A Comprehensive Guide on
Pregnancy and Related Issues
-- July, 2005 State Cable
R 142252Z JUL 05
FM SECSTATE WASHDC
TO ALL DIPLOMATIC AND CONSULAR POSTS COLLECTIVE
RUEHBC/REO BASRAH 1663
RUEHBE/AMEMBASSY BELIZE 2102
RUEHDBU/AMEMBASSY DUSHANBE 0801
RUEHKH/AMEMBASSY KHARTOUM 9811
RUEHKUK/REO KIRKUK 1737
RUEHMOS/REO MOSUL 1664
RUEHTRO/USLO TRIPOLI 3327
BT
TO HUMAN RESOURCES/ADMINISTRATIVE OFFICERS FROM HR/ER/EP
E.O. 12958: N/A
TAGS: APER, AMGT
SUBJECT: UPDATE - A COMPREHENSIVE GUIDE ON PREGNANCY AND RELATED ISSUES
INFORM CONSULS, FOR MANAGEMENT, HUMAN RESOURCES AND HEALTH OFFICERS FROM HR/ER
1. SUMMARY: Along with the joy of having a baby abroad there are many questions. To help pregnant Foreign Service employees and family members answer questions about leave, medical travel, and other pregnancy-related issues, the Bureau of Human Resources has updated its "Comprehensive Guide on Pregnancy and Related Issues" -- originally issued in 2000. Our goal is to provide employees with the most accurate and up to date information they can use. END SUMMARY
2. This guidance also includes information on medevacs to locations abroad for employees/mothers who wish to deliver their babies abroad (see paragraph 7B). We have also included references to the Foreign Affairs Manual (FAM) and other regulations throughout the guide to make it easier for employees who wish to research these issues further to find specific regulatory language. We ask that management and human resources officers distribute this guide widely among their missions and keep a copy on file at post.
Subjects covered:
Item 3. -- Coverage
Item 4. -- Non-Coverage
Item 5. -- Prohibition Against Pregnancy Discrimination
Item 6. -- Types of Leave
Item 7. -- Leave Programs for Employees
Item 8. -- Medical Travel
Item 9. -- Travel Reservations
Item 10. -- Per Diem
Item 11. -- Layette Shipment
Item 12. -- Information/Documents Needed to Take With You
Item 13. -- M/MED Contact
Item 14. -- Health Insurance
Item 15. -- Working In The Department Before/After Baby's Birth
Item 16. -- After the Baby is Born
Item 17. -- Birth Certificate
Item 18. -- Passport
Item 19. -- Travel Orders
Item 20. -- Medical Clearances
Item 21. -- Medical Records
Item 22. -- Return Travel
Item 23. -- Travel Vouchers
3. Coverage: This guidance applies to:
All American citizen Department of State Foreign Service employees, family members, and other agency employees who are covered under the Department of State's medical program (reference 16 FAM 115).
4. Non-Coverage: This guidance does not cover:
Foreign Service National employees (FSNs) (ref 5 USC 6301) and other locally employed staff (LE staff) including Rockefeller hires, Personal Services Contract/Agreement personnel (PSC) (3 FAM 8100 Appendix A. section 171.1), non-FMA employees on Temporary appointments (Note: FMA employees on intermittent non-work schedules (INWS) are eligible for applicable benefits as an eligible family member only) or any other individuals not participating in the Department of State's medical program.
5. Prohibition against Pregnancy Discrimination
The Pregnancy Discrimination Act is an amendment to Title VII of the Civil Rights Act of 1964. Discrimination on the basis of pregnancy, childbirth or related medical conditions constitutes unlawful sex discrimination under
Title VII. Women affected by pregnancy or related conditions must be treated in the same manner as other applicants or employees with similar abilities or limitations. For more details, see http://www.eeoc.gov/facts/fs-preg.html.
