOUS CHEMICAL DISCLOSURE REGULATION				Code No. 403.4R1
HARASSMENT - PERSONNEL	Code No. 403.5
ANTI-BULLYING/HARRASSMENT COMPLAINT FORM	Code No. 403.5 E-1
ANTI-BULLYING/HARRASSMENT WITNESS DISCLOSURE FORM	Code No. 403.5 E-2
DISPOSITION OFANTI-BULLYING/HARRASSMENT COMPLAINT FORM	Code No. 403.5 E-3
HARASSMENT INVESTIGATION PROCEDURES 	Code No. 403.5 R1
SUBSTANCE-FREE WORKPLACE	Code No. 403.6
SUBSTANCE-FREE WORKPLACE REGULATION	Code No. 403.6R
SUBSTANCE-FREE WORKPLACE NOTICE TO EMPLOYEES	Code No. 403.6 E-1
SUBSTANCE-FREE WORKPLACE EMPLOYEE ACKNOWLEDGMENT
FORM	Code No. 403.6 E-2
CONTROLLING OCCUPATIONAL EXPOSURE TO BLDBN.PATH	Code No. 403.7
CONTROLLING OCCUPATIONAL EXPOSURE TO BLDBN.PATH
.....UNIVERSAL PRECAUTIONS REGULATION	Code No. 403.7R
HEPATITIS B VACCINE INFORMATION AND RECORD	Code No. 403.7.1
CONSENT OF HEPATITIS B VACCINATION	Code No. 403.7.1 E
ABUSE OF STUDENTS BY DISTRICT EMPLOYEES	Code No. 403.8
ABUSE OF STUDENTS BY SCHOOL DIST. EMPLOYEES REGULATION	Code No. 403.8R1
COMPLAINT OF INJURY TO OR ABUSE OF A STUDENT BY A 
SCHOOL DISTRICT EMPLOYEE	Code No. 403.8 E-1
REPORT OF LEVEL I INVESTIGATION	Code No. 403.8 E-2
CONDUCT AND APPEARANCE OF PERSONNEL	Code No. 404
EMPLOYEE CONDUCT REGULATION	Code No. 404 R1
CODE OF RIGHTS AND RESPONSIBILITIES REGULATION	Code No. 404.R2
LICENSED EMPLOYEES SELECTION AND EMPLOYMENT	Code No 405.1
QUALIFICATIONS	Code No. 405.2
INDIVIDUAL CONTRACTS WITH CERTIFIED PERSONNEL
.....(EXCLUDING ADMINISTRATORS)	Code No. 405.3
CONTINUING CONTRACTS CERTIFIED PERSONNEL
.....(EXCLUDING ADMINISTRATORS)	Code No. 405.4
CERTIFIED PERSONNEL WORK DAY
.....(EXCLUDING ADMINISTRATORS)	Code No. 405.5
ASSIGN/TRANSFER OF CERTIFIED PERSONNEL	Code No. 405.6
EVALUATION OF CERTIFIED PERSONNEL 
.....(EXCLUDING ADMINISTRATORS)	Code No. 405.7
ORGANIZATION AFFILIATION-CERTIFIED	Code No. 405.8
LICENSED EMPLOYEE PROBATIONARY STATUS	Code No. 405.9
CERTIFIED STAFF SALARY/SCHEDULE ADVANCE
.....(EXCLUDING ADMINISTRATORS)	Code No. 406.1
CONTINUED EDUCATIONAL CREDIT (CERTIFIED STAFF)	Code No. 406.2
REGULATIONS FOR GRANTING CONTINUED EDUCATIONAL CREDIT
.....(CERTIFIED STAFF)	Code No. 406.2-R
EXTRA DUTY COMPENSATION	Code No. 406.3
INSURANCE BENEFITS FOR CERTIFIED STAFF	Code No. 406.4
TAX SHELTER PROGRAMS FOR CERTIFIED STAFF	Code No. 406.5
RESIGNATION OF CERTIFIED STAFF	Code No. 407.1
CONTRACT RELEASE OF CERTIFIED STAFF	Code No. 407.2
RETIREMENT OF CERTIFIED PERSONNEL	Code No. 407.3
CERTIFIED STAFF EARLY RETIREMENT BENEFIT	Code No. 407.3 E1
CERTIFIED STAFF, ADMINISTRATORS, AND SUPERVISORS 	
CERTIFIED STAFF EARLY RETIREMENT BENEFIT	Code No. 407.3 E2
SUSPENSION/DISCHARGE CERTIFIED STAFF	Code No. 407.4
REDUCTION IN FORCE CERTIFIED PERSONNEL	Code No. 407.5
PROFESSIONAL DEVELOPMENT	Code No. 408.1
CERTIFIED REQUIREMENT CERTIFIED STAFF	Code No. 408.2
PAY DEDUCTIONS – CERTIFIED STAFF	Code No. 409
PAY DEDUCTION REGULATION	Code No. 409 R1
LEAVES OF ABSENCE (ADMINISTRATORS)	Code No. 409.1
SUBSTITUTE TEACHERS	Code No. 410.1
SHARING CERTIFIED PERSONNEL WITH NEIGHBORING
     SCHOOL DISTRICTS	Code No. 410.2
SUMMER SCHOOL CERTIFIED PERSONNEL	Code No. 410.3
STUDENT TEACHERS AND INTERNSHIPS	Code No. 410.4
NON-CERTIFIED PERSONNEL DEFINED	Code No. 411.1
NON-CERTIFIED PERSONNEL CONTRACTS	Code No. 411.3
LICENSING/CERTIFYING NON-CERTIFIED STAFF	Code No. 411.4
ASSIGNMENT OF NON-CERTIFIED STAFF	Code No. 411.5
TRANSFER OF NON-CERTIFIED PERSONNEL	Code No. 411.6
EVALUATION OF NON-CERTIFIED PERSONNEL	Code No. 411.7
FAMILY & MEDICAL LEAVE	Code No. 411.8
FAMILY & MEDICAL LEAVE REGULATION	Code No. 411.8 R-1
FAMILY & MEDICAL LEAVE DEFINITIONS	Code No. 411.8 R-2
FAMILY & MEDICAL LEAVE NOTICE TO EMPLOYEES

YOUR RIGHTS UNDER THE FAMILY & MEDICAL LEAVE ACT
OF 1993	Code No. 411.8 E2
FAMILY & MEDICAL LEAVE CERTIFICATION FORM	Code No. 411.8 E3
FAMILY & MEDICAL LEAVE REQUEST FORM	Code No.411.8 E4
NON-CERTIFIED PERSONNEL SALARY	Code No. 412.1
INSURANCE/HEALTH NON-CERTIFIED STAFF	Code No. 412.2
TAX SHELTER FOR NON-CERTIFIED PERSONNEL	Code No. 412.3
NON-CERTIFIED PHYSICAL EXAMINATIONS	Code No. 412.4
RESIGNATION OF NON-CERTIFIED PERSONNEL	Code No. 413.1
RETIREMENT OF NON-CERTIFIED PERSONNEL	Code No. 413.2
NON/CERTIFIED STAFF EARLY RETIREMENT BENEFIT	Code No. 413.2 E1
SUSPENSION/DISCHARGE NON-CERTIFIED STAFF	Code No. 413.3
SUSPENSION/DISCHARGE NON-CERTIFIED STAFF	Code No. 413.3R
REDUCTION IN FORCE NON-CERTIFIED STAFF	Code No. 413.4
LEAVES OF ABSENCE NON-CERTIFIED 	Code No. 414
PAY DEDUCTIONS-NON-CERTIFIED STAFF	Code No. 415
PAY DEDUCTION REGULATION	Code No. 415 R1
VACATIONS/HOLIDAYS NON-CERTIFIED STAFF	Code No. 416
SUBSTITUTES FOR NON-CERTIFIED STAFF	Code No. 417
DRUG AND ALCOHOL TESTING PROGRAM	Code No. 418
DRUG AND ALCOHOL TESTING PROGRAM EXHIBIT FORMS	Code Nos. 418 E1
DRUG AND ALCOHOL TESTING PROGRAM EXHIBIT FORMS	Code Nos. 418 E2

STATEMENT

All policies in Series 400 were reviewed by the Board of Directors on December 8, 1992.  If changes were found to be necessary, the revision date was noted on the individual policies.

All policies in Series 400 were reviewed by the Board of Directors on January 10, 1995.  If changes were found to be necessary, the revision date was noted on the individual policies.

All policies in Series 400 were reviewed by the Board of Directors on March 24, 1998.  If changes were found to be necessary, the revision date was noted on the individual policies.

All policies in Series 400 were reviewed by the Board of Directors on March 27, 2001.  If changes were found to be necessary, the revision date was noted on the individual policies.

All policies in Series 400 were reviewed by the Board of Directors on August 15, 2006.  If changes were found to be necessary, the revision date was noted on the individual policies.

All policies in Series 400 were reviewed by the Board of Directors on August 14, 2007.  If changes were found to be necessary, the revision date was noted on the individual policies.

All policies in Series 400 were reviewed by the Board of Directors on December 10, 2009.  If any changes were found to be necessary, the revision date was noted on the individual policies.

All policies in Series 400 were reviewed by the Board of Directors on February 14, 2011.  If any changes were found to be necessary, the revision date was noted on the individual policies.

All policies in Series 400 were reviewed by the Board of Directors on February 8. 2016.  If any changes were found to be necessary, the revision date was noted on the individual policies.

Code No. 400.1

STATEMENT OF GUIDING PRINCIPLES

It is the policy of the board of directors of the Centerville Community School District to provide an educational program of the highest possible standard. Attainment of this goal will depend upon the competency of the professional and support staff and the cooperation of the community.  It shall be the policy of the board of directors to recruit and retain the highest caliber of employees.

The board of directors delegate to the superintendent and the administrative team decisions regarding personnel matters, except as may be specifically limited by board policy or by law.

Except where a specific provision has been negotiated governing the employment relationship, all employees of the Centerville Community School District shall be governed by the policies of the board of directors and by administrative procedures, rules, and practices.

Date of Adoption:  April 25, 1990  
Date of Revision: March 24, 1998

Code No. 400.2

DEFINITIONS FOR PERSONNEL

The following definitions shall apply to all references made in the 400 policies. 

ADMINISTRATOR.  The term "administrator" shall include professional employees employed under contracts issued pursuant to Iowa Code Section 279.23, and shall include, but not be limited to, the superintendent, assistant superintendents, principals, assistant principals, activities director, curriculum director, and athletic directors.  These employees will also be considered as “executive employees” for the purpose of the Fair Labor Standards Act (FLSA) and exempt from the overtime minimum wage requirements.  (Considered a licensed employee in reference to policy 402.2)

CERTIFICATED EMPLOYEE.  The term "certificated employee" shall include all professional employees who hold certificates or a statement of professional recognition from the Iowa Department of Education, whether full or part time, when such certificates or statements are required for the position the employee is holding, including administrators, teachers, nurses, counselors, coaches, and librarians.   These employees will also be considered as “professional employees” for the purpose of the Fair Labor Standards Act (FLSA) and exempt from the overtime minimum wage requirements.  (Considered a licensed employee in reference to policy 402.2)

NON-CERTIFICATED EMPLOYEE.  The "non-certificated employee" shall include the following employees, whether full or part time.  These employees are not exempt from the overtime and minimum wage requirement for the purpose of the Fair Labor Standards Act (FLSA).  

	a.  Custodial and maintenance employees.
	b.  Clerical employees.
	c.  Educational associates and aides.
	d.  Food service employees.
e.	 Transportation employees.
f.	Non-teaching coach
g.	Paraprofessionals (Considered a licensed employee in reference to policy 402.2)

FULL TIME EMPLOYEE.  "Full time employee" shall include all employees who regularly work a minimum of thirty (30) hours per week.

PART TIME EMPLOYEE.  "Part time employee" shall include all employees who regularly work less than thirty (30) hours per week.

SUPERVISOR.  The term "Supervisor" shall include non-certificated supervisory employees, including the Director of Transportation, the Director of Food Services, the board secretary, the technology coordinator and the Director of Buildings and Grounds.   These employees will also be considered as “executive employees” for the purpose of the Fair Labor Standards Act (FLSA) and exempt from the overtime minimum wage requirements.

Non-Categorical Employee.  The term “Non-Categorical” shall include salaried employees that may or may not be degreed nor considered a certified or Non-Certified employee.  These employees are exempt from the over time and minimum wage requirement for the purpose of the 

Code No. 400.2 (Continued)

DEFINITIONS FOR PERSONNEL

Fair Labor Standards Act  (FLSA).  (Could be considered a licensed employee in reference to policy 402.2, if applicable.)

The “Non-Categorical employee” shall include the following employees:

a.	Student Advisors
b.	Attendance Officer

Date of Adoption:  April 25, 1990     
Date of Revision: January 10, 1995
Date of Revision: March 24, 1998
Date of Revision: March 27, 2001
Date of Revision:  August 9, 2005
Date of Revision: March 21, 2006
Date of Revision: February 8. 2016

Code No. 400.3

RECRUITMENT OF PERSONNEL

In selecting personnel, applicants shall be considered without regard to age, race, creed, color, sex, national origin, religion, sexual orientation, gender identity and disability.  In addition, the board will consider the veteran status of the applicant.

The superintendent shall be responsible for recruiting personnel for the various positions within the district and may use other employees in recruiting and selecting personnel.  

The district shall use methods of advertising in media sources as may be appropriate to recruit personnel.  This shall not prevent the transfer of certificated employees without advertising when appropriate or required by a collective bargaining agreement.  A current file of applications shall be maintained at the superintendent's office.  

Certified personnel shall be eligible for a certificate or hold appropriate certification from the Iowa Department of Education for the position for which they have applied.  The school nurse shall be licensed to practice by the Iowa Board of Nursing.  Certified personnel must present current certification to the board secretary prior to payment of any salary each year.  

The board may employ non-certified personnel after receiving a recommendation from the superintendent.  A non-certified staff member may be employed on a temporary basis until a recommendation can be made and action taken by the board.

In all cases of personnel recruitment and advertisement, the district shall follow its affirmative action policy and rules (401.2 R1) and its “ Employment Procedures Manual.”

Date of Adoption:  April 25, 1990     
Date of Revision: December 8, 1992
Date of Revision: January 10, 1995
Date of Revision: March 24, 1998
Date of Revision: March 21, 2006
Date of Revision: February 8, 2016

Code No. 401.1

NEW EMPLOYEE ORIENTATION

Employees must know their role and duties.  New employees may be required to participate in an orientation program for new employees.  It shall be the responsibility of the employee's direct supervisor to provide the new employee with a review of the employee's job description including responsibilities, duties, and appropriate procedures.  Payroll procedures and employee benefit programs will be explained to the employee.  Regular employees ineligible for the school district's group health plan will be given information regarding where they can obtain health care or health care insurance.

Date of Adoption:  April 25, 1990     
Date of Revision:  January 10, 1995
Date of Revision:  September 12, 1995

Code No. 401.2

EQUAL EMPLOYMENT OPPORTUNITY

The Centerville Community School District will provide equal opportunity to employees and applicants for employment in accordance with applicable equal employment opportunity and affirmative action laws, directives and regulations of federal, state and local governing bodies.  Opportunity to all employees and applicants for employment includes hiring, placement, promotion, transfer or demotion, recruitment, advertising or solicitation for employment, treatment during employment, rates of pay or other forms of compensation, and layoff or termination.  The school district will take affirmative action in major job categories where women, men, minorities, and persons with disabilities are underrepresented.  Employees will support and comply with the district's established equal employment opportunity and affirmative action policies.  Employees will be given notice of this policy annually.

The board will appoint an affirmative action coordinator.  The affirmative action coordinator will have the responsibility for drafting the affirmative action plan.  The affirmative action plan will be reviewed by the board at least every two years.

Individuals who file an application with the school district will be given consideration for employment if they meet or exceed the qualifications set by the board, administration, and Iowa Department of Education for the position for which they apply.  In employing individuals, the board will consider the qualifications, credentials, and records of the applicants without regard to race, color, creed, sex, national origin, religion, age, sexual orientation, gender identity, marital status, socioeconomic status or disability.  In keeping with the law, the board will consider the veteran status of applicants.

Prior to a final offer of employment for any teaching position the school district will perform the background checks required by law. The district may determine on a case-by-case basis that, based on the duties, other positions within the district will also require background checks. Based upon the results of the background checks, the school district will determine whether an offer will be extended.  If the candidate is a teacher who has an initial license from the BOEE, then the requirement for a background check is waived.

Advertisements and notices for vacancies within the district will contain the following “AA/EOE”.  The same will also appear on application forms.

Inquiries by employees or applicants for employment regarding compliance with equal employment opportunity and affirmative action laws and policies, including but not limited to complaints of discrimination, will be directed to the Equity/Affirmative Action Coordinator by writing to the Equity/Affirmative Action Coordinator Centerville Community School District, 634 N. Main, Centerville, Iowa 52544 or by telephoning 641-856-0601.

Code No. 401.2 (continued)

EQUAL EMPLOYMENT OPPORTUNITY

Inquiries by employees or applicants for employment regarding compliance with equal employment opportunity and affirmative action laws and policies, including but not limited to complaints of discrimination, may also be directed in writing to the Director of the Region VII office of Civil Rights, U.S. Department of Education, 310 W. Wisconsin Ave., Ste. 800, Milwaukee, Wisconsin, 53203-2292, (414) 291-1111 or the Iowa Civil Rights Commission, 211 E. Maple, Des Moines, Iowa, 50309, (515) 281-4121.  This inquiry or complaint to the federal office may be done instead of, or in addition to, an inquiry or complaint at the local level.

Further information and copies of the procedures for filing a complaint are available in the school district's central administrative office and the administrative office in each attendance center.

Date of Adoption:  April 25, 1990     
Date of Revision:  December 8, 1992
Date of Revision:  January 10, 1995
Date of Revision:  March 27, 2001
Date of Revision:  May 14, 2002
Date of Revision:  September 27, 2005		
Date of Revision:  August 14, 2007			
Date of Revision: February 10, 2009
Date of Revision: May 18, 2015

Code No. 401.2 R1

AFFIRMATIVE ACTION COMPLIANCE CODE

The Centerville Community School District has an established policy of Equal Employment Opportunity with respect to race, religion, color, sex, age, national origin, disability, creed, sexual orientation or gender identity.  The district has an established policy of taking affirmative action in recruitment, appointment, assignment and advancement.  The district will affirmatively recruit women and men, members of diverse racial/ethnic groups and persons with disabilities for job categories where they are underrepresented.  We expect the administration to know of and fully accept the equal opportunity and affirmative action policies and to make certain that no employee or applicant for employment shall suffer any form of discrimination because of race, religion, color, creed, sex, age, sexual orientation, gender identity,  national origin, marital status, socioeconomic status or disability.  In order to effectively communicate and interpret the district's policies to all levels of the administration and to all other employees, community and educational agencies, and the general public, the following will be undertaken.

A.	Dissemination of Policy
1.	Employees will be reminded annually of the district's written statement of policy by:
a.	Description of policy by publication or reference in all issues or re-issues of personnel handbooks.
b.	When appropriate, publicize the EEO policy and such activities through news stories or other articles in district publications.
c.	Detailed discussions at administrative conferences and staff meetings.

2.	Employment advertisements will contain assurance of equal employment opportunity.

3.	All employment and recruiting sources where jobs are listed by the district will be reminded of our policy, both verbally and in writing.

4.	Notice will be posted on bulletin boards and in locations where applicants are interviewed.  These will inform employees and applicants of their rights under federal and state civil rights laws.

B.	Responsibility for implementing the Affirmative Action Program
1.	Responsibility is assigned to the Affirmative Action Coordinator, who will render full assistance and support for those seeking help and assistance in taking affirmative action.

C.	Recruiting
1.	Additional emphasis will be given to seeking and encouraging applicants from minorities, women, and the disabled where such applicants with the necessary qualifications or potentials are available.

Code No. 401.2 R1 (Continued)

AFFIRMATIVE ACTION COMPLIANCE CODE
D.	Training
1.	All training and in-service programs supported or sponsored by the district will continue to be equally open to minority, female and disabled employees on the basis of qualifications.

E.	Hiring, Placement, Transfer, Lay-Off and Recall
1.	The district recognizes that to accomplish the long-range objectives of its Equal Employment Opportunity policy, continued affirmative action must be taken to ensure that job opportunities of all kinds are called to the specific attention of members of minorities, women, and the disabled and that qualified members of such groups should be offered positions on the same basis as all other applicants or employees.  To assure achievement of the objectives, the district will periodically review its practices in hiring job applicants.

F.	Compensation
1.	All employees, including women, minorities and disabled employees, will receive compensation in accordance with the same standards.  Opportunities for performing overtime work or otherwise earning increased compensation will be afforded to all qualified employees without discrimination based on race, religion, color, creed, sex, age, sexual orientation, gender identity, national origin, marital status, socioeconomic status or disability.

This Affirmative Action Program will be reviewed and updated biennially.

Inquiries by employees or applicants for employment regarding compliance with equal employment opportunity and affirmative action shall be directed to the Equity/Affirmative Action Coordinator, Centerville Community School District, 634 North Main, Centerville, Iowa 52544-0370.

Further information and copies of the procedures for filing a complaint are available in the district's central administrative office and the administrative office in each district attendance center.

Date of Adoption:  April 25, 1990     
Date of Revision: December 8, 1992
Date of Revision: January 10, 1995
Date of Revision:  March 27, 2001
Date of Revision: March 21, 2006
Date of Revision: August 14, 2007
Date of Revision: February 10, 2009
Date of Revision: May 18, 2015

Code No. 401.3

PERSONNEL CONFLICT OF INTEREST 

Employees' use of their position with the school district for financial gain shall be considered a conflict of interest with their position as employees and may subject employees to disciplinary action.

Employees have access to information and a captive audience that could award the employee personal or financial gain.  No employee may solicit other employees or students for personal or financial gain to the employee without the approval of the superintendent.  If the approval of the superintendent is given, the employee must conduct the solicitations within the conditions set by the superintendent.  Further, the superintendent may, upon five days notice, require the employee to cease such solicitations as a condition of continued employment.

Employees shall not act as an agent or dealer for the sale of textbooks or other school supply companies doing business with the school district. Employees shall not participate for personal financial remuneration in outside activities wherein their position on the staff is used to sell goods or services to students, parents, or staff.  Employees shall not engage in outside work or activities where the source of information concerning the customer, client or employer originates from information obtained because of the employee's position in the school district.

It shall also be a conflict of interest for an employee to engage in any outside employment or activity which is in conflict with the employee's official duties and responsibilities.  In determining whether outside employment or activity of an employee creates a conflict of interest, situations in which an unacceptable conflict of interest shall be deemed to exist shall include, but not be limited to, any of the following:
(1) 	The outside employment or activity involves the use of the school district's time, facilities, equipment and supplies or the use of the school district's badge, uniform, business card or other evidences of office to give the employee or the employee's immediate family an advantage or pecuniary benefit that is not available to other similarly situated members or classes of members of the general public.  For purposes of this section, a person is not "similarly situated" merely by being related to an employee who is employed by the school district.
(2)  	The outside employment or activity involves the receipt of, promise of, or acceptance of more or other consideration by the employee or a member of the employee's immediate family from anyone other than the school district for the performance of any act that the employee would be required or expected to perform as part of the employee's regular duties or during the hours during which the employee performs service or work for the school district.
(3)  	The outside employment or activity is subject to the official control, inspection, review, audit or enforcement authority of the employee during the performance of the employee's duties.

Code No. 401.3 (Continued)

PERSONNEL CONFLICT OF INTEREST 

If the outside employment or activity is employment or activity in (1) or (2) above, the employee must cease the employment of or activity.  If the activity or employment falls under (3), then the employee must:

* 	Cease the outside employment or activity;
* 	Publicly disclose the existence of the conflict and refrain from taking any official action or performing any official duty that would detrimentally affect or create a benefit to the outside employment or activity.  Official action or official duty includes, but is not limited to, participating in any vote, taking affirmative action to influence any vote, or providing any other official service or thing that is not available generally to members of the public in order to further the interests of the outside employment or activity

It shall be the responsibility of each employee to be aware of and take the necessary action to eliminate a potential conflict of interest should it arise.

Date of Adoption:  April 25, 1990 
Date of Revision:  November 27, 1990
Date of Revision:  October 12, 1993
Date of Revision:  September 26, 1995
Date of Revision:  March 27, 2001
Date of Revision:  March 21, 2006
Date of Revision: September 8, 2009

Code No. 401.4

NEPOTISM
 
More than one family member may be employed. It is within the discretion of the superintendent to allow one family member employed by the district to supervise another family member employed by the school, subject to the approval of the board. Employment of more than one individual family member shall be on the basis of their qualifications, credentials, and records.

Date of Adoption:  April 25, 1990     
Date of Revision: March 21, 2006

Code No. 401.5

PERSONNEL CONCERNS

Employee claims of violation of board policy or administrative regulations not covered in a formal grievance procedure contained in a master labor agreement, shall be attempted to be resolved at the lowest possible administrative level within five days of the alleged violation.  Employees shall discuss the alleged violation with their immediate supervisor; and if unresolved, employees may discuss the concern with the building principal.  

If the concern remains unresolved, the employee may next place the concern, in writing, and within five days of the discussion with the principal, discuss it with the superintendent. 

If a resolution is not agreed upon with the superintendent, the employee may within ten days of discussing the issue with the superintendent, ask to have the item placed on the agenda for the next meeting of the board. 

Supervisors shall attempt to resolve employee concerns.  Any action on a concern by the board shall be final.

Date of Adoption:  April 25, 1990     
Date of Revision:  December 8, 1992
Date of Revision:  January 10, 1995

Code No. 401.6

PERSONNEL RECORDS

The school district shall maintain personnel records on employees.  The records are important for the daily administration of the educational program, for implementing board policy, for budget and financial planning, and for meeting state and federal requirements.

The records shall include, but not be limited to, records necessary for the daily administration of the school district, salary records, evaluations, application for employment, references, and other items needed to carry out board policy.  Employee personnel files are school district records and are considered confidential records and therefore are not generally open to public inspection or accessibility.  Only in certain limited instances, when the employee has given a signed consent, will employee personnel records be accessible to individuals other than the employee or authorized school officials.  Iowa courts have declared records such as salary and sick leave usage as public records.

Employees may have access to their personnel files at a time mutually agreed upon between the superintendent and the employee.  However, employees will not be allowed access to the employment references written on behalf of the employee.   Employees may copy items from their personnel files at a time mutually agreed upon between the central office and the employee.  The school district may charge a reasonable fee for each copy.  Board members will generally only have access to an employee's file when it is necessary because of an employee related matter before the board.

It shall be the responsibility of the superintendent to keep employees' personnel files current.  The board secretary shall be the custodian of employee records.

It shall be the responsibility of the superintendent to develop administrative regulations for the implementation of this policy. 

Other records may be maintained as by law or contract.

Date of Adoption: April 25, 1990
Date of Revision: December 8, 1992
Date of Revision: October 12, 1993
Date of Revision: March 24, 1998
Date of Revision:  November 10, 1998
Date of Revision:  March 27, 2001

Code No. 401.6R

EMPLOYEE RECORDS REGULATION	

Employee Personnel Records Content
1.	Employee personnel records may contain the following information:
*	Personal information including, but not limited to, name, address, telephone number, emergency numbers, birth date and spouse.
*	Individual employment contract.
*	Evaluations (Evaluation records may be kept with the evaluator.)
*	Application, resume and references
*	Salary information
*	Copy of the employee's license or certificate, if needed for the position
*	Educational transcripts
*	Assignment
*	Records of disciplinary matters

2.  	Employee health and medical records shall be kept in a file separate from the employee's personnel records.  Health and medical records may contain, but are not limited to:
*	Medical professional signed physical form
*	Sick or long‑term disability leave days
*	Worker's compensation claims
*	Reasonable accommodation made by the school district to accommodate the employee's disability
*	Employee's medical history
*	Employee emergency names and numbers
*	Family and medical leave request forms.
*	Hepatitis B records---keep for ten years

Applicant File Records Content
Records on applicants for positions with the school district shall be maintained in the central administration office.  The records shall include, but not be limited to:
*	Application for employment
*	Resume
*	References
*	Evidence of appropriate license or certificate, if necessary for the position for which the individual applied
*	Affirmative action form, if submitted

Record Access
Only authorized school officials shall have access to an employee's records without the written consent of the employee.  Authorized school officials may include, but not be limited to, the superintendent, building principal, or board secretary.  In the case of a medical emergency, the school nurse or other first aid or safety personnel may have access to the employee's health or medical file without the consent of the employee.  Board members will generally only have access to an employee's personnel file without the consent of the employee when necessary to conduct board business.

Code No. 401.6R (continued)

EMPLOYEE RECORDS REGULATION

Confidential records include, but are not necessarily limited to, birth dates, addresses, gender, employment applications, performance evaluations and individual test scores.

Employee Record Retention
All employee records, except payroll and salary records, shall be maintained for a minimum of seven years after termination of employment with the district.  Applicant records shall be maintained for minimum of seven years after the position was filled.  Payroll and salary records shall be maintained for a minimum of three years after payment.

Date of Adoption: October 12, 1993
Date of Revision:  January 10, 1995
Date of Revision: March 24, 1998
Date of Revision:  November 14, 2000

Code No. 401.7

PERSONNEL COMMUNICATIONS, ADMINISTRATION & BOARD 
 
It shall be the responsibility of the superintendent to develop avenues for communication between the board and the employees.  These avenues of communication will not be construed as denying the right of any employee to appeal an action or decision of the superintendent to the board.  

No board policy or administrative regulation shall be construed as denying an employee the rights that any other citizen has to appear before the board.

It shall be the responsibility of the employees to keep the administration informed about the day‑to‑day occurrences in their work place, and to keep the board informed, through their administrators, of current educational trends and issues.

Date of Adoption:  April 25, 1990       

Code No. 401.8

PERSONNEL INPUT IN DECISION MAKING

School district personnel may be required to make presentations to the board regarding students, educational programs, or other district related operations.  

The administration may consult with employees about proposed changes in the education program and operations of the school district.

The district’s vision for the future includes enhancing employee empowerment.  For improvement and reform to endure, those involved in implementing the change must normally be involved in defining the change.

Date of Adoption:  April 25, 1990       
Date of Revision: December 8, 1992
Date of Revision:  January 10, 1995
Date of Revision: March 24, 1998

Code No. 401.9

PERSONNEL USAGE OF EQUIPMENT/FACILITIES

School district employees may use school equipment for a school purpose or activity held during the school day or for a school sponsored event.   District employees may also use school equipment for events not sponsored by the school district with permission of their building principal, but the event should be educationally related.  District employees may borrow other equipment for non-educational purposes with the permission of the immediate supervisor.

District personnel may use the facilities when it does not interfere with educational programs or scheduled activities.  District employees may use the facilities for non-educational activities with permission of the principal.  A request by an employee to use the facilities will not take priority over requests made by other individuals or organization under board policies on use of school facilities and equipment.  The employee will be responsible to meet requirements set forth by the principal upon the granting of the request.

