Paid Family Research Articles

Getting Paid while Taking Time: The Women’s Movement and the Development of Paid Family Leave Policies in the United States by Megan A. Sholar

Getting Paid while Taking Time: The Women’s Movement and the Development of Paid Family Leave Policies in the United States by Megan A. Sholar

Getting Paid While Taking Time: The Women’s Movement and the Development of Paid Family Leave Policies in the United States. By Megan Sholar. Philadelphia: Temple University Press, 2016. 252p. $94.50 cloth, $29.95 paper.

Getting Paid While Taking Time: The Women’s Movement and the Development of Paid Family Leave Policies in the United States. By Megan Sholar. Philadelphia: Temple University Press, 2016. 252p. $94.50 cloth, $29.95 paper.

Getting Paid While Taking Time: The Women's Movement and the Development of Paid Family Leave Policies in the United States

Getting Paid While Taking Time: The Women's Movement and the Development of Paid Family Leave Policies in the United States

Paid Family Leave: Egalitarian Victory, Conservative Surrender - And a Budget Disaster

General income security, also known as paid family leave, is rapidly becoming the next item on the egalitarian reform agenda. This paper analyzes existing research on the subject, and presents data on the experience with paid-leave programs in Europe. Neither academic research nor the experience with paid-leave programs can present a case for such a program in the United States. Combined with a potential cost for the program of hundreds of billions of dollars per year, this paper recommends against creating a federal paid family leave program.

At the intersection of marketisation, diversity and migration: reshaping the provision of paid family eldercare in Sweden?

ABSTRACTThis article explores how paid family eldercare in Sweden is reshaped at the intersection of marketisation, accommodation to ethnic diversity and globalisation of international migration. Using a mixed-methods case study approach, the paper examines how implementation of customer choice in publicly funded homecare services to older adults in the city of Stockholm interacts with paid family care. The results show that some private homecare companies employ family caregivers as a business strategy; moreover, that the majority of employed family caregivers are foreign-born women coming primarily from non-European countries. The findings point towards gains but also risks for all parties involved. Though the family caregiver is ensured an income, the employment is generally associated with low wages and weak social security. In addition, employed family carers often lack formal training, which affects documentation procedures and monitoring of the daily care work. It is therefore difficult to evaluate the quality of care services performed by employed family carers. The results indicate a need for policy-makers to reconsider how customer choice in eldercare interacts with paid family care. Otherwise, unintended consequences may result in negative effects for integration as well as social work practice with foreign-born older adults.

Work–family balance in international perspective

In recent academic debates on work–family balance, there has frequently been a disparity between theory and practice. With ageing populations globally, it is expected that both men and women will work later into life, and greater effort is needed on the part of governments and families to ensure care and support for elderly and disabled people. These factors combine to make the relationship between work and care a crucial issue for social and employment policy. The books by Milkman and Appelbaum as well as Kroger and Yeandle discuss care comprehensively and extend current debates on the relationship between the policy context and human agency. They highlight the policy lessons to be learned from experiences of the reconciliation of work and care in various contexts. Unfinished Business by Ruth Milkman and Eileen Appelbaum investigates California’s Paid Family Leave (PFL) programme, implemented in mid-2004. This programme was designed to address the need for paid family leave and to assist, among other groups, the ‘sandwich generation’ – working people with caregiving responsibilities both to elderly parents and to their own young children. This book reports the results of four original surveys conducted in 2004, just prior to the introduction of the PFL programme, and in 2009. The programme came into force in July 2004, and provides eligible male and female workers with six weeks of PFL per year for caring for a new child or a seriously ill relative. PFL covers all private and non-profit workers and these employees receive up to 55% of their weekly wages. The programme is financed by an employee payroll tax and is administered by California’s Employment Development Department, together with the Temporary Disability Insurance (TDI) programme. Milkman and Appelbaum supplement the survey results with recent statistical data from California, and analyse the 604568WES0010.1177/0950017015604568Work, employment and societyJoint book review research-article2015

Unfinished Business: Paid Family Leave in California and the Future of U.S. Work-Family Policy

