As you know, the paid leave mandated under it could be applied for, "Any absence resulting from obtaining professional medical care." As drafted, professional medical care could apply to numerous cosmetic health procedures, and a host of other elective options. Do you believe that employers should be required to offer paid leave for procedures such as teeth whitening or Botox injections? Ms. O'LEARY. OK. Senator Enzi, first, I just want to thank you for your suggestion on Federal contractors. In my role as a Senior Fellow at the Center for American Progress, I wrote a paper suggesting that we should start with Federal contractors in terms of requiring paid sick days and requiring greater workplace policies. Because, as you say, we should not have our great Nation's Statue of Liberty or other national parks offering employees benefits that do not support workers. I just want to applaud you for that recommendation. I think it is so critical and I would like to work with you on thinking about how to move forward with that.

As to your question about paid sick days, I certainly think that there is room for having these open and honest dialogs. Certainly thinking about cosmetic surgery is for purely cosmetic purposes is not what was intended in terms of this law.

What we are talking about is the situations that Kimberly faced, frankly, that I face other than the fact that I have a good employer. But we have sick children. We have sick children who need us to take them to the doctor, and that is a very challenging situation. It is much more challenging for Kimberly than it is for me.

And I want to make sure that as Senator Harkin suggested, let us have a floor. We are not requiring everybody to have some cookie cutter suggestion, but we want to make sure that some basic, decent rights go on here that make sure that we, as a society, say, "Children need their moms and their dads to take them to the doctor." And research says that if they do, their children are healthier, they are doing better, they are thriving, particularly kids with chronic health conditions. That is what we are talking about here. Senator ENZI. Well, thank you.

And for Ms. Lichtman, the nonpartisan Congressional Budget Office has estimated that the Healthy Families Act will cost private employers $11.4 billion over 5 years, a substantial amount of that will fall on the smaller employers who are already struggling to make payroll in these difficult times.

My actual definition of a small businessman is you have not been a small businessman unless you have woken up in the middle of the night and said, "Payroll is tomorrow. How am I possibly going to meet payroll?" And you just sweat through it the rest of the night and you do find a way to pay your employees. You do not always get to pay yourself, but if this bill is enacted, employers will be forced to adjust somewhere and that would either be reducing current benefits or downsizing the number of employees, which adds to the ranks of the unemployed.

So could you put yourself in the shoes of a small businessman faced with these increased costs? What would you cut?

Ms. LICHTMAN. I have a couple of answers for you. The first, we are not comparing no cost and increased costs. Small businesses and large businesses today without the floor of a national law, like the one Chairman Harkin is talking about, have costs like in

creased turnover, increased training, lower morale. There are costs attendant to individual businesses by not providing the kinds of leave that families need, be it paid sick days or paid family leave. And I am happy to focus on the paid sick days' provision.

It is a sort of false dichotomy to say, "Oh, my God, there is going to be these increased costs." There are costs. There are costs to businesses, and for sure, there are costs to society.

The second, I think that addressing the requirements of contractors to that very agency you were talking about a little while ago, the Office of Contract Compliance, requiring of our contractors with the Federal Government, that they provide the kind of basic minimum floor protections for workers like my colleague here, could not be a better idea, and we will be talking to you right quick about how to move that as an important laboratory, if you will.

My third answer is that the very study done by SHRM pointed out that new mothers' access to fully paid maternity leave has declined. Since 2005, leave for new fathers, for adoptive parents, and for parents of seriously ill family members has also declined. So we are not in a static situation. Not only do we not have the floor that Chairman Harkin is talking about, we are going backward. Workers are hurting more today than they were before, by the very study you all were talking about. Not my study, SHRM's study.

I think when you look at, to tie back to Senator Harkin's question about competitiveness, certainly world competitiveness as Ann and Senator Harkin were having a discussion about, but competitiveness within this country requires that kind of minimum floor and safety so parents can do the exact kind of caregiving that Ann talks about to allow our children and our families to flourish.

For me, all your questions perform a wonderful, seamless web of an opportunity for me to tie it all together.

Senator ENZI. And you have tied it together for quite a while.
Ms. LICHTMAN. I have. I have. Age is on my side.

