Legislature(2021 - 2022)BELTZ 105 (TSBldg)

05/14/2021 01:30 PM LABOR & COMMERCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= HB 126 EXTEND BOARD OF PUBLIC ACCOUNTANCY TELECONFERENCED
Moved HB 126 Out of Committee
<Bill Hearing Rescheduled from 05/10/2021>
-- Invited & Public Testimony --
+ SB 131 WORKERS' COMP DISABILITY FOR FIREFIGHTERS TELECONFERENCED
Moved SB 131 Out of Committee
-- Invited & Public Testimony --
+= SB 41 HEALTH INSURANCE INFO.; INCENTIVE PROGRAM TELECONFERENCED
<Bill Hearing Canceled>
-- Invited & Public Testimony --
+= SB 38 NATUROPATHS: LICENSING; PRACTICE TELECONFERENCED
<Bill Hearing Canceled>
+ Bills Previously Heard/Scheduled TELECONFERENCED
**Streamed live on AKL.tv**
        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.                                                                                 
                                                                                                                                
SENATOR HOLLAND continued the PowerPoint reading the general                                                                    
statistics 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.                                                                                       
                                                                                                                                
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.                                                                                                           
                                                                                                                                
     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 might address  the number of required  medical examinations in                                                               
a future bill.                                                                                                                  

Document Name Date/Time Subjects