The Colorado Healthy Families and Workplaces Act has been around for a while, but the February 2026 updates are particularly important for health and dental practices. For most employers, the new definitions and pay rate calculations don’t change much. But in many practices where individual employees’ pay rates can vary, this makes a big difference. Catch up on the new Colorado sick leave laws and check if you’ve got compliance gaps.
| Our Employment Law Experts’ Advice: – Colorado requires almost all employers to offer paid sick leave up to 48 hours per year. – If an employee has a variable rate of pay, you’ll have to determine if they’ll receive the higher rate, lower rate, or an average while on sick leave. It just can’t reduce their expected take-home pay. – Would you rather offer combined PTO instead of doing the math? Colorado says that’s okay! HR for Health can help you set it up right. |
New Definitions and Calculations Under Colorado’s HFWA
Virtually all employers in Colorado must comply with the Colorado Healthy Families and Workplaces Act (HFWA). Here’s the short version of what the newly-updated law says:
- Accrual rate. Under the Colorado sick leave law, employees can earn up to 48 hours of paid sick leave per year. This time accrues at a rate of 1 hour of leave for every 30 hours worked. That’s the state baseline, so you can increase the amount of leave if you want. You just can’t lower it. Under this law, there is no waiting period before employees can start using their benefits. This information should look familiar, the sick leave accrual rate and maximums have not changed.
- Job Protections. You may not take away other benefits while employees are on HFWA sick leave, and you may not prevent employees from taking leave. It’s your job to find a replacement, not theirs, and you can’t punish them or impose any consequences for using sick time. It’s none of your business why employees need a sick day, so don’t ask for medical reasoning. If they choose to tell you, that’s fine, but keep that information private.
- Employee requirements. Under this law (and the law of good manners) employees should give you notice that they’ll be taking sick leave “as soon as practicable.” For appointments scheduled in advance, this means letting you know promptly, not last minute. If they wake up with the flu, they should call you first thing.
Employee notification. You’ll also need to provide employees with a notice about these updates and display posters about HFWA rights where they can see them. If you’re using HR for Health and this applies to your practice, you’ll have already seen this and distributed it to your team. We keep you totally compliant on any relevant laws because we actively monitor for them year round.
Why the New Colorado Sick Leave Law Matters So Much to Health and Dental Practices
This is the part of the law that’s new, and it’s especially pertinent to practices like yours. So take notes.
Colorado’s sick leave law states that employees need to be paid at the same rate they normally work. This excludes overtime bonuses and holiday pay. It gets trickier when you have employees who work variable rates, which is pretty common in health and dental practices. In a small to medium-sized practice, people may wear many hats, and employees might be paid differently based on which role they’re assuming that day. Instead of defaulting to their lowest (or highest) rate of pay, you’ll need to do some calculations.
How to Calculate Colorado HFWA for Employees Who Get Multiple Rates of Pay
As a rule, the Colorado Healthy Families and Workplaces act says that using leave cannot reduce the employee’s pay.
Consider a dental assistant who also works at the front desk, and those two roles have different rates of pay. If that employee takes a sick day when they would have been scheduled to do dental assistant work, they must receive the pay they would have earned on that day. If they were scheduled for front desk duties on the day they take off sick, then they receive the rate of pay they would have earned for front desk work.
But if the employee’s schedule isn’t set up so predictably, it becomes a math problem. Maybe the employee jumps across roles as needed, and the appropriate rate of pay follows them. In that case, use a 30-day lookback period and find the average, minus overtime and bonuses. This way, you’ll know that the employee will not lose pay they would have earned. You won’t be overpaying, either.
If a salaried employee takes a sick day, it’s easier. Just don’t dock their pay and make sure their benefits stay intact while they’re out.
This is Really Complicated! Can’t I Just Have a General PTO Policy?
Yes you can! The Colorado Healthy Families and Workplaces Act specifically states that general paid time off (PTO) policies are okay. If you want to combine sick leave and vacation together, go for it. The rules are that it has to encompass at least all of the HFWA guidelines, and your combined PTO can’t be more strict. According to Colorado sick leave law, if employees use up all their bundled PTO on a vacation, then that’s just the way it goes. The law states that additional HFWA leave need not be provided if they use it all up. The only exception is if there’s a public health emergency. That’s a whole different topic, though.
No Matter What the State Says, Sick Leave is Good Practice
Federally, offering sick leave is not mandatory. A lot of states don’t require it either, but if you ask us, it’s just good business if you do.
People get sick (as you obviously know from working in healthcare), and that can mean a need to take time off work. Research has shown that employees perform better, are less likely to quit, and stay healthier when they can use sick leave without fear of losing income. According to the Bureau of Labor Statistics, 80% of employees already get paid sick leave from their employer.
Sure, you’re going to have a few employees call in sick when they really aren’t. But most often, employees who use sick days truly are attending to medical matters. In a patient care setting, it’s safer to let employees take time to care for themselves.
HR for Health is Here to Help
Whatever your pay structure looks like, HR for Health knows how to handle it. We’ll keep you compliant with laws before you even notice they’ve changed. And if you struggle with payroll math, then you’re in luck. HR for Health syncs your practice’s policies with your time clock, payroll, benefits, the whole shebang to automate compliance for you. Got questions about compliance? Give us a call.
