Sick-leave standard as anti-flu weapon stirs debate

Editor's note: This story was edited after publication to reflect written remarks submitted to the committee by Rep. George Miller about how many coworkers can be infected when people keep working while sick.

Nov 17, 2009 (CIDRAP News) – Making paid sick leave a national standard is crucial to controlling the H1N1 pandemic and future epidemics, public health and business experts told Congress Tuesday. But others cautioned that forcing businesses to follow federal mandates will make them pay extra costs in a recession and could depress future hiring and investment.

The experts made their remarks at a hearing of the US House of Representatives' Education and Labor Committee. The committee's chairman, Rep. George Miller, D-Calif., 2 weeks ago introduced the Emergency Influenza Containment Act (HR 3991), which would guarantee any worker who is sick with flu up to 5 days paid leave.

Miller's is the second bill now before Congress that would guarantee paid sick leave. The first, the Healthy Families Act (HR 2460, S. 1152), has been introduced repeatedly for several years by Rep. Rosa DeLauro, D-Conn., and the late Sen. Edward Kennedy, D-Mass., but has been given fresh life by the H1N1 pandemic.

The H1N1 pandemic has brought paid sick leave into sharp focus. (Paid sick days accompanied by job protection are not required under US law except for the federal workforce, though the Family and Medical Leave Act mandates unpaid leave.) Miller said the US Centers for Disease Control and Prevention (CDC) estimates that a flu-infected person who comes to work may infect one in 10 coworkers, and a 2004 report by Emory University estimated that sick workers cost the economy $180 billion each year in lost productivity.

Definition disputed
The topic is contentious and even the definition and reach of "sick leave" are disputed. The National Compensation Survey, published by the federal Bureau of Labor Statistics, estimates that employers give more than two-thirds of US workers some number of paid sick days, but the survey includes "personal time off" and vacation days in its definition. The Institute for Women's Policy Research estimates that four-fifths of low-wage workers lack defined paid sick days, a situation that is more likely to impact women, minorities and young workers who are on the lower end of pay scales—categories that happen to match those most at risk from H1N1 flu.

"Workers fear they will be punished for taking time off, either by losing pay because they do not have paid sick days or even fired," Rep. Miller said Tuesday in the hearing's opening remarks. "Employees in the food-service and hospitality industry, schools and healthcare fields are among those who cannot afford to stay home when they're sick. Because these employees have direct contact with the public, the consequences of coming into work sick are not only damaging to their health, but could be damaging for the public's health as well."

But Rep. John Kline, R-Minn., the committee's ranking Republican, cautioned in his opening statements that "federal mandates are particularly onerous for small businesses" and warned that imposing new requirements could force businesses to cancel current, more flexible leave plans.

CDC, APHA weigh in
Representatives of the CDC and the American Public Health Association (APHA) testified that they support measures that will encourage workers to stay home from work if they believe themselves to be ill.

"Employed adults 18 years of age and over experienced an average of 4.4 work-loss days per person due to illness or injury in the past 12 months, for a total of approximately 698 million work-loss days," said Dr. Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases. While careful not to endorse Miller's bill, she said in response to lawmakers' questions, "Whatever will make it easy for people to do the right thing, is what we are promoting."

Dr. Georges Benjamin, executive director of the APHA, strongly backed paid sick leave, calling it good for businesses, workers and their families, customers, and the general public. He drew a link between sick-leave policies and pandemic-preparedness plans. "We've come a long way in being prepared for public health emergencies such as an H1N1 flu outbreak, but we have more work to do to protect America's health," he said. "Paid sick leave for employees is one important next step."

But agreeing to provide sick leave triggers a swarm of complexities, said A. Bruce Clarke, president and CEO of Capital Associated Industries, a North Carolina non-profit with 1,000 member businesses. "The marginal perceived visible benefit of a proposed national mandate will create far more invisible and unintended detriments," he said.

Current flexible personal-time plans, Clarke said, allow employees to stay home for their own illness or to care for a sick family member, and also protect employees' privacy because they do not have to disclose either living arrangements or medical details to employers.

While Miller's bill (which applies only to businesses with 15 employees or more) provides a "safe harbor" provision for companies with existing leave plans, Clarke said plans vary so much from business to business that most of his organization's members would have to rewrite their plans to comply.

But Debra Ness, speaking for the National Partnership for Women and Families, countered that flexible plans do not go far enough to protect workers in a public health emergency, precisely because they vary so much from employer to employer. Instead, she said, the country needs a national standard of 7 days per year of paid sick leave, accompanied by job protection and separate from vacation time, that can be used by workers on their own behalf or a family member's.

Crucially, she said, workers should be able to invoke the leave themselves, rather than having to report to work in order to be sent home, because commuting to work and appearing at the workplace are potential infection risks. And ideally, she said, such sick-leave protection should extend to businesses of all sizes, and should cover illness-related actions beyond a worker's family such as closure of a child's school due to H1N1.

See also:

Bureau of Labor Statistics National Compensation Survey

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