Date of Adoption:  April 25, 1990       
Date of Revision:  January 10, 1995
Date of Revision: March 24, 1998

Code No. 401.9 R1

EMPLOYEE PROFESSIONAL/ETHICAL USE OF TECHNOLOGY AND ELECTRONIC TRANSMISSION 
A.   Telephone
1	Primary use of the telephone should be for school-related business.
2	All current practices and policies still apply regarding personal costs for use of school district telephones.
3	Exchange of information involving school district phone lines and equipment should be conducted professionally, ethically and legally.
4	During instructional time, the phone system should be on voice mail.
5	Personal use of the telephone and private cell phone should be limited to an as needed basis, with business that cannot be accomplished outside the contracted day.
6	Personal use of the telephone and private cell phone should coincide with the least disruptive part of the individual’s contracted hours.
7	Student use of a classroom phone should be limited to class-related business.
8	Check your voice mail daily.
B.   Use of Internet
1.	Internet access is intended to be used for educational purposes that are in the best interest of students, staff and the district, remaining consistent with the Centerville Schools goals and objectives.
2.	Internet access should be used for professional and educational use only during the contracted school day.
3.	On-line etiquette is to be practiced by all staff.
4.	Inappropriate sites should not be accessed intentionally.
5.	Game use should be limited to those that are educational and used as part of the curriculum.
6.	Downloads can bring with them a risk of computer viruses. Any downloading of software should be done only with administrative/designee approval.
7.	Web pages or bulletin boards should be constructed to professionally reflect the school district beliefs, goals and objectives. The approval process for any Web pages will be through the individual supervisor.
8.	These Web pages should not be used to promote the personal interest of any staff.
9.	Sites should not be used to post private or confidential information about staff or students.
10.	Staff should observe copyright restrictions and give credit where applicable.
11.	Plagiarism of any information is not acceptable.
12.	During instructional time, Internet use should be limited to the lesson being researched or instructed.
13.	During non-instructional contract time, the Internet can be used to access information for professional use as related to the staff member’s job.
14.	Outside of contracted time, the Internet can be used for professional or personal use as long as it doesn’t interfere with the operations of the network system.
15.	Staff will be made aware that a tracking system exists to monitor Internet sites accessed.
C.   Use of E-mail
1.	E-mail should be used as a business tool for quick communications.
2.	Its use should be mostly professional with limited personal use.
3.	During contracted time, e-mail will be used for professional use only.
4.	Staff should avoid sending chain letters or joke messages.
5.	Messages should not contain profanities or language that is generally offensive, defamatory, harassing or threatening to another individual or group.
6.	The rules of netiquette will be followed by all.
7.	During non-contracted time, e-mail may be used for professional or personal reasons as long as it doesn’t interfere with the operations of the district.
8.	Each employee will be provided with a district issued e-mail address.
9.	That e-mail address will be considered the educational address for staff.
10.	Staff will be expected to use and check daily their district issued address for professional communications.
D.   Use of Computers, Software, Games, etc.
1.	Games will not be on school district computers unless they have an academic or learning intent.
2.	Software will adhere to all copyright regulations of the district and owner.
3.	Computer use will be limited during instructional time unless it applies to the class or instruction.
4.	Computer use during non-instructional times will be for professional use related to the job.
5.	Computer use outside of contracted time will be for professional use or personal use as long as it doesn’t interfere with school district operations and costs are reimbursed for products used.
6.	Invoices and receipts for software purchases will be kept for validation.
E.   Privacy/Passwords/Fortress
1.	Use of school network is a privilege not a right.
2.	If these privileges are violated, administrators can take the privilege away from school employees.
3.	When many users are involved, security on a computer system is a high priority.
4.	Security measures followed by all staff should include keeping passwords private, and not leaving personal or computer passwords available in obvious locations.
F.   Technologies Not Yet Known
1.	General principles above will be used to follow new and undetermined technologies at this point in time.
2.	Superintendent discretion will be used until guidelines are established.

Any staff infractions related to inappropriate use of communications technologies should be addressed by the supervisor.  The person who violated the rules should be addressed individually. The whole staff should not be addressed on the issue. Supervisors should maintain any needed records of the incident.

Date of Revision: February 8, 2011
Date of Revision: August 10, 2020

Code No. 401.10

ACCESS TO SCHOOL FACILITIES 

School district personnel may use the school building at a time other than regular school day or hours if the use is for educationally related purposes.

It shall be the responsibility of the superintendent, in conjunction with the administrative team, to develop administrative rules and an accounting system for keys to buildings and rooms.  

Personnel who abuse the access privilege, the facilities or who fail to properly secure the building may be subject to disciplinary action.

Date of Adoption:  April 25, 1990       
Date of Revision:  January 10, 1995

Code No. 401.11

TRANSPORTING STUDENTS BY SCHOOL PERSONNEL

Generally, transportation of students shall be in a motor vehicle owned by the school district and driven by a school bus driver.  In some cases, it may be more economical or efficient for the school district to allow another employee of the district to transport the student in their personal motor vehicle or in a school district motor vehicle, other than a school bus.  In the event of an accident when an employee or volunteer is using their personal vehicle, the district’s liability coverage is significant if the driver is liable.  If the driver is not at fault there is no coverage from the district auto policy.  The driver would need to rely on their personal policy for all damage (medical, physical damage, uninsured or under-insured).

District employees who transport students in school owned vehicles other than on the regular bus route for school purposes must have completed a transportation request and have received permission from the building principal and the director of transportation.  Transportation of students using privately owned vehicles must receive administration approval except in cases of an emergency. 

Travel compensation for use of personal motor vehicle will be followed according to the rate specified in the district’s master contract.

Date of Adoption:  April 25, 1990       
Date of Revision: December 8, 1992
Date of Revision: June 11, 1996
Date of Revision: March 21, 2006
Date of Revision: February 8, 2011

Code No. 401.12

SCHOOL PERSONNEL TRAVEL COMPENSATION

School district personnel traveling on behalf of the school district and performing approved school business will be reimbursed for their actual and necessary expenses. Authorization for the trip must be approved by the principal, supervisor, or superintendent.

Prior to reimbursement of actual and necessary expenses, the employee must provide the school district with a detailed receipt, indicating the date, purpose and nature of the expense for each claim item.

Reimbursement for actual and necessary expenses for travel outside the school district will be limited to the pre-approved expenses.  Pre-approved expenses for registration are limited to the actual cost of the registration.

It shall be the responsibility of the administrative team to determine whether requested trips are appropriate school business.

Date of Adoption:  April 25, 1990       
Date of Revision: December 8, 1992
Date of Revision: February 8, 2011

Code No. 401.13

ACTIVITY PASSES FOR SCHOOL PERSONNEL 

School district personnel may earn an activity pass to attend most school-sponsored activities at home without charge.  Admission will be charged to personnel who have not earned an activity pass.

A pass shall admit school district personnel and one adult guest, if designated, for meeting the requirements specified in the district’s master contract by working additional extracurricular assignments.  Non-Certified employees shall have similar opportunities to earn an activity pass in the same manner as certified staff, once certified requirements have been met.  It shall be the responsibility of the administrative team and activities/athletic director to determine how non-certified employees earn an activity pass.

Date of Adoption:  April 25, 1990       
Date of Revision:  January 10, 1995
Date of Revision:  March 27, 2001
Date of Revision: March 21, 2006
Date of Revision: February 8, 2016

Code No. 401.14

STAFF TECHNOLOGY USE/SOCIAL NETWORKING

Computers, electronic devices and other technology are powerful and valuable education and research tools and, as such, are an important part of the instructional program. In addition, the school district depends upon technology as an integral part of administering and managing the schools’ resources, including the compilation of data and recordkeeping for personnel, students, finances, supplies and materials. This policy outlines the board’s expectations in regard to these different aspects of the school district’s computer resources. Employees must conduct themselves in a manner that does not disrupt from or disrupt the educational process and failure to do so will result in discipline, up to and including, discharge.
General Provisions
The superintendent is responsible for designating a Technology Director who will oversee the use of school district technology resources. The Technology Direcotr will prepare in-service programs for the training and development of school district staff in technology skills, appropriate use of district technology and for the incorporation of technology use in subject areas.
The superintendent, working with appropriate staff, shall establish regulations governing the use and security of the school district’s technology resources. The school district will make every reasonable effort to maintain the security of the district networks and devices. All users of the school district’s technology resources, including students, staff and volunteers, shall comply with this policy and regulation, as well as others impacting the use of school equipment and facilities. Failure to comply may result in disciplinary action, up to and including discharge, as well as suspension and/or revocation of technology access privileges.
Usage of the school district’s technology resources is a privilege, not a right, and that use entails responsibility. District-owned technology and district maintained social media and e-mail accounts are the property of the school district. Therefore, users of the school district’s network must not expect, nor does the school district guarantee, privacy for e-mail or use of the school district’s network including web sites visited. The school district reserves the right to access and view any material stored on school district equipment or any material used in conjunction with the school district’s network.
The superintendent, working with the appropriate staff, shall establish procedures governing management of technology records in order to exercise appropriate control over technology records, including financial, personnel and student information. The procedures will address at a minimum: 
•	passwords,
•	system administration,
•	separation of duties,
•	remote access,
•	data back-up (including archiving of e-mail),
•	record retention, and
•	disaster recovery plans.

Code No. 401.14 (continued)

STAFF TECHNOLOGY USE/SOCIAL NETWORKING

Social Networking or Other External Web Sites
For purposes of this policy any web site, other than the school district web site or school-school district sanctioned web sites, are considered external web sites. Employees shall not post confidential or proprietary information, including photographic images, about the school district, its employees, students, agents or others on any external web site without consent of the superintendent. The employee shall adhere to all applicable privacy and confidentiality policies adopted by the school district when on external web sites. Employees shall not use the school district logos, images, iconography, etc. on external web sites. Employees shall not use school district time or property on external sites that are not in direct relation to the employee’s job. Employees, students and volunteers need to realize that the internet is not a closed system and anything posted on an external site may be viewed by others, all over the world. Employees, students and volunteers who don’t want school administrators to know their personal information, should refrain from exposing it on the internet. Employees, who would like to start a social media site for school district sanctioned activities, should contact the superintendent.

Date of Adoption: July 10, 2020
Date of Revision: November 14, 2022

Code No. 401.14R1
Page 2 of 2

Staff Technology Use Regulation 

•	Using the network to receive, transmit or make available to others messages that are racist, sexist, and abusive or harassing to others.
•	Use of another’s account or password.
•	Attempting to read, delete, copy or modify the electronic mail (e-mail) of other system users.
•	Forging or attempting to forge e-mail messages.
•	Engaging in vandalism. Vandalism is defined as any malicious attempt to harm or destroy school district equipment or materials, data of another user of the school district’s network or of any of the entities or other networks that are connected to the Internet. This includes, but is not limited to, creating and/or placing a computer virus on the network.
•	Using the network to send anonymous messages or files.
•	Revealing the personal address, telephone number or other personal information of oneself or another person without their consent.
•	Intentionally disrupting network traffic or crashing the network and connected systems.
•	Installing personal software or using personal disks on the school district’s computers and/or network without the permission of the Technology Director.
•	Using the network in a fashion inconsistent with directions from teachers and other staff and generally accepted network etiquette.

Employee Violations-Consequences and Notifications
Fines or Legal consequences of violations of copyright law will be the responsibility of the employee.
Employees who access restricted items on the district network or electronic transmission may be subject to the following:
1.	If criminal illegal activity is detected, law enforcement will be notified.
2.	A verbal and written “warning” notice may be issued to the employee by the immediate supervisor.
3.	The employee may lose privileges to use district computers, network, internet and electronic transmission.
4.	Violations may result in discipline up to and including discharge.
5.	
Date of Adoption: August 10, 2020

Code No. 402.1

RELEASE OF CREDIT INFORMATION

The following information will be released to an entity with whom a district employee has applied for credit without employee notice:  title of position, income, number of years employed.   Any other confidential information about an employee will not be released without a written authorization from the employee.

It shall be the responsibility of the board secretary or superintendent to respond to inquiries from creditors.

Date of Adoption:  April 25, 1990       

Code No. 402.2

REPORTING CHILD ABUSE 

In compliance with state law and to provide protection to victims of child abuse, the board believes incidents of alleged child abuse should be reported to the proper authorities. All licensed school employees, teachers, coaches and paraeducators are mandatory reporters as provided by law and are to report alleged incidents of child abuse they become aware of within the scope of their professional duties. 
 
When a mandatory reporter suspects a student is the victim of child abuse, the mandatory reporter shall make an oral report of the suspected child abuse to the Iowa Department of Human Services within 24 hours of becoming aware of the abusive incident and shall make a written report to the Iowa Department of Human Services within 48 hours following the oral report. If the mandatory reporter believes the child is in immediate danger, the local law enforcement agency will also be notified.  

Within six months of their initial employment, mandatory reporters will take a two-hour training course involving the identification and reporting of child abuse, or submit evidence they’ve taken the course within the previous three years.  Once the training course has been taken, the certificate will remain valid for three years.  Employees who have taken the two-hour training course will take the one-hour follow up training course every three years and prior to the expiration of their certificate.

Legal Reference:	Iowa Code §§ 232.67-.77; 232A; 235A; 280.17.
	441 I.A.C. 9.2; 155; 175.

Date of Adoption:  April 25, 1990       
Date of Revision: October 12, 1993
Date of Revision:  January 10, 1995
Date of Revision: March 21, 2006
Date of Revision: February 8, 2011
Date of Revision: August 8, 2022

Code No. 402.2R

CHILD ABUSE REPORTING REGULATION

Iowa law requires licensed employees to report to the Iowa Department of Human Services (DHS) instances of suspected child abuse which they become aware of within the scope of their professional practice.

The law further specifies that a licensed employee who knowingly or willfully fails to report a suspected case of child abuse is guilty of a simple misdemeanor and that the licensed employee may be subject to civil liability for damages caused by the failure to report.

Employees participating in good faith in the making of a report or in a judicial proceeding that may result from the report, are immune from liability.

Child Abuse Defined
"Child abuse" is defined as:
* 	Any non-accidental physical injury, or injury which is at variance with the history given of it, suffered by a child as the result of the acts of omissions of a person responsible for the care of the child.
*	The commission of a sexual offense with or to a child . . . as a result of the acts or omissions of the person responsible for the child .  . .Sexual offense includes sexual abuse, incest, and sexual exploitation of a minor.
*	The failure on the part of a person responsible for the care of a child to provide  for the adequate food, shelter, clothing or other care necessary for the child's welfare when financially able to do so.  A parent or guardian legitimately practicing religious beliefs who does not provide specified medical treatment for a child for that reason alone shall not be considered abusing the child . . . .
*	The acts or omissions of a person responsible for the care of a child which allow, permit or encourage the child to engage in acts prohibited pursuant to Iowa Code, section 725.1, which deals with prostitution.

Any mental injury to a child’s intellectual or psychological capacities evidenced by an observable and substantial impairment in the child’s ability to function within the child’s normal range of performance and behavior as the result of the acts or omissions of a person responsible for the care of the child, if the impairment is diagnosed by a licensed physician or qualified mental health professional.

An illegal drug is present in a child’s body as a direct and foreseeable consequence of the acts of omissions of the person responsible for the care of the child. 

The person responsible for the care of a child has, in the presence of the child, as defined in section 232.2, subsection 6, paragraph “p”, manufactured a dangerous substance, as defined in section 232, subsection 6, paragraph “p”, or in the presence of the child possesses a product containing ephedrine, its salts, optical isomers, salts of optical isomers, pseudoepherine or its salts, with the intent to use the product as a precursor or an intermediary to a dangerous substance.

Code No. 402.2R (Continued)

CHILD ABUSE REPORTING REGULATION

The commission of bestiality in the presence of a minor under section 717C.1 by a person who resides in a home with a child, as a result of the acts of omissions of a person responsible for the care of the child.

Teachers in public schools are not "persons responsible for the care of the child" under this definition.  However, a teacher who abuses a child is subject to civil, criminal, and professional sanctions.

Reporting Procedures
Licensed employees, including teachers and school nurses, are required to report, either orally or in writing, within twenty-four hours to the Iowa Department of Human Services when the employee reasonably believes a child has suffered from abuse within the scope of employment.  Within forty-eight hours of an oral report, a written report must be filed with the DHS.

Each report should contain as much of the following information as can be obtained within the time limit.  However, the law specifies a report will be considered valid even if it does not contain all of the above information.
*	name, age, and home address of the child;
*	name and home address of parents, guardians or other persons believed to be responsible for care of the child;
*	the child's present whereabouts if not the same as the parent's or other person's home address;
*	description of injuries, including evidence of previous injuries;
*	name, age, and condition of other children in the same home;
*	any other information considered helpful; and
*	name and address of the person making the report.

It is not the responsibility of employees to prove that a child has been abused or neglected.  Employees should not take it upon themselves to investigate the case or contact the family of the child.  The DHS is responsible to investigate the incident of alleged abuse.

Date of Adoption:  April 25, 1990       
Date of Revision: October 12, 1993
Date of Revision: March 24, 1998
Date of Revision: March 21, 2006

Code No. 402.3

SOLICITATION

No organization or individual may solicit funds of employees or distribute flyers or other materials related to fund drives within school facilities or on school grounds without the approval of the superintendent or administrative team.

Collecting money or distributing fund drive literature within the school will not be permitted without superintendent approval.

It shall be the responsibility of the superintendent and administrative team to keep fund drives to a minimum.  Board input and direction may be necessary to reach decisions on some fund drive requests.

Date of Adoption:  April 25, 1990       

Code No. 402.4

GIFTS TO SCHOOL PERSONNEL

Employees may receive a gift on behalf of the school district.  Employees shall not, either directly or indirectly, solicit, accept or receive any gift, series of gifts or an honorarium unless the donor does not meet the definition of "restricted donor" stated below or the gift or honorarium does not meet the definition of gift or honorarium stated below.

A "restricted donor" is defined as a person or other entity which:

*	Is seeking to be, or is a party to, any one or any combination of sales, purchases, leases or contracts to, from or with the school district;
*	Will be directly and substantially affected financially by the performance or nonperformance of the employee's official duty in a way that is greater than the effect on the public generally or on a substantial class of persons to which the person belongs as a member of a profession, occupation, industry or region; or
*	Is a lobbyist or a client of a lobbyist with respect to matters within the school district's jurisdiction.

A "gift" is the giving of anything of value in return for which something of equal or greater value is not given or received.  However, "gift' does not include any of the following:

*	Contributions to a candidate or a candidate's committee;
*	Information material relevant to an employee's official function, such as books, pamphlets, reports, documents, periodicals or other information that is recorded in a written, audio or visual format;
*	Anything received from a person related within the fourth degree by kinship or marriage, unless the donor is acting as an agent or intermediary for another person not so related;
*	An inheritance;
*	Anything available or distributed to the general public free of charge without regard to the official status of the employee;
*	Items received from a charitable, professional, educational or business organization to which the employee belongs as a dues paying member if the items are given to all members of the organization without regard to an individual member's status or positions held outside of the organization and if the dues paid are not inconsequential when compared to the items received;
*	Actual expenses of an employee for food, beverages, travel and lodging for a meeting, which is given in return for participation in a panel or speaking engagement at the meeting when the expenses relate directly to the day or days on which the employee has participation or presentation responsibilities;
*	Plaques or items of negligible resale value given as recognition for public service;
*	Items or services received by members or representatives of members as part of a regularly scheduled event that is part of a business or educational conference, seminar or other meeting that is sponsored and directed by any state, national or regional government organization in which the state of Iowa or a political subdivision of the state of Iowa is a member or received at such an event by members or representatives of members of state, national or regional 

Code No. 402.4(Continued)

GIFTS TO SCHOOL PERSONNEL

government organizations whose memberships and officers are primarily composed of state or local government officials or employees;
*	Funeral flowers or memorials to a church or nonprofit organization;
*	Gifts which are given to an employee for the employee's wedding or twenty‑fifth or fiftieth wedding anniversary; 
*	Payment of salary or expenses by the school district for the cost of attending a meeting of a sub-unit of an agency when the employee whose expenses are being paid serves on a board, commission, committee, council or other sub-unit of the agency and the employee is not entitled to receive compensation or reimbursement of expenses from the school district for attending the meeting; or
*	Gifts other than food, beverages, travel and lodging received by an employee which are received from a person who is a citizen of a country other than the United States and is given during a ceremonial presentation or as a result of a custom of the other country and is of personal value only to the employee.
*	Actual registration costs for informational meetings or sessions which assist a public official or public employee in the performance of the person's official functions.  The costs of food, drink, lodging and travel are not "registration costs" under this paragraph.  Meetings or sessions which a public official or public employee attends for personal or professional licensing purposes are not "informational meetings or sessions which assist a public official or public employee in the performance of the person's official functions" under this paragraph.

An "honorarium" is anything of value that is accepted by, or on behalf of, an employee as consideration for an appearance, speech or article.  An honorarium does not include any of the following:

*	Actual expenses of an employee for registration, food, beverages, travel or lodging for a meeting, which is given in return for participation in a panel or speaking engagement at a meeting when the expenses relate directly to the day or days on which the employee has participation or presentation responsibilities;
*	A non-monetary gift or series of non-monetary gifts donated within thirty days to a public body, an educational or charitable organization or the Iowa department of general services; or
*	A payment made to an employee for services rendered as part of a private business, trade or profession in which the employee is engaged if the payment is commensurate with the actual services rendered and is not being made because of the person's status as an employee of the district, but, rather, because of some special expertise or other qualification.

It shall be the responsibility of each employee to know when it is appropriate to accept or reject gifts or an honorarium.

Date of Adoption:  April 25, 1990
Date of Revision: October 12, 1993
Date of Revision: October 11, 1994
Date of Revision: March 21, 2006

Code No. 402.5

PUBLIC RELATIONS OF SCHOOL PERSONNEL

The board encourages active participation by school district personnel in community activities and events.  

Administrative team members are encouraged to participate in civic and community activities as a part of their administrative responsibility and to promote school and community harmony.

Date of Adoption:  April 25, 1990    

Code No. 402.6

OUTSIDE EMPLOYMENT OF PERSONNEL

School district personnel shall not accept outside employment without the approval of the superintendent and immediate supervisor if it may interfere with their current duties.  

The board expects employees to give their position in the school district precedence over any other employment, and the board reserves the right to request an employee to cease an outside employment as a condition of continued employment.

Date of Adoption:  April 25, 1990    
Date of Revision:  December 8, 1992
Date of Revision: March 21, 2006

Code No. 402.7

TUTORING

Every effort will be made by the licensed employees to help students with learning problems before recommending that the parents engage a tutor.  Since there are exceptional cases when tutoring will help students overcome learning deficiencies, tutoring by licensed employees may be approved by the superintendent.

Licensed employees may only tutor students other than those for whom the teacher is currently exercising teaching, administrative or supervisory responsibilities unless approved by the superintendent.

School district facilities, equipment, materials, or supplies shall not be used by any employee or private citizen for private tutoring, lessons, coaching, or other educational services or for an employee's private business or activities without prior approval of the superintendent.

Date of Adoption:  April 25, 1990    
Date of Revision: March 24, 1998
Date of Revision: February 8, 2011

Code No. 402.8

DISTRICT LANDLINE AND SCHOOL ISSUED CELLULAR TELEPHONE USAGE

The District provides telephones to employees because communication is essential for the performance of their duties, especially in times of emergency or when addressing safety issues.

The landline telephones provided by the district to employees are to be used primarily for school business.  Employees may use landline telephones for personal business, provided such personal use is limited in frequency and duration and does not interfere with the performance of an employee’s job.  From time to time, it may be necessary for employees to conduct personal business or to make personal telephone calls during school hours.  Employees shall conduct such business during lunch periods or breaks.

Personal school telephone or fax use shall be restricted to local calls unless employee charges such calls to their home phone, credit card, non‑toll, collect, or uses their personal cell phone.  In emergencies, if none of those are available, employees may pay the district 25 cents per minute for personal long distance calls. 

Payment should also be made for personal faxes sent out in the amount of 25 cents per page.  Employees making long distance school related calls shall report such calls to the building secretary, or record the call on the building telephone log. 

It shall be the responsibility of the administrative team to ensure this policy is not abused.

Certain employees are required to perform work outside of their offices or assigned work spaces, outside of the Centerville Community School District, or outside of the district’s regular business hours.  It is important to the mission of the district to provide for the communication with these employees when they are not in their offices.  Telephone communication is greatly enhanced by the use of cellular telephones.  With a cellular telephone, an employee may receive and respond to calls regardless of the time of the day or the employee’s location.

The billing for the cellular telephone service includes a charge for all calls that are transmitted or received by the cellular telephone, including unsolicited and misdirected calls, and local and long distance calls.  Itemized bills are prepared for all cellular telephones listing all calls made or received by a cellular telephone within a billing cycle by date, time, location, and duration.  Roaming charges are listed by date, time, location, duration, and roaming service provider.  The district’s policy concerning cellular telephones is as follows:

The district will issue cellular telephones for personal calls subject to the same restrictions that are imposed on landline telephones.

If the number of minutes charged to a cellular telephone exceeds the monthly time allotted for the service plan, the employee must reimburse the district for personal calls that exceed 

Continued Code No. 402.8

DISTRICT LANDLINE AND SCHOOL ISUED CELLULAR TELEPHONE USAGE

the monthly time allotted.  Cellular telephone users must send a check to the business office made payable to the Centerville Community School District for the monthly fee and any additional personal charges (roaming and excess time).  Payment is due upon receipt of the cellular telephone statement.

If a cellular telephone assigned to an employee is lost, damaged or is malfunctioning, the business office must be notified immediately.  Employees who fail to notify the business office immediately of a lost telephone may be responsible for all unauthorized calls made from their assigned cellular telephone.  Employees are responsible for replacement of a lost or damaged phone.

The district will not reimburse employees for business use of their own cellular telephone.  Employees are encouraged to use their office telephone for business telephone calls.  Employees who have a personal cellular telephone are not expected to use that telephone for district business.

The superintendent or his/her designee is authorized to review the use of district-issued cellular telephones by employees and to revoke the privilege of using a district-issued cellular telephone if it is determined that the cellular telephone is being used primarily for personal business or it being used in any other manner which is contrary to district policy.

Date of Adoption:  April 25, 1990    
Date of Revision: March 24, 1998
Date of Revision: May 16, 2006
Date of Revision: November 10, 2009

 

Code No. 403.1

PHYSICAL AND MENTAL EXAMINATIONS

Good health is important to job performance.  Employees will present evidence of good health, in the form of a physical examination report, within three weeks of their employment with the school district.  

School bus drivers will present evidence of good health every other year in the form of a physical examination report unless otherwise required by law or medical opinion.  Employees whose physical or mental health, in the judgment of the administration, may be in doubt will submit to additional examinations, when requested to do so, at the expense of the school district.

The cost of the initial examination will be paid as outlined in the master contract for certified staff and as outlined in the support staff handbook for non-certified staff.  The form indicating the employee is able to perform the duties for which the employee was hired must be returned prior to payment of salary.  The cost of bus driver renewal physicals will be paid by the school district as outlined in the support staff handbook.  The school district will provide the standard examination form to be completed by the personal physician of the employee.  Employees identified as having reasonably anticipated contact with blood or infectious materials will receive the Hepatitis B vaccine or sign a written waiver stating that they will not take the vaccine.

It is the responsibility of the superintendent to write an exposure control plan to eliminate or minimize district occupational exposure to bloodborne pathogens.  The plan for designated employees will include, but not be limited to, scope and application, definitions, exposure control, methods of compliance, Hepatitis B vaccination and postexposure evaluation and follow-up, communication of hazards to employees, and record keeping.

The requirements stated in the master contract between employees in that certified collective bargaining unit and the board regarding physical examinations of such employees are followed.

Date of Adoption:  April 25, 1990    
Date of Revision:  June 9, 1992
Date of Revision:  November 15, 2005
Date of Revision: May 16, 2006
Date of Revision: March 8, 2011
Date of Revision: May 18, 2015

Code No. 403.2

INJURY ON THE JOB

It shall be the responsibility of the injured employee to notify their supervisor of any injury within 24 hours of the occurrence of the injury.  It shall be the responsibility of the supervisor to report such injuries to the Risk Management Coordinator.  The employee shall be responsible for filing any claims, such as workmen's compensation, through the Risk Management Coordinator.  The Risk Management Coordinator shall be responsible for filing any such reports timely with the insurance carrier.

Requirements of the master contract, Article IX, Personnel, Section L, shall be followed.  Details whether or not to supplement worker’s compensation benefit by reducing the employee’s sick leave may be found in Support Staff and Faculty Handbooks.

Date of Adoption: April  25, 1990
Date of Revision: December 8, 1992
Date of Revision:  March 27, 2001
Date of Revision:  November 15, 2005

Code No. 403.2 E1

INJURY ON THE JOB EMC ACCIDENT REPORT

The EMC Accident Work Injury Packet can be found in shared “G” drive.  The following forms are to be used by any employee injured on the job effective September 1, 2010.

ATTENTION ALL EMPLOYEES
CENTERVILLE CSD
Workers’ Compensation Medical Treatment Change
EFFECTIVE September 1, 2010

If you are injured at work, you must immediately report the incident to your supervisor.
CENTERVILLE CSD has made a change in how ALL work related injuries/illnesses should be treated. 

The following medical facilities are the designated workers’ compensation treatment centers.
If you need medical treatment due to a work related injury or illness, seek treatment at:

PHYSICIAN/CLINIC ADDRESS PHONE HOURS
CENTERVILLE MEDICAL CLINIC
DOCTOR ON DUTY
19876 Saint Joseph Drive
Centerville, IA 52544 (641) 856-8684 8:00 am- 5:00 pm (Mon-Fri)

CHARITON VALLEY MEDICAL CENTER
KATHLEEN LANGE, MD
707 S Main Street
Centerville, IA 52544 (641) 437-4344 8:00 AM - 5:00 PM (Mon-Fri)

For A SERIOUS INJURY OR ILLNESS (or any treatment that should not wait until clinic hours the next day) seek immediate treatment at the nearest emergency facility. Hospitals included (but not limited to):

HOSPITAL ADDRESS PHONE HOURS
MERCY MEDICAL CENTER One St. Joseph’s Drive
Centerville, IA 52544 (641) 437-4111 24 HOUR SERVICE

Please Note
If you choose to be treated by any other medical facility and/or physician after September 1, 2010, you may not qualify for any workers’ compensation insurance benefits and you may be responsible for all medical costs related to this incident. This is in accordance with your state’s Workers’ Compensation statute.

If you have any questions regarding this procedure, please call Business Manager, the workers’ compensation contact, at (641) 856-0603.

CENTERVILLE CSD
Workers’ Compensation Medical Treatment Change
EFFECTIVE September 1, 2010

If you are injured at work, you must immediately report the incident to your supervisor.
CENTERVILLE CSD has made a change in how ALL work related injuries/illnesses should be treated. The following medical facilities are the designated workers’ compensation treatment centers.
If you need medical treatment due to a work related injury or illness, seek treatment at:

PHYSICIAN/CLINIC ADDRESS PHONE HOURS
CENTERVILLE MEDICAL CLINIC
DOCTOR ON DUTY
19876 Saint Joseph Drive
Centerville, Ia 52544 (641) 856-8684 8:00 am- 5:00 pm (Mon-Fri)

CHARITON VALLEY MEDICAL CENTER
KATHLEEN LANGE, MD
707 S Main Street
Centerville, IA 52544 (641) 437-4344 8:00 AM - 5:00 PM (Mon-Fri)

For A SERIOUS INJURY OR ILLNESS (or any treatment that should not wait until clinic hours the next day) seek immediate treatment at the nearest emergency facility. Hospitals included (but not limited to):

HOSPITAL ADDRESS PHONE HOURS
MERCY MEDICAL CENTER One St. Joseph’s Drive
Centerville, IA 52544 (641) 437-4111 24 HOUR SERVICE

Please Note
If you choose to be treated by any other medical facility and/or physician after September 1, 2010,
you may not qualify for any workers’ compensation insurance benefits and you may be responsible
for all medical costs related to this incident. This is in accordance with your state’s Workers’
Compensation statute.

If you have any questions regarding this procedure, please call Business Manager, the workers’ compensation contact, at (641) 856- 0603.
_______________________________________________ ___________________
Employee’s Signature (PRINTED) 					Date
___________________________________________________________________
Employee’s Signature

You are responsible for answering all questions on the Employee’s Work Injury Report accurately and in detail. This will make the processing of your claim both accurate and timely. This completed report should be given to the workers’ compensation contact within 24 hours of your work-related injury.

Employee’s Work Injury Report
Personal:
Name____________________________Social Security Number_____________________________
Address_________________________________ Birth Date_____________________ Sex M ⁪ F ⁪ 
City, State_____________________________ Zip___________ Telephone (_____)_____- _______
Married ⁪  Single ⁪  Number of dependents _____________ Home/School ____________________
Family Physician ________________________ Telephone Number __________________________
Are you currently entitled to Medicare Benefits? N__ Y __ Medicare #(HICN) _________________
Have you applied for Medicare or SSDI? N__ Y__ Pending ___ Rejected ___
Employment:
Job Title ______________________________ Employment Date____________________________
Salary/Hourly Rate__________________ Hours Worked Per Day____________________________
Building Location___________________ Time Work Day Begins____________________________
Injury/Illness:
Date of Injury__________________________ Time of Accident?____________________________
Where in the facility/job site did this injury occur?________________________________________
What were you doing when injured_____________________________________________________
_________________________________________________________________________________
How did the injury occur?____________________________________________________________
Describe the injury or illness in detail and indicate the part of the body affected. (Designate right or left if appropriate.) _________________________________________________________________
_________________________________________________________________________________
Any previous similar injury? If yes, explain______________________________________________
Was this injury witnessed? If so, by whom?______________________________________________
Did you lose time from work? Yes ⁪  No ⁪  Date(s) missed?________________________________
Have you returned?________________ If yes, what was the date?____________________________
Treatment:  Medical Facility_____________________________________________________________
Diagnosis/Care Prescribed?______________________________________________________________
Contact:  When you return to work, you must call Business Manager, the workers’ compensation contact, at (641) 856-0603.
___________________________________________________________________ _____________
Employee’s Signature (PRINTED) 									Date
__________________________________________________
Employee’s Signature
Code No. 403.2 E2
SUPERVISOR’S INSTRUCTIONS
Assisting the Injured Employee

1. An employee who is injured at work must immediately report the incident to their supervisor.

2. The supervisor is required to:
•	Obtain immediate medical attention for the injured worker: Call the physician or medical facility prior to the employee’s arrival, alert the staff of the injury/illness and approximate arrival time;
•	Follow company requirement for reporting job related injuries and illnesses;
•	Complete an incident investigation report.

