A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 Insight on the Issues Breaking New Ground: Supporting Employed Family Caregivers with Workplace Leave Policies Lynn Friss Feinberg AARP Public Policy Institute As the US population ages, more and more workers bear responsibilities for caring for family members with a serious illness or disability. These family caregiving responsibilities can have a substantial economic impact on workers, and pose a challenge for policy makers and employers to find ways to make the workplace more “caregiver-friendly.” Providing workers with access to paid family leave and paid sick days can lessen the strain of caregiving, provide family caregivers with greater financial security, increase employee retention, and help maintain a productive workforce. In one household, a spouse is recovering from difficulties or risk losing their jobs if they must take internal injuries from a bicycle accident; in another, time off to address specific and significant family an older parent is hospitalized with a broken hip caregiving needs. from a fall. Elsewhere, a grandparent suffers a In 2013, the AARP Public Policy Institute released stroke, while a cancer diagnosis requiring surgery a report that found only two states offered a paid befalls another family. In another household, family leave (PFL) program, and only one state and parents care for and bond with a new child. the District of Columbia had enacted a paid sick Each of these family and medical situations days law.1 As of June 2018, six states and the District necessitates a working adult to take a period of time of Columbia have PFL programs, and 10 states and off from work to care for himself or herself or for the District of Columbia have paid sick days laws others. Yet as common as such events are, existing that cover family caregivers. And a number of federal policy and most states’ family leave is additional states have legislation moving forward. unpaid, making it challenging for many employed Nevertheless, much work remains for working caregivers, particularly low-wage workers, to take family caregivers to receive the kind of support time off to care for a seriously ill family member they need from their employers—and for because they cannot afford to miss a paycheck. employers to realize the benefits of providing such As a result, millions of Americans face financial support. This paper highlights the challenges faced A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 by workers with family caregiving responsibilities, to strengthen family leave policies and support explains why many workers cannot afford to employed caregivers. take unpaid leave from their jobs, and reviews Workplace leave policies can be applied to workers research on workplace leave policies affecting caring for family members of any age or for one’s both employees and employers. It describes state own health issues. However, to specifically address family and medical leave laws that are more the needs of an aging population and workforce, expansive than the federal Family and Medical this paper focuses on leave policies for workers Leave Act (FMLA), and summarizes state-level PFL with family caregiving responsibilities for an older and paid sick days laws.2 The final section of the person or an adult with a chronic, disabling, or paper offers policy and research recommendations serious health condition. KE Y TERMS Employed caregivers include anyone employed in an organization or business who also provides care for an older relative or friend, or an adult family member or friend with a disability—the library administrative assistant, the hospital nurse, the factory worker, the government agency policy analyst, the hardware store clerk, or the company chief executive officer, for example. Family caregiving means providing a wide array of help for an older person or other adult with a chronic, disabling, or serious health condition. Such assistance can include help with personal care and daily activities (such as bathing, dressing, paying bills, handling insurance claims, preparing meals, or providing transportation); carrying out medical or nursing tasks (such as complex medication management, tube feedings, or wound care); locating, arranging, and coordinating services and supports; hiring and supervising direct care workers (such as home care aides); serving as “advocate” for the family member or friend during medical appointments or hospitalizations; communicating with health and social service providers; and implementing care plans. Paid sick days—also known as earned sick days, paid sick leave, or paid sick time—is generally limited to a number of hours or days (typically covering 4 hours per 30 hours of work, or between 3 and 8 days) to allow workers to stay home when they are sick with short-term illnesses, such as the flu. It also can mean limited paid hours or days off per year to care for sick family members or to accompany a family member to a medical appointment. Family leave means longer time off (either unpaid or paid) to care for a seriously or chronically ill family member. Family leave generally also includes parental leave. Parental leave covers mothers (maternity leave) and fathers (paternity leave), allowing them to bond with a new child after birth or adoption. Medical leave covers workers with a serious health condition who need time for self-care. Medical leave generally includes leave for medical conditions related to pregnancy and childbirth. Source: Adapted from Women’s Bureau, Findings from the 2014 Paid Leave Analysis Grants Program (Washington, DC: US Department of Labor, 2016); and Lynn Feinberg, Keeping Up with the Times: Supporting Family Caregivers with Workplace Leave Policies (Washington, DC: AARP Public Policy Institute, 2013). 2 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 THE EMPLOYED FAMILY CAREGIVER: projected to outnumber children under the age of 18 CHARACTERISTICS AND TRENDS for the first time in US history by the year 2035.6 The need for a sensible approach to supporting the Trends suggest that an increasing share of family employed family caregiver is greater than ever and, caregivers will be in the labor force in the future, in fact, the need is only increasing. Fueling that facing the dual demands of employment and need are several trends, on both the demographic caregiving responsibilities for aging relatives. A 2017 and individual levels. survey of benefits managers (mostly from large US Employed Family Caregiver: The New Normal employers) found that the vast majority (82 percent) agreed or strongly agreed that family caregiving Family caregivers are the most important source of would become an increasingly important issue for emotional and practical support for older persons their business over the next five years.7 or adults with a serious illness or disability. About 40 million family members, partners, or friends Half (51 percent) of employed caregivers are older in the United States—known broadly as “family workers themselves, ages 50 and older—in their caregivers”—provide an estimated 37 billion hours prime working years.8 Workers ages 55 and older of care to adults with self-care needs. The most are projected to remain the fastest-growing portion recent estimated economic value of their unpaid of working adults in the United States. With the contributions was approximately $470 billion in aging of the baby boomers, the US Bureau of 2013.3 Labor Statistics projects an estimated one in four Yet unlike previous generations, many American workers—25 percent of the total US workforce— families today do not have a nonworking family will be age 55 or older by 2024, up from 13.1 percent member to provide daily care to an older relative in 2000.9 Many of these older workers will also have with self-care needs, in large part because of the family caregiving responsibilities. By one estimate, increase in the labor force participation rate of two in five adults over the age of 50 may someday women, especially older women. Consequently, an need to take care of their parents or parents-in-law.10 estimated 24 million family caregivers—about 60 Many may also need to care for a spouse, partner, percent of family caregivers of adults—are also grandparent, or other relative or close friend. working at a paying job.4 Current labor force trends of an aging workforce • Nearly two in three (63 percent) of these are especially pronounced for older working employed family caregivers are caring for an women—those most likely to also be family individual age 65 or older. caregivers. The percentage of women ages 55 and older who work is expected to increase from 28.5 • On average, employed family caregivers work percent in 2013 to 35.1 percent in 2022. During the the equivalent of a full-time job (34.7 hours a week) on top of their caregiving and other family same period, the percentage of working women responsibilities. over age 64—those most likely to be caring for a spouse—is expected to increase from 14.4 percent • Most current family caregivers (55 percent) to 19.5 percent.11 expect to have some caregiving responsibility in the next five years, too.5 These shifts toward more older women in the labor force can add to family incomes and greater savings Ever-Growing Numbers of Employed Caregivers for retirement as well as contribute to overall Due to the aging of the US population, increasing economic growth. Yet, as women work outside the longevity, and a declining birth rate, US workers home to make ends meet and contribute to the may have more older relatives to care for than economy, the demands and pressures of working children in the coming decades. According to the families to balance work, caregiving, and other US Census Bureau, adults ages 65 and older are family responsibilities have grown. 3 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 Caregiving’s Impact on Employment: Among working-age family caregivers accessing The Financial Reality the Older Americans Act’s National Family Many people expect to continue working in later Caregiver Support Program, nearly 40 percent of life, often for financial reasons. Yet research shows nonworking family caregivers had quit their jobs that intensive caregiving (defined as providing or retired early from work because of intensive 21 or more hours of care per week) is associated caregiving demands. The majority of these nonworking caregivers were women who provided with early retirement12,13 and other work-related help with three or more activities of daily living impacts, such as giving up work entirely, reducing (such as bathing or feeding) for a spouse, and who work hours, or taking a less demanding job.14,15 In experienced high emotional stress.17 the Caregiving in the US 2015 survey, 45 percent of employed caregivers with intensive caregiving The economic consequences of reducing work responsibilities experienced these work impacts, hours, quitting a job to provide care, or taking an compared with 17 percent of employed family unplanned early retirement can be significant. Research shows that family caregivers who disrupt caregivers who provided 20 hours or less of care per their careers or leave the labor force entirely to meet week. See figure 1. full-time caregiving demands can face substantial Further, a recent national survey of family economic risk and short-term and long-term caregivers found that more than one in three (36 financial consequences by losing salary, personal percent) who were not currently in the labor force retirement savings, eventual Social Security and said they retired early or quit their jobs because of retirement benefits, career opportunities, and family caregiving concerns.16 overall financial well-being.18 FIGURE 1 Selected Impacts on Work Because of Family Caregiving Base: Employed caregivers of persons ages 18 and older (n = 724) Source: National Alliance for Caregiving (NAC) and AARP Public Policy Institute, Caregiving in the US 2015 (Bethesda, MD: NAC, and Washington, DC: AARP, June 2015). 