04/04/2019 03:00 PM House HEALTH & SOCIAL SERVICES

        HB 84-WORKERS' COMP: POLICE, FIRE, EMT, PARAMED                                                                     
                                                                                                                                
3:10:36 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  ZULKOSKY announced  that  the first  order of  business                                                               
would be HOUSE  BILL NO. 84, "An Act relating  to the presumption                                                               
of  compensability  for  a   disability  resulting  from  certain                                                               
diseases   for  firefighters,   emergency  medical   technicians,                                                               
paramedics, and peace officers."                                                                                                
                                                                                                                                
3:11:02 PM                                                                                                                    
                                                                                                                                
ELISE  SORUM-BIRK, Staff,  Representative Andy  Josephson, Alaska                                                               
State Legislature, presented  a PowerPoint titled "HB  84, An Act                                                               
relating to  the presumption of  compensability for  a disability                                                               
resulting  from  certain  diseases  for  firefighters,  emergency                                                               
medical  technicians,   and  peace   officers."     She  directed                                                               
attention to slide 1, "Purpose  of the bill," and paraphrased the                                                               
slide, which read:                                                                                                              
                                                                                                                                
     Firefighters are already covered in current law                                                                            
                                                                                                                                
     To extend  "presumption of compensability"  for certain                                                                    
     diseases to three more professions:                                                                                        
      Emergency Medical Technicians                                                                                             
      Peace Officers                                                                                                            
      Paramedic                                                                                                                 
                                                                                                                                
     These first responder professions  often are exposed to                                                                    
     the   same  dangerous   situations   and  toxins   that                                                                    
     firefighters are                                                                                                           
                                                                                                                                
MS.  SORUM-BIRK  pointed  out that,  although  firefighters  were                                                               
already covered under  a statute passed in the  25th Alaska State                                                               
Legislature  with bi-partisan  support and  an effective  date of                                                               
August  19, 2008,  this proposed  bill  would expand  presumptive                                                               
coverage for three professions left out of that legislation.                                                                    
                                                                                                                                
3:12:56 PM                                                                                                                    
                                                                                                                                
MS.  SORUM-BIRK  paraphrased  slide  2,  "What  is  "presumptive"                                                               
legislation?" which read:                                                                                                       
                                                                                                                                
     With work-related illness or injury-                                                                                       
      Typically worker must prove  their ailment is a result                                                                    
     of occupational exposures                                                                                                  
                                                                                                                                
     With presumptive legislation-                                                                                              
      Line-of-duty  claim, and  subsequent benefits,  can be                                                                    
     automatically   approved  as   long  as   the  specific                                                                    
     criteria are met under the state's regulations                                                                             
      Some states  choose broad language and  some choose to                                                                    
     be much more specific                                                                                                      
                                                                                                                                
MS. SORUM-BIRK explained that Alaska had used very specific                                                                     
language in the 2008 legislation, although many states used much                                                                
broader language.                                                                                                               
                                                                                                                                
3:13:26 PM                                                                                                                    
                                                                                                                                
MS. SORUM-BIRK paraphrased slide 3, "Alaska's Criteria," which                                                                  
read:                                                                                                                           
                                                                                                                                
     Narrowly defined and limited in AS 23.30.121                                                                               
      Presumption  of  coverage  may be  rebutted  based  on                                                                    
     tobacco  use,  physical   fitness,  weight,  lifestyle,                                                                    
     hereditary factors,  exposure from other  employment or                                                                    
     non-employment activities                                                                                                  
      May not  extend for more  than 3 months for  each year                                                                    
     of  service  or  60  months   following  last  date  of                                                                    
     employment                                                                                                                 
      Only to those  who have served for a  minimum of seven                                                                    
     years                                                                                                                      
      Only  to  individuals  who have  undergone  qualifying                                                                    
     medical  exam  and  requisite   annual  exams  with  no                                                                    
     evidence of disease                                                                                                        
      Only  if the  individual  with cancer  was exposed  to                                                                    
     known carcinogens in the course of employment                                                                              
                                                                                                                                