3. The supervisor and injured worker review information received from the doctor and jointly determine
if appropriate work is available.

4. Following an injured workers’ return to work, the supervisor or the workers compensation contact monitors the injured workers’ progress to assure that restrictions are carefully followed and assist to resolve any difficulties.

5. The injured worker must immediately report any difficulties with performing assigned work. Supervisor
and injured worker work to address the problem.

The Investigation Report
The purpose of this form is to determine what actions are needed to eliminate or control the hazards that have caused the accident. The information gathered will guide your staff in developing safety consciousness and knowledge of safe conditions and safe work methods. If you are not aware of the circumstances surrounding the injury, you should consult with the employee in order to complete the investigation report accurately.

The statements made in this report are very important and should not contain phrases as “Employee should be more careful.” As the supervisor, you should make the appropriate corrective recommendations for each accident such as“Notified the appropriate employee to place caution signs in the area when floors are wet.”

After you complete the investigation report, return it to the workers’ compensation contact within 24 hours of the employee’s work-related injury.

If you have any questions or concerns, call Business Manager, the workers’ compensation contact, at (641) 856-0603.

SUPERVISORS INVESTIGATION REPORT

Name of Injured Employee 					Date

_________________________________________________________________________________
Job Title and Department

_________________________________________________________________________________
Date and Time of Injury 					Type of Injury

_________________________________________________________________________________
Medical Facility

What was the employee doing when injured? Where in the facility/job site did the accident happen?
_________________________________________________________________________________

Describe what happened:_________________________________________________________________________________________________________________________________________________________

What corrective steps will be done (or could be done) to prevent recurrence?________________________________________________________________________________________________________________________________________________________

Was the employee working at designated job? Yes ⁪ No ⁪

Is there modified duty available for the injured worker? Yes ⁪ No ⁪

Has the injured employee returned to work? Yes ⁪ No ⁪ If so, what date?____________________

__________________________________________________ ______________________________
Supervisor’s Signature 								Date

_____________________________________________________ 
Reviewed by Workers’ Compensation Contact 					Date

Comments:________________________________________________________________________________________________________________________________________________________

Return completed form within 24 hours of the accident to Business Manager, the workers’ compensation contact, at (641) 856-0603.

Code No. 403.2 E3
PHYSICIAN AUTHORIZATION FORM
FOR MEDICAL TREATMENT

Injured Employee’s Name: 						Date

_____________________________________________________________________________________
Company Name & Address:  CENTERVILLE CSD 		Supervisor
				P.O. Box 370
				Centerville, IA  52544

	Do Not Use Your Group Health Membership Card if this injury/illness was sustained while
	working or acting in an official capacity for this company.

The following facilities are the designated workers’ compensation treatment centers. Taking this Physician’s Authorization Form with you will assist the staff in your care and in processing your medical bills correctly. You should call or have someone call for you to let the physician or clinic know you are on your way for medical treatment and the nature of the injury or illness.

PHYSICIAN/CLINIC 			ADDRESS 			PHONE 		HOURS
CENTERVILLE MEDICAL CLINIC	19876 Saint Joseph Drive	(641) 856-8684 	8:00 AM-5:00 PM (Mon-Fri)					Centerville, IA 52544
Doctor on duty
__________________________________________________________________________________________________

CHARITON VALLEY MEDICAL CENTER 707 S Main Street		(641) 437-4344 	8:00 AM-5:00 PM (Mon-Fri) KATHLEEN LANGE, MD	  Centerville, IA 52544

For A SERIOUS INJURY OR ILLNESS (or any treatment that should not wait until clinic hours the next day) seek immediate treatment at the nearest emergency facility. Hospitals included (but not limited to):

HOSPITAL 				ADDRESS			 PHONE 	HOURS
MERCY MEDICAL CENTER	 One St. Joseph’s Drive	(641) 437-4111 	24 HOUR SERVICE
					Centerville, IA 52544 

Please Note
If you choose to be treated by any other medical facility and/or physician after September 1, 2010, you may not qualify for any workers’ compensation insurance benefits and you may be responsible for all medical costs related to this incident. This is in accordance with your state’s Workers’ Compensation statute.

If you have any questions regarding this procedure, please call Business Manager, the workers’ compensation contact, at (641) 856-0603.
_______________________________________________ 	______________________________
Supervisor’s Signature 						Date

Work-Related Injury/Illness Report
							PLEASE FAX IMMEDIATELY TO BOTH:
Date of Service:_____________________		CENTERVILLE CSD FAX:		(641) 856-0672
							EMC Insurance Companies FAX :	(515) 345-2118
Patient Name:______________________

Employer:_CENTERVILLE CSD_______________________ 	Notified: Yes ⁪ No ⁪

Diagnosis: Is condition work related? Yes ⁪ No ⁪
Treatment Plan:
Medication(s):________________________________________________________________________
Date of most recent examination by this office: ___/___ /___. The next scheduled visit is: ⁪ as needed
						Month/Day/Year
OR ___/___ /___
Month/Day/Year
1. ⁪ Recommended his/her return to work with no limitations on________________________________
												Date
2. ⁪ He/She may return to work on _ ______________________________ with the following limitations.					Date
		Degree 									Limitations
⁪Sedentary Work. Lifting 10 pounds maximum and occasionally		1.  In an 8 hour work day, patient may:
lifting and/or carrying such articles as dockets, ledgers, and 			a. Stand/Walk ⁪ None	 ⁪ 4-6 Hours
small tools.  Although a sedentary job is defined as one which					  ⁪ 1-4 Hours ⁪ 6-8 Hours
involves sitting, a certain amount of walking and standing is 			b. Sit	  ⁪ 1-3 Hours ⁪ 3-5 Hours ⁪ 5-8 Hours
often necessary in carrying out job duties. Jobs are sedentary if			 c. Drive	  ⁪ 1-3 Hours ⁪3-5 Hours  ⁪ 5-8 Hours
walking and standing are required only occasionally and other			2. Patient may use hands for repetitive:
sedentary criteria are met.								 ⁪ Single Grasping	 ⁪Pushing & Pulling
⁪ Light Work. Lifting 20 pounds maximum with frequent lifting and			⁪Fine Manipulation
or carrying of objects weighing up to 10 pounds. Even though				3. Patient may use feet for repetitive movement as in 
the weight lifted may be only a negligible amount, a job is in this				operating foot controls: ⁪ Yes ⁪ No
category when it requires walking or standing to a significant 			 4. Patient is able to: Frequently  Occasionally  Not at all
degree or when it involves sitting most of the time with a degree 				a. Bend		 ⁪	   ⁪	      ⁪
of pushing and pulling of arm and/or leg controls.						b. Squat		 ⁪	   ⁪	      ⁪
⁪ Medium Work. Lifting 50 pounds maximum with frequent lifting 			c. Climb		⁪	   ⁪	      ⁪
and/or carrying of objects weighing up to 25 pounds.
⁪ Heavy Work. Lifting 100 pounds maximum with frequent lifting
and/or carrying of objects weighing up to 25 pounds.
⁪Very Heavy Work. Lifting objects in excess of 100 pounds with
frequent lifting and/or carrying of objects weighing 50 pounds
or more.

Other Instructions and/or limitations:
3.  These restrictions are in effect until _______________________ or until patient is reevaluated.
							Date
4.  ⁪ He/She is off work at this time.  Patient will be reevaluated on ____________________________
												Date
Treating Facility Name:_______________________________________________________________
					Please print
Physician’s Signature: _____________________________________Phone No: (___) ____-________

Release of Information Authorization
I authorize the treating physician to release copies of my medical records including lab and x-ray reports to the above-named employer and the insurance company.  I certify that I have received a copy of this report.

Employee’s Signature _______________________________________Date_____________________

Code No. 403.3

COMMUNICABLE DISEASES - PERSONNEL

Employees with a communicable disease will be allowed to perform their customary employment duties provided they are able to perform the essential functions of their position and their presence does not create a substantial risk of illness or transmission to students or other employees.  The term "communicable disease" shall mean an infectious or contagious disease spread from person to person, or animal to person, or as defined by law.

Prevention and control of communicable diseases shall be included in the school district's blood borne pathogens exposure control plan.  The procedures shall include scope and application, definitions, exposure control, methods of compliance, universal precautions, vaccination, post‑exposure evaluation, follow‑up, communication of hazards to employees and record keeping.  This plan shall be reviewed annually by the superintendent and school nurse.

The health risk to immunodepressed employees shall be determined by their personal physician.  The health risk to others in the school district environment from the presence of an employee with a communicable disease shall be determined on a case‑by‑case basis by the employee's personal physician, a physician chosen by the school district or public health officials.

An employee who is at work and who has a communicable disease which creates a substantial risk of harm to a student, coworkers, or others at the workplace shall report the condition to the Superintendent any time the employee is aware that the disease actively creates such risk.

Health data of an employee is confidential and it shall not be disclosed to third parties.  Employee medical records shall be kept in a file separate from their personal file.

It shall be the responsibility of the superintendent, in conjunction with the school nurse, to develop administrative regulations stating the procedures for dealing with employees with a communicable disease.

Date of Adoption: April  25, 1990
Date of Revision: October 11, 1994
Date of Revision: November 10, 1998 

Code No:  403.3 E 1

COMMUNICABLE DISEASE CHART

CONCISE DESCRIPTIONS AND RECOMMENDATIONS FOR EXCLUSION FROM WORK

DISEASE	Usual Interval		Minimum
*Immunization	between Exposure		Exclusion
is available	and First Symptoms	MAIN SYMPTOMS	From
	of Disease		School

CHICKENPOX	13 to 17 days	Mild symptoms and fever. 	5 days from onset 		Pocks are  “blistery.”	of pocks 
		 Develop scabs, most on	or until pocks
		covered parts of body.	become dry.
CONJUNCTlVlTlS	24 to 72 hours	Tearing, redness	During acute 
(PINK EYE)	          	and puffy lids,	state or until
		eye discharge.	treatment begins.
ERYTHEMIA	4 to 20 days	Usual age 5 to 14 years ‑	After 			unusual in adults. Brief period	diagnosis no
INFECTIOSUM		of low-grade fever followed	exclusion 			by Erythemia (slapped cheek)	from work.
(FIFTH DISEASE)		 appearance on cheeks,
		lace-like rash on extremities lasting a
		few days to 3 weeks. Rash seems to recur.		
GERMAN	14 to 23 days	Usually mild. Enlarged 	7 days from onset MEASLES*		glands in neck	of rash. Keep
(RUBELLA)		and behind ears.	away from
		Brief red rash.	pregnant women.
HAEMOPHILUS	2 to 4 days	Fever, vomiting,     	Until physician MENINGITIS		lethargy, stiff	permits
		neck and back.	return	
HEPATITIS A	Variable ‑	Abdominal pain, nausea,	7 days	15 to 50 days	usually fever.	from onset
	(average	Skin and eyes	of symptoms.	28 to 30 days)	may or may not	
		turn yellow.	
				
IMPETIGO	4 to 10 days	Inflamed sores,	Cover lesions		with pus	when
			attending work.
				
MEASLES*	3-7 days	Begins with fever,	4 days from onset (RUBEOLA)	to rash	conjunctivitis, runny nose	of rash.
			cough, then blotchy red rash.			

Code No:  403.3 E 1 (continued)
	
MENINGOCOCCAL	2 to 10 days		Headache,	Antibiotics for MENINGITIS	(commonly		nausea,	24 hrs. or 
	3 to 4 days)		stiff neck,	until physician
		fever.	permits return.
MUMPS*	12 to 25 days		Fever, swelling and	9 days after		(commonly		tenderness of glands	onset of swollen
	18 days)	at angle of jaw.	glands or until
			swelling disappears.
PEDICULOSIS	7 days	Lice and	None
(HEAD/BODY LICE) 	for eggs	nits (eggs)
	to hatch.	in hair.
				
RINGWORM OF SCALP	10 to	Scaly patch, usually	No exclusion from	14 days	ring shaped	work. Exclude
		On scalp	from gymnasium,			swimming pools,
			contact sports.
SCABIES	2 to 6 weeks	Tiny burrows in skin	After 	initial exposure;	caused by mites	first	1 to 4 days		treatment.
	re-exposure			
SCARLET FEVER	1 to 3 days	Sudden onset, vomiting,	24 Hours after 		sore throat, fever,	antibiotics
(SCARLATINA)		 later fine rash	 started and no 		(not on face).	 fever.
		Rash usually only
STREP THROAT		with first infection.		
WHOOPING	6 to 20  days	Head cold, slight fever, 	5 days after start COUGH*  		cough, characteristic whoop	of antibiotic
 (PERTUSSIS)		after about 2 weeks 	treatment.

Re-admission to work; It is advisable that school authorities require written permission from the health officer, school physician or attending physician before any employee is re-admitted to work following any disease which requires exclusion, not mere absence, from work.

Date of Revision:  June 14, 2005

Code No:  403.3 E 2

REPORTABLE INFECTIOUS DISEASES

The following infectious diseases are required to be reported to the state and local public health offices:

Acquired Immune	Hepatitis A,B,C,D,E	Salmonellosis (including 
  Deficiency Syndrome	Human immunodeficiency	  Typhoid fever)
  (AIDS)	  virus (HIV) infection	Severe acute respiratory
Anthrax	  including HIV-exposed	  syndrome (SARS)
Botulism	  newborn infants	Shigellosis
Brucellosis	Legionellosis	Smallpox
Campylobacteriosis	Listeria monocytogenes  	Staphylococcus aureus:
Chlamydia	  invasive disease  	  Invasive disease; Methicillin-
Cholera	Lyme disease  	  resistant, invasive disease
Cryptosporidosis	Malaria  	  Vancomycin-resistant
Cyclospora	Measles (rubeola)	Streptococcus pneumoniae,
Diphtheria 	Menningococcal,	  invasive disease
E. Coli 0157:h7 and related	  invasive disease	Streptococcus, Group A, 
   diseases including HUS	Mumps	  invasive disease
Encephalitis, arboviral (e.g.,	Pertussis  	Syphilis
   West Nile, St.Louis, ,	Plague	Tetanus
   LaCrosse,WEE, EEE, VEE)	Poliomyelitis	Toxic Shock Syndrome
Enterococcus, invasive disease 	Psittacosis	Trichinosis
Giardiasis 	Rabies (human and animal)	Tuberculosis
Gonorrhea	Rocky Mountain spotted	Viral hemorrhagic fever
Heamophilus influenza	  fever (RMSF)	   (VHF) (e.g., Lassa, Marburg,
  Type B, invasive disease	Rubella (including  	  Ebola, Crimean-Congo,
Hansen’s disease (leprosy)	  congenital)	  South American)
Hantavirus syndromes	  	Yellow fever

  		  

		

Any other disease which is unusual in incidence, occurs in unusual numbers of circumstances, or appears to be of public health concern, e.g., epidemic diarrhea, food or water borne outbreaks, acute respiratory illness.

NOTE:  Be sure to mail the appropriate copies to both the state and local public health offices.

Code No:  403.3 E 2 (continued)

REPORTABLE INFECTIOUS DISEASES
REPORTING FORM

REPORT THE FOLLOWING DISEASES IMMEDIATELY BY TELEPHONE (1‑800‑362‑2736)
Botulism	Poliomyelitis	Yellow Fever
Cholera	Rabies (Human)	Disease outbreaks of
Diphtheria	Rubella	   any public health concern
Plague 	Rubella (Measles

REPORT ALL OTHER DISEASES BELOW.	WEEK ENDING ______________
See Code no. 403.3 E 2 for list of reportable infectious diseases.

Name ___________________________ Parent (if applicable) ________________
Address __________________________________________________________
Attending Physician _________________________________________________
Birth Date ___________________  Sex ______________

Name ___________________________ Parent (if applicable) ________________
Address __________________________________________________________
Attending Physician _________________________________________________
Birth Date ___________________  Sex ______________

Name ___________________________ Parent (if applicable) ________________
Address __________________________________________________________
Attending Physician _________________________________________________
Birth Date ___________________  Sex ______________

Name ___________________________ Parent (if applicable) ________________
Address __________________________________________________________
Attending Physician _________________________________________________
Birth Date ___________________  Sex ______________

Reporting Physician, Hospital, or Other Authorized Person ________________________
Address ______________________________________________________________
Remarks: ______________________________________________________________
              ______________________________________________________________

FOR SCHOOLS ONLY: Report over 10% absent only. Total enrollment:

	No.	Monday	Tuesday	Wednesday	Thursday	Friday	
	Absent						
	% of 
	Enrollment						

Date of Revision:  June 14, 2005
Code No. 403.4

HAZARDOUS CHEMICAL DISCLOSURE

It shall be the responsibility of the superintendent to develop administrative regulations regarding communicating information about hazardous chemicals in the work place.  Each time a new school district employee is hired, information and training, if necessary, shall be included in the orientation of the employee.  Each employee will annually review information about hazardous substances in the work place.

Date of Adoption: April  25, 1990
Date of Revision:  May 16, 2006

Code No. 403.4R1

HAZARDOUS CHEMICAL DISCLOSURE REGULATION

Go to Great Prairie AEA website at http://training.aeapdonline.org/ click on the training you wish to take and follow the instructions provided by the aea:  

When hired and annually at the beginning of each school year. 
Right to Know 
•	Science Teachers
•	Custodial Staff
•	Cafeteria Staff

Date of Adoption: April  25, 1990
Date of Revision:  May 16, 2006
Date of Revision: March 8, 2011
Date of Revision: February 8, 2016

Code No. 403.5
	Page 1 of 3

ANTI-BULLYING/HARASSMENT - PERSONNEL

Harassment and bullying of employees/volunteers are against federal, state and local policy, and are not tolerated by the board.  The board is committed to providing all employees/volunteers with a safe and civil school environment in which all members of the school community are treated with dignity and respect.  To that end, the board has in place policies, procedures, and practices that are designed to reduce and eliminate bullying and harassment as well as processes and procedures to deal with incidents of bullying and harassment. Bullying and harassment of school employees and volunteers will not be tolerated in the school or school district.  Bullying/harassment by board members, employees, parents, and others doing business with the school district is prohibited. 

The board prohibits harassment, bullying, hazing, or any other victimization, of employees and volunteers, based on any of the following actual or perceived traits or characteristics, including but not limited to, age, color, creed, national origin, race, religion, marital status, sex, sexual orientation, gender identity, physical attributes, physical or mental ability or disability, ancestry, political party preference, political belief, socioeconomic status, or familial status.   

This policy is in effect while employees and volunteers are on property within the jurisdiction of the board; while on school-owned or school-operated vehicles; while attending or engaged in school-sponsored activities; and while away from school grounds if the misconduct directly affects the good order, efficient management and welfare of the school or school district.

 If, after an investigation, a school employee is found to be in violation of this policy, the employee shall be disciplined by appropriate measures which may include suspension or termination.  If after an investigation a school volunteer is found to be in violation of this policy, the volunteer shall be subject to appropriate measures which may include exclusion from school grounds.  “Volunteer” means an individual who has regular, significant contact with students.
 
When looking at the totality of the circumstances harassment and bullying mean any electronic, written, verbal, or physical act or conduct toward a employee/volunteer which is based on any actual or perceived trait or characteristic of the employee/volunteer and which creates an objectively hostile school environment that meets one or more of the following conditions: 
•	Places the employee/volunteer in reasonable fear of harm to the employee’s/volunteer’s person or property;
•	Has a substantially detrimental effect on the employee’s/volunteer’s physical or mental health;
•	Has the effect of substantially interfering with the employee’s/volunteer’s job performance; or
•	Has the effect of substantially interfering with the employee’s/volunteer’s ability to participate in or benefit from the services, activities, or privileges provided by a school.

Code No. 403.5

	Page 2 of 3
ANTI-BULLYING/HARASSMENT - PERSONNEL

“Electronic” means any communication involving the transmission of information by wire, radio, optical cable, electromagnetic, or other similar means.  “Electronic” includes but is not limited to communication via electronic mail, internet-based communications, pager service, cell phones, electronic text messaging or similar technologies.

Harassment and bullying may include, but are not limited to, the following behaviors and circumstances: 
•		Repeated remarks of a demeaning nature 
•		Implied or explicit threats concerning one's achievements, property, etc. 
•	Demeaning jokes, stories, or activities directed at the employee/volunteer Unreasonable interference with an employee’s/volunteer’s  performance 

Sexual harassment of an employee or volunteer means unwelcome sexual advances, requests for sexual favors, or other verbal or physical conduct of a sexual nature when:
•	Submission to the conduct is made either implicitly or explicitly a term or condition of the employee’s/volunteer’s job or benefits; 
•	Submission to or rejection of the conduct is used as the basis for job decisions affecting that employee/volunteer; or 
•	The conduct has the purpose or effect of substantially interfering with the employee’s/volunteer’s job performance by creating an intimidating, hostile, or offensive working environment. 

In situations between employees/volunteers and school officials, faculty, staff, who have direct contact with employees/volunteers, bullying and harassment may also include the following behaviors: 
•	Requiring that an  employee/volunteer submit to bullying or harassment by another employee/volunteer either explicitly or implicitly, as a term or condition of the targeted employee’s/volunteer’s job.
•	Requiring submission to or rejection of such conduct as a basis for decisions affecting the employee/volunteer.

Any person who promptly, reasonably, and in good faith reports an incident of bullying or harassment under this policy to a school official, shall be immune from civil or criminal liability relating to such report and to the person’s participation in any administrative, judicial, or other proceeding relating to the report.  Individuals who knowingly file a false complaint may be subject to appropriate disciplinary action.

Retaliation against any person, because the person has filed a bullying or harassment complaint or assisted or participated in a harassment investigation or proceeding, is also prohibited. Individuals who knowingly file false harassment complaints and any person who gives false statements in an investigation shall be subject to discipline by appropriate measures, as shall any person who is found to have retaliated against another in violation of this policy.    Any school employee found to have retaliated in violation of this policy shall be subject to measures up to, and including, 
Code No. 403.5
	Page 3 of 3

ANTI-BULLYING/HARASSMENT - PERSONNEL

termination of employment.  Any school volunteer found to have retaliated in violation of this policy shall be subject to measures up to, and including, exclusion from school grounds.  
 
The school or school district will promptly and reasonably investigate all allegations of bullying or harassment.

Supervisor or designee will be responsible for handling all complaints by employees/volunteers alleging harassment.

It is the responsibility of the board members, administrators, licensed and classified employees, volunteers and others having business or other contact with the school district to act appropriately under this policy.  It is the responsibility of the superintendent and investigator to inform and educate employees and others involved with the school district about harassment and the school district's policy prohibiting harassment.

This policy and accompanying regulations will only apply when an employee/volunteer is the victim of an alleged harasser or an employee/volunteer is the alleged harasser. 

Date of Adoption: April  25, 1990
Date of Revision: March 9, 1993
Date of Revision: October 11, 1994
Date of Revision:  September 27, 2005
Date of Revision: August 14, 2007
Date of Revision: November 27, 2007

Code No. 403.5 E-1
ANTI-BULLYING/HARASSMENT COMPLAINT FORM
(Supervisor)

Name of complainant: 	

Position of complainant: 	

Date of complaint: 	

Name of alleged harasser: 	

Date and place of incident or incidents: 	

Nature of Discrimination or Harassment Alleged (Check all that apply)

Age	
	
Physical Attribute	
	
Sex	

Disability	
	
Physical/Mental Ability	
	
Sexual Orientation	

Familial Status	
	
Political Belief	
	
Socio-economic Background	

Gender Identity	
	
Political Party Preference	
	
Other – Please Specify:	

Marital Status	
	
Race/Color	

	
National Origin/Ethnic Background/Ancestry	
	
Religion/Creed	

	

Description of misconduct: 	

Name of witnesses (if any): 	

Evidence of harassment, i.e., letters, photos, etc. (attach evidence if possible): 	

Any other information: 	

I agree that all of the information on this form is accurate and true to the best of my knowledge.

Signature: 	

Date: 	

Code No. 403.5 E-2

ANTI-BULLYING/HARASSMENT WITNESS DISCLOSURE FORM
(Supervisor)

Name of witness: 	

Position of witness: 	

Date of testimony, interview: 	

Description of instance witnessed: 	

	

	

	

Any other information: 	

	

I agree that all of the information on this form is accurate and true to the best of my knowledge.

Signature: 	

Date: 	

Code No. 403.5 E-3

DISPOSITION OF ANTI-BULLYING/HARASSMENT COMPLAINT FORM

Name of complainant:		
		
Name of or 
Employee/volunteer target:		
		
Building of 
or employee/volunteer:		
		
Name and position or grade of alleged perpetrator /respondent:	

		
		
Date of initial complaint:		

Nature of discrimination or harassment alleged (Check all that apply)
	
  	Age		Physical Attribute		Sex	
  	Disability		Physical/Mental Ability		Sexual Orientation	
  	Familial Status		Political Belief		Socio-economic Background	
  	Gender Identity		Political Party Preference		Other – Please Specify:	
  	Marital Status		Race/Color	  	
	National Origin/Ethnic Background/Ancestry		Religion/Creed		
		
Summary of investigation: 		

		
		
I agree that all of the information on this form is accurate and true to the best of my knowledge.		

Signature:___________________________		
	
Date:_______________________________	

Code No. 403.5R1

ANTI-BULLYING/HARASSMENT INVESTIGATION PROCEDURES

Employees/volunteers who feel that they have been harassed should:

		Communicate to the harasser that the individual expects the behavior to stop, if the individual is comfortable doing so.  If the individual wants assistance communicating with the harasser, the individual should ask a teacher, counselor or principal to help.
		If the harassment does not stop, or the individual does not feel comfortable confronting the harasser, the individual should:
		--	tell a teacher, counselor or principal; and
		--	write down exactly what happened, keep a copy and give another copy to the teacher, counselor or principal including;
o	what, when and where it happened;
o	who was involved;
o	exactly what was said or what the harasser did;
o	witnesses to the harassment;
o	what the harasser said or did, either at the time or later;
o	how the employee/volunteer felt; and 
	how the harasser responded

COMPLAINT PROCEDURE
Employees/volunteers who believe that they have been harassed shall notify their supervisor.  The supervisor may request that the employee complete the Harassment Complaint form and turn over evidence of the harassment, including, but not limited to, letters, tapes, or pictures.  Information received during the investigation shall be kept confidential to the extent possible.  Employees/Volunteers who feel they have been harassed should contact the supervisor, however the designated investigator or the alternate investigator may be contacted by employees/volunteers.

The supervisor has the authority to initiate a harassment investigation in the absence of a written complaint.

INVESTIGATION PROCEDURE
The supervisor shall reasonably and promptly commence the investigation upon receipt of the complaint.  The supervisor shall interview the complainant and the alleged harasser.  The alleged harasser may file a written statement refuting or explaining the behavior outlined in the complaint.  The supervisor may also interview witnesses as deemed appropriate.  Upon completion of the investigation, the supervisor shall make written findings and conclusions as to each allegation of harassment and report the findings and conclusions to the appropriate people.  

Code No. 403.5R1 (Continued)

ANIT-BULLYING/HARASSMENT INVESTIGATION PROCEDURES

RESOLUTION OF THE COMPLAINT
Prior to the determination of the appropriate remedial action, the supervisor may, at the supervisor’s discretion, interview the complainant and the alleged harasser.  The supervisor shall file a written report closing the case and documenting any disciplinary action taken or any other action taken in response to the complaint.  The complainant and the alleged harasser shall be informed of the conclusions of the investigation.

POINTS TO REMEMBER IN THE INVESTIGATION
	Evidence uncovered in the investigation is confidential.
	Complaints must be taken seriously and investigated.
	No retaliation will be taken against individual involved in the investigation process.
	Retaliators will be disciplined up to and including discharge.

CONFLICTS
If the supervisor is a witness to the incident, the designated investigator will be assigned the complaint.

Date of Adoption: April  25, 1990
Date of Revision: March 9, 1993
Date of Revision:  October 11, 1994
Date of Revision:  August 14, 2007

 Code No. 403.6

SUBSTANCE-FREE WORKPLACE

The board expects the school district and its employees to remain substance-free.  No employee shall unlawfully manufacture, distribute, dispense, possess or use on or in the workplace any narcotic drug, hallucinogenic drug, amphetamine, barbiturate, marijuana or any other controlled substance or alcoholic beverage as defined by federal or state law.  "Workplace" includes school district facilities, school district premises or school district vehicles.  Workplace also includes non-school property if the employee is at any school sponsored, school approved or school related activity, event or function, such as field trips or athletic events where students are under the control of the school district or where the employee is engaged in school business.

If an employee is convicted of a violation of any criminal drug offense committed in the workplace, the employee shall notify the employee's supervisor of the conviction within five days of the conviction.

The superintendent will make the determination whether to require the employee to undergo substance abuse treatment or to discipline the employee.  An employee who violates the terms of this policy may be subject to discipline up to and including termination.  An employee who violates this policy may be required to successfully participate in a substance abuse treatment program approved by the board.  If the employee fails to successfully participate in a program, the employee may be subject to discipline up to and including termination.

The superintendent shall be responsible for publication and dissemination of this policy to each employee.  In addition, the superintendent shall oversee the establishment of a substance-free awareness program to educate employees about the dangers of substance abuse and notify them of available substance abuse treatment programs.

It is the responsibility of the superintendent to develop administrative regulations to implement this policy.

Date of Adoption:  April 25, 1990    
Date of Revision: December 8, 1992

Code No. 403.6 R

SUBSTANCE-FREE WORKPLACE REGULATION

A superintendent who suspects an employee has a substance abuse problem shall follow these procedures:

1.	Identification - the superintendent shall document the evidence the superintendent has which leads the superintendent to conclude the employee has violated the Substance-Free Workplace policy.  After the superintendent has determined there has been a violation of the Substance-Free Workplace policy, the superintendent shall discuss the problem with the employee.

2.	Discipline - if, after the discussion with the employee, the superintendent determines there has been a violation of the Substance-Free Workplace policy, the superintendent may recommend discipline up to and including termination or may recommend the employee seeks substance abuse treatment.  Participation in a substance abuse treatment program is voluntary.

3.	Failure to participate in referral - if the employee refuses to participate in a substance abuse treatment program or if the employee does not successfully complete a substance abuse treatment program, the employee may be subject to discipline up to and including termination.

4.	Conviction - if an employee is convicted of a criminal drug offense committed in the workplace, the employee must notify the employer of the conviction within five days of the conviction.

Code No. 403.6 E-1

SUBSTANCE-FREE WORKPLACE REGULATION

SUBSTANCE-FREE WORKPLACE NOTICE TO EMPLOYEES

EMPLOYEES ARE HEREBY NOTIFIED it is a violation of the Substance-Free Workplace policy for an employee to unlawfully manufacture, distribute, dispense, possess or use on or in the workplace any narcotic drug, hallucinogenic drug, amphetamine, barbiturate, marijuana or any other controlled substance or alcohol, as defined in Schedules I through V of section 202 of the Controlled Substances Act (21 U.S.C. 812) and as further defined by regulation at 21 C.F.R. 1300.11 through 1300.15 and Iowa Code Chapter 204.

"Workplace" is defined as the site for the performance of work done in the capacity as an employee.  This includes school district facilities, other school premises or school district vehicles.  Workplace also includes non-school property if the employee is at any school sponsored, school approved or school related activity, event or function, such as field trips or athletic events where students are under the control of the school district or where the employee is engaged in school business.

Employees who violate the terms of the Substance-Free Workplace policy may be required to successfully participate in a substance abuse treatment program approved by the board.  The superintendent retains the discretion to discipline an employee for violation of the Substance-Free Workplace policy.  If the employee fails to successfully participate in such a program the employee shall be subject to discipline up to and including termination.

EMPLOYEES ARE FURTHER NOTIFIED it is a condition of their continued employment that they comply with the above policy of the school district and will notify their supervisory of their conviction of any criminal drug statute for a violation committed in the workplace, no later than five days after the conviction.

