Building an Economy that Works for Everyone

Family is Family, Chosen or Otherwise

The Need for More Equitable Paid Sick Leave in Washington


At one time or another, every worker will need to take time off work for health-related reasons. Without the protection of paid sick leave laws, they are forced to make tough choices between missing a paycheck or working while sick, risking their health and the health of their coworkers.[1] These decisions often create a multiplying effect, compounding the original issue. An ill worker without paid sick leave is more likely to acquire other health problems, often more severe. The delay of care can be costly and increase the time needed to recover – leading to an even greater need for paid time off. Many workers who delay care will often end up in the emergency room, which only adds to the cost of treatment. Additionally, delay of care has been found to cause anxiety and depression, a diagnosis that can lead to further health care needs[2].

These are not uncommon scenarios. Nationally 23%[3] of all workers, ~24 million workers, lack paid leave, but only 33% [4]of low-wage workers have access to paid leave benefits. There is no federal policy guaranteeing workers paid sick time. Congress has proposed legislation; the most current is the Healthy Families Act[5], which would guarantee workers across America to earn paid time off for their own health care or that of a family member. However, deep divisions in Congress prevent lawmakers from taking action. As a result, states and smaller jurisdictions are forced to step up to ensure their workers’ public health and safety.

Washington is one of 35 jurisdictions with a paid sick and safe law.

And while Washington’s rule is expansive, covering almost all workers in the state, the policy requires accessibility and inclusivity improvements to ensure the complete protection of Washington residents.


Paid Sick and Safe Days protection (PSSD) have been in place since Washington voters approved Initiative 1443[6] in 2016. The law provides short-term paid time off that nearly all workers in Washington can access. For every 40 hours worked, employees earn one hour of paid sick time, which they can use to deal with personal illnesses, injuries, or medical appointments of workers or their family members – including children, spouses, parents, parents-in-law, siblings, grandparents, or grandchildren. Paid leave is also available for legal, or safety concerns related to domestic violence, sexual assault, or stalking, and when business or a child’s daycare or school is closed due to a public health emergency like the COVID-19 pandemic. Initiative 1443 provides paid sick leave regardless of the employee’s hourly classification or seasonal or temporary worker status.

Even though Washington’s paid sick leave is available to most of the state’s workforce and their families, it does not expressly protect workers who don’t live with a nuclear or immediate family that they turn to for support. Black, Indigenous, and People of Color (BIPOC), immigrant families, unmarried couples, and the queer community are often unfairly impacted by this gap in the law. This is an important distinction to draw when making and implementing policies like sick leave. An estimated 82%[7] of family circles in the U.S.  take a different form than traditional nuclear structures. Instead, many Americans live in inter-generational or extended families. In many communities and cultures, living collectively is common; everyone has a title, like auntie, sister, or cousin even though there is no blood relation or legal connection[8].

As aging in place becomes more and more financially challenging and people are living longer, extended families in the U.S. continue to flourish. In 2001 there were 58 million families living in extended family structures and by 2014 that number had risen to 85 million. These families are reported to be disproportionately, but not exclusively, people of color.[9]

In Washington, there are also nearly 266,000 unmarried households cohabiting. Another 427,000 households are living with other relatives and 319,000 households are living with non-relatives[10].

These family structures – even if not through traditional means or measures – are not expressly covered by Washington’s PSSD policy. This costs Washington residents critical care during difficult times and must be addressed directly.

Consider this real-life scenario:

Maria, a widow, immigrant, and elderly mother lives with her grown son Angel, his long-time girlfriend Amy, and her 6-year-old daughter, Abbie. Maria’s niece Rebeca also lives with them. Rebeca moved with the family when her husband died of cancer in 2019. This non-traditional family lives under the same roof, share expenses and household responsibilities, celebrates birthdays and anniversaries and vacations together. However, under Washington PSSD law, Angel is the only one who can take paid leave to care for his mother. Angel, Amy, and Rebeca cannot not take paid sick leave to care for each other, nor the matriarch of the family.


Queer communities have always depended on chosen family[11]. LGBTQ people frequently experience stigma, discrimination, and physical harm because of their gender identity and/or sexual orientation. Often, this rejection can come from inside their own family of origin. As a result, young adults move away from their family structure, instead finding a chosen family of like-minded individuals for support and to receive affirmation of their identity and for stability in their lives. This has been a pattern within the LGBTQ+ community for decades and continues to be the case today. A 2022 survey reported that 34% of LGBTQ+ adults reported leaving their family to be in safer emotional and physical spaces and to avoid further conflict with their families. [12]

And despite the state’s reputation for being affirming and welcoming of the LGBTQ+ community, our paid sick leave laws don’t fully benefit these residents.

