Family and Medical Leave Act Survey- Employee Survey

2012 FAMILY AND MEDICAL LEAVE SURVEY

EMPLOYEE SURVEY

NOTE:

RESPONSE OPTIONS IN ALL CAPS ARE NOT READ ALOUD BY THE INTERVIEWER.

TEXT IN ALL CAPS IS A PROGRAMMER NOTE OR INTERVIEWER INSTRUCTION.

TEXT IN BRACKETS IS TO BE FILLED IN PROGRAMMATICALLY OR DETERMINED BY INTERVIEWER.

I. SCREENER (Sections S &T)

1. Screen for employment, etc.

2. Leave Designation

3. Telephone Usage (T1-6)

RDD INTRODUCTION

[CATI: If FRAME=0, start interview at INTRO1. If FRAME=1, start at INTRO2]

INTRO1. Hello, my name is [INTERVIEWER] and I'm calling on behalf of the U.S. Department of Labor. We are conducting a national study to find out about employees’ use of, and attitudes about, family and medical leave policies in their workplace.

[PROGRAMMER: START SCREENER TIME STAMP HERE]

S1. Are you a member of this household and at least 18 years old?

1 YES [GO TO S4]

2 NO [GO TO S2]

8 DK (VOL) [GO TO S2]

9 REF (VOL) [GO TO S2]

S2. May I speak to a household member who is at least 18 years old?

1 AVAILABLE [REPEAT INTRO1]

2 NOT AVAILABLE [SCHEDULE CALLBACK]

3 ALTERNATE NUMBER PROVIDED [UPDATE NUMBER, GO TO UP1]

4 THERE ARE NONE [GO TO THANK01]

8 DK (VOL) [GO TO THANK01] [SOFT REFUSAL]

9 REF (VOL) [GO TO THANK01] [SOFT REFUSAL]

[CATI: Ask UP1 if S2 = 3]

UP1. Is that a landline or cell phone?

1. Landline [CATI: Flag CELL = 0)

2. Cell Phone [CATI: Flag CELL = 1]

[IF NECESSARY: Household members include people who think of this household as their primary place of residence. It includes persons who usually stay in the household but are temporarily away, such as in the military, on business, on vacation, in a hospital, or living at school in a dorm, fraternity, or sorority.]

CELL PHONE INTRODUCTION

[CATI: Only ask INTRO2 if FRAME=1]

INTRO2. Hello, my name is [INTERVIEWER] and I'm calling on behalf of the U.S. Department of Labor. We are conducting a national study to find out about employees’ use of, and attitudes about, family and medical leave policies in their workplace.

If you are now driving a car or doing any activity requiring your full attention, I need to call you back later.

1 AVAILABLE/NOT DRIVING [GO TO S3]

2 NOT AVAILABLE/CURRENTLY DRIVING [SCHEDULE CALLBACK]

3 ALTERNATE NUMBER PROVIDED [UPDATE NUMBER, GO TO UP2]

8 DK (VOL) [GO TO THANK02] [SOFT REFUSAL]

9 REF (VOL) [GO TO THANK02] [SOFT REFUSAL]

[CATI: Ask UP1 if INTRO2 = 3]

UP2. Is that a landline or cell phone?

3. Landline [CATI: Flag CELL = 0)

4. Cell Phone [CATI: Flag CELL = 1]

S3. Are you at least 18 years old?

1 YES [GO TO S4]

2 NO [GO TO THANK01]

8 DK (VOL) [GO TO THANK01] [SOFT REFUSAL]

9 REF (VOL) [GO TO THANK01] [SOFT REFUSAL]

[CATI: Ask all S4]

S4. Results from this study will be used to assess the impact of family and medical leave policies on employees.

[IF INCENT=1, DISPLAY:]

If you qualify and then complete the survey, we will pay you $10 as a token of our appreciation.

To determine if your household qualifies for the survey, I need to get some information about the members of your household who are age 18 or over. These questions will take under three minutes to complete.

S5. How many adults age 18 or over live in your household? ______

[RANGE 1-11, 99 DK/REF SOFT REFUSAL]

Let’s start with you.

S6 (A1-X)	S7 (A1-X)	S8 (A1-X)	S9 (A1-X)	S10 (A1-X)	S11 (A1-x)	S12 (A1-x)	LEAVE DESIGNATION
What is [your/theA2-X]’s first name or initials?	What is [your/A2-X]’s age?	[IF NECESSARY: I know this may sound awkward, but I have to ask:] What is [your/A2-X’s] gender?	[Have you / has A2-X] worked for pay or profit in the last 12 months?	In the last 12 months, [have you / has A2-X] worked for the government, a private company, a non-profit organization, or [have you / has A2-X] been self-employed? [IF NECESSARY: Please think about your most recent/main job.]	TAKEN LEAVE IN LAST 18 MONTHS	NEEDED BUT DID NOT TAKE LEAVE IN LAST 18 MONTHS	FMLAFLG_A1-X IF [QS11=1 AND QS12>1], FMLAFLG=1. IF [QS12=1], FMLAFLG=2. IF [QS11=2 AND QS12=2] OR [QS11=2 AND QS12>1] OR [QS11>1 AND QS12=2], FMLAFLG=3. IF [QS11>2 AND QS12>2], CODE INELIGIBLE.
Your			YES (1) NO (2)	GOV (1) PRV (2) NON (3) SELF (4)	YES (1) NO (2)	YES (1) NO (2)
2nd adult’s			YES (1) NO (2)	GOV (1) PRV (2) NON (3) SELF (4)	YES (1) NO (2)	YES (1) NO (2)
3rd adult’s			YES (1) NO (2)	GOV (1) PRV (2) NON (3) SELF (4)	YES (1) NO (2)	YES (1) NO (2)
4th adult’s			YES (1) NO (2)	GOV (1) PRV (2) NON (3) SELF (4)	YES (1) NO (2)	YES (1) NO (2)
5th adult’s			YES (1) NO (2)	GOV (1) PRV (2) NON (3) SELF (4)	YES (1) NO (2)	YES (1) NO (2)
6th adult’s			YES (1) NO (2)	GOV (1) PRV (2) NON (3) SELF (4)	YES (1) NO (2)	YES (1) NO (2)
7th adult’s			YES (1) NO (2)	GOV (1) PRV (2) NON (3) SELF (4)	YES (1) NO (2)	YES (1) NO (2)
8th adult’s			YES (1) NO (2)	GOV (1) PRV (2) NON (3) SELF (4)	YES (1) NO (2)	YES (1) NO (2)
9th adult’s			YES (1) NO (2)	GOV (1) PRV (2) NON (3) SELF (4)	YES (1) NO (2)	YES (1) NO (2)
10th adult’s			YES (1) NO (2)	GOV (1) PRV (2) NON (3) SELF (4)	YES (1) NO (2)	YES (1) NO (2)
11th adult’s			YES (1) NO (2)	GOV (1) PRV (2) NON (3) SELF (4)	YES (1) NO (2)	YES (1) NO (2)

[IF QS6 = DK/REF FOR 2^ND-11^TH ADULT, REFER TO BY “second adult/third adult/etc” AND AGE/GENDER (QS7/QS8)]

[QS7: RANGE 18-97; DK/REF (99)]

[QS8: MALE (1) FEMALE (2) DK/REF (9)]

[IF QS9 = 1, ASK QS10. IF QS9>1, LOOP BACK TO QS6 FOR NEXT ADULT HH MEMBER]

[IF QS10 = 4, CODE INELIGIBLE AND LOOP BACK TO QS6 FOR NEXT ADULT HH MEMBER]

S11. In the LAST 18 MONTHS, that is, since [INSERT 18 MONTH PERIOD] [have you/has [FILL A1-X FROM QS6]] taken leave from work for ANY of the following reasons:

• to care for a newborn, newly adopted or new foster child; (IF NECESSARY: This includes both maternity AND paternity leave)

• for [your own/[FILL A1-X FROM QS6]’s] serious health condition or to care for someone else’s serious health condition;

• for pregnancy-related reasons (IF NECESSARY: [IF QS8 >1: your own/[FILL A1-X FROM QS6]’s or] a family member’s); or

• to care for a military service member, or for reasons related to the deployment of a military service member?

[IF YES: READ FOR FIRST LOOP ONLY; READ IF NECESSARY FOR ALL OTHER HH MEMBERS (A2-X): A serious health condition, for purposes of this survey, means a condition that lasted more than 3 days and required treatment by a health care provider, a condition that required an overnight hospital stay, or a long-lasting condition for which one must see a health care provider at least twice a year for treatment. It may also include a condition that makes one permanently unable to work or perform other daily functions, or that requires treatments to keep from becoming incapacitated.]

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

S12. In the LAST 18 MONTHS [have you/has [FILL A1-X FROM QS6]] NEEDED to take leave from work but DID NOT, for ANY of the reasons I just listed? [INTERVIEWER: IF NECESSARY, REFER TO JOB AID ON LEAVE DEFINITION]

[IF NECESSARY: I can read the reasons again if you’d like:

• to care for a newborn, newly adopted or new foster child; (IF NECESSARY: This includes both maternity AND paternity leave)

• for [your own/[FILL A1-X FROM QS6]’s] serious health condition or to care for someone else’s serious health condition;

• for pregnancy-related reasons (IF NECESSARY: [IF QS8 >1: your own/[FILL A1-X FROM QS6]’s or] a family member’s); or

• to care for a military service member, or for reasons related to the deployment of a military service member?]

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

[CATI: LOOP BACK TO QS6 –QS12 FOR NEXT ADULT HH MEMBER]

S13. Just to confirm, there [is/are] a total of [FILL QS5] adult household member(s). Is that correct?

