HB 84-WORKERS' COMP: POLICE, FIRE, EMT, PARAMED  3:18:28 PM CHAIR SPOHNHOLZ 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." 3:18:43 PM REPRESENTATIVE ANDY JOSEPHSON, Alaska State Legislature, as prime sponsor, introduced HB 84. He paraphrased the sponsor statement, which read in its entirety as follows [original punctuation provided]: First responders are exposed to a broad array of toxic chemicals daily in the course of their service to our communities. This level of exposure has been linked to increased risk of disease or disability among this sector of public servants. Under current Alaska law, the presumption of coverage for certain diseases or disabilities being caused by work only extends to certain firefighters. House Bill 84 (HB 84) has the core purpose of extending this presumption of coverage to emergency medical technicians, paramedics and peace officers. Emergency medical technicians (EMTs), paramedics and peace officers face toxic exposure comparable to those faced by firefighters and often are present when responding to fire calls or when dealing with a mediation of other environmental contaminants. Since these professions face the same daily risks as firefighters, they deserve the same legal protections. Additionally, HB 84 adds breast cancer to the diseases covered under Alaska's presumptive illness law. There is emerging evidence that breast cancer rates are significantly higher among female firefighters than the average population and that there are more instances of premenopausal breast cancer among these professional women. There is also evidence that many chemicals known to cause breast cancer form during thermal decomposition. Finally, HB 84 extends coverage to professionals who entered active service prior to August 19, 2008 and who, having gone through all official work-related medical examinations, did not show evidence of disease in their first seven years of service. Passage of HB 84 will ensure that Alaska adequately protects the individuals who choose professions to protect Alaska. I encourage you to support this legislation and urge you to reach out to my office with any questions or concerns. 3:24:31 PM ELISE SORUM-BIRK, Staff, Representative Andy Josephson, Alaska State Legislature, presented a PowerPoint entitled, "HB 84," on behalf of Representative Josephson, prime sponsor. She informed the committee that most categories of firefighters are currently covered under AS 23.30.121 [Presumption of coverage for disability from diseases for certain firefighters]. The purpose of HB 84 is to extend the presumption of compensability for certain diseases to three more professions: emergency medical technicians, peace officers, and paramedics. She noted that the first responder professions are often exposed to the same dangerous situations and toxins that firefighters are (slide 2). HB 84, she said, seeks to expand presumptive coverage to allow for line-of-duty claims and subsequent benefits to be automatically approved as long as the specific criteria are met under the state's regulations. Alaska has very specific criteria in place for someone to be eligible for the potential benefits (Slide 3). She outlined Alaska's specific criteria on slide 4, which read as follows [original punctuation provided]: ? 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 MS. SORUM-BIRK directed attention to slide 5, entitled "Sectional Analysis," which read as follows [original punctuation provided]: ? 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. MS. SORUM-BIRK continued to slide 6, entitled "Diseases covered in Alaska," which read as follows [original punctuation provided]: 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, prostate cancer ? Added by HB 84: breast cancer  ? Emerging literature suggests a higher rate of breast cancer among women firefighters 3:31:56 PM MS. SORUM-BIRK directed attention to slide 8, "Expands definition of firefighter." She explained that the current statutory definition of firefighter that's used in the presumptive illness legislation in presumptive illness law does not include individuals who are employees of the state of Alaska. This means that airport firefighters who are Department of Transportation & Public Facilities (DOT&PF) employees, employees of the state fire marshal, and wildland firefighters employed by the Department of Natural Resources are not covered by current law. For this reason, HB 84 adds firefighters who are state employees to the definition of firefighter. She noted that at least 13 states cover police officers, and 10 states cover paramedics and EMTs. She added that there is a growing body of research relating to the cancer risk for police officers. Several studies have found correlations between police work and increases in various types of cancer. She further noted that the most common hazards for EMTs and paramedics include responding to natural disasters, terrorist attacks, and chemical spills released during chemical transportation. Law enforcement personnel are also concerned with clandestine drug labs and exposure, specifically from methamphetamine production. REPRESENTATIVE JOSEPHSON noted that the 2008 legislation was restricted and constrained. 