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Paid Sick Leave: The Ultimate Guide for Employers

Giselle Solorzano
Posted by Giselle Solorzano on April 8, 2021

Healthcare practices know that sick leave is a must-have benefit. Here’s how to create and implement a policy that works for you — and for your employees.

The Healthcare Guide to Paid Sick Leave Policies

While some cities and states have implemented paid sick leave requirements, many others still don’t require employers to offer this benefit. It can be tempting to save on payroll costs by not offering a paid sick leave policy however, in order to stay legally compliant, and avoid employee claims, you’ll want to follow your state’s guidelines. 

Most healthcare practices have discovered that paid sick leave is the sort of benefit that pays for itself in a variety of ways. The biggest way paid sick leave pays for itself is that you cut down on “presenteeism” — employees coming in sick. Almost as important, a robust paid sick leave policy shows your team members that you care, and that is critical to creating employee engagement. 

Think of this: Your hygienist has a tight budget and can’t afford to lose a day’s pay. They come into work with a terrible cold, sniffling and sneezing their way through patient visits. At the very least, your patients are likely to be uncomfortable. In a worst-case scenario, you have patients with underlying medical conditions who end up seriously ill as a result of exposure to your hygienist. 

So what is paid sick leave? And how can you create a policy that works for you and your employees? More importantly, what options are available for tracking sick time accrual and payment without taking too much time out of your Office Manager’s day? 

What Is Paid Sick Leave?

Is Paid Sick Leave Required by Law?

The Benefits of Providing Sick Leave

Implementing a Paid Sick Leave Policy

Sick Leave for Federal Contractors

Waiting Periods

Front-Load Leave

Sick Leave For Part-Time Workers

Sick Leave and COVID-19

How HR for Health Can Help

What Is Paid Sick Leave?

There are many reasons your team members might need time off, and it is likely that you already offer benefits like personal days, bereavement, and vacation. Generally, these days are paid when your team members meet eligibility requirements outlined in your paid time off policies. 

Paid sick leave is similar to other types of paid time off, in that you cover your employees’ pay when they cannot work due to illness. Often, the biggest difference between sick leave and personal or vacation time is that sick leave is unplanned, so you cannot approve it in advance. 

Is Paid Sick Leave Required by Law?

For the moment, there is no federal requirement for you to provide paid sick leave to your employees. However, a growing number of states are passing legislation that mandates sick leave benefits — sometimes paid, sometimes unpaid. 

In addition to that, there are cities and counties nationwide that are passing their own version of these regulations. In some cases, the cities and counties are located in states with mandatory sick leave requirements, and the cities’ and counties’ policies are more generous. 

For example, Pennsylvania does not have a state law requiring paid sick leave. However, the city of Philadelphia does. Meanwhile, California has a paid sick leave requirement of at least 24 hours for eligible employees per year, but the city of San Francisco bumps that number up a bit.

Recommended Reading

Several States Implement New Sick Leave Laws under FFCRA Amid COVID Pandemic

The Benefits of Providing Sick Leave

This type of benefit has been a hot topic in recent years, and COVID-19 thrust it into the spotlight by illustrating the dangers of exposing others to illness. Paid sick leave works, because it means that your employees don’t have to choose between a paycheck and the rest they need to feel better. Healthcare workers value sick leave, because it helps to keep them safe. Offering it voluntarily — even if the law doesn't require you to — is critical for attracting and retaining top talent. 

Recommended Reading

 The Unofficial Guide to Paid vs. Unpaid Leave 

Implementing a Paid Sick Leave Policy

There is a lot to consider when putting your paid sick leave policy together, as it can get complicated quickly. You’ll want to be sure you cover the following:

  • How do team members accrue paid sick leave hours?
  • When do team members accrue paid sick leave hours?
  • What happens at the end of each year does accrued/unused paid sick leave carry over, or are you taking a use-it-or-lose-it approach? 
  • When are employees eligible to use paid sick leave? 
  • Are there guidelines on what increments team members can use sick leave? For example, can they use an hour at a time, or must they use a half-day or full-day of sick leave? 
  • Will you require a doctor’s note for sick leave approval? If so, under what circumstances? 
  • Can employees use sick leave to care for family members, such as children? 
  • What are your expectations for providing notice of the need for sick leave? 
  • Will team members be required to use paid time before unpaid time? 

