Lots Of Other Countries Mandate Paid Leave. Why Not The U.S.? : It's All Politics : NPR

Secondary school teacher Sarah Ward at home on maternity leave with her 3-month-old daughter, Esme Kelliher. A resident of New Zealand, Ward has access to paid leave, something many American mothers do not.
Secondary school teacher Sarah Ward at home on maternity leave with her 3-month-old daughter, Esme Kelliher. A resident of New Zealand, Ward has access to paid leave, something many American mothers do not.
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If you've been paying attention to the political news in the past couple of years, you know that the U.S. stands virtually alone in not mandating paid leave of any type for its workers.
It's hard to miss; the topic has become a top talking point for Democratic politicians. Hillary Clinton is advocating for stronger paid-leave policies on the campaign trail. In her Monday economic address, Clinton called for paid family leave as a way of helping women stay in the workforce. Sen. Bernie Sanders, her closest rival for the Democratic nomination, has advocated both paid vacation and paid maternity leave on the campaign trail. In addition, some cities and states have started instituting their own sick leave policies.
President Obama likewise brought new attention to paid leave this year as well, when he pointed out in his State of the Union address that the U.S. is the only advanced economy that doesn't mandate paid sick or maternity leave for its workers.
He was right about that — it's true that most American workers are covered by the Family Medical Leave Act, which allows workers up to 12 weeks of leave per year to care for family members. But that leave is unpaid.
Here, for example, is where the U.S. stands on paid maternity leave in comparison with other countries in the OECD, a group of highly developed economies:
The U.S. is the only one that doesn't mandate paid maternity leave. Likewise, the U.S. is one of nine OECD countries that have no leave policies in place for fathers.
It's not just parental leave, of course — when it comes to vacation, the U.S. is also unique. The chart below shows combined mandatory vacation days and federal holidays in all OECD nations. All of the U.S. days represented below are federal holidays (which are also not guaranteed days off for all workers); the rest of the nations mandate paid vacation days in addition.
It's a similar story on sick days — among high-income countries, the U.S. alone does not mandate sick leave, according to data compiled by the World Policy Forum.
It's not at all new to point this out, but data like these pose a tougher question: How did it get this way? Why is the U.S. so different from the rest of the world in not giving workers paid days off?

