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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