Again, it is important to note that cities and states with sick leave laws often cover some or all of these points. If those regulations apply to you, your policy must meet or exceed the legal requirements. 

Finally, decide how you will manage your sick leave benefit from a logistics perspective. You will need to put a process in place to track sick leave accrual, balances, requests, and use. Keep in mind that this can be time-consuming if you rely on manual data entry and calculations. Many practices choose automated solutions available through advanced HR software to keep the process simple. 

Recommended Reading

What Is Human Resources Software and Why Do You Need It?

Sick Leave for Federal Contractors

One of the frequently asked questions that comes up during the development of a new sick leave policy is whether practices are required to provide sick leave benefits to contractors. The short answer is that you don’t have to offer sick leave to contractors, but you might wish to include them anyway. The availability of this benefit protects the contractor, the rest of your team, and your patients from exposure to illness. 

Waiting Periods

If you aren’t required to comply with city or state-mandated sick leave regulations, you have a choice when it comes to whether you will require team members to wait before using the sick leave benefit.

As with the other benefits you offer — vacation, health insurance, and similar — you can implement a waiting period before your employees are eligible for paid sick leave. Many practices choose to delay this benefit until the end of the standard probationary period. However, you can certainly choose to permit use of paid sick time from the moment an employee is hired if you prefer. 

Of course, if state eligibility requirements apply, your policy must meet those guidelines. For example, in California, eligible employees begin accruing paid sick leave the day they start work. However, you aren’t required to permit use of paid sick leave until the 90th day of employment

Front-Load Leave

There are several methods of managing the accrual of sick leave hours. Many practices find that the simplest way is to front-load paid sick leave. This gives employees a new bank of sick hours at the start of each benefit year. For example, if you offer team members 24 hours of sick leave, those hours would be front-loaded and available at the start of the year. 

Of course, if you are in a city or state with sick leave laws, you must comply with those requirements. That means offering at least the minimum number of hours, and front-loading may or may not be permitted.

Recommended Reading

About California’s Sick Leave Laws: Rollover vs. Lump Sum

Sick Leave For Part-Time Workers

If you have part-time employees, you can manage their sick leave the same way you do for full-time employees. Alternatively, you can limit front-loading to full-time employees and use a per-hour accrual method for your part-timers. 

For example, you may have a hygienist who only works once a week and thus would only accrue 13–14 hours of sick leave during the year (52 weeks x 8 hours per week) x 0.0334 per hour worked, per most state regulations. Offering a per-hour accrual would make more sense than giving that employee the full 24 hours up-front. 

Sick Leave and COVID-19

Finally, keep in mind that many states that didn’t already have sick leave laws implemented specific COVID-19 sick leave regulations over the past year. In some cases, states that did have sick leave laws on the books enhanced the benefits employers are required to offer in an effort to reduce the spread of COVID-19. It’s critical to stay up-to-date with these changes in addition to existing state and local sick leave laws. 

Recommended Reading

COVID: Emergency Leave and Employment Litigation Risks

How HR for Health Can Help

If you are ready to create and implement your sick leave policy, HR for Health has the expertise necessary to ensure compliance with local and state regulations. We partner with you to develop a sick leave policy for your employee handbook that includes all relevant sick leave requirements. 

Better still, you don’t have to worry about manually entering and tracking data when you launch your paid sick leave policy. HR for Health offers an integrated timekeeping system that includes automated sick leave tracking. That means no more Excel spreadsheets for calculating accruals, checking balances, and managing requests. Instead, the HR for Health platform will handle all of that for you. 

Get started by contacting HR for Health here.

Schedule an HR Consultation

Topics: sick leave, sick time, paid leave, Independent contractors

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