Full Text
24 HB 451/AP House Bill 451 (AS PASSED HOUSE AND SENATE) By: Representatives Seabaugh of the 34th, Kennard of the 101st, Hitchens of the 161st, Gaines of the 120th, Camp of the 135th, and others A BILL TO BE ENTITLED AN ACT To amend Title 45 of the Official Code of Georgia Annotated, relating to public officers and 1 employees, so as to require the provision of certain insurance benefits to certain first 2 responders diagnosed with occupational post-traumatic stress disorder; to provide for 3 legislative findings; to provide for definitions; to provide for limitations and restrictions of 4 such benefits; to provide for methods of funding; to provide for treatment of premiums; to 5 provide for annual reporting; to amend Code Section 48-7-27 of the Official Code of Georgia 6 Annotated, relating to computation of Georgia taxable net income, so as to provide an 7 exemption for benefits received from such insurance coverage for first responders; to provide 8 for a short title; to provide for related matters; to provide for an effective date and 9 applicability; to repeal conflicting laws; and for other purposes. 10 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA: 11 12 SECTION 1. 13 This Act shall be known and may be cited as the "Ashley Wilson Act." 14 H. B. 451 - 1 - ---PAGE BREAK--- 24 HB 451/AP SECTION 2. 15 Title 45 of the Official Code of Georgia Annotated, relating to public officers and employees, 16 is amended by adding a new chapter to read as follows: 17 "CHAPTER 25 18 45-25-1. 19 The Georgia General Assembly finds that: 20 First responders are often exposed to traumatic events in the line of duty and are at 21 risk of developing post-traumatic stress disorder, which, if untreated, can result in the 22 inability to serve as a first responder as well as grave health consequences, including 23 death by suicide; 24 Major medical insurance provides coverage for mental health treatment on parity 25 with other illnesses, and major medical insurance companies are best suited to help first 26 responders identify healthcare providers who can treat post-traumatic stress disorder and 27 provide coverage for treatment by such providers; 28 The Office of Public Safety Support within the Department of Public Safety was 29 established to provide peer counselors and critical incident support services to first 30 responders exposed to traumatic events at work. The intent of this chapter is to expand 31 on this existing support by ensuring that, after a qualifying diagnosis of occupational 32 post-traumatic stress disorder, such first responders have financial resources readily 33 available to them; 34 Having financial resources readily available to meet the financial needs of first 35 responders at the critically important time of identifying the mental healthcare provider 36 of their choice and beginning treatment, as well as having additional financial resources 37 available for the continuation of treatment, pursuit of recovery, and return to service as 38 first responders, will better serve first responders and their families; and 39 H. B. 451 - 2 - ---PAGE BREAK--- 24 HB 451/AP Nothing in this chapter is intended to reimburse for or provide mental healthcare 40 treatment or replace or disrupt coverage for mental health treatment under major medical 41 insurance. 42 45-25-2. 43 As used in this chapter, the term: 44 'Covered condition' means an eligible first responder's occupational post-traumatic 45 stress disorder that is the direct result of an experience of or an exposure to a traumatic 46 event, wherein such experience or exposure takes place during the normal course of the 47 first responder's regular occupational or volunteer duties on behalf of a public entity and 48 the diagnosis is made no later than two years after the date of the traumatic event. 49 'Eligible first responder' means a first responder who experienced or was exposed to 50 a traumatic event during the normal course of performing regular occupational or 51 volunteer duties on behalf of a public entity and such experience or exposure resulted in 52 post-traumatic stress disorder, if the first responder received a diagnosis of post-traumatic 53 stress disorder arising from such experience or exposure no later than two years after the 54 traumatic event. 55 'First responder' means any of the following: 56 'Communications officer' as defined in Code Section 37-12-1; 57 'Correctional officer' as defined in Code Section 45-1-8; 58 'Emergency medical professional' as defined in Code Section 16-10-24.2; 59 'Emergency medical technician' as defined in Code Section 16-10-24.2; 60 'Firefighter' as defined in Code Section 25-4-2; 61 'Highway emergency response operator' as defined in Code Section 45-1-8; 62 'Jail officer' as defined in Code Section 45-1-8; 63 'Juvenile correctional officer' as defined in Code Section 45-1-8; 64 'Peace officer' as defined in Code Section 35-8-2; 65 H. B. 451 - 3 - ---PAGE BREAK--- 24 HB 451/AP 'Probation officer' as defined in Code Section 45-1-8; and 66 Law enforcement officer with the Department of Natural Resources. 67 salary' means regular earnings excluding overtime, bonuses, and 68 commissions. 69 'Post-traumatic stress disorder' means an anxiety disorder caused by experiencing or 70 being exposed to a traumatic event and which satisfies the clinical diagnostic criteria set 71 forth in the American Association's Diagnostic and Statistical Manual of 72 Mental Disorders, in effect on January 1, 2024. 