24 LC 46 0914S
The Senate Committee on Insurance and Labor offered the following
substitute to HB 451:
A BILL TO BE ENTITLED
AN ACT
To amend Title 45 of the Official Code of Georgia Annotated, relating to public officers and1
employees, so as to require the provision of certain insurance benefits to certain first2
responders diagnosed with occupational post-traumatic stress disorder; to provide for3
legislative findings; to provide for definitions; to provide for limitations and restrictions of4
such benefits; to provide for methods of funding; to provide for treatment of premiums; to5
provide for annual reporting; to amend Code Section 48-7-27 of the Official Code of Georgia6
Annotated, relating to computation of Georgia taxable net income, so as to provide an7
exemption for benefits received from such insurance coverage for first responders; to provide8
for a short title; to provide for related matters; to provide for an effective date and9
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 as the "Ashley Wilson Act."14
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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 2518
45-25-1.19
The Georgia General Assembly finds that:20
(1) First responders are often exposed to traumatic events in the line of duty and are at21
risk of developing post-traumatic stress disorder, which, if untreated, can result in the22
inability to serve as a first responder as well as grave health consequences, including23
death by suicide;24
(2) Major medical insurance provides coverage for mental health treatment on parity25
with other illnesses, and major medical insurance companies are best suited to help first26
responders identify healthcare providers who can treat post-traumatic stress disorder and27
provide coverage for treatment by such providers;28
(3) The Office of Public Safety Support within the Department of Public Safety was29
established to provide peer counselors and critical incident support services to first30
responders exposed to traumatic events at work. The intent of this chapter is to expand31
on this existing support by ensuring that, after a qualifying diagnosis of occupational32
post-traumatic stress disorder, such first responders have financial resources readily33
available to them;34
(4) Having financial resources readily available to meet the financial needs of first35
responders at the critically important time of identifying the mental healthcare provider36
of their choice and beginning treatment, as well as having additional financial resources37
available for the continuation of treatment, pursuit of recovery, and return to service as38
first responders, will better serve first responders and their families; and39
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(5) Nothing in this chapter is intended to reimburse for or provide mental healthcare40
treatment or replace or disrupt coverage for mental health treatment under major medical41
insurance.42
45-25-2.43
As used in this chapter, the term:44
(1) 'Covered condition' means an eligible first responder's occupational post-traumatic45
stress disorder that is the direct result of an experience of or an exposure to a traumatic46
event, wherein such experience or exposure takes place during the normal course of the47
first responder's regular occupational or volunteer duties on behalf of a public entity and48
the diagnosis is made no later than two years after the date of the traumatic event.49
(2) 'Eligible first responder' means a first responder who experienced or was exposed to50
a traumatic event during the normal course of performing regular occupational or51
volunteer duties on behalf of a public entity and such experience or exposure resulted in52
post-traumatic stress disorder, if the first responder received a diagnosis of post-traumatic53
stress disorder arising from such experience or exposure no later than two years after the54
traumatic event.55
(3) 'First responder' means any of the following:56
(A) 'Communications officer' as defined in Code Section 37-12-1;57
(B) 'Correctional officer' as defined in Code Section 45-1-8;58
(C) 'Emergency medical professional' as defined in Code Section 16-10-24.2;59
(D) 'Emergency medical technician' as defined in Code Section 16-10-24.2;60
(E) 'Firefighter' as defined in Code Section 25-4-2;61
(F) 'Highway emergency response operator' as defined in Code Section 45-1-8;62
(G) 'Jail officer' as defined in Code Section 45-1-8;63
(H) 'Juvenile correctional officer' as defined in Code Section 45-1-8;64
(I) 'Peace officer' as defined in Code Section 35-8-2;65
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(J) 'Probation officer' as defined in Code Section 45-1-8; and66
(K) Law enforcement officer with the Department of Natural Resources.67
(4) 'Monthly salary' means regular monthly earnings excluding overtime, bonuses, and68
commissions.69
(5) 'Post-traumatic stress disorder' means an anxiety disorder caused by experiencing or70
being exposed to a traumatic event and which satisfies the clinical diagnostic criteria set71
forth in the American Psychiatric Association's Diagnostic and Statistical Manual of72
Mental Disorders, in effect on January 1, 2024.73
(6) 'Public entity' means a department, agency, board, bureau, commission, authority, or74
instrumentality of the State of Georgia, any local government or authority, including a75
county, municipal, or consolidated government in this state, or any other political division76
in this state. Such term includes a school district, independent school district, or other77
local school system in this state.78
