When the Michigan Earned Sick Time Act (ESTA) replaced the Paid Medical Leave Act (PMLA), a lot of smaller employers panicked. All of a sudden, they had to offer paid sick leave, and not only that, larger employers had to offer more of it, and it could be used in more ways. Why now? Why such steep fines for non-compliance? What does this mean for keeping your practice’s lights on? Here’s everything you need to know about the Michigan Earned Sick Time Act, plus some federal guidance for those of you who don’t live in the Mitten State.
Why Did Michigan Change Its Sick Leave Laws?
Michigan kicked off its first paid sick leave laws in 2019 with the Paid Medical Leave Act (PMLA). Back then, paid sick leave was mandatory for employers with 50+ employees, and workers could accrue up to 40 hours per year. It was a pretty good setup, but Michigan voters decided to make it even better.
The Michigan Earned Sick Time Act (ESTA) had a bit of a bumpy start, with last-minute changes and delays, but in 2025, it replaced PMLA. This new law covers more employers, offers more to employees, and can be used in more ways.
How to Handle ESTA
Here’s where ESTA stands at the moment:
- If you have 11+ employees, you are considered a large employer and you must provide up to 72 hours of paid sick time per year. If you have fewer than 11 employees, it’s 40 hours per year.
- Paid sick leave time accrues at a rate of 1 hour of leave for every 30 hours worked. You may frontload these hours if you don’t want to worry about calculations.
- ESTA time is paid at the same rate as their working rate, and they can use it in the smallest time increments that you use to measure time at your practice.
- Almost all employees are eligible for ESTA. The rare exceptions are those who work for the government, unpaid interns, volunteers, and independent contractors (who aren’t employees anyway).
Employees can use ESTA for many reasons, too:
- Taking care of mental or physical health. This includes injuries, health conditions, diagnosis, and preventative care.
- Addressing needs following domestic violence or physical assault.
- Meetings at a child’s school or daycare to address the child’s health or disability.
- Taking care of a family member for any of the reasons above.
- Staying home during a public health emergency or to reduce exposure to disease.
The definition of a “family member” changed, too. It goes beyond the nuclear family to include stepchildren, stepparents, domestic partners, people in a committed relationship, and many more.
Under the Michigan Earned Sick Time Act rules, yes you can use a general PTO policy instead of a specific sick leave bank. We don’t usually recommend that, though. It sounds simpler, but sometimes it’s harder to manage. However you choose to set it up, you’ll definitely need an ironclad employee handbook that spells it all out. We can help.
Do You Really Need to Offer Sick Leave?
There are no federal laws that require you to offer sick leave to your employees. Most states do not have paid sick leave laws. And we get it. You run a tight ship and you don’t have the flexibility to just let your people take random days off. You’ve heard one too many fake coughs, and you’re absolutely sick of it (no pun intended, because we know they’re not actually sick either).
Let us change your mind on the value of offering paid sick leave.
- People actually do get sick. They’ve counted. People who don’t work in healthcare get two or three colds per year. Guess how many more you get if you do.
- “Sick” means different things at different times. Using sick leave for regular doctor’s appointments is the best-case scenario. But your people may need time to take care of their mental health, sick loved ones, chronic illnesses, serious conditions, and much more.
- Employees work better when they’re rested. Showing up sick leads to presenteeism and can extend the duration of their illness.
- They might not even use it. Did you know that about 25% of workers take zero sick days? They just want access if they need it.
- It keeps you competitive. 80% of employees already get paid sick leave, and the number is only growing. If you want top talent, you won’t want to be an outlier on this.
- Your state might roll out sick leave laws. Before 2011, no states had paid sick leave. Now, 18 of them do. The Michigan Earned Sick Time Act is just one of the more recent examples, and unsurprisingly, the concept has really taken off since COVID.
- It’s ironic if you don’t offer it. You’re in healthcare. Don’t limit your empathy to your patients.
How to Set Up Sick Leave with HR for Health
What do you think, sounds reasonable? We built HR for Health knowing full well that your practice’s scheduling can be precarious. We also know that state laws can change on a dime, and if you have locations across state lines, it gets even more complicated. As your employees accrue their paid sick leave, we’ll keep track of it in their payroll. When you update your practice’s policies, your employee handbook is already synced. Best of all, we’ll keep you compliant with whatever your state throws at you.
Ask our team about what your state, your team, and your practice needs for compliance. Better yet, get a demo to see for yourself.