3:14:22 PM                                                                                                                    
                                                                                                                                
MS. SORUM-BIRK shared slide 4, "Sectional Analysis," which read:                                                                
                                                                                                                                
     Section 1:                                                                                                               
        Amends AS  23.30.121(b) throughout to  add emergency                                                                    
     medical  technician,  paramedic  and peace  officer  to                                                                    
     professions   presumed   covered  for   disability   or                                                                    
     disease.                                                                                                                   
        Creates  a  new  section to  include  breast  cancer                                                                    
     under  diseases for  which a  covered professional  can                                                                    
     claim compensation.                                                                                                        
        Extends  coverage   to  certain   professionals  who                                                                    
     entered active service prior to August 19, 2008.                                                                           
                                                                                                                                
     Section 2, Section 3, Section 4:                                                                                         
        Includes  emergency  medical  technician,  paramedic                                                                    
     and   peace   officer   among   presumptively   covered                                                                    
     professions                                                                                                                
                                                                                                                                
     Section 5:                                                                                                               
        Provides    definitions   of    "emergency   medical                                                                    
     technician,"   "firefighter,""paramedic,"  and   "peace                                                                    
     officer."                                                                                                                  
                                                                                                                                
     Section 6:                                                                                                               
        Clarifies that  AS 23.30.121  as amended  applies to                                                                    
     claims  made on  or after  the effective  date of  this                                                                    
     Act.                                                                                                                       
                                                                                                                                
     Section 7:                                                                                                               
        Encourages  revisors  to  update catch  line  of  AS                                                                    
     23.30.121 to reflect changes made by this Act.                                                                             
                                                                                                                                
3:15:39 PM                                                                                                                    
                                                                                                                                
MS. SORUM-BIRK moved on to paraphrase slide 5, "Diseases covered                                                                
in Alaska," [original punctuation provided] which read:                                                                         
                                                                                                                                
     Currently   covered:   respiratory   disease,   certain                                                                  
     cardiovascular  events   related  to   toxin  exposure,                                                                    
     primary  brain  cancer, malignant  melanoma,  leukemia,                                                                    
     non-Hodgkin's lymphoma, bladder  cancer, ureter cancer,                                                                    
     kidney cancer, prostrate cancer                                                                                            
                                                                                                                                
     Added by HB 84: breast cancer                                                                                            
       Emerging literature suggests a  higher rate of breast                                                                    
     cancer among women firefighters                                                                                            
                                                                                                                                
MS. SORUM-BIRK directed attention to an article [Included in                                                                    
members' packets] regarding research regarding higher rates of                                                                  
breast cancer with earlier onset for women firefighters.                                                                        
                                                                                                                                
3:16:35 PM                                                                                                                    
                                                                                                                                
MS. SORUM-BIRK explained slide 6, "First responders who entered                                                                 
service prior to August 19, 2008," which read:                                                                                  
                                                                                                                                
     AS  23.30.121(b)(4)-Allows  these   individuals  to  be                                                                    
     covered   if    a   firefighter,    emergency   medical                                                                    
     technician, paramedic, or peace officer                                                                                    
       received  "all medical  examination  provided by  the                                                                    
     department"                                                                                                                
       no  evidence of  the disease  during the  first seven                                                                    
     years of employment                                                                                                        
                                                                                                                                
     August  19,  2008  is date  of  original  enactment  of                                                                    
     "presumptive" legislation in Alaska                                                                                        
                                                                                                                                
MS.  SORUM-BIRK stated  that  this would  set  up parameters  for                                                               
individuals who entered  service prior to this August  date.  She                                                               
reported  that the  one case  dealing with  this issue  which had                                                               
gone to the Supreme Court had referred to this presumptive date.                                                                
                                                                                                                                
3:18:29 PM                                                                                                                    
                                                                                                                                
MS.  SORUM-BIRK  referred  to slide  7,  "Expands  definition  of                                                               
firefighters," which read:                                                                                                      
                                                                                                                                