6. Types of Leave
For the period of incapacitation before and after childbirth or for any other associated medical reason, a pregnant employee may use the following leave categories: sick leave; annual leave; donated leave under the Voluntary Leave Transfer Program; leave without pay (LWOP); home leave (provided that eligibility for home leave coincides with the mother's period of incapacitation) (ref 3 FAM 3430); or any combination thereof. Advance sick and annual leave may be requested. Accrued compensatory time off may also be used (ref 3 FAM 3130). No other kind of leave is available for this purpose under the law. Appropriate medical documentation is required, except when an employee is on home or approved annual leave. For further information or clarification on leave issues, posts may contact HR/ER/EP at tel: 202-261-8171. Fax: 202-261-8186; or e-mail: hrleave@state.gov.
7. Leave Programs for Employees
An employee/mother or employee/father is entitled to use these programs for any maternity reason. There need not be a complication or emergency. Programs are described below only insofar as they pertain to pregnancy or pregnancy-related leave. Employees should check with the human resources or management officer at post for a more detailed description of programs.
A. Sick Leave
Sick leave regulations were changed by OPM in June 2000 giving federal employees greater flexibility in using sick leave for caring for a family member with a "serious health condition," including a period of incapacity due to pregnancy and childbirth or for prenatal care. Please refer to 3 FAM 3420 and 3 FAH-1 H3420 for more details regarding the expanded use of sick leave.
Sick leave regulations provide that an employee may be granted sick leave if she is incapacitated for the performance of duties by pregnancy or childbirth. Sick leave regulations also provide that full-time employees may use up to a total of 12 weeks (480 hours) of accrued sick leave for care of family members with a serious health condition, including a period of incapacity due to pregnancy and childbirth or for prenatal care. Up to 104 hours of sick leave may be used by a full-time employee to provide care for a family member receiving medical exams or treatment related to pregnancy. Part-time employees receive this benefit on a pro-rated basis. Whether using the sick leave to care for a family member with a serious health condition or to attend to a family member receiving medical treatment, the total amount of sick leave granted may not exceed 12 weeks. For general family care purposes, a total of 40 hours of sick leave may be used without regard to the employees' sick leave balance. To exceed 40 hours, the employee must maintain a sick leave balance of at least 80 or hours. Sick leave may be applied, as appropriate, to an absence invoked under the FMLA as discussed in paragraph B.
B. Family and Medical Leave Act (FMLA) (reference 3 FAM 3530). FMLA is an additional entitlement separate from the sick leave regulations. Employees qualify for an unpaid or paid absence under FMLA if they have been employed at least 12 months (not necessarily consecutive). Temporary employees on an appointment of one year or less do not qualify for FMLA. Under provisions of the FMLA, covered employees are entitled to take up to 12 administrative workweeks of LWOP in one 12-month period for childbirth and to care for a newborn child.
In the case of a tandem couple, both mother and father are entitled to the full twelve-week period. Employees applying for all or part of the 12-week absence should complete OPM Form 71 ("Request for Leave or Approved Absence") at least 30 days in advance of the absence whenever practicable, or as soon as possible. An absence under FMLA may begin prior to the birth and must be concluded within 12 months after the date of birth.
The FMLA provides that the employee/mother and employee/father may choose to substitute applicable paid leave for LWOP. The employee/mother may use leave in accordance with types of leave described in paragraph 5, for the period of her medical incapacitation, before and after childbirth, including medevac to the U.S. Bonding with, or caring for, a well baby may be charged to annual leave, home leave (if applicable), earned compensatory time off, or leave without pay. Sick leave may only be used to care for an ill baby or recuperating mother.
Under FMLA, the employee/father may charge his absence to annual leave, sick leave (as noted in paragraph A. above), compensatory time off, or LWOP. Sick leave may be used to care for the recuperating mother or an ill child and to take the mother and/or child to medical appointments. Questions on the FMLA can be directed to HR/ER/EP, (202) 261-8171, fax (202) 261-8186, e-mail hrleave@state.gov.