73 'Public entity' means a department, agency, board, bureau, commission, authority, or 74 instrumentality of the State of Georgia, any local government or authority, including a 75 county, municipal, or consolidated government in this state, or any other political division 76 in this state. Such term includes a school district, independent school district, or other 77 local school system in this state. 78 'Qualified diagnostician' means a physician, or who is duly 79 authorized to practice in this state and is certified in a medical specialty appropriate for 80 trauma related mental health diagnoses. 81 'Traumatic event' means an actual or threatened death, serious injury, or act of sexual 82 violence that occurs on or after July 1, 2024, and which the first responder experienced 83 or was exposed to during the normal course of the first responder's regular occupational 84 or volunteer duties on behalf of a public entity. In cases involving multiple traumatic 85 events occurring on or after July 1, 2024, the traumatic event is the most recent event 86 determined by the qualified diagnostician to be related to the of post-traumatic 87 stress disorder. 88 45-25-3. 89 A public entity shall provide and maintain sufficient insurance coverage on each of its 90 first responders to pay the benefits described in subsection of this Code section to 91 H. B. 451 - 4 - ---PAGE BREAK--- 24 HB 451/AP eligible first responders with covered conditions arising from a traumatic event which the 92 first responder experienced or was exposed to while performing first responder services for 93 such public entity. Such coverage shall also pay such benefits for covered conditions 94 arising from an employed first responder's services as a volunteer first responder for the 95 same or another public entity. In the event a volunteer first responder of one public entity 96 is simultaneously employed as a first responder by another public entity, the public entity 97 for which such person is a volunteer shall not be required to maintain the coverage on such 98 volunteer otherwise required under this Code section during the period of such employment 99 with the other public entity. In no circumstance shall a first responder be entitled, as a 100 result of this chapter, to more than the lifetime benefits described under this chapter. 101 An eligible first responder with a covered condition shall be entitled to the following 102 benefits: 103 One lump sum benefit per lifetime of $3,000.00 payable to the eligible first responder 104 upon submission to the insurer of acceptable proof of a clinical diagnosis of a covered 105 condition by a qualified diagnostician as provided for in subsection of this Code 106 section; and 107 An income replacement disability benefit payable as a result of a clinical diagnosis 108 of a covered condition, which disability benefit is payable as described below: 109 If the first responder's qualified diagnostician determines that the covered 110 condition precludes continuation of the first responder's regular occupational or 111 volunteer duties as a first responder and provides proof acceptable to the insurer, 112 including evidence of appropriate care and treatment, then the disability benefit shall 113 begin 90 days after the date the covered condition first precludes continuation of such 114 duties; 115 The disability benefit shall continue, subject to standard requirements of disability 116 insurances and subject to the cumulative lifetime disability benefit limit described in 117 H. B. 451 - 5 - ---PAGE BREAK--- 24 HB 451/AP subparagraph of this paragraph, during the period of continuous disability arising 118 from the covered condition; 119 The disability benefit shall cease when the first responder's qualified diagnostician 120 determines that the eligible first responder has regained the ability to perform the duties 121 previously performed as a first responder; 122 Subject to the cumulative lifetime disability benefit limit provided for in 123 subparagraph of this paragraph, the disability benefit shall recommence if the first 124 responder's qualified diagnostician determines that the eligible first responder has again 125 become unable to perform his or her regular occupational or volunteer duties as a first 126 responder due to a covered condition and provides proof acceptable to the insurer; and 127 The disability benefit shall end after a total of 36 payments in the amount 128 set forth below have been made to the eligible first responder: 129 If the eligible first responder is employed by a public entity, a benefit 130 equal to 60 percent of the eligible first responder's combined salary for all 131 public entities for which the first responder is employed as a first responder or a 132 benefit of $5,000.00, whichever is less; or 133 (ii) If the eligible first responder is a volunteer first responder and not employed as 134 a first responder by any public entity, a benefit of $1,500.00. 135 Any first responder who receives income replacement disability benefits under 136 paragraph of subsection of this Code section may be required by the insurer 137 providing such benefits to have his or her condition reevaluated by a qualified 138 diagnostician selected by the insurer. In the event any such reevaluation reveals that such 139 first responder has regained the ability to perform the duties previously performed as a first 140 responder, then such benefits shall cease. 141 The benefits under paragraph of subsection of this Code section, as applicable, 142 shall be subordinate to any other insurance benefit payable to the first responder for 143 medical expenses incurred as a result of the covered condition. 