June 8, 2017

NY Laws and Maternal Health:Your Role in Implementing the

NY Paid Family Leave ActBarbara A. Dennison, M.D.

The New York State Perinatal Association (NYSPA) ConferenceAlbany, NY

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Outline

• Background and Benefits of PFL

• NY Paid Family Leave

– Eligibility and Benefits

– Coverage and Costs

– Employees’ Rights

• Physician / Healthcare Provider’s Role

• Outreach

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Background - Paid Family Leave

•International•Recommended Maternity Protection and Leave

•United States •Federal Family Medical Leave Act (FMLA)

•Unpaid, 12 weeks•Employees must work 1 year; >50 employees•Covers about 50% workforce; fewer new mothers

•Paid Family Leave•U.S. Surgeon General

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Background - Paid Family Leave

•Other States - PFL Legislation•California (2004) - 6 weeks, up to 55% wages

•(2018) – up to 70% for lowest wage workers•Washington (2007) - passed, but not funded •New Jersey (2009) - 6 weeks, up to 66% wages•Rhode Island (2014) - 4 weeks, up to 60% wages

•Private Sector Employer-Sponsored PFL•13% nationally; 5% low-income workers

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Benefits of Paid Family Leave• Parents

• Lower parental stress• Stronger parent-child bonding

• Mothers• Fewer postpartum depression symptoms• Return to work later

• Infants• Reduced infant mortality rates• Lower rates of prematurity & low birth weight• Reduced infant infections

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Benefits of Paid Family Leave

• Increased Breastfeeding

• Women with 12 weeks vs. no PFL were more

likely to initiate breastfeeding and twice as likely

to breastfeed at 6 months (50% vs. 25%).

• After CA implemented PFL, the number of infants

exclusively breastfed increased by 3-5% and

those breastfeeding through 3, 6 and 9 months

each increased by 10–20%.

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Benefits of Paid Family Leave

• Employers

• More than 90% reported no cost increases

• Employees

• Lower turnover

• Increased job continuity

• Higher job satisfaction

• Higher labor force participation among women

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History of Paid Family Leave Legislation in NY•NY Legislature

•Proposed PFL legislation every year since 2008

•NY Medicaid Redesign Team, Social Determinants Workgroup (focus on employment) - 2014

•Included State Agencies, Stakeholders, Academics, Advocates•Made Ten Recommendations to Improve Health Care, Reduce Disparities & Reduce Medicaid Costs

#3- Paid Family Leave

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New York State

Paid Family Leave

Paid Family Leave

Upon full implementation,

NYS PFL program will be the

Most Robust Paid Family

Leave program in the nation.

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Governor Cuomo signed

legislation on April 4, 2016

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Provides Paid Time Off for

Family CareBonding

with a ChildFamily Issues Related

to Military Service

What Is Paid Family Leave?

Bonding with a Child

Covers:• Birth

• Adoption

• Foster Care

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Provides time for both parents to bond with a child.

Covers:

Family Care

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Provides time off to care for a family member

who has a serious health condition.

A serious health condition is an illness, injury,

impairment, or physical or mental condition that

requires:

• Inpatient care in a hospital, hospice, or

inpatient/outpatient residential health facility;

or

• Continuing treatment or supervision by a

health care provider.

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Qualifying relatives include:

• Spouse

• Domestic Partner

• Child

• Parent

• Parent-in-law

• Grandparent

• Grandchild

Family Care

These relatives can live outside of New York State and even outside of the country.

Provides time off for an employee to assist

when a family member is called to active

military service.

Qualifying family members include the

employee’s spouse, child, domestic partner or

parent.

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Military Service

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Who Will Administer PFL?Statewide, multi-agency effort led by:

Workers’ Compensation Board

Department of Financial Services

Department of Health, Department of Labor, &

Others

• The Paid Family Leave Program is included in Article 9 of the Workers’

Compensation Law.

• Provide Paid Family Leave claim dispute resolution by arbitration—through

a vendor.

• Resolve discrimination claims.

• The Board will also provide safeguards to ensure the payment of benefits

even in cases where the employer is uninsured.

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Role of the Workers’ Compensation Board

What Is the Benefit in Time Off?

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8WEEKS

10WEEKS

10WEEKS

12WEEKS

Time off benefits start January 1, 2018 at 8 weeks

and will reach 12 weeks by 2021.

2018 2019 2020 2021

What is the Wage Benefit?

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50% 55% 60%67%

*Wage benefits start January 1, 2018 at 50% of an employee’s

average weekly wage, and will reach 67% by 2021.

