SENATE BILL NO. 131(title am) "An Act relating to the presumption of compensability for a disability resulting from certain cancers in firefighters." 1:36:03 PM Co-Chair Merrick indicated the committee would take up the three amendments that were submitted to her office. 1:36:36 PM Co-Chair Merrick OPENED public testimony. 1:36:53 PM AT EASE 1:37:14 PM RECONVENED 1:37:28 PM RICHARD ETHERIDGE, ALASKA FIRE CHIEFS ASSOCIATION, JUNEAU (via teleconference), spoke in support of SB 131. He shared that he had been a firefighter in Alaska for over 30 years. During his career, he had learned that many job related things had been documented to cause cancer in firefighters. He listed items known to cause cancer to firefighters on the job including structure fire smoke, soot buildup in gear, firehalls that contained diesel buildup, fire foam, and protective gear containing PFAS. With the knowledge of the problems, methods had been developed to reduce risk as much as possible. He shared that if a firefighter's cancer was on the presumptive list, they had to prove they met the strict requirements to qualify for the workers' compensation program. He explained that if the cancer was not on the presumptive list, it still may be a workplace illness; it meant firefighters then had a harder job to prove what caused the cancer. Mr. Etheridge provided additional detail. He stated that SB 131 did not create additional liability for municipalities. The bill specified that if a person had an approved cancer, they would not be forced to go through a protracted bureaucratic process. He stated that according to the Workers' Compensation office, there had been very few claims filed. He relayed that the state insurance director had testified at a recent hearing that the cost to the state was so negligible it was not measured. He highlighted that female firefighters deserved cancer protection equal to their male counterparts. He asked the committee to pass the legislation to protect firefighters. 1:40:58 PM Co-Chair Merrick CLOSED public testimony. Co-Chair Merrick indicated there were two fiscal notes to review. SCOTT JORDAN, DIRECTOR, DIVISION OF RISK MANAGEMENT, DEPARTMENT OF ADMINISTRATION, reviewed Fiscal Note 3. The fiscal note was indeterminate because there was no data in the system regarding cancer diseases with firefighters. The department had attached average costs for cancers found online. He added the note factored in death benefits that would go to a firefighter's dependents if the firefighter died due to the illness. Co-Chair Merrick asked the department to review the second fiscal note. CHARLES COLLINS, DIRECTOR, DIVISION OF WORKERS' COMPENSATION, DEPARTMENT OF LABOR AND WORKFORCE DEVELOPMENT (via teleconference), reviewed the zero fiscal note (control code: iAIPv) by Department of Labor and Workforce Development. He relayed that the division did not cover any firefighters; therefore, there it would see no added expense. He noted the actuary was unable to provide a number on cost; the synopsis was included with the note. 1:44:13 PM Representative Josephson MOVED to ADOPT Amendment 1, 32- LS0598\G.1, (Marx, 4/29/22)(copy on file): Page 1, line 2, following "firefighters": Insert"; relating to the payment of workers' compensation benefits in the case of permanent partial impairment; relating to the payment of workers' compensation death benefits; and providing for an effective date" Page 3, following line 6: Insert new bill sections to read: "* Sec. 3. AS 23.30.190(a) is amended to read: (a) In case of impairment partial in character but permanent in quality, and not resulting in permanent total disability, the compensation is $273,000 [$177,000] multiplied by the employee's percentage of permanent impairment of the whole person. The percentage of permanent impairment of the whole person is the percentage of impairment to the particular body part, system, or function converted to the percentage of impairment to the whole person as provided under (b) of this section. The compensation is payable in a single lump sum, except as otherwise provided in AS 23.30.041, but the compensation may not be discounted for any present value considerations. * Sec. 4. AS 23.30.215(a) is amended to read: (a) If the injury causes death, the compensation is known as a death benefit and is payable in the following amounts to or for the benefit of the following persons: (1) reasonable and necessary funeral expenses not exceeding $12,000 [$10,000]; (2) if there is a widow or widower or a child or children of the deceased, the following percentages of the spendable weekly wages of the deceased: (A) 80 percent for the widow or widower with no children; (B) 50 percent for the widow or widower with one child and 40 percent for the child; (C) 30 percent for the widow or widower with two or more children and 70 percent divided equally among the children; (D) 100 percent for an only child when there is no widow or widower; (E) 100 percent, divided