Legislature(2021 - 2022)BELTZ 105 (TSBldg)
05/06/2021 03:30 PM Senate COMMUNITY & REGIONAL AFFAIRS
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| Audio | Topic |
|---|---|
| Start | |
| HB10 | |
| SB131 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 10 | TELECONFERENCED | |
| *+ | SB 131 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 131-WORKERS' COMP DISABILITY FOR FIREFIGHTERS
3:52:32 PM
CHAIR HUGHES reconvened the meeting and announced, the
consideration of SENATE BILL NO. 131 "An Act relating to the
presumption of compensability for a disability resulting from
certain diseases for firefighters."
3:53:02 PM
SENATOR ROGER HOLLAND, Alaska State Legislature, Juneau, Alaska,
sponsor of SB 131, stated that this subject initially seemed
complicated but the numbers make the argument that breast cancer
coverage for fire service members is clearly justified. He
deferred further introduction to his staff, Nikki Rose.
3:54:04 PM
NIKKI ROSE, Staff, Senator Roger Holland, Alaska State
Legislature, Juneau, Alaska, read the following sponsor
statement for SB 131 into the record:
Firefighting is an inherently dangerous job. It is
important that workers compensation insurance provides
coverage for the inherent risks in that job, but right
now there is a hole in that coverage: breast cancer.
This bill would add breast cancer to the list of
presumed disability coverages for firefighters, so
long as the firefighter could establish medically that
the breast cancer was caused by work as a firefighter.
Instances of cancer in firefighters is shown to be
higher than the general population. Studies that have
evaluated cancer risk among women firefighters suggest
women firefighters, like their male coworkers, may be
at an elevated risk for overall cancer incidence
(Daniels et al., 2014). These studies also suggest
women firefighters may be at an elevated incidence
risk for breast cancer (Daniels et al., 2014). This
bill protects not only women, because exposure to
carcinogenic chemicals, which is sometimes necessary
in the course of a firefighter's job, does not
discriminate based on sex or gender. Exposure to these
chemicals may be mitigated, but not eliminated,
through protective equipment. Firefighters are at a
higher risk of cancer, and this risk should be
covered.
Thank you for your consideration of the addition of
breast cancer to the list of presumed disability
coverages for firefighters.
3:55:46 PM
MS. ROSE presented the following sectional analysis for SB 131:
Senate Bill 131
Workers' Compensation Disability for Firefighters
Sectional Analysis for version A
Establishes this Act relating to the presumption of
compensability for a disability resulting from certain
diseases for firefighters.
Sec. 1 AS 23.30.121(b), relating to the list of
coverage for firefighters, is amended by:
• Adding the term "breast cancer" to list of AS
23.30.121(b).
Sec. 2 Clarifies this change applies to claims made on
or after the effective date of this Act.
3:56:25 PM
SENATOR HOLLAND advised that firefighters are exposed to
carcinogenic chemicals from both fire suppressant materials and
the burning structures and contents. Together they increase
firefighters' risk of cancer. Current practice is to use self-
contained breathing apparatus, immediately remove these
chemicals from the skin, and shorten individual exposure times
in burning structures, but there are still a host of previous
exposures that should be addressed, he said.
3:57:36 PM
SENATOR HOLLAND began a PowerPoint on SB 131 reading the
following points from slide 2:
• Firefighting is an inherently dangerous job.
• It is important that workers compensation insurance
provides coverage for the inherent risks in that job.
SENATOR HOLLAND advised that Lori Wing-Heier, the director of
the Division of Insurance, was available to confirm that adding
breast cancer coverage should not increase workers' compensation
costs significantly. The firefighters will bear the cost through
their workers' compensation fees.
SENATOR HOLLAND read the points on slides 3 and 4:
• SB 131 would add breast cancer to the list of presumed
disability coverages for firefighters, so long as the
firefighter could establish that the breast cancer was
caused by their work as a firefighter.
• Instances of cancer in firefighters is shown to be
higher than the general population.
• Studies that have evaluated cancer risk among women
firefighters suggest women firefighters, like their
male coworkers, may be at an elevated risk for overall
cancer incidence (Daniels et al, 2014).
• These studies also suggest women firefighters may be
at an elevated incidence of risk for breast cancer
(Daniels et al, 2014).
3:59:01 PM
SENATOR HOLLAND paraphrased the following general statistics
listed on slides 5 and 6:
• In the general population, less than one percent of
males are likely to develop breast cancer in their
lifetime.
• Studies have found strong associations between
firefighting and male breast cancer (Ma et al, 2005).
• Male firefighters are 7.5 times more likely to die
from breast cancer than their non-Fire Service
counterparts. (Ma et al, 2005)
• The same mechanism that would cause increases in
breast cancer in men is thought to result in
proportional increases in risk among women.
• In the general population, one in eight women (12 %)
will likely contract breast cancer in their lifetime.