Unfinished Business: Paid Family Leave in California and the Future of U.S. Work-Family Policy

Don’t Leave U.S. Behind

This article examines the pace at which Federal and State legislation were implemented to provide working parents and caregivers the ability to take time off for the birth or adoption of a child, to care for the elderly, sick or disabled family members, and others in need of care. Compared with many industrialized nations, the United States ranks alongside the least generous countries in terms of providing a balanced lifestyle between work and family life. For instance, the United States does not even provide national paid family leave. This article provides the history, purpose, and scope of the Family and Medical Leave Act, and later implementations of State programs. Furthermore, this article will present a brief survey of the paternal, maternal, and parental leave policies of other countries and will provide suggestions for changing existing federal policies to provide a more conducive family and work balance for employees.

Unfinished Business: Paid Family Leave in California and the Future of U.S. Work-Family Policy. By Ruth Milkman and Eileen Appelbaum. Ithaca, NY: ILR Press, 2013. Pp. 143. $69.95 (cloth); $19.95 (paper).

<i>Unfinished Business: Paid Family Leave in California and the Future of U.S. Work-Family Policy</i>. By Ruth Milkman and Eileen Appelbaum. Ithaca, NY: ILR Press, 2013. Pp. 143. $69.95 (cloth); $19.95 (paper).

A European postdoc for the family.

In the spring of 2011, I started a 2-year Whitaker International postdoctoral scholarship in bioengineering. My husband, an experienced mechanical engineer who is fluent in German, left his job in the United States and found a new one in Vienna. The next year, I learned I was pregnant. We didn't go to Europe to start a family—our goal was to experience a new culture and remain competitive in our fields—but we recognized almost immediately the advantages of Austria's support for young professionals pursuing careers and a family. ![Figure][1] “The parental-leave advantages that Europe can offer postdocs are worth considering.” ILLUSTRATION: ROBERT NEUBECKER Austria is far ahead of the United States in providing options for both women and men to take time off from work for birth and child care. First there is Mutterschutz , a mandatory paid maternity leave and job protection period of 8 weeks before and 8 weeks after the birth of a child. Then there is Elternkarenz , up to 36 months of financial support with allowances of as much as 80% of your monthly wage. Parents frequently opt for 14 months, with the father taking 2 months. Other European countries offer similar benefits. Dutch employment law, for example, entitles working women to 16 weeks of paid zwangerschapsverlof , men to 2 days of paid vaderschapsverlof , and both parents to 6 months of additional unpaid leave with job protection. In the United Kingdom, statutory maternity pay (SMP) is granted for up to 39 weeks, and employers often supplement these benefits with occupational maternity pay. Under the SMP program, fathers can receive 2 weeks of paid leave, with an additional 26 weeks if the mother returns to work. Specific restrictions vary, but non-E.U. nationals can qualify as long as they have an employment contract and an appropriate visa. A science Ph.D. makes it easier to secure the required credentials. According to a Pew Research Center report covering 38 countries around the world, the United States is the only one that does not mandate paid leave for new mothers. California is one of a few states to offer paid family leave, available to workers who have contributed to the state disability insurance program. But in most of the country, the postdoc parenting experience is institution dependent. After our son was born, I took 5 months off and my husband took 3 months. We wanted to share parenting responsibilities equally, as much as nature allowed. He planned to take off 5 months, too, but job opportunities in the United States brought us back sooner than expected. Still, my husband was able to experience caring for our son full time while I worked; they bonded in a way that is hardly possible for working fathers in the United States, where paid paternity leave is rare. Being the primary caregiver for 3 months allowed my husband time to find his own way of parenting while I got back to work. I wanted to stay connected during my leave, so I worked remotely when I could and often brought my son to lab meetings, which my colleagues were kind enough to schedule around naps. My immediate team of male colleagues did not seem to mind the infant intrusion—it helped that he was a calm baby—and meetings were productive. This flexibility, and the absence of pressure to return to work, allowed ample time to connect with my son as I learned to be a mom. Work was secondary when it needed to be. In the United States, the pool of qualified postdocs has grown and postdocs have gotten longer. There's now a greater likelihood than ever that training will overlap with starting a family. The decision when and where to have children is personal and depends on many factors; there's something to be said, for example, for having your mother nearby. But in deciding where to train, postdocs should consider the whole experience of working and living, not just time spent in the lab. Add to the mix Europe's ample opportunities for professional enrichment, and the parental-leave advantages that Europe can offer postdocs are worth considering. [1]: pending:yes