equally, if there are two or more children and no widow or widower; (3) if the widow or widower remarries, the widow or widower is entitled to be paid in one sum an amount equal to the compensation to which the widow or widower would otherwise be entitled in the two years commencing on the date of remarriage as full and final settlement of all sums due the widow or widower; (4) if there is no widow or widower or child or children, then for the support of father, mother, grandchildren, brothers, and sisters, if dependent on [UPON] the deceased at the time of injury, 42 percent of the spendable weekly wage of the deceased to such beneficiaries, share and share alike, not to exceed $150,000 [$20,000) in the aggregate; (5) $8,000 [$5,000] to a surviving widow or widower, or equally divided among surviving children of the deceased if there is no widow or widower. * Sec. 5. AS 23.30.215 is amended by adding a new subsection to read: (j) A death benefit payable to a child under (a)(2)(D) or (E) of this section continues until the child reaches 23 years of age, unless extended under AS 23.30.395(8)." Renumber the following bill section accordingly. Page 3, lines 9 - 10: Delete all material and insert: "APPLICABILITY. AS 23.30.12l(b), as amended by sec. 1 of this Act, and AS 23.20.121(?), as amended by sec. 2 of this Act, apply to claims made on or after the effective date of secs. 1 and 2 of this Act." Page 3, following line 10: Insert a new bill section to read: "* Sec. 7. This Act takes effect January 1, 2023." Co-Chair Merrick OBJECTED for discussion. Representative Josephson reviewed the amendment that was identical to a bill (HB 30) passed out of the House Finance Committee and was passed on the House floor by a vote of 29 to 10. He shared that he had been working on the topic for nine years. The amendment included an update to permanent and partial impairment. He had seen the issue through the House three times. He had informed the sponsor of SB 131 of his intention to offer the amendment. The sponsor had not asked him to offer the amendment or not offer the amendment. He stated that the bill was backed by the Alaska General Contractors, the Alaska Builders and Contractors, and the Fairbanks Chamber of Commerce. Additionally, the bill was affordable. He shared that Mr. Collins with the Division of Workers' compensation had testified there had been a cumulative reduction in in workers' compensation of 40 percent over the last eight years. The bill would cause a net 14 percent increase. He stressed that Alaska did not th want to be the 46 state for disability due to workers' compensation. Co-Chair Merrick WITHDREW the OBJECTION. There being NO further OBJECTION, Amendment 1 was ADOPTED. 1:46:24 PM Vice-Chair Ortiz MOVED to ADOPT Amendment 2, 32-LS0598\G.2, (Marx, 5/13/22) (copy on file): Page 1, line 2, following "firefighters": Insert"; relating to occupational diseases; and relating to the fishermen's fund" Page 3, following line 6: Insert a new bill section to read: "* Sec. 3. AS 23.35.150(5) is amended to read: (5) "occupational disease" means hernia; varicose veins of the leg; the respiratory diseases, novel coronavirus disease (COVID-19), bronchitis, pleurisy, and pneumonia caused by or aggravated by the fishing endeavor, but excluding the common cold and influenza; rheumatism, arthritis, and those musculoskeletal diseases (such as bursitis, traumatic sciatica, and tenosynovitis) directly caused by or aggravated by the fishing endeavor; and does not include a disease not common to both sexes, venereal disease, or a condition arising out of an attempt of a fisherman to injure self or another." Renumber the following bill section accordingly. Page 3, line 9: Delete "AS 23.30.121(b) and (f), as amended by this Act, apply" Insert "This Act applies" Co-Chair Merrick OBJECTED for discussion. Vice-Chair Ortiz explained the amendment was a self- contained issue to the Fishermen's Fund and there would be no added fiscal cost to workers' compensation, the state's fiscal obligations, or local municipalities' fiscal obligations. The amendment added the COVID-19 portion of SB 131 to the Fishermen's Fund. There was no cost to anyone other than fishermen, who had requested adding the benefit to their fund. 1:47:29 PM Representative Johnson asked if the amendment would add COVID-19 as one of the occupational [inaudible]. She asked for further clarification. Vice-Chair Ortiz replied that the virus spread more rapidly when people were confined in a fishing boat. He clarified the issue was whether or not people who were part of the Fishermen's Fund felt they needed some added insurance protection from COVID-19. He explained their health insurance was from the Fishermen's Fund. He explained that the inclusion may add to fishermen's premiums or other cost. He clarified that any associated costs would be taken care of by fishermen. He added the inclusion had been requested by fishermen. Representative Johnson surmised the amendment added the Fishermen's Fund to the bill. Vice-Chair Ortiz provided further clarification. He explained the amendment matched the theme of the bill because the bill talked about adding COVID-19 to workers' compensation. The benefit was only about the Fishermen's Fund and would be paid for by fishermen. He clarified it was the fishermen's health insurance program. 