2009 State Pandemic and H1N1 (Swine) Flu Legislation
Updated August 2010
2010 Update: The U.S. Food and Drug Administration announced that it has approved vaccines for the 2010-2011 influenza season in the United States. Seasonal influenza vaccine protects against three strains of influenza, including the 2009 H1N1 influenza virus, which caused the 2009 pandemic. Last year because the 2009 H1N1 virus emerged after production began on the seasonal vaccine, two separate vaccines were needed to protect against seasonal flu and the 2009 H1N1 pandemic flu virus, but this year, only one vaccine is necessary. According to the Centers for Disease Control and Prevention (CDC), between 5 percent and 20 percent of the U.S. population develops influenza each year, leading to more than 200,000
hospitalizations from related complications and about 36,000 deaths.
For further information, please visit: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm220718.htm
H1N1 Flu Legislation | Other Pandemic Flu Legislation | Health Care Worker Immunization | Mandatory Sick Leave Legislation | State Pandemic Flu Response Plans | State Quarantine and Isolation Laws | H1N1 Federal and State Responses
With the broad impact of H1N1 in 2009, states have considered a variety of legislative responses. As with past pandemic threats, such as avian flu, state preparedness in the event of pandemic flu is a general area of public health concern for legislators. These tables provide examples of introduced state legislation related to pandemic flu, including some specific to H1N1 (swine) flu. Note that a number of measures were filed prior to the H1N1 flu outbreak and have more general preparedness application.
H1N1 Flu Legislation
Multiple states have addressed H1N1 as it relates to the education system, addressing minimum school day requirements that may be threatened by closures due to H1N1. Others seek to raise awareness of H1N1 and prevention or treatment strategies. Finally, due to H1N1 being identified as swine flu by many, some states have acted to mitigate the effect of this association on the pork industry.
|
State
|
Summary
|
Category |
|
CA AB 317
Pending
|
Excludes absences due to H1N1 from school attendance calculations for state apportionment; establish waiver process if more than 50 students miss class due to H1N1.
|
Education |
|
CT HB 6678
Enacted
|
Amends definition of infectious disease to list "novel influenza A virus infections with pandemic potential" instead of pandemic flu.
|
General |
|
HI HB 2131
Did not pass
|
Requires gasoline vendors to provide customers with access to water to allow them to wash their hands after handling the pump, to avoid spread of H1N1.
|
Prevention
|
|
IL HB 4607
Pending
|
Includes H1N1 vaccine within existing mercury-free vaccine laws.
|
Vaccination |
|
IL HJR 73
Pending
|
Urges state agencies, their representatives and private media outlets to use the phrase "2009 H1N1 Influenza" instead of "Swine Flu."
|
Agriculture |
|
LA SCR 19/
SR 14
Adopted
|
Encourages the state and local governments and agencies and public and private hospitals to work together to prepare citizens to respond to the H1N1 virus.
|
Emergency Preparedness |
|
ME SB 630
Did not pass
|
Legislation to create mandatory sick leave, proposed as emergency order due to H1N1. See sick leave legislation for more details.
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Sick Leave
|
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MA HB 4137/
SB 2070
Pending
|
Contains line-item appropriation for costs associated with H1N1 response.
|
Appropriation
|
|
MN HB 2400/
SB 2159
Did not pass
|
Provides a property tax credit for property used in a farm operation that incurred losses due to H1N1.
|
Agriculture |
|
MN HB 2605
Did not pass
|
Prohibits terminating an employee on the basis of absences due to the employee caring for someone diagnosed with H1N1 or whose school or child care facility was closed due to H1N1.
|
Education/
Sick Leave
|
|
MN HB 2401/
SB 2151
Did not pass
|
Appropriates $25 million in grants to pork producers whose revenue has been hurt due to bad publicity resulting from the H1N1 virus.