You could write an entire book about the complicated forces at work here, but a mix of a few big factors has helped set this scene: The aftermath of World War II, business lobbying, a diminished American labor movement, and the American love of individualism and bootstrap-pulling all have combined to help keep the U.S. alone in not giving its workers paid leave.
American Democracy Is Different
One way of thinking about why the U.S. stands alone on paid leave is to zoom way, way out and consider how Americans think about democracy in general — another area where Americans are arguably unique.
Political scientist Seymour Martin Lipset spent much of his career thinking aboutAmerican exceptionalism — trying to understand what exactly makes the U.S. such a strange creature. Our voting rates are low, but our volunteering rates are high, he pointed out. We're deeply religious. And while some European democracies went in a more socialist direction, the U.S. veered the other way.
For a variety of reasons, Lipset argued, Americans have a different way of thinking about their democracy — the young American democracy was founded with values like individualism and equality of opportunity at its center. And unlike many European democracies, the U.S. has never been a monarchy or a feudal society — that means there's less awareness of class divisions and less deference to the state in the U.S., Lipset writes. He also proposes a similar explanation for how labor parties and trade unions managed to be stronger in other countries but not in the U.S. — where there's less class awareness, there's less likelihood to join unions. (This is just one of many factors he uses to explain U.S. unions' relative weakness, however.)
It's easy to see how that might play out in the realm of paid-leave policies. First of all, with less labor power, there's less support of these sorts of policies. But in addition, when it comes to social class, individualistic, ambitious Americans think of not where they are but where they assume they eventually could be.
"[Lipset's] argument was that Americans identify with the social class that they aspire to rather than the social class that they were in," explains Peter Cappelli, professor of management at the Wharton School at the University of Pennsylvania. "So Americans have a lot of sympathy for small business because American people you would have thought were workers historically thought of themselves as potentially being small-business people."
The result is that Americans tend to have a bit more sympathy for business — after all, when we all own our own shops someday, we won't want our hands tied by any more regulations than absolutely necessary.
How World War II Explains U.S. Maternity Leave
It's not just that America's attitudes differ from the rest of the world's; the gap in parental leave in particular also has its roots in the aftermath of the world wars.
"The European social democracies that emerged after WWII all wanted paid leave policies (some had them earlier) in part because of their concern about replenishing the population," Ruth Milkman, a professor of sociology at CUNY, wrote in an email.
Europe suffered both massive casualties and massive damage to its infrastructure, Milkman explains, and it needed to get more people into the workplace. That meant helping women get into work. Meanwhile, when the U.S. troops came home, it meant less of a need for women in the workplace.
"Here in the U.S., while the war was going on, you had women in jobs in factories and in all kinds of jobs the men had held. But women went home" when the soldiers returned from the war, explains Debra Ness, president of the National Partnership on Women and Families. And with all of those women returning to the home, there was less of a reason to create policies that helped them stay in the workplace.
A Loud Business Voice
One other force opposing paid leave is the business community. Trade groups like the National Federation of Independent Business and chambers of commerce at the state and national levels have repeatedly opposed paid-leave policies. In 2007, one U.S. Chamber of Commerce official said his organization would wage "all-out war" against paid-leave laws.
Businesses are not opposed to paid leave itself; 65 percent of U.S. civilian workers have paid sick leave, and 74 percent have paid vacation, according to the Labor Department. (The numbers are, however, slimmer for paid family leave — only 12 percent of private sector workers have access to that.)
But those in the business community say they're opposed to the government telling businesses how to institute those policies. Paid leave is expensive, they argue, and businesses should all be able to figure it out on their own.
"The challenge with mandates is it is a government one-size-fits-all approach that tries to bring all of these unique workforces and workplaces under this one-size-fits-all approach," says Lisa Horn, spokeswoman at the Society for Human Resource Management, a trade group for HR workers. "It limits workplace flexibility and company innovation in this area."
The U.S.'s campaign finance system helps businesses keep these laws off the books, says one expert.
"Money plays a role in politics in many countries, but the extent to which the amount of dollars [is] spent on campaigns in the United States just dwarfs the amount spent in campaigns elsewhere," says Jody Heymann, dean of the School of Public Health at UCLA. "The ability [to make] very large corporate contributions plays a much more substantial role in our elections than in other countries."
With paid leave a top issue for the two front-running Democratic presidential candidates, conservative groups that oppose paid-leave laws will certainly find themselves fighting this fight in 2016, just as big-spending liberal groups that support paid-leave laws, like unions, will be pushing the cause of inching the U.S. a little bit closer to its international peers in this area.

Webinar Now Available for Viewing: Strategies to Support Homeless and at-Risk Clients with Effectively Utilizing the Healthcare System

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U.S. Department of Housing and Urban Development HUD Exchange Mailing List

Webinar Now Available for Viewing: Strategies to Support Homeless and at-Risk Clients with Effectively Utilizing the Healthcare System

HUD's Office of Special Needs Assistance Programs (SNAPs) and Office of HIV/AIDS Housing (OHH), are pleased to announce the availability of a recently recorded webinar focused on strategies for supporting clients to effectively utilize the healthcare system. Originally presented live on June 24, 2015, this webinar builds on the resources and information highlighted in the preceding webinar, “Strategies for Enrolling People Experiencing Homelessness in Healthcare Insurance,” which was aired in February. Participants will have the opportunity to listen to national leaders offering firsthand knowledge and information on how to assist low-income clients who are newly enrolled in Medicaid or other health insurance options and living with HIV/AIDS, experiencing homelessness and/or are formerly homeless to develop resilient relationships with health homes, community health centers or primary care providers, reduce health disparities and increase their health and well-being.

Presenters included:
  • Roula K. Sweis, M.A., Psy.D., Supervisory Program Advisor, HUD’s Office of the Assistant Secretary, Community Planning and Development - Opening Remarks

  • Dr. Cara James, Director, Office of Minority Health at the Centers for Medicare and Medicaid Services - Presentation of the “From Coverage to Care” (C2C) toolkit developed to support newly insured adults with effectively utilizing the healthcare now available to them

  • Kim Nettleton, Product Development - Capabilities, UnitedHealthcare Community & State – Presentation of a white paper describing the operating environment for Managed Care Organizations (MCOs) and their motivations and incentives for forging stronger links with community-based housing and service providers

  • Jessie Beebe, Health Services Specialist, Center for Housing and Health, AIDS Foundation of Chicago - Presentation of lessons learned and best practices in establishing and maintaining healthcare access for more than two hundred newly enrolled extremely low-income Medicaid recipients in the Chicago area
Webinar participants will:
  • Receive an introduction to the “From Coverage to Care” (C2C) toolkit developed expressly by CMS’s Office of Minority Health for the purpose of supporting newly insured adults to effectively utilizing the range of healthcare opportunities now available to them. 