1 NUMBER OF HH MEMBERS IN MATRIX CORRECT

2 NUMBER OF HH MEMBERS IS INCORRECT  [RETURN TO MATRIX (QS5)]

[ASK QS14 FOR EVERY HH MEMBER WHERE AGE IS MISSING (QS7 = 99)]

S14. [Are you/Is [FILL A1-X FROM QS6]] 18 years old or older?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

[PROGRAMMER: END SCREENER TIME STAMP HERE]

TERMINATIONS:

READMSG. [READ THE FOLLOWING MESSAGE INTO THE ANSWERING MACHINE:]

This is [INTERVIEWER] calling for a study that is being conducted for the U.S. Department of Labor. We are conducting this study to ask you about family and medical leave policies provided in your workplace. Study results will be used to assess the impact of family and medical leave policies on employees, so your opinions are important. Your phone number was randomly selected and your answers will be kept private. [If you complete the survey, we will pay you $10 as a token of our appreciation.] We will call back within the next day or two. Thank you.

THANK01. Thank you very much, but we are only interviewing in households with members who are 18 and over.

THANK02. Thank you very much for the information. These are all the questions I have at this time.

THANK03. Thank you very much, but your household does not qualify for the study. These are all the questions I have at this time.

R

1) IF S5=1, HHFLG=FMLAFLG_A1.

2) IF ALL [FMLAFLG_A1 THRU FMLAFLG_AX=1], HHFLG=1.

3) IF ALL [FMLAFLG_A1 THRU FMLAFLG_AX=2], HHFLG=2.

4) IF ALL [FMLAFLG_A1 THRU FMLAFLG_AX=3], HHFLG=3.

SELECT 20% OF THESE HHFLG= 3 RESPONDENTS ONLY TO BE SUBSAMPLED.

5) IF [FMLAFLG_A1 TO FMLAFLG_AX=2] AND [FMLAFLG_A1 TO FMLAFLG_AX=1], ASSIGN HHFLG=2 WITH 90%, HHFLG=1 WITH 10% PROB.

6) IF [FMLAFLG_A1 TO FMLAFLG_AX=2] AND [FMLAFLG_A1 TO FMLAFLG_AX=3], ASSIGN HHFLG=2 WITH 90%, HHFLG=3 WITH 10% PROB (NOT ELIGIBLE FOR 20% SUBSAMPLE).

7) IF [FMLAFLG_A1 TO FMLAFLG_AX=1] AND [FMLAFLG_A1 TO FMLAFLG_AX=3], ASSIGN HHFLG=1 WITH 90%, HHFLG=3 WITH 10% PROB (NOT ELIGIBLE FOR 20% SUBSAMPLE).

8) IF [FMLAFLG_A1 TO FMLAFLG_AX=1] AND [FMLAFLG_A1 TO FMLAFLG_AX=2] AND [FMLAFLG_A1 TO FMLAFLG_AX=3], ASSIGN HHFLG=1 WITH 10%, HHFLG=2 WITH 80%, AND HHFLG=3 WITH 10% PROB (NOT ELIGIBLE FOR 20% SUBSAMPLE).

9) IF RESPONDENT IS A LEAVE TAKER OR LEAVE NEEDER [FMLAFLG=1 OR 2], CONTINUE TO SECTION T.

10) IF FMLAFLG=3 AND HAS BEEN SUBSAMPLED FOR EXTENDED INTERVIEW, CONTINUE TO SECTION T.

11) IF FMLAFLG=3 AND RESPONDENT HAS NOT BEEN SUBSAMPLED, THANK03 AND END.

12) IF [S11=1] AND [S12=1] FOR SELECTED RESPONDENT, THEN FMLAFLG_DUAL=1, ELSE FMLAFLG_DUAL=0.

13) IF [QS9=2] FOR ALL [A1 THRU AX], THANK03 AND END (SCREEN OUT).

IF [QS9>2] FOR ALL [A1 THRU AX], THANK AND END. CODE SOFT REFUSAL.

IF [QS11>2 AND QS12>2] FOR ALL [A1 THRU AX], THANK AND END. CODE SOFT REFUSAL.

14) IF MORE THAN 1 HH MEMBER HAS THE SAME FMLAFLG, AND THAT FMLAFLG = HHFLG, THEN RANDOMLY SELECT ONE RESPONDENT

CATI: CREATE 3 QUALIFIED LEVELS BASED ON:

QUALFIED LEAVE TAKER (HHFLG = 1)

QUALFIED LEAVE NEEDER (HHFLG = 2)

QUALIFIED SUBSAMPLED EMPLOYED ONLY (HHFLG = 3)

ESPONDENT SELECTION INSTRUCTIONS – FOR PROGRAMMING USE ONLY

SECTION T – TELEPHONE USAGE

Before we begin, we just have a few quick questions about telephone use in your household. These items will be used for statistical purposes to make sure that all households in the country are represented in this study.

[ASK T1 IF FRAME=0]

T1. Now thinking about your telephone use, do you have a working cell phone?

1 YES, HAVE CELL PHONE

2 NO, DO NOT HAVE CELL PHONE

9 DK/REF (VOL)

[ASK IF T1=1 OR FRAME=1]

T2. [IF FRAME=1: Including this one,] How many working cell phones do YOU personally have?

(1-6) RECORD NUMBER [ENTER 6 IF 6 OR GREATER]

9 DK/REF (VOL)

[ASK IF QS5 > 1 (2+ ADULT HOUSEHOLD)]

T3. Thinking about the other adults in your household, how many working cell phones in total do THEY have?

(0-6) RECORD NUMBER [ENTER 6 IF 6 OR GREATER]

9 DK/REF (VOL)

[ASK IF FRAME=1]

T4. Is a cell phone your ONLY phone, or do you also have a regular landline telephone at home?

1 CELL PHONE IS ONLY PHONE

2 HAVE LANDLINE TELEPHONE AT HOME

9 DK/REF (VOL)

[ASK IF FRAME=0 OR T4=2]

T5. [IF FRAME=0: Including this number,] How many different residential phone NUMBERS do you have coming into your household, not including lines dedicated to a fax machine, modem, or used strictly for business purposes? Do not include cellular phones.

(1-6) RECORD NUMBER [ENTER 6 IF 6 OR GREATER]

9 DK/REF (VOL)

[IF FRAME=0: ASK IF T1=1 OR T3=1-6

IF FRAME=1: ASK IF T4=2]

T6. Of all the telephone calls that you [IF QS5 > 1 (2+ ADULT HOUSEHOLD): or your family] receive, are:

1 All or almost all calls received on cell phones,

2 Some received on cell phones and some on regular phones, or

3 Very few or none on cell phones?

9 DK/REF (VOL)

[IF FMLAFLG=1 OR FMLAFLG_DUAL=1 FOR SELECTED RESPONDENT, CONTINUE TO SECTION A]

SECTION A – LEAVE TAKERS

[IF SELECTED RESPONDENT IS PERSON ON THE PHONE, SKIP TO INTRO3]

[IF SELECTED RESPONDENT IS NOT PERSON ON THE PHONE:]

HANDOFF1. [FILL QS6 AX] has been selected as the respondent for this survey. May I please speak to [FILL QS6 AX] for the rest of the interview?

1 YES/PHONE HANDED OFF [GO TO INTRO3]

2 NOT AVAILABLE [SCHEDULE CALLBACK]

3 ALTERNATE NUMBER PROVIDED [UPDATE NUMBER, GO TO UP3]

9 DK/REF (VOL) [GO TO THANK02]

[CATI: Ask UP2 if HANDOFF1 = 3]

UP3. Is that a landline or cell phone?

5. Landline [CATI: Flag CELL = 0)

6. Cell Phone [CATI: Flag CELL = 1]

INTRO3. [IF NEW RESPONDENT:] Hello, my name is [INTERVIEWER] and I’m calling on behalf of the U.S. Department of Labor. We are conducting a national study to find out about people’s use of, and attitudes about, family and medical leave policies in the workplace. Study results will be used to assess the impact of family and medical leave policies on employees.

[IF INCENT=1, DISPLAY:]

If you qualify and then complete the survey, we will pay you $10 as a token of our appreciation.

[ALL RESPONDENTS:] Your participation is voluntary and all information you provide will be kept private to the greatest extent possible under the law. We have many procedures in place to reduce the small potential risk of loss of privacy. If we should come to any question you don’t understand or don’t want to answer, I’ll try to clarify or we can move on to the next question. The survey should take about 15 to 25 minutes to complete, depending on your answers.

A1. [IF NEW RESPONDENT:] Can you please confirm that in the last 18 months, that is, since [INSERT 18 MONTH PERIOD],

[IF SAME RESPONDENT:] I want to confirm with you that in the last 18 months, that is, since [INSERT 18 MONTH PERIOD],

you have taken leave from work for ANY of the following reasons:

• to care for a newborn, newly adopted or new foster child; (IF NECESSARY: This includes both maternity AND paternity leave)

• for your own serious health condition or to care for someone else’s serious health condition;

• for pregnancy-related reasons (IF NECESSARY: [IF QS8 >1 FOR SELECTED RESPONDENT: your own or] a family member’s); or

• to care for a military service member, or for reasons related to the deployment of a military service member?

[IF YES AND IF NEW RESPONDENT; ELSE, AS NECESSARY:] A serious health condition, for purposes of this survey, means a condition that lasted more than 3 days and required treatment by a health care provider, a condition that required an overnight hospital stay, or a long-lasting condition for which one must see a health care provider at least twice a year for treatment. It may also include a condition that makes one permanently unable to work or perform other daily functions, or that requires treatments to keep from becoming incapacitated.

Is this correct? [Have you taken leave from work for one or more of these reasons?]

1 YES [GO TO QA2]

2 NO [GO TO QB2]

8 DK (VOL) [GO TO QS5]

9 REF (VOL) [GO TO QS5]

[IF R ANSWERS DK/REF TO QA1, RE-SCREEN TO CONFIRM LEAVE STATUS. IF THE SAME R COMES BACK TO QA1 AND ANSWERS DK/REF A SECOND TIME, GO TO SECTION C]

A2. Was there an event like this IN THE LAST YEAR [12 MONTHS, INSERT DATE]?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

A3. Are you currently on this type of leave from work?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

[IF QS8=9 FOR SELECTED RESPONDENT:]

GUESSGENDER1. 1 MALE

2 FEMALE

9 DK

A4. We are interested in the number of times you took leave from work for A SINGLE reason or condition (yours, or that of the person you cared for), and this is regardless of whether you took time off all at once or in separate blocks of time. So, for how many TOTAL reasons or conditions did you take leave from work since [INSERT 18 MONTH PERIOD]?

