Guaranteed paid time off work for personal illness is an essential component of job quality and economic security for workers. Still, many people of color and low-income people in the United States have no protections against lost wages or employment termination due to illness. Paid sick leave policies allow workers to earn a minimum number of paid and protected hours off work each year that can be used for sick time purposes, which may include illness and medical care for the worker or for the worker's family members.

There is broad public support for policy action to guarantee paid sick leave for all workers: according to polling by the National Partnership for Women and Families, 75 percent of Americans favor such a law, with strong support across all demographic and political affiliations. More than 34 million private-sector workers do not have access to a single paid sick day, including 38 percent of Black workers and 54 percent of Latinx workers.

Low-wage workers who cannot afford to lose a day's wages due to illness are less likely to seek medical care (for themselves and their families) than workers who have paid sick leave and are 1.5 times more likely to go to work with contagious illnesses. This means that lack of paid sick leave is a problem for individual workers and a public health threat.

In addition to improving job quality and stability for workers, guaranteed paid sick leave could also benefit employers and the economy as a whole, reducing employee turnover and increasing productivity, decreasing the spread of illnesses like influenza, and lowering health care costs.  But the federal government has yet to address this critical issue, so city and state governments have taken the lead in advancing this fundamental right for workers.

In addition to the PolicyLink resources listed on the right, see CEPR, National Partnership for Women and Families, and paidsickdays.org for more resources on paid sick leave.

• Elected and appointed city officials can institute paid sick leave through executive orders, ordinances, and resolutions unless state law prohibits such actions.
   
• Unions, working people, advocates, and community organizations can organize campaigns to promote paid sick leave and build critical support among residents and voters.
   
• Business leaders can play important roles in advancing access to paid sick leave through corporate policies and public advocacy.

Strong paid sick days policies should cover all workers regardless of business size, industry, employment status, or the number of hours worked. Cities seeking to implement or strengthen paid sick leave protections for workers should consider the following issues.

• State preemption: Several states now preempt their cities' ability to establish local labor standards such as paid leave.
   
• Accrual rates: Laws can mandate the same rate of paid sick leave accrual for employers of all sizes — for example, one hour of paid sick leave for every 40 hours worked — or a tiered approach in which smaller businesses may provide fewer paid hours, unpaid hours, or a combination of paid and unpaid hours.
   
• Covered use: Most paid sick leave policies allow earned time to be used for personal illness, family illness, and routine medical care. Some policies also allow accrued sick days to be used for "safe" time by workers who need time away from work to seek services, care, or safety related to domestic violence, sexual assault, or stalking. Policymakers should also consider adopting an inclusive definition of "family member" that recognizes the diversity of caregiving relationships.
   
• Making the business case: Securing the support of business leaders can be an important boost for coalitions advocating for paid sick leave. San Francisco has guaranteed paid sick leave to all workers in the city since 2007. Seven out of 10 employers have reported that the law has had no impact on their profitability. In Washington DC, the Office of the District of Columbia Auditor reported that the District's paid sick leave policy had no effect on business growth or retention.
   
• Enforcement provisions: City leaders should have strong mechanisms in place to ensure that workers are able to exercise their right to paid sick leave without interference, discrimination, or retaliation on the part of their employer.