  • Learn successful strategies for encouraging homeless and HIV/AIDS housing and service providers to make assuring clients’ strong and lasting connections to health homes/primary care providers a top priority in their program outcomes.

  • Hear first-hand from two communities, one urban and one rural/ex-urban, regarding how they are facilitating clients healthcare access and follow-through.

  • Review successful strategies for forging system-level links with a range of community-based services to support clients’ ongoing engagement in medical and behavioral healthcare.
To view the webinar go to: Strategies to Support Homeless or at-Risk Clients with Effectively Using the Healthcare System.

This webinar is part of a series of webinars being developed through HUD's Healthcare and Housing (H²) TA initiative. Sign up for the HUD Exchange Mailing List to learn about future webinars.

New Resource Available: USICH and Partners Release Key Strategies for Connecting People Experiencing Homelessness to SSI/SSDI Benefits

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U.S. Department of Housing and Urban Development HUD Exchange Mailing List

New Resource Available: USICH and Partners Release Key Strategies for Connecting People Experiencing Homelessness to SSI/SSDI Benefits

The U.S. Interagency Council on Homelessness (USICH) and its partners at the Social Security Administration (SSA), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the Department of Veterans Affairs (VA) are pleased to release Key Strategies for Connecting People Experiencing Homelessness to Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) Benefits.

This document is intended to improve practices and collaboration among SSA field offices, VA Medical Center staff, organizations and agencies that provide services to people experiencing homelessness, and other community-based partners. The strategies focus on assisting individuals experiencing homelessness with the initial disability application and medical determination process.
Key strategies include:
  • Assisting People Experiencing Homelessness with the SSI/SSDI Application Process
  • Coordinating with SSA Field Offices, Community Organizations, and Other Federal Agencies
  • Coordinating with Other Benefits and Entitlements
  • Working with Veterans and Other Special Populations
  • Assisting SSI/SSDI Beneficiaries Post-Entitlement

Registration is now open for SAMHSA's July 21st webinar on "42 CFR Part 2: Myths and Scenarios"

Join us for the next webinar in SAMHSA's Behavioral Health IT Summer Webinar Series!

42 CFR Part 2: Myths and Scenarios
Tuesday, July 21, 2015
1:00–2:00 p.m. ET

This interactive webinar will address (and debunk!) common myths associated with 42 CFR Part 2, the federal regulation governing the confidentiality of drug and alcohol use treatment and prevention records. Learn from the experts about the applicability of 42 CFR Part 2, permitted disclosures of protected data, and the ways in which the adoption of electronic health records (EHR) and health information exchanges (HIE) impacts compliance.

REGISTER NOW: https://attendee.gotowebinar.com/register/3463748967010283777

Featuring presentations by:
•          Kate Tipping, JD, Public Health Advisor, SAMHSA
          Deborah Reid, JD, Senior Health Policy Attorney, Legal Action Center
•          Katie O'Neill, JD, Consultant, Legal Action Center

Space for this webinar is limited, so we encourage you to register as soon as possible!

This webinar is the second in SAMHSA's three-part Behavioral Health IT Summer Webinar Series.  

Health insurance coverage among black and Hispanic Americans saw some big improvements last year