[RANGE: 1-100]

DK (VOL) 888

REF (VOL) 999

[IF QA4=1, CONFIRM: “So, that’s just one leave in the last 18 months?”]

[IF QA4=2-100, CONFIRM: “So, that’s [FILL] or more leave occasions for [FILL] separate reasons?”]

[IF A4=2-100 DISPLAY: INTERVIEWER: BEFORE PROCEEDING, RECORD REASONS AND DATES FOR EACH LEAVE IN EVENT HISTORY CALENDAR]

[IF QA2=2, SKIP TO QA5]

A4a. For how many TOTAL reasons or conditions did you take leave from work IN THE PAST YEAR, that is since [INSERT 12 MONTH PERIOD]?

[RANGE: 1-100]

DK (VOL) 888

REF (VOL) 999

[NUMBER ENTERED MUST BE LESS THAN OR EQUAL TO QA4.]

[IF QA4a=1, CONFIRM: “So, that’s just one leave in the last 12 months?”]

[IF QA4a=2-100, CONFIRM: “So, that’s [FILL] or more leave occasions for [FILL] separate reasons?”]

[IF A4=2-100 DISPLAY: INTERVIEWER: BEFORE PROCEEDING, CONFIRM PAST 12 MONTHS ENTRY IN EVENT HISTORY CALENDAR]

[IF QA4>1, READ:] Let’s begin by talking about the LONGEST time that you took leave from work since [INSERT 18 MONTH PERIOD].

A5. What was the main reason you took this type of leave from work [IF QA4>1, READ: on your [longest/most recent] leave]? [SINGLE MENTION]

1 OWN ILLNESS, DISABILITY OR OTHER SERIOUS HEALTH

CONDITION, EXCEPT MATERNITY-RELATED ILLNESS [GO TO QA10]

2 [IF (QS8=2) OR (GUESSGENDER1>1) FOR SELECTED RESPONDENT:]

FOR MATERNITY-RELATED DISABILITY, OR OTHER

PREGNANCY-RELATED AILMENT PRIOR TO DELIVERY [GO TO QA10]

3 [IF (QS8=2) OR (GUESSGENDER1>1) FOR SELECTED RESPONDENT:]

FOR MATERNITY-RELATED DISABILITY

AND TO CARE FOR A NEWBORN [GO TO QA11]

4 [IF (QS8=2) OR (GUESSGENDER1>1) FOR SELECTED RESPONDENT:] MISCARRIAGE [GO TO QA11]

5 TO CARE FOR NEWBORN [GO TO QA11]

6 TO CARE FOR NEWLY ADOPTED CHILD [GO TO QA11]

7 TO CARE FOR NEWLY PLACED FOSTER CHILD [GO TO QA11]

8 TO BOND WITH NEWBORN [GO TO QA13]

9 TO BOND WITH NEWLY ADOPTED CHILD [GO TO QA13]

10 TO BOND WITH NEWLY PLACED FOSTER CHILD [GO TO QA13]

11 CHILD’S HEALTH CONDITION [GO TO QA8]

12 SPOUSE’S HEALTH CONDITION [GO TO QA8]

13 PARENT’S HEALTH CONDITION [GO TO QA8]

14 OTHER RELATIVE’S HEALTH CONDITION [GO TO QA6]

15 OTHER NON-RELATIVE’S HEALTH CONDITION [GO TO QA7]

16 DOMESTIC PARTNER’S HEALTH CONDITION [GO TO QA8]

17 TO ADDRESS ISSUES ARISING FROM THE DEPLOYMENT OF A MILITARY MEMBER [GO TO QA5A]

98 DK (VOL) [GO TO QA10]

99 REF (VOL) [GO TO QA10]

A5a. What type of deployment-related issue did you need to address for this leave?

READ IF NECESSARY: PLEASE SELECT ALL THAT APPLY

1 Events or activities sponsored by the military before deployment

2 Childcare or school activities

3 Financial or legal arrangements

4 Non-medical counseling

5 Short-notice deployment

6 Events or activities sponsored by the military after the military member returned

7 Issues arising from the death of the military member

8 OTHER (SPECIFY) ________

98 DK (VOL)

99 REF (VOL)

[GO TO A9a]

A6. What is that person’s relationship to you?

1 GRANDCHILD

2 GRANDPARENT

3 SIBLING

4 AUNT/UNCLE

5 OTHER (SPECIFY) ________

8 DK (VOL)

9 REF (VOL)

[GO TO QA8]

A7. What is that person’s relationship to you?

1 PARENT-IN-LAW

2 CHILD THAT IS NOT YOUR BIOLOGICAL CHILD

3 OTHER (SPECIFY) _________

8 DK (VOL)

9 REF (VOL)

[IF QA5 = 11-16, READ:]

You said that you’ve taken leave to care for your [FILL PERSON FROM QA5/QA6/QA7, AS APPROPRIATE]. Throughout the rest of the survey, we will refer to this person as your “care recipient.”

A8. What was the age of your care recipient? [DO NOT READ LIST]

1 0-1 YEARS

2 2-17 YEARS

3 18-40 YEARS

4 41-59 YEARS

5 60-69 YEARS

6 70-79 YEARS

7 80-89 YEARS

8 90 OR OLDER

98 DK (VOL)

99 REF (VOL)

[IF QA8>2  ASK QA9, ELSE SKIP TO PROGRAMMING NOTE BEFORE QA10]

A9. Was this leave taken in order to care for a military service member for a service-related health condition or injury? [IF NECESSARY: This includes both current active duty members as well as reserve members.]

1 YES

2 NO [SKIP TO PROGRAMMING NOTE BEFORE QA10]

8 DK (VOL) [SKIP TO PROGRAMMING NOTE BEFORE QA10]

9 REF (VOL) [SKIP TO PROGRAMMING NOTE BEFORE QA10]

[IF A5=17]:

A9a. What is that person’s relationship to you?

1 SPOUSE

2 PARENT

3 SON OR DAUGHTER

4 NEXT OF KIN

5 OTHER (SPECIFY) ________

8 DK (VOL)

9 REF (VOL)

[ASK QA10 IF QA5 = 1-2, 11-16, 98, 99]

A10. What was the nature of the health condition for which you took this leave? Was it:

[READ LIST]

1 A one-time health matter, such as appendicitis or injury;

2 The treatment of an injury or illness that now requires routine scheduled care, such as chemotherapy or physical therapy; or

3 An ongoing health condition that affects one’s ability to work from time to time, such as diabetes, migraines, depression, or Multiple Sclerosis?

4 OTHER (SPECIFY): _______

8 DK (VOL)

9 REF (VOL)

[IF QA5 = 3, 5-7, READ:]

You said that you’ve taken leave to care for your [FILL PERSON FROM QA5]. Throughout the rest of the survey, we will refer to this person as your “care recipient.”

[IF QA5=1, 2, 4, 98, 99: READ “you”

IF A5=3, 5: READ “you OR your care recipient”

ELSE, READ “your care recipient”]

A11. Did [you/your care recipient] require a doctor's care at any time during this leave?

1 YES [ASK QA12]

2 NO

8 DK (VOL)

9 REF (VOL)

[IF QA11>1, SKIP TO A13]

[IF QA5=1, 2, 4, 98, 99: READ “you”

IF A5=3, 5: READ “you OR your care recipient”

ELSE, READ “your care recipient”]

A12. [Were/Was] [you/your care recipient] in the hospital overnight at any time during this leave?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

A13. For this leave, in what month and year did you start taking time off?

ENTER MONTH [RANGE: 1-12]

98 DK (VOL)

99 REF (VOL)

ENTER YEAR [RANGE: 2009-2012]

9998 DK (VOL)

9999 REF (VOL)

A14. Did you take this time off continuously -- that is, all in a row without returning to w0rk -- or did you take leave on separate occasions?

1 ONE CONTINUOUS BLOCK OF TIME

2 SEPARATE OCCASIONS [GO TO QA15]

8 DK (VOL)

9 REF (VOL)

[IF QA14 = 1, 8, 9  GO TO QA17]

A15. How many separate blocks of time did you take off from work during this leave? [IF NECESSARY: Please think about special events, holidays, or seasons to help you remember.]

[RANGE: 2-100]

888 DK (VOL)

999 REF (VOL)

A16. In what month and year did the last block of time for this leave begin? [IF NECESSARY: Please think about special events, holidays, or seasons to help you remember.]

ENTER MONTH [RANGE: 1-12]

98 DK (VOL)

99 REF (VOL)

ENTER YEAR [RANGE: 2009-2012]

9998 DK (VOL)

9999 REF (VOL)

[DATE ENTERED MUST BE LATER THAN OR EQUAL TO DATE FROM QA13. IF NECESSARY, INTERVIEWER CONFIRM DATES WITH RESPONDENT]

[ASK QA17 IF QA3 > 1 OR QA4>1, ELSE SKIP TO QA18]

A17. And in what month and year did this leave end? [IF NECESSARY: Please think about special events, holidays, or seasons to help you remember.] [IF NECESSARY, INTERVIEWER CONFIRM DATES WITH RESPONDENT – END DATE CANNOT BE EARLIER THAN [INSERT 18 MONTH PERIOD]]

ENTER MONTH [RANGE: 1-12]

97 CURRENTLY ON LEAVE

98 DK (VOL)

99 REF (VOL)

ENTER YEAR [RANGE: 2009-2012]

9997 CURRENTLY ON LEAVE

9998 DK (VOL)

9999 REF (VOL)

[LOOP 1: DATE ENTERED MUST BE LATER THAN OR EQUAL TO DATES FROM QA13 AND QA16

LOOP 2: DATE ENTERED MUST BE LATER THAN OR EQUAL TO QA17’S DATE FROM LOOP 1]

[IF QA17=9997, DISPLAY “and you are currently on this leave”

IF QA17<9997, DISPLAY “and it ended [FILL QA17]”

IF QA17>9997, DISPLAY “and you are not able to tell us when it ended”

IF QA5=1, FILL “your own serious health condition”]

A18. To review: You've taken leave for [[FILL QA5]; IF QA5=DK/REF DISPLAY "and you are not able to tell us the reason"], [and you began taking leave in QA13 MONTH QA13 YEAR - IF MONTH OR YEAR IS DK/REF LEAVE OUT, IF BOTH ARE MISSING DISPLAY "and you are not able to tell us when it began"], [and you are currently on this leave/and it ended in QA17 MONTH QA17 YEAR - IF MONTH OR YEAR IS DK/REF LEAVE OUT, IF BOTH ARE MISSING DISPLAY "and you are not able to tell us when it ended"]. Is that correct?