4 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 Evidence suggests that family caregiving for a Recognizing the Need for Workplace Leave spouse or a parent is associated with reduced Policies That Support Employed Caregivers labor force participation and a higher probability Caregiving responsibilities for ill family members of falling into poverty when compared with non- sometimes necessitate taking either scheduled caregivers.19 Income and benefit losses borne by or unscheduled time off from work, which some family caregivers ages 50 and older who leave the employers allow. However, workplace leave benefits workforce to care for a parent are estimated at for family caregiving needs are not available to all $303,880, on average, over that caregiver’s lifetime.20 workers in all work settings. Strengthening support Other research has also shown a link between for working family caregivers, therefore, starts in family caregiving and the financial strain of lower this area. income in later life.21 Workplace leave policies are a key component of The potential for falling into poverty is a high-functioning LTSS system. The stresses on particularly acute for women.22 Adult daughters employed family caregivers are compounded when who care for their parents are more likely to have they lack the supports and protections that could lower incomes than non-caregivers, and they are help them manage their dual responsibilities. The further penalized with fewer financial resources LTSS State Scorecard identifies the availability of and less economic security as they themselves age.23 workplace leave policies—including expansion of Women who quit their jobs to provide care may also state family and medical leave laws and access to find it challenging to return to the workplace once PFL and paid sick days—as a key component of a they no longer provide care to a parent.24 state’s high-performing LTSS system.28 In a national survey of adults ages 40 and older, For more background on employed family about two-thirds (64 percent) said they had been caregivers, see the AARP Public Policy Institute employed while providing long-term services and Spotlight, The Dual Pressures of Family Caregiving supports (LTSS)25 to a family member, and nearly and Employment.29 half (47 percent) said balancing work and caregiving UNPAID FAMILY AND MEDICAL LEAVE was difficult. In this survey, employed family The 1993 enactment of the federal Family and caregivers without access to paid time off were more Medical Leave Act was the first federal law to likely than those with paid time off to reduce their recognize the dual demands of work and family. work hours to part time to provide care (13 percent The FMLA established worker rights of up to 12 v. 4 percent) and to leave the labor force earlier than weeks of unpaid, job-protected leave to bond with planned for family caregiving reasons (14 percent v. a new child, care for oneself because of a serious 6 percent).26 health condition, care for certain ill family members Out-of-pocket spending can erode the financial (i.e., child, spouse, parent), or care for a military security of family caregivers. In addition to the service member with a serious injury or illness.30 job impacts of family caregiving, direct caregiving The FMLA applies to private employers with 50 or costs take a financial toll. An AARP study found more employees and public-sector agencies. that more than three in four (78 percent) family Only 60 percent of the workforce is eligible for caregivers incurred expenses as a result of FMLA protections because not all workers are caregiving, spending an average of about $7,000 eligible and small employers are exempt from the on out-of-pocket costs in 2016. To cover caregiving law.31 Sometimes a worker cannot take FMLA leave expenses, family caregivers reported dipping into because the person for whom he or she must care personal savings (30 percent), reducing retirement is not covered under the federal FMLA’s provisions. savings contributions (16 percent), or dipping into For example, time off to care for certain family existing retirement savings (11 percent).27 members, such as a seriously ill brother with cancer 5 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 or a grandmother with advanced Alzheimer’s multicultural.33 By one estimate, nearly one in four disease, is not covered by the FMLA. (24 percent) family caregivers are unfamiliar with Contrary to popular belief, most workers take the FMLA.34 FMLA leave to care for their own health issues. Nearly one in three states exceed the minimum Workers experience a range of personal health and requirements of the FMLA. Fifteen states and the caregiving needs during their work lives. According District of Columbia have broadened eligibility for to the most recent national study of the FMLA in workers beyond the federal provisions in the FMLA, 2012, about 16 percent of all eligible employees enhancing support for employed family caregivers used the FMLA during the previous year. While in three main ways (see appendix A): it is commonly believed that most workers take FMLA leave for the birth or adoption of a new child, • Covering workers in businesses with fewer than 50 employees; the majority of workers (55 percent) who use the FMLA do so to deal with their own serious health • Providing a more inclusive definition of an condition. Another 21 percent access the FMLA eligible family member to include domestic for the birth or adoption of a new child, and 18 partners, grandparents, parents-in-law, or siblings; percent do so to provide care for a qualifying family or member (i.e., ill child, spouse, or parent)32—a share • Expanding FMLA use provisions to allow that is likely to grow as the population ages and workers to take family members to medical continues to work longer (see figure 2). appointments. Unpaid family leave creates financial hardships FIGURE 2. for many working families and disincentives to Reasons for Taking FMLA Leave use it. In a recent national survey, about half (46 percent) of FMLA workers who needed family leave but did not take it cited “lack of pay” as the main reason for not using the workplace benefit. Nearly two-thirds (62 percent) of all FMLA leave takers with partial or no pay reported some difficulty in making ends meet as a result of their time off, and almost half of those families reported serious financial difficulty.35 Taking unpaid leave for caregiving demands can be costly, as can reducing work hours or taking a lower-paying and less demanding job. Not only do family caregivers experience an immediate loss of income or other benefits, but such job impacts can result in financial harm that they may feel for the rest of their lives. Many caregiving families that Source: Jacob Alex Klerman, Kelly Daley, and Alyssa experience these kinds of job impacts must use Pozniak, Family and Medical Leave in 2012: Technical their retirement savings to support their everyday Report (Cambridge, MA: Abt Associates Inc., 2014). needs and to help pay caregiving expenses, thereby affecting their future economic security.36,37 Some workers are still unaware of the FMLA By one estimate, employed family caregivers 25 years after its enactment. Many workers who between the ages of 18 and 64 who take unpaid are eligible for the FMLA are unaware of the law’s family leave lose an estimated $1.7 billion in benefits and eligibility requirements, especially wages owing to a lack of access to PFL for family workers who are younger, lower income, or caregiving needs.38 6 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 PAID FAMILY LEAVE FIGURE 3. Paid Family Leave Policies to Care for PFL offers a solution to many of the pitfalls the Health Needs of Children and Adults associated with unpaid leave; in fact, some states among 34 OECD Countries have implemented their own programs to provide PFL to eligible workers. The following is a look at the current state of play for PFL, including its level of use, barriers to greater adoption, how the employer benefits from it, and other relevant issues. PFL helps workers remain at their jobs and continue as family caregivers—benefiting workers, employers, and the economy. For workers who take on family caregiving responsibilities but cannot afford adequate time off to do so, PFL can provide peace of mind when they need to take a period of time away from work. For employed family caregivers, PFL can also promote economic security—a key component of social determinants of health.39 The lack of PFL policies disadvantages employed family caregivers across the life course—especially low-income workers—because most workers cannot afford the financial hardship of going without a paycheck while meeting the necessity of family Note: Excludes parental leave policies. leave. A 2017 Pew Research Center survey found Source: Adapted from Amy Raub et al., Paid Leave for that among those workers who had taken leave Family Illness: A Detailed Look at Approaches across from their jobs or had needed or wanted to do so in OECD Countries (Los Angeles, CA: WORLD Policy the past two years, having paid family or medical Analysis Center, February 2018). leave was the most helpful workplace benefit or arrangement.40 leave benefits in OECD countries for workers to care The United States has no national public for adult family members with health needs are policy that requires employers to provide generally less available and less generous than PFL PFL benefits. 