Expanding Paid Sick Leave to Reduce Inequity and the Spread of Infectious Disease in Wisconsin
Lauren Schrader*, Maia Gumnit**, Christopher Unterberger***
*University of Wisconsin-Madison School of Medicine and Public Health
**University of Wisconsin-Madison Department of Comparative Biosciences
***University of Wisconsin-Madison School of Pharmacy
The United States is the only industrialized country without federal laws guaranteeing access to paid sick leave (PSL). While some US states have enacted their own PSL mandates, Wisconsin places leave policies in the hands of employers, resulting in roughly 600,000 Wisconsin workers without PSL. The COVID-19 pandemic has highlighted the importance of all workers having the capacity to stay home while sick, and has illustrated the economic, social, and ethical consequences of allowing transmissible diseases to spread through workplaces and communities. Moreover, sacrificing income to stay home while sick worsens economic inequalities for low-wage workers, minorities, and women, who are all more likely to hold jobs without PSL. To address these issues, we recommend introducing legislation requiring Wisconsin employers to provide all employees with at least five days of PSL per year.
1. Statement of Issue
Current legal status
Federal PSL legislation is frequently introduced to Congress, such as the Healthy Families Act, which requires employers with at least fifteen employees to provide their employees with one hour of paid sick leave for every thirty hours worked. The federal Family and Medical Leave Act (FMLA) is often cited as an alternative to sick leave; however, FMLA is structured for long-term illness or family leave and is unpaid. All proposed PSL bills have failed to make it out of committee, leaving the US without any federally mandated PSL.
In the absence of federal PSL legislation, state-level legislation is necessary to close PSL access gaps. Thirteen state legislatures and the District of Columbia have successfully enacted a range of PSL mandates. The number of required PSL hours and the size of affected businesses varies between states. Most commonly, public and private employees earn one hour of PSL for every thirty hours worked, with a maximum of forty hours accrued annually, as is the case in Massachusetts, Arizona, and New Jersey.
In April 2020 as a federal response to the mounting COVID-19 pandemic, the Families First Coronavirus Response Act (FFCRA) provided temporary federal funding for PSL to allow more American workers to follow COVID-19 quarantine guidelines. This legislation expanded PSL access for Wisconsin workers on an emergency basis; however, 140,000 Wisconsin workers were not included due to restrictions on employer type and size. Despite the ongoing spread of COVID-19, the FFCRA expired on December 31, 2020 and the original PSL access gaps in Wisconsin resumed.
At present, Wisconsin has no local or statewide PSL policy. In 2011, Wisconsin Act 16 was signed into law preventing municipalities from implementing local PSL ordinances, further demonstrating the need for state-level legislative action.
Inequity in access to PSL
In the US, while 94% of high-wage earners can take a paid sick day when they or their children are sick, fewer than half of low-wage workers have that option. These same patterns of access inequity exist in Wisconsin.
These gaps in access to PSL can worsen economic inequalities and disproportionately impact minority workers. Black and Hispanic workers, for example, are more likely to hold low-wage jobs and less likely to have savings cushions than white workers. For low-wage workers living paycheck-to-paycheck, taking an unpaid sick day can significantly impact their financial stability and budget to pay for basic needs.
Lack of access to PSL also disproportionately impacts women, who are more likely to work multiple low-paying jobs while simultaneously bearing the majority of caregiving responsibilities. This burdens women of color especially: six in ten Latinas are sole income earners for their household, and without PSL are particularly disadvantaged. Moreover, when parents lack access to PSL, it can negatively impact the health of their families: children of mothers without paid sick leave are less likely to receive routine medical care such as dental care and flu shots.
Leaving large portions of the workforce without access to PSL also exacerbates health inequities for these groups. This phenomenon has been recently illustrated in the COVID-19 pandemic: according to health records, in the first months of the pandemic Black Americans had twice the infection rate and Hispanics three times the infection rate of white Americans, largely due to workplace exposure. Lack of PSL also impacts health inequity by serving as a barrier to healthcare access for low-wage workers and minority populations, groups who already face disproportionate burdens of chronic disease.
Public health consequences of PSL access gaps
Without access to PSL, it is estimated that three million American workers go to work sick each week. A large portion of the jobs without PSL are in public-facing roles such as food service, hospitality, and caregiving, leading to ample opportunities for disease spread.