Code No. 403.6 E-2

SUBSTANCE-FREE WORKPLACE REGULATION

SUBSTANCE-FREE WORKPLACE EMPLOYEE ACKNOWLEDGMENT FORM

I, _____________________________, have read and understand the Substance-Free Workplace policy.  I understand that if I violate the Substance-Free Workplace policy, I may be subject to discipline up to and including termination or I may be required to participate in a substance abuse treatment program.  If I fail to successfully participate in a substance abuse treatment program, I understand I may be subject to discipline up to and including termination.  I understand that if I am required to participate in a substance abuse treatment program and I refuse to participate, I may be subject to discipline up to and including termination.  I also understand that if I am convicted of a criminal drug offense committed in the workplace, I must report that conviction to my supervisory within five days of the conviction.

_______________________________	____________________________
(Signature of Employee)	(Date)

Code No. 403.7

CONTROLLING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS

A.	Exposure Control Plan
The Centerville Community School District shall establish a written exposure control plan to eliminate or minimize district occupational exposure to bloodborne pathogens and to meet the requirements of the Department of Labor, Occupational Safety and Health Administration, 29 Code of Federal Regulations (CFR), Part 1910.1030.  The district exposure control plan shall include:  exposure determination, schedule and method of compliance, provision for plan copies to be accessible and available upon request, and the review and updating of the plan.
B.	Exposure Determination
The school district and each building shall identify the following classifications of employees who in the performance of their duties may have:
	1.	reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials such as blood, semen, vaginal secretions, internal body fluids, and body fluids visibly contaminated with blood, and
	2.	reasonably anticipated contact with all body fluids in situations where it is difficult or impossible to differentiate between body fluids.
The exposure determination shall be made without regard to the use of personal protective equipment.  The list of employees and tasks and procedures in this exposure plan includes:
	1.	A list of job classifications in which district employees in those job classifications have occupational exposure (team members);
	2.	A list of job classifications in which specific building employees have occupational exposure (individual building team members); and
	3.	A list of all tasks and procedures or groups of closely related tasks and procedures that are performed by employees in job classifications listed in which occupational exposure occurs.
C.	Schedule and Method of Compliance
The plans for methods of compliance (universal precautions, engineering and work practice controls, personal protective equipment, housekeeping), hepatitis B vaccination and post-exposure evaluation and follow-up, communication of hazards to employees (labels and signs and information and training), and record keeping follow.
D.	Post-Exposure Evaluation and Follow-Up
Following a report of an exposure incident, the district shall make immediately available to the exposed employee, a confidential medical evaluation as specified in the standard.  Follow-up of the incident shall include documentation of the route(s) of exposure, the circumstances surrounding exposure incidents, failures of control at the time of the exposure incident, and other elements as specified in the standard.  It is recommended that employees who have an unexpected exposure and are not listed in the exposure determination follow the procedures outlined in the post exposure plan.
E.	Copies of the Plan 
A copy of the plan will be provided to all district employees and is available for examination and copying by other persons upon request.
F.	Plan Review and Update
The plan shall be reviewed and updated annually and whenever necessary to reflect new or modified tasks and procedures which effect occupational exposure and to reflect new or revised employee positions with occupational exposure.

Date of Adoption:  December 8, 1992
Date of Revision: October 12, 1993

Code No. 403.7.1

HEPATITIS B VACCINE INFORMATION AND RECORD

The Disease
Hepatitis B is a viral infection caused by the Hepatitis B virus (HBV) which causes death in 1‑2% of those infected.  Most people with HBV recover completely, but approximately 5‑10% become chronic carriers of the virus. Most of these people have no symptoms, but can continue to transmit the disease to others.  Some may develop chronic active hepatitis and cirrhosis. HBV may be a causative factor in the development of liver cancer. Immunization against HBV can prevent acute hepatitis and its complications.

The Vaccine
The HBV vaccine is produced from yeast cells.  It has been extensively tested for safety and effectiveness in large scale clinical trials.

Approximately 90 percent of healthy people who receive two doses of the vaccine and a third dose as a booster achieve high levels of surface antibody (anti‑HBs) and protection against the virus.  The HBV vaccine is recommended for workers with potential for contact with blood or body fluids.  Full immunization requires three doses of the vaccine over a six‑month period, although some persons may not develop immunity even after three doses.

There is no evidence that the vaccine has ever caused Hepatitis B.  However, persons who have been infected with HBV prior to receiving the vaccine may go on to develop clinical hepatitis in spite of immunization.

Dosage and Administration
The vaccine is given in three intramuscular doses in the deltoid muscle.  Two initial doses are given one month apart and the third dose is given six months after the first.

Possible Vaccine Side Effects
The incidence of side effects is very low.  No serious side effects have been reported with the vaccine.  Ten to 20 percent of persons experience tenderness and redness at the site of injection and low grade fever.  Rash, nausea, joint pain, and mild fatigue have also been reported.  The possibility exists that other side effects may be identified with more extensive use.

Date of Adoption: October 11, 1994

Code No. 403.7.1 E

HEPATITIS B VACCINE INFORMATION AND RECORD

CONSENT OF HEPATITIS B VACCINATION

I have knowledge of Hepatitis B and the Hepatitis B vaccination.  I have had an opportunity to ask questions of a qualified nurse or physician and understand the benefits and risks of Hepatitis B vaccination.  I understand that I must have three doses of the vaccine to obtain immunity.  However, as with all medical treatment, there is no guarantee that I will become immune or that I will not experience side effects from the vaccine.  I give my consent to be vaccinated for Hepatitis B.

	______________________________________________	______________
	Signature of Employee (consent for Hepatitis B vaccination)	Date

	______________________________________________	______________
	Signature of Witness 	Date

HEPATITIS B VACCINATION

I understand that due to my occupational exposure to blood or other potentially infectious materials I may be at risk of acquiring the Hepatitis B virus infection.  I have been given the opportunity to be vaccinated with Hepatitis B vaccine at no charge to myself.  However, I decline the Hepatitis B vaccination at this time.  I understand that by declining this vaccine, I continue to be at risk of acquiring Hepatitis B, a serious disease.  If in the future I continue to have occupational exposure to blood or other potentially infectious materials and I want to be vaccinated with the Hepatitis B vaccine, I can receive the vaccination series at no charge to me.

	______________________________________________	______________
	Signature of Employee	Date

	______________________________________________	______________
	Signature of Witness 	Date

I refuse because I believe I have (check one)

________ started the series  ___________ completed the series

Date of Adoption: October 11, 1994

Code No. 403.7.1 E

HEPATITIS B VACCINE INFORMATION AND RECORD

RELEASE FOR HEPATITIS B MEDICAL INFORMATION

I hereby authorize  ________________________  (individual or organization holding Hepatitis B records and address) to release to the Community School District, my Hepatitis B vaccination records for required employee records.

I hereby authorize release of my Hepatitis B status to a health care provider, in the event of an exposure incident.

______________________________________________	______________
	Signature of Employee	Date

	______________________________________________	______________
	Signature of Witness 	Date

Code No. 403.7.1 E
HEPATITIS B VACCINE INFORMATION AND RECORD
CONFIDENTIAL RECORD

	___________________________________	._____-______-________
	Employee Name (last, first, middle)	Social Security No

Job Title: _______________________________________________________________
	Hepatitis B Vaccination Date	Lot Number Site	Administered by
1.	_____________________________	__________________	__________________
2. 	_____________________________	__________________	__________________
3.	_____________________________	__________________	__________________
Additional Hepatitis B status information:
________________________________________________________________________		________________________________________________________________________		________________________________________________________________________	
	 
Post‑exposure incident: (Date, time, circumstances, route under which exposure occurred)
Identification and documentation of source individual:
________________________________________________________________________		________________________________________________________________________		________________________________________________________________________	
	________________________________________________________________________	 
Source blood testing consent:
________________________________________________________________________	 
Description of employee's duties as related to the exposure incident:
________________________________________________________________________	 
________________________________________________________________________	 
________________________________________________________________________	 
Copy of information provided to health care professional evaluating an employee after an 
exposure incident:
________________________________________________________________________	 
________________________________________________________________________	 
________________________________________________________________________	 
Attach a copy of all results of examinations, medical testing, follow‑up procedures, and 
health care professional's written opinion.

Training Record: (date, time, instructor, location of training summary)
________________________________________________________________________	 
________________________________________________________________________	 
________________________________________________________________________	 
________________________________________________________________________	 
________________________________________________________________________	 
________________________________________________________________________	 

Code No. 403.7 R

CONTROLLING OCCUPATIONAL EXPOSURE TO BLOOD BORNE PATHOGENS

UNIVERSAL PRECAUTIONS REGULATION

Universal precautions (UP) are intended to prevent transmission of infection, as well as decrease the risk of exposure for employees and students.  It is not currently possible to identify all infected individuals, thus precautions must be used with every individual.  UP pertain to blood and other potentially infectious materials (OPIM) containing blood.  These precautions do not apply to other body fluids and wastes (OBFW) such as saliva, sputum, feces, tears, nasal secretions, vomitus and urine unless blood is visible in the material. However, these OBFW can be sources of other infections and should be handled as if they are infectious.  The single most important step in preventing exposure to and transmission of any infection is anticipating potential contact with infectious materials in routine as well as emergency situations. Based on the type of possible contact, employees and students should be prepared to use the appropriate precautions prior to the contact.  Diligent and proper hand washing, the use of barriers, appropriate disposal of waste products and needles, and proper decontamination of spills are essential techniques of infection control.  All individuals should respond to situations practicing UP followed by the activation of the school response team plan. Using common sense in the application of these measures will enhance protection of employees and students.

Hand Washing

Proper hand washing is crucial to preventing the spread of infection. Textured jewelry on the hands or wrists should be removed prior to washing and kept off until completion of the procedure and the hands are re-washed.  Use of running water, lathering with soap and using friction to clean all hand surfaces is key.  Rinse well with running water and dry hands with paper towels.
	Hands should be washed before physical contact with individuals and after contact is completed.
	Hands should be washed after contact with any used equipment.
	If hands (or other skin) come into contact with blood or body fluids, hands should be washed immediately before touching anything else. Hands should be washed or wiped with sterile wipes whether gloves are worn or not and, if gloves are worn, after the gloves are removed.

Barriers

Barriers anticipated to be used at school include disposable gloves, absorbent materials and resuscitation devices.  Their use is intended to reduce the risk of contact with blood and body fluids as well as to control the spread of infectious agents from individual to individual.  Gloves should be worn when in contact with blood, OPIM or OBFW.  Gloves should be removed without touching the outside and disposed of after each use.

Code No. 403.7 R (Continued)

CONTROLLING OCCUPATIONAL EXPOSURE TO BLOOD BORNE PATHOGENS

UNIVERSAL PRECAUTIONS REGULATION

Clean up

Spills of blood and OPIM should be cleaned up immediately.  The employee

	Wear gloves.
	Clean up the spill with paper towels or other absorbent material.
	Use a solution of one part household bleach to one hundred parts of water (1:100) or other EPA‑approved disinfectant and use it to wash the area well.
	Dispose of gloves, soiled towels and other waste in a plastic bag.
	Clean and disinfect reusable supplies and equipment.

Laundry

Laundry with blood or OPIM should be handled as little as possible with a minimum of agitation.  It should be bagged at the location.  If it has the potential of releasing the substance when compacted, regulated waste guidelines should be followed.  Employees who have contact with this laundry should wear protective barriers.

Exposure

An exposure to blood or OPIM through contact with broken skin, mucous membrane or by needle or sharp stick requires immediate washing, reporting and follow‑up.

	Always wash the exposed area immediately with soap and water.
	If a mucous membrane splash (eye or mouth) or exposure of broken skin occurs, irrigate or wash the area thoroughly.
	If a cut or needle stick injury occurs, wash the area thoroughly with soap and water.

The exposure should be reported immediately, the parent or guardian is notified, and the person exposed contacts a physician for further health care.

Date of Adoption: October 11, 1994
Date of Revision:  March 27, 2001

Code No. 403.8

ABUSE OF STUDENTS BY DISTRICT EMPLOYEES

Physical or sexual abuse of students, including inappropriate sexual behavior, by employees will not be tolerated.  The definition of employees for the purpose of this policy includes not only those who work for pay but also those who are volunteers of the school district under the direction and control of the school district.  Employees found in violation of this policy will be subject to disciplinary action up to and including discharge.

The school district will respond promptly to allegations of abuse of students by school district employees by investigating or arranging for the investigation of an allegation.  The processing of a complaint or allegation will be handled confidentially to the maximum extent possible.  Employees are required to assist in the investigation when requested to provide information and to maintain the confidentiality of the reporting and investigation process.

The school district has appointed a Level I investigator and alternate Level I investigator.  The school district has also arranged for a trained, experienced professional to serve as the Level II investigator.  The Level I investigator and alternate will be provided training in the conducting of an investigation at the expense of the school district.  The names of the investigators shall be listed in the student handbook, published annually in the local newspaper and posted in all school facilities.

The superintendent is responsible for drafting administrative regulations to implement this policy.

Date of Adoption:  December 8, 1992
Date of Revision: October 12, 1993
Date of Revision:  January 10, 1995

Code No. 403.8R1

ABUSE OF STUDENTS BY SCHOOL DISTRICT EMPLOYEES REGULATION

An individual who suspects an employee has physically or sexually abused a student should immediately report it to the school district's Level I investigator.  "Employee" means one who works for pay or as a volunteer under the direction and control of the school district.  The report shall be written, signed and witnessed by a person of majority age. The witness may be the Level I investigator.  The reporter is the individual filing the report.  The report shall contain the following:

*	The full name, address, and telephone number of the person filing.
*	The full name, age, address, and telephone number, and attendance center of the student.
*	The name and place of employment of the employee who allegedly committed the abuse.
*	A concise statement of the facts surrounding the incident, including date, time, and place of occurrence, if known.
*	A list of possible witnesses by name, if known.
*	Names and locations of persons who examined, counseled or treated the student for the alleged abuse, including the dates on which those services were provided, if known.

Upon request, the Level I investigator may assist the reporter in completing the report.  An incomplete report shall not be rejected unless the missing information would render the investigation futile or impossible.  An employee receiving a report of alleged abuse of a student by an employee shall pass the report to the investigator and shall keep the report confidential to the maximum extent possible.  In performing the investigation, the investigator shall have access to the educational records of the alleged student victim as well as access to the student for interviewing purposes.

In order for the school district to have jurisdiction over the acts and to constitute a violation of the law, acts of the employee must be alleged to have occurred on school grounds, on school time, at a school‑sponsored activity, or in a school‑related context.  However, the student need not be a student in the school district.  The student can be from another school district.  To be investigable, the written report must include basic information showing that the victim of the alleged abuse is or was a student at the time of the incident, that the alleged act of the employee resulted in injury or otherwise meets the definition of abuse in these rules, and that the person responsible for the act is currently an employee.  If the report is not investigable due to lack of jurisdiction, the investigator shall dismiss the complaint and inform the reporter of other options available.  Other options available to the reporter include contacting law enforcement authorities, private counsel, or the Board of Educational Examiners in the case of a licensed employee.

If the Level I investigator believes the student is in imminent danger if continued contact is permitted between the employee and the student, the Level I investigator may:

*	temporarily remove the student from contact with the employee;
*	temporarily remove the employee from service; or,
*	take other appropriate action to ensure the student's safety.

The Level I investigator shall have access to the educational records of the student and access to the student for purposes of interviewing the student about the report.

Code No. 403.8R1 (Continued)

ABUSE OF STUDENTS BY SCHOOL DISTRICT EMPLOYEES REGULATION

Physical Abuse Allegations
When physical abuse is reported, the Level I investigator shall make copies of the report and give a copy to the person filing the report, the students' parents and the immediate supervisor of the employee named in the report.  The employee named in the report shall not receive a copy of the report until the employee is initially interviewed.

The Level I investigator shall use discretion in handling the information received regarding an investigation of abuse by an employee, and those persons involved in the investigation shall not discuss information regarding the complaint outside the investigation.  The entire investigative procedure will be thoroughly explained, including the confidential nature of the proceedings, to the student and other persons involved in the investigation.

Within five days of receipt of an investigable report, the Level I investigator shall complete an informal investigation.  The informal investigation shall consist of interviews with the student, the employee and others who may have knowledge of the alleged incident. If the Level I investigator determines that the allegations in the report are founded and that immediate and professional investigation is necessary, the Level I investigator may defer further investigation and contact appropriate law enforcement officials, the student's parents and the person filing the report.  Within fifteen days of receipt of the report, the Level I investigator shall complete a written investigative report, unless the investigation was temporarily deferred.

The written investigative report shall include:
1.	The name, age, address and attendance center of the student named in the report.
2.	The name and address of the student's parent or guardian and the name and address of the person filing the report, if different from the student's parent or guardian.
3.	The name and work address of the employee named in the report as allegedly responsible for the abuse of the student.
4.	An identification of the nature, extent and cause, if known, of any injuries or abuse to the student named in the report.
5.	A general review of the investigation.
6.	Any actions taken for the protection and safety of the student.
7.	A statement that, in the investigator's opinion, the allegations in the report are either:
	*	Unfounded. (It is not likely that an incident, as defined in these rules, took place), or
	*	Founded.  (It is likely that an incident took place.)
8.	The disposition or current status of the investigation.
9.	A listing of the options available to the parents or guardian of the student to pursue the allegations.  These options include, but are not limited to:
	*	Contacting law enforcement officials. 
*	Contacting private counsel for the purpose of filing a civil suit or complaint.
	*	Filing a complaint with the board of educational examiners if the employee is a licensed employee.

Code No. 403.8R1 (Continued)

ABUSE OF STUDENTS BY SCHOOL DISTRICT EMPLOYEES REGULATION

The investigator shall retain the original and provide a copy of the written investigative report to the school employee named in the report, the employee's supervisor and the student's parent or guardian.  The person filing the report, if not the student's parent or guardian, shall be notified only that the Level I investigation has been concluded and of the disposition or anticipated disposition of the case.

It is the responsibility of the Level I investigator to determine whether it is more likely than not that an incident of abuse as defined in the rules took place between the student and employee.  The Level I investigator does not make the determination of whether the use of physical contact was appropriate or whether any of the exceptions apply. That is the responsibility of the Level II investigator.  Upon completion of the report, if the Level I investigator determines the allegations of physical abuse are founded and serious, the Level I investigator shall notify law enforcement authorities.  If the allegations are founded but the physical abuse is not of a serious nature, the Level I investigator shall refer the case on to the Level II investigator.

The Level II investigator shall review the Level I investigator's final investigative report and conduct further investigation.  The Level II investigative report shall state the conclusion as to the occurrence of the alleged incident, the applicability of exceptions, the reason for the contact or force used, and recommendations regarding the need for further investigation.  In determining the applicability of the exceptions or the reasonableness of the contact or force used, the Level II investigator will use the following definitions:

Physical abuse is non‑accidental physical injury to the student as a result of the action of an employee.  Injury occurs when evidence of it is still apparent at least twenty-four hours after its occurrence.  The following do not constitute physical abuse, and no employee is prohibited from:
a.	Using reasonable and necessary force, not designed or intended to cause pain:
(1) 	To quell a disturbance or prevent an act that threatens physical harm to any person.
(2) 	To obtain possession of a weapon or other dangerous object within a pupil's control.
(3) 	For the purposes of self-defense of defense of others as provided for in Iowa Code  704.3.
(4) 	For the protection of property as provided for in Iowa Code  704.4, .5.
(5) 	To remove a disruptive pupil from class, or any area of school premises or from school-sponsored activities off school premises.
(6) 	To prevent a student from the self‑infliction of harm.
(7) 	To protect the safety of others.

b.	Using incidental, minor, or reasonable physical contact to maintain order and control.

In determining the reasonableness of the contact or force used, the following factors shall be considered:
a.	The nature of the misconduct of the student, if any, precipitating the physical contact by the school employee.
b.	The size and physical condition of the student.

Code No. 403.8R1 (Continued)

ABUSE OF STUDENTS BY SCHOOL DISTRICT EMPLOYEES REGULATION

c.	The instrumentality used in making the physical contact.
d.	The motivation of the school employee in initiating the physical contact.
e.	The extent of injury to the student resulting from the physical contact.

"Reasonable force" is that force and no more which a reasonable person, in like circumstances, would judge to be necessary to prevent an injury or loss and can include deadly force if it is reasonable to believe that such force is necessary to avoid injury or risk to one's life or safety or the life or safety of another, or it is reasonable to believe that such force is necessary to resist a like force or threat.

Upon completion of the Level II investigation, the Level I investigator shall forward copies of the Level II investigative report to the employee, the employee's immediate supervisor and the student's parent.  The Level I investigator shall notify the person filing the report of the current status of the case.

If the Level II investigator's report or law enforcement officials conclude abuse occurred, or the employee admits the violation, or the employee has surrendered the employee's certificate or license, the Level I investigator shall file a complaint with the State Board of Educational Examiners.  The Level I investigator shall also arrange for counseling services for the student if the student or student's parents request counseling services.

Sexual Abuse
Sexual abuse is defined as including sexual acts involving a student, acts that encourage the student to engage in prostitution, as well as inappropriate, intentional sexual behavior or sexual harassment by the employee toward a student.  "Sexual harassment" is defined as unwelcome sexual advances, requests for sexual favors or other verbal or physical conduct of a sexual nature when:
1.	Submission to the conduct is made either implicitly or explicitly a term or condition of the student's education or benefits;
2.	Submission to or rejection of the conduct is used as the basis for academic decisions affecting that student; or
3.	The conduct has the purpose or effect of substantially interfering with a student's academic performance by creating an intimidating, hostile or offensive education environment.

When sexual abuse is reported, the Level I investigator shall make copies of the report and give a copy to the person filing the report, the students' parents and the immediate supervisor of the employee named in the report.  The employee named in the report shall not receive a copy of the report until the employee is initially interviewed.  The designated investigator shall not interview the school employee named in a report of sexual abuse until after a determination is made that jurisdiction exists, the alleged victim has been interviewed and a determination made that the investigation will not be deferred.

The investigator shall notify the parent, guardian or legal custodian of a student in pre-kindergarten through grade six, of the date and time of the interview and of the right to be present or to see and hear the interview or send a representative in the parent's place.  The Level I investigator shall interview the student as soon as possible, but in no case later than five days from the receipt of a report or notice of the allegation of sexual abuse.  The Level I investigator may record the interview electronically.

Code No. 403.8R1 (Continued)

ABUSE OF STUDENTS BY SCHOOL DISTRICT EMPLOYEES REGULATION

The Level I investigator shall exercise discretion in the investigative process to preserve the privacy interests of the individuals involved.  To the maximum extent possible, the investigator shall maintain the confidentiality of the report.

It is the responsibility of the Level I investigator to determine whether it is more likely than not that an incident took place between the employee and the student.  If the Level I investigator believes the employee committed a sex act with a student or sexually exploited a student, the Level I investigator shall defer the Level I investigation and immediately notify law enforcement officials, the student's parents and the person filing the report.

If the Level I investigator determines an incident occurred, while not an illegal sex act with a student or sexual exploitation of a student, but where the employee engaged in inappropriate, intentional sexual behavior, further investigation is warranted.  If further investigation is warranted, the Level I investigator may proceed to interview the employee and other individuals who may have knowledge of the circumstances contained in the report.  Prior to interviewing other individuals who may have knowledge of the circumstance contained in the report, the Level I investigator shall provide notice of the impending interview of student witnesses or the student who is in pre-kindergarten through grade six, to their parent, guardian, or legal custodian, and may provide notice to the parent or guardian of older students, prior to interviewing those students.  The Level I investigator shall, if founded, arrange for the Level II investigator to further investigate the allegations.

Within fifteen days of receipt of the report or notice of alleged sexual abuse, the Level I investigator shall complete a written investigative report unless the investigation was temporarily deferred.  The written investigative report shall include:

1.	The name, age, address and attendance center of the student named in the report. 
2.	The name and address of the student's parent or guardian and the name and address of the person filing the report, if different from the student's parent or guardian.
3.	The name and work address of the school employee named in the report as allegedly responsible for the abuse of the student.
4.	An identification of the nature, extent and cause, if known, of any injuries or abuse to the student named in the report.
5.	A general review of the investigation.
6.	Any actions taken for the protection and safety of the student.
7.	A statement that, in the investigator's opinion, the allegations in the report are either:
*	Unfounded.  (It is not likely that an incident, as defined in these rules, took place), or
*	Founded.  (It is likely that an incident took place.)
8.	The disposition or current status of the investigation. 
9.	A listing of the options available to the parents or guardian of the student to pursue the allegations.  These options include, but are not limited to:
*	Contacting law enforcement officials. 
*	Contacting private counsel for the purpose of filing a civil suit or complaint.
*	Filing a complaint with the board of educational examiners if the school employee is certificated.

Code No. 403.8R1 (Continued)

ABUSE OF STUDENTS BY SCHOOL DISTRICT EMPLOYEES REGULATION

The investigator shall retain the original and provide a copy of the investigative report to the school employee named in the report, the school employee's supervisor and the named student's parent or 
guardian. The person filing the report, if not the student's parent or guardian, shall be notified only that the Level I investigation has been concluded and of the disposition or anticipated disposition of the case.

If the allegations are founded, the Level I investigation shall refer the case to the Level II investigator.  The Level II investigator shall review the Level I investigator's final investigative report and conduct further investigation if necessary.  The Level II investigative report shall state conclusively as to the occurrence of the alleged incident, conclusively as to the nature of the sexual abuse and recommendations regarding the need for further investigation.  Upon completion of the Level II investigation, the Level I investigator shall forward copies of the Level II investigative report to the employee, the employee's immediate supervisor and the student's parent.  The Level I investigator shall notify the person filing the report of the current status of the case.

If the Level II investigator's report or law enforcement officials conclude sexual abuse occurred, or the employee admits the violation, or the employee has surrendered the employee's certificate or license, the Level I investigator shall file a complaint on behalf of the district after obtaining the superintendent's signature with the State Board of Educational Examiners.  The Level I investigator shall also arrange for counseling services for the student if the student or student's parents request counseling services.

In cases involving founded physical or sexual abuse by a licensed employee, the board shall notify the Board of Educational Examiners.  Information of unfounded abuse at Level I or Level II shall not be kept in the employee's personnel file.  If the Level I investigative report is founded but Level II is unfounded, then the Level I report shall be removed from the employee's permanent file.

It shall be the responsibility of the board to annually identify a Level I and Level II investigator.  The board shall also designate annually an alternate Level I investigator, preferably of the opposite sex of the designated Level I investigator, to whom reports may also be made.  The names and telephone numbers of the Level I investigator and the alternate Level I investigator shall be included in employee handbooks, student handbooks, annually published in the local newspaper, and prominently displayed in all school buildings.

Date of Adoption:  October 12, 1993 
Date of Revision:  January 10, 1995
Date of Revision: March 8, 2011

403.8 E-1

ABUSE OF STUDENTS BY SCHOOL DISTRICT EMPLOYEES

Complaint of Injury to or Abuse of a Student by a School District Employee

Please complete the following as fully as possible.  If you need assistance, contact the Level I investigator in your school.

Student's name and address: 	

                                                                                                                                                           
Student's telephone no.: 	                                                     

Student's school: 	                                                                                                                                                           

Name and place of employment of employee accused of abusing student:

                                                                                                                                                                                       

Allegation is of                   physical               sexual abuse*

Please describe what happened.  Include the date, time and where the incident took place, if known.  
If physical abuse is alleged, also state the nature of the student's injury:

	

	

Were there any witnesses to the incident or are there students or persons who may have information about this incident?           yes  ___  no

	If yes, please list by name, if known, or classification (for example: "third grade class," "fourth period geometry class"):

*Parents of children who are in pre-kindergarten through sixth grade and whose children are the alleged victims of or witnesses to sexual abuse have the right to see and hear any interviews of their children in this investigation. Please indicate "yes" if the parent/guardian wishes to exercise this right:
 
         Yes            No    Telephone Number 	

Page 1 of 2
ABUSE OF STUDENTS BY SCHOOL DISTRICT EMPLOYEES

Complaint of Injury to or Abuse of a Student by a School District Employee

Has any professional person examined or treated the student as a result of the incident? 
____ Yes            No  _______ Unknown

If yes, please provide the name and address of the professional(s) and the date(s) of examination or treatment, if known:

	

Has anyone contacted law enforcement about this incident? ____ Yes             No

Please provide any additional information you have which would be helpful to the investigator.  Attach additional pages if needed.

	

Your name, address and telephone number:

Relationship to student: 	 

Complainant Signature					Witness Signature

Date							Witness Name (please print)

	Witness Address

Be advised that you have the right to contact the police or sheriff's office, the county attorney, a private attorney, or the State Board of Educational Examiners (if the accused is a licensed employee) for investigation of this incident.  The filing of this report does not deny you that opportunity.

You will receive a copy of this report (if you are the named student's parent or guardian) and a copy of the Investigator's Report within fifteen calendar days of filing this report unless the investigation is turned over to law enforcement.
Page 2 of 2

403.8 E-2
ABUSE OF STUDENTS BY SCHOOL DISTRICT EMPLOYEES

Report of Level I Investigation

Student's name:	

Student's age:                                                                    Student's grade:  	

Student's address:  		

Student's school:  		

Name and address of accused school employee  	  Building 	

Name and address of person filing report:

Name and address of student's parent or guardian, if different from person filing report:

Date report of abuse was filed:                                   physical                   sexual*

Describe the nature, extent and cause of the student's injury, if any and if known:  (Attach additional pages if needed).

		

Describe your investigation:  Attach additional pages if needed.  (Please do not use student witnesses' full names.):

		

*Were parent(s) or guardian(s) advised of their right to see and hear any interview of their pre-kindergarten through sixth grade children who are alleged victims of or a witness in a sexual abuse investigation?
	_Yes 		_No         Was the right exercised? 	 Yes 		 No 

Page 1 of 3

ABUSE OF STUDENTS BY SCHOOL DISTRICT EMPLOYEES
LEVEL I INVESTIGATOR'S REPORT FORM

Were audio tapes made of any interviews? _____Yes   _____No  

Were video tapes made of any interviews?  _____Yes   _____No  

Was any action taken to protect the student during or as a result of the investigation?
 _____Yes   _____No  

If yes, describe:

_____student excused from school		_____	school employee placed on
							administrative or other leave

_____student assigned to different class		_____other (please specify)

Level I investigator's conclusions:

_____	The complaint is being dismissed for lack of jurisdiction.

_____	Physical abuse was alleged, but no allegation of injury was made.

_____	Physical abuse was alleged, but no evidence of physical injury exists and the nature of the alleged incident makes it unlikely an injury, as defined in the rules, occurred.

_____	Sexual abuse was alleged, but the alleged actions of the school employee, even if true, would not meet the definition of sexual abuse in the rules.

_____	Alleged victim was not a student at the time of the incident.

_____	Alleged school employee is not currently employed by this school district.

_____	Alleged incident did not occur on school grounds, on school time, at a school-sponsored activity, nor in a school-related context.

_____	The complaint has been investigated and concluded at Level I as unfounded.

_____	Complaint was withdrawn.

_____	Insufficient evidence exists that an incident of abuse, as defined in the rules, took place.
Page 2 of 3

ABUSE OF STUDENTS BY SCHOOL DISTRICT EMPLOYEES
LEVEL I INVESTIGATOR'S REPORT FORM

_____	The complaint has been Investigated at Level I and is founded.

_____	The investigation is founded at Level I and is being turned over to Level II for further investigation.

_____	Investigation of the complaint was deferred at Level I and referred to law enforcement at this time.

_____	The investigation is concluded at Level I because the accused school employee has admitted 
	the violation, has resigned, or has agreed to relinquish any teaching license held.

Current status of investigation:

_____	Closed.  No further investigation is warranted.

_____	Closed and referred to school officials for further investigation as a personnel matter.

_____	Deferred to law enforcement officials.

_____	Turned over to Level II investigator.

Other comments:

	

	

I have given a copy of the report of abuse and of this investigative report to the employee named in the report, the employee's supervisor, and the student's parent or guardian and informed the person filing the report of the options of contacting law enforcement, private counsel, or the State Board of Educational Examiners, if the accused school employee holds an Iowa teacher's certificate or license.

Name of investigator (please print)			Investigator's place of employment

Signature of investigator				Date				Page 3 of 3

Code No. 404

CONDUCT AND APPEARANCE OF PERSONNEL

School district personnel shall conduct themselves in an appropriate manner and dress in attire appropriate for their position.  Clothing should be neat, clean, and in good taste.  Positions requiring uniforms shall conform to specifications as outlined by the superintendent, administrative team, and supervisor.  