41 Unlike the United States, most to care for ill children.43,44,45,46 industrialized nations guarantee workers some type of PFL. Some employers voluntarily offer the option of PFL benefits. However, although large companies PFL outside the United States is mainly for are increasingly adopting or expanding PFL benefits parental leave; access to leave for eldercare is less for certain employees, the vast majority of today’s common and less generous. According to a recent US workforce lacks meaningful access to PFL. systematic review of the paid leave literature from 34 countries in the Organisation for Economic According to the US Bureau of Labor Statistics, only Co-operation and Development (OECD), all OECD 13 percent of private-sector workers had access to countries, except the United States, have paid PFL through their employer in 2017.47 leave policies for new parents (parental leave)42 Low-wage workers, young adults starting their or personal medical leave; fewer OECD countries careers, multicultural workers, and employees at have PFL for workers with family caregiving small businesses are the least likely to have access to responsibilities for aging parents, spouses, or other PFL benefits at their job. For example, as of March ill family members. As shown in figure 3, paid 2017, only six percent of private-sector workers in 7 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 the lowest 25 percent of average wages have access FMLA. Furthermore, grandparents are typically to PFL benefits. In contrast, 24 percent of workers in not considered qualifying family members under the highest 25 percent of average wages have access employer-provided PFL policies. to PFL benefits.48 Some states have enacted laws establishing PFL Family leave is not just for new parents. Experts programs. To date, six states and the District of suggest that providing workers with some type of Columbia have modernized their work family PFL for caregiving demands might be the single policies for a changing workforce and enacted most important policy for employers to consider legislation that provides partial wage replacement in designing a caregiver-friendly workplace.49 Yet to eligible workers, including certain employed despite the aging of both the population and the family caregivers. These state PFL programs differ workforce, the great majority of private-sector paid in eligibility and waiting period requirements, leave is currently limited to parental leave to bond qualifying family members, amount of benefits with a newborn or adopted child. paid, maximum length of paid leave, whether a Although over 100 brand-name companies have worker’s job is protected during PFL, and how the voluntarily adopted or expanded paid leave policies program is funded (see appendix B). over the past three years, most cover only new The first four states to enact PFL (California, New parents.50 Only about 1 in 5 (20 percent) of these Jersey, Rhode Island, and New York) all had existing companies provide PFL for family caregiving needs Temporary Disability Insurance (TDI) programs.54 for certain ill family members. Moreover, in their These TDI programs provide workers a portion of eligibility requirements, these private-sector leave their wages for medical leave for their non-work- policies generally do not offer a broader, more related serious health condition or illness. These inclusive definition of family (i.e., beyond child, first four states added family leave to their existing spouse, or parent) or cover other relationships (such TDI programs and financed it through employee as siblings, grandparents, or close friends). payroll deductions. The limited scope of these coverages runs counter The three newest PFL programs do not have to today’s family makeup and roles. As the growing existing TDI programs and will be financed numbers of older adults experience the care gap51 through different insurance mechanisms. When and rely on friends and family members other than implemented, the District of Columbia’s PFL their own children for support, broader uses of program will be funded by employers. Washington family leave will be needed. State’s and Massachusetts’s PFL programs will be Prime examples of this need even today are jointly financed by a stand-alone social insurance millennial family caregivers. The rate of program that is funded by employee and employer employment is especially high for millennial family payroll deductions. These state PFL programs are caregivers (those born between 1980 and 1996). promising state models and incubators because, Almost three in four (73 percent) millennial family like most states, they do not have a TDI program to caregivers are employed and providing care for an build on.55 adult with a disability or an older adult with chronic Utilization of state PFL programs for family care needs; one in three (34 percent) employed caregiving needs is relatively low but climbing. millennial caregivers earns less than $30,000 a Although PFL leave benefits in the first three states year.52 to implement programs (California, New Jersey, and About one in five (22 percent) millennial caregivers Rhode Island) are utilized by both female and male care for a grandparent.53 Yet these younger workers from all income and age groups, there are adults—who are most likely in the labor force, substantial differences among claim types. and often earn lower incomes—are ineligible for The most recent study on the economic and social unpaid family leave because grandparents are impacts of California’s PFL program found that, not qualifying family members under the federal since the inception of the program in 2004, PFL 8 A ARP PUBLIC POLICY INSTITUTE INSTITUTE SEPTEMBER 2018 claims for bonding with a newborn or adopted child all PFL claims, estimated at about nine percent and have been substantially more common (88 percent) seven percent, respectively65 (see also appendix B). than claims for family caregiving (12 percent).56 In California and Rhode Island, in 2014 the average While family caregiving claims represent only 12 length of PFL used to care for a family member percent of PFL claims in California, such claims with a serious health condition was slightly under have steadily increased by 52 percent in the past four weeks; in New Jersey, it was a little over four decade, from 21,718 in 2007 to 33,033 in 2017.57 weeks.66 In New Jersey, 82 percent of PFL claims made The main barriers to use of states’ PFL laws and between 2014 and 2016 were to bond with a benefits are lack of awareness, limited wage newborn or newly adopted child; the remainder of replacement, and the absence of job protection in claims made were to care for a seriously ill family member. The number of family caregiving claims some states’ laws. has held steady at about 5,200 per year.58 • Public awareness of states’ PFL programs is Though small in number overall, family caregiving limited, especially regarding eligibility for claims in Rhode Island have increased about 17 family caregiving needs. percent in the past three years, from 1,023 claims in Research on the implementation of the first three 2014 to 1,198 in 2016. Since the program began in states to enact PFL programs (California, New 2014, about one in four (23 percent) PFL claims have Jersey, and Rhode Island) consistently shows that been to care for an ill family member and more only about half of each state’s population is aware than three in four (77 percent) claims have been of its state’s PFL benefits—with especially low to bond with a new child.59 One reason caregiver awareness about eldercare, and among lower-income claims may be proportionately higher in Rhode workers, and communities of color.67,68,69,70,71, 72 Island is because that state has job protection for Studies in these three states also consistently find workers who take PFL. significantly less awareness among workers that the Among the care claims for PFL in California over PFL benefit can be used to care for certain ill family the past decade, about one-third (34.4 percent) members compared with awareness that the benefit have been for employed family caregivers caring can be used to bond with a new child.73,74,75,76,77 for parents, another one-third (33.7 percent) were for care of spouses, one-fifth (20.9 percent) were Qualitative research in these three pioneering states for parents caring for ill children, and about 11 suggests a general lack of awareness of the meaning percent were for care of other ill family members.60 of PFL benefits—with workers perceiving that Caregiving claims in California between 2005 and the term paid leave is the same as sick leave and 2014 were highest for employed women ages 45 to vacation time.78 54—most likely caring for aging parents.61 A survey of Californians, taken more than a decade About two-thirds of care claims in California and after the state began providing PFL benefits for Rhode Island are submitted by female workers; eligible workers, found that those who were a family one-third are submitted by male workers.62,63 In New caregiver or had paid to provide care for another Jersey, in 2016 the majority of workers who filed family member were more likely than those who care claims were female (76 percent) and over the had not experienced LTSS to have heard of the age of 45 (64 percent).64 state’s PFL program.79 Research shows that between 2006 and 2013 in In Rhode Island—the state with the highest California, about one-third of paid family leaves for percentage of PFL claims to care for an ill family caregiving were taken to provide care to a parent, member and one that provides job protection for comprising about four percent of all paid leaves PFL— workers reported in one study that they were during that time. In New Jersey and Rhode Island, more likely to learn about the PFL program from leaves to care for a parent are a higher proportion of family and friends than their employers. Other cited 9 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 sources of information about PFL were co-workers half (45 percent) of workers surveyed said they and health care providers.80 would not have taken the PFL benefit without job protection.88 • Affordability is a barrier to taking PFL for some workers who cannot afford to live on only a Social stigma and workplace culture, and portion of their wages. acceptability of family caregiving needs for Research in California has shown that family eldercare, can also pose barriers to the utilization income plays a role in the utilization of the PFL of PFL. In contrast to the more accepted practice of program.81,82 To address this issue, California now bonding with a new child, some workers perceive provides higher pay to lower-income workers while their workplace culture lacks acceptability of the on leave—lifting the wage replacement rate for the concept of caring for ill parents, potentially keeping lowest-paid workers taking PFL from 55 percent them from applying for PFL benefits. to 70 percent, beginning in 2018.83 In studies of Feeling vulnerable to their employers’ possible California’s PFL program prior to the increase in reaction to needed incremental and sometimes wage replacement, one in three workers who were unplanned family leave—especially with the aware of the program said they were unable to take unpredictability of eldercare—is an issue for some the time off when they needed it because the wage employed caregivers. In the Caregiving in the US 2015 replacement rate was too low.84 survey, 44 percent of employed family caregivers While the wage replacement rates of the six states (who were not self-employed) said their supervisor and the District of Columbia that have enacted was unaware of their caregiving situation.89 PFL generally range from 50 to 66 percent, with Related to this issue, some supervisors may be less higher pay rates for lower-income workers in some familiar with the needs of family caregivers of older states (see appendix B), new analysis suggests that adults with a serious health condition or self-care wage replacement rates of at least 80 percent are needs. They may be less aware, for example, of how important to keeping low- and middle-income certain family caregiving situations may involve families out of poverty and able to meet essential intermittency and greater unpredictability than needs (such as rent payments) during an episode of the more familiar and continuous one-time leave PFL.85 arrangements associated with the birth of a child. • Lack of job security provisions in some state Common issues expressed in a three-state study PFL programs hinders workers from using the (California, New Jersey, and Rhode Island) of worker benefit. attitudes toward PFL ranged