For example, while the US Centers for Disease Control and Prevention recommends staying home from work during and two days following stomach virus symptoms, only 27% of food service workers have access to PSL, and nearly half have reported working while ill. Unsurprisingly, approximately 50% of all stomach virus cases in the US are contracted from eating at restaurants.
There is strong evidence that the implementation of PSL policies can have a significant impact on the spread of contagious disease for employees and customers. New York state nursing homes who provided PSL policies for their staff had 38% fewer respiratory or gastrointestinal disease outbreaks compared to nursing homes in the state without PSL policies. Moreover, it has been estimated that universal access to PSL for Wisconsin workers could have prevented 10,000 COVID-19 cases and seventy-five deaths per month in early 2021.
Impact of PSL on employers
Opponents of PSL policies fear that PSL mandates would have negative financial impacts on businesses. Specifically, they cite that PSL policies could burden employers with hiring additional part- or full-time workers to cover absent employees or increase administrative costs for tracking absences and payroll. Employers have also shared concerns that workers may take advantage of available PSL by requesting unnecessary days off.
However, there is evidence to suggest that PSL policies may be financially neutral or even beneficial for businesses. An overwhelming majority of employers in municipalities that have PSL policies such as New York City and San Francisco express strong support for the policies after their implementation. Further, Connecticut employers reported minimal effects on labor costs and thus made no changes in prices or employee hours after the state’s PSL policy enactment.
PSL can also benefit employers by reducing employee turnover. Access to PSL also reduces the incidence of employees coming to work sick, or “presenteeism”. Presenteeism decreases productivity, increases errors, and increases risk of potentially hazardous mistakes. The lost productivity and errors of presenteeism are estimated to cost United States companies an average of $150 billion per year, significantly more than the cost of employee absences.
2. Policy Options
Option 1: Introduce legislation requiring all Wisconsin employers with ten+ employees to guarantee employees one hour of PSL per thirty hours worked, up to seventy-two hours per year
Advantages:
- helps close the PSL access gap, expanding PSL to 91% of Wisconsin workers
- small businesses with fewer than ten employees are sheltered from potential financial burdens of providing PSL
- comparable to Milwaukee’s proposed PSL policy that was supported by 68% of voters in a 2008 referendum
Disadvantages:
- approximately 225,000 workers at small businesses such as restaurants and other hospitality services are excluded from the mandate
- recently hired workers have limited access to PSL
- part-time employees at a disadvantage for accruing PSL hours
Option 2: Introduce legislation requiring all Wisconsin employers to guarantee employees a minimum of five days PSL per year
Advantages:
- provides PSL to the approximately 600,000 Wisconsin employees without PSL, helping close income, race, and gender access gaps
- allows all Wisconsin workers to stay home when they or their children are sick, reducing opportunities for disease spread
- covers workers at small businesses
Disadvantages:
- potential for financial or logistical burden on businesses in the short-term
- small businesses required to comply may face greater challenges covering the short-term costs associated with PSL implementation
Policy considerations
There are a variety of factors to consider for a PSL policy that suits the needs of Wisconsin workers and employers. For example, funding sources could be established for small businesses that may otherwise struggle to provide their employees with PSL. PSL policies should also address how to calculate PSL for part-time employees to ensure they are compensated for their scheduled hours. Opportunities for compromise could come in the form of truncated pay on sick days, similar to other countries’ policies such as France, which covers a portion of sick days at 90% of normal wages. Compromises such as this could help disincentivize unnecessary sick days and reduce costs for employers while still providing adequate wages for employees who are sick.
Consequences of inaction
Without a statewide PSL policy, hundreds of thousands of Wisconsin workers will continue to work jobs with no reasonable solutions for days when they or their children are sick. For as long as these PSL access gaps persist, many women, low-wage, and minority workers will be left to choose between their health and their income, burdened with the subsequent health and financial consequences.
Lack of access to PSL will also continue to negatively impact the broader public health in Wisconsin. Significant opportunities to mitigate the spread of contagious disease will be missed, along with opportunities to promote health through preventive care, both of which could save the state and employers in healthcare costs and improve health in Wisconsin communities.
3. Policy Recommendation
We recommend option 2, which guarantees five days of PSL for all Wisconsin workers. This option provides the greatest protections for employees and addresses public health inequities associated with lack of access to PSL. While this option may pose a greater upfront financial challenge to small businesses, this drawback is largely outweighed by the benefits to women, minorities, and low-wage workers, and overall benefits to public health.
