[A] bill that would expand workers’ compensation to further cover mental health treatment remains in the House Commerce and Economic Development Committee, where members are looking at the cost to employers.
The bill, H.197, would require workers’ compensation to cover treatment for post-traumatic stress disorder for first responders, unless the insurer or employer can prove the PTSD was not a result of the job.
H.197 would also make mental health disorders that are sustained on the job — for all workers in Vermont — covered under workers’ compensation law in the same way as other workplace injuries.
The Vermont Department of Labor, which regulates workers’ compensation, already allows some coverage of mental health issues. However, first responders are prohibited from getting coverage for PTSD because of a 2003 Vermont Supreme Court case.
At a news conference Wednesday, Gov. Phil Scott said he would like to see the bill narrowed to affect only first responders, not Vermont’s entire workforce.
“The Department of Labor has concerns over cost and implementation,” Scott said. “I’m extremely sensitive to this with our firefighters, first responders, and I see a need.”
“I’d like to see it narrowed so it’s not too broad, and it sounds as though they’re narrowing those efforts in the House at this point in time, so we’ll work through the process,” he said. “I’m not necessarily opposed to it.”
The Legislature’s Joint Fiscal Office has not completed its analysis of what the proposed law would cost.
The House Commerce Committee considered an amendment Wednesday morning that would narrow the bill’s scope.
Under the amendment, a worker would be able to get treatment under workers’ compensation for a mental condition only if the work-related event or work-related stress experienced was “extraordinary and unusual in comparison to pressures and tensions experienced by the average employee across all occupations.”
Additionally, the worker would need to prove that the condition was caused by “the work-related event or work-related stress, and not some other event or source of stress.”
Any mental conditions arising out of disciplinary actions, layoff, demotion or similar actions would not be covered as long as the employer took that action “in good faith.”
Jess Gingras, the spokesperson for the Department of Labor, called the new bill “better” because it reduces the scope of the law, but it “still includes that presumption, which I think is where a number of our concerns still lie.”
Currently, there are only a handful of situations — all involving first responders — in which Vermont law presumes that an injury is covered under workers’ compensation. They include some heart attacks, cancers and bloodborne pathogen injuries.
Steve Monahan, the director of workers’ compensation for the Department of Labor, said it is hard to predict the effect on premiums, because insurers are already required to cover some mental health injuries.
“The definition (in the original version of H.197) does appear broader than we’ve applied, and to that extent, it would increase costs, if there were claims,” he said. “It would raise costs across the board. It’s just hard to predict how much.”
“I support taking care of PTSD for our first responders,” Botzow said. “This is a matter, for me, of how to go forward, not whether to go forward, and how, we have to take into consideration the potential impacts that are both fiscal and, for making it so broad that nobody will quite understand what we’re capturing.”
“I think mental health parity is going to be the hardest part of the issue,” said Rep. Mike Marcotte, R-Coventry. “The mental parity is a bigger bucket than just PTSD — that’s every worker, not just first responders.”
“We need to understand what the proposal is and compare it to what we already have on the statute for physical disabilities, so it doesn’t take on an offshoot that is so broad that we can’t control it or bring it in,” Marcotte said.
Rep. Anne Donahue, R-Northfield, a mental health advocate, said there is no evidence that covering mental health has a substantial effect on insurance prices.
She said the idea of premium prices going up was a “fear-mongering factor” used by opponents of mental health parity legislation the Legislature passed in the 1990s. After that law passed, she said, the price of health insurance went up “minimally.”
“I personally would find it staggering in 2017 that we did not catch up on a longtime oversight and not recognize that mental health is a part of health,” Donahue said. She added that most people filing a workers’ compensation claim for a mental health condition would still need to prove it was caused by the job.
“It’s hard for me to imagine why one wouldn’t say, ‘But of course, if it’s a mental condition that’s demonstrated to have been caused by your job responsibilities, of course it would be the same,’” Donahue said.
She said members of the House Commerce Committee are not deeply involved in health care issues, so they are more likely to be “misled by other people who are way behind the times.”
Botzow said there is no way yet to know how much money the bill could save overall. “(You) can’t figure out until you do it the savings that you would get from a firefighter or a rescue squad person receiving treatment and being able to return to work and perform,” he said.
Johnson said the committee is doing its due diligence and will find out that the cost of the bill will be “negligible.” She said the committee wants to get the bill right, rather than working toward a specific deadline.