C. Voluntary Leave Transfer Program (VLTP)(Reference 3 FAM 3340). The employee/mother may apply for donated leave for her period of incapacitation, which may include time before and after childbirth, with proper medical documentation. Any accrued annual and sick leave must be exhausted before she may draw from VLTP. To apply for VLTP to care for an ill employee/mother or ill newborn, the requesting employee must exhaust his/her entitlement to sick leave (see paragraph A. above) and all other types of leave. A full-time employee can apply for VLTP when it is apparent that he/she will face at least 24 hours of LWOP. A part- time employee must face LWOP in an amount that is at least 30 percent of the average number of hours in the employee's biweekly scheduled tour of duty. Donated leave may be used to liquidate advanced sick leave.
D. Leave Without Pay (LWOP)
(State only--Reference 3 FAM 3510). An approving official at post may approve LWOP of 80 hours or less. Requests for LWOP of more than 80 hours, but not exceeding 90 calendar days, may be approved by the approving official at post. Requests for LWOP of more than 90 calendar days must be submitted by the employee/mother or employee/father to her/his assigned Career Development Officer in HR/CDA for approval. For all LWOP requests in excess of 80 hours, Form SF-50, ("Notice of Personnel Action") must be issued.
Employees who take LWOP for more than 14 days at one time (whether at post or away from post) will not receive any allowances while they are in LWOP status. (Note: Following paragraphs 7-22 apply to employees only and family members covered by the Department of State Medical Program (16 FAM 110).
Employees of other agencies, and their covered eligible family members, must also check with their agencies for assistance with infant passports, health insurance, travel orders, travel vouchers, and return travel. End note.) Please consult checklist at post before departure for delivery in the United States.
8. Medical Travel
A. To the United States
The Office of Medical Services (MED) recommends a pregnant employee or family return to the United States for delivery. Medical travel will be authorized unless such travel is superceded by other U.S. Government funded travel such as Home Leave.
Medical travel funding for expectant mothers will be authorized to any location in the continental United States, Alaska or Hawaii rather than just to the first point of entry into the U.S. (Reference 3 FAM 3715.2-2). Per diem funding will be at the rate of the specified U.S. location. The patient should depart from post no later than six weeks prior to the expected date of delivery and is expected to return to post six weeks after delivery, if it is medically appropriate for her to travel at that time.
Post should alert MED/Foreign Programs (M/MED/FP) by telephone: (202) 663-1662, fax: (202) 663-1661 early in the pregnancy of the planned medical evacuation by contacting the Regional Medical Officer (RMO) or the Foreign Service Health Practitioner (FSHP) for the Post. Post is required to send a telegram to M/MED/FP requesting authorization for the medical evacuation (medevac). M/MED will reply with:
1) a MED CHANNEL telegram authorizing the medevac; and
2) an OPEN CHANNEL telegram providing a fund cite for medical travel for STATE employees or their family members (other agency employees must request fiscal data from their sponsoring agency).Medevac authorization telegrams contain other important instructions on administrative matters such as a letter of authorization for hospitalization (Form DS-3067) issued by M/MED, medical insurance, processing and reimbursement of medical claims, and medical clearances for the mother and newborn (ref 3 FAM 3713.5-3). Employees are urged to review these cables carefully and to seek clarification promptly of any questions.
B. Travel and Per Diem to a Location Abroad Away from Post
If the expectant mother elects to deliver abroad and away from post, travel will be cost constructed based on travel costs to Washington, D.C. This means transportation costs and per diem are paid at either Washington, D.C. based rates or that of the chosen medevac locality, whichever cost is lower. MED will authorize a medevac abroad only from a post with inadequate obstetrical and neonatal care to a location with suitable and adequate obstetrical and neonatal care. This suitability determination will be made by MED/Foreign Programs. Women planning an obstetrical medevac abroad are advised to contact MED/Foreign Programs through their Health Unit early in their pregnancy to determine suitability/adequacy of obstetrical and neonatal care at the proposed medevac location.
The expectant mother must have a local physician willing to assume her prenatal and obstetrical care upon arrival at the medevac location abroad, as well as a local pediatrician to provide newborn care.
Travel back to post will be authorized for the mother and the infant only after a medical approval has been issued for each of them by M/MED/FP.
