Children with special health care needs (CSHCN) make up 15% of all children and account for the majority of pediatric health expenditures. Parents of CSHCN experience greater work disruptions than other parents, largely due to episodic exacerbations of their children's chronic illnesses. Thus, for parents of CSHCN, the availability and type of family leave may be critical. In July 2004, the California (CA) Paid Family Leave Insurance (PFLI) program took effect, providing 6 weeks of paid leave for most employees and making CA the first state to legislate paid family leave. This controversial program markedly expands the current federal family leave law, which guarantees only unpaid family leave. Because the employment and leave-taking needs and behaviors of parents of CSHCN are not well understood, the effects of new policies are difficult to predict. Before PFLI began, we completed a baseline phone survey of 570 parents of CSHCN in CA and 572 in Illinois (which does not have PFLI). Preliminary analyses suggest major conflicts between child illness and parent employment, as well as the importance of family leave. We seek funds to conduct follow-up surveys of baseline parents (for longitudinal analyses) and surveys of a new cohort of parents (for successive cohort analyses) about three years after the baseline survey. Our study, the first to assess PFLI's effects on employment, leave-taking, and child and parent health among families with CSHCN, will provide critical information for researchers, parents, policy-makers, employers, and clinicians.
Our specific aims are to: (1) examine how PFLI, child illness, and other factors affect employment and leave-taking among parents of CSHCN; and (2) assess how use of PFLI and other family leave options affect parents' ability to care for children, children's quality of life, parents' mental health, and parents' employment. ? ? ?

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Exploratory/Developmental Grants (R21)
Project #
7R21HD052586-03
Application #
7621163
Study Section
Special Emphasis Panel (ZRG1-HOP-B (90))
Program Officer
King, Rosalind B
Project Start
2006-07-01
Project End
2010-09-29
Budget Start
2007-11-04
Budget End
2010-09-29
Support Year
3
Fiscal Year
2007
Total Cost
$104,613
Indirect Cost
Name
Children's Hospital Boston
Department
Type
DUNS #
076593722
City
Boston
State
MA
Country
United States
Zip Code
02115
Chung, Paul J; Garfield, Craig F; Elliott, Marc N et al. (2013) Access to leave benefits for primary caregivers of children with special health care needs: a double bind. Acad Pediatr 13:222-8
Schuster, Mark A; Chung, Paul J; Elliott, Marc N et al. (2009) Perceived effects of leave from work and the role of paid leave among parents of children with special health care needs. Am J Public Health 99:698-705
Schuster, Mark A; Chung, Paul J; Elliott, Marc N et al. (2008) Awareness and use of California's Paid Family Leave Insurance among parents of chronically ill children. JAMA 300:1047-55
Chung, Paul J; Garfield, Craig F; Elliott, Marc N et al. (2007) Need for and use of family leave among parents of children with special health care needs. Pediatrics 119:e1047-55