from discomfort with Some state PFL programs, including those in being viewed as less productive by an employer to Rhode Island, New York, Washington State, and fear of demotion, replacement, and even firing due Massachusetts (when implemented), provide job to lack of employer understanding and flexibility protection for workers who take PFL, meaning that regarding leave-taking to meet the ongoing workers must be allowed to return to their jobs after demands for a family member with LTSS needs.90 PFL has ended. Workers in other states may receive PFL can have positive benefits for workers, those job protection if they are entitled to unpaid leave for whom they care, and employers. Evidence under the FMLA or state family and medical leave shows that the benefits of PFL to both employee and laws.86 employer are shared and even intertwined. California’s PFL program does not provide job One new study examined the effect of California’s protection. Research conducted in that state with PFL law on nursing home utilization by older adults workers and employers suggests that lack of job in the state. This study is the first to examine LTSS protection is an important factor for workers in outcomes associated with state-level policy on PFL. deciding whether to apply for PFL benefits.87 In The research found that the use of PFL by employed Rhode Island, a state with job-protected PFL, nearly family caregivers in California showed an 11 percent 10 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 reduction in older adults’ nursing home utilization lower temporary staffing costs; and fewer costs in that state between 1999 and 2008.91 This suggests associated with recruiting, hiring, and training new that PFL can make it financially easier for workers workers.99 One national survey found that more to take time off from work to care for older relatives than eight in 10 (86 percent) workers who took time with serious health conditions and self-care needs off and received full paid family or medical leave at home and in their communities—which is where continued to work for the same employer following most older adults want to be. the time off. Only seven percent began to work for Other research on the early use of PFL in California a new employer, and another seven percent did not found that not only did workers who used PFL return to their job.100 have a greater ability to carry out their family A recent study of California’s PFL program found caregiving responsibilities, but also their loyalty to no evidence that turnover or wage costs increase their employer increased, as did the likelihood of for employers in businesses with higher rates of their returning to work with the same employer PFL take-up. Using data on nearly all California after taking PFL.92 In a more recent California study, employers between 2000 and 2014, the study when compared with workers taking paid parental found that the average business had a currently leave to bond with a new child, workers taking lower turnover rate than it did before PFL was PFL for family caregiving needs for an ill family introduced.101 member had a greater attachment to the labor force both before and after the PFL claim.93 PAID SICK DAYS One analysis found that greater availability of PFL Another important workplace leave benefit for and having a supportive supervisor can lead to employed family caregivers is access to paid improved emotional well-being for employed family sick leave, also known as paid sick days. But as caregivers and better health outcomes for the person with PFL, current federal policy does not require receiving care.94 employers to offer paid sick days as an employment Research shows that PFL is an important factor benefit. Consequently, many workers—especially in employment recruitment and retention, which low-wage workers—still do not have access to a can improve productivity and reduce absenteeism. single paid sick day to care for themselves if they Experiences of businesses in the first three states are ill or to care for family members with short-term to enact PFL laws—California, New Jersey, and caregiving needs. Rhode Island—show that once employers have As of March 2018, more than one in four (29 implemented PFL benefits, they are generally percent) private-sector workers lacked access to any supportive of paid leave, and indicate that PFL paid sick days.102 In businesses with fewer than 50 laws have had negligible to positive impacts on employees four in 10 (40 percent) workers lacked worker productivity, turnover, and morale.95,96,97 In paid sick time.103 a California study, small and medium businesses Paid sick time policies differ from paid family (those with fewer than 50 employees and those and medical leave policies. Workers can generally with 50 to 99 employees, respectively) reported use paid sick days in small, even hourly increments, the most positive outcomes—even more than large allowing them to use up their leave over a longer companies. About two in three of the companies period of time without losing their paychecks. Paid reported that they dealt with employee leave-taking sick days can be more flexible than PFL in that by assigning work temporarily to other workers; they allow time off for preventive care and short- one-third said they hired temporary replacements.98 term illnesses, as well as for providing intensive Research suggests a relationship between paid leave caregiving tasks for a family member, such as and job retention. Higher retention rates usually doing wound care for several days after a relative’s mean saved separation costs when an employee hospitalization or taking a family member to a leaves the job; unemployment insurance savings; medical appointment. 11 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 These paid sick days policies typically cover a home when sick or to care for ill family members limited amount of paid sick time off a year with full are more attached to employers, suggesting that wage replacement (see appendix C). One analysis paid sick days are an especially important benefit found that workers who have access to paid sick for worker retention.112 Where states or localities days typically use very little of the benefit—on have implemented paid sick days policies, research average, 2.1 days a year.104 suggests that employer costs to administer the A growing number of states are requiring benefit are minimal; in addition, employers have employers to provide access to paid sick days to not had to change their hiring and hours practices, their employees. Absent any federal law requiring use of these benefits are not abused, and workers’ employers to provide access to paid sick leave morale and work-life balance improves.113,114,115,116 for their employees,105 states and municipalities Paid sick days also provide public health have made progress in recent years to ensure advantages, including reduced spread of illness at that workers have some paid sick days when they work117 and reduced health care costs.118 The lack of themselves are ill, or when they need to care for ill paid sick days can lead to increases in emergency family members. room visits and delays in obtaining health care As of June 2018, 10 states and the District of services for workers or family members.119 Columbia require paid sick leave (Arizona, Other State Workplace Flexibility Laws California, Connecticut, Maryland, Massachusetts, New Jersey, Oregon, Rhode Island, Vermont, Some states, such as Illinois and Georgia, require and Washington) and over 40 local jurisdictions employers to give greater flexibility to their in nine states (California, Illinois, Maryland, workers on the use of existing leave benefits. For Minnesota, New Jersey, New York, Pennsylvania, example, an AARP model bill, the Eligible Leave Texas, and Washington) have passed paid sick days for Employee Caregiving Time (ELECT)— legislation.106,107 commonly known as the Illinois Employee Sick Leave Act—requires employers that offer unpaid There is a sharp income divide among workers or paid sick leave benefits in their business to with access to any paid sick days. Access to paid allow employees to use up to six months’ worth sick days varies greatly by income level. Nearly of earned sick leave benefits (effectively half of all (90 percent) of the highest-paid workers have the employee’s sick leave benefits) for family access to paid sick days, compared with less than caregiving responsibilities, including a family half (45 percent) of the lowest-paid workers.108 Some member’s illness or injury, or to accompany a localities are starting to close this gap. For example, relative to a medical appointment.120 a recent study found that the percentage of private- sector low-income workers in New York City with Georgia’s Family Care Act requires employers to paid sick days increased from 47 percent when the allow their eligible employees to use up to five paid sick time law in New York City went into effect days of earned paid sick leave per year to care for in 2014 to 71 percent in 2017.109 immediate family members.121 Access to paid sick days also varies across race, CONCLUSIONS ethnicity, and occupation. Hispanic and service- Managing paid work alongside providing care for industry workers are especially likely to not have an adult or aging family member with a serious any paid sick leave at their job.110 health condition or disability can be stressful for Paid sick leave has benefits for workers and employed caregivers when their needs are not employers alike, as well as positive economic being met by existing workplace policies. Because and health effects. Benefits of paid sick days for most family caregivers now hold paying jobs too, employers include improvements in productivity, employed caregivers need access to workplace reductions in workplace contagion, and reduced leave benefits that enable them to fulfill both their worker turnover.111 Workers who can afford to stay caregiving and paid work responsibilities. 