Paid Family Leave Insurance in North Carolina Would Improve Family Health and Economic Outcomes, Study Suggests

Man carrying his sleeping son. Newborn baby boy in his father's arms. March 13, 2019

DURHAM, N.C. – A paid family and medical leave insurance program in North Carolina would reduce infant mortality, nursing home costs and use of government assistance, according to a new report from the Center for Child and Family Policy at Duke University.

Paid family leave insurance (PFLI) is a type of paid family leave that is publicly provided and operates statewide. PFLI programs allow employees—and sometimes employers—to pay an insurance premium and gain access to a fund from which they can draw for qualified leave purposes.

The programs aim to help workers balance both work and family, and are already established in California, New Jersey, New York and Rhode Island. Programs also are starting up in Massachusetts, Washington State and Washington, D.C. Statewide programs help workers who can’t afford to take advantage of the federal Family Medical Leave Act of 1993 (FMLA), which requires employers to provide leave but does not require them to pay employees during their time off. In North Carolina, 64 percent of eligible working people cannot afford to take unpaid medical leave.

In the report, “Paid Family Leave in North Carolina: An Analysis of Costs and Benefits,” researchers model the costs, benefits and feasibility of two policy proposals for instituting a PFLI program in North Carolina.

“We analyzed two policy options to help North Carolinians see what different types of paid family leave programs might look like,” said Anna Gassman-Pines, a professor in the Duke Sanford School of Public Policy and an associate director of the Center for Child and Family Policy. “The proposals vary in the length of leave and the dollar amount of the leave benefit.”

The proposals are based on existing policies in other states and recommendations from the bipartisan American Enterprise Institute (AEI)-Brookings Institution Project on Paid Family Leave.

Proposal A offers an eight-week paid leave with 55 percent wage replacement, while Proposal B offers a 12-week paid leave with 80 percent wage replacement. Proposal A includes a weekly benefit cap of $486, which is lower than other state-enacted policies and lower than the AEI-Brookings recommendation (about $600). Proposal B includes a weekly benefit cap of $875.

In both proposals, funding for the PFLI program would come only from employees and would allow employees paying into the fund to take leave for their own health, a new child, or taking care of an ill family member.

Proposal A Proposal B
Maximum Duration of Leave 8 weeks 12 weeks
Amount of Benefit 55% of wages up to max 80% of wages up to max
Maximum Weekly Benefit $486 $875
Wages on which premium is paid Up to $25,292 Up to $45,526
Waiting Period One week No waiting period
Eligibility Worked at least 80 hours in the last year

At least $1,560 total earnings in the last year

Worked at least 80 hours in the last year

At least $1,560 total earnings in the last year


In evaluating the proposals’ effects on families and society, researchers estimated that both options would reduce infant mortality, low birthweight, nursing home costs and the use of state government assistance through Temporary Assistance for Needy Families (TANF). Under proposal B, researchers project 26 infant lives in North Carolina would be saved each year.

“The effect of PFLI on infant mortality is of particular significance for North Carolina, which has one of the highest infant mortality rates in the country,” said co-author Elizabeth Oltmans Ananat.

“Saving 26 infant lives would represent a three percent decline in infant mortality, reducing the North Carolina infant mortality rate to 7.1 per 1,000, from its current 7.3 per 1,000.”  Ananat is a Sanford School professor and a fellow with the Center for Child and Family Policy.

“Given the growing elderly population in North Carolina, we also looked at the potential effect of PFLI on nursing home usage and costs,” said Gassman-Pines.

Researchers estimated 205 individuals would be kept out of nursing home care each year, cutting costs by between $16.7 million and $18.6 million, depending on the room type occupied.

Previous studies have shown that PFLI reduces the likelihood that families will use TANF. In this report, researchers estimate a PFLI program would reduce the number of individuals receiving TANF by 956, saving $451,232 to $780,096 in North Carolina’s TANF costs annually.

For more information and findings from the study, access the full report here.



Experts say SC ‘Scared Straight’ program for troubled kids is child abuse

Photo of Kenneth A. Dodge, the founding director of the Duke Center for Child and Family Policy February 26, 2019

Child psychologist experts call ProjectSTORM, a Scared Straight jail program for at-risk children and teens in South Carolina, child abuse. A Rock Hill Herald photographer observed the program twice during the past year and shared video footage from those visits with six experts. After viewing footage of interactions between deputies and children, all six experts criticized the program and five called the treatment child abuse, including Ken Dodge.

