ALASKA STATE LEGISLATURE  SENATE COMMUNITY AND REGIONAL AFFAIRS STANDING COMMITTEE  May 6, 2021 3:31 p.m. MEMBERS PRESENT Senator Shelley Hughes, Chair Senator Robert Myers, Vice Chair Senator David Wilson Senator Elvi Gray-Jackson MEMBERS ABSENT  Senator Lyman Hoffman COMMITTEE CALENDAR  HOUSE BILL NO. 10 "An Act relating to the Funter Bay marine park unit of the state park system; relating to protection of the social and historical significance of the Unangax cemetery located in Funter Bay; providing for the amendment of the management plan for the Funter Bay marine park unit; and providing for an effective date." - MOVED HB 10 OUT OF COMMITTEE SENATE BILL NO. 131 "An Act relating to the presumption of compensability for a disability resulting from certain diseases for firefighters." - HEARD & HELD PREVIOUS COMMITTEE ACTION  BILL: HB 10 SHORT TITLE: FUNTER BAY MARINE PARK: UNANGAN CEMETERY SPONSOR(s): REPRESENTATIVE(s) HANNAN 02/18/21 (H) PREFILE RELEASED 1/8/21 02/18/21 (H) READ THE FIRST TIME - REFERRALS 02/18/21 (H) RES, FIN 02/24/21 (H) TRB REPLACES FIN REFERRAL 02/24/21 (H) BILL REPRINTED 03/01/21 (H) RES AT 1:00 PM BARNES 124 03/01/21 (H) -- MEETING CANCELED -- 03/03/21 (H) RES REFERRAL MOVED TO AFTER TRB 03/03/21 (H) BILL REPRINTED 03/09/21 (H) TRB AT 8:00 AM DAVIS 106 03/09/21 (H) Heard & Held 03/09/21 (H) MINUTE(TRB) 03/11/21 (H) TRB AT 8:00 AM DAVIS 106 03/11/21 (H) Moved HB 10 Out of Committee 03/11/21 (H) MINUTE(TRB) 03/12/21 (H) TRB RPT 4DP 03/12/21 (H) DP: FIELDS, ORTIZ, CRONK, ZULKOSKY 03/26/21 (H) RES AT 1:00 PM BARNES 124 03/26/21 (H) Heard & Held 03/26/21 (H) MINUTE(RES) 03/31/21 (H) RES AT 1:00 PM BARNES 124 03/31/21 (H) Moved HB 10 Out of Committee 03/31/21 (H) MINUTE(RES) 04/05/21 (H) RES RPT 7DP 2NR 04/05/21 (H) DP: MCKAY, FIELDS, CRONK, HOPKINS, HANNAN, SCHRAGE, PATKOTAK 04/05/21 (H) NR: RAUSCHER, GILLHAM 04/09/21 (H) TRANSMITTED TO (S) 04/09/21 (H) VERSION: HB 10 04/12/21 (S) READ THE FIRST TIME - REFERRALS 04/12/21 (S) CRA, RES 04/23/21 (S) RES AT 3:30 PM BUTROVICH 205 04/23/21 (S) 04/27/21 (S) CRA AT 3:30 PM BELTZ 105 (TSBldg) 04/27/21 (S) Heard & Held 04/27/21 (S) MINUTE(CRA) 05/06/21 (S) CRA AT 3:30 PM BELTZ 105 (TSBldg) BILL: SB 131 SHORT TITLE: WORKERS' COMP DISABILITY FOR FIREFIGHTERS SPONSOR(s): SENATOR(s) HOLLAND 04/28/21 (S) READ THE FIRST TIME - REFERRALS 04/28/21 (S) CRA, L&C 05/06/21 (S) CRA AT 3:30 PM BELTZ 105 (TSBldg) WITNESS REGISTER REPRESENTATIVE SARA HANNAN Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Sponsor of HB 10. TIMOTHY CLARK, Staff Representative Sara Hannan Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Answered questions and provided information regarding HB 10. MARTIN STEPETIN, Advocate Friends of Admiralty Island Juneau, Alaska POSITION STATEMENT: Testified in support of HB 10. RICHARD ZACHAROF, Advocate Tribal Council Saint Paul Island, Alaska POSITION STATEMENT: Testified in support of HB 10. JACOB MERCULIEF, representing self Saint Paul Island, Alaska POSITION STATEMENT: Testified in support of HB 10. SENATOR ROGER HOLLAND Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Sponsor of SB 131. NIKKI ROSE, Staff Senator Roger Holland Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Presented the sponsor statement for SB 131. TIM BENNINGFIELD, Chief Chugiak Volunteer Fire and Rescue and Alaska Fire Chiefs Association Chugiak, Alaska POSITION STATEMENT: Testified in support of SB 131. JUSTIN MACK, Southcentral Vice President Alaska Professional Firefighters Association Anchorage, Alaska POSITION STATEMENT: Testified in support of SB 131. LORI WING-HEIER, Director Division of Insurance Department of Commerce, Community and Economic Development Anchorage, Alaska POSITION STATEMENT: Answered questions related to insurance during the hearing on SB 131. ACTION NARRATIVE 3:31:03 PM CHAIR SHELLEY HUGHES called the Senate Community and Regional Affairs Standing Committee meeting to order at 3:31 p.m. Present at the call to order were Senators Myers, Wilson, and Chair Hughes. Senator Gray-Jackson arrived soon thereafter. HB 10-FUNTER BAY MARINE PARK: UNANGAN CEMETERY  3:32:06 PM CHAIR HUGHES announced the consideration of HOUSE BILL NO. 10 "An Act relating to the Funter Bay marine park unit of the state park system; relating to protection of the social and historical significance of the Unangax cemetery located in Funter Bay; providing for the amendment of the management plan for the Funter Bay marine park unit; and providing for an effective date." She identified the individuals available to answer questions. 