12 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 Workers should not have to choose between keeping Adopt at the state level such policies that exceed their jobs and providing care to a seriously ill family the current federal eligibility requirements. member when they need it the most. • Optimize worker productivity and retention by Without a paycheck to cover the basic costs of promoting access to PFL programs. This has living while providing care, low-wage workers are the potential both to facilitate family caregiving particularly vulnerable. They tend to have the least and to help alleviate its economic hardships. In access to paid time off for caregiving needs and addition, employers should be required to provide cannot afford to take unpaid family leave. a reasonable number of earned sick days that States are leading the way. As more states consider workers can use for short-term personal or family enacting PFL programs or providing access to paid illness, and to allow workers to take relatives to a sick days that can be used to fulfill caregiving medical appointment. responsibilities, policy makers and employers can • Advance public awareness campaigns at the draw on lessons from existing state programs in the federal, state, and local levels to educate the United States. public about all aspects of family leave policies— including coverage for eldercare—and the FMLA Given the aging of the population and the and PFL in states that offer such policies, to workforce, caregiver-friendly policies—such as PFL ensure that workers know how to access benefits and paid sick days—are important for maintaining if needed. Efforts should be made to coordinate both economic growth and a worker’s own with health care and social services providers and economic security. Workplace leave policies are a faith-based communities in states with PFL, to sound investment for employers and for America’s promote greater awareness of the benefits. working families with caregiving responsibilities. POLICY AND RESEARCH RECOMMENDATIONS • Improve data collection on employed caregivers with eldercare responsibilities (including • Implement policies that strengthen financial surveys conducted by the Department of Labor, security for employed family caregivers. The Department of Health and Human Services, Recognize, Assist, Include, Support, and Engage and Department of Commerce) to ensure that (RAISE) Family Caregivers Act of 2017 (Public challenges about work family responsibilities and Law 115-119) requires the Secretary of Health and access to workplace leave benefits and protections Human Services to form a family caregiving are identified and addressed for employees and advisory council, representing the private and employers. public sectors, to advise and work with the • A common limitation of research on existing Secretary to develop a coordinated strategy state PFL programs is combining claims for to recognize and support family caregivers. family leave across all kinship relationships Elements of a national strategy should include (i.e., child, spouse, and parent). Future research ways to improve financial security for family should disaggregate family leave claims in states caregivers, including workplace leave policies with PFL programs to monitor, track, and better to better support the intersection of family understand the usage and impact of PFL for caregiving and employment. eldercare. • Make improvements to the FMLA, such as • Conduct more research studies to examine expanding coverage to protect more workers whether PFL influences the use of home- and and expanding its scope to cover all primary community-based services, and delays or prevents caregivers, regardless of family relationships. more costly nursing home utilization. 13 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 APPENDIX A. States with Expansions of Federal Provisions of the Family and Medical Leave Act (FMLA) for Family Caregivers Lowers Threshold Broadens Definition of Allows Leave for to Cover Employers Family for Caregiving Family Members’ with Fewer Than 50 (Beyond Child, Spouse, Routine Medical State Employees and Parent) Appointments Domestic partner, stepparent, California blank blank parent-in-law, grandparent, sibling Colorado blank All relativesa blank Civil union partner, parent-in-law, Connecticut blank blank stepparent District of Columbia X All relativesa blank Stepparent, parent-in-law, Hawaii blank grandparent, grandparent-in-law, or blank an employee’s reciprocal beneficiary Civil union partner, sibling Maine X blank blank Maryland For parental leave only blank Massachusetts blank blank X Minnesota For parental leave only Stepparent, grandparent, sibling blank Domestic partner, stepparent, New Jersey blank blank parent-in-law New York X blank blank Domestic partner, parent-in-law, Oregon X blank grandparent, grandchild Rhode Island X Domestic partner, parent-in-law blank Vermont X Civil union partner, parent-in-law X Domestic partner, parent-in-law, Washington For parental leave only blank grandparent Wisconsin blank Domestic partner, parent-in-law blank Sources: “State Family and Medical Leave Laws (2016),” National Conference of State Legislatures, (accessed June 5, 2018) http:// www.ncsl.org/research/labor-and-employment/state-family-and-medical-leave-laws.aspx#2; “State Family and Medical Leave Laws That Are More Expansive Than the Federal FMLA,” National Partnership for Women & Families, (accessed June 5, 2018) http://www. nationalpartnership.org/research-library/work-family/fmla/state-family-leave-laws.pdf; National Academies of Sciences, Engineering, and Medicine, Families Caring for an Aging America (Washington, DC: The National Academies Press, 2016); Susan C. Reinhard et al., Picking Up the Pace of Change: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers (Washington, DC: AARP Public Policy Institute, 2017). a Includes relatives by blood, legal custody, or marriage, and anyone with whom an employee lives and has a committed relationship. 14 APPENDIX B. State Paid Family Leave Programs Covering Family Caregivers District of State California New Jersey Rhode Island New York Columbia Washington Massachusetts Status Enacted 2002, Enacted 2008, Enacted 2013, Enacted 2016, Enacted 2017, Enacted 2017, Enacted 2018, effective 2004 effective 2009 effective 2014 effective 2018 effective 2020a effective 2019 effective 2019 (premiums) and (premiums) and 2020 (benefits) 2021 (benefits)b Program Paid Family Leave Family Leave Temporary Paid Family Leave Paid Family Leave Paid Family and Family and Medical Name Insurance Caregiver Medical Leave Leave Insurance Administering California New Jersey Rhode Island New York Office of Paid Washington State Department Agency Employment Department Department State Workers’ Family Leave Employment of Family and Development of Labor and of Labor and Compensation Security Medical Leave in Department Workforce Workforce Board Department Office of Labor A ARP PUBLIC POLICY INSTITUTE Development Development and Workforce Development Qualifying Child, parent, Child, parent, Child, parent, Child, parent, Child, parent, Child, parent, Child, parent, Family parent-in- spouse, domestic spouse, spouse, spouse, spouse, parent-in- Members law, spouse, partner, and civil grandparent, and grandparent, grandparent, grandparent, law, spouse, domestic partner, union partner domestic partner grandchild, and sibling, and grandchild, sibling, grandparent, 15 grandparent, domestic partner domestic partner and domestic grandchild, sibling, grandchild, and partner and domestic sibling partner Maximum 6 weeks 6 weeks 4 weeks 8 weeks in 2018, 6 weeks 12 weeks 12 weeks Length of increasing to 12 Paid Family weeks by 2021 Leave Waiting None (beginning 7 days None None 7 days 7 days 7 days Period for in 2018) Benefits Coverage All private-sector All private- and All private-sector All private-sector All private-sector All private- and Private sector and employees, some public-sector employees, some employees; self- employees public-sector state government public-sector employeesc public-sector employed and covered by the DC employees; employees covered employees; employees certain public- Unemployment self-employed by the state self-employed sector employees Compensation individuals and unemployment individuals may can opt in. Act; self-employed independent insurance law opt in. individuals can contractors can opt in.d opt in. City and county employees are not covered, but their employer can opt in. SEPTEMBER 2018 Self-employed persons can opt in. APPENDIX B (CONTINUED) District of State California New Jersey Rhode Island New York Columbia Washington Massachusetts Wage Since 2004, the 66%, with a weekly 4.62% of wages 50% in 2018, Benefits will Benefits will Benefits will Replacement weekly benefit maximum of $637 paid during the rising to 67% in be paid from a be paid from a be paid from a rate has been in 2018 highest quarter of 2021; maximum new Family and new trust fund new Family and 55% of a worker’s a worker’s base of $653/week in Medical Leave effective January Employment weekly wage up period (about 2018 Fund effective July 2020. Security Trust to a maximum of 60% of a worker’s 2020. Fund, effective July $1,173/week in average weekly 90% of workers’ 2021 for family 2017. wage); maximum 90% of workers’ average weekly caregiving. of $831/week in average weekly wages on earnings Starting in 2018, 2018 wages for workers at or below 50% 80% of workers’ the rate is lifted paid less than or of the statewide average weekly to 70% for the equal to 150% of average weekly wages on earnings lowest-paid the DC minimum wage at or below 50% A ARP PUBLIC POLICY INSTITUTE earners. For all wage multiplied of the statewide other workers, by 40; 50% for 50% of workers’ average weekly the rate rises workers above average weekly wage to 60% up to a this threshold wages on earnings maximum benefit (currently capped above the 50% of workers’ of $1,216/week. at $1,000/week) statewide average average weekly weekly wage wages on earnings (currently capped above 50% of the 16 at $1,000/week) statewide average weekly wage (currently capped at a maximum benefit of $850/ week) SEPTEMBER 2018 APPENDIX B (CONTINUED) District of State California New Jersey Rhode Island New York Columbia Washington Massachusetts Financing Employee payroll Employee payroll Employee payroll Employee payroll Employer payroll Employee and Employee and Mechanism deductions deductions deductions deductions deductions employer payroll employer payroll deductions deductions 1.0% of taxable 0.09% of a 1.1% of the 0.126% of wages, 0.62% of wages 0.4% of wages, 0.63% of wages, wages up to a worker’s wages up first $69,300 in capped at an with the premium adjusted annually maximum annual to $33,700 earningse annual maximum generally shared withholding of of $85.56 in by employer (37%) Employees will $1,149.67 in Maximum annual 2018. and employee be required to 2018 payroll deduction (63%); can be cover 100% of is $30.33 in 2018. For workers adjusted annually the contributions earning less than after 2020g for Family Leave; the statewide employers (60%) average weekly Employers may and employees A ARP PUBLIC POLICY INSTITUTE wage ($1,305.92 deduct from the (40%) will share the in 2018), the employees’ wages contributions for annual payroll 100% of premiums Medical Leave. deduction will for Family Leave; be less than the the Medical Employers with cap, consistent Leave portion fewer than with their weekly is split between 25 workers are 17 wages.f employee (45%) not required to and employer pay into the fund (55%) payroll for the Medical deductions.h Leave portion, but employees will Employers with have to contribute 50 or fewer their payroll employees are deduction. exempt from paying the employer share of the Medical Leave premium. Job No No Yes Yes No Yes, for employees Yes Protection who work for during Paid an employer Family Leave with 50 or more employees and who have worked for their employer for at least 12 months and for at least 1,250 hours SEPTEMBER 2018 in the past year. APPENDIX B (CONTINUED) District of State California New Jersey Rhode Island New York Columbia Washington Massachusetts Utilization Since the start Since the start Since the start No data available No data available No data available No data available by Family of the program: of the program: of the program: to date to date to date to date Caregivers workers caring workers caring workers caring for a spouse/ for a spouse/ for a spouse/ domestic partner domestic partner domestic partner or parent/parent- or parent (9%), or parent (19%), in-law (8%), an an ill child (9%); an ill child (4%); ill child (4%); bonding with a bonding with a bonding with a new child (82%) new child (77%) new child (88%)i The majority of Of total care Of total