First Responders Mental Health Plan Act.

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
H 1
HOUSE BILL 463

Short Title: First Responders Mental Health Plan Act. (Public)
Sponsors: Representatives Clampitt and Reeder (Primary Sponsors).
For a complete list of sponsors, refer to the North Carolina General Assembly web site.
Referred to: Appropriations, if favorable, Rules, Calendar, and Operations of the House
March 20, 2025
*H463-v-1*
A BILL TO BE ENTITLED 1
AN ACT ESTABLISHING A SUPPLEMENTAL INSUR ANCE POLICY FOR FIRS T 2
RESPONDERS DIAGNOSED WITH MENTAL HEALTH CONDITIONS. 3
The General Assembly of North Carolina enacts: 4
SECTION 1. Chapter 58 of the General Statutes is amended by adding a new Article 5
to read: 6
"Article 86B. 7
"First Responders Mental Healthcare Plan Act. 8
"§ 58-86B-1. Short title. 9
This Article shall be known and may be cited as the "First Responders Mental Healthcare 10
Plan Act." 11
"§ 58-86B-2. First responder mental health care benefits plan. 12
A first responder mental health care benefits plan is established and shall be administered by 13
the Department of Insurance. The plan shall be a supplemental insurance policy that pr ovides 14
benefits required under this Article to eligible first responders with a diagnosis of a mental 15
condition outlined in this Article. The program aims to promote healing and the return to service 16
of first responders. 17
"§ 58-86B-3. Definitions. 18
The following definitions apply in this Article: 19
(1) 911 dispatcher. – A public safety telecommunicator or dispatcher at a primary 20
public safety answering point (PSAP) as defined in G.S. 143B-1400 or at any 21
public safety agency to which 911 calls are transferred from a primary PSAP 22
as defined in G.S. 143B-1400 for dispatch of appropriate public safety 23
agencies. 24
(2) Eligible mental condition. – Stress, mental injury, or mental illness that is 25
medically diagnosed as an anxiety disorder, conduct disorder, depressive 26
disorder, obsessive-compulsive and related disorder, sleep -wake disorder, or 27
trauma and stressor-related disorder as described in the most recent edition of 28
the Diagnostic and Statistical Manual of Mental Disorders published by the 29
American Psychiatric Association. 30
(3) Emergency medical technicians and emergency medical dispatchers. – As 31
defined in G.S. 131E-155 and includes the Director of EMS. 32
(4) Firefighter. – As defined in G.S. 58-84-5 and includes fire dispatchers, fire 33
inspectors, and fire marshals. 34
General Assembly Of North Carolina Session 2025
Page 2 House Bill 463-First Edition
(5) First responder. – A law enforcement officer, firefighter, 911 dispatcher, 1
emergency medical technician employed by a State or local government, 2
detention officer employed by a local government, correctional or probation 3
officer employed by the State, or a volunteer firefighter meeting the 4
requirements of G.S. 58-84.5. Included in this definition are first responders 5
employed by nongovernmental entities. 6
(6) Law enforcement officer. – As defined in G.S. 115B-1 and includes police 7
dispatchers, police inv estigators, sheriff 's deputies, bailiffs, corrections 8
officers, detention officers, and jailers. 9
"§ 58-86B-4. Eligibility. 10
To be eligible to receive benefits, first responders shall meet all of the following: 11
(1) Be currently employed as a first responder , regardless of the date of original 12
diagnosis. 13
(2) Be diagnosed by a healthcare provider, who establishes with a reasonable 14
degree of medical certainty that the condition is the result of a singular 15
incident or accumulative effect of employment-related activities. 16
(3) Have a diagnosed condition that resulted from the first responder acting within 17
the scope of his or her employment as a first responder. 18
A first responder is not eligible to receive benefits under this Article if receiving benefits 19
related to a mental condition under the North Carolina Workers' Compensation Act. 20
"§ 58-86B-5. Benefits under mental health care plan. 21
The following benefits are available under the mental health care plan: 22
(1) Medical costs reimbursement. – Eligible first responders shall receive 23
reimbursement of up to five thousand dollars ($5,000) per 12 -month period 24
for any out -of-pocket medical expenses incurred, including deductibles, 25
copayments, or coinsurance costs, for an eligible mental condition. Receipts 26
of out -of-pocket expenses must be produced to receive this benefit. This 27
benefit may not be used in conjunction with the disability benefit under this 28
section. 29
(2) Salary benefit. – If a first responder 's treatment plan requires leave from 30
employment as determined by a healthcare provider, either through Family 31
Medical Leave (FMLA) or a local government program, and sufficient proof 32
is provided to the insurance carrier, the Department, or other applicable payor 33
that this leave is necessary, a full-time first responder shall receive a monthly 34
benefit that is either (i) equal to seventy -five percent (75%) of the first 35
responder's monthly salary or (ii) five thousand dollars ($5,000) a month, 36
whichever is less. This benefit may only be used 12 workweeks in a 12-month 37
period. This benefit may be used in conjunction with the medical costs 38
reimbursement benefit under this section. 39
(3) Disability benefit. – Upon sufficient proof to the insurance carrier, the 40
Department, or other applicable payor of (i) total disability resulting from the 41
diagnosis of an eligible mental condition or (ii) that the eligible mental 42
condition precludes the first responder from serving as a first responder, the 43
following disability benefits shall be paid to a first responder beginning six 44
months after the total disability or inability to perform the duties of a first 45
responder, whichever applies: 46
a. For a full-time first responder who is not a volunteer firefighter. – A 47
monthly benefit that is either (i) equal to seventy -five percent (75%) 48
of the f irst responder 's monthly salary or (ii) five thousand dollars 49
($5,000) a month, whichever is less. 50
General Assembly Of North Carolina Session 2025
House Bill 463-First Edition Page 3
b. For a first responder who is a volunteer firefighter. – A monthly benefit 1
of one thousand five hundred dollars ($1,500). 2
"§ 58-86B-6. Limitations on disability benefits. 3
The following limitations apply to the disability benefits under this Article: 4
(1) Disability benefits shall continue for no more than 36 consecutive months. 5
(2) Any first responder receiving disability benefits may be required to have his 6
or her condition reevaluated to determine if that first responder has regained 7
the ability to perform the duties of a first responder. If reevaluation indicates 8
the first responder has regained the ability to perform the duties of a first 9
responder, then the monthly disability benefits shall cease on the last day of 10
the month the reevaluation was conducted. 11
(3) If there is no reevaluation performed under subdivision (2) of this section, but 12
the first responder's healthcare provider determines that the firs t responder is 13
again able to perform the duties of a first responder, then the disability benefits 14
shall cease on the last day of the month the healthcare provider made the 15
determination. 16
(4) If a first responder returns to work as a first responder before exhaustion of 17
the 36 months of disability benefits that the first responder may receive under 18
this section, and if there is a subsequent recurrence of disability caused by an 19
eligible mental condition that again precludes the first responder from 20
performing the duties of a first responder, then the first responder shall be 21
entitled to any remaining monthly disability benefits, not to exceed 36 months 22
in total. 23
(5) The monthly disability benefit shall be subordinate to any other benefit paid 24
from any source to the first responder solely for a disability related to the 25
eligible mental condition diagnosis, so long as that source is not private 26
insurance purchased solely by the first responder. Disability benefits under 27
this Article shall be limited to the difference between the benefit amount paid 28
by the other source and the amounts specified in this Article." 29
SECTION 2. This act becomes effective January 1, 2026. 30