Certified personnel shall follow the code of ethics for their profession as established by the Iowa Board of Educational Examiners.

It shall be the responsibility of the principals to counsel employees assigned to their facility on appearance and conduct when the individual appearance may have a negative impact on the learning environment.

Date of Adoption:  April 25, 1990 
Date of Revision:  March 27, 2001

Code No. 404.R1
Page 1 of 6

CODE OF PROFESSIONAL CONDUCT AND ETHICS REGULATION

This code of professional conduct and ethics constitutes mandatory minimum standards of practice for all licensed practitioners as defined in Iowa Code chapter 272.  The adherence to certain professional and ethical standards is essential to maintaining the integrity of the education profession.

Definitions. 
Except where otherwise specifically defined by law:
“Administrative and supervisory personnel” means any licensed employee such as superintendent, associate superintendent, assistant superintendent, principal, associate principal, assistant principal, or other person who does not have as a primary duty the instruction of pupils in the schools.
“Board” means the Iowa board of educational examiners.
“Discipline” means the process of sanctioning a license, certificate or authorization issued by the board.
“Ethics” means a set of principles governing the conduct of all persons governed by these rules.
“Fraud” means knowingly providing false information or representations on an application for licensure or employment, or knowingly providing false information or representations made in connection with the discharge of duties.
“License” means any license, certificate, or authorization granted by the board.
“Licensee” means any person holding a license, certificate, or authorization granted by the board.
“Practitioner” means an administrator, teacher, or other school personnel, who provides educational assistance to students and who holds a license, certificate, or other authorization issued by the board.
“Responsibility” means a duty for which a person is accountable by virtue of licensure.
“Right” means a power, privilege, or immunity secured to a person by law.
“Student” means a person, regardless of age, enrolled in a prekindergarten through grade 12 school, who is receiving direct or indirect assistance from a person licensed by the board.
“Teacher” means any person engaged in the instructional program for prekindergarten through grade 12 children, including a person engaged in teaching, administration, and supervision, and who is required by law to be licensed for the position held.

Standards of professional conduct and ethics.  
Licensees are required to abide by all federal, state, and local laws applicable to the fulfillment of professional obligations.  Violation of federal, state, or local laws in the fulfillment of professional obligations constitutes unprofessional and unethical conduct which can result in disciplinary action by the board.  In addition, it is hereby deemed unprofessional and unethical for any licensee to violate any of the following standards of professional conduct and ethics:

Code No. 404.R1 (Continued)
Page 2 of 6

CODE OF PROFESSIONAL CONDUCT AND ETHICS REGULATION

Standard I—conviction of crimes, sexual or other immoral conduct with or toward a student, and child and dependent adult abuse.  Violation of this standard includes:
a.   Fraud.  Fraud in the procurement or renewal of a practitioner’s license.
b.   Criminal convictions.  The commission of or conviction for a criminal offense as defined by Iowa law or the laws of any other state or of the United States, provided that the offense is relevant to or affects teaching or administrative performance.

 (1)  Disqualifying criminal convictions.  The board shall deny an application for licensure and shall revoke a previously issued license if the applicant or licensee has, on or after July 1, 2002, been convicted of, has pled guilty to, or has been found guilty of the following criminal offenses, regardless of whether the judgment of conviction or sentence was deferred:
1.   Any of the following forcible felonies included in Iowa Code § 702.11:  child endangerment, assault, murder, sexual abuse, or kidnapping;
2.   Any of the following criminal sexual offenses, as provided in Iowa Co e Ch. 709, involving a child:
•	First–, second–, or third–degree sexual abuse committed on or with a person who is under the age of 18;
•	Lascivious acts with a child;
•	Detention in a brothel;
•	Assault with intent to commit sexual abuse;
•	Indecent contact with a child;
•	Sexual exploitation by a counselor;
•	Lascivious conduct with a minor; or
•	Sexual exploitation by a school employee;
3.   Incest involving a child as prohibited by Iowa Code § 726.2;
4.   Dissemination and exhibition of obscene material to minors as prohibited by Iowa Code § 728.2; or
5.   Telephone dissemination of obscene material to minors as prohibited by Iowa Code § 728.15.
(2)  Other criminal convictions and founded child abuse.  In determining whether a person should be denied a license or whether a licensee should be disciplined based upon any other criminal conviction, including a conviction for an offense listed in 25.3(1)“b”(1) which occurred before July 1, 2002, or a founded report of abuse of a child, the board shall consider:
1.   The nature and seriousness of the crime or founded abuse in relation to the position sought;
2.   The time elapsed since the crime or founded abuse was committed;
3.   The degree of rehabilitation which has taken place since the crime or founded abuse was committed;
4.   The likelihood that the person will commit the same crime or abuse again;
5.   The number of criminal convictions or founded abuses committed; and
6.   Such additional factors as may in a particular case demonstrate mitigating circumstances or heightened risk to public safety.

Code No. 404.R1 (Continued)
Page 3 of 6

CODE OF PROFESSIONAL CONDUCT AND ETHICS REGULATION
c.   Sexual involvement or indecent contact with a student.  Sexual involvement includes, but is not limited to, the following acts, whether consensual or nonconsensual:  fondling or touching the inner thigh, groin, buttocks, anus or breasts of a student; permitting or causing to fondle or touch the practitioner’s inner thigh, groin, buttocks, anus, or breasts; or the commission of any sex act as defined in Iowa Code § 702.17.
d.   Sexual exploitation of a minor.  The commission of or any conviction for an offense prohibited by Iowa Code § 728.12, Iowa Code Ch. 709 or 18 U.S.C. § 2252A(a)(5)(B).
e.   Student abuse.  Licensees shall maintain professional relationships with all students, both inside and outside the classroom.  The following acts or behavior constitutes unethical conduct without regard to the existence of a criminal charge or conviction:
(1)  Committing any act of physical abuse of a student;
(2)  Committing any act of dependent adult abuse on a dependent adult student;
(3)  Committing or soliciting any sexual or otherwise indecent act with a student or any minor;
(4)  Soliciting, encouraging, or consummating a romantic or otherwise inappropriate relationship with a student;
(5)  Furnishing alcohol or illegal or unauthorized drugs or drug paraphernalia to any student or knowingly allowing a student to consume alcohol or illegal or unauthorized drugs in the presence of the licensee; or
(6)  Failing to report any suspected act of child or dependent adult abuse as required by state law.

Standard II—alcohol or drug abuse.  Violation of this standard includes:
a.   Being on school premises or at a school–sponsored activity involving students while under the influence of, possessing, using, or consuming illegal or unauthorized drugs or abusing legal drugs.

b.   Being on school premises or at a school–sponsored activity involving students while under the influence of, possessing, using, or consuming alcohol.

Standard III—misrepresentation, falsification of information.  Violation of this standard includes:
a.   Falsifying or deliberately misrepresenting or omitting material information regarding professional qualifications, criminal history, college credit, staff development credit, degrees, academic award, or employment history when applying for employment or licensure.
b.   Falsifying or deliberately misrepresenting or omitting material information regarding compliance reports submitted to federal, state, and other governmental agencies.
c.   Falsifying or deliberately misrepresenting or omitting material information submitted in the course of an official inquiry or investigation.
d.   Falsifying any records or information submitted to the board in compliance with the license renewal requirements imposed under 282—Chapter 17.

Code No. 404.R1 (Continued)
Page 4 of 6

CODE OF PROFESSIONAL CONDUCT AND ETHICS REGULATION

e.   Falsifying or deliberately misrepresenting or omitting material information regarding the evaluation of students or personnel, including improper administration of any standardized tests, including, but not limited to, changing test answers, providing test answers, copying or teaching identified test items, or using inappropriate accommodations or modifications for such tests.

Standard IV—misuse of public funds and property.  Violation of this standard includes:
a.   Failing to account properly for funds collected that were entrusted to the practitioner in an educational context.
b.   Converting public property or funds to the personal use of the practitioner.
c.   Submitting fraudulent requests for reimbursement of expenses or for pay.
d.   Combining public or school–related funds with personal funds.
e.   Failing to use time or funds granted for the purpose for which they were intended.
Standard V—violations of contractual obligations.
a.   Violation of this standard includes:
(1)  Signing a written professional employment contract while under contract with another school, school district, or area education agency.
(2)  Asking a practitioner to sign a written professional employment contract before the practitioner has been unconditionally released from a current contract.  An administrator shall make a good faith effort to determine whether the practitioner has been released from the current contract.
 (3)  Abandoning a written professional employment contract without prior unconditional release by the employer.
(4)  As an employer, executing a written professional employment contract with a practitioner, which requires the performance of duties that the practitioner is not legally qualified to perform.
(5)  As a practitioner, executing a written professional employment contract, which requires the performance of duties that the practitioner is not legally qualified to perform.
b.   In addressing complaints based upon contractual obligations, the board shall consider factors beyond the practitioner’s control.  For purposes of enforcement of this standard, a practitioner will not be found to have abandoned an existing contract if:
(1)  The practitioner obtained a release from the employing board before discontinuing services under the contract; or
(2)  The practitioner provided notice to the employing board no later than the latest of the following dates:
1.   The practitioner’s last work day of the school year; 
2.   The date set for return of the contract as specified in statute; or
3.   June 30.
Standard VI—unethical practice toward other members of the profession, parents, students, and the community.  Violation of this standard includes:
a.   Denying the student, without just cause, access to varying points of view.

Code No. 404.R1 (Continued)
Page 5 of 6

CODE OF PROFESSIONAL CONDUCT AND ETHICS REGULATION
b.   Deliberately suppressing or distorting subject matter for which the educator bears responsibility.
c.   Failing to make reasonable effort to protect the health and safety of the student or creating conditions harmful to student learning.
d.   Conducting professional business in such a way that the practitioner repeatedly exposes students or other practitioners to unnecessary embarrassment or disparagement.
e.   Engaging in any act of illegal discrimination, or otherwise denying a student or practitioner participation in the benefits of any program on the grounds of race, color, religion, age, sex, disability, marital status, national origin, or membership in a definable minority.
f.    Soliciting students or parents of students to purchase equipment, supplies, or services from the practitioner for the practitioner’s personal advantage.
g.   Accepting gifts from vendors or potential vendors where there may be the appearance of or an actual conflict of interest.
h.   Intentionally disclosing confidential information including, but not limited to, unauthorized sharing of information concerning student academic or disciplinary records, health and medical information, assessment or testing results, or family income.  Licensees shall comply with state and federal laws and local school board policies relating to the confidentiality of student records, unless disclosure is required or permitted by law.
i.    Refusing to participate in a professional inquiry when requested by the board.
j.    Aiding, assisting, or abetting an unlicensed person in the completion of acts for which licensure is required.
k.   Failing to self–report to the board within 60 days any founded child abuse report, or any conviction for a criminal offense listed in 25.3(1)“b”(1) which requires revocation of the practitioner’s license.
l.    Delegating tasks to unqualified personnel.
m. Failing to comply with federal, state, and local laws applicable to the fulfillment of professional obligations.
n.   Allowing another person to use one’s practitioner license for any purpose.
o.   Performing services beyond the authorized scope of practice for which the individual is licensed or prepared.
p.	Falsifying, forging, or altering a license issued by the board.
q.	Failure of the practitioner holding a contract under IOWA CODE section 279.13 to disclose to the school official responsible for determining assignments a teaching assignment for which the practitioner is not properly licensed.
r.	Failure of a school official responsible for assigning licensed practitioners holding contracts under IOWA CODE section 279.13 to adjust an assignment if the practitioner discloses to the official that the practitioner is not properly licensed for an assignment.

Standard VII—compliance with state law governing student loan obligations and child support obligations.  Violation of this standard includes:
a.   Failing to comply with 282—Chapter 9 concerning repayment of student loans.
b.   Failing to comply with 282—Chapter 10 concerning child support obligations.
Standard VIII—incompetence.  Violation of this standard includes, but is not limited to:
Code No. 404.R1 (Continued)
Page 6 of 6

CODE OF PROFESSIONAL CONDUCT AND ETHICS REGULATION

a.   Willfully or repeatedly departing from or failing to conform to the minimum standards of acceptable and prevailing educational practice in the state of Iowa.
b.   Willfully or repeatedly failing to practice with reasonable skill and safety.

These rules are intended to implement Iowa Code § 272.2(1)“a.”
Date of Adoption: January 3, 2006
Date of Revision: March 8, 2011

Code No. 404.R2

code of rights and responsibilities REGULATION

Purpose.  The code of professional conduct and ethics in 282—Chapter 25 defines unprofessional and unethical conduct justifying disciplinary sanction.  The board acknowledges that the discharge of professional obligations should occur in recognition of certain fundamental rights and responsibilities.  Accordingly, the board recognizes the following rights and responsibilities of all educators licensed under Iowa Code Ch. 272 and agrees that the exercise of these rights and responsibilities may present mitigating facts and circumstances in the board’s evaluation of allegations of unprofessional or unethical conduct.

Rights.  Educators licensed under Iowa Code Ch. 272 have the following rights:
1.   The educator has a right to be licensed and endorsed under professional standards established and enforced by the board.
2.   The educator has a right to refuse assignments for which the educator is not legally authorized, in terms of holding a valid Iowa license with the appropriate endorsement(s) or approval(s).
3.   The educator has a right, subject to board and administrator authority, to exercise professional judgment in the evaluation, selection, and use of teaching methods and instructional materials appropriate to the needs, abilities, and background of each student.

Responsibilities.  Educators licensed under Iowa Code Ch. 272 have the following responsibilities:
1.   The educator has a responsibility to maintain and improve the educator’s professional competence.
2.   The educator has a responsibility to accept only those assignments for which the educator is legally authorized.
3.   The educator has a responsibility to provide conditions that are conducive to teaching and student learning.
4.   The educator shall protect students from conditions harmful to learning or to health or safety.
5.   The educator shall not, without just cause, restrain a student from independent action in the pursuit of learning and shall not, without just cause, deny a student access to varying points of view.
6.   The educator shall not use professional relationships with students for personal advantage.
7.   The educator shall not discriminate against any student on the grounds of national or ethnic origin, religion, age, sex, disability, membership in a definable minority, or marital status, nor grant any discriminatory consideration or advantage.
8.   The educator shall accord just and equitable treatment to all members of the profession.
9.   The educator shall keep in confidence personally identifiable information regarding a student or the student’s family members that has been obtained in the course of professional service, unless disclosure is required by law or is necessary for the personal safety of the student or others.
10. The educator who has reasonable basis to believe that a student has been abused, as defined by law, shall make all reports required by law and the Iowa Administrative Code and which are necessary to ensure the safety and well–being of the student.
11. In the administration of discipline, the educator shall treat all students with respect and in compliance with all policies of the school district served by the educator.
Code No. 404.R2 cont.

code of rights and responsibilities REGULATION

12. The educator shall provide accurate, truthful, and complete information to the board and to the local education system concerning all licensure transactions.
13. The educator shall not refuse to participate in a professional inquiry, when requested by the board.
14. The educator shall not require or direct another educator to violate any provisions of the code of professional conduct and ethics or any rights of a student, parent, educator or citizen.
15. The educator shall not delegate assigned tasks to unqualified personnel.

These rules are intended to implement Iowa Code § 272.2(1)“a.”

Date of Adoption: 1/3/2006_________________
Date of Revision:_____________________

Code No. 405.1

LICENSED EMPLOYEES SELECTION AND EMPLOYMENT

Persons interested in a licensed position, other than administrative positions which will be employed in accordance with board policies in Series 300, "Administration," will have an opportunity to apply and qualify for licensed positions in the school district without regard to age, race, creed, color, sex, national origin, religion, sexual orientation, gender identity or disability.  Job applicants for licensed positions will be sought as provided in Board Policy Code. No. 400.3 and will be considered for employment on the basis of the qualifications established in Board Policy Code. No. 405.2.

The board will employ licensed employees after receiving a recommendation from the superintendent.  The superintendent is authorized to issue contracts to licensed employees before board action but upon the condition that they are not final until the board acts upon them.

Licensed employees must present evidence of current license and have a satisfactory background check on file with the board secretary prior to payment of salary.

The requirements stated in the Master Contract between employees in that certified collective bargaining unit and the board regarding qualifications, recruitment and selections of such employees shall be followed.

Date of Adoption:  May 14, 2002
Date of Revision:  August 14, 2007
Date of Revision: March 8, 2011

Code No. 405.2

QUALIFICATIONS

Selection of certified personnel shall be based upon the following:

a.  proper certification from the Iowa Department of Education;
b.  training, experience, and skill;
c.  needs of the district;
d.  demonstrated ability to fulfill all aspects and duties of position;
e.  ability to cooperate harmoniously with students, fellow workers, and citizens of the district;
f.  diligence and dependability;
g.  ability to exercise discretion and good judgment;
h.  ability to follow instructions and suggestions of supervisors;
i.  compatibility with the district's philosophy, goals, programs, and mission;
j.  adherence to professional ethics;
k.  personal qualities advantageous to the position;
l.  other qualities as may be determined by the administrative team and/or the board.

Date of Adoption:  April 25, 1990 
Date of Revision: December 8, 1992
Date of Revision: May 16, 2006

Code No. 405.3

   INDIVIDUAL CONTRACTS WITH CERTIFIED PERSONNEL 
(EXCLUDING ADMINISTRATORS) 

Contracts with newly‑appointed certificated employees in the district other than administrators or with temporary employees, shall be in writing and shall state the number of contract days, the compensation to be paid, and any other matters mutually agreed upon. Each contract will be for a one year period  unless otherwise specified for less than a year. A teaching contract is invalid if the employee is under a teaching contract with another board of directors during the same time period until a release is obtained.

It shall be the responsibility of the superintendent to complete the contracts for all certified personnel and present them to the board for approval.  The contracts must be signed by Board President followed by the employee.  The Board Secretary will finalize signed contracts.  

Date of Adoption:  April 25, 1990 
Date of Revision: May 16, 2006

Code No. 405.4

CONTINUING CONTRACTS CERTIFIED PERSONNEL
(EXCLUDING ADMINISTRATORS)

Contracts entered into with certified personnel, other than administrators, shall automatically continue from year to year for periods of one year unless the contract is modified by mutual agreement between the board and the employee or is terminated by the board.  

The first three years of a new certified employee’s contract is a probationary period unless the employee has already successfully completed the three-year probationary period in an Iowa school district.  New employees who have successfully completed a probationary period in a previous Iowa school district will serve a one-year probationary period.  In the event of termination of the employee’s contract during this period, the board will afford the licensed employee appropriate due process.  The action of the board will be final.

Certified employees whose contracts will be terminated at year end will receive notification in compliance with state law.  The superintendent shall make a recommendation to the board for the termination of the certified employees' contracts.  

Licensed employees who wish to resign, to be released from a contract, or to retire must comply with board policies in those areas.

Date of Adoption:  April 25, 1990 
Date of Revision: December 8, 1992
Date of Revision:  November 10, 1998
Date of Revision: March 8, 2011

Code No. 405.5

CERTIFIED PERSONNEL WORK DAY
(EXCLUDING ADMINISTRATORS)

Employee work day and hours shall be governed by the master labor agreement between certified employees in the collective bargaining unit and the board.

Date of Adoption:  April 25, 1990 

Code No. 405.6

ASSIGN/TRANSFER OF CERTIFIED PERSONNEL

It shall be the responsibility of the superintendent to make recommendations to the board regarding the assignment of the certified employees.  The requirements of the Master Contract between the collective bargaining unit and the board shall be followed.

Date of Adoption:  April 25, 1990 
Date of Revision: May 16, 2006

Code No. 405.7

EVALUATION OF CERTIFIED PERSONNEL
(EXCLUDING ADMINISTRATORS) 

Evaluation of certified employees on their skills, abilities, and competence is an ongoing process supervised by the building principals and conducted by approved evaluators. All certified employees, other than beginning teachers, will be evaluated at least every three years.  Beginning teachers are evaluated through the district’s mentoring and induction plan.  Annually, the licensed administrator will evaluate the certified employee on their goals of their individual professional development plan.  The certified employee performance review will include documented:

•	Classroom observations of the teacher’s performance;
•	Review of the teacher’s progress on the Iowa Teaching Standards as well as local standards and criteria; and
•	Review of the Teacher’s implementation of the teachers individual professional development plan.

The goal of the formal evaluation of certified employees, other than administrators, but including extracurricular employees, is to improve the education program, to maintain certified employees who meet or exceed the board's standards of performance, to clarify the certified employee's role, to ascertain the areas in need of improvement, to clarify the immediate priorities of the board, and to develop a working relationship between the administrators and other employees.

The formal evaluation criteria is in writing and approved by the board.  The formal evaluation will provide an opportunity for the evaluator and the certified employee to discuss performance and the future areas of growth.  The formal evaluation is completed by the evaluator, signed by the certified employee and filed in the licensed employee's personnel file.  This policy supports, and does not preclude, the ongoing informal evaluation of the certified employee's skills, abilities and competence.  

Certified employees will be required to:
•	Demonstrate the ability to enhance academic performance and support for and implementation of the school district’s student achievement goals.
•	Demonstrate competency in content knowledge appropriate to the teaching position.
•	Demonstrate competency in planning and preparation for instruction.
•	Use strategies to deliver instruction that meets the multiple learning needs of students.
•	Use a variety of methods to monitor student learning.
•	Demonstrate competence in classroom management.
•	Engage in professional growth.
•	Fulfill professional responsibilities established by the school district.
	It is the responsibility of the superintendent to ensure certified employees are evaluated.  New and probationary certified employees are evaluated at least twice each year.

The requirements stated in the Master Contract between employees in that certified collective bargaining unit and the board regarding evaluation of such employees will be followed.

Date of Adoption:  April 25, 1990 
Date of Revision: January 27, 2009
Date of Revision: March 8, 2011

Code No. 405.8

ORGANIZATION AFFILIATION - CERTIFIED  

Certified personnel who qualify may join the Centerville Education Association and participate in its activities as long as the participation does not, in any way, interfere with the delivery of the education programs and school district operations.

The superintendent shall have sole discretion to determine whether association activities interfere with the educational program and school district operations. All association individuals must follow the board policies stating requirements for the public when using school property for association purposes.

The board shall not interfere with the rights of an employee to organize, form, join, or assist any employee organization.

No employee of the district shall be required to be a member of any association or organization as a condition of employment and it is a policy of the board that each employee may exercise the right to join, or not join, any such association or organization without interference from any board member, the superintendent, any member of the administrative team, any certified personnel, or any other employee of the district.

The requirements stated in the Master Contract shall be followed.

Date of Adoption:  April 25, 1990 
Date of Revision: May 16, 2006

 

Code No.  405.9

LICENSED EMPLOYEE PROBATIONARY STATUS

The first three years of a new licensed employee's contract shall be a probationary period unless the employee has already successfully completed the probationary period in an Iowa school district. New employees who have successfully completed a probationary period in a previous school district will serve a one year probationary period.  For purposes of this policy, an employee will have met the requirements for successfully completing a probationary period in another Iowa school district if, at the teacher’s most recent performance evaluation, the teacher received at least a satisfactory or better evaluation and the individual has not engaged in conduct which would disqualify the teacher for a continuing contract.

Only the board, in its discretion, may waive the probationary period.  The board may extend the probationary period for one additional year with the consent of the licensed employee.  The board will make the decision to extend or waive a licensed employee's probationary status based upon the superintendent's recommendation.  During this probationary period the board may terminate the licensed employee's contract at year-end or discharge the employee in concert with corresponding board policies.

Licensed employees may also serve a probationary period based upon their performance.  Such probationary period shall be determined on a case-by-case basis in light of the circumstances surrounding the employee's performance as documented in the employee's evaluations and personnel file.

Date of Adoption:  November 10, 1998 
Date of Revision:  January 25, 2000

Code 406.1

CERTIFIED STAFF SALARY/SCHEDULE ADVANCE
 (Excluding Administrators)

The board shall establish salary schedules and rates of pay for the several positions in the district.  The board shall determine which certified employees will advance on the salary schedule.

It shall be the responsibility of the superintendent to make recommendations to the board annually regarding the salary schedule and advancement of certified personnel on the salary schedule.  The board shall have the authority, based on the superintendent's recommendation, to hold an individual on step for unsatisfactory performance.

The requirements stated in the Master Contract between employees in the certified collective bargaining unit and the board regarding wages and salaries of such employees will be followed.

The salary schedule shall be subject to review through the collective bargaining process.

Date of Adoption:  April 25, 1990 
Date of Revision: March 8, 2011

Code No. 406.2

CONTINUED EDUCATIONAL CREDIT (CERTIFIED STAFF)

Any certificated employee who plans to enroll in a course or seminar at an accredited college or university and who desires such course or seminar work to apply towards an educational lane change on the salary schedule must file a request with the superintendent by June 15.  All credit to qualify for lane changes above the B.A. Lane must be earned after the employee has been awarded the bachelor's degree.  All credit to qualify for lane changes above the M.A. Lane must be earned after the employee has been awarded the master's degree.  Credit in excess of what is needed for the specific degree earned before the awarding of the degree will not be credited for lane changes above the degree.  The superintendent, in conjunction with the administrative team, shall grant horizontal movement on the salary schedule in accordance with the following:

Certificated employees not on an established graduate program in education shall be granted credit toward horizontal movement on the salary schedule under the following conditions:

*  The hours are graduate level classification.

*  The hours are in the subject area in which the employee is presently teaching or are hours outside the employee's present teaching area but are in the judgment of the superintendent and administrative team related to the employee's present assignment.  Approval may also be based upon the teachers career development plan.

*  Proof of successful completion of the course or courses taken is provided.

Certificated employees who are on an established graduate program in education, in an area that supports their teaching assignment or as approved by the Centerville Administration, shall be granted credit for horizontal movement on the salary schedule in accordance with the following:
	
*Courses must be part of degreed program.
*Provide evidence of the successful completion of the course/s.

The employee shall file satisfactory evidence proving successful completion of course work or of the degree with the superintendent no later than November 5 for salary adjustments to be made for that school year.  Adjustments in placement will occur in accordance with the date the evidence was filed.  Salary will be prorated accordingly. 

Date of Adoption:  April 25, 1990 
Date of Revision: December 8, 1992
Date of Revision: May 20, 1993
Date of Revision:  January 10, 1995
Date of Revision: March 24, 1998
Date of Revision: August 15, 2006
Date of Revision: March 8, 2011

Code No. 406.2-R

REGULATIONS FOR GRANTING CONTINUED EDUCATIONAL CREDIT 
(CERTIFIED STAFF)

From time to time, the Administrative Team may support and encourage a course for staff which is specifically targeted to meet a district Staff Development need.  Credit toward lane adjustment for successfully completing the course may be granted as though the course was taken for graduate credit, even though the district helped pay the teacher to take the course under these conditions.

1.	The course received Administrative Team approval as a turnkey training course and staff members were chosen by the Administrative Team for this credit before the course began. 
2.	As a condition for taking the course, including for credit, while being reimbursed by the district the teacher agrees; if requested, to serve as a turnkey trainer for the district for a minimum of 3 years following the course.  A turnkey trainer presents the contents of the course to district teachers as requested for staff development opportunities, and is paid the prevailing rate for teaching those classes.
3.	The course was registered for Graduate Credit for members of the turnkey training group who choose to pay for these records.
4.	Failure to serve as a trainer when requested will result in rescinding the credit for future contracts. 

Date of Adoption: April 2, 1992
Date of Revision: August 15, 2006

Code No. 406.3

EXTRA DUTY COMPENSATION

The board shall follow extra duty compensation schedules established in the negotiated agreement with the Centerville Education Association.  The superintendent, following input from the administrative team, shall make recommendation to the board for assignments for extra duties.

Date of Adoption:  April 25, 1990 
Date of Revision: December 8, 1992

Code No. 406.4

INSURANCE BENEFITS FOR CERTIFIED STAFF

Licensed employees may be eligible for group benefits as determined by the board and required by law.  The board will select the group benefit program(s) and the insurance company or third party administrator which will provide or administer the program.  

In accordance with the Patient Protection and Affordable Care Act (ACA), the board will offer licensed employees who work an average of at least thirty (30) hours per week or one hundred thirty (130) hours per month, based on the “look back method” measurement method adopted by the board, with minimum essential coverage that is both affordable and provides minimum value.  The board will have the authority and right to change or eliminate group benefit programs, other than the group health plan, for its licensed employees. 

Licensed employees who work an average of at least (30) hours per week or one hundred thirty (130) hours per month, based on the measurement method adopted by the board, are eligible to participate in the group health plan.  Licensed employees who work 30 hours per week are eligible to participate in vision, dental, life and LTD group insurance plans.  Employers should maintain documents regarding eligible employee’s acceptance and rejection of coverage. 

 Regular part-time employees (i.e., employees who work less than 30 hours per week or 130 hours per month for health benefit purposes or employees who work less than 30 hours per week for benefits (other than health) who wish to purchase coverage may participate in group benefit programs by meeting the requirements of the applicable plan.  Full-time and regular part-time licensed employees who wish to purchase coverage for their spouse or dependents may do so by meeting the requirements of the applicable plan.  Licensed employees and their spouse and dependents may be allowed to continue coverage of the school district’s group health program if they cease employment with the school district by meeting the requirements of the plan.

The requirements state in the Master Contract between employees in the certified collective bargaining unit and the board regarding the group insurance benefits of such employees will be followed.  
Upon retirement, certified personnel and their spouse and dependents, who are eligible, shall be allowed to continue coverage in the school district group health insurance program at their own expense until medicare age by meeting the requirements of the insurer with proper notification and submitted resignation.

Date of Adoption:  April 25, 1990 
Date of Revision:  December 8, 1992
Date of Revision:  March 24, 1998
Date of Revision:  March 27, 2001
Date of Revision:  May 16, 2006
Date of Revision:  July 13, 2010
Date of Revision:  March 8, 2011
Date of Revision: April 27, 2015

Code No. 406.5

TAX SHELTER PROGRAMS FOR CERTIFIED STAFF

The board authorizes the administration to make a payroll deduction for certified personnel's tax shelter annuity premiums purchased from the companies or program chosen by the board and the collective bargaining unit.  

Certified employees wishing to have payroll deductions for tax shelter annuities shall make written request to the superintendent.

The requirements of the master contract between the collective bargaining unit and the board shall be followed.

Date of Adoption:  April 25, 1990 
Date of Revision: January 27, 2009

Code No. 407.1

RESIGNATION OF CERTIFIED STAFF

Certified employees who wish to resign must notify the board in writing within the time period set by the board for return of the contract.  Resignations of this nature shall be accepted by the board.

Employees who resign from an extracurricular contract may be required to continue in that position for one year if a good faith effort to find a satisfactory replacement is unsuccessful.

Date of Adoption:  April 25, 1990 
Date of Revision: December 8, 1992

Code No. 407.2
CONTRACT RELEASE OF CERTIFIED STAFF

The board recognizes that there are some circumstances which force an employee to request a release from a contract before the expiration date of the contract.  The board also recognizes that the district suffers difficulties and expenses in finding a suitable replacement.  The board believes that an employee should fulfill the contract to the best of the employee's ability.

An employee who wishes to resign from a signed contract or before the contract expiration date shall submit to the board secretary a signed written request setting out the reasons for the requested release.

A certified employee shall be released from the contract only if the board determines that a valid reason exists for release and a suitable replacement is found.  

Certified employees shall be expected to continue services under the contract until a suitable replacement is secured and a written release is obtained from the board.  Transferring current employees to fill the position does not mean a “suitable replacement” has been found until all vacancies resulting from transfers are filled with ”suitable replacements”.

Certified personnel requesting release from a contract after it has been signed and before the term of the contract expires will be required to pay the board for expenses incurred to locate a suitable replacement.  These expenses may include advertising costs, long distance telephone calls, interviewing expenses, and additional wages or salaries for employees who must work during days they are not under contract to find a replacement due to late resignations. When requests for release are submitted, the superintendent or designee will estimate the replacement costs.  The employee seeking release from the contract shall deposit a valid check or cash equal to the estimated amount with the administration office.  The employee requesting release will be provided an itemized expense list.  Any excess costs above the deposit must be paid prior to obtaining a release.  The district will refund any amount of the deposit not used for replacement costs.  Employees making a request for release and making a deposit, but who are never released, may still be responsible for the actual expenses of seeking a replacement.

A certified employee may seek a waiver from the board of any of the conditions set forth for requesting a release prior to the expiration date of the contract.  The board may, on its own or following a request, waive any of the conditions regarding release.

