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HUMAN RESOURCES
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February 18, 2025
D*d this I" day Of , ;4L4w 20
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TO: Board of County Commissioners C
FROM: Decorah Anderson -Cook, HR Director EWW of County C""
Gant County, Wahketon
RE: Sick Leave Donation Program
REQ #: 25-02 Di*82-rm
DEPT: New Hope Dist #1 Dist #1 Dist #1
CC: L-Kistina Crowder (EE) & Tara Dien (Superviso no
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Request SummJr)�"`
I Dist #3 Dist #3 Dist #3
An employee from the above -referenced department has requested a sick leave donation for 720 hours, not to exceed the
allowable amount. This request was made after exhausting both FMLA and WA State PFML programs.
SIR Director Recommendation:
As required by policy, I have reviewed this request along with policy language. Z I Recommend Approval
El I do not Recommend Approval
Donations must be received by close of business on:
Friday, February 28, 2025, by 5:00 PM.
The donation announcement to Grant County staff will be sent: E] Anonymously
Confirmed via email on 0112812025 Z With the Employee's Name
Analysis Summary:
The employee suffers from an illness, injury, impairment, or physical or mental condition that is extraordinary in
nature (i.e., life -threatening or causes long-term or permanent physical damage that could preclude the Yes
employee from returning to work). [:]No
The employee is a regular full-time or regular part-time employee who has worked for the County for at least Yes
twelve consecutive months prior to the request. No
The employee has exhausted all sick leave options, including annual leave and compensatory leave options. Yes
0 No
The employee has approval from his/her supervisor that the proposed use of sick leave is justified, Yes
No
The employee has previously abided by leave -of -absence policies. Yes
[� No
Sincerely,
Decorah .Anderson -Cook
Director —Human Resources
RECEIVED
FEB 19 2025
GRANT COUNTY COMMISSIONERS
Grant County Human Resources - PO Box 37 - 35 C Street NW, - Ephrata, WA 98823 ~ (509) 754-2011
GRANT COUNTY
III BOARD OF COUNTY COMMISSIONERS
To: Elected Officials and Department Heads
From: Board of County Commissioners '
Data February 19, 2025
Re: Sick Leave Donation Request
The Board of County Commissioners has received and approved a request to
initiate the Sick Leave Donation Policy.
iir—Crowder (ID #25-02) of Grant County New Hope is suffering from an
illness, injury, impairment or physical or mental condition which is extraordinary
in nature (life threatening or causing long term or permanent damage) and has
or will soon exhaust all leave balances.
Any County employee who is interested in donating a portion of their own sick
leave to this employee may do so by submitting to the attached, completed form
to the Payroll via interoffice mail or emailed to payroli@grantcount nMa.gov . The
deadline for sick leave donation forms to be received in Accounting is Friday,
February 28, 2025.
Employees who are eligible to accrue sick leave, may donate sick leave,
according to the following criteria:
• Sick leave may not be donated in less than two (2) hour increments.
• Employees must retain at least 10 (ten) days or eighty (80) hours in their
own sick leave balance after the donation.
Cc: New Hope
Accounting
Human Resources
"To meet current and future needs, serving together with public and private entities, while
fostering a respectful and successful work environment."
Grant County
Sick Leave Donation Form
Donor Certification
CONFIDENTIAL
To: Accounting
From: (name)
PIN - q 04
U I RX ILI
Date:
Re: Request to Donate Sick Leave
STATEMENT OF DONATION: I hereby voluntarily agree to donate a portion of my accrued sick
leave in response to the request to donate sick leave to an employee in the
I department/office.
I understand this donation is irrevocable. I understand that Accounting will take from my
donation, in two (2) hour increments, the whole or a portion of my donated leave that will assist in
meeting the requested leave, or the maximum allowed leave, whichever comes first.
Should all or part of my intended donation not be needed to meet the request, it shall not be taken
from my balance.
I am donating a maximum of hours (2 hour minimum increment) to be
,deducted from my sick leave balance and donated to Requestor No. (See
announcement).
Print Name:
Signature:
-Department Date
Accounting Certification
STATEMENT OF CERTIFICATION: I hereby certify that the above employee will, after the
donation is made, retain a sick leave balance of at least eighty (80) hours.
Name Title
Accounting Date
SUBMIT FORM TO:
PAYROLL ACCOUNTING
OFFICE, ROOM 309
3RID FLOOR OF COURTHOUSE ANNEX
Form GC 014 Revised 06/24/2022