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Agriculture/
Appropriation |
|
NY AB 8710
Enacted
|
Exempts days missed due to closure as a result of H1N1 flu virus from minimum day requirements in public school aid calculation. Pending legislation A8554, S5462 and S5912 also relate to school closures due to H1N1.
|
Education |
|
NY AB 9156/
SB 6202
Pending
|
Requires employers with at least ten employees to post approved signs to inform employees of H1N1 prevention strategies in the workplace.
|
Prevention |
|
NY AB 9244
NY SB 6247
Pending
|
Requires the Commissioner of Education, in conjunction with the Commissioner of Health, to create rules and regulations concerning school district communications on H1N1.
|
Education |
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OH HCR 21
Pending
|
Requests that Congress act to denounce the actions of the Russian Federation for imposing a ban on American pork products in response to the outbreak of H1N1, as it is not a food-borne illness.
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Agriculture |
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OH HB 357
Pending
|
Concerns the declaration of a health exigency. When a health exigency is declared, an "appointing authority" may require an employee to leave the workplace if they display one of the listed symptoms, to be reinstated when no symptoms are present. Proposed as emergency measure due to threat of H1N1.
|
Emergency Preparedness |
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PA HR 509
Adopted
|
Expresses support for influenza prevention efforts, especially H1N1.
|
Prevention |
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PA HR 525
Adopted
|
Designates October 2009 through January 2010 as H1N1 Virus Awareness Season and encourages Pennsylvanians to receive the H1N1 vaccine.
|
Vaccination |
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TX HB 4586
Enacted
|
Includes additional appropriation for costs associated with H1N1 (Swine) Flu.
|
Appropriation |
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WA HB 2764
Did not pass
|
Prohibits employer from disciplining an employee for an absence due to influenza-like symptoms.
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Sick Leave
|
|
WI AJR 71
Adopted
|
Urges state agencies, their representatives and private media outlets to use the phrase "2009 H1N1 Influenza" instead of "Swine Flu."
|
Agriculture |
|
WI AJR 94
Did not pass
|
Extends declared state of public health emergency related to H1N1.
|
Emergency Preparedness |
Other Pandemic Flu Legislation
General pandemic legislation often relates to public health emergency rules and emergency preparedness, vaccinations, or appropriates funding for preparedness or antiviral medication. Immunization legislation regarding health care workers is summarized separately below.
|
State
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Summary
|
Category |
|
CA SCR 21
Enacted
|
Reauthorizes a joint committee on emergency management with jurisdiction over pandemic flu.
|
Emergency Preparedness |
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CA SB 769
Pending
|
Appropriates, as part of supplemental appropriations for pandemic flu, money to expand California Health Alert Network or a similar communication network between the Department of Health and every acute care hospital and primary care clinic in the state.
|
Emergency Preparedness |
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CA AB 1225
Pending
|
Provides guidelines for emergency preparedness activities related to infectious diseases including pandemic flu.
|
Emergency Preparedness
|
|
CT SB 1010
Enacted
|
Requires hospitals to notify emergency responders that they treated a patient with an infectious disease including pandemic flu.
|
General |
|
GA HB 64
Enacted
|
Allows a wider range of medical professionals to sign a death certificate in the event of a declared state of emergency.
|
Emergency Preparedness |
|
GA HB 217
Enacted
|
Allows physicians to prescribe influenza vaccine to groups of people to be administered by pharmacists or nurses as part of a protocol agreement.
|
Vaccination |
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IL HB 342
Enacted
|
Requires facilities licensed by the Department of Health to implement a vaccination program offering employees the opportunity to be vaccinated against seasonal or novel/pandemic flu viruses.
|
Vaccination |
|
KS SR 1876
Adopted
|
Extends flu vaccination season.
|
Vaccination |
|
LA HB 1
Enacted
|
Appropriations bill includes line-item for pandemic flu preparedness.
|
Appropriation/
Emergency Preparedness |
|
MA HB 4129
Enacted
|
Budget includes appropriation of $1,133,713 for Pandemic and All-Hazards Preparedness Act.