Generally, certified employees shall not be released from their contracts if the request is made after June 1.  However, a late request for release from the contract will be considered by the board if special circumstances exist.  It shall be at the discretion of the board to determine whether special circumstances exist.

The superintendent is authorized to file a complaint with the Iowa Professional Teaching Practices Commission against any certified employee who leaves without proper release or to pursue any other remedies under the law.

Date of Adoption:  April 25, 1990 
Date of Revision:  December 8, 1992
Date of Revision:  March 24, 1998
Date of Revision:  September 28, 1999
Date of Revision:  March 28, 2000
Date of Revision:  March 27, 2001

Code No. 407.3

RETIREMENT OF CERTIFIED PERSONNEL

The Centerville CSD may from time to time establish a voluntary early retirement plan for qualified certified employees.  An early retirement plan will address eligibility, benefits and other pertinent items.  The most recent such plan offered by the district shall be retained in the Board Policy book as an illustrative exhibit for future reference.  The Centerville CSD may also include in its collective bargaining agreement with professional staff provisions for early retirement benefits for said staff such as payment for accrued, unused sick leave and flexible leave payable upon retirement which may be paid for early retirement in any year.

Certified employees who are eligible and who will complete their current contract with the board, may apply for retirement.  Certified employees will not be required to retire at any specific age.

Application for retirement will be considered made when the certified employee states in writing to the superintendent no later than the date set by the board for the return of the employee's contract to the board.  The letter must state the employee's desire to retire.  Applications made after the date set by the board for the return of the employee's contract to the board may be considered by the board if special circumstances exist.  It shall be the discretion of the board to determine whether special circumstances exist.

Upon retirement, certified personnel and their spouse and dependents, who are eligible, shall be allowed to continue coverage in the school district group health insurance program at their own expense until Medicare age by meeting the requirements of the insurer with proper notification and submitted resignation.

Certified personnel who retire may be eligible to continue health and dental insurance coverage at their own expense if they follow conditions established by the carrier.
	`

Date of Adoption:  April 25, 1990 
Date of Revision: March 24, 1998
Date of Revision:  March 27, 2001
Date of Revision: August 15, 2006
Date of Revision: December 10, 2009
Date of Revision: September 12, 2016

Code No. 407.3 E1
Certified Staff Early Retirement Benefit
Centerville CSD Certified Employee Early Retirement Plan
	
The Centerville Community School District offers a voluntary early retirement plan to currently employed administrative and teaching employees.  To be eligible, an employee must meet all of the following requirements:

1.	Be a minimum of fifty five (55) years old on the effective date of retirement.
2.	Have worked a minimum of ten (10) consecutive years to date of retirement as a teacher or administrator for the Centerville CSD.
3.	Submit an application requesting early retirement benefits on or after October 16, 2017 and by no later than December 1, 2017.
4.	Submit a resignation from employment with the District effective at the end of the 2017-18 work year.
5.	Receive Board approval of the employee’s application and resignation.
6.	Participation in this early retirement plan is limited to the first fifteen eligible applicants to be considered in the order of receipt of their applications. 

An employee is ineligible for participation in this plan if the employee is under consideration for termination from employment.  

Approval by the Board of an employee’s application shall entitle the employee to receive $30,000.  The employee shall also receive reimbursement for all accrued, unused sick leave but not to exceed 130 days payable at the rate of 60% of the 2017-18 daily teacher substitute rate. The employee shall also receive reimbursement for all accrued, unused flexible leave but not to exceed 60 days payable at the rate of 75% of the 2017-18 daily teacher substitute rate. All benefits listed in this paragraph will be prorated for part time employees determined by the FTE status in 2016-17. Failure by the Board to approve the employee’s application for early retirement benefits shall negate the employee’s resignation submitted in reliance thereon. No interest shall accrue on monies not yet paid. Payments for accrued, unused sick leave and flexible leave listed above will be the only payments for such leaves an applicant will receive and shall be in lieu of any such benefit listed in any Board policy, handbook or contract and Applicant waives any claim for any further such benefit. Payment per this paragraph shall be subject to all applicable taxes and withholding and shall be payable in one installment payable on or before December 31, 2018.

An employee who participates in the early retirement plan and who participated at the time of retirement in the District’s group health insurance plan, may continue to participate in the District’s then existing group health insurance plan at his/her own expense  only if allowed by the District’s group plan and carrier and if consistent with state law.  Continued participation will require the employee to submit payment for his/her monthly premiums in advance to the District according to District requirements.  The employee may only continue to participate as long as it is allowed by the District, its group health plan and insurance carrier. Nothing herein prohibits the District’s ability to prospectively change or eliminate its group health plan.   
In the event of the death of the retiring employee after Board acceptance for early retirement but prior to payment of any or all of the cash stipend, the cash stipend will be paid to the deceased employee’s spouse or other specifically designated beneficiary or if none, to the employee’s estate. 
 
This early retirement plan is in effect for eligible teachers and administrators who retire at the end of the 2017-18 work year only.  The District may or may not offer another early retirement plan in the future. 

The Board of Directors is the final arbiter of all questions of interpretation under this plan including, but not limited to, questions of eligibility or benefit calculation. The Board may in its discretion expand the participation cap or extend the deadline for application submission.

Adoption Date:  May 14, 1996
Date of Revision:  March 24, 1998
Date of Revision:  October 12, 1999
Date of Revision:  March 27, 2001
Date of Revision:  January 25, 2005
Date of Revision:  December 10, 2009
Date of Revision: October 9, 2017

  Code No. 407.3 E2
Certified Staff Early Retirement Benefit
Centerville CSD Certified Employee Early Retirement Plan
	
The Centerville Community School District offers a voluntary early retirement plan to currently employed administrative and teaching employees.  To be eligible, an employee must meet all of the following requirements:

7.	Be a minimum of fifty five (55) years old on the effective date of retirement.
8.	Have worked a minimum of ten (10) consecutive years to date of retirement as a teacher or administrator for the Centerville CSD.
9.	Submit an application requesting early retirement benefits on or after October 16, 2017 and by no later than December 1, 2017.
10.	Submit a resignation from employment with the District effective at the end of the 2017-18 work year.
11.	Receive Board approval of the employee’s application and resignation.
12.	Participation in this early retirement plan is limited to the first fifteen eligible applicants to be considered in the order of receipt of their applications. 

An employee is ineligible for participation in this plan if the employee is under consideration for termination from employment.  

Approval by the Board of an employee’s application shall entitle the employee to receive $30,000.  The employee shall also receive reimbursement for all accrued, unused sick leave but not to exceed 130 days payable at the rate of 60% of the 2017-18 daily teacher substitute rate. The employee shall also receive reimbursement for all accrued, unused flexible leave but not to exceed 60 days payable at the rate of 75% of the 2017-18 daily teacher substitute rate. All benefits listed in this paragraph will be prorated for part time employees determined by the FTE status in 2016-17. Failure by the Board to approve the employee’s application for early retirement benefits shall negate the employee’s resignation submitted in reliance thereon. No interest shall accrue on monies not yet paid. Payments for accrued, unused sick leave and flexible leave listed above will be the only payments for such leaves an applicant will receive and shall be in lieu of any such benefit listed in any Board policy, handbook or contract and Applicant waives any claim for any further such benefit. Payment per this paragraph shall be subject to all applicable taxes and withholding and shall be payable in one installment payable on or before December 31, 2018.

An employee who participates in the early retirement plan and who participated at the time of retirement in the District’s group health insurance plan, may continue to participate in the District’s then existing group health insurance plan at his/her own expense  only if allowed by the District’s group plan and carrier and if consistent with state law.  Continued participation will require the employee to submit payment for his/her monthly premiums in advance to the District according to District requirements.  The employee may only continue to participate as long as it is allowed by the District, its group health plan and insurance carrier. Nothing herein prohibits the District’s ability to prospectively change or eliminate its group health plan.   
In the event of the death of the retiring employee after Board acceptance for early retirement but prior to payment of any or all of the cash stipend, the cash stipend will be paid to the deceased employee’s spouse or other specifically designated beneficiary or if none, to the employee’s estate. 
 
This early retirement plan is in effect for eligible teachers and administrators who retire at the end of the 2017-18 work year only.  The District may or may not offer another early retirement plan in the future. 

The Board of Directors is the final arbiter of all questions of interpretation under this plan including, but not limited to, questions of eligibility or benefit calculation. The Board may in its discretion expand the participation cap or extend the deadline for application submission.

						________________________________________
					Employee Signature

						________________________________________
						Date

Date Approved: October 9, 2017

Code No. 407.4

SUSPENSION/DISCHARGE CERTIFIED STAFF

A certified employee may be suspended with or without loss of pay or benefits pending an investigation into charges against the employee for disciplinary purposes, or pending the commencement of discharge proceedings.  It shall be at the superintendent's discretion, pending an investigation, to suspend a certified employee.  

The board may terminate the contract of a certificated employee in accordance with applicable provisions of Chapter 279 of the Iowa Code, or may suspend a certified employee with or without loss of pay or benefits for a period not to exceed 90 days.

Date of Adoption:  April 25, 1990 

Code No. 407.5

REDUCTION IN FORCE CERTIFIED PERSONNEL

The board, based upon recommendations from the superintendent and administrative team, shall determine when a reduction in certified personnel is necessary.  

Requirements as outlined in the Master Contract regarding reduction in force of certified employees, shall be followed.

Date of Adoption:  April 25, 1990 
Date of Revision: May 16, 2006
 Code No. 408.1

PROFESSIONAL DEVELOPMENT

The board encourages licensed employees to attend and participate in professional development activities to maintain, develop, and extend their skills.  The board will maintain and support an in-service program for licensed employees. Professional development activities will include activities that promote and/or teach about compliance with applicable Iowa laws. 

Requests for attendance or participation in a development program, other than those development programs sponsored by the school district are made to the superintendent.  Approval by the superintendent must be obtained prior to attendance by a licensed employee in a professional development program when the attendance would result in the licensed employee being excused from their duties or when the school district pays the expenses for the program.

The superintendent will have sole discretion to allow or disallow licensed employees to attend or participate in the requested event.  When making this determination, the superintendent will consider the value of the program for the licensed employee and the school district, the effect of the licensed employee's absence on the education program and school district operations and the school district's financial situation as well as other factors deemed relevant in the judgment of the superintendent.  Requests that involve unusual expenses or overnight travel must also be approved by the board.

Legal Reference:  Iowa Code § 279.8; .74
281 I.A.C. 12.7; 83.6

Date of Adoption:  April 25, 1990 
Date of Revision: May 16, 2006
Date of Revision: November 14, 2022

Code No. 408.2
 
CERTIFICATION REQUIREMENT CERTIFIED STAFF

Certified personnel shall be certified for the position they hold as required by the Iowa Department of Education.  Each certified employee must present a copy of their current certificate to the board secretary prior to payment of any annual salary.

Date of Adoption:  April 25, 1990
Date of Revision: May 16, 2006

Code No.  409

PAY DEDUCTIONS – CERTIFIED STAFF

The district provides leaves of absences to allow employees to be absent from work to attend to important matters outside of the workplace.  As public employers, school districts are expected to record and monitor the work that employees perform and to conform to principles of public accountability in their compensation practices.

Consistent with principles of public accountability, it is the policy of the district that, when an employee is absent from work for less than one work day and the employee does not use accrued leave for such absence, the employee’s pay will be reduced or the employee will be placed on leave without pay if:
•	The employee has not sought permission to use paid leave for this partial-day absence,
•	The employee has sought permission to use paid leave for this partial-day absence and permission has been denied, or
•	The employee’s accrued paid leave has been exhausted.

In each case in which an employee is absent from work for part of a work day, a deduction from compensation will be made or the employee will be placed on leave without pay for a period of time that is equal to the employee’s absence from the employee’s regularly scheduled hours of work on that day.

Date of Adoption:  August 9, 2005
Date of Revision:  March 8, 2011

Code No. 409 R1

PAY DEDUCTION REGULATION

The district complies with all applicable laws with respect to payment of wages and benefits to employees including laws such as the federal Fair Labor Standards Act and the Iowa Wage Payment Collection Act.  The district will not make pay deductions that violate either the federal or state laws.

Any employee who believes that the district has made an inappropriate deduction or has failed to make proper payment regarding wages or benefits is encouraged to immediately consult with the appropriate supervisor.  Alternatively, any employee may file a formal written complaint with the superintendent.  Within 15 business days of receiving the complaint, the superintendent will make a determination as to whether the pay deductions were appropriate and provide the employee with a written response that may include reimbursement for any pay deductions that were not appropriately made.

This complaint procedure is available in addition to any other complaint process that also may be available to employees.

Date of Adoption:  August 9, 2005

Code No.  409.1

LEAVES OF ABSENCE (ADMINISTRATORS)

Certified employees not covered under the Master Contract shall be granted:

A.  Sick leave:  15 days per year of service.

Sick leave days may be accumulated to a maximum number of days equal to the length of the administrative employee's contract, based upon continuous, uninterrupted service to the district.  For newly employed certified staff who have held similar positions in other districts, up to 1/2 or maximum of 20 days, of their accumulated sick leave may, at the discretion of the board, be transferred. 

B.   Other leave:  Administrative employees may be granted paid leaves of absence upon request and approval of the superintendent

Date of Adoption:  April 25, 1990 
Date of Revision:  August 9, 2005
Date of Revision: May 16, 2006

Code No.  409.2

EMPLOYEE LEAVES OF ABSENCE

The board will offer the following leave to full-time certified employees:
•	Sick Leave Provisions
•	Flexible Leave Days
•	Flexible Leave Bank
•	Bereavement Leave
•	Extended Leave for Death or Serious Illness
•	Association Leave
•	Professional Days
•	Other Leave
•	Extended Leave-Illness or Disability
•	Extended Leave-Other
•	Job Related Injuries
•	Jury Duty
•	Unpaid Leaves of absence 

The board will offer the following paid leave to full-time non-certified employees:
•	Sick Leave Provisions
•	Flexible Leave Days
•	Flexible Leave Bank
•	Bereavement Leave
•	Extended Leave for Death or Serious Illness
•	Jury Duty
•	Staff Development
•	Injury or disability Leave
•	Military Service Leave
•	Unpaid Leaves of absence 
•	Extended Leave-Illness or Disability

The provisions of each leave offering will be detailed in the Master Contract for Certified Staff and in the Support Staff Handbook for Non-Certified Staff.

Leave offered by the district will not be less than what is required by law. In the event of an emergency or unforeseen circumstance, the superintendent may authorize additional paid leave.

Date of Adoption: August 24, 2020

Code No.  409.2E1

EMERGENCY PAID SICK LEAVE REQUEST FORM UNDER THE FAMILIES FIRST CORONAVIRUS RESPONSE ACT (FFCRA)

Name: _______________________________________

Anticipated Begin Date: _________________________

Expected Return to Work Date: ___________________

Employee Request for Leave at Full Pay

Employees satisfying one of the three standards noted below are eligible for two weeks of leave capped at 80 hours paid at the employee's full regular compensation rate. For a part-time employee it is the number of hours equal to the average number of hours that the employee works over a typical two-week period. Please select the applicable reason and follow the related instructions.

I am unable to work or telework for the following reasons:

___I am quarantined pursuant to Federal, State, or local government order.
___I am quarantined on the advice of a health care provider due to COVID-19 concerns.
___I am experiencing COVID-19 symptoms and seeking a medical diagnosis.

Please attach the applicable government order or documentation from medical provider corresponding to the item(s) selected.  If you are experiencing symptoms and seeking a medical diagnosis, please identify your symptoms and the date of your medical appointment.

Employee Request for Leave at 2/3 Pay

Employees satisfying one of the three standards noted below are eligible for two weeks of leave capped at 80 hours paid at the 2/3 of the employee's regular compensation rate. For a part-time employee it is the number of hours equal to the average number of hours that the employee works over a typical two-week period. Please select the applicable reason and follow the related instructions.

I am unable to work or telework for the following reasons:

___ I need to care for an individual subject to quarantine pursuant to Federal, State, or local government order or advice of a health care provider due to COVID-19. I represent that no other person will be providing care for the individual during the period for which the I am receiving Emergency Paid Sick Leave.

Please attach the applicable government order or documentation from medical provider.

___ I am experiencing a substantially similar condition as specified by the Secretary of Health and Human Services, in consultation with the Secretaries of the Treasury and Labor.

Please attach the applicable government order or documentation from medical provider.

___ I am unable to work or telework because I need to care for my child under age 18 because my child's elementary or secondary school, childcare provider, or child's place of care has been closed or is unavailable due to COVID-19. During this period of unavailability or closure, I represent that no other person will be providing care for my child during the period for which I am receiving Emergency Paid Sick Leave.

If the age of one or more of the children is between 14 and 18, the following special circumstances exist requiring me to care for the child during daylight hours:

Please attach notice or documentation related to the unavailability of the school, daycare, place of care or person providing care to the child. The District reserves the right to request confirmation regarding the nature of the closure or unavailability.

lf you are requesting 2/3 paid leave in conjunction with Expanded Family Medical Leave to care for a child under the age of 18 affected by school or care closure due to COVID-19, please complete the “Expanded Family and Medical Leave Request Form’ to submit with this form.

I acknowledge that the above information is true to the best of my knowledge.

Signed ________________

Date __________________

Note:  This type of emergency paid sick leave is only available through passage of the federal Families First Coronavirus Response Act and will expire on December 31, 2020.  After that date, this exhibit should be removed from policy 409.2, as the benefit will no longer be available to employees.

Date of Adoption: August 24, 2020

Code No.  409.2E2

EXPANDED FAMILY AND MEDICAL LEAVE REQUEST FOR UNDER THE FAMILIES FIRST CORONAVIRUS RESPONSE ACT (FFCRA)

Name: _______________________________________

Anticipated Begin Date: _________________________

Expected Return to Work Date: ___________________

Employees may be entitled to expanded family medical leave in accordance with the Families First Coronavirus Response Act (FFCRA) if the employee satisfies eligibility standards.

Reason for Leave

Employees satisfying the standards below are eligible for 12 weeks* of leave. The first two weeks of the leave are unpaid unless the employee selects available options in the next box. The remaining 10 weeks of leave are paid at 2/3 of the employee's regular compensation rate unless other options are selected on this form. Please select the applicable reason and follow the related instructions.

I,                                               , request family and medical leave because I am unable to work or telework because I need to care for my child(ren) under 18 because my child(ren)’s elementary or secondary school, childcare provider, or child’s place of care has been closed or is unavailable due to COVID-19. During this period of unavailability or closure, I represent that no other person will be providing care for my child during the period for which I am receiving expanded family medical leave benefits.

If the age of one or more of the children is between 14 and 18, the following special circumstances exist requiring me to care for the child during daylight hours:                                                                      

Please attach notice or documentation related to the unavailability of the school, daycare, place of care or person providing care to the child. The District reserves the right to request confirmation regarding the nature of the closure or unavailability.

* An employee who qualifies for and utilizes the Emergency Paid Sick Leave provisions of the FFCRA, is entitled to an additional 10 weeks of Emergency FMLA.	

Substitution of Paid Leave for the First Ten Days of Expanded Family Medical Leave

In accordance with the FFCRA, the first ten days of expanded family medical leave is unpaid, however you may be eligible to use Emergency Paid Sick Leave provided through the FFCRA to cover this period at 2/3 of full pay. In the event you have already used Emergency Paid Sick Leave, you are permitted to use available District-provided paid leave to cover this period at full pay. Please indicate if you would like to use paid leave during the first 10 days of your absence and how many hours you plan to use. Requested leave is subject to availability based on confirmation by the School District. If requesting Emergency Paid Sick Leave, please complete and submit an “Emergency Paid Sick Leave Request Form.”

___Emergency Sick Leave     ___Sick Leave    ___Personal Leave
	
Supplement 2/3 Pay with Accrued District Leave

Employees may choose to supplement the 2/3 pay provided through expanded family medical leave with accrued District leave to earn full compensation. Please indicate if you would like to use paid leave during your expanded family medical leave to supplement your 2/3 expanded family medical leave compensation. Requested leave is subject to availability based on confirmation by the District.

___Emergency Sick Leave     ___Sick Leave    ___Personal Leave

After completing the first ten days of expanded family medical leave, an employee may choose to take 10 weeks of continuous leave under expanded family medical leave for the reason indicated above. Continuous leave means the employee will not complete any District duties during this period but will be compensated based on the options selected above.

An employee may also choose to take 10 weeks of intermittent leave only with the District’s permission. Intermittent leave means an employee will complete some District duties on a modified schedule as approved by the employee's supervisor. When using intermittent leave, the employee will receive full regular pay for hours worked and 2/3 of regular pay during periods on expanded family medical leave unless supplemented in a manner noted above.

I am requesting (choose one):
___ continuous leave
___ intermittent leave

If your need for leave is intermittent, please describe the requested schedule for your intermittent leave:

__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

I acknowledge that the above information is true to the best of my knowledge.

Signed ______________________________________________________________

Date ___________________________________________________________________________

Note:  This type of emergency paid sick leave is only available through passage of the federal  Families First Coronavirus Response Act and will expire on December 31, 2020.  After that date, this exhibit should be removed from policy 409.2, as the benefit will no longer be available to employees.

Code No. 410.1

SUBSTITUTE TEACHERS 

The board recognizes the need for substitute teachers.  Substitute teachers shall be certified to teach in Iowa by the Iowa Department of Education.  It shall be the responsibility of the superintendent to maintain a list of substitute teachers who may be called on to replace regular certified personnel.  

Substitute teachers will be paid a daily rate as determined by the board. Normally, substitutes shall be reimbursed at least 1/2 day pay unless other arrangements have been negotiated by the administration.  After ten consecutive teaching days in the same assignment, the substitute teacher shall be paid at a daily rate based on the minimum base salary beginning with the eleventh day of service.

Date of Adoption:  April 25, 1990 
Date of Revision: May 16, 2006

Code No. 410.2

SHARING CERTIFIED PERSONNEL WITH 
NEIGHBORING SCHOOL DISTRICTS 

The board may, in the interest of educational programming and budget considerations, share certified personnel with neighboring districts.

It shall be the responsibility of the superintendent to investigate any such sharing opportunities and make recommendations to the board.

Date of Adoption:  April 25, 1990 
Date of Revision:  January 10, 1995

Code No. 410.3

SUMMER SCHOOL CERTIFIED PERSONNEL	

The board shall determine summer educational program needs, based upon recommendations of the superintendent and administrative team.  Certified staff may volunteer or apply for any summer program they are certified to teach and if employed, shall be compensated in addition to their regular duties during the academic year unless arrangements and compensation were negotiated as a part of their regular duties.

Date of Adoption:  April 25, 1990 

Code No. 410.4

STUDENT TEACHERS AND INTERNSHIPS

Student teachers and interns from accredited post‑secondary educational institutions may be accepted.

Experienced teachers in good standing shall be allowed to have student teachers or student interns, but shall not be required to accept student teachers.

The superintendent has the authority to accept or reject any student teacher applicant.  Post‑secondary institutions providing reimbursements shall reimburse the supervising teachers.

Date of Adoption:  April 25, 1990 
Date of Revision:  January 10, 1995

Code No. 411.1

NON-CERTIFIED PERSONNEL DEFINED

Non‑certified personnel are those district employees who do not require Department of Education certification.  Non-certified personnel positions may be full or part time.

It shall be the responsibility of the superintendent to establish job specifications and job descriptions for non-certified personnel positions.  All such descriptions shall be approved by the board.

Date of Adoption:  April 25, 1990 
Date of Revision: May 16, 2006

Code No. 411.3

NON-CERTIFIED PERSONNEL CONTRACTS 

The board will enter into written contracts with non-certified personnel employed on a regular basis.  The contract shall state beginning and ending dates, total wage for the contract period, and schedule of payments.

The board and the employee must give 2 weeks notice of the intent to cancel the contract except in cases of emergency.

It shall be the responsibility of the superintendent to complete the contracts for non-certified personnel and present them to the board for approval.  The contracts, after being signed by the board president, shall be filed with the board secretary.

Date of Adoption:  April 25, 1990 
Date of Revision:  March 27, 2001

Code No. 411.4

LICENSING/CERTIFYING NON-CERTIFIED STAFF
Non-certified employees who require special license or certification shall keep such licenses up to date at their own expense unless the board has adopted a plan to specifically reimburse the employee for the license.  The requirement for a license or other certification required for a position will be considered met if the employee meets the requirements established by law and by the Department of Education covering the position.

Non-certified personnel must present proof of certification or license to the board secretary prior to payment of salary each year.

Date of Adoption:  April 25, 1990 
Date of Revision: December 8, 1992
Date of Revision: May 16, 2006

Code No. 411.5

ASSIGNMENT OF NON-CERTIFIED STAFF

It shall be the responsibility of the superintendent to make recommendations to the board regarding the assignment of non-certified employees.  The board may approve assignments of non-certified employees for the upcoming year.

Date of Adoption:  April 25, 1990 

Code No. 411.6

TRANSFER OF NON-CERTIFIED PERSONNEL

A transfer may be initiated by the employee, the employee's direct supervisor, the principal, administrative team, or the superintendent.  The superintendent shall make recommendations to the board regarding the transfer of the non-certified employees. All transfers shall be at the discretion of the board and approved by the board.

Date of Adoption:  April 25, 1990 
Date of Revision: December 8, 1992

Code No. 411.7

EVALUATION OF NON-CERTIFIED PERSONNEL

Evaluation of non-certified employees on their skills, abilities, and competence is an ongoing process.  The goal of evaluation is to improve the educational program, to maintain non-certified personnel that meet or exceed board standards of performance, to maintain harmony and positive working relationships, to identify areas needing improvement, and to clarify priorities of the board.

It shall be the responsibility of the superintendent to ensure all job descriptions are kept current and non-certified personnel are evaluated at least annually.

Date of Adoption:  April 25, 1990 
Date of Revision: December 8, 1992
Date of Revision: January 27, 2009

Code No. 411.8

FAMILY AND MEDICAL LEAVE

Unpaid family and medical leave will be granted up to 12 weeks per year (26 weeks for military caregiver leave) to assist employees in balancing family and work life.  For purposes of this policy, year is defined as the school district’s fiscal year (July 1 to June 30).  Requests for family and medical leave shall be made to the superintendent.

Employees may be allowed to substitute paid leave for unpaid family and medical leave by meeting the requirements set out in the family and medical leave administrative rules.  Employees eligible for family and medical leave must comply with the family and medical leave administrative rules prior to starting family and medical leave.  It shall be the responsibility of the superintendent to develop administrative rules to implement this policy.

The requirements stated in the Master Contract between employees in that certified collective bargaining unit and the board regarding family and medical leave of such employees shall be followed.

Date of Adoption: October 11, 1994
Date of Revision: September 8, 2009

Code No: 411.8 R-1

FAMILY AND MEDICAL LEAVE REGULATION
For clarification or guidance, see definitions in Code No. 411.8 R-2.  These regulations supplement, but do not supplant provisions for employees covered by an official Negotiated Agreement.

A.  	School district notice.
1.  	The school district will post the notice in Code No. 411.8 E-1 regarding family and medical leave.
2.  	Information on the Family and Medical Leave Act and the board policy on family and medical leave, including leave provisions and employee obligations will be provided annually. 
3.  	When an employee requests family and medical leave, the school district will provide the employee with information listing the employee's obligations and requirements.  Such information will include:
a.	a statement clarifying whether the leave qualifies as family and medical leave and will, therefore, be credited to the employee's annual 12‑week entitlement or 26 week entitlement, depending on the purpose of the leave;
b.  	a reminder that employees requesting family and medical leave for their serious health condition or for that of an immediate family member must furnish medical certification of the serious health condition and the consequences for failing to do so or proof of call to active duty in case of Military Family and Medical Leave;
c.	an explanation of the employee's right to substitute paid leave for family and medical leave including a description of when the school district requires substitution of paid leave and the conditions related to the substitution; and 
d.  	a statement notifying employees that they must pay and must make arrangements for paying any premium or other payments to maintain health or other benefits.

B.  	Eligible employees.  Employees are eligible for family and medical leave if three criteria are met.
1.  	The school district has more than 50 employees on the payroll at the time leave is requested; 
2.  	The employee has worked for the school district for at least twelve months or 52 weeks (the months and weeks need not be consecutive); and 
3.  	The employee has worked at least 1,250 hours within the previous year. Full‑time professional employees who are exempt from the wage and hour law may be presumed to have worked the minimum hour requirement.
If the employee requesting leave is unable to meet the above criteria, then the employee is not eligible for family and medical leave.

C.  	Employee requesting leave - two types of leave.
1.  	Foreseeable family and medical leave.
a.	Definition ‑ leave is foreseeable for the birth or placement of an adopted or foster child with the employee or for planned medical treatment.
b. 	Employee must give at least thirty days notice for foreseeable leave.  Failure to give the notice may result in the leave beginning thirty days after notice was received.  For those taking leave due to Military Family and Medical leave, notice should be given as soon as possible.
Code No: 411.8 R-1 (Continued)

FAMILY AND MEDICAL LEAVE REGULATION

c.  	Employees must consult with the school district prior to scheduling planned medical treatment leave to minimize disruption to the school district.  The scheduling is subject to the approval of the health care provider.

2.  	Unforeseeable family and medical leave.
a.  	Definition ‑ leave is unforeseeable in such situations as emergency medical treatment or premature birth.
b.  	Employee must give notice as soon as possible but no later than one to two work days after learning that leave will be necessary.
c.  	A spouse or family member may give the notice if the employee is unable to personally give notice.

D. 	Eligible family and medical leave determination.  The school district may require the employee giving notice of the need for leave to provide reasonable documentation or a statement of family relationship.

1.  	Six purposes.
a.  	The birth of a son or daughter of the employee and in order to care for that son or daughter prior to the first anniversary of the child's birth;
b.  	The placement of a son or daughter with the employee for adoption or foster care and in order to care for that son or daughter prior to the first anniversary of the child's placement;
c.  	To care for the spouse, son, daughter or parent of the employee if the spouse, son, daughter or parent has a serious health condition; or 
d. 	Employee's serious health condition that makes the employee unable to perform the essential functions of the employee's position. 
e.	Because of a qualifying exigency arising out of the fact that an employee’s spouse; son or daughter; parent is on active duty status in support of a contingency operation as a member of the National Guard or Reserves.
f.	Because the employee is the spouse; son or daughter; parent; next of kin of a covered service member with a serious injury or illness.
2.	Medical certification.  
a.  	
(1) 	Employees shall be required to present medical certification of the employee's serious health condition and inability to perform the essential functions of the job. 
(2) 	Employees shall be required to present medical certification of the family member's serious health condition and that it is medically necessary for the employee to take leave to care for the family member.
(3)	Employees shall be required to present certification of the call to active duty when taking military family and medical leave.  Employees shall be required to present certification of the call to active duty when taking Military Family and Medical leave.

Code No: 411.8 R-1 (Continued)

FAMILY AND MEDICAL LEAVE REGULATION
b.  	Employee's medical certification responsibilities:
(1) 	The employee must obtain the certification from the health care provider who is treating the individual with the serious health condition. 
(2) 	The school district may require the employee to obtain a second certification by a health care provider chosen by and paid for by the school district if the school district has reason to doubt the validity of the certification an employee submits.  The second health care provider cannot, however, be employed by the school district on a regular basis.
(3) 	If the second health care provider disagrees with the first health care provider, then the school district may require a third health care provider to certify the serious health condition.  This health care provider must be  mutually agreed upon by the employee  and the school district and paid for by the school district.  This certification or lack of certification is binding upon both the employee and the school district.
c.  	Medical certification will be required fifteen days after family and medical leave begins unless it is impracticable to do so.  The school district may request re-certification every thirty days. Re-certification must be submitted within fifteen days of the school district's request.  Family and medical leave requested for the serious health condition of the employee or to care for a family member with a serious health condition which is not supported by medical certification shall be denied until such certification is provided.  
d.	Employees taking military care giver family and medical leave to care for a family service member cannot be required to obtain a second opinion or to provide recertification.
E.  	Entitlement.
1.  	Employees are entitled to twelve weeks unpaid family and medical leave per year.  Employees taking military care giver family and medical leave to care for a family service member are entitled to 26 weeks of unpaid family and medical leave but only in a single 12 month period.
2.  	Year is defined as: the fiscal year (July 1 to June 30).
3. 	If insufficient leave is available, the school district may:
a. 	Deny the leave if entitlement is exhausted 
b.  	Award leave available 
F.  	Type of Leave Requested.
1.  	Continuous - employee will not report to work for set number of days or weeks.
2. 	Intermittent - employee requests family and medical leave for separate periods of time.
a.  	Intermittent leave is available for a serious health condition of the employee, spouse, parent, or child when medically necessary without the school district's agreement; or because of a qualifying exigency arising out of the fact that the spouse, son or daughter, parent is on active duty or called to active duty status in support of a contingency operation as a member of the National Guard or Reserves; or because the employee is the spouse, son or daughter, parent, next of kin of a covered service member with a serious injury or illness.
b. 	In the case of foreseeable intermittent leave, the employee must schedule the leave to minimize disruption to the school district operation.

