NY Laws and Maternal Health: Your Role in Implementing the NY Paid Family Leave Act Barbara A. Dennison, M.D.

Transcription

1 NY Laws and Maternal Health: Your Role in Implementing the NY Paid Family Leave Act Barbara A. Dennison, M.D. June 8, 2017 The New York State Perinatal Association (NYSPA) Conference Albany, NY

2 June 8, Outline Background and Benefits of PFL NY Paid Family Leave Eligibility and Benefits Coverage and Costs Employees Rights Physician / Healthcare Provider s Role Outreach

3 June 8, 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

4 June 8, 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

5 June 8, 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

6 June 8, 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%.

7 June 8, 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

8 June 8, 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) Included State Agencies, Stakeholders, Academics, Advocates Made Ten Recommendations to Improve Health Care, Reduce Disparities & Reduce Medicaid Costs #3- Paid Family Leave

9 9 New York State Paid Family Leave

10 10 Paid Family Leave Governor Cuomo signed legislation on April 4, 2016 Upon full implementation, NYS PFL program will be the Most Robust Paid Family Leave program in the nation.

11 11 What Is Paid Family Leave? Provides Paid Time Off for Bonding with a Child Family Care Family Issues Related to Military Service

12 12 Bonding with a Child Provides time for both parents to bond with a child. Covers: Covers: Birth Adoption Foster Care

13 13 Family Care 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.

14 14 Family Care Qualifying relatives include: Spouse Domestic Partner Child Parent Parent-in-law Grandparent Grandchild These relatives can live outside of New York State and even outside of the country.

15 15 Military Service 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.

16 16 Who Will Administer PFL? Statewide, multi-agency effort led by: Workers Compensation Board Department of Financial Services Department of Health, Department of Labor, & Others

17 17 Role of the Workers Compensation Board 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.

18 18 What Is the Benefit in Time Off? Time off benefits start January 1, 2018 at 8 weeks and will reach 12 weeks by WEEKS 10 WEEKS 10 WEEKS 12 WEEKS

19 19 What is the Wage Benefit? *Wage benefits start January 1, 2018 at 50% of an employee s average weekly wage, and will reach 67% by % 55% 60% 67% *Benefits will be capped at the designated percentage of the statewide average weekly wage.

20 20 When Can an Employee Take PFL? Starting on January 1, 2018 Maximum benefit available once every 52 weeks

21 21 Who Qualifies for Paid Family Leave? 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.

22 22 Union and Public Employees 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.

23 23 Coverage, Costs, and Benefits

24 24 Coverage and Costs Virtually all private employers are required to secure Paid Family Leave coverage. Insurance coverage must be provided beginning January 1, Premium is funded by employees; may be deducted from paycheck and begin as early as July 1, 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.

25 Understanding NY Paid Family Leave Benefits 25 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.

26 Family Medical Leave Act (FMLA) and Paid Family Leave Paid Family Leave and FMLA may count simultaneously. 26 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.

27 27 Temporary Disability Insurance 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

28 28 The Physician / Healthcare Provider s Role

29 29 The Physician/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

30 30 The Physician/Provider's Role Bonding DOCUMENTATION Pregnant 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

31 31 The Physician/Provider's Role Bonding DOCUMENTATION Second 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

32 32 The Physician/Provider's Role Family Care 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

33 33 Implementation and Outreach

34 34 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.

35 35 Awareness Campaign: 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

36 36 For More Information Helpline: (844) Website:

37 Questions? 37