A mother and her son meet with a care coordinator.

This brief is one in a series of six on key early childhood issues for state policymakers. The series is designed to assist new state leaders in promoting informed policy decision-making in states to give kids a healthy start in life.

The Issue

A vast majority of parents with young children actively participate in the workforce, yet most do not have access to paid family and medical leave. Illness, the birth of a child, or the needs of aging family members too often force parents to choose between caregiving responsibilities and maintaining their incomes. Family and medical leave policies enable working parents to balance these demands and are broadly supported by the public.

Why It’s Important

The early years of a child’s life are a critical time for family bonding and early brain development. Families need time together to create strong relationships and address critical health needs as they arise. Research has shown that family leave policies that provide paid time off after the birth of a child reduce pre-term and low birthweight births, increase breastfeeding and infant immunizations, improve maternal mental health and women’s labor force retention, and have minimal impacts on businesses. The American Academy of Pediatrics recommends a minimum of 12 weeks of paid leave for infants while the American College of Obstetrics and Gynecology recommends a minimum of 6 weeks. Sick leave policies, which provide short-term leave for one’s own illness or a family member’s while maintaining pay and benefits, help caregivers meet their children’s health needs and can reduce transmission of infectious diseases in the workplace.

Considerations for State Policymakers

Forty percent of workers in the United States are currently excluded from FMLA coverage, and many people in low-skill, low-wage positions who qualify cannot afford to take unpaid leave. As part of the 2017 revision to the tax code, a new federal tax credit is now available for employers who provide paid family and medical leave to their employees. However, because of limitations in federal and private sector leave policies, states have acted to expand family and medical leave protections to additional workers through social insurance programs funded through worker and/or employer contributions, tax credits for businesses, or tax-deferred savings accounts for workers. For short-term sick leave, states have also adopted requirements for employers.

1.    Expand access to paid family and medical leave

Some workers are not able to take advantage of the job-protecting leave benefits under state or federal family leave policies because they cannot afford to take unpaid leave. To support healthy families, six states (California, Rhode Island, New Jersey, New York, Washington, and Massachusetts) and the District of Columbia have acted to provide paid family and medical leave to workers, regardless of size of employer or industry.

Key considerations for expanding access to paid family and medical leave include:

  • Worker eligibility including waiting periods to qualify, amount of time worked, wage minimums and contributions to temporary disability funds managed by the state.
  • Allowable reasons to take paid family and medical leave such as bonding with or caring for a new child or taking care of one’s own serious health condition or that of a family member.
  • Definition of family member such as in New Jersey which allows care for siblings, grandparents, grandchildren, and parents-in-law, along with children, spouses, and parents.
  • Length of leave which currently ranges from 4 weeks for family leave in Rhode Island to 12 weeks in New Jersey, Washington, and Massachusetts.
  • Benefit amount for workers which ranges from 55% of a worker’s average weekly wages in Rhode Island and New York to 90% of average weekly wages in Washington for lower-wage workers.
  • Job protection which is offered by Rhode Island, New York, and Massachusetts.
  • Funding and mechanism for accessing benefits including contributions by employees only, employers only, or through joint contributions. In California, where eligible workers are paid 60-70 percent of their average weekly wage for up to six weeks, benefits are funded through worker contributions to the California State Disability Insurance Fund.
  • Education and enforcement to enable employers to be compliant with new rules and employees to know their rights and obligations.

 2.    Expand access to unpaid family and medical leave (if paid leave is not feasible)

Many states have acted to expand access to unpaid family and medical leave beyond the federal FMLA through two specific approaches.

  • Broaden the definition of a caregiving relationship to recognize caregiving for family members not included in the federal FMLA. In Hawaii, for example, workers may take leave to care for grandparents and grandparents-in-law in addition to children, spouses, and parents as allowed by FMLA.
  • Extend leave to more workers since many employees at small businesses or part time workers are not covered by the federal FMLA. In Vermont, all employers with 10 or more employees qualify for leave associated with a new child or adoption.

3.    Expand access to paid sick leave

Eleven states and the District of Columbia, through legislative and ballot actions, have acted to provide paid sick leave for workers. Key considerations for establishing paid sick leave policies are like those for paid family and medical leave outlined above, with three additional considerations.

Worker eligibility including the size of the businesses that must provide paid sick leave, how leave is earned, and minimum standards for leave. In Arizona, employers with fewer than 15 employees must provide at least 24 hours of paid sick leave each year, while businesses with 15 or more employees must provide a minimum of forty hours yearly.

  • Health conditions that qualify for leave considering allowing sick leave for physical or mental health conditions and injuries experienced by the worker or family, including domestic violence and sexual assault.
  • Enable localities to enact stronger standards: States that adopt paid sick leave requirements should set a floor or minimum for all businesses operating in the state and allow localities to enhance leave benefits. Currently, twenty-three states prohibit cities, towns, and counties from considering their local policy needs.


About Ascend

Ascend at the Aspen Institute is a hub for breakthrough ideas and collaborations that move children and their parents toward educational success and economic security. Ascend takes a two-generation approach to their work—focusing on children and their parents together—and bring a gender and racial equity lens to their analysis. Learn more at https://ascend.aspeninstitute.org.