1 YES

2 NO [REVIEW AND CORRECT IF NECESSARY]

8 DK (VOL)

9 REF (VOL)

[IF QA17=9997, DISPLAY “so far”

IF QA14=2, DISPLAY “including all blocks of time”]

A19. Great, so how much time in TOTAL did you take off from work [so far] for the reason you mentioned [including all blocks of time]?

1 ____HOURS [RANGE 1-500]

2 ____DAYS [RANGE 1-500]

3 ____WEEKS [RANGE 1-100]

4 ____MONTHS [RANGE 1-24]

9 DK/REF (VOL)

[IF A9=1]:

A19a. How much time was needed for the care for the military member? [IF NECESSARY: Was the time you took off of work SUFFICIENT to care for the military member?]

1 ____HOURS [RANGE 1-500]

2 ____DAYS [RANGE 1-500]

3 ____WEEKS [RANGE 1-100]

4 ____MONTHS [RANGE 1-24]

9 DK/REF (VOL)

[ONLY IF ANYONE ELSE IN HH TOOK LEAVE BASED ON S11]:

A19b. In the last 18 months, did anyone else in your household take leave for the same reason you mentioned? [INTERVIEWER ONLY IF NEEDED: the reason mentioned is [A5]]

1 YES

2 NO [SKIP TO A20]

8 DK (VOL) [SKIP TO A20]

9 REF (VOL) [SKIP TO A20]

A19c. What is this person’s relationship to you? [IF NECESSARY: you said that someone else in your household took leave for the same reason you mentioned, what is THAT person’s relationship to you?]

1 Spouse

2 Unmarried partner

3 Parent

4 Child

5 Sibling

6 Aunt or Uncle

7 Son- or Daughter-in-law

8 Father- or Mother-in-law

9 Grandchild

10 Grandparent

11 Other (specify)

98 DK (VOL)

99 REF (VOL)

A19d. How much time in total did this person take off from work for the same reason you mentioned? [INTERVIEWER ONLY IF NEEDED: the reason mentioned is [A5]]

1 ____HOURS [RANGE 1-500]

2 ____DAYS [RANGE 1-500]

3 ____WEEKS [RANGE 1-100]

4 ____MONTHS [RANGE 1-24]

9 DK/REF (VOL)

[ASK QA20 IF QA4 = 2-100, ELSE GO TO QA21]

[IF R HAS GONE THROUGH LOOP TWICE (QA20 = 2)  GO TO QA21]

A20. You told me that you have taken [FILL A4] leaves, and we’ve just talked about your LONGEST LEAVE. Was your MOST RECENT leave for that same reason?

1 YES

2 NO [GO TO NEXT PROGRAMMING NOTE]

8 DK (VOL)

9 REF (VOL)

[PROGRAMMING NOTE:

IF QA20 = 2  LOOP BACK TO QA5 AND READ “Now let’s talk about the MOST RECENT time that you took leave from work.” FILL QA5 WITH “MOST RECENT”. CREATE NEW VARIABLE NAMES FOR MOST RECENT LEAVE DATA; DO NOT OVERWRITE LONGEST LEAVE DATA]

MOST RECENT LEAVE – EXTENDED BATTERY

[IF QA20=2, DISPLAY: For each of the following questions, please think about your MOST RECENT leave.]

A21. How did your employer designate or categorize the leave you just told me about? That is, WHAT TYPE of leave did your employer assign to your time off? [DO NOT READ LIST] [SELECT ALL THAT APPLY]

1 VACATION LEAVE

2 SICK LEAVE

3 FAMILY AND MEDICAL LEAVE

4 SHORT-TERM DISABILITY

5 LONG-TERM DISABILITY

6 OTHER (SPECIFY): ________

8 DK (VOL)

9 REF (VOL)

[IF QA5 = 8-10, READ:]

[QA5 – FROM 1^ST ITERATION IF QA20 = 1,8,9…FROM 2^ND ITERATION IF QA20= 2]

You said that you’ve taken leave to care for your [FILL PERSON FROM QA5]. Throughout the rest of the survey, we will refer to this person as your “care recipient.”

A23. I’m going to read you some possible effects from taking leave from work that you may or may not have experienced. As a result of taking leave:

[RANDOMIZE QA23a-f]

a. Did you lose your job?

b. Did you lose your seniority or potential for job advancement?

c. Were you unable to afford an unpaid leave?

d. Did you reveal personal information about yourself, your care recipient, or family relationships?

e. Were you treated differently because of the reason you took leave?

f. Were you able to maintain or pay for health insurance?

g. Did anything else happen? [SPECIFY]

[RESPONSE CATEGORIES:]

1 YES

2 NO

3 DOES NOT APPLY (VOL)

8 DK (VOL)

9 REF (VOL)

The following questions concern your employer’s conditions for taking leave.

A26. Did your employer require medical certification for this leave (IF NECESSARY: for yourself or the person you were caring for)?

[IF NECESSARY: By medical certification, we mean documentation from a health care provider to substantiate the medical need for you to take time away from work for this reason or health condition.]

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

[IF QA26=2, 8, 9  GO TO QA42]

A28. Was your medical certification accepted on the first submission for this leave?

1 YES [GO TO QA30]

2 NO [GO TO QA29]

8 DK (VOL)

9 REF (VOL)

[IF QA28 = 1, 8, 9  GO TO QA30]

A29. Why wasn’t your medical certification accepted on the first submission?

[DO NOT READ. SELECT ALL THAT APPLY]

1 INSUFFICIENT INFORMATION

2 PHYSICIAN WAS NOT ACCEPTED

3 CONDITION WAS NOT ACCEPTED

4 SUBMISSION NOT CONSIDERED TIMELY

5 OTHER (SPECIFY) _________

8 DK (VOL)

9 REF (VOL)

A30. Did your employer require multiple doctor visits – that is, a second or third opinion – to obtain your INITIAL medical certification?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

A33. Did you pay out of your own pocket for your medical certification (for example, a co-pay or a portion of the cost)?

1 YES

2 NO

3 THERE WAS NO COST (VOL)

8 DK (VOL)

9 REF (VOL)

A35. Did your employer require medical RE-CERTIFICATION (IF NECESSARY: for yourself or the person you were caring for)?

[IF NECESSARY: Medical RE-certification is documentation from a health care provider in support of continued or extended leave for the reason or health condition for which the leave was taken.]

A39. Did you pay out of your own pocket for your medical RE-certification (for example, a co-pay or a portion of the cost)?

1 YES

2 NO

3 THERE WAS NO COST (VOL)

8 DK (VOL)

9 REF (VOL)

A41. How much time did you need to take off from work in order to obtain medical certification [IF QA35=1, READ: and re-certification]? This does not include the time you needed for the reason or condition itself.

1 ____HOURS [RANGE: 1-100]

2 ____DAYS [RANGE: 1-100]

3 ____ WEEKS [RANGE: 1-50]

4 DID NOT TAKE EXTRA TIME OFF (VOL)

8 DK (VOL)

9 REF (VOL)

[INTERVIEWER: IF MORE THAN 2 DAYS, CONFIRM THAT RESPONDENT CORRECTLY UNDERSTOOD THE QUESTION]

[IF QA14=1, 8, 9, DISPLAY “leave”

IF QA14=2, DISPLAY “most recent block of time off from work”]

A42. How long before you took your [leave/most recent block of time off from work] did you provide notice to your employer?

1. ____HOURS [RANGE: 1-100]

2. ____DAYS [RANGE: 1-500]

3. ____WEEKS [RANGE: 1-100]

4. ____MONTHS [RANGE 1-24]

5. DID NOT PROVIDE NOTICE BEFORE LEAVE (VOL)

8 DK (VOL)

9 REF (VOL)

WHILE YOU WERE ON LEAVE

Now I have some questions about the time you were away from work. [IF QA20=2, DISPLAY: Please continue thinking about your MOST RECENT leave.]

[ASK QA44 IF QA19 >= (30 DAYS OR 4 WEEKS OR ONE MONTH)]

[FOR QA44-A45 AND QA49-A50: IF A3=1, REPLACE “your” WITH “this”]

A44. On your leave, did you keep your health insurance, lose part or all of your health insurance, or did you not have this benefit at the time you took leave?

1 KEPT ALL

2 LOST PART

3 LOST ALL

4 DID NOT HAVE THIS BENEFIT

8 DK (VOL)

9 REF (VOL)

A45. Did you receive pay for any part of your leave?

1 YES [GO TO QA46]

2 NO

8 DK (VOL)

9 REF (VOL)

[IF QA45 = 2, 8, 9  GO TO QA52]

A46. Was some of the pay you received part of…

a. Paid time off, or PTO, which provides a "pool" of hours that an employee can draw from to take time off from work. It can include vacation, sick time, and such.

b. [SKIP IF QA46a= 1] Your sick days or sick leave?

c. [SKIP IF QA46a= 1] Your vacation days or vacation leave?

d. Personal leave?

e. [ASK IF QS8=2 OR GUESSGENDER1=2 FOR SELECTED RESPONDENT:] Maternity leave?

f. [ASK IF QS8=1 OR GUESSGENDER1=1 FOR SELECTED RESPONDENT:] Paternity leave?

