Recently, the Tennessee State Legislature voted nearly unanimously to expand the state’s existing 6-week paid leave policy for state government employees to cover workers caring for a family member with a serious health condition at the end of their life. HB 915/SB 322 builds on the previous passage of a 6-week paid parental leave law for the birth or adoption of a child, which was enacted in 2023. Under this new policy, starting on January 1, 2026, state government employees will be able to use 6 weeks of paid leave to support a parent, spouse, child, or grandchild for whom they have custody when they need care at the end of their life.
The Tennessee Paid Leave Coalition – founded by A Better Balance and made up of 20 organizations representing the varied health, caregiving, and economic needs of Tennesseans – worked tirelessly to advocate for broadening the State’s paid leave policy beyond parental leave. Our initial goal was to cover caring for a loved one with any serious health condition, but through the legislative process, the bill was narrowed to focus on end-of-life caregiving. The final result is an incremental step that will provide a tangible benefit for workers, while also deepening our resolve to continue fighting for more robust paid leave for Tennessee state employees and all workers across the South. The passage of this legislation, which makes Tennessee the first Southern state to expand its public sector paid leave policy beyond parental leave, was the result of a powerful campaign by the Tennessee Paid Leave Coalition. Throughout this campaign, we learned many lessons about leading strategic, coalition-driven policy advocacy, even in today’s challenging and polarized political environment.
Lesson 1: Finding a Policy Window
Caregiving is often unseen and unappreciated, but vital to our communities and economy. This reality is incredibly clear in Tennessee, which is ranked one of the worst states in the nation by AARP for family caregiving support.
The challenges of caregiving without paid leave are deeply personal and all too common for the families our coalition members serve. Discussing this reality in pre-legislative session strategy meetings, we decided that building on our previous success in securing paid parental leave for state employees by expanding paid leave to family caregivers would be a positive and productive next step towards a more robust paid leave policy, allowing thousands of family caregivers who work for the State to stay employed while fulfilling their caregiving duties.The decision to pursue paid family caregiving leave for state employees in Tennessee’s 2025 legislative session reflects the identification of a strategic policy window.
Our next challenge was to demonstrate this reality to Tennessee’s lawmakers and communities. This was achieved, in part, through an op-ed in The Tennessean explaining the economic, health, and social benefits of paid leave for Tennessee’s family caregivers, co-authored by partners from AARP Tennessee, The Tennessee Caregiver Coalition, and AgeWell Middle Tennessee, with support from A Better Balance.
Lesson 2: Using the Strengths of Working in Coalition to Garner Bipartisan Support
After drafting the bill language and identifying Republican sponsors to introduce HB 915/SB 322, the Tennessee Paid Leave Coalition – which consists of a broad range of nonprofit organizations who advocate for working families, cancer patients, aging individuals, marginalized communities, and others who represent Tennessee’s vibrant population – leveraged the diverse policy expertise and unique strengths of each partner to build a strong case for the bill’s passage. Together, we drafted a fact sheet outlining the benefits of paid family caregiving leave and delivered a letter to lawmakers signed by a dozen organizations expressing our collective support for the bill.
In meetings with legislators, we found that many recognized the critical importance of paid family caregiving leave and had personal experiences with caring for a seriously ill loved one. Through persistent advocacy and conversations with lawmakers across party lines, we secured a broad, bipartisan group of nearly 30 cosponsors for HB 915/SB 322. Throughout the legislative process, we prepared detailed talking points and policy explainers for every committee hearing to address questions and concerns.
During the House State and Local Government Committee hearing, A Better Balance’s Southern Policy Director, Feroza Freeland, delivered compelling testimony in support of the bill. She emphasized the policy’s smart design, the strong recruitment and retention benefits it would offer state agencies, and the broad coalition of supporters backing the measure. Following the hearing, the bill successfully advanced to the House and Senate floors.
Lesson 3: Incremental Policy Change
After months of unflagging advocacy, the Tennessee General Assembly ultimately passed HB 915/SB 322, marking an unprecedented policy development. Before the passage of this law, no Southern states had integrated any aspect of family caregiving into their paid leave policies for state employees. Although the bill was amended to be less expansive than initially hoped, with the final version only covering end-of-life caregiving, this passage nevertheless moves the needle within the broader Southern push toward more comprehensive paid family and medical leave.
Alongside our partners across the South, we understand the value of prioritizing strategic, incremental steps toward paid family and medical leave. Because state governments are major employers—with women and people of color overrepresented in the public sector workforce—expanding paid leave policies for this workforce can advance equity for tens of thousands of workers and model just how successful these policies can be.
While we acknowledge this progress, we also know that end-of-life care doesn’t begin to cover the full range of caregiving needs families have, and we will continue to push for this law’s expansion. This legislation is heartening, and we’re committed to continuing the vital work necessary to ensure that all Tennesseans have the paid leave they need to manage all of their caregiving and medical needs.