care workers who took claimsh filed: claimsj filed: about paid family leave about 66% are A ARP PUBLIC POLICY INSTITUTE 66% are from in 2016 were from female female workers; female (76.3%) workers; 34% 34% are from male and over the age are from male workers. of 45 (63.7%).k workers. Sources: “State Paid Family Leave Insurance Laws,” National Partnership for Women & Families, updated February 2018, http://www.nationalpartnership. org/research-library/work-family/paid-leave/state-paid-family-leave-laws.pdf; “Comparative Chart of Paid Family and Medical Leave Laws in the U.S.,” A Better Balance, updated June 28, 2018, https://www.abetterbalance.org/resources/paid-family-leave-laws-chart/; Sarah Jane Glynn, Alexandra L. Bradley, and 18 Benjamin W. Veghte, Paid Family and Medical Leave Programs: State Pathways and Design Options (Washington, DC: National Academy of Social Insurance, 2017); AEI-Brookings Working Group on Paid Family Leave, Paid Family and Medical Leave: An Issue Whose Time Has Come (Washington, DC: American Enterprise Institute and The Brookings Institution, 2017); and National Academies of Sciences, Engineering, and Medicine, Families Caring for an Aging America (Washington, DC: The National Academies Press, 2016). a The District of Columbia begins collecting taxes from employers on July 1, 2019. Paid leave benefits will begin on July 1, 2020. b In Massachusetts, benefit payments for personal Medical Leave begin on January 1, 2021; benefits for Paid Family Leave begin on July 1, 2021. c Some exceptions apply for New Jersey government employees. d Employees of the DC city government and the federal government are not covered. e Rhode Island’s payroll deduction for paid family leave was 1.2 percent from 2012 through 2017. f For example, if an eligible worker in New York earns $27,000 annually in 2018, his or her payroll contribution will be 65 cents per week. g For example, when premiums become effective in Washington State in 2019, an eligible worker earning $50,000 would have a total annual assessment of $200, of which the worker’s annual payroll contribution would be $126.67, or about $2.60 per week. h In Washington State, an employer may elect to pay all of the Family and Medical Leave premiums. i “Paid Family Leave (PFL) Program Statistics,” California Employment Development Department, (accessed June 12, 2018), http://www.edd.ca.gov/Disability/pdf/ qspfl_PFL_Program_Statistics.pdf. j Excludes claims for bonding with a new child. Rhode Island Department of Labor and Training. Temporary Disability Insurance Annual Update, 2015. k New Jersey Department of Labor and Workforce Development, “Family Leave Insurance Workload in 2016: Summary Report,” (Trenton, NJ: Office of Research and SEPTEMBER 2018 Information, August 2017), http://www.nj.gov/labor/forms_pdfs/tdi/FLI%20Summary%20Report%20for%202016.pdf. A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 APPENDIX C States with Paid Sick Days Laws Covering Family Caregivers State (Year Enacted, Family Members Effective) Coverage Amount of Paid Sick Time Earned Covered District of Most workers employed by Maximum of 3 to 7 paid sick days per Child, spouse, Columbia an employer in Washington, year, depending on size of employer parent, domestic DCa partner, live-in (Enacted and Small employers with fewer than 25 partner, sibling, effective 2008, Employers in Washington, DC, employees: 1 hour for every 87 hours sibling’s spouse, expanded 2014) have a general prohibition worked, up to 3 days per year grandchild, parent- against employment in-law, or spouse of discrimination based on Medium employers with 25 to 99 employees: 1 hour for every 43 hours child family responsibilities. worked, up to 5 days per year Large employers with 100 or more employees: 1 hour for every 37 hours worked, up to 7 days per year Tipped restaurant workers: 1 hour for every 43 hours worked, up to 5 days per year Connecticut Service workers in Up to 40 hours or a maximum of 5 Child and spouse businesses with 50 or more paid sick days per year only (Enacted 2011, employees effective 2012) Workers caring for Connecticut law includes an their parents are not antidiscrimination provision covered. prohibiting employers from asking employees about their family responsibilities. California Most workers At least 24 hours or 3 days per year Child, spouse, parent, domestic (Enacted 2014, Starting in July 2018, In- Workers can accrue 1 hour for every partner, sibling, effective 2015; Home Supportive Service 30 hours worked. Employers may cap grandparent, amended 2015 (IHSS) workers are eligible the amount of paid sick time a worker grandchild, parent- and 2016, for paid sick leave. earns at 48 hours or 6 days. in-law, or parent of expansion domestic partner effective Employers may also cap the amount July 2018) of paid sick leave a worker can use at 24 hours or 3 days per year. Beginning July 2018, IHSS workers can begin to accrue paid sick time and use 8 hours of paid sick leave, increasing to 24 hours or 3 days per year. 19 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 APPENDIX C (CONTINUED) State (Year Enacted, Family Members Effective) Coverage Amount of Paid Sick Time Earned Covered Massachusetts Workers who work in a place 1 hour for every 30 hours worked (up Child, spouse, of business with 11 or more to 40 hours per year) or a maximum of parent, or parent- (Enacted 2014, employees (all others receive 5 paid sick days in-law effective 2015) unpaid sick time) Medium to large employers with 11 or more employees: 1 hour for every 30 hours worked and can accrue and use up to 40 hours Small employers with fewer than 11 employees: up to 40 hours of unpaid sick time per year Oregon Workersb who work in a place 1 hour for every 30 hours worked (up Child, spouse, of business with 10 or more to 40 hours per year) or a maximum of parent, grandparent, (Enacted 2015, employees (all others receive 5 paid sick days per year grandchild, or effective 2016) unpaid sick time) parent-in-law Large employersb with 10 or more Sick time can be used to employees: 1 hour of paid time off for deal with the death of a every 30 hours worked, up to 40 hours family member (including per year to attend the funeral, make arrangements, or grieve). Small employersb with fewer than 10 employees: receive equivalent unpaid sick time per year Certain home care workers who are hired and supervised by the client but whose salary and benefits are funded in whole or in part from the state, county, or a public agency may receive up to 40 hours of paid time off per year, including sick time. Vermont Most workers who work an 1 hour per every 52 hours worked Child, spouse, average of at least 18 hours (up to 40 hours per year when fully parent, grandparent, (Enacted of work per week implemented) or 5 paid sick days per grandchild, sibling, 2016, effective year in 2019 and each year after or parent-in-law 2017 for large New businesses have a employers and 1-year period of exemption Large employers with 6 or more 2018 for small before paid sick time benefits employees: 1 hour for every 52 hours employers) apply. worked; in 2017 and 2018 can accrue and use up to 24 hours; in 2019 and The law specifies that beyond, up to 40 hours coverage includes employees who accompany their Small employers with 5 or fewer spouse, parent, parent-in- employees: beginning in 2018, 1 hour law, or grandparent to an for every 52 hours worked; can use appointment related to long- and accrue up to 24 hours in 2018, term care. and 40 hours in 2019 and each year after 20 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 APPENDIX C (CONTINUED) State (Year Enacted, Family Members Effective) Coverage Amount of Paid Sick Time Earned Covered Arizona Private-sector workers Maximum of 24 to 40 hours, or 3 to 5 Child, spouse, paid sick days per year parent, domestic (Enacted 2016, State and local government partner, sibling, effective 2017) workers are exempted. Small employers with fewer than 15 grandparent, employees: 1 hour for every 30 hours grandchild, parent- worked; can accrue and use up to 24 in-law, parent of a hours of paid sick leave domestic partner, Large employers with 15 or more and any other employees: 1 hour for every 30 hours individual related worked; can accrue and use up to 40 by blood or affinity hours of paid sick leave whose close association with the employee is the equivalent of a family relationship Washington Most workers Minimum rate of 1 hour for every 40 Child, spouse, hours worked parent, domestic (Enacted 2016, partner, sibling, effective January No cap for paid sick leave accrual grandparent, 2018) Employer is not required to allow more grandchild, parent- than 40 hours of paid sick time to in-law, or parent of a carry over to the following year. domestic partner Rhode Island Most private-sector workers 1 hour for every 35 hours worked (up Child, spouse, who work in a place of to 40 hours per year in 2020) or a parent, domestic (Enacted 2017, business with 18 or more maximum of 5 paid sick days per year partner, sibling, effective July employees (all others receive grandparent, parent- 2018) unpaid sick time) Large employers with 18 or more in-law, grandchild, employees: 1 hour for every 35 hours or other person for worked; can accrue and use up to 24 whom the employee hours in 2018, 32 hours in 2019, and is responsible 40 hours in 2020 and following years for providing or Small employers with 17 or fewer arranging health employees: receive equivalent unpaid care sick time Maryland Most workers,a,c who work Maximum of 40 to 64 hours per year Child, spouse, in a place of business with or 5 to 8 paid sick days per year parent, grandparent, (Enacted 15 or more employees (all parent-in-law, or 2018, effective others receive unpaid sick Large employers with 15 or more sibling February 2018) time) employees: 1 hour for every 30 hours worked; can earn up to 40 hours per year, use up to 64 hours per year, and accrue up to 64 hours at any time Small employers with fewer than 15 employees must provide the same amount of time as unpaid, job- protected sick leave. 21 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 State (Year Enacted, Family Members Effective) Coverage Amount of Paid Sick Time Earned Covered New Jersey Most private-sector workers 1 hour for every 30 hours worked and Child, spouse, can accrue and use up to 40 hours or parent, grandchild, (Enacted May 5 paid sick days per year sibling, domestic 2018, effective partner, civil union October 2018) partner, spouse/ domestic partner/ civil union partner of parent or grandparent, sibling of spouse/domestic partner/civil union partner, and any other individual related by blood or whose close association with the employee is the equivalent of a family relationship Sources: National Conference of State Legislatures, “Paid Sick Leave,” May 2018, http://www.ncsl.org/research/labor-and- employment/paid-sick-leave.aspx; “Paid Sick Days—State and District Statutes,” National Partnership for Women & Families, updated February 2018, http://www.paidsickdays.org/research-resources/current-sick-days-laws.html#.Ws5bl8kUl7g; “Overview of Paid Sick Time Laws in the United States,” A Better Balance, updated March 2018, https://www.abetterbalance.org/resources/ paid-sick-time-legislative-successes/; National Academies of Sciences, Engineering, and Medicine, Families Caring for an Aging America (Washington, DC: The National Academies Press, 2016); and Susan C. Reinhard et al., Picking Up the Pace of Change: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers (Washington, DC: AARP Public Policy Institute, 2017). a Excludes independent contractors and certain other workers. b For Oregon cities with a population greater than 500,000 (such as Portland, Oregon), a small employer is five or fewer employees and a large employer covers six or more employees. c Employees who regularly work 12 or more hours a week for a business with 15 or more employees are eligible for paid sick leave in Maryland. 