important topic today in the midst of a global pandemic the h one n one virus is sweeping our country closing closing hundreds of schools eileen thousands of workers and infecting many millions of americans the h one n one flu virus is now officially the new highly contagious virus the quick identification and development of the vaccine the delays delivering the vaccine to target populations of concern millions of americans i am encouraged  report the pride of vaccine manufacturers have worked out the production issues and we seem to be back on track to getting the needed vaccine to the american people the h one n one vaccine is a new vital tactic to slow the infection rate while we while we fix the supply  public health officials emphasize that there are additional ways to slow the spread of this dangerous virus the c d c has issued guidance on recognizes the role employers and workers play in slowing the spread of the disease according to the c d c an individual who comes to work with the h one n one will affect about ten percent of his or her coworkers they recommend that any worker with the influenza type stay home and that employers should allow workers to stay home without fear of any reprisals without fear of losing their jobs but the recommendation is made then followed because for more than fifty million workers without paid sick leave taking a day off from work means a pay cut or worse workers fear they will be punished for taking time off either by losing pay because they do not have paid sick days or even fired employees in the food service hospitality school and health care field are among those who cannot afford to stay home when they're sick because these employees have direct contact with with the public the consequences of coming to work sick or not only damaging their health but could damage the public health as well let's face one simple fact when you're struggling to make ends meet you're going to do everything possible not to miss a day's pay the lack of paid sick leave encourages workers who may have h one n one to hide their symptoms and come to work sick spreading infection to coworkers customers in the public is not good for our nation's public health or for businesses the national partnership of women and families found that sick employees who go to work cost the economy about one hundred eighty billion dollars in lost productivity can schools and workplaces shopping centers and transit systems and the implementation of simple safeguards such as using hand sanitizer and limiting person to person contact in an effort to reduce exposure we're here this morning to talk specifically about workplace policies designed to limit the spread of h one n one including the availability of workers to understand these issues we need a bit of context we should know that in two thousand and eight nearly all full time mindful of the family medical leave act which provides unpaid leave for medical reasons and carries a host of notification and certification of its own with so many workers already having access to a variety of options we need to look very wise idea to put employers in the business of diagnosing medical conditions and deciding when workers should be sent home and when they're well enough to return to work out h one n one outbreak is a serious concern and employers across the country are taking steps already to minimize infection and prevent the spread of the flu in their workplaces this is clearly new and unknown territory and we must tread very carefully to minimize of h one n one while avoiding the costly new mandate that could harm the very workers we're trying to protect i look forward to hearing from our witnesses and gaining a better understanding of the existing policies and practices and how they are being applied to the current  our first witness will be dr who is currently serves the surgeon general of the united states public health service and director of the national center on respiratory diseases at the center for disease control and prevention in addition d there's been no change in the pattern pattern or underlying condition ninety percent of people who have died from this virus are under sixty five years of age a complete opposite with what we see from seasonal flu two thirds of the children who have died have underlying condition as mine or logic problems and so forth and so we know that pregnant women adults with chronic medical conditions are at higher risk than others so far there's been no change in the virus this is good news because it means it hasn't become more virulent it's also good news because the vaccines that we're making perfectly matched the strain and should have good effectiveness but influenza including the h one n one virus is unpredictable and we do not know the trajectory that the virus will have in the weeks and months ahead we know that previous pandemics have had multiple waves and we are mindful that disease may continue to spread and that we may have waves of this disease through the next several months the typical flu season goes from december to may and we are mindful that we have a long road ahead roll i'm going to go through in a little bit of detail but first i want to congress for the incredible support that we have received to strengthen the preparedness of the country it really is a little terrifying to think of where we would be if we had not been investing in the past several years in improved preparedness at the state local level the federal level and the global level  response has been comprehensive and aggressive using science as the basis for our approach we rapidly deployed assets including lifesaving antivirals and a significant portion of respiratory protection from our strategic national stockpile we prepared and shipped laboratory kids to states around the country and to over one hundred fifty countries we sent field team at home and abroad we've issued guidance for schools businesses and so forth reminding them about how important  we've issued guidance and updated that guidance for health care workers mentioning respiratory protection and the steps that could be taken to extend the supply of respiratory protection we've incorporated new any viral medicines that can be delivered  intravenously with the help of the f d a we focused on communication and we focused on back the nation we're in the midst of a large national voluntary vaccination effort that is unprecedented in scope we like others are disappointed in the vaccine production and have been to some extent the victim of a slow growing virus but production is accelerating and substantial amounts are now becoming available today forty eight point five million doses of h one n one vaccine