For healthcare practices operating in Missouri, staying informed about employment legislation is crucial for maintaining compliance and supporting staff effectively. Missouri’s Earned Paid Sick Time Law went into effect on May 1, 2025, requiring eligible employers to begin offering paid sick leave to their employees.
At HR for Health, we’re closely tracking these legislative changes to help healthcare practices navigate the complexities of leave management. Here’s what this new sick leave law means for your practice.
Current Status of Missouri Sick Leave Legislation
Missouri has joined the growing number of states that are implementing mandatory paid sick leave requirements. Beginning May 1, 2025, covered employees in Missouri will begin accruing and using earned paid sick time. The law applies to all private employers with gross annual revenue of at least $500,000. Government entities and retail and service businesses under that revenue threshold are exempt – other industries under the same revenue threshold are not exempt.
BREAKING NEWS:
As of May 14th, 2025 Missouri lawmakers moved to repeal the new Missouri sick leave law arguing that the provision would be damaging to businesses. Although lawmakers have been attempting to form a compromise, before the end of the session on the 14th, the question rule was used to force a vote on the law. The outcome of this was a repeal of Proposition A that , if signed by the governor, will result in the requirement being removed on August 28th. We will continue to monitor the changes and provide updates in this article, but users of HR for Health can enjoy the benefit of automated updates to their handbooks based on any changes that come to pass.
Key Requirements of Missouri’s Paid Sick Leave Law
Under the new law, employees will accrue one hour of paid sick time for every 30 hours worked. Other key provisions include:
- Annual usage caps of 56 hours for employers with 15 or more employees or 40 hours for employers with fewer than 15 employees per benefit year
- Unused sick time carries over from year to year up to 80 hours, but employees cannot use more hours than what is allowed under the law
- Sick time can be used for the employee’s own illness or preventive care, as well as for the care of family members
- Employers cannot retaliate against employees for using their earned sick time
- Employers may request documentation for absences exceeding three consecutive days
Healthcare employers should note that medical and preventive care appointments are qualifying uses under the law. This is particularly relevant in practices where staffing affects patient flow. Implementing efficient time tracking systems now can help you stay ahead.
How the Missouri Sick Leave Law Compares to Other States
Missouri’s sick leave law follows a national trend established in other states that have implemented similar legislation. More than a dozen states, plus Washington D.C., have passed similar paid sick leave laws with common themes: accruals based on hours worked, usage for family care, anti-retaliation protections, and documentation requirements. Missouri’s policy aligns closely with these existing laws.
Common Elements of State Sick Leave Laws
Employers should prepare for the following provisions:
- Accrual of one hour of sick time per 30 hours worked
- Waiting periods of up to 90 days before new employees can use accrued sick time
- Documentation requirements allowing employers to request verification for absences exceeding three consecutive days
- Notice provisions requiring advance notification when sick leave is foreseeable
- Clear anti-retaliation protections preventing adverse actions against employees who use their legally entitled sick time
To prepare, healthcare practices should review their employee handbooks and ensure sick leave policies can be easily updated.
Practical Steps for Healthcare Practice Preparation
Now that the deadline has arrived, Missouri practice owners should do the following as soon as possible:
- Conduct a comprehensive audit of your current sick leave or paid time off benefits versus Missouri’s requirements
- Evaluate your payroll and time tracking systems to ensure they can accommodate new tracking requirements. Integrated payroll systems designed for healthcare settings offer advantages for monitoring accruals while simplifying administrative processes.
- Consider how patient scheduling might be affected by expanded sick leave usage and develop contingency staffing plans.
- Review documentation protocols for leave requests and usage. Like other states, Missouri will permit reasonable documentation requirements for longer absences, but these must be consistently applied to avoid discrimination concerns.
- If you haven’t already – ensure you have notified your staff of the new requirements and circulated the required notice and poster. Effective onboarding processes should include clear information about leave benefits and usage procedures.
FAQs About the Missouri Paid Sick Leave Law
Q: When will the Missouri sick leave law take effect?
A: The Earned Paid Sick Time Law took effect May 1, 2025. Employers with qualifying revenue should be ready to comply by that date.
Q: Will our existing PTO policy satisfy the requirements?
A: It may, if it offers equivalent or greater benefits and allows usage for all permitted purposes. The policy must also meet documentation, notice, and carryover requirements. Stay tuned into any changing requirements to ensure that it continues to satisfy the requirements.
Q: How will this affect part-time employees in our practice?
A: Part-time employees accrue time based on hours worked and are covered under the law. Creating appropriate onboarding processes for all employee types will help ensure consistent policy implementation.
Q: What documentation can we require for sick leave use?
A: Employers can request documentation for absences exceeding three days, but must apply this rule consistently to avoid discrimination concerns.
Q: How does this interact with FMLA requirements?
A: The law operates separately from FMLA but may cover some overlapping reasons for leave. Sick leave is generally intended for shorter absences, while FMLA covers longer or more serious health conditions.
Contact HR for Health for help with Missouri sick leave requirements
HR for Health’s all-in-one platform helps you stay in compliance with state and federal employment laws without the guesswork. Our tools automatically track accruals based on local laws like Missouri’s new sick leave policy, and our team of experts ensures your handbooks, policies, and processes reflect the latest changes. If you’re not sure whether your business qualifies or if your current PTO setup is compliant, schedule a free compliance consultation to get clarity today.