3:32:42 PM REPRESENTATIVE SARA HANNAN, Alaska State Legislature, Juneau, Alaska, sponsor of HB 10, thanked the committee for hearing the bill a second time. She summarized that HB 10 would add acreage to the existing Funter Bay State Marine Park, including a parcel that has a cemetery for individuals who passed away while interned in a nearby relocation camp. She referenced the earlier question about whether the cemetery should have a name and relayed that the Unangan descendants would like to entertain that question, but recognize that it will be a lengthy process to come to consensus. She noted that naming a feature is allowed under existing state park regulations. 3:33:11 PM SENATOR GRAY-JACKSON joined the committee meeting. CHAIR HUGHES offered her perspective that naming the cemetery was a way to honor the Unangan people and their history in the state and nation. CHAIR HUGHES referenced a question that came up after the last hearing about private property in the area and the misperception that this might benefit one or more adjacent property owners. She asked the sponsor's staff to share a map to make it clear that this proposal is truly to honor the history of the Unangan people who were interned at Funter Bay and their descendants. 3:35:32 PM TIMOTHY CLARK, Staff, Representative Sara Hannan, Alaska State Legislature, Juneau, Alaska, displayed a topography map of Funter Bay. He related that the cannery was sold and subdivided into about seven parcels in the mid-1980s and there are also dozens of cabins scattered along the shoreline of the bay. The cabins are primarily recreational and are used seasonally. 3:38:41 PM CHAIR HUGHES opened public testimony on HB 10. 3:39:23 PM MARTIN STEPETIN, Advocate, Friends of Admiralty Island, Juneau, Alaska, stated that he originally came from Saint Paul. He relayed that his four grandparents were interned at Funter Bay starting in 1942 and he had been working to protect the cemetery there since 2014. His dad was born during that time and was lucky enough to survive. He noted that a number of the headstones in the cemetery were for babies who were not so fortunate. MR. STEPETIN related his journey working independently and then with Friends of Admiralty Island to determine that the cemetery was located on state land. Several options were discussed about how to protect the cemetery, one of which was through the National Historic Register. This effort was not successful. A second option was to protect the parcel though an internal departmental agreement, but that is subject to change with each administration. He said there was consensus that adding the cemetery parcel to the existing Funter Bay State Marine Park was the most lasting way to protect this valuable state, Alaska Native, and U.S. history. MR. STEPETIN concluded his testimony stating that the State of Alaska did not make the decision to relocate the Aleuts from the Pribilof Islands to Funter Bay, but because the Unangan Cemetery is located on state land, it is 100 percent the responsibility of the legislature and the state to protect this historic piece of property. 3:43:30 PM CHAIR HUGHES asked if the legislature could do anything to help qualify the cemetery for the National Historic Register. MR. STEPETIN answered he did not know but he believes the parcel would eventually qualify. 3:44:49 PM RICHARD ZACHAROF, Advocate, Tribal Council, Saint Paul Island, Alaska, stated that he visited Funter Bay in 2000 after he received a $50,000 parks and recreation grant to renovate the crosses and clean up the cemetery. A number of community members also made the trip to hold a memorial service for family and loved ones who were buried in the Funter Bay cemetery. MR. ZACHAROF emphasized the importance of HB 10 to protect and preserve the cemetery and the memory of the people who were relocated and died while interned at Funter Bay. It is important to the Aleut people, the State of Alaska, and the United States. He reported that about 10 percent of the 330 people who were evacuated from Saint Paul Island in 1942 did not survive. He shared the plan to go to Funter Bay in August for a memorial service if the bill were to pass. The plans also include a work party to construct a fence around the cemetery to protect the gravesites in the traditional Aleut fashion. 