|
Appropriation/
Emergency Preparedness |
|
MD HB 100
Enacted
|
Appropriates supplemental funding towards pandemic influenza medical surge capacity and capability.
|
Appropriation |
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MI SCR 29
Pending
|
Supports first responders personal emergency preparedness plans so that concerns over family do not cause a distraction from public services during an emergency.
|
Emergency Preparedness
|
|
MN SB 1462
Enacted
|
Creates an alternative, expedited system for mass dispensing drugs to combat pandemic influenza or another emergency event.
|
Emergency Preparedness
|
|
MS HCR 85
Adopted
|
Extends flu vaccination season.
|
Vaccination |
|
MS SB 2768
Did not pass
|
Allows state to borrow funds, temporarily, if facing a cash flow shortage in time of pandemic flu outbreak.
|
Appropriation
|
|
NY SB 1561
Pending
|
Creates a Pandemic Preparedness Task Force.
|
Emergency Preparedness |
|
NY AB 154
Enacted
|
Includes a line-item to appropriate funds for emergency preparedness and to stockpile medicine and supplies necessary in the event of pandemic flu.
|
Appropriation/
Emergency Preparedness |
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OK HB 1678
Enacted
|
Provides protection from legal liability for those providing volunteer medical service under the direction of the government during a declared emergency.
|
Emergency Preparedness |
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PA HB 492
Pending
|
Establishes the Public Health Emergency Planning Commission and provide for various measures to plan for and respond to a public health emergency.
|
Emergency Preparedness |
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PA SB 850
Enacted
|
Appropriations bill includes federal appropriation of $2 million for avian flu surveillance. Directs that federal funds for emergency assistance be placed into the general fund and provides for funds that the governor can disperse without legislative approval during an emergency.
|
Appropriation/
Emergency Preparedness |
|
PA SB 1042
Enacted
|
Requires the Pennsylvania Emergency Management Agency to provide semiannual reports on grants distributed using federal funding.
|
Emergency Preparedness |
|
SC HB 3393
Enacted
|
Expands access to vaccination in South Carolina through the authorization process for physicians.
|
Vaccination |
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SC HB 3560
Enacted
|
Appropriations would require the Department of Health and Environmental Control to assess the ability of the state to respond and stockpile medicine and supplies to improve state readiness in the event of pandemic flu.
|
Emergency Preparedness |
|
TN SJR 85
Adopted
|
Urges the Department of Health to review and enhance activities to promote childhood vaccination for influenza annually and in the event of a pandemic event.
|
Vaccination |
|
TX SB 1
Enacted
|
Allows Department of State Health Services to draw on appropriated funds to pursue federal funding to purchase antivirals.
|
Emergency Preparedness |
|
WA HB 1244/
HB 1694
Enacted
|
Appropriates $1 million in FY2008 to stockpile antiviral medication on one-time basis.
|
Appropriation |
Immunization and Other Public Health Measures for Health Care Workers
Immunization is recognized as an effective, evidence-based method to prevent the spread of infectious diseases such as influenza. In 2009, at least two states, Georgia and Indiana, enacted legislation providing for immunizations to be offered to health care workers. At least three states, in 2008-2009, enacted legislation (New Hampshire, Oregon) or modified existing law (Illinois) providing authority to require that health care workers receive influenza or other immunizations in the event of a public health emergency and with certain limitations. Two states (Massachusetts and New York) still have legislation regarding influenza immunization requirements proposed and pending in 2009.
In August 2009, New York's State Hospital Review and Planning Council (SHRPC) adopted an emergency regulation, 10 NYCRR Subpart 66-3, requiring certain health care facility personnel to be vaccinated with influenza vaccines. This controversial emergency regulation required that health care workers be immunized against both the seasonal flu and H1N1 flu, with exemptions for those workers with no patient contact or with medical contraindications. The mandatory health care worker flu immunization requirement was suspended in October 2009 due to insufficient vaccine supplies.