3:36:26 PM REPRESENTATIVE HANNAN questioned whether the statutory definition of peace officer includes village public safety officers (VPSOs) who in many communities, are the only first responders. MS. SORUM-BIRK said she would follow-up with the requested information. REPRESENTATIVE HANNAN inquired as to how firefighters verify that they were exposed to carcinogens on the job. 3:38:13 PM REPRESENTATIVE JOSEPHSON said he does not know; however, he read the following from the John Adamson case [ADAMSON v. State of Alaska, Intervenor.]: At the hearing, Adamson testified that he had been exposed to soot in the course of fighting fire and that he had been involved in fighting several large fires including a paint supply store in which paint was burning. Dr. Allems agreed that Adamson had been exposed to soot. Dr. Allems also testified that arsenic is used in paint pigments and cadmium is used in paints and batteries. Cadmium, arsenic, and soot are all listed as known carcinogens by the national toxicology program. CHAIR SPOHNHOLZ clarified that by "soot," Representative Josephson was referring to ash. REPRESENTATIVE JOSEPHSON offered his understanding that, not without a battle by the municipality, Adamson was able to provide anecdotal evidence of his exposure to carcinogens. He said keeping a log is typically how it's done. 3:39:47 PM REPRESENTATIVE HANNAN asked how many disability claims have been processed since the law passed in 2008 from which public employees or volunteer firefighters have received workers' compensation. MS. SORUM-BIRK offered her understanding that "just a handful" of cases have used this presumption of compensability in Alaska. Regarding the determination of carcinogens, she directed attention to page 2, lines 28-29 of the bill, which states that the lists of cancer-causing agents must be defined by the International Agency for Research on Cancer or the National Toxicology Program. REPRESENTATIVE JOSEPHSON offered to follow up with the requested information. 3:41:50 PM REPRESENTATIVE RASMUSSEN referencing AS 01.10.609(a)(7)(A)-(F), said the definitions of a "peace officer" include an officer of the state troopers; a member of the police force of a municipality; a village public safety officer; a regional public safety officer; a United States marshal or deputy marshal; and an officer whose duty it is to enforce and preserve the public peace. She expressed her concern that that subparagraph (F), "an officer whose duty it is to enforce and preserve the public peace," is too vague. REPRESENTATIVE JOSEPHSON acknowledged her concern and said he would look into the meaning of that categorization. CHAIR SPOHNHOLZ noted that subsection (F) may be regarding serious emergencies or larger disasters. She added, people who might not respond to certain kinds of emergencies in every given scenario will do so in the case of a serious emergency. In the case of a larger disaster, emergency responders of all different kinds will participate in different ways according to their training and could be exposed to things that they might not be in the course of their regular duties. 3:43:55 PM REPRESENTATIVE RASMUSSEN mentioned the research on women firefighters and breast cancer. She asked if "there's anything that correlates female firefighters to, maybe, starting a little bit later in life with starting their family ? getting themselves established in a career that's more male dominated." REPRESENTATIVE JOSEPHSON explained that the San Francisco Fire Department did a study that found six times the normal rate of breast cancer among its firefighters. He acknowledged that there could be other causalities. MS. SORUM-BIRK noted that the same study found a much higher level of breast cancer among premenopausal women compared to the general population. She said she's not sure if they looked at the specific factors mentioned by Representative Rasmussen. REPRESENTATIVE RASMUSSEN offered her belief that, in general, age is a factor for women. She said that as women approach age 55 it increases the likelihood of developing breast cancer. She went on to say she heard that women who breast feed are less likely to develop breast cancer and asked if there is any known correlation between the two. CHAIR SPOHNHOLZ agreed that when expanding presumptive illness to include breast cancer, it's fair to ask that [the committee] has a clear understanding of what the "linkage" is to an increase in rates. 3:47:20 PM THOMAS HOFFMAN, Public Safety Employees Association, said he has been a firefighter and police officer at the Ted Stevens Anchorage International Airport for the last four years. He stated that he and his co-workers are appreciative that HB 84 is being expanded to include the state firefighters. He said there are a lot of hazardous materials involved in responding to an aircraft or airport fire. He offered his belief that all firefighters who serve the state of Alaska, whether in training or responding to incidents, have been exposed to carcinogens. He expressed his support for HB 84. 3:49:33 PM REPRESENTATIVE RASMUSSEN asked how many state firefighters would be included in HB 84. MR. HOFFMAN replied that in his department alone there are anywhere between 68-75 firefighters, not including the Fairbanks Airport or the UAA firefighters. CHAIR SPOHNHOLZ thanked Mr. Hoffman and the rest of the public safety employees for their work for the state. 3:50:52 PM CHAIR SPOHNHOLZ announced that HB 84 was held over.