Legislature(2021 - 2022)BELTZ 105 (TSBldg)
05/14/2021 01:30 PM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| HB126 | |
| SB131 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 126 | TELECONFERENCED | |
| + | SB 131 | TELECONFERENCED | |
| += | SB 41 | TELECONFERENCED | |
| += | SB 38 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
SB 131-WORKERS' COMP DISABILITY FOR FIREFIGHTERS
1:49:17 PM
CHAIR COSTELLO 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."
1:49:37 PM
SENATOR ROGER HOLLAND, Alaska State Legislature, Juneau, Alaska,
sponsor of SB 131, stated that the scientific studies and the
statistics of breast cancer among firefighters provides a clear
and compelling argument for adding this disability coverage for
firefighters.
1:50:34 PM
SENATOR STEVENS joined the committee.
1:50:43 PM
NIKKI ROSE, Staff, Senator Roger Holland, Alaska State
Legislature, Juneau, Alaska, read the 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.
CHAIR COSTELLO asked if there were questions.
1:52:22 PM
SENATOR STEVENS said he supports the concept but he has concerns
about the language on page 3 that talks about breast cancer
being caused by an individual's work as a firefighter. He asked
the reason for the limitation.
SENATOR HOLLAND suggested he show the PowerPoint "Senate Bill
131 WORKERS' COMPENSATION DISABILITY FOR FIREFIGHTERS" to
clarify the reasoning. He read the following:
Firefighting is an inherently dangerous job.
It is important that workers compensation insurance
provides coverage for the inherent risks in that job.
SENATOR HOLLAND explained that firefighting has two sources of
risk. One is being inside a burning structure where burning
pieces are falling. The second is breathing and absorbing the
carcinogens from the burning structure and its contents.
Currently, there is an oversight in Alaska Statutes
regarding that coverage: Breast Cancer.
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.
SENATOR HOLLAND asked Senator Stevens if his question was about
presumed disability.
SENATOR STEVENS said yes but he wondered how a disability could
be scientifically proven to be the result of exposure during
firefighting as opposed to before or after that employment. He
noted that he would error on the side of the employee.
SENATOR HOLLAND responded that presumed disability is covered
toward the end of the PowerPoint.
1:54:50 PM
SENATOR HOLLAND continued to read the text from the PowerPoint.
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).
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.
1:55:52 PM
SENATOR HOLLAND read the following excerpt from a May 5, 2021,
letter from Paul Miranda, president of the Alaska Professional
Firefighters Association, to emphasize the need for presumptive
laws on this issue for both male and female firefighters.
Although breast cancer is much rarer in men, one of
our former male members in Fairbanks experienced a
long battle with breast cancer that was determined to
be directly related to his job as a 42 year fire
fighter. In 2017, Fairbanks Fire Chief Warren Cummings
passed away after battling breast cancer that had
metastasized into other areas of his body.
1:56:29 PM
SENATOR HOLLAND continued the PowerPoint reading the general
statistics on slides 5 and 6.
1:56:35 PM
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.
SENATOR HOLLAND reviewed presumptive laws reading the text 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.
1:58:10 PM
SENATOR HOLLAND read the text on slide 9
Alaska Statute 23.30.121.
Breast Cancer would join the existing list, including:
1. Respiratory Disease
2. Cardiovascular Events (Limited)
3. Primary Brain Cancer
4. Malignant Melanoma
5. Non-Hodgkin's Lymphoma
6. Bladder Cancer
7. Ureter Cancer
8. Kidney Cancer
9. Prostate Cancer
1:58:34 PM
SENATOR HOLLAND read the qualifying criteria on slides 11 and
12.
Once added to the list, several standard limitations
would apply. The firefighter must:
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.
Other qualifying criteria would apply, including:
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.
1:59:48 PM
2. Some post-employment coverage is available,
a. Three months accrued for every year of
service,
b. Five year maximum.
SENATOR HOLLAND advised that the two greatest risks for breast
cancer are being female and being over 50 years of age. He noted
that even with hereditary factors, it is possible to show
evidence that somebody's breast cancer is linked to their
service as a firefighter.