Book Review: Unfinished Business: Paid Family Leave in California and the Future of U.S. Work-Family Policy by Ruth Milkman and Eileen Appelbaum

Book Review: <i>Unfinished Business: Paid Family Leave in California and the Future of U.S. Work-Family Policy</i> by Ruth Milkman and Eileen Appelbaum

Book Review: Unfinished Business: Paid Family Leave in California and the Future of U.S. Work-Family Policy

Book Review: Unfinished Business: Paid Family Leave in California and the Future of U.S. Work-Family Policy

Implications of Paid Family Leave for Welfare Participants

Implications of Paid Family Leave for Welfare Participants

Consumer-Directed Personal Care: Comparing Aged and Non-Aged Adult Recipient Health-Related Outcomes Among Those With Paid Family Versus Non-Relative Providers

Risk factors associated with the incidence of recipient injuries, bedsores and contractures, and health care use (i.e., emergency department and hospital use) among aged and non-aged adult personal care recipients are investigated. Data are from a statewide survey of aged and non-aged adult personal assistance service (PAS) recipients (n = 913) in California's In-Home Supportive Services (IHSS) program. This is a consumer-directed PAS program. Outcomes among recipients using relatives (other than spouses or parents) as paid providers are compared with those of recipients having non-relatives as providers. No differences were found by provider-recipient relationships. Non-aged recipients, those in poorer health, those with more than three activities of daily living (ADL) limitations, and those changing providers during the year were all at greater risk for adverse health outcomes. African American, Hispanic, and Asian recipients were at lower risk for injuries and hospital stays than were White recipients.

Children with Health Issues

All children, even the healthiest, have preventive and acute health care needs. Moreover, a growing number of children are chronically ill, with preventive, acute, and ongoing care needs that may be much more demanding than those for healthy children. Because children are unable to care for themselves, their parents are expected to provide a range of health care services without which the current health care system for children would not function. Under this "shadow health care system," parents or parent surrogates often need to be with the child, a requirement that can create difficulties for working parents, particularly for those whose children are chronically ill. How federal, state, and employer policies and practices mesh with the child health care needs of families is therefore a central issue in any discussion about work and family balance. In this article Mark Schuster, Paul Chung, and Katherine Vestal describe the health care needs of children; the essential health care responsibilities of parents; the perspective of employers; and the existing network of federal, state, and local family leave benefits that employed parents can access. They also identify current gaps in policies that leave unmet the needs of both parents and their employers. The authors suggest the outlines of a national family leave policy that would protect the interests of parents and employers. In essence, such a policy would build on the federal Family and Medical Leave Act, which gives some workers time off with no advance notice required and no loss of job or health insurance. But it would also include elements of California's Paid Family Leave Insurance, which expands coverage to more workers and provides partial pay during leave. Employers could be given some financial protections as well as protections against employee fraud and abuse. Such a policy, the authors conclude, would help to provide security to parents, minimize effects on employers, raise societal expectations for family-friendly work environments, and help maintain the parental shadow system of care on which health care professionals depend.