C. Travel From U.S. to an Assignment Abroad
A woman who is in the United States for training, home leave, or pending U.S. to post transfer, and who is at 28 weeks or greater gestation will not be cleared to go to abroad until 4-6 weeks after delivery. MED may pay per diem, based on the given circumstances, for the woman to stay in the U.S. to deliver if she is on post-to-post orders, but prevented from transferring due to this 28-week rule. Per diem cannot be approved for a pregnant woman or newborn transferring from a U.S. assignment to an assignment abroad, even if the departure is delayed due to this 28 week rule. An employee may receive Separate Maintenance Allowance (SMA) payments on behalf of his pregnant spouse and any children who remain in the U.S. with the spouse provided that the employee and family members are separated for at least 30 consecutive calendar days. Employees may apply for SMA benefits using form SF-1190 (Foreign Allowances Application, Grant and Report) and are urged to apply before the separation so that benefits may commence as soon as the employee and eligible family members are separated. (See Department of State Standardized Regulations, Section 262 and 263 for more details.)
9. Travel Reservations
Travel cannot commence until medevac and fund cite telegrams have been issued, but reservations can be made beforehand. The ticket must be issued with an open return. The policies of American carriers require that the pregnant employee or covered eligible family member depart post six weeks prior to the expected delivery date. Medical considerations, however, may dictate an earlier departure from post.
10. Per Diem
A. The Department's Office Of Medical Services authorizes up to 90 days of per diem for periods before and after delivery, usually six weeks each, to a pregnant employee or eligible family member medevaced to the United States or elsewhere. Periods of hospitalization are not covered by per diem. Generally, per diem is not extended beyond six weeks after delivery. Per diem in excess of 90 days, but not to exceed 180 days, may be authorized by the Medical Director or designee or the Foreign Service medical provider when there is a clear medical complication necessitating early departure from post or delayed return to post. Per diem for newborns is authorized at one-half of the applicable local rate, excluding periods of hospitalization.
B. To the greatest extent possible, obstetrical travel should be scheduled to coincide with other non-medical travel, such as home leave or transfer orders, to avoid the necessity of additional medical travel expense. No per diem may be granted while on home leave. Minimum home leave when transferring to another assignment abroad is 20 workdays and maximum is 45 workdays (Reference 3 FAM 3430) for employees and their eligible family members. When transferring to a domestic assignment, the maximum number of home leave days authorized is 25 workdays (3 FAM 3435.1).
Note: Human Resources technicians in HR/CDA/AD mentioned in the following paragraphs are located in Room 4250, SA-3, telephone (202)-663-0405, fax: (202) 663-0449.
11. Layette Shipment
A layette shipment is a separate airfreight allowance not to exceed 250 pounds gross weight for a newborn child or an adopted child less than five years of age who is an eligible family member. Once post has certified that suitable layettes are not available locally (14 FAM 613.5), post must submit a cable to employee's HR technician (HR/CDA/AD) requesting that the employee's original travel orders be amended to authorize a layette shipment. This telegram must include post certification of unavailability. After the orders are amended, the employee must contact the Office of Transportation and Travel Management Division (A/LM/OPS/TTM) in the Department to make arrangements for onward shipment (tel: 202-647-4140 or 800-424-2947; fax: 202-647-5396; e-mail TransportationQuery@state.gov). The employee or eligible family member will arrange for a family member/friend/store in the U.S. to obtain a layette if s/he has not already done so before going to post. The family member/friend/store may also coordinate with A/LM/OPS/TTM for shipping. Air shipment of the layette must commence no later than 60 days after the birth of the child.
12. Information/Documents to Take With You
The medevac'd employee or eligible family member should carry the name and telephone number of employee's personnel technician in HR/CDA/AD and take with her a blank FORM OF-126 ("Foreign Service Residence and Dependency Report") and a blank diplomatic or regular passport application. Medical documents to be taken include a blank FORM DS-1622 ("Medical History and Examination for Foreign Service) for children 11 years and under; a letter of referral with medical reports in English; and insurance information for the attending doctor's office in the United States. Read instructions carefully and any information requested in MED channel telegrams.
