John Maddox says he knows how to motivate his 150 employees.

Paid sick leave is one of the perks he offers to the 13 managers who run his six franchised Modesto, Calif.-area pizza restaurants — rewarding them for proving themselves responsible and ambitious.

But if legislation now before Congress passes, Maddox will have to extend the benefit to nearly all of his workers at Mountain Mike's Pizza — some of whom, he said, miss work too often.

"As an owner, I know how to shape things to motivate my employees," he said, "but this bill will tie my hands."

Solid opposition from business owners like Maddox sank two previous efforts to pass a federal law mandating paid sick leave. But with Democrats controlling Congress and many employers trimming back the benefit, labor and family advocacy groups are trying again. This time, they are mounting a more visible campaign in support of the legislation, beginning with Senate hearings last month.

The United States is virtually the only industrialized nation that does not mandate sick pay for private-sector employees. Nearly half of full-time workers — an estimated 57 million — don't have the benefit.

Without it, workers lose pay — and sometimes their jobs — when they fall ill, according to Debra Ness, president of the National Partnership for Women and Families, which supports the legislation.

Companies insist that the mandate would add to costs, produce scheduling headaches and constrain how they run their operations. Those arguments helped kill previous versions of the bills in committee.

But opposition may soften this time, some workplace experts predict. With seven states considering their own sick-pay mandates and San Francisco the nation's first city to require paid leave for all public and private employees working within the city limits, business groups may ultimately decide that a single national standard is preferable to a collage of state and local rules.

A White House spokesman said President Bush had not taken a position on the measure. The bill comes amid other pro-labor legislation, such as a higher minimum wage, pushed by Democrats.

SEVEN DAYS REQUIRED

The Healthy Families Act, introduced last month, would require private employers with 15 or more workers to provide seven paid sick days annually. Employees could use the leave to recover from illness, attend medical appointments or care for a sick child. Part-time employees working at least 20 hours a week would be entitled to prorated leave.

Low-wage workers are least likely to have sick leave, especially those in food service, caretaking or retail jobs, according to Jody Heymann, a physician who studies labor and health policy at McGill University in Montreal. Many without sick pay are women. As a result, Heymann said, those who need sick pay the most, such as Chicago home healthcare worker Elnora Collins, are the least likely to have it.

The 57-year-old can stay home when she's ill, but she forfeits her $7.50-an-hour pay.

Collins said she sometimes went to work when she was ill but worried about infecting her elderly patients, including two who suffered from heart conditions.

"I tie something around my face if I'm coughing," she said.

Part-time waitress Madison Gray fears she could lose her job if she's ill too often or can't find a co-worker to cover her shift in a steakhouse in Beverly Hills, Calif.

"It's a manager's call," she said.

Gray, 34, found substitutes during a recent bout of the flu, but "when you're lying in bed, the last thing you want to do is call 20 employees and find someone to work for you," she said.

OBSTACLES AWAIT

Backers, including a broad coalition of family, labor, women's and public-health groups, are banking on stories from workers like Collins and Gray to draw public support and votes in Congress. A House hearing is in the works along with a public outreach effort, according to Ness.

But to get the bill through Congress, supporters will have to overcome solid opposition from the U.S. Chamber of Commerce and other business organizations.

To Kim Parker, executive vice president of the Sacramento-based California Employers Group, the federal bill "takes discretion completely away from the employer." Managers should be able to offer vacation or sick pay if they choose, she said, to attract and retain talented employees.

The across-the-board mandate will burden employers with significant additional costs and could encourage employees to play hooky, Parker added.

Maddox, the pizza parlor franchisee, said absences among his largely teenage workers were already a "constant problem," especially on Friday nights, when many call in "sick" an hour or two before their shift starts to attend a football game or a hastily called party.

Parker believes the leave measure could exacerbate those problems by putting employers "in the bad position of having to police whether someone's really sick."

Ness, like other supporters of the bill, insists that a lot of the concerns employers raise "are good old-fashioned discipline issues." Managers should deal with them as such, she said.

LESS SICK TIME USED

Most employees with sick pay don't use it all each year, noted Ophelia Galindo, a health and benefits consultant for Mercer Human Resource Consulting. The amount of sick time they've charged has dropped slightly in recent years, she said.

The employers Mercer surveyed gave an average of 8.1 sick days last year, down from 9 days in 2004. Workers charged 5.2 days to illness last year, compared with 5.7 two years ago.

Galindo noted that many companies that once provided separate sick and vacation accounts have switched to combined time-off banks in recent years to avoid having to second-guess their employees. Workers decide whether to spend the days on vacation or save them in case they become ill, she said.

Nearly 40 percent of companies now offer these leave accounts, according to Mercer, up from 33 percent in 2002. The federal bill, introduced in the Senate by Sen. Edward M. Kennedy, D-Mass., and in the House by Rep. Rosa DeLauro, D-Conn., would not affect companies that offer at least seven days in those accounts.

BARRIER TO SUCCESS?

Some employers also fear that mandated sick leave "will make it chaotic for me to manage my business," as Maddox put it, and tougher to expand and turn a profit.

McGill University's Heymann said there was little evidence to support Maddox's concern.

"Half of American companies do provide sick leave and have been able to successfully compete," she said. "This bill would address a huge equity gap for millions of Americans, but it's not something that's never been tried."

The San Francisco ordinance, approved by voters, requires that employers provide one hour of paid sick leave for every 30 hours worked by any employee, whether full- or part-time or temporary. The measure applies to telecommuters who live outside the city as well as to those who work there only occasionally. Businesses with 10 or fewer workers have to offer a maximum of five days a year, and larger employers max out at nine days.

The far-reaching mandate, the first local sick-pay ordinance, may cause some companies to rethink their opposition to the federal bill, Galindo said.

"Employers are worried about the trend of local entities making rules," she said, and might welcome a national bill as preferable to "every city and county making their own rules."