[RESPONSE CATEGORIES:]

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

[IF ANY ITEM IN QA46=1  GO TO QA47, ELSE GO TO QA48]

A47. Was receiving some of the pay as part of [FILL ITEMS FROM QA46 THAT EQUAL 1] your choice, did your employer require it, or both?

[DISPLAY ITEMS FROM QA46 THAT EQUAL 1:]

a. Paid time off, or PTO

b. Your sick days or sick leave

c. Your vacation days or vacation leave

d. Personal leave

e. Maternity leave

f. Paternity leave

[RESPONSE CATEGORIES:]

1 EMPLOYEE’S CHOICE

2 REQUIRED BY EMPLOYER

3 BOTH

8 DK (VOL)

9 REF (VOL)

A48. Was some of the pay you received part of… [READ STEM BEFORE EACH ITEM A-D]

a. Temporary disability insurance?

b. State-paid family leave?

c. State-paid disability leave?

d. Some other benefit I haven’t already mentioned? (SPECIFY) ________

[RESPONSE CATEGORIES:]

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

A49. When you received pay during your leave, was it the same amount as your regular pay or only part of your pay?

1 SAME AMOUNT AS REGULAR PAY

2 PART OF PAY [GO TO QA50]

8 DK (VOL)

9 REF (VOL)

[IF QA49 = 1, 8, 9  GO TO QA52]

A50. Over the entire time you were on leave, about how much of your regular pay did you receive in total? Would you say… [READ LIST]

1 One quarter or less,

2 More than one-quarter but less than half,

3 About half,

4 More than half but less than three-quarters, or

5 Three quarters or more?

8 DK (VOL)

9 REF (VOL)

A52. Now I’m going to ask you some questions about how your work was covered while you were away on leave. [IF NECESSARY: By cover your work, we mean what your employer did while you were away on leave to make sure that the work you usually did was completed.] Did your employer… [RANDOMIZE ITEMS a-d]

a. Cover your work by assigning it to other employees?

b. Hire a permanent employee to cover your work?

c. Hire a temporary employee to cover your work?

d. Let your work go undone until you returned?

e. Cover your work in some other way? (SPECIFY): ________

[RESPONSE CATEGORIES:]

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

[IF QA49=1, SKIP TO PROGRAMMING NOTE AFTER A55]

A53. In order to cover lost wages or salary during your leave, did you…

a. Use savings that you had earmarked for this situation?

b. Use savings earmarked for something else?

c. Borrow money?

d. Go on public assistance?

e. Limit spending?

f. Put off paying your bills?

g. Cut your leave time short?

h. Do anything else? (SPECIFY)____

[RESPONSE CATEGORIES:]

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

A54. How easy or difficult was it for you to make ends meet during your leave? Would you say…

1 Very easy,

2 Somewhat easy,

3 Neither easy nor difficult,

4 Somewhat difficult, or

5 Very difficult?

8 DK (VOL)

9 REF (VOL)

PROGRAMMING NOTE:

IF QA45 OR QA49 = 2, 8, 9, ASK QA55.

IF QA45 = 2, 8, 9, DISPLAY “some.”

IF QA49=2, 8, 9, DISPLAY “additional.”

IF QA45 = 1 AND QA49 = 1, SKIP TO PROGRAMMING NOTE AFTER Q55.

A55. If you had received [some/additional] pay, would you have taken leave for a longer period of time?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

PROGRAMMING NOTE: IF QA17 = 9997 FOR MOST RECENT LEAVE, GO TO QB1.

OTHERWISE CONTINUE

WHEN LEAVE WAS OVER

[IF QA20=2, DISPLAY: “most recent”]

The next few questions are about returning to work after your [most recent] leave.

A59. After your leave ended, did you go back to work: for the same employer, for a new employer, or did you not return to work at all?

1 SAME EMPLOYER [GO TO QA60]

2 NEW EMPLOYER [GO TO QA61]

3 DID NOT RETURN TO WORK [GO TO QA61]

8 DK (VOL) [GO TO QB1]

9 REF (VOL) [GO TO QB1]

[IF QA5=5-16  GO TO QA62]

A60. Did your employer require you to obtain fitness for duty certification before you returned to work?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

[GO TO QA62]

A61. Why didn’t you return to work [IF QA59=2, ADD: “at the same employer”]?

[MULTIPLE RECORD]

1 OBTAINED OTHER INCOME SOURCE (SELF-EMPLOYED)

2 HEALTH CONDITION CONTINUED (ILLNESS CONTINUES)

3 LAID OFF/FIRED/REPLACED

4 DID NOT WANT TO RETURN TO WORK

5 COULD NOT FIND CHILDCARE

6 COULD NOT FIND ELDERCARE

7 FOUND BETTER JOB

8 DID NOT PASS FITNESS FOR DUTY CERTIFICATION

9 CHANGE IN SCHEDULE OR JOB RESPONSIBILITIES

10 OTHER (SPECIFY): ____________

98 DK (VOL)

99 REF (VOL)

[IF QA59 = 3, GO TO QB1]

A62. I’m going to read some reasons that people give for returning to work after taking leave. Did you return to work because… [RANDOMIZE] [INTERVIEWER: CODE “NOT APPLICABLE” AS NO (2)]

a. You could not afford financially to take more time off?

b. You wanted to get back to work?

c. You used up all the leave time you were allowed?

d. You felt pressured by your boss or co-workers to return?

e. You had too much work to do to stay away longer?

f. [IF QA5 = 3, 5-16] Someone else took over your care-giving responsibilities?

g. You no longer needed to be on leave?

h. [IF QA5 = 1-4] Your doctor told you that you were ready to return to work?

i. [IF QA5 = 3, 5-16]Your care recipient’s doctor told you that it was safe for you to return to work?

j. You did not want to lose your seniority or potential for job advancement?

[RESPONSE CATEGORIES:]

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

PROGRAMMING NOTE: IF QA59 = 1, CONTINUE.

OTHERWISE, GO TO SECTION B.

A63. After your leave, did you return to a position that was the same, similar, better, or worse than the one you had before your leave?

1 SAME POSITION [GO TO QB1]

2 SIMILAR POSITION

3 BETTER POSITION

4 WORSE POSITION

8 DK (VOL) [GO TO QB1]

9 REF (VOL) [GO TO QB1]

A64. Did you choose to take a different position or did your employer ask you to take or assign you to a different position?

1 CHOSE DIFFERENT POSITION

2 EMPLOYER ASKED

3 ASSIGNED TO DIFFERENT POSITION

8 DK (VOL)

9 REF (VOL)

[IF FMLAFLG=2 AND FMLAFLG_DUAL=0 FOR SELECTED RESPONDENT, BEGIN AT SECTION B]

SECTION B – LEAVE NEEDERS

[IF RESPONDENT IS LEAVE NEEDER ONLY (FMLAFLG=2)  GO TO PROGRAMMING NOTE BEFORE HANDOFF2]

[IF RESPONDENT IS LEAVE TAKER OR DUAL TAKER/NEEDER (FMLAFLG=1 OR FMLAFLG_DUAL=1)  GO TO B1:]

B1. We’ve just talked about the leave[s] taken in the last 18 months. Now I’d like to ask you if, IN THE LAST 18 MONTHS, was there a time when you NEEDED to take leave from work but DID NOT, for ANY of the following reasons:

• to care for a newborn, newly adopted or new foster child; (IF NECESSARY: This includes both maternity AND paternity leave)

• for your own serious health condition or to care for someone else’s serious health condition;

• for pregnancy-related reasons (IF NECESSARY: [IF QS8 >1 FOR SELECTED RESPONDENT: your own or] a family member’s); or

• to care for a military service member, or for reasons related to the deployment of a military service member?

[IF NECESSARY: A serious health condition, for purposes of this survey, means a condition that lasted more than 3 days and required treatment by a health care provider, a condition that required an overnight hospital stay, or a long-lasting condition for which one must see a health care provider at least twice a year for treatment. It may also include a condition that makes one permanently unable to work or perform other daily functions, or that requires treatments to keep from becoming incapacitated.]

[IF NECESSARY: Have you needed but not taken leave from work for one or more of these reasons?]

1 YES [GO TO QB3]

2 NO

8 DK (VOL)

9 REF (VOL)

[IF B1 = 2, 8, 9  GO TO QE1]

[IF RESPONDENT IS LEAVE NEEDER ONLY (FMLAFLG=2) AND ALREADY ON THE PHONE  GO TO INTRO4]

[IF SELECTED RESPONDENT IS NOT PERSON ON THE PHONE:]

HANDOFF2. [FILL QS6 AX] has been selected as the respondent for this survey. May I please speak to [FILL QS6 AX] for the rest of the interview?

1 YES/PHONE HANDED OFF [GO TO INTRO4]

2 NOT AVAILABLE [SCHEDULE CALLBACK]

3 ALTERNATE NUMBER PROVIDED [UPDATE NUMBER, GO TO UP4]

9 DK/REF (VOL) [GO TO THANK02]

[CATI: Ask UP2 if HANDOFF2 = 3]

UP4. Is that a landline or cell phone?

1. Landline [CATI: Flag CELL = 0)

2. Cell Phone [CATI: Flag CELL = 1]

INTRO4. [IF NEW RESPONDENT:] Hello, my name is [INTERVIEWER] and I’m calling on behalf of the U.S. Department of Labor. We are conducting a national study to find out about people’s use of, and attitudes about, family and medical leave policies in the workplace. Study results will be used to assess the impact of family and medical leave policies on employees.

[IF INCENT=1, DISPLAY:]

If you qualify and then complete the survey, we will pay you $10 as a token of our appreciation.

[ALL RESPONDENTS:] Your participation is voluntary and all information you provide will be kept private to the greatest extent possible under the law. We have many procedures in place to reduce the small potential risk of loss of privacy. If we should come to any question you don’t understand or don’t want to answer, I’ll try to clarify or we can move on to the next question. The survey should take about 15 to 25 minutes to complete, depending on your answers.