The proportion of black and Hispanic-Americans without health insurance was greatly reduced in 2014, the first year of the Affordable Care Act, according to a CDC report released today. The US also saw a significant reduction in the proportion of Hispanics who didn't obtain medical care due to the high cost of that care. Taken together, the findings indicate that the US made important strides last year in terms of reducing the racial disparities that have plagued the country's health care system for so long — even if tremendous gaps remain.
Black Americans have the highest mortality rate of any racial and ethnic group for cancer, and they're 40 percent more likely to suffer from high blood pressure than white Americans. In addition, Hispanic and non-Hispanic black adults are more likely to suffer from diabetes compared with white and Asian adults. That's why this new CDC data is so important; it shows that the US is starting to reduce the health care imbalances that exist between people of color and white people in the US.
Overall, the biggest change in the rate of uninsured took place among Hispanic and black Americans. In 2014, the proportion of black and Hispanic adults without health insurance was reduced to 17 and 34 percent, respectively, down from 25 percent for black Americans and 41 percent for Hispanics in 2013. And the percentage of Hispanic-Americans aged 18 to 64 who saw a health care professional in the last 12 months rose to 70 percent from 68 percent — the only change in that category that was deemed statistically significant.
That said, a lot of things didn't change. Health care access remained largely the same for black and Asian adults in 2014. And despite the new health care law, the percentage of people who saw a health care professional in 2014 didn't budge significantly for white, black, or Asian adults.
The fact that the number of uninsured Americans was greatly reduced in the wake of the Affordable Care Act isn't entirely new information. At the end of 2014, private sector surveys and a government report showed that the number of Americans without health insurance had been reduced by 25 percent in a single year. That means that over 8 million people signed up for health insurance in 2014. But breaking down the data by race helps put that change into perspective.
Despite efforts by the US government, 34 percent of Hispanics and 17 percent of black people still didn't have health care coverage in 2014, compared with 12 percent of white Americans and 12 percent of Asian Americans. And in 2014, Hispanics were still far more likely to have trouble gaining access to health care services compared with white people. That means that making sure people of color have options for accessing health care services should remain a priority.

PATH HMIS Webinar Announcement

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SAMHSA's Homeless and Housing Resource Network (HHRN) presents: 
Privacy and Confidentiality in HMIS: 42 CFR Part 2
July 28, 2015
12:00-1:30 PM (EDT) 
This webinar will provide an overview of 42 CFR Part 2 regulations as they relate to entering and storing Projects for Assistance in Transition from Homelessness (PATH) client data in Homeless Management Information Systems (HMIS) and practical guidance around the implementation of these regulations. The presenters will also explain how to resolve common issues and/or concerns that may arise when entering PATH client data in HMIS, while maintaining compliance with 42 CFR Part 2 regulations. 
This webinar is part of a series of HMIS webinars that address privacy and confidentiality issues when entering PATH client data in HMIS. Upon completion of the webinar, participants will be able to:
  • Identify key components of 42 CFR Part 2 regulations as they relate to entering and storing PATH client data in HMIS;
  • Understand how to apply 42 CFR Part 2 regulations when addressing privacy and confidentiality issues;
  • Review local policies and procedures, as well as understand whether changes are needed to ensure proper handling of PATH client information in HMIS for covered programs under 42 CFR Part 2; and
  • Be active and informed participants in local conversations regarding privacy and confidentiality procedures.
To register for this webinar, go to: 
Please contact Joe Manney at jmanney@ahpnet.com for registration questions and assistance. 
Laura Rosas, J.D., M.P.H.,  serves as Lead Public Health Advisor of the Health Information Technology Team at the Substance Abuse and Mental Health Services Administration (SAMHSA), where she leads a team focusing on privacy issues, technologies, client and patient engagement through health information technology (IT), and electronic clinical quality measures. Prior to joining SAMHSA, Ms. Rosas served as a Senior Advisor to the Chief Privacy Officer at the Office of the National Coordinator (ONC) for Health IT. Ms. Rosas has broad experience in health care, particularly in public health, privacy and security, and health IT. Prior to her role at ONC, Ms. Rosas served as Director of Privacy and Compliance at the Primary Care Information Project (PCIP) at the New York City Department of Health and Mental Hygiene. In that role, she led PCIP's efforts to incorporate privacy and security into electronic health record implementation to providers throughout New York City. Ms. Rosas received a law degree and a Master of Public Health from the University of Pittsburgh.
Kate Tipping, J.D., is a Public Health Advisor with SAMHSA's Health Information Technology Team, and works primarily on privacy issues. Previously, she worked for the ONC for Health Information Technology, where she focused on behavioral health issues and served as a project officer for the State Health Information Exchange Program. Prior to joining ONC, Ms. Tipping was a legislative analyst and a project officer for health information technology and telehealth grants in the Health Resources and Services Administration (HRSA). She received a law degree from Widener University and a bachelor?s degree in Health Information Management from the University of Pittsburgh.

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SOAR Webinar Announcement

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July 15, 2015
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SOAR Webinar: How Working is Promoting Recovery for People with Mental Illness

Wednesday, July 22, 2015
3:00pm-4:30pm (EDT)

Join us for a webinar featuring researchers and trainers from the Dartmouth IPS Supported Employment Center. IPS stands for Individual Placement and Support, the evidence-based approach to supported employment for people living with mental illness. The Dartmouth presenters will provide an overview of the IPS model, and share information on how this model has been effective with supporting individuals experiencing homelessness work competitively in the community.