3:48:01 PM JACOB MERCULIEF, representing self, Saint Paul Island, Alaska, stated that his four grandparents were relocated and interned at Funter Bay. He said he was speaking on behalf of family members to voice support for HB 10 to protect and preserve the cemetery at Funter Bay and the history of his people. 3:49:56 PM CHAIR HUGHES closed public testimony on HB 10. REPRESENTATIVE HANNAN thanked the committee for its time and consideration. CHAIR HUGHES solicited the will of the committee. 3:50:22 PM SENATOR MYERS moved to report HB 10, work order 32-LS0096\A, from committee with individual recommendations and attached fiscal note(s). 3:50:31 PM CHAIR HUGHES found no objection and HB 10 was reported from the Senate Community and Regional Affairs Standing Committee. 3:50:38 PM At ease SB 131-WORKERS' COMP DISABILITY FOR FIREFIGHTERS  3:52:32 PM CHAIR HUGHES reconvened the meeting and announced, the consideration of SENATE BILL NO. 131 "An Act relating to the presumption of compensability for a disability resulting from certain diseases for firefighters." 3:53:02 PM SENATOR ROGER HOLLAND, Alaska State Legislature, Juneau, Alaska, sponsor of SB 131, stated that this subject initially seemed complicated but the numbers make the argument that breast cancer coverage for fire service members is clearly justified. He deferred further introduction to his staff, Nikki Rose. 3:54:04 PM NIKKI ROSE, Staff, Senator Roger Holland, Alaska State Legislature, Juneau, Alaska, read the following sponsor statement for SB 131 into the record: Firefighting is an inherently dangerous job. It is important that workers compensation insurance provides coverage for the inherent risks in that job, but right now there is a hole in that coverage: breast cancer. This bill would add breast cancer to the list of presumed disability coverages for firefighters, so long as the firefighter could establish medically that the breast cancer was caused by work as a firefighter. Instances of cancer in firefighters is shown to be higher than the general population. Studies that have evaluated cancer risk among women firefighters suggest women firefighters, like their male coworkers, may be at an elevated risk for overall cancer incidence (Daniels et al., 2014). These studies also suggest women firefighters may be at an elevated incidence risk for breast cancer (Daniels et al., 2014). This bill protects not only women, because exposure to carcinogenic chemicals, which is sometimes necessary in the course of a firefighter's job, does not discriminate based on sex or gender. Exposure to these chemicals may be mitigated, but not eliminated, through protective equipment. Firefighters are at a higher risk of cancer, and this risk should be covered. Thank you for your consideration of the addition of breast cancer to the list of presumed disability coverages for firefighters. 3:55:46 PM MS. ROSE presented the following sectional analysis for SB 131: Senate Bill 131  Workers' Compensation Disability for Firefighters    Sectional Analysis for version A  Establishes this Act relating to the presumption of compensability for a disability resulting from certain diseases for firefighters. Sec. 1 AS 23.30.121(b), relating to the list of coverage for firefighters, is amended by: • Adding the term "breast cancer" to list of AS 23.30.121(b). Sec. 2 Clarifies this change applies to claims made on or after the effective date of this Act. 3:56:25 PM SENATOR HOLLAND advised that firefighters are exposed to carcinogenic chemicals from both fire suppressant materials and the burning structures and contents. Together they increase firefighters' risk of cancer. Current practice is to use self- contained breathing apparatus, immediately remove these chemicals from the skin, and shorten individual exposure times in burning structures, but there are still a host of previous exposures that should be addressed, he said. 3:57:36 PM SENATOR HOLLAND began a PowerPoint on SB 131 reading the following points from slide 2: • Firefighting is an inherently dangerous job. • It is important that workers compensation insurance