        Adds firefighters who are state employees to the                                                                        
     definition of firefighter                                                                                                  
                                                                                                                                
MS. SORUM-BIRK paraphrased slide 8, "Conclusions," which read:                                                                  
                                                                                                                                
         A question of providing similar protections to                                                                         
     professional and volunteers who take comparable risk                                                                       
                                                                                                                                
     Protecting those who protect our state and communities                                                                     
                                                                                                                                
3:19:30 PM                                                                                                                    
                                                                                                                                
CO-CHAIR SPOHNHOLZ asked how the  rate of breast cancer in female                                                               
firefighters and  other first responders compared  to those rates                                                               
in the general population.                                                                                                      
                                                                                                                                
MS. SORUM-BIRK replied that, although research was still on-                                                                    
going,  it was  suggesting that  these  rates were  "quite a  bit                                                               
higher."                                                                                                                        
                                                                                                                                
CO-CHAIR SPOHNHOLZ  shared that a  concern for the  proposed bill                                                               
was for the costs related to  the inclusion of breast cancer, and                                                               
that  these facts  would be  important in  consideration for  the                                                               
proposed bill.                                                                                                                  
                                                                                                                                
3:21:24 PM                                                                                                                    
                                                                                                                                
PAMELA  MILLER, Executive  Director, Alaska  Community Action  on                                                               
Toxics  (ACAT), stated  that ACAT  was  an environmental  health,                                                               
research,   and  advocacy   organization  that   assisted  worker                                                               
concerns with chemical  exposure.  She paraphrased  from a letter                                                               
of support  for the  proposed bill dated  March 21,  [Included in                                                               
members' packets] [original punctuation provided] which read:                                                                   
                                                                                                                                
        Thank you for your leadership in introducing and                                                                        
        serving as prime sponsor for HB No. 84, "An Act                                                                         
     relating  to the  presumption of  compensability for  a                                                                    
     disability   resulting   from  certain   diseases   for                                                                    
     firefighters,     emergency    medical     technicians,                                                                    
     paramedics,   and  police   officers.  We   also  thank                                                                    
     Representatives  Tuck  and  Hopkins  for  co-sponsoring                                                                    
     this bill.                                                                                                                 
                                                                                                                                
     We strongly support  HB No. 84 because  it is inclusive                                                                    
     of  emergency  medical   technicians,  paramedics,  and                                                                    
     peace  officers in  addition  to  firefighters who  are                                                                    
     employed by  a state  or municipal fire  department and                                                                    
     volunteer  firefighters  who  are registered  with  the                                                                    
     state  fire marshall.  It is  critical  to include  all                                                                    
     first responders  under the provisions of  this bill so                                                                    
     that  they   and  their   families  are   eligible  for                                                                    
     compensation   in  the   tragic  event   of  disability                                                                    
     resulting from the performance of their duties.                                                                            
                                                                                                                                
     First responders risk their lives  every day to protect                                                                    
     the  communities they  live in.  However,  the risk  of                                                                    
     injury responding to fires is  not the only aspect that                                                                    
     makes  their  service  a  dangerous  occupation.  First                                                                    
     responders face  significant chemical exposures  on the                                                                    
     job  due to  the vast  quantity of  chemicals added  to                                                                    
     building   materials,   consumer   products   and   the                                                                    
     equipment they  use every day. Many  of these chemicals                                                                    
     have been  linked to cancer  and other  negative health                                                                    
     concerns. Firefighters  dying from occupational-related                                                                    
     cancers now account for 65  percent of the line-of-duty                                                                    
     deaths  each  year  as reported  to  the  International                                                                    
     Association  of  Firefighters.   This  is  the  largest                                                                    
     health-related issue facing the profession. Other first                                                                    
     responders are similarly at risk.                                                                                          
                                                                                                                                