Washington’s two paid leave laws (Paid Sick Days and Paid Family and Medical Leave) are inconsistent when it comes to recognizing non-traditional families. On one hand, the state has already led the way in expanding its Paid Family and Medical Leave law to include the ability for workers to care for a chosen family member. When the Paid Family and Medical Leave law passed in 2017, the definition was identical to the Paid Sick and Safe Days law.

In 2021, at the height of the pandemic, advocates, lawmakers, and coalitions like the Washington Work and Family Coalition came together to push for the program to expand its family definition and won[13], enshrining the rights of those with non-traditional family structures. The new expanded definition in the PFML gives workers the ability to take paid sick time to care for a “chosen family” member who are often low wage workers.

Notably, the expansion of the family definition did not increase usage of the PFML program in Washington as opponents of the law speculated, according to a report by the Department of Employment Security, which administers the program. The majority of claims (78%) that used chosen family were for a significant other, including boyfriend, girlfriend, and unregistered domestic partners. Fifteen percent of claims were for an extended member.

In total, 686 claims used expanded family definition between July 2021 and March 2023[14].

Despite Washington’s inclusive PFML program, our state lags in recognizing non-traditional families in the PSSD Law.

Look at the differences in how Washington defines “family” under the Paid Sick and Safe Law [15] and the Paid Family and Medical Leave Law [16]:

This inconsistency adds another layer of bureaucracy to the already-complicated web of our social safety net. Our systems create more confusion by failing to update one statute when a complimentary law is updated. And when people are confused about their access to rights or protections, they tend not to use them.


Nationally, of the 15 states including Washington, D.C., and 36 cities and counties that have passed their own paid sick time laws [17], nineteen governments have included or expanded to a broader definition of family.

Even the Federal government has, in a way, prioritized expanding or including a broader definition of family in recognition of our country’s diverse families. As the nation’s largest employer with roughly 2.25 million civilian employees, the Federal government has included a chosen family standard for more than 50 years. According to A Better Balance, the language for Federal employees includes individuals whose close association with the employee is the equivalent of a family relationship (even absent a blood relationship)[18].

Washington has, for many years, taken a leadership role on the paid leave front. Now, it’s time for our state to continue to that work by ensuring that Paid Sick and Safe laws are in alignment with the rest of the state’s policies. All workers deserve time to care for their loved ones, no matter who those loved ones are and no matter what the circumstances.



[1]National Partnership for Women and Families, Fact Sheet, November 2022,

[2] American Psychological Association, Are workers without paid sick leave more anxious and depressed? March 29, 2018,

[3] U.S. Bureau of Labor Statistics, Economic News Release, Employee Benefits in the United States, Thursday September 21, 2023,

[4] Economic Policy Institute, Elise Gould, “Two-thirds of low-wage workers still lack access to paid sick days during an ongoing pandemic”, Posted September 24, 2021,

[5] 118th US Congress, Calendar No.136, S. 1664, To allow Americans to earn paid sick time so they can address their own health needs and the health needs of their families,

[6] Department of Labor and Industries, Employee resources,

[7] Center for American Progress, Caroline Medina and Molly Weston Williamson “Paid Leave Policies Must Include Chosen Family”, March 1, 2023,

[8] Family Equality, Preparing for Parenthood: finding and forming a Chosen Family,

[9] A Better Balance, The Importance of an Inclusive, Realistic Family Definition in Paid Family and Medical Leave and Paid Sick Time Policies, posted: July 23, 2021 ,

[10] U.S. Census, Selected Social Characteristics in the US, Washington estimates,

[11] Family Equality, Preparing for Parenthood: finding and forming a Chosen Family,

[12] Center for American Progress, Paid Leave Policies Must Include Chosen Family, data highlights the importance of chosen family for LGBTQI+ individuals, March 1, 2023,

[13] Washington State Legislature, Final Bill Report, ESSB 5097, synopsis as enacted,

[14] Washington State Legislature, ESSB 5097 Family Member Expansion Analysis, 2nd report, June 2023, Employment Security Department, PDF,

[15] Washington State Legislature, See Paid Sick Leave:

[16] Washington State Legislature, Final Bill Report, ESSB 5097, synopsis as enacted,

[17] National partnership for women and families, Fact Sheet, June 2023,

[18] The Importance of an Inclusive, Realistic Family Definition in Paid Family and Medical Leave and Paid Sick Time Policies, A Better Balance, posted: July 23, 2021 and updated: July 23, 2021, 

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