BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 128
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          Date of Hearing:   May 13, 2009

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Kevin De Leon, Chair

                  AB 128 (Coto) - As Introduced:  January 16, 2009 

          Policy Committee:                              InsuranceVote:7-1

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill establishes a life-time workers' compensation cancer  
          presumption for public safety professionals (e.g.: fire  
          firefighters, police officers, highway patrol) with substantial  
          years of service credit. This bill eliminates a five-year cap  
          imposed following termination of employment, on a workers'  
          compensation cancer presumption for tens of thousands of public  
          safety personnel statewide. Specifically, this bill:

          1)Eliminates a current law five-year cap on the cancer  
            presumption following termination of service. The cancer  
            presumption means a current or former employee of hundreds of  
            state and local firefighting and law enforcement agencies who  
            is diagnosed with or dies of cancer receives the following  
            benefits:

             a)   Full hospital
             b)   Surgical
             c)   Medical treatment
             d)   Disability indemnity
             e)   Death benefits 

          2)Eliminates a current law requirement that extends three months  
            of presumption for each year of service and replaces this  
            provision with eligibility of one year of presumption for each  
            year of service.

           FISCAL EFFECT  

          1)Major one-time and on-going costs to state and local  
            government, potentially of billions of dollars. For state  
            employees such as the California Highway Patrol, the  








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            California Department of Forestry and Fire Protection, the  
            University of California, and a variety of peace officers,  
            costs created by this bill are 100% GF. 

          The cost of benefits that will accrue to individuals under this  
            cancer presumption range from several thousands of dollars to  
            $300,000 to $500,000  per claim  . These costs reflect less  
            serious diagnosis and treatment and major treatment, indemnity  
            benefits, and payments to eligible spouses and dependents upon  
            death of an eligible individual. More than 20,000 state-funded  
            law enforcement and firefighting personnel could eventually be  
            made eligible for the cancer presumption contained in this  
            bill. If 10% of this workforce eventually drew on the benefits  
            established by this bill at a cost of $200,000 each, costs  
            will increase by $300 million (100% GF). 

          2)This bill creates new benefits for thousands of retired  
            professionals for a leading cause of death, regardless of  
            workplace exposures. Under current law, the presumption is  
            capped at five years after retirement. By eliminating this  
            cap, this bill establishes a secondary life insurance policy  
            for professionals without regard to a myriad of other cancer  
            risks. 

          3)Cancer is a leading cause of death for individuals over 55  
            years of age and explains about one-third of deaths of the  
            retired professionals addressed by this bill. There are  
            several dozen major kinds of cancer with different risk  
            factors. For example, several cancers such as melanoma,  
            colorectal, and breast cancer have specific genetic risk for  
            which individuals can be tested. Many cancers, however, are  
            attributable to factors such as smoking, obesity, and sun  
            exposure. In addition, most research does not support a strong  
            association between cancer and workplace exposures. 

          4)Professionals with many years of service are likely to have  
            already accrued significant lifetime cash pension and health  
            benefits through their prior service. In the case of health  
            benefits, the health benefits provided through this bill will  
            create a significant increases in GF administrative costs. The  
            administrative costs in the workers' compensation system are  
            three times the amount of the benefit provided, so for each  
            dollar of health care delivered, $3 is spent on  
            administration, as compared to 25 cents per dollar in group  
            retiree health coverage. 








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           COMMENTS  

           1)Rationale  . This bill is sponsored by the California  
            Professional Firefighters (CPF) to establish a lifetime  
            workers' compensation cancer presumption for tens of thousands  
            professionals statewide. CPF represents more than 30,000  
            professionals statewide. According to the author and sponsor,  
            firefighters have routine exposure to carcinogens in the  
            course of their work. Under current law, some firefighters are  
            diagnosed with cancer when past the 5-year cap after  
            retirement and unable to access the presumption addressed in  
            this bill. 

           2)Presumptions  . California workers compensation law provides  
            that workers are provided compensation benefits when an injury  
            or illness arises out of and in the course of employment.  
            Current law specifies that certain medical conditions suffered  
            by public safety officers (e.g., cancer, hernia, heart  
            trouble, pneumonia, tuberculosis, blood-borne infectious  
            disease, meningitis, and exposure to biochemical substances)  
            are presumed to have arisen in the course of employment. The  
            purpose of these statutory presumptions is to provide  
            additional compensation benefits to employees who provide  
            vital and hazardous services by easing their burden of proof  
            of industrial causation.

           3)Recent Meta Analysis of Cancer Presumption Laws  . A study  
            commissioned by the National League of Cities and completed by  
            a private firm specializing in public safety research and  
            analysis was published in April 2009. The study addressed  
            cancer presumption laws enacted in 43 states, including  
            California. Overall, researchers concluded a lack of evidence  
            to confirm or deny linkages between firefighting and increased  
            risk for more than a dozen specific cancers. Studies focused  
            on fire fighting are too few and too small to draw reliable  
            conclusions. In addition, an evaluation of state laws found  
            wide variability in cancer presumptions, cancers addressed,  
            and eligibility requirements.  

           4)Concerns  . Dozens of city and county agencies strongly oppose  
            this bill. According to opponents, public entities that employ  
            safety officers already face a nearly impossible burden in  
            attempting to defend presumption claims. In addition, the  
            opposition is alarmed at the fiscal burden this bill creates  








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            by lifting the five-year presumption cap. For example,  
            opposition indicates this bill would allow a police officer  
            who begins work at age 25 and works for 30 years to file a  
            cancer claim with the benefit of a presumption until age 85.

           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081