provides coverage for the inherent risks in that job. SENATOR HOLLAND advised that Lori Wing-Heier, the director of the Division of Insurance, was available to confirm that adding breast cancer coverage should not increase workers' compensation costs significantly. The firefighters will bear the cost through their workers' compensation fees. SENATOR HOLLAND read the points on slides 3 and 4: • SB 131 would add breast cancer to the list of presumed disability coverages for firefighters, so long as the firefighter could establish that the breast cancer was caused by their work as a firefighter. • Instances of cancer in firefighters is shown to be higher than the general population. • Studies that have evaluated cancer risk among women firefighters suggest women firefighters, like their male coworkers, may be at an elevated risk for overall cancer incidence (Daniels et al, 2014). • These studies also suggest women firefighters may be at an elevated incidence of risk for breast cancer (Daniels et al, 2014). 3:59:01 PM SENATOR HOLLAND paraphrased the following general statistics listed on slides 5 and 6: • In the general population, less than one percent of males are likely to develop breast cancer in their lifetime. • Studies have found strong associations between firefighting and male breast cancer (Ma et al, 2005). • Male firefighters are 7.5 times more likely to die from breast cancer than their non-Fire Service counterparts. (Ma et al, 2005) • The same mechanism that would cause increases in breast cancer in men is thought to result in proportional increases in risk among women. • In the general population, one in eight women (12 %) will likely contract breast cancer in their lifetime. • At only about four percent of the firefighter population, small sample sizes make it difficult to draw conclusions about females and breast cancer in the Fire Service. • This bill protects not only women, because exposure to carcinogenic chemicals, which often occurs in the normal course of a firefighter's job, does not discriminate based on sex or gender. 4:00:14 PM SENATOR HOLLAND read the following points about presumptive laws listed on slides 7 and 8; Presumptive laws are regulations that assume a given disease is linked, by default, to a specific occupation. This means that when someone is diagnosed with an illness covered under a presumptive law, they are automatically entitled to disability or workers' compensation, medical expense coverage, and medical leave, provided they meet certain criteria. Without presumptive laws, to get these benefits, firefighters and other workers may have to prove that their line of work caused their disease. This process can be lengthy and expensive at a time when resources should be dedicated toward treatment, wellness, and, sometimes, end-of-life decisions. SENATOR HOLLAND displayed the nine presumptive diseases for firefighters in Alaska identified in AS 23.30.121: 1. Respiratory Disease 6. Bladder Cancer  2. Cardiovascular Events 7. Ureter Cancer  (Limited) 3. Primary Brain Cancer Kidney Cancer  4. Malignant Melanoma 9. Prostate Cancer  Non-Hodgkin's Lymphoma  SENATOR HOLLAND said the first two presumptive causes are limited to extreme, one-time exposures, but the other seven are linked to more chronic, long term exposure of carcinogens. Once breast cancer is added, the firefighter must meet the following standard limitations: 1. Have been a firefighter for at least seven years. 2. Have had initial and annual medical exams showing no evidence of disease. 3. Be able to demonstrate exposure to a known carcinogen while in the Fire Service. 4. At a minimum, be certified as a Firefighter I. SENATOR HOLLAND reviewed the additional qualifying criteria listed on slide 12: 1. Coverage may be denied based on: a. Use of tobacco products, b. Physical fitness and weight, c. Lifestyle decisions, d. Hereditary factors, and e. Exposure from other employment/non-employment activities. 2. Some post-employment coverage is available, a. Three months accrued for every year of service, b. Five year maximum. SENATOR HOLLAND said he was able to confirm that 14 states and the Canadian Province of Ontario include breast cancer in presumptive laws. He asked the committee to help add Alaska to the list. 4:04:37 PM SENATOR GRAY-JACKSON voiced support for the bill and noted that she introduced a similar bill during the last legislature. The difference was that her bill included emergency medical technicians, paramedics, and peace officers and it was retroactive to 2008. She asked if he was willing to entertain those additions as an amendment. 