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Mayor’s Task Force on Paid Sick Leave Public Hearing Testimony: Carol Rogers, Executive Director, Healthy Philadelphia

Healthy Philadelphia’s mission is to make high quality health care available to all Philadelphians, by bringing together health care providers, community, religious, labor, business, immigrant, and grassroots leaders to work on longstanding problems in the delivery of health care, with community at the heart of our mission. Healthy Philadelphia gives voice to those who are underserved, and works to develop public health messages, including education about existing and needed resources. Previous to my work at Healthy Philadelphia, I was employed by the Philadelphia Department of Public Health for 30 years where I worked as a clinician and also to develop and disseminate literacy appropriate, culturally sensitive public health messages.

Thank you for the opportunity to give testimony to the Mayor’s Task Force on Paid Sick Leave and to urge you to strongly support paid sick leave for all of Philadelphia’s workers. Paid sick leave is an important public health issue, an important issue to support appropriate use of health care resources and as an important issue of equity and fairness.

Paid sick time is an important public health issue because it allows workers to get timely, preventive health care. When workers cannot get paid time off to attend to their health needs, they are unable to access timely care, they end up sicker from preventable conditions, and often end up in the hospital. The ambulatory care sensitive hospitalization rate is a figure that reflects the number of hospital admissions that could be prevented if people are able to get treatment in a timely manner for some common conditions. Philadelphia’s ambulatory care sensitive hospitalization rate for 2010, the most recent year available, is 1,348 per 100,000 –approximately 20,936 hospitalizations a year (Philadelphia Department of Public Health, 2014). These hospitalizations could potentially be avoided if people were able to access outpatient care for common conditions like hypertension, asthma, COPD, diabetes, and epilepsy.

Paid sick time is an important public health issue because it allows parents to provide care for their sick children, and enables them to have access to on-going pediatric care. Parents without paid sick time are twice as likely to send sick children to school or daycare. They are five times as likely to take their child or a family member to the emergency room (ER) because they were unable to take time off during normal work hours. (Institute for Women’s Policy Research, 2013)

An ER is for emergencies—it is not the right place for children to get the comprehensive health care that they need: they lose opportunities for prevention and optimum health care. For example, children with asthma, who get their care only in ERs during asthma crises, are less likely to be given appropriate asthma controlling medication and monitoring, leading to more crises, missed time from school and disability. (American Medical Association Journal of Ethics, 2006)

The cost to provide care for non-emergencies in the ER is higher than providing care in out-patient health centers. It is estimated that nationally, if all workers had paid sick time, non-emergency ER use would decrease, and more than $1 billion per year in medical costs would be saved. (Institute for Women’s Policy Research 2013). But more important than the cost of providing health care in ERs, is the human cost: good health care prevents needless suffering, disability and deaths–when strokes and heart attacks are prevented, when asthma is treated before it becomes life threatening, when diabetes is adequately controlled to prevent complications like kidney dialysis, amputations and blindness.

Not that we can blame those who depend on ERs for their care and the care of their families. What are they to do, when their only choice is to lose a job or a paycheck? It makes perfect sense for people to rely on ERs for their care when they cannot get time off to take care of all of the things that all of us need to do to be healthy.

Recommended screening for cancers suffers from lack of paid sick leave as well: the percentage of workers who received mammograms and pap tests was significantly higher for those who had paid sick leave compared to those without it. (National Health Interview Survey, 2008)

When I worked at the Philadelphia Department of Public Health, part of my job was to develop public health messages to be disseminated to community and grassroots leaders to share with their constituencies. The public health strategy messages during flu season– get immunized, cover your mouth when you cough or sneeze, and do not go to work or school if you’re sick, were out of reach for too many Philadelphians. Giving one flu day to workers in small and large companies would decrease workplace transmission of the flu by 25%. Giving 2 flu days would result in a nearly 40% decrease in influenza infections due to workplace transmission. (University of Pittsburgh Graduate School of Public Health)

Sadly most of Philadelphia’s low-income workers are unable to follow the public health strategies to reduce flu transmission. Low income workers are much less likely to have paid sick time than higher paid workers. Only 32% of workers in the lowest paid quartile have access to paid sick leave, compared to 81% of the top wage earners in the highest paid quartile. Only 27% of food service workers and child care workers have access to paid sick leave. (Institute for Women’s Policy Research 2013.) The lack of paid sick leave makes life a lot harder for those who already work so hard, to make ends meet and raise their families.

More than 80,000 Philadelphians signed up for health insurance through the Affordable Care Act this year, granting them access to affordable, high quality health care. Yet, health care will remain out of reach for so many Philadelphians if they are not given paid time away from work.

The time is long overdue for Philadelphia to enact an equitable paid sick leave policy. The benefits will be great, not only for those who will be earning paid sick leave for the first time, and making their lives just a little bit easier—but for us all as we use our valuable health care resources to keep people healthy instead of using them at the back end to treat preventable complications of common illnesses.

Thank you very much for the opportunity present testimony at this hearing of the Mayor’s Task Force on Paid Sick Leave.

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