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.]