During the annual open enrollment period (usually mid-November to mid-December) or during an additional open enrollment period, eligible employees can complete and submit FSIS Form 4630-6, FSIS Leave Bank Program Application for Membership or Donation, and donate the required annual leave contribution amount depending on their accrual category. New employees and employees returning from an extended absence have 30 days from their entrance on duty (EOD) or return to duty date (respectively) to apply to become a member. The membership form can be submitted to LeaveBankProgram@usda.gov with the subject, “Leave Bank Program – Membership Application.”

Membership is effective in Pay Period 1 following the annual open enrollment period or the pay period following approval if outside of the annual open enrollment period. An FSIS Notice will be issued annually to announce the open enrollment period and the required minimum number of hours to become a member. Current members will be automatically re-enrolled for the next leave year, and the required minimum hours will be deducted from their leave balance prior to the beginning of the year. Current members may opt out of the automatic re-enrollment by emailing a request to FSISHR1@usda.gov by November 30.

In any leave year, a leave donor may not donate more than a total of one-half of the amount of annual leave they would accrue during the leave year in which the donation is made:

• Full-time employee maximum:
  • 52 hours if in the 4-hour leave category.
  • 80 hours if in the 6-hour leave category.
  • 104 hours if in the 8-hour leave category.
• Part-time employee maximum (determine using the following formula):
  
  13 x Duty Hours in Pay Period x Leave Earning Category
  ______________________________________________
                           
                            80      
  
  Example Part Time Maximum:
  
  13 x 64 hours x 8 = 6656/80 = 83.2 rounded to 83 hours
   
• In the case of a leave donor who is projected to have use or lose annual leave at the end of the year, the maximum amount of annual leave that may be donated during the leave year shall be the lesser of:
  • One-half of the amount of annual leave they would be entitled to accrue during the leave year in which the donation is made; or
  • The number of hours remaining in the leave year (as of the date of the donation) for which the leave donor is scheduled to work and receive pay.

NOTE: Only annual leave may be donated under the leave share programs. Federal regulations prohibit donating sick leave.

Eligibility Requirements

• Be a member of the program for the current year,
• Experience a qualifying personal or family-related medical emergency, and
• Exhaust (or expect to exhaust) all accrued annual and sick leave and be (or expect to be) in a non-pay (or advanced leave) status for a minimum of 24 hours.

Application Process

A request to become a leave recipient is not a request to be absent on leave. The applicant must obtain approval for the time off from work for a medical emergency, according to the standard procedures for requesting leave.

To apply to become a recipient, submit the following forms and/or documents (recipient package) to LeaveBankProgram@usda.gov.

• FSIS Form 4630-5, FSIS Leave Bank Program - Recipient Application.;
• Medical documentation must include a description from the health care provider of the reason for the leave, that the leave is necessary and the duration or frequency of the leave. The documentation from the health care provider is to include the name and address of the practice and requires the health care provider’s signature.  This can be included on letterhead from the health care provider’s office or can be provided on one of the following forms:
  • WH-380-E: Certification of Health Care Provider for Employee’s Serious Health Condition, or
  • WH-380-F: Certification of Health Care Provider for Family Member’s Serious Health Condition.
• FSIS Form 4630-8, Authorization to Release Medical Information.

The hours of donated leave that approved recipients can receive in a leave year from the bank are capped as follows:

• 480 hours (12 weeks) for personal or family-related medical emergencies (other than childbirth),
• 320 hours (8 weeks) for cesarean-section, or
• 240 hours (6 weeks) for natural birth.

Note: Recipients can receive additional hours from personal donations; however, the hours of donated leave approved recipients can use are limited to the hours they need based on the medical documentation. Unused donated leave will be returned to the leave bank for use by other LBP recipients.

Membership Application

Upon receipt of a complete and accurate membership form, the processing timeline is 1 week or less.

The process in detail:

• The employee submits a complete and accurate membership form.
• The LBP Coordinator:
  • Reviews the form, verifies the employee’s accrued annual hours and that their contribution amount meets the minimum requirement.
  • Approves and signs the membership form.
• The employee receives the approved form via email.
• The FSC receives the approved form from the coordinator and processes it in WebTA.

Recipient Application

Upon receipt of a complete and accurate recipient package, the processing timeline is 10 business days.

The process in detail:

• The employee submits a complete and accurate recipient package to LeaveBankProgram@usda.gov.
• The LBP Coordinator:
  • Reviews the package and verifies the information.
  • Submits the request to the LBP board for consideration and adjudication. The request includes the medical reason for the leave and the number of hours requested. No employee information is released to the LBP board.
  • Submits a redacted approval letter for the board chairperson’s signature.
  • Approves and signs the recipient form.
• The employee and immediate supervisor receive the approval letter and approved recipient form via email.
• The FSC receives the form and processes it in WebTA.