B2. [IF LEAVE NEEDER ONLY:] I want to confirm with you that in the last 18 months, that is, since [INSERT 18 MONTH PERIOD]:

You NEEDED to take leave from work but DID NOT, for ANY of the following reasons:

• to care for a newborn, newly adopted or new foster child; (IF NECESSARY: This includes both maternity AND paternity leave)

• for your own serious health condition or to care for someone else’s serious health condition;

• for pregnancy-related reasons (IF NECESSARY: [IF QS8 >1 FOR SELECTED RESPONDENT: your own or] a family member’s); or

• to care for a military service member, or for reasons related to the deployment of a military service member?

[IF YES AND IF NEW RESPONDENT: A serious health condition, for purposes of this survey, means a condition that lasted more than 3 days and required treatment by a health care provider, a condition that required an overnight hospital stay, or a long-lasting condition for which one must see a health care provider at least twice a year for treatment. It may also include a condition that makes one permanently unable to work or perform other daily functions, or that requires treatments to keep from becoming incapacitated.]

Is that correct? [Have you needed but not taken leave from work for one or more of these reasons?]

1 YES [ASK QB3]

2 NO [GO TO QS5]

8 DK (VOL) [GO TO QS5]

9 REF (VOL) [GO TO QS5]

[IF QB2>1, RE-SCREEN TO CONFIRM LEAVE STATUS. IF THE SAME R COMES BACK TO QB2 AND ANSWERS (2, 8, 9) A SECOND TIME, GO TO SECTION C]

B3. Was there an event like this IN THE LAST YEAR [12 MONTHS, INSERT DATE]?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

B4. How many different times did you need leave but not take it, since [INSERT 18 MONTH PERIOD]?

[RANGE: 1-100]

DK (VOL) 888

REF (VOL) 999

[IF B4=2-100 DISPLAY: INTERVIEWER: BEFORE PROCEEDING, RECORD REASONS AND DATES FOR EACH LEAVE IN EVENT HISTORY CALENDAR]

[IF QB3 = 2, 8, 9  SKIP TO Logic before B5a

IF QB3 = 1 AND QB4 = 1  SKIP TO QB6]

B5. How many different times did you need leave but not take it, IN THE LAST YEAR [12 MONTHS, INSERT DATE]?

[RANGE: 1-100]

DK (VOL) 888

REF (VOL) 999

[NUMBER ENTERED MUST BE LESS THAN OR EQUAL TO QB4. IF NECESSARY, INTERVIEWER CONFIRM WITH RESPONDENT]

[IF B4>1]:

B5a. Were all of the times you needed leave but did not take it since [INSERT 18 MONTH PERIOD] for the SAME reason or condition, or were they for DIFFERENT reasons or conditions?

1 SAME

2 DIFFERENT

8 DK (VOL)

9 REF (VOL)

[IF B5a=2,8,9]:

B5b. For how many TOTAL reasons or conditions did you need leave from work, but not take it, since [INSERT 18 MONTH PERIOD]?

[RANGE: 1-100]

DK (VOL) 888

REF (VOL) 999

[IF QS8=9 FOR RESPONDENT WHO IS LEAVE-NEEDER ONLY:]

GUESSGENDER2. 1 MALE

2 FEMALE

9 DK

[IF B4=1 OR QB5a = 1, DISPLAY “reason”

IF QB5b = 2-100, 888, 999 DISPLAY “reasons” AND “most recent” FOR THE FIRST LOOP

IF ON SECOND OR THIRD LOOP, BASED ON B5b, DISPLAY

"second reason"/“reason” FOR SECOND LOOP AND "third reason"/“reason” FOR THIRD LOOP.]

B6. Thinking of the [second/third] reason[s] you needed leave since [INSERT 18 MONTH PERIOD], what was the [most recent] reason for which you needed to take leave from work? [SINGLE MENTION]

1 OWN ILLNESS, DISABILITY OR OTHER SERIOUS HEALTH

CONDITION, EXCEPT MATERNITY-RELATED ILLNESS [GO TO QB11]

2 [IF (QS8=2) OR (ANY GUESSGENDER1-2>1) FOR SELECTED RESPONDENT:] FOR MATERNITY-RELATED

DISABILITY, OR OTHER PREGNANCY-RELATED

AILMENT PRIOR TO DELIVERY [GO TO QB11]

3 [IF (QS8=2) OR (ANY GUESSGENDER1-2>1) FOR SELECTED RESPONDENT:] FOR MATERNITY-RELATED DISABILITY

AND TO CARE FOR A NEWBORN [GO TO QB12]

4 [IF (QS8=2) OR (ANY GUESSGENDER1-2>1) FOR SELECTED RESPONDENT:] MISCARRIAGE [GO TO QB12]

5 TO CARE FOR NEWBORN [GO TO QB12]

6 TO CARE FOR NEWLY ADOPTED CHILD [GO TO QB12]

7 TO CARE FOR NEWLY PLACED FOSTER CHILD [GO TO QB12]

8 TO BOND WITH NEWBORN [GO TO QB14]

9 TO BOND WITH NEWLY ADOPTED CHILD [GO TO QB14]

10 TO BOND WITH NEWLY PLACED FOSTER CHILD [GO TO QB14]

11 CHILD’S HEALTH CONDITION [GO TO QB9]

12 SPOUSE’S HEALTH CONDITION [GO TO QB9]

13 PARENT’S HEALTH CONDITION [GO TO QB9]

14 OTHER RELATIVE’S HEALTH CONDITION [GO TO QB7]

15 OTHER NON-RELATIVE’S HEALTH CONDITION [GO TO QB8]

16 DOMESTIC PARTNER’S HEALTH CONDITION [GO TO QB9]

17 TO ADDRESS ISSUES ARISING FROM THE DEPLOYMENT OF A MILITARY MEMBER [GO TO QB6A]

98 DK (VOL) [GO TO QB11]

99 REF (VOL) [GO TO QB11]

B6a. What type of deployment-related issue did you need to address for this leave?

READ IF NECESSARY: PLEASE SELECT ALL THAT APPLY

1 Events or activities sponsored by the military BEFORE deployment

2 Childcare or school activities

3 Financial or legal arrangements

4 Non-medical counseling

5 Short-notice deployment

6 Events or activities sponsored by the military AFTER the military member returned

7 Issues arising from the death of the military member

8 OTHER (SPECIFY) ________

98 DK (VOL)

99 REF (VOL)

[GO TO B10a]

B7. What is that person’s relationship to you?

1 GRANDCHILD

2 GRANDPARENT

3 SIBLING

4 AUNT/UNCLE

5 OTHER (SPECIFY) ________

8 DK (VOL)

9 REF (VOL)

[GO TO QB9]

B8. What is that person’s relationship to you?

1 PARENT-IN-LAW

2 CHILD THAT IS NOT YOUR BIOLOGICAL CHILD

3 OTHER (SPECIFY) _________

8 DK (VOL)

9 REF (VOL)

[IF QB6 = 11-16, READ:]

You said that you’ve needed to take leave to care for your [FILL PERSON FROM QB6/QB7/QB8, AS APPROPRIATE]. Throughout the rest of the survey, we will refer to this person as your “care recipient.”

B9. What was the age of your care recipient? [DO NOT READ LIST]

1 0-1 YEARS

2 2-17 YEARS

3 18-40 YEARS

4 41-59 YEARS

5 60-69 YEARS

6 70-79 YEARS

7 80-89 YEARS

8 90 OR OLDER

98 DK (VOL)

99 REF (VOL)

[IF QB9>2  ASK QB10, ELSE SKIP TO PROGRAMMING NOTE BEFORE QB11]

B10. Was this leave needed in order to care for a military service member for a service-related health condition or injury? [IF NECESSARY: This includes both current active duty members as well as reserve members.]

1 YES

2 NO [SKIP TO PROGRAMMING NOTE BEFORE QB11]

8 DK (VOL) [SKIP TO PROGRAMMING NOTE BEFORE QB11]

9 REF (VOL) [SKIP TO PROGRAMMING NOTE BEFORE QB11]

[IF B6=17]:

B10a. What is that person’s relationship to you?

1 SPOUSE

2 PARENT

3 SON OR DAUGHTER

4 NEXT OF KIN

5 OTHER (SPECIFY) ________

8 DK (VOL)

9 REF (VOL)

[IF B10=1]:

B10b. How much time was needed to care for the military member?

1 ____HOURS [RANGE 1-500]

2 ____DAYS [RANGE 1-500]

3 ____WEEKS [RANGE 1-100]

4 ____MONTHS [RANGE 1-24]

9 DK/REF (VOL)

[ASK QB11 IF QB6 = 1-2, 11-16, 98, 99]

B11. What was the nature of the health condition for which you needed to take this leave? Was it:

[READ LIST]

1 A one-time health matter, such as appendicitis or injury;

2 The treatment of an injury or illness that now requires routine scheduled care, such as chemotherapy or physical therapy; or

3 An ongoing health condition that affects one’s ability to work from time to time, such as diabetes, migraines, depression, or Multiple Sclerosis?

4 OTHER (SPECIFY): _______

8 DK (VOL)

9 REF (VOL)

[IF QB6 = 3, 5-7, READ:]

You said that you’ve needed to take leave to care for your [FILL PERSON FROM QB6]. Throughout the rest of the survey, we will refer to this person as your “care recipient.”

[IF QB6=1, 2, 4, 98, 99: READ “your”

IF QB6=3, 5, 8: READ “your OR your care recipient’s”

ELSE, READ “your care recipient’s”]

B12. Did [your/your care recipient’s] condition for which you needed to take leave require a doctor's care?