(7) 'Qualified diagnostician' means a physician, psychiatrist, or psychologist who is duly79
authorized to practice in this state and is certified in a medical specialty appropriate for80
trauma related mental health diagnoses.81
(8) 'Traumatic event' means an actual or threatened death, serious injury, or act of sexual82
violence that occurs on or after July 1, 2024, and which the first responder experienced83
or was exposed to during the normal course of the first responder's regular occupational84
or volunteer duties on behalf of a public entity. In cases involving multiple traumatic85
events occurring on or after July 1, 2024, the traumatic event is the most recent event86
determined by the qualified diagnostician to be related to the symptoms of post-traumatic87
stress disorder.88
45-25-3.89
(a) A public entity shall provide and maintain sufficient insurance coverage on each of its90
first responders to pay the benefits described in subsection (b) of this Code section to91
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eligible first responders with covered conditions arising from a traumatic event which the92
first responder experienced or was exposed to while performing first responder services for93
such public entity. Such coverage shall also pay such benefits for covered conditions94
arising from an employed first responder's services as a volunteer first responder for the95
same or another public entity. In the event a volunteer first responder of one public entity96
is simultaneously employed as a first responder by another public entity, the public entity97
for which such person is a volunteer shall not be required to maintain the coverage on such98
volunteer otherwise required under this Code section during the period of such employment99
with the other public entity. In no circumstance shall a first responder be entitled, as a100
result of this chapter, to more than the lifetime benefits described under this chapter.101
(b) An eligible first responder with a covered condition shall be entitled to the following102
benefits:103
(1) A supplemental illness-specific benefit, with a lifetime limit of $3,000.00, payable104
to an eligible first responder upon submission to the insurer of:105
(A) Acceptable proof of a clinical diagnosis of a covered condition by a qualified106
diagnostician as provided for in subsection (f) of this Code section; and107
(B) Invoices or other acceptable documentation of out-of-pocket medical expenses108
incurred as a result of such condition; and109
(2) An income replacement disability benefit payable as a result of a clinical diagnosis110
of a covered condition, which disability benefit is payable as described below:111
(A) If the first responder's qualified diagnostician determines that the covered112
condition precludes continuation of the first responder's regular occupational or113
volunteer duties as a first responder and provides proof acceptable to the insurer,114
including evidence of appropriate care and treatment, then the disability benefit shall115
begin 90 days after the date the covered condition first precludes continuation of such116
duties;117
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(B) The disability benefit shall continue, subject to standard requirements of disability118
insurances and subject to the cumulative lifetime disability benefit limit described in119
subparagraph (E) of this paragraph, during the period of continuous disability arising120
from the covered condition;121
(C) The disability benefit shall cease when the first responder's qualified diagnostician122
determines that the eligible first responder has regained the ability to perform the duties123
previously performed as a first responder;124
(D) Subject to the cumulative lifetime disability benefit limit provided for in125
subparagraph (E) of this paragraph, the disability benefit shall recommence if the first126
responder's qualified diagnostician determines that the eligible first responder has again127
become unable to perform his or her regular occupational or volunteer duties as a first128
responder due to a covered condition and provides proof acceptable to the insurer; and129
(E) The disability benefit shall end after a total of 36 monthly payments in the amount130
set forth below have been made to the eligible first responder:131
(i) If the eligible first responder is employed by a public entity, a monthly benefit132
equal to 60 percent of the eligible first responder's combined monthly salary for all133
public entities for which the first responder is employed as a first responder or a134
monthly benefit of $5,000.00, whichever is less; or135
(ii) If the eligible first responder is a volunteer first responder and not employed as136
a first responder by any public entity, a monthly benefit of $1,500.00.137
(c) Any first responder who receives income replacement disability benefits under138
paragraph (2) of subsection (b) of this Code section may be required by the insurer139
providing such benefits to have his or her condition reevaluated by a qualified140
diagnostician selected by the insurer. In the event any such reevaluation reveals that such141
first responder has regained the ability to perform the duties previously performed as a first142
responder, then such benefits shall cease.143
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(d) The benefits under paragraph (1) of subsection (b) of this Code section, as applicable,144
shall be subordinate to any other insurance benefit payable to the first responder for145
medical expenses incurred as a result of the covered condition.146