Note that existing state laws on administration of influenza immunizations for health care workers are listed on the web site of the Centers for Disease Control and Prevention. Below is a selection of legislation relevant to immunization of health care workers, though some apply to broader populations.
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State
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Bill Summary
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GA HB 217
Enacted |
Provides that a hospital may offer its health care workers any vaccination, test, or prophylactic measure required or recommended by the Centers for Disease Control and Prevention pursuant to standing orders approved by the hospital's medical staff.
|
|
IN HB 1592
Enacted
|
Requires long term care health facilities to provide or make available influenza immunizations to employees who have direct contact with patients; provided that there is an adequate vaccine supply. Health facilities cannot require an employee to receive a flu immunization if (1) written documentation shows that the individual already received the required immunization ; (2) the immunization is medically contraindicated, meaning that a vaccine would be detrimental to an individual's health because of a medical condition of the individual; (3) receiving the immunization is against the employee's religious beliefs; or (4) the employee refuses to permit the immunization after being fully informed of the health risks.
|
|
IL HB 342
Enacted
|
Requires facilities licensed by the Department of Health to implement a vaccination program offering employees the opportunity to be vaccinated against seasonal or novel/pandemic flu viruses.
|
IL HB 3922
Enacted |
This bill amends existing Illinois laws to provide that specified public health measures also may be used by the Illinois Department of Public Health to respond to chemical, radiological, or nuclear agents or events. Public health measures in existing Illinois law (20 ILCS 2305/2) provide that the Department of Public Health may order the administration of vaccines, medications, or other treatments to persons as necessary in order to prevent the probable spread of a dangerously contagious or infectious disease. A vaccine, medication, or other treatment to be administered must not be such as is reasonably likely to lead to serious harm to the affected individual. An individual may refuse to receive vaccines, medications, or other treatments.
|
|
MA HB 2100
Pending
|
For the protection of influenza in health care workers and high risk patients, would require that any physician, nurse, or health care worker, who is employed in a health care setting or who provides health care to persons at high risk for influenza, shall receive an annual influenza vaccine unless exempted for any of the following conditions: (1) medical or religious reasons; (2) if an individual refuses the vaccine after being fully informed of the health risks of not being immunized; or (3) due to an inadequate vaccine supply. Would also require elder care facilities to offer and, upon consent, to administer annual influenza vaccines to their clients.
|
|
MA HB 2149
Pending
|
Would provide that no license for a convalescent or nursing home, infirmary maintained in a town, rest home, charitable home for the aged or intermediate care facility for the mentally retarded could be renewed, beginning on January 1, 2010, unless there shall be first submitted to the department by the authorities in charge of the facility a certificate verifying that all patients and employees were vaccinated against influenza each of the previous years in accordance with the current recommendations of the Advisory Committee on Immunization Practices for the Centers for Disease Control and Prevention with respect to indications such as age, timing, dosing, and administration. Immunization of all consenting patients and employees would be subject to the availability of an adequate supply of the necessary vaccine, and subject to exemptions for medical contraindications and religious beliefs.
|
|
2007 NH SB 512
Enacted
|
Concerns public health powers and duties. Provides that during a state of emergency, the commissioner of health and human services has, among other powers and duties, and subject to the direction and control of the governor, the power to order immunization of individuals as necessary to prevent the spread of contagious disease, except that an individual may refuse treatment or immunization, and this power is subject to due process of law.
|
|
NY AB 876/
NY SB 3911
Enacted
|
Requires a general hospital with a neonatal intensive care unit to offer every parent, person in parental relation, and person reasonably anticipated to be a caregiver in the household of a newborn being treated in the neonatal intensive care unit an influenza vaccination.