Code No: 411.8 R-1 (Continued)

FAMILY AND MEDICAL LEAVE REGULATION 

c.  	During the period of foreseeable intermittent leave, the school district may move the employee to an alternative position with equivalent pay and benefits.  

3.  	Reduced work schedule ‑ employee requests a reduction in the employee's regular work schedule.

a.  	Reduced work schedule family and medical leave is available for a serious health condition of the employee, spouse, parent, or child when medically necessary without the school district's agreement; or because of a qualifying exigency arising out of the fact that the spouse, son or daughter, parent is on active duty or called to active duty status in support of a contingency operation as a member of the National Guard or Reserves; or because the employee is the spouse, son or daughter, parent, next of kin of a covered service member with a serious injury or illness.
b.  	In the case of foreseeable reduced work schedule leave, the employee must schedule the leave to minimize disruption to the school district operation.
c.  	During the period of foreseeable reduced work schedule leave, the school district may move the employee to an alternative position with equivalent pay and benefits.  

G.  	Special Rules for Instructional Employees.
1.  	Definition ‑ an instructional employee is one whose principal function is to teach and instruct students in a class, a small group or an individual setting.  This includes, but is not limited to, teachers, coaches, driver's education instructors and special education assistants. 
2.  	Instructional employees who request foreseeable medically necessary intermittent or reduced work schedule family and medical leave greater than twenty percent of the work days in the leave period may be required to:
a.  	Take leave for the entire period or periods of the planned medical treatment; or 
b.  	Move to an available alternative position, with equivalent pay and benefits, but not necessarily equivalent duties, for which the employee is qualified.
3. 	Instructional employees who request continuous family and medical leave near the end of a semester may be required to extend the family and medical leave through the end of the semester.  The number of weeks remaining before the end of a semester do not include scheduled school breaks, such as summer, winter or spring break.
a.  	If an instructional employee begins family and medical leave for any purpose more than five weeks before the end of a semester, the school district may require that the leave be continued until the end of the semester if the leave will last at least three weeks and the employee would return to work during the last three weeks of the semester if the leave was not continued. 

Code No: 411.8 R-1 (cont.)

FAMILY AND MEDICAL LEAVE REGULATION 

b.  	If the employee begins family and medical leave for a purpose other than the employee's own serious health condition during the last five weeks of a semester, the school district may require that the leave be continued until the end of the semester if the leave will last more than two weeks and the employee would return to work during the last two weeks of the semester.
c.  	If the employee begins family and medical leave for a purpose other than the employee's own serious health condition during the last three weeks of the semester and the leave will last more than five working days, the school district may require the employee to continue taking leave until the end of the semester.
4.  	The entire period of leave taken under the special rules is credited as family and medical leave.  The school district will continue to fulfill the school district's family and medical leave responsibilities and obligations, including the obligation to continue the employee's health insurance and other benefits, if an instructional employee's family and medical leave entitlement ends before the involuntary leave period expires.

H.  	Employee responsibilities while on family and medical leave.
1.  	Employee must continue to pay health care benefit contributions or other benefit contributions regularly paid by the employee unless employee elects not to continue the benefits.
2.  	The employee contribution payments will be deducted from any money owed to the employee or the employee shall reimburse the school district at a time set by the superintendent.
3.  	An employee who fails to make the health care contribution payments within thirty days after they are due will be notified that their coverage may be canceled if payment is not received within an additional 15 days.
4.  	An employee may be asked to re-certify the medical necessity of family and medical leave for the serious medical condition of an employee or family member once every thirty days and return the certification within fifteen days of the request.
5.  	The employee must notify the school district of the employee's intent to return to work at least once each month during their leave and at least two weeks prior to the conclusion of the family and medical leave.	
6.  	If an employee intends not to return to work, the employee must immediately notify the school district, in writing, of the employee's intent not to return.  The school district will cease benefits upon receipt of this notification.

I.	An employee may substitute unpaid family and medical leave with any paid leave available to the employee under board policy, individual contracts or the collective bargaining agreement.  Paid leave includes, but is not limited to, sick leave, family illness leave, vacation, flexible leave, bereavement leave and professional leave.  When the school district determines that paid leave is being taken for an FMLA reason, the school district will notify the employee within two business days that the paid leave will be counted as FMLA leave.

Date of Adoption:  October 11, 1994
Date of Revision:  December 12, 1995
Date of Revision: September 8, 2009

Code No: 411.8 R 2

FAMILY AND MEDICAL LEAVE DEFINITIONS

Active Duty – duty under a call or order to active duty under a provision of law referring to in section 101(a)(13) of title 10, U.S. code.
Common law marriage-according to Iowa law, common law marriages exist when there is a present intent by the two parties to be married, continuous cohabitation, and a public declaration that the parties are husband and wife. There is no time factor that needs to be met in order for there to be a common law marriage.
Contingency Operation – has the same meaning given such term in section 10(a)(13) of Title 10, U.S. Code.

Continuing treatment-a serious health condition involving continuing treatment by a health care provider includes any one or more of the following:
•	A period of incapacity (i.e., inability to work, attend school or perform other regular daily activities due to the serious health condition, treatment for or recovery from) of more than three consecutive calendar days and any subsequent treatment or period of incapacity relating to the same condition that also involves:
a.	treatment two or more times by a health care provider, by a nurse or physician's assistant under direct supervision of a health care provider, or by a provider of health care services (e.g., physical therapist) under orders of, or in referral by, a health care provider; or
b.	treatment by a health care provider on at least one occasion which results in a regimen of continuing treatment under the supervision of a the health care provider.
•	Any period of incapacity due to pregnancy or for prenatal care.
•	Any period of incapacity or treatment for such incapacity due to a chronic serious health condition.  A chronic serious health condition is one which:
a	requires periodic visits for treatment by a health care provider or by a nurse or physician's assistant under direct supervision of a health care provider;
b	Continues over an extended period of time (including recurring episodes of a single underlying condition); and
c	May cause episodic rather than a continuing period of incapacity (e.g., asthma, diabetes, epilepsy, etc.).
•	Any period of incapacity which is permanent or long-term due to a condition for which treatment may not be effective.  The employee or family member must be under the continuing supervision of, but need not be receiving active treatment by, a health care provider.  Examples include Alzheimer's, a severe stroke or the terminal stages of a disease.
•	Any period of absence to receive multiple treatments (including any period of recovery from) by a health care provider or by a provider of health care services under orders of, or on referral by, a health care provider, either for restorative surgery after an accident or other injury, or for a condition that would likely result in a period of incapacity of more than three consecutive calendar days in the absence of medical intervention or treatment, such as cancer (chemotherapy, radiation, etc.), severe arthritis (physical therapy), kidney disease (dialysis).
Covered Service Member – 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 
Code No: 411.8 R 2 (Continued)

FAMILY AND MEDICAL LEAVE DEFINITIONS
otherwise in outpatient status, or is otherwise on the temporary disability retired list, for a serious injury or illness.

Eligible Employee - the district has more than 50 employees on the payroll at the time leave is requested.  The employee has worked for the district for at least twelve months and has worked at least 1250 hours within the previous year.

Essential Functions of the Job - those functions which are fundamental to the performance of the job.  It does not include marginal functions.

Employment benefits - all benefits provided or made available to employees by an employer, including group life insurance, health insurance, disability insurance, sick leave, annual leave, educational benefits, and pensions, regardless of whether such benefits are provided by a practice or written policy of an employer or through an "employee benefit plan."

Family Member - individuals who meet the definition of son, daughter, spouse or parent.

Group Health Plan - any plan of, or contributed to by, an employer (including a self‑insured plan) to provide health care (directly or otherwise) to the employer's employees, former employees, or the families of such employees or former employees.

Health care provider - 
*	A doctor of medicine or osteopathy who is authorized to practice medicine or surgery by the state in which the doctor practices; or
*	Podiatrists, dentists, clinical psychologists, optometrists, and Chiropractors (limited to treatment consisting of manual manipulation of the spine to correct a subluxation as demonstrated by X-ray to exist) authorized to practice in the state and performing within the scope of their practice as defined under state law; and 
*	Nurse practitioners and nurse‑midwives, and clinical social workers who are authorized to practice under state law and who are performing within the scope of their practice as defined under state law; and
*	Christian Science practitioners listed with the First Church of Christ, Scientist in Boston, Massachusetts.
*	Any health care provider from whom an employer or a group health plan's benefits manager will accept certification of the existence of a serious health condition to substantiate a claim for benefits;
*	A health care provider as defined above who practices in a country other than the United States who is licensed to practice in accordance with the laws and regulations of that country.

In loco parentis - individuals who had or have day-to-day responsibilities for the care and financial support of a child not their biological child or who had the responsibility for an employee when the employee was a child.

Code No: 411.8 R 2 (Continued)

FAMILY AND MEDICAL LEAVE DEFINITIONS

Incapable of self-care - that the individual requires active assistance or supervision to provide daily self-care in several of the "activities of daily living" or "ADLs."  Activities of daily living include adaptive activities cycle as caring appropriately for one's grooming and hygiene, bathing, dressing, 
eating, cooking, cleaning, shopping, taking public transportation, paying bills, Maintaining a residence, using telephones and directories, using a post office, etc.

Instructional employee - an employee employed principally in an instructional capacity by an educational agency or school whose principal function is to tackle and instruct students in a class, a small group, or an individual setting, and includes athletic coaches, driving instructors, and special education assistants such as signers for the hearing impaired.  The term does not include teacher 
assistants or aides who do not have as their principal function actual teaching or instructing, nor auxiliary personnel such as counselors, psychologists, curriculum specialists, cafeteria workers, maintenance workers, bus drivers, or other primarily non instructional employees.

Intermittent leave - leave taken in separate periods of time due to a single illness or injury, rather than for one continuous period of time, and may include leave or periods from an hour or more to several weeks.

Medically Necessary - certification for medical necessity is the same as certification for serious health condition.

"Needed for Care For" - the medical certification that an employee is "needed to care for" a family member encompasses both physical and psychological care. for example, where, because of a serious health condition, the family member is unable to care for his or her own basic medical, hygienic or nutritional needs or safety or is unable to transport himself or herself to medical treatment.  It also includes situations where the employee may be needed to fill in for others who are caring for the family member or to make arrangements for changes in care.

Next of Kin – an individual’s nearest blood relative.

Outpatient Status –the status of a member of the Armed Forces assigned to 
1. Either a military 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.
Parent - a biological parent or an individual who stands in loco parentis to a child or stood in loco parentis to an employee when the employee was a child.  Parent does not include parent-in-law.

Physical or mental disability - a physical or mental impairment that substantially limits one or more of the major life activities of an individual.

Reduced leave schedule - a leave schedule that reduces the usual number of hours or workweek, or hours per workday, of an employee.

Code No: 411.8 R 2 (Continued)

FAMILY AND MEDICAL LEAVE DEFINITIONS

Serious health condition  An illness, injury, impairment, or physical or mental condition that involves:
1	Inpatient care (i.e. an overnight stay) in a hospital, hospice or residential medical care facility including any period of incapacity. (for purposes of this section, defined to mean inability to work, attend school or perform other regular daily activities due to the serious health condition, treatment for or recovery from), or any subsequent treatment in connection with such inpatient care; or 

2	Continuing treatment by a health care provider.  A serious health condition involving continuing treatment by a health care provider includes:  A period of incapacity (i.e., inability to work, attend school or perform other regular daily activities due to the serious health condition, treatment for or recovery from) of more than three consecutive calendar days, including any subsequent treatment or period of incapacity relating to the same condition, that also involves:  
	Treatment two or more times by a health care provider, by a nurse or physician's assistant under direct supervision of a health care provider, or by a provider of health care services (e.g., physical therapist) under orders or, or on referral by, a health care provider; or 
	Treatment by a health care provider on at least one occasion which results in a regimen of continuing treatment under the supervision of the health care provider.
3	Any period of incapacity due to pregnancy or for prenatal care.
4	Any period of incapacity or treatment for such incapacity due to a chronic serious health condition.  A chronic serious health condition is one which:
	Requires periodic visits for treatment by a health care provider or by a nurse or physician's assistant under direct supervision of a health care provider;
	Continues over an extended period of time (including recurring episodes of s single underlying condition); and
	May cause episodic rather than a continuing period of incapacity (e.g., asthma, diabetes, epilepsy, etc.).
5-	A period of incapacity which is permanent or long-term due to a condition for which treatment may not be effective.  The employee or family member must be under the continuing supervision of, but need not be receiving active treatment by, a health care provider.  Examples include Alzheimers, a severe stroke, or the terminal stages of a disease.
6	Any period of absence to receive multiple treatments (including any period of recovery from) by a health care provider or by a provider of health care services under orders of, or on referral by, a health care provider, either for restorative surgery after an accident or other injury, or for a condition that would likely result in a period of incapacity of more than three consecutive calendar days in the absence of medical intervention or treatment, such as cancer (chemotherapy, radiation, etc.), severe arthritis (physical therapy), kidney disease (dialysis).

Code No: 411.8 R 2 (Continued)

FAMILY AND MEDICAL LEAVE DEFINITIONS

7	Treatment for purposes of this definition includes, but is not limited to, examinations to determine if a serious health condition exists and evaluation of the condition.  Treatment does not include routine physical examinations, eye examinations or dental examinations.  Under this definition, a regimen of continuing treatment includes, for example, a course of prescription medication (e.g., an antibiotic) or therapy requiring special equipment to resolve or alleviate the health condition (e.g., oxygen).  A regimen of continuing treatment that includes the taking of over-the-counter medications such as aspirin, antihistamines, or salves; or bed rest, drinking fluids, exercise and other similar activities that can be initiated without a visit to a health care provider, is not, by itself, sufficient to constitute a regimen of continuing treatment for purposes of FMLA leave.
8	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.  Ordinarily, unless complications arise, the 
common cold, the flu, ear aches, upset stomach, ulcers, headaches other than migraine, routine dental or orthodontia problems, periodontal disease, etc., are examples of conditions that do not meet the definition of a serious health condition and do not qualify for FMLA leave.  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 resulting from stress or allergies may be serious health conditions, but only if all the conditions of this section are met.
9	Substance abuse may be a serious health condition if the conditions of this section are met.  However, FMLA leave may only be taken for treatment for substance abuse by a
health care provider or by a provider of health care on referral by a health care provider.  On the other hand, absence because of the employee's use of the substance, rather than for treatment, does not qualify for FMLA leave.
10	Absence attributable to incapacity under this definition qualify for FMLA leave even though the employee or the immediate family member does not receive treatment from a health care provider during the absence, and even if the absence does not last more than three days.  For example, an employee with asthma may be unable to report for work due to the onset of an asthma attack or because the employee's health care provider has advised the employee to stay home when the pollen count exceeds a certain level.  An employee who is pregnant may be unable to report to work because of severe morning sickness.

Serious injury or Illness – an injury or illness incurred by a member of the Armed forces or Reserves in the line of duty on active duty in the Armed Forces that may render the member medically unable to perform the duties of the member’s office, grade, or rating.

Son or daughter - a biological child, adopted child, foster child, stepchild, legal ward, or a child of a person standing in loco parentis.  The child must be under age 18 or, if over 18, incapable of self‑care because of a mental or physical disability.

Spouse - a husband or wife recognized by Iowa law including common law marriages.
Date of Adoption:  October 11, 1994
Date of Revision:  December 12, 1995
Date of Revision: September 8, 2009

Code No. 411.8 E2

FAMILY AND MEDICAL LEAVE NOTICE TO EMPLOYEES

YOUR RIGHTS UNDER THE FAMILY AND MEDICAL LEAVE ACT OF 1993

FMLA requires covered employers to provide up to 12 weeks of unpaid, job-protected leave to "eligible" employees for certain family and medical reasons. Employees are eligible if they have worked for a covered employer for at least one year, and for 1,250 hours over the previous 12 months, and if there are at least 50 employees within 75 miles.

REASONS FOR TAKING LEAVE,: Unpaid leave must be granted for any of the following reasons:
*	to care for the employee's child at birth, or placement for adoption or foster care;
*	to care for the employee's spouse, son or daughter, or parent, who has a serious health condition; or
*	for a serious health condition that makes the employee unable to perform the employee's job.

ADVANCE NOTICE AND MEDICAL CERTIFICATION: The employee may be required to provide advance leave notice and medical certification. Taking of leave may be denied if requirements are not met.
*	The employee ordinarily must provide 30 days advance notice when the leave is foreseeable.
*	An employer may require medical certification to support a request for leave because of a serious health condition, and may require second or third opinions (at the employer's expense) and a fitness for duty report to return to work.

JOB BENEFITS AND PROTECTION:
*	For the duration of FMLA leave, the employer must maintain the employee's health coverage under any group health plan.  Upon return from FMLA leave, most employees must be restored to their original or equivalent positions with equivalent pay, benefits, and other employment terms.
*	The use of FMLA leave cannot result in the loss of any employment benefit that accrued prior to the start of an employee's leave.

UNLAWFUL ACTS BY EMPLOYERS:  FMLA makes it unlawful for any employer to:
*	interfere with, restrain, or deny the exercise of any right provided under FMLR;
*	discharge or discriminate against any person for opposing any practice made unlawful by FMLA or for involvement in any proceeding under or relating to FMLA.

ENFORCEMENT:
*	The U.S. Department of Labor is authorized to investigate and resolve complaints of violations.
*	An eligible employee may bring a civil action against an employer for violations.

FMLA does not affect any Federal or State law prohibiting discrimination, or supersede any State or local law or collective bargaining agreement which provides greater family or medical leave rights.

FOR ADDITIONAL INFORMATION: Contact the nearest office of the Wage and Hour Division, listed in most telephone directories under U.S. Government, Department of Labor. 

Code No.  411.8 E3

FAMILY AND MEDICAL LEAVE CERTIFICATION FORM

U.S. Department of Labor
Employment Standards Administration
Wage and Hour Division

CERTIFICATION OF PHYSICIAN OR PRACTITIONER
(Family and Medical Leave Act of 1993)

1.	Employee's Name:

2. 	Patient's Name (If other than employee):

3.	The attached sheet describes what is meant by a "serious health condition" under the Family and Medical Leave Act.  Does the patient's condition, for which the employee is taking FMLA leave, qualify under any of the categories described?  If so, please check the applicable category.

	(1)____ (2)____ (3)____(4)____(5)____ (6)____	or ____ None of the above

4.	Describe the medical facts which support your certification, including a brief statement as to how the medical facts meet the criteria of one of these categories:

5.	
a.	State the approximate date the condition commenced, and the probable duration of the condition (and also the probable duration of the patient's present incapacity, i.e. inability to work, attend school or perform other regular activities due to the serious health condition, treatment therefore, or recovery there from, if different):

b.	Will it be necessary for the employee to take work only intermittently or to work on a less than full schedule as a result of the condition (including for treatment described in Item 6 below)?

		If yes, give the probable duration:

c.	If the condition is a chronic condition (condition #4) or pregnancy, state whether the patient is presently incapacitated.

6.	
a.	If additional treatments will be required for the condition, provide an estimate of the probable number of such treatments:

		If the patient will be absent from work or other daily activities because of treatment on an intermittent or part-time basis, also provide an estimate of the probable number of and interval between such treatments, actual or estimated dates of treatment if known, and period required for recovery if any:

(continued) Code No.  411.8 E-3

FAMILY AND MEDICAL LEAVE CERTIFICATION FORM

b.	If any of these treatments will be provided by another provider of health services (e.g., physical therapist), please state the nature of the treatments:

c.	If a regimen of continuing treatment by the patient is required under your supervision, provide a general description of such regimen (e.g. prescription drugs, physical therapy requiring special equipment):

7.	
a.	If medical leave is required for the employee's absence from work because of the employee's own condition (including absences due to pregnancy or a chronic condition), is the employee unable to perform work of any kind?

b.	If able to perform some work, is the employee unable to perform any one or more of the essential functions of the employee's job (the employee or the employer should supply you with information about the essential job functions)?

If yes, please list the essential functions the employee is unable to perform.

c.	If neither a. nor b. applies, is it necessary for the employee to be absent from work for treatment?

8.	
a.	If leave is required to care for a family member of the employee with a serious health condition, does the patient require assistance for basic medical or personal needs or safety, or for transportation?

b.	If no, would the employee's presence to provide psychological comfort be beneficial to the patient or assist in the patient's recovery?

c.	If the patient will need care only intermittently or on a part-time basis, please indicate the probable duration of this need:

	___________________________________ 	_____________________________
	(Signature of Health Care Provider)	(Type of Practice)

	___________________________________ 	_____________________________
	(Address)	(Telephone Number

Code 411.8 E4

FAMILY AND MEDICAL LEAVE REQUEST FORM

Date _____________________	Name _________________________________

I request family and medical leave for the following reason:  (check all that apply)

____	for the birth of my child; for the placement of a child for adoption or foster care;
____ 	to care for my child who has a serious health condition; 
____ 	to care for my parent who has a serious health condition; 
____ 	to care for my spouse who has a serious health condition; or 
____	because I am seriously ill and unable to perform the essential functions of my position.

I acknowledge my obligation to provide medical certification of my serious health Condition or that of a family member in order to be eligible for family and medical leave within 15 days of the request for certification.

I acknowledge receipt of information regarding my obligations under the family and medical leave policy of the school district.

I request that my family and medical leave begin on ________________ and I request leave as follows: (check one)
 ____	Continuous I anticipate that I will be able to return to work on _________________.

____	Intermittent leave for the serious health condition of myself, parent, or child when medically necessary

Details of the needed intermittent leave:
______________________________________________________________________________________________________________________________________________________________________________________________________

I anticipate returning to work at my regular schedule on ____________________.

____	reduced work schedule for the serious health condition of myself, parent, or child when medically necessary

Details of needed reduction in work schedule as follows:
________________________________________________________________________________________________________________________________________________________________________________________________________________________

I realize I may be moved to an alternative position during the period of the family and medical intermittent or reduced work schedule leave.  I also realize that with foreseeable intermittent or reduced work schedule leave, subject to the requirements of my health care provider, I may be required to schedule the leave to minimize school district operations.

(continued) Code No. 411.8 E4

FAMILY AND MEDICAL LEAVE REQUEST FORM

While on family and medical leave, I agree to pay my regular contributions to employer sponsored benefit plans.  My contributions shall be deducted from mails owed me during the leave period.  If no monies are owed me, I shall reimburse the school district by personal check (cash) for my contributions.  I understand that I may be dropped from the employer‑sponsored benefit plans for failure to pay my contribution.

I agree to reimburse the school district for any payment of my contributions with deductions from future monies owed to me or the school district may seek reimbursement of payments of my contributions in court.

I acknowledge that the above information is true to the best of my knowledge.

Signed  ____________________________

Date  _____________________________

Date of Adoption:  October 11, 1994
Date of Revision:  December 12, 1995
Date of Revision: September 8, 2009	

(continued) Code No. 411.8 E4

EMPLOYEE FAMILY AND MEDICAL LEAVE CERTIFICATION FORM

A serious health condition means an illness, injury impairment, or physical or mental condition that involves one of the following:

1	Hospital Care – In patient care (i.e. an overnight stay) in a hospital, hospice, or residential medical care facility, including any period of incapacity or subsequent treatment in connection with or consequent to such inpatient care.

2.	Absence Plus Treatment – A period of incapacity of more than three consecutive calendar days (including any subsequent treatment or period of incapacity relating to the same condition), that also involves:
a.	treatment two or more times by a health care provider, by a nurse or physician’s assistant under direct supervision of a health care provider or by a provider of health care services (e.g. physical therapist) under the orders of, or on referral by, a health care provider; or
b.	treatment by a health care provider on at least one occasion which results in a regimen of continuing treatment under the supervision of the health care provider.

3.	Pregnancy – Any period of incapacity due to pregnancy or for prenatal care.

4.	Chronic Conditions Requiring Treatments – A chronic condition which:
a.	requires periodic visits for treatment by a health care provider, or by a nurse or physician’s assistant under direct supervision of a health care provider;
b.	continues over an extended period of time (including recurring episodes of a single underlying condition); and
c.	may cause episodic rather than a period of incapacity (e.g. asthma, diabetes, epilepsy, etc.).

6.	Permanent/Long-term Conditions Requiring Supervision – A period of incapacity which is permanent or long-term due to a condition for which treatment may not be effective.  The employee or family member must be under the continuing supervision of, but need not be receiving active treatment by a health care provider.  Examples include Alzheimer’s, a severe stroke, or the terminal stages of a disease.

7.	Multiple Treatments (Non-chronic Conditions) – Any period of absence to receive multiple treatments (including any period of recovery therefrom) by a health care provider or by a provider of health care services under orders of, or on referral by, a health care provider, either for restorative surgery after an accident or other injury, or for a condition that would likely result in a period of incapacity of more than three consecutive calendar days in the absence of medical intervention or treatment such as cancer (chemotherapy), radiation, etc.), severe arthritis (physical therapy) and kidney disease (dialysis).

(continued) Code 411.8 E4

EMPLOYEE FAMILY AND MEDICAL LEAVE CERTIFICATION FORM

7.   Regiment of treatment to be prescribed (indicate number of visits, general nature and duration of treatment, including referral to other provider of health services. Include schedule of visits or treatment if it is medically necessary for the employee to be off work on an intermittent basis or to work less than the employee's normal schedule of hours per day or days per week.):

a. By Physician or Practitioner:

b. By another provider of health services, if referred by Physician or Practitioner:

IF THIS CERTIFICATION RELATES TO CARE FOR THE EMPLOYEE'S SERIOUSLY ILL FAMILY MEMBER, SKIP ITEMS 7, 8, AND 9 AND PROCEED TO ITEMS 10 THROUGH 14 ON THE REVERSE SIDE.  OTHERWISE, CONTINUE BELOW.

Check Yes or No in the boxes below, as appropriate.

	Yes	No
8.	__	__	Is inpatient hospitalization of the employee required?

9.	__	__	Is employee able to perform work of any kind? (1f "No", skip Item 9 )

10.	__	__	Is employee able to perform the functions of employee's position? (Answer after reviewing statement from employer of essential functions of employee's position, or, if none provided, after discussing with employee.)

(continued) Code 411.8 E4

EMPLOYEE FAMILY AND MEDICAL LEAVE CERTIFICATION FORM

FOR CERTIFICATION RELATING TO CARE FOR THE EMPLOYEE'S SERIOUSLY ILL FAMILY MEMBER, COMPLETE ITEMS 11 THROUGH 15 AS THEY APPLY TO THE FAMILY MEMBER.

	Yes	No
11.	__	__	Does (or will) the patient require assistance for basic medical, hygiene, nutritional needs,. safety or transportation?

12.	__	__	Does (or will) the patient require assistance for basic medical, hygiene, nutritional needs,. safety or transportation?

13.	__	__	After review of the employee's signed statement (~ Item 14 below), is the employee's presence necessary or would it be beneficial for the care of the patient? (This may include psychological comfort.)

14.	Estimate the period of time care is needed or the employee's presence would be beneficial:

Item 15 is to be completed by the employee needing family leave

15. 	When Family Leave is needed to care for a seriously-ill family member, the employee shall state the care he or she will provide and an estimate of the time period during which this care will be provided, including a schedule if leave is to be taken intermittently or on a reduced leave schedule:

16. 	Signature of Physician or Practitioner

17.	 Date

18. Type of Practice (Field of Specialization, if any):

Employee signature:						

Date:								

(continued) Code 411.8 E4

FAMILY AND MEDICAL LEAVE REQUEST WORK SHEET

Complete this work sheet upon receiving a request for family and medical leave that may qualify under the Family Medical Leave Act.  Be sure to note the requirements relating to family and medical leave in the school district's policy collective bargaining agreement prior to relying on this work sheet as the sole source of the school district's obligations.  Also be sure to note the definitions in Code No: 411.8 R 2.

Section I:  Eligible Employee.  (Please check all that apply.)
____	Covered by a policy/collective bargaining agreement.  (If checked, please move to Section II.)

____	The employee must meet all criteria below to move to Section II.

____	50 or more employees are on the payroll of or under contract to the school district.
____	Worked 52 weeks in the school district (consecutive or non consecutive). OR
____	Worked 12 months in the school district (consecutive or non consecutive).
____	Worked 1250 hours for the school district in 12 months prior to the request.  Full‑time professional employees who are exempt from the wage and hour law may be presumed to have worked the minimum hours required.

Section II:  Family and Medical Leave Purpose. (One must be checked to move to Section III.)
____	Birth and care of newborn prior to first anniversary of child's birth.

____	Care of adopted child or foster care child prior to first anniversary of placement.

____	Care for serious health condition of spouse, child, child for which employee is "in loco parentis" and for any of these if they are over eighteen and have a disability which prevents the child from caring for himself or herself.
____	Requested medical certification for family and medical leave due to a serious health condition of the spouse, parent or child on                    (date).

____	Received medical certification within 15 days of the request on                 (date).

____	Serious health condition of the employee.

____	Requested medical certification for family and medical leave due to a serious health condition of the employee on                 (date).

____	Received medical certification within 15 days of the request on                  (date).

____	Other purposes contained in a policy/collective bargaining agreement.

Section III:  Timing of Family and Medical Leave Request.
____	Date of family and medical leave request	(date).
____	Date family and medical leave to begin	(date).
____	Provide FMLA leave information to employee at time of request                        (date) .

(continued) Code 411.8 E4

FAMILY AND MEDICAL LEAVE REQUEST WORK SHEET

(If one is checked, please move to Section IV)
____	Leave request for foreseeable family and medical leave is 30 days prior to date family and medical leave begins.
____	 Leave request for foreseeable family and medical leave is in compliance with policy/collective bargaining agreement.
____	Leave request for foreseeable family and medical leave was made as soon as practicable, and no later than one business day, prior to date family and medical leave begins.
____	Leave request for unforeseeable family and medical leave was made in accordance with the policy/collective bargaining agreement timelines.

Section IV:  Calculation of Available Family and Medical Leave.
Beginning date for 12-month entitlement period is July 1  (fiscal year)
Total family and medical leave for the 12‑month entitlement period  12 weeks 
Leave taken to date in the entitlement period  __________
Leave available for the entitlement period      ___________
If sufficient family and medical leave is available and the employee qualifies for family and medical leave, the family and medical leave will be granted in accordance with the policy and/or collective bargaining agreement.  The employee must be informed that the actual family and medical leave taken will be credited to the employee's 12-week entitlement.  If both spouses are employed by the school district, they may only take a combined total of 12 weeks during the entitlement period for the birth and(adoption, or foster care placement prior to the first anniversary of child's birth or placement and for the care of a parent with a serious health condition.   If insufficient family and medical leave is available the school district may award only the family and medical leave available or award the family and medical leave in accordance with other provisions of the policy/collective bargaining agreement.

Section V:  Types of Family and Medical Leave.  (Please check‑ all that apply.)
____	Continuous leave for purposes listed in Section II.
____	Intermittent leave if medically necessary for serious health condition of employee or family member and arranged as much as possible to not disrupt the school district's operation.
____	Reduced work schedule leave if medically necessary for serious health condition of employee or family member and arranged as much as possible to not disrupt the school district's operation.
____	Others contained in a policy/collective bargaining agreement.  (Please specify) ________________________________________________________________________
	________________________________________________________________________

Section VI:  Instructional employee Intermittent or Reduced Schedule Leave.
____	Instructional employees' intermittent or reduced schedule leave for greater than 20 percent of the work days in the family and medical leave period.

Total number of days during leave period 	_________________
	times    20
20 percent of leave days	_________________
Days of leave requested	_________________
(continued) Code 411.8 E4

FAMILY AND MEDICAL LEAVE REQUEST WORK SHEET

If the number of days requested exceeds 20 percent of the family and medical leave days, the school district may require the instructional employee to take family and medical leave for the entire leave period or transfer the instructional employee to an alternate position with equivalent pay and benefits.  The employee must be informed that the actual family and medical leave taken will be credited to the employee's 12-week entitlement.