22 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 1 Lynn Feinberg, Keeping Up with the Times: Supporting Family Caregivers with Workplace Leave Policies (Washington, DC: AARP Public Policy Institute, 2013). 2 States’ and municipalities’ paid family leave and paid sick time laws are current as of June 2018. 3 Susan C. Reinhard, Lynn Friss Feinberg, Rita Choula, and Ari Houser. Valuing the Invaluable: 2015 Update (Washington, DC: AARP Public Policy Institute, July 2015). 4 Lynn Friss Feinberg, The Dual Pressures of Family Caregiving and Employment (Washington, DC: AARP Public Policy Institute, May 2016). 5 National Alliance for Caregiving (NAC) and AARP Public Policy Institute, Caregiving in the US 2015 (Bethesda, MD: NAC, and Washington, DC: AARP, June 2015). 6 Jonathan Vespa, David M. Armstrong, and Lauren Medina, “Demographic Turning Points for the United States: Population Projections for 2020 to 2060,” Current Population Reports, P25-1144 (Washington, DC: US Census Bureau, March 2018). 7 Jeremy Nobel, et al., Supporting Caregivers in the Workplace: A Practical Guide for Employers (New York, NY: Northeast Business Group on Health, and Washington, DC: AARP, September 2017). 8 NAC and AARP Public Policy Institute, Caregiving in the US 2015. 9 Mitra Tossi and Elka Torpey, “Older Workers: Labor Force Trends and Career Options,” (Washington, DC: U.S. Bureau of Labor Statistics, Washington, DC, May 2017), https://www.bls.gov/careeroutlook/2017/article/older-workers.htm. 10 Barbara Butrica and Nadia Karamcheva. The Impact of Informal Caregiving on Older Adults’ Labor Supply and Economic Resources (Washington, DC: The Urban Institute, October 2014). 11 Mitra Tossi, “Labor Force Projections to 2020: A More Slowly Growing Workforce,” Monthly Labor Review, January 2012, https://www.bls.gov/opub/ted/2012/ted_20120216.htm. 12 Josephine C. Jacobs, Audrey Laporte, Courtney H. Van Houtven, and Peter C. Coyote, “Caregiving Intensity and Retirement Status in Canada,” Social Science & Medicine 102 (2014): 74–82. 13 NAC and AARP Public Policy Institute, Caregiving in the US 2015. 14 Butrica and Karamcheva, The Impact of Informal Caregiving. 15 Courtney H. Van Houtven, Norma B. Coe, and Meghan M. Skira, “The Effect of Informal Care on Work and Wages,” Journal of Health Economics 32 (2013): 240–52. 16 Transamerica Institute, The Many Faces of Caregivers: A Close-Up Look at Caregiving and Its Impacts (Los Angeles, CA: Author, September 2017). 17 Data are drawn from the 2009 Fifth National Survey of Older Americans Act (OAA) program participants, including the caregiving module that included 1,793 family caregivers. See: Margaret L. Longacre et al., “Work Impact and Emotional Stress among Informal Caregivers of Older Adults,” Journals of Gerontology: Social Sciences 72, no. 3 (2017): 522–31. 18 National Academies of Sciences, Engineering, and Medicine, Families Caring for an Aging America (Washington, DC: National Academies Press, 2016). 19 Butrica and Karamcheva, The Impact of Informal Caregiving. 20 MetLife Mature Market Institute, The MetLife Study of Caregiving Costs to Working Caregivers: Double Jeopardy for Baby Boomers Caring for Their Parents (Westport, CT: Author, 2011). 21 Yeonjung Lee and Karen A. Zurlo, “Spousal Caregiving and Financial Strain among Middle-Aged and Older Adults,” International Journal of Human Development 79, no. 4 (2014): 302–21. 22 Chizuko Wakabayashi and K. M. Donato, “Does Caregiving Increase Poverty among Women in Later Life?,” Journal of Health and Social Behavior 47, no. 3 (2006): 258–74. 23 Yeonjung Lee et al., “The Vicious Cycle of Parental Caregiving and Financial Well-Being: A Longitudinal Study of Women,” The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences 70, no. 3 (2015): 425–31. 24 Meghan M. Skira, “Dynamic Wage and Employment Effects of Elder Parent Care,” International Economic Review 56, no. 1 (2015): 63–93. 23 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 25 LTSS includes human assistance (with such tasks as bathing, toileting, paying bills, transportation), supervision, cueing and standby assistance, assistive technologies and environmental modifications, health maintenance tasks (such as medication management), information, and care and service coordination for people who live in their own home, in a residential setting, or in a nursing facility. LTSS also includes supports to family members and other unpaid caregivers. See Susan C. Reinhard et al., Picking Up the Pace of Change: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers (Washington, DC: AARP Public Policy Institute, June 2017). Prior editions (2011 and 2014) of the Scorecard are available at http://www.longtermscorecard.org/. 26 Center for Public Affairs Research, Long-Term Caregiving: The Types of Care Older Americans Provide and the Impact on Work and Family (Chicago, IL: The Associated Press and NORC, October 2017). 27 Chuck Rainville, Laura Skufca, and Laura Mehegan, Family Caregiving and Out-of-Pocket Costs: 2016 Report (Washington, DC: AARP, November 2016). 28 Reinhard et al., Picking Up the Pace of Change. 29 Lynn Friss Feinberg, The Dual Pressures of Family Caregiving and Employment (Washington, DC: AARP Public Policy Institute, May 2016). 30 Amendments to the FMLA allow unpaid leaves of up to 26 weeks for military family members caring for a wounded service member. 31 Jacob Alex Klerman, Kelly Daley, and Alyssa Pozniak, Family and Medical Leave in 2012: Technical Report (Cambridge, MA: Abt Associates Inc., 2014), https://www.dol.gov/asp/evaluation/fmla/FMLA-2012-TECHNICAL-REPORT.pdf. 32 Ibid. This national survey of the FMLA did not distinguish among the various caregiving categories of ill spouse, parent, or child. 33 Institute for Women’s Policy Research and IMPAC International, The Effects of FMLA Eligibility and Awareness on Family Leave- Taking (Washington, DC: Authors, January 2017). 34 Transamerica Institute, The Many Faces of Caregivers. 35 Ibid. 36 Butrica and Karamcheva, The Impact of Informal Caregiving. 37 National Academies of Sciences, Engineering, and Medicine, Families Caring for an Aging America. 38 Sarah Jane Glynn and Danielle Corley, The Cost of Work-Family Policy Inaction (Washington, DC: Center for American Progress, September 2016). The data for these analyses result from pooling 10 years of data from 2005 through 2015 from the US Census Bureau Current Population Survey’s Annual Social and Economic Supplement, with additional data from the Family and Medical Leave 2012 survey. 39 Social determinants of health are defined as conditions in which people are born, grow, live, work, and age. See “About Social Determinants of Health,” World Health Organization, accessed June 5, 2018, http://www.who.int/social_determinants/ sdh_definition/en/. 40 Juliana Menasce Horowitz et al., Americans Widely Support Paid Family and Medical Leave, but Differ over Specific Policies (Washington, DC: Pew Research Center, March 2017), http://www.pewsocialtrends.org/2017/03/23/americans-widely- support-paid-family-and-medical-leave-but-differ-over-specific-policies/. 41 The Tax Cuts and Jobs Act of 2018 includes a provision for employers to receive a tax credit if they provide paid family and medical leave for their workers. Employers that provide PFL to workers who earn less than $72,000 (in 2018) will be eligible for a tax credit of 12.5 to 25 percent of the cost of each hour of paid leave, depending on how much of the worker’s earnings the benefit replaces. Employers must compensate workers for at least 50 percent of their regular earnings. The credit does not apply to PFL mandated by state or local laws. The tax credit is available only until the end of 2019, and it covers only workers caring for the ill family members under the FMLA (spouses, parents, children), excluding such relationships as grandparents, parents-in-law, or siblings. Some experts suggest that this tax provision will primarily benefit companies already providing paid family and medical leave, rather than serving as an incentive to encourage new companies to offer a paid leave program. See Michelle Andrews, “Tax Bill Provision Designed to Spur Paid Family Leave to Lower-Wage Workers,” Kaiser Health News, January 23, 2018, https://khn.org/news/tax-bill-provision-designed-to-spur-paid-family-leave-to-lower- wage-workers/. 24 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 42 Of 34 OECD countries, the United States is the only country that lacks paid maternity leave. Thirty-two of 34 countries have PFL for fathers. Switzerland and the United States do not guarantee paid parental leave for fathers of newborns. See: Amy Raub et al., Paid Parental Leave: A Detailed Look at Approaches across OECD Countries (Los Angeles, CA: WORLD Policy Analysis Center, February 2018). 43 Amy Raub et al., Paid Leave for Family Illness: A Detailed Look at Approaches across OECD Countries (Los Angeles, CA: WORLD Policy Analysis Center, February 2018). 44 The 22 countries that provide PFL for adult family members’ health needs are Australia, Austria, Belgium, Canada, Czech Republic, Denmark, Estonia, Germany, Iceland, Ireland, Israel, Italy, Japan, Luxembourg, Netherlands, New Zealand, Norway, Poland, Slovakia, Slovenia, Spain, and Sweden. In Iceland and Slovenia, paid leave is available only to care for a spouse. For more information, see Amy Raub et al., Paid Leave for Family Illness. 45 Eight OECD countries provide 12 weeks or more of PFL for adult family caregiving needs, 1 country provides eight weeks of PFL, and 13 countries provide fewer than 4 weeks of PFL. In 2 countries, PFL is limited to cases of terminal illness. See WORLD Policy Analysis Center, A Review of the Evidence on the Length of Paid Family and Medical Leave, Policy Brief, (Los Angeles, CA: UCLA Fielding School of Public Health, February 2018). 46 Raub et al., Paid Leave for Family Illness. 47 “Employee Benefits Survey, Table 32—Leave Benefits: Access, Private Industry Workers,” US Bureau of Labor Statistics, published March 2017, https://www.bls.gov/ncs/ebs/benefits/2017/ownership/private/table32a.htm. 48 Ibid. 49 Nobel et al., Supporting Caregivers in the Workplace. 50 National Partnership for Women & Families, Leading on Leave: Companies with New or Expanded Paid Leave Policies (Washington, DC: Author, January 2018). 51 Donald Redfoot, Lynn Feinberg, and Ari Houser, The Aging of the Baby Boom and the Growing Care Gap: A Look at Future Declines in the Availability of Family Caregivers (Washington, DC: AARP Public Policy Institute, August 2013). 52 Feinberg, Dual Pressures. 53 Brendan Flinn, Millennials: The Emerging Generation of Family Caregivers (Washington, DC: AARP Public Policy Institute, May 2018). 54 Between 1942 and 1969, five states (California, Hawaii, New Jersey, New York, and Rhode Island) and Puerto Rico adopted TDI programs. 