The Crisis of caregiving: social welfare policy in the United States

Who Cares? The Crisis of Caregiving B.Reid Mandell Women's Work, Mothers' Poverty G.Mink Paid Family and Medical Leave R.Albelda & B.Reid Mandell The Privatization of Care B.Reid Mandell Shelters for the Homeless: A Feeble Response to Homelessness B.Reid Mandell Foster Care B.Reid Mandell Adoption B.Reid Mandell The Punitive State M.Rosenthal Alternatives to Welfare B.Reid Mandell Appendix A: Current Safety Net Programs in the U.S. B.Reid Mandell Appendix B: Advocacy organizations B.Reid Mandell

Riches of Poverty

DOI: 10.1200/JCO.2010.28.3986 For the past 20 years—since I began my professional practice as a clinical oncologist—a ritual is repeated practically every year in May. I close my work schedule for a week, leave everything set for my absence from home, and depart for the United States to attend the Annual Meeting of the American Society of Clinical Oncology (ASCO). At this meeting, physicians and scientists of international renown from centers of excellence dedicated to the investigation, teaching, and treatment of cancer meet to present the results of their current research and to discuss the future of oncology. Hailing primarily from the developed nations of the Northern Hemisphere, their names are familiar to me from books and articles that I have and will read throughout the year. At this meeting, with pride and confidence, inductive reasoning leads to scientific knowledge and the best evidence-based medicine. At this meeting, with the pragmatism and objectivity characteristic of Anglo-Saxons, I learn the updated pathways, pathophysiology, and prognoses of the many different types of cancer and guidelines that will dictate the best oncologic treatments. Each year, the return home leads to attempts on my part to incorporate, in the best possible way, this newly acquired knowledge into the reality of my daily practice providing personalized and individualized care. My challenge is enormous. My country, a developing nation, possesses more needs than resources, making treatment of the disease just one among many problems to be solved. The hospital where I work is entirely supported with public funds and is dedicated to the general care of the population, oncology being only one of many other medical specialties available. The number of practicing oncologists pales relative to the demand, creating increasingly grave work overloads. My patients are largely from less privileged classes, revealing great economic, educational, cultural, and social disparities between us. As a result, discussions about treatment and therapeutic options are difficult. The doctor-patient relationship is based not on the sharing of informed decisions, but on simple faith and trust, on their part, in my presumed professional ability and willingness to help them in the best possible manner. In addition, because my patients, their relatives, and I share the emotionalism and sentimentalism common to Latin cultures, conversations about prognoses and life expectancy are not particularly welcomed. When using my clinical reasoning to determine the best treatment for each individual patient, I cannot ignore the panoply of other nonmedical factors in the decision-making process. How far from the hospital does the patient live? Which mode of transportation will he use to come to the hospital? How long will it take for him to get there? What are the sanitary conditions in his home? How good is the patient’s diet? Can the patient understand and adequately follow a prescription with multiple steps? All these questions need to be evaluated and considered when trying to determine each patient’s ability to deal with and handle the potential adverse effects and risks associated with his treatment. Finally, and not infrequently, while trying to explain to a patient what his treatment will entail, I am constantly fielding requests to assist in the resolution of issues more relevant to their day-to-day needs, such as preparing written statements to obtain paid family medical leave, filling out forms for free public transportation vouchers to enable them to come to the hospital during treatment, and directing them to organizations that donate wigs, breast prostheses, colostomy bags, and other medical necessities. Throughout all of these years, the process of attending ASCO’s annual meeting and then returning post-ASCO meeting to the realities of my daily practice, with all its contrasts and challenges, has been fairly constant with few changes. What has changed during this period is me— and the way I deal with and respond to this process. The first years were a time of awe filled with the wonders, the promises, and the infinite potential of science. One day all this will be mine. One day I too will be able to do this in my country, in my hospital, with my patients, each and every day. Unfortunately, reality interfered with these dreams and what followed were years of envy, frustration, and disappointment. After all, these dreams would never be mine; they would not be my reality, my daily experience. JOURNAL OF CLINICAL ONCOLOGY T H E A R T O F O N C O L O G Y VOLUME 28 NUMBER 21 JULY 2

Awareness and Use of California's Paid Family Leave Insurance Among Parents of Chronically Ill Children

Awareness and Use of California's Paid Family Leave Insurance Among Parents of Chronically Ill Children

Focus Group Study of Ethnically Diverse Low-Income Users of Paid Personal Assistance Services

