Preparation: The Employee Impact Form is designed to be created immediately following the initial Program Discipline Review cycle at a location and to be on an annual basis as necessary. There are three major categories of information to Be captured on this form including:
Summary of Outcomes/Recommendations Related to Program Discipline Review Dated:
This information should be readily available from data and narrative developed as part of the Program Discipline Review process. The data is required in order to document the initial review. An example of the kind of information you might here is: The Mortuary Science program at DCCCD College was one of the initial college offerings beginning in 1966. Throughout the life of the program, the enrollment has steadily decreased from approximately 1000 full-time students annually to 100 full-time students annually. Coupled with the cost of the equipment required and the current loss of students, the College has decided to abandon the program effective with the 2000-2001 academic year. There is one full time faculty member currently assigned to this program, W. P. Salem, who is serving on a three-year faculty contract.
Summary of Options Available, and Source of Funding for Each:
This category is designed to capture the details of initial discussions with the employee impacted. Information should include ideas of possible options available to support the employment of the individual. Examples might include: Fall Sabbatical leave for the purpose of completing doctorate in another field for personal or organizational growth; developmental leave to pursue technological in an alternative field identified by the college; released time research and develop a new program identified by the college; time for interviews as requested by the individual, etc. Source of funding for options is designed to capture location/district budget liability early in the process.
Summary of Actions:
This category should document employment status issues (i.e. wind down contract, 90 day notice of position elimination for a professional support staff employee, etc.) In addition, this category should provide documentation of agreed upon actions for each fiscal year, as required.
Distribution: This form should be completed at the location and discussed with the impacted employee directly. The signatures, through the President, are required in order to document the process. The college human resources office should receive a file copy of the document. The original of this form should be forwarded to the District Director of Human Resources for filing in the official personnel file for the individual referenced.