55 Washington State originally passed a family and medical leave program in 2007, but implementation was delayed because of a lack of a funding mechanism. That initial law covered paid parental leave but did not include workers with eldercare responsibilities. See also Economic Opportunity Institute, The Road to Winning. Paid Family and Medical Leave in Washington (Seattle, WA: Author, November 2017). 56 Kelly Bedard and Maya Rossin-Slater, The Economic and Social Impacts of Paid Family Leave in California: Report for the California Employment Development Department (Santa Barbara, CA: University of California, Santa Barbara, October 2016). 57 “Paid Family Leave Program Statistics,” California Employment Development Department, accessed June 12, 2018, http:// www.edd.ca.gov/Disability/pdf/qspfl_PFL_Program_Statistics.pdf. 58 New Jersey Department of Labor and Workforce Development, Family Leave Insurance Workload in 2016, Summary Report (Trenton, NJ: Author, August 2017). 59 “Temporary Disability Insurance Annual Update 2015,” Rhode Island Department of Labor and Training, accessed June 12, 2018, http://www.dlt.ri.gov/lmi/pdf/tdi/2015.pdf. 60 Bedard and Rossin-Slater, The Economic and Social Impacts of Paid Family Leave in California. 61 Andrew Chang, Paid Family Leave Market Research (Sacramento, CA: California Employment Development Department, 2015). 62 California Employment Development Department, Paid Family Leave Program Statistics. 25 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 63 “Temporary Disability Insurance Program, January–December 2016,” Rhode Island Department of Labor & Training, accessed June 12, 2018, http://www.dlt.ri.gov/tdi/. 64 New Jersey Department of Labor and Workforce Development, Family Leave Insurance Workload in 2016. 65 Brant Morefield et al., Leaving It to the Family: The Effects of Paid Leave on Adult Child Caregivers (Washington, DC: L&M Policy Research, July 2016). 66 Sarah Jane Glynn et al., Implementing Paid Family and Medical Leave Insurance in Connecticut (Washington, DC: Institute for Women’s Policy Research, 2016). 67 Ruth Milkman and Eileen Appelbaum, Unfinished Business: Paid Family Leave in California and the Future of US Work-Family Policy (Ithaca, NY: Cornell University Press, 2013). 68 Eileen Appelbaum and Ruth Milkman, Leaves That Pay: Employer and Worker Experiences with Paid Family Leave in California (Washington, DC: Center for Economic and Policy Research, January 2011), http://www.cepr.net/documents/publications/ paid-family-leave-1-2011.pdf. 69 Linda Houser and Karen White, Awareness of New Jersey’s Family Leave Insurance Program Is Low, Even as Public Support Remains High (New Brunswick, NJ: The Center for Women and Work, 2012). 70 Barbara Silver, Helen Mederer, and Emilija Djurdjevic, Launching the Rhode Island Temporary Caregiver Insurance Program: Employee Experiences One Year Later (Cranston, RI: Rhode Island Department of Labor and Training, 2015). 71 Morefield et al., Leaving It to the Family. 72 Russell Tisinger et al., Understanding Attitudes on Paid Family Leave: Discussions with Parents and Caregivers in California, New Jersey and Rhode Island (Washington, DC: L&M Policy Research, July 2016). 73 Mark DiCamillo and Mervin Field, Just 36% of Workers Aware of State’s Paid Family Leave Program (San Francisco, CA: California Center for Research on Women and Families, 2015). 74 Chang, Paid Family Leave Market Research. 75 Appelbaum and Milkman, Leaves That Pay. 76 Houser and White, Awareness of New Jersey’s Family Leave Insurance Program Is Low. 77 Silver et al., Launching the Rhode Island Temporary Caregiver Insurance Program. 78 Tisinger et al., Understanding Attitudes on Paid Family Leave. 79 The Associated Press-NORC, “Paid Family Leave in California: Awareness, Support, and Barriers to Use,” Issue Brief (Chicago, IL: The Associated Press and NORC, 2016), https://www.longtermcarepoll.org/wp-content/uploads/2017/11/AP-NORC- Long-term-Care-2016_California-Leave_Issue-Brief.pdf. 80 Silver et al., Launching the Rhode Island Temporary Caregiver Insurance Program. 81 Chang, Paid Family Leave Market Research. 82 California Senate Office of Research, California’s Paid Family Leave Program: Ten Years after the Program’s Implementation, Who Has Benefited and What Has Been Learned? (Sacramento, CA: Author, July 2014), http://sor.senate.ca.gov/sites/sor. senate.ca.gov/files/Californias%20Paid%20Family%20Leave%20Program.pdf. 83 For all other eligible California workers, the rate of wage replacement in the PFL program increases from 55 percent to 60 percent of a worker’s weekly wage up to a maximum benefit of $1,216 per week, effective 2018. 84 Milkman and Appelbaum, Unfinished Business. 85 WORLD Policy Analysis Center, “A Review of the Evidence.” 86 Sarah A. Donovan, Paid Family Leave in the United States (Washington, DC: Congressional Research Service, March 2018). 87 Chang, Paid Family Leave Market Research. 88 Helen Mederer et al., Temporary Caregiver Insurance (TCI) Awareness and Outcomes: Findings from the 2015 TCI Survey, Slide Presentation, University of Rhode Island. 26 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 89 NAC and AARP Public Policy Institute, Caregiving in the US 2015. 90 Tisinger et al., Understanding Attitudes on Paid Family Leave. 91 Kanika Arora and Douglas A. Wolf, “Does Paid Family Leave Reduce Nursing Home Use? The California Experience,” Journal of Policy Analysis and Management 37, no. 1 (2018): 38-62, https://onlinelibrary.wiley.com/doi/epdf/10.1002/pam.22038. 92 Eileen Applebaum and Ruth Milkman, Awareness of California’s Paid Family Leave Program Remains Limited, Especially among Those Who Would Benefit from It Most (Washington, DC: Center for Economic and Policy Research, November 2011). 93 Morefield et al., Leaving It to the Family. 94 Alison Earle and Jody Heymann, “Protecting the Health of Employees Caring for Family Members with Special Health Care Needs,” Social Science and Medicine 73, no. 1 (2011): 68–78. 95 Ann Bartel et al., Assessing Rhode Island’s Temporary Caregiver Insurance Act: Insights from a Survey of Employers (Washington, DC: US Department of Labor, 2016). 96 Sharon Lerner and Ruth Milkman, “Paid Family Leave Pays Off in California,” Harvard Business Review, HBR Blog Network, January 19, 2011, http://blogs.hbr.org/2011/01/paid-family-leave-pays-off-in/. 97 Sharon Lerner and Eileen Appelbaum, Business as Usual: New Jersey Employers’ Experiences with Family Leave Insurance (Washington, DC: Center for Economic and Policy Research, 2014). 98 Applebaum and Milkman, Leaves That Pay. 99 David. G. Allen, Phillip Bryant, and James. M. Vardaman, “Retaining Talent: Replacing Misconceptions with Evidence-Based Strategies,” The Academy of Management Perspectives 24, no. 2 (2010): 28–64. 100 Menasche Horowitz et al., Americans Widely Support Paid Family and Medical Leave. 101 Bedard and Rossin-Slater, The Economic and Social Impacts of Paid Family Leave in California. 102 “Table 5. Selected paid leave benefits: Access, March 2018, ”U.S. Bureau of Labor Statistics, published July 2018, https:// www.bls.gov/news.release/pdf/ebs2.pdf 103 Ibid. 104 Institute for Women’s Policy Research, Paid Sick Days Access and Usage Rates Vary by Race/Ethnicity, Occupation, and Earnings (Washington, DC: Author, February 2016). 105 Executive Order 13706 was signed by former President Obama on September 7, 2015, establishing paid sick leave requirements for federal contractors. The Department of Labor published the final rule to implement the policy on September 30, 2016. Eligible federal contractors are entitled to up to seven days of paid sick leave annually, including family caregiving needs. Covered family members for family care include the worker’s child, parent, spouse, domestic partner, or any other individual related by blood or affinity whose close association with the worker is the equivalent of a family relationship. See https://www.dol.gov/whd/govcontracts/eo13706/. 106 “Paid Sick Days—State and District Statutes, and City and County Laws,” National Partnership for Women & Families, updated May 2018, http://www.nationalpartnership.org/research-library/work-family/psd/paid-sick-days-statutes.pdf. 107 Local jurisdictions with paid sick days laws (as of June 2018) include 7 cities in California (San Francisco, Oakland, San Diego, Berkeley, Emeryville, Santa Monica, and Los Angeles); Seattle, Takoma, and Spokane, Washington; Washington, DC; New York City, New York; Eugene and Portland, Oregon; Philadelphia and Pittsburgh, Pennsylvania; Montgomery County, Maryland; Duluth, Minneapolis; St. Paul, Minnesota; Chicago and Cook County, Illinois; Austin, Texas; and 13 cities in New Jersey (Jersey City, Newark, Irvington, Passaic, East Orange, Patterson, Trenton, Montclair, Bloomfield, Elizabeth, Plainfield, Morristown, and New Brunswick). 108 US Bureau of Labor Statistics, Selected paid leave benefits: Access, March 2018, Table 5. 109 Nancy Rankin and Irene Lew, Expanding Workers’ Rights: What It Means for New York City’s Low-Income Workers (New York, NY: Community Service Society of New York, January 2018). 110 Institute for Women’s Policy Research, Paid Sick Days. 111 Feinberg, Keeping Up with the Times. 27 A ARP PUBLIC POLICY INSTITUTE SEPTEMBER 2018 112 Kevin Miller and Claudia Williams, Valuing Good Health in Massachusetts: The Costs and Benefits of Paid Sick Days (Washington, DC: Institute for Women’s Policy Research, 2012), https://iwpr.org/publications/valuing-good-health-in- massachusetts-the-costs-and-benefits-of-paid-sick-days-3/. 113 IMPAQ International and Institute for Women’s Policy Research, Estimating Usage and Costs of Alternative Policies to Provide Paid Sick Days in the United States (Washington, DC: Authors, January 2017). 114 Robert Drago and Vicki Lovell, San Francisco’s Paid Sick Leave Ordinance: Outcomes for Employers and Employees (Washington, DC: Institute for Women’s Policy Research, February 2011). 115 Eileen Appelbaum and Ruth Milkman, Good for Business? The Case of Paid Sick Leave in Connecticut (Washington, DC: Center for Economic Policy and Research, January 2014). 116 Eileen Appelbaum and Ruth Milkman, No Big Deal: The Impact of New York City’s Paid Sick Days Laws on Employers (Washington, DC: Center for Economic Policy and Research, September 2016). 117 Supriya Kumar et al., “Policies to Reduce Influenza in the Workplace: Impact Assessments Using an Agent-Based Model,” American Journal of Public Health 103 (2013): 1406–11. 118 Kevin Miller, Claudia Williams, and Youngmin Yi, Paid Sick Days and Health: Cost Savings from Reduced Emergency Department Visits (Washington, DC: Institute for Women’s Policy Research, November 2011). 119 Ibid. 120 This Illinois law, which went into effect in January 2017, defines family broadly to include an employee’s child, stepchild, spouse, domestic partner, parent, stepparent, in-law, sibling, grandchild, or grandparent. 121 This Georgia law took effect in July 2017 and applies to employees who work 40 or more hours per week for a business with 25 or more employees. In this law, family member is defined as a child, spouse, grandchild, grandparent, parent, or other dependent. Insight on the Issues 136, September 2018 © AARP PUBLIC POLICY INSTITUTE 601 E Street, NW Washington DC 20049 Follow us on Twitter @AARPpolicy on facebook.com/AARPpolicy www.aarp.org/ppi For more reports from the Public Policy Institute, visit http://www.aarp.org/ppi/. 28