has become available for the states to order they have prioritized groups at highest risk to receive the vaccine during this phase where the limited supply and we are supporting states and local authorities to make the best decisions about how to reach the priority groups with this  vaccine we think it's very important to use that as soon as it's available as effectively and efficiently as possible we are focusing on safety and not taking any shortcuts either in vaccine release or in monitoring safety as the vaccine is in larger scale use working hard with our partners in h h s and beyond to focus on the state and local infrastructure that's so vital in our response today's hearing highlights the human and economic impact that influenza has and in general illness really can cause work loss and threaten business continuity our guidance is for individuals to stay home when they're sick twenty four hours after a fever is gone is what we've recommended based on  benefit well and stay in compliance with thousands of federal state and local workplace rules our members are concerned about employees their families and yes even business continuity in a pandemic we understand the emergency and are adapting to it but we also understand the longer term is paid leave mandates we survey our members and their benefits practices and link our survey data with similar groups around the nation when it comes to the availability of  member the flu shot if it was available employers are working hard to treat employees as they would wish to be treated within the bounds of hard economic realities these are the reasons why i decades i thank you for inviting me to testify in support of this legislation that workers urgently need during this national h one n one emergency a special thank you for all you've done to shine a spotlight on this issue the national partnership a very broad based coalition in support of paid sick days i'm testifying today of the millions of people represented by civil rights women's work to recover from their own illness or to care for a sick child or family member especially during this one and one epidemic it's a travesty that millions of hardworking people in this country have no  almost half of private sector workers and four and five low wage workers most of them women don't have a single day and especially now when h one n one has infected millions spread of the virus that's great advice but unfortunately millions of workers simply cannot take that advice for them risking their paychecks and even their jobs so what's responsible what's doing the right thing when staying home means risking the paycheck but your family depends on people who provide care for family members even greater challenges we know that the h one n one virus attack rate among children is especially high many of the need a parent to care for them when they get sick and that's why the lack of paid sick days is particularly challenging for working women who are primary responsibility for childcare as well as elder care our failure to guarantee also particularly hard on low income people and those in communities of color who tend to hold low wage no benefit jobs the boston public health commission recently reported that the the lack of paid sick days is also putting our public health at risk only twenty two percent of service and public accommodation workers have paid sick days workers in childcare centers and nursing homes disproportionately black  they're forced to work when they're sick and in so doing they put their coworkers those they care for and the public at risk and while the need for pay particularly compelling during this h one n one emergency the reality is that working families struggled without paid sick days prior to this emergency and they will continue to struggle unless and until congress acts every year the seasonal flu and other illnesses millions of us and every year our failure to let workers with the economic security of families at risk and the recession we're in exacerbates the problem i certainly don't need to tell you how many families that once lied on two incomes are now managing on one or none in a survey last month five out of six workers said the recession was creating more pressure to show up for work even when they're sick mr chairman and members of the committee we need a minimum standard of paid sick days so the taking time off for the flu or any other illness does not lead to financial disaster finally i'd like to end with the point that paid sick days are also good for business in our economy today stanford university press is releasing a book called raising the global floor a book by jody hyman that reports on an eight year study examining the impact of  y breastfeeding and other family friendly policies around the world it concludes that nations that guarantee leave to care for personal or family health needs are actually ranked highest in terms of economic competitiveness and i'd be happy to provide copies of that book for every member of this committee the research confirms that when businesses take care of their workers they're better able to retain them and when workers have paid time off their commitments their productivity and their morale increases employers reap the benefit of lower turnover and training because the cost of losing an employee is often much greater than the cost of providing short term leave to retain  employees and in this economy health emergency smart businesses know that they can't afford presenteeism workers who go to work sick and get other people sick and cause more absenteeism pr over the last several months we've heard a great deal about the h one n one pandemic from the shortage of vaccines to more than twenty two million individuals affected by the disease ninety percent of them are under the age of sixty five as a mom there's not an issue that's more important to me than ensuring that my son is healthy but the statistics also reveal the potential for serious strains on our nation's business strains employers and employees alike and for the most part businesses have been one step ahead implementing policies that promote healthy work environment such as telecommuting job sharing paid time off in fact according to the department of labor eighty three percent of businesses  the private sector offer their employees access to paid leave which can be used for illness or injury or situations such as h one n one flu despite these innovations several bills have been introduced to respond to this emergency including more mandates on small businesses in a stagnant stagnant economy with employment at its highest level since one thousand nine hundred eighty three in productivity inching along we need