The Families First Coronavirus Response Act temporarily requires employers to provide paid sick leave related to COVID-19 and amends and expands the Family and Medical Leave Act until December 31, 2020, to provide paid job protected leave to both full and part time employees who require leave due to the COVID-19 pandemic.

The Emergency Paid Sick Leave Act (ESICK) provides paid job protected sick leave to any employee who requires leave due to COVID-19 related quarantine, to care for someone under quarantine and/or to care for a son or daughter if the school or place of care of the son or daughter has been closed or is unavailable.

The Emergency FMLA Act (EFMLA) provides 10 weeks of paid job protected leave to any employee who requires leave due to a need to care for the employee’s child, if the child’s school or child-care provider has been closed, or if the child-care provider is unavailable, due to COVID-19.

Employees must report absence to their supervisor as normal, with as much advance notice as practical.  Employees requesting leave must complete this form online or submit a copy of the paper form to Human Resources via email only to jana.mcanally@txkusa.org and copy jim.powell@txkusa.org within two business days of taking leave along with any reasonable documentation. If you submit this online form, you do not need to email a copy to Jana and Jim.  Examples of reasonable documentation: Confirmation of contacting a health professional or providing an online link that verifies a childcare facility/school is closed.

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* 1. First Name

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* 2. Last Name

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* 3. Department

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* 4. Direct Supervisor's Name

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* 5. Email Address (for HR/Employee Correspondence)

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* 6. Requested Leave Start Date

Date

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* 7. Anticipated Return to Work Date

Date

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* 8. Please select the reason for requesting leave.

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* 9. If you selected numbers 1 - 4 above as the reason for needing leave, please provide the date of the order/diagnosis.

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* 10. If you selected number 5 above, please provide the name of the child/children and the name of the school or childcare provider.

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* 11. If the childcare provider was a family member, please indicate why they are unavailable now.

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* 12. Please attach any supplemental documentation.  Examples include:

For medically necessary reasons:
  • The source of quarantine or isolation order
  • Copy of order
  • Name of or note from healthcare provider advising order
For school closures and child-care related needs:
  • Copy of an email or letter from the school or child-care facility indicating the first day of closure and anticipated return date.


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* 13. By submitting this online form, I the employee, certify that:
  • The information provided by me is true and correct.
  • I understand that I may be required to provide Human Resources with periodic updates about my emergency leave, either verbally or in writing upon request.
  • I understand emergency leave pay is subject to the Families First Coronavirus Response Act.
  • I understand that any payment for leave that I may qualify for is limited to the maximum listed in the City's Family First Act policy allowed for by the Families First Coronavirus Response Act.
Please type your first and last name to acknowledge the above statements.

Human Resources Contact Information:

HR Director, Jim Powell; 903-798-3917; jim.powell@txkusa.org

J.W. Bramlett; 903-798-3533; james.bramlett@txkusa.org

Jana McAnally; 903-798-3915; jana.mcanally@txkusa.org

Joy Sartor; 903-798-3928; joy.sartor@txkusa.org

Once the leave is approved by Human Resources, the employee's direct supervisor will be contacted to verify the leave.  If clarification is needed or a denial is issued, the employee will be contacted by Human Resources.

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