1:49:57 PM Representative Carpenter understood the concept of occupational disease as something that specifically related to the occupation. He listed health problems such as varicose veins, a hernia, bronchitis, and pneumonia. He thought the Coronavirus had more in common with the flu than a hernia. He remarked that the amendment would add the Coronavirus, but current statute excluded influenza. He thought it appeared to go against the underlying theme of the statute. Co-Chair Merrick asked Mr. Collins if he had a response. Mr. Collins offered that Fishermen's Fund insurance did not work like workers' compensation. He explained it was merely a reimbursement of expenses to the boat or fishermen. He elaborated that fishermen did not pay premiums they paid a fee on their license purchased through the Department of Fish and Game. He informed committee members that the setup of the Fishermen's Fund had been set since prior to statehood. He was not aware of any requests from the Fish Fund Council on coverage for COVID-19. He was surprised to hear the amendment. He added the amendment would not impact the cost to any claims because it was a fee fishermen charged themselves to cover the Fishermen's Fund, which was a reimbursement vehicle and not insurance. Representative Carpenter asked why the common cold and influenza were excluded. 1:52:56 PM AT EASE 1:53:34 PM RECONVENED Co-Chair Merrick indicated Representative Rasmussen had joined the meeting. Vice-Chair Ortiz WITHDREW Amendment 2. He remarked there were some reasonable questions about the amendment, and he was not the person to answer them. He would get the answers to the questions. 1:54:07 PM Representative LeBon MOVED to ADOPT Conceptual Amendment 1 (copy on file): Page 1, line 13 Delete "skin cancer [MALIGNANT MELANOMA];" Insert "malignant melanoma;" Page 2, line 4 Add "and" Page 2, lines 6-12 Delete all material Co-Chair Merrick OBJECTED for discussion. Representative LeBon reviewed the conceptual amendment. He pointed to page 1, line 13 of the bill and explained the amendment would delete skin cancer and replace it with malignant melanoma. Additionally, on page 2, line 4, the word "and" was added following the words "prostate cancer" and lines 6 through 12 would be deleted. The paragraph would end with the words "and with breast cancer." The subsequent cancers would be deleted. He was trying to strike a balance between reasonable risk and cost and the burden that would befall municipalities, cities, and organized boroughs. The original version of the bill simply added breast cancer to the list of cancers firefighters had a presumption and that the claim for workers' compensation may result through their employment. He elaborated that due to the limited number of claims, breast cancer did not seem to have a significant impact on workers' compensation rates paid by the state and municipality employers of firefighters. Representative LeBon explained that the House Labor and Commerce Committee added the seven additional cancers he listed and proposed for removal. He stated that the indeterminate fiscal note from the House Labor and Commerce Committee only showed possible cost to the state as an employer of airport firefighters. He remarked that House Finance Committee had heard from Nils Andreassen with the Alaska Municipal League who had suggested that Alaska municipal communities, towns, cities, boroughs had raised concerns and suggested that the state consider capitalizing a trust fund that would cover the presumptive conditions. He noted at the current point in session it was difficult to evaluate the proposed solution. He continued that the amendment would help reduce the uncertainty to communities while consideration of the additional cancers could be raised at a future time if deemed appropriate. 1:57:10 PM Representative Josephson thought Ms. Lori Wing-Heier testified that it would not cost the state much because they [the cancers] were uncommon. He was disinclined to remove the additions. 