2018 2019 2020 2021

*Benefits will be capped at the designated percentage of the statewide average weekly wage.

• Starting on January 1, 2018

• Maximum benefit available once every 52 weeks

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When Can an Employee Take PFL?

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• Virtually every private employee in New York will be covered by Paid Family Leave.

• Workers are eligible if: – Employed for 26 consecutive weeks, or

– Work for 175 days

• Citizenship and immigration status have no impact on eligibility.

Who Qualifies for Paid Family Leave?

A union can collectively bargain for Paid Family Leave.

Public employers (New York State, county, town or village, Public Benefit Corporation) must opt-in for Paid Family Leave.

To opt-in:

• Provide written notice to employees and the Board at least 90 days before taking deductions from pay checks.

• Submit a copy of the Paid Family Leave plan to the Board.

• Follow all the applicable regulatory requirements for providing coverage.

• Provide written notice 12 months in advance of terminating coverage.

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Union and Public Employees

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Coverage, Costs,

and Benefits

Virtually all private employers are

required to secure Paid Family

Leave coverage.

• Insurance coverage must be provided

beginning January 1, 2018.

• Premium is funded by employees; may be

deducted from paycheck and begin as early as

July 1, 2017.

• Typically insurance will be included as a rider

to the employers’ existing NYS disability policy.

• Employers who fail to secure Paid Family

Leave insurance will be penalized.

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Coverage and Costs

• Time off can be taken in a continuous span of dates or

intermittently, but always in full day increments.

• Employees may NOT collect NYS Temporary Disability and

Paid Family Leave benefits for the same period of time.

• Employees may NOT collect Paid Family Leave benefits while

collecting workers’ compensation benefits for a Total

Disability.

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Understanding NY Paid Family Leave Benefits

Paid Family Leave and FMLA may count simultaneously.

Employer may track hours taken for FMLA, when hours

reach a full day, they may deduct one day of NY Paid

Family Leave.

Employer must notify employee of designation.

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Family Medical Leave Act (FMLA) and Paid Family Leave

Temporary Disability Insurance

• Requires Medical Documentation– Can be used by mother during pregnancy

• e.g., final 4 – 6 weeks of pregnancy

– Can be used by mother immediately postpartum

• e.g., 4 weeks (Vaginal delivery); 6 weeks (C/section)

• Can use FMLA benefit (if available) to protect job

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Temporary Disability Insurance

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The Physician /

Healthcare Provider’s

Role

INFORM YOUR PATIENT, THEIR FAMILY MEMBERS

• NYS has a Paid Family Leave Program• If you/family member is working, may be eligible• Talk to your Employer• Employee needs to notify Employer 30 days ahead (if

possible)

PROVIDE DOCUMENTATION

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The Physician/Provider's Role

DOCUMENTATIONPregnant Woman / Birth Mother

• Letter certifying pregnancy; including mother’s name and expected birthdate of the child, OR

• Healthcare provider certification of birth, OR

• Infant’s Birth Certificate

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The Physician/Provider's Role—Bonding

DOCUMENTATIONSecond Parent / Father• Voluntary Acknowledgement of Paternity, OR

• Court Order of Filiation, OR

• Birth Mother’s Documents (see previous), PLUS– Marriage Certificate, OR– Certificate of Civil Union, OR– Certificate of Domestic Partnership Relationship

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The Physician/Provider's Role—Bonding

DOCUMENTATION - Medical certification must include:• Patient Information• Patient diagnosis; corresponding ICD code (if available)• Provider’s medical license number• Estimated duration of patients’ need for care by a family

member• HIPAA release for care recipients to authorize disclosure

of their medical records to the employee and the Paid Family Leave carrier

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The Physician/Provider's Role—Family Care

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Implementation and

Outreach

• Awareness Campaign

• A commitment to making NY Paid Family Leave a success.

• Direct Outreach and Education

• Productively engage with health care providers, insurance

carriers, employers, employees, military and underserved

communities.

• Leverage stakeholder existing events, relationships and

resources to most effectively build PFL awareness.

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Implementation and Outreach

• Physicians / Healthcare Providers– Informational Brochure for Providers

– Fact Sheets (Bonding, Caring or Military)

– Posters (Bonding, Caring or Military)

• For Patients– Informational Brochures for Patients

– Palm Card (Summary)

– Videos to assist with completing a PFL claim

• For Employers – Carrier and Employer Responsibilities

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Awareness Campaign:

Helpline: (844) 337-6303

Website: www.ny.gov/PaidFamilyLeave

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For More Information

Questions?

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