This story by Rae Ellen Bichell appeared on Kaiser Health News (KHN) on November 30, 2021.

Economists and public health experts say paid sick leave is an essential tool – like tests, masks and vaccines – in the effort to prevent COVID-19 infection and keep places of life safe. job.

Yet the United States is in the middle of another COVID holiday season, and federal laws that offered workers paid sick leave related to COVID have expired. Colorado, Los Angeles and Pittsburgh are among a handful of places that have implemented their own COVID protections, but many sick workers across the country are grappling with difficult financial and ethical issues when deciding to stay at home.

“Millions of workers do not have access to paid sick leave, and we are still in a pandemic,” said Nicolas Ziebarth, labor economist at Cornell University.

The United States is one of the few industrialized countries that does not have a national policy on paid sick leave. In contrast, Germany, the homeland of Ziebarth, has had one for nearly 140 years.

The coronavirus pandemic has brought about short-term changes. According to Ziebarth, the Families First Coronavirus Response Act mandated paid sick leave nationwide, a first in U.S. history. The law provided for around two weeks full pay for employees who were quarantined or seeking medical attention for COVID-like symptoms and additional weeks on partial pay to care for a child trapped at home due to of COVID.

But the paid sick leave mandate routinely only applied to employers with 50 to 499 employees and lasted only nine months, expiring at the end of 2020. After that, employers could decide whether they wanted to continue offering services. sick leave paid in exchange for tax credits, although these expired at the end of September.

About 5% of U.S. employees have used federal COVID sick leave protection, Ziebarth and colleagues wrote in the PNAS journal, and that appears to have helped flatten the pandemic curve initially. But it was not enough. The number of people sick with any type of illness but unable to take leave has increased from around 5 million per month before the pandemic to 15 million by the end of 2020 – even with the federal leave in place.

People with the lowest incomes are the least likely to be covered by paid sick leave, said Dr. Rita Hamad, social epidemiologist and family physician at the University of California-San Francisco. “We are left with the patchwork of employer and state policies that existed before that leave the most vulnerable the least covered,” she said.

The Build Back Better law, which is due to be passed in the Senate after it passes the House on November 19, may grant paid medical and family time off so workers can deal with long-term illness or care, but it does does not include time off work to recover from short-term illness.

Jared Make, vice president of A Better Balance, a national nonprofit labor rights legal organization, has been pushing federal, state and local lawmakers to expand paid sick leave for years and has drafted model legislation. He said 16 states, Washington, DC and about 20 localities have permanent paid sick leave laws. One of the most generous, that of New Mexico, will come into effect in July. Colorado, Massachusetts, Nevada, New York and the District of Columbia offer COVID-specific emergency sick leave, as do Pittsburgh and a few cities in California, such as Los Angeles, Oakland and Long Beach.

In some places, employers are taking the initiative to tackle the problem. A recent KFF survey of around 1,700 employers nationwide found that 37% of workers work in a place that has extended or started paid time off, either to recover from an illness or to help a parent with to recover. Meanwhile, 1% of workers have seen their paid sick leave reduced or eliminated.

Still, calls to A Better Balance’s free legal helpline have skyrocketed since the start of the pandemic, Make said. “Many workers risk their jobs or have no choice but to go to work when they are sick, and this is a real public health problem.

In August, local California public health departments called on state leaders to extend paid sick leave to all workers, saying failure to do so discouraged people from getting COVID shots and affected in ways disproportionately disadvantaged communities.

Many people who have avoided the vaccination are afraid of suffering side effects that will require them to be off work for a day or two, which they cannot afford, Hamad said.

But without federal funds to reimburse employers, California and other states would have to find money to pay for sick leave – and lawmakers are reluctant to pass the costs on to businesses.

“It is a glaring shortcoming, in our opinion, that the federal government has not maintained some form of emergency sick leave for Covid-19,” Make said. “This is obviously a huge gap given where we are in the pandemic. “

Colorado, which is experiencing a wave of COVID, last year adopted what Denver-based Make considers the strongest COVID sick leave protection of any state. The law, which allows any employee to earn up to six days of paid sick leave per year and takes full effect in January, states that when local, state or federal authorities declare a public health emergency, employers must complete workers’ accumulated leave so that an employee can take up to two weeks of paid sick leave for, in this case, COVID-related reasons. The emergency leave provision will not expire until at least February.

However, some employers do not comply. In early November, the Colorado Division of Labor Statistics and Standards was reviewing sick leave law complaints against 71 employers, according to outreach manager Eric Yohe. This represented about 8% of all his salary complaints investigated. Yohe said his division has already reinstated paid time off for “a good number” of employees under the new law.

Colorado’s leave law still has limits. Workers do not receive “renewals” of COVID leave if they fall ill again or a parent falls ill – only 80 hours in total from January 2021 until the end of the public health emergency. And the law allows some workplaces to force employees to use their paid time off instead, as long as they notify employees in advance and offer employees at least two weeks of PTO on time. full.

Jamie Bradt, a special education teacher at a high school in Mead, Colorado, found herself in this situation this month after testing positive for COVID. Bradt, who is fully vaccinated, believed she could tap into state-sanctioned COVID sick leave. But her employer, St. Vrain Valley Schools, told her she should use her PTO, which she had been saving for a decade.

“It’s so frustrating that I’m being punished for accumulating my time off,” said Bradt, who was in self-isolation at home. The neighborhood did not answer questions.

Policies that cause employees to work when they are sick are counterproductive, said Barbara Holland, a consultant with the Society for Human Resource Management, a national professional group. “It’s a contagious disease,” she says. “You don’t want them showing up in the workplace. “

Since the federal provisions expired, Cristina Cuevas and her colleagues at a school in Minnesota have been required to use their accumulated sick and vacation leave if they fall with COVID.

Recently, a colleague from Cuevas went to work ill, thinking it was a cold. “She actually had covid all the time,” Cuevas said. The school had to close briefly, Cuevas said, and several students fell ill.

California Healthline correspondent Rachel Bluth contributed to this story.

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