This study examined the experiences of ethnically diverse, low-income consumers of paid personal assistance services (PAS) to understand the successes and problems they faced setting up and maintaining their assistance. A thematic analysis was conducted with transcripts from eight focus groups of ethnically homogeneous consumers (n = 67): African American, Latino, Chinese, Native American, and non-Hispanic white. These experienced consumers were generally satisfied with their current PAS but noted significant difficulties: Getting access to appropriate care, obtaining enough paid care to avoid unmet need, and dealing with confusing bureaucracies and cultural differences between them and agency staff/attendants. They desired more control over their care, including the use of paid family attendants when possible. Respondents recommended improved screening and training of attendants, more attendant time, higher wages for attendants, improved cultural sensitivity of attendants and agency staff, and greater consumer control over PAS. Although these low-income PAS consumers are ethnically and geographically diverse, the similarity of findings points to their ongoing struggle to access adequate high quality assistance. The burden they have in obtaining and maintaining services is substantial.

Paid Family Leave for Parents of Chronically Ill Children

PARENTS OF CHRONICALLY ILL CHILDREN FACE UNusual challenges in the current US health care system. The system is an odd mix of public and private insurance. Children are covered either through their parents’ employment-based insurance or through public insurance programs (Medicaid) that require meeting some type of financial means test. There is little health insurance support other than Medicaid for those individuals who lack insurance as a result of partial employment or for those who have employment-based insurance that provides inadequate coverage for the employed individual or family members. Children with special health care needs are defined as “those children who have or are at increased risk for a chronic physical, developmental, behavioral or emotional condition who also require health and related services of a type and amount beyond that required by children generally.” Methods using this definition to identify chronically ill children estimate that 15% of children have a chronic illness and that these children consume approximately 50% of the health care resources devoted to children. Individually, these children are expensive to care for and costs increase significantly according to the severity of the chronic condition. Expenditures for health care of chronic conditions in childhood generally cannot be anticipated. Consequently, a family with a child who has a chronic health condition faces many unexpected costs and personal choices. These unexpected costs include insurance co-payments, out-ofpocket expenses such as transportation needs, medications, special treatments, equipment, and home support of the child. One family member may have to stay home to provide parental care. There are choices concerning who will provide that home care and whose work-related insurance is essential. This decision can be difficult if the parent who would prefer to be the stay-at-home parent is also the one who has the most job satisfaction, best employer-based insurance coverage, or earns the most money. In addition, the loss or decrease in employment may have significant influence on a family member’s sense of personal worth or selfesteem. These losses increase according to the severity and needs of the child and, by necessity, may lead the family closer to Medicaid as the principal safety net insurance coverage. The 1993 Federal Family and Medical Leave Act provided job-protected leave for up to 12 weeks after the birth of a child and to care for an immediate family member (spouse, child, or parent) with a serious health condition. This act had limited success, in part because there was no provision for paid leave. According to surveys conducted in 2000, 46.5% of employees were covered and eligible, 41.9% had not heard of the law, and many individuals who needed the leave did not take it because they could not afford it. As part of an effort to correct some of the deficiencies in federal legislation, several states developed their own paid family leave legislation. California was the first to offer a paid family leave insurance program. In 2004, non–job protected family leave for workers caring for a child, spouse, domestic partner, or parent with a serious health condition became available. After missing 1 week of work, employees can receive up to 6 weeks of coverage at 55% of pay (maximum $917 per week in 2008). The article in this issue of JAMA by Schuster and colleagues is the first study to evaluate the use of paid family leave among families with a chronically ill child. The authors measured the awareness and use of the provisions of this legislation in a sample of employed parents in California with a child with a chronic illness, both prelegislative and postlegislative enactment, and in a similar control sample of employed parents in Illinois, where there is no similar paid family leave legislation. The program was not associated with increased rates of parents taking leave after the legislation was enacted (81% of parents in California and 78% of parents in Illinois with children with special health care needs took 1 day of leave to care for an ill child before the legislation, and 79% of parents in California and 79% of parents in Illinois did so afterward). Some families should have taken leave but did not for fear of loss of income or job loss or career damage (41% of parents in