Section VII:  Instructional Employee Family and Medical Leave Special Rule.
____	Instructional employee.
____	The school district can require the employee to remain on family and medical leave until end of the semester if each of the following apply:

____	Leave begins prior to five weeks before end of semester;
____	Leave is for three weeks or more; and
____	Employee will return during last three weeks of semester.

Last work day of the semester 	__________________
Date of fifth week before end of the semester	__________________
Date of third week before end of the semester	__________________

Date of requested leave	__________________
Length of requested leave	__________________
Date of return from leave	__________________

____	The school district can require employee to remain on family and medical leave for leave other than an employee's serious health condition until end of semester if each of the following apply:

____	Leave begins during last five weeks before end of semester;  
____	Leave is greater than two weeks; and 
____	Employee will return during last two weeks of semester.

Last work day of the semester	__________________
Date of fifth week before end of the semester	__________________
Date of second week before end of the semester	__________________

Date of requested leave	__________________
Length of requested leave	__________________
Date of return from leave	__________________
____	The school district can require the employee to remain on family and medical leave for purpose other than an employee's serious health condition until the end of the semester if each of the following apply:

____	Leave begins during last three weeks before end of the semester; and 
____	Leave is greater than five working days.

Last work day of the semester	__________________
(continued) Code 411.8 E4

FAMILY AND MEDICAL LEAVE REQUEST WORK SHEET

Date of third week before end of the semester	__________________

Date of requested leave	__________________
Length of requested leave	__________________

The employee must be informed that the actual family and medical leave taken under these rules will be credited to the employee's 12-week entitlement.

Section VIII:  Paid or Unpaid Family and Medical Leave.
____	Provide employee notice whether the family and medical leave is paid or unpaid leave after completing the work sheet in accordance with the policy/collective bargaining agreement.

____	Family and medical leave is unpaid leave.

Section IX:  Employee Progress Report.
____	Arrangements are made with the employee to report to the school district on a regular basis during the family and medical leave (please specify). ______________________________________
	________________________________________________________________________

____	Requested medical re-certification for family and medical leave due to a serious health condition of the spouse, parent or child on                         (date).

____	Received medical re-certification within 15 days of the request on                 (date).

Section X:  Employee Benefits During Family and Medical Leave.
The employee's health insurance coverage must be continued during the period of family and medical leave.  The school district may choose to continue other employee benefits to ensure their restoration along with the health insurance upon the employee's return to work.  The employee will pay the employee's share of health insurance and other benefits during the leave period.

____	Arrangements have been made with the employee to continue the employee's share of health insurance premiums while on family and medical leave:
____	From monies due to the employee
____	By the first of each month from the employee
____	Other (please specify)
____	Arrangements have been made with the employee to continue the employee's share of the employee's other benefits while on family and medical leave:
____	From monies due to the employee
____	By the first of each month from the employee
____	Other (please specify)
____	The employee has chosen to discontinue all employee benefits while on family and medical leave.

(continued) Code 411.8 E4

FAMILY AND MEDICAL LEAVE REQUEST WORK SHEET

____	Employees who fail to provide payment of the employee's share of benefits premium during the period of family and medical leave have 15 days following notice to pay the employee's share.
____	Employees who fail to pay within 15 days after receiving notice of payment due may have employee benefits discontinued.
____	The school district will deduct unpaid employee portion of benefits from monies due to the employee upon return to work, and the employee has signed a written statement authorizing the deduction.
____	The school district will seek recovery of unpaid employee portion of benefits through small claims court or other appropriate recovery process.

Even if the employee chooses to discontinue employee benefits during the period of family and medical leave, the school district should exercise great care before discontinuing employee benefits.  The school district is required to restore the employee to full benefits when the employee returns to work, including group health insurance, without any qualifying period, physical examination, exclusion of pre-existing conditions and other similar requirements..

____	The school district may discontinue the employee's benefits upon receipt of written notice of the employee's intent not to return to work.

Section  XI:  Key Employees
____	Salaried employees among the highest paid ten percent of a school district's employees are considered key employees of the school district.
Year‑to‑date earnings for employ	__________________
Total weeks of work and paid leave  	__________________
Highest pay for employee  	__________________

____	Provide notice to key employees stating they are a key employee and they may not be reinstated at end of the family and medical leave period if substantial and grievous economic injury exists.
____	Compile data to justify substantial and grievous economic injury. Substantial and grievous economic injury does not include minor inconvenience and costs typical to the normal operation of the school district.
____	The key employee is entitled to benefits during the family and medical leave in the same manner as other employees.

Section XII:  Employee's Return to Work.
____	Employee is fully restored the same or an equivalent position with:

____	Pay and benefits 	____	Health insurance	
____	Life insurance ___	Other benefits or requirements in a policy collective bargaining agreement
Date of Adoption:  October 11, 1994
Date of Revision:  December 12, 1995
Date of Revision: September 8, 2009

Code No. 412.1

NON-CERTIFIED PERSONNEL SALARY

The board shall establish wages for each non-certified/non-exempt employee compensated on an hourly basis considering such factors as the budget of the district, the mission of the district, the experience of the employee, training required for the position, and other consideration deemed relevant by the board.  These employees, whether full or part-time, permanent or temporary, will be paid no less than the prevailing minimum wage.  

Each non-certified/non-exempt employee, paid on an hour-by-hour basis, must complete, sign, and turn in a daily time record showing the actual number of hours worked.  Failure of the employee to maintain or falsification of a daily time record will be grounds for disciplinary action or discharge.

Whenever a non-certified/non-exempt employee must work more than 40 hours in a given work week, that person is compensated at one and a half (1-1/2) times their regular hourly wage rate.  This compensation is in the form of overtime pay or compensatory time.  Overtime will not be permitted without prior authorization of the supervisor.  

It is the responsibility of the board secretary to maintain wage records.

The superintendent shall make a recommendation to the board annually regarding wage for non-certified positions.  The board may, based upon recommendation of the superintendent, withhold wage increases due to budget or disciplinary reasons.

Date of Adoption:  April 25, 1990 
Date of Revision: December 8, 1992
Date of Revision:  March 27, 2001
Date of Revision:  August 9, 2005

Code No. 412.2

INSURANCE/HEALTH NON-CERTIFIED STAFF  

Classified employees may be eligible for group benefits as determined by the board and required by law.  The board will select the group benefit program(s) and the insurance company or third party administrator which will provide or administer the program. 

In accordance with the Patient Protection and Affordable Care Act (ACA), the board will offer classified employees who work an average of at least thirty (30) hours per week or one hundred thirty (130) hours per month, based on the “look back method” measurement method adopted by the board, with minimum essential coverage that is both affordable and provides minimum value.  The board will have the authority and right to change or eliminate group benefit programs, other than the group health plan, for its licensed employees.

Classified employees who work an average of at least (30) hours per week or one hundred thirty (130) hours per month, based on the measurement method adopted by the board, are eligible to participate in the group health plan. Classified employees who work 30 hours per week are eligible to participate in vision, dental, life and LTD group insurance plans.  Employers should maintain documents regarding eligible employee’s acceptance and rejection of coverage.  

Regular part-time classified employees (i.e., employees who work less than 30 hours per week or 130 hours per month for health benefit purposes or employees who work less than 30 hours per week for benefits (other than health) who wish to purchase coverage may participate in group benefit programs by meeting the requirements of the applicable plan.  Full-time and regular part-time classified employees who wish to purchase coverage for their spouse or dependents may do so by meeting the requirements of the applicable plan.  

Upon retirement, non-certified personnel and their spouse and dependents, who are eligible, shall be allowed to continue coverage in the school district group health insurance program at their own expense until Medicare age by meeting the requirements of the insurer with proper notification and submitted resignation.
 
Date of Adoption:  April 25, 1990 
Date of Revision: December 8, 1992
Date of Revision:  January 25, 1994
Date of Revision:  March 27, 2001
Date of Revision: April 27, 2015

Code No. 412.3

TAX SHELTER FOR NON-CERTIFIED PERSONNEL

The board authorizes the administration to make a payroll deduction for non-certified personnel's tax shelter annuity premiums from the companies or program chosen by the board and collective bargaining unit.

Non-certified employees wishing to have payroll deductions for tax shelter annuities shall make written request to the superintendent 30 days prior to the regular payroll date of appropriate remittance.

Date of Adoption:  April 25, 1990    
Date of Revision: January 27, 2009

	Code No. 412.4

NON-CERTIFIED PHYSICAL EXAMINATIONS

Physical examinations shall be required of all employees upon their initial employment. Evidence shall be on a prescribed form supplied by the district and shall be due in the superintendent's office no later than three weeks after the beginning of employment. School bus drivers will present evidence of good health every other year unless required by law or medical opinion.    

Food service employees shall have such examinations on file before employment commences.

The cost of the physical examination and tuberculosis test not reimbursed by the insurance company shall be reimbursed up to a maximum of $50.00.

Employees may be required to have additional examinations (physical and/or mental) when, in the judgment of the superintendent, administrative team, or the board, such examinations are relevant to the employees' performance or status.

Date of Adoption: April 25, 1990    
Date of Revision:  January 10, 1995
Date of Revision:  September 14, 2004
Date of Revision:  November 15, 2005
Date of Revision: May 16, 2006

Code No. 413.1

RESIGNATION OF NON-CERTIFIED PERSONNEL

Non-certified employees who wish to resign must notify the board in writing within the time period set by the board for return of the issued contract.  Resignations of this nature shall be accepted by the board.

Non-certified employees who wish to resign during the school year shall give the board 2 weeks written notice prior to their resignation date.  The board may choose to accept the resignation, may waive the 2 week requirement, or accept the resignation upon finding a suitable replacement.

Date of Adoption:  April 25, 1990    

Code No. 413.2

RETIREMENT OF NON-CERTIFIED PERSONNEL

The Centerville CSD may from time to time establish a voluntary early retirement plan for qualified non-certified employees.  An early retirement plan will address eligibility, benefits and other pertinent items.  The most recent such plan offered by the district shall be retained in the Board Policy book as an illustrative exhibit for future reference.  The Centerville CSD may also include in separate Board policy (see Policy 414 for example) provisions for early retirement benefits for non-certified staff such as payment for accrued, unused sick leave and flexible leave payable upon retirement which may be paid for early retirement in any year.

Non-certified employees will not be required to retire at any specific age.

Upon retirement, non-certified personnel and their spouse and dependents, who are eligible, shall be allowed to continue coverage in the school district group health insurance program at their own expense until medicare age by meeting the requirements of the insurer with proper notification and submitted resignation.

Non-certified personnel who retire may be eligible to continue health and dental insurance coverage at their own expense if they follow conditions established by the carrier.

Date of Adoption:  April 25, 1990    
Date of Revision:  December 8, 1992   
Date of Revision: March 24, 1998
Date of Revision:  March 27, 2001
Date of Revision: August 15, 2006
Date of Revision: December 10, 2009
Date of Revision: September 14, 2016

Code No. 413.2 E1
Non/Certified Staff Early Retirement Benefit
Centerville CSD Non-certified Employee Early Retirement Plan(2010) 
	
The Centerville Community School District offers a voluntary early retirement plan to currently employed support staff employees.  To be eligible, an employee must meet all of the following requirements:

13.	Be a minimum of fifty five (55) years old on the effective date of retirement.
14.	Have worked a minimum of ten (10) consecutive years to date of retirement as a support staff employee for the Centerville CSD.
15.	Meet the rule of 67, i.e. the employee’s combination of age and consecutive years of service as referenced above must total at least 67.
16.	Submit an application requesting early retirement benefits on or after October 14, 2009 and before February 1, 2010.
17.	Submit a resignation from employment with the District effective at the end of the 2009-10 work year.
18.	Be a full time support staff employee during the 2009-10 work year, i.e. contracted to work thirty hours or more on a regular basis.
19.	Receive Board approval of the employee’s application and resignation.
20.	Apply for and will receive IPERS benefits.

An employee is ineligible for participation in this plan if the employee is under consideration for termination from employment.  

Approval by the Board of an employee’s application shall entitle the employee to receive four payments of $5000 subject to all applicable taxes and withholding payable in four installments as follows:  the first installment on or before December 31,2010 and the second through fourth installments yearly thereafter by December 31 of each successive year.  Failure by the Board to approve the employee’s application for early retirement benefits shall negate the employee’s resignation submitted in reliance thereon. No interest shall accrue on monies not yet paid. 

An employee who participates in the early retirement plan and who participated at the time of retirement in the District’s group health insurance plan, may continue to participate in the District’s then existing group health insurance plan at his/her own expense  only if allowed by the District’s group plan and carrier and if consistent with state law.  Continued participation will require the employee to submit payment for his/her monthly premiums in advance to the District according to District requirements.  The employee may only continue to participate as long as it is allowed by the District, its group health plan and insurance carrier. Nothing herein prohibits the District’s ability to prospectively change or eliminate its group health plan.   

In the event of the death of the retiring employee after Board acceptance for early retirement but prior to payment of any or all of the cash stipend, the cash stipend will be paid to the deceased employee’s spouse or other specifically designated beneficiary or if none, to the employee’s estate. 

Code No. 413.2 E1 cont.
Non/Certified Staff Early Retirement Benefit
Centerville CSD Non-certified Employee Early Retirement Plan(2010)

This early retirement plan is in effect for eligible support staff employees  who retire at the end of the 2009-10 work year only.  The District may or may not offer another early retirement plan in the future. 
The Board of Directors is the final arbiter of all questions of interpretation under this plan including, but not limited to, questions of eligibility or benefit calculation. 

Adoption Date:  June 11, 1996
Date of Revision:  March 24, 1998
Date of Revision:  October 12, 1999
Date of Revision:  March 27, 2001
Date of Revision:  February 8, 2005
Date of Revision: December 10, 2009

Code No. 413.3

SUSPENSION/DISCHARGE NON-CERTIFIED STAFF 

A non-certified employee may be suspended with or without loss of pay or benefits pending an investigation into charges against the employee for disciplinary purposes, or pending the commencement of discharge proceedings.  It shall be at the superintendent's discretion, pending an investigation, to suspend a non-certified employee.  Only the board has the authority to discharge employees.

Date of Adoption:  April 25, 1990    
Date of Revision:  December 8, 1992   

Code No. 413.3R

SUSPENSION/DISCHARGE NON-CERTIFIED STAFF

A non-certified employee may be suspended with or without the loss of pay or benefits pending an investigation into the charges against the employee for disciplinary purposes or pending the commencement of a discharge proceeding.  It shall be the superintendent’s discretion pending an investigation to suspend a non-certified employee.  When said suspension exceeds five unpaid days, the president of the board of education shall be notified.

According to board policy, only the school board has the authority to discharge an employee.  “Discharged” as used in this policy shall refer to employees whose employment is terminated before the end of the contract period.  When the administration determines to pursue the discharge or termination during the course of the contract, they will present a brief statement of the reasons to the employee and to the board of directors.  The affected employee may request a hearing with the board of directors which may be a special meeting or in a regular meeting at the discretion of the board of directors.  Regardless of the type of meeting, a motion to discharge the employee must be approved in a public school board meeting.

The district’s administrators or directors will notify employees whose employment is not recommended for renewal at the end of the contract.  This notification will also be in writing and include a brief explanation for the non-renewal.  Employees who will not be offered a new contract may request a hearing with the board of directors within one week of being notified.  In the event, the employee accepts the non-renewal without a hearing, the board of directors will be informed by the administration of the non-renewal of the contract and the acceptance of the non-renewal by the employee.

Date of Adoption: July 13, 1999

Code No. 413.4

REDUCTION IN FORCE NON-CERTIFIED STAFF

The board, based upon recommendations from the superintendent and administrative team, shall determine when a reduction in non-certified personnel is necessary.  The superintendent will consider qualifications, skills, ability and demonstrated performance in making the recommendation.

The reduction in non-certified personnel will be attempted through normal attrition. If normal attrition does not meet the reduction in force required, the board will determine the reduction of non-certified personnel based on appropriate due process.

Date of Adoption:  April 25, 1990    
Date of Revision:  January 10, 1995

Code No. 414
Page 1 of 4
LEAVES OF ABSENCE: NON-CERTIFIED

The board shall determine the leaves of absence for all full time and part time non-certified employees, those who are regularly employed less than thirty hours per week. Full time non-certified employees are those nine to twelve month non-certified employees regularly employed thirty or more hours per week.  Part-time employees are those who are regularly employed less than thirty hours per week.
I.	Sick Leave Days

A.	Sick leave (less than 12 month employees):   
10 days first year of service.
11 days second year of service.
12 days third year of service.
13 days fourth year of service.
14 days fifth year of service.
15 days sixth and each succeeding year of service.

B.	Sick leave (12 month employees):   
12 days first year of service.
13 days second year of service.
14 days third year of service.
15 days fourth year of service.
16 days fifth year of service.
17 days sixth and each succeeding year of service.

Sick leave days may be accumulated to a maximum of 125 days available in a year plus (15) days for the current year of continuous, uninterrupted service to the district.  

C.	Definitions:  Illness, Injury, or Pregnancy:  An employee shall be allowed sick leave when he/she is unable to perform the duties of his/her employment because of personal illness, injury or pregnancy.  In the event the employee is absent due to personal injury, illness or pregnancy, the Superintendent may require the employee to furnish a statement from a licensed physician stating that he/she was unable to perform such duties for the period of his absence and that he/she is now physically able to return to work.

D. 	Other provisions.  Up to six weeks, of sick leave may be used for new adoptions if the following criteria are met.  
A.  	The newly adopted child is less than mandatory school age.  
B.	The adoption takes place during the school year.  If not the six week duration period starts with the effective date of the child moving into the home.  

E.	Unused Sick Leave Reimbursement.    Upon retirement, the school district will reimburse the retiree for all unused sick leaves not to exceed 125 days at the rate of $1.00 per day per year times the number of years employed. 

Code No. 414
Page 2 of 4
LEAVES OF ABSENCE: NON-CERTIFIED
II.	Flexible Leave Days
An employee shall be allowed flexible leave days each year, at the discretion of the employee, without any loss of pay.  No flexible leave days may be taken immediately prior to or immediately following a school vacation or holiday, without the permission of the superintendent.  Prior to taking any flexible leave day (at least 48 hours, if possible) each employee shall notify his/her principal or immediate supervisor.  Flexible leave days may be taken in increments of one-half day.

	12 month employees receive 5 flexible days per year.
	200 days or more employees receive 4 flexible days per year.
	199 days or less employees receive 3 flexible days per year.
III.	Flexible Leave Bank
An employee may bank up to the total annual allotted unused flexible leave days per year.  Bank days will be updated July 1st annually.  Requests for bank day “buy-back” must be made in writing to the board secretary at the time of retirement.  Banked days are for employee emergencies or family illness as approved by the superintendent.  Flexible leave bank days may only be used after current year flexible leave days have been exhausted.  Up to 60 days may be accumulated in the bank.

When an individual’s bank reaches ten (10) days or more, two bank days may be used upon written request to their supervisor without the superintendent’s approval.  Or, the employee may elect to have the district buy back all (up to a maximum of 60 days) bank days at the rate of 70% of the current daily substitute rate as per the support staff salary schedule for that position.  

Salaried, non-categorical employee buy-back rate will be at 70% of the same per diem percentage as certified teacher substitute’s pay as compared to certified teacher’s average per diem salary for the year.
For example:
1)	Divide average teachers’ salary by 188 to equal average certified per diem pay.
2)	Daily substitute pay divided by per diem pay to equal a percentage.
3)	Compute per diem rate for employee.
4)	Compute percentage by multiplying step 2 times step 3.
5)	Compute 70% of step 4.
   
IV.     Bereavement Leave
In the event of a death in the immediate family five (5) days of absence with full pay may be granted per occurrence.  The immediate family shall be construed to mean parent, brother, sister, parent-in-law, brother-in-law, sister-in-law, spouse, child, step child, son-in-law, daughter-in-law, guardian, ward, foster parent, foster brother, foster sister, foster child, step parent, step brother, step sister, grandparent, grandchild, and grandparent-in-law.  In the case of the death of other relatives, one (1) day of absence with full pay shall be granted.

Code No. 414
Page 3 of 4
LEAVES OF ABSENCE: NON-CERTIFIED
V.	Extended Leave for Death or Serious Illness
After all other applicable leaves have been exhausted, an employee may be allowed by the superintendent to use sick leave in the event of the death or serious illness of the employee’s father, mother, brother, sister, wife, husband, and children, or other relative whose regular residence is in the home of the employee and on the spouse’s side, mother, father, sister and brother.

VI.	Jury duty leave
A Non-certified employee required to serve as a juror shall be paid regular salary if assigned to work those days, provided the employee submits proof of jury service and provided the employee reports to duty during such time as not required to be on jury duty.  Pay received, except mileage, shall be remitted to the district. If jury duty pay exceeds employees wage, the employee may keep the payment from jury duty and not be paid by the school district.

VII.	Staff development leave  
Non-certified employees may request of the superintendent paid leave time to view other school facilities, programs, or to attend meetings or conferences pertaining directly to their assigned position.  The superintendent shall have discretion to grant such requests and to determine whether to pay for registration, actual expenses, and travel.  If an employee is required to attend, the employee shall be reimbursed actual expenses, registrations fees, and travel.

VIII.	Injury or disability leave  
In the event an employee is injured in the course of their employment and receives worker's compensation benefits, the employee shall be informed of their right to choose whether or not to supplement worker's compensation benefits by reducing the employee's sick leave as provided by law.

IX.	Military Service leave  
If a non-certified employee is called to serve in the armed forces, including the national guard, the employee shall be granted an unpaid leave of absence for military service until the military service is completed.  The leave shall be without loss of status or seniority.

X.	Unpaid leaves of absence: 
It shall be at the discretion of the superintendent to grant or deny an unpaid leave of absence request of a non-certified employee. 
XI.	General
1.	Permanent Record: A permanent record of sick leave and business leave shall be kept.  An employee's sick leave record shall be provided on the monthly paycheck stub.  At the beginning of each year, the employee shall be notified of the leave accumulation and can have any errors corrected.  Errors detected on the monthly stubs should be corrected as soon as possible.
2.	Emergency:  Sick leave provisions are intended to cover only emergency or necessary surgery.  If the employee's doctor is of the opinion that any elective surgery may be postponed or delayed until a vacation period, without injury or risk to the health of the employee, then the employee shall not be entitled to sick leave for such elective surgery.

Code No. 414
Page 4 of 4
LEAVES OF ABSENCE: NON-CERTIFIED
3.	Leave days may be taken on a one-half day basis.

XII.	Extended Leave - Illness or Disability
An employee who is unable to work because of personal illness or disability; or illness, disability or death of a member of his/her immediate family, and who has exhausted all sick leave accumulated, shall be granted a leave of absence, without pay for the duration of the current contract period, or until he is able to return to work, whichever occurs first. 

Date of Adoption:  April 25, 1990    
Date of Revision:  June 23, 1992   
Date of Revision:  June 28, 1994  
Date of Revision:  June 13, 1995 
Date of Revision:  July 14, 1998
Date of Revision:  March 27, 2001
Date of Revision:  September 9, 2003
Date of Revision:  May 16, 2006
Date of Revision: April 24, 2007
Date of Revision: April 12, 2011
Date of Revision: July 8, 2013

Code No.  415

PAY DEDUCTIONS – NON-CERTIFIED STAFF

The district provides leaves of absences to allow employees to be absent from work to attend to important matters outside of the workplace.  As public employers, school districts are expected to record and monitor the work that employees perform and to conform to principles of public accountability in their compensation practices.

If an individual is on leave without pay for five (5) days or less, salary will be deducted at the daily rate of pay.  If an individual is on leave without pay for five and one-half (5-1/2) days or more, salary and benefit will be deducted at the daily rate of pay.

Consistent with principles of public accountability, it is the policy of the district that, when an employee is absent from work for less than one work day and the employee does not use accrued leave for such absence, the employee’s pay will be reduced or the employee will be placed on leave without pay if:
•	The employee has not sought permission to use paid leave for this partial-day absence,
•	The employee has sought permission to use paid leave for this partial-day absence and permission has been denied,
•	The employee’s accrued paid leave has been exhausted, or
•	The employee chooses to use leave without pay.

In each case in which an employee is absent from work for part of a work day, a deduction from compensation will be made or the employee will be placed on leave without pay for a period of time that is equal to the employee’s absence from the employee’s regularly scheduled hours of work on that day.

Date of Adoption:  August 9, 2005

Code No. 415 R1

PAY DEDUCTION REGULATION

The district complies with all applicable laws with respect to payment of wages and benefits to employees including laws such as the federal Fair Labor Standards Act and the Iowa Wage Payment Collection Act.  The district will not make pay deductions that violate either the federal or state laws.

Any employee who believes that the district has made an inappropriate deduction or has failed to make proper payment regarding wages or benefits is encouraged to immediately consult with the appropriate supervisor.  Alternatively, any employee may file a formal written complaint with the superintendent.  Within 15 business days of receiving the complaint, the superintendent will make a determination as to whether the pay deductions were appropriate and provide the employee with a written response that may include reimbursement for any pay deductions that were not appropriately made.

This complaint procedure is available in addition to any other complaint process that also may be available to employees.

Date of Adoption:  August 9, 2005			

Code No. 416

VACATIONS/HOLIDAYS NON-CERTIFIED STAFF 

The board shall determine the amount of vacation and holiday leave that will be allowed on an annual basis for non-certified staff.

Vacation for non-certified personnel who are scheduled to work 12 months a year i.e., fifty two weeks, 5 days per week, will be five work days after the first full year of employment.  All paid vacations are based on the number of scheduled hours of work or a maximum of 40 hours per week.  

After three years of employment, ten days of vacation will be granted.  After eight years of employment, fifteen days will be granted and after sixteen years of employment, twenty days will be granted.  All vacation amounts specified in this policy are based on continuous, uninterrupted employment.  

Vacation days may be taken any time during the school year, provided the vacation will not disrupt the operation of the school district.  The employee must submit a vacation request to the superintendent and immediate supervisor and it shall be at the discretion of the superintendent to grant or deny the vacation request if it is determined that the absence will disrupt the operation of the school.

Paid holidays for non-certified personnel are:  New Years Day, Good Friday, Memorial Day, Labor Day, Thanksgiving Day, Christmas Day.  Employees contracted to work through the summer will also receive the Fourth of July as a paid holiday.  Employees contracted twelve-months will receive paid leave for day after Thanksgiving holiday and day before Christmas holiday.

Date of Adoption:  April 25, 1990    
Date of Revision:  June 9, 1992    
Date of Revision:  January 10, 1995
Date of Revision:  July 11, 1995
Date of Revision:  November 13, 2017

Code No. 417

SUBSTITUTES FOR NON-CERTIFIED STAFF

In the event a non-certified employees requires an extended leave of absence, the superintendent may employ substitutes until the employee is able to return to regular duties. The employee shall remain on substitute status unless the board formally hires him/her as permanent, non-certified employee.

Wages and salary for non-certified substitutes shall be determined in accordance with the "Support Staff Salary Schedule Provisions" adopted by the board.

Date of Adoption:  April 25, 1990
Date of Revision:  January 10, 1995
Date of Revision: March 24, 1998

Code No. 418

DRUG AND ALCOHOL TESTING PROGRAM

Employees who operate school vehicles classified as “commercial motor vehicles” by the U.S. Department of Transportation are expected to be drug and alcohol free, and are required to possess a commercial driver’s license (CDL) to operate those vehicles, are subject to drug and alcohol testing.  A “commercial motor vehicle” is a vehicle that transports sixteen or more persons including the driver or has a gross vehicle weight rating (GVWR) of 26,001 pounds or more.   For purposes of the drug and alcohol testing program, the term "employees" includes applicants who have been offered a position to operate a commercial motor vehicle owned by the school. 

Employees or employee applicants who will operate a school vehicle as described above are subject to pre-employment drug testing prior to being allowed to perform a safety sensitive function using the school vehicle.  In addition, employees will be subject to  random, reasonable suspicion, post-accident, drug and alcohol testing.  Employees operating school vehicles will not perform a safety-sensitive function within four hours of using alcohol.  Employees governed by this policy are subject to the drug and alcohol testing program beginning the first day they operate or are offered a position to operate school vehicles and continue to be subject to the drug and alcohol testing program as long as they may be required to perform a safety-sensitive function as it is defined in the administrative regulations.  Employees with questions about the drug and alcohol testing program may contact the transportation director at the Fleet Maintenance Facility located at 300 W. Franklin, Centerville IA 52544.

Employees who violate the terms of this policy may be subject to discipline up to and including termination at the discretion of the school district.  Employees who violate this policy, as a condition of continued employment, may be required to successfully participate in a substance abuse evaluation and, if recommended, a substance abuse treatment program.  Employees required to participate in and who fail to or refuse to successfully participate in a substance abuse evaluation or recommended substance abuse treatment program will no longer be allowed to operate a commercial motor vehicle owned by the school and in addition, may be subject to discipline up to and including termination.

The district shall inform applicants of the requirement for drug and alcohol testing in notices or advertisements for employment. 

The district will also publish and disseminate this policy make available access to the Department of Transportantion’s web site to employees operating school vehicles for regulations concerning this policy.  Information about substance-free awareness programs to educate employees about the dangers of substance abuse and available substance abuse treatment resources and programs will be provided by the district.

Date of Adoption:  January 9, 1996
Date of Revision: March 24, 1998
Date of Revision:  March 9, 1999
Date of Revision:  September 13, 2005
Date of Revision: September 8, 2009
 
Code No.  418-E1

DRUG AND ALCOHOL TESTING PROGRAM NOTICE TO EMPLOYEES

EMPLOYEES GOVERNED BY THE DRUG AND ALCOHOL TESTING POLICY ARE HEREBY NOTIFIED they are subject to the school district's drug and alcohol testing program for pre-employment drug testing and random, reasonable suspicion, post-accident, return-to-duty and follow-up drug and alcohol testing as outlined in the Drug and Alcohol Testing Program policy, its supporting administrative regulations and the law.

Employees who operate school vehicles are subject to drug and alcohol testing if a commercial driver's license is required to operate the school vehicle and the school vehicle transports sixteen or more persons including the driver or the school vehicle weighs twenty-six thousand, one pounds or more.  For purposes of the drug and alcohol testing program, "employees" include applicants who have been offered a position to operate a school vehicle.  The employees operating a school vehicle shall be subject to the drug and alcohol testing program beginning the first day they operate or are offered a position to operate a school vehicle and continue to be subject to the drug and alcohol testing program.

It is the responsibility of the superintendent to inform employees of the drug and alcohol testing program requirements.  Employees with questions regarding the drug and alcohol testing requirements shall contact the school district contact person.

EMPLOYEES GOVERNED BY THE DRUG AND ALCOHOL TESTING POLICY ARE FURTHER NOTIFIED that employees violating this policy, its supporting administrative regulations or the law may be subject to discipline up to and including termination.  Employees violating this policy or the law may be required to successfully participate in a substance abuse evaluation and, if recommended, a substance abuse treatment program.  Employees required to participate in and who fail to or refuse to successfully participate in a substance abuse evaluation or recommended substance abuse treatment program may be subject to discipline up to and including termination.

EMPLOYEES GOVERNED BY THE DRUG AND ALCOHOL TESTING POLICY ARE FURTHER NOTIFIED that employees violating this policy, its supporting documents or the law may be subject to discipline up to and including termination.  Employees violating this policy, its supporting documents or the law bear the personal and financial responsibility, as a condition of continued employment, to successfully participate in a substance abuse evaluation and, a substance abuse treatment program, if recommended by the substance abuse professional.  Employees required to participate in and who fail to or refuse to successfully participate in a substance abuse evaluation or recommended substance abuse treatment program may be subject to discipline up to and including termination.

Date of Revision: September 8, 2009

Code No.  418-E2

DRUG AND ALCOHOL TESTING PROGRAM ACKNOWLEDGMENT FORM

I, (name of employee), have received a copy, read and understand the Drug and Alcohol Testing Program policy and its supporting documents.  I consent to submit to the drug and alcohol testing program as required by the Drug and Alcohol Testing Program policy, its supporting documents and the law.

I understand that if I violate the Drug and Alcohol Testing Program policy, its supporting documents or the law, I may be subject to discipline up to and including termination or I may be required to successfully participate in a substance abuse evaluation and, if recommended, a substance abuse treatment program.  If I am required to and fail to or refuse to successfully participate in a substance abuse evaluation or recommended substance abuse treatment program, I understand I may be subject to discipline up to and including termination.

I further understand that drug and alcohol testing records about me are confidential and may be released in accordance with this policy, its supporting administrative regulations or the law.

								
(Signature of Employee)		(Date)

Date of Revision: September 8, 2009