4:05:27 PM SENATOR HOLLAND answered he views SB 131 as the first in a number of steps and his preference was to focus on breast cancer in firefighters first. SENATOR GRAY-JACKSON described the proposed amendment as housekeeping and suggested they talk about it offline. SENATOR HOLLAND said he supports the idea but wanted to maintain focus to add breast cancer to AS 23.30.121. 4:06:35 PM SENATOR MYERS referenced point 3 on slide 11 and asked about the feasibility of a firefighter being able to demonstrate exposure to a known carcinogen while in the fire service. SENATOR HOLLAND answered some states require the firefighter to identify the date and specific carcinogen but Alaska typically takes a broader view. The firefighter must prove that their job is an at-risk employment category. 4:08:12 PM CHAIR HUGHES asked when the current list was placed in statute and whether it might not have been when there were far fewer female firefighters than today. SENATOR HOLLAND offered to follow up with the information. He agreed that women were becoming a larger part of the fire service. He reported the anecdote that of the 1,500 firefighters in San Francisco, the 225 females experience a 15 percent higher incidence of pre-menopausal breast cancer than women who are not firefighters. CHAIR HUGHES asked if the requirement to be a firefighter for seven years would exclude volunteer firefighters. 4:10:13 PM SENATOR HOLLAND said he believes it means anyone who is a fulltime or volunteer firefighter I for seven years. He offered to follow up to confirm his understanding. 4:11:32 PM CHAIR HUGHES announced invited testimony on SB 131. 4:12:00 PM TIM BENNINGFIELD, Chief, Chugiak Volunteer Fire and Rescue, Chugiak, Alaska, stated that he was speaking on behalf of the Alaska Fire Chiefs Association in support of SB 131. He said the association started earlier this year to add breast cancer to the list of presumptive diseases to ensure balanced coverage for all firefighters in the state. Responding to Senator Myers' question about tracking exposure to carcinogens, he advised that when members come out of a fire they sign into an application and log the date and their exposure to carcinogens in a structure fire. Responding to Senator Hughes' question about seven years, he said that gap has been identified. Providing the initial and then annual medical examinations for each member for seven years is prohibitively expensive and out of reach for small fire departments like Chugiak. Nevertheless, the association believes it is important to add breast cancer to the list of presumptive diseases for firefighters in Alaska. SENATOR GRAY-JACKSON asked his thought on her proposed amendment to include coverage for emergency medical technicians, paramedics, and peace officers in addition to firefighters. 4:15:53 PM MR. BENNINGFIELD offered his belief that it would be as self- limiting as the seven-year requirement. [The call was dropped.] CHAIR HUGHES asked the sponsor to follow up to request Chief Benningfield's response in writing. 4:17:02 PM JUSTIN MACK, Southcentral Vice President, Alaska Professional Firefighters Association, Anchorage, Alaska, responded to the question about career versus volunteer firefighters. He cited the definition of firefighter in statute that clearly includes members of a municipal fire department or volunteer fire department that is registered with the state fire marshal's office. Responding to the question about knowing about exposure to specific carcinogens in fire suppressant products, he said that is a grey area because the chemicals may be used in a number of different types of products in a structure. He cited PFAS as an example. When temperatures reach a certain point, those substances can pass through a firefighter's gear and into the skin. He said it is not just firefighting foam that is a concern, it is certain substances in the foam. 4:19:00 PM MR. MACK began his prepared testimony. He stated that he was speaking on behalf of the Alaska Professional Fire fighters Association