1 YES [ASK QB13]

2 NO

8 DK (VOL)

9 REF (VOL)

[IF QB12>1, SKIP TO B14]

[IF QB6=1, 2, 4, 98, 99: READ “you”

IF QB6=3, 5, 8: READ “you OR your care recipient”

ELSE, READ “your care recipient”]

B13. [Were/Was] [you/your care recipient] in the hospital overnight at any time during the time that you needed this leave?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

[IF B4=1, SKIP TO B15]

B14. How many different times, since [INSERT 18 MONTH PERIOD], did you need leave for the REASON OR CONDITION you mentioned? [DISPLAY REASON FROM QB6]

[RANGE: 1-100]

DK (VOL) 888

REF (VOL) 999

B14a. And how many different times did you need leave for this reason or condition, IN THE LAST YEAR [12 MONTHS, INSERT DATE]?

[RANGE: 1-100]

DK (VOL) 888

REF (VOL) 999

[IF B5b=2-100, CREATE SECOND LOOP TO B6-B14a.

THEN IF B5b=3-100, CREATE THIRD LOOP TO B6-B14a. I.E., COLLECT DATA FOR REMAINING LEAVE-NEEDING REASON(S), MAXIMUM 2 ADDITIONAL LOOPS (3 REASONS TOTAL).

IF ANSWERED FOR MULTIPLE LOOPS, COMBINED B14 TOTALS SHOULD BE LESS THAN OR EQUAL TO QB4]

[IF QB6 (LOOP 1) = 8-10, READ:]

You said that you’ve needed to take leave to care for your [FILL PERSON FROM QB6]. Throughout the rest of the survey, we will refer to this person as your “care recipient.”

B15. I’m going to read some reasons why people who need leave from work don’t take it. Please answer yes or no to all that apply. Was a reason you didn’t take the MOST RECENT leave you needed because…

[RANDOMIZE QB15a-n]

a. You thought you might lose your job?

b. You thought you would lose your seniority or potential for job advancement?

c. You were ineligible?

d. Your employer denied your request?

e. You couldn’t afford to take an unpaid leave?

f. You wanted to save your leave time?

g. Your work is too important?

h. You were worried about revealing personal information about yourself, your care recipient, or family relationships?

i. You thought you would be treated differently because of the reason you needed to take leave?

j. [IF QB6 (LOOP 1) = 3, 5-16]: You thought that the person you wanted to take leave to care for was not considered a covered family member?

k. You thought that the health condition did not qualify?

l. Your employer’s process for taking leave was too complicated?

m. You were unable to meet your employer’s notice requirement for taking leave?

n. You were unaware of the availability of leave?

o. Of any other reason I haven’t already mentioned? (SPECIFY) ________

[RESPONSE CATEGORIES:]

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

[PROGRAMMING NOTE:

IF QB15 = 3 AND NOT 4, ASK QB16-QB17 THEN SKIP TO QB20

IF QB15 = 4 AND NOT 3, SKIP QB16-QB17 AND ASK QB19

IF QB15 = 3 AND QB15 = 4, SKIP QB16-QB17 AND ASK QB19

OTHERWISE, SKIP TO QB20]

B16. Were you ineligible because you only worked part-time?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

B17. Were you ineligible because you hadn’t worked long enough for your employer?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

B19. Were you denied leave… [RANDOMIZE ITEMS a-g]

a. Because your employer does not offer family or medical leave?

b. Because you hadn’t worked for your employer long enough to be eligible for family or medical leave?

c. Because you had worked too few hours in the previous year?

d. Because you used up all the leave time you were allowed?

e. Because you did not submit notification that was sufficient for your employer’s requirements?

f. Because the medical certification you submitted was deemed insufficient?

g. [IF QB6 (LOOP 1) = 3, 5-16]: Because the person you wanted to care for was not eligible for care under the FMLA?

h. For any other reasons? (SPECIFY)________

[RESPONSE CATEGORIES:]

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

[IF QB6 (LOOP 1) = 1, 2, 4, 98, 99: READ “your”

ELSE, READ “your care recipient’s care-giving”]

B20. Since you did not take leave from work for this reason or condition, what did you do in order to meet [your / your care recipient’s care-giving] needs? [READ LIST]

[PROGRAMMING NOTES:

READ QB20a IF QB6 (LOOP 1) = 1-4, 11-16

READ QB20b IF QB6 (LOOP 1) = 1-4, 11-16

READ QB20c IF QB6 (LOOP 1) = 5-16

READ QB20d IF QB6 (LOOP 1) = 5-16

READ QB20e IF QB6 (LOOP 1) = 3, 5-11

READ QB20f IF QB9 (LOOP 1) = 5-8

READ QB20g FOR ALL RESPONDENTS]

a. Did [you/your care recipient] forego (IF NECESSARY: do without) medical treatment?

b. Did [you/your care recipient] delay medical treatment?

c. Did someone else in your family take leave?

d. Did someone else take over your care-giving duties?

e. Did you pay someone to provide childcare?

f. Did you pay someone to provide elder care?

g. Did you do something else I haven’t already mentioned? (SPECIFY): ______

[RESPONSE CATEGORIES:]

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

[ALL RESPONDENTS SKIP TO QE1]

[IF FMLAFLG=3 FOR SELECTED RESPONDENT AND SUBSAMPLED, BEGIN AT SECTION C]

SECTION C – EMPLOYED ONLY

IF (R=SCREENER R) AND INTERVIEW IS TAKING PLACE ON SAME DAY AS SCREENING, START AT INTRO5.

IF (R ~=SCREENER R), START AT HANDOFF3.

[IF SELECTED RESPONDENT IS NOT PERSON ON THE PHONE:]

HANDOFF3. [FILL QS6 AX] has been selected as the respondent for this survey. May I please speak to [FILL QS6 AX] for the rest of the interview?

1 YES/PHONE HANDED OFF [GO TO QC1]

2 NOT AVAILABLE [SCHEDULE CALLBACK]

3 ALTERNATE NUMBER PROVIDED [UPDATE NUMBER, GO TO UP5]

9 DK/REF (VOL) [GO TO THANK02]

[CATI: Ask UP1 if HANDOFF3 = 3]

UP5. Is that a landline or cell phone?

1. Landline [CATI: Flag CELL = 0)

2. Cell Phone [CATI: Flag CELL = 1]

[IF NEW RESPONDENT:]

INTRO5. [IF NEW RESPONDENT:] Hello, my name is [INTERVIEWER] and I’m calling on behalf of the U.S. Department of Labor. We are conducting a national study to find out about people’s use of, and attitudes about, family and medical leave policies in the workplace. Study results will be used to assess the impact of family and medical leave policies on employees.

[IF INCENT=1, DISPLAY:]

If you qualify and then complete the survey, we will pay you $10 as a token of our appreciation.

[ALL RESPONDENTS:] Your participation is voluntary and all information you provide will be kept private to the greatest extent possible under the law. We have many procedures in place to reduce the small potential risk of loss of privacy. If we should come to any question you don’t understand or don’t want to answer, I’ll try to clarify or we can move on to the next question. The survey should take about 15 to 25 minutes to complete, depending on your answers.

C1. I want to confirm with you that in the last 18 months, that is, since [INSERT 18 MONTH PERIOD], you have NOT taken or needed to take leave from work, for ANY of the following reasons:

• to care for a newborn, newly adopted or new foster child; (IF NECESSARY: This includes both maternity AND paternity leave)

• for your own serious health condition or to care for someone else’s serious health condition;

• for pregnancy-related reasons (IF NECESSARY: [IF QS8 >1 FOR SELECTED RESPONDENT: your own or] a family member’s); or

• to care for a military service member, or for reasons related to the deployment of a military service member?

[IF YES AND IF NEW RESPONDENT; ELSE IF NECESSARY:] A serious health condition, for purposes of this survey, means a condition that lasted more than 3 days and required treatment by a health care provider, a condition that required an overnight hospital stay, or a long-lasting condition for which one must see a health care provider at least twice a year for treatment. It may also include a condition that makes one permanently unable to work or perform other daily functions, or that requires treatments to keep from becoming incapacitated.

Is this correct? [You have not needed or taken leave from work for any of these reasons?]

1 YES [GO TO QE1]

2 NO [GO TO QS5]

8 DK (VOL) [GO TO QS5]

9 REF (VOL) [GO TO QS5]

[IF QC1>1, RE-SCREEN TO CONFIRM LEAVE STATUS. IF THE SAME R COMES BACK TO QC1 AND ANSWERS (2, 8, 9) A SECOND TIME, CODE AS SOFT REFUSAL]

[IF QS8=9 FOR SELECTED RESPONDENT:]

GUESSGENDER3. 1 MALE

2 FEMALE

9 DK

SECTION E – EMPLOYMENT (ALL RESPONDENTS)

E1. Are you currently employed?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

E2. Have you ever heard of the federal Family and Medical Leave Act?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

[IF QE2 > 1 AND QE1 = 1, GO TO QE5

IF QE2 > 1 AND QE1 > 1, GO TO QD1]

E3. How have you learned about the federal Family and Medical Leave Act?

[SELECT ALL THAT APPLY; DO NOT READ LIST, BUT PROBE IF NECESSARY]

1 Media (TV, newspapers, INTERNET, etc.)

2 Co-workers

3 Employer OR HUMAN RESOURCE OFFICE gave out information

4 POSTERS [IF NOT SELECTED AND QE1=1, GO TO QE4]

5 Family member

6 FRIEND OR NEIGHBOR

7 Union gave out information

8 OTHER (SPECIFY) __________

98 DK (VOL)

99 REF (VOL)

[IF QE1 = 2, 8, 9  GO TO QD1]

[IF POSTERS (4) SELECTED AND QE1=1, GO TO QE5]

E4. At your place of employment, is there a notice posted that explains the federal Family and Medical Leave Act?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

E4a. To the best of your knowledge, are employees who are covered by the federal FMLA law entitled to take leave for the following reasons?

[PROGRAMMER: RANDOMLY SELECT 4 ITEMS FROM THE LIST BELOW, ONE AND ONLY ONE OF WHICH MUST BE EITHER {F,G,H} AND ONE AND ONLY ONE OF WHICH MUST BE EITHER J OR K].

a. For the care of a newborn?

b. For an employee’s own serious health condition?

c. For the care of a child with a serious health condition?

d. For the care of a spouse with a serious health condition?

e. For the care of a parent with a serious health condition?

f. For the care of a grandparent with a serious health condition?

g. For the care of a grandchild with a serious health condition?

h. For the care of a sibling with a serious health condition?

i. For the care of an adopted child or foster child?

j. For the care of a military service member?

k. For reasons related to the deployment of a military service member?