|
|
NY AB 8133/
NY SB 3265
Pending
|
These bills relate to the immunization of long term care facility residents and health care personnel against influenza and pneumonia. Both bills would require long-term care facilities to ensure that personnel, including all employees, members of the medical staff, contract staff, students and volunteers, who could potentially expose residents to influenza or who have direct contact with residents, receive a documented influenza immunization at no cost, unless medically contraindicated, or against an individual's religious beliefs or there is an inadequate vaccine supply for the year. Would require aggregate data collection for personnel and resident influenza immunization status. Allows residents to refuse immunization after being fully informed of the risks. Would require that any adverse reactions be documented.
|
|
OR HB 2009
Enacted
|
Creates a state health authority and gives it the authority, among other provisions, to require a person to obtain treatment and use appropriate prophylactic measures to prevent the introduction or spread of a communicable disease or reportable disease, unless:
(A) The person has a medical diagnosis for which a vaccination is contraindicated; or
(B) The person has a religious or conscientious objection to the required treatments or prophylactic measures.
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Mandatory Sick Leave Legislation
One of the best strategies to prevent the spread of illnesses—such as pandemic influenza—is for those who are ill to isolate themselves from contact with others until they have recovered. According to the Bureau of Labor Statistics, 40 percent of private-sector employees who do not have access to paid sick leave. For these workers, the loss of wages or perceived risk of job loss often prevents them from staying home when they are sick. This can be of particular public health concern for health care workers who are more likely to be exposed to sick patients and to patients with high-risk conditions. One proposed strategy is to require employers to provide paid sick leave. Opponents worry about the burden of mandatory sick leave requirements on employers, especially restriction on their ability to customize benefits to the needs or preferences of individual workplaces.
The District of Columbia (D.C. Law 17-0152), Milwaukee and San Francisco have enacted minimum paid sick leave requirements; however, there are no federal or state sick leave requirements. In part as a response to H1N1, at least 15 states considered mandatory sick leave legislation in 2009. In addition to state legislation, pending congressional bills (SB 1152 and HR 3991) would create mandatory sick leave benefits, with HR3991 being targeted specifically to the H1N1 pandemic.
Proposals for mandatory sick leave legislation typically apply to all employers and set a rate of accrual as one hour of leave for a given number of hours worked (ranging from 20 to 80 hours) as well as the maximum number of hours that can be accrued. Both the accrual rate and maximum amount often vary based on the size of the employer. Other provisions concern the ability to carry over hours from year to year, waiting periods after an employee is hired for accrual or usage and whether sick leave is maintained after a temporary separation from employment. Sick leave legislation can also vary based on the conditions under which the accrued leave can be used. Some are specific to the employee's illness while others cover absences to care for an ill family member, for medical appointments even without an illness or in dealing with domestic abuse.
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State
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Bill Summary
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|
AK SB 86
Carryover to 2010
|
Requires employer to provide at least one hour of paid sick leave, carried over from year to year, for every 40 hours worked, after 90 days of employment. Provides exemptions for those under collective bargaining agreements.
|
|
CA AB 1000
Did not pass
|
Requires employer to provide at least one hour of paid sick leave for every 30 hours worked, after 90 days of employment. Provides exemptions for those under collective bargaining agreements.
|
|
CO HB 1210 (2009)
Did not pass
|
Requires employer with more than 15 employees to provide at least one hour of paid sick leave, carried over from year to year, for every 30 hours worked, up to 72 hours in a 12-month period. Employers with six to 15 employees must provide at least one hour for every 60 hours worked, up to 40 hours in a 12-month period.
|
|
HI HB 1687
Did not pass
|
Requires employer to provide at least one hour of paid sick leave, carried over from year to year, for every 30 hours worked, after 90 days of employment. Employees can accrue up to 40 hours if business has fewer than 10 employees and up to 72 hours if business has 10 or more employees.
|
|
IL HB 3665
Pending
|
Requires employer to provide at least one hour of paid sick leave, carried over from year to year, for every 30 hours worked. Employees can accrue up to seven days of sick leave.