in support of SB 131. He related that he had worked for the Municipality of Anchorage for 10 years and currently served as a fire captain. He described the job and training and explained that even when firefighters follow up-to-date decontamination protocols and wear the best personal protective equipment (PPE), they are still exposed to some of the worst chemicals on earth. These permeate the firefighter's gear and penetrate the skin. The smell can last for days after a significant structure fire. MR. MACK said Alaska Workers' Compensation usually requires the injured individual to tie their injury to a specific event. It is difficult to pinpoint which structure fire caused cancer, but study after study shows that firefighters have a significant increase in cancer rates compared to the general population. It is an odd phenomena that firefighters generally start their careers as some of the healthiest in the population, yet retire as some of the unhealthiest. He concluded that SB 131 is a step in the right direction for public safety members who know the risk yet continue to respond to fire calls at all hours in hopes of making a difference in a stranger's life. He urged the committee to support SB 131. CHAIR HUGHES thanked him for his testimony and listed the individuals available to answer questions. 4:22:13 PM SENATOR MYERS asked Ms. Wing-Heier to confirm that the increase in firefighters' workers' compensation fees would be minimal if breast cancer were added to the list of diseases presumed to cause disability. 4:23:02 PM LORI WING-HEIER, Director, Division of Insurance, Department of Commerce, Community and Economic Development (DCCED), Anchorage, Alaska, explained that the fire department or company pays workers' compensation, not the individual firefighters. In Alaska, the 2021 workers' compensation lost cost base rate for fulltime and volunteer firefighters is $2.67 per $100 of payroll. For firefighters, the minimum payroll is $2,000 so the department would be charged (2,000/100 X 2.67) even if the firefighter is only called out on one fire in a month. She noted the total cost would be a little more because the lost cost does not include the loss adjustment expense or the profit and claims administration the insurance company adds. She estimated the multiplier would be closer to $3.20 per $100 of payroll. SENATOR MYERS asked what the increase would be if SB 131 were to become law. MS. WING-HEIER replied the division cannot find data to support that adding breast cancer would increase workers' compensation rates for fire departments. She noted that the rates had decreased 50 percent the last four years. SENATOR MYERS described that as good news. 4:25:13 PM CHAIR HUGHES offered her understanding of what would happen if rates were to increase. MS. WING-HEIER agreed with the description; once a year the National Council on Compensation Insurance files rates for different types of insurance with the division, a public hearing is held on each insurance type, and the division approves the rate. She referenced Senator Gray-Jackson's question about adding coverage for EMTs and advised that, by definition, EMTs who are also firefighters would be covered under SB 131. 4:26:33 PM SENATOR GRAY-JACKSON suggested that it would apply to paramedics who also serve as firefighters. MS. WING-HEIER advised that the literature indicates firefighters who also perform medical services would be included. The $2.67 rate would apply and she assumed the presumption would extend to those individuals as well. CHAIR HUGHES asked the sponsor for confirmation that he had not received any opposition from firefighting organizations or municipalities even though the rate may increase in the future. 4:27:33 PM SENATOR HOLLAND confirmed he had received no opposition. The rate Ms. Wing-Heier quoted already applies to the nine presumptive coverages and his assumption was it includes the many workers' compensation risks associated with being a firefighter. He said this adds one more risk to the large pool and any increase would be nominal. 4:28:42 PM CHAIR HUGHES held SB 131 in committee for future consideration. 4:29:42 PM There being no further business to come before the committee, Chair Hughes adjourned the Senate Community and Regional Affairs Standing Committee meeting at 4:29 p.m.