Outreach - PTSD - 1st Responders

Update June 2nd 2017 

When this bill came to the floor for its second reading vote on April 13th a number of interesting things happened. The voting on the bill was "divided." That means the question on whether the bill should pass was divided into two parts: the first portion related to First Responders and basically stated that the assumptions would be that diagnosed PTSD is job related. It must be proved otherwise in order for Workmans Compensation benefits to be denied. The second portion states that PTSD can be a legitimate work related injury. But for those that are not First Responders the case must be made that it is work related. The relationship between PTSD and the job is not assumed.

The vote regarding First Responders passed easily, 136 to 3. I voted in favor. Here's the details of the roll call.

R-Yea  48
R-Nay 1
D-Yea  76
D-Nay 0
R-Absent 4
D-Absent 6
Oth-Yea 12
Oth-Nay 2
Oth-Absent 0
Abstain 0
Not-Voting 1
150

The second part of the division had more difficulty, but eventually passed 102 to 39. I again voted in favor. And the bill was approved for third reading.

R-Yea  17
R-Nay 33
D-Yea  75
D-Nay 2
R-Absent 3
D-Absent 5
Oth-Yea 10
Oth-Nay 4
Oth-Absent 0
Abstain 0
Not-Voting 1
150

The next day is came up for third reading and there were attempts to amend it, but it passed by voice vote and was sent off to the Senate. Which is where it is now.

************ End of Update *************

H.197 has to do with Post Traumatic Stress Disorder (PTSD) and First Responders (firefighters, police, rescue and ambulance personnel). The bill has changed a bit while in the House Commerce and Economic Development committee. I believe this is the version that will be brought to the House floor for a vote.

The basic idea is: When a first responder is diagnosed with PTSD, the assumption should be that it is work-related unless shown otherwise. If work-related, medical expenses will be paid by Workman's Compensation. 

This is not an easy bill. Though everyone wants to help First Responders and there is increased recognition of how serious PTSD can be, there are economic implication. How much will the cost of Workman's Compensation insurance increase? Those costs will be borne by municipalities, and therefor, tax payers.

Here's the discussion:

Pros:
PTSD is a serious debilitating illness. We should do everything we can to help those upon which we depend in our greatest time of need. Yes, First Responders knew, when they sign up, what their job entails. They are trained to withstand stress. But sometimes things occur that are well beyond what they are trained to handle. In those situations they should not have the additional burden of proving that their PTSD is work related. That should be assumed.

Vermont already has such legislation for firefighters with regard to cancer, heart and lung disease and infectious disease. Those legislative initiative did not bring about the predicted rise in Workman's Comp rates.

Trained health case professionals can identify the source of the PTSD symptoms even if they occur years after the actual incident.

The cost will not be that much more than it is now. And considering that PTSD can ruin whole families, any additional cost is worth it. What about the cost of not treating PTSD?

This kinds of 'presumptive' legislation is what it takes to motivate police, fire and rescue departments to provide the  preventative services so badly needed. 

Supporters:

Cons:
We do not know the cost. Until the law is put in effect, we really don't know how many claims will be made and what effect that will have on the towns that must pay for the insurance.

Just because the law says it's assumed that PTSD is attributed to the workplace, doesn't mean it works out that way. There may be insurance company lawyers involved to counter such claims,

Different communities have different policies and resources. Though many communities realize the value of training their First Responders in resilience and stress management, other do not. The cases that occur in locations that do not adequately train for or manage such incidents will effect the insurance rates of those that do. 

A First Responder cannot be forced to deal appropriately with PTSD or an event that may lead to it. Yet the employer must shoulder the cost of that neglect.

Will this legislation force towns to have potential employees thoroughly tested for any baseline PTSD vulnerabilities? 

First responders work for different entities at the same time, responding to incidents in different towns. How do we determine who should bare the cost?

PTSD can have a delayed onset, triggered years after the actual event. Will this make towns less likely to hire military veterans for fear that the stress of combat will manifest itself while on the job and result in higher costs? 

Those opposed:
Those that express concerns:

My current perspective:
I am conflicted. I recognize the unique stress that comes with the job of First Responders. My original reaction was that it is what you sign up for when you take the job. I have found that point of view to be extremely naive. I've talking to some First Responders and heard stories of incidents that go well beyond the job description. 

PTSD is a recognized illness and treated seriously. For most people there are ways to move beyond the effects of the incident that caused the symptoms. But that does require treatment, time, and expense. 

The best approach is, as always, preventative. Training, monitoring and having resources available for treatment are essential. Programs within agencies that hire First Responders need to be developed and perhaps required.Does this bill provide for that? Not really. Will it provide the push needed to get those resources in place? I don't know.