Raquel Rojas has never worked for a company that gave her paid sick leave. Sometimes even unpaid leave isn't on offer.
The Baltimore resident said a restaurant that employed her as a line cook three years ago stopped scheduling her for work after she stayed home for two weeks to recover from pneumonia. She said she had worked through worsening symptoms for several weeks — fever, mouth sores and eventually a bad cough — until she couldn't go on.
"That happened to me, but also, not just to me," Rojas, 45, said through an interpreter. "This is probably happening to lots of workers."
Forty percent of Maryland's private-sector workers — nearly 820,000 people — have no option to take time off with pay if they're ill, according to estimates from the Institute for Women's Policy Research.
Now three Baltimore groups that advocate for workers are launching a campaign to require paid leave in the state, calling it a public-health issue as well as a matter of basic fairness. Business groups, however, argue that adding regulatory mandates can stall job growth.
Nationwide, there's a have-and-have-not aspect to paid leave. Most high-wage workers have it; most low-wage workers don't.
"All of us at some time do get sick, our kids get sick, our parents get sick," said Jason Perkins-Cohen, executive director of the Job Opportunities Task Force, one of the organizations behind the new Working Matters coalition. "If you aren't able to accrue leave … what are you supposed to do?"
Paid leave is guaranteed in much of the world but only in a few places in the United States: Connecticut, San Francisco, Seattle and the District of Columbia. Activists are also pressing for laws in several other cities, including New York, and more than a dozen states.
Local business groups aren't eager for Maryland to join in. They say that requiring paid leave would burden companies that don't have a lot of workers — or a human-resources department to manage leave.
"I think it's crossing dangerous territory when a government steps in and mandates these kinds of benefits for workers, especially for very small businesses," said Kathleen T. Snyder, president of the Maryland Chamber of Commerce. "We need to be careful about these well-meaning mandates, which may not have the effect that we want, which is to create more jobs for Marylanders."
The National Restaurant Association and its state affiliates have been among the most active opponents of paid-leave laws. Three-quarters of food preparers and servers aren't eligible for sick leave.
The Maryland proposal is still in the formative stage, and the Restaurant Association of Maryland said it couldn't comment on it until there's a specific proposal. Generally, though, the trade group is concerned about "one size fits all" requirements, said Melvin R. Thompson, senior vice president of government affairs and public policy at the association.
The few U.S. jurisdictions with sick-leave laws have set a lower requirement, or no requirement, for small employers. In Seattle, for instance, workers accrue a maximum of five to nine days a year, depending on the size of the employer, but businesses with fewer than five employees are exempted.
San Francisco's law, which also ranges from five to nine days but covers all employers, is the longest-standing in the country at six years old. Two-thirds of that city's employers said they support the law, and more said it had no negative effect on their profitability, according to a 2009 survey of 727 small and large businesses by the Institute for Women's Policy Research.
"We believe that paid sick leave is good public policy," said Donna Levitt, manager of San Francisco's Office of Labor Standards Enforcement.
The average cost for private-sector employers offering sick leave in the U.S. is 23 cents an hour per employee, according to the Bureau of Labor Statistics. That's about the experience of San Francisco restaurateurs, but it's hard to parse out the full impact because the city also increased the minimum wage and required employers to provide health care in recent years, said Rob Black, executive director of the Golden Gate Restaurant Association.
"You do want to make sure you've got people who aren't coming to work sick, but there's a real cost to it," Black said of paid leave. "It's a complicated issue."
Advocates contend that workers without paid leave are ultimately more expensive for their employers, and the community, because they spread illness or make mistakes.
Workers with paid leave are less likely than those without it to delay medical treatment for themselves or their family, or to end up at the emergency room, according to an Institute for Women's Policy Research analysis of Centers for Disease Control and Prevention data last year.
Workers with paid leave are also 28 percent less likely to get hurt on the job than those without, according to a study this summer by the National Institute for Occupational Safety and Health.
Fred Levy, senior co-director of the Center for Medicine and Law in Baltimore, said emergency-room doctors certainly see people who are reluctant to take the recommended time off. He'd like to see more research into the costs and benefits of paid leave.
"This may be beneficial, but it's a question we can attempt to answer a little more rigorously before marching forward," said Levy, whose center is part of the Johns Hopkins School of Medicine and the University of Baltimore School of Law.
The local Working Matters coalition — launched by the Public Justice Center and United Workers as well as the Job Opportunities Task Force — is holding a forum Wednesday in Baltimore to kick off its paid-leave efforts. Details still need to be hammered out, but the task force's Perkins-Cohen hopes that the General Assembly will consider a leave proposal in the session that starts in January.
The idea can be a tough sell. A Denver ballot initiative was voted down nearly 2 to 1 last year after the city's mayor gave it a thumbs down and an opposition campaign characterized it as a job-killer and too broad.
"They called it paid sick leave, but there was no requirement that an employee produce any evidence that they were sick," said Pete Meersman, president of the Colorado Restaurant Association.
Erin Bennett, Colorado director of 9to5, a national group that advocated for the Denver law, said paid-leave proponents should take a lesson from that campaign and prepare for big-spending business groups "spreading misinformation."
Employees wouldn't have had to provide a doctor's note for illnesses lasting two days or less, but Bennett said research into sick-leave use contradicts claims that workers would abuse it. The typical worker in San Francisco uses three days a year, less than the maximum allowed, the Institute for Women's Policy Research said.
Rojas, the Baltimore restaurant worker, said she needed three days to recover from a cold in October. No paid leave meant no wages, which was a problem. But she said she had a bigger problem while working at the Cheesecake Factory in Baltimore three years ago.
Rojas, who made pizzas and salads there, said she tried to reach managers by telephone after a clinic diagnosed her with pneumonia, but she said no one would talk to her. She said she brought her clinic paperwork in after she recovered. But over the next few weeks, her hours were reduced to zero, she said.
Sidney Greathouse, vice president of legal services at the Cheesecake Factory, which operates more than 170 restaurants nationwide, said the company obeys all sick-leave laws.
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"It is not the company's policy to reduce hours following, or as a result of, a permitted leave of absence," he said in a statement, adding that the company doesn't comment about individual workers.
Ellen Bravo, executive director of Family Values @ Work, a network of state coalitions that advocate for policies like paid sick days, said it's hard for big businesses to make the case that they can't afford it. So groups lobbying against paid leave "wrap themselves in the flag of small shops," she said.
"In San Francisco, after huge outrage and 'the sky will fall,' not only do 6 out of 7 employers say there was no negative effect … two-thirds now say they support it," Bravo added.
Elizabeth Torphy-Donzella, an employment-law attorney with Shawe Rosenthal in Baltimore, said it's not unreasonable to point to the effect on small businesses because large employers "already typically provide paid leave." She said she represents a family-owned restaurant that tries hard to provide its 50 employees with benefits, but finds it a struggle.
"The concern that I have is while it would be good for everyone to have paid leave, that which is good can't always be legislated because someone has to pay for it," said Torphy-Donzella, a member of the Maryland Chamber of Commerce's legislative committee.