1:58:12 PM LORI WING-HEIER, DIRECTOR, DIVISION OF INSURANCE, DEPARTMENT OF COMMERCE, COMMUNITY AND ECONOMIC DEVELOPMENT (via teleconference), indicated Representative Josephson's comments were accurate. She relayed there was no data for Alaska or other jurisdictions expanding benefits for firefighters. She explained that every state had the presumptions and Alaska's were fairly strict and the cases were few and far between. She elaborated there was not a trend for any actuary or insurer to attest that the bill and the inclusion of one cancer or ten cancers would have an impact on the cost to the firefighting organizations. She considered that perhaps it would in the future; however, at the current point, cases were so few and far between, there was no data to suggest the rates would increase. Representative LeBon asked how many of the firefighters impacted by the bill were state employed versus employed by cities, boroughs, and municipalities. Ms. Wing-Heier responded that she would have to follow up with the information. She noted that many of the smaller fire departments such as Chugiak and Cooper Landing (those fire departments surviving on bake sales) would not be able to afford to have their members get an annual physical to qualify for "this." As for the number of state firefighters, she deferred to Mr. Jordan. Representative LeBon asked who bore the cost of the risk for a municipality, city, or borough with their volunteer or paid fire departments. He asked if it would be the municipality versus the state. Ms. Wing-Heier responded that the employer of record would pay the cost for the workers' compensation claim if they were self-insured or for the workers' compensation insurance. Representative LeBon remarked that he was speaking about the bigger population, while Ms. Wing-Heier was referring to the smaller population. Co-Chair Merrick asked if Mr. Jordan could respond. 2:01:37 PM Mr. Jordan reported that there were 1,300 fire fighters working for the state; however, the majority were seasonal wildfire firefighters for the Department of Natural Resources. He believed about 100 to 120 of the total were fulltime employees working for the airports. Representative LeBon asked about the difference in the size of the two groups in major communities employing firefighters including Fairbanks, Anchorage, Kenai, Juneau, Wasilla. Mr. Jordan did not have the numbers, but he suspected the number was quite a bit higher than the number of firefighters working for the state. Representative Thompson asked Mr. Collins to comment. 2:02:52 PM Mr. Collins reported that under workers' compensation, Anchorage, Mat-Su, Kenai, Fairbanks, Juneau, and possibly Ketchikan, were all self-insured entities. He explained that any firefighters under the entities would be paid under self-insurance. The department did not track an organization's employees by job classification. He remarked that the self-insured entities likely had more firefighters than those employed by the two airports. Representative LeBon asked to hear from Mr. Nils Andreassen. He was interested in the firefighter population. 2:04:39 PM NILS ANDREASSEN, EXECUTIVE DIRECTOR, ALASKA MUNICIPAL LEAGUE, believed there were more than 1,000 municipal firefighters. He discussed the distinction between self- insured firefighters and those who were not. The larger municipalities were self-insured and managed their risk independently of other municipalities; they would manage the impacts of the bill on their own. He referenced letters in committee members' packets from APEI [Alaska Public Entity Insurance] and AMLJIA [Alaska Municipal League Joint Insurance Association]. He elaborated the entities were pools formed under statute to allow for risk sharing. He explained that all of the smaller municipalities were members of those pools. The impacts of the bill would be felt by every other municipal employer. He listed location examples including Kwethluk, Russian Mission, Kotzebue, and Kodiak. There was a distinction between an employer picking up the costs versus a pool picking up the costs. He explained that a pool would have very different assets available to deal with the claims. He stated that even infrequent claims could have challenging impacts to the pools. 2:06:25 PM Representative Josephson asked if malignant melanoma referred to a precancerous skin condition, which would allow for denial of claims. He asked if skin cancer was a broader disease than malignant melanoma. Ms. Wing-Heier responded that she did not have the answer to his question. Mr. Collins pointed out that melanoma was already in statute and there had been a change in the Labor and Commerce Committee to include the broader term "skin cancer." He believed the amendment would change the language back to current statute. Representative Wool stated that malignant melanoma was skin cancer. 