If you or someone you know may be experiencing a mental health crisis, contact the 988 Suicide & Crisis Lifeline by dialing \u201c988,\u201d or the Crisis Text Line by texting \u201cHOME\u201d to 741741.<\/em><\/p>\n

A paramedic for about 30 years, Susan Farren knew all was not well with first responders: Eight of her colleagues had died by suicide. Others had grappled with substance abuse or gone through painful divorces.<\/p>\n

So, in 2018, Farren founded a nonprofit in Santa Rosa to train and support emergency personnel struggling with trauma and stress. Hundreds of firefighters, police officers, and other first responders have since availed themselves of the organization\u2019s timely help.<\/p>\n

\u201cNobody prepares you to walk into a house where four people have been murdered,\u201d said Farren, executive director of First Responders Resiliency, Inc.<\/a><\/p>\n

Firefighters, paramedics, and police often respond to the worst days of people\u2019s lives \u2014 accidents, deaths, fires, and other distressing events. After the deadly mass shootings earlier this year in Monterey Park and Half Moon Bay, and countless others across the country, awareness of how such trauma affects first responders<\/a> has grown.<\/p>\n

But there is no national consensus on when and which emergency personnel should be provided workers\u2019 compensation benefits.<\/p>\n

\u201cWe wouldn\u2019t think twice about taking care of a first responder who broke their leg, and we shouldn\u2019t think twice about taking care of their mental health needs,\u201d Karen Larsen, CEO of the Steinberg Institute, a nonprofit public policy institute, said in an email.<\/p>\n

This year, there has been a push in California by first responders for laws that expand access to workers\u2019 compensation for post-traumatic stress injuries among their ranks. But some business groups and local governments want to pump the breaks, citing worries about potential fraud or abuse of the workers\u2019 compensation system.<\/p>\n

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The allegation that some people could take advantage of a more open workers\u2019 compensation system should not deter California from providing immediate access to mental health treatment to those who need it, said Farren, who noted that many of the first responders she works with are denied workers\u2019 compensation coverage or have to go through many steps to get it approved.<\/p>\n
\u201cThat shouldn\u2019t keep us from getting help to those who really need it. That help should be available often, and affordably, and it should be available immediately,\u201d Farren said.<\/p>\n
Perceptions about employers\u2019 responsibility for alleviating work-related mental stress have changed over time, and that\u2019s showing up in workers\u2019 compensation. Each state has its own workers\u2019 compensation laws, which provide benefits like disability pay and medical care to workers injured or sickened on the job.<\/p>\n
More than half have enacted PTSD policies or policy changes since 2018, according to a 2021 report<\/a> by Optum, a company that creates workers\u2019 compensation programs. Coverage varies widely for post-traumatic stress injuries, which can be triggered by a single traumatic event or continued exposure to high stress and traumatic events.<\/p>\n
In 2019, Gov. Gavin Newsom signed legislation into law to give California firefighters and police officers a stronger chance at earning workers\u2019 compensation. The bill, SB 542<\/a>, authored by state Sen. Henry Stern (D-Calabasas) changed state law so that post-traumatic stress \u201cinjury,\u201d such as PTSD, is legally presumed to be work-related for those first responders.<\/p>\n
It was a small step by lawmakers in a state where recognition of work-related injuries for workers\u2019 compensation has typically been limited to physical illnesses such as heart disease and cancer. Previously, psychiatric conditions were handled differently, with employers and insurance companies long contending that psychological injuries can have many sources and might be too easy to blame on work.<\/p>\n
Researchers at the Rand Corporation suggested in a 2021 report<\/a> that further study is needed to evaluate the financial toll the 2019 law has had on employers \u2014 particularly counties and other municipalities that pay for police, firefighters, and other publicly employed first responders. Rand researchers estimated the added costs for local governments and the state to cover post-traumatic stress injuries could rise from $20 million to $116 million annually.<\/p>\n
Firefighters and police in most cases now no longer have to prove that work was mostly responsible for their PTSD. But the law sunsets in 2025 and excludes many other first responders, including dispatchers, paramedics, and first responders at state hospitals.<\/p>\n
This year, legislation by state Sen. John Laird (D-Santa Cruz), SB 623<\/a>, co-sponsored by an advocacy group representing firefighters in the state \u2014 California Professional Firefighters \u2014 would extend PTSD workers\u2019 compensation coverage until 2032 and open it up to state firefighters, additional law enforcement officers, public safety dispatchers, and other emergency response communication employees who work for public agencies. The Senate Labor, Public Employment and Retirement Committee unanimously approved the bill in April, and it is awaiting a vote by the Senate Appropriations Committee.<\/p>\n
Business groups and local governments \u2014 many of which opposed the 2019 law \u2014 are lobbying against more expansion. In letters to lawmakers, groups including the California Chamber of Commerce, California Coalition on Workers\u2019 Compensation, California Hospital Association, and California State Association of Counties warned that pending legislation could \u201copen the door to abuse and fraud.\u201d<\/p>\n
\u201cThere is no evidence that workers are being inappropriately denied the care or benefits that they need,\u201d Virginia Drake, a spokesperson for the California Coalition on Workers\u2019 Compensation, told KFF Health News. The group represents employers, cities and counties, insurance brokers, and government agencies on issues of workers\u2019 compensation.<\/p>\n
Legislation that would extend benefits to more first responders would \u201cput taxpayer funds at risk by tying the hands of public employers and forcing them to pay even the most questionable claims,\u201d she added in a statement.<\/p>\n
In addition, there does not seem to be consensus on which emergency personnel should get covered.<\/p>\n
A measure by Assemblymember Freddie Rodriguez, a Democrat from Chino who worked as an emergency medical technician for three decades, has stalled. AB 597<\/a> would expand workers\u2019 compensation coverage to paramedics and emergency medical technicians, but it didn\u2019t get a hearing in the Assembly. Unions representing paramedics and EMTs in California did not return messages seeking comment.<\/p>\n
\u201cIt\u2019s a very stressful job,\u201d said Rodriguez, who told KFF Health News that two of his paramedic friends had died by suicide. \u201cIt affects people differently.\u201d<\/p>\n
Clearing a path to speedy mental health recovery, particularly after traumatic incidents, \u201cshould be automatic,\u201d he added.<\/p>\n
It\u2019s unclear if Newsom will back Laird\u2019s bill extending coverage for groups of emergency responders, amid a projected $22.5 billion deficit<\/a>. A spokesperson for his office, Omar Rodriguez, said the governor typically does not comment on pending legislation and \u201cwill evaluate the bills on their own merits if they reach his desk.\u201d<\/p>\n
Last year, the Democratic governor vetoed similar legislation<\/a>, saying in a statement that it would be premature to shift coverage of PTSD before any studies had been conducted on how the current law has worked for those who are covered.<\/p>\n
Broadening coverage, Newsom wrote, \u201ccould set a dangerous precedent that has the potential to destabilize the workers\u2019 compensation system going forward.\u201d<\/p>\n
This article was produced by <\/em>KFF Health News<\/em><\/a>, which publishes <\/em>California Healthline<\/em><\/a>, an editorially independent service of the <\/em>California Health Care Foundation<\/em><\/a>.<\/em>\u00a0<\/p>\n
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