Issues to address while in the United States
13. M/MED Contact
Upon arrival in U.S., the employee/mother or eligible family member must call M/MED Foreign Programs office located in State Annex 1, 2401 E. Street, NW, Room L-209, tel: 202-663-1662. This is necessary for arrival notification and administrative assistance.
14. Health Insurance
The Federal Employees Health Benefits program requires that all in-patient confinements must undergo pre-certification in the United States. Therefore, the employee mother or eligible family member or doctor must call her insurance company prior to admission to the hospital to give birth (or within two working days in the event of an emergency hospitalization) to receive full insurance benefits. To ensure maximum insurance coverage, employee mother/eligible family member should choose a preferred provider within the scope of her private health insurance. M/MED pays the deductible and co-insurance for covered pregnancies when a "Letter of Authorization" (Form DS 3067) is issued. An employee/mother serving under a FMA or Temporary appointment on intermittent non-work schedules (INWS) or LWOP status should review her medical coverage if she has elected self-coverage.
An employee/mother on LWOP may make arrangements with her human resources office at post or in the appropriate bureau Executive Office to repay her health insurance premiums when she returns to duty. It is the employee's responsibility to make sure that the baby is added to his/her health insurance policy. If the parents are both U.S. federal government employees who each have self-only coverage, two SF-2809s must be completed to terminate one self-only plan and change the other to family coverage. Questions regarding this or other health insurance issues on the addition of a child should be faxed to HR/ER/WLP (202 261-8182) or an e-mail message sent to Shelly V. Kornegay.
15. Working in the Department Before/After the Baby is Born
(State employees only). An expectant mother who has her baby in the United States generally spends at least six weeks in the U.S. prior to the delivery of her baby, and 4-8 weeks after delivery. If she travels to the Washington D.C. area and desires to work at the Department during this time, a short-term detail in the employing bureau or in another bureau may be possible through the employing bureaus Executive Director and Human Resources officer. If the pregnant employee works a short-term detail in the Department, she will be considered on work status without charge to leave, and M/MED will continue to authorize per diem.
16. After the Baby is Born
The employee/eligible family member and the baby may return to post after the baby is issued a birth certificate and passport and after both mother and child receive their medical clearances. (Per diem will not be extended due to delay in passport issuance.)
Checklist for return to post
17. Birth Certificate
The first step in getting the baby back to post is obtaining the birth certificate. Hospitals typically start the paperwork. The process can sometimes be expedited if the employee/eligible family member explains the special circumstances (i.e., the baby cannot travel to post without a passport that can only be issued with a birth certificate). It is advisable to obtain two certified copies of the birth certificate, one to be used for passport processing.
The mother and father (if the father is also an American citizen) of a child born abroad should apply at the ACS Unit in the country where the baby was born for a "Consular Report of Birth Abroad" which is the record of the birth abroad of a U.S. citizen. The document is full proof of U.S. citizenship and although not a birth certificate, serves as a birth certificate in the U.S. The parents should simultaneously apply for a regular passport, to be issued immediately at post, and a diplomatic (dip) passport to be issued by the SpecialIssuance Agency in Washington, D.C. The processing time for the dip passport is not long, and is usually expedited for overseas applications, especially in urgent situations. The ACS unit should mail the application for the diplomatic passport to the Passport Special Issuance Unit by overnight courier, and the passport will be returned in the same manner.
18. Passport
The baby must have a passport (preferably diplomatic), and in many cases, a visa as well, to travel to post. The baby cannot travel on the parent's passport. Application for the passport will require the personal appearance of both parents and the infant before an authorized acceptance agent in the country where the newborn is located. If both parents cannot be present, the reason must be explained in a notarized statement from the absent parent, who also gives consent to issuance of the infant's passport.
