ࡱ> XZW Dbjbjo>o> vH T T=$,T.2DDDD-|q@-------$/t2.i@-.DD.!!!RDD-!-!!+l"m-DP/>2,-.0.,:3~$:3 m-m-:3-`Qr!\.. ^.:3 : STATE PERSONNEL MANAGEMENT SYSTEM APPEAL AND GRIEVANCE FORM (Attach copies of any earlier agency decisions. If appealing a disciplinary action, the notice of discipline must be attached.) EMPLOYEE S NAME:  FORMTEXT      EMPLOYING AGENCY:  FORMTEXT      DIV. or UNIT:  FORMTEXT      EMPLOYEE S CLASSIFICATION:  FORMTEXT      HOME ADDRESS:  FORMTEXT      HOME PHONE #:  FORMTEXT      WORK PHONE #:  FORMTEXT      Issue of employee s grievance or reason given by agency for taking disciplinary action (attach additional pages as necessary):  FORMTEXT      Date grievance or discipline was discussed with appointing authority:  FORMTEXT      State the issues of fact and law, to the extent possible, that support the employee s action (attach additional pages as necessary):  FORMTEXT      Employee s Requested Remedy:  FORMTEXT      EMPLOYEE REPRESENTED BY:  FORMTEXT      Address:  FORMTEXT      Phone Number:  FORMTEXT       EMPLOYEE S SIGNATURE: DATE SIGNED: Please Circle Appeal Category: 10 Termination 40 Forfeiture of Annual Leave 11 Termination on Probation 42 Written Reprimand 20 Suspension Without Pay 50 Involuntary Demotion 22 Emergency Suspension With Pay 60 Denial of Pay Increase 30 Grievance (If complaint involves a denied reclass, 80 Retaliation for Whistleblower Disclosure give date of last audit:  FORMTEXT      )  See reverse side for process to file your appeal DBM/ERD-1 (Revised 4/17) PROCESSES FOR FILING APPEALS Appeal of Disciplinary Action (appeal categories 10; 11; 20; 22; 40; 42; 50 and 60) An employee (or former employee) in the Skilled or Professional Service (other than an employee under a Special Appointment) who is disciplined according to Title 11 of the State Personnel and Pensions Article (SPP) may appeal the discipline as follows: (1) Within 15 calendar days of notice of the appointing authoritys disciplinary action, file a written appeal with the head of the principal unit. The head of the principal unit shall issue a written decision on the appeal within 15 days of its receipt (SPP 11-109(e)); however, the failure of the head of the principal unit to issue a written decision within 15 days constitutes a denial of the appeal from which the employee may appeal further, as noted below. SPP 11-108(b). (2) Within 10 calendar days of receipt of the decision of the head of the principal unit, either in writing or by action of law as noted above, appeal to the Department of Budget and Managements Office of Personnel Services and Benefits, Employee & Labor Relations Division, 301 West Preston Street, Room 607, Baltimore, Maryland 21201. An appeal to the Department shall include a copy of the decision being appealed. The Department of Budget and Management has 30 days in which to attempt to resolve the appeal. If the appeal is not resolved, the Department of Budget and Management will forward the appeal to the Office of Administrative Hearings for a hearing and advise the employee of this action. The disposition of the appeal by the Office of Administrative Hearings is the final administrative decision. For employees under a Special Appointment or in the Management or Executive Service, an employee (or former employee) who is disciplined according to SPP Title 11 may appeal the discipline within 15 calendar days to the head of the principal unit. Within 15 calendar days after receiving the appeal, the head of the principal unit will issue a written decision, which is the final administrative decision. Each party shall make every effort to resolve a disciplinary matter at the lowest possible level. Appeal of Grievance (appeal category 30) A covered employee (see SPP 12-102) may file a grievance in the following manner: Step One. Before initiating the grievance procedure the employee must first discuss the grievance with the employees supervisor. Within 20 calendar days after the alleged cause of complaint, or within 20 calendar days after the employee reasonably became aware of the alleged cause of complaint, the employee may present the grievance in writing to the appointing authority. A copy of the grievance shall be given to the employees supervisor. The appointing authority shall hold a conference with the employee within 10 calendar days after receipt of the written grievance and shall issue a written decision within 10 calendar days after the conference. If the employee is not satisfied with the decision, the employee or employees designated representative may appeal to the head of the principal unit or designee within10 calendar days after receipt of the written decision. Step Two. The head of the principal unit or a designated representative shall hold a conference with the employee within 10 calendar days after receipt of the written appeal, and shall issue a written decision to the employee within 10 calendar days after the conference. If the employee is not satisfied with the decision, the employee or the employees representative may appeal to the Department of Budget and Managements Office of Personnel Services and Benefits within 10 calendar days after receipt to the written decision. If this decision is appealed, it should be directed to Department of Budget and Management, Office of Personnel Services and Benefits, Employee Relations Division, 301 West Preston Street, Room 607, Baltimore, Maryland 21201. An appeal shall include a copy of the decision being appealed and any other prior decisions. Step Three. Within 30 days of receipt of the employees appeal, the Department of Budget and Managements Office of Personnel Services and Benefits Dxz| ~        $ & . 2 4 H J L V X \ p r ӺӲxjfhWUjhWUmHnHujhWUjhWU hW5\ hJX6]hd!hJX]jhJXUmHnHujhJXUjhJXUhJX hJX5\ hW6] hWCJhW5CJ \hW/Dxz| ~  Z ckdt$$Iflu*+04 laytJX$If$a$ Z \ !ckd$$Ifl4^*+04 laf4$Ifskd$$Ifl0*p04 la       2 4 6 @ B F P R \ ^ b d f z | ~ B D X Z \ f ̶̫̠̕jhWUjhWUjhWUjhWUjRhWUhW hW5\ hW6]jhWUmHnHujhWUj`hWU: D F H y dh$Ifvkd:$$Ifl40*`p04 laf4$If  dh$Ifvkd?$$Ifl40* p04 laf4 j l .ckd8$$Ifl4*+04 laf4 dh$IfckdD$$Ifl4*+04 laf4f h j l vx,.268LNPZ\^`nrt޺ޯޤޙj hWUj hWUj hWUjhWUjhWUmHnHujhWUhW hq5\ hW6] hW5\jhWU<^.ckd $$Ifl4z*+04 laf4 dh$Ifckd,$$Ifl4*+04 laf4^`.ckd $$Ifl4*+04 laf4 dh$Ifckd $$Ifl4Q*+04 laf4 !"A   ʽʭʐ~u~lha h05\h0hS|5CJ\h5CJ\hd45CJ\hW5CJ\hW5>*CJ\$jhW5CJU\mHnHujz hW5CJU\jhW5CJU\hW5CJ\ hW>*hW hW6] hW5\jhWUjhWUmHnHu&"A V^ dhckd $$Ifl4*+04 laf4| `G 3##hA & Fgd0`gd0^gd0^gd0gd0dhgd0$^a$^ #@AAvCwCxCyCCCDDDDžh"Zjh0hW hW5\ hWCJjh0UU h0CJh05>*CJ\ h0aJh0CJaJh05>*CJ\aJmay confer with the parties and attempt to resolve the grievance. If a settlement is not reached, the Department of Budget and Managements Office of Personnel Services and Benefits will forward the appeal to the Office of Administrative Hearings. The disposition of the appeal by the Office of Administrative Hearings is the final administrative decision. The parties are obligated to attempt to resolve the grievance at the lowest possible step. Appeal of Whistleblower Complaint (appeal category 80) An employee may appeal to the Office of Administrative Hearings for a hearing either: (1) Within 10 days after receiving a decision on the complaint from the Department of Budget and Managements Office of Personnel Services and Benefits; or (2) When a decision is not issued within 60 days after the complaint is filed and the complainant requests a hearing.  FAILURE TO FULLY COMPLETE THIS FORM WILL DELAY THE PROCESSING OF THIS APPEAL OR IT MAY RESULT IN ADVERSE ACTION ON THIS APPEAL. 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