to ensure that the response provides  flexibility that employers and employees need flexibility that ensures employees can take care of themselves and their families and flexibility that allows businesses to remain productive with this in mind i'd like to ask each of the witnesses to comment what does mandated paid sick leave offer that a flexible workplace program doesn't shouldn't both employers and employees decide what's best for them not  go to anything they want to use it for i think that be a step back also as congressman congresswoman morris rogers small businesses are struggling right now and what i would do to encourage in just proposals we're looking at today take into consideration the needs of our nation small businesses when they employ so many americans in the american workforce on september ninth two thousand and nine the committee on small business how to hearing on the impact of h one n one influenza virus and small firms and we learned as suspected that small business owners are making strides to keep workplaces healthy during the flu season witnesses testify that they are crafting flexible working employees schedules as  clarke made reference to some of those as he has observed and are doing their best to address each one n one outbreak and employers and employees have the freedom negotiate benefits structure that works best for letter was also signed by the ranking member the small business committee in addressing some of these issues as committee moves forward we need to take into account small businesses unique needs and sure that we don't create policies where well intentioned may have an adverse of the bills targeted employers who do not offer paid sick leave and claim that employers who do not offer paid sick leave currently would not be affected by the legislation is that how you read the bill and if not how would you particular details and you also provide seven days otherwise you don't have to add it however i really cannot think in my mind of an employer that has a sick pay plan that meets the current safe harbor so import is going to have to open up their plans to try to comply with that safe harbor is going to have to we'll i believe open up a broader look at their paid time off policies and try to balance the cost with what's being added in response the glass over eighty percent full and that is going to be a fairly rare circumstance or one that's occurring primarily in part time employment  time employment typically does in this country not carry very many paid benefits about half the imports provide a benefit in a part time environment part time is very common in hospitality and is likely i don't know that that individual one in this country that works for a living that has no paid time off and one of the consequences that you mentioned my point is that the pool is much much smaller than those statistics and i want to give an example of why that and people that care for children but it seems like what's happened and we we had a change in how the vaccines are delivered and not just going around and seeing so many places where they say they have the vaccine and then you'll see these long lines of people waiting for several hours and holding the children and it didn't seem to be the best way that that should be given out particularly and even getting the people together that had the potential of  supplies are relatively scarce came from advisory committee on immunization practices it's a science based committee and they came up with these five groups that ought to be vaccinated before others the vaccine is coming from five different manufacturers and it's going to a central distributor that manages states and large cities order vaccine proportionate to their population and have it shipped from that central distributor to the sites that they designate there is and local authority in directing those we know that thirty four states have already carried out school located clinics to reach large numbers of children that virtually all states have directed doses to hospitals for health care workers  high risk populations most states have sent some aliquot to providers offices to reach the high risk people there have also started i believe i think fourteen states have started to provide some doses to the retail pharmacy then use that can reach additional people some have gone to employer clinics the states in the cities are directing the vaccine doses in the ways that they believe are the most effective to reach the priority groups we know that the vast majority of vaccine has gone for the high risk population but they've been doing mass clinics i think everyone wishes there were long lines that were easier for people particularly pregnant women parents of young children to easily get their loved ones vaccinated and with a limited supply it's been challenging but it is getting better each day it will indeed your advisory committee give any information on how they wouldn't have given this out it seems to me that if you've got different groups and priorities doctors offices as a component one of the challenging things about vaccinating during a pandemic is how busy the doctors offices have been particularly the offices we know that in the spring in new york city doctors pediatricians were actually having to cancel their well child visits which is where they give out back so this was much more of a flexible approach often trying to find you know lots of doctor's offices but also other venue critical pieces that doctor's care for pregnant women rarely give really had to push hard to get to sign up for back in some states it's been a great response in others it's been a little trickier so local health departments hospitals and others are really pitching in where the provider community system has been much lower stepped up and made sure that there were school lunches the kids schools did have to be closed much better this fall than we did in the spring responding with the business community i think we've been trying but we could always do better w if they came in to make up that i'm suggesting that many are telling me that is their current plan i don't know exactly that we'll do that but i can tell you there's a growing awareness of that need a growing awareness of the medical facts  twenty five campaigns across the nation on paid sick leave i know that there could be local initiatives with regard to paid sick leave but why in this case is it important to have a federal standard  mainly because right now there are only three localities in this country where there is a standard san francisco washington d c and milwaukee which is actually be contested at the moment and  we're talking about millions of workers who