• At only about four percent of the firefighter
population, small sample sizes make it difficult to
draw conclusions about females and breast cancer in
the Fire Service.
• This bill protects not only women, because exposure to
carcinogenic chemicals, which often occurs in the
normal course of a firefighter's job, does not
discriminate based on sex or gender.
4:00:14 PM
SENATOR HOLLAND read the following points about presumptive laws
listed on slides 7 and 8;
Presumptive laws are regulations that assume a given
disease is linked, by default, to a specific occupation.
This means that when someone is diagnosed with an illness
covered under a presumptive law, they are automatically
entitled to disability or workers' compensation, medical
expense coverage, and medical leave, provided they meet
certain criteria.
Without presumptive laws, to get these benefits,
firefighters and other workers may have to prove that their
line of work caused their disease.
This process can be lengthy and expensive at a time when
resources should be dedicated toward treatment, wellness,
and, sometimes, end-of-life decisions.
SENATOR HOLLAND displayed the nine presumptive diseases for
firefighters in Alaska identified in AS 23.30.121:
1. Respiratory Disease 6. Bladder Cancer
2. Cardiovascular Events 7. Ureter Cancer
(Limited)
3. Primary Brain Cancer Kidney Cancer
4. Malignant Melanoma 9. Prostate Cancer
Non-Hodgkin's Lymphoma
SENATOR HOLLAND said the first two presumptive causes are
limited to extreme, one-time exposures, but the other seven are
linked to more chronic, long term exposure of carcinogens. Once
breast cancer is added, the firefighter must meet the following
standard limitations:
1. Have been a firefighter for at least seven years.
2. Have had initial and annual medical exams showing no
evidence of disease.
3. Be able to demonstrate exposure to a known carcinogen
while in the Fire Service.
4. At a minimum, be certified as a Firefighter I.
SENATOR HOLLAND reviewed the additional qualifying criteria
listed on slide 12:
1. Coverage may be denied based on:
a. Use of tobacco products,
b. Physical fitness and weight,
c. Lifestyle decisions,
d. Hereditary factors, and
e. Exposure from other employment/non-employment
activities.
2. Some post-employment coverage is available,
a. Three months accrued for every year of
service,
b. Five year maximum.
SENATOR HOLLAND said he was able to confirm that 14 states and
the Canadian Province of Ontario include breast cancer in
presumptive laws. He asked the committee to help add Alaska to
the list.
4:04:37 PM
SENATOR GRAY-JACKSON voiced support for the bill and noted that
she introduced a similar bill during the last legislature. The
difference was that her bill included emergency medical
technicians, paramedics, and peace officers and it was
retroactive to 2008. She asked if he was willing to entertain
those additions as an amendment.
4:05:27 PM
SENATOR HOLLAND answered he views SB 131 as the first in a
number of steps and his preference was to focus on breast cancer
in firefighters first.
SENATOR GRAY-JACKSON described the proposed amendment as
housekeeping and suggested they talk about it offline.
SENATOR HOLLAND said he supports the idea but wanted to maintain
focus to add breast cancer to AS 23.30.121.
4:06:35 PM
SENATOR MYERS referenced point 3 on slide 11 and asked about the
feasibility of a firefighter being able to demonstrate exposure
to a known carcinogen while in the fire service.
SENATOR HOLLAND answered some states require the firefighter to
identify the date and specific carcinogen but Alaska typically
takes a broader view. The firefighter must prove that their job
is an at-risk employment category.
4:08:12 PM
CHAIR HUGHES asked when the current list was placed in statute
and whether it might not have been when there were far fewer
female firefighters than today.
SENATOR HOLLAND offered to follow up with the information. He
agreed that women were becoming a larger part of the fire
service. He reported the anecdote that of the 1,500 firefighters
in San Francisco, the 225 females experience a 15 percent higher
incidence of pre-menopausal breast cancer than women who are not
firefighters.
CHAIR HUGHES asked if the requirement to be a firefighter for
seven years would exclude volunteer firefighters.
4:10:13 PM
SENATOR HOLLAND said he believes it means anyone who is a
fulltime or volunteer firefighter I for seven years. He offered
to follow up to confirm his understanding.
4:11:32 PM
CHAIR HUGHES announced invited testimony on SB 131.
4:12:00 PM
TIM BENNINGFIELD, Chief, Chugiak Volunteer Fire and Rescue,
Chugiak, Alaska, stated that he was speaking on behalf of the
Alaska Fire Chiefs Association in support of SB 131. He said the
association started earlier this year to add breast cancer to
the list of presumptive diseases to ensure balanced coverage for
all firefighters in the state. Responding to Senator Myers'
question about tracking exposure to carcinogens, he advised that
when members come out of a fire they sign into an application
and log the date and their exposure to carcinogens in a
structure fire. Responding to Senator Hughes' question about
seven years, he said that gap has been identified. Providing the
initial and then annual medical examinations for each member for
seven years is prohibitively expensive and out of reach for
small fire departments like Chugiak. Nevertheless, the
association believes it is important to add breast cancer to the
list of presumptive diseases for firefighters in Alaska.