In a video interview with The Charlotte Observer, Dodge says the Scared Straight-style approach is based on the mistaken assumption that delinquent behavior is a matter of choice. “It’s not a matter of choice. It’s a matter of skills, social competence to get through the day,” he said. “You don’t will that. You have to learn it.”

The Charlotte Observer »

In some NC counties, traditional schools are being squeezed by charters

January 31, 2019

Charter school enrollment in North Carolina has grown by more than 200 percent in the past 10 years. Today, there 109,389 students being served by charter schools, about 7.3 percent of the total public school population of 1.5 million. CCFP faculty fellow Helen Ladd has concerns about the growth in rural areas because of the burdens they place on school districts. She explains in NC Policy Watch that charters often leave traditional schools with students that are more challenging to educate. “They [charter schools] attract the ones who are less costly to educate and what that does is impose cost on the remaining traditional public schools,” says Ladd.


NC Policy Watch »

New study finds pre-k benefits endure through eighth grade

January 22, 2019

New research from the Duke Center for Child and Family Policy was featured on NBC Nightly News as part of a story about the benefits of Pre-K. In a newly released working paper, Kenneth Dodge, former director of the Center, Clara Muschkin, Helen “Sunny” Ladd and Yu Bai, share findings from their analyses, which show the benefits of Pre-K last longer than previously thought — through eighth grade and possibly even beyond. NBC Correspondent Kerry Sanders interviewed Dodge about these benefits during the episode, which aired January 20.



NBC Nightly News »

Benefits of Pre-K do not fade with age

Kindergarten teacher and children with hands raised in library January 14, 2019

New analyses from the Center for Child and Family Policy reveal that positive benefits of NC Pre-K and Smart Start do not fade with age. Ken Dodge writes in the News & Observer about findings from his recently released working paper, co-authored by Helen Ladd, Clara Muschkin, and Yu Bai, which show that the positive impacts of NC Pre-K and Smart Start continue through grades 6, 7, and 8 grades. By eighth grade, for children in counties with average funding, NC Pre-K has reduced the likelihood of placements into special education by over one third. Dodge writes, “To grow these benefits, state funding for these early childhood programs must grow and must be coupled with equally healthy funding for high-quality public schools.”

News & Observer »

Adolescents who self-harm more likely to commit violent crime

January 4, 2019

Young people who self-harm are three times more likely to commit violent crime than those who do not, according to new research from the Duke Center for Child and Family Policy. The study, published in The American Journal of Psychiatry, also found young people who harm themselves and commit violent crime — “dual harmers” — are more likely to have a history of childhood maltreatment and lower self-control than those who only self-harm. “We know that some individuals who self-harm also inflict harm on others,” Leah Richmond-Rakerd, lead author of the study. “What has not been clear is whether there are early-life characteristics or experiences that increase the risk of violent offending among individuals who self-harm. Identifying these risk factors could guide interventions that prevent and reduce interpersonal violence.”

US News & World Report » MedPage Today » HealthDay » Medical Xpress » » Tech Explorist » Business Standard »

Family Connects Featured on CBS This Morning

Kenneth Dodge, Duke University, and Dr. Tara Narula, CBS News, walking down hallway, talking January 2, 2019

Family Connects International, a nurse home visit program initiated by Kenneth Dodge, former director of the Center, was featured on CBS This Morning.  Family Connects is a community-wide nurse home visiting program for parents of newborns, with a goal to increase child well-being by bridging the gap between parent needs and community resources.

CBS This Morning »

Low-income parents want a white picket fence, not just money, before getting married

Bridge and Groom cutting wedding cake November 29, 2018

Marriage rates in the U.S. are declining, especially among the lowest-income Americans. However, in October, wage growth in the U.S. hit a nine-year high, with low-wage workers seeing some of the biggest gains. Some scholars have suggested that if low-income people have more money, they might be more likely to get married. But according to findings from a new study by Center Faculty Fellows Christina Gibson-Davis and Anna Gassman-Pines, couples want more than just more money to get married. They want the white picket fence.

The Conversation »

Home visits for new moms offer a more robust social safety net in Tulsa

Kenneth Dodge, Duke University November 27, 2018

Family Connects International has inspired a free nurse home visiting program for new moms in Tulsa.  The visits, modeled on Durham Connects in Durham, N.C., are part of the city’s initiative to build a more robust social safety net in a state where public services have suffered repeated deep cuts.

In addition to the nurse’s expertise, families in Durham benefited from referrals to community resources that they might not otherwise have accessed, says Kenneth Dodge, former director of the Center who helped develop Durham Connects.

Christian Science Monitor »