For employees or eligible family members in the Washington, D.C. area, the employees personnel technician in HR/CDA/AD prepares a form DS-1640 ("Request for Passport Services") authorizing issuance of a no-fee Diplomatic Passport for the baby and forwards it to Passport Services, Special Issuance Agency (202-955-0198). There is also a passport desk located in the Employee Services Center (Room 1252, hours: 9 a.m. to noon, 1:00 p.m. to 2:30 p.m.).
For employees or eligible family members outside of the D.C. area, there are two options:
A. A regular passport may be issued rather quickly at any regional passport office for a $45 passport fee plus a $35 expedite fee; or
B. A diplomatic passport may be obtained quickly at no cost, but additional time may be needed to allow for visa processing. For information regarding diplomatic passport issuance and visa requirements, please contact passport services at 202-955-0198 or e-mail them at diplomatictravel@state.gov prior to the baby's birth.
When the baby is born and has been added to the employee's orders, the personnel technician in the department can fax or mail to the mother a completed Form DS-1640 authorizing issuance of a no-fee diplomatic passport for the child. Present the DS-1640, a completed passport application including photos, at either a regional passport office or an authorized U.S. post office (see local phone book). If the clerk is unfamiliar with the processing of diplomatic passports, explain that the Department is expecting the application. Provide the clerk with a stamped express mail envelope addressed to Passport Services, Special Issuance Agency, 1111 19th St., N.W. Suite 350, Washington, D.C. 20036, Attn: Diplomatic Travel Branch.
See paragraph 16 above regarding passport applications for children born abroad.
19. Travel Orders
Send a copy of the birth certificate and completed, signed OF-126 ("F.S. Residence and Dependency Report") to the employee's personnel technician (HR/CDA/AD). The technician will amend the employee's orders to include the newborn baby, once the infant is medically cleared for travel. A copy will then be forwarded to the Travel Management Center at HST.
20. Medical Clearances
MED provides medical clearance services for all agencies which participate in the Department of State Medical Program. A medical clearance may be granted after the mother's obstetrician and baby's pediatrician provide M/MED/FP (Foreign Programs, (202) 663-1662) with necessary medical information to accomplish the clearance action. A newborn child will not be cleared before 4 weeks of age. The pediatrician must fill out a Form DS-1622 (Medical History and Examination for Foreign Service for Children Under 11 years). This needs to be done when the baby is 4 weeks of age or older, but within 90 days of birth. The completed form must be forwarded to M/MED/FP by fax to 202-663-3247, if on medevac. If not on medevac, the form must be forwarded to M/MED/MR. To enroll a new baby as an eligible family member in the Department of State Medical Program, an OF-126 (Foreign Service Residence and Dependency Report) must be submitted to the HR Technician. All other agencies must send a Memorandum of Eligibility to M/MED/MR.
21. Medical Records
Employees/eligible family members are reminded to hand carry, fax, or mail pertinent medical records to the responsible physician at post for appropriate follow-up.
22. Return Travel
The newborn requires an airline ticket to return to post. Employee/eligible family member should call the Travel Management Center (TMC) at HST for reservations for mother and baby. (For current information concerning the TravelManagement Center, please contact the Transportation Division at (800) 424-2947). The employee/eligible family member can also go directly to the TMC at HST, Room 1243 or call toll-free on 1-800-752-2320) for reservations and/or information. Remember that travel to post may take place only after medical clearances have been issued (medevaced mothers and their infants are cleared by M/MED/FP and after the HR/CDA HR technician has provided the Travel Management Center with a copy of the amended travel orders. Depending on circumstances, the TMC may either mail the baby's ticket or provide a prepaid ticket at the airport on the day of travel.
23. Travel Vouchers
Employees are responsible for keeping track of travel voucher expenses. Vouchers must be completed by Department of State employees and submitted within 7 workdays following completion of travel as required by 4 FAH-3 H4651.1-1a.
Within 10 workdays following receipt of the completed travel voucher, post is requested to report to M/MED/EX the dollar amount of transportation, per diem, taxi, and miscellaneous expenses claimed on the voucher.
24. Minimized considered.
RICE