2:00:43 PM
SENATOR HOLLAND displayed the list on slide 13 of states
confirmed to have presumptive laws that include breast cancer.
He expressed his hope to add Alaska to this list.
1. Arizona 6. Maine 11. New York
2. Arkansas 7. Maryland 12. Oregon
3. Colorado 8. Missouri 13. Virginia
4. Idaho 9. Montana 14.Wisconsin
5. Iowa 10. New Mexico 15.
2:01:07 PM
CHAIR COSTELLO asked what entity makes the decision about the
presumptive law.
SENATOR HOLLAND deferred the question to the Director of
Insurance Lori Wing-Heier or Fire Chief Benningfield.
CHAIR COSTELLO noted that in an earlier conversation, he gave
the impression that it was an oversight that breast cancer was
not included in Alaska's presumptive law. She asked if that was
accurate.
SENATOR HOLLAND said he believes it was an oversight. Statistics
show that male firefighters are 7.5 times more likely to die of
breast cancer than males who are not firefighters and he
believes that as more women enter the firefighting profession
the incidence of breast cancer for this group will be
proportionately higher compared to women who are not
firefighters.
2:03:08 PM
LORI WING-HEIR, Director, Division of Insurance, Department of
Commerce, Community and Economic Development, Anchorage, Alaska,
explained that the process for a typical workers' compensation
claim would be that an adjuster would look at the laws and
findings and make a determination. If the claim were denied, the
remedy available to the firefighter would be an appeal to the
Workers' Compensation Board or in court.
CHAIR COSTELLO asked if anyone asked the division to have an
adjuster look at breast cancer even though it is not in the list
of presumptive conditions.
MS. WING-HEIER replied she did not know about workers'
compensation but nobody had approached the Division of
Insurance.
CHAIR COSTELLO asked if the administration had a position on the
bill.
MS. WING-HEIER answered that the administration is neutral on
the bill. She added that there is no data to show that this
would increase costs. In fact, workers' compensation has come
down significantly in the last few years.
2:05:00 PM
SENATOR STEVENS asked how the presumptive law works.
MS. WING-HEIER explained that after a diagnosis, an adjuster
would look at the cause. She noted that workers' compensation
usually looks at injury but an occupational injury would require
a deeper dive into how the person contracted the condition. This
would include a look at the person's medical and occupational
histories as well as hobbies to narrow it down to the
presumption that the person had a clean lifestyle and there was
no other contributing cause for the breast cancer.
SENATOR STEVENS said his concern was that insurance companies
never want to pay but he appreciated the comments.
CHAIR COSTELLO offered her understanding that if there was a
hereditary link to breast cancer, the individual would not fall
under the presumptive laws.
MS. WING-HEIER replied that factor would be carefully reviewed
before saying the presumption was not that they were a
firefighter but that it was hereditary.
2:06:41 PM
SENATOR MICCICHE pointed out that the conditions already on the
presumptive list are about workers' compensation and he believes
that breast cancer clearly belongs on the list too.
MS. WING-HEIER replied that coverage under workers' compensation
would provide lifetime medical and lost wages that health
insurance may not pay for.
2:08:33 PM
SENATOR STEVENS asked for confirmation that volunteers have no
coverage under workers' compensation.
MS. WING-HEIER answered no; most volunteer firefighters are
covered under a workers' compensation policy. The potential
difficulty is that the person must have a physical before they
start work and annually thereafter to determine whether or not
cancer is present. A finding of cancer after employment would
trigger the presumption, but many smaller municipalities and
volunteer fire departments cannot afford the annual physicals,
and that would exclude those firefighters.
CHAIR COSTELLO asked Mr. Collins to provide testimony and answer
any questions he heard in the foregoing discussion.