SENATOR GRAY-JACKSON asked his thought on her proposed amendment
to include coverage for emergency medical technicians,
paramedics, and peace officers in addition to firefighters.
4:15:53 PM
MR. BENNINGFIELD offered his belief that it would be as self-
limiting as the seven-year requirement. [The call was dropped.]
CHAIR HUGHES asked the sponsor to follow up to request Chief
Benningfield's response in writing.
4:17:02 PM
JUSTIN MACK, Southcentral Vice President, Alaska Professional
Firefighters Association, Anchorage, Alaska, responded to the
question about career versus volunteer firefighters. He cited
the definition of firefighter in statute that clearly includes
members of a municipal fire department or volunteer fire
department that is registered with the state fire marshal's
office. Responding to the question about knowing about exposure
to specific carcinogens in fire suppressant products, he said
that is a grey area because the chemicals may be used in a
number of different types of products in a structure. He cited
PFAS as an example. When temperatures reach a certain point,
those substances can pass through a firefighter's gear and into
the skin. He said it is not just firefighting foam that is a
concern, it is certain substances in the foam.
4:19:00 PM
MR. MACK began his prepared testimony. He stated that he was
speaking on behalf of the Alaska Professional Fire fighters
Association in support of SB 131. He related that he had worked
for the Municipality of Anchorage for 10 years and currently
served as a fire captain. He described the job and training and
explained that even when firefighters follow up-to-date
decontamination protocols and wear the best personal protective
equipment (PPE), they are still exposed to some of the worst
chemicals on earth. These permeate the firefighter's gear and
penetrate the skin. The smell can last for days after a
significant structure fire.
MR. MACK said Alaska Workers' Compensation usually requires the
injured individual to tie their injury to a specific event. It
is difficult to pinpoint which structure fire caused cancer, but
study after study shows that firefighters have a significant
increase in cancer rates compared to the general population. It
is an odd phenomena that firefighters generally start their
careers as some of the healthiest in the population, yet retire
as some of the unhealthiest. He concluded that SB 131 is a step
in the right direction for public safety members who know the
risk yet continue to respond to fire calls at all hours in hopes
of making a difference in a stranger's life. He urged the
committee to support SB 131.
CHAIR HUGHES thanked him for his testimony and listed the
individuals available to answer questions.
4:22:13 PM
SENATOR MYERS asked Ms. Wing-Heier to confirm that the increase
in firefighters' workers' compensation fees would be minimal if
breast cancer were added to the list of diseases presumed to
cause disability.
4:23:02 PM
LORI WING-HEIER, Director, Division of Insurance, Department of
Commerce, Community and Economic Development (DCCED), Anchorage,
Alaska, explained that the fire department or company pays
workers' compensation, not the individual firefighters. In
Alaska, the 2021 workers' compensation lost cost base rate for
fulltime and volunteer firefighters is $2.67 per $100 of
payroll. For firefighters, the minimum payroll is $2,000 so the
department would be charged (2,000/100 X 2.67) even if the
firefighter is only called out on one fire in a month. She noted
the total cost would be a little more because the lost cost does
not include the loss adjustment expense or the profit and claims
administration the insurance company adds. She estimated the
multiplier would be closer to $3.20 per $100 of payroll.
SENATOR MYERS asked what the increase would be if SB 131 were to
become law.
MS. WING-HEIER replied the division cannot find data to support
that adding breast cancer would increase workers' compensation
rates for fire departments. She noted that the rates had
decreased 50 percent the last four years.
SENATOR MYERS described that as good news.
4:25:13 PM
CHAIR HUGHES offered her understanding of what would happen if
rates were to increase.
MS. WING-HEIER agreed with the description; once a year the
National Council on Compensation Insurance files rates for
different types of insurance with the division, a public hearing
is held on each insurance type, and the division approves the
rate.
She referenced Senator Gray-Jackson's question about adding
coverage for EMTs and advised that, by definition, EMTs who are
also firefighters would be covered under SB 131.
4:26:33 PM
SENATOR GRAY-JACKSON suggested that it would apply to paramedics
who also serve as firefighters.
MS. WING-HEIER advised that the literature indicates
firefighters who also perform medical services would be
included. The $2.67 rate would apply and she assumed the
presumption would extend to those individuals as well.
CHAIR HUGHES asked the sponsor for confirmation that he had not
received any opposition from firefighting organizations or
municipalities even though the rate may increase in the future.
4:27:33 PM
SENATOR HOLLAND confirmed he had received no opposition. The
rate Ms. Wing-Heier quoted already applies to the nine
presumptive coverages and his assumption was it includes the
many workers' compensation risks associated with being a
firefighter. He said this adds one more risk to the large pool
and any increase would be nominal.
4:28:42 PM
CHAIR HUGHES held SB 131 in committee for future consideration.