(e) The benefits under paragraph (2) of subsection (b) of this Code section, as applicable,147
shall be subordinate to any other income replacement disability benefit payable to the first148
responder for such disability from any employer funded group long-term disability plan or149
workers' compensation benefit, not including any disability insurance purchased in whole150
or in part by the first responder, and shall be limited to the difference between the amount151
of such other paid benefit and the amount specified under subparagraph (b)(2)(E) of this152
Code section, as applicable.153
(f) Proof of a first responder's covered condition requires both of the following:154
(1) A clinical diagnosis of post-traumatic stress disorder made by a qualified155
diagnostician which substantiates that the clinical diagnosis is the direct result of156
experiencing or being exposed to a traumatic event, or repeated experiences or exposures157
to traumatic events, during his or her regular occupational or volunteer duties on behalf158
of a public entity. Such clinical diagnosis shall be made within two years following the159
date of the traumatic event, and such clinical diagnosis shall include documentation160
indicating the date and nature of the traumatic event or the most recent traumatic event161
related to the symptoms of post-traumatic stress disorder if due to repeated experiences162
or exposures; and163
(2) Written documentation of criteria required for the diagnosis of post-traumatic stress164
disorder under the American Psychiatric Association's Diagnostic and Statistical Manual165
of Mental Disorders, in effect on January 1, 2024.166
(g) Information that could reasonably be used to identify individuals making claims or167
who have made claims or who have received benefits under this Code section shall be168
treated as sensitive mental health information and, absent express authorization by the169
individual, shall only be used and shared for administration of benefits, underwriting, and170
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for purposes of aggregation and de-identification or for purposes of compliance with171
Article 4 of Chapter 18 of Title 50 or other applicable laws. Communications, in any form,172
between such individuals and the administrator or insurer of the benefits shall be173
confidential and privileged.174
(h) The benefits shall be administered in a manner designed to ensure that first responders175
are able to obtain the lump sum benefit provided for in paragraph (1) of subsection (b) of176
this Code section in a confidential manner similar to receiving mental health benefits under177
an employer sponsored major medical health plan or employee assistance program, or, for178
the disability benefit provided for in paragraph (2) of subsection (b) of this Code section,179
in a confidential manner similar to receiving other employer sponsored disability benefits180
involving mental health issues. In no event shall information solely about an individual's181
diagnosis, claims, or benefits be used for any employment action.182
(i) The benefits shall be administered in a manner designed to enforce lifetime limits and183
to coordinate benefits. Any insurer or self-insurer of the benefits shall disclose the amount184
of benefits already paid to an individual upon written request by another insurer or185
self-insurer that is evaluating a claim by such individual as provided under subsection (b)186
of this Code section.187
45-25-4.188
The governing authority of any county, municipality, or consolidated government is189
authorized to use available revenues, including, but not limited to, proceeds from county190
and municipal taxes imposed under Chapter 8 of Title 33, for purposes of providing191
insurance under this chapter.192
45-25-5.193
Funds received as premiums for the coverages specified in this chapter shall not be subject194
to premium taxes under Chapter 8 of Title 33.195
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45-25-6.196
The computation of premium amounts by an insurer for the coverages specified in this197
chapter shall be subject to generally accepted adjustments from insurance underwriting.198
45-25-7.199
The Commissioner of Insurance shall submit an annual report summarizing the use of the200
benefits provided for in this chapter to the chairpersons of the House Committee on201
Insurance and the Senate Insurance and Labor Committee no later than July 1, 2025, and202
annually thereafter. The Commissioner of Insurance shall not be required to distribute203
copies of the annual report to the members of the General Assembly but shall notify the204
members of the availability of the annual report in the manner which he or she deems to205
be most effective and efficient."206
SECTION 3.207
Code Section 48-7-27 of the Official Code of Georgia Annotated, relating to computation of208
Georgia taxable net income, is amended in subsection (a) by adding a new paragraph to read209
as follows:210
"(12.5) Payments received by a first responder pursuant to subsection (b) of Code211
Section 45-25-3, to any extent such amounts are included in the taxpayer's federal212
adjusted gross income and are not otherwise exempt under any other provision of this213
Code section;"214
SECTION 4.215
This Act shall become effective on January 1, 2025. Section 2 of this Act shall be applicable216
to taxable years beginning on or after January 1, 2024.217
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SECTION 5.218
All laws and parts of laws in conflict with this Act are repealed.219
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