2:09:48 PM
CHARLES COLLINS, Director, Division of Workers Compensation,
Department of Labor and Workforce Development (DOLWD), Juneau,
Alaska, referenced the questions about presumption and explained
that unless a medical professional finds that the injury or
disease was caused by the person's work, the case would not be
accepted as a workers' compensation claim. He said prostate
cancer was added to the presumptive list under AS 23.30.121
about six years after the law passed in August 2008 and he
believes that adding breast cancer at this time is a natural
progression.
MR. COLLINS agreed with Ms. Wing-Heier that volunteer
firefighters would be covered if they had a physical before they
started work and each year thereafter for seven years, and they
held a firefighter I certificate or greater. He acknowledged
that the bar was high. He said the division's records indicated
that the cost to workers' compensation to add breast cancer
coverage would be minimal, although there is no actuarial data
for some of the larger municipalities because they are self-
insured so the evidence is not definitive. He advised that the
division had a neutral position on the bill.
2:14:15 PM
CHAIR COSTELLO asked if an individual would be able to
retroactively assert that their visit to a doctor was related to
a workers' compensation claim.
MR. COLLINS replied that is not generally an issue. In fact,
medical professionals often alert the division that there is a
work-related claim in process.
2:15:50 PM
SENATOR STEVENS asked if a firefighter could work in several
different fire departments to meet the seven years of work
requirement.
MR. COLLINS answered yes, and deferred further explanation to
Chief Benningfield or Justin Mack.
CHAIR COSTELLO asked Chief Benningfield to provide his testimony
and answer any questions from the foregoing discussion that
relate to his experience.
2:16:52 PM
TIM BENNINGFIELD, Fire Chief, Chugiak Fire Department, Chugiak,
Alaska, stated that he was representing the Alaska Fire Chiefs
Association. He explained that AFCA picked up this issue after
recognizing the gap in the presumptive law. He said he is
personally interested in the issue because 32 percent of
firefighters in the Chugiak Fire Department are females. His
belief is that Alaska has more women firefighters than other
states so it is important for Alaska to fill this gap. He
acknowledged other gaps in the presumptive law, but said breast
cancer is the biggest discrepancy and that gap needs to be
filled.
CHIEF BENNINGFIELD confirmed that a firefighter could work in
several different fire departments to meet the seven years of
work requirement. However, he wanted to point out that if breast
cancer were added to the list of presumptive diseases today,
nobody at the Chugiak Fire Department would be covered by this
presumptive legislation seven years from today. He said that has
to do with the fact that it is cost prohibitive for a fire
department like Chugiak, and the majority of volunteer fire
departments statewide, to provide the initial medical
examination and annual examinations for seven years.
CHIEF BENNINGFIELD concluded, "We will likely never benefit from
this presumptive legislation. However, we are adamant that we
want to work hard for all of our departments across the state."
CHAIR COSTELLO thanked him for his service.
2:20:32 PM
SENATOR STEVENS asked what the known carcinogens are in burning
buildings.
CHIEF BENNINGFIELD answered that certified level 1 firefighters
operate in an IDLH [immediately dangerous to life or health]
atmosphere where hundreds of known carcinogens contaminate gear
and leach through skin.
2:22:21 PM
SENATOR GRAY-JACKSON asked him to clarify the statement that
volunteer fire departments would not be covered by the bill.
CHIEF BENNINGFIELD replied that the legislation covers volunteer
fire departments but most volunteer departments cannot afford
the required annual medical examinations.
2:23:54 PM
CHAIR COSTELLO opened public testimony on SB 131; finding none,
she closed public testimony.
2:24:07 PM
At ease
CHAIR COSTELLO reconvened the meeting and solicited a motion.
2:24:30 PM
SENATOR GRAY-JACKSON moved to report SB 131, work order 32-
LS0598\A, from committee with individual recommendations and
attached fiscal note(s).
CHAIR COSTELLO found no objection and SB 131 was reported from
the Senate Labor and Commerce Standing Committee.
SENATOR HOLLAND thanked the committee and said he hopes this is
just the first step in fixing problems with the presumptive law.
He shared that he might address the number of required medical
examinations in a future bill.
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