Senator ENZI. Which prohibits me from doing some followup questions, which I will submit in writing. I was scheduled to leave 15 minutes ago, but I could not pass up the opportunity to ask some questions, and I do appreciate the answers. There are some things that can be done, but I think some of the people have not been in small business before.

The CHAIRMAN. Thank you, Senator Enzi.

Senator Franken.

Senator FRANKEN. Well, I do also think that the Ranking Member's suggestion on applying this to Federal contractors is a very good idea, interesting idea. I will say, I know this about the Ranking Member, he is a voracious reader and I suspect that he may have read your paper, Ms. O'Leary, and gotten the idea from there. I just suspect that.

And I also know that he knows Yellowstone very well because Wyoming shares that with Montana and it is beautiful, beautiful. But he says he does not know about the Statue of Liberty. It was given to us by the French.

[Laughter.]

Senator ENZI. And the arm was put on upside down the first time.

Senator FRANKEN. Was it? And the torch was like down? OK. Well, I think I am wasting my time now and I am the one to blame.

I would like to ask about the Older Americans Act. I think we ought to reauthorize it. And I was wondering if anybody has any thoughts about, for example, a National Family Care Giver Support program, and what role that plays for supporting mothers and families? We have the situation where we are just going to have a lot of seniors.

And the Older Americans Act, for those who are not familiar with it, was first authorized in 1965 as a way of allowing seniors to stay in their homes and not go to nursing homes. And it provides all kinds of great stuff and one of them is respite care, which is if you are taking care of an older parent, say, or a husband who maybe has Alzheimer's or something like that, there are these great volunteers who come in and provide that kind of care.

Can you speak to the reauthorization of the Older Americans Act? I see Ms. Lichtman has her hand up and eagerly wanting to answer, and then anybody else, obviously.

Ms. LICHTMAN. I think Ann as well wanted to respond.

I think it is very important. It is a vivid example of what the Government can do to help individual families, frankly, make it through every day . And the plethora of programs you outlined are very important in sustaining our families.

The growth as we age as a population healthy and very often in place of the "sandwiched generation," of people who are helping both their children and their parents, and sometimes their grandchildren, and their parents cries out for just the extension of programs like the Older Americans Act. I cannot speak more strongly in favor of those programs and the real difference that it makes in people's lives. It is a wonderful example of Government working at its very best, I think.

Senator FRANKEN. Ms. O'Leary.

Ms. O'LEARY. I was just going to add on to Judy's statement that one of the things that you mentioned, Alzheimer's, is something that our country is really facing in great degree; which is that because people are living longer, Alzheimer's is the disease that largely impacts people who are 65 and older. We are expecting to see a tremendous increase in individuals who are living with Alzheimer's. And, as a result, these policies that the Government has put in place are so critical to keep people in their homes and to ensure that we have families who are able to care for their ailing and elder relatives.

It is frankly based on the idea that there is somebody at home and that we actually have workplace policies that allow people to be away. We need to have both. We need to make sure that people can stay in their home, but that there is a family member there to help, and that they get the respite they need.

I just want to applaud you for working to reauthorize that. I think it is incredibly critical, but it also makes-we need to make sure that, for example, under FMLA, when I did a report on Alzheimer's and I found that 4 in 10 caregivers of individuals with Alzheimer's did not qualify for FMLA because they were taking

care of somebody who did not meet the definition of somebody in the family they could take care of.

For example, they were taking care of their mother-in-law or their father-in-law. They were taking care of their aunt or uncle, and none of those people are people who can actually qualify for FMLA leave, and that is a problem.

Senator FRANKEN. Ms. Ortiz, thank you for coming to speak today. I do think we are talking about two different worlds. I think INTUITIVE.

Ms. PHILLIPS. INTUITIVE.

Senator FRANKEN. Yes, it sounds like a great company and again, the second best. Again, every other company is worse except for one.

You know, hearing about the struggle that you face with a newborn paints a pretty stark picture of what, I think, a lot of women working for those other companies are facing.

