Beyond FMLA: Making the Case for State-Level Paid Family Leave, the Path to Policy Adoption

The Family Medical Leave Act (FMLA) was established in 1993, and while limited in scope, it is the only national policy in place to support individuals that need to take time away from work to care for a sick family member. Paid Family Leave, a state-level mechanism of FMLA, creates a safety net to support these workers. Despite its potential impact, such programs currently exist in only 6 states and the District of Columbia. Further, even within these states, individuals are often unaware of the policy's existence. A systematic review of peer reviewed literature from 1994-2019 explores the predictors of the adoption and implementation of state-level Paid Family Leave and public awareness of Paid Family Leave programs in these states. This presentation will explore these findings and their implications on future state level adoption, implementation and awareness of Paid Family Leave.

Employment concerns experienced by ovarian cancer patients and caregivers.

69 Background: Our aim was to obtain patient input on the impact of cancer treatment on employment. Methods: We recruited patients with ovarian cancer receiving systemic therapy who screened positive for financial distress using Comprehensive Score for Financial Toxicity <26. Participants completed a 45-minute interview with 2 interviewers on their costs of care, including employment concerns. Interviews were recorded, transcribed, and coded by 3 analysts using inductive thematic analysis. Results: Of 22 participants, 86% were <65 years old and 28% were on curative intent treatment. There were 18 with currently evaluable interviews. Themes are shown in the table. Conclusions: Cancer care has a negative impact on patient and caregiver work productivity, income, and employer benefits. Incorporating resources to navigate workplace factors, such as Family Medical Leave Act benefits and negotiating accommodations with an employer, could improve care delivery. [Table: see text]

Analysis of Pregnancy Anti-Discrimination Policy in Kentucky: Application of Kingdon’s Multiple Streams Framework

While several federal laws including the Pregnancy Discrimination Act, Family Medical Leave Act, and the Americans with Disabilities Act provide some freedom from discrimination due to pregnancy and breastfeeding-related conditions, many pregnant workers in Kentucky were not covered under these existing laws. The intent of Senate Bill 18, the Kentucky Pregnant Workers Act, was to provide clarity to employers about the protections afforded to pregnant workers by law as well as the need for employers to provide the same level of accommodations for pregnant workers that are available for those who are disabled. Similar bills had been filed during the 2015 to 2018 legislative sessions, and in 2019, Senate Bill 18 passed 87-5 and was signed by the Governor on April 9, 2019. The purpose of this article is to analyze a pregnancy anti-discrimination bill that passed during the 2019 Kentucky General Assembly utilizing Kingdon’s Multiple Streams Framework. This article also contains multiple policy alternatives, interest group involvement related to pregnancy anti-discrimination policy, unintended consequences of policy implementation as well as potential issues with enforcement of the Kentucky Pregnant Workers Act.

Parental Leave for Residents at Programs Affiliated With the Top 50 Medical Schools

ABSTRACT Background Of the top 15 medical schools with affiliated graduate medical education (GME) programs, 8 offer paid parental leave, with an average duration of 6.6 weeks. It is not known how other GME programs approach parental leave. Objective We searched for the parental leave policies for residents in programs affiliated with the top 50 medical schools. Methods In 2019, we identified the top 50 medical schools designated by US News & World Report in the research and primary care categories (totaling 59 schools), and identified the associated GME programs. For each school, we accessed its website and searched for “GME Policies and Procedures” to find language related to maternity, paternity, or parental leave, or the Family Medical Leave Act. If unavailable, we e-mailed the GME office to identify the policy. Results Of 59 schools, 25 (42%) described paid parental leave policies with an average of 5.1 weeks paid leave; 11 of those (44%) offer ≤ 4 weeks paid parental leave. Twenty-five of 59 (42%) programs did not have paid parental leave, but 13 of these specify that residents can use sick or vacation time to pay for part of their parental leave. Finally, 13 of 59 (22%) offered state mandated partial paid leave. One school did not have any description of parental leave. Conclusions While paid parental leave for residents has been adopted by many of the GME programs affiliated with the top 50 medical schools, it is not yet a standard benefit offered to the majority of residents.

Family Medical Leave as a Resilience Resource for Family Caregivers

Case managers mobilize family networks to care for patients. Family medical leave can be a resource for case managers who seek to enhance resilience among family caregivers. The Family Medical Leave Act, passed in 1993, was the first U.S. policy to regulate employee leaves from work for family care purposes (29 CFR 825.102). This policy offers family caregivers increased flexibility and equality. Current and emerging policies also can reduce financial strain. The discussion examines how case managers can integrate family medical leave into best-practice models to support patients and family caregivers.

Beyond Reputation: Debate on the Role of Corporate Influence in Occupational and Environmental Medicine

In his article in this issue, Tee Guidotti casts recent works addressing corporate influence on occupational medicine as “collective act[s] of disparagement … undertaken … for political reasons.” We move beyond the question of reputation to address key conflicts in the history of occupational medicine, including the American Occupational Medical Association's historical role in weakening the beryllium standard and the American College of Occupational and Environmental Medicine's recent efforts to limit the extent of the Family Medical Leave Act. The corporate practice of externalizing health and safety costs makes industry influence an important ongoing topic of debate in occupational and environmental medicine.