HB 204-WORKERS' COMP DISABILITY FOR FIREFIGHTERS  8:07:03 AM CO-CHAIR FIELDS announced that the first order of business would be HOUSE BILL NO. 204, "An Act relating to the presumption of compensability for a disability resulting from certain cancers in firefighters." 8:07:28 AM REPRESENTATIVE KAUFMAN, as prime sponsor, explained that HB 204 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. 8:08:29 AM MATTHEW HARVEY, Staff, Representative James Kaufman, Alaska State Legislature, presented a PowerPoint [hard copy included in the committee packet] titled "House Bill 204; Workers' Compensation Disability for Firefighters," on behalf of Representative Kaufman, prime sponsor. He presented slide 2, "HB 204: Introduction," which read as follows [original punctuation provided]: Firefighting is an inherently dangerous job. It is important that workers compensation insurance provides coverage for the inherent risks in that job. Currently, there is an oversight in Alaska Statutes regarding that coverage: Breast Cancer. MR. HARVEY presented slide 3, "Breast Cancer Risk - Firefighters," which read as follows [original punctuation provided]: Key Facts: .notdef Male firefighters are 7.5 times more likely to die from breast cancer than their counterparts not in fire service (Ma et al, 2005) .notdef Studies that have evaluated cancer risk among women firefighters suggest they may be at an elevated incidence of risk for breast cancer (Daniels et al, 2014). .notdef Women in the U.S. have a 1 in 8 (12 %) lifetime risk of contracting breast cancer. MR. HARVEY presented slide 4, "House Bill 204," which read as follows [original punctuation provided]: HB 204 would add breast cancer to the list of presumed disability coverages for firefighters, so long as the firefighter could establish that the firefighter was exposed to a known carcinogen associated with breast cancer MR. HARVEY presented slide 5, "Alaska Statute 23.30.121," which read as follows [original punctuation provided]: Breast Cancer would join the existing list of diseases alongside: 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 MR. HARVEY presented slide 6, "Alaska Statute 23.30.121," which read as follows [original punctuation provided]: Several standard limitations apply for presumption of compensability. 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. 8:10:51 AM CO-CHAIR FIELDS asked how a firefighter would demonstrate exposure to a known carcinogen. MR. HARVEY discussed keeping a record of exposures. 8:11:27 AM MR. HARVEY resumed his PowerPoint with slide 7, "Alaska Statute 23.30.121," which read as follows [original punctuation provided]: 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. Post-employment coverage is available: a. Three months accrued for every year of service b. Five-year maximum. MR. HARVEY presented slide 8, "Senate Bill 131," which read as follows [original punctuation provided]: Fourteen states include breast cancer in presumptive laws: 1. Arizona 2. Arkansas 3. Colorado 4. Idaho 5. Iowa 6. Maine 7. Maryland 8. Missouri 9. Montana 10. New Mexico 11. New York 12. Oregon 13. Virginia 14. Wisconsin 15. (Alaska?) 8:12:23 AM TIM BENNINGFIELD, Fire Chief, Chugiak Volunteer Fire and Rescue, provided information on HB 204 on behalf of the Alaska Firefighters Association. He pointed out that the PowerPoint presentation stated that 4 percent of firefighters in the U.S. are female; in Chugiak, however, women comprise 34 percent of all firefighters. He said there are multiple ways for firefighters to use technology to document exposure to carcinogens. 8:15:14 AM CO-CHAIR FIELDS asked for some more detail about the tracker. MR. BENNINGFIELD explained that when there is a fire, the firefighters are documented as having entered a structure. Later, he said, the firefighter can log the exposure on an app. 8:17:20 AM REPRESENTATIVE MCCARTY asked whether the tracking record is sent to a collective site within the state or a certain division. MR. BENNINGFIELD replied, "That would be attached to each individual firefighter." REPRESENTATIVE MCCARTY asked whether the information goes to a database for analysis. MR. BENNINGFIELD responded that the vendors that created the apps currently archive the information, as well as control who has access to the data. REPRESENTATIVE MCCARTY asked whether there are multiple apps used, and where the information goes. MR. BENNINGFIELD replied that there are multiple apps, so there is not a single repository of the information. 8:19:26 AM CO-CHAIR FIELDS asked whether there is a central state repository, and how to make sure firefighters are protected in the event that one of the apps stops functioning. 8:20:10 AM LORI WING-HEIER, Director, Division of Insurance, Department of Commerce, Community, and Economic Development, responded that if the firefighters are all using individual apps, and there's not a central repository for the information, she wouldn't be able to answer the question. If firefighters use the app of their choice and the data is somehow lost, she said, there would be no way of accessing the records. 8:21:03 AM CHARLES COLLINS, Director, Division of Workers' Compensation, Department of Labor and Workforce Development, said that there's no tracking of which he is aware. He said that it's the responsibility of each individual firefighter to track exposures. CO-CHAIR FIELDS commented that it seems like a structural weakness. He asked Ms. Wing-Heier whether he's "wrong" to be worried. 8:21:30 AM MS. WING-HEIER replied, "It would seem to me that, perhaps, the fire departments are keeping a track of what they were exposed to, for all their members, that perhaps the individual could then rely on." She expressed that the lack of tracking appears to be a weakness within the system. CO-CHAIR FIELDS suggested checking with the municipal fire department in Anchorage. 8:22:15 AM CO-CHAIR SPOHNHOLZ commented that if the responsibility for tracking exposure lies with the firefighter, the current system is problematic. 8:23:04 AM REPRESENTATIVE SNYDER asked how workers' compensation claims for cancers have been handled in the past. MR. COLLINS replied that there have been five cancer-related workers' compensation claims since 2016. He said that the Division of Workers' Compensation doesn't track medical records. REPRESENTATIVE SNYDER asked what the outcomes were in the claims. MR. COLLINS responded that four claims were paid, and one person was deceased. He said the Division of Workers' Compensation tracks the costs for benefits, and outcomes are sometimes not shared. 8:25:49 AM CO-CHAIR FIELDS asked whether hereditary factors have been used as an excuse to not cover someone. MR. COLLINS replied, "Yes ... that's a very common argument for the employer's attorney or carrier's attorney." He said hereditary factors and tobacco use are both used as arguments against coverage. CO-CHAIR FIELDS discussed the possibility of considering narrowing the consideration of hereditary factors. He then asked Ms. Wing-Heier whether the Division of Insurance has experienced issues. 8:27:02 AM MS. WING-HEIER said that the Division of Insurance has the responsibility of overseeing policies and rates, while the Division of Workers' Compensation works with individual claims and how the system works for an injured employee. 8:27:25 AM CO-CHAIR FIELDS asked Mr. Collins study whether hereditary factors have been used to deny workers' compensation. [HB 204 was held over.]