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Making Them Choose: Life Without Paid Sick Leave In Massachusetts

Dan Clawson + Naomi Gerstel: "Massachusetts workers without sick leave are forced into impossible situations in which they must choose between their job and the health of their families." (Lino Steenkamp/flickr)closemore
Dan Clawson + Naomi Gerstel: "Massachusetts workers without sick leave are forced into impossible situations in which they must choose between their job and the health of their families." (Lino Steenkamp/flickr)

Massachusetts has a strong record of supporting workers and families. But in a state that recently passed legislation that will give it the highest minimum wage in the country by 2017, it’s still possible to be fired for being sick or for caring for a sick loved one. Even in some of the state’s top care facilities, nursing assistants can be penalized for taking a day off for their own, their child’s or their parents’ illness. It’s unfair and unhealthy — for employees, their families and the people they are hired to care for.

...in a state that recently passed legislation that will give it the highest minimum wage in the country by 2017, it’s still possible to be fired for being sick or for caring for a sick loved one.

Next month, Massachusetts voters will decide Question 4, Earned Sick Time for Employees. If passed, employers with more than 10 employees will be required to provide them paid sick time, and employers with fewer than 10 employees will be required to provide them unpaid sick time. Similar legislation has passed statewide in Connecticut and California, and in nearly a dozen cities across the country. Massachusetts should follow suit.

In hundreds of interviews throughout New England for a book about the increasing trend of unpredictable scheduling at work, we found that Massachusetts workers without sick leave are forced into impossible situations in which they must choose between their job and the health of their families. Our research suggests these patterns are prevalent in the health care industry — one of the fastest growing sectors of the U.S. economy.

In one New England nursing home serving an affluent population, the policy is simple: Every 90 days, each time a worker is unable to work for any reason, management classifies that as a “call out,” which leads to a series of escalating punishments. The first call out comes with a verbal warning; the second with a written warning; the third with a stronger written warning; and the fourth with termination. The clock resets every 90 days, giving the worker a clean slate. At this particular nursing home, the newly-hired nursing director found the 90-day policy far too lenient.

But even as workers try to limit sick days to emergencies, “everyone has their moments where they call out,” one nursing home assistant said. If there is something going around, a single mother of two may have to stay home because her youngest gets sick, then again because the older child catches it, and then again because she gets sick. If she has just one more day out in the next 10 weeks, that mother will be fired.

Such policies disproportionately punish low-wage workers. Nursing assistants, the people who provide much of the care in nursing homes — washing, dressing, toileting and feeding residents — are paid slightly over minimum wage. According to our research, the average nursing assistant’s income was $21,000 per year.

They are overwhelmingly women. Many are single mothers. Many are black or Latina. Like other low-wage service workers, their lives are filled with complications. As the breadwinners for their families, most of them rely on extended family to help care for their children, and it’s not so easy to find someone to stay with a sick child, especially if your shift is eight hours in the middle of the night or not regular from one week to the next.

The nursing assistants widely consider these policies unfair. Even if they are in the emergency room with a child having a life-threatening asthma attack, there are no excused absences. They feel devastated by having to choose between the children they love and the job they need to support them. They report being told, “Okay, if you are absent one more time, you’re gonna be fired.”

If there is something going around, a single mother of two may have to stay home because her youngest gets sick, then again because the older child catches it, and then again because she gets sick. If she has just one more day out in the next ten weeks, that mother will be fired.

Putting aside the harm to families, these policies also affect public health. One nursing assistant, echoing what we heard from many in her position, said, “If you’ve got diarrhea or vomiting, they still want you to come in. At our meetings, they say a sore throat is not really a sore throat.” This means that to protect their jobs, ill workers go to work sick — to wash, feed and expose frail 90-year-olds to whatever they might have. The nursing assistants worry about the effects on the people in their care, people to whom they are often emotionally close. If they want to keep their jobs and support their families, however, they have no choice.

At a large nonprofit, non-union facility we observed, workers feel powerless to change their circumstances. “What are you going to do? You’re not going to be able to really change it,” one nursing assistant told us. “[Management] do what they want, basically.” Other employees described a culture of intimidation. When asked whether she had brought her grievances and concerns to management, one nursing assistant replied, “Others have and lost their jobs.”

They might be powerless, but Massachusetts voters are not. Soon, it will be up to them to decide whether workers such as these should be entitled to five days of paid sick leave, or not.


Naomi Gerstel is distinguished university professor at the University of Massachusetts, Amherst, and is co-author, with Dan Clawson, of "Unequal Time."

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