144 H. B. 451 - 6 - ---PAGE BREAK--- 24 HB 451/AP The benefits under paragraph of subsection of this Code section, as applicable, 145 shall be subordinate to any other income replacement disability benefit payable to the first 146 responder for such disability from any employer funded group long-term disability plan or 147 workers' compensation benefit, not including any disability insurance purchased in whole 148 or in part by the first responder, and shall be limited to the difference between the amount 149 of such other paid benefit and the amount specified under subparagraph of this 150 Code section, as applicable. 151 Proof of a first responder's covered condition requires both of the following: 152 A clinical diagnosis of post-traumatic stress disorder made by a qualified 153 diagnostician which substantiates that the clinical diagnosis is the direct result of 154 experiencing or being exposed to a traumatic event, or repeated experiences or exposures 155 to traumatic events, during his or her regular occupational or volunteer duties on behalf 156 of a public entity. Such clinical diagnosis shall be made within two years following the 157 date of the traumatic event, and such clinical diagnosis shall include documentation 158 indicating the date and nature of the traumatic event or the most recent traumatic event 159 related to the of post-traumatic stress disorder if due to repeated experiences 160 or exposures; and 161 Written documentation of criteria required for the diagnosis of post-traumatic stress 162 disorder under the American Association's Diagnostic and Statistical Manual 163 of Mental Disorders, in effect on January 1, 2024. 164 Information that could reasonably be used to identify individuals making claims or 165 who have made claims or who have received benefits under this Code section shall be 166 treated as sensitive mental health information and, absent express authorization by the 167 individual, shall only be used and shared for administration of benefits, underwriting, and 168 for purposes of aggregation and de-identification or for purposes of compliance with 169 Article 4 of Chapter 18 of Title 50 or other applicable laws. Communications, in any form, 170 H. B. 451 - 7 - ---PAGE BREAK--- 24 HB 451/AP between such individuals and the administrator or insurer of the benefits shall be 171 confidential and privileged. 172 The benefits shall be administered in a manner designed to ensure that first responders 173 are able to obtain the lump sum benefit provided for in paragraph of subsection of 174 this Code section in a confidential manner similar to receiving mental health benefits under 175 an employer sponsored major medical health plan or employee assistance program, or, for 176 the disability benefit provided for in paragraph of subsection of this Code section, 177 in a confidential manner similar to receiving other employer sponsored disability benefits 178 involving mental health issues. In no event shall information solely about an individual's 179 diagnosis, claims, or benefits be used for any employment action. 180 The benefits shall be administered in a manner designed to enforce lifetime limits and 181 to coordinate benefits. Any insurer or self-insurer of the benefits shall disclose the amount 182 of benefits already paid to an individual upon written request by another insurer or 183 self-insurer that is evaluating a claim by such individual as provided under subsection 184 of this Code section. 185 45-25-4. 186 The governing authority of any county, municipality, or consolidated government is 187 authorized to use available revenues, including, but not limited to, proceeds from county 188 and municipal taxes imposed under Chapter 8 of Title 33, for purposes of providing 189 insurance under this chapter. 190 45-25-5. 191 Funds received as premiums for the coverages specified in this chapter shall not be subject 192 to premium taxes under Chapter 8 of Title 33. 193 H. B. 451 - 8 - ---PAGE BREAK--- 24 HB 451/AP 45-25-6. 194 The computation of premium amounts by an insurer for the coverages specified in this 195 chapter shall be subject to generally accepted adjustments from insurance underwriting. 196 45-25-7. 197 The Commissioner of Insurance shall submit an annual report summarizing the use of the 198 benefits provided for in this chapter to the chairpersons of the House Committee on 199 Insurance and the Senate Insurance and Labor Committee no later than July 1, 2025, and 200 annually thereafter. The Commissioner of Insurance shall not be required to distribute 201 copies of the annual report to the members of the General Assembly but shall notify the 202 members of the availability of the annual report in the manner which he or she deems to 203 be most effective and efficient." 204 SECTION 3. 205 Code Section 48-7-27 of the Official Code of Georgia Annotated, relating to computation of 206 Georgia taxable net income, is amended in subsection by adding a new paragraph to read 207 as follows: 208 "(12.5) Payments received by a first responder pursuant to subsection of Code 209 Section 45-25-3, to any extent such amounts are included in the taxpayer's federal 210 adjusted gross income and are not otherwise exempt under any other provision of this 211 Code section;" 212 SECTION 4. 213 This Act shall become effective on January 1, 2025. Section 3 of this Act shall be applicable 214 to taxable years beginning on or after January 1, 2024. 215 H. B. 451 - 9 - ---PAGE BREAK--- 24 HB 451/AP SECTION 5. 216 All laws and parts of laws in conflict with this Act are repealed. 217 H. B. 451 - 10 -