2:08:36 PM Representative Josephson shared he had seen a Centers for Disease Control and Prevention (CDC) report from 2016 that indicated firefighters were subject to cancers like testicular cancer and multiple myeloma. He stated the cancers were listed in the bill. He did not believe the change would be significantly impactful and he trusted in the co-chairs of the House Labor and Commerce Committee. Co-Chair Merrick MAINTAINED the OBJECTION. A roll call vote was taken on the motion. IN FAVOR: LeBon, Thompson, Carpenter OPPOSED: Wool, Josephson, Ortiz, Rasmussen, Johnson, Foster, Merrick Representative Edgmon was absent from the vote. The MOTION to adopt conceptual Amendment 1 FAILED (3/7). Vice-Chair Ortiz relayed he would not be offering Amendment 2. Representative Josephson spoke in support of the bill. He referred to SB 131 as "a very fine bill" that was not costly and would help keep Alaskans healthier and safer. Representative Carpenter asked how the International Agency for Research on Cancer (ARC) and the National Toxicology Program (NTP) defined exposure. He cited testimony stating the following items were hazardous: diesel particles at the fire station, smoke from fires, soot residue on the personal protective equipment (PPE), and materials in the manufacturing of the PPE. 2:12:18 PM NIKKI ROSE, STAFF, SENATOR ROGER HOLLAND, responded that there had been prior testimony in several committees from fire fighters stating the exposure was logged by Alaskan fire fighters in incident logs. She elaborated that fire fighters were instructed to record which chemicals they were exposed to. She explained that the incident logs included the information on chemical exposure and dates. The legislation stated that after a period of seven years of annual exams and no cancer detected, there was an opportunity to reexamine the information in the logs. The fire departments were responsible for storing the logs. 2:13:34 PM Representative Carpenter asked if it indicated that any time a fire fighter wore their PPE they filed an exposure record in the log. Ms. Rose did not know the answer to the question. Co-Chair Merrick invited Mr. Etheridge to answer the question. 2:14:14 PM Mr. Etheridge responded that detailed training records were kept. Additionally, anytime firefighters went into a fire or hazardous materials response, the department was required to record the information. He stated there was no record if someone merely put on the protective gear at the fire station. Representative Carpenter considered the definition of exposure. He used a hypothetical example where the PPE equipment was carcinogenic. He elaborated that if a person put on the PPE during a training session it was not considered exposure; however, when the person wore the equipment while fighting a fire it was considered an exposure. He remarked that under the scenario, the firefighter was deciding when they were exposed. He pointed out that the law specified an exposure was defined by the ARC and NTP. He did not understand whether the process involved an individual specifying when exposure occurred or whether the agencies defined when a person could consider when exposure had occurred. Mr. Etheridge did not have any comments about how they define exposure based on those organizations. He relayed the department had only found out about the PFAS in bunker gear fabric in the past year and a half. He remarked it showed the trend of all of the new things that could potentially cause cancer. Representative Johnson commented that in the research she had done on the bill she had learned firefighting equipment contained cancer causing materials if exposed to fire. She remarked that one of the safety mechanisms was to separate firefighters from the equipment after a fire. She asked if Representative Carpenter was trying to say that a person's exposure may not be defined by the length of time spent fighting a fire, but also in the equipment associated with cancer causing elements. Representative Carpenter had some personal military experience with wearing PPE that was supposed to provide protection from hazardous things. He used an example and stated a person would know if they had been exposed to anthrax because they would get sick and possibly die. He noted there were decontamination processes when PPE was donned to provide protection from the environment. He stated the law specified the firefighter was exposed to a known carcinogen as defined by the two organizations. He was trying to understand how the organizations were defining exposure because the firefighter was not dying immediately when gear was removed. He did not know whether the firefighter had actually been exposed when the gear was removed. Co-Chair Merrick asked Ms. Rose if it was possible to do some research and get back to the committee. Ms. Rose answered that she had just received information from the firefighters that the ARC and NTP listed and categorized known carcinogens. She elaborated that firefighters likely had to prove to the workers' compensation board that the exposure took place. The board would refer back to the list of known carcinogens. 2:20:03 PM Co-Chair Foster MOVED to report HCS SB 131(FIN) out of Committee with individual recommendations and the accompanying fiscal notes. There being NO OBJECTION, it was so ordered. HCS SB 131(FIN) was REPORTED out of committee with five "do pass" recommendations and five "no recommendation" recommendations and with one new zero fiscal note from the Department of Labor and Workforce Development and one new fiscal impact note from the Department of Administration. 2:20:29 PM AT EASE 2:22:01 PM RECONVENED