[RESPONSE CATEGORIES:]

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

Now I’m going to read you some questions about your current employment situation.

E5. Since [INSERT 18 MONTH PERIOD], have any co-workers where you work taken leave for family or medical reasons?

1 YES [ASK QE6]

2 NO [GO TO E7]

8 DK (VOL) [GO TO E7]

9 REF (VOL) [GO TO E7]

E6. As a result of these co-workers taking leave, did you… [SELECT ALL THAT APPLY]

1 Work more hours than you usually do?

2 Work a shift that you do not normally work?

3 Take on additional duties?

4 Take on different job responsibilities?

5 NONE OF THE ABOVE (VOL)

8 DK (VOL)

9 REF (VOL)

E7. I’m going to read a list of benefits that some employers offer to their employees. Are you eligible to receive any of these benefits? [RANDOMIZE]

a. Flextime [IF NECESSARY: a flexible work schedule which allows you to choose when you work, as long as you meet your total expected work hours]

b. Flexplace or telecommuting [IF NECESSARY: an option which allows you to work away from the regular office site for a specified number of hours]

c. Job sharing [IF NECESSARY: a work arrangement in which two people share one position in a company, with each working a part of the week]

d. Paid family leave [IF NECESSARY: this includes maternity leave, paternity leave, and paid adoption leave]

e. Paid vacation

f. Paid sick time

g. Paid time off [IF NECESSARY: Paid time off or PTO provides a "pool" of hours that an employee can draw from to take time off from work. It can include vacation, sick time, and such.]

h. [READ IF (QS8=2) OR (ANY GUESSGENDER1-3>1) FOR SELECTED RESPONDENT:] Break time for mothers who are breastfeeding [IF NECESSARY: a reasonable amount of break time provided for an employee any time she needs to nurse her child]

[RESPONSE CATEGORIES:]

1 YES

2 NO/BENEFIT NOT OFFERED BY EMPLOYER

3 DEPENDS ON CIRCUMSTANCES

8 DK (VOL)

9 REF (VOL)

E8. Does your employer have an attendance policy that includes penalties for absences?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

E9. Are you salaried on this job, paid by the hour, or paid some other way? [CODE ALL THAT APPLY]

1 SALARIED

2 HOURLY

3 PIECEWORK/COMMISSION

4 OTHER/COMBINATION

8 DK (VOL)

9 REF (VOL)

E10. Are you a contract worker?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

E11. At the place where you work -- for example the site, store, or building -- would you say there are 50 or more employees?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

[IF E11=1, DISPLAY RESPONSES 6-99 ONLY]

E12. Please think now of all of your organization’s work sites within 75 miles. How many people are employed at your organization across all of the work sites within that 75 mile range, including this site?

[IF DK, READ: “Would you say it is…”]

1 1-9

2 10-19

3 20-29

4 30-39

5 40-49

6 50-99

7 100-249

8 250-499

9 500 OR MORE

98 DK (VOL)

99 REF (VOL)

PROGRAMMING NOTE: IF R IS LEAVE TAKER (QA1 = 1), ALSO DISPLAY “except for the leave you just told me about”

E13. Between [INSERT 12 MONTH PERIOD] and the present, have you worked continuously for the same employer [except for the leave you just told me about]?

1 YES

2 NO [GO TO QD1]

8 DK (VOL)

9 REF (VOL)

E14. Between [INSERT 12 MONTH PERIOD] and the present, were you always a full-time employee [except for the leave you just told me about]?

1 YES [GO TO QD1]

2 NO

8 DK (VOL)

9 REF (VOL)

E15. Between [INSERT 12 MONTH PERIOD] and the present, how many hours per week have you worked on average?

[RANGE: 0-80]

DK (VOL) 888

REF (VOL) 999

[GO TO QD1]

SECTION D  DEMOGRAPHICS

And finally, just a few questions for statistical purposes only.

D1. What is the highest level of education you have completed?

1 Less than high school

2 Some high school

3 High school graduate

4 GED

5 Some college/ASSOCIATE’S DEGREE

6 College graduate

7 Graduate school

8 DK (VOL)

9 REF (VOL)

[ASK IF QS10 = 1 FOR QS6 AX]

D2. Earlier [you/someone in your household] said that you had been employed by the government. Would that be the federal, state or local government?

1 FEDERAL

2 STATE

3 LOCAL (COUNTY, CITY, TOWNSHIP)

8 DK (VOL)

9 REF (VOL)

PROGRAMMING NOTE:

IF QE1 = 1, DISPLAY “Are”; OTHERWISE, DISPLAY “Were”

D3. [Were/Are] you a member of a labor union?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

D4. What is the total combined income of all members of your FAMILY during the past 12 months? This includes money from jobs, net income from business, farm or rent, pensions, dividends, interest, social security payments and any other money income received by members of your family who are 15 years of age or older.

D4a. Was your family income $35,000 or above?

1 YES

2 NO [GO TO QD4f]

8 DK [GO TO QD5]

9 REF [GO TO QD5]

D4b. Was it $40,000 or above?

1 YES

2 NO [GO TO QD5]

8 DK [GO TO QD5]

9 REF [GO TO QD5]

D4c. Was it $50,000 or above?

1 YES

2 NO [GO TO QD5]

8 DK [GO TO QD5]

9 REF [GO TO QD5]

D4d. Was it $75,000 or above?

1 YES

2 NO [GO TO QD5]

8 DK [GO TO QD5]

9 REF [GO TO QD5]

D4e. Was it $100,000 or above?

1 YES [GO TO QD5]

2 NO [GO TO QD5]

8 DK [GO TO QD5]

9 REF [GO TO QD5]

D4f. Was it $30,000 or above?

1 YES [GO TO QD5]

2 NO

8 DK [GO TO QD5]

9 REF [GO TO QD5]

D4g. Was it $20,000 or above?

1 YES [GO TO QD5]

2 NO

8 DK [GO TO QD5]

9 REF [GO TO QD5]

D4h. Was it $10,000 or above?

1 YES [GO TO QD5]

2 NO

8 DK [GO TO QD5]

9 REF [GO TO QD5]

D4j. Was it $5,000 or above?

1 YES [GO TO QD5]

2 NO [GO TO QD5]

8 DK [GO TO QD5]

9 REF [GO TO QD5]

D5. Do you consider yourself to be Hispanic or Latino? [IF NECESSARY: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.]

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

D6. What race do you consider yourself to be? Please select one or more of the following.

[READ LIST]

1 American Indian or Alaska Native,

2 Asian,

3 Native Hawaiian or Pacific Islander,

4 Black or African American, or

5 White?

6 SOME OTHER RACE (VOL) _______________________

8 DK (VOL)

9 REF (VOL)

D7. How many children under 18 years old are in your care?

[ENTER RANGE 0-7; 7 = 7 OR MORE]

8 DK (VOL)

9 REF (VOL)

D8. How many people over age 65 are in your care?

[ENTER RANGE 0-7; 7 = 7 OR MORE]

8 DK (VOL)

9 REF (VOL)

D9. Do you think of yourself as:

[READ LIST]

1 [For men / IF FINGEND=1 FOR SELECTED RESPONDENT:] Gay / [For women / IF FINGEND=2 FOR SELECTED RESPONDENT:]  Lesbian or gay

2 [For men / IF FINGEND=1 FOR SELECTED RESPONDENT:] Straight, that is, not gay / [For women / IF FINGEND=2 FOR SELECTED RESPONDENT:]  Straight, that is, not lesbian or gay, or

3 Bisexual?

4 SOMETHING ELSE (VOL)

8 DK (VOL)

9 REF (VOL)

D10. Are you currently…

[READ LIST]

1 Married,

2 Living with a partner, [GO TO QD12]

3 Separated,

4 Divorced,

5 Widowed, or

6 Never married?

8 DK (VOL)

9 REF (VOL)

[IF QD10=1, 3-9  GO TO QD11]

[FOR QD11]:

IF QD10 = 1, DISPLAY “Is your spouse”

IF QD10 = 2-6, DISPLAY “Do you have a partner”

IF QD10 = 8-9, DISPLAY “Do you have a spouse or partner”]

D11. [Is your/Do you have a] [spouse/partner/spouse or partner] living outside of the household?

1 YES

2 NO

8 DK (VOL)

9 REF (VOL)

[CATI: Ask END1 only if INCENT=1]

END1. Those are all the questions we have for you at this time.

Can I please have your name and address so I can send you your check?

1 YES [GO TO QEND2]

2 NO [GO TO QZIP]

[CATI: Ask ZIP if END1=2 OR if INCENT=0]

ZIP. So that we can group households geographically, may I have your zip code?

RANGE: 00000-99999

999998 DK (VOL)

999999 REF (VOL)

[GO TO QEND3]

[CATI: Ask END2 only if INCENT=1]

END2. ENTER:

NAME [ASK FOR SPELLING IF UNSURE]

ADDRESS

CITY/STATE/ZIP

[RE-READ ALL TO CONFIRM]

END3. Thank you very much for your time. If you have any questions or would like further information about this study, you can call Allison Ackermann at (1-877-666-8756) during normal business hours.

[FOR INTERVIEWER USE ONLY:]

LANGUAGE OF INTERVIEW:

1. ENGLISH

2. SPANISH

[FOR PROGRAMMER USE ONLY:]

CLASSIFICATION:

1. LEAVE TAKER ONLY (A1 = 1 and (B1 NE 1 or B2 NE 1))

2. LEAVE NEEDER ONLY (A1 NE 1 and (B1 = 1 OR B2 = 1))

3. EMPLOYED ONLY (C1 = 1)

4. DUAL TAKER/NEEDER (A1 = 1 and (B1 = 1 or B2 = 1))

EMPLOYEE SCREENER 2