Parents of chronically ill kids are helped by better access to federal and employer leave

Working parents are more able to care for their chronically ill children when given greater access to federal and employer-provided time off from their jobs, according to a RAND Corporation study.

"We found that having the time and financial flexibility to miss work is clearly important for parents who have children with serious chronic illnesses," said lead author Dr. Paul Chung, senior natural scientist at RAND and assistant professor of pediatrics at the David Geffen School of Medicine at UCLA.

"Children in our study missed an average of four weeks of school or daycare a year," added Dr. Mark Schuster, senior author of the study and director of the health promotion and disease prevention program at RAND Health. "They also had 12 doctor or emergency department visits and one hospitalization."

"Unfortunately, many parents who don't have access to family leave are forced to choose between being with their child and keeping their job," said Schuster, who is also professor and vice-chair of pediatrics at UCLA.

Researchers at RAND, a nonprofit research organization, surveyed 574 full-time employed parents of chronically ill children between November 2003 and January 2004. The study examined the availability of paid and unpaid leaves of absence from work, how often parents missed work to care for their ill children, and the length of absences from work.

The study appears in the May edition of the journal Pediatrics.

Researchers found that less than half of the parents interviewed qualified for benefits under the federal Family and Medical Leave Act. The law provides eligible workers up to 12 weeks of unpaid leave per year to care for ill family members without the risk of being fired.

Only 30 percent of parents reported having employer-provided leave that could be used to care for ill family members, and just 15 percent reported having access to paid leave.

Most parents reported missing some work in the past year to care for their ill children. Of those parents, however, 40 percent admitted returning to work before their child's health improved. Of those who went back to work before their child was better, more than 60 percent said they returned because they needed the pay.

Almost half of adults reported that at least once in the past year they could not miss work at all even though their children needed them. Of those parents, more than 70 percent reported that they would have missed work if they had received at least some pay during their time off.

Parents who were aware of their eligibility for Family and Medical Leave benefits, had access to employer-provided leave, or had access to paid leave were more likely than other parents to miss work to care for their children.

After the study was conducted, California implemented the Paid Family Leave Insurance program, which uses a statewide payroll tax to provide up to six weeks of partial pay for employees to care for ill family members. This first-in-the-nation paid family leave program is being closely watched as a potential model for other states and the federal government.

"Paid Family Leave Insurance is a major attempt at change and California is the only state right now to have it," said Chung. "However, what effects it will actually have on families and businesses are still very unclear."

The RAND Health study recommends:

• Evaluating the potential impact of expanding eligibility for the Family and Medical Leave Act and educating more employees about these benefits.
• Examining the likely effects on families and businesses when access to employer-provided or state-provided leave benefits is increased.
• Assessing the long-term effects of California's Paid Family Leave Insurance and similar programs in other states.