     In 2010,  a NIOSH (National Institute  for Occupational                                                                    
     Safety and Health) study  examined cancer incidence and                                                                    
     cancer  deaths  in  approximately  30,000  firefighters                                                                    
     from  San  Francisco,  Chicago, and  Philadelphia  fire                                                                    
     departments between  1950 and 2009. The  results showed                                                                    
     that firefighters  have higher rates of  the digestive,                                                                    
     oral,  respiratory, and  urinary  systems cancers  than                                                                    
     the  general U.S.  population.  A  meta-analysis of  32                                                                    
     studies found  an association between  firefighting and                                                                    
     increased  incidence  of  cancers such  as  2  multiple                                                                    
     myeloma, non-Hodgkin's  lymphoma, prostate  cancer, and                                                                    
     testicular cancer, compared to the general population.                                                                     
                                                                                                                                
     We  support the  inclusion of  breast cancer  among the                                                                    
     diseases  for  presumptive  compensability  because  of                                                                    
     increasing  evidence  of  the association  with  higher                                                                    
     rates among  women firefighters.  A study  conducted in                                                                    
     the  San Francisco  Fire Department  found the  rate of                                                                    
     breast cancer  among female firefighters aged  40-50 is                                                                    
     six times the national  average. Studies also show that                                                                    
     firefighters  are at  greater risk  of contracting  the                                                                    
     following  cancers:  testicular  cancer  (102%  greater                                                                    
     risk);  multiple  myeloma   (53%  greater  risk);  non-                                                                    
     Hodgkin lymphoma  (51% greater risk); skin  cancer (39%                                                                    
     greater  risk);  prostate  cancer (28%  greater  risk);                                                                    
     malignant  melanoma (32%  greater  risk); brain  cancer                                                                    
     (32% greater  risk); rectum (29% greater  risk; stomach                                                                    
     (22% greater  risk); colon  cancer (21%  greater risk).                                                                    
     Testicular cancer should be  included in the provisions                                                                    
     of this bill for  presumptive compensability because of                                                                    
     the  high  occupational risk  and  the  fact that  PFAS                                                                    
     exposure (used  in industrial firefighting  foams), for                                                                    
     example, is closely associated with testicular cancer.                                                                     
                                                                                                                                
     We urge  support and  passage of  HB 84  and additional                                                                    
     measures to protect the health  and safety of our first                                                                    
     responders.                                                                                                                
                                                                                                                                
3:25:10 PM                                                                                                                    
                                                                                                                                
CO-CHAIR   SPOHNHOLZ  asked   how   the  rates   of  cancer   for                                                               
firefighters compared to the population at large.                                                                               
                                                                                                                                
MS. MILLER offered to provide the information.                                                                                  
                                                                                                                                
3:26:20 PM                                                                                                                    
                                                                                                                                
DARCEY   PERRY,   Vice   President,   Public   Safety   Employees                                                               
Association, said  that she had  been a firefighter  at Anchorage                                                               
International Airport since  2005 and was shocked to  find out in                                                               
2008 that she was not covered  by the legislation.  She explained                                                               
the oversights  in that legislation  and offered her  belief that                                                               
it had not been intended "to leave  our own off."  She stated her                                                               
support of the proposed legislation,  pointing out that all first                                                               
responders should be covered as  they were often entering unknown                                                               
situations.                                                                                                                     
                                                                                                                                
3:29:11 PM                                                                                                                    
                                                                                                                                
CO-CHAIR ZULKOSKY opened public testimony.                                                                                      
                                                                                                                                
3:29:49 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JACKSON asked if  the firefighters were covered by                                                               
an insurance policy.                                                                                                            
                                                                                                                                
MS.  SORUM-BIRK  replied  that   there  was  some  insurance  for                                                               
firefighters, dependent  on their employers.   She clarified that                                                               
the proposed bill was directed toward workers compensation.                                                                     
                                                                                                                                
3:30:57 PM                                                                                                                    
                                                                                                                                
CO-CHAIR ZULKOSKY closed public testimony.                                                                                      
                                                                                                                                
[HB 84 was held over.]