We know that childcare is not cheap. My home State of Minnesota, infant care costs as much as $15,000 per year and a toddler can cost well over $12,000 a year. As you mentioned in your testimony, when you cannot find care for your child, you have to call out of work, and that does not sit kindly with your employer, obviously.

Can you tell us a little more about what it was like trying to find childcare for your two kids and how not having childcare affected your job?

MS. ORTIZ. It was especially difficult because my kids are special needs, so it is not like I can just go to any daycare and enroll them in there. They do need to have speech therapists, APA therapists, occupational therapists, so it made it that much harder to find childcare.

And, to be honest, like I am grateful that my mom is able to help me out with childcare, but if she is not available, my resources are very limited because of their special needs. So it is just extremely hard, emotionally, financially, I mean, it was tough.

Senator FRANKEN. It is interesting, because when we talk, I know that there is kind of this push-pull. Senator Enzi was talking about the cost of business.

Ms. Lichtman, I thought your answer about the costs that we already have was really important and you talked about the cost of businesses. But look at the cost to Ms. Ortiz, I mean, look at that cost. That is hard to measure. Well, you probably can measure it in terms of lost work, lost income, but think of the cost, the human cost, and think of the costs of going into work. I am sorry to take so much time.

Think of the cost to the children too that, "OK, I have got to go in; I have just got to go in, so I am going to leave my kid who is sick at home. He can handle it. He is sick, but he is 6 or he is 8. He has got an ear infection." What does that do to the health of our kids? What does that do for healthcare? What does that do for our educational system? Think about the other costs. That is what we have to weigh and what we have seen from Ms. Ortiz is a real cost. I mean, that is a cost. We know that is a cost.

So we are paying for not having this right now.
Thank you, Mr. Chairman.

The CHAIRMAN. Thank you very much, Senator Franken.

I just want to say that our staff, our committee staff and Senator Enzi's staff are now engaged in talks on reauthorization of the Older Americans Act.

Senator FRANKEN. Great.

The CHAIRMAN. Any thoughts that you might have, or your staff, please weigh in on it.

Senator FRANKEN. Absolutely. Thank you.

The CHAIRMAN. Thanks. So we are proceeding on that.

Again, I want to thank all of our witnesses for being here. Ms. Ortiz, I might say that you may have sparked a possible bipartisan piece of legislation. So this may actually move ahead.

I thank you all for your enlightening testimony. On the one hand, I think companies like INTUITIVE, we need to hold up as an example for other companies to follow. We need to do more to encourage that and to exemplify companies like that.

At the same time, I would say-it is obvious I would, since I introduced the legislation-that we need a Federal floor. And the Healthy Families Act only says 7 days, 7 days, of paid sick leave a year. I mean, that is hardly nothing, which women could use if their job does not even provide for paid maternity leave. Now, at least they could use that for that. That is only 7 days, for crying out loud. It is just the barest of minimums. I think it would, at least, begin to move us in the right direction. So both, holding good companies up, but put some kind of a national floor there below which we will not go.

I thank you all very much for your leadership, all of you, and for being here today. Mother's Day is this weekend. I am going to throw out a thought that has kind of beguiled me for some time. now. We have a Mother's Day now and then we have a Father's Day in June, right. Why do we not have a Mother's and Father's Day ? It just seems to me that we are kind of all in this together. But I will say that the reason we wanted to have this hearing today was to highlight the fact that most of the people in this country who are stressed out, who find this big tug between work and family, work and kids, work and elderly are women; the vast majority are women. They work in the kind of jobs Ms. Ortiz is talking about, and many times they are the caregiver of the children. We would like fathers to be more involved than they are, but let us be truthful about it. In most cases, it is the women, it is the mother who is the basic caregiver, and it is the mother who is working, and trying to provide for her children and her family.

I think it is important with Mother's Day coming up to recognize that the women and the mothers in this country need better support. They need a better deal in terms of their work life and their family life. And that is what I think we need to do: to provide at least a basic minimum of paid sick leave every year. It covers everyone, but I do know from the data and the statistics that the largest beneficiaries of this would be the women of this country and the mothers of this country.

That is why we wanted to have this before Mother's Day , to let the public know that if we really love our mothers, it is not enough just to give flowers and a card. I think we have to do more than that.