|
|
ME SB 630
Did not pass
|
Requires employer with more than 24 employees to provide at least one hour of paid sick leave, carried over from year to year, for every 40 hours worked, up to 52 in a 12-month period. Employers with fewer than 25 employees must provide at least one hour of paid sick leave for every 80 hours worked, up to 26 hours. Accrual starts upon employment and can be used after 90 days of employment.
|
|
2009 MD HB 1296
Did not pass
|
Requires employer to provide at least one hour of paid sick leave, carried over from year to year, for every 30 hours worked. Employees can accrue up to 40 hours if business has fewer than 15 employees and up to 72 hours if business has 15 or more employees.
|
|
MA HB 1815/
MA SB 688
Pending
|
Requires employer to provide at least one hour of paid sick leave, carried over from year to year, for every 30 hours worked. Employees can accrue up to seven days of sick leave.
|
|
MN HB 612/
MN SB 461
Did not pass
|
Requires employer with 50 or more employees to provide at least one hour of paid sick leave, carried over from year to year, for every 40 hours worked, up to 52 hours in a 12-month period. Employers with 15 to 49 employees must provide at least one hour for every 80 hours worked, up to 26 hours in a 12-month period. Accrual starts upon employment and can be used after 90 days of employment.
|
|
2009 MO HB 782
Did not pass
|
Requires employer with 10 or more employees to provide at least one hour of paid sick leave, carried over from year to year, for every 37 hours worked, up to 40 hours in a 12-month period. Employers with fewer than 10 employees must provide at least one hour for every 80 hours worked, up to 26 hours in a 12-month period. Accrual starts upon employment and can be used after 90 days of employment.
|
|
2009 MT HB 579
Did not pass
|
Requires employer with 10 or more employees to provide at least one hour of paid sick leave, carried over from year to year, for every 30 hours worked, up to 72 hours in a 12-month period.
|
|
NH HB 662
Pending
|
Requires employer to provide at least 40 hours of paid sick leave in a 12-month period. Accrual starts upon employment and can be used after six months of employment.
|
|
NY AB 3647/
NY SB 2666
Pending
|
Requires employer to provide at least one hour of paid sick leave for every 20 hours worked. Employees can accrue up to 40 hours if business has fewer than 10 employees and up to 80 hours if business has 10 or more employees. Provides exemptions for those under collective bargaining agreements.
|
|
2009 NC HB 177/
2009 NC SB 534
Did not pass
|
Requires employer to provide at least one hour of paid sick leave, carried over from year to year, for every 30 hours worked. Employees can accrue up to 32 hours if business has 10 or fewer employees and up to 56 hours if business has more than 10 employees. If an employee is rehired after a separation from employment of fewer than 90 days, he or she retains accrued sick leave.
|
|
PA HB 1830
Pending
|
Requires employer with 10 or more employees to provide at least one hour of paid sick leave for every 40 hours worked, up to 52 hours in a 12-month period. Employers with fewer than 10 employees must provide at least one hour for every 80 hours worked, up to 26 hours in a 12-month period. No more than 40 hours can carry over from year to year. Accrual starts upon employment and can be used after 90 days of employment.
|
|
VT HB 382
Did not pass
|
Requires employer to provide at least one hour of paid sick leave, carried over year to year, for every 30 hours worked, up to 56 hours in a 12-month period. If an employee is re-hired within one year of a separation from employment, he or she retains accrued sick leave.
|
|
DC Act 17-0324
Enacted (2008)
|
Requires employer with 100 or more employees to provide at least one hour of paid sick leave, carried over year to year, for every 37 hours worked, up to seven days in a 12-month period; an employer with 25 to 99 employees to provide one hour of leave for every 43 hours worked, up to five days in a 12-month period; and an employer with fewer than 25 employees to provide one hour of leave for every 87 hours worked, up to three days in a 12-month period. Accrual starts upon employment and can be used after 90 days of employment. If an employee is re-hired within one year of a separation from employment, he or she retains accrued sick leave.
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Source: Pandemicflu.gov, 2009.
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