need basic workplace protection and a patchwork approach isn't going to help too many millions of those workers we need a basic labor standard and the arguments that we hear today about why we can't do this now are the same arguments we've heard every time we would put in place a workplace protection like this and the evidence shows that most of the claims about negative impact on business a negative impact on jobs never really materialized we have good evidence that shows that this makes sense both for workers and for businesses and we've reached the point where we need to a d i'd like to just highlight this was one reference to my earlier testimony which is that communities of color and low income communities are particularly hard hit by the lack of this protection that it's easy for people to do the right thing and we've issued guidance from the federal level to help employers schools health care workers and others know what the best science suggests and that suggests that staying home when you're sick for twenty four hours after the fever has broken is the best medical advice it helps you get better but it helps you from infecting other people so this is really our approach you know as a center director i have about eight hundred people who work for me and i'm very committed workforce that wants to come into work it's very fortunate that my work my workforce has benefits and let them stay home when they're sick and that they do the kind of work to let them telecommute so it's just i think our goal is just to make it easy for people to do the right thing and not infect their coworkers misson as i would share an underground economy when i was in the legislature in california and i know that it's very difficult to enforce the standards even very basic things such as minimum wage how can we ensure that once we pass this law that it could be enforced how could we sure that there would not be employers that would just send employees home and then just stop their pay and also to report when the law is not being followed and the department of labor would need to set up some rapid response to make sure given the emergency nature of legislation that we got the right in for a tragedy that occurred with a woman named monica rodriguez who was pregnant and went to a hospital and she was coughing center home with cough syrup she went to another hospital two days later and was admitted into intensive care and it turned out she did have h one n one and she died as well as her unborn child it seems crystal clear at what the guidelines are with regard to pregnant women with severe flu like symptoms can you tell me what kind of important mechanisms there are for hospitals to actually follow these guidelines we have really been intensifying our outreach to the community to the health care community there's just a long term tradition of reluctance among pregnant women and their caregivers to give the medicines we don't know if this is a safe approach there's been some misunderstandings about the lab tests on their accuracy we've really been working hard to get the message out that a woman who's pregnant who's got a fever and cough really needs to be given a viral medicines they can be lifesaving this is not just something to do and something we want women to know to take that seriously and their doctors we've done a lot of outreach much more intensively over the past couple months as disease has increased and me if maybe you didn't read this properly but in your testimony your written testimony you appear to have looked rather closely at employees that in general have relatively high wages more flexible  service hospital back office work that's not highly paid at all what we're on where i'm going with that is that i think our mix of markets fairly well but we're i'm going with that again neither of these bills  side or telephone line to report retaliation or discrimination based upon employees taking time off do you really think that a telephone hotline or website are enough to encourage workers to take time off in the proper enforcement they need all the tools they need to be able to do the data collection to make sure that employers are doing the right thing and they need to do education of both employers and the employee enforcement should be combined with strong education but if we're talking about emergency legislation there probably needs to be some very quick rapid response telephone hotline not as a substitute for  you found that the employer mandate is a great burden on employers and employers and our employers in those cities complaining about workers abusing the  positions food service caring for the elderly for children and it is quite a few people in that category of course tend to be the lowest not covered and but you still contend that a person should be responsible for their own sense in many instances these places do not provide that how do you reconcile all the food service industry is not a you know a model where there are some large very large companies that play in that space  they're going to have a different set of benefits perhaps a different view toward all types of paid leave a very small player a very local individual a caterer for example not to pick on caterers might not have that level of sophistication or it has now spread to forty six states and that it is certainly a serious threat to public health particularly when workers come to work because they can't afford to do otherwise ultimately emergency legislation is needed i think we need to tweak it here and there but that's why the emergency employment containment act was introduced by chairman miller  which by the way i hope everybody's aware we keep talking about small businesses this legislation exempt small employers and actually over eighty percent of our workers in two thousand and five anyway were because of the negative impact it would have on the health care system thank you or is there a way to actually track what's happening in that area i'm not aware of a systematic tracking it may be the department of commerce or department of labor has something that we're not collaborating on we have been doing general surveys or polls with some universities to understand the impact that the pandemic is having on different sectors we did one harvard did one i think this summer that looked at employers and their policies it was before the increase in disease in the fall and so whether will need to check and see if there's anything ongoing or that might be done that we're looking at it seems like there might be a fairly simple way of doing that and allowing them to kind of report those numbers because if in fact it's spreading faster and our general population thank you