School Administrative Unit #9

FMLA provides unpaid, job-protected leave for up to 12 weeks per 12 month period for qualified employees, with the continuation of health insurance coverage by the district. This means that for eligible employees under FMLA, the district will continue to pay its portion of any health care coverage (employee is still responsible for their portion) and guarantees the employee will return to the same or similar position when they come back.

When an employee is out (or is planning to be out) for more than 5 consecutive days and/or they will be out intermittently for more than 5 days for the same condition, they must fill out FMLA paperwork. Where your need for FMLA leave is foreseeable, employees must provide notice of their need for leave to the SAU office not less than thirty (30) days before the leave is scheduled to begin. If the need for FMLA is not foreseeable (for example, where a need for medical treatment requires leave to begin in less than thirty (30) days), you must provide notice as soon as practicable.

 If you are an eligible employee you are entitled to FMLA leave for any of the following reasons:
a) To care for a newborn, an adopted child, or a foster child within a year of the child’s arrival;
b) To care for a spouse, child, or parent who has a serious health condition
c) For a serious health condition that makes you unable to perform the functions of your job;
d) For qualifying exigencies related to the foreign deployment of a military member who is the employee's spouse, child, or parent.

To be eligible for FMLA an employee must have been employed by the district for at least 12 months and worked the required amount of hours per federal and state law in the past 12 months, not including any paid or unpaid leaves they have taken (aka sick or vacation days). To make sure you are eligible, contact the SAU office.

NO, FMLA is unpaid leave. FMLA runs concurrently with any accrued sick time the employee is using *our policy requires that an employee use all accrued sick, personal and vacation time while on FMLA (see collective bargaining agreement or personnel policies for exclusions). The use of any accrued sick time, in addition to FMLA coverage, will be monitored by the SAU #9 Payroll Manager.

• Request for Family and Medical Leave form 
• WH-380-E (Employee) *Section #2 must be completed and signed by attending physician 
• WH-380-F (Family member) *Section # 3 must be completed and signed by attending physician 
• WH-385 (Military)  
• WH-384 (Military Family Member) 
  
  FMLA forms can be faxed to Jackie Dziedzic at 603-447-8497.

• CONWAY
• BARTLETT
• JACKSON
• EATON
• SAU#9

Contact Jackie Dziedzic at 603-447-8368 x1019.
FMLA forms can be faxed to Jackie Dziedzic at 603-447-8497