We will also hear from a SOAR program at Columbus House/Pathways to Independence in New Haven, Connecticut, which offers supported employment services to SOAR applicants considering employment.

You will learn how to talk to SOAR applicants about the possibilities of work early in your engagement with SOAR applicants who are considering work.

  • Robert E. Drake, M.D., PhD., Director, Dartmouth Psychiatric Center in Lebanon, NH
  • Deborah R. Becker, M.Ed., CRC, Senior Project Director at the Dartmouth Psychiatric Research Center in Lebanon, NH
  • Thomas Fortuna, Manager, Pathways to Independence at Columbus House in New Haven, CT
  • Carl Reynolds, Employment Services Coordinator, Pathways to Independence at Columbus House in New Haven, CT
Intended Audience: SOAR practitioners, SOAR State and Local Leads, Employment Specialists, Vocational Rehabilitation Counselors and others who are interested in learning more about employment supports.

Click here to register for this webinar

Rich Neighborhoods: Build More Apartments Near Transit!

New Jersey’s extensive public transportation system is a source of envy for most other states, many of whose larger metropolitan areas are only recently scrambling to build the kinds of transit systems that New Jersey residents have long taken for granted.  Public transportation allows people to get from one place to another without having to rely exclusively on private vehicles, a fact that is especially important to lower-income households, which tend to spend a disproportionate share of their disposable income on transportation.
2013 analysis of data from Caltrans’ California Household Travel Survey, conducted by TransForm and the California Housing Partnership Corporation, found that “lower-income households drive 25-30 percent fewer miles when living within a 1/2 mile of transit than those living in non-TOD [transit-oriented development] areas.” Living near transit may even enable such households to forgo a car–and the accompanying expenses–altogether. A recent Rooflines post recently discussed how transportation is a more important factor than school quality or crime in helping households escape poverty. . . .
Given the benefits of transit-oriented development to lower-income households, are New Jersey’s transit-hosting municipalities making it easy for such households to live near transit? A recent New Jersey Future research report, OFF TRACK? An Assessment of Mixed-Income Housing around New Jersey’s Transit, looks into this question, examining all 244 of New Jersey’s transit stations (including rail stations of all types, ferry terminals, and major bus terminals) and assessing the degree to which the distribution of household income within each station’s immediate neighborhood matches up with, or departs from, the distribution of household income in the larger region in which the station is located.
The results are mixed. Some station neighborhoods, mainly in the state’s largest urban areas, have so far been unable to capitalize on the renewed demand for walkable, mixed-use, transit-accessible living that has resurfaced in the wake of the Great Recession and remain stubbornly characterized by chronic disinvestment and concentrated poverty. In almost every case, a high concentration of households at the low end of the income spectrum is accompanied by a scarcity of households at the high end; in fact, upper-income households in generally lower-income station areas are more uniformly rare than are lower-income households in more upper-income station areas. The challenge here, as it has been for decades, is how to entice middle- and upper-income households to move into long-distressed places, while not displacing long-time residents.
Of perhaps more immediate interest to housing advocates are the stations whose neighborhoods are dominated by households earning at least double the regional median household income, particularly because most of these higher-income station areas also host a higher percentage of single-family detached housing units than the statewide percentage. From a regional equity standpoint, a housing supply skewed toward single-family detached units, which are generally more expensive than other housing types like apartments or townhouses, can price out many households of more modest means, leaving the neighborhood and its mobility opportunities available only to wealthier residents.
Of course, in some of these wealthier places, the shortage of housing options may not be an accident, since, as a recent CityLab article reminds us, “For more than a century, municipalities across the country have crafted zoning ordinances that seek to limit multi-family (read: affordable) housing within city limits.” This exclusionary zoning is particularly tragic in TOD neighborhoods, in light of the outsized role that transportation plays in the fortunes of lower-income households. But the recent New Jersey State Supreme Court decision removing jurisdiction over affordable housing from the Council on Affordable Housing (COAH) and throwing it back to the courts may present a new opportunity to create housing diversity in places that have lacked it in the past. With municipalities uncertain how the courts will decide to define compliance, many will be looking to get out ahead of potential lawsuits. Promoting mixed-income development or redevelopment projects near transit stations is a good way for transit-hosting municipalities to help satisfy their affordable housing requirements while simultaneously creating transportation options for the types of households that need them most.